Transcript
Noah Laack-Veeder (00:00) a yup.
Noah Laack-Veeder (00:22) Howdy. Hey… hey… is third caller ready with this team? Dream team? Let’s see.
Noah Laack-Veeder (00:41) I was telling myself not that in Spanish but that in the mirror this morning, yes… you can do this. You can do this.
Kyle Bettencourt (00:51) Got it.
Noah Laack-Veeder (01:14) Is there contacts?
Kyle Bettencourt (01:15) By enrollment positioning PE? Yeah, they just upgraded Healthstream… and they’re actively evaluating potentially doing credentialing stream enrollment as well. So, figured the, you know, likely path forward or initial need is to kind of discuss enrollment, but I think we’ll obviously touch on the fact that we can kind of do the end to end process as well. But overall… I just want to learn how the Healthstream is working, how the recent upgrade went? What’s driving the interest in enrollment? What’s Eric’s.
Noah Laack-Veeder (01:57) title?
Kyle Bettencourt (01:57) He’s the CFO. All right. How big is metro nse? They’re like 130 providers. Okay? So you can join it now.
Kyle Bettencourt (02:20) Hey, good morning, Eric.
Noah Laack-Veeder (02:36) You might be on mute if you’re talking, Eric. Can you hear us?
Kyle Bettencourt (03:09) Yep. I lost him. Oh… hey, Eric, you there?
Kyle Bettencourt (03:24) Yeah. Can you hear me now there you are. Yes, sir. How’s it going?
Erik Hemingway (03:29) Hey, pretty good. Sorry about that. I’m in the car and I think it was jumping between my home WI fi and the cell phone.
Kyle Bettencourt (03:37) Got it. No worries at all. Thanks for hopping on this morning. Yeah, appreciate the time.
Erik Hemingway (03:45) Yeah. So, I mean, I know you’ve been what’s the term pleasantly persistent, right? So I think I, you basically just broke me down and I said, yes, I’ll take a call. So, I know I told you that we’re kind of in the middle of, we did a healthstream software implementation change and so there’s probably not a whole lot of opportunity, but just kind of agreed to have a conversation to find out more about you guys and what you’re doing just to log that information in case it could be a fit for something. Yeah.
Kyle Bettencourt (04:21) No, absolutely. And yeah, I appreciate you making some time and, you know, apologies for the over the top persistence there, but.
Erik Hemingway (04:28) That’s all right?
Kyle Bettencourt (04:30) So, I made some slides. I’ll maybe just hold off if you’re in the car, but, you know, kind of ultimately why we reached out, right? Is we saw that metro has what looks to be a fairly complex credentialing and enrollment landscape couldn’t find out that you actually just upgraded credentialscream but you mentioned that you guys are looking into some options to help with the payer enrollment piece as well?
Erik Hemingway (04:54) Right. So.
Kyle Bettencourt (04:55) You know, kind of happy to give you the overview of medallion and sort of everything that we do. I think like just the best way to think of what we can do is sort of the end to end, you know, provider operations platform, right? And so we work with a lot of folks that are using credentialscream to actually help automate the payer enrollment piece, and so definitely kind of dive into that a little bit more, but maybe just as like a starting point, what’s driving the interest in that payer enrollment piece upgrade for you guys?
Erik Hemingway (05:26) Yeah. So I’ll give you the quick version of who we are and what we do. So metro anesthesia was formed in the.
Erik Hemingway (05:40) Dallas, Fort Worth, metroplex. So we’ve never acquired a practice. It has grown organically since the nineties and today we’ve got right around 100 docs and another probably 20 mid level providers.
Erik Hemingway (05:56) So we’re mostly all MD, but we do care team as well. And, you know, if you guys think back to like the 2013, 1,415, all that timeline, just consolidations were rampant, you know, usap and a lot of the big guys were buying up independent practices left and right? That’s really settled down. But back in that time frame metro, I mean, we’re staunchly independent and want to figure out how to keep it that way. And so we came up with a strategy that really right around the time I started to form a clinically integrated network. And so we’re not pioneering cins by any stretch of the imagination, but we are I think the only one doing it in anesthesia. And so we formed a sister company that really kind of launched in 2019 and it’s been sort of a slow build. But as of now we’re supporting, I think it’s around 420 providers across 10 different practices and right now only in the state of Texas.
