Transcript
Bradley Eral (00:00) hey, Kurt, you got Brad here with medallion?
Kurt.Connolly (00:04) How’s it going?
Bradley Eral (00:05) Good. How are you doing today? Good. And I gotta ask, I saw you went to Iowa. My dad went to Iowa, so I was pulling for the hawkeyes, but what a run this year in March madness. I don’t know if you kept up with that at all, but it was great to see. It’s. Been a minute since I’ve been excited about Iowa basketball.
Kurt.Connolly (00:23) Where are you from?
Bradley Eral (00:24) I’m out of Minneapolis, Minnesota. Okay. How about yourself?
Kurt.Connolly (00:27) I grew up in Iowa. I live in Kansas City.
Bradley Eral (00:29) Now, okay, nice, whereabouts in Iowa did you grow up?
Kurt.Connolly (00:32) So, well, the simplest part is to tell people if, you know where the field of dreams is at. Yeah. Okay. I grew up five minutes from there.
Bradley Eral (00:38) That’ll do it that’s awesome. Yeah, my dad’s side’s from a small town in northwest Iowa, Pocahontas.
Kurt.Connolly (00:44) Okay. Wow. Okay. Yeah.
Bradley Eral (00:46) Absolutely. But no, hey, we’ll get to some introductions here shortly. I appreciate you jumping on really. The goal today is to understand a little bit further what you guys are working towards from a credencing standpoint and I could ultimately provide you with enough information about medallion so you can determine, does further discussion make sense or not both of which are perfectly okay outcomes. But does that fall in line with what you’re hoping to get out today?
Kurt.Connolly (01:08) Yeah. So, yeah, yeah, it does. I think I’ll back up a little bit. Yeah. So, been in healthcare for 31 years, healthcare specifically. Okay. Prior to this, I was over at a company called everhealth or evercommerce. And I think we did a dance with you guys a little bit at that time as well. Yep, around trying to think through some stuff on the credentialing side of the house. So, I’m a little familiar with what credential like, I’m a little familiar, but I’m not a lot. I think Morgan knight was my primary point of contact working with you guys as well. Is it another Guy named Jared union gotcha.
Kurt.Connolly (01:44) And they were running with it, but, yeah. So, I know a little bit, but we never, I don’t think we ever progressed it far enough to figure out how to, what a business model could or should look like. Yeah.
Bradley Eral (01:55) Absolutely. No, that’s helpful perspective. And, you know, by way of introduction, Freddie rall, director of strategic partnerships here. So work with, you know, I can’t believe many of your peers in the ehr space as they look at layering on credentialing for, you know, a variety of reasons, whether that be new revenue stream, differentiate their offering, reduce denials and help on the rev cycle side. So, whatever that may be, we’ve seen all. But I guess I’m curious Kurt today, what’s kind of driving it, from your guys’ side where credentialing’s top of mind, or something that’s potentially worth exploring? I.
Kurt.Connolly (02:28) Think so a little bit about kipu. I don’t know how much you’ve dug into it. So I like to kind of walk people through this concept of there are 42 inside of healthcare. There are 42 specialties, right? Yeah, anesthesiology, surgical specialties, you could be ophthalmology, behavioral health is one of those 42 within behavioral health. There are another 29 subspecialties, so Aba you kind of run the gamut inside of there, there’s a specialty. There’s an area around addiction and treatment, eating disorders. That is where kipu’s primary core business is at where we service mainly commercial pay, private pay, commercial pay, self pay. That’s the majority of our business. We do have some state based reimbursement as well. Really no, no medicare based reimbursement for our customers. Yep, in terms of how they get reimbursed. And so that is who we are, we’re an emr RCM CRM platform. So, our, these treatment centers, they, you know, buy the keypoof platform. The keypoof platform is what they use to get patients in the door, you know, obviously they provide care and then post care. They are going through the financial reimbursement model. Yep, a lot of our customers, there’s really probably three things going through that one. They’re either acquiring other customers. So they, you know, merging together that’s less of an issue. The bigger issue is probably, I think twofold. One, a lot of them prefer to be out of network. They’re used to prefer to be out of network, but mainly because it was a lot easier really to navigate the reimbursement for them or at least they felt like, but getting more and more pushback and being forced in network as payers start to put more rules in place around where you can and can’t get care. So there’s a shift of people having to go now become, you know, become an in network provider, certain plans. And then obviously, as they open up new programs and new treatment centers, they have to go through that process as well of getting onboarding. And all of those things create delays in from my point of view, from a business model, someone might open up a center might bring on, you know, a new payer, you know, rolling out growing their business, and the process of going through credentialing does potentially create delays when they can actually start using our software.
