Transcript
Hassan Zahir (00:00) are they in the waiting room?
Cliff Marg (00:01) Yeah, I’m letting her in.
Cliff Marg (00:07) Hi, nilmarie. How are you?
Nilmarie Molina-Santiago (00:11) Hello? Good morning. Hi. How are you?
Cliff Marg (00:13) Good to see you again.
Nilmarie Molina-Santiago (00:15) Likewise.
Cliff Marg (00:17) I wanted to just kick things off. I wanted to have Hassan introduce himself. He’s kind of going to be the star of the show for today.
Hassan Zahir (00:24) You’re putting such lofty expectations on me, cliff. I hope I can live up to them. I’m nilmarie, a pleasure to meet you. My name is Hassan Zahir, I head up the solutions consultant team here at medallion and support cliff through these sorts of engagements. And, you know, really my goal here today is to show you the platform, answer questions about how medallion functions, how it operates, ask you some questions about how you’re operating and go from there.
Hassan Zahir (00:52) I saw you guys are based in Florida, correct? Are you based in Florida? Nilmarie? Yeah. Where about in Florida? Are you?
Nilmarie Molina-Santiago (00:59) Well, the company itself, it’s in Naples. I work remote from Miami. So, yeah.
Hassan Zahir (01:05) Okay. Well, I’m jealous of the fact that you get to live in Florida and enjoy the nice warm weather, but hopefully we have a great time going through this today.
Nilmarie Molina-Santiago (01:15) Absolutely. And then you say that it’s a warm weather and here I am wearing a jacket. So, yeah, I’m always cold. So, what can I tell you?
Cliff Marg (01:23) You’re spoiled, you don’t know how good you have it.
Nilmarie Molina-Santiago (01:27) Definitely.
Cliff Marg (01:29) That’s great. Cool. So we have 45 minutes today. I just want to start with just like a quick recap of our previous conversation of kind of understanding current state and kind of walking through like what we’re planning to show you before.
Cliff Marg (01:42) So, I guess, yeah, I mean just as a quick summary, it sounds like today, nilmarie, you guys are leveraging a third party vendor for payer enrollment. I froze for a second looking to make a hire. I don’t know why my camera is freaking out, okay, looking to make a hire and kind of take more of that ownership in house. Given the current vendor. I think you mentioned the challenges are basically like you kind of toss something over to them. It’s very much a black box. There’s no communication from them. You have no visibility into enrollment statuses. When recredentialing is coming up, you get a kind of a weekly report for them. And I think you mentioned like some of the challenges when something comes back from a payer and you get maybe a denial or something comes up wrong with the enrollment process and you have a difficult time like triaging what happened and kind of who’s going to take ownership of that. You mentioned, you guys are in the process of kind of building and opening your first new hospital towards the end of the year and looking to bring on probably like 20 to 30 providers today. And so it sounds like that will kind of introduce also kind of the joint commission credentialing aspect where you need to get your providers privileged at the hospital as well. Does that sound about right?
Nilmarie Molina-Santiago (03:06) Yeah, that’s a good summary.
Cliff Marg (03:08) And in terms of the new hire, did you all end up making? I know you mentioned you had an offer out to that credentialing specialist. Did that person end up signing or how’s that looking? So.
Nilmarie Molina-Santiago (03:19) I heard updates today. They were waiting now, so they took longer to extend the offer. So it went out yesterday. I heard that today this morning. So I’m hoping to hear to have updates by next week. I’ll say cool.
Cliff Marg (03:39) Yeah. I think like what we want your feedback on is ultimately… you know, do you feel like the best route is that one kind of new additional hire plus more of like a database kind of a repository versus, you know, potentially is medallion overkill for what you all need just given, you know, it sounds like potentially that one credentialing specialist could handle the volume. I think there are a lot of advantages to some of the automations in place with medallion. But as I mentioned last time, like we also have an operations team that is kind of taking point on like communications with the payers, and then we’re updating everything in the platform. So I think that’s the biggest thing that we just kind of want to get your take on after we run you through the demo here.
Nilmarie Molina-Santiago (04:30) So I don’t want to discard any of the possibilities, right? Because I don’t know how is it going to go with the hiring process, right? And through the onboarding process? Because I can say I do have the offer already out there, but I don’t know what’s going to happen throughout the onboarding process. So I would like to still keep both options open although I will say that I’m going to incline more into just having the software rather than anything else because I’m in the expectation of getting this new hire.
Cliff Marg (05:04) No, that makes a lot of sense. And I think part of it also will come down to the cost comparison of adding an fte plus medallion is obviously going to be more expensive than probably what you could just get a standalone database for, but it would be interesting to hear and we’ll talk about it after the demo but how it compares to current cost with the vendor that you’re using today.
