Transcript
Chris Jones (00:00) good afternoon, Debbie. How are you?
Chris Jones (00:06) Oh, it looks like you’re muted up, yep I.
Debbie Tuck (00:09) am sorry. Good afternoon. How are you?
Chris Jones (00:12) I’m doing pretty well. Thank you and yourself?
Debbie Tuck (00:15) Yeah, doing well.
Chris Jones (00:16) Thanks. Good. Appreciate you carving out a few minutes for me today. Yeah.
Debbie Tuck (00:22) Sorry about that mix up.
Debbie Tuck (00:23) Yeah, we had the strange… you know, it used to be Cesar Chavez day, but then it became farmers union worker day, so.
Chris Jones (00:33) Okay. Yeah, that wasn’t even on my radar.
Debbie Tuck (00:37) Someone enjoyed them.
Chris Jones (00:39) Yeah, I hope so. I was surprised. I was like, no, I hope there’s at least some foot traffic going by that I’ll notice them and enjoy them. Yeah, that was a bummer. I got a message from the, whatever doordash driver, I guess, and he said the door’s locked, the lights are off and I was like, no, and sure enough, he’s at the right place, but yeah, good intentions nonetheless. But yeah, I just want to chat for a few minutes and I’m not sure if you’re familiar with medallion and what we do or if you’re involved in credentialing at all? Does that fall under your wheelhouse at all?
Debbie Tuck (01:13) It doesn’t fall under my wheelhouse, but we do work like… of our team, right? Does the credentialing piece. And so, you know, I’m not sure how, what medallion does there, but the county who we work with right now, right? They do a lot of the credentialing they’re actually, they have put out a pilot program actually to kind of help and fix the credentialing right now. Oh.
Chris Jones (01:42) Interesting. So that’s at the county level. And then there’d be a number of organizations that fall under it.
Debbie Tuck (01:48) Yeah, exactly.
Chris Jones (01:49) Okay. Interesting. Okay. Yeah, I wasn’t aware of that. Yeah. So, but currently, you’re you handle it internally, you have a couple folks that work on it.
Debbie Tuck (01:59) Yeah, we handle it internally. We have, we might only have one maybe two people that do it. The credentialing. Yeah, it’s not too much of an issue for us actually to be honest with you. What’s more of an issue is ensuring, right? The county state have their records updated. So that’s usually, what happens is we’re like, well, no, you know, Chris got his credential. I don’t know what you’re talking about here’s. The blah, blah blah. So we’re really just dealing with them to make sure that what they have again is, you know, is accurate. We’re finding that they’re kind of slow which is, I think is why they’re trying to do some pilot program.
Chris Jones (02:41) Gotcha. Okay. Yeah, that makes sense. What about, on the payor enrollment side? So getting your folks set up with the, you know, the medi, cal, the aetnas anthems, et cetera, of the world? Do you have, does that fall under the same group or?
Debbie Tuck (02:57) No, it’s a different group.
Debbie Tuck (02:59) We actually have a Qi and compliance team that works on getting the contract right? So they’re in our legal department. So they work on getting those payers contracted with us to ensure that, you know, we, you know, have the right, you know, insurance so that, you know, any of our clients that come through, right? Have that? And so actually, it’s been a big discussion of like, hey, what payers do we have? Right? And so just getting that process to make sure that everybody’s on board. And so, yeah, we have a team like I said, on the legal side that tracks the payers.
Chris Jones (03:36) Gotcha. Okay. And the reason I ask is just to tell you a little bit about medat, actually, you know what? I’ll share my screen, just give you just a quick three minute overview if that’s all right. Yeah. Okay. Cool. Can you see my screen?
Debbie Tuck (03:52) Yeah. So.
Chris Jones (03:53) Really, I mean, there’s three key reasons that companies come to medallion and it’s one, right? They’re looking to accelerate revenue. So think about on the payer side where, you know, it can take 120, 150 days to get, you know, a provider enrolled with the payers, we use automation and technology. We can generally cut that in half, right?
