Transcript
Zo Hooda (00:00) look at us matching.
Noah Laack-Veeder (00:01) I know you stole my take. I was going to make that. All you need is a mustache and then we’re like totally matching.
Zo Hooda (00:09) Almost there, man. I need some glasses too.
Noah Laack-Veeder (00:12) Hey, there you go. Just, yeah, there you go. Just do it.
Zo Hooda (00:17) Did you have your track meet yesterday or was that, how’d it go? Oh, wait, Kelly’s here. Well, let’s chat about it later. Yeah, exactly. Hey, Kelly.
Kelly Mumford (00:34) Hey, y’all, how you doing good?
Zo Hooda (00:37) Good. How’s your morning going?
Kelly Mumford (00:39) So far? So good.
Noah Laack-Veeder (00:41) Nice. So far? Well, hopefully, we don’t make it worse.
Kelly Mumford (00:46) Unlikely unlikely. I like that painting. Oh, thank you. I.
Zo Hooda (00:52) Like that painting. Your background of your office is very, it gives me a very calming vibe. I like the color.
Kelly Mumford (01:00) You should see this part.
Zo Hooda (01:01) Oh, wow. Did.
Noah Laack-Veeder (01:03) You do that yourself? Or did you, are you the artist?
Kelly Mumford (01:06) No, no, no, that’s a van gogh. It’s a recreated van. Gogh. Oh,
Noah Laack-Veeder (01:09) that’s cool. I mean, you could have just told me you did it. I would have believed you, but yeah.
Zo Hooda (01:16) Not.
Kelly Mumford (01:16) quite, not quite. I wish, right?
Noah Laack-Veeder (01:19) Yeah, you know, we have other talents, you know?
Kelly Mumford (01:22) Exactly. Mostly analytical in nature. Hey?
Zo Hooda (01:27) Hey, Jennifer.
Jennifer Pantleo (01:30) Hey, it took me a minute to find the audio there. Apologies. Hi. How’s everybody doing?
Zo Hooda (01:34) Doing good, doing good. Sounds like looks like you, Jennifer, you spoke with our team a couple years ago, so, it’s good to be reconnected.
Jennifer Pantleo (01:43) Yep.
Zo Hooda (01:45) Awesome. Kelly, are we still waiting for Gabe?
Kelly Mumford (01:49) Should be, but let me just check in with him in case he got there’s. Actually a couple people.
Zo Hooda (01:56) Okay. Actually, yes, they, I’m admitting them right now.
Kelly Mumford (01:59) Oh, good. Okay. Hey, David.
Kelly Mumford (02:12) Let’s see if we have Rocio. We do welcome. Rocio.
Rocio Salinas (02:18) Good morning.
Kelly Mumford (02:20) Okay. There’s two more people, but I don’t know if they’ll be here. I don’t think we should wait, I think these are the most important people in terms of the utilization of the application that would be directly impacted. So, I think we can get going.
Zo Hooda (02:37) Okay. Sounds good. Well, nice to meet everyone. Let’s kick things off as far as the agenda goes. Let’s kick things off with a quick round of introductions. There’s new people to the conversation from both sides. And then I did want to recap Kelly kind of our understanding of the current state and the goals and what future state looks like, just to make sure we’re really aligned because that’s what’s going to shape the demo. And then Noah here is going to walk through the operational workflow of understanding exactly where the bottlenecks are. That way we can give a very tailored demo. We’re not in the business of giving generic demos and throwing spaghetti at the wall. We really want to make sure we make the best use of everyone’s time. And then we’ll leave some time at the end for next steps. How does that agenda sound? Kelly?
Kelly Mumford (03:24) Sounds good?
Zo Hooda (03:25) Perfect. Let me go ahead and share my screen then. And while I do that, let me kick off the round of introductions on our end. So for those I haven’t met, my name is Zoe. I am the account executive in charge of the relationship with Solis here at medallion. So I’m the main point of contact for an evaluation of medallion, making sure I get everyone the information they need and bring in the relevant resources. Joining me is, Noah is my technical counterpart. So he’s going to be leading the demo. Any technical questions. He’s going to be the Guy, he’s one of our brightest ses, or the brightest. I’m very glad that he was assigned here really a high.
Noah Laack-Veeder (04:02) Bar. So you all will be the judge.
Kelly Mumford (04:06) And.
Zo Hooda (04:06) then lastly, from our end, we’ve got garrison garrison’s, my VP. I wanted to make sure he was part of this call here. He manages a lot of the relationships with some of our largest customers. So that is everyone from the medallion side, but would love to kick it over to the Solis team for some introductions.
Kelly Mumford (04:23) Sure. My name is Kelly. I am the VP of Solis position group. I work very closely with everyone else on the Solis side, and I will hand it to Jennifer.
Jennifer Pantleo (04:35) Hi, everybody. My name is Jennifer pantleo, and I’m the VP of clinical programs for Solis.
Kelly Mumford (04:41) David.
Kelly Mumford (04:46) You’re on mute if you’re talking. I also don’t see you. Is he gone? Oh, there you are, okay?
David Phurrough (04:54) My apologies. So, my name is David ferro, I’m the director of operations for SPG and I report to Kelly mumford.
Kelly Mumford (05:02) All right. And Rocio. Good.
Rocio Salinas (05:05) Morning, all, my name is Rocio. I am the operations specialist here at SPG and I report to David and Kelly.
Kelly Mumford (05:15) And really quick, we should add Rachel… to this.
David Phurrough (05:20) That’s what I was thinking and.
Kelly Mumford (05:21) Shannon.
David Phurrough (05:23) let me forward this to them, okay?
Kelly Mumford (05:25) Okay. I thought they were already on here.
David Phurrough (05:27) I don’t see their names. Okay? I’ll forward and ask them to join.
Kelly Mumford (05:32) Okay. Sounds good. Cool.