Nilmarie Molina-Santiago (05:28) Okay, cool. I’ll hand it over to Hasan and we’ll get the party started awesome.
Hassan Zahir (05:33) Thanks cliff. And so normally, my intent today is that this is collaborative that I’m able to bring the platform up. The goal is to show you kind of like going through onboarding new provider starts, how we’re able to really accelerate getting their information into the system, how you could make requests for credentialing, how we automate those primary source verifications that occur. And then also how we can automate the enrollment process with the payers as well through automation and requesting in the platform. And so that’s my plan. Is there anything else that maybe I’m missing here? I know you since you’re opening a new facility will need to do this to joint commission standards for the credentialing, we’ll show you how we handle and automate the enrollment process and map from providers’ profiles to those applications. But was there anything else of like interest or anything else that you’re looking to solve for?
Nilmarie Molina-Santiago (06:30) Nothing I can think of right now. However, I’m pretty sure that once we start going through the platform, if I have any questions, then I’ll let you know.
Hassan Zahir (06:39) Okay. Fair. So let me go ahead and I will share.
Hassan Zahir (06:49) Maybe I’m going to share, okay, I am going to share my environment. Can you see my screen? Okay? Yeah.
Nilmarie Molina-Santiago (06:57) Okay.
Hassan Zahir (06:58) And so you can see here I’ve done like some small things to customize it. So you can see that, you know, medallion can allow you to make sure that your logo is there and all those sorts of things. Medallion is designed to make sure we surface to you all of the information that’s important to you like at a quick glance. And so the home screen that you launch or that you land on when you launch the platform, it’s just kind of focused on giving you a little bit of a quick glance or snapshot. So in this demo environment, like there’s 62 enrollment requests, nine are awaiting processing and, you know, eight are in the queue to be finalized. So the biggest thing about medallion is that we give you the snapshot on every portion of the platform. And then we have full analytics and reporting as well. And so really it’s about making information accessible… and available for all the individuals in the platform and then also aggregating it in analytics. And so analytics will probably be where you wrap up. But I just did want to highlight that all you have to do is log into the platform and you have instant visibility into what’s going on when it comes to getting new providers in the platform. That’s really easy with medallion too. You’ll notice the consistency of this action button in the upper right hand screen is where you’re going to initiate all of the workflows that you would be completing. So as someone working there at DLC, you’ll say, hey, new provider starts. I need to invite this new provider and that provider’s options are going to show up. So it’s like, okay, email, first name, last name, profession. And we’re able to invite that individual to join the organization. What’s going to happen is we’re going to send them an email and it’s going to walk them through that entire process. What does that process look like for you today? Is it like an email that goes out, new provider starts? Are you sending them like a packet of information that they need to complete? Or how does that work? So?
Nilmarie Molina-Santiago (09:12) It will be there’s a packet and it goes directly from HR. So it’s not going to be like any type of software because we do not have currently access to the platform that’s been used for credentialing. And our credentialing vendor is very… bad in communicating. So we barely get any feedback, right? So we do have this packet that we put together. We send it on an email, internal email right through DLC to the new hire. And then it’s just kind of part of the overall enrollment not enrollment, sorry, onboarding process, right? So where they have to provide back such information like malpractice and all of that, right? So, and then if any of that is missing, then we try still to gather all that information and solve those issues before we hand those documents over to the credentialing company.
