Transcript
Noah Laack-Veeder (00:02) hey, had to change rooms, huh?
Taylor Ryan (00:06) Yeah. We’re like getting ready to go, to drive to Austin. So my husband’s just upstairs. He was upstairs finishing packing.
Noah Laack-Veeder (00:15) Nice.
Taylor Ryan (00:18) All right. Cool. He is here. So, I’m going to introduce you and then stop talking.
Noah Laack-Veeder (00:27) All right.
Taylor Ryan (00:28) Ready.
Taylor Ryan (00:35) Good afternoon.
Dr. Avael (00:41) Good afternoon. Can everyone hear me?
Noah Laack-Veeder (00:42) Yes, happy Monday.
Dr. Avael (00:45) Perfect. Nice to see you all.
Taylor Ryan (00:47) Yeah, you too. All right. Well, I want to just introduce really quickly Noah. And then dr abayal will, if you wouldn’t mind maybe just introducing yourself to Noah and then we can kind of jump into things.
Noah Laack-Veeder (01:00) Yeah. So, hey, dr. Abayal. My name is Noah lockbeater. I’m a lead solution consultant here. So I’ll be leading you through a demonstration of the platform. I’m based in Madison, Wisconsin. I’ve been at medallion for about two years now. So, great to meet you. Nice.
Dr. Avael (01:14) Meeting you as well. I appreciate you taking time out of your day to meet with me.
Dr. Avael (01:18) Dr. Abayal. I’m one of the founders of the mso. We provide access to mental health care in 20 different states, a few 100 locations on school campuses. I think you might have seen from previous notes that we’re looking for a good traditional platform that could expedite enrollment for various providers in our groups that are in our network.
Noah Laack-Veeder (01:41) And.
Dr. Avael (01:42) I’m a visual learner, so it helps me to I’m a visual learner, so it helps to visually see it. So we’re not sitting in the abstract, no.
Noah Laack-Veeder (01:50) 100 percent. Yeah. So we’ll jump into it, walk through a demo. Now, we only have 30 minutes. Does the 30 minutes still work for you? Oh, yeah. Let’s roll. Okay, let’s roll. And then I might ask some questions and pepper them in as we go on. But really what I’m open to understand is through demonstration medallion, is this platform kind of seemingly what you’re looking for with your ideal credentialing partner? So that’s kind of what we’re going to try to figure out today. All right. Here we go. So organization of yours? Sounds complex, right? We’ve got provider hiring. We’ve got people getting credentialed, getting enrolled payers, all sorts of activities. Are you seeing tasks on my screen by the way?
Dr. Avael (02:35) Yes, I am. Okay. So.
Noah Laack-Veeder (02:37) First things, first, what medallion is a platform to store and house all of your provider data. Why we do that? Because at the end of the day, anything credentialing related needs to be a function of your provider data. And so with medallion, what we do is we make it really easy for providers where they just have to give you a couple pieces of data. And then we’ll take as much as we can from external sources, right? So, your providers today, I’m assuming they have ceqh profiles?
Dr. Avael (03:07) Yeah, every one of them.
Noah Laack-Veeder (03:08) Every one of them. Awesome. So what medallion, what it looks like is we can invite a provider, very basic information. But then when a provider joins, they’ll get a email from your organization. It’s white labeled. It’s not going to say medallion, they click, get started. And then what we’ll do is we’ll guide them through a very easy onboarding process. So if they give us their ceqh id, SSN, what that’ll do is it’ll bring all of their information from ceqh directly into medallion?
Dr. Avael (03:48) Great. So they don’t need their passwords, correct?
Noah Laack-Veeder (03:51) No, not for this part. No medallion. I’m sure you’ve kind of been shopping around to other vendors. We’re the only one that can ingest this without username and password. So that’s like kind of our secret sauce. So far, how does this compare to the current process of provider onboarding?
Dr. Avael (04:12) Yeah. So what we do right now provider comes in, they provide us their ceqh id, of course, their social through a provider profile, and then we have to text them and get their username and password, so we can access their ceqh platform and then start mapping them to the correct group providers. Excuse me, groups and payers.
Noah Laack-Veeder (04:32) Got it. This is.
Dr. Avael (04:34) A big shortcut for us. Love it.
Noah Laack-Veeder (04:36) Yeah. And it pretty much is going to save you a text at least, but let’s kind of walk through what this experience looks like then. So if you’re already having to kind of text individuals, how this is going to be a little bit different with medallion is before you’re like the first time a provider logs in the system, it’s going to be pre loaded with all of their information. So all the stuff that’s in ceqh, like I said is brought over and that also extends to documents as well. So if they have documents on ceqh, we can pull that in… one question I have for you is kind of as you’re collecting this information, right? There might be some gaps. Some items might be outdated. You are collecting their username and password. Is your organization also on behalf of your providers updating their ceqh profiles after the fact?
