Transcript
Jack Schell (00:00) hi Sonya. Hey.
Sonia Bajwa (00:01) Jack. How are you doing?
Jack Schell (00:03) Good, good, busy day. Yeah.
Sonia Bajwa (00:06) Apologies for being a little delayed, just a couple of fun stuff in the morning and having some bad weather in Chicago right now. My internet’s been a little wonky. So, apologies for that.
Jack Schell (00:19) No worries. We can use the time that we have. Let’s see real quick. I was getting ready to send you a note and log off. Sorry. No worries. What’s the weather like in Chicago? Stormy? Rainy?
Sonia Bajwa (00:37) Yeah. Over the past week in the midwest, we’ve been getting some tornadoes and really bad thunderstorms and so it looks like it’s just going to happen for the next few days over here, started over the weekend and it’s been some good times to say the least, but, yeah.
Jack Schell (00:57) Well, I hope you stay safe. Yeah, of course. Well, I have a standard agenda to review. I could take you through might have to go through the first part a little quickly, but in terms of some medallion updates, wanted to just share with you what we’re looking at in terms of QT roadmap. So what we’re seeing here are the three outcomes that are really driving our QT roadmap and where we’re investing. So just faster time to revenue with AI driven execution. So just continuing to automate workflows and leverage tech to support with processing and ensure that manual work, we’re reducing that, continuing to reduce manual work. We are focusing in on the provider and admin experience as well. Wanting to continue to reduce friction. Oops, wanting to continue to reduce friction there and automate some collection. And just again continuing to minimize touch points. All of this is about efficiency and trying to move even faster than we already do. And then third area here, enterprise ready scale and control. So thinking about supporting more complex clients with their enterprise structures perhaps applies less to synapticure today. But we have many clients that do have, you know, various parent child hierarchies, multiple entities working with a medallion and that’s where that focus is coming from is creating greater visibility and optimizing workflows there. In terms of a look back on Q1, some things that we achieved that we wanted to share are we’re continuing to invest in automating the enrollment application process. So we’re continuing to work with payers to automatically populate applications for payers that we have strong relationships with. And so we have added 35 additional payers to this in terms of our follow up again leading into our technology about 18 point three percent more of the payer follow ups that are being performed, are we’re leveraging AI to do so? And then this is more specific to credentialing which I know synapticure is not utilizing our credentialing specific software or products today. But 100 percent of caqh, credentialing, bulk uploads are now trackable on platform. It’s a visibility and monitoring that we’ve been working on adding. So again… when is there a list of.
Sonia Bajwa (03:25) payers that you’re able to send that were the additional ones?
Jack Schell (03:30) Let me take that as a follow up, see if there’s a comprehensive list of payers involved in the automatic application generation… that’s the one you’re talking about, correct? Yes.
Sonia Bajwa (03:44) The, yeah, the 35 additional online enrollment applications. Yeah, that one.
Jack Schell (03:50) Of course, I’ll look into that for you. Now. Thinking about, those Q2 outcomes that we’re hoping to drive in terms of the core platform focusing on again that provider and admin experience, continuing to try to reduce manual data entry and making pro provider profiles specifically more streamlined and easier to complete. So we can cut down on intake complete timing, and then that enterprise ready scale and control. So just continuing to work on various integrations and our infrastructure as well as allowing folks to have more organization around data access and workflows for various groups… on the payer enrollment side. Again with the outcome tying back to faster time revenue with AI driven execution. We’re looking at automating pre submission checks as well as expanding coverage to a number of payer forms and rosters that are handled end to end via automation. And then for burden free provider and admin experience again continuing to try to make things more intuitive within the platform. So one thing here that’s pretty exciting is just giving a more centralized timeline view of each enrollment request. So consolidating all payer updates, actions and outstanding tasks. Hopefully, this improved timeline view will give more visibility to where things stand and greater visibility. In an intuitive way. The last one there is just preventing workflow disruptions. This is specific to terminated practice locations. So having clear statuses across practice locations. So I want to just check and make sure are you receiving our product update emails? They come from helpmedallion. Co. The last one was sent, I believe on April seventh.
Sonia Bajwa (05:45) Let me make sure that I do April seventh. Yeah, I do. Okay.
Jack Schell (05:54) Great. So you can pay attention to those updates for the small movement that we make throughout the quarter on each of those items. Of course, we’ll use this time to provide updates on that roadmap as well.
Sonia Bajwa (06:08) Okay, great. And then I’ve got a question.
