Transcript
Jack Koonce (00:00) hey, Dreama. How are you?
Dreama Hembree (00:02) Good morning. Good. How are you, Jack?
Jack Koonce (00:05) Good. Nice to virtually meet you.
Dreama Hembree (00:08) Yes, you too.
Jack Koonce (00:10) I’ll put some time together with us once we’re you know, next week or so just to kind of touch base or whatever I can do to help Andy get to know you a little bit.
Dreama Hembree (00:18) Okay, perfect. Yeah, I wasn’t able to make the internal handoff call because I was ahead on their client call. So, yes, that would be great. Sure.
Jack Koonce (00:28) Thing. Hey, Brennan. Hey, Jack. How’s.
Brandon Bradshaw (00:30) it going?
Jack Koonce (00:31) Good. How are you? Good weekend?
Brandon Bradshaw (00:34) Yeah, overall, I would say, so we actually, it’s my daughter’s birthday tomorrow, but so we were trying to do everything this weekend, but then we all ended up getting sick, so we had to kind of cancel something or reschedule things, but it’s all right. We’ll be okay.
Jack Koonce (00:46) Okay. How old is she going to be?
Brandon Bradshaw (00:48) She’s going to be five?
Jack Koonce (00:49) That’s exciting. Yeah.
Brandon Bradshaw (00:51) She looks, yeah, she’s very excited.
Jack Koonce (00:53) Yeah. What’s the current fixation? Like what theme was the birthday stuff going to be? Oh?
Brandon Bradshaw (00:58) Her fixation right now is unicorns and mermaids, of course. Sure. Okay.
Jack Koonce (01:03) Understandable.
Brandon Bradshaw (01:04) Awesome. Yep. Yeah.
Jack Koonce (01:08) I have a six year old goddaughter and her fixation is the garbage truck. So a little bit different vibe.
Brandon Bradshaw (01:14) Oh, yeah. Yeah.
Jack Koonce (01:17) All right. Hey, Nick. Good morning, guys.
Nick Scallion (01:20) Jack got the master’s polo on nice. I.
Jack Koonce (01:23) Did I actually got to go to the practice round? Tuesday? My dad won lottery tickets. So fresh merch from the source.
Nick Scallion (01:32) Epic man. Yeah, I had a couple buddies and family there as well. That’s awesome. Good for you. Yeah, it was fun.
Brandon Bradshaw (01:40) Hey, Jen.
Jack Koonce (01:43) Hey, guys. Happy Monday.
Brandon Bradshaw (01:45) Monday. Happy Monday.
Nick Scallion (01:52) I haven’t been on a call with you in a while, Jen. I like this zen environment you’ve created there with the candle?
Jack Koonce (01:58) And you’re trying anything to make it a little bit more zen, right?
Nick Scallion (02:03) Taking notes.
Brandon Bradshaw (02:07) Okay. We’ve got some of their team in here so far, I can start letting them in everyone good with that. Yes. Okay. We’ve got Kevin Tammy, Kate, and then just a phone number here. So we’ll see who that is?
Brandon Bradshaw (02:30) And I’m Mary.
Jack Koonce (02:39) Good morning. Everybody. How we doing?
Brandon Bradshaw (02:41) Good… morning.
Nick Scallion (02:48) Kevin. It looks like you guys in the conference room, you might have to click the audio button because they have you muted by default. There you go for.
Kevin Riley (02:56) The tip. There you go.
Jack Koonce (03:02) Good morning. It looks like we might still be waiting for a few folks. I think we’re good on the medallion side… on the fireland side, anybody else joining you guys are aware of?
Kevin Riley (03:16) I don’t know, so we’ve got Mary, Tammy, biglin, Kate, erf, and obviously, Ryan and myself. I don’t know if I’m.
Dreama Hembree (03:30) on.
Kevin Riley (03:32) Tammy petrie… yep. Yep. Got it. Thank you. So, I think those are the folks we need, right?
Jack Koonce (03:43) Awesome. Well, great to hear. We can, you know, if anybody missed this, we can certainly follow up and supplement information they may have missed. I’m sorry, I think I missed you there for a second. Nope. Okay. All right. Well, we’re going to get started here in a second. Thank you guys for your time today. Especially on a Monday. I hope everyone had a wonderful weekend. We are going to walk through a number of things here. I know we’ve got some good time on the calendar but we’ll do our best to get everything covered. If you have questions, feel free to ask them, you know, throughout the presentation or following. We’re going to share out, you know, the necessary contact info for the medallion side too. So you’ll always know where to find us to answer any questions beyond today, but we are excited to kick off this strategic partnership. So Brandon, if you want to go to the next slide just to kind of a quick overview here of the plan today, we’ll cover some quick intros, a partnership overview.
