Transcript
Addison Stearns (00:00) bye, Addison. There we go. Hey, how you doing?
Cliff Marg (00:04) Good. How’s your day going? It’s.
Addison Stearns (00:06) going well. How about yourself?
Cliff Marg (00:08) Not too bad. We are off site this week. We’re in Austin, I’m leaving in a couple of hours, but we had a good couple days here and head back home.
Addison Stearns (00:18) Nice. Always a good spot.
Cliff Marg (00:21) Yeah, yeah. It’s central for everybody. We’ve tried the coast and like half the team is just like super tired and pissed off. And then central makes a lot of sense. Get some decent food. Yeah, cool. Yeah. Excited to meet you. Looking forward to learning a little bit more.
Cliff Marg (00:37) I think, you know, we’ve got 30 minutes here. Very high level would love to just spend some time, you know, learning a little bit about the company, how you guys are approaching credentialing, you know, what’s kind of pushing you to look at maybe switching, how you guys are handling it today. Yeah, happy to share a little bit more about medallion and just kind of align on potential fit and some next steps if it seems appropriate. Does that sound like a good plan?
Addison Stearns (01:01) Yeah. Just to give you a little background. So we’re a multi specialty revenue cycle management company. We strictly focus on professional billing. We have a large focus in geriatric post acute. So long term care providers probably have about 5,000 providers that we credential for today. Now, some of those providers may be in multiple states, multiple tax ids. There’s more than just, you know, a provider that’s at one facility type of thing… where we’re kind of struggling today is really just on our software. So we’re looking at for a software solution from… that standpoint, as we’re looking at the software. It’s like, okay, what do we want to look at potentially changing as our model in general? Do we want to look at, you know, maybe using a vendor for credentialing versus trying to go get the software. So we’re kind of going back and forth right now. So we’re really just kind of exploring the options of what makes the most sense. We have about 25 team members all onshore that handle our credentialing today. So just looking to see what we can do to change that up, what’s out there. You guys were referred to us by another company that’s part of our… I guess PE boards. Someone knows them over there. So.
Cliff Marg (02:08) Yeah, that’s great and super helpful… context there. Can you share a little bit more on, I guess the why behind it? Like I assume you guys have been doing it this way for a long time, obviously built out like a pretty big team, but like what’s happening that’s making you look at potential alternatives?
Addison Stearns (02:24) Yeah, it’s just so as we get more and more customers, we’re kind of going into obviously do a full service. So we don’t just do credentialing, right? So, a lot of times we were asked to add on credentialing as part of the service. So we don’t sometimes get to charge for it. So we’re looking at it as more of like it’s a gloss leader for us really. So it’s what ways can we either reduce our cost or can we automate more features within credentialing? So while we’re looking at the new software, our current software is archaic. It’s an Healthstream one app. It’s like healthstream’s like older version. Yeah, super slow. I mean, even if you just look at it, you go, oh, that’s old. So, you know, I think regardless, no matter what direction we go, we have to upgrade that. So again, I think as we’re looking at re, upgrading, is this something we need to change as well from a resource standpoint? Yeah.
Cliff Marg (03:06) So, so if I’m hearing you, it’s more around like a scalability concern like being able to offer this?
Addison Stearns (03:12) Exactly. Yeah. And then without being to say like, hey here’s our rates and then we lose the business which we don’t want to lose the business because the RCM part is what we really want. We’re like credentialing, we just do because it’s asked to be done. It’s important obviously for RCM but the RCM process is where we thrive and where we excel. Yep.
Cliff Marg (03:28) That’s what I was going to ask is just how do you, how do you view credentialing like necessary evil versus revenue stream? It seems like, yeah, just.
Addison Stearns (03:35) Something it needs. I mean, it’s important. I think it helps drive a lot of our follow up issues if there’s issues there, working with them to make sure things get corrected. And again, we have a lot of groups that have new providers that constantly start. So making sure they’re able to start on time and everything.
