Transcript
Nick Scallion (00:00) good morning. Hello, Lisa is in the waiting room so I’m going to pop her in, you ready? I figure as much.
Nick Scallion (00:24) Hey, Lisa.
Lisa Lasick (00:26) Trying to figure out the settings on the zoom here.
Mallory Smith (00:30) Every single day for me understand?
Nick Scallion (00:34) We’re making you a pro.
Lisa Lasick (00:36) Yeah, we use teams a lot. So, it’s like zoom… isn’t every once in a while thing we.
Nick Scallion (00:44) Do have teams. So if we have the pleasure of speaking again, I will do teams next time although now you’ve gotten the hang of zoom. So I don’t know. I’m.
Lisa Lasick (00:52) okay. Now, I’m in all.
Nick Scallion (00:54) Right. Good. Well, good to see you again. Lisa just wanted to introduce my colleague Mallory actually, I won’t steal your thunder. Do you want to say hi Mallory?
Mallory Smith (01:04) Absolutely, Lisa. I’ve heard wonderful things. So, I’m a solutions consultant here, and I’m based in Nashville, Tennessee. I’ve been in the provider data space roughly 10 years or so and I’ve been with medallion just under two years now. So looking forward to the conversation today.
Lisa Lasick (01:20) Sounds good. Nice.
Nick Scallion (01:22) To meet you and Lisa. Yeah, I gave Mallory just a bit of a recap from our conversation. You know, the high level was that you folks are using healthstream today. And there was a couple different topics. We talked about. You had mentioned, you know, you folks weren’t actively looking to switch providers, but always looking for improvements or some type of return on investment if possible. So, we talked about how you folks are doing some credentialing for all your providers as well as the enrollments that you have both on the provider and facility side. So, our objective today was to give you a look into the platform, a demonstration to show you how we can operationalize your workflows and then just see where maybe you see how that could benefit you folks. So if things go well today, perhaps we can have more conversations and look on, you know, is there a return on investment? Is there any challenges that we can mutually solve together? But we’ll see if we get there. So, you know, I think in the demonstration, you’ll see kind of two different, three different lenses where what can the provider experience look like? And then from an administrator perspective, how are administrators requesting credentialing files to be generated? How are we automating enrollment? And then the third kind of more of a macro view that you yourself might be looking into just for the overall health of the operation, what are turnaround times looking like? Where are you cutting those down? So, is there anything else you wanted to cover just from our conversation? I just want to make sure we’re using this time.
Mallory Smith (02:46) Productively nope.
Lisa Lasick (02:48) I think we got it covered.
Nick Scallion (02:51) Cool. All right, Mallory. I’ll let you run your show.
Mallory Smith (02:57) Nick, I thought you were presenting the demo today, I.
Nick Scallion (03:00) Can I can do the demonstration?
Mallory Smith (03:04) April fool’s. Yeah.
Lisa Lasick (03:06) I thought about that today. I’m like what am I going to tell my team? I got to think of something good.
Mallory Smith (03:11) I got it. I thought about that this morning and I was like, I think I can do it on Nick. I think he’s a good sport. We can do it. My husband agreed. So we’re good. Well.
Nick Scallion (03:21) That’s way easier than I was. I went to get my trash can this morning and saw my neighbor. And every time I talk to him, it turns into a five minute conversation, but his wife is really into April fool’s and she swapped out the toothpaste with mayonnaise. So, this morning, he brushed his teeth with mayonnaise. I will gladly have you poke some fun at me, Mallory, as opposed to what the alternative is out there.
Lisa Lasick (03:46) Absolutely. Ew that’s a gross one. Ew.
Nick Scallion (03:49) Lisa.
Mallory Smith (03:50) Let me let you know. I love pranks. My husband’s not as into them. So, if you want to live vicariously and you want me to call anyone in your circle and prank them, you just let me know. Okay, I fully volunteer.
Lisa Lasick (04:03) All right. Well, we can have you pose as their new boss?
Nick Scallion (04:09) I.
Mallory Smith (04:09) love that idea. I,
Lisa Lasick (04:10) want to introduce your new boss and I won’t be, I’m sorry, but I’m going to be leaving Friday’s. My last day here’s, your new boss… although they might like that idea. And then that might backfire on them.
Mallory Smith (04:23) That might backfire. No, no, no. Do they have to come into the, so, do they have to come into the office at all?
Lisa Lasick (04:29) No, we get to 100 percent work remotely.
Mallory Smith (04:33) Okay. I was thinking you could just be like, why aren’t you at the office right now? But it’s.
Lisa Lasick (04:37) fine. Yes. Okay. I know I have to think of something good. I got him one year. I think I told him I won the lottery or something and that my last day was today or something. Well, I don’t know we’ll think about it. I.
Mallory Smith (04:52) Love it. Okay. Well, I’ll give you my number after this. Now, if you need my service, let me know. Okay?
Lisa Lasick (04:58) All.
Mallory Smith (04:59) right. So let me just confirm, are you able to see my screen? Yes. Okay. Wonderful. Thank you. So I love for my first demos especially with potential partners in the space just to be exploratory. I would want them to be informal conversational, the different products and different services that Nick and I have discussed previously. What we’re going to discuss today. We’re going to start with the provider onboarding experience. I know you currently use healthstream, you seem to be a fan of that. So I just want to see a side by side comparison how you currently do things today. If you think they’re going to be efficiencies with medallion from onboarding, we’ll go over to credentialing, we can talk about the different standards that you credential to all the different components of that. We’ll talk about standard payer enrollment, and then of course, analytics recording anything of that nature. Is there anything you would like to add to that today?
