Transcript
Philip Stefani (00:00) what’s up, Noah?
Noah Laack-Veeder (00:01) What’s up, man?
Philip Stefani (00:03) It’s the Phil and Noah show today, you?
Noah Laack-Veeder (00:06) Mean, the Noah show… I’m the,
Philip Stefani (00:14) MC.
Noah Laack-Veeder (00:15) Hey, you know that’s hey, every good show has a good MC.
Noah Laack-Veeder (00:25) 100 percent. I got to talk to rob about the workout we did last night. So better give me two minutes to talk about that.
Philip Stefani (00:36) And then I need 15 to 20 for the proposal. Yeah, for sure. We should be able to go through the process stuff pretty quickly. Let’s get rob in right now and hit the, yeah.
Noah Laack-Veeder (00:47) And just orient towards what we talked about.
Philip Stefani (00:55) Hey, afternoon, rob.
Rob Horrar (00:58) Hey, hey guys. How are you?
Philip Stefani (01:01) Doing well. How are you? Good?
Noah Laack-Veeder (01:04) You seem like you’re in a different spot today? No, same spot, oh, just different background, not the, yeah. Yeah… I was telling Phil, I had to talk to you about the workout. I had the track team do last night. Did you ever do any split runs or broken for hundreds? Oh, yeah.
Rob Horrar (01:27) Yeah, yeah.
Noah Laack-Veeder (01:29) You know, those, so I had to, we had to do it because our second 200 was looking really bad. So I had to put them through the ringer, but we emerged victorious, rob, we did.
Rob Horrar (01:42) Good for you. All right. That’s got to be rewarding in coaching. Yeah, I didn’t think that level, but I was coaching my boys sports teams and I did like it.
Noah Laack-Veeder (01:53) Yeah, the theme of the week has been identity. And so I asked the team. I was like, do you all want your identity to be when it’s challenging you give up and collapse? Yeah, of course, they say no, and I say, how about this? When you are challenged… you rise up and give it your all, how’s that sound? And they’re like, yeah, and I was like, I’m going to give you all a test to show me if that’s who you are and boom, it was so fun. And then you just see the kids like embrace it. They’re all tough. They’re helping kids off the ground. It was, it was awesome. It was sweet.
Philip Stefani (02:34) Fantastic. All right. We got Kyle.
Noah Laack-Veeder (02:36) Hey, guys. Hey, Kyle.
Philip Stefani (02:38) We’re still waiting for garrison. We can catch him up when he joins. I know we are limited on time. We got a lot to cover so we can just jump right into it. The agenda for today. We want to show you both specifically on the rbt enrollment process piece kind of just walk through the sops for like, hey, what does it look like when medallion actually enrolls rbt specifically to get your comfort on that piece?
Philip Stefani (03:01) And then want to walk through like what would it cost to do this with medallion and get your feedback on that? Those are the two pieces. I wanted to cover anything else that you guys wanted to go over that I didn’t mention nope. All right. And we’re going to be pretty direct just because of the timing, but I should be able to move through everything. So in terms of the medallion… process just real quick. So essentially, what we’re going to show is the most time intense. The time and resource intensive pieces of the rbt process that we’ve aligned on are the data collection pursuant to the payer requirements, as well as those requirements around bacb, certification, the state specific fingerprinting requirements, and following up with the rbt’s on those, the application, QA, getting those applications out the door, follow up with the payers and then status tracking through to par. So we’re essentially going to show in this process, you know, by eliminating the most time and resource intensive pieces here with medallion, we’ll enable you to enroll rbt’s with any of those payers that require it without adding any additional headcount there. So that’s kind of what we’re attaching to? Is there anything specific in what you’re looking to solve there that we’re not accounting for that you want to make sure we track? I don’t think so. Rob anything on your end?
Noah Laack-Veeder (04:25) No.
Philip Stefani (04:26) And just, and,
Noah Laack-Veeder (04:28) just like valley, do you agree that these are the most resource intensive tasks like the follow up application, QA pair, follow up and status tracking?
Rob Horrar (04:37) Absolutely, that’s it that’s all of it. Okay?
Noah Laack-Veeder (04:41) Excellent.
Philip Stefani (04:43) Cool. So we can pass to Noah to go through that process for rbt’s.
Noah Laack-Veeder (04:50) absolutely. So I talked to my operations team, Phil and I have spent say a couple hours at this point, just like really wanting to make sure we’re equipped to speak to this. So let me share, my screen. So wanted to talk through just the two swim lanes here and just highlight in this like lighter blue color, what we feel the automated and then highlight the areas and kind of white where there’s still going to be a hopebridge component to it. Cause those are the areas where like truly those aren’t necessarily able to be automated. But first of all, we want to talk about that syncing data from paylocity to Salesforce and to medallion. If that is a priority for us to do. That is something that we can accomplish. And ultimately, what we’re saying here is that if there’s data in paylocity, we can get it to the necessary places to feed downstream Salesforce being that ultimate source of truth, what medallion will do is over the QA that data and generate tasks based on the unique requirements for rbts. So based on the states that we’re looking for, obviously there’s the background checks and fingerprints, and we want to make sure we have those custom instructions for Indiana and Arizona specifically having tasks that illustrate exactly what needs to be done so that teams can work with those providers, whether it’s medallion, working directly with those providers or your team to resolve those tasks. But then within the platform, we’re making sure that we’re able to associate supervising physicians or in this case, the bcbas to these individual rbts as well as gathering and checking that bacb verification because we want to get that upfront. So it’s not rejected downstream later. Then information is all entered in medallion. It’s checked. So we’re making sure that these supervisor relationships are valid, checking to make sure that we have the evidence that proves the bacb verification. And if there are any issues that are coming up, medallion will resolve them. If we can. If we can’t that would be something that we would route to your organization to work with your providers to automate, then like kind of the most intensive processes post kind.
