Transcript
Philip Stefani (00:00) Karen, you keep going into the waiting room for my calls. It’s super weird.
Karen Mok (00:03) I think it’s because I’m not logged in.
Philip Stefani (00:06) Oh, could be… that’ll do it. It thinks you’re a customer?
Karen Mok (00:12) Yeah.
Philip Stefani (00:15) Did you get in late last night from napa?
Kenya Jones (00:17) Yes, I did it was.
Karen Mok (00:19) Late.
Philip Stefani (00:21) Was it the red eye or was it just late at night?
Karen Mok (00:23) Not the red eye. I’m too old for red eyes. I do not take those anymore.
Kenya Jones (00:28) Red.
Philip Stefani (00:28) Eyes are tough.
Noah Laack-Veeder (00:32) What’s up guys? Long time. No talk.
Hassan Zahir (00:34) Karen is a baby talking about. She’s too old for red.
Karen Mok (00:37) Eyes, I am too old. I stopped doing that when I turned 30. I was like, there’s no way. I’m taking a red eye again.
Noah Laack-Veeder (00:43) Look, I’ve never done one and I’m never going to that’s. Good. Not gonna do it.
Philip Stefani (00:49) They really ruin the next day. Like if you want to just torpedo your next day, take a red eye.
Karen Mok (00:56) And I was like, I got this eagle telemed call on Thursday. I cannot be taking a red eye.
Noah Laack-Veeder (01:02) Yeah. My baby woke up at four a M and I was like, sky don’t you know, that I have eagle telemed this morning. Can you go back to bed, honey? She didn’t get the memo. So.
Philip Stefani (01:14) All right. We got Kenya in the waiting room. I’m letting her in.
Philip Stefani (01:23) Hey, good morning Kenya.
Philip Stefani (01:28) You are on mute by the way? Let’s chat. Good.
Kenya Jones (01:34) Morning.
Philip Stefani (01:35) Hey, good to see you. How are you?
Kenya Jones (01:37) I’m good. How are you guys?
Philip Stefani (01:40) Doing well, excited to be chatting with you. You seem to.
Noah Laack-Veeder (01:45) Have a lot better weather than us in the midwest. It’s like thunderstorming and I see sunshine behind you.
Kenya Jones (01:50) Really, it is absolutely beautiful here today and if my boss is listening too beautiful for me to be in this office, yeah. And working, can?
Noah Laack-Veeder (02:01) You take this call outside, can we just try?
Philip Stefani (02:06) Nice. I.
Hassan Zahir (02:08) thought you got dressed up for us when we were there on site, but I see you’re just stylish every day. Huh?
Kenya Jones (02:13) Oh, thank you. Well, I lead by example because for my employees that work remote, they get a little lax sometimes and I’m actually doing a meeting today with them about professionalism so, lead by example, but thank you.
Philip Stefani (02:38) That’s important that’s what it’s all about. Absolutely, excellent. Well, cool. We can get started. I know we’ve got 45 minutes on the calendar. Does that still work for you?
Kenya Jones (02:49) Yes, I’m fine.
Philip Stefani (02:50) Perfect. So, yeah, in terms of the agenda for today, we got two new faces from the medallion side. So I want to do some quick intros. And then, yeah, for the conversation, I think we left the on site meeting. We kind of did surface level discovery and overview of the medallion privileging process. We really just want to go deeper on that today. I think from the medallion perspective, we’d love to understand specifically like how that process works for you. And then, yeah, just kind of share more information on how it could look with medallion and get your feedback on that. Then we can chat next steps from there. I know we still got reference calls in flight and a couple other pieces, but is there anything else you were hoping to cover today that I didn’t mention? I,
Kenya Jones (03:38) think for the most part, that is it, I would like to see the like the reports because you have a dashboard, right? Yep. Well, I would like to see your dashboard. That’s one of the things that, I don’t have right now. And which would really help as I’m trying to see the volume that is coming through every month without manipulating a excel spreadsheet basically.
Noah Laack-Veeder (04:07) And Kenya, I’m Noah, by the way, I’m a lead solution consultant, I report to Hassan, so kind of a tag team here. Okay? When I hear about the reporting piece that’s interesting, you said something about volume. So, what is like if you had that report, what would that help you be able to do so?
Kenya Jones (04:26) I’m always looking to see how many providers that we’re bringing through every month. My team consists of 24 employees. And when we talk about your company, and what you’re offering, I just want to see the volume that I currently have versus, over time. How is that increasing? Are we getting more volume in, or is it decreasing? I just want to see the peaks and valleys because like we’re currently in the process of building, we just got done with neuropods and that was a lot of volume coming through. It would have been great to see it at a glance, and, you know, is.