Lisa Lasick (05:52) Nope. I think we’re good.
Mallory Smith (05:53) Okay, wonderful. So with the screen that I have pulled up here, this is just a provider dashboard. So this is where you’ll see the directory of all your provider profiles. I know that Nick mentioned you have about 700 or so. Is that accurate? Yes. Okay. What’s the typical onboarding and attrition that you see with a group that size?
Lisa Lasick (06:15) We have a lot of attrition especially with the social workers. Our clinical staff, we have a lot of turnover and a lot of turnover with the nurses. Not so much with the medical staff, like the nurse practitioners, and the MDS usually stay a long time. But when it comes to the clinical staff and the nursing staff, it’s like forget it. It’s like they’re in and out a lot.
Mallory Smith (06:37) Absolutely. No. I understand. I have a friend that’s a nurse and she has the same stories. Are you thinking? Yeah?
Lisa Lasick (06:43) I feel like we don’t grow in our number substantially. When I first started, we had about 500 providers. That was five years ago. We’re up to about 750, but that number has been the last two years. Pretty much been staying the same. So even though we’re constantly onboarding people, we’re losing people. So we end up staying at an even keel even when we open up a new facility. I feel like the numbers really aren’t going up. They’re really, pretty much staying stable because they’re coming in and going out. We’re just replacing people. So it’s crazy. Yeah.
Mallory Smith (07:20) I would argue that it seems pretty operationally efficient, right? So you lose people, you backfill for those roles. You have a healthy turnover just to make sure when we’re speaking the conversation especially like bulk import with your.
Lisa Lasick (07:33) RN.
Mallory Smith (07:34) staff mas, things like that. Are those included in the number of 700 providers or are there 700 billable providers? No?
Lisa Lasick (07:43) There’s not 700 billable providers. There’s probably about 350. About half of the 700 is about 350. I would say, okay, and billable providers, yeah.
Mallory Smith (07:52) Okay. Are you storing all 700 in the healthstream platform today?
Lisa Lasick (07:56) Yes. Okay. Perfect. Thank you because we still do an ongoing monitoring. We don’t do provider enrollment obviously, right? And we don’t enroll our interns, which we have probably about another 100 providers that are interns, which we don’t enroll them either. So that’s included in that 750 number. So enrollable providers is probably around 350, I would say.
Mallory Smith (08:21) Okay. Thank you. Yes, completely understand. And if you were to pursue a partnership with medallion in the future, you are allowed of course, to keep as many core seats in there. It sounds like you do sanctions monitoring for all your providers regardless if they’re billable or not. That would be parity, pretty much a seamless transition if you were to consider a new platform. So thank you for confirming that for me. What we can do now is I want to walk you through just the provider onboarding experience. So we do have a participating organization status with caqh. I know that I worked five years in operations. Sometimes the caqh profiles were a hot mess if I’m completely honest, right? So I know that there may be some hesitancy around caqh. I wanted to dig into that a little bit more today and also show other data ingestion methods such as our resume scanner, API integrations, anything of that nature? So before I get into that, when we think of caqh, what’s just your general experience when you think of it?
Lisa Lasick (09:21) Well, we do have a caqh import function in what Healthstream calls their hub, which is different. We do our medical providers differently than we onboard. Obviously, our nurses and people that are non medical staff. So our onboarding process for medical staff is different than everyone else, just to let you know. So when it comes to medical staff, they go into something that’s called an application hub, the provider gets an invitation to that, they fill it out, but they have an option to upload from caqh. So similar how you have a caqh bulk import, they have an option to click on that before they start their application and import all their caqh into that application. It is always a hot mess when we’re always cleaning up stuff. Our staff once the provider’s onboarded, still go into caqh anyway because we have to put our locations obviously there, you know, we have to do all that. And then we clean up the whole thing. We upload our malpractice certificates and we clean up whatever caqh garbage has imported. Basically. So I’m not the biggest fan of the caqh imports. Because of that reason to me, it’s just more of a problem than not sure. I would say.
Mallory Smith (10:48) Absolutely. I understand that.
Lisa Lasick (10:50) It’s like you either import the garbage and you clean up the garbage or you just let them put in whatever, and they still have to clean up the garbage. So it’s really one half of the other doesn’t really matter.
Mallory Smith (11:03) Exactly. Garbage in garbage out, is what my ovp used to say.
Lisa Lasick (11:07) All the way around.
Mallory Smith (11:08) Absolutely. So what I’ll show you today, I just want to show you that we are able to utilize caqh. But a really important note here is that we get the caqh may not be the cleanest all the time. So where we are able to import using three data points such as just their caqh id, their npi and their last name, the provider can link it. You can link it for the providers. There’s several different things there. We also have automatic integrations with different third party sites such as npes and the npi registry to verify that the information coming from caqh is actually accurate. So that happens automatically. I’ll give you a visual of that today and we’ll go ahead and get into it. Okay. So when it comes to inviting providers to the platform, you do have the bulk import option. This is basically you give us the provider’s npi last name and their email, it’ll bulk import it’ll, connect their caqh. You have a single invite option and of course, role based access control. So, I’m curious with your providers, currently, are they able to access that hub continuously or is it just a onboarding hub? Are you able to communicate with them day in and day out there?
Lisa Lasick (12:19) Is ways for us to do that, but we opted not to do that because we obviously can communicate them through regular email instead of because we don’t invite everyone to the hub app process. It would be half of the providers would be on one side and the other half would be communicating differently. So we just make it, you know, one place, okay? If that makes sense. It.