Sonia Bajwa (06:19) Just lost my train of thought. Oh, for like the payor enrollments just kind of taking a look at the landscape. I know we’ve talked about this in the past a little bit with Lee, but wanted to just get your thoughts and information on, you know, how it’s looking as far as like approvals or denials in different geographics for payors right now, especially in the telehealth space. I think it’s just been a little up and down when it comes to payors in certain states rejecting and denying due to network adequacy, or just really not opening up their, you know, their network to telehealth providers. And so, how does medallion help in those scenarios? Have you been experiencing that with organizations? And, yeah, just want to get some updated information there too.
Jack Schell (07:08) So specifically on approvals and denials with certain payors. Yeah, like tied to being a telehealth provider, right?
Sonia Bajwa (07:18) Or like network adequacy is a big one, right? That a lot of payors will reply back when or their, you know, their network is closed for whatever reason or telehealth, just kind of understanding from you all as a, you know, pair enrollment organization, if you’re seeing that continue to increase in the industry across certain geos, is it popular with certain types? Just want to get some information?
Jack Schell (07:44) Yeah. I mean, I can go to our pair enrollment lead who owns our pair enrollment organization and understand if we’re we’ve collected any recent data or updates with regard to that. I don’t have any information readily right now to share, but I’m happy to take that thought leadership question back to our team to see if we can help. Is there, are you receiving a lot of denials that are unexpected?
Sonia Bajwa (08:12) It just, I mean, it varies at times. I think, you know, there are a handful of payers in different like states that really, I would say have been denying more than others blue plans, deny more than others. Florida has been one of them, Texas, California, New York. There’s just like certain areas that I’ve seen. And so, you know, last time when I spoke to Leah about it, she said really gave me a lot of good information that, yes, you’re right, Sonia, we’ve seen a high denial in this region or a high denial by this type of payer. And this is the reasons. And so these are the things that medallion does to help in those moments. So it’s just, it’s helpful for us if we ever wanted to utilize your AI tooling for payer enrollments in the future and make sure that we are, we know that information. We’re not submitting requests and paying for stuff that we know is going to be denied. I want to make sure that you, we have some visibility in that too if we want to, you know, move forward with additional payer enrollment support in the.
Jack Schell (09:11) know… future. Yeah, absolutely. Let me, let me link with Lee to see what she shared previously, that was helpful. And then also get with my, our PE team lead to see if there’s any additional information and what’s that question that you just asked, what specifically does medallion do to help in those moments or situations?
Sonia Bajwa (09:37) Yeah. I think like if it’s a frequent denial and we know that they’re going to deny, I wouldn’t want to put in a request, pay the enrollment fee for that enrollment. Yeah, if we already know, and I’ve seen that like happen a little bit. And so, I want to prevent that in the future, you know, just to make sure, yeah, that we’re just being cost effective too.
Jack Schell (09:57) For sure. Okay. I have that noted down. I want to take your questions exactly back to the team, see if we can provide any guidance there. You know, we obviously aren’t publishing anything specific to, what it is that we see or like gathering that data necessarily for current reporting. But like you mentioned, Lee and other experts on our team who have been doing payroll for years may be more aware of trends that are popping up.
Sonia Bajwa (10:28) Yeah, that’d be, yeah, that’d be great.
Jack Schell (10:30) For sure. Okay. Any specific to synapticure, any updates for what you’re pursuing or where your team’s focused for the next quarter or two?
Sonia Bajwa (10:42) I don’t think there’s been any major changes since the last time we talked. I think, you know, I’ll just be honest. I’m still kind of waiting on updates from the last time we discussed on some of the licensing things, some of the payer enrollment that I had questions about escalations and the credit request for some of the back and forth that we’ve gotten. So I don’t know if you have updates on that.
Jack Schell (11:04) When you’re meeting with Lee, are you, you’re going through the?
Sonia Bajwa (11:10) We don’t meet with Lee anymore. We meet with Dreama.
Jack Schell (11:12) Dreama. Sorry, right? Completely forgot. My apologies when you’re meeting with Dreama, are you going through the line by line? Payer enrollment priorities? Yeah?
Sonia Bajwa (11:25) So these are outdated ones, right? These are ones that like I had escalated in our last chat when we talked, Kyle. And with Dreama together, I haven’t gotten any follow ups from them. You all were going to send me information. Kyle was about the nurse practitioner’s prescription authority. Dreama was going to look into some of those payer enrollment items that we escalated. We haven’t gotten any follow ups and I think you were going to take a look with them. And I had requested information on potential credits for anything just given we had repeated rejections. And so, I’m just wondering if there’s any updates from you all on some of those previous items that we’re still waiting on.