Jack Koonce (04:44) We’ll talk a lot about the implementation process which is kind of the big important piece today, provider engagement, the payer enrollment process, some success factors that we found super helpful with some of our other partners in this space. And then next steps in Q a. So without further ado, if you want to skip to the introduction slide, we can run first in the medallion side over here. And then if your group wants to give some brief intros, but my name is Jack koontz, I’m an account manager here at medallion. I am based in Raleigh, North Carolina, born and raised in North Carolina. So if there’s any other north carolinians or east coasters would love to hear about your experience over here. But on my side, I’ll be kind of your executive contact throughout this partnership, right? So dedicated resource for commercial needs, all things contract related. You know, I’m going to be really in tune with your consumption and your data through the different kind of skews you’re contracted with us for. And my job is going to be to make sure that whatever metrics goals success that are important to your team. I’m going to do everything in my power to make sure we’re there, right? And then… I know I connected with Nick on kind of the deal over there. But I think Kevin, you and I are going to be more closely aligned than anybody else. So I’ll work with you to set up kind of a regular touch base and then other team members as need be. But that’s kind of the gist of me I’m going to kick it over to Dreama to give a quick introduction.
Dreama Hembree (06:17) Good morning, everyone. It’s great to meet you. My name is Dreama. Hembree. I am based in Phoenix. I will be your engagement manager. So I’ll be kind of hanging around through the implementation process. But after implementation, I’ll be your operational partner throughout the partnership, long term for daily operational needs, process improvements, all that good stuff. It’s great to meet everyone.
Brandon Bradshaw (06:48) And then I’ll go ahead and go next. Hi, everyone. I’m Brandon Bradshaw, I’m your implementation manager. So I will be leading the implementation phase of this. So really kind of your main point of contact at this point in time as well. And so I’ll guide you through setup, data, intake and system readiness. So if you have any questions, you can first and foremost reach out to me. And then also on the call today, we have Naomi if you can see her through all the people here. But she is also an implementation manager that will be supporting us through this process as well. So you got quite a team here as we start to work through implementation. Yeah, we.
Jack Koonce (07:24) Also have a TBD there for technical solutions, right? We kind of include that on an as needed basis. So if we need to pull someone on our side, we certainly will. And we’ll make sure the proper introductions are shared. And then I also have Genevieve on the call who’s my boss and she’s here to make sure that you guys have all the visibility you need up to the medallion food chain today and moving forward. Yeah.
Genevieve Seney (07:47) It’s good to meet you guys. Quick introduction. My name is Jen sini, as Jack mentioned, I’m a manager here on the account management side. So just joining to sort of, you know, hear what the partnership is looking for, long term and how we can support that from the sort of broader strategy. But excited to meet you all. And thanks for taking the time.
Jack Koonce (08:09) Great. Thanks. And if anybody on the, we want to do intros now for the medallion or the firelands side or if you guys want us to keep rolling, we can certainly do that.
Jack Koonce (08:23) Silence might be golden. We can, we can cover intros in kind of future cadence calls. I know as we’ll break out implementation teams, you know, the team that Jen will be working with, and then me and Kevin et cetera. So.
Sean Steffanni (08:34) This is Sean Stefani. I thought Kevin was going to jump in, so I didn’t say anything, but I’m the senior director of it for firelands. I just thought I’d jump in and say hello. I’m just… getting caught up on this whole thing and, you know, just interested in seeing, what we have in this presentation and getting myself situated so that I know, what our role is going to be to support the initiative.
Jack Koonce (08:58) Awesome. Thank you, Sean. Yep.
Jack Koonce (09:04) Anybody else on the firelands side?
Jack Koonce (09:11) Shy group today? I’m going to get that out of you guys, but I appreciate you joining today. We’ll like I said, we’ll cover the rest of the intros and subsequent calls. And as we kind of dive from this deck, we will send this out, but if you have questions, just raise your hand. So on our side, once the contract signed, we work, you know, to get internally in meet and talk about what the contract looks like, what your priorities might be. So this is, I know there’s probably more than this. This is what we kind of gleaned from our internal handoff at kind of a high level, right? We understand that firelands has dealt with historic reliance on spreadsheets and manual processes. You’ve probably been drilled into this in the sales process, but we’re here to provide a single source of truth, real time updates, dashboards, or visibility, and end goal of like significantly reducing turnaround times for all the work we’re going to be doing through part of this contract partnership. We also hear that your, payroll enrollment resources are being reduced. So I’m very happy to say that, you know, as you’re probably aware we’re going to take on the bulk of that payroll enrollment work. So the other priorities in house can be focused on. And then as we move towards year two and year three of the partnership really drilling into supporting with your credentialing and delegation roster creation. I know there’s more than this. This is kind of the crux of what we talked about in our internal handoff. Is there anything here on this slide, that feels out of place to you or something we may have missed?
Kevin Riley (10:37) Hey, Jack. I’m sorry, this is Kevin and Ryan.
Kevin Riley (10:40) Can you hear us? Yes, we can, we had some technical difficulties with connectivity. So… I’m not seeing, I’m, not seeing the slide decks. I don’t know if that’s something we did on my end, but so is everybody else seeing the slide deck? I’m.
Jack Koonce (11:04) getting nods from Sean and some other folks on your side. Yeah.
