Transcript
Dgprince (00:00) hey back again.
Dgprince (00:36) Okay. Let’s see. She’s joining now?
Dgprince (00:53) Good morning, Doris. You’re on mute. It’s our fault. It’s zoom as always. It’s okay. Oh, hey, what’s happened in the life since we talked yesterday? Anything exciting? Not that I can think of it’s like, goodness, gracious. It’s a whirlwind right now. We have a ton of leadership changes, growth, you know, it’s like, I think it’s just the new year. And then I’ve been here a very long time. I’ve been with sentara for 39 years. Wow, and started out as a file clerk and worked my way all the way up, you know, that’s so impressive that’s awesome. Yeah, it’s like I got married, moved from Virginia to here because my husband’s in the military. So he did 31 years in the navy always gone. So, we, I kind of just stayed here with our children. Yeah. So, I, you know, learned really quickly with a military spouse. I need to be somewhere steady, knew what my hours are going to be, that kind of thing. And, and sentara at the time was how healthcare gave me that opportunity. So, anyway, where I was trying to deal with that is, I’ve been here so long that everybody’s leaving and I’m like my goodness… where are you going? Yeah, I was here with you all the other day, that the VP that I worked with for almost 18 years. She just recently retired and that was a huge hit for all of us. But again, she’s 67 years old. She should go and retire and enjoy life and have fun. So, we’re going to our house in the outer banks and, off she went and she’s enjoying life. So, I’m happy. Yeah, we have a lot of that. We have a lot of retirements. And, people are at that stage in their life and retiring, but it’s a lot of, knowledge. So since I’ve been here forever, kind of like what’s happening is all those folks have left. And now it’s like the landslide, you know, what about this? And how is this done? How do you do that? What do you recommend for this? You know, how about, you know, and I’ve been on the revenue cycle side and credentialing is very new for me. I typically am the queen, the cleanup queen, you can call it that go in and look at workflow processes, make it better and try to, and, you know, help them clean up areas that’s losing money or not functioning well. So that’s how I end up with credentialing and, still trying to do it, still trying to get it over with. Yeah, here we are… so not a whole lot of them putting out fires. Have you ever seen, this much growth, in your time there, or is this kind of unprecedented?
Dgprince (03:27) Oh, no. When I, when I first, it’s so funny because I was at Virginia general hospital, called tidewater healthcare, which was acquired by sentara in 19, my son was 81 and 85. I want to say in 19, 96, maybe 95, 96. And rob rohrman, he was our, CFO at tidewater and he became the CFO over at sentara and he looked at the medical group and he’s like Doris prince. I’m gonna take, he says, will you do me a favor and come over to the dark side? And I said, my God, rob, I don’t know anything about medical group and, he says I need you to push up your sleeves. So, needless to say, I came over and at that time, we only had about 46, maybe 50 providers at most. Wow. So, needless to say, in the late nineties, early 2000, it was insane. The growth that we went through. And then again, in 2018 and 2018, we bought three medical groups and I don’t know like two or three hospitals. So, whew, that was a lot. So it’s pretty much stable. I would call it. I won’t say stabilized because I feel like we’re always growing, but our region is growing, our markets are growing, you know, with population and that, so that’s what’s really driving. It is trying to have enough providers to render the care for the population that now lives in our areas. I think that’s what a lot of folks are because people are living longer, as well. And, you know, the medicare population, with that population of patients, it takes longer care. You have to spend more time. And then it tends to, you know, spin off into a lot of specialties and different things. So, anyway, but yes, we’ve had a lot of growth over my years with the medical group. So this, it’s busy, but it to me is not nothing like when we took on three medical groups literally within six months of each other. That, that about killed me. And then 2000. I want to say it was 2008 or 2009. We acquired three large cardiology groups and the largest vascular group all on January one. That was a lot, almost 300, you know, physicians all at one time. So, thank goodness, other than anesthesia, about killed us in. November and December because the same thing, our anesthesia group decided to pull out and only gave the organization like 60 days notice. So it was a scramble. So the bulk of that we have, onboarded 381 clinicians whether it be crnas or anesthesiologists between November seventeenth and March seventeenth. But again, with the majority of them locums, so, you know what that is? That in and out in and out, a lot of busyness with a little bit of retention, because they’re not going to stay, but, so, yeah. So I expect it to be even, you know, I expect it to be like the same, hopefully not another 300 all at one time. But we do expect it, we do.
Garrison Goodman (06:59) Expect it. Yeah, you guys are growing. I think your email said 40 percent so that’s like over 800 or so closer to nine, right?
Dgprince (07:06) Correct, correct?
Garrison Goodman (07:08) That’s that’s no walk in the park?
Dgprince (07:10) No, it’s not. And that’s why I said, so that’s the reason like last year, we had over a 1,000. Well, I think it was like a 1,000, 11,000, 12 new provider requests that we had to process last year and that was the highest we’ve had yet. Part of that was the anesthesia at the end of the year. But again, it didn’t it doesn’t matter if it’s anesthesia or what it is.
Dgprince (07:34) It still, it still is what it is and they plan to expand because that was only for two hospitals. We have 12. So what we’re trying to do is make sure that we own, not own, you know, say, but anything that we do own that our, we employ the physicians who are going to render the care there. So you don’t have to have all that. Do we have control? Do we not have control? Do we have to do this? Do we have to do that type thing? So that’s the other reason we see the growth trying to make sure that we employ and have things in house. Yeah. And the smaller guys can’t live and they can’t manage on their own anymore. It’s too expensive in this environment. Yeah, that’s the other thing that we’re experiencing. We have quite a few… family medicine groups, you know, that were independent and remain independent. And now they’re knocking on our door saying we need help, we can’t survive. Y’all, have got the technology. Can you also manage it? Those type of things. So when.
Garrison Goodman (08:35) a doors to fixer gets put on something that gets fixed. You know, what does it mean for you, to fix? You know, credentialing from your perspective, and, you know, does that free you up to do other things or kind of what’s the it’s.
