Transcript
Hassan Zahir (00:00) good morning. Hey, good morning. How are you today?
Meredith O’Neill (00:03) I’m great. How are you?
Hassan Zahir (00:06) I’m also great. Great. Is the great way to be.
Kathleen Lehman (00:10) You know, it’s.
Meredith O’Neill (00:12) almost Friday today’s. Kind of giving a Friday vibe.
Hassan Zahir (00:15) It is, it’s kind of a fake Friday, yes?
Meredith O’Neill (00:20) Yes, it is. Nicole was sick yesterday, so I’m not sure if she’s going to be joining, but we are a, okay, if she can’t.
Hassan Zahir (00:38) yeah, if she can’t. We’re fine.
Kathleen Lehman (00:40) Okay. Your.
Meredith O’Neill (00:41) face like looked concerned. I was like shoot, he’s really worried about me. I’ll.
Hassan Zahir (00:48) be passing meeting slots while I wait.
Kathleen Lehman (00:52) Gotcha.
Hassan Zahir (00:54) There’s always enough of them. Never a shortage of slacks coming across.
Meredith O’Neill (01:00) Okay. Silly question. And I can let them in because we’re already at 10 of one, but slack, I’m new to it with sharing my screen. It messages won’t pop up.
Hassan Zahir (01:11) No, as long as you share, don’t share your entire screen, just share a window. That’s.
Meredith O’Neill (01:19) okay. That’s good to know. I’m a big entire screen sharer. So, good to know. Yeah. Okay. Well, if you’re okay with it. I’ll let Kathleen in here.
Hassan Zahir (01:30) Sounds good. Okay?
Meredith O’Neill (01:35) Hi, Kathleen. Good morning.
Meredith O’Neill (01:45) Can you hear us and see us? Hi?
Kathleen Lehman (01:46) How are you?
Meredith O’Neill (01:48) Good. How are you?
Kathleen Lehman (01:49) I’m well, thanks. Good. Thanks for the cookies again.
Meredith O’Neill (01:54) I am so glad you liked them. I, well.
Kathleen Lehman (01:57) I, the entire department liked them. I mean, it’s more like a cake that you cut into.
Meredith O’Neill (02:03) They are pretty good. I know Kansas City. So I said, I told you, I’m local. We have a lot of options. I don’t know if you’ve ever had those blue chip cookies. Have you ever, those are a big favorite of mine. So I kind of go back and forth between blue chip and crumble.
Kathleen Lehman (02:20) You know, there’s nothing, cookies. They’re all good. Yes. Yeah, let me send a message real quick and let’s see because I know, I think, is… this scheduled for half an hour? Is that right?
Meredith O’Neill (02:35) Half an hour? Yes. Okay. I saw most everyone you forwarded it to accepted. So, maybe they’re just running.
Kathleen Lehman (02:47) Late running a little behind?
Meredith O’Neill (02:52) Or at least Melissa did. And I’m not sure. Actually, I’m not sure if Amy did.
Meredith O’Neill (03:29) Oh, there’s Amy in the waiting room here. Good morning, Amy.
Kathleen Lehman (03:38) Good morning. How are you today? I’m good. Thank you. Sorry. I’m running a little behind all good.
Meredith O’Neill (03:48) No worries.
Kathleen Lehman (03:50) Yeah, I just sent, go ahead. Yeah, I just sent Melissa a message that we are having new hire orientation this week. So, I know they’re joining, they may just be running a little late too.
Meredith O’Neill (04:05) Okay. No worries. So we,
Kathleen Lehman (04:07) is it okay if we just give them just a couple of minutes?
Meredith O’Neill (04:11) Yeah, of course. Okay. No worries. And.
Kathleen Lehman (04:15) While, while we’re waiting… so will the presentation be split up into between provider enrollment and actual privileging PSV process?
Hassan Zahir (04:29) You?
Meredith O’Neill (04:30) Know, we kind of tackle it all high level. At least my goal for today was kind of to get an understanding of current state at kvc kind of understand how you guys break it up. I know you told me via email, but it will be helpful for us to dig in there and then just give you a high level overview of medallion. And then at the end of the call, if we see that there’s a mutual fit, we can certainly schedule another call, to go a bit deeper. Does that, does that sound good?
