Transcript
Mallory Smith (00:00) hey, Meredith.
Meredith O’Neill (00:01) Hello? Oh, I just am realizing I’m not on camera. Okay, Patrick is in the waiting room. Okay? Perfect.
Meredith O’Neill (00:19) Hi, Patrick. How are you today?
Patrick Fithen (00:25) Good morning.
Meredith O’Neill (00:26) Can you hear us and see us? I can hear you and see.
Patrick Fithen (00:29) You?
Meredith O’Neill (00:30) Perfect. How are you doing?
Patrick Fithen (00:32) Not too bad. How about yourself?
Meredith O’Neill (00:34) Good, good. It’s a Thursday that’s kind of giving Friday energy to me. So I’m in a great mood. Awesome. I don’t know if you’re feeling that on your end, but yeah, it kind of feels like Friday.
Patrick Fithen (00:48) I was already trying to get ahead of my yard work this morning. So I don’t have to worry about it this weekend. Oh,
Meredith O’Neill (00:53) look at you. That’s awesome. Yeah, I don’t know how the weather is. I’m in Kansas City. I don’t know how the weather is in Idaho, but it’s getting more spring like here.
Patrick Fithen (01:02) Yeah, same here. Yeah.
Meredith O’Neill (01:05) Well, I know that you took a call yesterday with my colleague Delaney. So thank you so much for taking two calls in a row. My colleague, Mallory and I just kind of wanted to give you a deeper dive of medallion who we are and then understand a little bit more about your current state and some of your goals. So, if that works for you for the call today, that’s kind of our plan and then see at the end if it mutually makes sense to move forward, we can continue conversations and go from there.
Patrick Fithen (01:35) Okay, great.
Meredith O’Neill (01:36) Perfect. So, Patrick, I guess I’m curious what made you reach out to medallion and just a little bit more about your role.
Patrick Fithen (01:46) Oh, yeah. You know, in short, I have a growing company. I have about 100 employees. We’re all based in Idaho. And then I do have telehealth therapists that are licensed in Idaho that see clients throughout the country… in short. We do all the credentialing in house right now. I’d seen headway was saying they did all their credentialing and I noticed that somebody put in a chat. They’re just using you guys, you know? So I just wanted to see if this would be a shortcut for me for saving administrative costs. I have a pretty robust billing team. We’re devoting about 20 hours a week to credentialing needs. It’s not 20 every week, but yeah, I just kind of thought see if this would make sense for my company, you know, just because it’s ridiculous, the packets that we have to give our therapists when they’re hired.
Meredith O’Neill (02:51) Oh, yeah, yes. We’re very familiar. Well, I do have a couple slides for just to kind of review and kind of walk through. But before we do that, yeah, Meredith O’Neill, probably should introduce myself formally. I’m part of the partnerships team. I want to make sure my colleague Mallory gets to introduce herself. So before we kick off.
Mallory Smith (03:13) Of course, you do have Friday energy, Meredith. I love it.
Meredith O’Neill (03:18) Patrick.
Mallory Smith (03:19) It’s a pleasure to meet you. I am based in Nashville, Tennessee. I’m a solutions consultant. So I’m just here to support the technical conversation today. I may have a few questions just to make sure that we’re scoping this out appropriately. And then we would be encompassing all of your needs, but it’s a pleasure to meet you, so.
Meredith O’Neill (03:35) To… kick us off, I know you mentioned I’m going to share my screen here. Apologies for the delay. I know you mentioned credentialing and credentialing across the healthcare sphere can mean a lot of different things and a lot of different tasks and processes. So one, I’m curious, can you see my screen? Yep? And two, I kind of took some notes based on your conversation with Delaney yesterday, but really my main question is that split between what your HR and billing team is tackling as far as what you define credentialing as at your organization.
Patrick Fithen (04:17) Yeah. So in short, I’m hiring folks that are lpcs… lcpcs, lcsws, lmsws, make up a good 50 percent of my therapy team I work with. I’d say about 65 70 percent medicaid, which in Idaho is administered by magellan. And then I got various other payers, blue cross select health… tricare, you know, just some of your larger insurance companies that we see clients with process. Right now, I do all the recruiting hiring, pass the torch over to my HR, you know, they get them all the new hire information, getting their background check, their license information, all that stuff that we need on file, get all the, that information sent over to my credentialing coordinator, and then her role is to help and assist the new therapists with completing their credentialing, and then staying on top of any requests and needs as they maybe need to be.