Hassan Zahir (05:08) It just like seeing it as a glance from those dashboards or are there like other people who would get benefit like out of getting that data to who maybe aren’t in medallion where like custom reports or like scheduled reports would benefit you as well?
Kenya Jones (05:21) I think both, I’m sure my leaders would like to look at it, but like today, I have a meeting with my leadership and I want to talk about metrics. I want to talk about at what point in time have we seen a shift? I’m literally having to manipulate that data. But if it’s available, you know, before I, when I was at piedmont healthcare, we were in a system called Symplr Symplr provided that, right? I literally would pull my dashboard up and I could see who was working on what. And I know that’s going to be a little different from you guys if you’re doing all the work but I would still like to see the number of files I’m bringing through every month, the number of facilities or physicians that got approval. I still want to see that.
Kenya Jones (06:16) And I want to see the lag over from. Okay. Let’s see we had… we received 20 new provider applications and we’re just going to be 30 days or less. We received them April first. Okay. So now it’s may first, how many of those from last month tripled over into the next month, you see? So I want to be able to look at that at a glance if that’s possible.
Noah Laack-Veeder (06:45) Yeah, 100 percent. So what I’m just so I’m tracking, it sounds like there’s kind of a couple things that we want to see. Ultimately, it’s coming down to volume of files getting through really related to the number of providers because you just want to see kind of what’s our provider count at any given time. And also what is your team or medallion kind of working with? When I hear that sometimes it’s like, I mean, I know this is like an integral operation, so it has to get done and it has to get done fast. A lot of times, what I hear is that the faster we can do that, it’s linked to patient access, right? We can get more people involved with more providers or we can get people or providers onboarded faster, like kind of when you’re having to report at these meetings, like, what is the capacity meaning for them? Like how are they taking that information and doing stuff with it? Oh.
Kenya Jones (07:33) Yes. So, great question. So every month we report out like, you know, your volume for my department because my work is very straightforward. Yeah. So I report out how many new providers I bought in that were onboarded, the reappointments that were done. And I’m looking at the turnaround time right now, we’re approximately at 45 days and I’m pushing for 30 days. Okay? And so while we’ve made great strides, we still want to see, well, is there where’s the lag? Yeah, because even though we may have 10 new facilities that went live, how many of those applications, how many of those providers that were assigned to that facility were board approved prior or on the day that implementation went live? That’s important because the lag is usually not the onboarding or the facility application, the lag usually comes from payer enrollment. So, while when I spoke with Phillip and Hassan, what I said… to them was, you know, there are things that are out of our control. Payer enrollment is one of them. And most facilities want the provider credentialed first at their facility before they will do payer enrollment. So we’re at the mercy of those facilities. So I’ve done a lot of research on what your company offers, like I was telling your team when they came to visit, but those are bottlenecks that are out of our control. And so it would be good to see. Okay, well, I want to see if it’s a trend. I know one hospital, they are definitely outliers, there’s no way around it. They are just, they are very, I call it very old school credentialing where even if a provider let’s… say, has been in practice, let’s say, has been in practice for at least 30 years. They’re going back 30 years from the time that they completed training. Yeah, to today, a lot of companies now are no longer doing that. We’re going back 10 years, but that facility, they don’t care.
Kenya Jones (10:11) They want cois, they want work history to match. If there are 300 affiliations, they want a verification for each one of them, whether they’re resigned or active, which is crazy to me. Yeah. But that’s the reality of it. So, those type of facilities I know are outliers. But when, and I came from piedmont healthcare, I was there 20 plus years and I know their process like the back of my hand.
Noah Laack-Veeder (10:44) Okay. They.
Kenya Jones (10:44) Usually do not want to or will not onboard a provider until the payer enrollment piece is complete. Yeah. Won’t start billing for them. I get it. They can, I get it, but that causes a delay with the provider. So I just want to see what are the trends at this hospital. We see that this happened six months in a row. Okay. That’s an outlier. But here we have another 15 hospitals. We were right on time. You know, we missed the window by maybe five days. So do we tweak that process? Is it a recruitment thing? Do I need to have more conversations with the operations team there or the clinic piece to see what can we do differently? Those are the things that I’m trying to… figure out. Does that make sense? I know that a.
Noah Laack-Veeder (11:38) 100 percent a little bit of background, this isn’t a brag or anything. But I, I’m like a six sigma black belt. So it’s all around KPIs and operations. And just like what you’re kind of making me think of is like you’ve got this control dashboard. Like I just want to see what’s going on that’s what?
