Transcript
Lewis Elder (00:00) hey, Sam.
Samantha Bouchard (00:04) Hey, Louis. How’s it going? Oh,
Lewis Elder (00:06) it’s going. I just scarfed down some lunch. How about you?
Samantha Bouchard (00:10) We’re doing the same thing. I’ll be on camera in like two seconds. Good. All right?
Lewis Elder (00:16) I see them in the waiting room. I’ll add them in a second, and then Nicole will be joining us as well.
Samantha Bouchard (00:26) Awesome. Did you end up meeting with them this week? Louis, for the scoping thing? I.
Lewis Elder (00:33) did. Yeah. And we got essentially that’s kind of what preempted this conversation? We got kind of a sense of budget and that’s why Nicole and I just want to kind of clarify before we spend additional time. All right. Yeah. All right. I’m going to go ahead and add them in.
Lewis Elder (00:55) Hey, Tasha and Taylor.
Tasha Cutaia (01:08) Sorry, I forgot to unmute. How are y’all,
Lewis Elder (01:10) no, no worries. I’m doing all right. How are y’all, good.
Tasha Cutaia (01:13) I’m forwarding this on because I’m not sure that everyone got the meeting. Amanda’s trying to jump on. Now. Let me see if chetna has it.
Lewis Elder (01:24) Okay. Chetna is on the invite and accepted. So, okay, that’s all I can see though on my end.
Tasha Cutaia (01:30) I’ll forward her the meeting just in case.
Lewis Elder (01:34) All right.
Lewis Elder (01:42) Yeah. Take your time. We’re actually waiting for one other colleague on my end to hop on. So we have a minute… okay?
Lewis Elder (01:56) Hit a call.
Lewis Elder (02:01) We’re just waiting for maybe one or two other folks from the oak orchard side. Amazing.
Nicole Campbell (02:06) I think my voice just cracked going through puberty. Again. Sorry, everyone.
Lewis Elder (02:11) Congratulations.
Tasha Cutaia (02:12) your puppy’s adorable?
Nicole Campbell (02:14) Oh my gosh. Yes. I was going to say, usually, I save it for intros, but this is lulu. I swear she’s very present and a very valuable team member of ours. She’s so bored of me. She’s.
Tasha Cutaia (02:29) like mom really another meeting?
Nicole Campbell (02:32) It’s been her whole life. She was like a covid foster fail of hers. So, her first every like when I first got her, I would keep her close because I was just watching her and so she’s been sitting in the back of my zoom meetings for now six years. So, she just knows like in the morning, I’ll be like, okay, go to work and she like runs into my office and gets on the chair.
Samantha Bouchard (02:54) Aww. Yeah, your voice is probably like her sound machine.
Nicole Campbell (02:58) Oh, yeah. She’s always sleeping… droning on about technology. She’s like my nap time.
Lewis Elder (03:09) And Tasha, you guys will have to let us know. Are we expecting chetna to join? I know she accepted the invite I,
Tasha Cutaia (03:15) just asked Amanda and she said chetna’s jumping on so, and it looks like Amanda’s on now, all right?
Lewis Elder (03:22) We’ll give her a moment and then we’ll I have, you know, Nicole’s news. So then we’ll do quick introductions and get started. Is it hot up by you guys? It is pretty warm here in Pittsburgh today. No. Okay. It’s.
Tasha Cutaia (03:35) 35.
Lewis Elder (03:36) 35. Well, that’s it’s.
Tasha Cutaia (03:38) rained the last three days.
Lewis Elder (03:40) Okay. Wow. I don’t know why, you know, Pittsburgh is kind of in the middle more in the middle of the country than, you know, not as far east as y’all, but I expect it to be warmer, not 35 yeesh.
Tasha Cutaia (03:51) Yeah, no, no, hey, chetna.
Chetna Chandrakala (03:54) Oh, I’m so sorry. I was waiting to join. And then suddenly I don’t know when two o’clock happened.
Lewis Elder (04:00) So, no, no, not a problem at all. I’ve been there myself. Well, I think that’s everybody we can, I’ll do kind of quick introductions. I think we have a couple of new people, one, at least one new person from oak orchard.
Lewis Elder (04:11) I have one new person from the medallion side. So I’ll reintroduce myself and we’ll do a round on the medallion side. And then I’ll let the oak orchard folks do quick intros. But yeah, if you haven’t met me yet, my name is Louis elder. I work on essentially the account and customer team here at medallion.
Lewis Elder (04:26) I have Sam and Nicole on with me, Sam. I’ll let you introduce yourself and then Nicole, you can round us out.
Samantha Bouchard (04:31) Yeah. Hi, everybody. Nice to see you again. Sam Bouchard. I am louis’ product and technical counterpart. So really answer any questions about the platform and just really make sure that, you know, we’re setting you up for success for a long term partnership. So, nice to see everybody again and Nicole, I’ll pass it to you, yes.
Nicole Campbell (04:52) Thank you, Sam. Thanks Louis. My name is Nicole. I am louis’ manager here at medallion. I run our enterprise sales division and I’m based outside of Portland, Oregon. So it’s not as cold as it is for some of you, but it’s still, we’re dealing with the rain in the springtime over here. But I’m really excited to help support this evaluation and conversation. And then I know Tasha and Taylor, you already got the introduction, but for chetna, this thing in my background that’s lulu, she’s, very excited to help you as well.
Chetna Chandrakala (05:24) Oh, that’s right. Hi, lulu.
Nicole Campbell (05:27) Most important person. But yeah, Louis, I’ll pass it back to you. Awesome.