Patrick Fithen (05:37) I don’t know their license expires or we’re having to send over affidavits, just all that fun stuff and working with insurance. Thanks.
Mallory Smith (05:49) Patrick, if I could just jump in here really quick, you mentioned that you’re looking to grow this year, especially, I think you have about 40 providers right now. Is that accurate?
Patrick Fithen (05:58) I have, yeah, about 40 professionals. And then I got another 25 paraprofessionals that do outpatient work with us, that see medicaid, okay? And the rest is built up from my administrative teams.
Mallory Smith (06:15) Okay. So, would you want to track your, sorry?
Meredith O’Neill (06:19) Oh, go ahead. Sorry.
Mallory Smith (06:21) You’re fine. Would you want to track your paraprofessionals in the system as well? Or are you really focusing more on those billable providers? Well?
Patrick Fithen (06:30) Do you work with magellan at all?
Mallory Smith (06:33) We do. Yes.
Patrick Fithen (06:35) Magellan for my paraprofessionals, it’s a very minor credentialing, but we do have to go into, I believe it’s availity… enter in their information that’s a kind of a new requirement that they have now.
Mallory Smith (06:52) Okay. All right. Thank you. And then just as far as if we could quantify the growth that you’re expecting, are you looking to add a certain number of providers that are billable this year or are you just kind of adding them as they come?
Patrick Fithen (07:05) I could add, yeah, as many as I want.
Patrick Fithen (07:10) I get, I’m pretty busy. We’re at a funky spot in our business where I’m trying to also move to a new ehr platform because we’ve kind of hit this peak of so many gosh darn excel spreadsheets or just even our credentialing tracker, you know, like just got to make sure that when I get new clients in that, my intake team can get them scheduled with the right insurance.
Patrick Fithen (07:44) So it’s quite a process. So that’s part of my growth plan too. Is I’m spending anywhere 120 140 hours a week auditing, because we don’t have a efficient ehr that could get rid of a lot of our spreadsheets. So I’m pretty much feel like I’m an ehr pro consultant. Now. I think I’ve probably demoed 50 of them in the past year and a half, just taking my time trying to find the right one. But, yeah, growth, I could keep growing, but I’m trying to cut down on administrative costs in doing that.
Mallory Smith (08:24) Okay. That makes sense. Thank you. Yeah…
Meredith O’Neill (08:29) Is my understanding correct? I, you might have already said this previously, but like 12 to 15 payers today that you guys are working with.
Patrick Fithen (08:38) Give or take. And then, I didn’t include any of the eaps just because they are such low volume. I’ve pretty much stopped credentialing new providers with them.
Meredith O’Neill (08:50) Okay. That makes sense. And then… Mallory, did you have any questions more on the enrollment side? Did we cover that? Yeah?
Mallory Smith (09:01) Absolutely. So when and I’ll go kind of go through and maybe Meredith, if you can go to the rainbow slide, then I can talk a little bit more. Absolutely. I call it the rainbow slide. It, it’s basically all the services that we offer here at medallion. So we are comprehensive end to end. We are software plus services. So what we really want to take away from this call today is how are we going to reduce the 20 hours you’re currently spending as well as your HR teams to complete this? What a partnership with medallion would look like is that you would have a repository for your information. We would be able to track all your provider’s information, track the expirables, communicate back and forth with them with task management and emails. So someone from your team would be responsible for inviting the providers to the platform. We would handle the onboarding with them. We would collect all the information there’s, auto notifications that go out to them. And then someone from your team would need to request the number of enrollments needed for each provider. From that point, it’s pretty hands off. We show you full transparency. You’ll see every note, every email that’s happening back and forth between us and the payer, you’re able to see that should you want that level of visibility. But the big picture with medallion and I’ll let Meredith get into this is we have contracted slas. So when we onboard a provider, we’re currently seeing a two day average onboarding timeframe from the time they’re requesting or requesting to join the organization to completion. And then we can submit the applications with enrollments. We average about three to four days from the time you request them to get them out the door. And then we average to think about. I’d have to look it up for behavioral health especially with like lpcs and lcsws, but just under 50 to 54 days to get a par status with payers. Is that about what you’re seeing right now?