Kenya Jones (11:53) I want to see.
Noah Laack-Veeder (11:53) Yes. So I can direct my attention to these areas where we need to improve things, acknowledging that there are going to be bottlenecks out of our control kind of redirecting kind of thinking about that. We’re going to have a little bit of a four to five day turnaround time today. What I was hoping to do is kind of give you a view into what we typically hear the process looking like. And I can share my screen and walk through that. But what we would love to understand is like in your opinion, what is preventing us from getting to 30 days in the process today? Because ultimately, what we want to align to is if they’re you know, using payr enrollment, for example, right? Like if it’s taking the team 20 days to do all the quality checks to get the enrollment application out, how can we automate that to make that go faster? So in your world, what we’re trying to understand today is what are those big opportunities for time savings? And just aligning to do we think medallion can help there. So that’s what our objective is today. So does that sound like a good use of time?
Kenya Jones (12:50) Absolutely. It does. Okay.
Noah Laack-Veeder (12:52) So let’s just let’s speak the same language then and in true spirit of process improvement. So let me share my screen.
Philip Stefani (13:01) And real quick, just while Noah brings that up, I want to introduce Karen mock as well for this discussion, who runs our privileging and joint commission product development. Karen, if you want to say, hi… perfect, yeah, we.
Noah Laack-Veeder (13:18) Just want to make sure like Karen’s here because we just want to make sure we’re bringing all our resources here to make sure you know, you feel comfortable that medallion is able to address that because I know that your team has spent a lot of time really trying to optimize this process. So, can you see eagle telemed process on your screen?
Kenya Jones (13:36) Yes. Okay.
Noah Laack-Veeder (13:37) Have you seen like a process map like this before?
Kenya Jones (13:40) I, have, we’ve actually done these as well?
Noah Laack-Veeder (13:43) Sorry. What was that? Kenya?
Kenya Jones (13:44) Yes, I have do.
Noah Laack-Veeder (13:46) You, do you have any of these for your team that you kind of have to explain the process? Or because why I’m asking is if you would like this as a lead behind? I’m happy to send this over to you after the call it.
Kenya Jones (13:58) Would be great to send this over. I did some very early when I first came here, but I don’t have anything recently. Okay? So, it’s about time to revise.
Noah Laack-Veeder (14:07) There we go. So this is again generally what we see the process being. And I think what we ultimately just want to figure out like what are the areas that are taking the most time here? And also are there things that we’re missing in this process that are critical? But when a provider is hired, you’re going to receive an onboarding request and that means that we need to get some provider data collected because we got to start doing primary source verifications and create this cred packet, right? So, what that typically looks like is that the providers on the hook to submit some of this provider data. And then the eagle cred team would be reviewing that, identifying if there’s any gaps. If there are, you might reach out to the provider, maybe via email, maybe through some tasking or excel spreadsheets. And once you have everything or you can kind of do in parallel, you’re running some primary source verifications. Once those are done, you’re going to generate the packet. And depending on if the facility allows the cred by proxy or not, there might be one or two processes happening. If there’s cred by proxy, then your own mdstaff can review and perform the credentialing, if not, you’ll have to complete the hospital app sent to the facility and the facility is responsible for awarding those privileges. So so far, am I kind of directionally accurate with what the process looks like today? Or am I pretty far off?
Kenya Jones (15:34) Somewhat. But so egle is we’re split up into several different areas. What you’re describing right now, if you could scroll back over to the beginning of the grid, what you’re describing right now is the facility side where facility credentialing where the provider has been vetted by egle, and they are completing an application now for the facility. So that’s the second piece of it that’s probably our biggest piece, then we have the internal piece at the very beginning where it’s a new provider, dr jones msa has been signed the contract and they are now completing an application to be affiliated and privileged with egle. So that’s a completely different process. But this is good for the facility side.
Noah Laack-Veeder (16:29) Yeah. So it sounds like if I’m hearing that correctly instead of this process happening in parallel like this would be happening before we get into the facility side like the credential actually.
Kenya Jones (16:43) It could be both because for a facility that does, so, you’re right on with credential by proxy, if the facility accepts credential by proxy, yes, it would send the information to the facility. And keep in mind, not all facilities truly are credential by proxy even though they say that it’s basically a full process. But then you have the no credential by proxy which is a full application sent to the facility. So, this part is right. The difference in the internal process is that we’re just vetting all of the information on these providers to make sure that they are egle approved. So, the providers in this, when it gets to this area, they’ve been vetted, they may have even been with egle for years now, and we’re just adding them to another facility.