Erik Hemingway (07:03) But we’re actually looking to expand that to other states. So we’re currently negotiating with a couple of practices in different states looking to create a cin in their state. And then, you know, go from there and build other independent practices under their cin. And so the benefit of the cin is that it really kind of operates like an mso model where we do all the back office services, but they maintain their clinical autonomy. They maintain ownership of their own tax id and their business control of the business, where they do work, how they pay themselves? We literally just do everything but the medicine. And because we’re a cin, they get access to our payer contracts. So that’s part of the value proposition that helps, you know, drive people to want to look at that as we’ve got better payer reimbursement and they get access to our whole benefit platform for medical insurance retirement and all those types of things. So it allows us to be operating as a collective group without owning and controlling those groups. And so we see it as a real viable business model to keep independent practice viable where independent practice is probably the fastest shrinking segment. People are going to employee hospital or owned by big corporate America. And so as we’ve grown, we are internalizing, finally getting the answer to your question. But as we’ve grown, we’re internalizing more and more of the revenue. Cycle process right now, we have a third party vendor that does a lot of the work and we will never 100 percent do it all internally. I mean, no one really does that anymore. Everyone’s got outsourced pieces of it but we’ve had some issues with payer enrollment in the past. And so we’re actually looking at taking over that piece of the process as well. And so that’s the answer to your question is like, you know, why are we even considering that? And that’s the reason why is because they haven’t done a great job in the past and we’ve of course, lost money due to enrollment issues.
Kyle Bettencourt (09:16) Okay. Yeah, that’s certainly helpful. So, and when you as far as like losing money or kind of what those issues, I mean, it sounds like just the turnaround times to completing these are too long or is there like a claim denial aspect of having inaccurate missing info or what are some of those issues that you guys have run into? I guess if you don’t mind me asking, yeah.
Erik Hemingway (09:40) Yeah, turnaround time too long or they’ll just flat out miss a provider. And, you know, right now we’ve actually started hiring our own follow up people so we can track trends and be watching for those things. But you’ll have a provider that’s getting denied for a payer for six months and nobody notices that as a problem. And so just, I mean incompetence is what that is. But… so, yeah, just kind of a mixed bag of things, but ultimately just missing payers, missing provider enrollments and, or taking too long, you know, especially with the government with medicaid, you’ve only got 95 days or 92, whatever it is. So they give you a pretty short window to get people enrolled.
Kyle Bettencourt (10:29) Yeah, that makes a lot of sense. And that’s you know, really in line with what we hear with a lot of folks that we partner with and, you know, ultimately what medallion can do is kind of act as an extension of your internal team, but we can step in to automate really all of the workflows around the, you know, application submission, payer enrollment follow up. And, you know, on average, we’re reducing turnaround times from, you know, 40 to 60 days. We can maintain 99 point five percent credentialing file accuracy. So we can, you know, essentially eliminate credentialing related claims denials or delays. And then lastly, because we’re leveraging AI and automation throughout that whole process, you know, we can generally scale up to a 1,000 providers with a single employee when managing the payer enrollment applications for your team. And so those are kind of the three main areas that we typically help folks. So it sounds like that, you know, turnaround time reduction and just claim denials in general would be, you know, potentially valuable for you guys.
Erik Hemingway (11:34) Yeah. I’m not going to tell you how many credentials we have, so, but definitely not a 1,000 to one. So, but tell me like, so you guys do, if you look at your book of business, how much of it is the facility credentialing versus payer enrollment?
Noah Laack-Veeder (11:56) I think it’s facility Eric. Sorry, this is Noah. I didn’t get the chance to introduce myself. I’m a solution consultant here at medallion. When you say facility credentialing, are you saying like we typically hear that being like facility enrollment. So you’re enrolling sites with particular health plans similar to a provider enrollment? Is that what you mean or is that a little bit different than what you all consider facility credentialing?
