Transcript
Chris Jones (00:00) good morning, cuddling. How are you?
Chris Jones (00:08) Morning, Hassan?
Hassan Zahir (00:10) Good morning, everyone.
Kacheung (00:22) Sorry. Do you hear me?
Chris Jones (00:23) We’ve got you now.
Hassan Zahir (00:25) We’ve got you. Thank.
Kacheung (00:26) you? Sorry?
Chris Jones (00:28) Good morning. Good.
Kacheung (00:29) Morning. How are you? Good. Thank you. It looks a little bit rainy day today in Boston.
Chris Jones (00:38) Oh, okay.
Kacheung (00:40) How about your area?
Chris Jones (00:42) Yeah, Hassan and I are both in Columbus and it’s kind of cool and damp, but certainly spring like, so it could be worse.
Kacheung (00:51) Yeah.
Chris Jones (00:55) All right. Hi, Mike. How are you? Good morning. I’m good. How are you doing well. Thank you. Good to see you again. Likewise. Good morning, Taylor, Alexi, hello?
Tayler Wyss (01:10) Good morning.
Chris Jones (01:15) How is everybody this morning… present? All right. We’ll take it. Okay. Let’s see. I think we have most people. We don’t have Anik yet.
Tayler Wyss (01:31) Yes, and he was looking forward to the call, so I feel confident he will be joining us.
Chris Jones (01:39) Okay, cool. And I think that’s the crew at this point. Okay, perfect. All right. Let’s give him a moment.
Chris Jones (02:20) I’m waiting to realize it’s April fool’s day. Nobody’s tried to prank me yet, but I’m sure it’s coming at some point.
Tayler Wyss (02:27) I keep forgetting that it’s April fool’s day.
Chris Jones (02:31) Yeah. Usually my wife will try and sneak one by me but nothing yet.
Tayler Wyss (02:40) It’s very early yet. In this day.
Chris Jones (02:45) That is true.
Chris Jones (03:02) Do we want to give Anik a couple minutes or you want to jump into it? I.
Tayler Wyss (03:09) Think we’re probably okay to jump into it. I’m sure kayling is also excited to see all of the various ways this would impact her positively as well.
Chris Jones (03:21) Yeah. I know it’s kayling’s show today, right? So, I know we’re hoping to get to it last week and we spent the majority of the time on the privilege side or credentialing side rather. Okay, cool. So let me just kick it off and recap here. So obviously, last week, we spent some time kind of going through the platform and then just simply ran out of time. So that’s usually a good thing. It means you’re engaged and have a lot of questions. So really the focus of the call today will be more on the provider enrollment, the payer enrollment piece which I know is key for you. And then also dive into reporting and analytics and kind of the visibility tools that come with the product. So let me pause there. Is that on point with what everybody was hoping to accomplish? And is there anything else? Any kind of lingering questions from last time we met that we want to address up front?
Tayler Wyss (04:23) Not that I’m aware of Alexei. Did you have any questions after having some time to digest the presentation last time? Not at the moment? Yeah, I think we’re good. Okay.
Chris Jones (04:38) Cool. It looks like Anik is joining now. Good morning, Anik. How are you? I’m all right.
Anik Conley-Das (04:47) Proceed without me. I am only here to listen all.
Chris Jones (04:51) Right. Fair enough. Yeah, we’re just getting started and just briefly. So, you know, the focus of today’s demo is really just to pick up from where we were last week.
Chris Jones (05:00) So it’ll be on the provider enrollment, payer, enrollment, reporting, visibility, those types of things. So I think everybody’s aligned on that front. So unless you had any questions or comments before we’ll just we’ll jump into it and get things going. Okay? That’s all any questions or comments. Anik, are we good to go? Good to go? All right. Perfect. All right. Then we’ll jump into it. Keep it interactive. We love questions. So I’ll pass it on over to you Hassan all.
Hassan Zahir (05:33) Right. All right. And so everyone can see my screen. Okay? Gotcha. And see that was the place. I should have just shared nothing and then that would have been the April fool’s joke. But we’ll just pretend that it happened and not actually do it. What you’re looking at is the medallion platform. As Chris alluded to, the goal today is to show you how medallion can really solve for those challenges that organizations are having those pain points with onboarding providers, getting information into the system, consolidating all the information in a single pane of glass view and then being able to automate the submission of those enrollment applications to really eliminate those bottlenecks and those constraints that happen also to identify and ensure that everything that’s required prior to an enrollment application being submitted is captured on the front end and really reduce that provider abrasion associated with onboarding and enrollment requests, reducing those duplicate requests or multiple requests for the same information. And so the goal today is to walk you through how we’re solving for those pain points and really just highlighting the value of utilizing an automated system like medallion to accomplish that. I’ll go ahead and proceed but I’ll first want to make sure that that’s what everyone is expecting today. Were we expecting to do any more or look at anything beyond the onboarding, the enrollment and the analytics today? Was there a thought around privilege anger or anything? I just want to make sure that we’re completely aligned before I proceed?
Kacheung (07:09) How about I have a question on your website that is some delegated payer enrollment. Maybe you can talk a little bit later after you go through the demo? Thank you. Okay.