Dgprince (08:48) a combination. So, I guess that’s probably one of the things I probably should have started out with you all to start with. But I know again Melinda’s like do this now and then from my perspective, you know, we’ve been on this three year journey. I was over all of our revenue cycle for all the medical groups, you know, whether it be cash posting, you know, all the way all the way through had coding charge entry, all of that all the way through. So, very intertwined with practice operations management and all that. And then all of our revenue cycle all reported up through me. And then, you know, I have my managers over each one of those teams. So one of the biggest pain points that became really real very quickly was credentialing. You know, when I started digging in, everybody thinks… that the denial is credentialing doesn’t necessarily mean that. But one of the things that we could not do was get where we needed to because all the folks that worked in credentialing, I’m going to say were clerks, were admins, you know, was a secretary was this and everybody just assumes that in order to work in credentialing, as long as your skill set is data entry, you’re good to go. Well, that’s not the case. You need to, know, you need to understand what you’re doing, how it impacts everything. So, long story short with that garrison is, I am trying to connect the dots. That was my number one, connect the dots between our epic team, our Ar team and our credentialing team and our operational folks… the amount of turnaround or the amount of time it was taken to onboard bring clinicians in. It was very dysfunctional. We were like, I think I explained that yesterday or I can’t remember what day it was. But we had everybody collecting their own applications. I can’t tell you how many provider complaints I would have from administration on a regular basis and credentialing would report to me at that time, you know, but it was constant, they’re like you got to fix this, you know, okay, let me see what I can do. So I would go to the hospital group. I would go to the credentialing team who reported up through recruitment at the time trying to work with them. And the next thing I knew, it became mine. So with that, the first thing I want to do is try to fix the provider satisfaction. So we’ve got everybody in a room worked through came up with a singular application to make sure that we were all stopping, you know, doing that across the board with everybody, the hospital, us recruitment HR even. And then we have phos as well. We have three phos in three different markets. So you had a physician who could easily be going through five applications just to join sentara, ouch. Yeah. And then if it was a locum, they added even another level on there. So again, it would be six for them. So, the first thing I started looking at is where’s the repetitiveness and how do we break it? You know, how do we stop that craziness? So that’s where I kind of started. But then I also had to deep dive into the denials because the denials were off the chain. And part of that was because medicaid, they changed their prss system. They went to the prss system. I don’t know if you guys are aware of that or not, but they changed their platform and they did not copy over accurate data. They overlaid a lot of inaccurate data in their new data source. So that created a ton of downstream denials. And the third thing was our vendor that we had at the time. They absolutely, I don’t know, didn’t understand how they were doing things. They had a lot of staff that were overseas and I don’t think communication was very clear with them. But a good example is medicaid was about to kill us. We had over 5,000,000 dollars in denials just for medicaid alone and it was just about to kill us. And what was happening is every time they would go in to do the application, if that clinician already was existence, they would just accept everything that was in the application. They weren’t fixing the taxonomy code. Those type of things weren’t linking all the locations, that type of thing. And before you know it, you got a ton of denials. Location is pretty easy to pick up. And taxonomy code should be easy for Ar, folks to pick up on. But they just keep looking at what’s going on in the claim. Well, the taxonomy code is right? But no one would take a step back and say, but how were they credentialed? So that was part of the process, been able to reduce the denials, been able to streamline things, make things much better. Those type of things for me. Now, it’s the technology, what we have is very clunky. It doesn’t work well and staff are frustrated. I’m frustrated because again, just like right now, I’ve been working on a sanction report which our prior third party vendor did for us all the time. Can I get the dang thing to work? I put in a ticket three times we are now a month in and I have to show proof that I ran these full sanctions every month and they’re telling me today, well, we’ll try to work on us. They’re gonna try it’s month in today. I don’t need it. You’ve got to get there type thing. So that’s been my number one dissatisfaction with credentialstream is I often can’t give people what they need and they need it. They need to have the knowledge. They need to know where our clinicians at in their process. How far along are they? What payers have we done? And it tends to be a very manual report manual, pull, manual lookup those type of things. Again. I’m just going to look at it from top to bottom garrison. I know it’s a long answer but it’s like really for me, I’m going to say, what can we fix? What can we not fix? What can we do? Knowledge is powerful. And I do believe having things internally is key, you know, having a finger or finger whole hand into all of it and making sure that we kind of control things, understand things. So, you know, for me, I’m trying to look, is this a fully in house or just new technology? Maybe is this a hybrid where we have folks in house working along with technology? You know, try to automate the things and help that, you know, with a partial outsource of, you know, staffing things on your side, which I kind of heard that yesterday or is it a fully outsource? And I don’t know how we would ever do a fully outsource because you’re always going to need people on this side. And that’s what I’m trying to get administration everybody else to understand, you can call it fully outsourced. That’s what they tried to do before they put me over here and they let go a team of like… it didn’t work. It didn’t work. Things started backing up. It got ugly. Next thing, you know, we’re up to six people pretty quick because you still have to do that onboarding piece, that data gathering piece, get it where it needs to be. You’ve got to have someone for someone to connect to and talk to. So that didn’t work. So I think it would be somewhere in the middle a hybrid. You know, what I’m saying, where it’s in house with new technology and partially outsource some of the work, you know, to that third party vendor. So that’s the reason we’re here with you? Guys, because I’m trying to find something that will work and I just need, I… need everybody to understand that we don’t fit into the hospital credentialing bucket which is where everybody tries to shove us. So credential string works very well for them. It doesn’t necessarily work for payer enrollment. So that’s kind of where we’re at.
Garrison Goodman (16:18) Yeah, that’s really helpful, I mean, and.
Dgprince (16:23) In pretty.
Garrison Goodman (16:23) Common, it’s like, hey, we want to be able to move fast leverage technology. But when things come up, we want to be able to fix it and we want to have a great system and a great partner that works with us to do so and have some of that control. So that was great. It helps us understand. And also for you like you want to be able to answer the questions for that you’re getting but also probably be a bit more proactive too. So you’re not as reactive to some of the things that come up. So, no, that’s helpful. And one of the things that we wanted to understand is how… and you kind of shared yesterday, like, hey, we want to start with enrollment. There’s a lot more that medallion can do. We’re going to start there. The other thing is like, how do you want to approach this internally with your org? And it sounds like more on the future like cost avoidance, right? And one of the questions we had is, you know, is… that’s probably a good approach. We want to better understand if there’s anything that we can do on the turnaround times from direct enrollment, but also wasn’t sure if from the folks that you brought on, we brought this house out. Do you want to approach this by thinning out the team at all? Or do you want to keep it as is? And what’s going to make it best for you internally? I think.
Dgprince (17:43) It can be a combination of things. Again… the teams that we have today, some of them have again, there’s a lot of things that go on behind the scenes that’s the other thing that I’ve tried to explain to administration. It’s not about just standing this up and going. We have a mailbox that a full time. It takes a full time person to man to answer all those questions. We have 350 practice locations, you know, that’s 350 practice managers. And then you have clinicians who are getting emails and paper and stuff all day long. And since we are credentialing, and we’re the ones that they have the relationship with, they may get paperwork at their practice that’s Ar, related. Well, guess who they call, they get a patient who calls and says, hey, my claim process out of network. They’re not calling our customer service team. They’re calling my team, you know what I’m saying? It’s that kind of stuff.
Garrison Goodman (18:34) So, it’s.
Dgprince (18:34) not a matter of just a credentialing. It’s a support piece as well. And we are very project heavy as you can understand with all the growth and everything. So, I myself, Kristen, Nicole, or joy or some of our staff because again, there’s so many projects going on and they’re overlapping and we all can’t be on them at the same time. Yeah. So we’re dividing and conquering, they’re sitting in meetings and having that kind of stuff. So even if it’s not heads down credentialing, some of the staff is going to have to do some of that support work. Those support things that need to be there. So again, I think we need to figure out what it is that’s best. And again, if it is a smaller staff, I literally, I’ve got three or four folks that are at retirement age, you can say. And again, it’s one of those things as we’re working through this. And if things get better, when those folks retire, we don’t replace them. Does?
