Transcript
Mallory Smith (00:00) what’s up, Mel? Hey?
Jacob Andreasson (00:02) How are you?
Mallory Smith (00:04) It is a good day.
Jacob Andreasson (00:07) I like, your hair’s still up?
Mallory Smith (00:11) It’s very up. Yes. Look, when I shake my head, it’s very bouncy. I’ve got the demo environment and everything prepped, which I love that we can do that because we can, I can basically build it out with your logo and then just save it and then come back right before the demo and open it up. I don’t have to build anything out right before the demo anymore.
Jacob Andreasson (00:30) Did you not, you still want to do that? Do you have to like keep it open?
Mallory Smith (00:34) Yeah, because like if I want to put the customer’s logo in there or like do anything like that, I have to reconfigure everything. And with this one, you just attach the logo, you change what the name you want it to be, and it’s done like, it’s a really cool tool. Awesome. It has its issues, don’t get me wrong, but like overall, I’ve been very happy with it.
Jacob Andreasson (00:51) It’s great. Devin is in here. Did you get my message? Where I’ve got a quick like command of the message slide and then I’ll let you jump into it.
Mallory Smith (01:00) Okay. Just got it. Yeah, sounds good.
Jacob Andreasson (01:01) Okay, perfect.
Jacob Andreasson (01:08) Hey, Devin. How are you?
Jacob Andreasson (01:16) Hi, Lori.
Lcoverdell (01:19) Hi, how are you?
Jacob Andreasson (01:21) Good. How about yourself?
Lcoverdell (01:22) Good. Thanks.
Jacob Andreasson (01:23) Yeah, happy Monday.
Lcoverdell (01:25) You too. Thanks. And.
Jacob Andreasson (01:27) Then I see I actually have two devins in here, so I’m curious which one I’m going to hear the voice of first, there we go. Yeah.
Devon Murray (01:35) I’m seeing two too. I don’t know why I have another one. Sorry. Hey, the.
Jacob Andreasson (01:38) More the merrier, right? How are you doing, Devin?
Devon Murray (01:43) I’m good. How are you?
Jacob Andreasson (01:44) Fantastic. You guys have good weekends. Yeah, I did beautiful. Awesome. Well, Lori, I know we haven’t had the chance to meet yet, but my name is Jacob. I’m on the partnerships team here at medallion. So I had the pleasure of meeting with Devin a couple of weeks ago, just to kind of talk to you guys current credentialing process, determine… if there’s an opportunity for medallion to support, but would love to just get a quick intro on your end. And then I can have Mallory do one on our end as well. Okay?
Lcoverdell (02:16) Yep. So I’m the director of physician billing. So I have billing coding and prior auth under my scope and of course, enrollments is a huge piece of what we have to do to get a provider on enrolling. And yeah, we have one point five ftes devoted to that right now, but it’s you know, it’s a, even with that, it’s a challenge to keep up with all the.
Jacob Andreasson (02:43) That one point five that is not including you, correct?
Lcoverdell (02:46) Right. Yep. Those are separate. Yep. Awesome.
Jacob Andreasson (02:50) Thank you for that. And then, yeah, I have my solutions consultant Mallory on our end here. So I’ll have her do a quick intro and then we can jump into it.
Mallory Smith (02:59) Thanks, Jake, Lori, Devin.
Mallory Smith (03:00) It’s a pleasure to meet both of you. I’ll be running the visual platform demo for us today. I am a solutions consultant. I’ve been in the provider data space for roughly 10 years or so and I’ve been with medallion just under two. So I do love for my demos just to be informal conversational. I want to make sure that you would see it as an ideal fit and a potential partnership by the end of the call. So based in Nashville, Tennessee… I think it’s pretty much about me. I’ll pass it back to.
Jacob Andreasson (03:28) You Jay? Awesome. Yeah. So the goal for today, you guys is really just to put you two in a spot to determine, can medallion’s platform be an improvement from what we’re seeing today? If that makes sense, we can talk about some next steps if you don’t think so. That’s totally okay as well. But as far as an agenda, I had a quick slide just kind of recapping some of the points that we discussed. Devin would love your feedback there as well, Laurie to see if we missed anything. But then from there, we can jump into the demo. Does that sound like a good agenda?
Mallory Smith (04:02) Beautiful. And just fyi, beautiful is Jacob’s word. So if you want to make it a game amongst yourselves and count how many times he says it today.
Jacob Andreasson (04:13) Over under 25. I’m ruthless… Mallory’s a couple hours ahead of me. So I’m on Pacific Time, so she’s probably had a little more coffee than I have.
Mallory Smith (04:25) A couple cups, yes?
Jacob Andreasson (04:27) Awesome. So current state kind of what me and Devin had discussed a couple weeks ago, credentialing is being done by a team of one point five kind of to your point Laurie using spreadsheets and Healthstream in a very limited capacity. The biggest holdup is really the documentation or gathering information from the providers to kick off medstaff and payer credentialing timelines for payer, credentialing is usually 30 to 45 days longer, ones stretching 90 plus. You guys have, you know, looked at solutions to try to streamline this in the past but a lot of it still created or didn’t really fill in any manual gaps for your team if anything. It sounds like it kind of made it worse extending enrollment times and putting more work on your team’s plate. So you kind of just gone forward with, I think as Devin mentioned elbow grease so far to kind of get this from point a to point B. But some of the challenges that that’s kind of creating is the team of one point five is completely absorbed by credentialing. And then of course, the extended onboarding timelines that frustrate providers. They can’t see patients, you know, they’re kind of sitting idle. So that’s frustrating for them. A quick question I had there that Devin or Lori, I was hoping you could elaborate on is, I guess if this team was not so consumed with credentialing right now, what would you have them be doing? Or like what is more? Is it more like strategic work? Things like that? Can you give me an example?