Chris Jones (04:17) So it accelerates the revenue. So you don’t have, and, you know, sometimes you can have like backdated contracts or whatever. But, you know, oftentimes you’re not, and you have folks that are kind of sitting on the bench or not able to bill. So we can accelerate that. The other piece is just reducing the operational costs. So, you know, typically when companies are growing, they, you know, may have a couple of people that are working on credentialing. And then as they scale up, they need to hire more people. It really only takes one person to manage medallion. And then the last piece is just removing provider abrasion, right? So, it’s a pain in the butt getting credentialed and all that. And through our platform, it makes it super easy. So we have a, or what’s called a participating member with caqh. Are you familiar with that at all? It’s basically where the providers house all of their credentialing files and data. So we can pull that automatically. So you’re not having to do the back and forth of, you know, chasing down documents. And then, and then just kind of the other thing is, you know, we’re end to end. So like I said, we use AI and automation to manage the whole credentialing process. So, you know, think about your provider data management. Maybe it’s a spreadsheet, maybe you have software, but something to manage all of that, that’s all in our system. And then, you know, you do all your, you know, verifications, your payer enrollments, roster management, you know, everything that comes with it and then having a single pane of glass into the entire process. So you’ll know exactly where you stand with your payers, you’ll know where your, you know, where your providers are in terms of their licensing and renewals, and all that’s managed within a platform. So really kind of what the day to day looks like for you where you have two teams today that are currently managing both ends of the piece, they would both be in medallion. And all you’re doing really is making requests. So you’re making a request to get your provider credentialed you’re making a request for a payer enrollment and then medallion’s doing everything behind the scenes with AI and automation, but with human oversight. So, you know, all those phone calls that you guys are doing. All the back and forth that goes away. We’re doing it on your behalf, but you have visibility, you know, real time visibility in exactly where everything sits. So that’s super high level. But that’s what we do. We’ve been, you know, this is our sixth year, but the team is, you know, comes from healthcare largely, we’re backed by Salesforce ventures. We’re backed by Google ventures, optum. So we’ve got some, you know, pretty big players that are investing in us just because we’ve completely changed the way that credentialing is handled.
Debbie Tuck (06:54) Yeah, we don’t have much of an issue with credentialing that I’m aware of. It’s more on I’ll call it maybe the intake and assessment side of the house and automating that. And then really kind of our billing side is, which is a function of everything that isn’t working in the front end, right? Falls on the billing side to do audits and reconcile and all of that.
Chris Jones (07:18) Right. But,
Debbie Tuck (07:19) credentialing itself, it can be like I said like time consuming for the team and I know, you know, that they’ve talked about that, but as I mentioned, they are, we’re actually already doing a pilot program with, you know, our main, with one of our, with the county right? To improve that process. It’s more of it’s really more about ensuring their records are up to date. Yeah. Right.
Chris Jones (07:46) Okay. So, is that Santa Clara county? Is that who it is? Yeah. Okay. That’s interesting. I’ll have to look. We’re actually working with the state of Nevada right now to kind of do something similar for them. So I’d be curious to see what, you know, what they’re doing from that standpoint, yeah.
Debbie Tuck (08:02) Yeah, I don’t know it just, you know, the person that does our credentialing… she had come to our executive team and was telling us about this and wanted to kind of a green light to be part of the pilot, so.
Chris Jones (08:20) Okay. Interesting.
Debbie Tuck (08:21) That’s all I know about it.
Chris Jones (08:22) Yeah, no, that’s fair. Okay. And that’s fine. I, like I said, appreciate the time, wanted to just share that information with you, see if there’s an opportunity for us to help. Sometimes we can, sometimes we can’t but, you know, but certainly, you know, you’re aware, you know, we exist if anything comes up or if, you know, anything rings a bell with, you know, slow payer enrollment times that’s right in our wheelhouse, so we can certainly help you out there.
Debbie Tuck (08:45) Yeah, no, I wanted to see what you guys were doing because, you know, I’m kind of new to this org, you know, four months or so but I’m looking at, you know, process improvements, how can we automate things? How can we use AI to do that? So I was interested in that.
Debbie Tuck (09:01) So I appreciate the time, and so we’ll see, I mean, I don’t know what’s going on with that. Maybe it will work. Maybe it doesn’t if it doesn’t maybe who knows, might be giving you a call.
Chris Jones (09:11) Yeah, that’s fair. Maybe if you don’t mind, maybe I’ll just touch base with you in a few months and just see if anything’s changed. Yep, sure. Yeah. Okay. Cool. All right. Debbie. Well, thanks again. And yeah, sorry for the mix up on those cookies but hopefully, they went to somebody and they enjoyed them. That’s all right. All.
Debbie Tuck (09:28) Right. Well, I appreciate it. Thanks so.
Chris Jones (09:29) Much. You bet, take care. Thank you. Thanks you too. Bye bye bye.