Transcript
Brandon Chase (00:00) Christine. Hey, Christine, morning. Thank you, Brandon. Still is morning? Yeah… barely for you guys. I guess another hour, right? 11 o’clock here. Yeah. How was the weekend? It was good.
Jalen Parton (00:24) Good rainy.
Kevin Murphy (00:26) What?
Brandon Chase (00:27) Was that a rainy Easter yesterday? Oh, was it? Yes… but it was good. How was yours? That’s good. It was good. We had, we live, apparently, we live in the most arid place in the country now in Denver. So it was perfectly dry and it was, the weather was great… but you guys got all of our snow this year and apparently, now you’re getting our rain, so it’s going to cause serious issues. They’re already talking about, you know, doing like a two day a week max on the, on watering your grass and all that fun stuff. So it’s oh, really? Yeah, gearing up for a dry season here. I think we have everybody, everybody’s very punctual this Monday morning. So let’s get started, Kevin, I just want to confirm, is that everybody on your side as well?
Kevin Murphy (01:24) I believe so. Yeah.
Brandon Chase (01:29) Perfect. There’s one unfamiliar face to me on your side. So… but yeah, all right. So let’s kick things off. I appreciate everybody being here. And for today’s, call, I figured… I think most, everybody knows each other on the call. So maybe I can just kind of provide a, an unfamiliar face update on our end. And Kevin, if you want maybe want to do the same for the team on your end rather than just kind of going around the, with everybody just, to save some time. And then we’ll get into scoping. So, the purpose of this call really is just to dive deep, on the isims process. Scott and I have worked with Christine, on several different calls and Christine and demeter on scoping out sort of the overall process. So, we’ll probably kind of show that as a reference point, but we’re really focused around that integration, with isims today. So I don’t think it’s going to take the full hour. But, you know, we do have the time if we need it. And then we’re happy to obviously answer, you know, questions and stuff like that if we need to. Yeah. So if that works for everybody, I will let everyone know that Sammy is our head of implementation, and our technical team. So really, he’s going to be the one sort of driving today on our end. But I think everybody else should be familiar, if not, you know, happy to introduce them as well, but.
Kevin Murphy (03:16) I would just say for, because I know Jalen has not met anybody. I don’t think on this call. So if you just like, high level for garrison Scott as well, I think just to give her an understanding.
Brandon Chase (03:28) Sure. Yeah. So, Jalen, how you doing? Nice to meet you? My name is Brandon, I’m director of partnerships here at medallion and essentially kind of a single point of contact, for the relationship between healthpro and medallion. I reported to garrison. So garrison is, my manager, my leader. And then Scott Everline is, our solution consultant. So, he’s been riding with me shotgun if you will some, you know, sometimes in the driver’s seat, right? Scott, but it’s been him and I mostly working closely with Kevin. And now, just because where we’re at in the, in kind of the cycle, you know, garrison’s involved and Eric is obviously now involved, from the healthpro side as well. So hopefully that’s helpful. Yeah, thanks.
Jalen Parton (04:20) To meet y’all and my name is Jalen. I am director of onboarding. So I manage our isims program and kind of how everything flows from getting them in. I work really closely with Christine for our direct bill.
Jalen Parton (04:35) clinicians. So that’s why I’m here today to help start having those conversations about integrations and things like that.
Brandon Chase (04:43) Perfect. It’s going to be you, Brandon, I know that.
Kevin Murphy (04:47) You’ve been working. You have, you and Scott have, a flow chart. I, Jalen and Christine put together a very high level flow chart of how this works right now. And I think some things have changed since you and Christine and demeter talked about this, but I think it was towards the end of last year, I know Christine and Jalen have done a lot of work. So, I think it may make more sense to kind of level set with like what is our current process and what do we like about it? What don’t we like about it? And then, I think, you know, we can use that as a jumping off point. I think it’s going to be still pretty close to what you all put together. But I think we’re leveraging isims a little bit more than we were previously. And, I think we want to try to keep as much of this work in place as possible if possible. So, does that make sense?
Brandon Chase (05:40) Yeah, yeah. I know you mentioned that there’s been a lot of consolidation into isims, kind of taking some of those other disparate processes and kind of aligning it to that. So, Sammy, I’ll defer to you. Would that be helpful? I think, I mean, from my perspective, getting a baseline would be helpful so, but I’ll defer to you. Yeah.
Sami Alouani (05:56) No, absolutely. I think we have a fairly good idea of what you all are looking for just based on work we’ve done with other groups, but would love to, you know, get that validation based on what you’re doing today. So, yeah, please go ahead.
Kevin Murphy (06:07) I’ll pull this up, Jalen. I don’t know if Christine told you I went in and did a little bit of lucid cleanup to streamline that a little bit. So it’s going to look a little bit different. I didn’t change any words. The content is still the same.
Jalen Parton (06:20) All right.
Jalen Parton (06:33) Like I’m still getting my lucid, like sea legs under me. The possibilities are endless.
Kevin Murphy (06:41) They, yeah, they are. If you.
Scott Everline (06:43) Want to. I’m in lucid with you. It’s my, like it’s my bread and butter. Oh, yeah. Like family trees in lucid. Because they see so much of it at home. So, yes.
Jalen Parton (06:53) I would love that.
Kevin Murphy (06:56) Is this big enough? Should I zoom in a little bit and we can move around?
Jalen Parton (07:00) I can see it a little.
Sami Alouani (07:02) For me.
Kevin Murphy (07:04) All right. Sorry. Okay. So, I don’t know, I don’t feel like I’m the right person to walk through this? I don’t know Jalen, if you want to.
Jalen Parton (07:13) So initially the new hires, so they signed their offer letter the intent and the work that Christine and I have been doing are consolidating her team’s efforts. And my team’s efforts because they’re the venn diagram is almost basically overlapping except for a few pieces and so making isims a source of truth. So previously, and probably what y’all had discussed before my team was reaching out, which is the onboarding team. So we’re collecting professional licensure, CPR, TB, testing, HR forms. And then her team was reaching out separately to collect the direct bill paperwork, but also a lot of the same things, proof of education resume. And so what we’ve done is consolidate all of that. So that all of the requirements for our direct bill sites that they would have to submit are all collected in isims now. So that’s based on the feedback that we’re getting from our candidates as they’re coming in that it’s just overwhelming. There’s a lot of different portals and people and things to keep up with. So, trying to have everything in one place, they just have to go just into isims to do all of their forms to submit all of their paperwork. So they sign their offer letter. They’re pushed into onboarding, the direct bill team at that point is notified via email that there’s a new person in there. My team, the onboarder is the main point of contact. So they’re the ones that are following up. They’re the, if there are any questions from the candidate, they’re reaching out to them. If any questions come up on the direct bill specific items, then at that point, the direct bill team is looped in. So both teams are reviewing documents as they’re submitted. So my team is reviewing for our purposes and making sure it’s valid. Christine’s. Team also has access directly into isim. So they’re reviewing as things are submitted as well. So for the direct bill piece, once everything is received, they’ll verify that, and then it submits currently to advantum. So then advantum then… complete yeah down there in the pink. So they’ll complete the cvo verification… submit to payers and Christine, I mean, which y’all actually probably don’t even need that level of detail because aware of that process. So once all of that happens, then advantum will report back to Christine’s. Team, Christine’s team then reports back to us of, yes, this person is clear, they can start working or, no, we need additional information on this or their, this and this was whatever. Once my team is verified that all of our requirements are met, and once Christine’s team has gotten clearance from advantum at least to the level of clearance needed for that specific site, then my team will approve the candidate to start push them into our payroll system ukg which then flows over to nethealth, our emr, and then the new hire is notified of all of that, overall like collecting in isims. And then each of our different teams are pulling from isims to get what we need. Christine takes it for processing. And then we take it for verification on our end.