Dreama Hembree (11:09) I can see the slides. Kevin. This is Tammy biglin.
Kevin Riley (11:12) Yeah. Okay. Thank you. All right. So let me see if there’s something I need to do here in my view setup or what view let’s see view?
Jack Koonce (11:27) Yeah. And maybe we can get a copy over to you via email really quickly too, just to see.
Kevin Riley (11:34) Yeah. Let me see if I can get that to you. Okay? Thank.
Jack Koonce (11:37) You Brandon. Yeah, because.
Kevin Riley (11:38) I’m just, yeah, we’re just seeing you guys as the speaker, but getting a few gallery. Just give me one more minute to try something else. I’ll play speaker gallery.
Jack Koonce (11:54) Computers can have Monday moments too. So that’s.
Kevin Riley (11:57) how it goes? Yeah. All right. Okay. So putting that aside, yeah, if you could send that over to me, that’d be great. So, I don’t know if we did introductions while we were a little… lost in transition there. But so Kevin CFO and I got Ryan here… yes, president accounted for. So, so we, yeah, obviously, we’re taking on this solution. So, for those of you, this old news just bear with me but, you know, we, right, we have a transition going on with Tammy petrie leaving the organization. And so, and so folks, Mary, shoup transitioning to a, another role in our ambulatory or our physician employed practice group, which is great. So, okay… see the note there. So in any event, so we obviously, while doing all of this, like there’s big enough transition, we, and we also have resource transitions right on top of it. So, you know, I’m just asking of everybody. So we’re going to be, we’re going to be dealing in a little bit of strategic ambiguity might be a term, right? So, so we’ve got some things given that additional variable dynamic with the transition. Not only, this initiative but also the resources Ryan, is taking on an additional role to supplant what the work that Tammy petrie was doing and also intended to take on the facilitation of the fbg enrollment under medallion, but also some of the legacy stuff. So we got to have her work with Mary and Tammy and that team as well. And then Kate, irf and her team are going to manage the, again… both the legacy and in the medallion environment on our outpatient behavioral health provider component. So just wanted to level set everybody that’s sort of, the very rough framework that we’re and the dynamics we’re dealing with right now. Thank.
Jack Koonce (14:24) You Kevin, I appreciate that. When, when we were doing the introduction on our side, were you able to hear those or was that kind of lost in?
Kevin Riley (14:30) Translation? I did. Yes. I did hear your introductions and then we, yeah, so we’re all good there.
Jack Koonce (14:35) Awesome. Okay. Well, I think that’s great.
Jack Koonce (14:39) And so, you know, here here what you’re talking about there, a lot of transition on the firelands side, our goal is going to be just to make sure that implementation through day to day touch work through my meetings with you. You know, nothing’s going to be lost in translation. We’ll work together to make sure it’s super seamless and we’re really proud, of our portal and what it’s going to do to help supplement, you know, the transitions you guys are going through and then work moving forward.
Kevin Riley (15:04) So,
Jack Koonce (15:04) if we look at the next slide, Brandon, and then one more just kind of a quick overview for year one, right? So you’re contracted for, you know, this number of seats for medallion core, we’ll be looking at enrollment revalidation, caqh, management, payer, enrollments, facilities, enrollments, and facilities, demographic updates. I think it’s important to note that these numbers on the right side are outlined in the contract, but they’ll also be trackable within the platform. You’ll have, you know, real time consumption numbers. Part of my job will be putting those in front of you on a regular basis, making sure we’re tracking towards the consumption for each contract year. There’ll never be any surprises from kind of a tracking perspective. And I will note that while this is what’s outlined for year one, I do know in year two and three, we’ll ramp up into credentialing, ncqa, compliance monitoring and delegation roster generation. For the sake of this call, right? The implementation is to be focused primarily on what you’re seeing on this screen. But the medallion team is super aware of what’s coming in year two and year three, and those will be part of our conversations whether that’s requirements or deliverables we need from the firelands team or, you know, any additional calls in advance of year two and three and working with you guys to get delegated status. Any questions there?
Kevin Riley (16:22) Sorry, Jack didn’t mean to jump ahead there? No?
Jack Koonce (16:24) You’re all good. Cool. Okay. Next slide. And then, you know, really our focus is on you, right? This is a partnership and we’re going to make sure that we’re always aligned. So through, you know, some of my digging and conversations with Nick and the rest of the team, right? We understand it’s super important for your team to have direct visibility into the credentialing enrollment progress. Again, that’s real time tracking reporting. We’re going to be introducing some automation and more accurate workflows to significantly increase your turnaround times, avoid any errors, denials, et cetera. Getting all your providers into the medallion platform will allow for one source of truth again real time updates. And then again, my plan will be to align with you Kevin, whoever else regularly to make sure that whatever your top goals and focus are, we’re hitting or exceeding throughout each contract year… on this slide. I like to ask, you know, are there any metrics goals, specific targets up front that we should be aware of? So we can make sure we’re tracking right away. And if we don’t answer now, that’s fine. My plan will be to meet with you Kevin pretty quickly to figure out what those goals or metrics may be. But I wanted to know if anyone on the call has any immediate questions.