Zo Hooda (05:35) Well, it’s nice to meet everyone. Thanks for the introductions, excited to work with you all. So, yeah, let’s kick things off then. So as I mentioned, just really want to recap kind of our understanding before we get into the platform to make sure we’re really aligned here and feel free for those who are new to the conversation to chime in. But from what you shared, Kelly, I understand the Solis physician group is operating as a standalone division within Solis, we’ve got 45 employed physicians today with the target of 90 to 100 by year end. And I understand there’s some complexity underneath that, right? There’s four lines of business. You’ve got JVS acquisitions, de novos, direct contracting, multiple billing entities and providers who are licensed across 10 to 15 states. That screams complexity, right? And right now, all of that credentialing, parent enrollment, licensing, med, maltracking is being managed by one person, right? And I understand the current tool set excel symplr, which means the process is largely manual, right? And dependent on who’s running that. And I understand that’s where the cracks show, right? It’s not just that things are slow. Things are breaking. I understand that there was some money lost in the business last year due to payer applications that were never submitted at all because of no flags card rails, just something that was critical to get done that slipped through.
Zo Hooda (06:57) And on the timeline slide, I know you’re you know, for physicians that are licensed, right? 30 to 45 days to get them enrolled. But for those who are not, right, it’s 120 plus days on a growth trajectory that can’t absorb that kind of lag, right? So this is kind of my overview for the current state and challenges. But before I get to what future state looks like? Kelly? Is this a good summary of what we discussed… it?
Kelly Mumford (07:24) Is, but as we move forward two things, the lost business wasn’t payer contracting, it was hospital credentialing.
Zo Hooda (07:32) Oh, okay. And.
Kelly Mumford (07:34) The 90 to 100 includes a bunch of undisclosed new business. So that should be, I would change it to a percentage up to 100 percent growth.
Zo Hooda (07:49) Okay. Got it. Taking some notes here. Yeah, up to 100 percent growth and hospital credentialing. Okay, cool. If we review this information in the future, I’ll make sure that’s reflected what you said, sure.
Kelly Mumford (08:03) Cool. Okay. That looks great. Thank you so much.
Zo Hooda (08:06) Of course. And then, yeah, just real quick on the flip side given all that here’s, what I heard as the goals, right? And tell me if this lands or if there’s anything I’m missing, I understand the objective is not just to fix the current bottleneck, right? It’s to build the right foundation before the next wave of growth hits. And Kelly, you said it clearly, right? You want to build the team around technology and not hire a lot of people and try to retrofit a system around them. You want to make it as efficient as possible. So that means that your team stops being the one that’s executing every single task and becomes hold on meeting. Someone becomes the person directing the operation, right? While medallion handles the execution. And so the outcomes that matter are pretty straightforward, right? Like first getting providers to billable size, faster, the target is 30 to 60 grades, 60 days across the board, which is a meaningful shift from where things stand today. And especially important given the short term engagements you have where, you know, a week of delay is pretty significant, second not having to, you know, hire one to two additional ftes to absorb the growth that you have planned because medallion can handle that volume through automation and third, eliminating the failure mode you described where, you know, there’s no guardrails, you know, maybe application there’s bottlenecks within the current process. That won’t happen in a system with automated guardrails and real time visibility. So as far as future state goals, is this a pretty accurate summary or is there anything I’m missing here as well?
Kelly Mumford (09:37) Very accurate. Nothing missed.
Zo Hooda (09:40) Amazing. Perfect. So last thing before I kick it off to Noah, you know, everything that we talked about, Kelly, there was a theme that stuck out to me which was speed and accuracy, right? So I did want to just call out a couple things here, some key metrics that medallion has. So when it comes to credentialing, we have a one day average of turning around an ncqa committee ready file with a three day guarantee. When it comes to submitting pay enrollment applications, we have a five day average of submitting those to payers with a 10 day guarantee.
Zo Hooda (10:12) And then when it comes to accuracy, we have a 99 point five percent credentialing file accuracy. So when it comes to denials related to credentialing errors or revalidation errors, we’re minimizing those and in some cases removing them altogether. So, wanted to call these out. Any questions here before I kick it to Noah? Nope. Amazing. All right. I’ll pass it over to you cool.
Noah Laack-Veeder (10:39) And hey, just before we jump in, David, Rocio, Jennifer, Shannon, or Rachel, anything else that you wanted to highlight before I jump into the current state? I?
David Phurrough (10:51) Would like to identify that. Shannon and Rachel are actually, they’re the ones doing the credentialing. Currently, Rachel has just joined our team. Shannon’s been with the company for about 10 years, so she’s been doing a lot of the credentialing. And I believe Rachel’s had some exposure to medallion in her prior work.
Kelly Mumford (11:07) In the past. Yes, thank you, David.
Noah Laack-Veeder (11:10) Okay. And yeah, Rachel, when was that? Was that? Like fairly recent? Many?
Rachel Cabrera (11:14) Years ago? It was probably about two and a half three years ago. It was roster management, okay?
Noah Laack-Veeder (11:19) Yeah. We’ve made a lot of changes since then. We’ve grown a ton. So I’m excited to kind of walk through what the technology looks like. And I’d love to hear kind of what’s changed in the last two and a half three years from then. Okay. And then, yeah. So I think what we can just do is just jump into the process. A bit big thing. What I want to do here is we offer services across licensing, credentialing, economic credentialing, payer, enrollment, delegated credentialing all across the board. So I want to make sure the things that I cover in the demo are going to really align with what you’re looking for and just really drive to the most value. So with that, let me share my screen. And then I want to make this an interactive session where we kind of talk about what today looks like. And then I’ll wrap that into what the future could look like with medallion. So are you all seeing a diagram here with like a person on the side? It says Solis mammography in the top?
Kelly Mumford (12:17) Yes.
Noah Laack-Veeder (12:19) Excellent. So what I like to do is just start high level and just talk about the different processes and then also highlight areas where I typically see organizations spending a lot of time. But I also want to make sure that we cover all the different systems that we’re using. So I was Kelly reviewing the call again. I think I heard mdstaff, excel and symplr, is there any other systems that we’re using today to do this work? We’re.
Kelly Mumford (12:45) actually not using mdstaff. I was using it as a comparison benchmark for how we preferred an application to use as.
Noah Laack-Veeder (12:55) We use.
Kelly Mumford (12:56) Versus how we think it doesn’t work, right? So, we had just met with them and didn’t think they would be a good fit. Okay?
Noah Laack-Veeder (13:04) Sounds good. So, excel symplr, and are there any like HR systems that you’re using today?
Kelly Mumford (13:09) No, just cloud based storage.