Patrick Fithen (10:52) No… I’d say for most of my payers, 30 business… days for my big ones is like blue cross. As soon as I turn in the credentialing app, they’re retro so I can start seeing clients right away. Magellan’s been kind of a pain in my butt. It, you know, they require you get their background uploaded and it’s been really disappointing because it used to be with medicaid as soon as you hired somebody, they were like game on. And now it’s taken anywhere from three weeks to get from magellan to get everything processed, which is not ideal with the volume of clients that get referred to us.
Mallory Smith (11:47) Absolutely. And when you mention background checks, are you using a specific service for that?
Patrick Fithen (11:54) Yeah. For the Idaho behavioral health plan, we have to go through our local health and welfare here. So that can again, you know, working with the state, it’s like working with turtles to get stuff back.
Mallory Smith (12:10) It is, yes, no, you’re not wrong. And I just have one other question here. You did mention with telehealth that your providers are seeing across the different states. Do you help them apply for the cross state licensure? Or is that something they usually come equipped with? And you say you have a Virginia license already, you can see Virginia patients. It’s.
Patrick Fithen (12:33) 50 50 Idaho’s pretty cool. You know, like I’m not seeing like let’s say Washington clients or all Idaho clients. And Idaho, if somebody has a good standing license, say in West Virginia, all they have to do is complete this one form for 35 bucks and it lets them do telehealth in Idaho.
Mallory Smith (12:54) Amazing. Yeah. Okay. We.
Patrick Fithen (12:57) Have a big shortage of providers here in Idaho.
Meredith O’Neill (13:02) So, would you say, you know, your staff is kind of from all over, or am I understanding that correctly?
Patrick Fithen (13:09) It’s not a ton. I probably have… five, six providers that are out of state.
Meredith O’Neill (13:17) Oh, okay. So, not a ton.
Patrick Fithen (13:19) Not a ton.
Meredith O’Neill (13:20) Okay. Well, yeah, just to follow up on what Mallory kind of hit on here, really, what sets us apart is the automation and AI integration throughout, our platform. So, you would think of medallion as that single source of truth. I don’t know how many other places you’re documenting from? I think you mentioned excel spreadsheets for credentialing. I don’t know how many day to day clicks your credentialing coordinator is making as well as the HR and billing team for enrollment. But this would be all kind of parsed together in one place, your bird’s eye view for all of your providers to see where they fall in the process from credentialing to an enrollment.
Meredith O’Neill (14:00) And then we have the hands on experts to assist getting those tasks done as well. So, as you continue to grow, you wouldn’t necessarily need to add members of your team to get these processes completed.
Patrick Fithen (14:13) Okay.
Meredith O’Neill (14:15) Any questions there, you?
Patrick Fithen (14:17) Know, I guess the thing that maybe I, you know, what I thought that Delaney had explained to me was you guys had some special contracts that enabled providers to get credentialed within three to four business days that’s where when she told me it was like 50 K, you know, that’s that would be more than I’m investing with somebody doing this 20 hours a week, but where I thought I would, where we might come ahead on this is if you had these special contracts that would enable quicker turnaround time with somebody getting approved. Yeah.
Mallory Smith (14:57) And, and I can jump in there really quick. So, Delaney was accurate that we have that for credentialing but to mirror this point earlier, credentialing in this industry can mean a couple different things. So, the one that Delaney was referring to is what we call credentialing to ncqa standards or primary source verification. So, the two purposes behind that is you, you’re vetting out your providers, you’re ensuring they’re compliant, they have their licensure, Coi, and so forth. We do have a three day guarantee on that component, so.
Mallory Smith (15:30) We do have a three day guarantee on that component. So, we do have a three day guarantee on that component. We, we ran some rough numbers this morning to see if you would qualify within that 50 K range, and you do qualify for it, but I want to unpack what you said a little bit more. So it sounds like you’re having someone spend 20 hours or so a week and that spend is less than 50 K currently?
Patrick Fithen (16:00) That’s correct? Yeah. Okay. So.