Kyle Brinkworth (07:01) Of, can I ask you just a quick question? Yeah, go ahead. How much of that is net new for you guys in practice versus you’re already doing it today?
Noah Laack-Veeder (07:10) So like specifically like the supervisor relationship?
Kyle Brinkworth (07:14) Yeah, typically that and the verification stuff. So.
Noah Laack-Veeder (07:17) No, we, so there’s other, you know, we’ve done this with rbt’s other like if you’re talking about like NPS for example, there’s also a supervision relationship that is required. You have to have a collaborative agreement and evidence of that in the platform. So we’ve built that already and we utilize that for the rpts as well. So yeah those two things are not new to us and our technology, it’s kind of like we built that module thinking that that’s going to be expanded across multiple specialty types. So that’s it’s a very similar process.
Kyle Brinkworth (07:51) But going to the bacb to get said information is new.
Noah Laack-Veeder (07:57) No, it’s not new. Yeah, yeah. Got it. And then kind of back to this other part. So this is all, I mean, a lot of these pieces, right? We talked about these… being important and there’s things that we can’t get around like we have to do the background check and the fingerprints using tasks and things to make it easier to find these. But the crux of a lot of the work is the auto preparation of applications submitting them and then automating that payer follow up. So after you request the enrollments and say we need rbt, Kyle enrolled with X payers, we’ll take care of everything else other than the things that we can’t automatically resolve. So because we’ve been upfront in collecting all of these things we’re addressing usually 80 to 90 percent of the reasons why a payer may need follow up. If there is a reason that we can’t automate that we would resolve, we would again, that would be something that we would route to your team to address. But if it’s something that we can automate, we can follow up with medallion absolutely will and again percentage wise, it’s around 80 to 90 percent of the follow ups that teams are typically handling today. And then if we’re doing the medicaid one first and then working with managed medicaid as soon as that medicaid is done, or if we’re allowed to submit both at the same time, we’ll follow an immediate next step. So if medicaid is done, we’ve got the par status. We will then move to that submit managed medicaid and do the same process here. So if we’re thinking about all the follow ups, all the status, tracking, all that work that’s being done to track the medicaid and the managed medicaid and the dependencies. Medallion is the one handling that. So really your team at the enrollment process is only going to be responsible for the things that medallion… can’t automate and that the payer needs your attention, and.
Kyle Brinkworth (09:55) Do you have a sense though for what that actually looks like?
Noah Laack-Veeder (09:58) I mean, truly, from what I’ve seen, the resubmission rate is so low that we’re not really getting a whole lot of follow ups other than payers making mistakes. Like you sent me this document, they misread it and sent it back. And so those are instances when medallion can resolve that. It’s like an example could be… trying to think on the top of my head. It just comes up so rarely but just highlighting that there may be something we can’t automate and that would be routed to your team. Got it. Okay. Yeah. But so again, back to the initial problem statement kind of expediting these timelines, medallion’s perspective is by automating these resource intensive steps, we will speed up these timelines especially if payr follow up is a huge resource constraint and we can’t follow up as much as well as we have resource constraints to scrape status and get that updated. All that’s going to be handled. So what we feel though is what we feel as though is that we are going to be expediting these timelines so that we’re not missing those timely filing windows with medicaid and the managed medicaid as well. So what other open questions do you all have on this process or like, are there any pieces that we… just need more insight into? Yeah.
Kyle Brinkworth (11:32) I mean, I think it’ll like the diagram makes a ton of sense. I think just in like actual practice is the confirmation for like where you can really, because what I don’t want to have is like, hey, yeah, this works but we still have because we can’t auto submit something where the application is different than anticipated. We have to like ping our team a bunch. So thinking about, you know, if we were to move forward, how would we run like an actual true example through to see what you guys could like really do versus what’s just on the diagram. Because again, I think it’s like, hey, if we’re if we want to pay for how it’s outlined in terms of like the total streamline, but then in reality, it comes back to like, yeah, well, we can help gather a couple of the points of information. And then we’re constantly pinging our team to do the other pieces. I just that’s where my concern is.
Noah Laack-Veeder (12:21) And what are those pieces that like you think of that? You’re trying to avoid us pinging?