Lewis Elder (05:32) Yeah, that’s it from our side. I think just since Nicole’s new to the conversation, if you guys want to do a quick round of intro of role and everything, that would be great. Maybe we can start with Tasha’s. The first on my screen, let’s start there and work our way around.
Tasha Cutaia (05:47) Sure. I’m Tasha, I’m the HR director for oak orchard.
Nicole Campbell (05:51) And I’m Taylor, I am our senior HR generalist here.
Lewis Elder (05:58) Amy, I believe it’s Amy, I just see a Carter.
Acarter (06:02) Amanda, sorry, that’s okay. I am the revenue cycle manager and I am doing all of the credentialing for the payer enrollments right now.
Chetna Chandrakala (06:13) Hi, everyone. I’m chetna, chandrakala, I’m the CFO here at oak orchard with responsibilities for revenue cycle functions.
Nicole Campbell (06:21) Credentialing.
Chetna Chandrakala (06:23) And overall finance perfect.
Lewis Elder (06:25) Awesome. Thanks y’all for joining. I know we chatted on Tuesday and just talked a little bit more around where things are at the idea of budget other vendors you guys are evaluating before we get started. I just want to check in. Anything new. There has there been any additional thought put in any of those pieces or anything there to raise any new revelations?
Chetna Chandrakala (06:49) I don’t think there’s anything here.
Nicole Campbell (06:54) Nope. I got nothing new right now, sure.
Lewis Elder (06:58) Okay. Got it. All right. And then, so goal for today, Nicole, maybe I’ll let you get us kicked off there. And then, yeah, we can go from there.
Nicole Campbell (07:08) Absolutely part of me supporting this conversation, I want to come on and we’re really excited to show the demo to the team today with Sam, but also after the pricing conversation, I just wanted to like set some leveled expectations and make sure we’re being fully transparent inside of our process. Louis shared with me the other providers that you’re looking at and kind of the range in terms of what you need to get approved for internally. So wanted to just set the expectation that we will not probably be your cheapest solution in the market. We do have a minimum spend for partnerships with other teams.
Nicole Campbell (07:45) So I want to make sure that’s not like outlandish in terms of what you’re able to potentially invest in a solution. And then also make sure that we’re showing the value today of why we price where we’re priced at and have that conversation further. But just for you, chetna and the rest of the team, just so as you’re going through this demo, you have this in mind over a three year contract with us. We need the average spend to be around 50 K. So that can be over the course of three years, happy to have further conversations, chetna. But just wanted to make sure there wasn’t any surprises as we continue this evaluation in terms of minimum partnerships.
Chetna Chandrakala (08:25) Okay. So, are you saying that 50,000 per year is the minimum? So?
Nicole Campbell (08:29) It has to be an average of it. So we could do a smaller amount in year one. Let’s say the team and the organization is growing a little bit in year two and three, as long as the average spend over the course of three years averages out to 50 K. That is the minimum. So.
Chetna Chandrakala (08:45) 50,000 across three years, correct?
Nicole Campbell (08:47) Like average amount? Yeah. So if it was like 25 K in year one, but then you were spending more in year two and year three, we could, we are able to make that partnership work for us. Yeah. Okay. So, yeah, happy to have more detailed conversations too after you see the scope of the work with the demo, but chetna just wanted to make sure that was transparent for you. Yeah.
Lewis Elder (09:13) And, I just wanted to bring Nicola just, I obviously we talked about budget. I know you guys are in fqhc, so I didn’t you know, I don’t want to continue to, you know, drag you guys on meetings. If, you know, the cost of medallion is just totally unfeasible or something or way out of range.
Lewis Elder (09:25) So just wanted to keep you in the loop and like we can hammer, you know, dial in, the price exactly, but a high level, I wanted to make sure that it at least is within the realm of like worth it to continue, you know, exploring.
Nicole Campbell (09:39) Yeah… chetna or team, any questions for me on that information, or we can then proceed forward?
Chetna Chandrakala (09:48) Yeah, I think, I definitely, I mean, I don’t know how to react to that right now but without seeing the product. So if the product says that, you know, after seeing the credentialing portion of this that I’m getting a value of twice as much, perfect. If I’m not getting the value of twice as much, then of course, it’s not worth it. So that’s.
Lewis Elder (10:08) so,
Chetna Chandrakala (10:09) let’s go through the demo and then we can react to it. Yeah.
Nicole Campbell (10:12) Okay, great. And that is why I wanted to set that. I didn’t want to be like surprise here’s. What’s coming rather, set the expectation up front for you. And then excited to hear your feedback after the demo.
Chetna Chandrakala (10:24) Cool.
Lewis Elder (10:26) Awesome. That’s it from Nicole and I, Sam, I will kind of kick things over to you. I also will open it up. We’re going to go through like a enrollment workflow. Anything, any lingering or like odds and ends questions that maybe have come up? Or, you know, does that have to be finance related, more product functionality related that you guys want to shout out before we get going, it’s okay, if not, but figured I’d open the floor in case.
Acarter (10:50) I do have a question. Can’t remember if this was addressed or not before, but like some of the pairs you have to have a roster for, right? So, is that something that you guys would do like humana, I believe is one of them? Like would you guys manage that roster? So when we have a new provider coming on, you would just, you know, take off said.
Nicole Campbell (11:11) Provider?
Acarter (11:13) And then add on a new provider to submit that to humana? Like would you guys manage those? Amanda?