Dr. Avael (05:28) Yes. And we’re trying to move away from that. We want this to be provider run provider oriented?
Noah Laack-Veeder (05:35) Got it. So with medallion, what we’ll do is if there’s any updates to the information, let’s say like for whatever reason they change some contact information, you won’t have to remember that we’ll actually automatically push that to caqh. So there’s no downstream impacts related to credentialing. So as you are aware, if anything doesn’t match caqh, it’s an excuse for a payer to reject something. So what medallion will do is we’ll just auto populate and auto correct the caqh information. So today, seemingly you don’t necessarily have like an automated solution doing that. Usually what I hear what was that?
Dr. Avael (06:19) That’s manual for us?
Noah Laack-Veeder (06:20) It’s all manual. Okay. So with a manual process like that, what I typically hear is like you got to update caqh, maybe you got to check mpez and all that’s happening manually. How is that process going today? Are things falling through the cracks ever? Like, are we missing stuff like just how’s the it’s.
Dr. Avael (06:37) not about missing stuff it’s about. We are having to always nudge our providers. Did you update this? You need to provide this to us? We’re still missing this. We’re still missing that, and then we’re having to manually do it for them. So we’re absolutely need to move away.
Noah Laack-Veeder (06:53) Got it. Yeah. And usually the impact I see there because I know we talked about credentialing is it might delay the, you know, the enrollments. So how is that showing up for you all today?
Dr. Avael (07:04) Absolutely delays the enrollment. And since we work on the, since we’re always working ahead, we’re always working a year in advance for any school system we’re going into.
Dr. Avael (07:13) So that gives us a pretty good runway. We want to be able to get a school in and go live in 90 days without having to wait a whole 180 school calendar year. Yeah.
Noah Laack-Veeder (07:24) That makes sense. Is that kind of the average turnaround time today? Like 180 days or it depends on the school? Yeah, it’s.
Dr. Avael (07:28) usually taking us a full school year to get. So we roll out in units. So each unit, there will be 10 providers attached to a group. Okay, right? And then that group would go live into a school system across various different schools. But depending on how quickly or like thereof a provider responds, that could be the difference between rolling out with four providers in the unit versus a full slate of 10. Yep that.
Noah Laack-Veeder (07:56) Makes complete sense. So it sounds like if we can optimize this process, we’re reducing these delays and there’s a whole chain of events that happen here. But if we can speed this up, it’s going to speed up the rest of the chain as well. So when you said credentialing, that means a lot of things to a lot of different people. So like I have these conversations all day, as you can imagine, I’ve probably had like a 1,000 at this point, which who’s counting me, when you say credentialing, are you talking about enrolling with the payers? Does it mean getting appointed to the different hospitals within the universities? Like what does credentialing mean to your organization?
Dr. Avael (08:33) Payers?
Noah Laack-Veeder (08:33) Payers? Okay. Excellent. And so… after you get all the provider data today, are you all manually preparing the applications and submitting them out to the different payers?
Dr. Avael (08:49) That is correct. Got it. Okay. And then, you know, you bring on a group and then you have that single provider, then you have to start attaching various different providers to a single group. And that’s very time consuming.
Noah Laack-Veeder (09:00) Yeah. And so you’re kind of talking about groups like we have in the platform, a way for you to link providers to groups. Why I want to highlight this is because when it comes to enrolling with payers, this makes it really easy. So if I’m you right? And I’m working with medallion, the way that you enroll a new provider is you just tell us what you need. So like I need a provider linked. So we’ll do Naomi linked to community health center? What this will do is it’ll automatically say which states are already licensed for this individual. So let’s do Arizona. But also we’ll say look here’s, all the plans that are associated with community health center, which ones do you want to enroll with? And you can enroll with all of them with one click. So you’re not going to have to do.
Dr. Avael (09:47) Do you have all your mcos, your medicaid managed cares in there as well?
Noah Laack-Veeder (09:52) Yep. Every payer that you would work with, we have in our system. Wonderful… you can tell us the line of business as well. You talked about like the mcos, whatever the other part I want to talk through is if you’re kind of doing that manual process of linking to the different groups, you’re also probably having to do some linkages of locations today that is correct with medallion, you can just enroll providers with every location if you’d like to or you can kind of pick and choose. The big thing I want to highlight with this process is if you’re doing this manually, you kind of have to have like a rolodex or excel spreadsheet that says here are all the providers part of which group? And as you’ve seen, look at so much of this matrix, something get missed with medallion. Since everything is linked together, we don’t miss something. So the impact here is that when you have to get that cohort of 10 as part of that group contract, it’s just a couple of clicks and then you click next and submit and I’ll show you how we do this. But this is the extent of what provider enrollment looks like for your organization. What I’m gonna show you next is everything that medallion does afterwards and we automate that piece as well.