Bradley Eral (05:00) Gotcha. Through.
Kurt.Connolly (05:01) the system.
Bradley Eral (05:02) Interesting. So you’re looking at it through a perspective of delays of when they can use the software itself. And then are you also seeing like is it delaying for the clients? I guess on the revcycle side, are you doing end to end revcycle services for your clients? We.
Kurt.Connolly (05:15) don’t today, we have a network of, we do have a network of third party billers that we work with that use our software as well to service customers. Yeah. But today, our model has historically been, it’s the customer’s job to work with folks in the industry. Yeah, and they will go in or you’re on your, it’s a little bit of on your own, go get some credential go do it. So it’s a little bit of that.
Bradley Eral (05:40) Yeah. No, that makes sense. And I guess I’m curious you mentioned kind of, hey, it’s delaying your ability for your customers to use a platform. Is it costing people like dollars or is it more so just the user experience where, hey, they’re still paying whatever the, you know, whether it be a monthly fee structure, however, they’re not able to get the benefit of the platform itself.
Kurt.Connolly (06:01) Two things. One, I’d say it’s three if they’re if they don’t go live when they can, because there’s delays in getting credentialed for whatever reason. Then we are not able. We usually end up having to work through an exemption process. So they don’t pay.
Bradley Eral (06:16) Gotcha. Yeah. Two, when.
Kurt.Connolly (06:20) they, when they go roll out to a new payer, for example, and they’re dealing with that. They’re not running those transactions through our system, right? So that’s lost revenue on a transaction based model. And then three, we often deal with denial, you know, every year payers roll out new plans, sometimes they have to re enroll the providers.
Kurt.Connolly (06:41) It just starts to create a headache where they’re getting denials and then we have to go back and manage that on our side because it creates thrashing and noise in our system to go trouble. Yeah. So.
Bradley Eral (06:53) Gotcha. Okay. So it’s kind of a three legged stool or lack thereof when this has taken place from, you know, obviously causing denials, causing your ability to collect internally on, you know, the utilization platform. And then it sounds like you’re kind of reworking contracts to accommodate for the delays in the go live period. And then I guess in a perfect world is you’re looking at credentialing at a high level, right? We don’t need to get in the weeds today. But like what are you looking for in a partner of how to necessarily? Like what would good look like if you fast forward six months from now medallion or other? But what would kind of good look like in a partnership in your eyes Kurt?
Kurt.Connolly (07:28) For me, the perfect side of the house from a partnership point of view is that it’s baked into our standard implementation model. Okay? Where a customer comes in and says, hey, I need to roll this out and we’re like, hey, we’ll include, you know, the credentialing for X, number of providers as part of our proposal and we just take care of it inside of our proposal, inside of our process. Okay? Then there’s no, because right now it’s all, hey, you go get it done and let us know when you’re complete and that creates a lot of back and forth. We lose visibility. So to me, it would be on our paper, managed through us whether it’s a white labeled service or not. I sometimes tend to not care.
Bradley Eral (08:06) Yeah, but.
Kurt.Connolly (08:07) Really, we would talk about it as part of our service offering and what we do?
Bradley Eral (08:14) Yeah, no, that makes perfect sense. Yeah. And then you mentioned visibility today. So today, is it like, I guess a little bit of black box? Obviously, you guys aren’t owning any of the dynamic and it’s just back and forth ping pong with your customers of, are we in network? Are we out of network? We don’t know, and it’s just, you know, exasperates all like the delays you’re seeing?
Kurt.Connolly (08:32) Well, it’s for example, it could be, hey, customer. We’re waiting to next step in the implementation project. Where are you at? With getting credentialed? They then have to go whoever they’re working with. So it’s a little one, two three punch, right? Exactly. So then the telephone, we send them an email on Friday. They read it on Monday. They send an email to their person. Yep they get back, they get back to them on Wednesday. They shoot us an email back the following Thursday and we’re like, hey, so we lost a whole week and maybe, and if we have some questions and follow up, it can even get longer. Yeah. Okay. They were just, we knew exactly what it was. We would come and say, hey, customer needs to be live on this date. Let’s manage against that and go.