Samantha Bouchard (11:21) Yes, we would manage and follow like if you have a special process set up for the payer, we can mimic that, but otherwise we would follow the standard process through that payer. So if humana is like a roster based submission, we would accommodate that as well. Okay. Yeah. And I’ll definitely show that today. So Louis, I’m happy to kind of take over. And what I want to make sure we just kind of start with is just kind of level setting. It’s been a little over a week since our last discussion. So a couple of the things you know, last week, we walked through onboarding, we looked at, we learned a lot about your current process and some of the challenges you all are facing… you’re taking somewhere between 15 to 20 payor applications per provider. It can be one to two weeks to submit the applications, 90 to 120 days to get those providers billable. And there’s you know, some challenges kind of scattered in there as it’s going from team to team. So I’m going to share my screen and did you all want to revisit anything from the provider onboarding piece that we looked at last time or just kind of go forward into the payor enrollment component? I’m okay with going forward in the payor portion. Okay. Great. So at this point in the process you have sent out a link to your provider, their caqh profile has been connected. We’ve imported up to 70 percent of the data with that integration that we have really streamlining the overall data collection process to on average two days. So really drastically reducing the time it’s taking to ingest data from providers, giving a better experience to not only you as the administrator but also to the provider as well. So all that’s been done. And as we looked at the credentialing piece, so you all then have the step in the process where you’re creating a credential file to the hrsa standard. So we looked at that last time as well. Anything you wanted me to revisit there or just, I know Tasha or Taylor, one of you just said payer enrollment, but just kind of want to make sure everybody’s kind of set on what we had already looked at. All right. You’re good. Okay, perfect. Great. So we’ve generated that credential file to hrsa standards through our direct API connections generating that file in an average of three days. And then the next step would really be to generate those payer enrollment requests. So what I want to highlight here is this is the visibility that we’re giving. You into every single request that comes through the system. But what I want to make clear is what you all will do and where medallion comes in to execute. So as an administrator, we really look to you all to own the strategy, right? You know, your providers, you know, your practice locations, you know, your payers. So you are going to come here, select new payer enrollment. You would select the provider or multiple providers that you’re looking to get enrolled. You would select the provider group that you’re looking to enroll them under. And then you would select their state from here. You are going to be shown a list of all of your contracts that are enrolled with that community health center. So with your specific tin and with the click of a button, if you’re enrolling them in your list would be 25 payers, you can kind of just select all or you can, you know, pick and choose the payers that you’re looking to do that enrollment with. At that time, once you select the payers, you’re looking to enroll with, you would select the lines of business. There’s a couple other clicks here just ensuring the practice locations. And then there’s some optional fields here as well. Once you hit submit, that’s really where your work ends and medallion takes over. So, Amanda, I imagine this is going to be the, you know, most exciting potentially to you since right now you’re doing all of that work one by one, you’re logging into each portal, you’re filling out the rosters, you’re populating the payer enrollment application so that’s very time consuming, has the possibility for errors, right? If you’re copying and pasting data from the spreadsheets. And so with this system, you would make that selection, your work ends. And where medallion really comes in is we are going to automatically verify the npi with our technology to make sure that that’s accurate. We’re gonna verify the taxonomy code. We’re gonna check caqh, make sure all the information on the application matches, making sure it matches in caqh as well. The purpose of that is if it doesn’t match, there’s an instant rejection. We want to eliminate that for both Amanda and then the downstream revenue cycle teams as well. We are going to use our automation to pre fill the portals. So here’s, a quick video of some automation that we have built in the system. So you can see here the system’s really gonna pull that data, complete the applications… very quickly and get that submitted and sent out the door. Once we send the application out the door, we are going to give you visibility each step of the way. So we’re going to have individual notes on each one of these lines that say when the application was submitted, you’re going to have an attachment of the application. You’re going to see when it went to the payer, the exact date stamps, any email activity, all of that’s going to be tracked here. And then we’re going to follow up all the way through to our status. So one thing that we hear and Amanda, I’m curious if this happens to you is, you know, a payer could have approved and maybe you got the letter like two weeks later. And so there’s potential a two week that you could have been billing for that payer but, you weren’t aware, is that something that ever happens to you all, if you don’t have the ability to follow up with payers regularly?
Acarter (18:25) Yeah, I’ll get notice, you know, today that somebody was approved, maybe on, you know, 320 or something like that, right?
Samantha Bouchard (18:35) Yeah. So that’s just, you know, some lost time from a billing perspective, chetna, that or, you know, and as well an impact to the patients, right? That’s a period of time that patients could have been seen by that provider. So what medallion does is we have portal scrapers. So this is a medicare example where daily we’ll log in and we’ll check all of our enrollments to get a status so that the second that it’s available on the portal, we are surfacing that to you so that you can automatically really start that billing process. We’ll also have AI phone calls. If the payer requires a phone call method and we’re doing all of this with an average of a 54 day turnaround time. So that 90 days that you all have experienced in the past 90 to 120 with this technology, we’re having less errors.
Samantha Bouchard (19:32) We’re getting these applications done faster. We’re getting them done in a scalable fashion, right? So if Amanda gets 10 providers at the same time, and she can typically get one provider’s 25 applications out the door in a, week and a half, if 10 providers come in at the same time, Amanda, I imagine that tail is going to get pretty long for even the submission portion. And with medallion, because we have our team of experts and our technology on the other side of this, you don’t have to worry about that volume increases or the scaling capacity because medallion’s able to flex to your needs. One other thing I’ll just point out that a lot of our revenue cycle teams will either download or potentially tap into via API is this enrollment tab. So this is really going to tell you the enrollment summary. It’s going to tell you the locations that are active for billing and this data gets updated in real time. So from, if you have schedulers that are looking to schedule certain patients and wondering where the enrollment sits, they can log in, this can be downloaded. Like I said, dropped on an sftp or api’d so that you have that instantaneous ability to know when that enrollment is active for patient viewing for patients to be seen. So I’ll pause here because I covered a lot Amanda, since you’re the closest to this piece, I would love to hear if anything stood out to you or, you know, how you can see this improving your process today.