Devon Murray (06:07) Yeah. Honestly, I don’t know that I have a good answer because that really kind of has been their life. So.
Jacob Andreasson (06:12) Far. Yeah. Gotcha. And is that something that I guess, would they be frustrated with that if they were kind of boomed off of credentialing and, you know, like say that work was automated and they were put on something else?
Devon Murray (06:32) Yeah, I guess I don’t know that I see a world where we can completely shift all of them away.
Jacob Andreasson (06:38) Yeah, we.
Devon Murray (06:39) Have, so we have one and a half ftes. I think the person who’s on a half fte, probably, would, we have plenty of other things that we could have her join in. I think the person who does primarily credentialing is.
Jacob Andreasson (06:55) this?
Devon Murray (06:55) Is this is kind of all that she’s done? And so I don’t know that there’s an easy transition for her to do something else and this is something that she enjoys really well. So, yeah, but at the same time, I don’t know that I see a world where we completely are able to shift her away from this work. Yeah.
Jacob Andreasson (07:15) That makes sense. I mean, this is transparently a situation where one to half an fte could easily manage, you know, payer credentialing across your entire network using the medallion platform. So that’s something to keep in mind there. We would absolutely need somebody to, you know, go and invite the providers to the platform, submit the enrollment requests, things like that. Still. So it wouldn’t be a situation where, you know, completely eliminate that department by any means… but moving on here. I’m just talking a little bit, you know, about greater pastures, potentially a desired future state. So freeing up staff time. You know, we can talk about what that might mean later on the road, but automating a way or automating the manual part of the credential payer credentialing process, getting rid of that manual work that’s taking up so much of the team’s time and then of course, faster onboarding, so that providers are seeing patients not waiting in a queue. And then kind of talking about what that would mean for the business. Of course, providers are able to see patients generate revenue sooner. And then just reducing the cost of credentialing as a function. If we’re automating this work. We often find that we’re able to reduce the costs as well. Lori, I asked Devin this question last time we met, but I’d be curious to get your take as well. So like say you were to make a change 12 months down the road, how would you be able to look back? Knowing, you know, this was a success. We made the right decision. What would that look like for you?
Lcoverdell (08:48) I mean, obviously the reduced fte not needing as much fte allocated to this. I don’t know. I don’t have a set number in mind but that would be the biggest thing. And then also just, I think being able to keep our enrollments moving smoothly, you know, I think, I mean, for the most part, we’ve had the team, the two of them have done very well. Yeah, things happen. It’s not perfect all the time but they really have been very efficient and effective and tried to, you know, really there’s been very few issues that were within their control. You know, obviously some of that depends upon contracts and when, you know, how quickly that happens and what kind of notice they have. So, yeah, I think just that we would continue with the enrollments like we have been without, you know, any.
Jacob Andreasson (09:44) Being.
Lcoverdell (09:44) missed or delayed or, you know, those kinds of things that hold up services and payments. So it’s… kind of hard to quantify that, but those would be the things that I would look for. Yeah.
Jacob Andreasson (09:55) Speaking of quantification, are there any like I know you mentioned, maybe it’s not very clear on the fte side, but in terms of like quantifying, maybe if you can close that documentation gap or, you know, certain time to this provider’s, hired to this provider’s team of patients, how would you quantify like what success would look like there?
Lcoverdell (10:14) Well, I mean, we haven’t really tracked in terms of time, what that looks like for what they’re currently doing, what, you know, how much time they’re spending to get an average provider’s documentation, but it’s definitely more cumbersome than I’d like it to be, it would be, you know, we’ve tried a few things that we thought would help with that. You know, I think there’s been varying success on that, but that’s probably the biggest source of frustration and delay. And just, you know, just kind of chasing their tails. So, yeah. So I think that’s yeah, if we could find a solution for, that would accomplish a lot, yeah.
Jacob Andreasson (10:54) You’ll see some automation today that I think you’re really going to like kind of take a lot of burden off the team’s plate and the provider’s plate, make that a lot Symplr. And then I guess the last question I had here so, you know, using veritystream in a limited capacity and then the spreadsheets as well. Like where, what would you say is the single source for like provider data? Is it the spreadsheets? Is it verity, can you talk to me about the relationship between those two?
Lcoverdell (11:20) That’s a good question. I’m not sure if I can give you a really good answer on that just because I don’t I’m not, you know, our team, Jeanette and Quinnell are the ones that are really close to that. I know they use verity but I think it’s almost it’s become less helpful and useful to them as time has gone on more as opposed to more. So I think I would say that the bulk of their work and tracking is still done with manually tracking and using spreadsheets. So, and maybe that’s not completely accurate. They may have a different answer. But in our conversations, I feel like verity has become less effective for them as opposed to more got it. And they do, you know, I think, you know, it’s just hard to, some providers are very helpful and some aren’t they get emails, they get different things and they’re suspicious using the programs like caqh have been kind of mixed. Some of the providers are familiar, some not, some are suspicious, you know, when they get requests for things which, you know, naturally, I think that’s kind of how we all approach requests for information anymore. But yeah, it would be nice to have a better solution for sure.
Jacob Andreasson (12:35) Gotcha. And that makes sense. Thank you. And then I guess seeing as verity and Eric would love to get your feedback here as well. Seeing as verity has kind of not been as helpful. Is there a reason you guys are still, I guess using it… as opposed to like eliminating, I guess the system?
Lcoverdell (12:54) It’s kind of what we have medstaff uses it. So they entered into a contract. I think I can’t remember how long their contract was, but that’s what they have used for their part of their work and that’s kind of part of it too. I think that’s they’ve kind of they’re kind of getting away from it too from what Jeanette says. So it’s kind of what we’ve had really. Yeah.
