Transcript
Mike Manson (02:59) Hey, John. Hey.
John Reel (03:01) Mike, how are you?
Mike Manson (03:02) I’m doing well. How are you doing?
John Reel (03:03) I’m doing good.
Mike Manson (03:05) Appreciate you making some time for me this afternoon.
John Reel (03:08) Yeah, absolutely. So you’ve been working with matt for a long time?
Mike Manson (03:13) Yeah, I have. Yeah, I actually haven’t met him face to face yet, but yeah, he’s been a great partner and he’s been very successful, with medallion, and just a good human.
Mike Manson (03:25) It’s always nice to work with people that are good at what they do, but also just fun to work with. So.
John Reel (03:31) Yeah, yeah. You know, it’s funny. I haven’t talked to him in a little while, but, we grew up together. So nice. We’ve been friends a long time. I just, you know, how it is you get off doing life?
Mike Manson (03:44) Yeah, I get it. I’m in my mid thirties and I still, I, I’m born and raised in Boston that’s where I’m located now. And me and I, all my best friends are still guys that I’ve known since elementary school. We’re actually all getting together for dinner on Friday night, but I’m at the age where it’s starting to be less and less. We, we’ve got to really make the plan and get people’s wives and kids on board.
John Reel (04:08) Yeah. Well, good. You still see quite a few of them. I’ve still got a few from high school and college. I run around with when I get when I get time, right?
Mike Manson (04:19) Nice. Very nice. And, are you still in Nashville?
John Reel (04:22) Yeah, I’m in Nashville, and our actually, our corporate office in Nashville too, but I’m I mainly work from out of the house to be honest, yeah.
Mike Manson (04:33) Same here. We, we’re headquartered out of san Fran. So we don’t even have, a Boston location. So I’m if I’m not on the road seeing customers, then I’m here.
John Reel (04:43) Gotcha. Yeah, but no.
Mike Manson (04:46) Listen, I really appreciate it. I know you’re a busy Guy. Appreciate you making the time we’ve got 30 minutes on the calendar.
Mike Manson (04:52) You know, really appreciated, of matt making the connection. And really the reason I was reaching out, I was doing my homework, on urgent team. I came across your name. Obviously, I saw the connection with matt which piqued my interest. And I was doing my homework, and looking into urgent team, and they reminded me, or, you know, your org reminded me a lot of what I’m doing, with one oncology, I don’t know if you’re familiar with that name, but they’re an mso, one of the larger msos in the country.
John Reel (05:19) Yeah, yeah. So.
Mike Manson (05:20) I actually, I helped to onboard them last year. We actually just met, with their revcycle team and they’re really happy with what we’re doing for them. I think, you know, the mso model as I’m sure, you know, can be very complex when you’re trying to deal with, you know, multiple tins and multiple brands and just kind of getting the partners, you know, fully integrated into your system and things like that.
Mike Manson (05:48) And we were really able to help kind of give them a good backbone specifically for onboarding credentialing, and then working on the payer side and rolling providers. They were seeing some pretty messy turnaround times, you know, 120, 150 days from the time or more from the time they added, a new oncologist to the time that they were billable and it was really, a pretty heavy strain on their opex, which is why they came to us.
Mike Manson (06:18) So, there’s you know, there’s I, I’m assuming from your seat, you maybe see some of that upstream effect. I’m assuming you’re not in the day to day of credentialing, but yeah, curious, if that resonates with you, if you’re seeing some of those financial implications, of credentialing and things like that. No.
John Reel (06:38) I actually do super. It, it falls to me. I’ve got a manager over there and it is a challenging… department for sure. Over the years, I’ve you know, turned it over, you know, here and there a couple of times. But I will say I was telling matt this, I’ve got a really good team that has been in place for a couple of years now that have kind of humming along. They’re they’ve got some pretty fairly quick turnaround times with the exception of unitedhealthcare. And I think that’s just the nature of them, but, you know, we, it’s been a lot of it’s been a battle getting it there. And I told matt, you know, I’d love to take the call just in case I ever do need to fall back or, you know, something does happen where we, you know, lose some folks or decide we want to go that route to outsource, it. But right now, I will say, we know… we’re doing a really good job at not letting a whole lot sneak through there occasionally, it happens, but we’ve got, you know, pretty good turnarounds within the 30 45 day range with these payers.
Mike Manson (08:03) That is good.
John Reel (08:05) Yeah. And, you know, like I said, unitedhealthcare seems to be my biggest one just because they’ll future date on you. But we’ve got a pretty good kind of set plan in place and just transitioned over to a new platform with Healthstream one with their cloud based. I forget what it’s called… gosh. Credentialstream.