Garrison Goodman (19:29) That make sense? Yep, yep. Yeah, we can.
Dgprince (19:31) Look at it that way as well. Am I looking to… you know, not have the 21 people that are here not really. Because again, we still have it’s going to take us a while anyway to get us where we need to be. So we need them now, we have to look at what that structure looks like. Yep.
Garrison Goodman (19:53) That makes sense. Okay. So we, thanks so much for the quick response on the information, helped us understand things, you know, Kyle and Noah and myself have put some things together. We have some questions. So this is by no mean a final, okay? Not a.
Dgprince (20:08) Worry. So we’ll.
Garrison Goodman (20:09) show you what we’re thinking, how we’re thinking about things. And then we’ll just kind of work through this together. And then from what we take away from you, we should be able to get something before your meeting today at four P. M. Not a worry. So, but thank you for that background. It’s incredibly helpful and, you know, please do call our baby ugly if you see something that doesn’t make sense, not my seventh month old.
Kyle Bettencourt (20:32) Not Noah’s.
Garrison Goodman (20:33) seventh month old, but, you know, this pretty deck here that Kyle put together. We are not married to it by any means. Okay? All.
Dgprince (20:41) Right. Yep. Cool. So, yeah.
Kyle Bettencourt (20:44) I figure we just kind of start by reframing the current state, current challenge, right? So you guys have a massive footprint, right? 2,300 providers expecting 40 percent growth over 20 years, received a 1,000 provider requests in this past year. And you have a team of 21 that’s trying to manage everything today. So like big challenges, right? It seems like ultimately over the next, you know, two to three years that team is going to need to double in size to handle this growth along with the new divisions, right? I think you mentioned six additional ftes that are going to be needed this year alone for the medical groups, right? And then you’re also running caqh maintenance for, you know, projected 3,000 practitioners. It’s taking about an hour and a half per profile. So just a ton of work that’s involved for just maintaining status quo today. And you guys are going to be growing far beyond that. And then you also mentioned one point 4,000,000 in credentialing related clean denials alone this past year. And I’d like to be tracking probably slightly over that already this year.
Garrison Goodman (21:44) And so.
Kyle Bettencourt (21:44) Recommended starting point, you know, like we discussed, it seems like just tackling payer enrollment is probably like the best path, right? I mean, you’re kind of tasked specifically to solve the payer enrollment piece, you know, Healthstream has served the hospital for, you know, 17 years now. So it’s definitely a bigger discussion. But, you know, we feel, you know, really confident after, you know, the first few calls here that we can absolutely help you guys out with the payer enrollment aspect along with caqh automation. And then not only that we think we can, you know, give you guys a really strong, you know, return or value for helping to solve that.
Garrison Goodman (22:21) So, this is.
Kyle Bettencourt (22:22) Kind of our thought on like the phase approach and like the current state of things, I guess I’ll quickly pause here. Is this sound aligned to how you’re thinking about it? Yes. Okay. Excellent.
Garrison Goodman (22:37) And then, yeah, as.
Kyle Bettencourt (22:38) Far as what we automate, right? Yeah, I think that caqh, the bidirectional sync seems like, you know, a huge win kind of based on what we were hearing yesterday and then just highlighting some of the AI automations that we have in the platform, you know, to help alleviate a lot of work for your team here and ultimately reduce, you know, reduce turnaround times, reduce the administrative burden that’s on your team to handle and ultimately help you guys manage this with ideally no additional ftes. And so, these are kind of the projections that we put together sort of based on, you know, the number two… you know, essentially double over the next… which, you know, at 100,000 dollars per fte. That’s I mean, two point one to, you know, two point 4,000,000 in salary costs that we can, that we can avoid is.
Garrison Goodman (23:33) that the right figure to use Doris of like a fully loaded employee? Okay. Yeah.
Dgprince (23:37) Yeah. I mean, basically, you know, I mean, you might as well say it’s 100,000 or 100,000 plus per employee year. You know what I’m saying by the time you do benefits salary and everything else, it’s easily that. Yeah. Okay.
Kyle Bettencourt (23:50) And I think one of the other interesting things for you to kind of relay today is that we can really future proof the entire credentialing in an enrollment org, we can typically handle anywhere from a 1,000, I’m sorry, 500 to a 1,000 providers with one fte, which is kind of like the standard ratios with medallion that we’re seeing with our customers and.
Garrison Goodman (24:12) I think just to add color that’s typically across like provider onboarding, credentialing and enrollment. So again, depending on how you want to position this, you can feel confident on based upon your volume, just on the enrollment piece, you wouldn’t over the next, you know, few years probably would not need to add anybody to the current team. Yeah. And the.
Dgprince (24:33) hospital credentialing side is huge, which I guess you guys know that, you know what I’m saying? Again, I know we haven’t even approached that. And again, I was, Ron and I both were tasked to solve because again, we did this huge project to bring this in house. And when I was talking about the changing the guards, this is kind of where I got caught in the crossfires. You know, we’ve had three three VPS in our department leave over the last three years, and this has been a three year process. So, needless to say started with one leader, it passed to another leader, that leader left, then it passed to another leader. And then now Ron is my first.
Garrison Goodman (25:09) Person, Doris, you can’t leave, I know.
Dgprince (25:11) So, it’s like I said that to Ron the other day, I said here soon, I’m going to put, I, Doris prince hereby am retiring today and he’s like I won’t accept. I said we got to figure it out. But anyway, we’ve had these huge wave initiatives say, how can we save money? So initially the thought was bring payr enrollment back in house, have control of it and we can save some money. You know, you save the, to me it’s almost a wash. You save on the expense of outsourcing it, but you increase the expenses for staffing, you know what? I’m saying type thing. But then we kind of got… I don’t want to say shoved or pushed voluntold that we were going to go to a singular application across sentara, and that’s how we ended up with credentialstream definitely did not like it did not want it we were looking at, is it modio, there were like three other ones that were much better.
Dgprince (26:09) I can’t remember the names of them now. But anyway, that’s kind of like how we got here. So, you know, for us, we just finished a wave initiative of bringing this in house to improve things. But it took three years because we had to wait on the hospital. To be honest, we had to wait on the hospital to get all their… dops fixed. They had to, there was a lot of things that they were working on. They just couldn’t get organized. And I don’t think that they would have been live yet on credentialstream if we hadn’t joined with them because I can be a bulldog or a bull in a China shop, I guess because I’m like we are going to get this by Friday.
Dgprince (26:44) We’re going to get this by Thursday. We’re going to get this by next week. And until Kristen and I stepped in to do those things, we probably wouldn’t have been live now. Yeah. So a lot of things that I felt like we could gain efficiencies for I’ve already done those as best we could with what we had. So like the millions of loss in revenue that’s out the door. I mean, we’ve already fixed those things for the most part. Not to say we can’t still do better because we can, but that’s been fixed turnaround times. You know, I put the third party vendor on a cap, stayed on them for, you know, every month, we met three and four times a month and we got much better with that still could be better? So again, to your point, everything you’re saying? Makes sense. Sorry, I digress there, no.
