Transcript
Mike Manson (00:00) hey, man. Hey, Noah. What’s up, dude? Let Jared in.
Mike Manson (00:10) Hey, Jared. Good to see you again.
Jared Arnott (00:12) You as well. How’s it going?
Mike Manson (00:14) Pretty good. Happy Friday to you. Thank you.
Noah Laack-Veeder (00:21) You got any weekend plans, Jared? You going to the mountains behind you?
Jared Arnott (00:26) Not in the middle of Ohio. I’m not, yeah.
Noah Laack-Veeder (00:28) Is that a photo that you took or is that?
Jared Arnott (00:31) No, it’s auto generated over here?
Noah Laack-Veeder (00:34) Got it. Or are you a mountain Guy? Do you like the mountains I do?
Jared Arnott (00:38) I do. I’ve had a chance to see some of them. I’m in central Ohio, so I can get down to the appalachian side, smoky mountains, those type of things pretty easily. I’ve done a little bit out west through yellowstone and the rockies and then into some of northern California and yosemite and stuff like that. So, I’ve had a chance to get around a little bit. It’s been a week and a half up in Alaska. So, yeah.
Noah Laack-Veeder (01:04) I mean, you’re like I’ve gotten around like, you’ve pretty much seen all of the mountains in the U. S. Not.
Jared Arnott (01:09) So much like, I have not literally have not been through Colorado, like those areas like the rockies have been much more foothills… those types of things, I guess, like I said up into Alaska and a little bit of the northwest there, but we’ll see there’s more to go. Yeah.
Noah Laack-Veeder (01:24) That’s super cool. I lived in Denver for a couple years and it was just really cool to be able to just go to so many different mountain areas just within like a 30 minute drive. It was super cool.
Jared Arnott (01:36) Yep. Outside of a, you know, hour and a half layover in Denver. A few times. I’ve not made it out that way. Yeah.
Noah Laack-Veeder (01:42) Yeah, it’s not a super fun drive from Ohio, but it is, I wouldn’t no.
Jared Arnott (01:48) I wouldn’t unless I had a month of time to kill. I wouldn’t.
Noah Laack-Veeder (01:52) yeah, participate.
Jared Arnott (01:54) In that adventure of a drive that.
Noah Laack-Veeder (01:57) Makes sense. Cool.
Mike Manson (02:00) Well, you guys are already getting to know each other but formal introduction. This is Noah who I work very closely with. He’s one of our lead solutions consultants. He’s your go to technical expert for all things medallion. He’s worked with some of our best customers. So a lot of the meeting today is going to be Noah. I think, you know, Noah and I had the chance to catch up yesterday, went over our conversation from earlier this week, Jared, I kind of filled him in on what we heard from you, what you’re looking for.
Mike Manson (02:30) So we’ll spend, I’ll just pull up a quick agenda here. We’ve got 60 minutes calendared. Does that still work for you? You got the time blocked? Okay. What we had planned for today is I wanted to spend like five minutes on just a readout of what we heard just to make sure I captured everything accurately. I think I put it in the notes in the email I sent yesterday, but just want to make sure we’re on track there. I have not a ton but just a few slides on y medallion like I think we touched on it a little bit last time but just some of the differentiators for us. I actually, I put together basically like a one slider on a potential business value assessment based on what you told me about your turnarounds last time, what your current opex looks like. We’d love to just gather your feedback on that because, you know, ultimately hopefully we can prove the technical fit, but then want to make sure we have a strong business case for the investment as well. And then Noah will be taking over a majority of the call today. We’ll be showing you what we can do, taking your feedback on the platform. And then if we can just save like five minutes at the end, we’d love to just kind of take your initial feedback, assuming it’s good, just kind of planning out like what happens next? Does that sound good to you? I think you’re on mute… or maybe not. I don’t know.
Jared Arnott (04:00) Can you hear me at all? Yeah.
Noah Laack-Veeder (04:02) I can. Yeah, there we go.
Jared Arnott (04:04) I guess it was just me.
Mike Manson (04:07) Anything change? I know it’s only a few days ago, but anything change on your end since we last spoke?
Jared Arnott (04:14) No, no. Still pretty much the same spot.