Dr. Avael (11:07) But,
Noah Laack-Veeder (11:07) yeah. So I know this seems like a improvement from the current process, but could you just help me understand like with a request process like this? Like how does this match up to what the ideal state was gonna look like for your credentialing software? How does it, what, how does this compare to kind of how your ideal solution at this point? Is that, are we, like, are we hitting the mark?
Dr. Avael (11:28) We are perfectly aligned right now?
Noah Laack-Veeder (11:30) Okay, perfect. So you submit it. And then what happens is let’s just use this blue cross blue shield, for example, manual processes. Someone has to log in the blue cross blue shield. They have to copy and paste all this provider data back and forth. And the likelihood of something getting missed is high just because people make mistakes with medallion, what we’ll do. And this is actually a real example. And this is slowed down. We have robocallers or crawlers that go on to any portal or any payer submission that you can imagine. And we automatically populate all the information that we have in medallion. So the impact here is that your organization doesn’t have to log in and do all this work. Medallion does this automatically. And the impact there is our resubmission rate. It goes from like, yeah, did you say beautiful?
Dr. Avael (12:21) Yeah, this.
Noah Laack-Veeder (12:23) Is, yeah. So this is happening across any payer that you can imagine. And the big piece here that I want to highlight is in this process, the pieces that take the most time preparing and submitting, the apps, qaing, the apps performing payer follow up status tracking with status tracking as well. Among the other things I’m talking about, we automatically scrape these portals. So you’re seeing payco’s, we’ll go directly to payco’s or medicare and we’ll get the status directly here. So the impact there is that you don’t have to have someone on your team constantly looking for status.
Dr. Avael (12:57) We will do it on.
Noah Laack-Veeder (12:59) Your behalf.
Noah Laack-Veeder (13:03) So, yeah, dr avial so far kind of looking at this compared to the more manual process, if it’s taking like 180 days today to get credentialed with medallion. Our average performance is around 50 55 through these automations.
Dr. Avael (13:21) I’m happy.
Noah Laack-Veeder (13:23) Okay. I like that. Well, the last thing I’ll say is visibility is also something that a lot of organizations are looking for. What is your visibility in terms of who’s enrolled with? Who? Like how good is that today?
Dr. Avael (13:37) No, it’s very accurate, but it’s again, it’s a manual process. It’s a manual process. So, I’ll give you an example. Hey, we’re launching Texas in these very specific regions. I need to make sure that we have, at least, you know, 20 providers ready for two units and the Austin… area, or they’re in the San Antonio area, because every state’s a little different as it manages its regions. And every, you know, some mcos have coverage in regions and some do not, right? Yep. So the fact that this is automated and I like this dashboard that I’m looking at here as well. So we’re it’s much better than what we’re using.
Noah Laack-Veeder (14:21) Yeah. And how this shows up. And I mean, I talk to organizations all the time. Like if it’s manual. If we miss an effective date, we miss an email, like the downstream impact could be provider access concerns. Like I know we talked about like, yeah, maybe it’s a year out, but this isn’t what this does is it creates that predictability and reliability where, you know, when someone’s effective. As soon as we get that effective date, we’ll notify you and the provider saying you’re enrolled so that there’s not a risk of that, you know, write off or denial because someone wasn’t a network. So from like a scheduling perspective, a lot of organizations use this because they’ll know and have confidence that this person could see patients for this different plan because we have an effective date.
Dr. Avael (15:05) Now, what about their re attestations? Re, attestations, because now, depending on the provider, it could be annually, it could be nine, 90 days, you know, the big beautiful bill brought all type of compliance issues that we have to track.
Noah Laack-Veeder (15:18) Yeah. So the re, attestations. I mean, do you have like a resource who’s doing that today? Or do you have providers doing that?
Dr. Avael (15:27) We’re doing it manually on this side because, you know, you can’t trust the providers to keep track of their re attestations, they lose track of all of them.
Noah Laack-Veeder (15:35) Yeah, 100 percent. So ideal solution. I mean, I’m just going to take a guess a vendor can automate it for you. So you don’t have to worry about ceqh re attestations anymore that’s what medallion does. So on a 90 day or 90 to the 120 day schedule, we’ll update the ceqh and those attestations so effectively. You don’t have to worry about it. And then the revalves, every payer will have like a, you know, three to five year window revalidations, we’ll automatically process those as well. So what the impact there? Is that look, you don’t really want to worry about this stuff. You just want to trust that all this is getting done. Working with medallion is we’ll use the automations just to get these things done. So you’re like, hey, we’re expanding, there’s a lot of different things that need to happen here. If you just request it through medallion, have medallion take it over. We do all of the credentialing work that you’d otherwise have to do manually in house.