Garrison Goodman (27:31) No understanding how the organization works and how we can support you with your conversation, makes us a good partner. So the push.
Dgprince (27:38) Was to get, you know, Ron and everybody flipped out when I started telling them the numbers like, well, then now we’ve negated everything I said. Yeah, and we have a system that sucks on top of it. So you’re going to have to add even more staff. I said, because if all you have to do is manual entry, all we did was move from excel spreadsheets, which was better than the system because I could go this way and do everything across, yeah, exactly. Or now have them do a workflow for every payer. Oh, and then by the way, now these payers want multiple applications. So add an hour and a half, you know, per each one of those applications. You’re trying to do that kind of stuff. So we just, we’re going to have to add staff if we don’t fix it. Yeah. Okay.
Garrison Goodman (28:16) So, just on the PE side, you have nine people currently, And I think your email said you expect to add six this year to keep up with growth, correct? Right? And have those people been added yet or no?
Dgprince (28:30) No, this is kind of where when, well, I started saying about the budget, my prior VP, prior to Ron, when we halted it, she meant to go into our budget to kind of say we’re going to stop here and not add ftes.
Dgprince (28:49) She flipped the chart and it was going this way, it was showing that we were going to reduce staff. So instead of being at, 21, she shows my, financials of being at 11 ftes right now. So now, I’m having to do a whole justification of why I have 21 instead of 11. Yeah, this.
Garrison Goodman (29:11) Sounds familiar. What we typically, well, sometimes we’ll have to do to be like, hey, here’s, how much work it takes to do an enrollment. And here’s how much time is in a day? And here’s how many enrollments that we’re going to have to do? And.
Dgprince (29:22) The six ftes that I was looking to add is part of it is I need someone that’s going to be able to audit this stuff and look at this stuff. I don’t have that. I don’t have a business analyst today. Yeah. So any kind of reporting, any type of analytical work that’s on my shoulders after hours, Saturday and Sunday, you know? So some of those six ftes were support and others were as well because caqh we have one and a half is what I’ll call it doing caqh today. We’re not going to survive that in this manual world. We are already so far behind that I’ve had to pull my payer enrollment team in and start pushing up their sleeves to help us get where we need to be because we are starting to get, a ton of notifications, attestation, not completed attestation, not completed. So we’ve got to get where we need to be with that sooner than later. And Doris, is that teams?
Noah Laack-Veeder (30:12) That I talk to who are starting… to keep up with the attestations? Like eventually they are actually seeing some financial impacts. Has that shown up yet?
Dgprince (30:22) Not yet, but we will, it’s going to come if we don’t get ahead of it. Yeah. Okay.
Noah Laack-Veeder (30:28) Yeah. So, yeah, I think that’s that to me really reiterates the fact that the caqh piece is kind of like a super low hanging fruit. So if you can have some automation that, so, okay, that makes sense.
Dgprince (30:39) Great. Agreed.
Garrison Goodman (30:43) And then, so one of the things we’re thinking about, we typically look at things over like a three year period and so, do you expect growth to continue at a similar clip in years two and three from now? So typically?
Dgprince (30:59) You don’t see that? I don’t know how you’ve seen it with the industry, but typically for us, we don’t see that you’ll typically have a really big, maybe one or two year growth. And then it’ll kind of level out, you know what I’m saying? And then it’ll kind of pick up again.
Garrison Goodman (31:15) I hope to find.
Dgprince (31:16) Out more guys because I haven’t been in the win room yet, yeah, but I’m supposed to be added to that win room so that I can hear those conversations and be part of those discussions. But I can ask Bryce and Melinda and others, I know right now, it’s a 40 percent growth this year and they were looking, they’re definitely pushing primary care, but they did say it was going to be a 40 percent growth overall, but I can, when I get in front of them, I can ask some of those questions this afternoon as well.
Garrison Goodman (31:45) Just so just so is that just this year, 40 percent or 40 percent over the next three years?
Dgprince (31:51) I know it’s 40 percent this year, but I don’t know if it’s a three year, but that’s what I’ve heard. So, again, I haven’t seen that forecast because I haven’t been at that level or at that table with those level of discussions.
Garrison Goodman (32:03) Okay. I can verify.
Dgprince (32:04) That, okay.
Garrison Goodman (32:06) So, yeah. What, as we were talking, I think that’d be helpful. So, we’ll make that follow up because we’re trying to, make this make sense from justification of future cost avoidance, right? You know, just based upon the volume of what that looks like of, hey, you’ve got, you know, of the payers, half are direct enrolled, you know, at, you know, call it roughly 900 new providers, you know, seven to eight direct enrollments each. It’s quite a bit of work. And so, there’s.
Noah Laack-Veeder (32:40) a couple other levers that.
Garrison Goodman (32:41) We’ll probably need to make this total make sense? We don’t need to 100 percent, figure that out for your call today. But, one is, hey, do we want to thin the current PE team out at all? That’s one lever and then the other is for the direct enrollments, how much business goes through the direct payers. And if we can speed that up significantly, what new revenue could we capture? I know on like our first or second call, you said, hey, I can maybe see a 1,000,000 dollars of revenue acceleration if.
Noah Laack-Veeder (33:16) we could.
Garrison Goodman (33:16) Understand the turnaround times from your direct enrollment and how much business goes through those.
Garrison Goodman (33:22) Then we could actually have a pretty strong case around what new revenue we could bring in that. But that’s not understanding if there’s any other factors such as, you know, who you may back, be able to backdate billing to how long you’re able to do that, some of those factors. So, how easy would it, I shouldn’t say how easy, you know, what would it take to be under, to be able to understand the turnaround times, by the different payers that you work with, well, and.
Dgprince (33:54) that’s where we’re at, I’ll just say a disadvantage is because we just started doing payer enrollment in January, in house and prior, all the data that we got from advantum,
Garrison Goodman (34:12) Sucked.
Dgprince (34:14) That’s not a very professional word. But they didn’t go in there and take outliers and other stuff out. So, the data that they always gave us was pretty ugly. Let me play with that and see what I can get. Because again, just know it’ll, only be off of, you know, a couple of months worth of data, of submissions. So, it’s gonna look really good, but I’m gonna tell you it’s not gonna be good. You know what I’m saying? It’s just only pull the ones that we’ve got the approvals for. Okay. So, I don’t know that they’re accurate if that makes sense.
Garrison Goodman (34:48) It, it does. I think between yourself, Ron, Melinda, whatever you want to feel comfortable with there, if you give, us, if you give us like, you know, what your numbers are, we’ll go to our analytics team. What are our turnaround times today for those particular, payers? And we’ll be able to assess that. So.
Dgprince (35:07) Yeah, I mean, I think if you were to even tell us what your typical turnaround? I mean, again, I know you’re trying to get for the return on investment, but even if you could tell me what your current turnaround times are, even if you compare that to industry standard, is it better, you know, than current industry standard across folks who may have it in house or with other organizations?