Jack Schell (12:02) We double check.
Jack Schell (12:16) Okay. I thought that Kyle had followed up already.
Jack Schell (12:26) On the licensing piece… let me check my updates with Dreama.
Jack Schell (12:40) Okay. I will follow up with them again to make sure that those updates are provided. I’m not sure why they weren’t sent out or provided in your most recent meeting that was Dreama on Tuesday.
Sonia Bajwa (12:54) Correct. Right? Or last Tuesday, it was last Tuesday and we didn’t get any updates there.
Sonia Bajwa (13:03) Okay?
Jack Schell (13:11) All right. Let me revisit that with them. Okay? Thank you because the updates that let’s see.
Jack Schell (13:31) In terms of the service requests, everything should be closed. Like from the ones that we talked about before that we talked about. Those are moving and, or closed correct?
Sonia Bajwa (13:44) Some of them are. And yeah, I think… again, I think I used those examples, right? To understand and want to understand one, the nurse practitioner licensing processes, how are you doing prescriptive authorities? Like I think there was one question that I had there that I haven’t gotten a follow up on the payr stuff. I escalated due to like repeat like enrollment requests, repeat fees that we’ve had to pay for rejections and corrections that weren’t followed through by medallion. Even though you all had mentioned that you guys would be the ones to follow through on any corrections that were needed for some of the follow ups. So, like if we’ve paid for an enrollment item three or four times and it was due to rejection of lack of follow up that’s where I’m like, can we take a look and see if there’s a credit opportunity there? So you all were going to be looking into those, seeing what happened and following up to make sure that like we have some information. But so even if the line item has been completed or not, the examples that I provided were just areas that I wanted clarification on for processes. And then again like the, yeah.
Jack Schell (14:52) Which which I know we discussed the processes and we looked at those four specific examples. Were there additional new payment requests that no, no, no.
Sonia Bajwa (15:07) I’m referring to the same conversation that I haven’t gotten a follow up on those because yes, we did discuss them during that call, but there were follow up items that Kyle and Dreama were going to come back and say, yes, we were going to take a look at these examples, make sure that this is it and follow up to ensure everything was set and I haven’t gotten that yet.
Jack Schell (15:28) Okay. I’ll revisit it again. I have in my notes that we discussed each of them, but I’ll follow up again with them to make sure that they have these items, the prescriptive authority for nurse practitioners. And then with the PE, you’re looking for a credit essentially for.
Sonia Bajwa (15:54) Yeah. I mean, I like again, like I said, due to the fact that we’ve… I wanted to one verify if we had paid for those line items three or four times because they were coming back as rejections due to the fact that there wasn’t a follow up in some of the requested information for corrections. And if you did pay for them multiple times, then I, yes, I am requesting a credit because I was told that you all follow up if a correction is requested for a line item that you all are working on. Okay?
Jack Schell (16:33) All right. I will take a closer look at those PE requests because with regard to a credit request, I’ll have to go with my team and the ops team to investigate the consumption. And then if it’s depending on what we find in terms of how it was consumed, then we would be able to, I’d be able to request a consumption credit so that that’s put back into your allocated services. Okay?
Sonia Bajwa (17:00) Okay. Yeah. I think that was, I think essentially what we had talked about last time. So I just wanted to see if that had been done and if it happens.
Jack Schell (17:08) Well, I know that the one example we were talking about, we did talk about how it was resubmitted because it was timed out and because there were items that had been requested. But then there was follow up that needed to be done et cetera. I know that we talked through that. I’ll have to take the credit request investigation to the team. Okay. I’ll get with them, see what I can get with each of them about their items. I’m curious with the PE items. I thought that maybe there were additional ones that had come up that you were asking for follow up on. No.
Sonia Bajwa (17:56) It was still the other ones and I’ve been like, I don’t I’m not always able to attend every single meeting with Dreama. So my team also will like have asked for updates and they haven’t gotten any specifically from her. Okay?
Jack Schell (18:14) All right. I’ll have that as a takeaway. Okay. Any other items? No?
Sonia Bajwa (18:23) Nothing else on our end? Okay?
Jack Schell (18:27) Well, we have about three minutes. I of course, have just the execution readouts as well for you. So the completed date for payor enrollments, what’s in progress, and then certain turnaround times. The one thing that I would want to call out here is that it does seem like the task completion rate is continuing to creep up with regard to synapticure tasks. It’s possible that there are some outliers here, maybe things that need to be closed out that need to be revisited in terms of task age. But I did want to call that out because that would be of course just adding additional days to potential to keep things moving. Yeah, with regard to request intake complete, that is somewhere where we see things get slowed down quite a bit, but you all are still tracking healthfully at four business days. So, you know, we’re getting to a workable status pretty quickly and the request to complete for pay enrollment is still sitting at a pretty healthy 62.