Kevin Riley (17:46) I don’t nothing. Nothing that comes to mind right at the moment, Jack.
Jack Koonce (17:51) Okay. Thank you. With that. I’m going to kick it over to Brandon who’s our implementation guru here. And again, if you guys have questions, let us know but take it away. Brandon.
Brandon Bradshaw (18:04) All right. Thank you, Jack. Yeah. So today we’re going to cover our implementation phases here, our data strategy, and the milestones, the key milestones for implementation. So following our internal team sync that the medallion team had we identified a few specific call outs we’ll dive into later to ensure we’re aligned on the technical requirements here right now, in regards to the implementation phases here, we’re currently in the kickoff phase. So our primary focus right now is prepping your data for import. It sounds like you may have already received this like our data import spreadsheet, but I’ll make sure you’ll receive that today as well. When I follow up via email, it’s a comprehensive spreadsheet covering providers, groups, practices enrollment data and all that. So we’ll make sure too that we spend some more time talking about that throughout this implementation process as well?
Kevin Riley (18:53) Hey, Brandon, real quick. One thing we did, I believe we did. I know we went over on some previous call but one, you know, so Mary or Tammy Ryan, I think you and I talked about this briefly just looking through those initially. It seems like obviously, there’s a ton.
Naomi Denson (19:15) of worksheets.
Kevin Riley (19:16) Right? Information, but it seems to me that there’s a number that are.
Jack Koonce (19:22) That are duplicate?
Kevin Riley (19:25) Which makes would make sense, in general, right? But the question, is there a way to like, hey, if I’m entering a, if I’m entering in a common piece of information on one worksheet that, and it’s also utilized in another worksheet that it’s just carried… over. Like, so… I don’t know if you guys are, have had that issue with other clients but it just seems like if I’m entering a provider name, you know, I know provider name and specialty or npi et cetera, is used in one worksheet. And I know it’s used in like five other worksheets. We just, instead of having to re enter it five times, can we just carry it over from a core worksheet? So, I don’t know if that makes any sense at all. But that was just an, that was an observation to me. Looking through it. It’s like it seems like we have to enter in a bunch of information repeatedly on several different worksheets. If there were a way to make that easier, that would be welcome.
Brandon Bradshaw (20:30) Yeah, no great question. I believe. I’m understanding here but Naomi, I wanted to see, if that’s something that you’ve heard before, yeah.
Naomi Denson (20:38) So, the import template, the primary tabs, the providers, the practice and the groups. So you’re going to create the group profiles, practice profiles and provider profiles with like their email npi name, all of that needs to be on that first sheet and then any subsequent tabs where the data is being loaded to that specific profile. We do need. It re entered into the new separate tab with at least the, either the practice name, the group name depending on, what the information is, so that it maps correctly to the correct profile. So, I think what would be helpful is for us to set up a detailed walkthrough of the template, to outline, you know, what’s needed, where and why it wouldn’t just copy over because we’re relying on you all for your data as a source of truth. So if we just copied everything over to, from one tab to the other, that doesn’t necessarily mean that it’s true or applicable to that provider or practice. Does that make sense?
Kevin Riley (21:44) Okay. Yep. Fair enough. Yeah, I’m sure. The technique again, it was just an observation. I, and so, yeah.
Naomi Denson (21:51) It’s all about after the providers practices and groups tabs. All of the other tabs are about mapping to the correct profiles. Okay. And.
Nick Scallion (21:59) Then just to pile on here while we’re talking about the import templates, I know, I think Tammy just sent an updated provider import template. So one of the tabs specific to the providers for the frmc tin. And so I think we talked about this on the implementation scoping conversation. We just want to make sure that the other tins that are going to be participating in enrollment and revalidations that we’re also getting the provider import template for those tins too. And I just dropped that medallion folks, the updated one in our group channel as well. So just highlighting Tammy, just a, we’ve received that. And then B, that we’ll just want to make sure that we’re getting that for the other tins that are participating in the enrollment function.
Brandon Bradshaw (22:39) Cool. Thank you, Nick. Yeah. And I mean, great question, Kevin, and to be honest, you know, transparent, this is like where it’s the most like labor intensive part of the process. But after that, you know, it’s pretty streamlined from there. Typically. Yeah, we want to make sure that we get that core provider group and practice info and then so that’d be like our phase one of this. And like Naomi mentioned as well, we usually want to schedule a separate call to go through the data import template to make sure we answer all your questions. You know, exactly what you would need to do. And also just, you know, we want to make sure to get it right right off the bat as well. But yeah, once the data is prepped, I’ll handle the important system configuration. And then during our weekly, we’ll be setting up some weekly implementation calls as well. And this allows us to address specific, you know, workflows or provider questions well before we reach the formal training portion here. So our training philosophy once we get to that part of the implementation process is hands on. So we conduct sessions directly within your environment using your loaded data. So it feels like a true go live scenario. And then also all sessions are recorded. So I’m always happy to send those over, make sure that you have those on hand or do multiple trainings as well. So we want to just make sure that you all feel ready prepared and feel like, you know, could be like the experts using the system once we hit that launch phase as well. So aside… from the data question, any other questions on the roadmap here or about implementation before we dive more into the details as well?