Mallory Smith (12:43) Does absolutely, it really does. So in that case, the way that the medallion platform would work with your providers is you can use it as that ongoing communication, every email, every task, everything is tracked at this level, automated tasks are created and so forth. Or you can still be that middleman and the liaison for those providers. So ultimately, with role based access control, the providers will have access into their own platform. They’ll be able to see all the information. And I’m going to show you a visual of that. Your access would be admin. So you can see anything and everything that’s happening within the platform. And then we even have team manager team viewer. So if you have certain members of your team that manage this provider type or this state, demographics, geographics, whatever it may be, then you can also divide the providers up that way. But the really big picture here is that to invite a provider to the platform, it’s very easy whether it’s individual or in bulk email name, start date, provider type. What’s going to happen next is an email is going to go out to those providers. We do allow the ability to white label. So they will receive a welcome email that looks something similar to this. So you would have your logo up at the top. It would have your information as a part of the email. You can control the messaging in the email itself. It’s always really important for us because we need them to see it and recognize it so that they act on it. And then essentially, they would just click in to get started. So full control for your team when it comes to the email that goes out to them, whether it’s a current provider, if it’s a new provider, when you want to control to send that email as well. When they’re able to click the email and get started, then they’ll be walked through this welcome screen of what you can see here. So advanced recovery systems partnering with us for maybe it’s licensing, credentialing, enrollment, whatever it may be to get started. They’re going to kickstart their profile. They’ll have a few different options. So caqh, of course, honestly, we see this with about 85 percent of our customer base right now because it’s those three data points. And you don’t have to have the username and password. And once a year, Lisa, I have a, my sister in law is an obgyn. And in April, like I’m expecting it, I know she’s going to call me today because it’s April fool’s I know she’s going to call me and say, do you have my caqh password and I’m going to have to say no, Amanda, I don’t but we’re going to reset that together, right? So that is a very typical experience that you’ll have with providers. It’s too many things to keep up with in the first place. So they don’t have to have that information to connect it. The other options I want to explore with you is also a resume scanner. So especially if you have new graduates straight out of school, if they have their CV or their resume, we use optical character recognition and AI technology to basically scan it in. They can take a picture with their phone if they want to. It then populates the profile for them. So that’s another option. And then of course, API, I would be remiss not to mention the API. It is open ended bi directional especially with you having to manage 700 different providers. So I’m curious with your current healthstream platform. Do you have an API set up with your HR platform, with your billing, with your scheduling you?
Lisa Lasick (15:56) Do we have it set up with? Well, we.
Mallory Smith (15:59) have it?
Lisa Lasick (16:00) Set up with our HR platform? It’s adp. So we have a bi directional API set up. I want it to be able to do more. So, it’s just been a challenge for me internally to get prioritized on the list of it projects that they’re working on. But my goal was to share all the license information with adp as well. So, but yes, we do have a current API connection that’s working with credentialstream today. Okay?
Mallory Smith (16:29) Awesome. Thank you. So you mentioned that you wanted to do a little bit more? Can you give a little detail as more comprehensive?
Lisa Lasick (16:37) Well, I needed to be able to share the provider’s license numbers and expiration dates because I have pretty much stood firm with everyone in the company that I refuse. If I have a platform in which I store licenses, maintain them, monitor them. I’m not putting it in two places. So when we have audits, I put our information into our, for our share drives for audit purposes when we do audit review. And then I do not store things in adp because it’s all manual. So if I don’t have to do it manual in my platform, I have today, why would I want to do? Why would I want to like have to do that manually in another platform? So that’s why I said, no.
Mallory Smith (17:25) Absolutely. Stick to your gun. I appreciate it. Yeah, yeah.
Lisa Lasick (17:29) I’m like I’ll give you anything you need to know if you need to know it. I’ll give you whatever you need in a second, and I’m good about that, but I refuse to do things twice because, what’s the efficiency of that?
Mallory Smith (17:42) It’s not well said cheers, I like it. So ultimately, I guess, my question with that, is healthstream, are they able to help you build that API connection? Since it sounds like your team is already strapped.
Lisa Lasick (17:56) Well, they’re okay, they give us full access to their API. So, we have full access to the to that. So our programming and developers worked with them and they gave us full autonomy to get whatever we wanted out of the system. It’s just us putting it into adp in.
Mallory Smith (18:16) Other words, so.
Lisa Lasick (18:17) It’s the mapping of where things need to go. I already know I have a lot of experience in implementations and software. So I even volunteered to help them with all of that. And just, I’m just not on the list. I’m like way on the bottom of the list of projects until something becomes critical and then somebody else says we have to have this. Then I might get bumped up. But right now, I’m at the bottom.
Mallory Smith (18:45) No, I’m sorry to hear that.
Lisa Lasick (18:47) I’m the chopped liver you’re.
