Transcript
Delaney Crowe (00:00) yay. Bye. Good morning.
Taylor Ryan (00:03) Morning.
Delaney Crowe (00:04) It’s early for you.
Taylor Ryan (00:06) I know. I,
Delaney Crowe (00:07) realized that I was like, why did I do this to myself? I don’t.
Taylor Ryan (00:10) know… no, it’s good.
Delaney Crowe (00:20) I was just listening back to the gaunt to make sure that I knew how to pronounce his name. He introduced himself as dr. Aviel. I think Aviel.
Taylor Ryan (00:30) Okay. Yeah.
Taylor Ryan (00:37) Oh, my God, my allergies are so bad. I.
Delaney Crowe (00:40) Was going to say, I kind of hear you sound a little sniffly girl.
Taylor Ryan (00:43) This fucking bronchitis is still here like it will not go away for the life of me. It actually reminds me of that.
Delaney Crowe (00:57) I mean, there’s probably different pollen and like trees in Texas too. You know? Yes, totally.
Taylor Ryan (01:03) And like all the counts of stuff in San Antonio right now are like really high like the pollen count, like the mold. Yeah, apparently, I don’t know, my mother in law watches… the news every morning and keeps up on the pollen and the, I don’t know the allergen counts.
Delaney Crowe (01:25) Yeah, up to date on the pollen. I know. I think I want to get an air purifier this year because we get fire season in the summer. So like, it’s just good to have. But, yeah, I’ve heard people like really like them get.
Taylor Ryan (01:43) Them before fire season starts because they’ll be sold out.
Delaney Crowe (01:47) That’s so true.
Taylor Ryan (01:49) They, I like the, I can send you the ones that we’ve got. Okay. Yeah, they’re awesome. I, we have them in truckee, and then we also have them in Manhattan beach, big fan. They’ve got like hepa filters.
Julio Avael (02:04) Okay.
Taylor Ryan (02:04) He’s here, I’ll let him in. Do you, and then do you want to just kick it off? Yeah.
Delaney Crowe (02:10) I’ll just intro, I’ll say hi, thanks for joining. Okay. Look to my colleague Taylor.
Taylor Ryan (02:15) Perfect. All right. I’m going to let him in.
Delaney Crowe (02:20) Hello?
Julio Avael (02:28) Good morning. Can everyone hear me good?
Delaney Crowe (02:30) Morning. Yes, we can thank you for joining. How are you doing? Very.
Julio Avael (02:36) Well, thank you. Nice to see you both this morning, yes.
Delaney Crowe (02:38) Yeah, I looped in my colleague, Taylor here. She’ll be able to speak more on medallion, and kind of answer some of those questions that you had. So I’ll let her kick it off and introduce herself.
Taylor Ryan (02:50) Awesome. Thanks, Lainey. So, before we get started, can you, I don’t want to mispronounce your name, dr avail.
Julio Avael (02:58) You got it. Okay?
Taylor Ryan (02:59) Perfect. Well, it’s great to meet you. Thanks for joining. And like Delaney said, I’m Taylor Delaney and I are, you know, on an account team together. So, I’m going to be responsible for kind of being the main point of contact going forward. I, you know, today is really just for us to get to know each other, for me to get a better understanding of your interest in medallion. I’ve got the notes that Delaney sent over. So I’ve got a bit of background but I’d love to just understand a bit more about what you’re doing, your business and where your needs are. And I think, you know, success of today’s. Call is either coming away from the conversation with next steps and yes, we should continue the conversation or even, you know… determining if there’s not a fit. I think either of those would be appropriate. But given what I understand about your use case thus far, it seems like there might be a fit. So, if you wouldn’t mind, I’d love for you to introduce yourself and give me a bit of background, on your role and, the business and then we can kind of jump off from there. Does that sound good?