Noah Laack-Veeder (13:12) Okay, perfect. And then I think what I heard and just creeping around there’s three critical functions that are happening today. We’ve got a licensing function, a hospital credentialing function as well as a payer enrollment function. Is that correct? Anything I’m missing in terms of like critical functions when it relates to credentialing?
Kelly Mumford (13:33) Just the medmal enrollment, okay?
Noah Laack-Veeder (13:37) Let me just add that in here… we’ll talk about that one as well. All right. So what I like to do is, so when I talk about licensing typically organizations are, you know, when you’re hiring locums or others like they might not have licenses in the states that you are going to be hiring them for. And so as I understand you all today are doing the licensing for providers in house, correct? Yes. Okay. And so kind of thinking about that process. Typically, what it looks like for organization is that we hire someone or it’s before we hire them. It’s kind of like 50 50 I’d say, but there’s going to be data collection reaching out to providers, actually getting that license by preparing the license application, submitting it, tracking status, following up with the boards and then completing that license. Is that generally the process that you all are following today when it comes to licensing?
Kelly Mumford (14:43) Shannon?
Shannon Young (14:44) Yes, it is.
Noah Laack-Veeder (14:46) Excellent. And so when I typically talk to organizations, like when I ask how it’s going, the things that are challenging, especially navigating multiple states is having to keep track of all the different state requirements, all different license applications, all the different boards. So just generally speaking, like how is licensing going for you all today? Are there areas that you think are going really well or vice versa? Are there areas where you’re spending a lot of time getting stuck or really looking for some help? I mean.
Shannon Young (15:21) It’s definitely a challenge to keep them up to date and keep that tracking current. So anything that would help would definitely be beneficial for us.
Noah Laack-Veeder (15:31) Yeah. And Shannon, when I hear about the tracking, I hear both the tracking, the applications that are going out the door, like tracking, are they getting their fingerprints done, and all those different items? And then there’s also like the renewals piece like the license renewals, is that all kind of tracking that you think could be improved today?
Shannon Young (15:49) Absolutely.
Kelly Mumford (15:49) Absolutely.
Noah Laack-Veeder (15:50) Yeah. And then typically with the licensing, so you’re using excel and symplr. Do you have any like automated reports that tell you like what’s outstanding? Like what’s expiring coming up? No?
Shannon Young (16:05) It’s all on excel?
David Phurrough (16:07) Okay. Now, we do have some identifiers on excel where the licenses will highlight different colors.
David Phurrough (16:14) Yeah, if they’re 90 days out, 60 days out and 30 days out for expiration? Sure, however it’s still very manual.
Noah Laack-Veeder (16:21) Got it.
Noah Laack-Veeder (16:26) And can you remind me like how many, whether it’s like a month or like a year? Like how many licenses are you all responsible for getting completed a year or like a month?
Kelly Mumford (16:38) What do you think Shannon?
David Phurrough (16:40) Yeah.
Shannon Young (16:42) As far as renewals, maybe five to 10, if that?
Kelly Mumford (16:50) New.
Shannon Young (16:50) Licenses is a little bit, have been a little bit more here lately?
Noah Laack-Veeder (16:56) Yeah. Would you say it’s like, did you say five to 10 a month? Or is it five to 10 a year for the renewals?
Shannon Young (17:02) I would say five to 10 a year. Okay? And then you’re.
Noah Laack-Veeder (17:07) saying like it’s a little bit more. Would you say it’s like new licenses like 25, like 50 roughly or it’s.
Shannon Young (17:14) not 50, I would say maybe 20, okay.
Noah Laack-Veeder (17:20) And that’s a lot that’s a lot of work, to track obviously.
Noah Laack-Veeder (17:23) And, so you’re using excel we’re using conditional formatting, like and Shan, I think, were you, the, are you the one who’s been here for 10 years?
Shannon Young (17:33) Yes, sir.
Noah Laack-Veeder (17:34) Yes. So, over that 10 years, you’ve probably gotten pretty familiar with the different state requirements for licensing. They’re all kind of different, right?
Kelly Mumford (17:43) How?
Noah Laack-Veeder (17:43) Are you, how are you tracking those today? Do you have like a license database? Do you have or not a database like a requirements document? Or is it kind of like how do you, how do you track the different state requirements?
Shannon Young (17:59) Not as well as we need to. I have just documents saved in our files, what they are, but I don’t have a tracking system to put that.
Noah Laack-Veeder (18:10) On, got it.
Noah Laack-Veeder (18:17) And so, I’ll go ahead.
David Phurrough (18:19) Yeah. Currently, we’re actually using excel workbook that has been designed and worked on by multiple people now. That is actually how she’s identifying what licenses are active, what licenses need to be renewed, things of that nature. And they’re just folders with all the provider data in each one of them. Yeah. Okay. And,
Noah Laack-Veeder (18:45) then, Shane, I was, on the phone. Are you all responsible for licensing credentialing, payer, enrollment and the medmail? Are you kind of like the two person shop running all of this stuff?
Shannon Young (18:55) We are, yes.
Noah Laack-Veeder (18:56) Okay. Yeah. Wow. That’s a, that’s a lot to track and manage. So like definitely excited to walk through this. Like with so much things going on like in the tracking being manual, like typically, when I talk to organizations, things will get missed. Like we miss an expiration date. We kind of work with the provider, like how is that, how is that showing up today? When, when like maybe, you miss something with this manual workflow? Like how is that showing up?
Kelly Mumford (19:24) So, a couple of things, so I want to make sure that we spend our time on the demo, like we know how our workflow works. We know what our problems are. They brought it here. This to me is a little like should we start to implement, then we would need to do this. But from my perspective, like all of these people are here to see the product in use. But in terms of what outliers look like, what does it look like? It looks like? You want to schedule somebody and you can’t because they don’t have a license. They’re not approved payers, the hospital didn’t send the application. The provider didn’t provide the application information. The amount of fail points are almost in double digits. I mean, they are just absolutely enormous, but only in the ways that you would expect based on workflow of this complexity and size, being managed by an individual. Yeah.
David Phurrough (20:27) Has.
Kelly Mumford (20:28) been here for five minutes, like.
Noah Laack-Veeder (20:30) Yeah.
Kelly Mumford (20:31) And Shannon has been here for 10 years, you know, every amount of growth that could come. There was basically a period of time where I would say, you know, it was being managed like growing trees like just water it, and it’ll be fine and.