Noah Laack-Veeder (35:24) Yeah. And Doris, I think we’re kind of talking about that and like I was at an organization yesterday and, you know, I get this a lot. I’ll ask about their current performance and they’re like look guys like we don’t have it. Like I can’t even give you the data, right? Because either, like you said in the ventum’s case, they’re giving you cherry picked data. In other cases, organizations are so strapped that they literally can’t even measure that kind of stuff right now. So, the industry average, I mean, it kind of like I used to think about it as like how well do you think it was going?
Noah Laack-Veeder (35:54) And then that will kind of dictate the industry average if you’re like it wasn’t going well, then I like to say that average was 150 days. Like that’s what the industry average is. If people say it’s going fairly well and we’re overworked it’s normally around 100, 120 days, right? But that’s the status quo. I’ll talk to organizations that go yep things are going well. And then we present our industry averages where it’s around 120. They’re like, yeah, that’s where we’re at, right? So with medallion, our average across the board is around 60.
Dgprince (36:27) So, if we’re.
Noah Laack-Veeder (36:28) looking at what Kyle just said, like if we are really conservative and say that we can drop down to 30 days, you tell us the revenue per day per provider is X average utilization is y, we can give you a meaningful number and that’s going to be a conservative estimate.
Dgprince (36:44) Yeah. And I would say typically 90 days, 90 to 120 is the turnaround time, you know. But again, you’re going to have some payers that are much quicker. And when I say that medicaid right now and I’m going to shoot myself in the foot because I probably jacked us up by saying this out loud, our current Virginia medicaid turnaround time is like 14 days.
Dgprince (37:03) Okay? Now, if you’d asked me that last year, I’d have told you 90, you know, but right now my team can go in and roll Jennifer’s amazing. And she’s very detail oriented and that’s the other piece guys getting it right. The first time, you know, I’ve got a superstar that was my Ar team and she hates denials. She’s like, please, let me work in credentials. It’s not a problem. Baby. Come on. Let me tell you what a difference. My medicaid denials went from here to here. You know what I’m saying? The new one? Yeah, it’s like she’s cutting that almost in half because she knows what she’s doing. Yeah, but she knows what she’s doing for revenue cycle. So she checks before we do the before she does her enrollment, she goes in and looks what we have that provider set up at epic, what’d you put their taxonomy code in? What’d you put their specialty in. Then she goes and checks their board certifications to make sure they’re right? She checks in. You know what I’m saying? She checks all the dots to make sure everything aligns. Then she submits her application and they go out clean and we’re getting them. I mean, she had three last week that came in less than seven days, yeah.
Noah Laack-Veeder (38:08) And that’s kind of like you’re if you have a team that’s operating so well, it’s like imagine what we talked about, right? They don’t have to do the repetitive mundane tasks anymore. Right? Like now, all she’s doing is being a superstar more often. And then I.
Dgprince (38:23) Have two commercial folks that are doing commercial. And I have one person again who’s very meticulous and my managers are all over her because they’re telling her it’s taken her too long to get the applications out the door. But then when I look at her turnaround times compared to her partner who’s doing the other half of the commercial, hers are all getting rejected, not all, but a lot of them are getting returned or rejected or additional information needed. But my meticulous person is getting approved first time out the door. You know what I’m saying? So I’m like you really have to look at the big picture Kristen. You can’t just go by. It’s. Taken her an hour to get through, but she’s updating caqh for the stuff the caqh folks missed. She’s seeing things aren’t right there. She goes in npez and the onboarding team didn’t update npez. Again, she was an Ar person. So she’s looking at epic. No, wait a minute. The taxonomy didn’t write in all three places. We got to fix it first. So, you know, she’s like Jennifer, she’s doing the meticulous stuff and getting it right? But it’s getting approved the first time. There’s no rejections.
Noah Laack-Veeder (39:24) So,
Dgprince (39:25) you know, we all have those issues but that’s the other part. Yeah.
Noah Laack-Veeder (39:31) So, medicaid and medicare are generally faster and then commercial. So should we say like just for a baseline? Should we say that… of medicaid on average kind of historically around 60 days. And then for commercial, should we go closer? Yes?
Dgprince (39:49) I would say, yep, yep. And the whole hold up that we would have and that’s what I’m trying to explain to our leadership is provider didn’t sign as E signature. You know what I’m saying? They give a surrogacy and it’s set out there for 120 because of E signature, that type of thing.
Noah Laack-Veeder (40:02) And it wasn’t tracked. We didn’t remember. Yeah, it’s like I got it. Yeah.
Dgprince (40:07) But they do what they’re supposed to do. Yeah, 60 days easily… united. I don’t know what the heck is going on with them. They’re running, I would say upwards of 90 days or more. I’m not sure what’s going on with them and cigna, cigna’s, somewhere between the 60, probably more around the 60 day time frame. Trying to think of who else humana, military lord help us with them? They’re about 120, don’t know what’s going on with them.
Noah Laack-Veeder (40:35) Sorry, who’s 120?
Dgprince (40:37) Humana, humana, tricare, or humana, military is what we call it. It is another line of humana, another division of humana, but they separate the military part out completely.
Noah Laack-Veeder (40:49) Yeah. I mean, if you, if you’re you know, again, like this could be in parallel, I know you’ve got the meeting later today and we got some directional numbers that I think can generate some excitement. Yep, if you want to send us your list of payers and the states that they’re in. I can work with our analytics team to get, some numbers, fairly quickly, and yeah, I think at the end of the day,
Dgprince (41:13) Kind of, the.
Noah Laack-Veeder (41:14) problem statement or the opportunity is you’ve got a really high functioning team who’s really boggled down in like the mundane tasks and I think you can, and you talked about kind of the preferred approach being that hybrid where we have specialists, we have technology, but we’re really working with you all as a partner. I think that in terms of the outlier performance, you would actually be one of our most successful customers, right? Because, we do work with a lot of organizations that say, look, we have nobody left. We have no credentialing knowledge, right? And we jump in and we help them. But if again, like, you can kind of speak to that. If we remove the mundane tasks, you tell us what’s going to happen, right? It’s going to be a lot more efficiencies. Yeah. And,
Dgprince (41:59) I’ve got a combination of things. So I’ve got, oh… I’ll say it’s going to be very direct. I have some of my folks including my leaders who think they know credentialing but they know how they’ve always done it. And that’s been the hardest struggle for me because they’re very high functioning folks. They bring a lot of, technology to the team, but their talent isn’t knowledge. And I’m trying to get them to understand that, you know, like caqh, I argue every day and I’m like, Does that make sense to you? That does not make any sense? You go in here a good example, you know, pretty much we’re in Virginia, you know, Noah to your question, we are pretty much Virginia.
Dgprince (42:41) We have a small medical group, you know, in North Carolina. So we do, blue cross, blue shield of North Carolina. We do North Carolina medicaid, and any of our telehealth providers who render care, you know, to those patients or to our hospital there, like our hospital medicine, clinicians, like cardiology, neurology, whoever do telehealth, we also have to enroll them in those North Carolina plans. But 99 percent of the time it’s going to be Virginia. We’re in Virginia, our northern Virginia, rockingham medical group. We do that group and I think there’s what 100 and maybe 130, maybe closer to 200. Now. We do enroll those in West Virginia medicaid. But other than that, they’re all Virginia plans. So pretty much we’re a Virginia based organization. We just have that small medical group and one hospital in North Carolina. I mean, it’s, very small.
