Transcript
Jessica Boston (00:01) hey, how’s it going?
Stephanie Ryan (00:03) Good. How are you?
Jessica Boston (00:05) Good. Let me make sure I got the right microphone on here. Oh, hold on. Okay. How’s it going?
Stephanie Ryan (00:19) I’m good. How are you?
Jessica Boston (00:20) All good.
Stephanie Ryan (00:22) I.
Jessica Boston (00:22) included.
Stephanie Ryan (00:24) a new colleague of mine, Jack on the call. He’s just here to sit in and listen as he’s learning and kind of onboarding with our team. So, Jack is based out of North Carolina and we actually worked together previously too.
Jessica Boston (00:39) Hi, Jessica. Nice to meet you. Thanks for letting me tag along.
Stephanie Ryan (00:44) Cool. Okay. I have like a regular deck to pull up and dive into. And then there was some other reporting in the analytics tab of the platform. I wanted to look at with you. But before I pull up the qgenda items, do you have anything you wanted to talk through with us?
Jessica Boston (01:08) Not top of mind… I’m assuming the invoices came through, I didn’t look at them. I was going to tell you, I saw like the, I don’t know if like the way you guys normally send invoices through is through like a link, but like I saw the link, I needed to click like we don’t have a human who clicks links like they’re all automatically ingested through workday through that email address I sent you. And so, I guess I just want to make sure that you guys have the capability to attach an invoice to an email because that’s how they’ll get ingested. And if you don’t I just want to know that so that I can like know that I have to find a human to click that link.
Stephanie Ryan (01:52) Okay, great feedback. I will check with our finance team and just make sure that it’s not just accessible by link only. And, if we need to change our process on our end, I’m sure we can. But if I run into any issues, I’ll let you know.
Jessica Boston (02:09) Okay. Yeah. I was just like most like workday, all the systems like automatically OCR, whatever the attachment is on those emails. Like if you send something to that email address, and so it automatically uploads it into workday and sends it through the approval chain. So like we don’t miss. But if you’re like, hey, I don’t have that capability to like attach an invoice to the email, like just let me know. And then we’ll figure something out so that they don’t get missed in our automated process. Yeah,
Stephanie Ryan (02:38) perfect. That sounds great. I’ll circle back if I run into any issues, but I think we’ll be okay. Thank you for giving me that heads up though. Okay. Are you in Florida? Are you in Ohio this week?
Jessica Boston (02:51) I’m in Florida still? Oh.
Stephanie Ryan (02:53) Good.
Jessica Boston (02:53) Yes, I’m staying a while longer.
Stephanie Ryan (02:57) I am getting an ice storm in Minneapolis this morning. So, oh.
Jessica Boston (03:02) Really? Okay. That validates why I’m staying a while longer, like a lot of our Minnesota and Wisconsin neighbors went back like at the end of the month is like the end of March is like really natural time for people to go back north and I saw a lot of them leave and I questioned why they were going. I don’t know, but yeah, we’re staying through like mid may and then I think I might go back, I might go back to Ohio for like a few months like for the summer or something.
Stephanie Ryan (03:28) Yeah, the summers are much nicer, and Florida is so hot in the summer. So, I hear you. It’s.
Jessica Boston (03:35) starting to get hot here for sure.
Stephanie Ryan (03:36) Yeah. We were supposed to get 12 inches of snow, so I’ll take the ice storm over the snow, but I just, oh, my God, it’s April second. No more snow please?
Jessica Boston (03:49) I know, well, hopefully the ice will melt faster than 12 inches of snow would maybe.
Stephanie Ryan (03:54) For sure. Okay. So diving in here, this is just our regular consumption slide. You have 588 providers on the platform that are also being monitored from an ncqa perspective. And then your rosters as well. So, again, the way that this works is you’ve purchased up to 600 and we don’t track upcoming consumption for these QS because they’re just daily prorated, accruals, but you’re sitting well like you’re just under what you purchased, no concerns.
Stephanie Ryan (04:33) And I know that you said from a hiring perspective, like we were feeling good about the number that we had contracted for, so.
