Transcript
Noah Laack-Veeder (00:00) yo, howdy, hey, what’s up, guys? Howdy?
Noah Laack-Veeder (00:40) Do you post that call plan again? Kyle?
Kyle Bettencourt (00:44) Yeah.
Noah Laack-Veeder (01:06) You guys asked for access?
Kyle Bettencourt (02:30) Hey, good morning, Jolene, and Eric?
Rhonda Koehn (02:37) Good morning.
Noah Laack-Veeder (02:40) Good morning. Happy Friday?
Erik Hemingway (02:42) How are you guys doing today? Good?
Kyle Bettencourt (02:47) To reconnect here?
Noah Laack-Veeder (02:51) Either of you have any fun weekend plans?
Erik Hemingway (02:56) Nothing fun on my side, not.
Rhonda Koehn (02:58) Here?
Noah Laack-Veeder (02:58) Not here. Yeah. Well, I got a seven month old daughter. So, this weekend is her eating some new foods. So that’s going to be our big weekend plan. So, we’ll see there you go… man.
Erik Hemingway (03:11) Seven months old, that’s hard for me to remember those days.
Noah Laack-Veeder (03:15) Yeah. How old are your kids now Eric?
Erik Hemingway (03:18) I just have one. She’s 16, oh,
Noah Laack-Veeder (03:20) wow. Yeah. I was talking to a friend of mine like a friend slash coach of mine. He was like, he’s like you forgot how to change a diaper. And I’m like, there’s no way you forgot. Like, there’s no way you forgot.
Erik Hemingway (03:33) You know, only a man could forget how to change a.
Noah Laack-Veeder (03:36) Diaper.
Rhonda Koehn (03:38) I.
Noah Laack-Veeder (03:38) did think that I didn’t say that, but, yeah, yeah.
Kyle Bettencourt (03:42) Yeah, that’s funny. Hey… Nicole. Thanks for joining.
Nicole Conditt (03:50) Hey, there. How’s everyone doing?
Kyle Bettencourt (03:53) Good. Just talking weekend plans here. Yeah, looks.
Noah Laack-Veeder (03:55) Like none of us have anything exciting happening except for me feeding my daughter some sardines maybe that’s going to be, the big reveal.
Kyle Bettencourt (04:04) Wow.
Nicole Conditt (04:06) Interesting.
Kyle Bettencourt (04:07) Hey, we do have the masters to watch. I don’t know if we got any golf fans here, but that’ll.
Erik Hemingway (04:12) be, oh, there you go.
Nicole Conditt (04:15) Have y’all, seen the videos with the golfers and their kids? I don’t know what it’s called, but they’re like their kids are like, it’s almost like a mini masters and it’s the cutest thing ever that is awesome. Yeah, it’s got these pro golfers with their little kids out there. I mean, just hitting, amazing shots. Yeah… yeah.
Kyle Bettencourt (04:35) They’re all going to take over for the next wave. We’ve got like John Daly and tiger woods kids that are now coming up on the tour, so.
Erik Hemingway (04:41) Yeah, you know?
Kyle Bettencourt (04:44) It’s like, I thought I was young but it’s like now, I’m looking at all my idols’ children going pro now. So I’m just like, yeah, geez that happened quickly there, but… cool. Well, yeah, I think it looks like we got everybody from the metro side. Anybody else that we’re waiting on Eric?
Erik Hemingway (05:00) Ron, this is all you’ve had, right?
Rhonda Koehn (05:02) Yeah. Sorry, I’m late. I just had a phishing attempt on my computer. So I was with our it person trying to make sure that was all it was. Oh.
Noah Laack-Veeder (05:12) Wow. When he said phishing, I was like, I immediately thought you were going on a phishing trip, but,
Rhonda Koehn (05:16) then not.
Noah Laack-Veeder (05:17) The good type of phishing. I.
Rhonda Koehn (05:20) made a mistake typing a URL. And then all of a sudden, my screen went black. My computer starts beeping at me and telling me like, you know, Microsoft servers or that, and like asking me to put all this info in my computer. Luckily, I.
Noah Laack-Veeder (05:36) you took the training to know not to do that. Yeah, I talked.
Rhonda Koehn (05:41) To someone. So, yeah. So we have a URL that we’re going to blacklist and he’s going to, actually, he’s going to type it in and take a screenshot so he can send it out to everyone as an example. And it’s kind of funny that it was related to unitedhealthcare. Just since, you know, we had the whole change health thing a few months ago. So, I was actually trying to get the, for my daughter and mistyped myuhcvision com. So, oh,
Kyle Bettencourt (06:10) no.