Kathleen Lehman (04:57) Sure. Okay. Yeah, that’s great.
Meredith O’Neill (05:00) Hassan I, it looked like you wanted.
Hassan Zahir (05:01) To say something that’s exactly it. Medallion does support both like the credentialing PSD workflow and the payer enrollment flow out of the same platform, separate modules, but still kind of consolidate it, in the same place. And so, when we get to that point, more than happy to really dive in deeper there. But I think, to Meredith’s point, we want to just kind of align on what’s happening today.
Kathleen Lehman (05:26) Sure.
Hassan Zahir (05:27) We’ll learn more about you and what you’re doing. We can talk medallion all day, but I would love to hear, you know, more what’s happening over there first at kvc?
Kathleen Lehman (05:39) Got it. The only reason I ask is because I think I mentioned in the email, our structure is split a little bit. And so I thought maybe we could get started on the provider enrollment piece because Amy Crawford is our executive vice president over the RCM team and manages the provider enrollment piece. And then Ben and Melissa are over, the privileging PSV piece, so that’s the only reason that I mentioned it but, we can probably get started. Hopefully they’ll join shortly, but you’re taping it too, right?
Meredith O’Neill (06:14) Yes, I believe so. And we can certainly kind of, I, we’re going to have some questions throughout the call, for you to understand current state. So we can certainly start with the questions on the enrollment side while we have this audience. And, and as others trickle in, we can make for wider conversation if that works.
Kathleen Lehman (06:33) Perfect.
Meredith O’Neill (06:34) Perfect. Well, if you don’t mind, I promise, I won’t bore you with too many slides here. I’m going to share my screen, but my name is Meredith O’Neill, nice to meet you guys and put faces to names. I have been in the provider data management space for about eight years. I really appreciate you taking the time and do you mind Kathleen just telling me a little bit more about your role? How long you’ve been at kvc before we kick off?
Kathleen Lehman (07:03) Sure, absolutely. So, my name is Kathleen Lehman. I’m the executive administrative coordinator with kvc and I’ve been here for 10 years.
Meredith O’Neill (07:13) Oh, wow. So.
Kathleen Lehman (07:15) I used to handle all of the privileging and provider enrollment and we’re just transitioning that over to Melissa and to Amy. So I’m here to kind of just help with the conversation, help facilitate meetings. Perfect.
Meredith O’Neill (07:35) And Amy, I know Kathleen kind of introduced you, but is there anything you wanted to add about?
Amy Crawford (07:41) Your role? No, I’m still a little newer to the organization. I think I’m at nine months old, 910 months here. So I come from the hospital space, the acute hospital space, just local to Kansas City for the past 20 plus years in revcycle, so familiar with the provider enrollment components, but it looks different at every organization I’ve been at as to who manages, whether it’s managed in house, whether it’s outsourced different company, different technology. So, yeah.
Meredith O’Neill (08:16) Okay. Sounds good. Well, Hasan, before I jump into the slides, do you want to do a quick intro?
Hassan Zahir (08:21) Yep, for sure. Thank you, Meredith and ladies. My name is Hasan Zahir, I’m the head of solutions consulting here at medallion. I’m supporting Meredith through this entire conversation. So I’m going to be riding shotgun with her if you will just excited to have the conversation and learn more about what’s happening and see if there’s a place where, you know, medallion could assist and if a partnership makes sense.
Meredith O’Neill (08:48) Perfect. Oh, looks like we got one more person here. Can you hear us and see us?
Kathleen Lehman (09:04) Melissa, if you can hear us, you’re on mute.
Mcatlett (09:11) I can hear you.
Kathleen Lehman (09:13) Perfect. Hi.
Meredith O’Neill (09:15) Melissa, Meredith, O’Neill, here with medallion. We actually just did intros. I was just about to jump in. So if you don’t mind, I can hop in here or you could do a brief intro and we can get started.
Mcatlett (09:29) Sure. My name’s Melissa catlett. I am the HR compliance manager. I’m on the HR team, but I’m doing privileging for hospitals as well.
Meredith O’Neill (09:41) Perfect. Nice to meet you. Well, can you guys see my screen? Yes. Okay. So, I know Kathleen, you had reached out to medallion. It looked like about a month ago and shared a, excuse me shared a little bit about kvc with my colleagues.