Acarter (21:18) So when you’re going in like in the beginning you had showed where you were selecting like what payers?
Samantha Bouchard (21:26) So.
Acarter (21:26) Are you going to have all of them there? So like I have somebody a new behavior health therapist that’s going to be starting? I actually have her stuff right in front of me. So, are.
Samantha Bouchard (21:40) like,
Acarter (21:40) is it what’s going to show up? Is that literally everything that oak orchard is like credentialed with, or is that like just behavioral health or, you know what I mean? And the same thing goes like for, dental?
Samantha Bouchard (21:53) Yeah. So this is like a type ahead list so you can find specific payers by kind of like typing and searching for them individually, but you can also create like lists of payers as well. So like you could theoretically like configure something by provider type, so that it would be very simple for you to just click all for that particular provider type. Okay.
Chetna Chandrakala (22:26) Anything else? Sorry, go ahead.
Samantha Bouchard (22:30) Chetna?
Chetna Chandrakala (22:30) Yeah. Can you repeat when we click all those payers, how long does it take behind the scenes to send that application out? We?
Samantha Bouchard (22:42) Have a 10 day SLA that we guarantee chetna, getting the applications out the door. But on average, we’re getting those out in five business days.
Chetna Chandrakala (22:52) And how is it happening behind the scenes? Is it AI computer generated or manual? It?
Samantha Bouchard (23:00) Is a combination? So primarily, we’re going to use our technology first. So we’re going to have automated form mappers. We’re going to have those portal submissions that we just looked at. We’re going to have some workflow orchestration that our AI kind of comes in. And then we do have a human in the loop from a QA perspective. So we know these enrollments are complicated. There can be additional tasks that are needed. All of that is really handled through the technology. But we do have humans that get flagged. If anything kind of goes outside of the ordinary, we have humans to do some QA before the file goes out the door as well to just ensure that optimum accuracy rate.
Chetna Chandrakala (23:45) So that SLA for 10 days is for whether we have one provider or 10 providers.
Samantha Bouchard (23:53) Right. Like if you have 100 applications that you’re submitting, right? Because that’s one provider times 25. If you have 100 applications or, yeah, 10, it’s just going to be consistent with the 10 day SLA?
Chetna Chandrakala (24:10) And then I had a question about your 54 days turnaround. How, does that factor in medicaid? Is that why it is 54? Or because 54 is a pretty long turnaround time? Yeah.
Samantha Bouchard (24:28) So, it’s looking across all the payers in our system chetna, to get that average. If you provide us your payer list or like your top five payers, we can provide you like the exact turnaround time that we see for that. But really where the time savings come into play is really in that optimized data collection. So we’re optimizing the time it takes to collect the data for your providers. Then we are getting those applications out the door and on average five days. And so Lewis can definitely like put together an analysis of what that looks like and what that means for you from a revenue perspective. And then of course, we will have payers that come in 20 days that are less than that overall time.
Samantha Bouchard (25:15) So, yeah, we’d be happy to look at your exact list and kind of give you what those turnaround times look like today.
Lewis Elder (25:21) Yeah. If that could be like maybe a piece of homework from this chetna, I don’t know who on the team can, if you guys can share with me like list of top 510 payers a priority. I can, we make those all the time. I’ll make like a turnaround time analysis so we can compare and see, you know, how medallion stacks up to your current numbers?
Chetna Chandrakala (25:39) The payers. So at the background, so it’s a combination of automation technology… and manual interface. But how are you submitting? Do you have feeds… or apis or connections with payers? Or are you submitting in a normal manner like by mail by email or by dashboard? Yeah.
Samantha Bouchard (26:05) If we’ve been able to establish like, so some payers, we are like on a roster format with where like their normal application might be a portal or might be a paper application. So we have established relationships with providers to streamline this process. And then surely based on the volume of applications that they’re getting from us, we do find that we are like they are processing the medallion applications sooner. However when it comes to, you know, if there is a paper application and we aren’t able to establish like a special connection with a payer, we would just be following their exact requirements to a tee because some of the payers just really aren’t able to, you know, create any of those like special relationships.
Samantha Bouchard (26:59) And so I can show you here. So this is an example. So all of our payers, this is like a little bit of like a look behind the hood. So, Amanda, I’m not sure how you’re storing all of your payer requirements today. Do you just like create a word doc that you kind of pull up? Or how do you know if you know medicaid of New York requires like a blue ink signature for example?
Acarter (27:29) So a lot of the really a lot of.
Samantha Bouchard (27:33) The stuff can be it.
Acarter (27:37) Doesn’t really need like a wet signature except for medicaid, everything else. It can just be done. Like I can back some of this paperwork to a provider or to give some of this paperwork to somebody else to get to a provider. And then they can have them sign it. But there’s no other than medicaid. There’s no specifics thus far as, you know, signatures other than it just being a wet signature for medicaid?
Samantha Bouchard (28:00) Yeah, exactly. Are you? So like for blue cross for example, like are you just going to their website every time and like pulling down the form or do you kind of like create your own database of like the research you’ve already done well?
Acarter (28:14) I have a rep that I reach out to, and then I just ask her if you know each said provider, if they are currently credentialed or not. And then she would just let me know which form that I need to do. Okay. And then the same goes for like fidelis and welfare because some of them, it’s just a quick link letter. And then some of them, it’s a full on credentialing application.
