Transcript
Jake Shubert (00:00) hey, man. Hey, Jake. How you doing good? Sam is joining, right? Yeah, yeah, she’ll be on, Katie’s here. By the way, I don’t know if we want to wait for Sam or just… let her in. That should work.
Jake Shubert (00:23) Hey, Katie. How’s it going? Hey, Katie. Hello. How are you? I’m doing pretty good. How about you?
Katie Sandlin (00:30) Doing great. Thank you.
Jake Shubert (00:32) Yeah, it’s great to meet you. Yeah.
Katie Sandlin (00:33) Nice to meet you. Thank you for the flexibility with all the schedule changes, Central Time, and then had a very quick day trip Monday back yesterday to Arizona. So my time zone is really kind of off at the moment. So, thank you.
Jake Shubert (00:46) No, you’re totally fine. I was going to thank you because I feel like I’ve been a little like, I don’t know, overbearing a bit over email time, like schedule stuff, and.
Katie Sandlin (00:53) No, not at all. I appreciate the urgency because I have a sense of urgency around it as well. I just, and I thank you for that because the traveling over the past two days, I’ve spent more time in an airport than I have in front of my computer. It feels like. So I appreciate the follow up.
Jake Shubert (01:07) Yeah, no, no problem. Where was the day trip? I?
Katie Sandlin (01:11) Went to Scottsdale Arizona for announcement on a new acquisition we just acquired last Friday.
Jake Shubert (01:16) Oh, nice. That’s super exciting. Yeah.
Katie Sandlin (01:18) Yeah, it’s always nerve wracking though. You don’t know how it’s going to be received when you walk in and announce, hey, we just bought your company, but it wouldn’t pay.
Jake Shubert (01:26) Yeah. Well, I’m glad you heard that. I also heard Scottsdale is like beautiful. I’ve never been, but I’ve heard it’s super nice.
Katie Sandlin (01:31) Gorgeous. This was my second time. The first time was like 2018 with my husband on a work trip and this was such a quick turnaround I wish I could have stayed longer. I would definitely recommend visiting the area very nice me.
Jake Shubert (01:42) And David actually talked about it yesterday where it’s like whenever we travel for work trips, we feel like we never are in the city that we’re actually in it’s like, oh, we went to Chicago, like, I don’t know what it’s like, you know, it’s just always fun.
Katie Sandlin (01:53) That is the unfortunate thing. When you travel for work, you’re getting to experience but not really experience because you’re there on a mission and there’s not a lot of downtime or at least if y’all are like me, I don’t have much time for downtime because you’re there for a mission, you got to get back to work.
Jake Shubert (02:06) But yeah.
Katie Sandlin (02:07) Definitely would recommend in an off season time because I hear it’s it was actually pretty busy and I guess that’s because it’s off season and, or in season, whatever they call it. Everybody wants to go there in July. So.
Jake Shubert (02:21) Yeah, I don’t blame them. Well, Katie really appreciate the flexibility. We have one other person from our team who’s going to be joining. Her. Name is Sam. We can get started before she hops on and do a little bit of intros here. So, I know you’ve met David before, but my name is Jake. I’m out in Portland, Oregon, and I’m part of the partnerships team over here at medallion.
Jake Shubert (02:41) So we’ll be working together just on your evaluation, making sure you have everything you need on your side, and then hopefully figuring out, you know, what is the best sort of path to support, you know, you and the whole team. And also Sam just joined. So I’ll let her introduce herself.
Jake Shubert (02:55) But when we do a demo tomorrow, it looks like Sam will be the one really leading that demo. So, I wanted her on the call today to make sure that when we do demos as tailored to what you’re looking to see and what answers you need as possible. So that’s kind of our plan. But Sam, I’ll let you introduce yourself. Yeah.
Samantha Bouchard (03:12) Hi, Katie. Sorry, just jumping from call to call. So a few minutes late here, but Sam Bouchard. I am solution consultant here that supports Jake. So that product and technical expert. And as he said, I’d be, I’ll be giving you the demo tomorrow. So looking forward to learning more about you and the organization and just making sure that we’re really showing, you know, your high priority items and making the most of your time tomorrow.
Katie Sandlin (03:39) Yeah, thank you. Nice to meet you, Sam. Cool.
Jake Shubert (03:42) And then Katie, for the time I did pick off your calendar for tomorrow for the demo, I just want to double check. Does that still work for you?
Katie Sandlin (03:48) That’s perfect. Yeah, it’s at 10 pacific 12 central my time.
Jake Shubert (03:52) Yeah, exactly.