Erik Hemingway (12:21) Yeah, no, I mean more like actually getting a physician, a provider credentialed and added to the medical staff at the individual facilities. So, right now, our internal credentialers via that Healthstream or Healthstream, whatever it’s called like that tool is what we’re leveraging to do all of our facility credentialing, yep. And our third party biller right now actually has the software that they use for the payer enrollments. And if you listed all the ones, no, I can pick it out of the lineup probably. But I can’t remember the name of it right now. But so, yeah, facility credentialing is more about getting on with medical staff privileges.
Noah Laack-Veeder (13:03) Yep. And we do both. Typically organizations that are using and you all are using healthstream today, Eric, is that correct? Yep?
Erik Hemingway (13:12) Yep. Huh.
Noah Laack-Veeder (13:13) Typically organizations are using healthstream primarily for that med staff credentialing piece, but then they evaluate another solution for payer enrollment because the automations for payer enrollment aren’t there. And kind of what you were alluding to is there’s a lot of kind of manual work that you have to supplement on top of it. So where medallion fits in is we can do both. But typically organizations with a healthstream doing the hospital part, it’s working like fairly well. And then they need a solution for that payer enrollment more urgently. But we have experience in both to answer your question.
Erik Hemingway (13:56) Gotcha. And so are you guys at that point? Just tapping into credentialstream to pull data as the starting point for payer enrollment? Yeah.
Noah Laack-Veeder (14:06) Sometimes we’ll do that. A lot of times we’ll also tap in a caqh. Do your providers have caqh profiles today that you’re aware of?
Erik Hemingway (14:15) Yeah, that’s a big debate internally right now. Sure. So our revcycle director is trying to push our credentialing director to make that our standard procedure.
Noah Laack-Veeder (14:27) Okay. We.
Erik Hemingway (14:28) haven’t exactly agreed on that internally, but yes, we’re trying to get everyone to have an active caqh profile because that will drastically reduce the hours required to do payer enrollments and facility credentials.
Noah Laack-Veeder (14:43) Yeah, absolutely. And one area where we definitely help organizations using healthstream for that medstaff credentialing piece is that healthstream doesn’t really have a really robust integration with caqh. And the piece of caqh management and attestations ongoing still seem to be a pretty… high amount of work for teams. So, medallion, we’re a participating organization with caqh, which means that we have a bi directional integration with them. So ultimately, what that means is we can automate the attestations, the updates of caqh as well as pull information in directly from caqh. And I’m not sure if this is kind of the impetus of why your organization is thinking about leveraging more with caqh. It’s mostly what we hear is the payers are requiring it being updated as part of the enrollment process. And if things aren’t updated, then things might get rejected. You know, is that showing up for you all today in any way like those caqh mismatches or profiles not being updated?
Erik Hemingway (15:55) Yeah, I can’t speak to that, but I can only imagine the answer is yes. So, because we really aren’t mandating that the docs keep them, keep that up right now. So I’m sure there are a lot of issues when we’re trying to use that data.
Noah Laack-Veeder (16:11) Yeah. And I think ultimately where this shows up is if any of those discrepancies exist, then the payers have a really easy way of just rejecting your application, which can lead to some delays and turnaround time. So ultimately, by having that automated, which medallion can do, it can really expedite those timeframes. And obviously, there’s a lot of other things that we do as well. But the caqh piece is becoming more and more important for that reason. And oftentimes when we talk to healthstream organizations, I mean, actually we’re talking to one this morning that’s a critical piece that they need automated. So then that’s why they’re pretty far down the evaluation line with a medallion is their kind of PE service.
Erik Hemingway (16:59) Gotcha. So I’m a little out of my Lane on this phone call, so, which is fine. But I don’t like, who are the top five? Who are y’all’s, biggest competitors? Where do you rank?