Sami Alouani (10:34) This is incredibly helpful. Thank you for the visual. A couple of questions before we dig in here, on the, as far as the scope with medallion, maybe Brandon Scott, just a refresher for me. Are we talking both the cvo element as well as payer enrollment or just payer enrollment today? Both both? Excellent. Okay. So, really what we’re looking at then is, you know, just as a hypothetical, there’s going to be a layer in between or where advantum ultimately is doing that completion of the cvo verification and payer enrollment submission like that’s kind of the meat and potatoes of what medallion is going to be potentially supplementing, right? So, given that I want to talk about like kind of the inputs from isims into what’s going into advantum today. And then the outputs of, you know, once advantum is done with their work, there’s kind of, that floodgate that opens up so to speak, such that, you know, your ukg and your downstream systems can allow providers to start practicing. Does that, does that gel with everyone as far as the touch points we want to zoom in on today?
Kevin Murphy (11:30) Yeah. And I, I’ll say that, you know, I think this process has come a long way. There are still some like, I think where we have, the most, some of the most challenges are kind of the like obviously, the integration between us and advantum. This is a manual process, right? Christine’s, people are taking files and literally taking them out of isims and putting them into a shared folder.
Rehab (12:01) We we,
Kevin Murphy (12:03) have a hard time tracking, the completeness of these and how quickly you know, they’re getting submitted and that is, you know, from the provider on down, right? The new hire owes us X number of documents. It’s hard for us to kind of track that, you know, how long does it take? Christine’s people to move something over? You know, things get lost in these when there’s a lot of hands involved. And it’s tricky for us to kind of track all that. So, I know that, you know, what medallion, what you guys can do in these three buckets is, you know, what we’re really excited about? But I think that there’s a lot of based on what I’ve heard from Brandon and Scott, it seems like there’s you know, some opportunity here to help us streamline, and really track this better. And then the second piece of that is the back end here, right? So getting this information out, this is, you know, once the credentialing is done, the new hire is cleared to start. But that is just, you know, for a certain set of payers every time a new payer is, you know, enrolled. And those things happen on different timelines, you know, really we’re talking about, they’ll probably get, you know, between six and 10 approvals that go out right over a different period of time because the payers are returning that information at different times. So, how we… set up that part of this is also where I think we should talk about. I think that’s what you were kind of getting at Sammy, but I think a little bit more information from our side is like we really like this to like we need better oversight and tracking. So we don’t so, so folks don’t fall through the cracks because it happens, yes.
Scott Everline (13:55) How much redundancy? Sorry?
Rehab (13:57) No, that’s okay. Go ahead, I.
Scott Everline (13:59) Was going to say how much redundancy is happening in the documentation collection between Christine, what your team is doing and then what the onboarding team is doing well?
Rehab (14:09) There was a lot in the past but Jalen and I have worked over the past year to ensure that my team is no longer reaching out for that. So like she stated before, both teams were reaching out for the same pieces of information by her and I connecting to say, how can we reduce? You know, there’s timelines on certain things and complaints from onboarders, not onboarders, but, you know, departments and providers coming on board. That’s why we reduced it where her team is just collecting all the information, uploading it into the system. We have access to it, we pull it and that’s when we send it over to advantum, so there shouldn’t be any redundancy now… put in the same place?
Scott Everline (14:51) Yeah, I’m wondering and Sam may point me in a different direction, but is there even an opportunity to kick off because we don’t need a lot on the medallion side to like initiate the work? And we’re importing a lot of that data that you’re probably trying to capture through caqh, like TB tests and things like that. Maybe not. But some of the documentation and a lot of that data is going to come over from our caqh import, might be able to circle back and fill in, but.
Sami Alouani (15:17) I just want to pull this back just a second before because that’s like kind of the meat of what we want to discuss. So like let’s start from the very beginning here and just kind of walk through what it looks like, where exactly medallion would fit in here. And then we can kind of inject some of that conversation. But first off, I want to start off by saying this is really helpful. If you all can send us this visual, we can take all of the discussion we’re having today and memorialize it in like what an updated flowchart would look like so that you all can have this. And, you know, our memories are we all have a lot of stuff going on. So we have some to refer back to. So if you all could do that as a next step, that’d be great. But ultimately where I see medallion fitting in is a lot of the direct bill credentialing elements that are happening in isims today. In that yellow box like medallion can cleanly take over not only from a process perspective but from a platform automation perspective. So I still see for example, you know, if you look at the very top, you know, provider signs the offer letter, there is an onboarding, a level of onboarding task that has to happen, right? That’s not just cvo specific. It’s like more organizational onboarding. And so I still see that happening. But the next step there is in the yellow notified via email of new hire in onboarding, that requires DB credentialing. So that won’t be an email process anymore. That won’t be a manual kind of trigger notification. Medallion can actually tap directly into isims to identify programmatically when a new provider is in the system that has that bare minimum information that Scott mentioned, you know, their name, their email address, their caqh id, very, minimal information. And then automatically trigger the creation of the provider and the start of the workflow in medallion.
Rehab (16:50) So, can I just interrupt you there? So the only problem with that is we do have some candidates are up for recruitment but may not accept the position. So I think we have to figure out the trigger from when they actually are pushed into the onboarding phase versus just in the recruitment stage.
Sami Alouani (17:09) Absolutely. You’re exactly right?
Kevin Murphy (17:11) Don’t forget the non direct bill.
Rehab (17:13) The non, yes. And then we have the non direct bill as well. Yeah.
Kevin Murphy (17:17) These are probably triggers, you can solve for though, I assume.
Sami Alouani (17:21) Absolutely. And that’s part of what we’ll figure out in the implementation process like that’s not those aren’t details necessarily we need to hammer out today. But long story short, there is a payload in isims that has the contextual information for us to build business logic and say, like, yeah, this provider is still in recruitment, ignore them, right? Or this provider is not eligible for direct bill or credentialing, maybe they’re like, I don’t know a cna or something for whatever reason that you all don’t need to know directly credential or enroll for, right? So like those are the details we can figure out during the implementation process. But the goal here is to both your points, we ultimately are going to filter out the providers we care about that meet your business logic and use that to automatically create the providers that would mesh with what you’re doing today just automatically.