Dr. Avael (16:27) And we say medallion, is that 100 percent the technology that’s working? Or am I getting an fte as well?
Noah Laack-Veeder (16:35) So the way that this works is, I mean, and I’m sure you’ve kind of talked to other software so far there’s like self serve only, which means that they have a software. But all it really does is make it so you have to have an employee that does the work. It’s just theoretically more efficient. The second type of company is you just outsource everything. The caveat there is usually the visibility is something that you don’t get because you don’t have that technology front end. Medallion’s a hybrid where we do have specialists who work and use and kind of like think of them as our experts, that kind of walk everything through the process using our automations. What your team needs to do is really just like tell us what you need. And then if there are anything that we can’t automate. So, for example, let’s say we’ve bugged a provider three to five times. They haven’t got back to us yet. Medallion tried their best. We need to escalate that to your team to work with that provider. Those are the only instances that you would have to actually jump into the platform and work things to help us out. Medallion usually automates around 80 to 90 percent of the workflow. And then again, so if let’s say how many providers do you have today? Roughly speaking… we have 72 72. And then do you have like a full time credentialing person?
Dr. Avael (17:59) Yeah, we have three people that are taking on various different functions. So we have one person who’s responsible for state medicaid enrollment. And I’ll get back to that in a moment. And then when we have a team, once the medicaid enrollment happens, they take on the mcos.
Noah Laack-Veeder (18:14) Oh, interesting. Okay. So how medallion, like just we can kind of two things you’re going to want that you’re going to want to ask about like what’s the price look like? And also what’s the Roi look like? From what you described, typically organizations can have around 500 providers managed by a single fte. So in terms of efficiency, if you’re going to have those three folks manage those 72 providers… it would look like a kind of point two five fte allocation of credentialing through all these automations. I.
Dr. Avael (18:48) Think Taylor said something to that effect as well. Yeah. Now, talk to me about the medicaid enrollment because medicaid enrollment can vary by state, right? You could do group enrollment, type one or you can do type two group enrollment, or you could do a facility based enrollment where the facility is enrolled in the state. How does, can medallion accommodate that? Or is that something we still have to do internally?
Noah Laack-Veeder (19:17) No, we can accommodate all three of those. Well, you just need to tell us as your model, like do you want to do it as a site enrollment? Do you want to do it as a provider enrollment? We’ll handle the rest?
Dr. Avael (19:29) We don’t want to do any of this. You know, we’re very technology heavy. So, this is one of the last manual elements associated with the network. Yeah. So the reason why I’m being so specific with mco is because give me an example, state of Florida. If you want to be a type two in the state of Florida, you have to become a community based behavior health facility. Now, I just want to be, I want to be certain that we’re talking about the same thing because I’m not certain that the state of Florida allows automated enrollment for… type two facility, as a community mental health facility… outpatient facility. Am I making sense? Are you familiar with the terminology? Yeah.
Noah Laack-Veeder (20:15) So, is the question, like can medallion handle these nuanced enrollments in different states? Yes. Yeah. The answer is yes.
Dr. Avael (20:23) All right. Perfect. In New Jersey, like we’re doing very well using atypical providers underneath the a statute allows a outpatient mental health practice, right? So it’s not your normal.
Noah Laack-Veeder (20:38) Group where.
Dr. Avael (20:39) You have a bunch of lpcs that are just attached to each other. In the state of New Jersey, you can be enrolled as a mental health outpatient facility that you can have associate level providers built under the facility? Yep. So your team is familiar with those nuances.
Noah Laack-Veeder (20:56) Yes, yep, to give you some confidence, right? So we have around 300 specialists on staff, and then we also have processed the last year on 200,000 enrollments. So like, this is all we do. So to your point, we handle all sorts of different enrollments. And I have no, no question that we could handle those. And we certainly do. If you want to send us like some, what some organizations like to do is they send us their list of payers, and then they are interested in how what medallion’s performance looks like for those payers. So if you send us those, we can do a kind of apples to apples comparison to kind of tell you what our performance is in terms of how long it takes. But on average, across all those enrollments, our turnaround times around 50 days. Now, there are some payers that are longer than others, right? We, we can definitely make it faster if you have kind of these bottlenecks up front and doing things all manually. But on average, it’s around 50 to 55 days all.
Dr. Avael (21:57) Right. And I know you guys are speaking about specialty because, you know, as our mso has grown, we take on, we’re doing a lot of spine business as well. Do you handle privileges as well with ambulatory surgery centers? Yeah?
Noah Laack-Veeder (22:11) Absolutely. So that earlier when I was asking around like the credentialing, the payer enrollment. So we do the privileging as well. Do you go? Like how does how’s this up to you? Are you guys doing the credentialing in house like to joint commission standards and then sending applications out to the facilities? Or like what does that process look like for you all today?