Meredith O’Neill (09:59) So I kind of took some notes from that and then did some research but I know you guys have a large multi state presence across Kansas, Missouri, Nebraska, Kentucky and West Virginia. And then exciting times for you all, I see that there’s a new facility opening in webster groves, actually a place that’s very close to my heart and late this year. And then I did some digging. It looks like you guys are actively hiring over 180 job postings. And then Kathleen, as you mentioned, you kind of divide and conquer the credentialing enrollment, privileging through HR and revenue cycle. So probably a couple of questions just to verify with you all on this slide. Is this all accurate first before we kind of dive in? Yeah.
Kathleen Lehman (10:47) I think the only thing to note is that currently the Kentucky and West Virginia locations aren’t utilizing our third party partner. So they do all of their own credentialing in house, also Nebraska, Kentucky and West Virginia inpatient and residential services don’t apply at this point at this stage.
Kathleen Lehman (11:10) So, our Kansas and Kansas, our kvc Kansas location as well. So, kvc Kansas and kvc Nebraska utilize provider enrollment only for psychiatric community based outpatient services.
Hassan Zahir (11:24) And so, is it safe to assume then for those non included services or service lines that you’re providing today? And for Kentucky and West Virginia that the scope of this conversation, we’re not going to include them in the scope of this conversation, or should we address it as if what the options are holistically?
Kathleen Lehman (11:44) I’ll leave that to Amy. I know at some point there was a conversation about bringing them into the fold, but I don’t know the update, okay?
Amy Crawford (11:54) Yeah, I think right now, let’s just focus on the current locations and what the offerings are in this space.
Hassan Zahir (12:03) Okay, perfect. And just the reason why I was asking as medallion does support, obviously, you know, multi location, multi facility, multi 10 configurations and we’ll be able to show that in absence or including them just was curious as far as how we talk about the structure as we move forward. So thank you for elaborating there both ladies.
Meredith O’Neill (12:27) Kathleen, you mentioned you’re utilizing a third party today. Do you mind explaining what that third party is doing for kvc right now?
Kathleen Lehman (12:35) Sure. We’re working with two different departments within the same organization. On one side. They’re doing what they call PSV services, privileging services, which is all of the, from request for privileges application to board. And then provider enrollment services are in the same company, different departments. So as, you know, there’s a lot of crossover there, but they’re taking care of all of those services for us. Okay?
Hassan Zahir (13:06) Including like working with the providers on the dop forms and everything happening, getting the privileges assigned. And it sounds like pushing through like your committee or whatever your board structure is to get those privileges approved as well.
Kathleen Lehman (13:20) So, yes and no, I mean not to go into too much detail and get into the weeds too much. They’re not providing. They’re not working directly with the providers all the way through from cradle to grave necessarily. They’re not conducting the tjc surveys themselves. I mean, they’re providing a online format to contain the files. I mean, there’s some limitations where we have to jump in.
Hassan Zahir (13:47) Okay, cool. Thank you for explaining that.
Meredith O’Neill (13:52) And is that webster groves location? Is that still on track to open later this year? It is okay.
Kathleen Lehman (13:59) Yeah. And that facility will provide residential services as well as acute inpatient hospital services, just like we do in our other facility, well in Kansas City and hays.
Meredith O’Neill (14:16) Okay, perfect. And I guess hopefully Hasan, you might be able to ask this question better than I can, but is there anything else from a revenue cycle perspective that you all are overseeing task wise? I know enrollment is quite a task in itself, but is there anything else that you guys are responsible for?
Kathleen Lehman (14:41) Not.
Amy Crawford (14:42) necessarily. Except, I mean just keeping the attestations current within availity, for example, so just all of the follow up work that, you know, keeping the providers current are?
Hassan Zahir (14:57) You managing their caqh profiles as well? Or is that up to the provider?
Amy Crawford (15:02) We’re managing it via the vendor that we work with. Okay?
Hassan Zahir (15:10) Okay.
Meredith O’Neill (15:11) Hasan, do you have any other questions on this slide before I kind of jump into?
Hassan Zahir (15:16) No, that really gives me like the lay of the land. What’s being done? What’s kind of being, you know, managed by the partner and kind of gives us an idea of what should be in scope. So, it’s been really beneficial.