Samantha Bouchard (28:36) Yeah, exactly. So for like 900 payers across the United States. So if you do end up adding more payers over time, we are going to have a process guide. So this is a little bit of like a look behind the hood in our system. But essentially, it’s a process guide for every single requirement of every single payer. And all of this is really baked into our system. So it’s going to tell us exactly if there’s any prerequisites, if there’s dependencies, what the application method is, what those exact steps are, if there’s any additional forms mailing application. So all of this is stored. So like required documents, things like this, it’s all baked into the system. So if you go ahead and need, you know, 10 payer enrollments for, you know, five providers, right? That’s 50 enrollments. And if each enrollment needs X number of unique requirements like that requirement list is kind of getting pretty large pretty quickly with our technology. When you make that request for all of those providers, we’re going to instantly surface those the tasks we’re going to compare that against the provider profile. So we can instantly surface if anything additional is needed for that payer as well. So that’s really another way chetna, that the technology really comes into play. And then also, you know, just… with the quality checks that I mentioned as well making sure that when the application’s going out the door, we’re getting a par status on the other side rather than having to restart that.
Samantha Bouchard (30:16) Okay. Thank you. Any other questions on payer enrollment? Like how we’re using the technology? How we’re optimizing the submission of these forms? Any other questions here before we look at hospital applications?
Acarter (30:32) I do have a question which it might go into your hospital, but I’m going to ask it anyways. Now. So like for highmark, that’s always one that I get stuck at sometimes because they want the participating like for hospital, you know, they want to know what hospital that you are participating at, where you have privileging at. So obviously that needs to be updated into the caqh, and then sometimes they’ll even send me an email and they want a letter for that too. So let’s just say you have this new provider and you’re credentialing her for highmark and they come back and they want that letter. What is the workflow for that? Yeah.
Samantha Bouchard (31:15) So if that letter is like an instantaneous requirement that we have Amanda, it’s going to be flagged before we even send it out of the system. So we’re not going to have to get that submission and then kind of get that additional request. Also if we see that the privileges are a requirement on the application, we’ll kind of flag that. And if we don’t see those in the provider profile, we’ll create a task for that. And so all the tasks then can be assigned to the provider. But then you as an administrator also have this ability. So if it’s something that you could resolve on behalf of the provider, that would be surface here. And I think the way that it relates to privileging is if we see that there’s like a privileging request that’s in flight, there can be like dependencies against these individual lines. And so if you need the privileges to be approved before it can kind of go on the highmark application, that can kind of get triggered into like a step process as well.
Acarter (32:24) Okay. So if I went in and I just checked all those insurances to start getting one of my providers credentialed, and highmark was one of them, it would be flagged. So I would know that I need to hop in here every day or a couple times a day or whatever it may be.
Samantha Bouchard (32:42) And.
Acarter (32:42) then I can check and see, geez highmark was one of them and it says right here that said document is required. Now, I need to get that document and then upload it in.
Samantha Bouchard (32:52) Here, exactly. Yeah, we’re not going to, we’re not going to send anything out the door until we have all of the requirements. Okay? Yep. And so like the provider is also going to get notified of that. So they’ll have their own provider portal. So they have the ability to also update, like to update things as well. But as an administrator, you have full complete visibility. Okay. So transitioning into the hospital applications. So this is another area very similar to payer enrollment where each hospital can have their own requirements and some of the application requirements can be pretty lengthy to submit. And similarly, they can be in a variety of formats like portal, PDF, email, et cetera. So similar to the request process, this is where your team would come, you would select the provider that you’re looking to enroll at the time of implementation. We’re going to load in all of your entities. So we’d work with you during our implementation process to understand exactly who your partners are, get those loaded into the system. So in this list, you would only see the entities that you are associated with. And then from here, you would select or multi select the entities that you’re looking to work with… and hit submit. So once you hit submit, it would create a line item here. We’re going to begin to populate their specific, like if they have a pif form, Amanda remind me, are you doing the hospital applications or which team does that fall to? No?
Acarter (34:47) I do not.
Samantha Bouchard (34:49) Tasha, is that you guys, or?
Chetna Chandrakala (34:50) Yeah, I’m actually not sure. Taylor, Tasha, does Teresa do this? I mean, I don’t know if we, I.
Samantha Bouchard (34:59) Believe it’s Teresa that does that. Yeah. Okay. So typically there’s a provider information form as the first step we would complete that then you get notification that you can submit the application. So very similar to our payer enrollment process, we’re going to have all of those processes stored. We’re going to surface if anything additional is needed. We’re going to pop, we’re going to create the packet of information. We give it as a task to the provider to review everything and just make sure it looks accurate. Once that’s approved. We’ll send it over to your partner and then give you visibility each step of the way. So it will move into ready when it’s been submitted. And then we will follow up with your partner until you get until you get that status. And then once we get the status that it is approved, it’s going to live in this closed tab which would… show you exactly where, you know, each provider has privileges, what’s the entity, what’s the approval date, and then when they need reappointment, which tends to be every two or three years. So, just another way that medallion is using our automation to really populate these applications quickly with less errors, get them out the door for you, and then taking on that end to end management. So really taking some of this work off your individual teams staff and giving you visibility throughout the process.
Lewis Elder (36:38) And we can send, I’ll send a recording of this too. So if you want to like forward along this, I can clip this portion if you want to forward it along to Teresa. You know, we’re also happy to meet with whoever you know handles this part of the process if they have further questions.