Kevin Murphy (18:04) One thing real quick. We’ve had struggles in the past when vendors have said we will figure this out on like during implementation because we find out that we don’t have that, right? The right data. We don’t have it set up correctly? I think it would be really helpful pre implementation to know like what are the fields that you need in order to do this? So we can actually validate that. They’re in there because I can, I literally cannot count on both of my hands how many times we’ve said we’ll figure that those details out during implementation and it doesn’t happen because, you know, or we need to work around or something. So I just want to make sure that we note that and whatever we can to limit the things that we need to figure out during implementation will be, really helpful.
Sami Alouani (18:53) Absolutely. Yeah. And for what it’s worth like that’s not exactly something we can figure out. It’s something that you all would tell us because we don’t know what your business logic is for which providers we care, we should care about, right? So kind of answering a question with a question a little bit. But if you can, if you can give us, you know, hey, here’s the business logic, right? Like we only care about providers that meet this criteria in layman’s terms and we can reverse engineer that and tell you like here are the fields that you need happy to do that, you know, that we can definitely do that before implementation. However for what it’s worth with isims, we’ve done integrations with them before and the fields that exist in isims are like the fields, are there, it’s just a matter of how do we translate your business logic into the specific fields that we care about? Sure and for what it’s worth, I’m happy to even do a deep dive with this group, you know, before implementation. I just what I really meant is I want to make sure we’re on the same page about the overall approach and then we can.
Kevin Murphy (19:44) Totally agree. I’m just, it’s in the back of my head and I want to make sure that it’s out there for this.
Sami Alouani (19:50) Group. And I mean,
Jalen Parton (19:50) we can, probably, I could Sammy, I could connect you with the lead of our engineering team to kind of talk who has created isims to just he’s typically the one that will anytime we talk about integration or anything like that can speak to that. So probably just a conversation between you and him and whoever else on your team just to bring him up to speed on what the plan is and make sure that he doesn’t have any concerns or issues or anything like that, but that.
Sami Alouani (20:18) Absolutely. Yeah, no, that’s totally fair. And for what it’s worth like Kevin, I definitely feel your PTSD there. We’ve you know, been there done that too. But when it comes to just the business logic for filtering out providers, frankly, that’s one of the more straightforward things as far as these integrations are concerned, totally get it. So yeah, in any case, it’s something that we’re confident we can figure out and, you know, whether that’s you know, pre implementation or post, we can absolutely work together. But back to the flow here. So, you know, your onboarding team is going to initiate, you know, the general onboarding the provider is going to have, you know, their organizational level onboarding and some of that information that’s captured is going to ultimately be fed back to medallion via isims once we’ve identified which providers we care about. And so the next step there is between kind of that notified via email and review isims for submitted documentation. There’s going to be a kind of phantom step if you will. And that’s what Scott was mentioning where once we identify those providers, we have the bare minimum information that we’ve collected. We can then trigger that caqh import which will bring over the vast majority of what you would need in that documentation. And so there is still that review step but it’s not just reviewing documentation that the provider has submitted, it’s, reviewing documentation that we initially pulled from isims before the provider has to submit anything. Does that nuance make sense there?
Rehab (21:40) It does. So, can I clarify that you’re going to submit? You’re going to get everything from caqh including documentation. Some of it may be updated. Some of it may not because we know the cois for different organizations and obviously practice locations and things. But as far as like licensure, certifications, obviously social date of birth and things like, that will all be pulled from caqh?
Sami Alouani (22:06) That’s exactly right. Will.
Jalen Parton (22:07) it be a bi directional feed in that the caqh will feed back into isims or just hits medallion. And then we… have to manually put it from y’all’s portal into isims. How will that work?
Sami Alouani (22:22) It’s a great question. So the goal here is for isims to not need that information anymore. The goal is for medallion to kind of be the source of truth there. And that, so, for example, like all the things that isims is doing today like putting together the file that ultimately needs to be, you know, a PSV verified by adventum today that no longer should need to happen in isims. So the goal is it doesn’t need to be in isims medallion hosts it. If we find, for whatever reason, we do need to push that back to isims or it’s possible, but that’s we’d have to scope that kind of as a separate integration.
Jalen Parton (22:52) Yeah. So it will need to go back into isims because the direct bill is such a small portion of the business. I mean, we have a lot of other staff that are not direct bill credentialed. So it has to be in isims. Isims then flows to our payroll system, employment management and everything all of that information has to flow over there. So we as the employer have to have that information on our side so that it can go where it needs to go to fill in for benefits or for a one K and things like that.
Rehab (23:27) I was thinking Sammy that from speaking before that you would obtain some of the information from isims, but everything else should come from caqh to medallion, not back into isims.
Sami Alouani (23:42) That’s right? Oh, okay. I just wanted to make sure it sounds like there might be a little bit of confusion… conflicting of understanding there potentially because what you just described is exactly the model that we take, right? So, isims is going to have some information that you would need for four one KS and general employment information. But the information we pull from caqh is typically not something that you would need back into your HRIS system, right? So we take the core info from your HRIS system, bring it into medallion, which would then trigger our pull of supplemental information from caqh that we would only need in medallion and not in isims. So like in other words, we want isims to remain the source of truth for things that you need for your four one K, your employee benefits. All that good stuff. We don’t want to write that back from caqh. Okay?
Rehab (24:34) Sometimes I worry about is socials and date of births. The reason being is I’ve seen where sometimes caqh is incorrect. So is there a process where you’re pulling the basic information from isims and comparing it to what comes through on caqh or any type of QA or when that data comes in from caqh? Yeah.
Sami Alouani (24:55) It’s a great question. So we use a number of things and it’s a combination like we’ve got several scenarios but the goal is for us to take not just the provider’s name and caqh id, right? Like that’s just one element of it, but we also use npi and we use social security as, through various levels of confirmation against what’s coming through caqh. So, to your point, you know, a provider could give us a bad caqh number. And if we just use their name and caqh number or just their caqh number, you could pull a completely different provider’s information, right? And so we do have safeguards in there between the name, the caqh id, the npi and the social security number to confirm that what we’re pulling from caqh is for that, right? Provider?
Rehab (25:34) Yeah. I think what I’m getting at is sometimes I’ve seen because it’s manual, someone’s actually updating caqh. So sometimes they can transpose numbers in there very human error that’s what I’ve seen it before where caqh might not match what we have on file. And we have to go back to the provider and say, okay, we need a copy of your social security card now because what caqh is saying is not what you’re giving us. So it might not happen all the time, but it does happen. So I just want to see if there’s some type of a mechanism where we’re looking at both of those socials coming from isims and caqh and saying, if there’s a discrepancy, which one’s correct?