Rhonda Koehn (06:11) Anyway, well.
Kyle Bettencourt (06:12) Glad it was handled properly. Yeah.
Erik Hemingway (06:17) Well, Kyle, I’ve got another call and I’m not the important one on this call anyway. I’m going to hop off here in like 15 minutes, but I appreciate you guys setting some time aside. I know we had a quick intro call earlier and just wanted to introduce you to Rhonda and part of her team.
Erik Hemingway (06:35) Rhonda’s our revcycle leader internally, and Jolene and Nicole are part of RCM as well. And I know we talked about a lot of different things. But one of the items just associated with our transition is us kind of positioning ourselves internally to take over payer enrollment. And so, I know specifically, you know, this team wanted to kind of hear about that piece of medallion, but also knowing, you know, you guys could play a big role in how we do facility credentialing or, you know, facility enrollments as well. But I think for today would be specifically just to let Rhonda and team hear and understand about what your service offering is on the payer enrollment side, and then they can pick it apart and ask you guys all kinds of questions as they prepare to figure out how to do that on our side of the fence.
Kyle Bettencourt (07:27) Yeah, perfect. That sounds great. And yeah, I appreciate you hopping on here, Eric, and yeah, Rhonda and team great to meet you guys as well. So, yeah, like Eric mentioned, we had a great conversation earlier this week about, you know, some initiatives that we, you know, we think we can help you guys out with as you guys are looking to scale and grow and then take on pay your enrollment and delegated credentialing. So, I guess, you know, maybe a good starting point Rhonda would just to be to hear from you guys, you know, like what does your guys’ operation look like today? You know, what are some of the challenges that you guys are running into that you would like some help out with? And you know what? I guess maybe what do you know about medallion as well? So.
Rhonda Koehn (08:10) I don’t know much about medallion. I have a long background in payer contracting, credentialing, enrollment, all the things practice management wise right now, all of our payer enrollment is. So credentialing is done in house but by a department that doesn’t report out through me. Payer enrollment is currently done by our outsource billing vendor. And… you know, the challenges are unlimited there from knowing that they’re not doing it correctly or they’re not using electronic resources where they could for enrollment. You know, they’re still doing paper to, you know, missing things, just not following them up in a timely manner, whatever. So, our plan is we will probably be bringing that payer enrollment in house at some point in the not so distant future. And Jolene on my team is going to be leading that effort. I don’t know that she will be the person doing it, but she will be responsible for that area. And then Nicole who is also on the call has been with our group about nine years and does all of our basically technology and applications work where revcycle is involved.
Rhonda Koehn (09:21) So, Jolene does have some fairly significant payer enrollment expertise around caqh and pcos and all those things. And I had brought up, you know, right now when we scale up, we don’t usually add a really large practice. So it’s not usually a big deal. But a couple, maybe 18 months ago, we were looking at adding about 200 doctors all at once. And so I had brought up at that point, the concept of we should probably get ncqa certified and consider asking for delegated credentialing in each, at least of our major commercial contracts.
Rhonda Koehn (10:05) It hasn’t really gone anywhere but obviously something that I still know we need to do, we didn’t end up adding 200 all at once. So it didn’t hurt us that it didn’t go anywhere. But that would, you know, from my perspective be something that if we really are going to grow a lot over the next five years, we need to be looking at doing. So. I’ve done ncqa certification for other things like patient centered medical homes. I’m pretty aware of, you know, how you do it and why you do it in private practice versus what hospitals can get away with in terms of delegated credentialing. So, and I know Eric mentioned that might be something that you guys could help us with too. So just, you know, we’re very automation focused on our team. We’re looking at growing fairly significantly in the next 90 days. And we, I think are automating about everything that we could possibly automate in that process. From day one, not planning, you know, have worked through a process that’s going to allow us to hire only about 50 percent of the people that were originally projected.
Rhonda Koehn (11:08) We would need to hire. So interested in talking to you guys because Eric… you explained that you already have a lot of automation, so.
Kyle Bettencourt (11:18) Yeah, no, that’s really helpful. And yeah, I think really everything there that you kind of mentioned, we can certainly help out with one quick question. So, have you guys handled payer enrollment internally in the past and then outsourced and then bringing it back? Or is this kind of like getting that new function that you guys are looking to bring in house on the payer enrollment piece? It’s.