Hassan Zahir (10:15) Yeah. And I don’t know what you’ll see with medallion as I navigate through this is, we’re going to make that so much easier and you’ll have visibility into every step of the process and where, you know, what’s missing from a provider. We can notify them, we can send text messages, we can have automated phone calling. We really streamline that process. So, I was referring to the email that they get. This is an automated email that goes out once you send them the, or once you make the profile request for them. And it’s just going to say, hey, you know, DLC is part of medallion. So simplify and expedite this process. Again, we brand it as your logo there. So they know, you know that this is coming from you. The medallion name is there in case they have challenges, then we support them with like all of the technical support and they’re able to get started and it takes them to this onboarding flow. And it just says, hey, you know, in this case, it’s just a demo provider, Naomi Ely, and it’s like, hey, Naomi, go ahead and get started. We’re going to tell the providers everything that we’re going to need from them. And so the goal is that we collect all this information from them up front one time. But I’m going to show you how we also automate a lot of this. And the way that we automate a lot of this is for providers who are like not new providers and have a caqh profile, we can pull down 70 percent of what’s needed for payer enrollment, and 100 percent of what’s needed for credentialing from our integration with caqh. So we are what’s known as a participating organization, Delmarie, and so we don’t have to have a provider give their username and password. I’ll show you on the next screen that is really simplified for us to get this information. But even for those new providers, if they don’t have a caqh profile set up yet, just right out of school, then we can still pull in data from a resume. So we can still pull in all of their education, all of their demographic information. If they’ve got their license and their license, we can pull that information in. And so the goal here is because like you’re saying, sometimes those providers don’t provide you with all the information it’s like how do we reduce the amount of information that’s required? And that’s the way that we do it. In this case, you can see they only have to put in their caqh id, their social security number and their last name. We’ll verify that information, confirm that is the provider. And then what we’re going to do is confirm and link it. And that will bring them to this page, which is their individual provider profile. In medallion. The key thing here being that the provider has their own portal and every time that something is needed, it doesn’t have to go back and forth over email. They’re not sending something. They have their own portal where we will show them all of the information that has been pulled in on them. And so we can pull in information from caqh, they can add information. They get this basic information page that shows kind of the basic information, all of their professional information. We can pull in their professional history. So everything that exists. If there’s supervision agreements that needed to be in place, we’ll pull in all of their license information. We’ll track the status of it. If any of that is missing, then the provider can go in and add an existing license. But also an administrator can go into a provider’s profile and add an existing license. And so, the key here being just how easy it is to update the information on a provider doing it from one single place and not having to have all of this back and forth over email or the likes with the provider. The provider always knows by going to this basic info tab, what’s missing for them, what they need to be able to put in. And then all of these sections, you only get a green check mark when that section has been completed. We make it easy for providers to add documents because we store all of the documents associated with that provider. And we also track if they expire when they expire some things by default, like board certifications, driver’s license, those things that we know expire will automatically add those expiration dates from the document. For the other ones the provider can put in the expiration date, administrative user can put in the expiration date. But we track all of this. And so you’ll then also have a page where an administrator will show you this is expiring for this provider. This is expiring for this provider. Again, from like that reporting and visibility perspective, we put it all in one place for you. Once the provider has completed these sections, then they will just sign and attest to this information being correct and allow us to use this information to do their credentialing, their joint commission level credentialing, and then also allow us to submit enrollment applications on their behalf, automate the submission of enrollment applications, you would make the request, but they were saying they’re giving you the ability to make the request to auto populate enrollment applications on their behalf. They also give us the ability to pull the data or push the data rather back to caqh. They sign and attest really easy to do it here. But also want to highlight that this is really mobile friendly as well. And so normally, what happens is providers are busy. They’re on the go. They don’t always have access to a laptop, but we make this really excuse me really easy to do. And so that same agreement section, you can go to it from a smartphone. You see the same information, you agree to the information and you add your signature. And then in this case, they’re just touching the screen and they’re able to add that information. So it doesn’t matter where they attest to it. They’ll get a notification when they complete this, that their profile has been completed and that they’re good to go. In this case, there was one outstanding task, but we just completed that task. And so now we can see that provider who we invited put in her information from caqh, attest it to the information being complete. And now Naomi’s profile is 100 percent complete. And so I want to pause here because we’ve talked a lot, but really the goal here is that you can invite the provider. They get a welcome email that’s automated. They get access to a portal. They see what they need to add. You can then go to any of these profiles for any of these providers who haven’t completed their profile. And you can see what is missing from their profile, what they need to add, what percentage they are at. And so you always know what’s missing. They always know what’s missing. And once the profile is complete, then it’s a really automated process to credential them or to get them enrolled with the payers. But I’ll pause there because I know I threw a lot at you. I’ve been talking a lot. I should probably pause, catch my breath and see what questions you have.
Nilmarie Molina-Santiago (17:47) So far, the only question I have aside from all the part of gathering the information from the provider is how to move forward into enrolling them with the different payers, right? But I’m sure that that’s going to come next.
Hassan Zahir (18:02) It is and,
Cliff Marg (18:04) nilmarie, my only question is this all stuff that HR is handling today? Because I know you mentioned HR is handling the primary source verification. For providers. Is all of this to this point in that department? It?
Nilmarie Molina-Santiago (18:19) Is in between HR and the person we have currently handling those, which is the admin for the coo. So she has been doing the parts that HR is not doing, but it’s kind of in house still.
Cliff Marg (18:35) Yeah. And do you think it’s interesting potentially like let’s say there’s a scenario where medallion makes a lot of sense and this credentialing specialist doesn’t accept and you’re kind of looking at more of a kind of end to end service. Would that be a value add for the HR team? Or would you say like that process is moving smoothly? And like, you know, maybe it’s interesting, maybe it’s not, no.