Jacob Andreasson (13:20) Okay. That makes sense. And it’s we hear that a lot. I know we’re focused on just the payr credentialing side today. But what, I want you guys to think about medallion as a single pane of glass that you’re looking through for everything. So it’s going to be your single source of truth for all your provider data. You’re going to be able to do payr enrollments in there. You’re going to be able to do med, you could do med staff credentialing in there, everything from really onboarding to the point that this provider is seeing patients bringing in revenue for the organization. You can handle that entire life cycle within medallion. So I think that is a perfect segue to let Mallory jump into the platform here.
Mallory Smith (14:01) Sure. I’ll go ahead and share my screen.
Mallory Smith (14:11) Is everyone able to see it?
Lcoverdell (14:14) Yeah, we can see it. Yes. Thank you.
Mallory Smith (14:15) Thank you. So based on this conversation that we just had, I did have an idea and an outline of how we would take the demo today. I’m going to switch it up, Jacob. I’m switching it up on us. So I’m actually going to start with the provider onboarding experience first. I think that one is more of a priority point. So the flow that I would like to take today is to focus on onboarding your providers, what we’ll do with your current providers. And then we’ll transition to payer enrollment, delegated agreements. And then I’ll save analytics and reporting for last. Is that okay for our flow today? That works? Yeah, thanks. Yeah, of course. Okay. So kind of based on what you’ve said so far with the onboarding process, like Jake was saying, it is difficult when we have two separate teams where it’s medstaff credentialing. And then of course, your PE and contracting team as well. What we typically see especially for health systems of your size is that we’re able to take both of those teams, still keep them separated in the platform. But there’s one profile. There’s only one request going to the provider to go ahead and complete their application information. And then the two teams can take off on their separate workflows. So just something to keep in mind as we continue the conversation. I’m going to keep it focused on your side for today. But overall we do frequently work, we’ll have medstaff using one software, PE’s, using a different software. They want to keep those separate for a number of reasons. They’re still able to do that in the medag platform, but still be able to share the information. So rather than having to send emails back and forth to each other, it’s at least one platform. So when it comes to inviting new providers to the platform, first, I’m going to familiarize you with the platform itself. This is a browser agnostic cloud based proprietary system. It was stood up from the ground up in 20 20. And then from here on the left, you’ll be able to see the different areas that we can store your information as well as track the service requests that you need our team to assist with. And then of course, you’ll have your own tenant. You’ll have your logo up at the top left. So we do allow white labeling options throughout the platform as well as the emails that go out directly to the providers and then to onboard a new provider. My first question for you is how many providers do you typically onboard in a month or in a year?
Devon Murray (16:38) It could vary a lot depending on the month. In a typical year. We’re probably onboarding 20 to 30. Does that seem fair? Lori? Yeah, with.
Lcoverdell (16:50) The locums, yeah, I would say that makes sense. Thank you.
Mallory Smith (16:56) And how long do the locums usually stick around?
Devon Murray (17:02) Again, it varies a lot. A lot of the locums that come in here. We’re not going through the full credentialing process, but we do have quite a few that we.
Mallory Smith (17:15) know, are going.
Devon Murray (17:16) To be here for multiple months. And so, we’ll actually… go through the process of credentialing with them, okay?
Mallory Smith (17:26) Thank you. Yeah, that absolutely answers my question. The reason I ask is we do have two different ways to do the data ingestion, we can do single which I’ll show you here. Just invite the provider, someone from your team. So probably the fte that you leave with the PE would be role based access control. All we would need is their email name, start date and provider type if they are just a provider and they’ll need to see only their information. Perfect. We’ll set them up with that access your fte or really either of the two of you could also get admin access into the platform. We actually charge based on provider count or how many provider seats are in the platform rather than users. So you could set up everyone at your organization, whether it’s HR billing scheduling with access to the system. And you can also control what they’re able to do within the system.
Mallory Smith (18:12) So if you have a scheduling team that only needs read only when it comes to the providers participating and effective, then they can do that. We also have the ability to send reports directly from the system to the scheduling team. So multiple ways of working that. But the big picture when we think of onboarding is that you can invite one by one or we also have bulk import. So with the bulk import, all we would need from you is the provider’s caqh id, their last name, their npi and their email. But those four data fields are all we would need to be able to create a shell profile, automatically link that provider’s caqh, bring over the data and the documents. I’m going to show you an example of what that looks like now. And then it’ll also send out a welcome email to the provider, letting them know that you have now been invited to medallion. We are now partnering at st Peter’s and things like that. When you invite a provider to the platform, they’re going to receive an email that looks something similar to this. You would of course, see your logo. You do get to control the body of the message itself. So whatever you think is going to grab your provider’s attention the most, which we’ve seen success with in the past. When they receive this email, they’ll have the option to go ahead and get started with the credentialing process. When they click, get started. I’ll take us through the onboarding flow. This is very interactive. The other thing that I’ll call out here and you can do this from your phone or from the tablet. So if they’re not available on their laptop or they’re busy seeing. Patients day to day maybe they’re walking, then they can do so from their cell phone, they’ll be able to see that st Peter’s health has partnered with medallion for licensing credentialing enrollment, whatever services you’re looking for to… kickstart their profile. We have multiple different ingestion methods. So the first one of course is caqh. We are a participating organization with caqh. We are the only vendor in the space that actually has that access. What that means is caqh will populate 70 to 75 percent of the provider’s initial profile in medallion, getting you an average onboarding timeframe from start to completion in roughly two days. So all of our customers that are currently using the platform, see about two days for their providers. If they use the caqh method. If a provider does not have a caqh, then we also have a resume scanner. So maybe they’re a fresh graduate. Maybe they have a CV or a resume that’s five pages long and it’s not all in caqh, whatever the reason. They are able