Julio Avael (04:05) Yeah, sure. I’m one of the executive managers here at the company, we’re a mso. We focus in operating a large mental health care network over multiple different states. We’re looking for a solution that could assist us credential our groups and our providers in those groups at a more efficient effective and speedy process.
Taylor Ryan (04:29) Okay. Got it. Awesome.
Julio Avael (04:32) That’s that’s it in a nutshell. So, we’re looking for providers to be able to keep track of their own credentialing. We’re looking to get them enrolled quicker with the plans. And I’ve watched some, I’ve watched some of your demo videos, and it appears to me that that’s exactly what your company does.
Taylor Ryan (04:51) Yeah, no, absolutely. And we can kind of I’ll spend a couple minutes on today’s, call. Once we get, I get a bit more detail where we can kind of just I’ll give a high level overview of medallion. And then typically, from here, we, you know, would move into more of a technical call. So, I know that you said that you saw some demos, but typically, we can, you know, customize it once we get a better understanding of your workflow and your needs. So, you know, we can play it out a little bit more in line with what exactly your workflow would be. That’s typically the next step from here. But so, I, there, I have a couple questions and, you know, feel free, to kind of guide me if there are questions I’m not answering asking that you think are important. But I’d love to get a understanding a bit more about like how, you know, the footprint, of the business. I know you guys are an mso structure, multi state. How many facilities do you, are you working with, you know, how many providers do you have? What kind of providers do you have? I, I’d love to get a better understanding of that.
Julio Avael (05:56) Yeah. So, we have 80, we have 80 facilities in our network. Okay? That rep that represents about, and right now we have 79 active providers across various different facilities. So just because we have the facilities, doesn’t mean they’re act that they’re active at the time, but that’s what we’re currently working on. We’re doing a big build out. Now, all of our providers in the network, they’re going to be lcsws, licensed marriage and family therapists, lpcs, psychiatrists, psychologists. So all of your mental health practitioners?
Taylor Ryan (06:33) Great. And, I know that you’re in the New York area or the company’s based in New York. So I would assume multi state, is it mostly like, you know, providers going across multiple facilities or does you know each provider kind of stay within whatever facility, they, you know, they all?
Julio Avael (06:55) Of our providers are medicaid specific. So they’re going to be state specific, and they need to participate in the medicaid health plans?
Taylor Ryan (07:04) And any… commercial plans or just the state?
Julio Avael (07:12) Yeah, we do, have, we have commercial plans, make about 10 percent of what we do. But we, our interest is the medicaid solution.
Taylor Ryan (07:20) Okay, great. And… in terms of how many states you guys, are working in, is it, you know, like just the northeast or what I guess we’re about?
Julio Avael (07:33) 20 28 different states? Okay?
Taylor Ryan (07:35) That’s a lot. Got it. Okay. That’s super helpful. Awesome. Okay. And then in terms of your current workflow, can we talk a little bit about that? And, you know, like let’s say provider gets hired to when they’re actually able to see patients, can you talk me through like how licensing works? How you’re credentialing today? I know you’re using modio, but I guess, you know, like who’s responsible for that process? And could you just kind of walk me through? Like, what that looks like?
Julio Avael (08:06) Yeah, sure. Let’s let’s back up a little bit. What does, your, can your product assist or not? That’s what I’m trying to understand. You’re asking me a lot of questions. We’re the customers seeking out a.
Taylor Ryan (08:17) Vendor solution for sure. And I don’t want to.
Julio Avael (08:19) Spend all that time getting into the workflow of an organization. The research we’ve done online indicates and based off the claims made by your company, that medallion can expedite the provider enrollment process with multiple different panels using its advanced technology. So, can it or can it not do that well?