Jessica Boston (04:40) Yeah, I mean, I’m a little concerned because like most of our recruits start in August, right? They come out of residency in June or July. They take a month off, and then they start in August and September. So, we usually have, you know, like 12 or 24 docs start like in that August September time frame. I can see what we have contracts signed for, but I mean, I’m definitely a little concerned that we might exceed the 600 but not by like a lot like maybe by a handful. Yeah.
Stephanie Ryan (05:12) Well, and just remember you’ve got that SKU flexibility. So, I know you purchased a ton of revalidations that I don’t think are all going to be used. And so what you aren’t using there, you can borrow for where you may be over consuming in other areas or where you’re using and you haven’t contracted for. So. And I think another part of the conversation we had last month was you have a pretty large amount of providers who are going to be retiring, right?
Jessica Boston (05:45) Sorry, everything froze, can you hear me?
Stephanie Ryan (05:48) Yes, we can hear you. Okay?
Jessica Boston (05:50) I don’t know like it wouldn’t let me unmute but I got it. Not necessarily like we have about the same amount, retire as we recruit like we replace on a one to one basis. My concern is like we’re doing a big rally for apps like we’re adding a ton of apps which also count for these metrics. And so that’s where like my concern is.
Stephanie Ryan (06:15) Okay. Well, we’ll keep an eye on this. And again, we’re looking at it monthly. So, you know, if we see a huge spike, it’s something that we can talk through. But just based on where you’re at from a contract perspective, I think we’ll be okay. But again, like it’s something that we’re looking at and paying close attention to from a credentialing perspective, you’ve used 31 percent of what you’ve purchased. So we have consumed 75 credentialing files this year. And from a payer enrollment perspective, we have consumed 241. And there are 27 additional payer enrollment apps that have been requested but have not hit consumption yet. Your revalidations, we’ve consumed 25 which has increased since the last time we connected. I think the last time we connected, they were in single digits. So you do have more revalidations coming through. And then we do continue to see those demographic updates which you did not purchase the SKU, but it’s okay. You’re using them and we’ve got that SKU flexibility. So no concerns there either.
Jessica Boston (07:25) Okay. I think the revalidations are going to come in waves, right? Because like all of our docs are going to need revalidated for like said plan and so those are going to like go from zero to 600 in one of those loops because like we’re going to revalidate, like everybody like, right? Is that how you.
Stephanie Ryan (07:43) guys see?
Jessica Boston (07:45) It?
Stephanie Ryan (07:45) Yeah, for sure. And then from a credentialing performance perspective, we have delivered 75 credentialing files this year. The median days from when your team requests a credentialing file to the provider application actually being completed is five days. Five days is great. I will tell you that I have other customers where it’s looking like it’s two. So we can work on getting that to be even better than five. But I’m not concerned with seeing the five day turnaround time, okay? With your recredentialed providers. 100 percent of them have been recredentialed on time and your SLA. So that is within your contract. I think it’s 95 percent or above. We are sitting at 100 percent. So things are looking really good there and we don’t have any. Oh, I did not complete this. The average task completion rate. Let me show you what that is really quick. I’m so sorry, give me just a second. I want to pull it up.
Stephanie Ryan (08:57) I think it was looking really good, but I just want to make sure… task summary.
Stephanie Ryan (09:12) Specific thread. Sorry, being a little slow, there we go.
Stephanie Ryan (09:23) Oh, it’s not, no, there’s actually just no data. Let me check into that really quick. I’ll take that as a takeaway and make sure that what I’m seeing is accurate. I’m wondering if what could happen is that your credentialing applications look really good and there’s no tasking that’s needed. And so there wouldn’t be an average, but I want to confirm that. So I will double check and make sure that if the report isn’t populating the way it should be that it does. And if that’s actually the case, then your team’s all over it. They’re rock stars. So I will double check on that. And then from… a… pay your enrollment perspective, I was actually really excited to see these metrics. I know that like come January is really where we got started.
Stephanie Ryan (10:17) So as of February when we met last, you had six enrollments completed to date. You’re up to 97, which is very exciting. Total enrollments and process to date are 480. Some of these. I think when we spoke last time I told you, I would anticipate these numbers to increase because we were so fresh and we were completing enrollments pretty quickly as we have more requests. We know those are going to sit longer. So applications that are, have been submitted by your team and are in follow up, meaning our team is working with the payers to complete those, there’s 335 there and they’ve been open for 60 plus business days. OK, go ahead.