Rhonda Koehn (11:40) outsourced right now with our revenue cycle company. And so basically, we’re looking at bringing the payer enrollment piece of that in house to try to have closer control over it. It’s a little too much all outsourced together. And so sometimes there’s a payer enrollment issue that happened on the payer enrollment department that doesn’t get related to the billing department. And so if we were in control of the whole process, we would have a better picture of that. And then they often just don’t move quickly enough, right? So they’re not using caqh, they’re not until fairly recently, maybe six months ago. They were not even doing pcos electronically. They were still submitting paper signatures which of course, requires additional time and they were not doing blue cross blue shield electronically. I’m still not sure if they are consistently doing it electronically. So I just think, you know, Jolene and I’s background and Nicole also enough to know that we could shorten the approval window if we use all the electronic options that were available to us for submission.
Noah Laack-Veeder (12:52) Yeah. And so I’m Noah by the way, I don’t think I’ve introduced myself besides I have a seventh month old daughter, but in my job, I’m a solution consultant here at medallion. So you can think of me as like the technical resource and I talk to organizations like yours all the time evaluating when and if it makes sense to automate this process or take it more in house.
Rhonda Koehn (13:10) You know, I just.
Noah Laack-Veeder (13:11) wanted to kind of dive in a little bit. So kind of you’re working with an outsourced vendor, they’re doing paper processes today. From what I hear other organizations in similar situations, visibility can be a challenge, right? Like in your kind of talk, we’re talking, revenue cycle visibility is everything, right? Is someone credentialed or able to see a patient for a particular payer, and not having that visibility for some organizations can lead to write offs or, you know, having to try to appeal denials, downstream. How is that showing up for you all? Is that like a downstream impact that you’re all seeing from this visibility challenge? Well, so.
Rhonda Koehn (13:48) We’re anesthesia, so we have some protection under nsa, but we also don’t get the luxury of saying, oh, they just can’t see blue cross blue shield patients today, right? So it’s not like primary care or a surgical practice where they can put that patient on someone different schedule. So, we’re either holding them from working or allowing them to work, recognizing that we may not get paid for everything or holding claims, knowing that they’re going to have an approval that will be retroactive to a certain date. But, and, you know, just, I think for us, it’s a delicate balancing act of okay, when’s it okay to let them go to work knowing that we’ll maybe have a little bit of loss but not a lot of loss.
Kyle Bettencourt (14:30) Yeah. So.
Rhonda Koehn (14:32) And it’s not, I guess not so much visibility into who’s approved or not approved because they do communicate regularly with Jolene. She has every two week meeting with them now since we’ve taken.
Noah Laack-Veeder (14:42) This, oh, two weeks, okay?
Rhonda Koehn (14:44) So, and they send, I think they send, you know, fairly regular updates especially if there’s someone that we’re concerned about. And we do have some visibility into payer portals and things to see for ourselves like pcos when things are going wrong or not, and appeal wise, like they should be doing that if there’s an issue and they, it needs appeal. But oftentimes my in house team gets involved in that also because I do have some in house complex claims reps. So, but it’s more just wanting overall control of the process and wanting to make sure that every choice we make for how we’re going to enroll someone is the most expeditious choice. So, you know, we need to have caqh. Everyone needs to be on caqh. So basically, cigna humana, blue cross blue shield are instantaneous, right? So, like we have enough, Jolene and I together have enough knowledge to be dangerous about knowing where they’re not using electronic options is slowing the process. So.
Noah Laack-Veeder (15:48) Absolutely. And yeah, the caqh, I love how you’re all getting ahead of that with the attestations, and the caqh management. Is that something that the billing company that you’re working with is taking on? Or is that something that you all have to do? We?
Rhonda Koehn (16:01) Would have, they don’t work with caqh. So where?
Noah Laack-Veeder (16:04) We have caqh?
Rhonda Koehn (16:06) Is we have two tens or three tens? Our clinically integrated network 10? Because those groups came from other organizations, affiliations. A lot of them have a caqh profile and, you know, we can, we aren’t working in it yet. We just know we need to, right? So a lot of those groups have a caqh profile and that can be updated and we can get their attestations current. And those people will be ready to go the medtrainer and the seizure 10 for the most part. Unless those providers have worked somewhere else that has required them to have caqh, they do not have caqh profiles set up because leadership prior to me and the billing company said, oh, we don’t do caqh for anesthesia. So most of metro do not have it, we’ll be starting from ground zero to create a caqh profile, get their documents uploaded and then be able to use caqh going forward. And that’s something that I mean, Jolene and I have been looking at hiring someone and over the next 90 days before we bring it in house, that was one of the projects that we knew we needed to get accomplished. And then Eric introduced you guys. So, you know, we’re exploring, I had explored another option but it was cost prohibitive. So we’ll you know, be interested to see what you all come up with for pricing to see how that might support us and allow us to make different decisions around hiring.