Bradley Eral (09:11) No, that makes sense. Okay, perfect. And the final question for you and I’ll kind of touch on where I see potential alignment here with medallion. But within like obviously understand your niche of, you know, treatment centers within behavioral health. But what’s kind of if you were to look at your typical customer, how many providers is it, you know, on the smaller end, larger scale? Like what’s kind of typical customer for you folks from a?
Kurt.Connolly (09:39) These are not big facilities. Yeah. So it’s not, wouldn’t surprise me that for a majority of our customers, they have one. So I would say it’s kind of this weird. I would say, I would say… I would put… them in probably the three to five provider base. Yeah. And then above that, we get into the medium and large where they’re multi facility, multi location. So if you thought through about three per location on average and some of our customers have dozens or more locations. Yeah. So we have around 6,000 total locations that we would probably think through.
Bradley Eral (10:22) Okay. Now that makes sense. And then are you seeing kind of similar demand across both of those spectrums, the small and then the medium to large?
Kurt.Connolly (10:28) Yeah, the smaller likely more of a problem for us than the large?
Bradley Eral (10:32) Yeah. Okay. I had a feeling that’s what we’ve seen with other partners of ours. So what I’ll say from a medallion perspective, it sounds like obviously like some experience with medallion in the past, of course, but we’ll give you the 30,000 foot view of, you know, first off like what makes us unique? And then how do we work with many of your peers in a very similar model to what you just described? But essentially, if you look at credentialing as a whole, there’s kind of historically been two ways to solve it. You can buy software, build out a large team, right? Which comes with its whole myriad of challenges, right? It becomes a huge cost center with many of our ehr customers who, you know, break into revcycle, and then fall into credentialing when they build out internally. It just becomes a point of friction because with the best intentions, they’re delivering this to their customers but not delivering it well. And it kind of becomes a black eye in the whole relationship. And alternatively, there’s kind of what you’re seeing to an extent with your customers where they can outsource it entirely. But it just becomes a black box of, you know, take that historically manual process and then just pass that to someone else, right? So, medallion, what makes us unique is we kind of sit in the middle of where we’ve built the platform from the ground up over the last, what five years now with an automation first approach. And then we also have a team of experts that sit behind the scenes. So essentially what we’ve done is, you know, automated everything we possibly can in the process, have human intervention when applicable and when required. And the output is that we actually contractually commit to how fast this work is done via an SLA with teeth where if we miss our slas, there’s financial ramifications for us. So essentially, it gives just the model like complete stability and reliability. And then of course, you’ll have visibility with the software itself into the platform. Your customers will have visibility. And then your team can have kind of that roll up visibility that I imagine you’re looking for. But what I’ll say is I guess I’ll pause there before I jump into kind of what our typical partnership looks like with some of your peers. Any questions on medallion at a high level there?
Kurt.Connolly (12:28) No, I think, I mean, the biggest thing I need to understand or think through is probably going to be what you guys offer versus what they’re getting today. Yeah, how do we help? How do they help distinguish what they might be getting today from either free services or working?
Kurt.Connolly (12:44) Most likely, they usually work with a consultant, that consultant’s probably charging them an hourly rate to do the work, right? And that’s neither here nor there that’s just probably what they’re doing.