Mike Manson (08:39) Credstream. Okay. Yep. Yeah.
John Reel (08:41) Yeah. So we just moved over to that platform late last year. Okay? And, you know, that’s really helping with the reporting. We were on a, an older version of that, you know, hard drive based say, you know, saved on there. It was, the reporting was a bit of an issue. So we finally upgraded to get there. And, but yeah, we do, you know, I, I’ve been really happy with them lately. I, you know, I, that’s why I told matt, I wouldn’t mind, you know, having a conversation with you just to see, you know, see what you guys do and, you know, in the future if I need, you know, I don’t know if you fill in gaps where people get, you know, if you lose people or you do the entire outsource, I’m assuming you guys do both,
Mike Manson (09:34) Fill in gaps like, you know, add, a head, you know, a temp resource.
John Reel (09:39) Yeah, yeah.
Mike Manson (09:41) Now, yeah, we wouldn’t do that. We really look at.
John Reel (09:44) It as, yeah.
Mike Manson (09:45) We, we look at it as an end to end solution. I mean, so here’s what I would say like, we do have, you know, there there’s, our best customers like matt’s organization, they’re using us for kind of, the soup to nuts from, you know, we, we’ve got the software itself that your team would have access to. It’s not like your team would be doing zero. They would still be there. There’s, we like to say usually about a half an fte per 500… 500 providers, or one full fte per a 1,000. And really what they’re doing, is, you know, keeping track of the data. We, we have analytics. We’ve got all kinds of dashboards that show where everybody is in the process so that you can plan and forecast. But really, their role in the process would be to go in, and basically click request on a credentialing file and then request on a pair enrollment. And then our technology, we try and automate it as much as possible. And then of course, we do have boots on the ground, and people doing things like QC and making sure that all the files are accurate. So it’s not a, it’s not a full replacement of the team but we do, you know, some of, the financial benefits that we’ve seen like specifically with one oncology, they had a team of 40, they partnered with us and they were able, to cut their team down to six, and not that you’re looking to go in and start, you know, slashing folks, but it’s that’s you know, over time, that does become kind of the, part of the opex driver there.
John Reel (11:22) So, is that an AI? Like, is it a, is it mainly a software like, from an AI perspective?
Mike Manson (11:27) Yeah. So, we’ve got software that would be a provider data management system that would store all of your provider’s data. It would store, also store, your payer data. And then it’s really kind of our team partnering with your team, to fill the gaps where the automation isn’t possible. Yeah. And, you, there’s I would call it services on top of that. So, like if you, I do have some organizations that come to me and say, hey, listen, you know, we’ve got a really tight process for credentialing, and when I say credentialing, I mean, in this case, specifically creating, you know, doing PSV checks and creating an ncqa ready file, but we’re having a lot of trouble on payers, right? Like we’re you know, we’re seeing a lot of gaps in our game and being able, to follow up and see through, the payer side. And so we could say, hey, you know, your team continue doing what you’re doing work out of our system and then our team, will handle, the payer follow up. And there is a lot of automation that we’ve been able to build on that side as well.
John Reel (12:33) Okay. And then you’re I mean, the people that you would have are just doing QC checks on that data, I guess, right?
Mike Manson (12:41) Yeah. I mean, there are times, you know, if there’s, a payer that’s being a real pain in the butt which I think we all know that happens. We do have humans available, to follow an sop, on how to follow up with that specific payer. I mean, we’ve got, I think we’ve worked with 900 payers across the country. So, pretty much everywhere, we’ve got a playbook down, on how to follow up and usually a contact there too, which is good.
John Reel (13:10) How are you guys interacting with the providers to get their like onboarding info and all that? Yeah.
Mike Manson (13:17) That is that’s, always a pain point that I hear in almost every conversation and that I would say is, a bonus for us as well. So we’ve got bi directional. We’re a participating member of caqh. What that means is we’ve got a bi directional integration with them. So typically if your provider has a caqh profile already, they would just give us their first name, last or someone on your team could collect that from them. And we don’t have to interact with them at all. If they get us a first name, last name and a caqh number. We can usually auto populate like 80 to 85 percent of their information in our system just from that because we can just pull it directly. And then we can also push data back to caqh to automatically update that for them as well. So that cuts down a lot on the time of just collecting data. We hear that’s painful in and of itself because we all know providers hate this process and hate having to fill out forms. And we have a lot, it’s like, you know, 10 days to two weeks on average just to collect data from the provider because a lot of times it’s just done over email. Yeah?