Hassan Zahir (07:24) For sure, let’s kind of jump into the demo and maybe we’ll actually answer the questions throughout the course of the demo. And if not, then we’ll get to it at the end. I’ll pause frequently. Like Chris said, the goal is that this is interactive. And so what you’re viewing today is medallion. We’re starting on the dashboard. I’ve got this configured for PE enrollment requests. This is kind of like that centralized hub where an administrator can take a look and say, okay, there’s 62 enrollments that are out there that are awaiting requests. None of the profiles need to be completed. So all the profiles are complete. Medallion is processing this many. And so this is kind of like steady state where you’re logging to the platform and kind of get a snapshot of what’s going on. But let’s start earlier. Let’s start with how we get to this point. So first and foremost, it’s about getting the providers into the medallion platform. We do have a partnership with caqh, medallion is what’s known as a participating organization. So any provider that has a caqh profile, we have the ability to import that data through our caqh integrations, a couple of different ways that we can import data via caqh. First and foremost, you can see that we’ve got the ability to bulk import the data. So we can pull down all of the data for the provider. A couple of things that are unique. If we bulk import the data, we’re just going to pull in everything that exists for that provider in caqh and pull it in. It’s a little bit discriminatory in the fact that like everything that’s in there comes in, sometimes there may be additional information that’s not relevant to you… but we’re able to pull that in mass. Also what we’re able to do and what a lot of organizations do is as a new provider starts, they take them through an onboarding process. So at bhcp, I’m imagining that you may take this flow. And so it’s hey, we’re going to invite a new provider to Miami. This is the onboarding process you’ll put in their email address, first name, last name, their estimated start date, and then their profession type. Obviously, we support a whole host of every kind of profession that you can think of that would need to get enrolled with the health plans, or go through a credentialing or whatever the case may be. And then that’s going to send a welcome email out to that provider that email is not. Going to look too dissimilar from what you’re seeing on the screen. It’s just going to say, hey, medallion or bhcp is partnering with medallion to simplify and expedite this process. When it comes to credentialing and enrollment. It’s going to kind of talk about who we are, how we function. And then it’s going to allow the provider to get started. When they get started. It’s going to take them to the medallion portal and allow them to click through the process. It’s just going to kind of tell them who we are and the ways that we can get that information in this is what’s really important.
Hassan Zahir (10:25) I think that I was just speaking about caqh and how we’re a partner organization. We can pull in 100 percent of the data that’s needed for like medstaff level credentialing, and 70 percent or so of the data that’s needed for the enrollments with the health plans. And that’s 70 percent. On average, sometimes it can be, you know, 75 percent for one health plan, 65 percent for another health plan. But in generalized terms, we’re able to pull in this data. We also have the ability to extract data from documents. So, think of how many times a provider has been asked to provide a document and then they have to give the same information that’s on that document.
Hassan Zahir (11:05) It’s so redundant. And it’s frustrating for providers. And with medallion, we have the ability to utilize technology to extract the data from that document. And then we use that to fill in that remaining 30 percent of the profile that’s not complete wherever we can. So we can get 70 percent from caqh. We can oftentimes supplement that with a lot of the documents. And then of course, the provider can also always manually fill out their profile. But when we’re getting started, generally, what we’re going to do is link that information from caqh. The provider’s going to put their information in. We’re going to verify that exists. And then it’s going to pull the data into a profile in medallion. I’ll pause there first and foremost to say, hey, is this tracking provider gets their own way to get invited, they can put in their credentials for caqh when, I mean credentials is not username and password. As a participating organization, they only need to put in their caqh id, and then their social security number. So every email that they get from caqh has a caqh id. And if they don’t know, their social security number, then we’ve got bigger problems, but what it does is allows us to pull in that data really seamlessly and then highlight to them all of the data, that was pulled in from caqh. I’ll pause there. I’ll make sure that’s tracking. Is, is that making sense? Is it, does this differ in a way from how you’re like capturing the data for providers today?
Kacheung (12:41) They mean that, you know, the bhchp need to be enrolled as a organization participating in caqh, right?
Hassan Zahir (12:50) I’m, sorry.
Kacheung (12:52) I’m just wondering like, you know, do we need to give the know, the providers login to mcdonald or we need to be a participating organization in caqh?
Hassan Zahir (13:07) Yep. So, so, great question. So what happens is the provider will sync their account. You do not need to be a participating organization with caqh because medallion is a participating organization with caqh. So, what’s going to happen is we have the ability to pull that provider’s data down as a participating organization. The provider will simply need to provide the verification of who they are and link their own profile. So you do not have to be a po with caqh in order for us to take advantage of this input or import.
Kacheung (13:44) Okay. We don’t need to be a participating organization.
Hassan Zahir (13:48) Correct. You do not need to be a participating organization. It’s just one of those many benefits of partnering with medallion is the fact that since we are a participating organization, we can pull down these providers’ profiles from caqh and all they have to do is put in their caqh id and their SSN. And we’ll pull that data over and populate these profiles.
Kacheung (14:13) Great. Thank you.
Tayler Wyss (14:14) Absolutely. This is going to be, a very basic, a very basic question as somebody who doesn’t do credentialing, but how are providers interacting with caqh outside of like credentialing practices, like how, why how would they be connecting with caqh to get that id?
Hassan Zahir (14:34) Yeah. And so most providers today, I would say the vast majority, maybe 70 percent of providers, if they’ve been practicing for over a year, they will have a caqh ID, already, they will already have a caqh account. If it’s a new provider. I’m not quite sure what your process is for them, if they’re getting caqh ID. S, but generally speaking, any provider who is enrolled in any of the federal programs, so, medicare medicaid, or who has participating status or par status with any of the commercial plans that utilize caqh for their applications, would have an account in caqh and you can think of like the bucas, so like your blues, your unitas, your humanas, your aetnas, like all of those organizations utilize or all of those payers utilize caqh in some capacity. So, a provider, if they’re already accepting insurance, not private pay, or have a affiliation a medicare medicaid. ID, then they would have a caqh profile Taylor.
Tayler Wyss (15:34) I feel like we’re often, I’ll let Alexei get to his question, but I feel like we’re often like for nurses… are nurses part of this conversation… or is this, are we thinking like MD and ppas?