Bradley Eral (12:55) Yeah, exactly. Exactly. So typically, and we’ll obviously dig into this as we, if we continue conversations but typically like first off, it’s going to be the fastest option in the market with medallion due to the level of automation like we hit thresholds. We just haven’t seen elsewhere. And then also the nice thing for our ehr partners is you benefit from the economies of scale where essentially you’re getting a really advantageous unit cost that you can rely on your customers bake in some margin if you see fit. But it ultimately provides a lower cost option to your customer base. So typically that combination of speed and a reduced cost is what really we see a good adoption with our ehr partners. But ultimately, from a partnership perspective, what you outlined candidly is like our ideal scenario of bake it in the platform, right? And then whether you prefer to white label it, whether you prefer it to be just kind of standalone, a fully integrated experience, like whatever that flavor of like integration you’re looking for. We’ve seen it all we can accommodate. But essentially, what we’ve seen a lot of success with is what you described of bake it into the offering, have a fixed number of enrollments or like however we wanna structure that. But ultimately, it makes it easy from a transaction perspective helps differentiate your offering as well. This is something we’re seeing. I mean, you’re seeing it obviously on the mental health side where kind of the shift from out of network to in network. What we’re seeing a huge impact. We’re seeing the same on, you know, mental health with the therapists, right? Kind of a big push towards getting a network there as well. And we’re seeing it really impact customer acquisition, having this as a differentiator in your offering to capture market share. But anyways, like huge success in that front, get them in network. Your team will have visibility throughout every step of the way, as will the provider into what’s the status of the enrollment, what do you expect to be completed by? Well, of course, what you care about is when are they enrolled in a network? We can trigger automatic alerts to your team. So that no longer becomes a bottleneck. And at that point, you know, really they’re a network they’re live, they’re happy and your team, it serves as a really good additional revenue stream as well if you choose to, if you want some margin on this, right? You’ll benefit from the economies of scale, so that’s kind of the typical partnership. We see. Obviously we can set up some follow up sessions around showing you the platform itself talking. Through logistically from a structure perspective, what does this look like financially? I think that’s always helpful to understand. But I’ll pause there. What questions at a high level here so far?
Kurt.Connolly (15:25) Is your business model one of we purchase a set number of credentialing activities per month and we just burn like that’s. What we basically like buying cell phone minutes for lack of a better term.
Bradley Eral (15:39) Yeah, that’s a great way to look at it essentially. Yes. Okay. We do have an annual commitment like it can be broken up into quarterly payments, of course. But what we do is we’ll forecast. Hey, what’s a very conservative like year one volume perspective because like you do benefit from the more you buy, the better the unit costs. But I’m always of the belief you can always buy more, let’s not get too aggressive with what we’re forecasting for year one. But essentially, you’d allocate, hey, here’s a set bucket of, you know, minutes or, you know, enrollments for year one that you can allocate across your customer base as you see fit. It’s kind of the structure. Okay?
Kurt.Connolly (16:18) Gotcha. Okay. Yeah. And that’s what I was expecting. I think when we went through this, I think that was the biggest challenge was trying to figure out what the commitment was. Yeah. And then no one, like when we were at the, no one really wanted to commit to anything. And I’m like, well, we have to commit to something. They’re not just going to sit there and wait for a ball to come like they’re not playing left field.
Bradley Eral (16:38) Yeah, exactly. So I can work with you. We have a lot of experience with, you know, many of your peers can work with you on what is a really conservative estimate where you’re not going to be in a situation where you overestimate like it’s kind of find that nice middle ground of, hey, how do we make this a, win and give you the benefits of conservative estimate but also improved unit cost to help with margin and just make this more attainable.
Bradley Eral (17:01) So, let me ask you this. I think like at a high level, I’ll ask you this, like seems like some good alignment with what you’re looking to solve. If you agree, what would make sense from a next steps perspective? We could do two things or both in parallel but can talk through, hey, high level here’s, kind of typical structure from a financial perspective.
Bradley Eral (17:19) And then we can also do a follow up demo like what would be as you’re starting to explore this? Would love to hear what would be helpful for you guys at this time?
Kurt.Connolly (17:25) Yeah. I think it would be good to know. Part of what I laugh about is words matter. So, I was doing some research prior to this of like, okay, where are our credentialing challenges? And of course, a bunch of dr first credentialing items popped up and I don’t think you guys do E, prescriber enrollments, do you?
Bradley Eral (17:44) You know, let me confirm. I don’t want to misspeak on that.
Kurt.Connolly (17:48) But is there two different, like because like payor enrollment, payor, credentialing, and, you know, npi, yeah, you have the ability to prescribe controlled substances. Those are two different things, right?
Bradley Eral (17:59) Yeah, exactly. But.
Kurt.Connolly (18:01) It would be nice to know the spectrum of services you do offer yep and I think it would be good for me to bring in our probably someone from our RCM team and from our services team to sit through and say, okay, here’s, what we, how we could do this today. It’s also going to be fun as I know I’m going to get some pushback… yeah, pushback from folks who are going to be like, no, no, Kurt, we help with this and I’m going to be like, okay, but do we do so in a way that’s a value add to the customers? And are we really, or are we just basically, so are we basically acting as the, you know, like just we’re tracking credentialing through a process, right? Yeah. But we’re not getting any. We’re not adding any value to the process itself other than we’re just doing status checks, right? That’s not credentialing that’s project management. And so it would be helpful to understand it’ll, be helpful to understand like what are the things that are adding value to the process that you guys do as well in that conversation?