Samantha Bouchard (36:55) Any questions on privileging before I look at analytics quickly? I don’t okay, awesome. So our analytics tab, these are customizable dashboards, but essentially, they’re really going to focus on volume and turnaround time and they’re going to surface all of the granular data that we looked at the system in real time so that you all know who’s billable today, what’s still pending, what’s at risk. So you can really come here with a couple clicks. And so chetna, this is something that you would have visibility into as well as other executives at the organization. You can see how many enrollments you’re submitting month over month, the different steps in the process as they’re completed. They’re going to be surfaced here. But you’ll also get an active notification to your email the second that we get that par status. And then you can also see kind of like the transition time as things are going through. And then additionally, from the credentialing perspective, you’re going to have visibility into that as well. Oh, this is a demo… site. So it looks like we don’t have good data here for credentialing. But essentially, you know, very similar format and we also have our report builder. So a lot of systems that I know you all are just using spreadsheets today, but sometimes like extracting the data that you’re looking for can be extremely challenging. And so medallion really makes data export very simple for you. So you can come in here, click the information that you’re looking for from this searchable list, move it over here to the right hand side. This could be like provider practice group status, who’s located where which payers are enrolled. You can go ahead and export this. If it’s a one time report, you can save it and you can schedule it on a certain cadence to different people in the organization. If it’s something that you need to see regularly as well. So ultimately, really every tab here in the system is also downloadable. So we make it extremely easy for you to access the data in the system and get that information that you need for your business.
Lewis Elder (39:24) All right. I’m sorry, I just wanted to ask, I know, I’m assuming you guys aren’t doing a lot of analytical work or analytics like reporting today, just given that it’s spreadsheets or something. Is that anything that you guys are doing currently? And I’m also we haven’t talked about it much but is that something that you guys are interested in like using as a functionality to get like a clearer picture of the overall state of the state?
Chetna Chandrakala (39:49) No, I think I can’t think of anything that we, I think some of the chart strengths should be good. But other than that, I’m not thinking, I mean this is a lot of this could be used for the privilege and committee or the credentialing committee from finance perspective. I’m not involved in that as much from our perspective. I think just the information of overall like how many are like in which process? Where would be more to not to senior leadership as much as like provider, like I mean, internally at our level, so that we are billing now the schedulers now, that kind of thing. So, nothing big.
Lewis Elder (40:43) Sure. Yeah. It makes sense. Just trying to get a sense of like what for you guys is valuable? What’s you know, what’s most exciting et cetera. Appreciate that, chetna? Yeah, thank you.
Samantha Bouchard (40:55) Awesome. So really just kind of want to level set with, you know, today you all have like some manual data collection, manual entry across 15 to 20 payers, can take weeks to submit months to bill. And you’re really lacking some of that overall visibility. And so really with medallion, you can streamline the data collection, submit that those applications in days. And then most importantly, just really track everything in one place and know exactly when those providers are billable or have the privileges as well as those credential file completions in less time than it’s taking you all today. So hopefully you found the demonstration helpful. I’m happy to poke around in any other areas or answer any other questions that you all might have?
Lewis Elder (41:45) Yeah. Is there anything that we didn’t show that you guys are hoping we have or hoping to see, or any, anything like that please, you know, now’s the time to call it out.
Chetna Chandrakala (41:57) Now, is this the look of the dashboard or platform that’s going to be available? Or is this just a demo screen? Is that how it’s going to look? I mean, I’m trying to.
Samantha Bouchard (42:11) Yeah, this is the administrator view. So the only thing that would really change chetna is like if you didn’t purchase privileging, like you wouldn’t see this, and if you didn’t purchase licensing, you wouldn’t see that. But otherwise, yeah, this would be your view.
Nicole Campbell (42:27) Okay.
Chetna Chandrakala (42:29) And it’s fully web based?
Samantha Bouchard (42:33) Yep. Exactly. Would we?
Acarter (42:36) Have somebody that we can reach out to? Like, would it be Louis or one of you ladies like let’s just say we get it and I start somebody tomorrow and I’m having an issue, do we have somebody directly that I can reach out to? So then that way I can get an answer tomorrow. And I don’t have to wait, you know, three days and hold up putting in for somebody to become credentialed with some insurance. Yeah.
Samantha Bouchard (42:57) Great question. Amanda. So the way that our kind of team like your onboarding experience would look like is you would have a designated implementation manager and a technical solution manager. They are really there for the eight to 12 weeks to kind of stand up the platform and support you, get you trained, get you up to speed. Another person that would be there throughout the implementation is your engagement manager, and your account manager, your engagement manager stays with you and your account manager stay with you long term, but your engagement manager is your ultimate like point of contact for day to day operations. So as you graduate from implementation, you might want to meet weekly with your engagement manager until you feel really comfortable in the system. And then maybe you move on to like a monthly or an ad hoc basis. That really would be, you know, your preference. But if there is a question on a line or, you know, you need something prioritized in the system, you can work directly with your engagement manager for those questions. And then your account manager will meet with you likely randomly throughout the year. But most importantly, on like a quarterly basis, they’re really going to be your strategic partner that looks at your usage of the platform and someone that you can really have some of those like longer term strategic conversations with as, you know, grow your business and.
Lewis Elder (44:26) I, of course, will still be around, you can always reach out to me if you need additional point of contact as well. And.
Nicole Campbell (44:32) Team, Amanda specifically. So Sam actually came over from our implementation team before she joined us as a solutions consultant. So you have a, really good in depth view into what our implementation process is like since Sam was running that prior to working with our team.
Samantha Bouchard (44:50) Yeah. And the engagement managers, Amanda are wonderful. Like they all have backgrounds in credentialing, licensing, payer, enrollment, like they’ve done this for like a really long time. So they’re just wonderful resources to support you. But yeah, definitely that human touch opposed to, you know, kind of having to wait for, you know, X amount of days for something to get back to you. So, yeah.