Hassan Zahir (15:50) So nurses can all, definitely, all providers are a part of this conversation. Mid levels generally can bill on their own and don’t have to have a supervisory agreement or supervisory agreement. Obviously, MDS, physicians assistants dos, all of them would have caqh profiles if it’s like, I guess like a nurse as opposed to like an NP, then odds are they likely have a caqh profile. They may not. If they don’t again, we can pull data in from documents. We can pull data from resumes. We can pull data in from a whole host of sources. We’ll pull data in when we verify their license. We’ll pull data in when we verify their npi from npis. And so there are other multitude of ways that we can get data into the system. But caqh is kind of like, the default or de facto way of doing it.
Tayler Wyss (16:46) Okay. If we pull info from their resume, like you had said, or, you know, other sources, does that in some way back, go back to caqh and start their profile it?
Hassan Zahir (17:01) Can, and so medallion, that is an additional service, but medallion does have a service known as caqh management. Caqh doesn’t by default like allow bulk updating, but medallion has built a proprietary automation that allows us to maintain parity between what’s in a provider’s medallion profile and what’s in their caqh profile. So, we do have an automation that allows us to do that. So the short answer is not by default, no. Is it possible 100 percent with medallion?
Tayler Wyss (17:36) Thank you. That’s helpful for me to understand what we’re talking about a little bit.
Hassan Zahir (17:42) Absolutely. And Alexi, we see that you have your hand up.
Alexei Alvarado (17:46) Yeah. I just wanted to answer some of those questions and also maybe just give context for everyone. What was your first question? Something about nurses? Well, I never heard of a nurse. I don’t know. I don’t know what, I don’t know, but I’ve never heard of a nurse having a caqh profile. A lot of them don’t even know what an mpi is, but, yeah… I’m not seeing… any reason why we would need any of our nurses to have caqh profiles… just to answer Taylor’s question. Yeah.
Hassan Zahir (18:27) I agree. I was just saying a nurse can have a profile. I believe they’re like eligible for a caqh profile, but like they’re probably not billing again at their own. They’re probably like an NP may be billing without a supervisory agreement, but a nurse would all of their work would go under a MD or a do.
Alexei Alvarado (18:46) Yeah. And yeah. And then the other thing there, maybe this goes without saying, but just like the process is so much Symplr for an RN than an NP. For example, there’s so many fewer documents, so many fewer credentials things to track. So whether… it’s pulling information from a resume that might be helpful, but it’s also, there’s so little information that we need that it’s really pretty simple no matter what.
Hassan Zahir (19:20) Absolutely Alexi. I couldn’t agree more. And that’s the reason why Taylor and et al, that when making that invite to medallion that we identify, you know, what provider type is it going to be? Is it an RN that we know what the requirements are for an RN? If we were going to do something for an RN? And generally like that’s, just kind of like renewing a license. But if it is a doctor, then we have those requirements and so important that we know like the estimated start time and then the profession type. But that is a reason that, that’s built into the onboarding workflow.
Alexei Alvarado (19:59) Oh, yeah. And just to answer another question that Taylor had, and also to give context for everyone currently, for the past couple of years, I’ve just been telling providers… if you’re an existing provider, someone probably created a profile for you and never told you about it but figure it out and get back to me or if they’re like a new graduate. I say here’s where you need to go to create your profile. Let me know once you have it, and that seems to be working fine. And, yeah, I’m of the opinion of letting them figure that out at least to start, yeah.
Hassan Zahir (20:39) And Alexi, the question that Taylor asked, I think is really important too because once they do have that figured out, if you so choose to partner with medallion, we can push that information back up to caqh. So when it’s time for those revalidations, then you can be pretty confident that the data that’s in caqh is the data that’s matching in medallion. So when those applications are submitted on the provider’s behalf, you don’t run into those issues or errors for an application being denied because something is out of date or something’s not in sync. We’ll make sure that caqh is always up to date. You can see here what I went to was the external accounts and that’s where like you can store securely the username and password for a provider that gives us the ability to update caqh you’ll see at the bottom, there’s kind of some disclosure questions and attestations, things they agreed to. And one of the things that if you chose to partner with medallion that they would agree to is us pulling data down for them from caqh and us pushing data up to caqh on their behalf. As well. And so we will make sure that if that’s something that’s important to you or something that you’re interested in, we can support it. If Alexi, the onus is on the provider to continue to do that, then that can be the case as well. You do not have to partner with medallion to do that, but the option is yours obviously, like I said, that’s an additional service and you will want to do a cost benefit analysis there.
Chris Jones (22:12) How soon did you see the question in the chat around integration to HRIS, workday? Or ukg? Yep. And.
Hassan Zahir (22:20) So medallion has a fully bi directional API and the ability to integrate with essentially any HRIS system that’s out there. We do have some out of the box integrations. I believe workday is one of those I’ll have to verify that, but I do know that we can connect with any HRIS… excuse me, scheduling system ehr, regardless of what it is. It’s just a matter of, is this out of the box or will it require some form of like customization… from an integration perspective? But we do have the ability to support those integrations, yes.
Tayler Wyss (23:00) A side question off of that because you said you can integrate with ehrs. And I don’t want to derail us. But what sort of integrations have folks done with their ehr? Like if we use epic it?
Hassan Zahir (23:14) Just depends on like what modules you’re using in the ehr, and so like we could really go down a rabbit hole there. Taylor, I would say a quick one is like if you’re using scheduling module from epic to schedule providers, you only want to make sure providers are getting scheduled with patients who have a health insurance or a payer, who that provider is in network with. And so, like we could push over the par status from medallion of any provider and run that on a set cadence so that the scheduling system isn’t causing disappointments or you’re not having to call a patient the day before to tell them that the provider that they were coming in to see, can’t see them because they’re not in network. Thank you, which we see happens all the time. Not sure if that’s something that’s happening to you, but something that we see happening all the time.
Tayler Wyss (24:01) Yes, I think we probably run into patients just not having insurance the most, but we could talk about.
Alexei Alvarado (24:10) more.
Tayler Wyss (24:11) About that at another time.
Kacheung (24:14) Excuse me, I have a question.