Addison Stearns (03:49) But, you know, it’s one of those it’s just part of our overall package. Not necessarily like a standalone service that we want to continue to offer. We don’t make money there just being Frank, yeah.
Cliff Marg (04:01) Yeah, totally makes sense. And I think, you know, very similar to obviously not only our RCM customers but also like the larger provider groups that we work with just in terms of, you know, yeah, eventually as you scale any sort of provider network you have to think about like scaling headcount proportionately or, you know, cause I think like the difference in medallion’s model obviously is not, is that we are not just like a software platform for your team to use.
Cliff Marg (04:31) Like really the problem that we’re trying to solve for is the scalability piece. So really thinking about like how we can leverage the technology that is kind of the medallion platform, but it’s much more focused on automation and AI, where probably your team is doing a lot of the heavy. Yeah, absolutely.
Addison Stearns (04:51) I mean, we have a few integrations but for the most part, it’s pretty manual. They’re logging on to payr websites, looking at applications, maybe pulling some data in from caqh, the software, but even then it’s slow. It’s archaic. They’re missing things. So, I guess that’s it a platform has to be solved for the next question becomes, do we go invest in a platform or is it, do we look here something like a medallion where you guys come in and help kind of take things over?
Cliff Marg (05:15) Yeah. Fair enough. And I guess that my next question is just like, what is the general sentiment from customers on credentialing today? I mean, is it super noisy? Are they, you know, is it errors popping up left and right? And it’s causing issues or is it just future thinking? I think.
Addison Stearns (05:33) It’s future. I mean, we have a few issues here and there, but I would say it’s future thinking… and the most and two, I think like again we’re all on shore. So it’s a big expense for us 25 team members all on shore and credentialing’s a higher salary point than some of the other areas within our organization. So that’s a big driver too. Yeah.
Cliff Marg (05:54) 25 person team is getting up there and I can imagine, I guess is.
Addison Stearns (06:00) Your, can you?
Cliff Marg (06:02) Talk a little bit about like who your customers are in terms of like provider? Are they generally larger groups? And I guess where do you see that kind of going, in the future? Yeah.
Addison Stearns (06:11) So we have, a good mix. So what I mean by that is like you probably have, I would say 20 percent of our business is probably less than 10 providers. You’ve got a big chunk of our business probably anywhere from, I don’t know, 35 to 65 percent is probably that 50 to 200 provider group range. Yeah. And then the remaining pieces of business is the 400 to 500 plus provider groups. Yeah. I would say if I’m being honest, we’re probably always going to thrive within that anywhere 200 to like 600 provider group range. It’s typically where we do the best, anything over that people want such low fees. There are these huge SLA, it gets much harder. Obviously the revenue is great, but there’s a lot more competition for those. I think that 200 to 600 is usually where we thrive at. And the big piece of that is it might be a 200 provider group, but they could be in, you know, 10 states.
Addison Stearns (07:05) Yeah. So you’re credentialing that provider, not just one time but 10 times. So that’s kind of where we get the gotchas on some of these groups. As they might start with us. They’re in one or two states and all of a sudden they’re like, hey, we’re going to start up three new tax ids we want to do telehealth, and all these get everyone set up and it’s like, well, hold on now, we’re credentialing like a 1,000 providers.
Cliff Marg (07:23) Right, right. And what you guys have now signed up for on the credentialing side as like a loss leader is maybe turning into a bit more than you expected.
Addison Stearns (07:32) Exactly. And then it’s like, okay, well, then they want all this stuff done right away. It’s like, well, holy smokes here. Like what happened? We didn’t even know now we’ve redone our contracts maybe before like started accommodating certain things, but it just exposed some things like, hey, if this does pop up, we don’t want to one go back to the customer and say, no, we can’t do it. You know, we’re always like a very yes kind of company, a forward solution company where we say, hey, if we can’t do something exactly how you want it here’s what we can do. And here’s we’re gonna make it work. So we definitely want to continue with that cool.