Garrison Goodman (43:39) And we work with.
Noah Laack-Veeder (43:40) pretty much any payer you can imagine. So again, if you doesn’t have to be formatted super well, just name of the payer and we can just assume Virginia. I know you said you have a couple, North Carolina, maybe a West Virginia. Yes, that’s a common next step is we can give you, our perspective,
Dgprince (43:59) And so,
Noah Laack-Veeder (43:59) kind of thinking about this meeting later. Do you think you have what you need or anything else that we can be helpful with?
Dgprince (44:10) Here. No, I think so. I mean, again today, I know we’re supposed to be meeting, Melinda task, dr hooper. He was our VP of the hospital, all divisions of the hospital for physicians, and lines of service and all that kind of stuff. So, I think he’s trying to level set everybody today because I think there are so many leaders that heard the message. And then it is like an octopus, everybody trying to do their own thing. So, I think today we’re trying to reel it in. Because I spoke last Thursday, no, Wednesday with the hospital leader and he was trying to reorg and restructure my department without me, and I said, well, hold on a moment. You know, that’s not going to happen. So we all need to get in a room and understand one, what is the direction that we’re all going in? And then two, we’re going to have to figure it out, I said, but you need to understand that I’m trying to solve a now issue to prevent loss in revenue for the organization. From a medical group perspective hospital is not going to lose the money because they’re going to grant the privileges. They’re going to push the providers through and they’re going to get what they need to do. But the hospital will start losing money because if my providers are not payer enrolled, their claims are going to start denying as well because they’ll be the attending, you know, I’m saying, and they’re not going to be in the payer system and they’re going to have issues. So, I’m trying to get everybody to understand that piece. I need to solve for what we need to solve for and then also solve for long term. You know, is this a solution for both the hospital and the medical group? Maybe not, maybe it is, but that’s the type of decisions we need to start talking about this afternoon guys. You know, what I’m saying is, are we solving for? And I think bill does want to do that. I think he, he’s not a fan of Healthstream at all. And while the hospital has been on it a very, long time, he says it’s antiquated. It’s very clunky. He said, I don’t feel like it’s where we need to be. But then we also have our sister organization sentara health plan, who moved to it five years ago. So, you know, it’s as an organization. Again, they’re gonna have to go back and look at that and say, do we change everybody or do we only take the areas that we know that we’re struggling in right now and look at a five year plan you’re saying and say, move the health plan later because again, you don’t in my opinion, it’s dangerous to move everybody all at once. Yeah.
Garrison Goodman (46:36) Because if.
Dgprince (46:37) you start messing everything up, not messing up, you don’t say, but changing everything, it’s kind of hard to figure out what went wrong if everybody’s changing all at once. And.
Garrison Goodman (46:46) And Doris, we haven’t heard anything across any of the teams that would give us pause for concern. But the one thing you did say is like how long it would take to move that ship. And, you know, we talked yesterday about how quick we can be up and running. So, you know, it’s going to be on how y’all want, to do it, right? But in terms of just tackling the enrollment piece, I think we’ve got something here for your conversation today. I think it’s hey, we can avoid the future headcount, we may even be able to thin out some of the team today. And then there’s a turnaround time piece where we might be able to get additional revenue. And then from an accuracy standpoint, and this is kind of the piece that people like they’ll like, you know, scratch their head a bit, but we contract to it 99 point five percent accuracy. It’s often more than that, but we give ourselves a point five percent buffer, right? So there’s some of that denial rate due to just data issues or not following up or something. So, I think we have some good information here. You gave us the payers, some of the timer turnarounds.
Garrison Goodman (47:50) We’ll follow up pretty quickly here with some questions and then we’ll summarize everything to hopefully make it as easy as possible for you for your conversation today. In terms of all, the players timelines, decision process, you know, what potentially happens today and then what maybe happens you.
Dgprince (48:10) Know going forward well, I think today we’re going to finally hopefully get everybody on one page so that everybody isn’t off in silos, because again, like I said, I kind of once I had a free that I could tell, they knew I wasn’t happy because I walked into a meeting last week and someone had prepared a whole entire powerpoint presentation only around my team and where they were going.
Dgprince (48:34) But this person’s, never done payer enrollment in their life or worked in a medical group in their life. So I was like hold on a moment. Half of those you have on there is not going to be successful. And we’re not looking at that. So we kind of just had to back up. So I think we now have everybody on the same page. So today, it’s my understanding that we’re all coming together to hear again, what are the things we’re trying to solve? For? I know for me, I have to solve payer enrollment sooner than later. Just like the caqh. To your point, Noah, we’re going to really start seeing a financial impact here very soon if we don’t get something fixed. So either I got to have labor to it or got to have technology to it, one or the other. And I’m still going to have labor in the meantime. So again, even if it takes us eight weeks guys to stand everything up, I have eight weeks of, we got to get this done and everybody’s got to stop dragging their feet. So I think today we’ll get our marching orders. I’ll say our direction of, these are things that we expect you all to do. And, you know, the first thing you need to solve is payer enrollment, but do we solve payer enrollment? Knowing that the long term goal is to be hospital privileging and payer enrollment, you know, I’m saying to all be in the same software, yes or no. And I think they’re going to tell us, yes, to be honest because that’s where we’re going as an organization. We want five different applications or software solutions that we’re managing and paying fees for, you know, when you can do it all in one, you know, saying it makes it easy for our it teams. It makes for all the interface engine folks. It makes for all the apis, all of those things. Yeah. So again, you know, and we’re gonna, they’re gonna ask us to solve for which is what we were trying to do and have been doing in Healthstream is our marketing because every, there is no singular database within sentara. That we have a provider database and they’re trying to use Healthstream for that. So, we’ve spent a lot of time with our marketing department to use our Healthstream data to be able to publish that one 800, you know, sentara. Com and our providers and, you know, the practice information, all that. So we’ve actually built a marketing entity is what I would call it within Healthstream where we’re capturing all that we’re capturing. They’re pretty, you know, glamorous camera shot photo, we’re capturing a little video maybe from them. We’re capturing a little bio. These are my favorite things or these are things that I, you know, focus on in my care. So again, I’m marketing things so they can go in and pull that but yet not mess up or touch any of our credentialing pieces for the hospital or for the medical group because initially they were going in there and overriding my practice information because they wanted to display differently for marketing, they wanted the specialty to display differently. I’m like hold on a minute. I get audited. My data doesn’t match the application that I submitted and please understand this also feeds epic because they direct apis out to epics. And I got a ton of claims denying that’s. What I was talking about. Everybody has to understand the impacts… and they don’t would it be?
Garrison Goodman (51:42) So there’s a couple things there one, it sounds like, hey, you want to solve provider and payer enrollment, but everyone’s got to be okay with like, hey, can whatever solution we bring in work and play nicely with everything else that we’re doing?