to upload a PDF version of that and have it populate the profile for them and finally API integrations. So of course, we are open ended bi directional. We would be able to connect to any of your systems that are also open ended. Where we typically see this the most would be with HR platforms. Other examples would be to billing or scheduling systems for the payer enrollment, participating statuses as well. But the big picture is that you are able to connect apis if your technical team does not have the bandwidth at this time, our team can also build it for you. So just something to keep in mind for these providers, we’re going to connect their caqh. So they’ll provide their social caqh id. And the last thing, so the important thing to call out here is typically, when you’re connecting to caqh, there’s other vendors in the space that say that they can connect to it. But typically you need the provider’s username and password to be able to access that. I don’t know if either of you have ever called a provider and asked them for their caqh or their username or password. They don’t remember their office assistant from two offices ago, kept it. They’re not sure how to reset their password. It’s always a little bit of a cluster if we’re honest. So this one, you only need their caqh id. Your team is actually able to find this information as well. So there’s two different ways of onboarding a provider, we can send the link to the provider. They link everything themselves or your team can link their caqh complete as much as they need to, and then let the provider know. They can log in and review it. So either way, we have customers, probably… 60 40 that they’ll have the providers connect to themselves and then a good 40 percent of our population. They will white glove service and collect as much information on the providers they can before inviting the providers to the platform. So either way connecting with caqh is going to reach out via that direct API. It will now pull in all the data and the documents that we need. So we see about a two day turnaround time there. And then just so you see what a profile looks like from the provider’s view, this is the great thing about medallion. This is all in one system. So if you want to have your med staff team, if you want to have your privileging, your payer, enrollment, your ongoing monitoring, everything can be step stored within the platform and the provider gets their own way to access it. They can send tasks back and forth with your team. This is a way to track communication. So rather than your fte goes on vacation, they send something to their email. Your team doesn’t know about it for the full week until your fte gets back. Just an example that everything can be tracked here in the system instead. So this is the provider’s view. They would be able to see any of their tasks. The profile completion will be indicated with the green check mark that you see to the left. They’re licenses, they’re payers. So not only is this a way to communicate back and forth with a provider to go through the onboarding process as well? But it’s also a way for them to store anything that they need. So they can store their Facebook passwords in here if they wanted to, right? So this is a repository as well as a tool for the providers. In addition to getting quicker turnaround times for your team. Another really nice benefit of this. If I go to the documents, we have what we call a QR Code scanner. So if the provider has their diploma hanging up on the wall rather than taking it down, untacking it, finding a printer scanner, having the admin, email it over whatever that may look like. They are able to just upload by photo. So they can take their cell phone, hover over the QR Code, hold it up to the wall, hold it up to the piece of paper, the face sheet that’s on their desk, and it’s going to scan it in the API and OCR technology will then take over and help identify the document, save it as a PDF, even help name the document too. So that is one of the biggest. I tend to focus more on business outcomes. But if we think of like features and functionality of the platform itself, we’ll have a voice of the customer, where a provider will speak to us at a quarterly basis from our customer base. This is the one that they always just love the most quite frankly because it’s easy. They’re on the go. They’re able to just take a picture or just upload it from their phone. And that last piece, I want to show you the mobile experience. So so far, this would be the provider’s view and their experience. If they were to do this from a desktop or a laptop, with the mobile view, they’ll be able to see it from their cell phone. They’ll know that, oh, the profile is 94 percent complete. If I open this up what is still needed, the agreements they can sign from their laptop or from their phone, they click on the document, review the information, add it, signature. It is electronic signature integration within the platform and then finally sign the two or three documents we need save and finish. So, all of those steps is how we ascertain a two day onboarding average for your providers across the board. I’ll pause there for a minute just to see if there’s any initial feedback. If this is similar to the timelines you may be experiencing. Now? Any questions with it?
Lcoverdell (25:46) No questions so far? Thanks nothing for.
Mallory Smith (25:48) Me in terms of your.
Jacob Andreasson (25:50) Guys, I guess how current documentation done? Is it mostly like you guys send out a form? Is it email communication or give staff calling? Can you talk to me a little bit about that?
Devon Murray (26:05) Again, I think it depends on the payer and the provider. Jeanette is on the phone. A lot, just kind of tracking things through each of the payers has.
Mallory Smith (26:18) A different.
Devon Murray (26:18) Form, but it also depends on what providers want to supply. Jeanette has most of their information, but not all of the providers want to share their caqh or medicare… logins?
Jacob Andreasson (26:34) And then I guess just general sentiment of like reducing the time two to three weeks to two days. How would that impact the provider experience? Do you get any feedback on their end about when they are having to wait or what would be the general sentiment on being able to speed that up?
Jacob Andreasson (26:58) Yeah, I don’t.
Devon Murray (26:59) know, I don’t know that we’ve gotten the feedback. I think part of the challenge that we have right now is that a lot of the providers aren’t you.
Mallory Smith (27:08) Know, willing to go.
Devon Murray (27:10) In and complete.
Mallory Smith (27:13) Even the.
Devon Murray (27:14) basic forms that we have.
Mallory Smith (27:17) And so, I.
Devon Murray (27:18) think part of the, one of the questions that I have that.
Mallory Smith (27:22) You know, to kind of.
Devon Murray (27:23) Discuss with Lori is, do we really think that people will finish this if we were to send it out? I don’t know Lori, what’s your take on that?
Lcoverdell (27:34) Yeah, I mean, kind of what, I think I mentioned a little bit before that it, she kind of has mixed success. I mean, I know she does try to email and, you know, some providers are responsive. Some are not, it’s just, I think it’s kind of a honestly a crapshoot, you know, in terms of getting the information she needs from, you know, at this onset… some of them she has to chase down and kind of babysit. So, yeah, it’s.
Mallory Smith (28:03) a hard, it’s hard to know, hard to question and answer. Okay. No.