Meredith O’Neill (15:32) Perfect. Okay. Well, I kind of wanted to walk through what we see across the industry today. What we see just in, across the country, I’m curious from collecting that provider data and submitting an enrollment application. These are some estimates that we see as we talk to organizations like yourself. But do you know how long it takes from, you know, hire to get that provider to the bedside, what that time is looking like at kvc right now?
Kathleen Lehman (16:06) Well, I mean, as you know, it really depends on the provider response, right? Yeah… yep. And.
Hassan Zahir (16:16) So, is your flow then like the offer goes out to, the provider then goes through onboarding, you’re collecting data. I won’t go into the weeds like which department it’s like you got to collect the data. You’ve got to do something with the data. Are you running like your credentialing privileging process or your partner? Is that credentialing privileging process being run in parallel or does the PE process start after the provider has been credentialed and privileges have been assigned?
Kathleen Lehman (16:43) They run in parallel run?
Hassan Zahir (16:45) In parallel. So, best practice, of course, I’m just not sure how that always works. Some organizations run in parallel because you’re probably seeing less than three percent of the providers who don’t make it through credentialing. So it doesn’t make sense to kind of delay that process provider provides the information. The bottleneck is getting information from provider where the provider’s not providing it. It sounds like the third party is probably reaching out to the provider to get that information or is that something happening internally? No?
Kathleen Lehman (17:14) Correct.
Hassan Zahir (17:15) They reach out, they get the information, they start the process. All of the psvs are run, the enrollment applications are completed, submitted, any delegated agreements where you’re doing like roster submission and ncqa guidelines off of that as well or no?
Kathleen Lehman (17:32) So, I know that we do some roster submission, but I’ll let Amy speak to the delegated credentialing yeah.
Amy Crawford (17:38) That’s what I was going to respond. We don’t have the technical delegated credentialing in place, but yeah, some of our payers just allow a roster.
Hassan Zahir (17:47) Not delegated roster submission. We see that all the time as well. Has there been any interest in getting delegated agreements in place? Okay? We’ve.
Amy Crawford (18:00) discussed it. It’s just getting all of the requirements rounded up the boards created internally, that we just haven’t gotten there yet. Yeah.
Hassan Zahir (18:10) Just curious. The reason why I ask that is medallion supports and we have supported a lot of organizations health systems with getting their policies and procedures in place, their board structure their committees in place. And we do have in application meaning in the medallion application, digital committee structure. So those clean files that come through and there’s nothing that’s been filed like those tier one or level ones if you will. You can approve those virtually through the committee and add your notes in platform. And so that way the committee is only meeting on those ones where something was found that needs attention. And so just again, when I’m talking about like the capabilities of medallion, the more we understand what you’re doing, the better it is for us to kind of highlight where we think there could be benefit. And so when you go through that process, the provider completes the donation of privileges, forms, they get credential, get assigned privileges, enroll with the health plans. And then now technically like they’re you know, they’re eligible based upon the timeframes that it takes for the different plans. And they’ve probably got to get medicaid, medicare in place first before some of the commercials are coming through. And then they start seeing patients. Is that like a fair high level of what’s occurring today?
Amy Crawford (19:22) Yeah, it is. It is. And I have a question for you. So I know we’ve only got about 10 minutes left and I kind of want to get like a 10,000 foot view of what medallion is. So medallion, if you could share, is it the service itself or is it the service itself plus technology that’s showing us the status of things because our current relationship is more a spreadsheet share. So I just, I don’t know medallion at all. So you’ll have to familiarize me with.
Meredith O’Neill (19:53) What medallion is, I think this slide is like a 10,000 foot view. So perfect timing. Yes. And we only have 10 minutes. So I want to make sure you understand who we are. So we are a provider data management platform. And just like you said, Amy, we know that there’s competitors in this space that really provide the workflow. We are the end to end. We have the platform in place that supports all of these pieces of the puzzle from ongoing monitoring enrollment. Hasan already mentioned the delegation piece CV the credentialing privileging licensing. So we have AI automation throughout all of these processes. We have a bidirectional integration with caqh as well. So we really automate 90 percent of these processes and you have a bird’s eye view into all of that at your fingertips. We also have the hands on experts to help get you delegated to work with the payers as well. So we’re kind of a combo of the two that you just described.