Sami Alouani (26:12) Got it. Okay. Yeah. No, that’s totally fair. What we will do is if there is not enough information to have a high confidence that the provider is the right provider in caqh, then we will stop the import completely and say, hey, caqh is not eligible because there’s not enough matching info. But specifically, what you’re asking about is like social and pardon my assumption here. But my assumption is that you’re using that as an opportunity to try to correct what’s in caqh.
Rehab (26:40) Yes. Okay. Yeah.
Sami Alouani (26:42) We can do that. We can basically say, hey, you know, we’ve got enough information to confirm this is the right provider. So we’re going to go ahead and move forward with the caqh import. But when we were doing that, we noticed a social discrepancy. So, you know, provider, you know, here, you know, we can send like we can automate an email or something to your onboarding team to say, hey, you know, fyi, provider, your social security number is wrong in caqh or something like that. That should be doable. Okay?
Rehab (27:09) Thank you. I have one other. So for caqh, there are some providers that have not set up their caqh yet. They could be newly graduates. Whatnot, how would you handle that situation? So currently, right now, advantum, they’ll get it started for the providers, where they’ll build their caqh for them. Is that something that your team will do it’s?
Sami Alouani (27:34) A great question. It depends on if you, we have a skew for caqh management, where that’s basically, what will happen is our team would either build the caqh profile, start it or if, for example, you know, that scenario where the social security number is incorrect, we can actually update that on behalf of the provider. So there is a caqh management skew. If you all decide, you know, that’s something worthwhile to purchase on your end. Otherwise, what would happen is kind of if you look back at the current flow chart where it says… you know, review isims for submitted documentation to confirm, we would actually flip the arrow backwards to then assign providers tasks based on, hey, we got information from caqh. It was either incomplete or inaccurate. And then at that point, we would actually task the providers. And so in the case of new providers, for example, we wouldn’t have any caqh information. And so, you know, one of two things would happen then we would either task the provider to create and populate their own caqh info or, you know, our caqh management team, would, you know, we would still need to get the information from the provider, but we could start the profile. If you were using that SKU, so.
Rehab (28:38) You would task my team then not, we don’t want any outreach to the providers, the provider. My team will be doing direct outreach. I think that I.
Kevin Murphy (28:47) was waiting to ask this question because I didn’t know if Sammy was going to get there at some point, but I know that there is a provider facing portal with medallion, right? And I think the question that we have, is that something that we need to leverage because of how your workflow integrates? I think one thing we’re concerned about is, and Jalen can speak to this better than I can, but we, I believe we asked them to sign into a bunch of different, you know, products to get started here. So it’s as Jalen put it last week, alphabet soup. They get 700 different things to sign into. And I feel like, you know, adding one more just, you know, complicates the matter. So, is there a way to do this where there’s I guess, have you done this in scenarios where you’re not leveraging that kind of provider facing portal directly?
Sami Alouani (29:47) Yeah, that’s a good question. There is there’s a spectrum, right? So to your point of like, for example, for tasks, absolutely, we don’t need, we don’t need providers to go in and complete their own tasks. Necessarily, the one thing that is generally not possible to get around unless we make an exception here is the attestation. So ultimately, at some point, we need the provider to look at the data that we’re about to start, you know, psving for credentialing and get their sign off on it. You know, we’ve done it in the past where, you know, if you all have employer agreements with the providers that allow you to attest on their behalf, like we can look into solutions there, but the default is at minimum, the provider is just signing in to look at the information, make sure it’s correct, before we start psving, just from a compliance perspective.
Rehab (30:35) Currently, we have them sign several documents. One of them is for verisys, which is the cvo vendor. So they have to sign that and they have to sign obviously caqh and answer all the questions and sign the attestation. Are you actually referring to the way they’re set up in medallion to like look at social date of birth, practice, location and things like that.
Sami Alouani (31:00) Correct. Right. Yeah. So basically, we will, I don’t know if.
Rehab (31:03) That’s I don’t know if that’s a possibility for the provider. We’re trying to make it like Kevin was saying, they have so much that they have to sign and return on not just on the provider enrollment side, but on the HR side. That’s something that probably internally here, we would do that administrative work for the provider, it.
Kevin Murphy (31:25) Sounds like we might be getting rid of some things though, right? If because they’re not going to be signing the verisys thing, like, I wonder if there’s a give and take here where they’re not signing a bunch of stuff that, because they are able to go into medallion in a test. And I also think it like, I think we probably need to know how much they’re going to have to go in and take a look at. So, I don’t want to like shoot this down off the top. It’s just something that, we need to figure out if that’s the right approach here. And Jalen, you talk to the providers more than I do. So you tell me if I’m way off base here?
Jalen Parton (31:56) I would say having one other place that they’re going to have to create a username set up their password, remember the login just to go in and look at the data they’ve already given us to confirm that it is what they gave it. I think we will hit a delay there because people just don’t want to mess with it. So, but I mean, we certainly could do some type of attestation of, you know, this is what we’re doing. We’re going to take the information that you provide, whatever the legalese is there, just that they’re attesting that they’re consenting to that happening. But I would really strongly recommend against making them sign into an additional portal just to look at information to.
Sami Alouani (32:43) Kevin’s, point though I wouldn’t think of this as an additional portal. I would think of it as a supplementary to an existing portal that we would get, we would get rid of. So like verisys for example, whatever documentation.
Jalen Parton (32:54) They’re not getting into verisys. Okay?
Sami Alouani (32:56) What systems are they getting into? Just out of curiosity, so.
Jalen Parton (33:00) It’s we have isims. They get the like ceu three, they have an I nine. They have their background check, and then the HRIS system, we have careconnect, which is like our support portal coupa, which is, I mean reimbursement. So it’s not, yes, it is the, some of those happen a little bit after the fact, but they’re all happening within a very short amount of time for them from specifically onboarding. It would be isims… first advantage the background, and then those are the two main ones pre start… yeah.
Rehab (33:48) I mean, if anything, I would say if there’s some type of profile that your team can generate and you make that an attestation, it’s something like, hey, we, you know, you’re in the credentialing system, whatnot here’s all the information and they look at it. But again, I think that’s once again something that they have to review when they’re giving us the information to pass on. Of all the vendors I’ve worked with. It was usually just us giving you the information and, you know, they’re good to go. They do get weekly a status they have access where they can go into what we, it’s a credentialing icon that has a status of every payor, you know, what was submitted, if they’re effective or not, or if they’re still in process, but it doesn’t give the detail of here’s. Your social here’s, your date of birth, here’s, your practice location, you know, things like that. What we’re trying to do is we call it like a one stop shopping where, you know, you have one contact and you know, the provider doesn’t have to keep on reviewing or submitting things. And because of over the past year, all of the information we received back from providers joining what’s delaying it, what’s the process, how long it’s taking? And then they don’t want to come on board, they want to go somewhere else. So we’re trying to avoid all of that where we can just, you know, have one thing up front and they don’t have to keep on, let’s face it. Providers are just here to work right and see patients. They’re really not here to look at credentialing and making sure that they’re half of them don’t even know what credentialing is or hey, what am I enrolled for? They’re just seeing patients, right? The administration is more in charge of what they’re enrolled with sure.