Noah Laack-Veeder (17:29) Yeah, that makes sense. And I’m.
Erik Hemingway (17:31) about to hop off. So, Rhonda and team, thanks for joining. We all make sure that you also talk about just the known issues. You know, I told you guys, we have healthstream internally and I know you all talked about some of the issues with healthstream and how you could work, you know, with it and, or replace it. I just want to make sure you all touch on some of that stuff with Rhonda and team today, too. Definitely appreciate it. Everybody have a good weekend.
Noah Laack-Veeder (18:01) Thanks.
Rhonda Koehn (18:02) Eric.
Noah Laack-Veeder (18:05) Yeah, we can definitely start there. So if you’re the organization kind of not doing PE today, doing it through the billing company, I’m sure that the requests are happening like via email or something, correct? Rhonda, Jolene, just sending them an email to get some of that work done. So, you know, nod there. Yeah.
Rhonda Koehn (18:23) The.
Noah Laack-Veeder (18:23) credstream piece. Is that being used more for the internal credentialing piece? Like to get someone like able to go to a facility. Jolene. I see you nodding. Can you just tell me a little bit more about that?
Jolene Nelson (18:34) That’s actually all that we’re using it for. We haven’t even gone through all of the steps to even implement the payer enrollment side of credentialstream at this time.
Rhonda Koehn (18:47) Yep. And that facility credentialing is not in our purview, no, that’s handled by another vertical in medtrainer and co practica. So we don’t we only have a limited knowledge into that because the three of us have been given access into the system and because Nicole is great at technical support, she’s helped them with some of the things that didn’t go well in their implementation and she’s helped them clean that up. So, we have some basic knowledge of the system. But as Jolene said, we’ve not done any piece of the implementation for payer enrollment, yeah, but it is contracted and we are paying for it, just that we are not using it. So, yeah. Well, I mean, I.
Noah Laack-Veeder (19:31) Think this is why I’m super excited to talk to you all and show you kind of what medallion can do because I do have a lot of conversations with healthstream organizations. And what ends up happening is usually it’s the facility credentialing team that’ll be using it like and they’re doing it. There’s a lot of configuration. Nicole, sometimes they’re lucky to have a resource like you that can get it to work and fit your needs. And sometimes they don’t but then what ends up happening is the payr enrollment team doesn’t use it. And so what ends up happening is they’re usually using spreadsheets. I talked to an organization the other day where they created a whole Smartsheet system mostly because one, the implementation is going to take too long. And two, they just claim that it just doesn’t have the automation that they’re looking for. It’s more of just like a tracking tool. So where medallion fits is look if you’re like look healthstream with facility credentialing is working totally fine. We don’t want to touch that right now. Totally an option, medallion can jump in and take over the payr enrollment piece, take over the caqh piece that can kind of walk through what all that works, looks like. But at the flip side if you’re like, hey, you know, healthstream is not really working very well for our other use cases as well. Some organizations choose to just take healthstream out of the picture and then have medallion take over everything. But again, a lot of organizations kind of do it stepwise or maybe it’s just be first then healthstream, but kind of thinking about your immediate priority. Rhonda is like the payr enrollment piece, the top priority to get set up right now. And how does the facility credentialing piece kind of fit into that priority? Well?
Rhonda Koehn (21:09) Facility credentialing is separate and I think that, you know, the one urgency there is, you know, we at least need to see the cost because they are going through a transition of staffing right now with possibility… of needing to move a couple of positions they’ve had offshore into something different and they’re into a different company. And so they’re looking at onshoring it, which obviously, you know, four times the cost probably of what it has been. So that’s I think, you know, what you guys give us, we need to see a cost projection for both facility credentialing and pay enrollment. The pay enrollment piece is my decision. And so if, you know, we’ll Jolene, and Nicole and I will make that with Eric’s approval. But the facility credentialing piece is something that I’m happy to present. I mean, I’ve already been sort of discussing with them that having people put stuff from one screen application into the other screen application is something that’s right for automation and we really shouldn’t be paying people to do that, but that’s just maybe a difference in philosophy of where our revenue cycle team is in bracing automation versus some of the other departments here.