Nilmarie Molina-Santiago (19:02) The process is not moving smoothly just to answer that part. So, yes, this is very beneficial. Just like you mentioned right now, right? Sometimes, we have to be chasing providers and it’s very difficult to obtain that information through emails and it’s just, we keep following up on a specific topic, not all of them. So imagine the amount of emails that we have per provider per category, whether they are missing one at the station or something else, right? So it’s a bunch of emails that we can minimize with this solution.
Hassan Zahir (19:40) For sure. And that’s why we surface that screen. So the providers know Marie, so they know what’s missing. But also the reality is some providers are going to be not as responsive as others and we want you at a glance or at a snapshot to be able to see all of those. And so I did mention how we will surface to you. This provider is missing, this provider is missing. This, this provider is missing this. And what happens is we send a task out to that provider and we can configure that to use both text messages and emails or phone calls as well. And that is automated. We have an automated cadence. So it doesn’t require someone to manually draft an email and send it out to a person saying, hey, this is missing or that’s missing. And when we send that notification, if it’s just as simple as a document. If you recall, I talked about the platform being really mobile friendly. And so if I was to go into a provider’s profile, what you’ll see here under the document section is that not only do we track those documents, but I talked about the ability to upload a document, a provider could upload a document by photo. So they could take just a picture of the QR Code and a picture of the document and it uploads that document directly into their profile. So something that maybe took 10 or 15 minutes in the past takes 10 or 15 seconds with the medallion platform to be able to get that document done, it will check the box and allow them to complete their profile. So that is something that’s really beneficial as well. We see a lot of benefit from our existing… customers who are utilizing this to your question. Then we can initiate the payer enrollment. And so I’ll jump in and show you what that process looks like. Because again, it’s driven by automation and it’s driven by this action button here. What I’m about to show you just because I think you would really enjoy the benefit of it is something that we don’t expose to customers in the platform. But I’m going to show you because I want you to understand how we drive our automation processes for it, are you okay with me showing you something that most people don’t get to see absolutely? And so what I’m going to do is I’m going to jump into the back end of one of these platforms, process guides. This one probably isn’t going to be completely populated because I am in a demo environment. But what happens and how we know what to do for each payer, is we have something known as a process guide, if I go to this process guide, I can choose it across the different lines of business and what the requirements are per enrollment per health plan. And so in this case, what we track are all of the prerequisites and dependencies. So a dependency for certain health plans or sub plans could be that the provider has to have a medicaid id. And so providers must be enrolled with traditional medicaid first when there’s a managed medicaid plan, or providers must be enrolled with medicare first when there’s a med advantage plan. And so like we track those requirements, what’s the best way to submit this application. Even though this is with blue cross, blue shield of Ohio. The best way where we get the fastest results is not directly through blue cross and blue shield’s website, but it’s going through availability and they take advantage of caqh. And so us being a participating organization with caqh, it gives us the ability to ensure we pull the information from caqh, but we also have a caqh management opportunity where we push the information back up to caqh, if that was something that you’re interested in. But it tells us the steps it tells us when can we perform outreach? How quickly can we follow up? So when can the first follow up occur? When can the second, when can we escalate? And then we track again I’m in a demo environment, but in a real environment, we track all of the follow up methods. If there’s any additional notes, any additional processes. And so this is what drives what happens when you make a request to get a provider enrolled with a health plan, or multiple plans, health plans. And so that’s just a little bit of a peek behind the scenes. And so how that works in real world. Like everyday application in Delmarie, is a request gets made for a new payer enrollment, and you would choose who the provider is. I’ll just use the same provider. We just went through this process with. We will select a group that provider is associated with. In this case, we’ll come in here, choose community health center. We’re only going to be able to do it for the states that the provider is licensed in. I’m, just going to choose Florida, just even though she’s not licensed there, you’re in Florida. So I’m going to choose Florida. It won’t allow us to, you know, show a submission to a payer because, you know, she’s not enrolled. But let’s say, you know, Advent health is big down there, right? And so, needs to get, you know, enrolled with Advent health’s plan, but Aetna and also Aetna better health, but also… and better sunshine state, right? And I’m sure these are health plans that you see and you’re familiar with and so needs to get enrolled with, you know, ascension care. And so you choose all of the health plans that provider needs to get enrolled with. And then you can choose which lines of business for, you know, the, each health plan. This could be commercial, but this could be also aca exchange. This could be a managed plan since it’s Aetna better health of Florida. This could be exchange for ascension. We can actually choose medadvantage and exchange. And so one singular request is how you identify this provider needs to be enrolled with these plans. And then you will hit next, you’ll populate the practice locations and say, hey, this provider is going to be enrolled across all locations or we can choose what specific practice locations, this provider practice is at application, what we have to fill