Jessica Boston (11:01) I think we might need to add a metric on which so we can clearly see like on what’s 90 plus because the difference between 60 and 90, right? Like because that like a 335 could be open 90 days. And we don’t know because I think I told you I wanted to look at over 60, but now I’m realizing that was probably an error because we can’t differentiate like do we have a real problem? Because if it’s 60, I’m like, okay, like it’s training up? Like are we closing them fast enough? But then if it’s if three, if you told me 331 of those are over 90. I’m like, okay, Houston, I got a problem, you know, with the payers processing them in a tummy manner? And then of course, we have our mmo problem that I told you about last time. So, yeah.
Stephanie Ryan (11:50) For sure, what I’ll do is I will change this to 90 going forward. And then in my email, I’ll differentiate with my recap of what’s sitting open at 90 plus. Okay.
Jessica Boston (12:03) Okay. In.
Stephanie Ryan (12:05) Terms of turnaround times from when the applications have been submitted to when they’re actually completed, we’re looking at 16 days right now for what like an average of what’s been completed so far so that I mean, that’s looking really good. And like I said, I know we reported seven days last time because we’re so new. I did anticipate this number to creep up. But as we, you know, look towards summer, I think that number will stabilize a little bit more.
Jessica Boston (12:33) What does that, what does that represent that turnaround time? Is that from when we submit it to you guys that you’re turning around to the payer to?
Stephanie Ryan (12:43) When the application is actually completed by the payer. So when you submit it to medallion, and then we complete the enrollment with?
Jessica Boston (12:57) The payer? Yes, how can that be 16 days if we have 335 that are above 60?
Stephanie Ryan (13:03) Because it’s only based on what is completed today.
Jessica Boston (13:06) Completed. Okay. So of the ones that are completed like,
Stephanie Ryan (13:11) our average turnaround time is 16?
Jessica Boston (13:13) Days? Okay. I’m trying with you.
Stephanie Ryan (13:16) You’ve got four that will.
Jessica Boston (13:17) continue to grow as well. Yes.
Stephanie Ryan (13:20) That one, I would anticipate to grow as well. That being said, I think we will get to a point where it will level out and you won’t see as such big shifts because we’ll be more in the process, yeah.
Jessica Boston (13:33) Gotcha.
Stephanie Ryan (13:34) There’s just four open tasks for payer enrollment and the task completion rate is up five days. So you’re hovering right between a little under a week, for tasks to be completed on your side?
Jessica Boston (13:47) Okay. I mean, given like the amount that we’ve grown with what we’re processing through, I’m like I feel like that’s fairly stable, but we can continue, you know, I’m sure to go up and we’ll work it back down as we can as the team continues.
Stephanie Ryan (14:00) To get for sure. And I think when we met last time, I think you talked about potentially adding like a KPI for your team around some of these metrics as well. Yeah, we did. Okay. You did. What do you know what your KPI is? Yeah.
Jessica Boston (14:14) So, we, so the KPIs that they have internally is two things, the turnaround time between a provider being approved by the credentialing committee and submitting the application to medallion for pay or enrollment, right? Because as soon as somebody gets approved by our committee, like we immediately want to get them started to start the enrollment part of the process. So they’re the turnaround time for them is three days. Okay? So we have committee on Wednesday. They have Thursday, Friday and Monday and they have to send a summary email after every committee saying that every single person has been submitted for pay or enrollment. So I know I’m going to hit that 100 percent because I wait on my email and I make sure that they do it like or deb and Melissa make sure that they do it. And then the second one is… turnaround time for… to respond to you guys. So it’s this one, I guess technically like is that, so I want, I would like for that to be three days as well, like it should be no more than three days, but they’re still working on that one especially as we’ve ramped up the volume, yeah.
Stephanie Ryan (15:27) For sure. Okay. That sounds good. Great insight. Thanks for sharing that. And I’m actually going to pass that along to Jason too, just because as we look at these numbers, if things are creeping up and we have to like help address like where are you getting hung up from a platform perspective? We can do that too. Okay.
Jessica Boston (15:46) That sounds good. Okay.
Stephanie Ryan (15:49) And then I wanted to show you just some reporting in the platform that I wasn’t sure if you had seen or were aware that it was there. So give me a moment. I’m gonna pull it up and then I will share my screen here. This is specific for payer enrollment.