Hassan Zahir (21:05) So said another way you would have access to the medallion platform and visibility into everything that’s occurring. It’s happening in real time. There’s no spreadsheets as an actual platform. Medallion has automated the psvs. We can do that to whatever standard it needs to be done to, we do that for our fqhc partners, to hrsa standards, we do it for our joint commission partners, to tjc standards.
Hassan Zahir (21:33) We do it for our ncqa partners, for the delegated agreements to ncqa standards. And so essentially medallion as Meredith just share is the platform, we have a dedicated provider portal. It makes that onboarding so much easier. We have the caqh integration, the npez integration. And so as opposed to just solely waiting on providers to give us that data, we pull down 70 to 80 percent of all of the data that’s going to be needed through the entire process generally that’s 100 percent of the information that’s needed for like your standard psvs, and that’s 70 to 80 percent of the information that the payers are going to require for those direct enrollment applications.
Hassan Zahir (22:15) We then map the data from those provider profiles using automation to the applications. We submit those, audit those applications, and we follow up on those applications in an automated manner. So essentially, what you’re doing is taking control of the process. You’re not just kind of handing it over to someone you’re taking control of the process, but you’re utilizing automation to complete the functions as opposed to using outsource individuals to complete the functions.
Amy Crawford (22:45) Okay. And we do find that there is a little bit of kind of like a white glove, you know, hand holding that has to take place at times with some of our payers. And so we are accustomed to our vendor having a relationship with our payers when it requires emails or jumping on a call. So I just want to make sure there’s that balance because I can appreciate the benefit of automation and AI, but also having more of the personal touch too is important for some of the things that can’t be accomplished through technology. Yep.
Hassan Zahir (23:16) And that’s where Meredith was saying, we have our experts. So we have an operations team of a couple of 100 us based employees and they’ve come from, you know, different organizations including a lot of the payers. We actually are the cvo for like, optum, behavioral health, a lot of the blues. And so not only do we have relationships with them, but when other companies are sending those direct enrollment applications in, we’re the ones who are processing the psvs on behalf of the payers and selling the payers, the results of the PSV. So not only do we have the managed services… component from like supporting the relationships with payers, we also are the cvo for a payer. So rest assured, we do have the human component of it, we have those relationships, we process psvs on behalf of like I said, a lot of the payers who you’re probably submitting direct enrollment applications to, which also gives us a leg up in the turnaround times that it takes in order to get those applications completed because we have a component on both sides of the deal. Okay? Thank you. Absolutely. Yeah.
Meredith O’Neill (24:26) I know we’re tight on time. So I just want to make sure to hit home on some of our value drivers that sets us apart in the industry. Really, our mission is to help your providers get to the patient faster, be billable faster. So accelerate revenue. We want to make sure your providers are at par status as quickly as possible and then reducing operational costs. We know that there’s a lot of cooks in the kitchen when it comes to all of these processes across your organization. So as you continue to grow, I know you said that there’s the webster groves opening this year. I don’t know if that growth and expansion is continuing but your team doesn’t have to necessarily continue to grow as well. We are able to reduce the required ftes to oversee these processes. And then I know that it’s hard to, it’s difficult out there to hire providers right now. And we want to make sure that our providers stay happy and just overall reducing burnout. So we reduce that abrasion by getting them to the bedside quicker. And then having that single system of record. I know you mentioned that there’s a couple of different systems you’re monitoring these processes. Now, this is really single source of truth for you.
Amy Crawford (25:45) Great. Do you, do you assign one person or a group of people to an organization in these types of relationships or is it more generally supported? And?
Hassan Zahir (26:00) Are you asking? Well, let me first answer and then see if that answers the question. So first and foremost, you would get a dedicated account team. So you would have a dedicated account manager who obviously would be your liaison to the relationship with medallion, you would get a dedicated engagement manager. And that engagement manager would be the person who essentially functions on your behalf. You were asking those questions like outreach to the payers or something isn’t they are that dedicated resource for that. When it comes to like an escalation or a follow up that can’t be automated, that is the entire team jumping in and making sure that you get the first available person to manage that response, but you would have a dedicated resource that owns the relationship with you, a dedicated resource who owns the relationship with your payers on your behalf. But when it comes to like an individual task, we won’t, wait for a dedicated resource to become available. We’re gonna use the first expert available to ensure that your task is getting addressed in a timely manner.