Sami Alouani (35:35) Yeah, totally. Totally hear your concerns. I think the biggest thing is just from a compliance and a legal perspective, if the provider, so as it relates to the relationship here, if the provider hasn’t looked at the data and it changes, right? Like let’s say we do caqh management and we change their social, and maybe the social in caqh was right? And the social in isims was wrong just as an example, or, you know, we end up adding information to the provider’s profile that they have not had a chance to look at. There is a legal and compliance risk and that’s why in platform today, there’s at minimum a 30 second one time attestation. Now, when it comes to like reattestation and things of that nature. Like we can absolutely work around that. We can leverage caqh attestation. If that’s the source that we’re pulling from, et cetera. The other thing to note is we do have sso integration. So, like all they would need to do is via sso like click login with their enterprise account, and then click attest. I mean, it really could be a 30 second exercise, but we absolutely hear what you’re saying as far as like the one stop shop, given we have a little bit more to discuss today, and we completely hear you out there, give us a beat. Let us see what we can come up with as far as potential solutions there. But I would say like based on today, at worst, we’re talking sso into medallion, click one button to verify everything.
Jalen Parton (36:50) They won’t have, they don’t have company… equipment at that point. So won’t be able to include the sso in that. I also.
Erika (36:59) don’t have individual Microsoft accounts and they log in. Jalen, I don’t know that they would ever have it because they don’t all of our machines like each provider doesn’t receive their own machine. There are sometimes shared machines at sites like they don’t each per, we have thousands of providers. They don’t all have a Microsoft account. So they don’t all have an identity.
Rehab (37:20) Yeah. From.
Erika (37:21) an enterprise standpoint, their.
Jalen Parton (37:24) Own username with their personal email address and a password.
Sami Alouani (37:28) Okay. Got it. Yeah. As.
Jalen Parton (37:29) We’re having this conversation that’s what the scenario will have to be understood.
Sami Alouani (37:33) Okay. So sso, not an option right now. Well, we do have, so let me ask you this today. When you all are tasking providers, do you all have any sort of centralized tracking of that tasking system? Like when you ask a provider, hey, provider, I need this information, where does the provider go today?
Jalen Parton (37:47) Isims?
Sami Alouani (37:48) Got it. Okay. Yeah. Okay. There is a world we’re actually developing this. It’s not fully ready yet, but there is a world where we can look at putting a one click login into isims where we do like an isims powered sso such that the provider can click one button and jump directly into their medallion profile without having to log in at all. So we would take the isims saml handshake and effectively say, yep, this is dr smith, jump them over to dr smith’s profile medallion and then do the attestation there or the completion of tasks, right? So then, so that is an option. But yeah, long story short, completely. Hear you out. I think we can look at some options here. So, yeah, appreciate you all chatting through that.
Rehab (38:30) Currently, do you have a form where providers fill out to say, I grant my permission to release all of my documents for medallion to, you know, do my credentialing and enrollment on my behalf.
Sami Alouani (38:45) Yeah. I would say that would be at minimum. We would need that if we can so transparently right now, there is a technical assumption in the platform that there has to be a provider driven attestation before the PSV elements components can start. And there is a restriction on admins being able to go in and provide that attestation. So assuming we would have some sort of legal cover to say, like, yes, admins can do that on behalf of providers. We would just need to figure out on our end like how can we technically accommodate for that? So, yeah, but problem statement and ideal solution heard loud and clear and we can.
Rehab (39:23) Take that. Yeah, because that’s the form I was referring to with the verisys form. Basically, it’s a form that their compliance team came up with to say, okay, for every provider that’s joining us, you are required to give this information here is the form. Basically the provider is saying, okay, I am giving you my social, I’m giving you my date of birth, I’m giving you everything that you need to do this on our behalf and they sign it.
Sami Alouani (39:47) Right. Okay. Yeah, that makes sense. From a legal and operational perspective. I think it’s just how do you translate that into the technical changes that we would need to make in platform to accommodate for that?
Rehab (39:56) Totally.
Sami Alouani (39:56) Makes sense. Okay. Yeah. So really the kind of just to put a pin in this for now, the crux of what we’re talking about is like there’s this world of isims where there’s like the HRIS element of isims like the onboarding and talent management transition element. And then there is a hey, we’re kind of using isims as the precursor to the cvo elements where the provider is providing supplemental information for the purposes of the cvo process, right? And what we’re proposing is we sever that, right? And we take the cvo portion and take it out of isims, put it in medallion. And the problem with that is you’re saying it adds additional friction because the provider now has to log into one other place as opposed to logging into one in isims, and we, yeah, that problem is it totally makes sense. Okay. That sounds good. So let’s assume that we’ve got that sorted and now we’re at the point of, hey, we’ve got all the information from the providers. All the tasks have been completed. We have a profile that’s ready for cvo. So then at that point, we would on the medallion side, no longer need to send any information to adventum. As far as that’s concerned, we would automatically then via our intake process, launch the credentialing process from within medallion once the profile has a certain threshold met. So at that point, we would complete the cvo verification. You all, you know, would leverage the platform to like track the credentialing file and ultimately approve or reject it via committee… at which point we would start submitting the credentialing application to payr. So basically those first two pink boxes in the adventum space, we would cover that. And Kevin, keep me honest here. My understanding is we’ve had several conversations about the details of the actual credentialing and PE process in medallion. Yeah. We need to get to that. Perfect. Okay. Sounds good. So then at that point, there’s this third box of, hey, we’ve got, you know, cvo complete, and we’ve got payr enrollment complete for at least a subset of payers. Then there’s really kind of two arrows that spawn off here because remember, medallion is now kind of the pink box. So you would have a new swim Lane for adventum to ultimately, you know, pass that enrollment information to adventum for the purposes of RCM, right? Like adventum needs to know, dr smith has been enrolled with Aetna and cigna and all the other payers for the purposes of RCM billing. And then we would also trigger that notification or automation on the back end to, I guess maybe before I make an assumption there, let me ask you all once that’s done today, there’s a notification that goes out to the onboarding team. What exactly does the onboarding team do once they get that notification from adventum today? So we.
Jalen Parton (42:30) have to verify that they’re clear on both ends. But like the HR onboarding, and then the direct bill onboarding. So as long as everything on the HR side of onboarding has been done and complete, once we get that clearance that they’re cleared on direct bill, then we would approve them to start and like push them through as an employee if we get that, but maybe we’re still waiting on background check results or something like that. Then we would have to hold until we get those back. So basically we have to make sure that both of those pieces are complete, but then we would approve them got.