Brandon Bradshaw (24:24) All right. Take silence as we’re good to move forward. All right. And this is just another slide. So as Jack mentioned, we’re going to send this slide decked over. So there are a bunch of slides in here that are just more informational for you to be able to look through and be able to read through as well. This just talks a little bit more about our implementation process here just based off of that last slide kind of breaking it down more as well. All right, let’s talk since we were talking about data, let’s talk a little bit more about it. So I’d like to dive a little bit deeper into our data strategy here specifically regarding that data import template to ensure a smooth setup. There are three critical pieces of information we need for every provider. So that’s going to be the email address, caqh id, social security number. And the reason we prioritize these is that medallion integrates directly with caqh. This allows us to automatically pull in roughly 70 percent of providers profile data… while we pull the data directly in from their caqh profile. You as the medallion administrators in here will have permissions to edit and refine this information once the import is complete. And then we’ll be collaborating with you on a timeline to invite your providers into the system allowing them to manage and update their own details in here as well. There are a couple provider must haves or just call out here as well. Two specific items that only the providers can do to complete their profiles in here. So that’s going to be disclosure questions, standard attestation required for every provider. And then agreements specifically like the release of information documents as well. So the bottom line really here on this slide is, and with this information is providers must log into a tester profile, make sure it’s 100 percent accurate before we can officially trigger any payer enrollment workflows. I know we’ll talk a little bit more in another call regarding the data. But just from what I mentioned, there, any other questions on data requirements or rcaqh integration?
Brandon Bradshaw (26:51) Naomi, anything you want to add there or does that let all get on our end? Nope? Sounds, yeah, no, you’re good. Nothing else from me. Perfect. All right. Let’s move along here. Next we’ll briefly touch on again another slide here regarding… our implementation and data migration process here. Typical turnaround time when we have that data that’s where we’ll loop in our technical solutions manager here to assist us in making sure the data is imported and imported correctly as well. So we’ll make sure to introduce you to them once we get your data and they’re assigned to your account. And that way, you know, who’s working through that process and they can answer any questions, jump on calls with us as well if needed.
Brandon Bradshaw (27:44) All right. So provider engagement. So I’m going to share several resources with you after this call including a provider announcement, email template. That is you’re welcome to use it as is modify it, create your own communication. We just recommend notifying providers about the medallion partnership ahead of time so that they recognize upcoming communication from us and they’re not blindsided there. But during onboarding, providers will receive an invitation notification and I’ll show it here in a minute as well. But they’ll receive a provider packet, outline requirements. You’ll have the option to customize the invitation email as I mentioned as well. And we can include your company logo and messaging. So providers clearly recognize the connection to firelands health. And with medallion… that visibility tends to increase response rate, reduce confusion during the onboarding process here. We won’t send out this communication until you’ve given us the green light to do so. So just some more information on that. Like I said, I’ll make sure you have this so you can read through this as well. I know there’s quite a bit of text here on the screen, but just want to make sure that you have all the details here. And like I said, there’ll be some other resources in my follow up email as well.
Kevin Riley (29:09) All right. Yeah, Brandon, it’s… not clear. I certainly don’t have an understanding at this point about what type of communication we’re going to be seeking from or what kind of information we’re going to be seeking from physicians. So we’re talking about our current state, our existing state physicians and requesting additional information from them.
Brandon Bradshaw (29:37) Is that correct? Yeah, that’s correct? If I’m understanding you correctly? Are you just talking about the communication that you’re going to be sending out to them?
Kevin Riley (29:47) Yeah, I have no feeling. And so Tammy and Mary please weigh in here. I’d like to obviously hear from the folks who lead the administrative side of the physician engagement or employed physician engagement or Tammy petrie on your side. I don’t have a feel for what type of communication and information we’re going to be asking for them as part of this process. So, if others, I just want to make sure everybody’s level set and understands that so that we understand that we set up the communication to them about this change correctly?
Brandon Bradshaw (30:32) But,
Kevin Riley (30:33) I’m operating at like a preschooler’s deficit here in terms of what we’re asking, so, Mary, Tammy, any issues or questions from your perspective, this?
Tammy Dyer Biglin (30:44) Is Tammy biglin? So my assumption and again underline the word assumption is we’re going to do that heavy lift on our part. So, Mary, Hsu Madison collins?
Kevin Riley (30:56) We’re.
Tammy Dyer Biglin (30:57) going to do that heavy lift inputting all that existing information so that medallion can get that moving forward. Any communications that our new onboarded providers would be getting, that’s the education that we need to put out to our new providers that they will be getting communications with medallion to, and it’s okay to respond and to engage in conversation with medallion at that time. So, it’s my assumption that we’re not going to have each provider be communicating to medallion. We here at fpg are going to be inputting all their information. Yes or no… correct?