Stephanie Ryan (16:13) I thought this might be helpful for you as you’re having more internal conversations on the value that medallion’s bringing to the team. So I’m under analytics, I’m under payer enrollment here’s where you can see what’s in progress. Again. I pulled metrics yesterday. So things probably shifted a little bit. Even the completed requests is up by three. So I’m looking… down here. So your average turnaround times, this is the first application submitted to request completed, that’s that metric that I report out on. And we’re looking at the 15 total business days. But then down here which I think is going to be really helpful for you is you’ve got your payer average of requests to requests completed in calendar days by payer?
Jessica Boston (17:09) Oh, that’s very helpful. Yes. And then to them saying you guys aren’t working, you’re not working fast enough for us? Yeah.
Stephanie Ryan (17:18) Yeah. And then average of apps submitted to request. So this is when the actual request happened. This is when the application was actually submitted to the payer, and when it was completed.
Jessica Boston (17:29) Okay. So, I would probably want to look if I’m trying to hold the payers accountable. I want to look at the second column.
Stephanie Ryan (17:35) Yeah, exactly. Yeah, this is more like from, you know, because medallion and your team and our team before it gets submitted to the payer, your team’s submitting the request, we’re making sure that the application has all of the information that we need. So there’s some back and forth there where your team may get tasked with things. And then once it’s submitted to the payer, it’s really just us following up with them to make sure that they have what they need to get it across the finish line. And.
Jessica Boston (18:03) What’s reflected here in like the second column is only the ones that have been completed.
Jessica Boston (18:08) So it shows like medical mutual at 22 days, which we know, like we have outstanding applications that are over 90 days with them. Yes. Yeah.
Stephanie Ryan (18:16) So this is going to be anything that is completed. Anything in process would not be applicable to these numbers. Okay? And then here, this is by.
Jessica Boston (18:24) State.
Stephanie Ryan (18:25) We.
Jessica Boston (18:25) have applications that are over 90 days, but yet they’ve completed some in 22 days.
Stephanie Ryan (18:31) Yeah, I don’t… know how the plans work and I don’t know how they get some things done quicker. I don’t know if it’s I’m not sure. I’m sure your team may have a little more insight there or mine may, too. I can check. I don’t know how some can move so quickly and some can just be so stale well.
Jessica Boston (18:54) I think my, I think my like out standing question is like when we were using our previous process because those are the ones I know are outstanding with like we have some that are outstanding like eight or nine months with medical mutual, like that they’ve granted waivers back to the original date of hire, but we still haven’t gotten paid. Like, so I’m just wondering like since we switched to medallion, is there something in this electronic process that’s made it easier for med mutual to respond and process our applications? Whereas in our like manual paper process, like there was something hindering their ability to do that? So that’s my only question. I need to look deeper into like what other things do we have? Outstanding with medallion and see like do we have our like, are things getting processed more timely with medallion than our previous process? But that’s just med mutualism fair. I.
Stephanie Ryan (19:52) Know. It’s tough. It’s really tough. You’re not the only one. So if it makes you feel better, there’s oh.
Jessica Boston (19:59) No, we’re hearing all across the market. Yeah. The other like hypothetical the other like the story out there just again just, you probably don’t care. But just so you know, is that like anthem’s leadership locally went to med mutual. And now med mutual is acting a lot like anthem does like with some of their like bag of tricks that they pull. And so it’s just like interesting that they had a leadership change. That leader happened to be a previous anthem leader that they hired. And now, like we’re experiencing them being much like anthem used to be or is. So anyways, it’s a real headache the.
Stephanie Ryan (20:35) Saga continues, right?
Jessica Boston (20:37) Yeah, it’s never ending.
Stephanie Ryan (20:39) It’s never ending. So again, this is accessible, these metrics again will change as we start to close more out. But something that you can always look at in real time within the platform. If you need to pull metrics, I just thought, I don’t think that we’ve looked at this one together and I saw it. And I was like Jessica’s going to want to see this, yeah.
Jessica Boston (20:58) I need to spend a little time. I think, you know, before when it wasn’t quite as populated. I was like, okay, I’ll wait to get some like data in there where we can really start to tell like what turnaround times are looking like. But I need to spend a little time and I benefit greatly from you showing me and pointing out those different pieces.