Jacob Andreasson (28:08) That makes sense. Appreciate it. You guys kind of filled some gaps there. I’ll hand it back to you Mallory. Yeah, thanks, Jake. Okay. So where we can?
Mallory Smith (28:16) Transition from here is we’ll go ahead and show you the standard payer enrollment process. So I go back into my software platform here. What we’ll be able to review first is I’ll go to the payers tab. And then what I’ll call out is going to be for each of your tax ids or your practice locations. You’ll have a specific payer list that will be automatically configured. So part of how we structure the groups and facilities in the platform, is you’re able to see the roster of providers that are at each group, as well as the payer or contract execution agreements that you have for each of those payers at the group level or facility. So that way when your team member is logging in the platform and you have a new provider, onboarding, providers completed the onboarding process. Someone from your team would then access payers, go to enrollment request, and they would be able to request the new applications for your new provider that’s joining. So what I’ll point out first though is just the full transparency and visibility. I would say that medallion is a hybrid solution where we’re going to perform the work. We’re going to have contracted slas, to get the applications out the door in a certain amount of time. We have a high level of accuracy on the application. So they don’t have to be resubmitted for errors, missing information, incorrect information, anything of that nature. But you also get to see every step of the way should your team want that level of visibility. And when I say every step of the way, I mean every email that we send to the payer or provider, the submitted application, the welcome letters, anytime that they respond, everything is tracked directly here at the payer line. You’re able to see when the follow up date is occurring. We do have automated follow up for every single payer. So we have an internal directory for the payers that has over 1,200 payers per nation or for the entire nation. And with that, we have prescriptive steps. So how our team is able to get the applications out in a record amount of time. And that’s going to work for economies of scale as well. Is that if I were to go into medicaid of New York, for instance, our team would be able to see what’s the parent payer, what’s the process guide? Is it a medical behavioral, dental vision provider? And this is what the workflow engine uses to populate the application, whether it’s a PDF or an actual portal application. Now, which application method we’re using, if it’s paper portal. If we need to fax something in there’s still a few payers out there that do that. And then of course, the application steps that will follow. So you’re getting the guaranteed turnaround times the accuracy rating. But you’re also seeing how our team does this internally just so we can get the, we can meet those standards for you.
Devon Murray (31:07) This includes the.
Mallory Smith (31:07) required documents, how we’ll need to follow up the automated follow up calls that will happen from our team, and then even an escalation pathway. So we have an escalation for each of the payers.
Devon Murray (31:18) And then finally.
Mallory Smith (31:19) Any additional notes that would be good for our team to know?
Devon Murray (31:23) So we have that built.
Mallory Smith (31:24) Out for over 1,200 payers just across the nation itself. And then the other great aspect is that when you’re reviewing these lines, you’re able to see that it is currently in the request status. You can see that it’s been assigned the provider start date. If there are any dependencies. Sometimes in this space, we’ll see that you cannot submit, take Texas, for instance, you cannot submit Texas medicaid without the medicare id number. So that’s an example of a dependency. Our system will automatically have that baked into the platform so that your fte, whenever she’s reviewing it, she’ll be able to know if this application hasn’t been submitted. It’s because we’re waiting on X y and Z. Another great aspect is that you’re able to see our notes as well as store your own notes for whatever internal tracking purposes you may see. I think the big picture here is full transparency. And if there’s a date, we can track it. So you’ll now have access to all those metrics that you were talking about earlier, whether it’s when the provider was invited? When did they complete their profile? When did we submit the request for these applications, comprehensive audit history. So that’s what I’ll show you when we wrap up the demo today is just the analytics and how you’re able to track each of those. Since you don’t currently have access to it today… come through and make a request so that you’re able to see the process and how it’s tracking.
Devon Murray (32:48) Your fte?
Mallory Smith (32:49) Would highlight request?
Devon Murray (32:51) New payer enrollment?
Mallory Smith (32:52) We also do demographic updates as well as revalidation for payers.
Devon Murray (32:58) Indicate if it’s.
Mallory Smith (32:59) group provider or facility, we are comprehensive in services. So we can do all three and then finally select the provider in question. So the system is intuitive. And actually I do have a quick question for you. Do you have multiple tax ids, multiple groups or is it all sitting underneath one?
Devon Murray (33:21) All one, all under one? Love that for?
Mallory Smith (33:25) You guys? Okay. Thank you. So essentially, it would just be one group or one tax id here?
Devon Murray (33:31) Identifying the,
Mallory Smith (33:32) state. So if the provider doesn’t have a license in that state, you’re going to notice that it’s missing. So yet another way that we’re able to make sure that redundant errors aren’t being made that you’re submitting the correct information for the correct provider at any time, then we’ll be able to highlight it here.
Devon Murray (33:49) And then that last.
Mallory Smith (33:50) Step selecting a payer. So if you are all under one tax id and all of your providers go through the exact same payer list that’s perfect. One click and it can highlight all the payers that are assigned to the tax id, if you have any that you would rather just select from the list, you can do.
Devon Murray (34:07) That as well. The same lines.
Mallory Smith (34:10) Of business can be indicated. Yes or no. This really depends on your fte, how she’s managing this, if it’s.
Devon Murray (34:17) medicare?
Mallory Smith (34:18) Advantage for some of the payers, not for some of the payers. So there’s either, or that will give you the ability to there.
Devon Murray (34:24) And then finally,
Mallory Smith (34:25) the practice locations?
Devon Murray (34:27) Do you want to use the?
Mallory Smith (34:29) Same practice location for all payers details and notes?
Devon Murray (34:33) So, this?
Mallory Smith (34:34) Is essentially the process she would need to go through whenever you think of onboarding a new provider and making the request from there, she can be hands on. So once the request has been submitted?