Noah Laack-Veeder (22:21) Yeah, no, that’s totally fair. I don’t.
Rhonda Koehn (22:23) control that, but I think we need to see the cost and then, you know, Eric and I can take that across the leadership team to that other vertical if that seems appropriate. Yeah. And that makes.
Noah Laack-Veeder (22:33) sense and definitely I’ll kind of we can definitely talk about costs later and Kyle and garrison can walk through that. But like just so I’m kind of understanding a little bit more about like what the needs are for the payer enrollment function. I just want to make sure I’m tracking and just present back what I’ve heard so far. It’s like if you’re looking for an ideal solution for payer enrollment like one just very, simply you want it to work and you want it to be automated, you don’t want it to be a headache. And how that looks is that with the caqh piece being more important, caqh is integrated into the solution in some shape or form whether it’s taking data into the solution or updating caqh downstream. You just don’t want to worry about that. The second piece is just full automation across payer enrollment, making sure we’re submitting applications correctly populating the data, correctly, doing that quality check. So things don’t get denied later and also payer follow up. How can we use modern technology to automate some of that? So your team doesn’t have to spend hours on the phone getting updates? How can we do things like integrate with the paycoast portal, which medallion does to give you an automatic status update on the application? And then two other things that I think I heard that I just want to make sure is with the caqh piece, a big workflow that’s going to be part of that is that quarterly attestation process. So every three months, you’re going to have to test that the information is right? I’m guessing that you probably don’t want to have to do that because it’s going to be a lot of work having a vendor or a partner that can do that piece for you. And then ultimately kind of just broadcasting this just more broadly being able to use that automation so you can scale without having to bring on more resources, right? So we don’t want to hire 20 people to do this. We want to have an automation partner that can let us do more with less is that, am I kind of covering everything. It’s kind of what’s on your wish list. Yep. Anything that I’m missing Jolene or Nicole?
Rhonda Koehn (24:27) No, I’m I think that you summarized it perfectly actually agreed.
Noah Laack-Veeder (24:31) Perfectly. I’ll take that. I’ll tell my wife. Someone called me perfect today. I had.
Garrison Goodman (24:35) a question, Rhonda, you mentioned the things that are important to you when you think about decision making. One of the things I don’t think that we’ve talked about today is just in regards to the like enrollment turnaround times and I don’t know if you could share maybe a bit of estimates on those and if the, you know, typically what we see is that we can significantly help reduce those times. That also plays into some of the decision factor on what would make sense to go with medallion. So just curious in general, if you could share like high level turnaround times you’re seeing on the enrollments, and just to add,
Noah Laack-Veeder (25:08) in usually with a billing company partner, we’re seeing things like if you are tracking the visibility around like 120 150 days, and that’s kind of like what we see across the board just wondering if that’s kind of what you see or if it’s no.
Rhonda Koehn (25:20) We’re not that bad. In general, we’re only that bad when they have an issue. When they, what, when they have an issue with, you know, provider not responding to something which everybody’s going to have that issue, right? So, I don’t know Jolene, do you have, I would say we’re probably averaging around 60 days or less except for maybe Texas medicaid because of the oig issue right now. Okay, right. I would agree. I don’t think we’re not, we are a lot shorter than it was when I came here four years ago because I have been pounding on our billing service to use electronic options. So they have picked those up in some cases or, you know, where do you need to just send a roster? Quit sending individual stuff if you don’t have to that kind of stuff. So, I’d say in general, we’re at 60 to 90 days and really… don’t have a lot of issues other than… medicaid of Texas. Yeah.
Garrison Goodman (26:17) Okay. You know, typically, on average, we’re seeing somewhere in the realm of 45 to 50 days, you know, would that 15 day difference be meaningful for y’all,
Rhonda Koehn (26:29) probably, I don’t know, hard, you know, it’s cost depends on the cost to be very honest and honest garrison. Yeah, getting from 45 days to 60 is not a big deal for a lot of our practitioners, but for some, it’s a big deal, right? So, yeah, would really just kind of depend upon the cost to get there. If we… continue to outsource, yeah, on.