Noah Laack-Veeder (17:34) Got it. Okay. That makes a ton of sense. Kind of. So, thinking about that 45 day turnaround time and thinking about the process that you outlined like, could you help me understand kind of the start and end of that? Like is the start when someone’s hired and then the end? Oh, yes. Okay. So.
Kenya Jones (17:56) The internal process, is the one that I’m talking about for the 45 days? Okay? So, it starts with recruitment, recruitment.
Kenya Jones (18:09) They’ve got a new provider. Once everything is in order, they send it over to our contracting team, contracting creates the msa, it’s signed. Then we get a letter from contracting, our email, excuse me saying that the… I, you know, the provider’s information, and then my team sends out the application within 48 hours, it’s mostly done within a couple of hours, but we put in 48 hour window. Once they receive the application back, and they do have 14 days to get the application back to us before we give them a, so we give a seven day warning. We give a 14 day and then we will work with them as long as they’re working with us. But after 30 days, if the documents have not been submitted, that application is archived. Okay? So, once the completed application is back, it is sent over to, it is assigned to a coordinator. The coordinator, processes the application. We take it to mec. If it passes mec, it goes to board for approval.
Noah Laack-Veeder (19:29) And you said, yeah, you said like, the acronym, you’re talking, the medical committee, mec?
Kenya Jones (19:35) Medical executive committee. Yep.
Noah Laack-Veeder (19:38) Yep. They, then they approve or deny, yes.
Kenya Jones (19:40) And they approve or deny. And then it goes to the credentials board.
Noah Laack-Veeder (19:49) And then cred board reviews as well.
Kenya Jones (19:51) Yes. So, we have two boards approvals here. Once that process is done and they are approved, usually within 24 hours, we’ve sent out an email to the organization saying… here are the board approvals for this month with an effective date, blah, blah, from there, that process again, is averaging about 45 days.
Noah Laack-Veeder (20:22) So, okay. So, then this, so if I’m.
Kenya Jones (20:25) this is internal credentialing?
Noah Laack-Veeder (20:26) Yep. This will… say like the process of collecting data to the email with the org summary is 45 days, yes. And then we go into the facility process, correct? Should we just go through that process?
Kenya Jones (20:49) Sure. And we.
Noah Laack-Veeder (20:50) can do like two like facility like by proxy. Okay? And then we can go not… by proxy, right? Let’s maybe do the easy one first, the not by proxy, so.
Kenya Jones (21:03) Before you, so let’s go back a little. So, after the email goes out to the organization, recruitment picks it back up and reaches out to the provider, introduces them to operations. Then what we call books them in quickbase, which is the system we use to assign providers. So, once they’re booked in quickbase, the facility credentialing manager, she assigns those files out. Now, there are a couple of factors or a couple of requirements. Is the provider pending a license? Does the provider have an active license? Can we move forward with that facility right now? Some of the facilities are out of cap. So, if they already have 10 providers, we need to either remove someone or that provider, can’t be added now? Granted? You would say, okay, why did operations book them? I’m still working on that? I don’t know.
Noah Laack-Veeder (22:05) Yeah. Okay. 1,000,000.
Kenya Jones (22:07) Dollar question. However, there are some things that we have to review. It’s. Not just us going in the system. Oh, this provider, has been booked at this facility. Let me assign it to a coordinator. Okay? If the provider needs a license, we send it, the licensing coordinator will assign it to someone on her team to get the license?
Noah Laack-Veeder (22:34) And like you mean, like if they need, if they don’t if they’re like a New York provider and they don’t have a,
Kenya Jones (22:39) Connecticut license, yes. And they don’t have a, because all the providers are not already licensed in the states.
Noah Laack-Veeder (22:45) Oh, interesting.
Kenya Jones (22:48) So, then, okay.
Noah Laack-Veeder (22:49) Go ahead, yeah.
Kenya Jones (22:50) So, so we are running several different things sometimes parallel, sometimes individual, but for the sake of a new provider, let’s just say dr jones, I want to work in Georgia and I’ll use piedmont because I was there so long, piedmont is Georgia based and I am a provider from New York. I’m licensed in five other states. I’m a neuro provider, but I don’t have a license in. Georgia takes about six months to license. So while we will go ahead, the licensing team will go ahead and assign that provider and get them licensed. We will hold off on applying at certain facilities because not all facilities will start the application process. They won’t even send us an application if the license is not in process or it’s a situation where the license is, I’m sorry, I got thrown off, the license is in process or the license is not active.