Noah Laack-Veeder (17:15) I can try to like, I’ll sound salesy, but, I kind of want to educate you a little bit on like the market. So there’s kind of three different types of solutions that are out there there’s. Self serve only, which means like you have an in house team and they just use a tool to hopefully make the process a little bit faster. The second piece is a completely outsourced model. So it sounds similar to your third party experience today where you just say look just handle all of my operation. And then there’s a hybrid approach where you have a technology interface as well as specialists on the vendor side to expedite things. Medallion is one of the few in that hybrid model in the third. And then credstream typically is more of a self serve software. And there there’s pros and cons of each. But I’d say kind of filling in the gaps in those different categories. Like medallion is the hybrid solution. But then you’ve got modio, healthstream, others that are more of that self serve. And then those completely outsourced tools. It’s more like they’re usually just like consulting companies that you’ll outsource with. But kind of where medallion’s different is because we offer resources and that technology, we can guarantee outcomes. So, when it comes to those turnaround times, a self serve tool can’t promise that they can get things done in X days because it’s kind of relying on your team using the software. But because we have automations and specialists on our side and you have full visibility, we can actually contract a timeline so that’s where we’re much different as we can kind of produce more predictability in your operation. So if we’re saying, look, you know, we’re going to get these things done in X days, we can contractually commit to those.
Erik Hemingway (19:17) Gotcha. Does that?
Noah Laack-Veeder (19:19) Answer your question, Eric?
Erik Hemingway (19:21) Yeah, it does. And thanks for the info. And when you guys can, you look in your CRM and see if sales has ever talked to anyone from metro anesthesia. I’m just curious if, so this whole healthstream decision was made probably 18 months ago. So maybe 20, it was made a long time before we pulled the trigger and then we just pulled the trigger and that team took forever to implementation and it’s really just been live for a short period of time on our side. And then now we have this, I mean payer enrollment we are going to be handling that ourselves literally in the next three months. So we’re saying you caught us, you caught us like we’re right in the middle of figuring out like how we’re going to do that? And we’re having some issues with the healthstream tool. So I mean, you kind of caught us at the right time, but I’m just curious historically just so I know like what I’m walking into if I jump out of my Lane, I have conversations internally. I want to know if our company ever evaluated your software.
Kyle Bettencourt (20:33) I don’t see any record of any conversation. So, I think, yeah, I don’t believe we have. I did, I think kind of around the time I was reaching out to you, I reached out to Chris sale, your chief administrative officer on LinkedIn and I think she mentioned she was going to ping you. She actually just responded to me yesterday, of course, of all timing there. But yeah, outside of that, no conversations really.
Garrison Goodman (20:59) Yeah, Eric, my name’s garrison. I lead the team here. I’ve been following along so it doesn’t look like we have any record, but we typically engage with financial organizations first. Typically they, you know, oftentimes they’ll lead the revenue organizations as well. And, you know, where you guys are at 18 months plus bringing in enrollment. Like this is a perfect time that we see to evaluate this and we can tackle it a couple of different ways because, you know, obviously there’s dynamics at play in your organization and, you know, we’re not aware of those yet, but we like to start with folks like yourself because we can say, hey, we can tackle this on just the enrollment side or if there’s like a big win on the credentialing side as well for two main focuses. One, we can oftentimes you know, get credentialing done in one to three days. I shouldn’t say often we contract to that and that’s significantly often faster. And then when you think about the amount of staff that you have, you can either, you know, repurpose them to other things, keep them on. Like I said, there’s so many different ways that you, can, you know, kind of skin the cat here with how you want to think about where your team lies, but there’s just a lot of manual things that don’t need to be done by your team. So there’s wins in terms of opex savings. There’s wins in terms of revenue acceleration or even net new revenue because we’re now credentialing folks faster. And then as the team previously mentioned like any errors or accuracy issues, we also contract to 99 point five percent as well. So those are a couple of the threads to pull on from a financial aspect of why this makes sense. And so, what typically we do is take a look at like, hey, where and how you might want to think about approaching this. And then there’s several different ways that we can make a strong business case.
Erik Hemingway (22:52) Okay. And crystal, she’s… actually over credentialing for both sides of the house metro. And copractica is the cin. If you look at them, we just rebranded to that not too long ago. It’s independent physicians network, but it’s called copractica now. But she’s over credentialing for both and then the likely next steps. And I don’t know that they would be looking to do anything differently. It’s probably a pretty big uphill battle on that front. I mean, like where it would make sense, is on the payroll piece because we’re smack in the middle of trying to decision how that’s going to work. That would be Rhonda Keene on our side as our revcycle director and she would be who I’ll pull in for next conversation. I just need to, in fact, I have a one on one with her today so I can follow up and just see where they’re at in decisioning, how that’s going to work. And then let you know about next steps. I don’t think we’ve made a decision yet. There’s still an opportunity to at least hear you guys out and have a conversation, one of the goals just so.