Garrison Goodman (26:54) The last call we understand that you guys were, I think thinking about bringing this internally and based upon what we understand so far, we’re probably going to be like similar to even slightly less than what the cost would be of hiring people. So we obviously need to explore that a bit more. But if that were the case, does that, you know, what are the other things that become, you know, more meaningful outside of just like cost, if we’re going to be either net neutral or less?
Rhonda Koehn (27:25) I mean, I think, you know, onboarding the service level. I mean, all the things that as a vendor, you know, you have to provide if you want to keep us as a client, it’s not really. Yeah. Okay. How much work we’re doing to make it happen for you versus, you know, what we could truly turn over? Okay? And I mean also frankly, when you say yours is going to be about the same cost of hiring people or the same cost of hiring people onshore or hiring people offshore, you know, the same cost of us automating. We do have our line on automating the caqh piece already with a vendor that I’ve worked with on automating a number of revenue cycle things. So, you know, that’s why I say we just, we have to evaluate what the whole service line and the cost of that would be, yeah.
Garrison Goodman (28:16) Were those resources that you’re bringing on going to be onshore?
Rhonda Koehn (28:21) I don’t I think that’s credentialing’s plan for the facility credentialing side. We’ve still been evaluating. We really think we only need one person other than Jolene and Jolene has other will have other supervisory responsibilities, but that one person we think we would onshore because we also don’t think it’s a full time job. So, yeah, you know, it’s going to be a full time job initially because we have 420 some providers to get under our wing out from under our billing company. But once we have a process in place, I don’t know that it’s a full time job with our current volume.
Rhonda Koehn (29:03) So, you know, it just depends what it looks like for us. And I think I’m very much, you know, willing to look, but look, I’m going to look at the whole picture, yeah.
Garrison Goodman (29:14) Okay. In that vein, would you be willing to help us understand kind of like your process as it exists today? And like understand like kind of operationally how you’re managing things? And then we kind of compare that to how it would be with medallion to kind of give you the full scope of like, hey, how would things operate today? I mean.
Rhonda Koehn (29:35) We don’t really have a process today, right? Because we’re not doing it. So our process today is we send them a completed tsca and a driver’s license copy and they take it from there. So we’re doing is monitoring that they’re adding the practitioners that we’re sending them to add and that they’re taking them through the process with all the payers that we know that particular geographic needs to be taken through. So, I mean, for example, we have a lot in the panhandle of Texas. So those providers get enrolled with not only medicaid of Texas but they get enrolled with Oklahoma and New Mexico. Those are just some of the idiosyncrasies by geographic locale that Jolene manages for the groups as we forward them and the managing of the billing service doing this. I was doing, it came out from under my vertical, went under credentialing for a while, that wasn’t really working very well. And so it came back under my vertical. And that’s when Jolene took it over. And that was probably… four months ago, Jolene, maybe less maybe three. And as a part of doing that, like, you know, we were told well here’s, Healthstream. You know, you have this payer enrollment tool, but we said, well, we don’t know if we’re going to use it and we’ll evaluate it. We’ve done evaluations with caqh and looked at what would be available to us there both on a free and a paid subscription point. We, you know, we understand, what Healthstream can and can’t do well with caqh. So, I mean, I think, you know, to be quite honest. My, my ask is this, can you enroll, how, what’s it going to cost per doctor initially in an ongoing basis? You know, what are you going to bring that, we can’t do ourselves easily or can’t do quickly? And, you know, what does that look like? And that’s really, I can’t give you much more detail about what we’re doing because we’re not doing that. Yeah.
Noah Laack-Veeder (31:41) 100 percent. And so, I mean, I famous last words, I feel like I have enough to really give you a narrative around that with a demonstration if that makes sense. I’d like.
Rhonda Koehn (31:52) One thing I just.
Noah Laack-Veeder (31:53) Ask, I know that maybe you are hoping to see the product today. I’d like to get just a dedicated 45 minutes and start to 60 minutes with you all to do a demonstration to really walk through that. If that works for you all as a next step. And I think within that demonstration, I can really just tie into what the resource allocation would need to be from your end. Like truly, what does medallion take on versus what your organization?
Rhonda Koehn (32:17) Yeah… would that?
Noah Laack-Veeder (32:19) Be, would you all be interested in that as a next step?
Rhonda Koehn (32:22) Yeah, that’s fine. I would hope that with that week would also have some idea of cost.
Noah Laack-Veeder (32:28) Yeah. We can, we can send over the input.
Rhonda Koehn (32:29) We’re on a short time frame. I have to have this done and working before July first. Oh.