Cliff Marg (08:00) And Addison, I, obviously we skipped over some brief intros. I took a look at your LinkedIn, you’ve obviously, you know, been with compmed for a long time. Does credentialing roll up to you directly? Is that something like, are you overseeing?
Addison Stearns (08:12) Yeah, I oversee all. So give you some background. So, compmed’s, been in business for like 30 years about two and a half three years ago. Now we sold to ovation healthcare. So, ovation healthcare is our parent company. I run all of compmed. So then I report up to a team member that’s on the ovation side. But on compmed, everything all departments roll up to me. Got it.
Cliff Marg (08:32) Okay. That’s helpful. And yeah, I guess like the only other thing I’m kind of thinking about is from your perspective, you know, it sounds like you’re probably early on exploring what’s going to make sense for something like this? Like in your mind, I guess the question’s like what has to be true for you in order for a model like medallion to make sense? Is it let’s compare, you know, opex today versus opex tomorrow. Let’s compare, you know, just like overall turnaround times, it doesn’t sound like that’s as much of a focus. But if we talk about kind of the steps of an evaluation for.
Addison Stearns (09:05) You all? Yeah, I think it’s going to be a kind of expectation setting. So like obviously, let’s say we can file applications within two days at the same on medallion side. So that’s kind of our normal kind of slas we have with groups. Yeah. And then two, what does reporting look like that’s? Obviously a big one for groups. And then the third piece would be how would we interact with your team? So what I mean by that is like obviously, if we start getting denials and follow up, our team’s submitting tickets internally to our team and say, hey, you know, reach out to this payer, it’s showing a provide enrollment issue. We.
Cliff Marg (09:31) Can.
Addison Stearns (09:32) interact very quick. And we usually get problems solved. Like those would be my three big areas I would assume cost wise even if we broke even. And then you say, okay, well, we’ve got a better process and to your point, we can scale with it and, you know, it solves our problem from going to get a new software as well. Yeah, there’s a lot to play with there yep.
Cliff Marg (09:50) Yep. Okay. That makes a lot of sense. And in terms of your familiarity with medallion, it sounds like just heard of us for the first time.
Addison Stearns (09:57) I think we talked to you guys about a year ago, but it was something that we were always going to just keep it in house at that point. I think we looked at you guys just for a software solution and obviously, it just didn’t make sense at the time but obviously, we haven’t done anything since then. So, yeah.
Cliff Marg (10:12) Yeah, fair enough. Okay. So I think like ultimately just based on the three things that you just mentioned kind of understanding like how does medallion interact with our team? You know, how do we have visibility? What does this look like for customers? Like ultimately going through kind of like a process workflow will probably be the best next step. I work really closely with one of our solutions consultants who is kind of product and subject matter expert. So I think that’s kind of where I’m leading but I want to give you just at least a little bit of context on medallion kind of what makes us different. So medallion, like at our core, we are definitely a technology company, right? Like we are a provider data management solution, that for all of our customers, like we will manage all of the provider data and documents, and monitoring expirables, everything kind of in one central interface. So, we have raised about 150,000,000 dollars at this point from a lot of the top VCS in silicon valley, optum, as an investor, sequoia, Google, Salesforce, ventures. And really our number one focus is like, how can we automate as much of that manual work tied to credentialing as possible and enabling organizations to? Yeah, the story is scale with technology as opposed to ftes. What makes us particularly unique, I would say is that we, you know, because we manage the process end to end for our customers, right? As opposed to just a software solution. We will actually commit via slas to how fast and accurate this work is getting done, which then I think ends up being really nice for our RCM and ehr customers, where you can also pass those slas back to your customers. And I think the key component there is the slas have financial impact for us, right? Like if we are essentially missing our SLA, which we can talk about like the specifics for the provider enrollment process. Like you essentially are being credited back for those units of work and that kind of trickles down obviously to your customers. So I think that is particularly unique when you think about the model of like partnering with an organization to own this stuff is we are giving you guys the guarantees that we are going to do it, you know, ideally better, faster, cheaper? Essentially. Yeah.