Noah Laack-Veeder (20:47) Just follow.
Kelly Mumford (20:47) up and blah blah blah.
Kelly Mumford (20:49) And now we’re like cooking right? All the time. It’s new people. I think my estimation of the licenses is that it’s more than 20 even in a six month period.
Noah Laack-Veeder (21:01) Okay. Because.
Kelly Mumford (21:02) I’m the person having to decide how many people are licensed in new states. When we’re setting up new businesses and that alone will be five, right? So that’s even in the last handful of months that’s South Carolina, it’s Nevada. It’s we did Missouri that’s.
David Phurrough (21:20) North Carolina.
Kelly Mumford (21:23) That’s 20. That doesn’t even include anyone who’s actually scheduled that’s just to set up new business. So the complexity is high. We’ll benefit significantly from automation. And I think this group here is interested in how that could work for them. Yeah.
Noah Laack-Veeder (21:43) No, absolutely. Yeah. And that was just really helpful. I think when I asked those questions around how things are currently working, it just helps me kind of overlay just how it’s a little bit different than the spreadsheets. So definitely want to jump into it. One thing. I just, I promise we’ll get right into it for the hospital credentialing. I promise, I just need to know a little bit more about the hospital credentialing piece. All right, when you guys are doing the hospital credentialing, are you doing it via proxy or are you actually having to submit third party apps to the facilities?
Kelly Mumford (22:15) Proxy that’s really important, yes.
Noah Laack-Veeder (22:18) And then our, so proxy agreements typically say like look, as long as you’re doing joint commission credentialing, you’re good. Is that how that’s working with you all? Or do you have a different set of standards that you’re credentialing to for these facilities? I.
Kelly Mumford (22:35) Was implying that the word proxy meant that they were doing it for you, but it sounds like you’re doing it on your behalf. No, we’re submitting it to the hospital system and they are taking it to their credentials committee with their own representation.
Noah Laack-Veeder (22:50) Yeah, no, I can totally see why you think that would be the reverse but, yeah, proxy, how we define it would be the facilities like, yeah, you can do the credentialing for us by proxy. So like you’re actually doing the work. So you’re submitting the hospital apps?
Kelly Mumford (23:04) That’s all we’re doing is submitting the application. And that’s another part of this that doesn’t sit under our control. That’s problematic. Is Shannon, there’s at least one provider that Shannon has been trying to credential for three or four months that it took us two months to get the application, right? So that’s kind of a problem on our end. Yeah.
Noah Laack-Veeder (23:27) And the two months to you said like two months to get the application approved or like?
Kelly Mumford (23:32) I don’t know too much just to give them everything they wanted from us to get everything they wanted. It took a long time and that was due to a business negotiation and, you know, lack of communication on their side et cetera. Et cetera. These are things we’ll continue to have to manage even while this is being automated. Yeah.
Noah Laack-Veeder (23:54) That makes sense. And look, there are things that are going to be out of our control. It’s ultimately like how can we optimize everything that is in our control so that we don’t have to what ends up happening? Is that these turnaround times can decrease the things out of our control? Because we’re minimizing that back and forth. But Shannon, just, I promise, I’m going to show the platform. Just one last thing here. When you are preparing those applications. I think what I’m hearing is that our kind of provider data is in some cloud tool today. Are you using caqh at all today to get provider data?
Kelly Mumford (24:30) Yes, we are okay.
Noah Laack-Veeder (24:32) That is really good news. So with that, let’s jump in the platform, and then I might ask more questions, but at least I’ll be showing you something but any questions before we jump in?
Kelly Mumford (24:46) Nope. Okay. Excellent.
Noah Laack-Veeder (24:48) So what I’m going to demonstrate to you is a couple things one, what does this onboarding process look like for a new provider? Like how are we getting all their data in our system automatically, reducing Shannon, the time it probably takes you to reach out to providers, get their caqh information, just all the things that you need to do your job. And then how medallion can take the information and automate things like licensing, hospital, credentialing, payer, enrollment. And also when it comes to the reporting and the visibility, Kelly, I’ll wrap that up and show you how you can see all the operation. One view here. Does that sound like a good plan? Good plan yep?
Kelly Mumford (25:27) Let’s.
Noah Laack-Veeder (25:28) do it? Okay. So you are now seeing Solis mammography tasks on your screen? Correct? Yes. All right. So what medallion is at its core is a provider data management tool. And Shannon, how I would think about it would be it’s probably a combination of the like the shared drives that you might be using in the excel to have your documents and provider information all in one place. So if I want to get information on the provider, I can just jump into their profile and I’ll have all their information all in one place. But the 1,000,000 dollar question would be how do I get this information into your system without having to start from scratch? And so with medallion, how this works is we are a participating organization with caqh which means that when we invite a provider to the medallion platform, we can ask for a couple pieces of data points from them to speed up this process. So if they have a caqh profile, all they need to do is give us their caqh id, their SSN and their last name, and then we can bring in all of their information from caqh directly to medallion without you, Shannon having to copy and paste that information. The other piece too that I’m going to highlight is that not only can we ingest the data, but if you’re maintaining caqh information for your providers, we can push any updates to caqh automatically and maintain and handle all those quarterly attestations, which thinking about all the work on your plate, that would be a huge time saving. So you click confirm and link. And what that looks like for the provider is their profile when they log in has at least 70 percent of the data that we need to kickstart this process. There’s going to be a couple things that are outstanding. I can’t sit here and promise you that everything is going to be ready because there’s always going to be gaps. But how medallion handles that? Is that there are gaps, we summarize those in tasks. So what I typically hear is that organizations are having to look at the information that you’ve got figure out what’s missing. And then something might get missed. With medallion, we’re not going to let you miss something. We’re going to organize all the things that we need by the providers to make sure that we can get these profiles completed. So I want to pause there, Shannon. I’m sure the work that you’re doing is probably very similar to this. But the way it’s being done is much different, much more automation happening. How do you see this kind of improving this first part of? The process for you. I.
Shannon Young (28:07) Definitely think this would better streamline everything for us. So I definitely think this is a positive thing.
Noah Laack-Veeder (28:15) I like.
Shannon Young (28:17) the idea that we can pull it from caqh that’s very beneficial. Yeah, because we do keep those up to date and attested to.