Kyle Brinkworth (12:28) Your team, I mean, I think if this fundamental is like literally grabbing the stuff from the bacb and appropriately submitting like the application, like I think that’s a like things as simple as that. Just like very clearly saying, yes, this is the exact workflow. We can absolutely do this like all of those things. Just like really again confirming that we can. So maybe that would be, you know, again, if we walk away from the call saying, hey, this would make sense for us, then we could say, how do we do like not a pilot or like a further test like with the team to ensure that we can deliver what we’re saying?
Rob Horrar (12:58) Yeah, one more thing to add would be just to make sure, what the end result looks like, what is the real time visibility for a center manager to know they can put an rvt to work, you know? And that has and I think it said differently to, if we build this mousetrap, but we still are doing a lot of the same work behind the scenes, we haven’t really solved anything, right?
Noah Laack-Veeder (13:22) Yeah, no. 100 percent. So if I’m tracking kind of two things, one, the bacb piece specifically where we’re having to go to the portal, grab a screenshot of the verification and put it in the medallion question being, hey, medallion, can you just do that for us? Is that what you’re asking Kyle?
Kyle Brinkworth (13:40) Yeah, generically. Yeah.
Noah Laack-Veeder (13:42) Yeah, it, I mean some organizations aren’t comfortable with us doing that. If you, if you’re willing to let medallion take that over for you, we can do that. It’s just more, yeah, go.
Kyle Brinkworth (13:53) Ahead and what’s well, I guess and we can talk just when we get to the quote. What will be reflected in the quote one way or the other? And then importantly, is that like agentic work or is that offshore work or how do we think about it? Because we are seeing an… increased, I don’t know reach out from payers with flagging and saying, of the AI stuff that we’ve got working or the, you know, like auto calls and all this stuff. They’re basically declining them and, or blocking any sort of offshore IP like all that stuff. So we can help to understand like how you’re thinking through that just to ensure that we go in eyes wide open as well.
Noah Laack-Veeder (14:33) Yeah, no, I think that’s a really good thing to think about. So just, I’m tracking it’s like, I mean, there’s several options for the bacb piece. Ultimately, we just want to make sure we’re doing the one that’s going to work and so that’s typically why organizations are just taking that on or initially. But there are other options and there’s going to be, you know, not. I’m not going to say pros or cons but just different… workflows associated. But if we kind of think about the other bottlenecks like the status tracking, the payer follow up, et cetera, like it’s kind of this whole universe of what we want to automate versus what’s going to be part of, you know, so definitely something that we can walk through and do that. And that second piece rob around like real time status visibility, knowing, you know, who’s enrolled with who immediately. So we’re not making mistakes and saying, look, dr, Kyle is seeing patient a, when they’re not supposed to. I’m happy to, if we have time at the end, I can show you that again in the platform, but ultimately how that works is that as soon as someone is effective, we are scraping that portal to get that. So we don’t have to necessarily wait for the email from the payer that’s reflected in our system. And you’ll have a running list of who’s effective with who at any given time. And it’s just a real time dashboard. So I can show you that at the end of the call just to get that validation there. But that’s a piece where I’m confident we will be able to provide that right away. And,
Garrison Goodman (15:56) Kyle, could you potentially share a list of like what your payers are saying? Like some of their concerns are coming up just so we can validate anything.
Kyle Brinkworth (16:03) On the like offshore slash other things. Yeah, yeah, literally. So there’s well, so, Arizona is a good example. They allow no offshore activity whatsoever even if you like let’s say VPN, whatever it is. It’s against the medicaid rules and access rules. And then we’ve gotten an increased amount of, in Georgia, this has popped where payers have called us and said, you’re calling us via AI, you know, bots to do benefit checks, things like that, we will not respond to them. And like we will keep like, if it gets to a point, they will like actually say, hey, we’re going to like kick you out. So, it’s been few and far between, but we are seeing both increased legislation from an offshore perspective that concerns me. And then just the one offs of a small portion of AI calls that we are doing, they’re coming back and saying, what? The heck? Yeah. Okay. Well, we’ll.
Garrison Goodman (16:56) check on those two things. And then I think too, just like I think if I’m you, I’m like, hey, what if things change with the payer? Like how do, you know, they come up with a new policy? How would you manage this internally? That’s why we tend to take a hybrid approach where we use AI or other automation or integrations where we can, and, but we also have human expertise where needed because those things are constantly changing.
Kyle Brinkworth (17:18) And each state with.
Garrison Goodman (17:19) each payer, their portal. So, I think if we just like understand where you guys are at today. And then also, from your perspective, know that we have like a backup in case there’s a change. Does that, will that like satisfy some of your requirements? That could even be like, hey, if something changes in Arizona, we want to know that you guys have the capability and they say no AI, you have an onshore resource that could be used like, yeah. Okay.
Kyle Brinkworth (17:41) Yeah, I think that’s just because what we don’t want to have happen, right? Is all of a sudden we build a process around all this working and it’s black and white to say, well, if all of a sudden they disallowed offshore, we’re screwed. And now I’ve got to figure out like what to do, right? And so like that’s my biggest concern. That makes sense. And look we have today, right? We have an offshore team that handles some of the back office administration stuff. And what we’ve done today to just say, look, we can’t allocate any of that team’s time to Arizona, right? So we’ve got this piece but it’s just, it’s always, it’s just come up in terms of like, I don’t want to go all in on something and realize that we have to take it all back because of something else.