Dr. Avael (22:34) Whatever the surgery center requires, they go to their website, reach out to their facility person who’s responsible for privileges. They’ll send us over an application. We’ll complete it, manually, send that in and then track it in our platform. Okay? Yeah.
Noah Laack-Veeder (22:52) So we can do those. I, to be honest with you with only a couple minutes left. Like if that’s something of interest, we should have another conversation. So I can demo what that privileging product looks like. But yeah, we definitely do those, but just kind of based on what you’ve seen today, right? Sounds like today we have a manual process. What we’re trying to do is get this, get folks enrolled as soon as possible. There’s opportunities to make providers respond quicker. But more importantly, maybe make it easier for them by doing caqh integrations, updating caqh downstream. Like from the payer enrollment perspective, what you saw today, how are you feeling about how medallion compares to what that ideal solution was for you?
Dr. Avael (23:32) No, like I said before, we are aligned. Okay. So what are you want to get into price points now? Or is there something in the product that you haven’t shown me yet? Yeah?
Noah Laack-Veeder (23:42) Well, so, the privileging demo probably takes like another like 10, 15 minutes and I want to do it justice. I just don’t want to rush through it. So it’s kind of like. But, but if you’re like, hey, yeah, from what I saw today looks good, like we can absolutely handle the privileging piece. I just have to get to know a little bit more about like that unique structure like if facilities, if it’s kind of like up to the facility, great. But if there’s instances where sometimes the facility needs you to send a file over or sometimes it’s just a hospital application. Medallion can handle both of those. But from a price point, it’s a little bit different because obviously like a full on cred file plus an application is going to be more expensive than just an application. So that would just be the outstanding item from that point. But from the technology standpoint, it’s a very similar process. I showed you the pair enrollment. We’re just doing it now for your facilities versus payers?
Dr. Avael (24:32) Excellent. And, you know, the, there’s a lot of… in the moment. I just want to gather my thought here. We’re seeing a lot of reciprocity allowed across state lines with various different disciplines, whether it’s psychology, mental health counseling, and even medical… can medallion handle the licensing requirements in those states for individual providers enrollment. Yeah, we.
Noah Laack-Veeder (24:59) Can, I mean it’s I mean, it sounds like it maybe because it sounds like what you’re looking for is like an end to end solution with licensing payer enrollment and credentialing broadly speaking, meaning this person from start to finish, they got licensed, they’re with payers and they’re appointed to the facility. So if that’s kind of the use case that you’re looking for like in terms of if you want to get to price, we can send you some of the inputs that we need for that. But like kind of in terms of the, this project is kind of, could you help me understand a little bit about like, is this something that you’re trying to get instituted this quarter? Like what’s the timeline look like? And is this like, are you trying to open a clinic soon? Just help me understand a little bit more about like the timeline of this? Yeah.
Dr. Avael (25:44) We’re always expanding but let’s just talk with high and talk in terms of high priority items. So, what you demoed today with the mental health piece would be the high priority item, something that we can go with, live immediately, right? Okay. And then we can start talking about special case uses because, for the most part, you know, we need to get some of our physicians enrolled in DC, or the state of Washington or Texas. We get that done within 30 days, right? But what’s really eating up our clock, is the mental health piece that’s what’s really taking up a lot of time because we enroll groups. Then we bring in providers and we need to attach providers to those groups and.
Noah Laack-Veeder (26:28) Yeah, we do.
Dr. Avael (26:29) So much volume there. And the intricacies are so time consuming that’s the high level priority in terms of our physician based practices. In the meantime, we could do those manually as we’re building up mental health first because it just doesn’t take as long, right? It just doesn’t take as long for the physicians internally because there’s one physician versus all these. We’re trying to add a 1,000 providers right now. So it’s going to be a huge, oh wow.
Noah Laack-Veeder (26:57) Okay. Yeah. I mean, because we’re going from 75 to a 1,000 that’s.
Dr. Avael (27:00) I mean, it’s huge. Yeah. And the issue that has really prevented our growth in the past is getting providers attached to the group practices in an expeditious fashion. Yeah, we don’t want to roll out providers on the school campus and then the groups are not filling correctly under those mpis. Yeah.
Noah Laack-Veeder (27:18) And are they already licensed? Because if you’re talking like mental health like it usually, it’s the whole workflow is we got to hire them, get them licensed in the appropriate state and then get them enrolled. Is licensing not going to be part of that top priority for you then?
Dr. Avael (27:33) For licensing? No, when it comes to the mental, when it comes to licensing for mental health providers, we don’t worry about licensing. We worry about that with our spinal business.