Mallory Smith (16:02) In that case, I think your head is in the right direction. We do have the ability to accelerate revenue. We would take your current turnaround times with payers, compare them to ours. I’ll go back and get more specific information when it comes to behavioral health, the specific provider types, you have, what we’re seeing in Idaho versus West Virginia and so forth. And then the other areas we look at is reducing your opex. So rather than having your rep spend 20 hours a week, they could spend a couple hours a week just inviting new providers making the request and then their hands are clean. So if you’re interested, we could definitely move it forward to a business value assessment to see if it makes sense. But I think just preliminarily here because we do have that minimum threshold, you’re not going to necessarily see a savings just from opex, if that makes sense?
Patrick Fithen (16:52) Yeah, no, that makes sense. But, you know, and then I guess another question I have, you know, I’m trying to lessen the burden on our providers with what they need to complete.
Patrick Fithen (17:06) What I was hoping your platform kind of did was, you know, most of these apps are pretty similar, you know? So more or less getting, hey here’s. Our tax id here’s. Our mpi here’s, their license number here’s, their background check. And then do you fill out all those apps or do you still require the providers to fill out the applications?
Mallory Smith (17:30) That’s a great question. We do fill out the applications. So it really is end to end management. So your team would request the enrollment and then we would go through and auto populate the applications we would submit. We would follow up with the payers. And then we would get you the par, effective dates. So less of a burden for sure on your individual providers. Really what they would be responsible for Meredith. If you wanted to mention the caqh piece, yeah.
Meredith O’Neill (17:56) It’s Mallory, it’s their last name and their caqh number, correct?
Mallory Smith (18:07) Yes, their last name, npi caqh id rather than having the provider remember their username and password. So.
Meredith O’Neill (18:15) That’s really all that they’re providing and then we’re able to pull in that information and get the process started rather than them filling out countless paperwork. Or I guess if you’re looking at other organizations filling out things online as well?
Patrick Fithen (18:34) Okay, cool.
Meredith O’Neill (18:36) So, yeah, that’s kind of go ahead, Mallory, you’re.
Mallory Smith (18:40) fine. I was just going to say just to answer your question, Patrick, it would be a significant burden lift off of your providers just because we’re collecting so much of that information already. So if you think about the onboarding process and what you would experience with medallion, someone from your team would invite them with those three data points that are needed, it would automatically connect their caqh application. It completes about 75 percent of their profile immediately. We have mobile friendly ways to view the information. There’s electronic signature integration. There’s even a QR Code scanner. So if your provider has their diploma on the wall rather than take that down untack, it, find a printer, scan it to the admin, upload it to the system, then they can just take a picture of it with their phone. So we can, it definitely makes the burden on the providers much Symplr. And that’s how we have a two day average onboarding timeline.
Patrick Fithen (19:32) Okay, cool.
Meredith O’Neill (19:35) Yeah, we know burnout and it’s hard enough to get providers hired on. So making that process a little bit more simple is great from where you sit in an organization.
Patrick Fithen (19:48) Oh, yeah. 100 percent any.
Meredith O’Neill (19:51) Other questions just based on like our value drivers, I know we kind of talked about almost all of these. So just wanted to make sure you understood kind of what sets us apart.
Patrick Fithen (20:03) No, I guess really I’d like to see what the, if you have like a demo like what the platform looks like and showing… me like a provider that has approved pending with the payers. Do you have something like that I could look at? Yeah.
Meredith O’Neill (20:24) We, I mean today, we really just kind of wanted to make sure this was a mutual fit and get a little bit more information. I’m sorry, I know you’ve had two calls with us this week, but I would suggest kind of walking through what the investment would look like the Roi as like a next step and we can include a demo in that call as well if that would be something you’re interested in.
Patrick Fithen (20:49) So, what would the Roi be for… just kind.
Meredith O’Neill (20:53) Of around what we talked about, you know, the 20 hours a week like we wanted to make sure, you know, we want to make sure the investment’s worth it to you. We want to kind of show the overall investment and Roi that you would receive. So we would kind of talk through that as a next step.
Patrick Fithen (21:12) Sorry, I’m a dummy return on investment. I’m thinking release of information in my.
Meredith O’Neill (21:17) Own, oh, you know what? I probably should? I probably should specify that in the healthcare space.
Patrick Fithen (21:22) That’s all good. That’s all good. Hey, I’m a little bit of both. So I’ll get a hybrid there with you.