this out, application details. And then there’s specific like notes or individuals who you always speak to at a given health plan. You can add those. We’re going to automate this process and automate the mapping of the information to the application. But we’ll follow your process if you will. Once you create that, then an enrollment request will show up. In this case, it would be for a community health center. We would track the group mpi in this case. But then you can see all of the different statuses. So this is showing everything. If I filter it by requested, you’ll see. Okay, these are the enrollment requests that I just made for these health plans. This is the status. None of them have dependencies. Maybe one has something that medallia needs to complete once they are done in the request, and we’ve guaranteed that everything is correct, then you’ll see what happens when they’re processing. And so I call this like the domino’s pizza tracker because it’s just tracking when you know, how far along something is. So you can see this one is with the application team. This one is with the payer team. This application has been submitted at the payer, and we’re going to follow up on, you know, this day or we’re going to follow up on this day. So you always have visibility into where something is for a given provider with a given health plan, at all points in time, we’ll track any of the notes that are being shared. And so if the health plan is telling us this well, every time we follow up as you remember, I showed you like the schedule of our frequency, a follow up per payer. You’ll get all of the information until a enrollment request is completed. So throughout the entire process, even though we automate this, you own, making the request, we’ll track all of this, make this information available to you until these enrollment requests have been completed, we’ll show you how long it took who owned the request, everything that occurred, the fact that it’s completed. So we know what happened here in these, the staying inspired because it’s already done. But we’ll show you all this information. It will move from the request tab and it’s going to live then under existing enrollments at that point in time. And so you’ll be able to say, okay, the request has been completed. Now, this enrollment is live, I can see which provider this is for a provider enrollment. I can see which provider, this is for, what are the practice locations? What are the lines of business? What is the provider id that health plan provided? What is that status? So we know par status, we know the effective date. And then if we’re going to revalidate again demo environment. So we turn revalidations off. But when the revalidation would need to occur as well. And so you have full visibility into that entire process, all you own is the request process. And from there, medallion owns everything else and provides updates for you. And so to cliff’s point earlier, utilizing something like medallion end to end, you really just need an individual to own the request because once you’ve identified who this provider is, where they’re going to be practicing, which health plans they need to be enrolled with, then medallion will automate that process all the way through par status and give you visibility into it end to end.
Cliff Marg (29:37) And nilmarie, the only other thing I’ll add to that is if something comes back from a payer, and you get a notification that a provider is out of network, we’re also attaching all of the documentation and proof so that if a payer reaches out, you say great, I’ve got this document right here… that?
Nilmarie Molina-Santiago (29:58) Was one of the questions I wrote down. So exactly that not only denial but approval as well. Because in the instances of me, you know, receiving those denials, how can I fight those back? Whether I’m going to have access to any type of confirmation that comes directly from the payer right? To support that effective date?
Hassan Zahir (30:18) That is correct. Medallion will attach that information again. I’m in a demo environment. So it’s not showing up everywhere. But what happens is under the document section, the proof of enrollment and participating status if you will, the practice locations, all of that shows up right here. We also do support demographic updates as well. And then Marie, I know I talked about just new enrollments, but if like in this case, a new hospital is opening up and you need to add that practice location, you can do a single demographic update or you could do a bulk demographic update and add that new practice location for all of those providers at one time who are already enrolled with health plans. It just really streamlines and makes that process faster. But you could also, if a provider moved from the… direct Miami area up north towards hollywood beach and the fort lauderdale area. And you wanted to add an additional practice location, you would be able to do that as well.
Nilmarie Molina-Santiago (31:22) Excellent. And so what you’re showing me here is the medallion solution, end to end, right? So, would I have access to these documents as well in the event that we were to just obtain, get the software on its own, like the data, right? Rather than the entire end to end opportunity?
Cliff Marg (31:48) So, so medallion, we really don’t offer a model that is software only just the way that we approach things with, you know, it is a combination of primarily technology, right? Like that is, our goal is how can we automate as much of this process as humanly possible? When there are things that need human intervention that is typically coming from medallion’s team. So, so that is, I think the thing for you to consider nilmarie when you’re thinking about like, does medallion make sense, as a partner? The only thing I’ll add to that is like the benefit of medallion. And, and part of the reason why we only offer this end to end model is because we also offer like contractual guarantees, in our slas that guarantee both from an accuracy perspective as well as an end to end turnaround time perspective. So, I know when we talked last, it didn’t sound like turnaround times were a huge pain point, or something that’s like really causing issues today. But we do contractually guarantee to how quickly these applications are getting out the door as well as how quickly a new provider will be par with payr abc. So, that is, I think, the benefit really, of medallion? Okay?