Mallory Smith (18:49) chopped liver and, you know, what liver can be really good actually if you season it… but I hear you loud and clear Lisa what I would offer just as you’re exploring streamlining efficiencies it sounds like you’ve got your head in all the right places. We do have the API resources at medallion that we can help build that connection for you. So it’s perfect for instances where your it resources are already at their maximum capacity. There’s other things on fire. I feel like in healthcare, everything is on fire but they would be able to help build that connection. So just something to keep in mind as we continue talking. Okay. All right. So when we think of onboarding a provider, there’s of course, the caqh aspect there’s the resume scanner, there’s the API. We are very familiar with adp, a lot of our customers have the API with that consideration. If we would go with caqh, the pieces I want to show you today, three data points. The provider can link this or you can link this for the provider, just depending on the white glove service, it will then link directly to their caqh profile. They’ll be able to go directly to their profile from here. And I’ll give you a visual. So this next screen that I’m going to show is what the provider would see when they log in. So caqh completes 70 to 75 percent of that profile. So we’re seeing across the board with our customer base, a two day average onboarding timeframe. So the two days is from the time that they’ve been invited to the platform until they’re complete and they’re ready to move forward. Big majority of that is caqh. But I would also argue that it’s the caqh cleanup pieces that matter just as much because we have those integrations with mpi registry and things like that. So this is the provider’s view. Of course, they have their overview tab. They’ll see all their tasks. They’ll be able to see what information is currently missing from their profile, their licenses, their payer list. If they need to contact anyone from our team, and then there’s a mobile friendly option of this. So if they wanted to do this from their phone or from their tablet, the mobile friendly option looks just like this. So essentially with their profile, they can open it up and they can see, okay, it looks like I need to review the agreements. They can access the agreements, review everything electronically, electronic signature integration. These forms are basically can medallion monitor your caqh, can we work on your? Behalf. So it’s just legalese in my opinion from here, they would add the signature. Again, they can sign from their phone… go through the caqh, add a station, and then basically save and finish. So linking their caqh or their resume, reviewing for any gaps and information and then electronically signing it. You’ll see about a two day average when it comes to onboarding. So I’ll pause there. I am curious Lisa with your current onboarding timeframe, are you seeing similar times with the hub with healthstream or what are you currently experiencing?
Lisa Lasick (21:50) Well, we don’t have really that much. We really don’t have that many issues with the way that it works with credentialstream. Our biggest challenge is the provider getting confused between our onboarding and our credentialing. And having the provider understand and building that bridge between what the onboarding functions do and what we do for credentialing, because we still have the… area that does our recruitment, for example, does onboarding with we use, we now change, we used to use checkr, we use, we used to use ism, sorry was the platform that we used and we switched it to workable. I don’t know if you’ve ever heard of workable. It’s.
Mallory Smith (22:39) Not a familiar one for me. Ism checkr, sterling absolutely. But no, tell me about workable. Well.
Lisa Lasick (22:46) Workable is replaced our ism’s product, but I can tell you it’s not the greatest thing. We’re already having challenges with it. It’s not that bad. It just sends you an email on every single thing in the world like you have. We have, we now just went from not just isolated email conversations to every time someone sneezes an email pops out. So we have we’re having email overload. So we’re trying to work through all that. They just, they just got that platform in December. So we’re working through all of that. But we did have ism’s before. What we’ve been trying to do is I wanted to eliminate the credentialing component altogether and have the onboarding completely done for ism on the onboarding side, meaning that we would be a task located in their workflow that we clear them for credentialing. But we do all of our stuff within credentialstream or within your platform. We would do our functions and then we would clear them. Our only thing that slows us down is the peer reference process, not because it’s a difficult process. It’s a simple process. It’s just getting the providers to answer the peer references, so that we have to chase if we get the provider to agree to speak to their peer references, we can have a turnaround time of a day within I’ve had people in 24 hours be done completely finished with credentialing. Wow. So, it’s really on the onus on the provider that we have the biggest problems and the peer references not complying. But other than that, we can literally have it done. My medical director all the time says, Lisa, can you get this done? Can you get it done? I’m like, yeah, I can get anything done really quickly if the provider complies. So if the provider agrees and helps and gets it all going, then, yes, we can turn it around in 24 hours. So I don’t know we’ll see my average time frame though is probably more like five to seven days. I would say on just normal time frame, I would say it’s not on our side. It’s really the provider driven side.
Mallory Smith (24:53) Absolutely. That’s an impressive turnaround time we have. If we have ncqa level credentialing, it’s a three day SLA that we’ll have to complete. And with joint commission, we have a five day. So it sounds like you’re already right at that buzzer beater anyway. So that’s impressive.
Lisa Lasick (25:07) Yeah, thank you. Yeah, of course.
Nick Scallion (25:09) Can we validate to which accrediting body you follow? Lisa? I’m sorry if I missed that. Are you folks doing joint commission or ncqa? We?
Lisa Lasick (25:16) Do joint commission. So we have never on the credentialing side. When I first started five years ago, we got dinged for a PSV because somebody was on vacation on a Friday and the PSV was not done. And so we were not 30 days prior to expiration, date. So we got dinged now. That wasn’t my fault because I wasn’t here, but I swore that would never happen. One day I was on board. So we have never been cited for anything in joint commission. When it comes to credentialing, there may have been some HR issues surrounding training and lack of training and stuff like that or Bla, you know, the bfas and blss, some of that’s been caught, but that’s an HR function. We make them do that. That’s.
Mallory Smith (26:05) hashtag. Not my problem. Yeah.
Lisa Lasick (26:07) Hashtag, not on my watch for sure, right? So, my.
Mallory Smith (26:13) nursing friend, she says that every time Draco comes in the building, she has to hide her water bottles from their little like desk that they hang out. Is that true? Are you allowed to have water? Like at their nursing station? They cannot have water bottles. So, she works at Vanderbilt university here in Nashville and they have to hide their water bottles. I thought that was crazy too, Lisa.
Lisa Lasick (26:36) That was a joint commission survey. Yeah.
Mallory Smith (26:41) You might want to check into it but, you know what else is not?