Noah Laack-Veeder (24:02) If.
Erik Hemingway (24:03) that conversation happens, you guys can speak to this is, I mean this whole business model doesn’t make sense at 420 or whatever our number is today. This is really about, you know, getting us to 2000 or maybe 3,000 providers. We don’t know kind of where the sweet spot is, but it’s not 425. We haven’t really achieved the scale. We need to get to the cost that we want. And so that’s where we’re headed. We know we can’t do that based on how we’re doing it today. It’s way too manual. And so the changes that we’re making in revenue cycle, we have a heavy technology focus which is the same play that, you know, obviously the people that are still going to be here five or 10 years are doing that’s what it sounds like you all are doing. So I think it would be a good fit. So I just want to share like that’s where we’re headed. So we definitely need someone that can help us scale. And then one other thing is, I don’t know if I’m going to call it the right thing. But one of the, I know one of the goals internally for the team kind of responsible for all this is to become what is it delegated credentialing or like some sort of deal where you can fast track? Yeah. And is that something that you guys can help us partner with? Like, can help us achieve? Yeah, the.
Noah Laack-Veeder (25:33) Short answer is yes, Eric, but we’d want to definitely talk through that with you more. But that’s ultimately where organizations want to get to is a pair enrollment turnaround times are taking too long. And then you get the provider account where payers are willing to do delegated credentialing with you that’s how you can take your turnaround times from let’s say 120 days down to one theoretically. So it’s very advantageous for organizations and there’s a lot of requirements to get there one from like a technology standpoint, some from a process standpoint, a whole laundry list and we can help organizations that even share a case study of one that we’ve done where we can help you secure those delegation agreements and then make sure you’re passing all the audits that you’ll need to pass to get that status. I.
Erik Hemingway (26:23) Mean, is that a, is that a realistic goal for an organization that wants to be 1,500 or 2000 providers? Like where does that make sense? From your view? Like the people you help do it? How big are we talking to these like 15, 20,000 provider routes or are they smaller like us both? So?
Garrison Goodman (26:42) I would say we’ve you know, helped, you know, some of the larger health systems out in the country. But also, you know, family behavior health, a company that had, I think it was like 120 providers in about two years. They scaled to I think 800. And in the first year, we helped them get, I think seven delegated contracts. And then now they’re at 10 in their second year.
Erik Hemingway (27:06) Gotcha. Because what happens to us in the sales cycle, mean we’ve had a hard time selling it because anesthesia was so full of consolidations that a lot of people, it’s almost like it’s too good to be true. Like why are you? Like, why are you doing this? Because you don’t make a lot of money? Like it’s a low margin play. It’s kind of like a costco business model. It’s all about volume and all the value is pushed back into the individual practices. This is really about survival of independent anesthesia groups. And so, I think a lot of people look at it with kind of one eyed shut thinking that you’re trying to steal their business or something like that. And so the sales cycle takes forever. And then they’ll call you up one day and say, okay, I need to start in nine days… that’s literally, how like we took a practice that was part of envision. We’ve been negotiating with them for 18 months and they literally called us and said, I’m giving my term notice tomorrow. We want to start inside of 100 days and we set up their entire practice, pulled them out of envision, set up their independent practice and got them going. But I mean, you can imagine that cash flow wasn’t great. And so we have a line of credit, but I mean, that only takes you so far. So delegating credentialing has to be part of the solution. At some point, we’re not going to be able to get enough financing from banks to make all the cash flow problems go away. So that’s why I mentioned that. I just think that that’s you know, not that we want the sales cycle to work that way, but that’s just typically the way it’s worked for us so far. Don’t see it changing anytime soon.
Garrison Goodman (28:52) Yeah, Eric, we’re coming up to the time. Do you have a few more minutes to run over or do you got to jump?
Erik Hemingway (28:58) Yeah. Let me see. I think I have it on the phone. Yeah, I’m good for like 15 more minutes.