Dgprince (51:55) Yeah. Or, or do we have separate applications? I don’t know, I’m saying or are they going to keep credential strength? I don’t know because again, we wanted to add on, we were an add on guys. I mean, yeah, we get an enterprise contract, so it payer enrollment didn’t cost anything from a technology standpoint, which it’s an ugly system. I wonder, yeah, I’m sorry, yeah.
Garrison Goodman (52:16) No, I mean, we’re not here, to bash our competitors, but I will say.
Dgprince (52:20) I’m not either. I’m just saying I’m very I’m in.
Garrison Goodman (52:22) You know, we’re very familiar with what you’re doing, what you just said on hey, a data centrality from a provider data management, some perspective. It’s funny that you mentioned that because like literally we are our whole focus this year. I should say our whole focus. One of our main messages this year is just data centrality around provider data because once you have that centralized, you can do all of the workflows, you can integrate to all of the systems. It just, you need one source of truth.
Dgprince (52:56) Absolutely. And even if.
Garrison Goodman (52:58) that’s pulling from different places, you need one place that is the source of truth. Yeah. And sentara?
Dgprince (53:03) Had internal software solutions that they had created. And somehow it got missed when we went to Healthstream, they were going to send set it. And then after we went live all.
Garrison Goodman (53:17) of a sudden, everybody started.
Dgprince (53:18) screaming about the data not working, this not working. And we didn’t know we went from Healthstream because everything was routed to Healthstream to Healthstream. I mean, I knew nothing about it because we didn’t even use Healthstream. I mean, I didn’t use Healthstream anyway. Yeah, they’re actually owned.
Garrison Goodman (53:34) by the same company, but completely, yes, they are. Yeah. Funny. You mentioned that cred, you know, I will tell you credstream doesn’t make it easy to get their data out of their system. So that ends up being when we move customers over depending how they’ve done. Things. Sounds like you guys just went through it. So it won’t be as bad as like a, you know, a legacy 10 year old system that’s a frankenstein system, right? But credstream does not make it easy to get off because they don’t want you to leave, but it put, it puts a ton of risk as you think about how things are changing in software in the future.
Dgprince (54:10) Yeah. And.
Garrison Goodman (54:10) what’s going to play nicely as the software landscape changes? And I was just talking to a CTO of a company who’s like, I am terrified that I am stuck because I can’t make a change. So it’s either I have to do a huge facelift now so I can be mobile, you know, in the future or just continue on and hope I don’t get fired.
Dgprince (54:30) Like I said, signature and date, yeah.
Garrison Goodman (54:38) Okay. So, so, that makes sense. Sounds like we’ll know more. We’ll we’ll kind of arm you with everything that we have here and try to make it easy for your conversation. Okay? In terms of do you, the thing that I’m hearing is like there’s going to be a little bit of friction because, we can solve the problem. Sounds like everyone’s going to have to sign off. And so I.
Dgprince (55:01) think what I’m going to need to do is again, depending on how today’s conversation goes. I mean, Bryce and Melinda both know I have to solve a payer enrollment period we have.
Garrison Goodman (55:11) Who’s Bryce? Sorry? So.
Dgprince (55:12) They get it. And, and she, both of them pushed really hard on me about AI technology. Okay? I’m looking for software solution to either compliment and, or do it. You know what I’m saying or again, I don’t think they had a.
Garrison Goodman (55:34) me.
Dgprince (55:34) selecting something that would work outside of credential strength. I’m just going to be honest because at the end of the day, we still have to put all of our providers in credential strength. So that will not change. So that data will still be there. They’ll still be a source of truth for centera. That part will not change because the hospital’s still in there, they’re still doing all the privileging today. My team builds a whole entire shell. We put everything about that clinician there. We add all the locations, we add the hospitals. We put all that information in there today. So the data, we’re main hole. So again, I don’t think we would break things so to speak. So those are all the pieces we’ll have to walk through what would that look like? But yeah, but I do know that they typically have for the last five years pushed really hard and that’s to move forward a one center approach, you know, one solution. One, everything. I just don’t think it’s going to happen quickly plus they’re locked in the hospital is pretty much locked into. Sorry?
Garrison Goodman (56:34) People trying to.
Dgprince (56:36) Call my cell phone. I mean, where’s that trying to? I mean, we’re locked in to that or they’re locked into that. I don’t know for how many years because I was a part of those negotiations. I don’t know if it’s a year three year, five year. I don’t know, I know we’re in year two, if it was a three year or five year, I’m not quite sure. Okay.
Garrison Goodman (56:54) But we’ll find out those things today. One question who’s, Bryce?
Dgprince (56:58) Snyder. He is the senior VP that Ron reports to and Bryce reports up to Melinda got.
Garrison Goodman (57:05) It. Okay. So, Bryce, Ron, you, Melinda, and then some of the folks on the hospital side will probably have to weigh in. Yeah.
Dgprince (57:14) Okay. Todd Rourke is the VP over, he reports up, dr hooper, dr. Hooper reports up through Melinda with all that said, Todd Rourke. I work very closely with him as the VP for the hospital side, and he’s in it to win it. He’s not married to anything that they’re doing at all their workflows or processes are nothing. He’s like Doris. We got to blow this up. I’m like, yeah, we do because again, he was interest practitioner. So he understands the clinician side of the house as well as the clinical side of the house and all the paperwork that goes along with it. So he’s very easy to work with. So, I think he would be very excited to see a tool such as this that.
Garrison Goodman (58:00) Would help. Yeah, here’s, you know, we obviously can do all that. It obviously becomes a much bigger project. We want to solve your problem, Doris? Yeah.
Dgprince (58:11) That’s what we have to do.
Garrison Goodman (58:13) Today, but, I understand that the team wants to understand like, hey, this is going to mess up our larger strategy and what is possible with this one sentara. So, would it, I mean, we’ll put together in our follow up, but yes, we do all that all the way from provider data management, provider, onboarding, credentialing, hospital, like we do end to end. Okay? So, but our intention is to work with you and solve that. And if we’re successful, then hey, maybe that opens the door to something else, but I agree, like you were saying with credstream that’s gonna be a multi year thing and that doesn’t solve your problem?
Dgprince (58:46) It does not like I said, it was free for a reason, but.
Garrison Goodman (58:51) Anyway, so when it comes like, we’re happy to, you know, pound our chest and show how big we can be and all the companies and health systems that we’ve worked with and to make y’all feel confident that we’ve done this at scale before, but, you know, our goal is, to hopefully move quickly with you. Yeah?
Dgprince (59:10) I know the delegations is one of the things that we’ve really struggled with no matter what organization we’ve been with, whether that was with advantum or even doing the load and set up within Healthstream or even, the prior folks who are doing the delegation side. That has always been a challenge. And I don’t know if you all run into that and I didn’t get into that a whole lot yesterday or day or the last time we met, but each payer is very different with their rosters and all you guys probably experience that today with your clients anthem being by far the worst of all of them. They are also the most strictest on their verifications. I can tell you we’ve gotten hit every year or the last three times we’ve been audited, we’ve been hit because they don’t necessarily, our contract says ncqa, but the auditors who do the auditing like well, that’s just a guideline. These are all the additional things she has here’s. One little line in here says and all other anthem… audit guidelines. I’ve never seen it. So I went pulled absurd off. She’s right? It’s in there. It’s in there. Well, all these internal guidelines and audits that they have are insane. So, I’m now working with our corporate contracting team and say you get that language out of there or you tell them peace out, we’re not doing delegation anymore. I mean, we’re gonna, I mean, because again, it’s ridiculous the amount of work and the level of verifications and different things that we have to do for them that you don’t have to do for anybody else.