Mike Manson (04:19) Okay, cool. So what we heard, so looking on the left here, this is the kind of the key takeaways I took from last time. Basically, it’s kind of, you know, this function has fallen onto you to take on pretty much solo. It sounds like. And yeah, you know, obviously that’s a great place to start. But I think as you guys continue to scale like it doesn’t seem like it’s going to be a tenable solution for the long term, you probably would have to hire one, maybe two people depending on how much you scale over the years. And it sounded like there’s nothing in house today. As far as software. I think one of the questions that Noah had as we’re kind of debriefing on this. It sounded like to me my takeaway was a lot of the work that you’re doing a lot of the pain pointers around the payer side. So like getting the payers enrolled, you know, getting those payer applications out and then having to do the manual follow up for the credentialing. And what I mean by credentialing is like the first piece of that process, are you doing in house credentialing to like an ncqa standard or some kind of, you know, before, like take the payers out of the equation at all? Like are you credentialing like?
Jared Arnott (05:37) DS to an ncqa standard? No, you.
Mike Manson (05:40) Know, PSV checks to make sure that folks important to you… it is.
Jared Arnott (05:48) From the standpoint of a lot of the payers have utilized that as part of their credentialing. So we collect that information. I try to have the providers keep that up to date. Although outside of one or two providers, 90 95 percent of our providers are all 10 99 independent contractors. Obviously, this is a side gig for them. They have other professional jobs where they own a practice or work at a practice. So keeping that up to date for our purposes is more difficult just because we’re not top of mind for them. It’s not something like, oh, what I really add in like teledentistry Texas address. So I can make sure I can get credential with blue cross blue shield in Texas and their mpi, all that kind of stuff. So I do run into issues there although again, we do collect that information and utilize it for the credential process with payers but not so much as far as on my end of things.
Mike Manson (06:41) Yeah, that’s helpful. I think the reason I ask is I think the potential benefit for ncqa certification is that you have the ability if you do continue to grow, if you get to 100 providers total, then you can start to look at delegation which makes the entire process a heck of a lot easier. And part of the benefit of having us take this on is that we are an ncqa certified cvo. So like we, you know, we basically, you know, that’s our business, right? Like we’re getting audited by them. You know, we are a strict compliance to their standards. So you essentially get to take advantage of that, you know, pursue delegation without having to go through your own audit in house. So just you,
Jared Arnott (07:25) know, down the road future… goal for sure is to get to the point of delegating being a real option. Yeah.
Mike Manson (07:34) Yeah. Okay. Very good. Noah. Any, any thoughts or questions from you before we add on? No?
Noah Laack-Veeder (07:41) It’s not yet. And I guess Jared, sorry to peck you with questions, but it’ll help me with the demo since you’re kind of collecting some of that data early on. I know dentistry across the board is adopting caqh more often. Is caqh a component that the physicians are having to update themselves or is that something that you’re also going to be taking over going forward?
Jared Arnott (08:06) I would like to, I would say the world but probably unlikely again just based off of our provider base. I mean, as far as I would like to take that over from an updating standpoint on their end, I doubt it again just with our provider base being tremendously just part time gig work type things. I don’t want to say there’s a lack of trust but there is, you know, hey, I’m not going to turn this over to you. Is it very different than if they’re you know, embedded and put this here that they own and they work at and they’re going to be there for 10 years and they’re sitting in front of their office manager and turning that over to them versus somebody they’ve never met 10 states away that, you know, they work for a couple patients on the weekend and make 500 bucks. Like it’s just a very different level of commitment that makes.
Noah Laack-Veeder (08:54) sense. And typically how I, oh go ahead. Sorry.
Jared Arnott (08:56) Through providers as well. Because of that, you know, we’ll have some that drop off whatever they work for us for a few years. Then they get busy. They do this. They start a family. They do whatever they drop off. We add three more in and it’s a very constant cycle of addition and subtraction. Yeah. Does that?
Mike Manson (09:11) Mean a lot of like double credentialing for the same providers? Like, you know, if they work for you for six months and then they drop off and then they come back into the network six months later. Is that, I don’t know if you’re seeing that as a trend?
Jared Arnott (09:25) We’re not seeing too much back and forth once they drop. Unfortunately for us, once they drop off, it’s typically gone a little bit. It gets a longer word round. Maybe some of them do come back. It’s possible, but not seeing that currently. Okay. Yeah, Jared.