Sami Alouani (43:04) It. Okay. So there’s not really a clear path to fully automating that function because there’s another half of the world that you all are kind of serving as the gatekeepers to make sure they’re complete. Okay. Got it. Where do you get the notification today? Is it just an email that the direct bill is complete? Or how are you notified that direct bill is complete?
Jalen Parton (43:21) Tracy and Nakia, which is who are on Christine’s team, will send a message to whichever onboarder is responsible for that specific candidate, alerting them and letting them know that they’re clear. Yeah.
Rehab (43:31) It goes to Jalen’s team, but it also goes to the rvps of the locations and probably a program manager and whatnot so that they know that they can set up appointments. But I think Kevin was referring to this before medicare for senior living is one of our highest payers and they backdate. So when we say complete, it’s not really complete. It’s more clear to start clear to start on our side, the enrollment is not officially complete because the commercial pays can take anywhere from 30 to 60 days, but they can start right out from the gate from medicare. And then we have spnnet which is workers’ comp, which in humana is site specific. So if the location is already enrolled, providers don’t get enrolled with humana, they get enrolled with the site and that’s how the billing is done. So they can get cleared from three payers right out of the gate. But we never say the enrollment is not fully complete for our site. It’s clear to see these payers, and that Jalen can then go ahead and say, okay, well, they’re cleared for these. And on her side because sometimes the people get confused when HR says they’re cleared, and when provider enrollment says, they’re cleared because technically they could be cleared on HR but not with enrollment yet and vice versa… right?
Sami Alouani (44:52) That makes sense. And so that’s another one of those business logic elements that we would need you all to kind of define for us and tell us, you know, hey, you define, because obviously we can’t nor should touch the HR part, you know, clearance element that’s a totally separate world, right? So for the direct bill element, you all need to tell us, OK, what is that threshold that would today, you know, direct somebody from the direct bill team to send an email to these folks saying, hey, direct bill is clear, right? Like we just need to paper that out and tell us what that logic is. And then we can do a couple of things with that info, right? One is at minimum, we could automate the email so that, you know, nobody from direct bill has to remember to pull up, their console and remember who to send an email to. We could look at automating the notification that way or we could have like for example, a CSV file or something that says, hey here’s. Today’s, batch, of providers that have completed the direct bill onboarding element. And then you all could centralize that or do whatever it is that you ultimately need to do with that. But that’s one of two options short of obviously like the ideal way of your magic wand, utopia world where we could fully automate it. We could at least automate the notification.
Rehab (46:01) We have statuses. Jalen and I have added statuses on the direct bill side where cleared means, you know, like I was just explaining we hit cleared or pending and pending needing additional information, pending, no response from the provider. It, it could have been rescinded. The offer could have been rescinded. So a lot of those, maybe that’s something that you could feed off of those statuses.
Sami Alouani (46:26) Yeah, absolutely. Especially in the direct bill world. So, if, yeah, whatever you all come up with, right? Like we can, this would be something that we would write code tailored to your use case. So it’s not like we have to, you know, have to fit into a rigid box here. It’s just, you know, you tell us, is it a status? Is it a status plus, you know, an action having been taken? Is it a status plus zero outstanding tasks? Is it, you know, some combination of those things? Like you all kind of, you know, define the criteria the.
Jalen Parton (46:55) Feed the integration feed could go from medallion to isims in that like they’re.
Rehab (47:04) clear per.
Jalen Parton (47:05) Our business rules. And so there’s going to be a change in medallion that happens that triggers the status in isims to change to cleared to notify my team that direct bill is done. Is that correct?
Sami Alouani (47:17) Yes. As long as that status is at the payer level or at the I’m sorry, at the provider level and not at the individual payer level.
Jalen Parton (47:25) Yes. Yeah. It would just.
Sami Alouani (47:26) Be, yeah, yep, exactly. Yes. Then in that case, that’s an easy thing for us to do is write back that status to isims and that’s a good call Jalen, because it sounds like isims is already wired up from, to do the rest of the workflow, like going back to onboarding. Yes. Yeah. So that’s an easy thing for us to do and.
Kevin Murphy (47:45) This is, this is the like initial clearance is what we’re talking about. But then there are those additional, you know, commercial and medicaid, other payers that we’re waiting on enrollments for which we’re still going to need like that’s. The next piece in my mind to solve is once those are complete, how to like, what’s the notification process there for us? That’s a.
Sami Alouani (48:07) Good question. That is up to you. So we have in medallion, we have really robust apis that do list or that do exist at that payroll, that payer specificity level. So we can say not only if this payer is ready, but this payer is ready for this list of locations, but maybe not this other list of locations, right? Like we can get really granular there. What you want to have done based on that data is up to you, right? So, what I will say is if we’re talking about updating isims at a granularity lower than the, we wouldn’t.
Kevin Murphy (48:37) do that. Okay? We don’t have to go down that rabbit hole. We’re not going to do that.
Sami Alouani (48:41) Good. Okay. Yeah, that’s where it gets really complicated. So if we’re not going down that rabbit hole, then we’re in a good spot. So, you know, we can, we have reporting we can do, we can automate, you know, like we can do a weekly email with an attachment that says here are all the providers that have changed into a ready status and their payers. Like there’s a lot we can do there. We just, we would need to you all would just need to define it. We would need to kind of get a level of effort. And then, you know, of course, as you can imagine there would be, you know, a statement of work and potentially some pricing associated with that, but we can do it is the long and short excuse.
Rehab (49:15) Me, I would like to right now, currently, I don’t have the capability of seeing weekly updates. So for instance, we get weekly reports, but I don’t get the notifications of these 50 providers are now enrolled with blue cross blue shield or these 10 are now enrolled at that. You?
Kevin Murphy (49:32) Don’t get the change, right? Yes, you.
Sami Alouani (49:34) Just get the, you get a.
Kevin Murphy (49:35) Static update. This is an update and the next week you get an update and you don’t have the notification? Yeah.
Rehab (49:40) Right. Because for me to do that, I would have to go through the entire report and see when the date was that it’s now participating. And that’s a lot of work, you know, a lot of time taken out, but that’s something I would like to see on a weekly basis. It doesn’t have to be daily, of course, but weekly would be nice, yeah, another.
Sami Alouani (50:01) Thing we could do is look at it less from an integration perspective there and more of a custom reporting perspective. And so what we could do is build you not only a report in platform like that’s embedded into the medallion platform admin view that you could go check at any time, real time or close to real time. Like let’s call it updated every hour or so. And then we could also use that report to trigger an email notification at the same time. So that way you would get like the real time. And then you could say like I got 20 emails today. I don’t really want to think about that. I just want to go look at the, you know, the last two weeks who all has been added and for what payers, definitely a custom report. We could look at again just so we’re clear like that’s something that we would need to, you know, make sure, we spell out the dot, the I’s and cross the T’s on statement of work and price and all that good stuff. But to be clear that’s not something we need to figure out like, you know, right at this moment, even if it’s after implementation, let’s say we’re implemented in six months later. And you’re like, hey, I identified this thing that would make my life easier. Like we’re always going to be here to evaluate those expansions. I know.