Garrison Goodman (18:19) I’m actually really encouraged by that because we think about things similarly, that’s why we like we’re hybrid. We’re always going to be hybrid because things are changing on the other spectrum of that. We’re also constantly scanning for when does AI get the thumbs up? And when can we release certain things that we have already built to be deployed that aren’t allowable yet? So kind of takes care of you on that spectrum as well. We’re like working with a vendor like us whose whole business is focused on this. Not only are you covered but like also future planning for when these things change because they are changing fast, some of it in regards to positive, where, hey, you’re allowed to use AI more and more. And so that’s where we’re going to kind of be on the bleeding edge of that when that becomes reality.
Kyle Brinkworth (19:02) Got it. This is a,
Rob Horrar (19:04) this is a Indiana issue… for us. Have you all done some research into Indiana fssa medicaid to make sure there’s no barriers to the portal access and things like that. Things are changing so rapidly in the state of Indiana. We’re getting another round here today or tomorrow of more changes to Aba. I’m just curious… because we’re talking about medicaid on this rbt process, right? It’s not, it’s not a commercial payer where you, could you’re probably accepting a lot of medicaid’s just have a whole different mindset. I’m… just curious, is there some level of comfort that you have that we could get this done through Indiana?
Philip Stefani (19:56) That we could do the rbt enrollments with Indiana medicaid? Yep. Yeah. So we definitely could do that and then kind of zooming out like we just as a standard at our organization, like we have a payer research team kind of dedicated to those changing requirements, and they’re influencing, you know, how these processes get built out in our product kind of specifically to what Noah was talking about, where it’s like we’re grabbing this information, for this provider type when they’re enrolled with this payer. So those are changing in the product as kind of the regulations change at, the state medicaid level, for instance.
Rob Horrar (20:32) Good. Okay. Yeah.
Garrison Goodman (20:33) And rob the same way you’re typically notified of those things. So are we, right? We subscribe to all the lists and everything. And so, you know, when you’re and oftentimes earlier too just because we have longstanding relationships, with a lot of these organizations. So we typically get, some heads up so that we can make any changes, if necessary.
Kyle Brinkworth (20:52) Good. Okay. Good, perfect.
Philip Stefani (20:56) So, yeah, it sounds like there are some outstanding action items just around the degree of automation when AI would be used versus when it would be people. We can definitely map those specific elements out for you. But in the meantime, don’t want to keep you guessing on how much something like this costs. So we want to walk through how we would price this out specifically for the rbts and then also have another way to think about this in terms of a proposal. But we’ll walk through the rbt specific piece first. And essentially what this shows is there’s a medallion platform subscription which is charged per rbt per year.
Philip Stefani (21:34) There’s a per payer enrollment application fee which is charged per application. Kyle, thanks to, the numbers that you had sent over. And then there’s an implementation fee which is the setup cost and kind of aligning on the rbt data in the platform. So this is what that looks like for the first year. We have five year and three year options. So we’re just looking at the five year for this proposal here. It is broken out line item by line item. I’ll pause here before we kind of walk through what we think about this.
Philip Stefani (22:17) The run.
Kyle Brinkworth (22:20) Me through again the quantity on the core versus the payer enrollments because I think for this specific purpose, we’ve got about a third of our rbts that are going to be under some sort of enrollment item. So it’d be closer to like a 1,000, but I want to make sure that I’m not missing something on that front.
Philip Stefani (22:36) Yeah, absolutely. So the rbt number that was, it sounded like you have 3,000 and you’re adding about five percent per year. And then, yeah, I think the email I had from you was just like 3,300 as the starting point for rbts adding five percent year over year. And then the enrollments that were listed were three states with credentialing requirements, 1,000 in Indiana, 300 in Florida and 50 in Oklahoma.
Kyle Brinkworth (23:10) Yeah. Okay. So that’s I think that’s my maybe disconnect. So in this example, we’re going to pay for an extra like round numbers for a moment, 2000 rbts that will likely never touch the platform to a certain extent. So I don’t know if that’s apples to a certain extent. Oh.
Philip Stefani (23:28) I see what you’re saying. So you would essentially only have in medallion the rbts that need. Yeah.
Kyle Brinkworth (23:34) Unless I’m off base there, which is a high possibility. But I don’t know that. I would say that probably over. If we look at where we’re at today versus in five years, that number will be everybody. But today, only that portion of folks are included in the, that… would have to actually go through this process. And.
Philip Stefani (23:55) It would essentially be this 1,350 number close to it. Okay? That’s actually really helpful? Yeah, the number I had was the 3,300 if it’s just the ones that are getting enrolled.
Kyle Brinkworth (24:04) Yeah. So.