Noah Laack-Veeder (27:43) Okay. That sounds good. So, I mean, I think there’s a lot more for us to kind of scope out here from this approximately. But the top priority is the mental health payer enrollment. We can definitely send you over some scoping inputs that we need to kind of put together a proposal. But like, how are you, how are you thinking about evaluating us versus the other? The other tools that you’re probably looking at?
Dr. Avael (28:09) Like your competitors? Yeah, I’m already familiar with competitors. They don’t have the technology piece that you have. We’ve already vetted you guys. We did a pre vet on all the available technology that exists out there that’s doing this. So, we know at least right now medallion’s very ahead of the game. We’re very familiar with how credentialing works and payer relations work. So we need something that can move quickly. That is that’s well integrated. I love how you’re how the technology crawls and completes that’s. You know, that makes me very happy. So yeah, we’re just coming down to the price point now yep.
Noah Laack-Veeder (28:50) Okay. And you know, when you’re go ahead, Taylor? No.
Taylor Ryan (28:55) And I was just going to say to that point, I think Noah alluded to some of the inputs that we need just to give you background on how we price. It’s very a la carte. So, you know, you’ve kind of gotten a high level overview of what the product can do. We try and price to exactly what you need. So let’s say that you need licensing for part of your business but not for the other part. You’re just paying for what you need. And so we try and get really specific on those inputs. So if price is the next piece of the puzzle that you need, we can send over those, the inputs that we would need to put the quote together and then meet to review. Does that sound like a good next step?
Dr. Avael (29:35) Perfect. Okay. Great. Go ahead, Taylor.
Taylor Ryan (29:41) I was just going to say, so, yeah, we’ll work on the email. We should be able to get that over to you later today or early tomorrow with just the inputs that we need and we can go back and forth over email. And then once we’ve got that, we can turn around a quote pretty quickly.
Dr. Avael (29:56) Perfect. Do you?
Taylor Ryan (29:58) On the other items, do you want to kind of wait until we’ve talked pricing before we go into any further demos?
Dr. Avael (30:05) Yeah, we can jump right into demos. I mean, I’m not really concerned about the price point unless you guys are just through the roof, but we have a pretty good understanding of where the pricing will start. Okay?
Taylor Ryan (30:17) So, then if it would be helpful, you know, maybe we find another, what do you think Noah, like? Do you want to find 30 minutes or 60 minutes to walk through the other workflows that we didn’t cover in depth? I.
Noah Laack-Veeder (30:30) Mean, I know you’re probably really busy, dr. Avial, so I don’t want to like take up too much of your time. If you ask me, I’d say let’s do at least 45 minutes so I can really give justice to everything. And I know this is.
Dr. Avael (30:42) Friday at noon?
Noah Laack-Veeder (30:44) Let’s take a look here.
Taylor Ryan (30:46) Eastern Time, correct?
Dr. Avael (30:47) Yes.
Taylor Ryan (30:52) It looks like you’ve got another call Noah, Friday at noon. We’ve got Friday at one?
Noah Laack-Veeder (30:57) Let’s do it. Okay? Yeah, I’ll send that. And then… dr avial, are you kind of the one who’s making the decision on this? Like is there anyone else?
Dr. Avael (31:09) That I will make the decision on this?
Noah Laack-Veeder (31:11) Sorry, what was that? I?
Dr. Avael (31:12) Will make the decision on this, okay?
Noah Laack-Veeder (31:13) So, given we show you what you want and kind of like the price point isn’t through the roof? What… medallion’s implementation looks like is we can really, we can move as fast as you want to. So if you’re shooting for like let’s say a June first go live date medallion’s implementation can take like anywhere from four to eight weeks. So, it’s kind of like what I like to do is sometimes just think about working backwards, like when you want to be live. And then if this is an ASAP priority, then, you know, given everything goes well on Friday, we can really move as fast as you need to.
Dr. Avael (31:50) I was hoping to move quicker than that. Can you just walk me through why it would take four to eight weeks for implementation? I,
Noah Laack-Veeder (31:57) mean, really, it’s if you can, it can be faster than that. Like, and so you said kind of you’re hoping quicker than that, like can you give me the let’s say ideal situation?
Noah Laack-Veeder (32:06) When are you live with medallion? And if you say tomorrow like fine, but like kind of more like you like may first maybe or?
Dr. Avael (32:12) Backwards from September. So September, I need all my providers enrolled. Okay. So that means that anything that we’re currently, all of our current projects that we’re working on, we’ll need to migrate over to medallion that will pick up on that will give me a clear understanding of where all of our groups and providers are currently enrolled yep, right? And what their status is. I need to get them enrolled by September. So that means I need to go live really by may. Okay?
Noah Laack-Veeder (32:41) Yeah. I mean, yeah, they’re.
Dr. Avael (32:43) usually just a human factor in terms of how quickly we move with. Medallion. Yeah.