Nicole Campbell (45:18) Question for the team, I know based off of the beginning conversations with Lewis, you’ve been looking at other solutions as well. You know, chetna, Tasha, Taylor, Amanda would love to know how we’re comparing to what you’re seeing in the market? What did you really love? And was there anything that you were like? I thought medallion could do this that maybe we didn’t show today?
Acarter (45:41) Ooh… I know you guys didn’t mention the caqh today, but I feel like you mentioned it last time you guys monitor that as well. Yeah.
Lewis Elder (45:53) We can, we automate, we have a bi directional API connection to caqh. So for provider onboarding, we instantaneously, like pull 80 percent of the provider’s profile to like automate a lot of that manual work that the provider would have to do. And then we also will update caqh for your providers as well to keep their caqh profile up to date. And that way the providers also don’t have to remember their caqh logins which I’m sure you guys have run into before. So.
Acarter (46:19) You do the attestations, then?
Lewis Elder (46:22) Yes. Yep.
Samantha Bouchard (46:23) Okay. Quarterly attestations. And then ideally, Amanda, medallion becomes your source of truth. So if a provider changes their address or changes, adds a different practice location, you make that change in medallion, that’s your record of truth. And then we’ll push that information into caqh so that everything stays aligned.
Acarter (46:42) Okay. So when we have a new provider, you would go ahead and update all the information in caqh with said location that they’re at their mpi, all, you know, the, everything that I need to do? Yep?
Samantha Bouchard (46:54) Once that’s all set up in medallion that can get pushed over. Yep. Okay, great.
Chetna Chandrakala (47:00) Question, is that also done manually or manually, right? Because there’s no way to do that automated? No?
Samantha Bouchard (47:08) We do have some automation there, chetna. So we are able to auto log in and then we have like a bot that reviews the profile in medallion compared to that, and then can make some of those changes as well. A.
Lewis Elder (47:21) Little bit of like behind the scenes is we’re actually the only company in the country that has a API write back connection to caqh. And it literally is just because like our founder and CEO, Derek, when he started medallion, he knew people at caqh and he was like, hey, I have this idea for a company and that’s like, you know, six, seven years ago. But, and he was like, is there any way, you know, I’d like to be able to push data back into caqh directly? And so they gave him like API write back access. Any group can get API read access from caqh which we, of course, have, but the write back is like a medallion unique thing that we do.
Samantha Bouchard (47:54) Okay. And that makes sense?
Lewis Elder (47:56) Yeah, I.
Tasha Cutaia (47:58) Did have a quick question. This is Tasha and we might have covered this in the first meeting Louis. Oh, please. You guys do the monthly exclusion run, correct? That we have to pull every month for like to see if someone’s not?
Samantha Bouchard (48:12) Yeah, the ongoing monitoring. Yep. So we do have ongoing monitoring built into the system that’s actually stored in our analytics tab. And so essentially, it’s going to have all your checks, medicare opt out, npdb, Sam, oig, and then the full sanctions audit log. And so any of those that you have added, you have access to look at it yourself if you want more of that passive notification. But we are going to give you an active notification if there are any flags that come over.
Tasha Cutaia (48:47) Okay. And then you said if we go with this, the implementation is three to six months, right? Was that correct?
Samantha Bouchard (48:54) It’s eight to 12 weeks is typically what we see. But around week four is when we can start supporting like your net new provider needs. So the, you know, the big piece of the data is just really that data migration. Since you have a lot of this data in spreadsheets, we actually have an import template that we can send to you and you essentially populate that import template. And then we get that bulk uploaded. But that’s really that big milestone. So if these conversations continue and we send you the import template and that’s something you all can start kind of like working in the background. We then can, if we have that on day one, we’re going to be off to the races and we’ll be able to implement much faster. So it’s really just that data piece before you’ll have access to the system around like week one or two, and that’s when you could start inviting net new providers to the system and start making those requests. So I know it sounds like a little bit confusing, but essentially, we just want you all to get that instantaneous benefit of the system when it comes to new providers coming in while we separately work that work stream to just get all of your data uploaded, if that makes sense, it does.
Lewis Elder (50:22) Good question so far. Yeah.
Samantha Bouchard (50:25) And I have that just the ongoing monitoring analytics tab up here. So you can kind of just get a sense of what that looks like, but it’s essentially going to show you what that outcome is, the links and any information or flags that might kind of come across… the.
Tasha Cutaia (50:47) One other question I do have with this is because we run this for all of our staff, whether they’re clinical or non clinical. Could we upload like a, how would we handle our non clinical employees? Great?
Samantha Bouchard (51:00) Question. Yeah. So non clinical employees actually live under this monitoring tab. And then we just do the checks for oig and Sam, and essentially you come here, you would upload your employee list, click submit and we would run these on a monthly basis. Okay? So.
Tasha Cutaia (51:19) Can we just add to that and remove as we add and remove a headcount?
Samantha Bouchard (51:22) Exactly. Okay. I think.
Tasha Cutaia (51:28) That was the only questions I had. And then what would the next steps be? Obviously, we have to talk about the elephant in the room, which is pricing.
Samantha Bouchard (51:35) Yep. Definitely.
Lewis Elder (51:38) Just want to make sure any other questions before that, like chetna, Amanda… any other questions about tech? Okay? No.
Samantha Bouchard (51:47) Problem, and,
Lewis Elder (51:49) I am curious, have you guys done, and you can be honest with us. We’re not, you know, I’m just more nosy and interested. Have you done demos with like symplr or provider passport? And if so like I’m interested how they, you know, stack up or if they’re strong in some areas that you liked that better than what you saw at medallion or you like medallion better? I’m interested just in your, you know, qualitative assessment there.