Noah Laack-Veeder (09:43) Typically in like organizations of your like of your model, right? Like if they’re treating it more like a part time piece, you want to make sure that anything related to credentialing is incredibly easy because it’s maybe you have like one shot. You don’t want things to get delayed. So kind of thinking about the workflow a bit more today. Obviously, there’s the provider component, giving that data et cetera. But there’s going to be like the preparing the applications, submitting them, tracking status, doing the follow up tracking, revalidations.
Mike Manson (10:12) Which pieces?
Noah Laack-Veeder (10:13) Of those are taking the most time for you today?
Jared Arnott (10:19) The initial application is what’s taking the most time?
Noah Laack-Veeder (10:21) Okay. That makes sense.
Mike Manson (10:25) We’ll keep it moving here. This is what I put together and, you know, love to just kind of hear your overall feedback. When I was thinking about the business case for this. I had it as like six to four weeks from total time from the time they start till the time that a payer application gets submitted. Is that accurate? It’s.
Jared Arnott (10:49) obviously highly dependent upon what insurance we’re looking at. We work with a lot of medicaid ones that could be longer than that application process wise. We work with several that are have… their own portal like delta dental California or delta dental ins. We can get done in less than a week. We have a nice deal with them where I can just send them in different things, but I’d say you’re probably in the ballpark on average, but yeah, it’s obviously very dependent upon who the payer is and.
Mike Manson (11:15) Is that timeframe there call that? The average? Is that, is that like to the time that they’re fully par status or?
Noah Laack-Veeder (11:22) Is that like?
Mike Manson (11:25) That’s oh, it is okay. All right. Now, that changes things.
Jared Arnott (11:29) There’s some of them, especially some of these medicaid ones we work with across a handful of different states where it could be three to six months of time. So there’s obviously a very wide variety there of what it could be, what it is.
Noah Laack-Veeder (11:45) Yeah, that makes sense.
Mike Manson (11:47) And then just the last piece on this side, I was sort of thinking about this on like a five year plan, right? Like, what would it look like, if you continue to scale three providers a month over the next five years, you know, conservatively speaking, you probably have to have an additional three admins, which that’s where I got this opex cost if you’re keeping it kind of the status quo, that size with medallion, you know, this, the size that you have right now, I don’t even think it would be a half an fte. So that’s where we kind of that’s where a lot of our customers try to look at like, hey, what is it going to cost me to staff this? Versus I give this to medallion? You know, what is the cost comparison there? So, I think, you know, the goal for potentially the next call is to kind of like dial these numbers in and come up with a, an Roi that makes sense. All right. I’ll keep us moving. We talked a little bit about this last time but like these are just some of the kind of numbers that we’re seeing across all of our customers, you know, expanding complexity with payers, we’re seeing like upwards of 20 payers for a lot of our customers getting per provider. I know that’s going to depend on states. Obviously, you know, you’re going to see a lot bigger in California, maybe smaller in other states. But average in, this number we would probably want to tweak for you just because it seems like a lot of these folks are part time but full time providers every day that they’re not billable. Is, is three K lost to the business. So we’re all about trying to get speed and accuracy for your applications.
Mike Manson (13:28) I don’t think I’d already hit on this but a lot of folks we talked to are just looking at, you know, they tried to go the in house route. They’re just throwing bodies at the problem. You know, it might, you might see an incremental relief if you bring in an in house tool, but medallion is really just, you know, taking this operations off your hands so that you can focus on going out and winning new payer contracts, getting new providers in house and getting providers, you know?
Noah Laack-Veeder (13:52) More more work.
Mike Manson (13:57) And then, yeah, what you’re going to see today and I’m going to hand it over to Noah now, but you.
Noah Laack-Veeder (14:02) Know how we.
Mike Manson (14:03) help automate the data collection piece. So make it really easy for the providers to get onboarded and get all of their data uploaded into medallion. You’re going to be able to track everything that you need. You’ll have dashboards of where everybody is getting enrolled, where they are in the process. You’ll see, you know, everything that our team is doing and you’ll be able to have like just really strong visibility. And I think ultimately that will help with, you know, prediction around revenue and then also help potentially with recruiting as well because you’re going to be able to see like, hey, you know, we’re light in these states. We’ve got leads coming in these states. We need to go either hire people or get them cross state licensed. But it’s really an end to end solution for kind of all of the needs that you listed out last time we spoke.
Noah Laack-Veeder (14:46) All right. Any questions?
Mike Manson (14:48) Or feedback before I hand it over?