Taylor Ryan (08:38) I think, and my goal in these questions is just to understand like because credentialing can mean a lot of different things to a lot of different people. So I just want to make sure I understand like are you managing caqh profiles? Are you managing licensing for your provider? So let me just take a step back and give you a bit of a background on medallion. And that’ll kind of help place my questions a little bit sure. So at a high level, you know, we’re a technology company. We’re I think not to oversimplify the problem. But what we’re trying to solve for is the gap and the lag between when a provider gets hired to when they can actually see patients and bill for the organization, right? There are a lot of things, a lot of things that happen and, you know, a lot of different steps are unique to each organization. But I think, you know, the investors that we’ve got up here on the screen as well as, you know, the customers that we’re supporting. That is at the crux of it the problem. And I think what, you know, described you’re running into as well. I think what’s worth mentioning that’s unique about medallion and maybe a little bit different from what, you know, are seeing in modio is kind of how we operate. You with medallion, you have, we have a software plus services model. I think traditionally in the industry, the folks out there have either one or the other. So they kind of give you a self serve tool and, you know, hire staff and it kind of it’s a software solution that helps, you know, organize things but you don’t really have the expertise or a team that you can go to and ask for help. And there’s not really any augmented workflows or you’ve got completely outsourced and, you outsource it to a team. But the downside there is lack of visibility and we kind of sit in the middle. So to answer your question, if you guys are trying to streamline your credentialing and enrollment workflows. Yes, that’s exactly what we help solve. You know, if we get into a demo and I’m not exactly sure what you saw but you may have seen parts of the platform. If you were to become a medallion customer. Not only would you have a software solution, right? So like at any point, you can track, I’m not sure if licensing for example, is something that you manage for your providers, but let’s say that is or maybe it’s credentialing packets, whatever. That may be you click request. In medallion, our team handles everything, handles the workflow. We let you know when there’s something that we can’t solve whether it’s we need provider data or we need assistance from you right in the platform. But 90 percent of the workload is done by medallion and automated via the platform or our specialists. You also would have a medallion SME that is there to help guide you. A lot of things when you get into payer enrollment can become really hairy, especially if you’re working across different states, there are state specific requirements, payer specific requirements. And so you would have the expertise of our team not only taking the workload off of you. Typically, we see as far as like a number of employees managing medallion for our customers, one fte per a 1,000 providers. So with your current provider count, this would be like a side of the desk job. You know, 20 percent of one employee time spent on this, just given our average ratios. These are, you know, some of the things that you might be aiming to solve, but I think for our customers like these are the north stars, you’re looking to accelerate revenue, reduce operational costs, and remove provider operation, make it easier for your providers to get onboarded and seeing customers. And then from like a medallion, what exactly do we offer standpoint? And this is where some of my questions are going. I wanted to understand, you know, every org is different. You know, some orgs are managing a lot more for their providers. Some have providers that are really touchy and want to manage their own licenses. This is the full breadth, you know, breadth of what we offer. The way that we work is an a la carte model. So if you don’t need all of these things, you can use what is necessary for you and, you know, skip what is not. But thinking about, you know, some of the use cases that I’m hearing up front. I think credentialing sounds like it’s important. And then the payer enrollment and managing that process, the phone calls, all of that is very time intensive. So those are some of the assumptions that I’ve made but, you know, I’m just trying to understand a bit more about if my assumptions are correct. So any questions there? Like does that kind of help place where we fit?
Julio Avael (13:35) What is credentialing alliance?
Taylor Ryan (13:38) Credalliance. I don’t know that would be as relevant for you guys. It’s a new offering for us that we can go into, but that’s not when I talk credentialing. I’m referring to the cvo credentialing.
Julio Avael (13:56) The cvo credentialing, what?