Devon Murray (34:44) You’re going to have a,
Mallory Smith (34:45) payer line appear just like you see here?
Devon Murray (34:48) You’ll be able to see.
Mallory Smith (34:49) The request details?
Devon Murray (34:51) We’ll of course, be.
Mallory Smith (34:52) Using the internal processing guide for each of these payers, you’ll have the visual task reminder to the right here.
Devon Murray (35:01) You’ll see.
Mallory Smith (35:01) When the latest follow up occurs and any notes that you would find relevant?
Devon Murray (35:06) As well once we’ve gone?
Mallory Smith (35:08) Through followed up with the payer after we submitted the application and received a welcome letter or an effective.
Devon Murray (35:14) Date, it will then.
Mallory Smith (35:16) Automatically transition to the enrollment summary. So billing status active versus inactive. This can be very specific. We can be, you can have effective dates tracked at the specific line of business and practice location. Should you need that level for typical billing, we would see the information that.
Devon Murray (35:37) You see here, but we do have the.
Mallory Smith (35:39) Level of granularity, that if you need to be very specific when it comes to this line of business for this provider type at this practice location or this facility, then you’re able to.
Devon Murray (35:49) Track it there as well. So you have that single.
Mallory Smith (35:52) Source of truth at the end of the day, you do have the ability to go through and filter based on the needs that you currently have.
Devon Murray (35:58) And then when we.
Mallory Smith (35:59) show you analytics and reporting at the end of this, I’ll show you how you can even build your own reports in the platform and just how simple it is to monitor.
Devon Murray (36:09) I’ll pause.
Mallory Smith (36:10) There for just a quick minute. I’m just interested in general feedback. Do you think your fte and I’m so if you just want to tell me her name, then I can stop saying fte, that would be great. Just general feedback.
Devon Murray (36:26) Yeah, Jeanette’s.
Lcoverdell (36:27) our one point. Oh, and then we have Quinnell helping her. So, yeah.
Mallory Smith (36:31) Thank you. I appreciate it. I felt so bad. So what?
Lcoverdell (36:36) Do… you think?
Mallory Smith (36:40) About, the enrollment request itself? Do you think Jeanette would enjoy this? Do you think it’s similar to what she currently does?
Lcoverdell (36:49) I think that, you know, I mean, she manually does a lot of this. So, yeah, it seems like it would be helpful to have it kind of automated and then have the tracking behind it. Yeah. Okay. Awesome.
Mallory Smith (37:04) I appreciate the feedback. Thank you. How long does it?
Jacob Andreasson (37:07) Typically take her to? I guess once she has all the information, populate an app, get it out the door. How long does that typically take?
Devon Murray (37:18) That’s a good question.
Lcoverdell (37:19) I’m not really sure to be honest. I mean, I know, you know, she gives me updates and we talk, you know, constantly through the week. Usually if there’s issues or she’s running into problems, you know, I think she’s juggling all of this, you know, all these different ones at the same time. So I don’t know that, I don’t feel like I can really answer that very well. I do.
Devon Murray (37:40) Feel like usually within a couple of days, don’t you feel like Gloria, yeah.
Lcoverdell (37:45) I mean, she, from?
Devon Murray (37:45) The time that she gets all of the information to the time that we are able to submit applications, it never takes more than a week.
Lcoverdell (37:53) Yeah, I would agree. She’s very, I mean, she’s juggling all these and prioritizing them and she, you know, she’ll review it with me here and there to make sure she’s on the right track, but yeah, I think she’s efficient once she has what she needs, the hardest part is getting everything she needs. Yeah.
Mallory Smith (38:11) That’s.
Devon Murray (38:12) great.
Jacob Andreasson (38:13) Has there ever been a situation where, you know, maybe a lack of visibility or insight, has, you know, led to a downstream problem because it sounds like obviously she’s very doing. She’s.
Devon Murray (38:25) very good at her.
Jacob Andreasson (38:25) Job and she is handling these timelines well, but from like,
Devon Murray (38:29) it seemed like there may.
Jacob Andreasson (38:31) Be a lack of visibility in some areas. Has there ever been a situation where that’s created downstream challenges or anything like that?
Lcoverdell (38:44) What do you mean by lack of visibility? I’m not sure. Do you mean like that? She’s not getting the, yeah.
Jacob Andreasson (38:50) Just in terms of like being able to quantify certain timelines, how long, you know, things are taking anything like that. Usually, like when we think of like the biggest bottlenecks, it’s usually an area that maybe is not easily.
Devon Murray (39:04) Like there’s.
Jacob Andreasson (39:06) limited visibility into it so to speak. And that’s just kind of an area where the analytics and like this kind of the platform is typically able to help. So, I’m just trying to understand if there’s any challenges that have arisen because of that.
Lcoverdell (39:24) I don’t even really think of off the top, you know? Yeah, nothing specific comes to mind.
Mallory Smith (39:29) Okay. No, that’s.
Jacob Andreasson (39:30) great. Thank you.
Mallory Smith (39:35) Alright, thanks, Jake. So what I’ll do next is I’m going to go ahead and show the delegated portion. I know that Jacob told me you basically have, I think three or four delegated agreements right now. I’m just going to show you how we would be able to monitor those for you. I think the biggest benefits when you think of the value that you’ll see with delegated agreements is first, we have a three day turnaround time to credential your providers to ncqa standards. The other aspect is we have fully automated roster generation. So if Janelle is currently having to go through and spend hours per month populating the rosters showing which providers have been added, who has been removed, especially with locums involved, we can see demographic updates. All of this is something that is completely done and automated by medallion. We would send those reports to Janette a few days before she has to submit them to the payers. So I’m interested in your feedback. When I show you the delegated piece just to see if it would be close enough. And Janette, everyone wants to have a conversation with us and I can show her what that looks like. We can do that as well.