Lisa Lasick (26:43) Good. I’ll have to ask. I’m going to have to ask because I’ve never seen it’s. Never come up in any audit that I’ve been in the five years with all the joint commission audits. I’ve been through it’s. Never come up about water bottles. The only thing that came up was we had an outpatient location that a nurse came in. I was talking to another nurse and the surveyor was in the break room, taking a break and the girl says these patients love my Jamaican, whatever dish it was and she goes, I’m going to heat it up for them and they just get so excited when I bring them food from home after I’ve cooked it for the weekend or whatever. We got dinged for that. Because a number one, you can’t bring outside food and you can’t give it to the patients if you want to eat it with the break room with the employees. Yeah, but you can’t give it to the patient because that’s a safety issue. So we got dinged on that. But that was like one of those discovery things. I’m sure they thought it was fine, right? Exactly, doesn’t even think about it and it’s like God, but yeah, I don’t know about the water bottle thing.
Mallory Smith (27:48) Okay. Well, now, I’m going to tell her about the Jamaican because I’m going to be honest, that sounds really good. I probably would have had some too.
Lisa Lasick (27:55) Yeah. I mean, I don’t know if it was curry goat or what she was bringing in but it was just, it was just that wrong timing that she walked into the break room and put her curry goat in the microwave and mentioned it was going to be given to the patients.
Mallory Smith (28:10) But, yeah. Oh, I appreciate the story.
Lisa Lasick (28:15) Yeah, that was a good one. Yeah. Okay.
Mallory Smith (28:19) So, sorry, before we transition over to the credentialing flow, I’ll show you joint commission level privileging, we’ll talk more about the five day SLA, and things like that. Was there anything else that you had questions with concerning the onboarding flow?
Lisa Lasick (28:34) No, it seems to be similar to what we’re doing today. I do like we don’t have the mobile platform which I do like that. I still think that we probably… would have to talk about maybe integrating the onboarding platform with your platform. So we could have one application. So right now, what we’re talking about and what we were trying to eliminate the hub and Healthstream. The only reason why I needed it was for two purposes one, so we could do the peer references but I do not need the hub to do it. I can still recreate it in our actual application. I don’t have to go through the hub and through the attestation forms. So right now the forms are linked to that hub application process for them to sign and acknowledge their application that is thorough and complete and the authorization for allow us to do their peer references. Again, those two things do not have to be done in the credentialing platform. They could be done in the application process on onboarding. So that’s what we’re I would prefer that certain things be done in the onboarding, so that we don’t have the situation where providers are confused. Do I go through medallion or do I go through workable? And so that’s what slows down the process a lot because even though we communicate there’s two separate processes. They’re getting two separate emails, they’re getting emails from workable, and they’re getting emails from credentialstream. And to avoid that, I think everything should be done in the initial stages through the onboarding process because we don’t initiate the background screening that’s done by onboarding. So the initial gathering of information applications that they’re filling out, all that’s being done is redundant at this point. So they’re doing it twice. And that upsets them because we’re having to do it twice. I like that. I like the way that your system is set up as far as how you’re you know, visually, I can tell you it’s better than the product that we’re using today. So I do like that option. I like that you have an option to do it on the phone as well. But I feel that the best way for our company would be to move everything to onboarding side, how that gets integrated, whether it’s still your product that we integrate within their system. I don’t know as far as launching it from there. But that’s something to be talked about. You know, what makes more sense? We’re trying to make a better experience for the provider. Yeah, no, I.
Mallory Smith (31:23) appreciate that. That’s honestly one of the core pillars that we stand on here is just reducing provider abrasion and the frustrations that they experience. Something we’ll typically do with customers especially of your size. We have visual workflows that we’ve built in the past just to show if we have multiple onboarding tools such as adp or isoms or workable, or the medallion platform. We can actually build some swim lanes and just give you an idea of what data points are being collected at each one, what data points could be collected at each one. So if you ever wanted to do that in the future and do more of like a current state versus what the future state could look like, I’d be more than happy to grab an hour of your time and we could build that together. Okay. So what we’ll do now is I’ll just transition back to the environment and the provider directory. So this is going to be again your view in the platform, what I want to hit first of course is going to be monitoring. This is something I like to call it just the set it and forget it. So if you need monitoring for your RNS for anything like that, perfect. You basically as soon as you add them to the provider platform, invite them, they’ll start getting monitored. The other aspect with ongoing monitoring is that as soon as a sanction or a red flag or my practice case, anything of that nature comes back, you will receive a reminder and a task as an admin, and your provider will receive notification too. So you can control the communication preferences that go out to the provider. But the big thing that we always want to express with the ongoing monitoring, it’s something that runs in the background, continuous query within PDB, oig, Sam, death masters, examples like that are in accordance to joint. Essentially, you don’t have to worry about it until something comes back, but you’ll be notified immediately.
Lisa Lasick (33:08) Yes, we have some, we have that today, but we have a dashboard that we manage. Okay? So that’s where our alerts come from. It’s not really from an alert that sends an email or notifies us and we know from the dashboard as soon as we log in. So as soon as we log in, there’s a dashboard that indicates that we have providers that have a flag. Yes. Yeah, we monitor it that way. Yeah, that’s.
Mallory Smith (33:30) pretty much how our task and home overview would look as well. So we have the provider tasks, the admins, even the expirables documents, everything is loaded and stored here on the platform. So I like to say if there’s a date, we can track it, I’m all about the fun sayings as you can see. But you’re able to track everything in here. And then of course, auto notifications.