Patrick Fithen (21:28) Got it. Yeah. Let’s let’s do that for the next step. And what I’d probably do is I would… probably invite like my credentialing coordinator to look at the demo with me because this is just at a, I assume I know what they’re doing, but there’s probably a 1,000,000 steps. I don’t know what they’re doing at this point. So it would be kind of good to just get some of their feedback if we do look at a demo together.
Meredith O’Neill (22:00) Absolutely. Yeah. Mallory, I know some of our team is traveling next week. So let me see. Can I send you some times, Patrick for next week?
Patrick Fithen (22:13) Oh, yeah, for sure. Okay.
Meredith O’Neill (22:15) And I wanted to double check. I’m not sure that Delaney asked this yesterday, but from a timing perspective, I know you have a ton on your plate right now. You said you were looking at ehrs, is there, when would you want in an ideal world like a system in place to make this a little bit more streamlined?
Patrick Fithen (22:34) We are so close, like I anticipate signing on a new ehr this month, you know, and that does take time to implement… it just depends on, you know, I guess to answer that when you bring on a new client, what is a typical turnaround time to implement this into their company?
Mallory Smith (23:04) Yeah, I’ll jump in there really quick. So I would say the turnaround time is pretty subjective. A lot of it depends. We have a data import template that we would basically share with your team. If you’re already on spreadsheets. We kind of love to hear that because first you’re getting the automation with medallion platform, but we would send you a similar spreadsheet and you would just move your columns around to match the spreadsheet format that we need. So really the data migration and import takes the longest bit of it. We quote out the gate eight to 12 weeks for implementation. What that usually entails is we’ll have a kickoff call within a week of contract signature. We’ll have that first data migration call the next week. And then basically we’ll provide you with that template before we even sign the contract just so you can get an idea of the information we need. And then we will train your staff on how to use it. Very minimal training is needed just because we’re performing so much of the work ourselves and then we’re pretty much good to go. I’ve seen implementations take anywhere from four or five weeks up to 12 just depending on the size of the volume considering you have about 40 providers right now. You’re already on spreadsheets. So we could just transpose the information a little bit. I could see it being quicker than that.
Patrick Fithen (24:17) That’s kind of where I’m at where, you… know, my team sticks around, you know? So all my folks are like all the 40 that I have now are pretty good to go. And I just have, I’m at like capacity at all my locations. So I just have one add out to hire one therapist in boise at this time. But when I open up another clinic, you know, maybe even two this year that’s where I see this being valuable.
Patrick Fithen (24:52) So, you know, maybe what we look at maybe what I needed the ehr, is the first component that I have to implement in my company. Both of them. The two that I’m looking at, it should have a pretty quick turnaround time of six to eight weeks. Maybe it’d be maybe it’s more appropriate that I follow up with you in June after I just kind of have that in place just so I don’t put too much on my team’s plate. I was thinking that maybe this is just something we kind of log in and it’s something they could implement in like a week.
Mallory Smith (25:28) Now, I completely understand. I wish you were that good.
Patrick Fithen (25:31) Yeah, right. Yeah.
Mallory Smith (25:32) But unfortunately, we don’t necessarily have a turnkey solution like that. Just because we want to give you to get you off the spreadsheets, get you into one consolidated platform. If you would rather push this to June, we can absolutely do that as well. And whatever works best with your timetables with.
Patrick Fithen (25:48) This, with this, with your six to eight weeks, how many trainings do you do? What does a training look like on that timeline? How many meetings are you having per week?
Mallory Smith (25:57) We usually have a 30 minute call with you per week just to make sure that you’re populating the import spreadsheet again, like just to give you a visual of the platform. The training for your team is really just we’ll show you the analytics and reporting. If you want to create your own reports, we’ll show you how to invite providers and how to request it. From there. It’s just full visibility on how we’re handling the process for you. So it’s very minimal when I say training that’s needed.
Patrick Fithen (26:23) And then, you know, each insurance that we work with again, Idaho’s I don’t know how it is out of every state. So maybe this isn’t true, but half of my staff are lmsws and, you know, it’s another pain in our butt is we have this down now. But for you all, if you’re not familiar with the Idaho health plans, how do you know which ones can be credentialed and which ones can’t or which ones can work under supervisory protocol? If you hear that term, I guess where you’re at?