Rehab (51:01) Kevin, this is on your mind too once we get the effective date. Is there a way, to put that into our billing system? So instead of me manually going in and saying these providers, so is there a way, that can be into Kevin? Are you looking for net health and athelas or just no, no, no, we.
Sami Alouani (51:22) Would just be talking to athelas at this point. Yeah. So we’ve reviewed that. It’s been a while. So we might need, we might need to dust that off. We have the apis on our end to do it. The question is, will athelas, can athelas accept the data that we have to push? The answer is TB. So, yeah, on our end, we absolutely can, but we would need to, yeah dust off that conversation. Yeah. Okay. Awesome. So to put a, to put a nice bow on this, I think largely, you know, a good chunk of the yellow and pink at the highest level would ultimately transition over to medallion. The major kind of shift up front would be instead of a manual initiation of the C of the direct credentialing process, we would use some business logic from isims to identify when a provider is eligible and ready to start the cvo process. We would pull up providers information from isims plus caqh, any gaps in that information, we would then task out to admins to complete. We have, the small gap, of the attestation that we’re going to take back on the medallion side to figure out potential solutions for. But once we have complete profile that is attested medallion takes over cvo takes over payer enrollment, and then will at minimum push back a provider level status update into isims once those activities are complete. And then at, you know, to take it to a more optimal state, we’re going to look for a solution for, the future payers and the deltas for the team to be able to see, you know, who all has that’s already active has been enrolled with additional payers? Does?
Rehab (52:58) That generally?
Sami Alouani (52:59) Gel, with everyone’s understanding from our conversation today, I.
Rehab (53:04) think just the notification. I was thinking Kevin, let me know. Let me know what you think… I think you, this is what I’m thinking we get the email that says, okay, the provider’s joining has the provider’s name start date and the location that they’re going to work at? If my team forwards that over to medallion, then you can swoop in and go into isims too. Is that something that would work as well? Do?
Sami Alouani (53:32) You say that one more time? I just want to make sure I fully understood, so.
Rehab (53:34) Currently, we get an email PE provider enrollment gets an email that, hey, by the way this provider, Christine rogers and MD, whatever is joining health pro or infinity or whatever organization that here’s the primary location here’s. The potential start date. We could actually forward that over to your team. And that would because we only get direct bill here. My team does not do anything outside of direct bill. Once we get that notification that’s basically, Christine here’s direct bill, and then you can take it from there… and go into isims. And it’s if that’s possible. I don’t know if that’s something that’s possible, you can do that.
Sami Alouani (54:15) I guess my question is go into isims and do, what exactly is it just to start any?
Rehab (54:20) Information, yes, pull the initial information that you need a shell of an, you know, the information.
Sami Alouani (54:26) We wouldn’t necessarily need that because we can tap into isims directly based on your business logic and whatever threshold is triggering an email to you, we could read directly from isims. So we wouldn’t need the email to tell us anything that new that we wouldn’t be able to pull directly from isims.
Rehab (54:43) So, Jalen, you and I would just have to sit and go over what triggers that email. And I think it’s the email… yeah, offer letter, right? That sign. I.
Jalen Parton (54:53) think we probably need maybe connect internally because I know with the structure of the payment per person, it’s a little different. And so where, you know, if we have somebody come into onboarding and they never do anything? And like, when are we charged? Do we want to be part of the threshold to make sure like, okay, they’re serious. They’ve initiated xyz. So like they’re fine to be pushed to credentialing or are we comfortable and confident? Like does it matter? We’re pushing everybody? So, yes, I think you and I would just have to figure out what the threshold is. And then if it’s everybody goes in that’s easy, we can do it based on when they are like pushing onboarding if we want to set it. If we manually need to be able to determine like, yeah, this person is serious or no, they’re not serious, then it may need to be something like your team goes in and changes the status and when that status changes and it triggers the message to them. So, but yeah, I think we would just have to figure that out.
Rehab (55:57) Okay. Yeah, that’s because we don’t currently, we’re being charged for providers, if we push it over to advantum because they have all the documentation and they started the enrollment, we’re being charged based on that, and we do have some providers that after two weeks decide, okay, they’re not going to join.
Kevin Murphy (56:22) It’s going to be a challenge here too. Yeah. So we’ll have to figure that out. Okay. Well, I.
Brandon Chase (56:31) think that was a very productive call, in terms of next steps, I know Sammy kind of already outlaid it, but Kevin, if you could send us this, if this flow chart here is ready to go, if you can send that over to us, we will incorporate that into the current flow that we have and build out, you know, a more detailed one with the specifically around isims, and then it sounds like Christine and Jalen y’all, have to kind of get together and figure out what that business logic will be. Good news is it’s we’re fairly flexible, but we’re just going to have to wait on you, to let us know what that business logic is. So we could kind of, we could build it out technically. And then we’ll take that attestation piece internally.
Jalen Parton (57:14) Like,
Brandon Chase (57:15) Sammy was talking about and see, you know, what we might be able to do around that. And then I think this group should get back together for a 30 minute call just to kind of go over, the solution and the updated flow. And then, you know, that, that’ll allow us all to kind of collectively sign off on, you know, feeling good about, this icems piece.
Jalen Parton (57:37) Yeah. I mean, I think the attestation piece will be big because that’s going to that’s going to major, determine whether we’re going to have to make them get into a separate system or not. So. Yeah.
Brandon Chase (57:50) Yeah, we’ll take it fairly and figure out if we can offer any solutions for that.
Rehab (57:55) Something creative with less interaction where they have to go in and look.
Jalen Parton (58:00) at it even.
Rehab (58:01) If it’s like I say, a profile that’s printed out and, you know, we can say here’s what, your information looks like in the system.
Sami Alouani (58:10) Quick question. Just a hypothetical. This is not something I’m promising or committing to right now. But if we could work with you all to develop in isims like a button that basically like I mentioned earlier, that jumps the provider directly into the medallion profile, like on a new tab where they just need to look at the exercise and like, or look at the data and perform the exercise of attestation. Does that meet your need or is it truly? Hey, we don’t want them looking at or touching another system, that would.
Jalen Parton (58:36) be great. I mean, if it was something that they could just click it and verify and then mark it approved. That’s awesome. Okay.
Sami Alouani (58:43) Great. So even so them being in medallion to do that exercise is not the problem. The problem is them having to log in, create a login and log into medallion.
Jalen Parton (58:51) That’s the problem. There’s one other place that they have to find the email and create an account and set it up. And, yeah, sure.