Noah Laack-Veeder (28:26) Oh, that’s great. And then, I mean with the volume that’s happening, like I’m sure. When Kelly was like, hey, we’re hiring all these providers, like maybe it might not be the first thing that came in your head but you’re like man? Okay, that’s a lot more quarterly out of stations I have to be managing and I have to maintain a lot more caqh profiles. So, Kelly to the scale piece there are like the complexity is only going to increase and the work that seemed to be done is only going to increase. So with medallion’s integration here, what the impact will be is that you add the providers? Shannon’s doing the work that she’s always done. All the things that require her to log into two different systems are just going to be automated, right? So that’s just the onboarding piece. And that’s going to be the most important part for anything else that we do. We need the data to move forward. But before I move on from the onboarding piece, are there any other questions that folks wanted to ask about before I jump into licensing?
Kelly Mumford (29:18) That was my biggest question.
Noah Laack-Veeder (29:22) Is licensing? No.
Kelly Mumford (29:24) Is how the data was going to get inputted into the platform?
Noah Laack-Veeder (29:29) Cool. And then, I mean, Kali, how do you feel about it? Is that like matching what your ideal solution was going to look like… it’s.
Kelly Mumford (29:37) a good start. I would say it that way… Rachel. I just.
Rachel Cabrera (29:42) had a quick question about logistics. So, does the provider have to have a login that they have to keep track of?
Noah Laack-Veeder (29:48) So we actually do sso. So if they have like do you guys use outlook Gmail outlook? Yeah, we can use sso to make sure that they just, it’s like they’ll for their experience, it’s pretty much like a get started button. They can click. And then what they experience is when I showed you Naomi’s profile being completed, that’s usually their first entry point in medallion. It’s just my information’s here. That’s great.
David Phurrough (30:14) Can I ask a question real quick if their sso messes up or they have problems utilizing it? Who will help support that sso sign on?
Noah Laack-Veeder (30:22) Oh, yeah. That’s a, that would be a medallion support thing that we could help with. Yeah, I will say though, David, there’s… like the piece that makes medallion unique, is that like we automate so much but we also try to make it. So if you’re providing provider support, you have what you need. So if there are any issues there, medallion will obviously tackle it. But we’d also route any visibility of that to your organization. So you’re not like in you’re not like guessing where things are getting stuck. Like we will alert you to know where things are, no.
David Phurrough (30:56) I was just my question for that is because we’ve still got people using yahoo accounts. We’ve still got people using Gmail accounts even though they have outlook accounts and it’s just going to continue as we bring on more providers, our radiologists. So that is my biggest concern on that is great. I just want to make sure that we’re not, hey, this is great. It’s automated. But now we’re supporting all the single service sign on, you know, the sso that’s what I need to make sure of because that can be way more time consuming and sometimes take up to 20 to 30 minutes just for one provider who doesn’t know how to do what they’re supposed to do.
Noah Laack-Veeder (31:27) Yeah. I totally hear you, David, in the current process like are you having them like fill out a form via email? I’m trying to like just compare kind of what.
David Phurrough (31:38) The they’re just utilizing email currently. Okay?
Noah Laack-Veeder (31:41) So I would say something we should definitely dive into more. But there’s several options. The sso, Rachel if we think that username and password makes the most sense. That is another option there’s but let’s come back to that because I definitely want to talk about, you know, the licensing piece and everything else. But there are going to be things that providers get stuck on and we just got to make sure we have full visibility and transparency about what needs to get done to move that forward. So I’m totally hearing you there, David.
David Phurrough (32:07) Thank you. Excellent.
Noah Laack-Veeder (32:10) So, let’s talk about licensing. So we’ve got the data. How do we get a new license for a provider? So, I’m just going to move to another screen here because I got this all set up. So, Shannon, what’s probably happening to you is, and I don’t mean this to tease you Kelly. But you said earlier like, hey, I’m saying that we’ve got 20 providers coming. I need them licensed in five states like just get this going. And that’s a lot of work to do. We’ve got to find 20 different applications. We’ve got to make sure we’ve got all the data. We’ve got to make sure we’re queuing all those applications with medallion. You’re all seeing licenses correct on your screen?
David Phurrough (32:48) Yes, you.
Noah Laack-Veeder (32:49) Just tell us what you need. So Shannon, if Kelly’s telling you like this is what we need for a particular provider, you select that provider. So let’s say it’s Michelle anderson who’s an MD and I need her to get a, she needs an MD license in several states. So what you’ll do is you’ll just select the states that you want to be licensed in and you don’t have to think about what the process is going to be to get this license. What medallion will do is if you select a state, say like Alabama, we will then take all the information that you have from the system and auto populate all the state requirements and applications necessary and communicate that directly to the board. So ultimately what your process is, you tell us what you need. You tell us you need these different Das or csrs, you submit the request, and then you’ll have full visibility into what’s going on. So when you submit that request, medallion will process that information, identify any gaps. If there’s gaps that we can’t handle. That would be where we would generate one of those tasks for your team. But you’re not going to have to log into the board website, whatever it might be. Enter the provider’s information, make sure caqh is updated. All that kind of stuff. We will be taking care of all of that. What you would be responsible for is monitoring the status checking notifications when things are moving. But if we are ever getting stuck and need something from your group to move it forward, let’s say there’s just a document or something that the state asked for that we don’t have in our system, we would route that over to you. But the impact here is that on average across our different licenses, it takes us less than 20 days and that’s again, we can do state by state analysis to get all these licensed processed and completed. So big change there. Shannon. How I see it is that you don’t need to know all the complexity of a new state. You’ll be kind of managing the work, managing, helping these providers with anything that gets us stuck while medallion will automate all the things that you probably love doing like and that’s a joke like filling out the applications, double checking you keyed everything in correctly. All that work is going to be off your plate.
Rachel Cabrera (34:56) Okay.
Kelly Mumford (34:58) That sounds great. Yeah. So you were saying that we have to monitor the application to see if something is stalled?