Devon Murray (40:39) But starting.
Mallory Smith (40:40) off with delegated agreements just to show you what they would look like visually in the platform, you would have all three or four of yours effective here. In the delegated agreement section, you would be able to see which providers are a part of those rosters, if they’re eligible, if the roster is complete or not, how many practices or locations that they’re attached to the groups and documents that can be stored at the delegated or group level.
Devon Murray (41:06) And then that’s just going to be.
Mallory Smith (41:08) Visibility our team is going to really handle the rest. All that Jeanette would be responsible for is clicking into credentialing here. She’s going to be accessing requests, provider, initial credentialing. Letting.
Devon Murray (41:22) Us know if it’s.
Mallory Smith (41:23) existing providers that need to go through the re, credentialing process, or if it’s for new providers that need to go through there as well.
Devon Murray (41:29) And then finally, you’ll.
Mallory Smith (41:30) see the request. So once it is submitted, it’s just a click of a button. You’re able to see every bit of the aspects that you see.
Devon Murray (41:40) So.
Mallory Smith (41:40) Of course, we missed an SLA, because I don’t know how to submit this otherwise, but processing if everything has been unblocked. So you get a high level of detail when we think of ncqa level credentialing.
Devon Murray (41:52) And then when those.
Mallory Smith (41:53) files are ready for your review, this is a completely automated and virtual committee voting process. So your committee members can gain access to the system. They’re able to review all the files, electronically, vote electronically and do it on their own time. So whether it’s a seven am or nine PM, whenever they have time to review, what you’ll see there is, it’s going to shorten your committee timeframes if they have to meet once a month, maybe every couple of weeks for an hour or two to review it, they no longer have to have those meetings. So, the other great benefit of using medallion as your subdelegate and having us manage your delegated credentialing so everything is virtual, there’s nothing that needs to be printed out. There doesn’t have to be meetings on the calendar anymore. And then you’re able to see exactly everything that’s happened. So if I were to look at the first one here.
Devon Murray (42:41) For the.
Mallory Smith (42:43) MSV reports, we’re able to see what has been verified, what hasn’t been verified. While we do have a three day turnaround time for these, we typically complete them in just under a business day. That is because we have 90 percent of the integrations.
Devon Murray (42:58) That.
Mallory Smith (42:58) are needed for ncqa, like 13 out of 15 of the different checklist items are fully automated. So our team clicks a button, is able to verify each of those aspects and then have that file ready for you.
Devon Murray (43:12) When we’re ready.
Mallory Smith (43:12) To send that to the credentialing file, your committee would be able to open it up.
Devon Murray (43:18) They give you all of.
Mallory Smith (43:19) This electronically. They’re able to approve or reject, approve with contingencies, you’re able to see who has yet to vote on the actual file, automatic notification or reminder emails can go out to the committee members as well to make sure this is moving forward.
Devon Murray (43:36) And then finally,
Mallory Smith (43:36) you’re able to see the actual credentialing packet. So if I were to open this up, it’s going to show me a comprehensive the how, what, when, where and why for every element that’s needed for ncqa, you can download this packet. Your committee members can leave their notes to the right of what you see here. You’re able to see if there’s any immediate flags or sanctions that need to be identified or discovered.
Devon Murray (44:01) And this could be.
Mallory Smith (44:02) What a file and a committee process would look like once your committee team member does go through and makes the vote and says yes or no, it then closes out the file as approved or rejected. You’re going to have all of that information as a central source of truth right here in the platform. So, whether that’s historic or new provider files that are coming through, and then the other great benefit of it, it’s automatically scheduled re creds. So, rather than Jeanette have to remember to log in every three years and make the re, credentialing request or perform the re, credentialing. This is going to send out an automatic notice to that provider, 60 days before it’s time for a re cred, that way you’re not missing deadlines, you’re not missing effective dates, the provider remains clean.
Devon Murray (44:45) And compliant.
Mallory Smith (44:45) As we do continuous ongoing monitoring for these providers as well.
Devon Murray (44:51) I’d like to.
Mallory Smith (44:52) Give you a visual of what we think with the delegation process. If I were to summarize that.
Devon Murray (44:55) Jeanette would come to the.
Mallory Smith (44:57) system, make a request for a new credentialing file, have that back within a guarantee of three days. Your committee members can vote within the platform at whatever time works best for each of them. And then you’ll have all of those outcomes recorded here. You would then see those new providers added to the roster under delegated agreements here.
Devon Murray (45:18) I.
Mallory Smith (45:18) know you have delegated agreements with three or four payers? Are they the typical like the blues, humana, Aetna? Cigna?
Devon Murray (45:29) We do have some regional payers that are pretty large for us. So, pacificsource, allegiance, mountain health co op, are the three probably smaller payers that are fairly large for us? Okay? Thank you.
Mallory Smith (45:46) And are those delegated agreements or non delegated?
Devon Murray (45:48) Non delegated?
Mallory Smith (45:50) Okay. Will there be an interest in getting them delegated? No. Okay. All right. Perfect. So it sounds like you got a good mix of it. So we are all encompassing here at medallion when it comes to delegated agreements, if you wanted us to stand up or establish more delegated agreements, we can, if you would rather us just start credentialing your providers and then manage the process, do the automatic roster generation, we can do that as well. So just so you’re aware that we can do it from start to finish, or we can just be as involved as you need us to be.
Devon Murray (46:22) Okay. So, before I show you,
Mallory Smith (46:24) analytics and reporting? As we kind of wrap up the demo today, are there any additional questions concerning payr enrollment, delegated credentialing, onboarding? Anything of that nature?
Devon Murray (46:39) We’ll keep going. So with analytics.