Noah Laack-Veeder (23:56) And.
Kenya Jones (23:57) piedmont is one of those facilities that since I was there, I’m calling in a favor. Hey, this application has been in process with the state for about three months. Can we start the process? Yes, because I know the process at piedmont and it’s going to take them anywhere from 60 to 90 days to process that out.
Noah Laack-Veeder (24:17) Got it. So, like every day longer for this license or for this internal credentialing is just going to delay us even further. And that’s why you’re trying to get from 45 days to 30?
Kenya Jones (24:30) And the thing of it, is, you know, for every facility we’re currently in over 40 states, I may have one provider going to 15 different facilities at any time. All the facilities have different checklists. So we’ve created very detailed checklists for every facility. So we know what they need. We know what the applications look like. We know that if we can start an application, we even have it written out to the point where I’ll… pull up one to see if I can show, we even have it written out to the point that we’re saying… can we start this facility prior to the contract?
Noah Laack-Veeder (25:20) Because.
Kenya Jones (25:21) sometimes the contract piece and the negotiation piece can take two to three months.
Noah Laack-Veeder (25:28) Yeah. And while you’re pulling that up, so like thinking about this process so far like that 45 days in the beginning?
Noah Laack-Veeder (25:44) Where’s the lowest hanging fruit in your mind? Like which step here is like taking way longer than you think it should.
Kenya Jones (25:54) So it varies and I’m sure Karen can relate to this part when you’re looking at malpractice carriers that’s a third party verification, that are we’re really at the… we’re really depending on the facilities to respond. And then sometimes once you run those verifications, even with work history, once you run those verifications, you’re like, well, wait a minute. He didn’t give me this one or you run, you look at caqh and here are all these hospital affiliations, but we all know that caqh is not always accurate and the doctor’s like I’m not there. I didn’t go there. So or we complete an application, the facility process and the facility starts to process the application and they say, well, hey, we’re missing all these. This wasn’t noted on the application. So I think for the 45 day, as far as internally goes, the biggest thing is getting all the data up front and then vetting it the references. They’re not really a problem, right? In most cases, I see the biggest bottlenecks with malpractice work history and affiliations. I have one provider that literally had over 150 hospital verifications and the majority of them were sealed active.
Noah Laack-Veeder (27:40) Got it. 150 and you had to verify all of them, yes.
Kenya Jones (27:45) Yes. And that’s something else that I am and the only reason because I know you may say, well, why are you verifying those? How much value do they offer? Did the provider really work there? Why didn’t you just use the data bank to see if there were any red flags? Great questions. Because I know that’s what you guys are thinking. I’ll tell you why our facilities are need a month and date format of all of these affiliations. So, how do we know where they are or if it’s even accurate if we’re not pulling this data? Yeah. So I’m utilizing like MD query that’ll grab the majority nams, pass that’ll grab a lot of them as well. But, and then we go by what the provider has put on the application. But sometimes when the application gets over to the facility side and I have a Carl health, I don’t know what system they’re using. They may pull 50 more affiliations and we’re like, whoa, how did we miss these here’s another locums company that we missed verify. And here are all these hospitals that were attached to it?
Noah Laack-Veeder (29:01) Whether.
Kenya Jones (29:02) the provider ever stepped into that facility or not. So given let’s.
Noah Laack-Veeder (29:09) say someone’s got 100 verifications and a lot of these things aren’t going to be done automatically. These are things that are folks having to pick up the phone, right? Pick.
Kenya Jones (29:22) Up the phone. Sometimes we can go back and find them online, but usually it’s picking up the phone, got it. And.
Noah Laack-Veeder (29:31) I mean, so again… the volumes you’re talking about. So like if you’ve got, is it like 40 providers a month, you were saying? Or like how many providers a month is kind of like the.
Kenya Jones (29:42) average. So for initials, we’re talking about 15 to 20. I usually have anywhere from my goal was to have 15 initial applications come through a month. Right now. We’re averaging anywhere from, I think it’s I… would say maybe 1,215, but then reappointments, it’s about 30. Yep. And my numbers may be a little off sorry.
Noah Laack-Veeder (30:11) I mean, and this, and because I’m just trying, to, because, this reminds me a lot because I have these conversations for organizations like yours related to the verifications. And then for payer enrollment, it’s a very similar concept with payer follow up. This is a big list of.