Lisa Lasick (33:56) Let me ask you a question because this is one of the challenges I come up with is that, yes, it sends it out. It’s you know, I don’t know what you just said but we do 45, we do 45, 30 and 15 day notifications. However after it gets past that no notifications go out anymore. So if they get less than that, then it becomes, we have our own internal process that we do that for. But so even though they all get notified, we still notify them because it just is not usually they’re not compliant, they wait until the midnight on the night before it’s going to expire to get it renewed.
Mallory Smith (34:38) They just love the rush don’t. They, yeah, they have.
Lisa Lasick (34:42) to give us anxiety and more work because technically today, we have to, for joint commission to… check their expirables 30 days prior to their expiration, date, right? So it’s that’s the minimum standard. So once that time frame happens and it’s 30 days prior to every week, we monitor those people that are going to expire by the end of the month. Let’s say, for example, so weekly, we’re sending out emails reminding them again that their license is going to expire in the next three weeks, the next two weeks, the next week, when we get to the last week, that’s when their supervisors are copied, they’re told that they have to have it by the end of the week or by expiration date, or they will be removed from the schedule.
Lisa Lasick (35:31) So that’s how we do it today. We’ve had to remove. I think maybe three people in the five years I’ve been here, but they wait until the eleventh hour to get it done absolutely.
Mallory Smith (35:46) Yeah.
Lisa Lasick (35:46) So as far as the one thing I can say is probably… not working well in Healthstream is the fact that we have to still email the providers daily like, we, in the last week, we’re emailing them daily, gotcha?
Mallory Smith (36:04) So with medallion, it’s automatic. It’s configurable if you need to send them a daily email, we.
Lisa Lasick (36:10) Can email them daily until the last week. Okay?
Mallory Smith (36:13) That way you’re not having to pull up outlook and send out an email and be like, and per my last email that I said this and things like.
Lisa Lasick (36:20) That, right? Exactly. Okay. I.
Mallory Smith (36:23) Appreciate that feedback. That absolutely has to be frustrating. So you do have the ability to configure that in medallion platform? Okay?
Lisa Lasick (36:32) That’s good to know. So.
Mallory Smith (36:33) What I can show you next because you do kind of work with credentialing to joint commission standards is just the privileging flow. I know we’ve got about eight or so minutes left in our time today. Is that correct? Nick? Yep. Okay. Then what I’ll do is I’ll just transition to the privileging and I just want to give you an idea of what this would look like if you were to partner with us. So we do have a five day SLA, all your team would be responsible for is coming into the platform and making the request for the provider. So of course, indicating the provider name, the entities, the dop forms that they’d like to see what that does is it automatically adds it into the queue. And the important thing to note here is that you get full visibility and transparency throughout this entire process. So where your team is not having to do the actual legwork of chasing down the verifications, we have apis built to grab the information. We have conversational AI to assist with the peer references. You mentioned that earlier. You’re constantly having to track them down. So we do have the ability to have calls and text messages sent to those individuals just to keep them reminded. And that’s how we’re able to maintain the five day SLA.
Lisa Lasick (37:43) So explain that a little more to me because I’m going to explain something to you that we, for us, we don’t refer to it as privileging in our facilities because all of our doctors and all of our staff are employed. They’re employees. So while we give them an appointment letter to the medical staff, we’re… not giving them privileges because it’s not like they’re a cardiologist going into an acute care hospital to utilize an or, and so they have to be privileged in order to use the facility, right? All of our doctors are all employees. All of our staff are employees of the facility. So I’ve always dismissed the privileging. I do it, I do the appointment letters and the reappointment letters out of compliance standard checklist. I check the box that I did the letter. But as far as privileging, we don’t really do that. That.
Mallory Smith (38:42) Helps a lot. Thank you. And my mind always goes to joint commission and these privileging. But what I’ll show you instead, since you don’t have to deal with the dop forms and things like that, we’ll just show you the credentialing flow. I.
Lisa Lasick (38:55) don’t even know what they are. I don’t know what a dop form is. They’re.
Mallory Smith (38:59) awful is what they are. They are so lengthy and they have so many different services on there. So for any of those like hospitals and health systems that deal with that, just God bless them, but.
Lisa Lasick (39:12) So, well, I mean, I hope that I’m correct in what I’m saying because I’ve said that since I’ve been here, it doesn’t make sense to me.
Mallory Smith (39:20) Because I wouldn’t doubt what you’re saying. Yes, absolutely. I mean, when we think of credentialing, it can be to ncqa or it can be to joint commission. Usually that next leg for it. If you do have to have inpatient services and things is the privileging component of it. But it doesn’t sound like that’s necessary. You’ve had joint commission at your doorstep more than a few times, they would have said something at this point yeah.
Lisa Lasick (39:41) Nobody has ever said anything about privileging and I’m assuming well, it bothers me because when we go, we want to become a delegated provider for optum specifically. And I worry that they’re going to require things that we don’t need to do. I’m worried about that. Yeah. So I think.
Mallory Smith (40:02) if you’re already credentialing to joint commission standards, optum will be more than happy with that. And if you want to have a future conversation with us where I kind of show you our experience with optum more than happy to help out there as well. So I’ll just show you this really quick flow. Essentially, it’s the same process. So you would still request a provider initial credit file if it’s a new provider, if it’s existing with joint. Are you currently recredentialing them every two years or every three years?
Lisa Lasick (40:29) Every three, every?
Mallory Smith (40:31) Three? Nice. You’re able to get that from?
Lisa Lasick (40:33) Two to three. So we’re good with that. But, okay. So here’s my other comment I’m going to make on that. I know we’re short on time. I don’t have a hard stop unless you have a hard stop, we can go over if it’s okay with you?