Noah Laack-Veeder (35:10) No, not necessarily. So what I was saying is that this here is like if you want to let’s say, Kelly, you just have a random question to your team. You’re like, hey, what’s the status of dr anderson’s? California license? Like this is your real time dashboard to get that status. Really, we’re taking on everything. And if we need your immediate attention with something that requires your team’s intervention like a missing document, that would be when we would alert you if everything is going great, you’ll get like three alerts, status change to sent to board, next to board processing and then license completed. That’s really like what the happy path looks like. The non happy path would be. Hey, we’re stuck because we don’t have this part for the provider or the PSV went off and we found a sanction for this provider. Those are the things that would come up that would alert you earlier. But like Shannon, compared to your current process, it’s like, hey, this is going on. I may be having to field an email to figure out what’s next here. But medallion’s taking on about 80 to 90 percent of the work that would be necessary to get these licenses submitted and completed. Does that answer your question? Kelly?
Kelly Mumford (36:26) Yes, it does. And just to be clear, Rachel’s… going to be working in the application as the primary and Shannon will be backup just so, you know, okay, perfect.
Noah Laack-Veeder (36:37) Yeah. So, Rachel, how do you feel about this process? Yeah?
Rachel Cabrera (36:42) I like that the tasks are clearly laid out. I could see what I would need to do and what the provider would need to do, and where I could liaise that. So this would be my admin account. I can see. Yes.
Noah Laack-Veeder (36:52) It’s pretty clear. Yeah, really good way of thinking about it. And we talked about existing licenses and expirables. So you’ll have a view into who’s licensed where, and we’ll be tracking expirables automatically. And David, you mentioned that kind of that conditional formatting happening today, so that’s happening here as well. But something that’s happening with medallion is if something’s coming up for expiration, let’s say in the next 90 days, we would alert you. And if you want us to process that renewal as well, we can process the renewal so we can do either. Or so I’d say how it’s materially different than your current processes. You don’t have to manually track the status. We’ve got it. Expirables will be automatically tracked. And then if you need, if these expirables are coming up, we can process them automatically for your organization that’s.
David Phurrough (37:42) awesome. So when you process a lot of times when we have to do that, we have to end up paying for the license renewal and the fee, does medallion take care of that and just fill it back to us? Or do we have, is there, how does that happen?
Noah Laack-Veeder (37:57) Yeah. We built, we, so there’s going to be, we’ll definitely talk about pricing, but there’s two components like one, the like the processing fee of us doing a license and there’s all those pass through fees that your organization is already handling. It. Sounds like today we take care of those and just fill them back to our organization. Okay?
David Phurrough (38:15) And my other question is when we were looking at the sheet before this, for the requests. Sure. So these are the license that are right now in process, correct? Yep. Okay. So how would I, is that the eta? Sorry, I’m trying to, I’m blind as a bat?
Noah Laack-Veeder (38:35) Yeah. I can also zoom in if that’s helpful that’s.
David Phurrough (38:38) fine. It doesn’t need to be too big. I was just looking. So I see eta, December 20 fifth through may 20 26, trying to figure out what that means, that’s a large gap in between those. So does that mean we’re looking at possibly a five month period before a license is issued that’s.
Noah Laack-Veeder (38:57) a really good question. One thing all this caveat is this isn’t like real production data. This is like a demo environment. So it’s not necessarily accurate to what the normal experience would be. What I can say is that when it comes to predictability, we have estimated median turnaround times for every state and every license type. And so that eta that you get would be representative of a very large data set. We’ve done around 100,000 licenses. So what I typically see is if today predictability around this is a challenge, like we don’t know when this person is going to see patients. The estimate that will give you is going to be pretty accurate. So then you can at least get ahead of pipeline and how that, and that’s something that from, the current setup, do you have predictability like that to see when a patient will get licensed? We?
David Phurrough (39:51) Normally reach out like Shannon will reach out currently because I’ve been on quite a few of those with her while she’s doing it and been copying and following along. And what I see now is normally it’ll come back with an automated message or if she’s reaching out to somebody, it’ll be like, you know, it might be four weeks, four to six weeks. It might be 30 days. It might be 60. It depends on the state where they’re trying to get licensed at. But then of course, if we want to try to follow up and speed that process up, we’re able to do that. How does medallion go about that communication? If we need to try say we’ve got a provider coming on, we need to try to get them on within the next 45 days. The only thing we’re really waiting on is licensure because we can flip a radiologist if they’re not set up with the payers yet, then we can flip them to almost like a locum situation or fill in, but we have to have that license first in order to do that. So that’s why I was trying to figure out Shannon’s really good currently at, pushing and following up. How does medallion take care of that? And is there any visualization on what’s going on with those reach outs in medallion? I don’t want to jump ahead if that’s more.
Noah Laack-Veeder (41:00) No, for sure. Yeah. So again, this is not the best environments doesn’t have like the real stuff. And I can show you some examples if that’s helpful. But Shannon, I mean not to speak for you, but a lot of the follow up whether it’s for licenses or for payer enrollment is emailing or calling and just waiting on hold or waiting for a response. So we’re doing is, I’m sure you’re all aware of like all the pioneering inogenic AI where we can send emails, we can write them as if it came from you. We can leverage inboxes and we can even do like virtual phone calls. So the difference with the medallion is if you’re doing this in house, you’re going to have to do all those activities sequentially like one by one, one email at a time, one phone call at a time with medallions, we’re utilizing that new technology. We’re doing those all in parallel. And then if a response comes in, we’re going to digest that response and then put it into the email activity here. And if we think that look after looking at, this scene, this is much better equipped by Shannon or Rachel. In your case to follow up with the board, we will summarize that for you and then alert you to your attention. So really like if your follow ups are what’s the status that’s going to be automated typically on a daily basis, right? You’re going to see what the real time status is. And then if there are things that you need to act on, we’ll find those immediately and notify you. So you don’t have to search through your email inbox to figure out what’s the next step. Does that, does that answer your question David?
David Phurrough (42:31) Yes, that does. Thank you. I.
Noah Laack-Veeder (42:33) Think one other thing though is, can you just?
David Phurrough (42:34) Touch on like, hey, what average?
Noah Laack-Veeder (42:36) You know, turnaround times they could expect from licensing?
Noah Laack-Veeder (42:38) Yeah, for sure. And if you give us all the states, I can even give you a back. But we, our business started five years ago with licensing and we’ve just improved it. Since then the average turnaround time across the board is 20 days, but in some states, it’s less than 10. And so if you give us your states, I can give you a realistic estimate about how long these licenses will take. But today, I’m hearing that it’s taking what 45 days? Is that correct on average to get these licenses at.