Hassan Zahir (24:17) Go ahead for.
Kacheung (24:19) The caqh management. Do you also like, you know, will offer the service to attest the provider profile every 120 days or 90 days regarding about the provider directory? I mean, the directory requirement, you know?
Hassan Zahir (24:38) For the traffic, we do perform the attestation, yes. So, medallion will go in and perform that update on behalf of the provider.
Kacheung (24:49) That’s so great. Thank you… absolutely.
Hassan Zahir (24:53) And so, to get to that point, what happens is let’s say a provider has went through, we pull their data in from caqh, they’ll come in and then they’ll electronically sign to this. And this is saying like, hey, I give medallion limited release to be able to perform these things on me. I give them the ability to attest to my profile in caqh, and I give them the ability to update data when that data needs to be updated or changed. They come in. They sign. I do want to highlight that this is also mobile friendly. So, a lot of times providers aren’t going to be in front of a laptop, they’re going to be utilizing smartphones. They can access their, the medallion instance, same place they will see that this agreement needs to be signed. They can go through, they have the ability to electronically sign, perform all of these same functions that I can perform in a standard view from, you know, a mobile device. So same capabilities just want to highlight that once this is done, they will come in, they will save it. And then they’ll save and finish. And the provider’s profile at that point in time is complete. And we have the data that’s needed in order to complete the next steps to perform those downstream workflows. And so the biggest point for us is reducing that provider abrasion, reducing how long it takes to onboard a provider because we’ll pull the data in from caqh. We’ll give them the option or the ability to supplement the data with what’s missing or what’s needed depending upon the health plans that you want them to be enrolled in. And we’ll have them attest to that being correct. And then we’re able to perform those downstream workforce. Mind you, that is the happy path. What I’m going to show you is like what happens if a provider is not responding? If they don’t upload something? What does the outreach look like? Because again, when we talk about bottlenecks and getting data from providers, oftentimes that can be as big of a problem as anything else in the process? And I imagine that, that’s something that’s likely a challenge for you today is getting providers responsive and getting information in?
Hassan Zahir (27:10) Any questions though on the provider profile? Or is that process… a process that you would see as beneficial being able to do this electronically, giving the provider that portal? Like could you see time savings that are coming out of that?
Tayler Wyss (27:34) As someone who doesn’t do this workflow, I would say a 1,000 percent, but I will let kayling answer if that seems like it would be helpful. Yeah.
Kacheung (27:46) So far, I think, you know, it’s so helpful with the caqh. I mean, that’s the first step. And I mean, what happens is like, yeah, if the provider not respond, you know, are you going to look for me to chase down with the provider? Or I mean, what is the time thing? You want the provider to complete the information, you know, within a reasonable time? Yeah?
Hassan Zahir (28:09) Great, great question. And exactly where I wanted us to go to because I agree from the, you know, the hundreds of organizations that I speak with every year from, you know, the people I speak to when I’m at himss and vive and the conferences, they’re all saying the same thing is that, this, yes, this is an improvement. This really speeds up the process. But now, what when a provider is unresponsive and what happens is we don’t want to put that onus on you. Kayling, we don’t want you to be the person who’s solely responsible for reaching out to these providers. What medallion has is a task based system where outreach can occur automatically to these providers. And so, if a provider has not completed a task, when we go to that provider’s, profile, you will be able to see in the individual profile for the provider, when this loads, what tasks are outstanding. And so on the provider profile, I can go to the overview. I’m sorry, my computer’s running a little slow right now. It’s doing something a little wonky. I can go to the provider’s view. You can see I have no outstanding tasks for this given provider right now. I should have jumped here before I completed signing the attestation. But this provider’s profile. Okay. Maybe these are they’re there? They’re showing that they’re ready, they were completed, but they’re ready. And so what happens is one, every provider will know the things that they need to have completed and that’s going to show up under their profile. Under their individual tasks. I’ll show you momentarily that how you as an administrator can see all of the tasks that span all of the providers. These tasks are like ready to be completed because we just went through and did that. But you can see that medallion is going to show like, hey, these are the tasks that needs to be completed. You could go in and I would be able to complete these tasks had they not already been completed and ready to be done. Or actually these, I haven’t finished these. So I can go through, we can see, okay that’s because those tasks expire but we can go in and we could complete those tasks. The way that we perform outreach to providers is in one of three ways kayling, first and foremost, we capture that email address when you’re signing a provider up. So we can perform email outreach that’s kind of like layer one. We all know that people who sit in offices probably check their email on a frequent basis. Providers, probably not checking their email on a frequent basis. And so, while that is step one, we don’t stop there. The next thing that we do is we send out SMS text messages. And so we will send a text message to their phone that allows them from the link sent to their phone to navigate to medallion. And to complete that task. What’s really important? There is oftentimes what we’re asking for is we’re asking for a provider to give us some form of documentation. Medallion makes that process easy. I talked about the mobile experience. Medallion makes that process easy. So we can say, hey, you’re missing this document, a provider can navigate to their profile and they can hit upload and upload a document if they’re on a laptop. But again, most of the time they’re on their phone. So what we allow them to do is we provide them with a QR Code. And then they literally snap a picture of the document, that QR Code associates the document with that task. And now that work is done, so if they have the document sitting in their drawer, if they have a document at the office… they can snap a picture of that document. And now that task can be marked as complete. And so we give them the SMS, let them navigate directly to where they need to go. And then have the mobile experience to where they’re just snapping a picture of the document. Again because we can extract texts and information from documents, we can complete that task on their behalf. And then the last way that we support it is through conversational AI as you’re all familiar with. Like with the rise of artificial intelligence, we have conversational AI where a phone call will be dispatched to that provider. It’ll say, hey, this is so and so calling on a secure line representing medallion, and you have outstanding tasks that need to be completed in order for us to submit your enrollment, please navigate to medallion to do this. They can talk back to it. They can ask questions. It is really interactive. And maybe on a subsequent call, if it would be worthwhile we could give you an example of what that conversational AI looks like. And you could have a phone call and interact. But so medallion is going to send an email. Medallion is going to send text messages out to the provider, and the amedallion is going to actually call the provider as well. And so we’ve got a three tiered method for doing that. And then if a provider is still unresponsive as an administrator, Kaylin, at that point in time, that’s when you can come in and you can see all of the tasks or you can see the specific provider tasks that are outstanding.