Addison Stearns (12:36) How would it work? And this may be more on like the next phase but like how would it work? So we get a new group on board or a group has like let’s say 50 new providers are going to start in a couple of months. Yeah. How does that intake process work? Do you guys work directly with the group? Is it our team working with it, collecting everything, sending it over to you? Yeah, I’m sure it’s the next call but it’s like high level.
Cliff Marg (12:53) What would that look like? Yeah, we can show you pretty clearly. I think part of it depends on your preference. I think the cleanest way ultimately would be and I don’t know how you guys are doing it today. It’d be interesting to hear but like typically it’s someone from the customer is basically just like making a few requests. It’s like a couple of clicks in the platform. That is basically hey new provider started. We send them out a welcome packet. We are doing things like.
Addison Stearns (13:20) But it goes to the provider directly, yeah.
Cliff Marg (13:23) When we need it, right? So ideally, what happens is new provider starting admin on their side, clicks here’s. A new provider invites them to the platform that kicks off like a welcome packet and invites them to essentially link their caqh and give us like a couple of pieces of information. We’re going to pull as much data as we can from not only caqh, but a couple of other kind of external sources. And then we’re going to task out directly either to the provider or to their admin, whatever they prefer to just ask them for the couple that.
Addison Stearns (13:56) Was going to be my question. It’s like sometimes the provider’s like we’ll just work with our admin or whatever. And they’re going to like they already have everything or I’ve already done this with our own, you know, when I came on board with the company, I’d already given all this information and reached out to the admin. So that’s why I was asking that, yep.
Cliff Marg (14:08) Yep. Either way, it totally depends on the partner, but from a workflow perspective, it’s like pretty lightweight for that admin. And then also like our goal is to reduce provider abrasion ultimately, like we want to be able to do as much of the heavy lifting pulling in those documents as possible so that providers can come in, you know, attest to the information in the platform. And then they essentially never have to do anything again. Cool.
Addison Stearns (14:34) Yeah, that was a big question that’s something I knew would be an issue of like we couldn’t reach out to the admin directly just because sometimes these providers just don’t respond. And again, maybe not say like, hey, we’ve sent all this in before. Why are you bothering me? Bother this person? Yeah, I mean.
Cliff Marg (14:48) I think realistically too like we’ll also want an escalation path whether that’s.
Addison Stearns (14:53) someone, yeah, we have that we have that today. So, for some groups, they do have us reach out directly to the providers or vice versa. Like if we’re working with an admin and we know a provider’s going to start, you know, in 30 days and we’ve got nothing back like we have escalation steps that it goes to with that group. They’ll let them know. Hey, we’ve got nothing for this provider? Yeah.
Cliff Marg (15:09) Yeah, exactly. So I think being able to show you kind of what those workflows look like will be helpful. I’m curious Addison on just like from a timing perspective, I’m curious if there’s anything driving it from your end, whether that’s new partnerships that you guys are eyeing that are making kind of re, look at headcount and staffing, things like that or, yeah.
Addison Stearns (15:29) It’s really just more of, I mean, I think like any business we’re all looking at cost savings like that’s a huge area for us obviously 25 ftes again. And then too, it’s we’ve got to make a decision here very soon on. Do we go with our own platform or not our own? But find a platform or do we again choose something like a medallion and then go that direction? So it’s something we want to make within the next probably 60 to 90 days, that decision of where we’re going and try to get implemented pretty quick just so that we’re getting some of those savings from this year.
Addison Stearns (15:56) But, and too that we’re ready to go, we have some bigger groups that we’re looking at to potentially sign at the end of the year that we want to make sure if they come on board, we’ve got this piece all ready to go yep.