Kenya Jones (30:29) Work that someone needs to do. The great thing, is that with payer enrollment, we don’t enroll with the payers. Yes. So that part of it, we don’t have those stressors, however we do have two people that assist with payer enrollment. So some of their roles is trying to get surrogacy, assisting the facilities with the paperwork, just making sure that you have a contact there’s. Not as much of a struggle there. I don’t believe as much as getting to the 30 days with the internal team. And then, and, we’ve cut the time tremendously even with, the facility side as well because it was, at one time it was taking them about… it was crazy. It was taking them away from six months to get a provider on board which was crazy. That is long gone. We’re we’re averaging maybe 90 days max. Okay. I mean, that’s a.
Noah Laack-Veeder (31:33) Huge improvement.
Kenya Jones (31:35) Absolutely. But I still know, I still feel that we can do more with the right system.
Noah Laack-Veeder (31:41) Exactly. And, and what I meant is it’s I’d say there’s an analogy or like it’s very parallel where if you’ve got 15 apps coming in and they have 50 to 100 verifications. And what would you say like percentage wise, are 50 percent of them automated and 50 percent like having to manually pick up the phone? Like how… what’s the split?
Kenya Jones (32:08) For which part, like the,
Noah Laack-Veeder (32:09) hospital affiliation verifications?
Kenya Jones (32:13) So, for the hospital side, so keep in mind for the hospital side, Noah, we’re completing the application. Yeah. So a lot of times we’re not having to run verifications. Now, the facility side may have to run verification to make sure we have the correct data. Yeah. Let’s say it’s a provider that hasn’t worked or hasn’t been credentialed newly credentialed at a facility in the last year. So we got to go back and we got to check their references, their licenses to make sure that this information is accurate before we put it on this application. Yeah. So what we don’t want to happen is the application is kicked back, yes, as incomplete or the provider failed to notify them of a claim, and that’s room for denial. Yeah.
Noah Laack-Veeder (33:09) Yeah. So what I’m hearing is… we’re doing these checks up front to prevent rejections downstream. Yes. And sometimes the only thing we can do is either use these different tools you said to kind of come up with these dates. And to… I don’t know why I can’t talk today, get rid of that gap. I was telling them earlier. I was seventh month old and today, she knew I was meeting with eagle telemed. So she was like, let’s get up at four a M. So that’s that was my morning.
Kenya Jones (33:47) She’s my kind of girl. I’m always up by five. She’s an.
Noah Laack-Veeder (33:51) Early riser, she’s you know, and I love it. But then there’s instances where the bottleneck seems to be like man, we’ve got a lot of manual work we have to do, we have to either contact these institutions. We have to call them. We have to look at their portal, but that’s like, and if you have 50 of these each per provider, like that can really add up. So that seems like there’s a, that’s an area where that, it kind of like the, there might be capacity constraints. Is that what you’re seeing? Yes?
Kenya Jones (34:23) Yes.
Noah Laack-Veeder (34:25) And so, yep, okay. And so if I’m thinking about the bottlenecks here, so I just want to make sure I’ve got all of these captured. So malpractice verification… the work history verification, double checking that caqh is accurate. Anything else I’m missing here that you think are prime areas for improvement?
Kenya Jones (34:55) Those are the most as far as internally, I will tell you from a facility standpoint since our providers are at so many facilities. And Karen, I’m sure you’ve seen these struggles as well. As far as references go, they give you three references, maybe five sometimes. And those references are worn out. If I’m sending Karen, you know, 10 people to I’m being credentialed at 15 facilities. And the same three references have been contacted over and over again, it becomes a struggle to get a response. And so sometimes we have the lag there. So one of the things that I’m currently doing is I’m having four providers, let’s say that have been credentialed at multiple facilities. We’re now trying to see if there’s anyone internally, any of our egle, providers that can complete a reference for them versus some of their peers that they’ve worked with in the past. Now, granted, some facilities will accept that others will not because they say it’s a conflict of interest.
Kenya Jones (36:17) And then maybe this is very rare, but I’m seeing it more, some of our facilities are now asking for a leadership… reference such as a department chair or CMO at a facility. Well, these are telemedicine providers. They never step in a facility. I don’t know who came up with that idea but how likely are you to get a true reference that really knows them? So we end up making multiple calls, sending emails, seeing if the provider has spoken with someone, if they won’t, take our leaders here.
Philip Stefani (37:02) And for those reference pieces, I guess, how have you been solving around that lately?
Noah Laack-Veeder (37:10) I’m.