Hassan Zahir (33:09) And if you need to escalate at that point in time, then you have the ability to escalate, but we give you a couple of pathways to support it.
Kacheung (33:22) Yeah, great. Thank you. Yeah, I know sometimes when the provider not responded in the mid level, I will contact the supervisor and then, or maybe for the provider MD, even the last resource, I’m going to page them and saying that I need this form by today or as soon as possible and then they will sometimes it works, but I don’t use that template that often, as little as possible. I think, yeah, great. I mean, that is a good way to go. Yeah.
Hassan Zahir (33:53) And I’m not going to say you won’t ever have to do that, but I’m going to say, hopefully the amounts of times that you have to do that shrink by 90 95 percent because we have the persistent outreach. We can set the cadence. The text messages go out at times where we, where you can say, hey, we want MDS to be messaged around this time or phone calls around this time. Like we have the ability to really structure that in a way that best supports the way that your providers work. And so, I think that we’ve been really thoughtful in that. And I could really see that reducing the amount of outreach that you have to perform, would you agree?
Kacheung (34:34) Yeah, definitely. You know, because I think, you know, I always want to minimize the interruption with the conditions like, you know, section. Yeah, yeah, we.
Hassan Zahir (34:44) Don’t want to interrupt the continuity of care, but we want to make sure that you’re getting the information that you need. And again, we can schedule the time and the frequency and how many times these things go out. But you’ll always be able to see in the notes section if a phone call went out, you’ll see a phone call to this provider at this point in time or text SMS at this point in time. And that’ll be the last activity associated with that task. So you’ll always have visibility into the outreach that’s occurring from the medallion side. Once we have all this information from the providers, now, it’s like we need to do something with it. And this is where the automation really goes into hyperdrive. What we’ll do is you’ll see that I’m in a demo environment. So I’ve got a whole lot of payers but these will just be the payers who you need your providers to be enrolled. With. What we’ll do is we’ll have those payers listed. And then you can make a request. Excuse me, the really powerful part of making a request here, kayling, is that you’ll choose that, hey, this is medallion. That’s making this request. We’re going to do this for a provider, we can choose who that provider is. I’m going to choose dr Ely here since we just onboarded dr Ely, and we’re going to say, hey, these are the groups. Let’s imagine. These are the groups that Naomi is associated with. And then these are other groups… that we want to get these enrollments for. And so I’ll just choose a default one here for example. And then we can say, okay, these are the states where Naomi is licensed in and again, just a demo environment here. But I’ll choose a state medallion will not allow for enrollment of a provider in states where they’re not licensed. And then I can choose how many of these we need to get this provider enrolled with. So a single request can be for all of the payers. Again, just a sample environment or demo environment. So, I’m looking at Tennessee, but I can say, hey, dr Ely needs to get enrolled with these seven payers. And then I can make that request. So one single request, I can choose across the various lines of business for any of the payers, whether it’s commercial, the advantage, the exchange, traditional, whatever the case may be, I can say, hey, the same line of business across all of these. I just have the option of defining what all of these enrollments look like. And a single request. For this provider, I can make the request to get them enrolled with eight payers. And medallion is going to track the dependencies. It’s going to say, hey, for this commercial plan, it requires a medicaid id or a medicare id, whatever those dependencies are. Medallion tracks those. So you make that request, we will follow the process associated with those payers. Our secret sauce is that we track that information in what’s known as a process guide or a payer process guide. But you would make that enrollment request. And then under enrollment requests, medallion then takes all the data from those providers’ profiles, and then medallion maps it to those enrollment applications. So from that point on, Kaylyn, you don’t have to do anything but kind of monitor this. You can see we’ll see how many have been like all of them, how many have been requested, we can see how many are on hold, how many are stagnant. But once that enrollment request has been made, they’re going to go from requested, medallion will start processing those. I call this my domino’s pizza tracker because you can see what’s the status of any of, these ones are with the payer. And they’re almost done with processing. This one is with the medallion team and is going through intake. This one is with medallion. These ones, the application has been submitted and we need to follow up. This one is ready for intake. This one has been assigned to the team. So you always have visibility into what’s going on with any of these enrollments. You’ll always see kind of like what the provider start date is, and are we tracking to the enrollment being completed by the time the provider starts? Are there outstanding tasks you can see? Like all of the notes that I have in here for following up with the payers. We can see the groups, the line of businesses, the number of practice locations, when was intake completed, how long ago was this application submitted? And we will track all of that information and make it serviceable to you either here or from the analytics page until these enrollments have been completed. Once these enrollments have been completed, you’ll see everything that’s associated with that completed enrollment. You’ll be able to see the lines of businesses, the facilities, all of those notes where any dependencies met, what the request status was, follow up date, no need to follow up because those are like all completed. But ultimately, what’s going to happen is then these are going to move from the request to just the enrollments. You’ll be able to see here, the active enrollments, the practice locations, the provider id from the health plan, the effective dates. We can auto revalidate and track revalidation for these. If medallion is performing this enrollment, then we’ll also where applicable from the payers, show you the evidence document. So if there was ever an enrollment related denial or issue, medallion has all of the information tracked for you, the evidence document to show hey this provider was enrolled on this date, this is the proof of it. This is all of the practice locations the groups. All of the information is right there for you, but medallion owns that process end to end giving you visibility at every step of the way. But we will automate taking that data from that completed profile, mapping it to that application, submitting that application and tracking it through par status on your behalf. I know that’s a lot. And I went through that a little quick, but I want to pause there again for seeing making sure that one that’s resonating and two seeing like, could you see the value in owning the request and choosing who the payers are? The health plans are, and making sure everything is in there, but not having to do any form of even adding data via form mapping. Like I know that that’s an improvement a lot of times but we’ll do that for forms. We’ll do that for online portals, we’ll do that for availability, whatever the methodology is, medallion has an automation to support it.