Jake Shubert (03:53) Okay. Cool. So for today, kind of our plan was to just better understand what you’re looking for and what the current state looks like for choice health. That way. Like I said, it’ll inform the demo and sort of how we’re talking about things tomorrow and making sure we address exactly what you’re looking for. I already have a lot of notes from the conversation you had with David. So I understand, you know, choice health doing both home health and hospice care. Sounds like you guys entered your tenth state last week and obviously are growing via acquisition, which is really exciting and a goal to be in 15 states by the end of the year. Sounds like you guys have about 80 providers today currently managing all the licensing, credentialing, et cetera, all that work on Google sheets today. Yes. And kind of the sounds like the origination of this conversation was the legal firm you all work with. Pulsinelli. Sounds like you have some experience with medallion before and put in a positive word which we always appreciate. So that’s kind of like the understanding that we have coming from this conversation, but is that kind of an accurate summary it?
Katie Sandlin (04:56) Is, yeah. And I just pulled up two Google spreadsheets that I actively use in case that’s an example for me to kind of show you what your current state looks like. I’m more of a visual person. I don’t know if that’s helpful for you all. But yeah, so we have 83 distinct mpi numbers currently to date across 10 states that’s between home health and hospice. When we look at our provider services, it’s… going to be about 15 for them. So if y’all, don’t mind, I’ll share just briefly and then maybe.
Jake Shubert (05:26) I’ll have some.
Katie Sandlin (05:27) Conversations. Okay. Assuming y’all, can see my screen, yes.
Jake Shubert (05:33) We can.
Katie Sandlin (05:35) This is just what I house as our master entity spreadsheet. So this is our hospice tab that lists all of our hospice agencies. This is both parent and branch offices. If that’s applicable. We have the same for our home health and then the same for our provider services. This spreadsheet basically is just for all departmental use. It’s just a way to keep track of the license mpi, ptan, medicaid, tax id, their phone, fax, and addresses, and what’s on this spreadsheet is how it’s listed within the state medicare and medicaid portal. So if anyone in the company goes on here, they know exactly what the federal government has listed for our organization as we operate. And then I have a separate spreadsheet that we maintain for tracking. So we have one for home health, one for hospice. And basically, it just has our state license, the expiration date, what the status is, same for medicare, same for medicaid, and then our accrediting body and clia medical laboratory license. And then from within here, we track it a different way. So for our medicaid, I would click and any notes when I follow up on applications are logged here with the processor that I visit with and where I’m checking on status of applications. So essentially, now that y’all, kind of see what we’re doing now, as we continue to grow, this method is not going to be easy to maintain for much longer. I think it’s just not, it’s not easy to ensure that something doesn’t get missed. And that’s one thing we can’t have is a missed license, of course, so something that could better help me with this workflow management of knowing what applications are coming up for renewal, which ones do I need to start working on and submitting? And then if there’s any way to track that, I don’t know if y’all have any access within portals like I don’t know what that looks like. So obviously, if we’re in 10 states, we’re in 10 different state portals, one medicare portal, and up to 10 medicaid portals, if it’s applicable for the state. So that’s 21 different portals that myself and team are having to go in to update applications and whatnot. So now that you’ve kind of seen, this is probably my priority at the moment. Yeah, just until I can hire more assets. And I really don’t even know if I need to hire an asset, if myself and one other lady can oversee a platform that’s going to better help us track these. Yeah.
Jake Shubert (08:13) So a few things to say there. So starting maybe at the end of what you just mentioned. So the idea with medallion, what we do is if you were to leverage a platform like us, you would not need to hire additional staff to manage this. We enable like what we call half of an fte, which is really just means a person who’s not working in medallion full time. So one person who’s just the admin for medallion can support up to 500 providers between 500 and a 1,000. Actually. So you guys would not need to add headcount to your team to support this if you leverage our platform. And obviously, we’ll show you what that looks like tomorrow and sort of how easy and how much work we’re taking off of your plate, but I’ll start there… backing up. You mentioned a few different important call outs. One thing I did want to ask when we’re talking about licensure, are you guys getting the licenses on behalf of your providers or are they handling getting their licenses for themselves? And you guys are doing sort of the renewals? We’re doing it? Okay. Yeah.
Katie Sandlin (09:13) Compliance is doing it for all the organizations, not the administrator of the company. Compliance is owning all the applications as far as submitting, following up on them with the processor. And then we just provide the completed application once it’s been renewed to the administrator to hang at their location, got.