Nilmarie Molina-Santiago (33:07) And so this is a part for enrollments, and then you showed me providers as well. Is there a way of tracking enrollment in the sense of just obtaining a new contract and ensuring that all documentation has been submitted to the standards, of the payers requirement as well?
Hassan Zahir (33:30) You, you can, and so we support that process. Generally, what we’re what we would do is you would utilize, I shouldn’t say what we would do, what you would do is utilize the same area of the platform, but you would be selecting which group you’re looking to get a new enrollment for, with a health plan. And so essentially, you would go in, you would choose the group information, come in and choose why am I not seeing Florida? And I’m not going to keep it. Okay. Choose Florida and then select the payer that you want to establish a new group contract with. In this case, we can just say Aetna better health, which blinds of business. You’re looking to establish that with. And then you would, you know, choose all of the providers, you know, who you want to be available under that new group enrollment as well or if the payer wants you to first establish the new group enrollment and then add the providers, whatever the case may be. We can support both of those workflows. We can support the lines of business that they offer. In this case, just the managed care plans. You would choose, the practice locations that are going to be a part of that group contract and submit it. We will submit that to the payer. What’s going to happen is then they’re going to kind of give us like that standard boilerplate contract. We’ll supply that to you. We do not negotiate like fee schedules, rates, terms and conditions that is up to you to negotiate. You could just accept like the standard boilerplate and then be in network with that health plan or you can negotiate those on your own. Once you do that, then the dependency for a group enrollment will be resolved. And so how I showed you dependencies… under enrollment request. So like this is like for example, a new group enrollment. And that’s why there’s no provider that’s listed or anything. This is requested, but we’ll track and show if there’s any dependencies. A medallion task could be to share the boilerplate template with you. And so we 100 percent do support that workflow and it’s done from the same location in the platform if for whatever reason, excuse me… if, for whatever reason, thank you. If for whatever reason, that panel is closed or something along those lines, like we’ll notify you. We’ll help you with that process and kind of say, hey, this is how other organizations have gotten around like a panel being closed and this sort of thing. So we do support the submission for you. You have to negotiate the terms and conditions. Of your own. But we’re here to be a partner for you if you’re looking to establish new contracts with payers?
Nilmarie Molina-Santiago (36:23) Excellent.
Hassan Zahir (36:25) the last piece that I didn’t talk about was the credentialing piece. It sounds like HR is doing the, or is HR doing the PSV stay? Or do you have a third party who you’re partnering with, that’s doing that HR has been?
Nilmarie Molina-Santiago (36:37) Doing it yeah?
Hassan Zahir (36:38) Okay. And so in a similar way to making the request for the enrollment, I won’t belabor this because I want to show you analytics and then be respectful of time but you would choose again to credential a new provider. This could be like a net new provider to the organization or an existing provider in the system who hasn’t been credentialed… yet, we’re going to assume that this is an existing provider just because we went through this process. And so I could choose someone who doesn’t have like an active request. I can choose like Ethan, but I could also choose if you’re starting like a cohort of two or three, then I could choose two or three individuals at once and I would make the request to get them credentialed. What’s going to happen is they’re going to live in that ready tab and we’re going to automate the running of the psvs. And so what happens is it’ll tell you kind of like, hey, these psvs or, you know, these are all coming back clean. They may not all be completed, but all of the ones that are coming back right now are clean. They’re not ready yet for a committee, but you can get a quick glimpse of like which ones are coming back clean. You can see this one is going to be one that needs attention. Something was flagged for mpi. Maybe mpi is wrong, maybe a provider name changed and it hasn’t been updated to reflect that mpdb. Maybe something was there. We’ll give you full access to the credentialing packet. So not only will we run those psvs but we’ll put together first a summary. And so everything that’s been run and everything that’s come back. We can include social security, death master. We can include ofac, we can do, you know, standard joint commission credentialing requirements for Sam, oig, the full application, a test, and verification, the disclosure questions, board, CSR, Dea for prescribers like I said, death master, but we’ll do the education and history. We’ll do a licensure for all of these ones. Again, this is just kind of a demo environment, but we will have the evidence document that actually lives there. So we’ll put together the full packet. We’ll do all of the psvs. And then you have the ability once that’s done to be able to move these to a committee based upon like the results of what happened in platform. And so you can move them to committee, you can move them to a clean file committee or a needs review? Committee, is that, how that works today is like if something comes back, do you have a committee or is there a medical director? What does that process look like?