Noah Laack-Veeder (60:45) Yeah, your timelines really aren’t yeah, improved. It doesn’t really make a whole lot of sense. So.
Dgprince (60:52) Correct. So, that’s an area we help like.
Noah Laack-Veeder (60:55) We do, we do ncqa but we also do more because we have payer customers that use us for like credentialing for payers. So they’re, and blue cross funny enough is one of our customers. So, so it’s something that because again, when we say end to end, we can support really that. But I think kind of I’m aligned with what garrison said, I don’t want to get in the way of solving your immediate problem because as you said, attestations being missed or things happening is going to do revenue. So like we can solve that and then kind of we’re end to end, but we’re also plug and play, tell us what you need and we can add things on.
Dgprince (61:29) So, yeah, if it’s.
Garrison Goodman (61:31) helpful. I mean, we’ll you know, I think we’ve maybe sent you a deck before, but if it’s just like, hey, what do we cover? We can include all this here’s. This beautiful rainbow of all the things that we do.
Noah Laack-Veeder (61:42) One color, yeah.
Garrison Goodman (61:44) Beautiful shades of blue. So we’ll have that in there. So like you can, you know, hey reference it. Hey, there end to end, you can pick what you need. The other thing that I think is helpful, is this right here when you’re talking about like, hey, you know, for your talk track internally, it’s like, look, we’re not, yeah, our goal is to replace the expertise that we have. We want to do what machines do better, which is data work and follow up and accuracy, but give the capability to our people on staff to actually make the complex decisions. But then even beyond that, now that we have a centralized data perspective, we’ve got really good automation and workflows. Now, we can actually be helpful to the business and strategic and how we think about planning, scaling, forecasting those things. And the other thing is, you know, when you think about the team and people on.
Noah Laack-Veeder (62:35) Staff those.
Garrison Goodman (62:37) Folks that you’re retaining that give experience to a platform like medallion elevates their capabilities in their career as well versus do you really just want to be stuck and spread the seeds and like calling payers? No, like, you want to develop your skill set to work across many payers to impact your relationship with providers and do things, that actually drive a business forward. So, those two things from an internal conversation both with like the employees as well as, the higher ups tend to land pretty well. But we’ll follow up, summarize everything that we have here. And there might be a few we’ll follow up with the questions that we have for you as well. Okay, we can, Kyle and I have a meeting at 12. So if you can get some of that information back to us, we know you got month end and a bunch of other stuff going on. This is.
Dgprince (63:25) Priority because this is going to be my saving grace. So, okay. Okay. Yeah. Well.
Garrison Goodman (63:31) Thank you so much for the time that you’ve already allocated with us in the partnership. Like we were, we’ve been talking a lot internally. We’re really excited. We think we can help you all. I.
Dgprince (63:39) think so too. And that’s the reason I’m excited. I mean, it’s the first application, you know. And just with the technology that you all have, it’s hands down so much better than anything else that I’ve seen so far, you know, so again, I’m excited about it. I know I’m always kind of tough. I’m like don’t give me a sales pitch, show me the real, and I don’t mean that negatively.
Garrison Goodman (63:58) No, no. It’s true.
Noah Laack-Veeder (63:59) This is, we just know.
Garrison Goodman (64:01) We, we talk about a lot of times like why would they do this? Like what is the business case? Like it has to make sense? And if that makes sense, then we get excited. If it doesn’t then yeah, hey… see we’ll be friends but we,
Dgprince (64:14) can’t do business moving forward? Absolutely. Yeah. Absolutely. All right. And that’s really a kind of off the wall question. But can you send me your caqh stuff that you do? Or is that something we need to wait to do? Like all the verifications and things? Because some of the things that we have run into barriers like the anc, you know, nurse practitioner certifications, ecfmgs, those type of things. I don’t know if all those are things or we can get more into the weeds with it later. Maybe you?
Noah Laack-Veeder (64:40) Sent that over email. I can kind of work on that in parallel. Like again, I think there there was a follow up around like the, your team around the op, operational pieces there. So, yeah, just any typically, what customers will do is that you’ll have conversations there’ll. Be questions that come up like if you just start a shared doc with us, we can start just updating them and,
Garrison Goodman (65:00) Doris, I just want to make sure I understand. Are you just asking for like a list of all the things we do for caqh or what?
Dgprince (65:07) Yeah, like for your delegated payers, you know, do you have like your ncqa?
Noah Laack-Veeder (65:13) The verification? Yes.
Dgprince (65:15) All the verifications that you, do you have that? Did you share that?
Noah Laack-Veeder (65:17) Yeah, I can, I have like a,
Dgprince (65:20) standard questions. Okay. Yeah.
Noah Laack-Veeder (65:21) I have a standard like requirements document that I will put customers on. And then there’s like a piece for like, so yeah, I can send it over for.
Dgprince (65:29) Sure. Okay. That’ll be because I know the hospital team are going to ask me all kinds of questions today as soon as I mentioned, well, are you doing this? And you’re like guys, we haven’t signed anything yet. We’re in the discovery stage that’s what Kristen went after we hung up yesterday. Why didn’t I say something? She’s I know you’re trying to keep us on track. I’m like now we have to have the high level conversations, then you get into deep dive and we, yeah, we’re not partners yet. We’re trying to become partners. So, Doris.
Garrison Goodman (65:57) By chance, are you all a company that uses like teams or slack by chance? We?
Dgprince (66:03) Do teams? Yes, we definitely have teams. Yeah.
Garrison Goodman (66:07) Maybe there’s a way that we can open up a teams channel. And just that way, if you have questions, you know, you can just ping us and we can start a thread there because we can do email, but it tends to get.
Dgprince (66:16) I know, and you know, we were doing sharepoints for some reason? I’ve not been able to because we use guidehouse to help us with our Healthstream build. I never could get them into our sharepoint, but onto my Healthstream sharepoint, I could. So we put everything on the Healthstream sharepoint and called it a dgp folder and we shared everything there, which was, yeah, but yes, we should be able to do something. I would think in teams, I’ll reach out to matt and ask him. Yeah, there’s a way to do.
Noah Laack-Veeder (66:54) That because I’ll kind of ask because, I mean, ours, we respond really quickly. So, yeah.
Dgprince (66:59) And I know that at advantum, they had a sharepoint site at advantum. So we would log in to their advantum sharepoint, and they had a one that was locked down just for us and we’d go in there and share things as well. So again, yeah, we’ll do whatever we need to do to be able, to do that, make it easier. Okay? All right. Thank you guys so much. Thank you bye.