Cliff Marg (16:06) Are you, are you leaning one way or the other? I guess even just conceptually?
Addison Stearns (16:13) Gut sense is like a platform just because, but that’s like we’ve always done it that way type of thing. Yeah, but then also too, I’ve seen like if you really look at our process, I mean, the platform is like I said, it’s archaic, but even our process there’s so many things we haven’t automated. Yeah, I don’t know if a new platform solves that, it might give us some more bells and whistles, but I don’t know how much it automates. And that’s my concern is, are we just getting a new platform? It looks better. We’ve got some new reports, but we’re still missing a lot of those pieces to where, like if we do start getting some groups that like add even more tax ids, are we just getting more underwater? Now, we have this new investment in software that hasn’t really made us much better. So.
Cliff Marg (16:50) Yeah, yeah. I think, you know, our focus and like what we want to be able to suss out over the next like handful of calls is like, can we drive meaningful business impact? And typically, that’s either cost saving? So, understanding you guys are probably spending, you know, certainly seven figures on salary. You know, what does that look like with medallion? And then, you know, sometimes it doesn’t sound like that’s the case for you all. But sometimes credentialing can lead to, errors which are then turning.
Addison Stearns (17:18) into, we still have them. Don’t get me wrong? Yeah, yeah, everyone.
Cliff Marg (17:21) Does. But it doesn’t sound if you would have came to us and been like, hey, our team is not set up for success and, you know, yeah. Yeah. Sometimes that is more of the conversation in which case again kind of, medallion’s SLA, as contractual guarantees are a pretty big, right spot versus… obviously, there’s pros and cons of build versus buy. But, yeah, yeah.
Addison Stearns (17:43) I mean, I don’t like this isn’t our core competency of it’s something we’ve always added on. I think it’s becoming something more and more groups request, and they expect an RCM vendor to be able to have it, right? So, you know, I think we’ll always have it a part of it. But if we’re going to go in and say, hey, I want to really invest in compmed work, we make the biggest impacts. It’s not going to be here. So that’s kind of where we’re leaning like, well, do you bring in a vendor that is going to do that? And we go focus on the areas that we want to be successful in the most and know that we can drive the most change. So, when we go out in the market against other competitors, we’re competing on things that we think we’re the best at versus trying to stay above water on credentialing definitely.
Cliff Marg (18:20) Yeah, that makes a lot of sense. How easy would it be for you to like, essentially figure out how many, you know, enrollments or, you know, units of work did you guys do on behalf of your customers last year? I’m just curious from like a scoping perspective,
Addison Stearns (18:37) I don’t know, I mean, I could find out, so we have all of our stuff tied into Power BI. So let me see what I can pull from it. See if, like applications are submitted, how many payers? I can probably pull some data out and see what I can pull. Yeah, yeah.
Cliff Marg (18:49) Averages in terms of numbers of customers, times, number of, providers, times pay, you know, anything?
Addison Stearns (18:55) Like,
Cliff Marg (18:55) that.
Addison Stearns (18:55) providers and, payers and all that like facilities, all that we should have. But, I can pull some data points together.
Cliff Marg (19:01) Are you guys doing facility enrollments?
Addison Stearns (19:04) Only facility enrollments for like, if it’s like a medicaid plan that asks for like, them to be added. We’re not doing any facility credentialing?
Cliff Marg (19:12) Okay. That makes sense. And then, my, only, I think only other question from my end is just… how large is the committee of folks that are interested in this project? Like, who else? Well,
Addison Stearns (19:27) The recommendation came from the board. So, oh, okay. Yeah. So that’s where we were talking about just, we’re looking at a shift in general for compmed. So, compmed right now, our model’s probably flipped from, staffing standpoint, like onshore versus offshore compared to most other RCM vendors. Yeah. So we’re making that push anyway. Yeah. And obviously, someone saw that, hey, 25 onshore team members and credentialing, and we’re looking at making more investment with the platform. Yeah. Do we need to look at other things? So there’s a lot of eyes on it that’s helpful.