Amy Crawford (27:04) Okay. Thank you. Yep. That answers my question. Okay. And.
Meredith O’Neill (27:08) Amy, Kathleen, I know Kathleen you had mentioned or reached out to my colleague about a month ago. Is there something driving the interest in having the conversation today? Is there like a timeline that you’re working with or a contract that is expiring soon? I’m just curious for timing wise. I.
Amy Crawford (27:30) Think, I mean really we were just stepping back to making sure that we’re getting full value out of our relationship with our current support and just seeing what other offerings are available. If there is more, you know, technology or automation that we can layer on top of it turnaround times, all the things that you all have mentioned here today. Those are things that we’re interested in. Even some of those just supplemental components that, you, know I had mentioned doing attestations and availability and things like that. I just, we just want to understand what is within the full service scope of other similar offerings to make sure that we have a good situation moving forward. I don’t know Melissa if you would offer anything additional about interest in reviewing potentially new partnerships, but that would be it from the revenue cycle perspective?
Mcatlett (28:21) Yeah, I’m just interested to see what’s out there. NPR is the only other.
Kathleen Lehman (28:28) Partner.
Mcatlett (28:29) I’ve ever seen so just interested to see what’s out there while we are expanding our services.
Meredith O’Neill (28:38) Yeah, absolutely.
Hassan Zahir (28:40) That’s fair. One question I would ask while we’re short on time is what are the challenges that you see with the existing process? I know oftentimes it boils down to visibility being big, right? It’s like they’re telling you something is occurring. It’s hard for you to track where a given enrollment request line is or sometimes it’s hard to know where a new provider who’s starting is at in the process. I would be curious, Melissa, as we continue these conversations, if it sounds like this is worth pursuing just kind of what those challenges look like, not something I’m looking for an answer for today because we’re short on time, but that is something where it’s like, hey, if you’re seeing challenges today, let us show you what that could look like with medallion to allow you to not only compare functionality but to compare outcomes.
Amy Crawford (29:30) I’d say the automation is of most interest. If we were to move forward. I think that would be the next step for me is just to see what that provider side view looks like. And we can compare that to what our current kind of peek behind the curtain is of what we have with our existing partner.
Kathleen Lehman (29:51) And I think, Melissa, if you wouldn’t mind, I think from the privileging perspective, we’re just looking for a complete provider file. So I think there are certain aspects of the process that our current partner, they just don’t manage. And so it’s a lot of us juggling multiple files where we would prefer to have everything in one place, maybe a little bit more support with our surveys. I mean, those are just a couple of examples. Okay. Yeah.
Hassan Zahir (30:23) Those are both great. Medallion provides that consolidated file, the ability to go in and view it, view the psvs that were run. But also, we put together the entire packet and then the ability to review that in application just from like how it sounds, would it make sense to schedule some more time to see the platform? Yeah?
Kathleen Lehman (30:44) Yeah, I think it would, I think maybe having the calls split between the provider enrollment and the privileging piece might be more effective just so we’re not wasting. Not that this is a waste of anyone’s time, but we do have this divided pretty neatly. So if that’s possible, that would be really helpful it.
Hassan Zahir (31:09) Is I understand? Not wanting to get those wires crossed, you know, you would work out of the same platform. It would be completely separate modules. So that aligns with how a lot of our customers today operate. Perfect.
Kathleen Lehman (31:19) Perfect.
Meredith O’Neill (31:21) Kathleen, would you want me to work on scheduling that with you?
Meredith O’Neill (31:25) I know there’s two separate teams involved, but I’m happy to reach out with times if we want to get that on the calendar.
Kathleen Lehman (31:31) Absolutely. Yeah, I can definitely coordinate on our end. Okay? Perfect.
Meredith O’Neill (31:36) Well, yeah, I want to be mindful of everyone’s time. Was there any other questions for us before we end the call today?
Kathleen Lehman (31:48) I don’t think so. This was a good introduction. Yeah, thank you. We really appreciate.
Meredith O’Neill (31:53) It, yeah, we’re looking forward to keeping the conversation going and I’ll reach out via email here shortly with some times, but hope you have a great rest of your week. Thanks so much for the time you.
Kathleen Lehman (32:05) As well. Nice to meet you both. All right, bye.