Kenya Jones (37:10) begging and smiling a whole lot, Phillip, and sometimes it works. So by the time it comes to me, my team will exhaust all options. So when it comes to me, I know that they’re over it, they’ve tried. And usually I’ll call the provider first, the applicant and say, hey, here we are. And this is what’s missing from your application. Can you think of anyone? And then I go into detail and explain to them your reference needs to be a chair at a hospital. Tell me someone you’ve worked with in the past two years. Are you still active at that facility? Can you think of anyone or how about this? You give me their names of the leaders there. And if you don’t have the name of the leader, where are you doing the majority of your work even if it’s outside of eagle? Because all the facility is really looking for is clinical competency, right? So, tell me what’s your primary hospital? If he says piedmont healthcare. My next step is to say, hey, medical staff office, who’s your chair of neurology at piedmont. I need to see if I can send them a reference form. Sometimes I’m successful and honestly, in most cases, I am, but there are times I’m not, and if I can’t get additional references and the facility won’t waive that requirement. So that would be my next step is to say, hey, our provider is strictly telemedicine. They don’t speak directly with the chair at that facility. Can we waive this requirement and give you a reference from either some say yes, some say no, if they say no, and I have exhausted my options. Then my next step is possibly to go back to operations and say, hey, I can’t get this provider credential because of X y and Z. And before I do that, Phillip, I’m pulling out all stops like, hey, this provider’s been practicing for over 30 years. All of the references are great, clean database, no malpractice, no red flags… but that doesn’t always work. References can be a problem with our providers because of the volume, yeah.
Philip Stefani (39:37) That’s super helpful. Okay. So just kind of summarizing what we’ve talked about because I know we’ve just got a couple minutes left. It sounds like overall, Kenny, what I’m hearing like your team is pretty effective with the process for handling these references even though it’s like cumbersome and it’s a burdensome process like you have that pretty dialed in for what you need to do there. It sounds like on the bottleneck pieces like, you know, around malpractice verifications, caqh, being inaccurate, work history verifications. I think just based off of this list, I think that’s maybe the opportunity area for where we might be able to offer some automation and take that off your plate. I guess from your perspective, like what are the things that, you know, if you could focus on more? Like what would you want taken off your team’s plate?
Kenya Jones (40:29) Oh, hands down, work history and playing history.
Philip Stefani (40:36) Work history. And what was the second one? Claims history?
Kenya Jones (40:39) Malpractice claims, history, malpractice verifications. Those would be primary two.
Noah Laack-Veeder (40:47) Yeah. And if you were able to take those off your plate, like what would that for your team’s plate, what would that lead to?
Philip Stefani (40:56) What, what?
Kenya Jones (40:57) Would that say that again?
Noah Laack-Veeder (40:59) So one, it would make the timeline go, you know, shorter, but are there other things that you think your team like? Could your team double down on getting these references done earlier? Like if we were to automate those, oh, yeah, they.
Kenya Jones (41:11) Could they could focus on some other items? But… when I think of the two biggest bottlenecks these two because you’re having to match those cois to the work history.
Noah Laack-Veeder (41:28) Yeah, you.
Kenya Jones (41:29) Need a Coi and a claims history and you need a work history verification and you’re depending on third parties, those are not clickable mouse. Most affiliations are clickable mouse, you know? So… I think those are, the main two that I see if I just had to pick two. Now, if you want me to give you more, I.
Noah Laack-Veeder (41:54) Mean, hey, we’ll start with two.
Philip Stefani (41:56) Yeah, I mean, if you have a list, we’ll.
Kenya Jones (41:57) start with the two. Yeah.
Noah Laack-Veeder (42:00) We do want your wishlist. It’s not December but we still would like a wishlist, you know, it’s I guess almost July. But yeah, I mean, that’s what we’re here. I think one, thank you so much for giving us more insights into your process. I can definitely send this over to you. So you’ve got it. But I think as a next step, we’ll definitely, you know, if it’s we have to kind of ultimately if these are the things that you think we could, if we automated or made them faster, could lead to the most significant drop in that turnaround time. I think that’s where it’s up to us now to show you or talk through how that’s going to happen. So, I think as a next step, we can get together internally and just make sure we’re all aligned and where we think we can help. And then in terms of a next step, Phil, Karen, Hassan, what do you think would be the best use of time and Kenya also, do you all just be interested in what we think would be the best next step? Yeah.