Brandon Bradshaw (31:46) So you’ll be inputting their information, a lot of that in the data import template. They’ll be logging into the system. So where they get notification, sorry to someone?
Tammy Dyer Biglin (31:54) Nope. I was just confirming, okay?
Brandon Bradshaw (31:57) Yeah. So then they’ll be logging into the system to complete like their profiles. So they’ll be from you while what we’re looking for is like an initial communication like, hey, you’re going to start to receive notifications from medallion that like, hey, you need to like, you know, log into your system, complete your profiles, but it, we want you first and foremost for you all to send out that initial communication, letting them know like, hey, you’re going to start receiving information or like notifications from medallion. And we’re partnered with them. We just want to make sure that you do, you know, complete the tasks and all that they’re going to be, you know, following up with, and this isn’t just like spam or anything like that. Okay? And so we’re going to go ahead. I,
Kevin Riley (32:37) think what, Tammy, thank you, Tammy for that. Is again, we have 100 providers in current state, right? Let’s just say, you know, we got they’re enrolled. Everything. Are we talking about them communicating to them that they have some task that they need to do in medallion those current fully enrolled legacy providers? Or are we only talking about… understanding that if they had some change in something that they might need to update in the future? But putting that aside, are we actually talking about in my example, those 100 current state already enrolled legacy providers that there’s some task that we are asking that we would be asking them to do as part of this integration process?
Brandon Bradshaw (33:30) Yeah. So the main thing would be just communicating to them that you’ve partnered with medallion. A lot of the tasks and notifications will be coming from medallion. And maybe I’m not 100 percent understanding this correctly. Naomi, do you have anything you would add to that?
Naomi Denson (33:45) Yeah. I don’t know that. I’m understanding 100 percent either. So we’re going to load all of your providers to medallion unless you active, like we could invite just net new providers and not legacy providers. But if we’re going to be doing revalidations or demographic updates for your legacy providers on their already existing enrollments, then we would absolutely invite them. But to start out, we’re just focusing on net new providers, the legacy providers just because they’re in medallion, unless they’re invited, they’re not going to be getting any tasks or automated email notifications or reminders or anything like that. It’s just a matter of communication on who needs what, and when to engage them.
Kevin Riley (34:30) Okay. That makes sense. I mean, I just again, I was trying to get, so they, yes, understandably if we want everybody to be operating in this ecosystem. And for those legacy providers that are already enrolled, that we’re going to get them imported to medallion. If they had a revalidation, if they had something that required you to interact with them, then we’d want them to know who you are and what you are and what you’re asking for. But what I was trying to get at is out of the gate… absent any requirement for, you know, revalidations or some other missing piece of information. They don’t not every single one of these legacy providers again, right out of the gate as part of this process is going to need to do quote unquote something, right? They just need to be, they just need to have awareness and when it comes up that you need to interact with them. So that answers the question. I appreciate it. Yep.
Brandon Bradshaw (35:31) Awesome. Thank you, Kevin… Jack. I saw you come off and on mute a couple of times. I don’t know if you, we got like we’re covered or all.
Kevin Riley (35:38) Good. I think I was understanding the question. So it’s going to help out if need be. Sounds like we’re good.
Naomi Denson (35:42) Okay, cool. I do.
Mary Shupe (35:44) Have a quick question too. This is Mary just I guess to, I guess our peace of mind or maybe Kevin’s peace of mind, some of that information like we already have like the authorization for, you know, release of information, stuff like that. Is that something that we, you know, like in the organization as an administrator can upload to their profile rather than the provider having to log in and complete new, or how does that work?
Naomi Denson (36:09) You’re talking about the agreements? Yeah. No. So an administrator with your organization can log in and do everything else for the provider, but the provider does have to be the one that logs in and signs their agreements and attestations. And it should only be one time to start off with. Unless anything happens like every year on recredentialing or new credentialing request. If the attestation is expired, which I believe is 120 days. They’d have to come back in and redo that, but it should be just a one time deal to start off with. And then meeting with the reappointment schedule or recredentialing schedule. Okay? But you can do everything else for them. They just have to be the one to sign.
Mary Shupe (37:03) All right.