Mallory Smith (40:45) I’m going to double check, Nick. Do you have a hard stop? I would.
Nick Scallion (40:48) Have to run at like 1,220 or 1,120, but let’s get through the next 10 minutes or so and then more than happy to schedule a follow on. Lisa. I think this is good that we’re answering some questions as we go. This is actually how I prefer it to go. And if you’re open, I’m more than happy to schedule some more time next week if that’s okay?
Lisa Lasick (41:04) Yeah, yeah, that’s fine. But now I forgot my question anyway. So we can go ahead. I might take a minute as we go along. Now that I thought about that, I was going to ask you another question but now I forgot, but go ahead.
Mallory Smith (41:14) Oh, you’re Nick has that effect.
Mallory Smith (41:15) It’s completely fine. Alright. So, so what I’ll do I’ll just briefly run through to give you a visual and then we can meet next week to talk about more details there. But essentially, you would request the credentialing that you need done, we have apis that automatically perform it five day SLA for joint commission level. So the request you’re able to see that they’re currently in process, able to see exactly what elements are still missing or not. It then heads over to the ready area. This is where your team is now becoming involved. So with the ready area, if they’re clean files versus flagged files, I’m also able to see more of like a PDF visual of the file itself. So comprehensive, how, what, when, where and why? If I’m a committee member, for example, I can leave my notes here. Lisa, you could leave your notes here and just say, okay, if you’re voting on this file here’s, something to call out that we found. You can download this if you want more of a PDF view. And then what happens next is it’s sent to the different committees that you have? So two.
Lisa Lasick (42:18) Levels, I do like that function. Yeah, I do like that function. We could build that function, I believe, but we don’t use that function. I just remembered my question. One of the reasons why I don’t really talk about recredentialing is because we’re constantly monitoring and we’re constantly doing psvs. So every year we’re doing our PSV checks. If they expire, we’re checking those and renewing them. So I feel like our files are always being monitored. It’s like a consistent monitoring continuously. Mpdb is on continuous monitor. We got continuous monitor through all of the agencies. So to me, that’s the other thing that I laugh about because what am I recredentialing? I’m constantly credentialing, right? So when we’re talking about, you know, that’s why I just kind of like shake my head because it’s like what are the other companies doing? Am I doing too much? Because really I’m not doing a lot. The systems do it for me. The systems run the monitors every month. It does it automatically. It sends out the queries, comes back and gives me the results. And so, since we’re on that constant monitoring platform, there is no surprise. I don’t need to run through everything. I don’t need to check their peer references because they’re already working for us. I don’t need to do there’s. Nothing else that I see in a re credentialing process that I need to be doing that I’m not already doing continuously.
Mallory Smith (43:43) Absolutely, right. That’s the thing that’s a perfect reason to have this because these notes are going to be recorded for however long you need them. And they’re right attached to the file. So you could even go into each of these areas and leave notes if needed. So, yeah, I think it’s a great call out. I’m glad that you see some value there.
Lisa Lasick (44:01) So then, yeah, I do like that it’s different than what I have. Yeah, can you show me really quickly the payor enrollment things? I know we have only a couple minutes left.
Mallory Smith (44:11) Yeah, of course. Let me head back here. I’ll go to payors. Yeah. So with payors, there’s different ways to view this. Ultimately, this is the comprehensive view. So demo environment, I want to show you what these would look like. You’re able to see first your payors list. So, however many tax ids you have will be broken down by 10, the executed group contracts you have at that level. And then you have the existing enrollments that are available here. So you can see if they’re active or inactive. We can be so granular with this. We can show you the effective date for this line of business with this practice location with this plan if needed. And we build scheduling reports all the time for customers, just they can type in a zip code or a certain provider type, and you’ll see who’s available for scheduling purposes that way.
Lisa Lasick (45:00) Can you, do you have a way of managing license types to say these types of license cannot be enrolled? Because right now, I have a major spreadsheet that does that, but.
Mallory Smith (45:12) Yes, that’s actually just automatically configured as a part of the payr moment and licensing piece of this. So if you were to come in and request a payr moment application here. If the provider doesn’t have the correct license type, you won’t be able to submit the request. So that’s how we keep our accuracy rating really low. And then you’re able to see notes. And then you would have your engagement manager that you could email and say, hey, don’t need to do this or this is a one off case. This is just for medicaid, whatever it may be. Okay?
Lisa Lasick (45:41) So quickly. So the application process that you have is a form that you get from the payr that is filled out and then submitted? Or are you connected with their online platforms like availity and provider express and stuff like that. We are.
Mallory Smith (45:59) big on portals here. So full portal automation, we’re able to auto populate the portals. We also have portal scrapers that check the latest status every single night at midnight. It’s great because imagine you have an effective date coming on Monday. You don’t find out about it until the following Friday and you’ve missed five to 10 days that you could have been billing that you could have been seeing patients for them. So, yes, we’re very big on automation if you want to make payr only a part of our conversation next week. Happy to add that as well?
Lisa Lasick (46:28) Because right there, that makes me happy.
Mallory Smith (46:31) Awesome.
Lisa Lasick (46:34) Okay.
Mallory Smith (46:37) Oh, and then just the enrollment request. So when you do make the request in the platform, you’ll see the request details, the practice locations, we have an internal payr’s directory. So everything that doesn’t have a portal, we have a process guide. So I can come into the process guide and say, for medical, I want to view this is how our team and the workflow engine is able to turn around and have three to four days submission process, 96 percent accuracy rating that they don’t need anything from the time we submit until we get the par status, prereqs application method, two factor authentication needed or not. So this is built out for over 1,200 payers right now in our directory. And.