Taylor Ryan (13:58) Is a cvo, right? So… and, you know, I’m not sure how you’re doing it today, but typically folks will either have an in house, you know, group of credentialing experts… that have a lot of knowledge in the different plans and what they require. And then, you know, the different state by state requirements. You basically as an organization, you choose what kind of risk you want to take on when onboarding your providers, right? And the credentialing process allows you to identify some of that risk background checks, you know, malpractice, essentially gathering all of the information on the provider, whether that’s for an internal committee review or to be sent off to, the payers so that you can get them enrolled in a plan. A cvo, a credentialing verification organization can sort of take the burden of you guys having to make sure that you’ve got all of your ducks in a row medallion is a cvo. So we, you know, there are integrations in the product that allow us to automate it. But the long and the short of it is, if you guys are doing credentialing and kind of gathering that information up front for whatever, you know, either of, those use cases, we would do that we would automate it. And then if, you know, you can decide what standards you want it to be up to. Maybe it’s ncqa standards. Maybe it’s, the joint committee, you know, it’s org by org, but that’s kind of what that means.
Julio Avael (15:33) And what is credalliance?
Taylor Ryan (15:36) So credalliance is on the payer side. It’s a clearinghouse essentially to help support and speed up the process of getting your providers enrolled with payers. So when I talk about cvo credentialing that’s you know, that doesn’t necessarily need to involve the payers. It can, it can, it’s but it’s not always for the purpose, of getting enrolled with payers. Credalliance is a specific clearinghouse that is to support the process of credentialing for the purpose of enrolling with payers.
Julio Avael (16:13) But why wouldn’t you think we need that, our payers can’t provide services to an in network patient unless they’re credentialed with a health plan?
Taylor Ryan (16:23) That’s right? Yeah. And so I’m just trying, I think that I need to get a better understanding of what your needs are. And then I’ll be able to guide you on if credit alliance would be the best path for you or not from what I understand about the complexity and sort of what you’re working with. I think that credit alliance could be valuable for you, but I think I need to just better understand your workflow, your needs, what, you know, what are you guys credentialing up to what kind of standards who’s handling it right now? Is that knowledge in house? What, you know, I just understand.
Julio Avael (16:59) We already handle all of this in house and we’re very familiar with how credentialing works. We’re doing it across the United States. I’m just looking for a solution that can do it quicker. I’m trying to take my providers from 90 days to 30 days so they can turn around and build health plans. Can medallion do that or not?
Taylor Ryan (17:16) Yeah. I mean without getting into like plan by plan and, you know, state by state specific turnaround times, yes, that is the main metric that we aim to solve for our customers, bringing down.
Julio Avael (17:27) That. And how much experience does your team have working with the medicaid health plans a lot and medicaid managed. So they’re very familiar with medicaid managed care and how it works across state lines for mental health services.
Taylor Ryan (17:38) Yep, that, yep, that is the expertise of that team.
Julio Avael (17:43) Okay. So you want to move forward with the next slide or how would you like to proceed today?
Taylor Ryan (17:50) We’re not going to go into a demo today is really just for us to understand like a bit more about if it’s a fit or not, you know, if you’d like to move straight into a demo and see what it looks like and how it works. We can certainly do that. But I guess my question to you is like what are you looking to understand, how are you going about an evaluation process? Is it, you know, as simple as, hey, I want to see exactly what the turnaround times are, and if you’re claiming to, you know, lower the time by X y Z, then we’re good or, you know, what does your evaluation process look like?
Julio Avael (18:25) That’s all I’m concerned about right now. If we get everyone enrolled in six to 90 days, I’m looking for someone to get us down to 30 to 45 days.
Taylor Ryan (18:32) Okay. Do.
Julio Avael (18:33) You have any ideas? Whoever can do that? Go ahead.
Taylor Ryan (18:36) I was going to just ask what I mean? Typically, the longest part of the process is the payr part, but with medicaid, it can be a little bit quicker for the commercial plans. It typically takes longer. Do you happen to know like which, you know, what part of the process is taking the longest? Like is credentialing easy for you guys? It’s the payr, it’s the payr side? Okay?
Julio Avael (18:59) Gathering licensing and caq information and credentials from the providers. Our software already takes care of that. Medallions makes the claim online that it can increase enrollment with the payrs, increase payment time with the payrs that’s what we’re interested in. Okay?