Noah Laack-Veeder (32:34) So, July first is when?
Rhonda Koehn (32:36) So, if I have to still do the caqh piece, I need to know that soon. So, if we can put that demo up next week and we can have the cost data available to us at the same time or even the day before would be great. Ashley can, who set this up for us can help coordinate that. Yeah, that would be fine. I just can’t this cannot be a long drawn out process towards the decision because we either have to make a decision and get it implementing or we have to implement Healthstream pay enrollment side. And the caqh piece is done ourselves because our expectation is we have to have all of that done before July one when we take it over. So we’re not trying to crumble and do all of that after we also have responsibility for new practitioners to get enrolled. So, yeah, I.
Noah Laack-Veeder (33:24) totally hear that. Just, I mean, just asking you a pretty direct question like I know you mentioned that you are all currently paying for the cred stream pay enrollment? Like if we are the solution, that kind of matches what garrison said in terms of price, like is that going to be a factor in the decision? Are you willing if we are able, let’s say because medallions implementation timeframe we can get.
Rhonda Koehn (33:45) It’s about.
Noah Laack-Veeder (33:46) Eight to 12 weeks, right? That July first deadline works for us. We can even get that faster. If you can give us some of the data before we have a partnership like that’s. We can expedite that. If we’re able to do that. Does that, is that going to factor in the decision at all? I don’t.
Rhonda Koehn (34:06) think so. Not for pay enrollment. So I’ll tell you not for pay enrollment that’s Jolene and Nicole. And I’s decision to make. They’ve already signed the contract for Healthstream. I don’t know how long it goes for, but I made it very clear when pay enrollment came back under me that I didn’t see a ton of value to that product from what we’ve seen so far other than organizing us, right? And other than that, it already has all the provider data in it because the credentials team has put the provider data in it. So that’s not really a factor. Where we’re concerned. It may be a factor before the credentialing team would make a decision to make a move at least until such time as that credentialing stream contract is up. And I honestly don’t know when that is. I think that’s probably for a couple more years, okay?
Noah Laack-Veeder (34:52) And yeah. So I, from like a technical perspective, I definitely want to show you demonstration. I think given you have your credentialing data in healthstream and you’ve already done that hard part of the implementation. I think getting us the data that we need is going to be not as challenging for you than other groups. So that eight to 12 week turnaround time seems… like conservative. I think we could be going a little bit faster. And so, yeah. So I definitely want to move as fast as you want to move in that July first. Let’s do my quick math. You’re trying to make a decision. Then if we think about that 812 week implementation… by like may first, is that yeah?
Rhonda Koehn (35:31) At the latest?
Noah Laack-Veeder (35:32) The latest, okay. So besides the besides like the demonstration proposal kind of implementation stuff like what else do you think you need from an evaluation standpoint to make?
Rhonda Koehn (35:47) A decision. I mean, I think that’s really it, so to understand pricing what, you know, what will we still have to do? Because from a staffing perspective, I have to decide if that becomes something that Jolene can just take advantage of what the credentialing team has done and afford and that’s all we have to do or if we’re still doing more things so we can make staffing decisions around that. And then just the cost of that compared to, I mean, we’re already exploring our other avenues and staff including staffing. So we just need to kind of have all those come to a point before may first that we can make a decision. Yeah. And you said?
Noah Laack-Veeder (36:25) Like the staffing thing, are you also considering other technologies besides medallion?
Rhonda Koehn (36:31) Not other services per SE. I mean, I got one quote and it was ridiculously high. And so I kind of honestly left that. I think it’s probably ridiculously high because I don’t think they had a lot of automation. So I’m.
Noah Laack-Veeder (36:42) hoping that, oh, interesting. Okay.
Rhonda Koehn (36:43) A bit more reasonably priced, but we are looking at some automation and getting pricing on that because of the caqh piece. Again as I said, just because that’s the automation partner we used and are actively using in other revenue cycle projects. And so have asked him for a quote because we basically know what work that will take away for us. And so we can pretty easily price compare that. So, okay.
Noah Laack-Veeder (37:11) That doesn’t.
Rhonda Koehn (37:11) automate the whole process, but if it helps us.
Noah Laack-Veeder (37:14) But it’s a big chunk that’s for sure. Like if I talk about the biggest time commitments, it’s the caqh management and the attestation piece, pay your follow up application preparation, and then the status tracking like those are the things that take. Yeah, would you all agree anything else in that process that you think takes a ton of time? Not from our perspective. Yeah. Okay. So we’re aligned there. So, yeah, Kyle, Gary said, do we want to start scheduling next steps or what do we want to do? I just had.