Kacheung (41:20) Wow. That’s unbelievable. A lot of data here. For example, medicaid, our, like Massachusetts health, the provider need to sign the orp application. I mean, how it work? You will send an email for the provider to sign the application? Yeah.
Hassan Zahir (41:38) So, we have a couple of different ways and it does depend on the state. And so like we always talk about like New York medicaid, where you actually have to physically sign. It needs a wet signature, blue ink. Some states just require a signature, well, depending on what the requirement is for that payer in that state, we have what’s known as a payer guide. And so if I go back to like the payers really quick, I’ll be able to show you this is a sneak peek. I don’t show this to everybody. So you got to consider yourself special, but we have what’s known as like a process guide. That process guide tells us like, hey, this is the process for these different lines of business. How we do this. In the instance where an application needs to be signed, we will track like the actual application… we’ll map the data to it. The application will be sent either for electronic signature by the provider, or in worst case scenarios where it does require like a blue ink, wet signature, we’ll literally send that application to the best location, whether that’s the practice location or the home location of the provider for them to sign. And then for that, but in most instances, we’re able to use the electronic signature that the provider has supplied to us. We’ll map the data to the application, apply the signature and then submit the application.
Kacheung (42:57) But again,
Hassan Zahir (42:59) we’ll track like the, again, I’m in a demo environment. So this isn’t populated, but for every one of these payers, we’ll say, hey, what’s the best application method? Does it require multi factor authentication or a two step process? What are all the steps? What are all the requirements? What are the follow up instructions? How frequently can we reach out? Do we have a default schedule that we utilize from the payer? Or do you have a default schedule based upon your payer contracts? All of this information is tracked. And then that’s how we automate the process for you.
Kacheung (43:29) Okay. Talk about before we send out the information to the payer, we always experience a challenge in the program. For example, we need to get the status if the provider is a PCP or if the patient accepting the new, I mean, sorry, if the provider accepting the new patients, and that information usually not ready until I’m ready to do the like enrollment. My question is like, I don’t know how I’m sure you guys can help, you know, but is it the way you guys can generate automatic email to notify the provider supervisor to provide this information in somewhere so that we can like, you know, because this is an almost required field for most of the payers, right? Yeah.
Hassan Zahir (44:22) And so in the provider’s profile, we track whether they’re currently accepting new patients or not. So that’s a part of the status of the provider’s profile. The provider can update that at any given point in time or if you want that supervisor to function as an administrator, they could also as an administrator, go into any provider’s profile and update the status of accepting new patients or not. So, that is a part of the default settings of a provider’s profile.
Kacheung (44:47) Okay. Yeah. I think this needs to be done by supervisor. That’s why I’m not sure where we can connect this kind of piece of work. Yeah.
Hassan Zahir (44:56) And so it really just depends, we would map that out with you kind of like through onboarding, we would say, hey, this is where this needs to occur or this is where that needs to occur in the process. But through onboarding with your engagement manager and your account manager, we would figure that out. And I’m sorry, everyone, if you can give me one moment my laptop, I’ve got it plugged into the laptop, but I must not have it plugged into the wall because my battery alert is popping up. So if you could give me 30 seconds, I’m going to plug that up.
Chris Jones (45:26) You got it. So, Kayleen, I know you were patiently waiting to see this piece. Does it check the boxes and make life a lot easier for you? Yeah.
Kacheung (45:37) Definitely. I think it’s good. We have an overview for a lot of information in front of us right now. Yeah, I know, you know, the information is like, you know, tracking, I think the tracking is so good because now I just use the excel spreadsheet for each provider. And then every time I need to, like after I track this one, I need to update the data to our database. Oh, and yeah. And also like, I know that you talk about the provider enrollment. What about the facility enrollment?
Hassan Zahir (46:14) Yeah. And so we definitely can get to that as well. That’s why I was trying to level set on earlier. Let me show you the analytics. And then we’ll jump over to that if that’s fair. Yeah. Okay. And so seeing the visibility when it’s happening and tracking the request is important but also having that historical view I think is equally as important. So medallion does have built in analytics on each of the modules that exist in the platform. Again. Not quite sure why my computer is running a little slow. I’ll probably need to give it a restart after this call. You’ll see here once my computer stops deciding to freeze up on me, we provide you with analytics across all of these workflows. Here it goes, it’s finally starting to load for me. You’ll see here that we provide data across all of these workflows and we can customize these dashboards and these reports. What you’re going to see is the out of the box reports that show up, kayling, and those are going to kind of show you like across timeframes. So, how many enrollments have been issued by month? What’s the current state across all of your enrollment requests? How many are in intake? How many have been going through intake? How many are with the payer? How many are requested? How many are actually out for enrollment? Who have these enrollments been completed for? And this is only going to show the first 2000 rows, but you’ll be able to always have all of this data. How long is it taking in intake? How long is it taking for the application to submit it? What’s the total turnaround time before an enrollment application is coming back? And so we can customize all of this data and all of these dashboards to present and represent the data that you want to be able to see if it’s not available out of the box?
Hassan Zahir (48:04) Is this a level of reporting that you have today, Kai ling, or would this be an upgrade for you?
Kacheung (48:10) Definitely. It’s an upgrade. I mean, I have something manually. I mean, I have something in my mind and knowing that how long it takes for this insurance and yeah, but not that detailed. You know, no way to not get on one screenshot. Yeah.