Philip Stefani (24:07) This number would come down significantly… that actually is helpful in terms of how we were going to think about this. So this is what this looks like for one year and then kind of with five percent increase to the rbt volume, it grows to the tune of, you know, this much year over year. The enrollment volume stays the same. Obviously, this would change with the updated rbt volume that we’re just talking about. However, you know, we’re comparing this to the two ftes that you essentially have provisioned to this today. So, Kyle, as I mentioned to you on the phone like it’s not necessarily a break. Even the question is kind of like, do you want to go out and pay this extra cost to kind of solve this problem and not have to dedicate any fte resources to it? And it’s potentially even closer to the one 30 when we update for the actual rbt enrollment number. So potentially a break even here. And then if there is at any point an additional state that gets added where you’re needing to. Now, do you know a 1,000 more rbt enrollments? Then it potentially flips in the medallion favor for this rbt scenario, we just don’t know.
Kyle Brinkworth (25:11) Yeah. Can you flip back to the first view though? Because I just want to make sure so the enrollment though… because I think one of the things right? Is we have about 1,350 rbt’s that need to be enrolled, but they’ve got varying different pieces you’re just for overwhelming clarity, right? So whether it’s two enrollments, 10 enrollments, whatever it is it’s included in what I in that 1,350, and what would be the 128?
Philip Stefani (25:35) Yeah, I think you said Indiana 1,000 enrollments, but it’s like five payers that are rolling into that. Florida is 300 enrollments, but it’s four payers that are rolling into that, that’s accounted here?
Kyle Brinkworth (25:47) Sorry, we are on a totally disconnect here and that’s my bad. So it’s 1,000 rbt’s… in Indiana and there are five enrollments that, that’s the number. So the numbers that I gave were the rbt’s associated with it. So that’s totally on me here. I think I’ve screwed you up. So we have 3,300 rbt’s we have 1,350 today that are subject to. And then, so Indiana, which is a 1,000. We’ve got, we have to do five enrollments… what’s the other one, Florida is 300 of the rbts and we have to do four enrollments each. And then Oklahoma is 50 and there’s three enrollments each. So I think that probably changes this math fairly materially.
Philip Stefani (26:33) OK. So it’s closer to just glancing at it, maybe 7,500 enrollments give or take?
Kyle Brinkworth (26:41) Yes, correct. OK. Yes.
Philip Stefani (26:44) That would change this math significantly. We can go back and update that. With that in mind. I think it just goes back to the original perspective that we had on this which is like, you know, to do this just for the rbts, you know, it’s either a potentially a break even or, you know, a premium to go and do this with medallion. Where we think this gets way more interesting is if you were to potentially include all of your billing providers as well just for the enrollment piece. So to be clear, not touching anything to do with standing up verifiable cbo just where you’re doing direct enrollments for those providers. Once we’re at that volume of enrollments, we’re able to offer, you know, much more economy of scale for something like this. The cost goes down. And at that point, you’re able to, you know, redistribute the team that are doing these enrollments today. Whereas with the rbts, you wouldn’t actually, you know, they would just go back to doing bcba enrollments.
Kyle Brinkworth (27:55) Got it. Okay. So why don’t you sharpen the pencils then with the updated like data structure that I provided. And again, that’s my fault for lack of clarity on that one. So I think that would be helpful and then would love to just kind of see a refresh of what pieces could look like to ensure that we’re all on the same page? Yeah.
Philip Stefani (28:15) Happy to update those pieces. The one other question kind of on if we were to look at this expanded scope for the billing providers is like obviously when you’re looking at providers who are dropping claims, they’re you know, you’re open to if you can speed up this timeline. Obviously, there’s accelerated revenue associated with that. And if there are errors associated with credentialing, then there would be claims denials associated with that as well. Again, this is all in scope for the billing providers but not for the rbts.
Kyle Brinkworth (28:42) Yeah, I totally get it. And then this is a, this would be a subset of the non delegated credentialing, right? So that’s where we’d have to try and refine to say here is what here is what this would look like differently. Is that, is that a fair? So, if you go down to 13 for a second… this the hopebridge time versus medallion time in this scenario which would be 16 days, this would be only where we’re not delegated, correct? Because delegated, we could basically get them up and running on day one.
Philip Stefani (29:15) Yeah, exactly. Right. So for the delegated plan that you have like you’re going down to one day for getting par there, this would be for all the other payers, where you’re in that 90 to 120 day timeline, medallion’s cutting it down to an average of 74, potentially even less for a lot of the behavioral health plans. It’s like what are those additional billable days mean for the business? Got.
Kyle Brinkworth (29:34) It, the other thing just for clarity would be helpful to see, you know, typically size of team, right? Because again, I think this is there’s upside here, but I also want to confirm like I don’t typically like to go in and say, hey from a cost perspective today, just like no revenue upside. Where does that look like? Which I’m assuming you’ve done? Yeah, great. Yeah.
Philip Stefani (29:56) So the thinking here is in the top section that’s assuming you’ve got the team set up today, this doesn’t account for any potential growth to that team. It’s just keeping it flat. So about 715 K per year. And then what we think it would be with medallion year over year.
Philip Stefani (30:13) I think, you know, assuming this is interesting to you, we would want to, you know, work very specifically on what the recommendation for the go forward of the team would be. But for similar Aba organizations of your size, we’ve seen it move to a setup like this.