David Phurrough (43:08) least at?
Noah Laack-Veeder (43:10) Least. So, yeah. Like a range like what? 45 to 90 Ish is like a good estimate. Yeah. So yeah, I am very confident that we’ll be able to cut that in half. And if we did cut that in half, I think that broader goal David and others that you talked about like this patient access and predictability, we’ve done 100,000 of these licenses. So if we’re telling you it’s going to take 20 days, it’s like it’s going to take 20 days Ish. So you’ll have that predictability, and we’re getting material savings from the things that we can control before the facility process. That makes sense. Thank you. Yeah, for sure. You’re asking really good questions.
Noah Laack-Veeder (43:48) So I appreciate it. And again, if we want to spend more time, you have more questions afterwards just we can either have another session, send it via email. I’m happy to address them because this is a lot of information. Any other questions on licensing before I jump into that payer enrollment and hospital credentialing piece? Nope? Okay. And I think I did promise I might ask another question. So I was reviewing the call Kelly with you and Zoe and I think that there’s a loca model there’s a de novo model. And like that sometimes results in a little bit of complexity around how you’re doing payer enrollments and how you’re billing. So, are you currently like it’s like thinking about the different types of operations we’re multi state. Are you doing a combination of linking providers to group contracts with payers and doing normal direct enrollments? Are you also billing at the facility level? Like what’s the general structure of your payer enrollment that’s happening today?
Kelly Mumford (44:52) So our intersection with the payer enrollment, largely mirrors our hospital credentialing process in that we provide the requisite information to the enrollers. And we also more recently are more engaged with holding them accountable for driving outcomes in a certain time period. So you’ll see a little bit of a theme here where we’re kind of like in the middle of a lot of things. I think that’s been part of the issue. Historically we’re just trying to shore up everything that we can.
Noah Laack-Veeder (45:29) That makes sense. And I’ve talked to organizations that have that. Like, so, is it like you and maybe Shannon, you can help me with this one? Are you like sending a single application out to this to the hospital or the mso that is handling the enrollments and they process many payers at once. Are you doing that? And some individual applications for payers? Like what’s that look like?
Shannon Young (45:55) It’s all individual apps. Okay? So.
Noah Laack-Veeder (45:59) If you’re like Callie needs to be enrolled with Aetna, you would complete an Aetna application and send it to.
Shannon Young (46:10) Well, we don’t complete the Aetna application ourselves. Okay? We just send that information to the billing company for that location and then they submit it.
Noah Laack-Veeder (46:21) Okay. So all the enrollments happening through your billing company? Yes. Okay. And so the typical information that you’re sending to them, I guess, I know this sounds like a really silly question, but is it like you’re sending just a file to that RCM company? Are you sending like a paper application to that billing company? Like, what is on? What’s like what information are you having to send?
Shannon Young (46:46) We have to upload. We have a template that we enter specific information for the doctor that would be needed for the apps, and then we upload those documents to a shared drive.
Noah Laack-Veeder (46:58) Okay. That sounds good. And the reason I’m asking is like we do both, like a lot of times we’ll do the agreement where look, you have to send some sort of application or documents to this billing company to process these payroll enrollment applications. And generally that’s because if you go through them, there’s advantageous rates. You’re part of a better contract. But there’s other organizations that are like, look, the contract is ours. We want to take payroll enrollment in house to kind of remove the whole out of our control piece. Like is there a reason why you’re using the billing company to do payroll enrollment today, or is it just like they’re just offering that service to you?
Kelly Mumford (47:41) It’s bandwidth.
Noah Laack-Veeder (47:42) Bandwidth. Okay. So there’s no like contractual obligation to do that. No. Okay. Why I promise that’s an important question and answer because medallion can function as that billing company doing enrollments. And we, I’m not sure what your current turnaround times are, but on average, ours are around like 50 days end to end. So if that sounds like a material improvement if you add like the licensing piece, we’re looking at roughly getting your providers enrolled with payers in around like 60 70 days. And I think today you said if they’re not licensed, it’s around like 120. So, like if, would you be interested in potentially having medallion do the enrollments? If we were able to hit those types of timelines?
Kelly Mumford (48:34) So, something important to flag is that SPG is a division of Solis? Oh.
Noah Laack-Veeder (48:42) Okay. Yep.
Kelly Mumford (48:43) We are not all of solis’ business. So the amount of people that our billing teams are working with far exceeds what we are doing. OK, in the sense that they’re for solus, you know, they have a bunch of types of practice agreements that are structured in a variety of complex ways across the entire nation that solus physician group is not a part of. So… would we be interested in it? Sure. Do I see that happening? I don’t.
Noah Laack-Veeder (49:23) OK. Yeah, totally fair. Let me just demo to you. Like what enrollment looks like with medallion is it’s the same idea as that license request. I know that you have like a very complex organization. Providers might be part of one or two group contracts. They might be part of like several different locations as well. And there’s a lot of complexity to manage and there’s a lot of complexity to make sure is correct. So with medallion with our payer enrollment, we house all that information. So when you need a new enrollment, let’s say it’s for Naomi, we’ll auto pull all of the group contracts that she might be a part of. And then we’ll also be able to tell you which state she’s already enrolled in, what have you? But the big thing here is that if you want to enroll her with all the payers for your group contract, effectively, what you’re doing, Shannon is just telling us what you need again and then which line of businesses that need to be part of this, which I think are, this is probably a very similar process in some shape or form to what you’re doing with the third party, but we can also auto enroll them in all associated practice locations. So you wouldn’t necessarily need to keep track of all of that complexity. Like if you’re like I just want them enrolled in all these locations. Great. Click this button. The opposite of this would be, I have to remember every practice location that this person is part of and that this can take a really long time. And if something’s missed, we might not know until we have this person at this location and we’re getting denials or something because something was off. So with medallion that’s the process of submitting it. And then what we’ll do is for example, if you’re doing medicare enrollments, what you’re seeing here is we have integrations with medicare medicaid and commercial portals where we’ll actually get the status automatically. So you don’t have to go reach out to the payer to figure out where we are with this because visibility can be a big challenge for a lot of organizations when it comes to payer enrollment. And when it comes to the actual… applications, you don’t have to fill them out yourselves. This is actually a video showing you that we will populate these in applications, whether it’s a portal, whether it’s a roster, whatever it might be automatically. So this isn’t a human doing this. This is actually like a very slowdown version of our robocrawler and it’ll. Submit these enrollments on your behalf. So ultimately the impact there is that if you have a lot of work to prepare these applications to QA them and all that different work, medallion automates that. And then we’ll get turnaround times much faster than organizations who are having to do this all manually.