Kyle Bettencourt (37:45) a couple of questions just around the scope just to make sure that we’re aligned. I know Eric sent over some notes I think yesterday, but so he mentioned you guys have 417?
Rhonda Koehn (37:55) Providers?
Kyle Bettencourt (37:55) Currently, and then you’re looking to add an additional 100 to 200?
Noah Laack-Veeder (37:59) In the next 12 months?
Kyle Bettencourt (38:01) Is that accurate?
Rhonda Koehn (38:05) Well, we have 417 providers today. We don’t have any of those other 100 in the contracting phase. So I can’t really speak to, I mean, yes, that would be how many we would like to be adding, but I don’t know that, that’s will.
Kyle Bettencourt (38:20) Happen. Yeah. Okay. And then out of those 417… I guess, are you looking to re, enroll them with all, I think you mentioned there’s 20 providers today that you guys are typically working?
Nicole Conditt (38:35) With payers?
Rhonda Koehn (38:37) No, they don’t need to be re, enrolled. There’s no change to their enrollment status. It’s just continuing to manage their enrollment staff status forward.
Nicole Conditt (38:48) Okay.
Rhonda Koehn (38:49) There’s no reason to re, enroll any of them. There might be, we might enroll some of them under an additional 10 without, that would only be a medicare medicaid enrollment because that tax id is out of network, so there would be no commercial payer enrollment there beyond sending them out of network roster.
Nicole Conditt (39:07) Got it.
Kyle Bettencourt (39:08) Okay. Well, that sounds good. I just wanted to, yeah, make sure I fully understood that piece of it so we can have some notice for you, but why don’t we pull up some calendars here and figure out what day would?
Nicole Conditt (39:20) Work for the group?
Kyle Bettencourt (39:25) On our side, I think Monday, Thursday or Friday are probably the best days, but we can make ourselves available if needed.
Nicole Conditt (39:34) Yeah. So, Monday?
Rhonda Koehn (39:35) Is out for me, but I could do,
Rhonda Koehn (39:46) And Jolene, could you guys do Thursday morning from nine to 10? Nicole? Do you have a commitment on? Is it Thursdays or Wednesdays?
Noah Laack-Veeder (39:55) Wednesdays? No, I can do Thursday, nine to 10. Is that, Eastern Time zone? Central?
Rhonda Koehn (40:00) Sorry?
Noah Laack-Veeder (40:01) That’s the only time I can’t do, unfortunately, but I could do how?
Nicole Conditt (40:07) About 11?
Rhonda Koehn (40:07) 30 on Thursday morning, 11 30 central?
Nicole Conditt (40:12) Does.
Rhonda Koehn (40:12) that work for you, Jolene, and Nicole?
Nicole Conditt (40:17) That works.
Noah Laack-Veeder (40:18) For me, garrison, and Kyle, does that work for you?
Kyle Bettencourt (40:20) Yeah, I think, I think that’s good on our side. Cool. Well, I’ll, I’ll send an hour out, like knowing medtra, we should probably be able to get through it in about 45 minutes or so but, yeah, we’ll plan to review a demo and, get some initial numbers for you and.
Nicole Conditt (40:37) Yeah, and we’ll send.
Noah Laack-Veeder (40:39) Over email, Ron on medtra, if you’re the person or we can send it to you, but also everybody just to help us with that initial scope for the proposal because how we price is related to like the number of services that we’re providing, right?
Noah Laack-Veeder (40:52) So, we can send you those. So then we’re at least able to give you, we can, we just talk through that more in in the meeting?
Nicole Conditt (41:02) Yeah, if you could send that.
Rhonda Koehn (41:03) Out today so I can try to get to it this weekend. So, the really full first of next week, I probably won’t have time.
Nicole Conditt (41:08) So, okay.
Kyle Bettencourt (41:10) Okay, great. Awesome. So, it’s.
Rhonda Koehn (41:11) nice to meet you all. I look forward to learning more next week.
Noah Laack-Veeder (41:14) Yeah, no, I’m super excited. It’s going to be a lot of fun, I think.
Rhonda Koehn (41:17) All right. Thank you.
Kyle Bettencourt (41:18) Thanks, everybody.
Rhonda Koehn (41:19) Bye.