Kyle Brinkworth (30:33) It’s not overly surprising. Okay. Can you refresh this with again my updated like context around the data that was provided, and then send it over when you guys get a second?
Philip Stefani (30:46) Yeah, we can update that for the rbt piece. So then just outside of this, I guess in terms of like expanding the evaluation, like, I guess, is it interesting to also pursue this for the like, would it also make sense to, or would it make sense to pursue this for the entire billing providers?
Kyle Brinkworth (31:06) So, I think two things, right? Rob’s initial comment around like we’re going down the path of verifiable and we can’t change that. And maybe over a period of time, you know, again as that contract changes, recognize that you guys could take that on, right? So I think that’s like we’re pretty hard on that front. The question that I’m going to get and I’m just trying to like get ahead of right of like what the best path because there’s clearly there’s two there’s I can do. I can, you know, onboard better tech or we can offshore and think about, you know, what that looks like. My preference is tech, right? I do think there is risk around further offshore pieces because there has been legislation addressed in two of our other states. Both of them were not passed but I do just wonder if it’s going to be more pervasive. So it’s absolutely of interest for us but we need to ensure that we have the appropriate viewpoint into like where does verifiable start and end? And then where does medallion come in? I think some of the issues that we’ve had over the period of time is like, look, our credentialing team does a pretty good job. There are things that we screw up and honestly, it’s from an mpi structure for us of like, hey, we make it too complicated and then we don’t drive that forward. But basically, I think there’s an opportunity to frankly keep our top performers here to help manage the process differently and then also make it a little bit more hard to screw things up because that’s when you get into the big delays, like it’s again, this to me is if I could get 80 percent better at the 20 percent we screw up. That’s huge, right? Because it’s not like we don’t screw this up on a regular basis. But if we do screw it up, it tends to be costly, right? Because it’s you don’t find out about it for another 90 days, then you’re like man, I gotta restart this. So we know we need help on the rbt side like bar none, and we’re trying to evaluate what our best options are. I would frankly pay the same like to me. It’s almost not like a cost play. It’s like if I could guarantee that I’m going to do this better than I’m doing it today at the same level of, you know, cost. I would probably opt for a tech partner here. And then I do see, I think the benefit of the billing provider end to it, but I want to make sure we’re just not like throwing a bunch of stuff of new tech at the wall to say, well, we’re going to do this and then all we look up and say, wow, none of this works together very well. So a little bit long winded there, but that’s how kind of rob and I have had a conversation back and forth. So rob, anything you think I’m missing in that viewpoint? No.
Rob Horrar (33:29) That’s spot on that’s spot on. I mean, the problem, the most significant problem we have is this rbt issue. And I would say the company is more than happy to look at that, you know, a couple of years down the road if this is going really great and there’s a way to integrate with one company provider that’s an option. But today you solve this rbt issue, it’s definitely meaningful for us.
Garrison Goodman (33:55) Yep, rob, Kyle, that’s helpful. And, yeah, I just want to be clear our second option here. I just want to make sure we’re on the same page was not to replace verifiable, we hear you like, hey solve the rbt and you’re open to other things. We thought it was more interesting because we always look at this from a business case perspective first. But I hear you Kyle saying just like, hey solve the problem for me. I don’t 100 percent need to break even. I just need this solved.
Kyle Brinkworth (34:19) And so,
Garrison Goodman (34:20) I think we were, we just wanted to be clear like, hey, we’re not the second option is just for doing the enrollments or the other clinicians not doing credentialing. And the way in which you’re solving that today, I believe is still manually with people and there might not be as many errors or issues per SE but we could do it in a much more cost effective way. And so that’s what we wanted to make sure was clear and just what you were picking up as well. Okay. Yeah. Okay.
Kyle Brinkworth (34:50) No, again, I think it’s an interesting area and it’s frankly, it was one that is based on the volume of internal team was relatively untouched in terms of like a real focused tech review. And so it’s kind of like the last piece for us to really focus on. Okay. And frankly, as I mentioned earlier, like the team does a really good job like that’s. I’m actually very pleased with the team. And I think where I get a little bit of heartburn is it’s only going to get more complex and we could look up one day and be like wow our credential denials or our, you know, our time to get a network or whatever metric you want to look at here is goes from good to like really bad. And then we’re just all of a sudden look up and like we have a real problem here that we’d have to like walk back. So I think we’re probably worth it. We’re at the pivotal stage for us is that what we’re going to do this or something like this now is like a really good time to like really evaluate it and where we want to spend, you know, some time on, okay. Okay. So I think if you can update that just so we’re all kind of like looking at the same document. And I’m not sure if just based on the enrollment increase that does help get us further kind of like scale with providers or with cost, that would be helpful. And then I think rob and I will just spend some time with it and discuss across the organization to see if this is something that we frankly want to think about. It would be helpful if it wasn’t included in the presentation to get rough idea of like implementation timeline, required resources. On our end. Frankly we are, we have three if not four significant projects that are all going on right now across the organization that are taking up 120 percent of our it resources. So I’m trying to be like thoughtful around that. So if not even if we say, hey look, it’s not right this moment but like what time can we like thread that in it would just be helpful to know like from a resource allocation perspective, what that would look like? Yeah, maybe Noah if you could just spend a couple of minutes touching on that, what?