Jack Schell (19:36) So really the one that I just wanted to call out was the task completion rate. And again, this could be creeping up because of just like outlying or old tasks that need to be closed. So, you know, I’m flagging this to dream as something to take a closer look at because I don’t know if this is truly reflective of your task completion rate today based on how I know how you work. Yeah.
Sonia Bajwa (20:04) Like we monitor it pretty closely, our admin tasks. We have four in there. Right now. There is one old outdated one that I’ve been going back and forth with the team on. And then the other ones are just from the tenth, like ones from the tenth ones from the sixteenth and sixteenth, which is today. So admin tasks we’re pretty good on. I think the provider tasks are like, there are two that are from 30 plus days ago. One is a standard protocol that we are cleaning up for a state license and medicaid application. This is another one that we… escalated the New York medicaid application that’s like 30 plus days in the admin queue for, I mean in the provider queue for pay enrollments. This is the third application. Now, I think that we’ve had to do for New York medicaid and that Drema was going to look into that one as well. But that one is probably skewing our data a little bit. Otherwise… some of these are pretty recent… Ish where I feel good about the turnaround time with some of them. But there are providers that linger. Yeah.
Jack Schell (21:10) Yeah, I just wanted to call that out just so that we made sure to take a look at it. Otherwise everything else seems to be trending and like, right, you know, right where we would want it to.
Sonia Bajwa (21:22) Definitely. Yep.
Jack Schell (21:24) And then we’re at time and I actually, I unfortunately do have to go to another meeting but the licensing readout here… wanted to call out license app submitted to completed is continuing to trend down, which is good to see. And then license app requested to complete also down to 77 days. So we are hustling and, you know, hopefully these results are well received and we can continue to see good results here. In terms of turnaround times definitely hear you on the continued conversation around the frustrations that you’ve raised and apology that the follow up wasn’t executed as expected. I will make sure that I get with Kyle and dream on that. I have your consumption readout here which you can review as well… to date, 84 percent consumed. You have 25,000 left in available services. We know that the renewal is coming up in September. So hopefully that is enough to get you there. But, you know, feel free to review you and Sam as needed. Absolutely from there, you know, I don’t have anything additional to review.
Jack Schell (22:42) I have the action item I’ll get with dream and Kyle at least async today and make sure that they have the marching orders from the follow up of the conversation that we had. I don’t know if it was a circumstance where, you know, we had the conversation, we addressed the items and they thought that was, you know, okay, we’ve closed it out, but clearly, there’s follow up that we was expected that we didn’t deliver on. So I need to get to them on that. Okay?
Sonia Bajwa (23:12) No, I appreciate it. Yeah, and happy to provide any additional information if they need it. But yeah, any follow up would be great. I think the license?
Jack Schell (23:22) Yeah.
Sonia Bajwa (23:23) But the payer enrollment ones, those line items that we’ve again done repeated applications. I just want to make sure that like if there have been fees that have been paid multiple times for the same thing that we.
Jack Schell (23:34) Can, yeah. So it’s it sounds like the PE update that you’re looking for is actually from me, then it seems like if we’re just talking specifically about the credit, were there, was there an additional PE like question mark that you had that we didn’t answer?
Sonia Bajwa (23:51) I think on my end was just again just reconfirming that you all will be following up for corrections on these things was really it since we talked about it with Lee, and then we were good to go. And then a couple additional ones kind of happened. So, I just want to make sure that like,
Jack Schell (24:09) and we should be following up for corrections and we should be tasking out when we get, when we get word from whomever that something’s missing or that additional materials are required or that a correction needs to be made. We should be tasking that back out to synapticure. Okay. Yes. Okay. I will follow up. I’ll… get you a follow up by the end of the day on where that stands with kylondrema.
Sonia Bajwa (24:44) Okay. I appreciate it. Thank you. And then.
Jack Schell (24:46) the credit request that might take me a couple days, but I’ll elevate the examples that you provided and make sure that we’re looking at the consumption to see how it was consumed.
Sonia Bajwa (24:58) Okay. That sounds good. Okay?
Jack Schell (25:01) All right. Thank you, Sonia. All right.
Sonia Bajwa (25:02) Thank you. Bye bye.