Brandon Bradshaw (37:04) Any other questions at the moment? Okay. So why don’t we go ahead and we’ll walk through the parent enrollment process next here. So this slide outlines the overall process and timeline. You’ll notice the icons in the top right corner. These indicate which steps are medallion’s responsibility, and which steps fall on your team. So during the implementation, we’ll begin the data migration and account set up as we’ve talked about, that includes creating provider group and practice profiles. As well as completing those profiles. We’ll also import any like existing enrollments currently have in place for your providers or your group from there. When a new enrollment request is needed, the provider’s profile will need to be created and completed and the provider will log in and sign their agreements, Naomi was mentioning. And later on we’ll show you the workflow for how to submit an application request to your team. Once the request is submitted, our team will complete the application, submit it to the payer and continue following up until we receive confirmation that the enrollment has been processed and the provider is officially in this network and participating under your group and tax id. In terms of timing, your contract… includes a SLA. Once you submit an enrollment request, it moves through our intake process. When it reaches a status called intake complete. That means our team has reviewed the provider profile and confirmed, we have everything needed to submit the application successfully. And from that point, we have, you know, 10 business days to submit the application to the payer as far as total turnaround time. You’ll see here more at the top for creating a profile to confirming enrollment completion. The typical time frame is about two to four months that said timelines can vary depending on the payer and their specific processing times. So this is meant to be a bit more of like a high level overview of the process. And like I said, we’ll be sharing this slide deck. So you can read through this as well and reference it later. And we’ll circle back to it as well in this process during implementation… and then just to add and just move to another slide here, just to add a little bit more context here as well. So this slide highlights our payer enrollment structure and how medallion organizes data within the platform, the way medallion structures, enrollment data you’ll see reflected in the import template as well as based on three main levels and that’s the group practices and providers… within the system. Providers can be associated with multiple practice locations, and those practice locations all roll up under a group. And then you’ll have the ability to designate a primary practice location for each provider as well. So. Overall, there are three profiles that will be maintained and linked to each enrollment request and that’s the group profile, the practice profile and the provider profile. And when we submit an enrollment request, it typically looks something like this. We are requesting that this provider be enrolled in this state with this payer and under this group at these practice locations. And sometimes it’s just mainly like a single practice location. So we’ll have some questions here in a moment on that. But let’s… see here. One thing you’ll notice as well in the data import template, there is a tab called the practice provider group tab. And that tab is where you’ll document how providers are connected to specific practice locations and how everything rolls up under the group. It’s a key piece for defining how your organization is structured within the platform. So we have a couple of questions on the side here and some additional ones. And Naomi, if you have any other questions too, I’ll ask you as well. Do you know how you all are structured today and how many tax ids you’ll be utilizing as well?
Kevin Riley (41:38) I mean, we have two principal… tax ids. Well, we’re not even, you know, there’s two principal. At this point, we haven’t talked about tvh, but so, yeah, so we have two, right? The main hospital, and then the physician group. Okay. I think, I mean, Tammy petrie, let me know if I’m missing anything there, but I think that’s essentially it.
Naomi Denson (42:16) Did you mention bellevue? I?
Kevin Riley (42:18) Just, I was saying on the side to Ryan, we need to, we need to… figure out, bellevue is another hospital that we just acquired last year. So we’ll need to, yeah. So technically three.
Brandon Bradshaw (42:38) Okay. Make a note of that. Thank you. Well.
Tammy Dyer Biglin (42:47) Brandon, I have a quick call or a quick question, please. This is Tammy biglin on the fpg side. So when we’re talking about payer enrollment and sometimes there are delays and such, would it be appropriate then for our ensemble is, our revenue cycle team that we use as a third party? Would it be common then for ensemble to engage in conversation with medallion and those kind of communications to go back and forth on the payer mix and payer enrollment?
Brandon Bradshaw (43:26) I’m actually going to pivot that question. I appreciate it to Naomi if you wouldn’t mind picking up on that one?
Naomi Denson (43:32) Can you repeat the question? So.
Tammy Dyer Biglin (43:34) Right now, we have, we’re enrolled, let’s say, for example, united and there are conversations that our third party billing revenue cycle, we use ensemble and there are questions… due to delays or whatnot. So, would it be common and normal practice for medallion and then ensemble to engage in communications back and forth updates?
Naomi Denson (44:06) No, not typically, it would only be those that have access to the medallion platform for your organization that we would communicate with?
Tammy Dyer Biglin (44:16) So, what if I am?
Mary Shupe (44:20) Hey, Tammy. Yes, I think to answer your question, like the administrator on the firelands side would be able to see any of that information if there is a delay with a payer enrollment or something along those lines, if a, you know, say united is waiting on a document or something along those lines, the administrator on the firelands side would be able to see that and be able to communicate that with ensemble.
Brandon Bradshaw (44:43) Okay. That’s what I was exactly.
Naomi Denson (44:45) Saying. Thank you, Mary. Yep.
Brandon Bradshaw (44:50) Awesome. Thank you both. Naomi. Anything else you want to add to the slide or any other questions you had for the team?
Mary Shupe (44:58) No, we’ll.
Naomi Denson (44:59) dig deeper into the payer enrollment structure and processes as we move through implementation?