Stephanie Ryan (21:17) Perfect. Okay. Well, I can absolutely take a screenshot of this and include it in my email just so you don’t have to go back but know it’s in the platform and I’ll include it in my follow up as well.
Jessica Boston (21:30) Okay. That sounds good. Thank you. Yeah.
Stephanie Ryan (21:32) Of course, that’s kind of all I had planned today but wanted to check in with you. I know in the past, the team has felt really comfortable with the platform. They’re liking it, but want to check in with you, make sure that feedback is staying consistent there. If there’s any pain points, please share. Yeah.
Jessica Boston (21:50) I don’t think there’s any new pain points. We have a new team member joining. So it’ll be kind of interesting. We’ll onboard our first person after like the original training and group. This person has a really significant experience in credentialing but has not worked in an electronic process, right? I mean, most people are coming off of like a paper process and so it’ll be interesting to see like what her feedback is because I actually think she’s got like real strong knowledge in this space but like hasn’t experienced like the seamlessness of a more efficient process.
Jessica Boston (22:25) So it’ll be good to get like see if there’s any pain points from like a new member of the team trying to understand the new process and if there are, we’ll pass those along but I think they’re doing fine. I think I haven’t heard anything from Melissa or deb and I think I sent you an email like they had declined that additional email that we had talked about before they’re like, you know, what we’ve gotten like our feet under us and we don’t think we need it right now, which I think is what you told me before and it would probably happen. And so, I think we’re good on that as well. All good.
Stephanie Ryan (22:58) Things to hear then… if your new person needs any like one on one training with us, just let us know Jason can happily connect with them and do kind of a overview session of the platform. And then of course, we’ll want to get them access to the platform too, so they can make that request and we can get them set up when the timing’s right there, too.
Jessica Boston (23:21) Yeah, they start on Monday. So, I think Melissa, if Melissa hasn’t already went down that path, the request access, she will be shortly for sure.
Stephanie Ryan (23:31) Perfect. That sounds great. Okay. So next steps here, I am going to send you a recap of the deck that we reviewed. I’m going to change the 60 plus to 90 plus so that you have an idea of where you’re sitting at there. And then I’ll send you a screenshot of the payr calendar. And then am I missing anything else? Is there?
Jessica Boston (23:56) Anywhere in the analytics platform piece that I can look at 60 and 90 myself on a real time basis? I don’t right? Or do I have to wait for you?
Stephanie Ryan (24:05) You don’t have the access that I do because mine’s not built in the platform. It’s a separate report. But if you’re ever like, hey, can you send me this? Send me an email, I can pull it for you. No problem. It’s.
Jessica Boston (24:19) fine. I just thought if there was somewhere in the self service part that I would just want to know about it because that’s I mean, that’s probably the biggest like pain point organizationally that I’m speaking to is like how fast are we getting these enrollments completed? So that we can get paid, right? Because that’s when, because we keep individual, I don’t know if I’ve ever told you this, like we keep 600 individual financial statements for the docs and so they, like if we don’t as an organization aren’t getting paid, they aren’t getting paid. Like literally it’s a one to one basis. And so they, it’s really meaningful to them to get through the enrollment process because.
Stephanie Ryan (25:00) Then, right?
Jessica Boston (25:01) The money comes rushing through. And so that’s where like the majority of the reporting out that I do organizationally is like, or the majority of emails and complaints that I get about this. Our process is like, why am I not getting paid yet? And it’s in the hands of the payor, but that’s like probably most what I want to keep an eye on. Okay?
Stephanie Ryan (25:20) Yeah, I’m sorry, I don’t have it built into the platform. It’s feedback that I can share for sure. Like it would be nice to see this at some point but something that I’ll continue to report out on monthly for you?
Jessica Boston (25:31) That sounds good. Thank you.
Stephanie Ryan (25:33) Yeah, no problem. And then I’ll just give my finance team a heads up on the attachment and if we run into any issues there, I’ll circle back, but I think we’ll be okay.
Jessica Boston (25:42) Okay, great. Okay.
Stephanie Ryan (25:43) Well, thank you so much. It was great to connect with you. We will connect again here in like another month.
Jessica Boston (25:49) All right, cool. Thanks so much. See you guys later. Bye Jack. Bye.