Nilmarie Molina-Santiago (39:25) Yeah, we do have the medical director. Okay?
Hassan Zahir (39:28) And so the medical director in this case could be the person who we’re identifying as the committee. The medical director can come in again, they can view all of the psvs that were done. They can review that credentialing packet. And based upon that, then they have the ability to say, okay, I am going to vote for a given provider, multiple providers, and cast, their vote. And so I can go in and say, okay, as the medical director, I reviewed this person’s information and it’s approved by me. What that reduces memory. Is there’s no need for paper packets. And for, you know, a medical director to print something off. It just makes it easy. They can log into the medallion system from anywhere. You would give them a profile as an administrator, they would log in from anywhere and be able to make their assessment, their review, cast the vote, and then that’s going to go into close in close. It’s going to show the disposition from what was the decision of the, you know, of the medical director or any other additional committee members. Maybe there’s someone who’s a backup. If the medical director is out, you’ll see all of the PSV reports and then the outcomes like all of these look like they were approved. So all of those were good. And then we’re going to automatically schedule when recredentialing needs to occur as well. So again, full visibility into who the provider is when they were credentialed their activity, their recredentialing start date, their recredentialing deadline, and then again showing that, they are active providers. I know we’re coming up on time. So I went through that a little fast. But, but that is the way that works. Medallion, automates those psvs. We show you the results of those psvs, we’ll do the work history and the peer reviews as required for joint commission requirements and we put together that entire packet for the medical director to be able to review it?
Nilmarie Molina-Santiago (41:24) Awesome. I like this the.
Hassan Zahir (41:27) Last thing that I want to show you, I’m going to take a minute.
Cliff Marg (41:31) Nilmarie, do you have a hard stop in two minutes?
Nilmarie Molina-Santiago (41:34) I do not, I have it at 12.
Cliff Marg (41:36) Okay. All right. Perfect. I.
Hassan Zahir (41:38) promise I’m, still only going to take two minutes, the analytics, you have the dashboards, really cool views just to be able to show, you know, how many of something has been done. I think I’m in the licensing one, I can jump into the payr enrollment one. But how many new enrollments have been issued? What’s the status of all the requests that you have? How many of these have been completed? How long is it taking? All of that information is available to you? And then also if reports need to go to different areas of the organization or to people who don’t have access to the platform, you can make a payr enrollment request report. You can say, hey, I want to say for which payr across which state and which line of business. Maybe you don’t care about the state. Maybe this is all in Florida. You’ll say which line of business, who is the provider? What’s their mpi? What is the status of the enrollment request? When was the application submitted? How long has it been? And if they are done, what’s the effective date and revalidation date, just click one button after you want that information, and it populates instantly into a report. For those who have been completed, you see the revalidation date. For those who haven’t it’s not there yet. It shows you the status who the providers are, who the payers are really easy to make those to make those reports. Do you think that the dashboard and the reporting would be something that would add value to you? Nimari?
Nilmarie Molina-Santiago (43:03) Definitely visibility transparency at the end of the day, right? Because that’s something that I do not have right now.
Hassan Zahir (43:09) Exactly. And that would be the goal. So, even if medallion is doing this stuff end to end, the automations make it so that you really don’t have to do anything on your own. And that’s why medallion does it end to end. But if there’s ever a question on where anything is at any given point in time, you can go into that module, be it the enrollment module or the credentialing module or you can run any kind of custom report or you can go to a dashboard. And if you don’t see a dashboard view that you like, you could ask us to customize and make a different view on the dashboard for you as well. Thank you. Absolutely. I know I bumped right up to time but cliff I’ll hand it back to you. Yeah.
Cliff Marg (43:50) I guess just generally, I’m really curious to get your feedback. If you think this seems like it could be a fit. I think if I’m in your shoes, I think… there’s two types of customers where medallion is like a home run no brainer fit. And that is one for an organization like DLC. If you just had that kind of like administrative person who’s currently, the liaison with the current vendor like that is a perfect person in terms of like how much credentialing expertise you need to kind of operate medallion like that would be a perfect fit. Sometimes organizations are just thinking about like how big does this team have to get compared to how much growth we’re expecting. It doesn’t sound like you guys are running up against that. I do still think that medallion could be valuable. It may come down to cost and just a matter of like whether you extend this offer and this person accepts the role or not, but curious to hear kind of how you’re thinking about it.