Noah Laack-Veeder (36:53) They could expect, yeah for sure. And I think that piece you just brought up is really important. Like if you have 10 projects coming in and they’re all going to be really resource intensive and take a while. Like the last thing you want to do is add another one in that’s where I’d say medallion is pretty unique. Our typical turnaround time for implementations is around eight weeks or less implementation. The biggest piece of it is just getting your, you know, your existing provider data into our system. So when you log in for the first time, it’s representative of it. However what I’ll say is like your time to value can be faster if look, you know, we’re waiting on the existing data but we get your, you know, your contract data in the system, we have all that kind of stuff. We can start submitting enrollments much faster than eight weeks ultimately from a resource perspective. As Phil’s alluded to, we just need someone to help us get the data that we need. And then that resource will be the one more or less pressing the button to say submit enrollments and field like just those items that come in that’s the only resource that we need in terms of implementation during the implementation, how much time they have to dedicate to us? On average, we see the biggest part being around that data collection piece. But if we can get ahead of that earlier, it can be much less. But in terms of hours, it’s looking around like five hours or less during that period of time to get the data. But early and late, it’s like one hour a week to check in with the team. And then the training, it’s pretty there’s not like a learning curve because it’s just to request enrollment. And a piece like that. So total commitment can be relatively light if you’re comparing it to other projects where you need to have multiple resources managing it. So again, comparing to other projects in your play, I think the implementation could be lighter but in terms of prioritization, is that like a piece of it where if the implementation is lighter, can it kind of become a higher priority and kind of jump into that framework? Or how are you thinking about that?
Kyle Brinkworth (38:55) Yeah. I think what all makes sense maybe slightly better than I had anticipated. I think frankly because of where this is at in terms of like maybe baseline level performance. And the other two or three projects that are at like that are being actively worked on, those are going to take priority for clarity because those are going to be massive opportunities for us, things that we like desperately need to do. And if we screw that up, then we’ll screw up a lot of other things that we won’t even be able to have this conversation. So, I think that’s where I think about it. The other thing would be helpful just to note because as we’re integrating with verifiable, I know you guys work with verifiable in that sense, like how does that potentially change the implementation? So we’re all kind of on the same page there as well. Yeah.
Noah Laack-Veeder (39:42) I mean, I think a lot of the data that you’re going to have to put into verifiable or you have already put into verifiable is going to be very similar to what medallion would need because they’re just using your same kind of structure to do a different service. So in that sense, I think it would only lead to efficiencies with the implementation. Okay? Got it.
Philip Stefani (40:02) Yeah. We can include just like high level info on what the process looks like. And then assuming we’re barking up the right tree here, we would set up a call and kind of, you know, specifically scope out what the process would entail.
Rob Horrar (40:15) I was going to ask that how much would you need from us in terms of, do you have like an initial integration data request? And like a chart that shows timeframes for each of that? I mean, I’m assuming that Salesforce will take a little bit of time to integrate, we’ll need to look at our systems and sandboxes and objects and things like that. I’m just wondering, do you have a baked in data request list on what you do when you kick this off?
Philip Stefani (40:48) Yeah, it’s going to depend on like where this information is coming from, if it’s coming from Salesforce, we’ll have no, keep me honest here. But like we’ll have the specific or we’ll map out specifically how we would get that from Salesforce. Usually we just, we have like an import template that can be kind of populated with what we need. So it kind of depends on like where this data lives today. I think.
Garrison Goodman (41:19) More specifically, it’s like, hey, you know, is it a data upload? Are you wanting a direct integration to verifiable? Are you wanting an integration to Salesforce? If it’s something direct to verifiable? It’s probably something that, you know, we or you would have to build if you want us to do it, we’d have to scope it out, right? That would, you know, which is easy for us to do just based upon hours to build that work. If it’s Salesforce, we obviously have some other integrations that exist there.
Kyle Brinkworth (41:46) What?
Garrison Goodman (41:47) Where are you thinking? Information? Yeah.
Rob Horrar (41:49) This would just be internal. I don’t see any integration with verifiable, they’re doing this, the cvo piece. So it would be Salesforce internally. All this would for rbts, it would be internal data. Yeah.
Noah Laack-Veeder (42:10) And yeah, just to, for the proposal that we’ve reviewed so far just to call it out that does not include an integration. So we’ll just have to walk through like there are some questions we can ask rob to talk about what that effort might be. But we have built a Salesforce integration before. It’s just a matter of which objects do we need to connect to? And then like what data needs to go back and forth. So it sounds like it kind of evaluating this. There’s an option of what Phil just talked about, updating the numbers based on what you said, Kyle, do you also want us to include an option with the integration?
Kyle Brinkworth (42:48) I think it would be helpful. Look, I think this is one where again just because we haven’t you guys haven’t asked the question yet, but it’s going to take some time for us to circulate this internally with all the other projects that are going on. So I think let’s go ahead and get kind of everything out in the open now as we start to have conversations, and then we can start to give you guys, you know, some thoughts around where a, if it’s a go, no go.