John Reel (14:29) Yeah. So like one oncology, they’ve still got like an onboarding person getting that info from them and uploading it to caqh. And then you guys grab it from there. Yeah. So they’re working on their payers.
Mike Manson (14:43) Everybody’s a little different. So one of the, like the way they looked at it is they were actually very upfront and direct with us that they didn’t want our folks directly interacting with their providers at all. And the reason for that was they really promote themselves as like a, you know, white glove onboarding experience. And the folks that were doing that on their cred team were even saying to us. Even people within the organization. If you reach out to a provider, you know, you get nasty emails back interesting. So they really wanted to have control over that. And that was kind of part of the value propositions like, hey, instead of having your team, you know, doing PSV checks manually, let us take that off your plate. And then you can really be like the white glove service for onboarding to the providers. So that’s how we worked it out with them.
John Reel (15:37) Okay. Yeah. So they’re kind of, okay. Yeah, I’m just thinking through that piece because, you know, we’ve got urgent care accreditation where we do primary source verification and all that. And our onboarding process. We also have grabbed their P of a on the power of attorney on the front end. And so for any kind of signatures on the payer apps and all that, I guess you guys are doing that, all that through that on that, I guess the local team, my team would do all that still. And then all that information on the back end is where, you would do all the primary source automatic and most softwares do that. Now, I think like our Healthstream is doing a lot of that now.
Mike Manson (16:23) Yeah. And.
John Reel (16:25) then the payer app apps are the ones. So you would take all that info, do the payer app. And then I guess if you had any, that 20 percent information you didn’t get on the 80 percent side, you would just follow up with your contact back at urgent team or one oncology, is that kind of how that works?
Mike Manson (16:43) Yeah. It totally depends. I would say for most customers, they, we work with them out. So typically how it works is the providers would get an email from us that says, and typically like an HR person would prime them and say, hey, you know, fyi providers, we just partnered with medallion to help us, you know, with onboarding, and credentialing, expect an email from them in the next few days. And then they would get an email. And we actually can, we can customize that language in the email to kind of brand it for urgent team, however you want it to sound that would go out to the providers. And then we try and make it as easy as possible for them. Like, you know, we’ve already completed at 80 percent. We need these four, you know, tasks. We call it tasks. Basically, they would get tasks that says, hey, you need to come in. The one thing I know that we can’t get around is we would have to have them come in and attest their profile, like they do have to come in to the platform once to at least attest it because that’s just a legal compliance thing. Yeah.
John Reel (17:45) That’s probably your power of attorney to do that, right? Exactly.
Mike Manson (17:48) Yeah, but we do have some pretty cool tech in there like, you know, we’ve got QR codes that they can scan on their phones and basically like upload their resume automatically. There’s some pretty interesting tech that we’ve built on the front end just to help make it as smooth as possible. So they don’t have to go in and fill out forms.
John Reel (18:11) Okay. Yeah, that’s pretty neat. Yeah, no, I mean, it’s interesting. You know, I don’t know if you guys have, I don’t know that we’re you know, urgent to jump on anything new over in the credentialing side. So it is going so well, but I would be curious to kind of see if you’ve got like some info you’d send over a standard pricing or something. I’m sure you package that out, right? Like if you do the whole onboarding piece and everything or if you just do the, you know, that outside of the onboarding piece, if you still work through them, they’re not contacting the providers. I’m sure that’s I don’t know how you guys do that. I’m guessing it’s kind of a la carte as you want to go.
Mike Manson (18:52) It is, yeah. So we would, we, there’s a per provider cost for the software itself. That kind of comes standard with every bundle. And then from there, it is somewhat a la carte. You know, if you want us to do credentialing for you that’s a line item. If you want us only doing peer enrollment that’s a line item or you can have us doing both. Like we would just have a scoping conversation with you on where you want to get started, and price it out for you that way. But yeah, I’d be more than happy, to share. I can probably even have one of my guys put together like, a short, you know, video overview that I can share with you to kind of demo it. So that, yeah, a little some insight there. And, and, you know, we’re not going anywhere if things if, you know, become a little bit more urgent. But, are you delegated with most of your payers today?
John Reel (19:49) We’re not.
Mike Manson (19:51) Yeah.
John Reel (19:52) Which we’ve we have reached out on several. They haven’t some haven’t allowed it. Some, we are smaller that we just didn’t fool with it because we were, you know, having to do, the bigger payers anyway. Yeah. That would be nice. I supervised this when I was in hospitals too, and that was a lot easier than this.