Noah Laack-Veeder (32:50) Really? That’s it. I mean, we just need you to give us our data that we need to get started. And then if you can give us that, we can move incredibly fast, like who is going to be kind of like the go to person in your organization to kind of run this? Do you have like a project?
Dr. Avael (33:04) Yeah, it’s going to be William Alvarez, okay? And he’s going to be the point. And then we have a couple of other people. And then if we don’t need them any longer, you know, we’ll take care of that internally. But what we can do is if you just need a data drop, everything’s sitting real cleanly in a citrix based platform. Are you familiar with podio P o DI o.
Noah Laack-Veeder (33:24) Podio or modio?
Dr. Avael (33:26) Podio P o DI o, it’s an agile system that we’ve built out.
Noah Laack-Veeder (33:30) Yeah. I mean, it’s on, yeah, we have a data import template that like we can. I mean, I can, once I know what products you need, I can send you that import template, and then we don’t have to wait until an agreement to get that thing populated that’s the thing that takes the most time. Truly. We.
Dr. Avael (33:47) Can do a data drop or we can API as well, okay?
Noah Laack-Veeder (33:50) Okay. That makes sense. Yeah. So I mean, I think… I don’t know how direct you want to be in terms of through the roof but I think like the next steps typically are like, we kind of have a proposal. We can show you the rest of the product and things like that. But if you want to move fast, like if you could give us any direction in terms of what you’re trying to work towards, then I think that could help us move fast.
Dr. Avael (34:12) Yeah. So right now, we need to get, we have a… providers who need to be providers and groups that need to be immediately connected to the managed care plans in Florida, Iowa, Illinois, Rhode Island, West, Virginia, Ohio, and Texas.
Noah Laack-Veeder (34:30) And then, do you have a budget you’re working with?
Dr. Avael (34:33) Yeah, we have a budget but I don’t want that to lead the discussion, no.
Noah Laack-Veeder (34:37) Yeah, for sure. It’s more like is this because Dwight asked it as like if this is a product that’s already been budgeted right? Then that gives us something to work with. But yeah, we’ll send those inputs over and I think ultimately, it’s going to come down to are we kind of quote unquote through the roof. But I think through your, the different payers and kind of the current timelines that you’re working through today, I think that we’re going to, we’re going to be able to accomplish your need and get live. Especially if we can get that data import template filled out early. A.
Dr. Avael (35:07) Couple of questions maybe or one for group enrollments. I’m assuming we do that in your platform as well, yeah?
Noah Laack-Veeder (35:15) We just can’t sign the agreement on your behalf. Like are you all like expecting to negotiate rates with our payers? Yes. So like when you do a group, so the group, right? I’m assuming what you’re meaning is that you’ve got a new tax id that you want enrolled with a payer?
Dr. Avael (35:35) Exactly. So we’re an mso, we have multiple different tax ids within our network. Yep. So when you come into our network, we need to one, we’re going to vet, make sure that you’re that’s another question I have for you. We’re going to vet, make sure that you are networked with a stated, you’re a networked group in your network application and then whomever you’re not, we’re going to have to enroll your group with a provider and then attach the providers. Yeah.
Noah Laack-Veeder (35:57) For sure. So that provider link is something that we do. It’s the question I was asking is like some organizations I work with, they don’t have group contracts period. So they’re like establishing their group. They’re getting a group contract established. We call that the group enrollment, but there’s a piece of it where you need to work with the payer to negotiate the rates of reimbursement, yeah.
Dr. Avael (36:16) We can handle that. Yeah.
Noah Laack-Veeder (36:19) We’ll take care of everything else. Yeah, we do all of the other stuff like the paperwork. We’ll submit the request for bid on your behalf. So we’ll take those in this. I mean, we can, pretty much, yeah, starting the platform, we can start designating which providers are part of that group, and then we can start linking them ASAP. So we can take care of that as well, but.
Dr. Avael (36:39) The group enrollment, the group credentialing with the payer, you can handle? Yes. Okay. Yeah, we can handle, yeah, most of these nine out of 10 of these medicaid msos are going to whatever medicaid rates exist is what the plans? Yeah.
Noah Laack-Veeder (36:51) Exactly. Yeah. They’re not there’s not a whole lot of negotiation power there. So, yeah, that makes sense. So we can take that. Perfect.
Dr. Avael (37:03) All.
Noah Laack-Veeder (37:04) right. Was there another question or was that?
Dr. Avael (37:06) I think that was, oh, the vetting. So, if a group says, hey, we’re in network with these three health plans or these four health plans, once we bring them into the medallion piece, we’ll be able to see in real time whether they are or not. Is that correct?
Noah Laack-Veeder (37:20) Yeah. I mean, the only thing I’ll say is like, do you have that data today or is that a current gap?
Dr. Avael (37:27) Do we have, whether, what data specifically?