David Phurrough (52:14) Can I ask a question on that?
Noah Laack-Veeder (52:15) Yeah, absolutely. David.
David Phurrough (52:17) Real briefly. So with the company that we use now for our payroll enrollment, like Kelly said, that’s through our larger organization, there is still a lot of steps for us to submit that information to that third party payroll enrollment. Is there a possibility instead of you guys going straight directly to the payers and doing that? Would you be able to also assist in your platform submitting to our third party instead? Yeah.
Noah Laack-Veeder (52:43) Absolutely. The only challenge there is it kind of adds like another layer of tracking for status. So it’s kind of like, so the issue where, like, hey, does the third party representing status to you correctly? We’re kind of limited to that. In that case, it’s definitely possible. But when we are working with the payers directly, you just get a little bit more real time visibility. The things that we can control in that process though is making sure the applications are filled out correctly, data’s coming in, all downstream systems are updated. But if the third party is like not giving you that visibility, there’s not like a magical way medallion will get it. Does that make sense? David? Yeah, no.
David Phurrough (53:26) That makes perfect sense. They’ve been pretty good whenever we inquired about the timelines. So, yeah.
Noah Laack-Veeder (53:33) So I know we’re getting at time. I covered the data coming in the system. I covered licensing. I covered the peer enrollment. Credentialing is another piece that I think we just need more time on just to show you how that works in the platform. But just generally speaking, from what you’ve seen today, what are folks’ thoughts? Is this like leaning towards the like kind of when you’re thinking about that ideal solution of what this looks like? Are we getting close? I’d just love to hear some feedback from what you saw today.
Kelly Mumford (53:58) Certainly closer, right? So my brain works like a big puzzle. And every time you tell me something, it’s filling in a new spot, right? So today, we probably hit maybe 60 percent of those spots, right? So, there’s we haven’t discussed credentialing. We don’t know exactly how the payer enrollment could be optimized with this third party situation. We have the unaddressed issue with the hospital credentialing thing that you can’t address. We haven’t talked about structure. We haven’t talked about how much it would cost. We haven’t talked about implementation. We haven’t talked. So I do think we need another meeting but in terms of just going all the way back to the original conversation with Zoe, which was we want our tasks to automatically perform for everything we have covered. It looks pretty good to me. It looks pretty good to me, right? So, but that’s achievable when you have a sense of clarity about what you want. And I did a lot of research before we reached out to you. So I had a set of expectations based on what I thought the application could perform, doing that demo where you show the automatic slowdown production of your robot is kind of a key element of just… reflecting the capability of the system. I appreciate that as a kind of back end thinker. So I think it was good. I think it was a lot of progress. I think we have a little bit more to go and I appreciate it. What can I say?
Noah Laack-Veeder (55:32) No, that’s totally fair feedback. Yeah. And there’s if I could do all that in an hour, I think that I would get a promotion but, you know, so.
Kelly Mumford (55:42) That’s the thing I was just thinking is that it was like, really ambitious to think that we were going to deal with this level of complexity in like a total of 55 minutes like it was, you know, we’re talking two, two and a half hour and Zoe and I probably talked at least 30 minutes probably also. So just have another meeting, do the next steps. I think you’ve done a really good job capturing what the actual situation is. Zoe and I have talked a lot about that. So I think that’s kind of key going into demonstrating these capabilities. And, you know, once we get through the credentialing portion, then we can look at structure things and then reflect internally as a team and take it from there. Yeah.
Noah Laack-Veeder (56:24) No, that’s I don’t think I could ask for more. So I really appreciate that. And again, I’m just conscious of your all time and your bandwidth, but we can have as many conversations as you want for me to make sure I’m covering everything in the platform.
Zo Hooda (56:37) Yeah, I think.
Kelly Mumford (56:39) I think you’re doing a good job covering it, and it makes more sense to me now while you’re asking all the questions because I can see the way that you’re framing the information. So that makes sense like, yeah, so I appreciate that and just another meeting to go over the credentialing and then we can talk about structure and I think that would be great. Yeah.
Zo Hooda (56:59) I think those are great next steps that’s actually what I was about to suggest. Let’s get another call on the calendar to tackle all the rest of the technical pieces that we weren’t able to hit. And then Kelly, you and I can talk async around like cost and implementation or whoever needs to be involved in that discussion.
Zo Hooda (57:17) But I think immediate next step, let’s make sure technically we’re getting to the 100 percent right now. We’re at 60. So I do have Noah and I’s calendar up if we wanted to schedule some time versus going back and forth via email. What do you think, Kelly?
Kelly Mumford (57:30) I’ve got a hard stop in three minutes, but it won’t take three minutes. So Tuesday, how does Tuesday look?
Zo Hooda (57:41) Tuesday, we’ve got kind of this company review. So I actually know when I will be tied up a bit. How does we have availability Monday as well as Wednesday afternoon? And then our Thursday is pretty open. Okay?
Kelly Mumford (57:57) So we’re out Wednesday, Thursday, Friday. So Monday.
Zo Hooda (58:01) Monday. Okay. So on Monday, we have 11 a. M eastern as well as any time between two 30 and four eastern. Okay?
Kelly Mumford (58:13) We’ll do the, did you say 11 a M eastern? That’s right? Yeah, let’s do that. Okay? Great.
Zo Hooda (58:19) So, I’ll send an invite for that time and then I know you have a hard stuff, Kelly. So maybe we could talk async around scheduling or perhaps after that call, we can schedule some more time to talk more about structure and implementation and stuff like that. Okay?
Kelly Mumford (58:34) Sounds cool. Sounds good. Thanks. Y’all.
Noah Laack-Veeder (58:36) Awesome. Thanks, everybody. Thanks team. Nice.
Kelly Mumford (58:38) To meet y’all.
Zo Hooda (58:39) Nice to meet you. All. Nice to meet.
Kelly Mumford (58:41) You.