Jake Shubert (09:29) It. Okay. Yeah. So you guys are doing the new licensure for all of them and then also managing renewals, things like that. So that is super helpful. And then you obviously showed the spreadsheet which I’m also a visual learner. So that was very helpful for me. I’m curious like if you could walk me through the process of let’s say choice south, you guys hire a new provider. Tomorrow? You’re hiring Sam, what does the process look like to get the data you need from the provider? So that you guys can then do the work you need to support them, get them, licensed, get them credentialed. Curious what that upfront process looks like?
Katie Sandlin (10:04) Okay. So twofold, and it could just be in my vernacular of using provider. So I’m referring this more or less to an agency that we operate out of, not a clinician. Okay? So these are companies that we have purchased. So when we acquire an agency, those initial filings are taking place from pulsinelli as they complete the change of ownership filings with all of those medicare medicaid state entities. And then once they’re ready for a warm handoff, then it comes to my team for maintenance mode to keep that license clean. So this isn’t we don’t track in the compliance department, any clinicians that’s all completed by the HR department. So our providers are really just the agency that we have that is operating a physical location where patients are being served out of. The only clinician that compliance oversees contracting for is our medical director other than medical director contracts. The rest of that’s handled by HR. They have an HRS system. I don’t know if they’re eventually going to want to migrate to whatever compliance decides to go to. Maybe I don’t know. But for now, my main focus is how can I keep up with all the state medicare medicaid license specific in order to continue to operate an agency compliantly? So we don’t lose any. We don’t have a reason that we can’t operate because I didn’t maintain licensing status yep.
Jake Shubert (11:31) Yep. Got it. I guess Sam, I realize I’m monopolizing the questions. What questions do you have? Sam? I?
Samantha Bouchard (11:41) Say those spreadsheets were so well maintained, Katie. So for not having a system, you all are certainly, you know, really organized and like doing the best you can obviously to stay on top of everything. And then, you know, one of the ways that we actually migrate data into our platform is through a bulk import template. And so it always just kind of warms my heart to see like data reorganized because the more organized your data is, the easier it is to get into our platform. And I think that you will really appreciate just kind of like how we structure a lot of the data… I do want to dig into the agency piece a little bit more to make sure I understand. So when we looked at the licensing sheet that you’re all tracking. So you’re not tracking by individual provider licenses, it’s by, is that by a higher level?
Katie Sandlin (12:42) Yeah. So I.
Samantha Bouchard (12:43) will, can you hear me?
Katie Sandlin (12:45) Sorry, I can.
Jake Shubert (12:47) Yes, we can hear you but your WI fi is a bit choppy. So going camera off might help. We see that helps the audio. It seemed like your WI.
Samantha Bouchard (12:58) Fi. Yeah, I just tried that. I’m so sorry. Yeah, something’s going on in my area?
Jake Shubert (13:03) No, you’re totally fine. That’s.
Katie Sandlin (13:07) okay. So, yeah, whenever we’re can you hear me? Sam, and I can keep answering your question?
Katie Sandlin (13:16) Maybe might be having issues, huh? Yeah, I.
Samantha Bouchard (13:19) Can hear you. I can hear you. Yeah, I can hear you okay?
Katie Sandlin (13:23) Perfect. Yep. Okay. So, yeah, to answer your question on the licensing, it… is an agency specific.
Katie Sandlin (13:34) So let me just kind of take you to one for an example. We have one location that, and when I do the licensing updates, it’s for the parent and the branch. I’m kind of going to make you all dizzy for a second as I go across multiple, but we have a license for a parent, and then I’m also renewing the branch, but all of that’s done through one application. So where I have 86 different individual locations, we probably have over 120 different offices combined because some of them are branches or alternate delivery sites off of that parent office.
Katie Sandlin (14:17) Got it. I’m not sure if that answered the question, but I wanted to kind of demonstrate how it’s looking across all of our states.
Jake Shubert (14:26) Yeah, absolutely. I think Sam’s trying to hop back in but that was helpful. Okay. And then I’m also just curious like Katie, what do sort of the timelines look like for you right now to gather this data to manually put it together to submit what you need for the agencies? Like I guess just out of curiosity, how much work is that taking for you guys to, do, you know, agency by agency? It depends?