Taylor Ryan (19:18) That’s super helpful. Yeah, a lot of our customers do come to us for credentialing and gathering information. And it sounds like you guys have that handled pretty well. The reason I wanted to understand that is because a lot of folks do actually have a lot of trouble with that. So I just want to make sure I wasn’t discounting that, but I hear you payr side.
Julio Avael (19:38) We can leave our current platform. I’m looking for a system that can get us enrolled with the payrs quickly and handle the volume that’s coming that’s what we’re looking for.
Taylor Ryan (19:48) Okay. In terms of, yeah. So I mean, what we can do is if we can get you if we get a list of the states that you are working across, we can do a turnaround time analysis and get you exact turnaround times that you can expect on the payroll process, state by state. If that would be helpful, if you want an average, we can also provide that. But a lot of folks find value in having the data broken down state by state. So we can do that for you. If you’d like would it be helpful to see the product in action? Yeah.
Julio Avael (20:27) I can see the product. I’m not providing any information until I see the product.
Taylor Ryan (20:32) Okay. That is going to be a little bit tough. I think if we’re going to do a demo, we want to make sure that it’s customized to what you care about. As you saw, we’ve got a plethora of different products. And so my technical counterpart is going to want more information to just understand which parts of the product you care about and that’ll help us customize the demo for you. We.
Julio Avael (20:58) Haven’t really established what your company does. Usually companies would demo at this time. You’re making it a very mysterious product here. And so what you’re telling me we might be able to do something but we can’t do it and we don’t know if we can do it unless you provide us information, either you guys do it and can demo that you can do it or you can’t.
Taylor Ryan (21:22) understood. Sorry, if I’ve left you with the impression that it’s unclear, I think given what we understand about your use case, if you’re looking to speed up payer, enrollment timelines, that is what we do.
Julio Avael (21:36) Okay. So, can you have someone demo the product so we can see how it works? Or is that not a possibility? If you guys can’t do it, that’s fine. My time is precious. I need to know if you guys can do it or not. So I can get to the demo?
Taylor Ryan (21:48) Understood. And yeah, the purpose of us kind of doing this is so that we don’t waste your time on a demo that doesn’t hit on what you care about. We will take what we have if you kind of want to stop here and you don’t want to share any more information and we can certainly set up a 30 minute demo to walk you through the product. My recommendation would be to, you know… I guess have more time with my technical counterpart to have to make sure he has what he needs. But if you don’t have the time, then, we can certainly just move to, you know, a standard demo.
Julio Avael (22:26) That would be very helpful for us, okay?
Taylor Ryan (22:28) Do you want to choose time now?
Julio Avael (22:31) Yeah, that would be great.
Taylor Ryan (22:34) You’re east coast?
Julio Avael (22:37) Yes, ma’am has Monday one PM work eastern standard… it.
Taylor Ryan (22:44) Does not, do you have Monday? We can do two 33?
Julio Avael (22:52) Two 30 works. Perfect. Okay. Great.
Taylor Ryan (22:58) Well, I will send over an invite. What kind of timeline are you looking to work under? And is there anything else that you need me to provide in tandem?
Julio Avael (23:11) It all depends on how your product operates. We can go live may and June. We can go live ASAP of your product, of your company’s product and do what it claims to. Okay?
Taylor Ryan (23:24) All right. Well, I will send over that invite. Is there anybody else that I should include from your end?
Julio Avael (23:32) Not at this time. No. If I like what I see, I will get my credentialing team and some other people involved?
Taylor Ryan (23:38) Okay. Sounds good. Well, is there anything else that I can answer for you today?
Julio Avael (23:44) No, ma’am Taylor. I really appreciate your time.
Taylor Ryan (23:46) Yep. Same here. Thank you. Talk to you soon.
Julio Avael (23:49) Thanks.