Hassan Zahir (48:23) This would give you all of that information at your fingertips at the click of a button. And even as fast as it went today, that’s really slow compared to how fast we’re able to get this information because my machine is running a little slow. I will highlight the fact that we also have a custom report builder. So if you have to send reports up to leadership or if there’s monthly reports that you want to be able to run, we can do this on the providers or the enrollment request. You have the ability to say, hey, I want to know for which payer, which line of business, which state I want to include all of the provider information. Naturally. I want to know what’s the current request status, what’s the overall status? And when was this application submitted? Also tell me how long it’s been since these have been submitted, you can send that over and it instantly builds out that report for you. So you can see who the provider is, the request status, when they’re assigned the submission date, all of that data is right there at your fingertips. Not only is that at your fingertips, but you don’t have to constantly rerun that. You can name this report as like your PE report. And then you can export that out or you can save that report and have it set to run on a set cadence. So, I want this to run automatically every week on Monday, starting on next Monday. And so you have that full capability. Would that be beneficial to you as well? Are you currently running reports or would there be added benefit of having a report like that?
Kacheung (50:03) I think, you know, yeah, this gives us, you know, a sense how long it takes and telling, you know, the front end, we need the information as soon as possible. That is how we lose the money, the loss of revenue because of the delay often, you know, getting all the like onboarding or initial credentialing?
Hassan Zahir (50:24) Exactly. And you would have the ability to run any of those kind of reports and then again run any of those kind of analytics from any of the dashboards that are up there. And then you asked a question and I said yes, and I don’t know why my mind just went blank but we were supposed to jump into one last thing before we drop… because we talked about payer enrollment, but was it like, I think it was facility privileging, right? Is that what the question was? Oh.
Kacheung (50:56) Yeah, the facility?
Hassan Zahir (50:57) Providers need to get privileges at facilities. Are we talking about internal facilities or third party facilities? We’re talking about facility credentialing for billing, not provider privileges. Oh, okay. So you’re billing at the facility level?
Kacheung (51:13) Social rentee, social rentee, yeah, we have some payers billing at facility level. But my question is like if we need to have more new payers, what we need to do is a facility application first. And then, you know, how we’re doing right now is like if we are going to have a new payer… I know, but each payer, they require different kind of, you know, application.
Hassan Zahir (51:42) I mean,
Kacheung (51:42) we want to, you know, the bhchp want to enroll as a, you know, I mean contracting with a new payer, you know, right now, we have so many medicare advantage that we may not have the contract with all these, you know, payers. Okay. It’s what we call doing the facility credentialing.
Hassan Zahir (52:02) Okay. I appreciate you clarifying that because, you know, sometimes when we say that we’re credentialing depending on who I’m speaking to, it can mean a 1,000,000 different things. So, there’s a couple of things I want to highlight here first as, first and foremost, we do have the ability to support you with getting new group contracts. So if you don’t have an established group contract with a payer, we have the ability to support you getting that new group contract. We’ll make the request. You’ll do it at the group level. You’ll select the group who you want to establish that contract with. You’ll establish the state and the payer who you want to be able to get that contract with. And so, if I was going to mass.
Hassan Zahir (52:43) I could say, hey, in the state of Massachusetts, I need to get a new group contract with whomever, this person, whomever this payer was. And so I have the ability to go in there and request a new group contract and start the process of you getting the group contract. Medallion is going to then get back like that boilerplate template. You would negotiate like the terms and conditions like we don’t support the negotiation of fee schedules or T’s and C’s or any of the things of that. But we will help support you get the new group contract. And then also if you’re going to do an enrollment at a facility level, then I’m going to switch this over. We have full facility profiles the same way that we have provider profiles in the system where you can store all of the information associated with that facility, everything from your documentation to clia information, whatever the case may be. We have full facility profiles in there as well. So, if you are doing your billing at the facility level, then we have the ability for you to do that facility enrollment with the health plan. In addition to doing the provider enrollment with the health plan, you would simply choose that this enrollment is going to be for a facility, choose the facility, corresponding mpi and tax identification number associated with that facility, and make that request. So we can both support network expansion by setting you up and supporting you getting an initial group contract. We also can support the enrollment with the health plans at the facility level as well. It all comes out of the same payers module where you would make the provider enrollment request.
Kacheung (54:19) Okay. Good. Yeah, I mean, we have 10 different like, you know, code mpi that’s why when we negotiate the contract, we want to make sure these 10 code mpi for our facility is included. But where do, you know, put your facility information? I mean, like bhchp, like we have different site, different address. Yeah, the mpi.
Kacheung (55:01) Wow. That’s great. If all this documentation is attached, yep.
Hassan Zahir (55:07) And so all of that would stay and be associated with the facility profile. So that all of that, that’s required. Excuse me, all of that, that’s required would be included in that application.
Kacheung (55:25) Okay, great. And then,
Hassan Zahir (55:28) also, if you need to send a roster the first time to those payers as opposed to doing individual enrollments, then you’ll we would be able to kind of see all the providers who are associated with a given facility as well. And then once that facility enrollment requests have been made, then you would be able to see all of the payers who you’re contracted with for that facility as well. So the same level of tracking in detail for a provider. But obviously the relevant information for a facility.
Kacheung (55:58) What happened is like if a payer have a standardized provider roster, doesn’t mean that you will help to like fit in the data in the required, you know, provider roster because I experience different insurance, have different kind of like data fields that’s happening yep.
Hassan Zahir (56:17) That, that is correct. And so I’m behind the scenes, we have the ability to generate those roster exports for those non delegated agreements. And so if the payer has a format, we would choose just like you as the organization medallion would generate this and send that over. But we have the ability to choose the organization, which group profiles associated with. We can choose all the providers who have a corresponding link. We would choose who that payer was. And then we would generate that roster template based upon what their requirements are. So all of these places and states that we can support are listed here. If there was a one that we didn’t support, we would partner with you through onboarding again, a little bit of a peek behind the scenes, but we do have the ability to support that as well.