Kyle Brinkworth (43:15) But more importantly, like when we would be able to slot it in, you know, if we want to go down that route. So I think that’s what we need to probably just have some more conversations that frankly will just take time and from an agenda perspective. Yeah.
Garrison Goodman (43:28) And obviously to you two, who are the other, you know, stakeholders that could, you know, thumbs up or thumbs down this.
Kyle Brinkworth (43:37) It’s going to be a fairly collective group. Frankly, we have a brand new like entire leadership team. So there’s just a lot of kind of nuance there that didn’t exist previously because everyone gets up to speed, but we’re making collective decisions broadly as an officer group at this point in time. So frankly, like the two other or three other folks would really be like our CEO, our head of it. And then probably our chief strategy officer who’s going to play a role of some of these things going forward. So.
Garrison Goodman (44:05) Okay. And then when do you plan to bring this to everybody? And when do you know, everyone on this call need to be aligned ahead of that conversation? Yeah.
Kyle Brinkworth (44:14) It’s probably a couple weeks, I’m out next week and then we’ve got some board meeting planning the following week. So if we can try to have some conversations like the week of the thirteenth that probably would work internally and get kind of a pulse and we’ll circle back, it’s probably out of vision. I think the only other thing rob, I don’t know if you’ve mentioned but rob is officially retiring, so he’s going to be stepping back next week, well.
Noah Laack-Veeder (44:40) Congratulations, rob. That’s huge.
Garrison Goodman (44:43) Now, you get to go run.
Noah Laack-Veeder (44:44) Full time… I was.
Rob Horrar (44:48) telling Kyle earlier that my neighbor just retired last month and he’s got a gas leaf blower and he loves that damn thing. I just want to do anything but not that.
Kyle Brinkworth (44:58) I’m not going to be.
Rob Horrar (44:59) That.
Kyle Brinkworth (45:00) Guy. Yeah.
Noah Laack-Veeder (45:02) That’s hilarious… not to change the subject, but I do need to ask this question. Who can I work with on your team to scope out this integration more?
Kyle Brinkworth (45:13) If you can get the numbers back to me, that would be really, I would say helpful and I’m going to try to get like a, hey, is this something that we want to really think about or not before we then spend any other team’s time because I think we’ll just need to, again, what I don’t want to do is we’ve got again in team tons going on as we all do, but I just want to make sure that like, hey, I don’t want to waste my internal team’s time. Frankly, if this is like hard pass absolutely not, then I don’t want to waste your time or our time.
Noah Laack-Veeder (45:42) Yeah, 100 percent, just, very basic information I need is like, and I think I can just confirm this with you guys right now. Like integration from Salesforce would be ingesting any demographic information related to credentialing or sorry enrollment from Salesforce. Yeah, could include but not limited to documents and information and then post enrollment completion, sending any… material enrollment data back to Salesforce. So, things like effective dates, revalidation, dates. Is that like generally speaking, what that needs to include anything I’m missing?
Kyle Brinkworth (46:20) No, I think that’s fair. And.
Noah Laack-Veeder (46:21) would you say go ahead, rob it?
Rob Horrar (46:23) Strikes me that if we’re going to integrate with Salesforce, Kyle, I’m just thinking they might not need access to paylocity since that is going to populate the Salesforce. It might just be a simple Salesforce type of thing.
Noah Laack-Veeder (46:39) Yeah, yeah, absolutely. And it.
Kyle Brinkworth (46:42) Depends. I know there’s a lot of times like pre built demographics connectors in paylocity exactly. We can go. If that’s like an easy button for us, it lives there. It lives in Salesforce. We can do kind of all of the above.
Noah Laack-Veeder (46:53) Yeah. And the reason I was asking that is because like my head of integrations is going to ask me like, okay, like tell me more about what this needs to do. We’ve got some pre built Salesforce integrations before. And if I just say like, look, I think it’s going to be very similar to the ones that we’ve already done where it’s demographic data and enrollment data back, then it’s obviously going to be a much lower cost than if you’re like, hey, this is something that adalian’s never done before, right? So we have the integration you’re looking for with Salesforce. It’s pre built. So this is information that I can just tell them to make sure we include… in the proposal. Yeah. And,
Kyle Brinkworth (47:28) totally, if it needs to be a rough… structure with what we have that’s fine, we can just kind of flag it again. I think for us, it’s like, look, I recognize that there’s some level of implementation fees and structure and integration there. But the real underlying decision is not going to be based on that. It’s going to be based on what the outcome in the business case there is. So it just again is one of the things that if we’re going to tackle it or not.
Noah Laack-Veeder (47:55) Yeah, totally fair. Yeah. But thank you guys for confirming that. Yeah. Okay. All right. We’ll get to work and.
Kyle Brinkworth (48:02) we’ll get back to you soon.
Rob Horrar (48:03) Yeah, okay.
Noah Laack-Veeder (48:05) Thank you. Yeah, thanks so much.