Lisa Lasick (47:18) that’s my staff that would do that, right? So if.
Mallory Smith (47:22) you use the payer enrollment services at medallion, we would be able to submit the actual applications and follow up. We would probably have your staff do more higher strategy such as the contract negotiations with payers.
Lisa Lasick (47:35) If.
Mallory Smith (47:36) there’s specific nuances that they need to follow up on, they’ll be submitting the request within the platform. So it would be a little bit different if you think about the enrollment piece.
Lisa Lasick (47:48) That disappoints me a little bit. Okay. I think that’s fair. I like the concept of what you’re going with. I’m not real comfortable with other… people’s parameters and staff working them. I think.
Nick Scallion (48:08) Part of the idea, yeah, no, this is good. I think this is good to work through Lisa. So, I think, you know, where we alleviate a lot of those concerns is with the service level agreement that we have with our customers. So we’re more focused on the outcomes than the features and functionality. So what the service level agreement does is protects customers, how quickly we’re submitting these applications. And then we’ve got a full analysis on the response times that we’re seeing from payers and what we’re typically seeing particularly for healthstream customers is about a 30 day reduction in the time it takes from requesting a payer enrollment application to ultimately getting our approval from those payers. And so the administrator role is more.
Lisa Lasick (48:51) Kind of.
Nick Scallion (48:52) White glove service, right? A provider liaison to help get that profile complete, get all the information needed and then let medallion and the automation kick in because it’s a lot of mundane tasks, right? The job of a coordinator with healthstream is a lot of copy and pasting. And with the technology that we’re instituting, we mitigate that. So neither party really has those hands on keyboards and that automation also is part of the follow up process as well. So, those portals we talked about submitting application. The same can also be done for follow up. So that cadence, hey, we know that we can follow up in X portal after 10 business days to say, hey, have you folks gotten this application yet? What’s the status? Okay? There was a piece of information missing. Now, we’re tasking that back to the administrator and the provider, so that we’re closing that loop faster. And I think to Mallory’s point, we look at resubmissions, right? So, I think one of the concerns if you give that control over is this organization going to be submitting a lot of faulty applications. We are having a running metric of resubmissions, which we see less than about two percent of the applications are resubmitted. So, these are running metrics that we’re keeping a close eye on what ultimately can get in the way of getting a provider in network faster. But again, don’t want to.
Lisa Lasick (50:03) Well, my team struggles with that too, and I’m not saying my team is perfect. They have their struggles and they do take like I would be interested to see where you are with cigna applications… because I can tell you internally for cigna that the processing time on cigna’s end is anywhere from four to six months.
Nick Scallion (50:24) But,
Lisa Lasick (50:24) that’s not an us problem that’s a, them problem. So, it’s like how like you’re going to submit them timely? So let’s say that your SLA says that you’re going to submit them within two days of… Friday, starting, for example, right? And then you submit that application and you’re at the hands and the mercy of what the payer does with that, that’s.
Nick Scallion (50:47) true. I think, yeah, I mean, I think, the one area that we can forego that in some instances and not across the board is that we do have roster relationships which is something that can help us get responses faster. But you’re right? Right? This is one reason we do, yeah.
Lisa Lasick (51:00) I’ve been rostered like I’ve reduced like 50 percent of my staff’s workload just by being able to roster certain, changing our provider agreements from ub billing only when we did ub and professional, we had to do applications. Now, we do not have to do that like for Aetna for example. So it’s a ub billing only platform. So we don’t even have to do a roster. We don’t do anything for Aetna anymore. So we’re able to reduce some of that. That’s why with optum, it would be great if we got became delegated but it’s like too many bells and whistles that they’re expecting us to do. That doesn’t it seems like ridiculous amount of work to get the value of, what they’re going to offer us because we’re basically doing their work… yeah. And.
Nick Scallion (51:45) I think that’s where, you know, it’s kind of where I was going to go with the waiting time with the payers is as an ncqa cvo, right? One, we can satisfy the ncqa requirements. So you folks don’t have to go through all those hurdles to get accredited. And then two, you know, we do all that, you know, we can help with the setup support to get those agreements executed with the policies and procedures, etc. So ultimately, maybe that’s an area that, we spend some time as well, which commercials would you be eligible for delegation? So that we’re stopping the waiting game because you’re right? Medallion is also at the liberty of the payers. There’s no, no, no avoiding that, yeah.
Lisa Lasick (52:19) Well, I know we’re out of time. I’ve enjoyed the time that we spent so far. I wouldn’t I would be up to finishing the demonstration again, going through the other additional things that you have to offer and then be able to talk about pricing and things like that to see if that, you know, the reward outweighs the, you know, cost and we’ll look from there, we’ll go from there, let’s do.
Nick Scallion (52:41) That, do you mind if I send, I can send you a link for so I or like some calendar availability via email. Let’s look to get together next week, if that’s okay. The following now we are going to be at a company off site. So if we can squeeze in some time next week, should be able to give you enough information for us to align and more than happy to get into pricing and return on investment. That’s necessitates any change, right? So let’s plan on that. I’ll shoot you an email today and let’s look to get back together next week. But thank you again for your time today, Lisa? Yeah.
Lisa Lasick (53:09) Thank you so much. Thank you. It’s nice meeting you. Happy pranking. Thank you. Give me a call if you need anything done. Okay? Thank you. All right. Bye folks.