Cliff Marg (19:56) Yeah. Just just trying to get a sense for like where this stands in the organization. It sounds like it’s kind of a board level priority to look at, you know, some cost saving inefficiencies, where you can. Yeah, that makes a lot of sense. Okay. Listen, what other questions do you have for today’s? Time, I think again most.
Addison Stearns (20:14) I don’t think right now, I think this may be next steps. It would be good to see, just obviously apply like a demo. And then, I can probably put together some questions like maybe we’d want to answer. Obviously, we talked about the intake, but it’d be things like reporting. What does reporting look like? What does reporting look like for our clients? Yep. Because like I said, we give them access to Power BI now, which we pull all the data into. So if we move away from that, what does your guys’ reporting platform look like? And then, too, what does an interaction look like? If our follow up team’s having issues with getting a payer, or if, a client reaches out to one of our client service reps and says, hey, where’s this provider at in the process? Yep, you know, how would we solve some of those things that we have a solution for today? Or we know our process today. How do we, what would that look like in medallion? Basically, definitely, okay.
Cliff Marg (20:53) Excited, to talk a little bit more about that. Are there other people on your team that would be interested in some of those next steps, or not? Yeah, so.
Addison Stearns (21:02) I’ll bring in Ryan, who’s our SVP of ops, on the next call. Okay. His background’s more, he’s newer to the team, but, he’s got, a very large, provider enrollment background, however, he’s been more on the in house stuff. So like modio, and then, some larger groups on that. Yep, makes.
Cliff Marg (21:20) sense, that sounds like a plan. Do you want to schedule some time now? I’m out next week. It sounds like we should probably look at the week after anyways just for the sake of coordinating calendars, but do you want to do that now or do you want to schedule that?
Addison Stearns (21:34) Yeah, give me a second here.
Addison Stearns (21:43) Do you want to do like Wednesday the 20 ninth? I guess same time as now. So, one eastern take a look…
Cliff Marg (22:11) Okay. I think that should work. Let me, I’m going to send over an invite and if I need to move it, I will confirm, but we’ll schedule for 45 minutes. Yeah, would be the plan, and, we’ll I’ll loop in, folks from our team as well to run that demo.
Addison Stearns (22:29) Yeah. And do you guys have anything like this high level? Like, I mean, I’ll share it now, but like something you could share just like high level pricing or just get some type of like idea?
Cliff Marg (22:38) Yeah, it would be, it’s very bespoke based on volumes, it.
Addison Stearns (22:43) Would be based, if I get you some of that data first?
Cliff Marg (22:47) Exactly. Then then I’m happy, to provide like a, at least a jumping off point. Yeah.
Addison Stearns (22:52) Yeah, it doesn’t need to be like a final number or anything. I’m just getting that idea. Yeah.
Cliff Marg (22:56) Let, let’s, do you, if it’s helpful, like I’m, happy to send over just an outline of like here’s the metrics that would be helpful for us to. Yeah, yeah.
Addison Stearns (23:04) Metrics or any, like a marketing anything you guys have, just shoot it over so I can review a few things or be like, a reporting package, anything that gives you some reading material before next time we meet.
Cliff Marg (23:14) Okay. I can do that. And then what is, did you say Ryan, his name was? Yeah, do you want me to add him or do you want to add?
Addison Stearns (23:21) Him? I’ll just forward to him once you send it to me. Okay, perfect. All right.
Cliff Marg (23:23) Invite sent. I’ll shoot you a follow up email, later this evening and then, yeah, we’ll touch base in a couple of weeks. Cool. Awesome. All right. Thanks.
Addison Stearns (23:32) Addison. Thanks. Yeah, you too. Have a good one.