Nilmarie Molina-Santiago (44:50) Anyways, yeah, I like the system a lot. It brings a lot of visibility, which is something that we do not have the tracking of it, right? Being able to track other aspects of it that currently we are just having emails and it’s very difficult to handle. So it’s a very beneficial solution from my point of view, right? Of course, we need to compare to the other vendors that I mentioned to you that it’s also on the line and the pricing… right will be another contributor. Let’s.
Cliff Marg (45:27) talk about that. So, are you saying, are you comparing medallion to another like end to end vendor or to like the software only solutions? So the.
Nilmarie Molina-Santiago (45:39) other vendor has both as well. So, and then it all depends on the onboarding of the new hire whether if it happens or not, right? So we’re looking at both solutions and still keeping those open just because what if, right. Yeah.
Cliff Marg (45:58) Yeah, totally hear you. So, and are you familiar with like what the current vendor that you’re leveraging costs?
Cliff Marg (46:07) I’m happy to share medallion pricing, but just wondering if you have kind of like the apples to apples comparison in your head?
Nilmarie Molina-Santiago (46:13) Not yet. I do not have, that one will be with the CFO? No?
Cliff Marg (46:18) I mean, the one that you’re leveraging today the?
Nilmarie Molina-Santiago (46:22) Cost of that one, yeah, that will be the CFO will have those numbers, okay?
Cliff Marg (46:27) Got it. So I ran just based on like the information you shared last time, we can probably hone in on this a little bit deeper if it seems like it’s worth continuing the conversation with medallion. But I think I’d… feel pretty comfortable… estimating the cost to be anywhere from like 70 to maybe 75, 78,000 dollars annually with medallion.
Nilmarie Molina-Santiago (46:53) Okay. Let me write that down. Yeah. Okay. So I will have to those pieces of it, those run through the CFO, right? He will be reviewing what we currently have versus the offers, the potential offers that we have out there to then come up with that final decision.
Cliff Marg (47:17) Okay. And do you think final decision? It sounds like it will primarily be based on like what happens with this hire and then ultimately cost from there. Yeah.
Nilmarie Molina-Santiago (47:28) Because it depends, right? If we don’t do the hire, then it comes to an end to end solution. And now, how much this solution will be assisting us in the event to reduce the actual manpower and the multiple departments contributing. So at the end of the day, it doesn’t matter if we have to pay more in the event that we are reducing the workload from other departments as well.
Cliff Marg (47:54) Exactly. Yeah, totally fair. So I understand how you’re thinking about it. I will say like if it does not end up working out with the credentialing specialist that you make an offer to. Like, I feel very strongly that medallion will be the best fit from an end to end partner perspective specifically because of the slas that we offer, we are the only partner in the space that is offering like contractual guarantees with financial implications if work is basically not being done accurately and timely. So I just wanted to put that out there. Tell me what you think, but it sounds like I should probably touch base with you like the week of the 20 seventh to see what happened with that hire. And if it makes sense to continue or not, I’ll.
Nilmarie Molina-Santiago (48:38) stay like the first week of may just to make sure if you could. And then I’m very interested in seeing if you could share with us, right? Some like a pricing estimate, right? It doesn’t need to be definite. So I could sit down with the CFO as well because I want to keep these options open. I’m very interested to be honest with you. And the other part of it is like, the contract… termination clause and all of that, right? So that information, if you could share that with us because it’s very important when we are making the final decision.
Cliff Marg (49:21) Absolutely. Yeah, I can do all that. So, in terms of the pricing that you want, is it enough if I send over like the pricing estimate or are you asking for like an itemized kind of order form? Like I can send the numbers that I shared, but you.
Nilmarie Molina-Santiago (49:35) could send the numbers that you shared. The only contributing factor will be if those numbers would change depending on additional providers, right? Or enrollments or that type of capacity. Yeah.
Cliff Marg (49:50) So, and I can explain this in an email too, but basically all of our partnership agreements are like a 24 month commitment minimum. And the reason we do that is we understand that we’re asking organizations to forecast their growth, which is not easy, right? Like our goal is like we get as close as possible and typically play it on the conservative end. But we offer what’s called skew flexibility. So if in that first year, you go way over or way under consumption, you can push and pull units of work to and from that second year.
Cliff Marg (50:23) So there’s a lot of flexibility there. So I’ll explain that all in an email. So you have it. And then, yeah, I’ll plan to follow up, you know, the week of the fourth, just to hear kind of how you guys are thinking about it. Perfect. Sounds.
Nilmarie Molina-Santiago (50:36) Like a plan. Thank you so much for the time guys.
Cliff Marg (50:39) Thanks, nellmarie. It was a pleasure. Have a good one. Talk to you soon. Bye bye.
Nilmarie Molina-Santiago (50:43) Bye.