Bradley Eral (18:59) Yeah, for sure. That makes sense. And then today, I guess it sounds like more of a project manager just like check and roll, but like is your team ever submitting these applications on behalf of your customers for the payers or? Okay, gotcha. So it’s really just to your point, project management. Yeah.
Kurt.Connolly (19:16) It’s really project management. So, yes.
Bradley Eral (19:19) Perfect. And then a few kind of just like things I want to be mindful of. Is there a certain date that you need something live and delivering value or is this more exploratory? Both are perfectly. Okay. I don’t want to make sure we’re not holding you up from any you’re.
Kurt.Connolly (19:34) not holding me up from anything, but I don’t think this is something. I mean, if we let this, it will linger for a year. Yeah. So I think we just need to create some urgency around it, but we have our first customer event coming up in two weeks, the 20 second where we’re going to have roughly 150 customers in person. Oh?
Bradley Eral (19:54) Nice.
Kurt.Connolly (19:55) So, it might be interesting to know. I think the other part we do use waystar as our primary clearinghouse. Okay? I don’t know what if they offer services, if they do, it would be helpful to understand if they’re white labeling oftentimes, I find people like that. Yeah, we can do it and you find out under the covers, they’re just using somebody else. So you’re just they’re just adding a text onto.
Bradley Eral (20:15) Somebody.
Kurt.Connolly (20:16) Else’s service. So I’m like, well, I can do that. So, so it would be good to know those things but also heading into that conference, it might be good. So I don’t know if we want to look for something the week of the actually next week?
Bradley Eral (20:29) Yeah. Let’s go.
Kurt.Connolly (20:31) And I can sort of get something on the books.
Bradley Eral (20:35) Yeah, I’m looking at our calendars as well.
Kurt.Connolly (20:57) I don’t know if you could do the next Monday or at noon?
Bradley Eral (21:03) Next Monday at noon. So we do have a company off site next week. So got to navigate travel.
Kurt.Connolly (21:12) Let’s see.
Bradley Eral (21:16) So we got Monday at noon… and then bear with me a second. How does your schedule look? Tuesday afternoon… anytime after?
Kurt.Connolly (21:37) I could do a, that would be, I could do a four, you do a four 30 call. Yeah, that’d be perfect. Four 30 Central Time. Yeah. Okay.
Bradley Eral (21:47) Yeah. I’ll send over an invite. I’ll include josh or one of our solutions consultant that works strictly like in parallel with me working with ehr and RCM partners. So I’ll have some good perspective. And then what we’ll do during that meeting is kind of, I guess all three things we discussed, but walk through the breakdown of hey here’s. Everything that’s available with medallion, right? Give you an idea of the services. What makes it unique? How does it compare to what else is out in the marketplace can do a very light just high level demo just to show you more importantly the visibility that you’ll have? And then we can start talking, hey, what’s the typical structure of, you know, what’s some to give you an idea of like what’s some typical tranches we see our ehr partners purchase with medallion to like what’s ultimately give you visibility into the unit cost? Does that sound like between those three things?
Bradley Eral (22:33) A good use of your time? Or is there anything else? Is there anything else that’d be helpful during that meeting? I?
Kurt.Connolly (22:38) Think it would be a little bit might be helpful to understand if there’s other folks like kipu using you guys for the service and how you work with them?
Bradley Eral (22:45) Yeah, absolutely. Well, no, this is great, Kurt. I appreciate you. I’ll send over the invite for four 30 on Tuesday. And yeah, looking forward to the discussion, I think again.
Kurt.Connolly (22:55) And then the urgency would be then within our customer, we could actually have some conversations as well and float some topics and ideas.
Bradley Eral (23:02) Okay. Yeah. At that, at that, where the meeting where there’ll be 100 of your customers, yeah.
Kurt.Connolly (23:07) Perfect. We can start to gauge interest as well at that event. Yeah.
Bradley Eral (23:11) Absolutely. Well, no, this sounds great. Appreciate you thinking of us. I’ll send over the calendar invite and looking forward to continuing the conversation here.
Kurt.Connolly (23:17) Cool. Thank you guys. Thanks, Kurt. Bye.