Mike Manson (20:19) Yeah, that is something that we’ve helped several customers with as well. We, you know, we, we’re always transparent about, what we will and won’t. Do we’re not going to go out and negotiate contracts for you? That’s.
John Reel (20:32) not.
Mike Manson (20:34) our game. But because we are an ncqa certified cvo, we would, you know, there, there’s a lot of support that we can give you in helping to have those conversations. And we do think we do offer services like automated roster generation and… delegation audit support as well. So, like if you did become delegated and, you know, you would have, I forget how often it happens. I’m sure it differs by payer, but you would get audited throughout the year, and we would basically, you know, run that audit for you so that your team doesn’t have to do it.
Mike Manson (21:09) So, so there’s some support there. I can share information on, how many providers do you have today? I thought I saw like around 160.
John Reel (21:18) I would say a little over 300, oh.
Mike Manson (21:23) Okay. A little over 100. That’s typically a good size to go get delegated. I’m surprised that.
John Reel (21:30) Yeah, I don’t well, it’s kind of split up into. So we’re you know, different payers, different, we were in five states in the southeast. Yeah. So that may be part of it is we’re not big enough. And some of those we’ve and let me double check that number. I don’t want to lie to you but.
Mike Manson (21:53) Sorry to, while you’re looking that up, is that 300, is that across all of your brands like baptist urgent?
John Reel (22:00) That’s right? Yeah.
Mike Manson (22:02) That’s across.
John Reel (22:02) Everybody. Yeah. And so the way we work is we’ve… got JV… partners in different states but we’ve only got those billing entities. That kind of it rolls up to. So, we only have five kind of group entities. And then we’ve got rural health clinics as well. So that brings in another little twist to it. I don’t know if you guys have, I’m sure you guys have experience doing those, but, yeah.
Mike Manson (22:37) We actually just ran a program that was pretty interesting. I’m sure you probably heard about, the big beautiful bill with, the rural health transformation project. Did you catch, yeah.
John Reel (22:50) Cut medicaid and stuff. The.
Mike Manson (22:53) The, yeah, there was, so, that was part of it. But on the more positive note, they actually, and we, where I’m actually working on this with the, a rural health organization out in New Mexico where we actually helped them apply to get federal funding because they basically, they put out a grant that gives funding.
Mike Manson (23:16) They have a certain amount of funding allocated for each state. If you go and apply, you can get federal funding to pay for things like digital transformation. And, you know, there’s like three categories that medallia would fall under. So they were actually able, they haven’t gotten approved yet, but we were able to help them get them their application submitted and they’re going to ideally use that funding to help bring us in to help kind of upgrade their tech infrastructure.
John Reel (23:44) Nice. Yeah. I did see that in Tennessee. And I guess the states, are the states doing that? Or is that federal? I?
Mike Manson (23:52) I believe it’s federal, it’s I believe it’s federal. And then each state, from federal gets a certain amount of, yeah.
John Reel (23:59) Okay. So the federal funds it, and then the state gets to allocate it depending on. Okay. Yeah. I did see that. I think our governor come out and said that, you know, I don’t know… I don’t know if we’re large enough with that from that rural health perspective, I would say, you know, we’ve got what now 15 clinics?
Mike Manson (24:24) Okay. And,
John Reel (24:25) you know, they’re all, you know, it’s like five in Tennessee and, you know, three or four in Mississippi. So it’s kind of like split up like that. So, I don’t know if we’d have enough leverage in each state, I guess is where I’m going with that. Sure. But that is good to know. I mean, that’s interesting stuff. Yeah.
Mike Manson (24:42) Yeah, we put together a one pager on that. I can share that with you as well. Absolutely. Yeah. I know we’ve only got a few minutes left. I don’t want to keep you over. One other thing. I just hoping to understand a little better. You mentioned the 30 day average turnaround time on the payer side. How are you clocking that? Is that from the time you submit an application to the time they’re par status?
John Reel (25:13) Yeah. So we can, you know, like with blue cross for example, well, and I guess I’ll go back, some of our… some of our contracts are facility based urgent care contracts where you just have to do the facility. We don’t have to enroll the provider, yep, it just builds through there. And, but like for example, on blue care in Tennessee, we can see the tracking through availability.
Mike Manson (25:44) Okay. Gotcha. Okay.