Mallory Smith (46:42) This is going to give you the visuals that you need within the platform. So with the biggest for our focus today being payr enrollment, these are standard analytics dashboards that are built for your team. So you’ll be able to start tracking all of those specific metric points, whether it’s the completed enrollments, how many enrollments happen per month? If you want to track the information, I know locums are really big in June and July. If you want to see how many you’ve actually been able to hire and get enrolled before their tenure ends, just examples of metric points that you’re now able to track status transactions, transition time. This is an area that Jeanette could really find useful. So if you’re able to see how long is it taking the provider to respond to the email? If it’s taking longer than normal, this report would basically identify that. And then she could go back and see how can we work with this? So she could then work with our team. You would have your own engagement manager, someone that you can email or call day to day communication. And then we could identify areas that we could streamline and make that more efficient.
Devon Murray (47:43) If there is an.
Mallory Smith (47:44) issue between the intake to app submitted, is it because we’re still missing information from providers? Is there a lag on the payer side? Are there things that we need to go through and identify? And then finally, how long from the request to completion. This analytics is going to give you a visual representation. You do have the ability to export any of these. They can be added to leadership decks or presentations. So I’m hoping that this opens the door for you to track any of those metrics that you’re not able to currently see in the system?
Jacob Andreasson (48:17) Yeah, this is kind of sorry, really quick. This is kind of what I meant when I referenced the visibility piece earlier is just really kind of getting being able to get granular and find out if there are holdups or bottlenecks or anything like that. Where exactly are those happening?
Mallory Smith (48:33) Great point. Thanks Jake.
Devon Murray (48:34) So whether that is.
Mallory Smith (48:36) With bottlenecks, with ongoing monitoring, provider, summary, providers being onboarded. What points are we tracking here? You’re going to have a visual for each of those different segments that you choose to partner with. Medallion.
Devon Murray (48:50) On the flip side?
Mallory Smith (48:50) Of that, we also have reporting. So I can create my own reports. There are standard reports that are included within the platform. The my previous career that I had, we had to use SQL server and crystal report writing. And it was a nightmare. And I think from like the 19 eighties. So the biggest benefit that I’ve been able to see with the reporting here at medallion is I’m going to show you how easy it is first to create the report. But the true value is that these reports can be automatically sent by the platform to anyone on your distribution list. So it could go to your scheduling team. It can go to your HR team to let them know that the onboarding is complete. They’re now enrolled, it can go to anyone on the leadership team that needs to know where is the revenue going currently? How are we looking as far as market share coverage across the state? Just examples like that?
Devon Murray (49:41) To build a report, you would simply.
Mallory Smith (49:45) Identify the information that you need. I could absolutely see Jeanette building these reports. And then in the order that you select the fields?
Devon Murray (49:53) Or data?
Mallory Smith (49:54) Points is the order that it builds the report. So, if you have any payor specific rosters that they need their information in a certain formatting, which we typically see a lot of especially humana, for some reason, then you’re going to be able to come in system. And in the order that you select it, let me say state payor lines of business, let’s get the provider information, maybe.
Devon Murray (50:17) Their.
Mallory Smith (50:18) practices status, how many days has it been since submission? What’s the effective date I’ll then transition this to the right. I now have a report with that required or missing information that I was needing. I can filter this right within the window.
Devon Murray (50:35) I can record this.
Mallory Smith (50:36) For an ad hoc reporting functionality or I can save this to be scheduled to be sent to anyone on a distribution list, daily, weekly, monthly, quarterly, annually, whatever you prefer to see here. So very configurable when you think of the analytics and reporting, just to round up the demo today.
Devon Murray (50:57) So, I’ll.
Mallory Smith (50:58) open it up now for questions. Just general feedback before I stop sharing and pass it back to Jake.
Devon Murray (51:09) I have any questions. Thank you.
Mallory Smith (51:11) Of course.
Devon Murray (51:13) Okay. I’ll go ahead and stop sharing now. Sorry, Laura, did you have something?
Mallory Smith (51:17) On my site? No, I don’t think I do either. Yeah. Okay.
Devon Murray (51:22) Awesome. Well, yeah, thank you.
Jacob Andreasson (51:24) Mallory. So I guess I’d love to just understand. It seemed like, you know, there were some areas where there could be some efficiencies. Does this seem like something that’s moving the needle for you guys enough to, you know, continue the conversation? Or is there anything that I guess you were looking to see that you didn’t.
Devon Murray (51:45) anything that I was looking to see that, you know, looking for that? I didn’t see? I think that the biggest question for us is whether it’s going to move the needle enough. And I think that’s something that we probably need to talk about internally just to kind of gauge that a little bit more.
Mallory Smith (52:01) Yeah, yeah.
Jacob Andreasson (52:03) Absolutely. I mean, yeah, yeah. Let’s go ahead and do that. Then in terms of next steps, we’d love for you guys to just, you know, give a better understanding what that would look like on our end just to give you guys some context. If we were to continue the discussion, we would do what we call a business value assessment. So we would take, you know, what are your turnaround times, what are your current costs? And then compare that to, you know, how much revenue could you accelerate with medallion? How much faster would providers be seeing patients? How much money could you be saving by automating this work? So we’ll package that up in, you know, essentially one big holistic presentation to that we call the business value assessment to really kind of paint the full picture and Roi of what a partnership would look like. Obviously, I understand you guys have your processes on your end as well. But if you did want to continue the conversation, that’s something that we could put together. So, you know, it makes sense in real, you know, dollars and cents terms if it does make sense to partner.
Jacob Andreasson (53:09) Good to meet you. Okay, great. Well, yeah, I will, I’ll plan to maybe follow up around this time next week. If I hadn’t heard from you guys, but if there’s any questions that come up in the meantime, please feel free to reach out.
Devon Murray (53:21) Sounds good.
Mallory Smith (53:23) Alrighty. Have a good one. Thank you.