Garrison Goodman (29:05) Okay. So, yeah. As Noah was saying, that’s a huge component to why customers will come over if there’s a need to achieve a delegation, the fact that we have relationships with the payers, and just that we’ve done hundreds of thousands of enrollments last year. So, not only like, hey, when you achieve that volume, and it sounds like it happens in spikes as well with you, and that probably means that you’d have to bring on potentially spike hiring and, or either retain those folks or contract or whatever and manage that or you’re paying for a lot of downtime with us. It’s much more of like a utility based model.
Noah Laack-Veeder (29:48) Yeah. And.
Garrison Goodman (29:49) So, and the speed component helps significantly when you’re you know, bringing on these new partnerships. So, I think there’s something really to explore here. You mentioned some pretty significant, you know, I would say like provider growth numbers like you?
Erik Hemingway (30:06) Know, could.
Garrison Goodman (30:07) You know, would you share a couple a bit about like, hey, what is the provider growth? And therefore credentialing and enrollment needs look like over the next couple of years?
Erik Hemingway (30:17) Yeah. So, you know, really we’ve done a horrible job marketing the business. We literally kind of hide under a rock till last year and then we’ve you know, finally it’s a physician owned, right? So, you guys, I’m sure have dealt with those like they’re not, it’s not like private equity where they understand, you know, marketing and you got to put up, put all this money out to go hopefully get revenue coming in the door. And so we’ve had like a lot of organic grassroots type marketing campaigns go on the trade shows like it works, but you generate one, maybe two clients, new clients a year and that’s just not that’s not what we’re all here for like we know it needs to be, you know, three, four, five X that. And so that’s what we’re gearing up to do. We’ve kind of just completed our marketing campaign. We have specific practices in the state of Texas that we’re targeting. And then we’ve got practices like four or five other states that we’re talking to right now. So, you know, what’s in the sales pipeline that’s going to materialize in nine days right now. Nothing, but I’m way more optimistic about what the future looks like and trying to get to that two or 3,000 provider number. And I would expect that, you know, by the end of this year, we’ll probably add at least one larger group. And then I would think next year we add, you know, four or five groups. And I think at some point the snowball just starts rolling faster down the hill, cause we’re just we’re not that big of a company, right? So you just need critical mass and more people out there talking about how we have impacted their practice. And, and now the health systems are starting to like hca is really behind us. This one did an RFP presentation with them last week and they were going complimentary about revenue cycle and just the yield that they’re getting, you know, a lot of times, it’s the problem with a lot of independent practices. They don’t have good contracts for one. And then for two, their billing company doesn’t perform and get the cash that they need to pay the bills, which ultimately leads to high subsidies. So people, the health systems are starting to realize it. Actually, one of them has asked us to do billing for all of their employed anesthesiologists so we’re looking at those types of things too. So just, you know, just being real with you like right now there’s not a whole lot like that’s near the end in the sales cycle, but there’s 15 times more in the pipeline than there’s ever been. Yeah.
Garrison Goodman (32:53) Okay. So, a couple of things that, to pull on number one, when you guys do go into new states that adds complexity to the team that you have to hire, right? You gotta have experience in those states. Those payers and the overhead of managing that internally, can become a bit cumbersome. I hear you on the fact that, hey, we don’t have anything closing right away. We aren’t expecting a big credentialing or enrollment spike. And so, the, you know, question I go is like, hey, you guys are bringing this internally right now? What is kind of like the budget, to staff that? And could, you know, we offset that with technology rather than people and then put you in a position, to scale when you’re ready?
Erik Hemingway (33:39) Yeah, I mean, you’re singing our song, okay, that’s exactly what we want to do. And, and I’ll just tell you one other tidbit is we’ve got some people that are through a third party that are out of India that we’re probably going to terminate. And so, it’s kind of just thinking outside of the box like we have the, right now, we’re just discussing internally moving those two credentialers from India back to stateside. So, you can imagine what that’s going to cost. Yeah. So maybe there’s an opportunity to say, hey, what if we did part of our credentialing with you guys and the other internally and kind of pair them against each other. See how that works. I don’t know if you’re open to that. I know crystal won’t be open to that. I’m just being honest, that’ll take someone to have her be open to that like our CEO, but I just want to ask like, is that even a structure that you would consider where we do some internal and some through your team?