Noah Laack-Veeder (37:30) As in, like, so when you’re saying they’re in network with someone, do you have like provider? Like do you have the enrollment record that would say that dr avayal is in network with Aetna with effective X date?
Dr. Avael (37:45) No. The only thing we, the only thing we, what it looks like is this, no, you enrolled, no, LLC, a mental health practice into our network. We sign an agreement with your LLC in your application. You’ll tell us. Yeah, I’m in network with, you know, Aetna united and centene, right?
Noah Laack-Veeder (38:08) And.
Dr. Avael (38:09) what we have to do now is either a, you reach out to the provider to you, owner of the LLC and say, all right, prove that you have those contracts, send over a copy of those contracts. But with what’s happening now, a lot of these medicaid plans are contracting with these groups without sending the contracts. Okay. So you have to sign in to the centene portal to confirm that tax id is indeed enrolled. And then you have to check whether that provider is also attached to that group contract.
Noah Laack-Veeder (38:42) So,
Dr. Avael (38:43) what we’re hoping for is no LLC says, yes, I’m in network with centene and united that medallion will pull in the data and tell us whether that group is contracted or not. That’s a gap, but I just need, yeah, let.
Noah Laack-Veeder (38:56) Me go back. I think, let me talk to some folks on my ops team to see how we handle those unique situations. Let’s say it’s an instance where medallion doesn’t do that piece. Would it be a deal breaker if that would be one piece that’s still?
Dr. Avael (39:14) No. Okay. We just need to know what we need to manually continually to track on this, yeah.
Noah Laack-Veeder (39:21) I think that would be a piece where maybe your organization would have to work with the provider to get that information to us. But if you tell us the information that we need to process this, then we can definitely, and if it’s publicly available to us, we can work with it. But let me definitely walk through that scenario with our ops team. But for next steps, we’ve got the call on Friday, we’ll send the scoping inputs over to you and then talk through the proposal, talk through a high level Roi. If everything goes well on Friday, what happens next?
Dr. Avael (39:56) If everything… goes well on Friday, you’ll send me over the numbers you’ll send me over the contract. I’ll send the contract to legal, make sure that they’re happy with it. If there’s any redlining that needs to happen, we’ll push that back over to your team. I’m sure your team will send that over to legal on your demo screen. How many tax ids can we track? Is there a limit to the number of tax ids?
Noah Laack-Veeder (40:18) No, it’s unlimited.
Dr. Avael (40:18) Yeah. So we would sign in to that demo screen that you just showed me and say, sbhsn at the top. And then where would we find the various tax ids that we’re managing? Yeah.
Noah Laack-Veeder (40:29) I can answer that more, but it’d be in that group panel.
Dr. Avael (40:35) Beautiful. Excellent.
Noah Laack-Veeder (40:37) Thanks for going over. I know that we went 10 minutes, but anything else before we meet on Friday?
Dr. Avael (40:45) No, just so I’m clear, we can manage all of our groups, our individual providers attached to those groups and individual providers who are enrolled in those plans separately as an individual provider.
Noah Laack-Veeder (40:56) Yeah. We, those individual providers that, are they not part of a group?
Dr. Avael (41:02) There will be. Yeah. So the route we’re taking too is we’re now since a lot of our… groups and not to confuse the group, I doubt I am. So we are now getting a lot of referrals directly to the mso from the health plans, which would make it available for individual providers to take on medicaid patients in their individual capacity, not attached to a group.
Noah Laack-Veeder (41:29) Does that?
Dr. Avael (41:30) Make sense?
Noah Laack-Veeder (41:31) Yeah. Let’s maybe let’s walk through that scenario in more detail on Friday. Okay? Because I, we do that for some organizations, it’s just like a little bit different of a process. So, let’s walk through that. But primarily like our biggest bulk of business is enrolling providers as part of those group contracts, like we do a very small amount of individual practitioners.
Dr. Avael (41:56) Yeah, because we’re going to want to test next year a scenario where we have three individual providers and we’re just feeding them referrals as they come in from the health plans, okay?
Noah Laack-Veeder (42:06) And that’s.
Dr. Avael (42:07) a nuance that we didn’t expect. But now, you know, we’re probably getting about 10 referrals a week. Okay? And we, there’s no need for those referrals to go through the groups when they just can go to the, through the individual providers themselves as well.
Noah Laack-Veeder (42:21) Yeah. Okay. That makes sense. Okay. Well, hey, it was really, it was a pleasure meeting you today, doctor.
Dr. Avael (42:26) Yeah.
Noah Laack-Veeder (42:28) Excited to chat again on Friday?
Dr. Avael (42:30) All right. You got it. Folks. Thank you. Yep.
Noah Laack-Veeder (42:32) Thank you. Appreciate the time.