Mallory Smith (26:57) Yes, of course, now we provide enrollment services for individuals groups, facilities all across the nation. How we’re able to configure that? And know is we have an internal payers directory. It has over 1,200 payers built out. So, I know what the medicaid for New York process is. I know what Idaho with blue cross would be. So with our system, we have a workflow engine that goes through and checks for all of those conditions, if it is supervising or collaborating physician eligible? We know if it’s a new medical, behavioral health, dental vision, what steps we would need to follow to submit the application, how often to follow up as well as how to escalate that application if it’s taking too long. So, we have that built out for every single payer across the nation. Okay?
Patrick Fithen (27:42) Cool. And then, do, you know, I know some practices like Idaho’s unfortunately not one of the higher paying states… if I wanted to like Washington’s on the border and Oregon’s on the border of two of my other clinics. And if I wanted to get paneled in other states, can you assist with that as well?
Mallory Smith (28:06) Yes, absolutely. We have actually that’s really how medallion got its rapid start in the industry. So when 20 20 happened and then they shut down everything and then everyone was needing doctors, the federal, I guess regulation said, hey, you don’t have to have an active state license to offer care, just see the patients, right? Like I don’t care if you’re in Texas and you want to see Rhode Island patients. So, because that was in effect for two years, we rapidly grew in the industry with cross state licensure, cross state enrollment, and so forth. So really I would say that’s our bread and butter actually is helping you expand to different areas, different provider groups in different states.
Patrick Fithen (28:42) Okay. Cool. Well, let me do this. Let me, let this marinate in my noggin, maybe send me an invite for next week or the following week or just some dates that you have. Yeah. And then I just really need to think on, is this something that I can implement along with my new ehr or something I need to wait on? Just because when we’re looking at new ehrs, these damn clearinghouses that we might have to switch to is going to take a lot of work to ensure that we’re getting paid. I just need to make sure that my team would have the capacity to do both.
Meredith O’Neill (29:26) Yeah. Well, and I think you said waiting until June is better for their plate. Obviously, you know, June is going to creep up at some point. Yeah, I’m happy to just send you a couple times in the next two weeks to look at a demo. If it doesn’t if the timing’s not right, the timing’s not right? Completely understand. But we’ll kind of summarize, I’ll send you an email kind of summarizing what we talked about today.
Meredith O’Neill (29:52) What kind of medallions value drivers are. So, it’s top of mind if, you know, it’s something that you want to re, engage down the future, but in the meantime, don’t be a stranger. If there’s any questions, feel free to ask me. I’ll like I said, follow up via email, but I’ll include my phone number as well.
Patrick Fithen (30:11) Okay. And then one other quick thing do you do any, do you do any pay rate negotiation since you’re working with so many payers?
Mallory Smith (30:21) Unfortunately, not at this time, I know that it’s been on the roadmap for quite a while right now. We’re just gauging market interest in that. So we don’t currently offer that. We do offer you a repository for all your group contracts to be stored, but we don’t do any active negotiation.
Patrick Fithen (30:36) Okay. I’ve been getting my hands dirty in that the past year. It’s terrible. Yeah, it sucks. Yeah, five more dollars like what? That doesn’t match the cost of living, but, yeah, I was just curious because it’s like, hey, what if one group’s getting paid more than me? I have no idea, you know, I’d be nice to leverage that information.
Mallory Smith (30:56) Yes. Well, for what it’s worth, I attend a lot of conferences and there are players in this industry that they want to work with pay or directory accuracy as well as other components of it. So, I’m hoping that they are doing really well at what they’re doing.
Patrick Fithen (31:10) Yeah, me too. Yeah, you got to be a shark to get that from the insurance company, you?
Mallory Smith (31:14) Sure do. Okay.
Patrick Fithen (31:15) Well, no, I appreciate both your time this morning. I’ll talk with my team. I’ll look forward to those invites and we’ll just kind of assess if we want to push that out till June for, to revisit this. Sounds.
Meredith O’Neill (31:28) Good. Thank you for the time, Patrick. Yeah, I will follow up here shortly, but feel free to reach out if you need anything in the meantime.
Patrick Fithen (31:35) All right. Thank you, Meredith. Thank you. Mallory. Thank you have.
Mallory Smith (31:38) A good one.
Meredith O’Neill (31:39) Bye.