Garrison Goodman (34:46) Yeah, I mean that we have some customers that are like, look like we just have, you know, part of our business set up in a certain way that we don’t want to make a change. And, but we have this other part of our business that we’re open to changing because it’s less risk, less chaos, like less political, you know, fallout.
Garrison Goodman (35:06) So there’s like I said before, there’s so many different ways that you can scale the cat or skin the cat. So we’d be open to that. I think, what it typically comes down to is like, all right, for us to stand this up internally. It’s going to take us, you know, two head count, call it that’s going to be, call it, you know, 100 120 K of overhead. And then it becomes like, all right. What, what are our turnaround times? And like, can, we be even there? And, and most likely, you know, what we hear is turnaround times for enrollments are, you know, industry averages are 90 to 120 days. I don’t know where y’all are at, but our, on average are like 45 to 50. So… if that’s compelling in regards to potential revenue acceleration or new revenue for you, all, there’s another lever there. And then I think it becomes extremely interesting when you do start to scale and enter new states. And the huge win I think would be the delegation too. So I think there’s a way that we can make a good business case. The questions that would, I would have to, you know, better understand is like, hey, what does the team look like today? I think you said you’d have to bring on two people. Do you have to bring on any more? How many enrollments do you actually need to do? How many payers? I guess it’s you know, on average what is a typical provider, how many payers do you have to enroll them with? And then how long it takes. And from there, if you can get us that information in a matter of hours, we could turn around probably a extremely high level business case that could inform your conversation. I think you said with Rhonda later this week?
Erik Hemingway (36:49) Yeah, I actually meet with her today and I just like, I don’t know, that’s probably our best bet. I mean, I just don’t think and I don’t want to speak for crystal, but I mean, I don’t know that she’d be as open to considering something like that, like we may have to show success somewhere else… to then kind of make her want to ask the question, but we are, I mean, literally within the next 90, 120 days, going to have to move those two credentialers from being India to being U. S based. So we have to make those hires now. So, which makes me think it’s the right time to at least have the conversation about what it could look like. Okay?
Garrison Goodman (37:34) I think it makes sense and we could start small. And then as you guys scale have a much better option for you. Do you have a sense of how many providers you’d expect to bring on this year?
Erik Hemingway (37:47) I mean, I would say.
Garrison Goodman (37:48) Yeah, let.
Erik Hemingway (37:50) Me say, what if you guys will send me? I know you just rattled off a list of.
Garrison Goodman (37:55) Five or six things. Yeah, send.
Erik Hemingway (37:58) That in an email. And when I reply with those answers, I’ll also in talking with Rhonda and some other leadership, I’ll kind of give you a projection of what I think 12 months looks like, you know, one of our other problems too is that a lot of our practices, it might take three providers to equal one fte. So it creates a lot of work on the credentialing front. A lot of our, a lot of our groups use part time and kind of PRN help. Got it. So, you know, the numbers I’m telling you, I don’t think really is reflective of even the current head count. It, it may be, I think it’s around 425 including the PRN people, but I can give you some more information on that when I reply to your email yep.
Garrison Goodman (38:44) Okay. Yeah. We’ll make it easy for you at least, to know what variables to look for. And then, I think, I know you got to go here soon just at a high level. You mentioned some of the potential growth initiatives. You know, what would you say would be like, you know, your top charter that this might fall under? Is there cost growing initiatives? Is there digital transformation stuff? Is there, you know, overall just, hey, we’re potentially, you know, looking towards, a, you know, PE, funding event or acquisition strategy, something that this might fall under?
Erik Hemingway (39:19) As far as how do I pay for it as?
Garrison Goodman (39:21) Far as far as just like prioritizing it, you know, and just saying like, hey, if this is something that you, it sounds like it’s going to be, you know, crystal Rhonda, they’d have to get behind it. But, but ultimately, if there’s either you or from the CEO CEO like another initiative that this could say like, hey, this falls under like a priority of ours.
Erik Hemingway (39:40) Yes. I mean, right now, we’re in the middle of transitioning more of our RCM internally. And so, I mean, that’s the immediate way in is, to do pay to repair enrollment. And then, you know, unless we look at the credentialing because of the move of those two mdstaff, all… of that would have become secondary but that’s the way that the way in is through what we’re doing with revenue cycle right now because, that’s an active program that we have board support and funding over. And so that, that’s the big initiative and push for us right now. Okay.