Chris Jones (57:07) So quick time check, we’ve got about two or three minutes left. So, was there anything you guys were hoping to see today that we did not cover?
Kacheung (57:19) How about you say, can we generate our own report? I know that you say you have some report ready, but probably mainly some report have different kind of data field as requested by the payer only… reporting you explain.
Hassan Zahir (57:35) A little bit more to me what you’re looking for there?
Kacheung (57:40) The report like some and not currently in our database, we need to generate the report in order to like fulfill the requirement for certain payer, like probably something you can do it for us, right? Because some payers say, okay, like we now we have the mgb, the mass general breakdown. You know, they send me, a report and say, okay, I want you to fill out this one. But three months later, they switch the data field and send me another new excel worksheet. Hey, can you do this one? I said, okay, I need to generate another report. That’s why. I just wondered if I have the template, how does it work? Yeah.
Hassan Zahir (58:23) If you have the template, then one of the things that you can do first and foremost, you can log into medallion and all of those fields. We expose them for you to build the report in the same way that they’re requesting it. So, you would be able to come in and do that on your own. If you wanted support from medallion, then yes, we could build custom reports for you though.
Kacheung (58:46) Okay. That’s a good note. I mean, as long as you have this feature, I think we will learn how to do it right now. Let me apologize.
Hassan Zahir (58:52) Because I have, a back to back demo. So I am going to have to drop and leave you with Chris, whatever follow up questions you have. You can feel free to give those to Chris. And I am more than happy to get on another follow up call. I just want to give them the same time and opportunity that I gave everyone today to be able to see the platform. So I thank you all so much for your time. Like I say any follow up question, feel free to give it to Chris. I’m excited for the potential to partner with you. And, if we need to get on another call, we’ll just find some time where we have a little bit. I’m not quite as back to back. Thank.
Chris Jones (59:33) You very much.
Kacheung (59:34) Take care. Okay?
Chris Jones (59:38) So, I guess with that said, so next steps thoughts from here?
Anik Conley-Das (59:51) I think we need to circle internally, Chris. So I think that’s going to be our internal next step. We obviously want to debrief about what we saw today. Probably, you know, I think Taylor, Mike, kayling and Alexa, we probably want to circle about back and sort of accumulate any other questions that we may have about it and then get back to you, Chris about sort of like where do we go from here?
Anik Conley-Das (60:12) What happens? I think Chris, you are very well aware that I think between Dave and yourself, we will need to approach the topic of pricing and how this could all potentially make sense for us in the immediate future versus like.
Kacheung (60:28) You know,
Anik Conley-Das (60:28) if it’s not now, then when sort of the question becomes and I want to just make sure that we’re all on the same page as we head into that part of the conversation. Yeah, I’ll stop talking. I don’t know if anybody else has any other thoughts or any other questions for Chris?
Kacheung (60:43) Hey, Chris, can I ask, you know, hopefully two more questions? Do you have a client in Massachusetts?
Chris Jones (60:51) Do we have a, what in Massachusetts, you?
Kacheung (60:53) Have a client? You know, do you have a client? Have you been working with, you know, or I mean, working with the Hawaii? Is there?
Tayler Wyss (61:00) Anyone else that you work with?
Kacheung (61:02) Oh,
Chris Jones (61:02) yeah. Yeah. For sure. I can send some over. I don’t know off the top of my head, but, you know, I’m relatively new to the company, but we can certainly, you know, if you want to speak with another customer, I know we have plenty of folks in Massachusetts, so we can certainly set up a reference call if you want to talk to somebody… additionally, you know, we have all sorts of different customer success stories I’m happy to share out as well. Was that the nature of your question? Yeah.
Kacheung (61:31) Thank you. Yeah, I think probably, you know, Taylor will follow through, right?
Chris Jones (61:34) Yeah, for sure. Okay?
Kacheung (61:36) One more question. Sorry. Do you have a dummy demo so that we can play around it if you’re interested with your like system?
Chris Jones (61:45) Not, we don’t really have a like a demo environment for you to play around in… you know, we’re happy to set up another session though, you know, like Hasan said, we can take you through and, you know, poke around, make it more of a workshop if that’s helpful… but we don’t offer like a demo environment per SE. Okay?
Kacheung (62:04) Yeah, fine.
Anik Conley-Das (62:09) Chris, one last question from me and that is probably something for you to take back to Hasan and others. I wonder, you know, during sort of the implementation phase if there’s a sandbox environment because what I want to be able to do is obviously not push big things live unless they’re really ready to go live. So, I’m curious, does medallion have like a sandbox feature as part of it? Yeah.
Chris Jones (62:34) We do indeed. And we can talk through that. I’d say, you know, next conversation, we can dive into that and kind of talk through what the, you know, implementation process looks like and non prod environments et cetera. Thanks, Chris. You bet. Okay, perfect. So I’ll sit tight. I know you guys need to meet and have conversations internally.
Chris Jones (62:57) So, you know, we’ll sit tight, look forward to hearing back from you on, you know, next steps and, you know, like Hasan offered, if we want to jump back in, we’re happy to do so.
Tayler Wyss (63:08) That sounds good. Give us, you know, a week and a half, two weeks to internally touch base and get back to you with I’m imagining we will more questions will arise and we’ll want to do another one of these. So thank you. They’re very helpful.
Chris Jones (63:26) Perfect. All right. Great. Well, thank you all for your time and running over a few minutes and we’ll look forward to speaking again in the next couple weeks all.
Tayler Wyss (63:33) Right. Thank you so much, Chris. Thanks.
Chris Jones (63:35) All. Take care. Bye bye.