Brandon Bradshaw (45:05) Okay. Cool. Yes, we will. All right. So next I’m going to go ahead and we will talk through some success factors here. I think we’re doing well on time. There’s a couple more things we want to cover with you all. And then we’ll talk next steps here. Okay. Next, just want to highlight a couple key success factors here that will keep the implementation moving smoothly. One of our primary goals is to get provider profiles to 100 percent completion. When we run the caqh bulk import that typically brings profiles to about 70 percent complete. The remaining 30 percent usually includes items that are required for enrollment but not required within the caqh. So for example, in caqh, if a field doesn’t have like a required indicator, providers will often we’ve seen will like skip it. So however there… will, you know, there’s many of those fields are still necessary for payer enrollment. So the same applies to documentation as well. So even though it may not require certain documents for attestation, we often need them for enrollment purposes. So examples of commonly required documents would include things such as like copies of professional licenses, diplomas, residency, certifications, and board certifications. So if those documents are already in there in caqh, that is that’s great. They may transfer over. However even when they do some cleanup is often needed to properly map and associate those documents to the correct records within our system. So really to support this process, I’ll be sending over what is a provider packet. This is essentially a checklist that outlines all required fields and data elements and documentation needed to be fully complete to complete a provider profile. It also includes a list of required documents and is broken out by provider type as well. So for example, there like an MD profile will have different requirements than an MD profile and behavioral like health providers may have additional specialties, specific requirements to capture the areas of expertise. So our system is designed to adjust requirements based on provider type and specialty, to ensure everything needed for enrollment is captured. Let me just make sure. Okay, go back here. Sorry… I guess that’s really all I would have there any questions… on that at all?
Brandon Bradshaw (48:01) Moving over to our… next steps here.
Brandon Bradshaw (48:10) So regarding next steps would be, and as we said, we’re going to want to get your import template over to medallion. But first, as we’ve mentioned, we’d love to schedule a call where we can talk through that a bit more just the data requirements, how to best, you know, best practices and setting up your data and filling out that spreadsheet. And so myself and Naomi would especially like to jump on a call with you all to go through that. We’re going to send over a delegation agreement as well. So I’ll make sure we’ll make sure to follow up with that… as well after our kickoff here regarding the get ahead start on npdb setup. From my understanding, this is more of a important… piece of next year like initiatives with that you all have with medallion. So if you want to get a head start on that, you can and I’ll make sure you have the information you need for that, but not something that I understand is, you know, really like required and needs to be completed at this moment. There’s also a payr processing scope template that I’ll send over as well. But that initial data import template is what’s going to be our focus at the moment. And, and then yeah, really after that, we’ll just want to make sure what we like to do is just make sure that we’re being efficient with our time moving implementation along, just making this a priority on our end and your end and making sure we’re moving forward within a great timeline as to schedule weekly implementation calls.
Brandon Bradshaw (49:51) And so we’ll follow up. I’ll follow up. Sometimes, I know we’ve got a handful of people on the call here. So just who needs to be involved? And just make sure that I’ll send over some times of just like and I’ll have you as a team just let me know which one of those works best. And then we’ll make sure to just connect on a weekly basis. But other than that, I’ll make sure like I said to get you all the information that we talked about today and that I would follow up with as well as this kickoff deck as well.
Kevin Riley (50:26) All right. Thank you, Brandon. So.
Kevin Riley (50:33) Tammy P, as in petrie and Ryan and Kate, I would like you all to get together ASAP because I know Tammy P, you’re this year last week because I’m assuming we got to fill out the form, Kate even though you sort of had the outpatient BH, but we’re not, it’s all got to be on because that’s under the frmc tin, right?
Kevin Riley (50:58) So I’m assuming we got to do these… worksheet fill out these various worksheets collectively. But, right? Including outpatient BH. So like that.
14197227305 (51:15) I have that started just so, you know, Kevin, I have that going it started. I just kind of figured I’d keep going and get as much done as I can during the week and then hand it off to Ryan and Kate to kind of take it from there.
Kevin Riley (51:28) Sure. Yeah. So I just want to make sure you guys are, I know you have been pretty well connected. Tammy said, thank you for that. Just make sure you kind of meet and go, hey, this is where I’m at, this is where I think I’m going to aspire to get to before, you know, tapping out. And so, yeah, I just appreciate if you would all do that together earlier this week, whether… you’re meeting virtually or in person. So, and then the same thing relative to, you know, with Mary and Ryan and Madison kind of meeting together and aligning on the… basket of work that needs to be done and how, you know, what portions Ryan can again, I just want to sort of get that going. So I appreciate if you all would meet or if we need to meet collectively including Tammy biglin to align on that, that’s fine too. But so if you can work on getting that set up, okay?
Kevin Riley (52:40) All right. So, it sounds like we have a bunch of other stuff that you’re going to send to us, Brandon? No.
Brandon Bradshaw (52:47) Or, yes, I’m going to, there’s nothing else on our end at this point, so, but yes, there’s going to send over some more information, whatever, you know, I send over there’s. Going to be quite a bit of, to be honest, quite a bit of information in that email. So if you have any questions about any of it, please don’t hesitate to reach out. We’re here to support you. So if you have any questions, you know, fire away, let us know, let us know what you need to know. I mean, like I said, we’re excited to be working with you and we’re excited about this partnership. So we look forward to our next call and diving deeper into this implementation. So it was very nice to meet you all and thank you so much for your time today. Thanks.
Kevin Riley (53:29) Everyone. Thank you guys. Nice meeting, you all. Take care. All right. Have a good day. See you soon. Bye bye.