Garrison Goodman (40:21) Well, hey, Eric. Thanks so much for being generous with your time and sounds like Kyle’s persistence might’ve pulled on a thread here. And, you know, we’ll work to kind of figure this out. And the way we operate Eric, is we just want to make sure it makes business sense first. And if that, you know, business and, you know, kind of political sense for your team. And if that’s the case, then we’ll obviously get into the weeds of process mapping and making sure everything aligns to how you actually need to operate.
Erik Hemingway (40:51) Okay. Yeah. And I, and I’ll find out really quickly if, I mean, our revcycle team right now has about 15, 16 people internally. And so I’ll find out real quickly if anybody has experience with you guys and positive or negative. I mean, that I can give you that feedback pretty quickly sure after I talk to Rhonda.
Garrison Goodman (41:16) Yep. That’s totally fair. So, okay, well, well, I’ll.
Kyle Bettencourt (41:22) work on getting those questions over to you ASAP here.
Kyle Bettencourt (41:26) And then just so you’re aware we’re actually, yeah, right. We’re actually hosting a customer event in Dallas at stilwells in about a month so I can send some details of, you know, conversations progress would love to meet y’all in person. So just to throw that on, okay?
Erik Hemingway (41:41) And we’re I’m sure y’all, are spread out all over the place, but, where are most of your people?
Kyle Bettencourt (41:49) So, I’m actually in weatherford myself. So not too far. Yeah, yeah, yep.
Erik Hemingway (41:55) Country Guy, huh? Yeah.
Kyle Bettencourt (41:58) I don’t know if I can claim I’m a country Guy. My, my girlfriend got me there, but,
Garrison Goodman (42:04) y’all, and I actually grew up together. My, my wife brought me to New Jersey and, his lady brought him, to Dallas. Yeah.
Kyle Bettencourt (42:14) Well, very easy. Yeah. And you’re in Dallas proper?
Erik Hemingway (42:19) Yeah, weatherford. Yeah, as little as I have to be, but I’m up north in Mckinney, but our office is down like almost downtown. Okay. But I’m up in Mckinney in the suburbs and, yeah, weatherford used to be pretty country. It’s not so country anymore. It’s kind of a big city.
Kyle Bettencourt (42:39) It’s it’s crazy how many people are out here? You know, I’d never even really prior to moving out, but, yeah, it’s blown up for sure. I mean, just the whole area, the whole metroplex in general is just exploding. So, makes sense too.
Erik Hemingway (42:54) Many people and,
Kyle Bettencourt (42:55) you know, we’ll.
Garrison Goodman (42:56) actually, both be out there next week. We’ll be in Austin, but it’s not too far, to come see you all. Given you guys kind of got a quick timeline. We could, if the conversations go well, we could potentially come see you guys the latter part of next week.
Erik Hemingway (43:12) Okay. Well, yeah, let’s see how this progresses. So, our, I’ll know after today after talking to our revdirect revcycle director if she has, you know, some experience with you guys that’s negative. I’ll know that really quickly. And then otherwise, I can give you feedback and turn around responses on your questions. So, and she’s out of Denver just so, you know, so our revcycle team, I mean, our corporate office is here. We’ve got kind of a hybrid schedule, but revcycle, we’ve actually taken the approach of hiring the best talent, not the best local talent. And so, I think our revcycle team is in about five different states but our leader is out of Denver and she’s here about a week or so happens to be here this week. So just so you know, like a lot of meetings with her will be virtual if this moves forward.
Garrison Goodman (44:05) Okay. Sounds good. Yeah, we’ll take y’all’s, lead on what makes sense, and when and where to be. So.
Kyle Bettencourt (44:15) Well, Eric, great. Connecting.
Garrison Goodman (44:16) Man, really appreciate the time.
Erik Hemingway (44:20) Yeah, thank y’all, have a good one.
Kyle Bettencourt (44:22) Absolutely. You too. All.
Erik Hemingway (44:23) Right. Bye all.
Kyle Bettencourt (44:24) Right.