Chetna Chandrakala (52:10) Yeah. So for sure, we’ll bring that back to you. So we, as a group here with madat, Tasha, Taylor, we haven’t done all of those together. So… once we get through those, maybe we can bring it back to you. So at that, at this point, we’re not completed and provide a passport. I was the only one at that time. So we haven’t seen it as a group. So you.
Lewis Elder (52:35) know, cool. I,
Chetna Chandrakala (52:37) don’t remember now fully what the difference is between medallion and them. The, some of the questions that I was asking about automation, from what I remember was that they had, they definitely had automation and not, but again, you know, maybe, you know, there may be some things different at that time that I didn’t perceive correctly. So I’ll.
Lewis Elder (53:03) find out. I can also go ahead. Sorry.
Samantha Bouchard (53:06) I’m just going to say, yeah. So chetna, some of the differences when you’re evaluating these to just consider is if it’s self serve or full serve, right? So medallion is really end to end where we really look to you to own that strategy. Tell us what you need. We’re going to execute all the way through until you get to par status. And what that means for you is, you know, you don’t have to scale with people, you scale with technology with a company like provider passport. They are going to have some of those primary source verification… like checks that we have in the system for the cred file where we’re able to get that to you in the an average of three business days. But it’s human powered, right? So you have the technology and then you kind of still have the staff really behind it kind of powering some of those workflows. So that’s just kind of something to keep in mind as you’re looking as you’re looking at this, yeah?
Lewis Elder (54:06) And whether or not, you know, we end up being the right solution for you guys or if we’re not like the way that kind of Sam to piggyback on what Sam’s saying. It’s like there’s kind of like the build versus buy dichotomy and it’s like right now you guys are in fully like in build mode, you’re doing it all yourselves, just spreadsheets manually, provider passport is kind of like in between, right? It’s like got some tech, but then you’re staffing it yourself and you’re doing things manually. That’s why it’ll be cheaper because it’s like it’s less of a full service offering. And then you have medallion which we are the other end of the spectrum which is like, hey, we want to offload all of this work to like a technical platform and like the medallion employees themselves, that handle the parts of the payer enrollment and credentialing process that can’t be done by tech. So just when you’re thinking of like, do you know, do we like medallion? Do we want to go with medallion? It’s it’s, it will be a change from what you guys are doing today, significantly like, it is a, we are really like, you no longer want to, you know, have to consider hiring people to staff this process. Do it yourselves? You want a, you know, a company and a platform to take it over for you. But yeah, I think that’s a good synopsis. Keep me in the loop chetna, when you talk with those groups because I’m you know, we will always be honest with you if there’s things that they can do that we can’t or, you know, we’ll make sure that you feel confident with ever, you know, whatever avenue you guys end up going with. Next steps would be a couple things. Can y’all, get me a list of your top payers?
Chetna Chandrakala (55:29) Yeah. Okay. Yep.
Lewis Elder (55:32) So, that would be like a critical piece. If I can get that. What I will do then is I will put together basically two things, a turnaround time analysis, and then what we call like a bva business value assessment that’s basically like here’s, how much it’ll cost here’s. How that breaks down. And we can run through that with you guys, and walk you through, you know, pricing what we’re offering what you’re you know, if there’s any pieces you’re looking to add on or remove from what we can, you know, offer you, to cover for you guys. So, that would really be the next piece turnaround time analysis and basically like a pricing proposal and review. Okay?
Tasha Cutaia (56:07) Cool. Sounds good.
Chetna Chandrakala (56:09) So, Amanda, can you send that bear list to?
Tasha Cutaia (56:13) Luis?
Chetna Chandrakala (56:14) Okay. All right. And.
Lewis Elder (56:16) Do you have my email, Amanda? I think you do, but?
Samantha Bouchard (56:18) Yeah, yep. Because you were on one of these invites, perfect.
Lewis Elder (56:22) Yeah, it’s just Luis elder at medallion co. Okay. Anything else that y’all, need any last second questions?
Tasha Cutaia (56:29) Yeah, it’s Tasha, can you send us the two demos just because there’s a couple of things I want to run by a couple of people without getting everyone together versus where you can go to specific sections and be like, does this meet your needs? Oh, yeah. Yeah.
Lewis Elder (56:44) Yeah, I can definitely, I’ll send you the Gong recording from the last one, and it usually takes about an hour or so for them to process. I’ll send you, the recording from this one and please like, I’m happy, we’re happy to chat with any of those folks directly too, if they have questions or whatever. So we’re you know, we’re here to answer those. But we can definitely do that. Any.
Samantha Bouchard (57:02) Other questions?
Lewis Elder (57:03) Or things y’all, need?
Tasha Cutaia (57:05) Yeah, I don’t think that was it. Cool.
Lewis Elder (57:08) All right. Well, thank y’all, so much. Enjoy the 35 degree rainy weather. We will see y’all, next time once I get the payer list and I put, I will start on the turnaround time analysis and proposal. Give me like a day or so and then I’ll send over some availability would next week be about, do you guys have availability? Is anybody gone? I’m just thinking about meeting for the next step. I’m.
Tasha Cutaia (57:33) going Wednesday through Monday next week, but if it’s if we do a meeting on Wednesday, I can just jump on via phone. Okay.
Lewis Elder (57:42) We can, we can aim for Wednesday, as soon as I get that list, I’ll just, I just need to talk internally with a couple of my colleagues, and see how quickly I can put that together. And then I’ll send over some available times that we have for next week.
Tasha Cutaia (57:54) Okay. Sounds good. All right, all.
Lewis Elder (57:55) Right. Thank y’all, so much.
Chetna Chandrakala (57:57) Thank you guys. Bye.
Samantha Bouchard (57:58) Have a great day.
Lewis Elder (57:59) Y’all, too. Bye.