Katie Sandlin (14:49) On when something’s due. So when a license is and each state has different requirements, Oklahoma is still all paper. They don’t even have a portal. So it’s all paper applications that they have to mail in snail mail with a physical check. Other things are through portals. So it could take up to an hour to complete an application. The hard part is then just tracking it until we know that we’ve got it renewed because then we have that waiting period of processing that we’re having to put notes in and follow up and make sure we know the status and who do we speak to check on the application? And so that’s where all these notes are coming into play. So renewals typically once a year. Unless there’s any changes with a relocation or an admin is being replaced on the license with someone different. We have to open up the application. So I wouldn’t say the work itself doesn’t take a long time. The hardest part is getting to a state where we have it now being organized. And then every day we’re just going in and we’re filtering to see which one’s due first out of the licensing and the state of the medicare. So we can make sure we know what do we need to start working on right now? That’s the hardest part is tracking what’s due. So we don’t miss any deadlines.
Jake Shubert (16:02) Yeah, totally. And then I’m also curious you mentioned like medicare, state medicaid, obviously, are there any, you know, commercial plans, things like that? Like I’m curious sort of just make sure I understand the sprawl of work that needs to be done yeah.
Katie Sandlin (16:15) We do have a lot of payers that are contracted within each of these agencies. So not all of them, we don’t have a corporate umbrella with unitedhealthcare that everyone has the same rates. So some hospices do not have a contract with any payer, some have blue cross blue shield home health. It just depends they may have well different medicare advantage plans that they contract with right now, those plans, if I’m answering your question correctly, they’re being managed by our billing department. Okay? So where compliance doesn’t necessarily manage those renewals and the credentialing our billing team does. So, I would like to think whatever we go with for the license management, we could also fold our billing team in to manage those within the same system so we can make sure the payers stay up to date because a lot of what they need is what we have anyway. So license, they’re going to have to submit those kinds of things that’s.
Jake Shubert (17:09) why I was asking that question? Because I wouldn’t really make, I mean you obviously could do just a licensing component, but it’s going to be like I said, it’s duplicative data, right? So the idea would be managing both. So and to make sure I understand it correctly also for the HR compliance side who’s managing the commercial payers and credentialing. Is it also being done on a facility agency basis or is that being done by provider?
Katie Sandlin (17:34) So from HR compliance, they’re just dealing with employee relations. The billing is dealing with the payer credentialing, and it’s done by them based on each agency that has a contract with that provider.
Jake Shubert (17:48) Yes. Okay. That’s great. I was asking because there are some groups similar to yourself who do it sort of that model where it’s kind of what we would call like facility credentialing, so by agency. And there are some who do it like provider by provider where each individual provider needs to be enrolled with the payer. So some of you guys are doing facility based, which makes perfect sense. Okay, cool. Sam mentioned to me. She’s having some issues there’s like a verizon outage where she is right now. So that’s totally fine. I want to make sure any other questions that I have on my side… no, I think it might make sense. I can share a little bit more about medallion right now. And then from there, we can talk through maybe what would be most helpful to show in the demo tomorrow, if that works for you? Yeah, that’s great. Okay. Cool. So to sort of zoom out for medallion what, we are a tech enabled platform. And the idea of what we do is that we have built a digital solution from the ground up to manage the entire provider lifecycle and agency lifecycle. So making sure that we’re getting data, we have real time checks to all the necessary data sources to pull data. So you don’t have to do that manually and then all the paperwork process, you know, it’s work that we do on your behalf to actually send things out the door to medicare, to medicaid, to state boards, et cetera, to make sure that work gets done. The idea here kind of like I teased earlier in the call is that we don’t want folks teams like choice health to have the staff as you grow like we don’t want it to be, hey, we’re making these acquisitions. We’re moving to new markets. We’re growing. And now we have to add via headcount to support this growth. The idea is to be able to put it, push it through a platform that’s managed end to end where whether it’s yourself or someone else in your team, you would just need an admin who is clicking requests inside the platform and the medallion. We take the baton and we do the rest of the work for you and things are tracked real time inside of the platforms. You have those updates on renewals, revalidations, they’re getting processed automatically. You don’t constantly have to sort of like be on that spinning hamster wheel. So that’s what we do. We can support things on a provider basis. We’re also on an agency or facility basis, which would be more attuned to what you’re looking for. So that’s kind of like the zoomed out, you know, understanding of what we do just want to make sense or check. Does that make sense? Any questions you have there? Is that kind of along the lines of what you’re hoping for? Yeah, it is okay. Great. And I know that you’ve evaluated some other tools if I understand correctly and seen some other demos. Curious. How have like other platforms with their demos sort of stacked up for you? Have you been encouraged by what you’ve seen? Are you sort of still looking for the right solution? I know we’re like a little bit behind the eight ball in your evaluation. So just curious there. Yeah, no.