Philip Stefani (42:55) So, I mean, I feel like we’re just scratching the surface here which is great for going in deeper on these pieces. Yeah, I think what we would want to do understanding like Kenya where you think the low hanging fruit is, it sounds like those pieces that we listed out. Yeah, we just want to identify and show you essentially how exactly we would do those pieces. And I think, you know, because part of this is what your team is doing today. The way I would envision the next session going is kind of like understanding what’s okay. This is what the process looks like. When the eagle team does it, we want to be able to say, this is what the process looks like. When medallion does it. Like this is what you would still be responsible for. This is what medallion would be taking over and that’s kind of like the deliverable that we would want to share with you sounds.
Kenya Jones (43:39) Good. I am looking forward to hearing more. Okay?
Philip Stefani (43:42) Perfect. So, yeah, I think we have to sync internally to kind of think about how we would put that together. And then kind of in parallel, I think we’ll also want to set up those reference calls that you had asked about. Okay?
Kenya Jones (43:56) I’m.
Philip Stefani (43:56) trying to think if there’s anything else we’re kind of like working through the Roi pieces. I guess it sounds like a lot of this will just be like the timeline savings and understanding what that means for the organization. I guess we’ve talked about it a little bit here. I guess if you can, if we’re able to shorten down to 30 days, like do you have a sense of like what that means for the business?
Kenya Jones (44:21) Quicker onboarding, quicker onboarding, which means quicker revenue for the providers. Again, I… will tell you from my standpoint, Phillip, and I think Lisa may have shared this with you as well. In accounting. I’ll be honest with you. I don’t see the internal piece even though I want to get down to 30 days. I don’t see the internal piece being the barrier I see from a facility standpoint. The barrier in most cases is that payer enrollment or those facilities that will just not start without that payer enrollment piece. What I’ve seen so far from your company, seems to be wonderful and great. But I struggle with knowing how can you do that? How can you get those facilities to move forward when, if they can’t bill… for the provider? And that’s the payer enrollment piece and they won’t start until the provider is credentialed, then how do we get around that?
Philip Stefani (45:40) Yeah. It sounds like so a lot of where this is getting stuck then is still with the facilities. I guess. Do you think if you had kind of the increased visibility that we were talking about at the beginning of the call through that reporting, would that allow you to like push the facilities on specific providers more?
Kenya Jones (45:58) Absolutely. Yes, it would. Yeah, if I had visibility to see, hey, I have and I don’t know how, you know, your system works yet. So I’m eager to see that. But if I had a dashboard where I could see and this may be the perfect world, I can say and they have it in quickbase, but it’s still not at a dashboard glance where I could see, I have 15 providers currently at piedmont, but I have another five pending without… going into directly into the system running the report. And then filtering.
Philip Stefani (46:43) So you could just see like at a glance like where the providers are held up that’s.
Kenya Jones (46:48) one of the things, so with caqh, I could actually see who had, what application… I want to say. It even showed me how many days the application had been in process. I can’t recall specifically. But even at the top of the dashboard, it would tell me 500 applications… pending or… 1,250 providers active at piedmont Fayette hospital because, you know, they have like 18, 20 facilities. So I could see at a glance how many providers I had at each facility. Whereas now every time I want to see the number of providers that, I have to go into modio, it’ll show me the number at the bottom of active providers. But then if I run the report, some of those are pending, some of those are not active egle providers. And the number is usually very low because it’s just what I have internally. But what about a facility report? It’s it’s I have to run it manually and then it comes into an excel spreadsheet. Then I have to filter through it.
Philip Stefani (48:05) Got it. So you just have to spend a ton of time like hunting for that information essentially when you want it.
Kenya Jones (48:11) Yes, yes, that.
Philip Stefani (48:13) Is really helpful context. So, I know we’re over time here. I think, yeah, for a next step, the medallion team, we’re going to sync internally and kind of solution around this. It sounds like the biggest pieces are automating the verifications that we’re able to automate. And then in parallel just giving you greater visibility with the reporting, those would be the two biggest things that we want to show you. And then kind of the deliverable would be, this is what your team is still doing. This is what medallion’s taking over. This is the timeline savings associated with that.
Kenya Jones (48:41) Sounds good. Okay?
Philip Stefani (48:43) Perfect. Well, we’ll be in touch with next steps in the email thread. If any questions come up, happy to be a resource. Is there anything else that you wanted to cover?
Kenya Jones (48:53) No, thank you guys so much for your patience and explaining everything. I love these conversations. So I truly have a passion for figuring it out. So, thank you guys for your input today, and I look forward to our next call.
Philip Stefani (49:07) Perfect us as well. Thank you.
Noah Laack-Veeder (49:09) Likewise. Thanks Kenny.
Kenya Jones (49:11) Have a good day.
Philip Stefani (49:11) Bye, cheers.