John Reel (25:46) So that’s it’s kind of our major payers that I say that on, I don’t know that as an average on all, but our bigger payers being that way, I kind of assume, you know, that’s about what we’re doing. It’s probably a little higher than that, but I would say the majority of our revenue probably falls in that 30 45 day range.
Mike Manson (26:14) Gotcha. Okay. Yeah. I mean, if that’s 95 percent of your business, then, yeah, you’re probably in a good spot. Well.
John Reel (26:21) And the good part, is like probably a quarter of our business in Tennessee alone sits on that facility credential. Yeah. So we don’t have to individually do those providers. So that helps. Yeah, that’s a big difference. Yeah. So, there’s a nuance there for us where we’ve got both, you know, urgent care contracts that used… to bill on ub. Now, they’re some of them are allowing still on a 1,500 or whatever. I don’t know if there’s more you need to know, but facility versus like a primary care fee schedule.
John Reel (26:58) Okay? You have to enroll each individual provider. We don’t have to enroll the individual providers on those facility based contracts.
Mike Manson (27:05) Right, right. Yeah. I worked with the hospice care company and they were, they had 500 facilities and it was all they didn’t enroll directly any of their providers, so.
John Reel (27:15) Yeah. So, yeah.
Mike Manson (27:18) Very good. I know we’re coming up on time. I am going to just kind of summarize things in an email. I’ll send over some additional information and, you know, I may check in with you towards the end of the year and see how things are going. And I’m an open door here. So if things change, I’m more than happy, if you do see something that piques your interest and you want to get back together and do a more of a live demonstration, I could bring in a solutions consultant. We’re happy to do that just so you can see it.
John Reel (27:44) Yeah. And then,
Mike Manson (27:45) I guess last question I had for you so candidly, I found this piece of information out after I had reached out to matt for an introduction. I saw that Tom dent your CEO. I believe he is either on the board or definitely involved with healthstream. Yeah, that’s.
John Reel (28:08) correct.
Mike Manson (28:10) I have to imagine that would make it pretty difficult to move off of that. Does he give you any kind of autonomy on that stuff or? Yeah.
John Reel (28:20) We have autonomy on that. He doesn’t Tom separates that. He’s good at that. I think Tom is an old school hca before hca Guy that, you know, was a company before it became hca kind of thing. Okay? And then he’s kind of spun off. So he’s just very well known in the healthcare environment and especially by the old hca regime, the frist and all, that actually owned healthstream as well.
Mike Manson (28:54) Okay. And.
John Reel (28:55) So, of course, I guess healthstream is probably public now. Who knows? But yeah, Tom doesn’t dictate for the department, see, you know, if things whatever works well and new, he’s not going to, you know, he’s not going to step in and do that. You know, unless he just thinks it’s not… a good product, but, he’s never dictated to me one way or the other. The way, you know, we should run things if they’re working. How about that? If they’re not working, he’ll step in, but he’s never, you know, you’ve got to use healthstream… products or hca products or anything like that, you know, so.
Mike Manson (29:38) No, it’s good to know. I figured I’d ask because I saw that and I’m like this is going to be a hard sell.
John Reel (29:44) No, no, yeah. I mean, it’s he’s just, you know, he’s one of those old school Nashville guys that has sold companies and, you know, more private equity back. So, he was actually placed as our chairman, and then the, and this is before I came here, but he was placed as the chairman, the CEO left… in some form or fashion and they asked Tom to step in as the CEO. So he’s the board chair and CEO, so that’s kind of how, that worked. He, he, I think he gets placed on quite a few boards because of his knowledge and history. So.
Mike Manson (30:30) Nice, very good. Yeah.
John Reel (30:33) But no, I would love to just see the info. I mean, I’m you know, intrigued by the product, it sounds like a great product and, you know, I will say, I’m not in any hurry to jump into anything just because I’ve got it smooth rolling that I feel like right now but you never know, like if you can save some money or see something improve, you know, I’m always open to it. So, I’d love to check it out and take a look, yeah.
Mike Manson (31:03) I will, I’ll send over some info. I will keep you in mind if we, if we’ve got anything that I, you know, any product releases or things like that I think could be relevant for you. I’ll reach out and we do host regional events too. I know we’ve done quite a few in Nashville. So if we’ve got something like that going on, usually kind of more of a networking, less of a medallion sales pitch, kind of a, an event. I’ll keep you involved in that as well. Yeah.
John Reel (31:28) Awesome. Great.
Mike Manson (31:30) To meet you, John hope you have a great rest of the day.
John Reel (31:32) Yeah, pleasure to meet. You. Take care.
Mike Manson (31:34) All right. Take care. See you bye.