Katie Sandlin (20:31) I think I’ll have six total. Whenever I complete my demos this week. Several of them. I’m not going to go back with. It just doesn’t align with what we’re looking for. It’s mainly specific towards an employee and they can’t build out anything at an agency level. Yeah. There’s another that I looked at. And because of… the settings that the state agencies or medicare has with the third parties being able to log in remotely that they were prohibiting some of that transfer of data or whatever that looks like. And so it was going to be a lot of manual entry. And so I kind of, I don’t know if I’ve already got the manual thing down. I kind of I need something that’s going to give me some more automation, and tell me what I need to focus on for the day versus having to filter in Google sheets. So that’s kind of where I’m at right now. I honestly don’t know what to do in this space. I’ve never, I didn’t know that this existed. I just had an employee, a remote employee I had in Colorado resign that was really just doing all the hospice licensure. And so I’m taking those back on myself. I’ve done it once before, but I’m so heavily involved in overseeing the department in M a that adding the licensure is just something that I just don’t have the bandwidth for. So I’m looking for something that’s going to make that as easy as possible for me to oversee and still complete the task but not spend all the time trying to organize myself that it’s taking away from productivity yep.
Jake Shubert (22:04) That makes total sense. And as you’re looking at sort of expansion for the rest of the year, like how many, you know, agencies do you expect to bring on between, you know, now, and maybe over the next like 12 months?
Katie Sandlin (22:15) I’ve got 15 right now under Loi, oh.
Jake Shubert (22:18) Wow. Okay. Cool. Yeah. So.
Katie Sandlin (22:20) We’ve got quite a few.
Jake Shubert (22:22) Yeah. And I imagine all those have to do the same process, right? They need to be licensed. They need to be enrolled with the payers. Okay, cool. That makes sense. And do you know, like roughly on average, I know that’s probably a wide range, but like per agency, how many payers those agencies need to be enrolled with and credentialed with?
Katie Sandlin (22:44) I think when we’re looking at home health, they let’s say anywhere from five to 10 if I’m guessing, yeah, hospice, I would have to get with the billing team since they really oversee that side of things. We just deal with a couple of insurances that we have contracts with. For the most part. Most of our patients are medicare, eligible, okay?
Jake Shubert (23:06) Great. I think that sets a good scene for us for tomorrow’s. Call… anything in specific. I’ll relay the message to Sam, anything specific you want to make sure that we spend time on, in the demo tomorrow or like certain functionality you’re looking to see. You just want to make sure it’s as useful time for you as possible. Yeah.
Katie Sandlin (23:25) I appreciate the question because of what I have seen whenever I’ve gone on to the demos was a little bit different than what I was looking at. They were still kind of focusing more on kind of the payer and then also the employee. So what I’m just curious is how can I get an agency… one? I’ll refer to it as mpi for better terms. So I have this one mpi that’s sitting in Oklahoma City, for example, that has three different branches off of it. I’m having to license them. I’m having to make sure medicare’s updated. So I’m just kind of curious what does the workflow look like to maintaining kind of a, do I have a way to do an internal repository room where I can go into this provider, see where I am on the licensing, what’s due for renewal? But then also if I want to be able to find a document, their tax identification number, their assumed name certificate, prior applications. Can I download or upload various documents to make it easier for myself and team to find things specific for this agency? Currently, I have like a virtual data room that’s set up for all of our providers that I kind of showed y’all would go in and get that license. So any way I can move from a shared drive to this being a one stop shop to not only check the status and when things are due in a workflow setting? But can it be a one place where I can go and enter key information to extrapolate so much? So that even our finance team and our controller can go in there and take a look at things that they needed to that’s kind of what I’m looking for that’s.
Jake Shubert (24:56) great. And also just on the last piece there, you can have unlimited admins or personnel inside of medallion. So we don’t charge that way. So if there was finance folks, controllers, other colleagues of yours who you wanted to have visibility inside of medallion like that’s totally at your discretion. So no problem there. Okay. Yeah, cool. Okay. That’s super helpful. I’ll relay the message to Sam since she wasn’t able to be on today, there’s a chance maybe she’ll also like follow up email questions just to help her best prep for tomorrow. So if she does, I’ll compile them and send them over to you. But hopefully we’re all good here. Like I said, I really appreciate the flexibility today and also for tomorrow, looking forward to showing you the platform? Yeah.
Katie Sandlin (25:38) Sounds good. I’m looking forward to seeing it. Y’all, have a good rest of the day. And if I don’t hear back from y’all, any questions, I’ll see y’all, tomorrow. Sounds great. Thanks Katie. Thank.
Jake Shubert (25:46) You.