Sami Alouani (58:58) Yeah. And if you all, so for what it’s worth again, we are building that functionality in the very near future. So that would be something that we would need your dev resources for, because you would obviously have to do some dev on your isims instance to like integrate that on your end because we can’t develop against your isims. So just keep that in the back of your mind. If that’s an option that, we can commit to, we’ll let you know. And if it is that it will require some dev resources on your end. But just very helpful to understand what like your threshold? Just one question on?
Brandon Chase (59:27) That.
Kevin Murphy (59:28) who?
Brandon Chase (59:28) Would be the appropriate person to connect with regarding.
Kevin Murphy (59:31) Dev?
Brandon Chase (59:32) Resources on isim, his.
Jalen Parton (59:34) name is matt hale. Matt hale would be, he’s the lead on our engineering team. So he would be the one to connect with there. Okay?
Kevin Murphy (59:45) He’d be the one doing it. But I mean, I mentioned this in an email, I think to you guys or maybe it was on the phone. I forget, but we have a new CIO starting right very soon, I think next week, so.
Brandon Chase (59:56) Probably.
Kevin Murphy (59:57) Have to have that person involved in the conversation around resources because I don’t know what else is on the plate? Matt, you’re talking about matt hale? Yeah, he does like.
Jalen Parton (60:06) 600 things. Yes, he does, so.
Kevin Murphy (60:10) To understand, yeah, almost like a blessing.
Jalen Parton (60:13) But, yeah, I mean, as far as priorities lie, 100 percent would be, yeah.
Brandon Chase (60:19) Kevin, you and I were talking about that, right? So, you know, we said let’s put a pin in the overall kind of implementation call until the new CIO gets his feet under him for a couple weeks and that would be part of that conversation. So I think we could take this internally kind of, you know, noodle around on it a little bit. And then, you know, we naturally have a little bit of time built in just because of the new CIO starting and stuff like that. So, yeah, I think the timing could work out nicely. And yeah, Kevin, obviously, you and I, you know, we’re connecting at least once a week if not multiple times a week. So, you know, that’ll be top of mind for both of us to make sure that, you know, we’re kind of tracking his onboarding and stuff like that. Yep.
Kevin Murphy (61:03) I know Sammy just dropped. I think one thing that I don’t know if I heard in his kind of action items is I think it’d be helpful for us to understand the options and then the potential costs associated with the notifications coming out. When it comes to, you know, whether it’s custom reporting, whether it’s emails that are going out, whether it’s API integration with athelas, like what are the potential costs associated with that? As we like, there’s that initial clearance which I think seems like you can tap that back into isims pretty easily. But for every additional payer and site, like we’re going to need to be notified, either Christine’s team’s going to need to be notified, but our operations team’s going to need to be notified as well. So does it, you know, does it make sense for us to put together? This is what we think would be best? Or is it better for you to kind of come up with a menu of options and we can talk through how those would best work.
Brandon Chase (62:02) I’ll take that back to Sammy and ask him if it’s better to, if it’s better to kind of receive it from you, or what, the best way to do that is. I’ll ask him yeah.
Garrison Goodman (62:14) Either way, Kevin, we’re going to be like, hey here’s our understanding this is the work that needs to be done here would be associated costs, you know, do you want this? Yes or no? Like we’ll make?
Brandon Chase (62:23) Sure we go.
Garrison Goodman (62:24) Through it and diligence with it.
Brandon Chase (62:26) Then.
Rehab (62:26) One question I had and it’s probably for Sammy, what’s the timeline on when the providers would have to go in and review? Because obviously, some things might not be in the system at that time because we’re sometimes providers might not get you. It could be piece by piece. They’re getting you, not all the documentation right away. So, when would they be expected to actually go in and review that?
Brandon Chase (62:50) You mean like is there like a regulation or something like that once they have, like, is there a window of time that they have before it?
Rehab (62:57) Expires or something? Yes. So that button that they click on, is that going to be, hey, what like are we going to get a trigger that says, okay, Christine we have all this information here. The profile’s completed or like because I don’t want to have the provider log in and click the button and there’s no information in there yet or there’s some information and not all.
Brandon Chase (63:17) Yeah, the trigger will be defined like we will work with that’s. I think that’s where we need that business logic from you to figure out when, like when is that complete? So we can then trigger that because, yeah, to your point, like we don’t need the provider in there attesting to anything if they’re not, you know, if they’re not like 100 percent it.
Rehab (63:38) Would be complete when you have everything that you need to be able to submit. I mean, I feel like that would be the trigger. Yeah. Right. But now, are we getting this? I thought we were getting the information. Are we getting it from caqh? Is that, so you’re pulling the information from caqh once, you know, hey, this provider is joining you’re. Pulling the information. I’m assuming like all of that data, right? The existing social data. Yeah. Okay. Yeah. So maybe, okay. So, I think we just need to know like when your team pulls that data, how do we know when it’s actual there for the provider to, you know, click the button and go in and see and then verify it?
Brandon Chase (64:16) Yeah. If that’s we are pulling it from caqh and I don’t want to speak for Sammy, but I think the way that I’m understanding this is there is a way that we can work from isims to then push that notification or use that business logic in isims. I think that was something that we’ll have to figure out because I know that you were asking that question Christine of like, you know, what’s the system of truth. Well, we know isims is, but yeah, we, I feel confident on the trigger piece, but I want to make sure I heard you correctly with how long does the provider have? Is that a concern as?
Rehab (64:58) Well, yes. Like when are we, when are they expected to go in? And maybe that’s something internally that we have to talk about. Like with Jalen, we might have to say, hey, listen, you have to go in and approve, review all your information, make sure everything is updated and I guess that’s something that we have to work internally as well too. Yeah, yeah.
Brandon Chase (65:18) I think it’s I think it is built around that business logic and that trigger. I, the question I can’t answer because I’m not 100 percent but I could easily get it for you is like once we determine what that trigger is, and then, you know, that allows the provider to, you know, get into isims and click over in the medallion and all that stuff. Do they have? You know, hey, you have to do this within 30, 30 days or something like that, right? I don’t know the answer to that. It could be, it could be, you know, wide open. It could be six months. I’m not sure what that is, but I could get that if that’s an outstanding question for you, I could get that for you. Thank.
Rehab (65:58) you. I appreciate it. No problem.
Brandon Chase (66:02) Well, appreciate y’all’s, time as always. That was a really informative and I’m glad that we could do that. I think it gave Sammy a lot to follow up on and tighten up. So… yeah, appreciate it. Like I said, we’ll take some of these things internally? Sammy’s off for the next couple weeks here. But… Kevin, we’ll, I’ll work with you to get back together at least for this team to get back together. So we could, you know, tie a bow on the isims piece which will allow us to, you know, put that into the overall kind of implementation scope as well. So appreciate… it as always reach out with any questions. But y’all, have a great day you.
Rehab (66:43) Too. Thank you.