Noah Laack-Veeder (14:54) I think I saw the no, Jared. Well, I don’t have a nice mountain background in medallion, but we’ll be close. Ultimately just I’ll share my screen here and Jared just so I’m aligned generally the opportunity. It sounds like from talking to Mike, you’re investigating other solutions as well. So I just really want to show you kind of like what medallion does and how we fit, are you seeing tasks on your screen? Yeah. And then ultimately, just so I’m aware like the decision ultimately is like, hey, I’m evaluating getting more individuals or kind of scaling with technology. I want to make sure that whatever partner that I choose, they’re going to automate as much as possible. Give me the best peace of mind, ultimately the best turnaround times. So, is that kind of like the just general opportunity that we’re trying to solve here with the technology? Yeah.
Jared Arnott (15:46) I think you’re on track. We’ve not really discussed expanding headcount. I don’t think that’s the direction we want to go by any means. So, I think it’s going to be some sort of the technology automated type solution. And I think you’re on my, how much can we automate? How quickly can we do things? What makes the most sense? And then obviously cost that puts you in there. But yeah, those you’ve got, the just a excellent.
Noah Laack-Veeder (16:09) Cool. Well, let’s talk about, the initial piece here where we’re trying to onboard providers. Something we talked about earlier is we want to make this as easy as possible for them because maybe we get limited opportunities, to interact with them. So, there are as, you know, requirements where a provider does need to sign things and they need to attest the information is right? So with medallion, what we try to do is make that as easy as possible. So if you have a new provider joining, let’s say you’ve got three coming in per month, you just have to give us a little bit of basic information about who that provider is and what we’re going to do is kick off an automated email out to that provider. And so what it looks like is something like this, it’s going to be white label the organization. It’s not going to say medallion on it just to say, hey, we need a couple of things from you in order for us to complete the enrollment process and get you seeing patients. They click, get started. We’ve got single sign on but it’ll open up an onboarding flow for them just to tell them that, look if you do have a ceqh profile, which if they’re kind of working in a bunch of other places they might, we can actually streamline this process by grabbing their information. The thing else was that I.
Jared Arnott (17:21) said most of everybody I’ve talked to has a ceqh profile. How up to date is it? Is a different question? But pretty much everybody that I talked to has a profile, yeah. And.
Noah Laack-Veeder (17:31) I’d be surprised if they didn’t at this point because like payers are requiring it being updated as part of the enrollment process. But to the provider, what they’re doing is just giving you some information so that we on their behalf can start pre populating all their information as part of the enrollment process. So they verify this information. What this ends up doing is for our providers. Actually, I’ll go back to the service here. I go back to my providers when Naomi logs in for the first time or if you’re looking at Naomi’s information, all the information from caqh will be brought into medallion automatically. So, what you’re seeing here is like what the first experience could look like for a provider compared to typical organization. I see it’s like maybe in a spreadsheet, maybe in a form. It’s kind of opaque, maybe back and forth via email here. There’s a single place with all their information, including their documents. Everything else that’s gonna be on caqh?
Jared Arnott (18:31) What the.
Noah Laack-Veeder (18:31) impact of this, is, look if you only have a couple opportunities to reach out to these providers, you say, look, I’ve already pre populated a lot of this information for you. Can you just address a couple gaps for me once those gaps are resolved, we can start sending them out and do those payer applications without getting those errors?
Mike Manson (18:47) So, I wanna.
Noah Laack-Veeder (18:48) Pause and talk about this for a second, considering the workflow today about getting this information from providers, checking everything’s accurate. How does what I showed you compare to what’s going on currently?
Jared Arnott (19:05) Gathering similar information. There’s certainly much more information… probably more robust.
Noah Laack-Veeder (19:12) The term process.
Jared Arnott (19:12) Is very simple. It’s just manual. It’s an email that goes from me. It’s three different PDF files that is filled out by hand. One, I’m obviously just standard agreement. The other one’s a pretty standard credentialing packet that goes through, you know, where’d you go to school at, where’d you work at? History of the last seven years, mpi number check, yes or no for these 10 questions, type of, you know, again standard crap that everybody does. So, it’s not super complex by any means. Again, it’s just manual. It’s manual on my end from an email and reaching out. Once they fill it out, it’s all manual. They have to send it back to me. We have to manually store that someplace. Then we have to enter it into, you know, our type of a, CMS systems that were utilized and those types of things. Again, everything along the line, is standard, it’s just manual, yeah.
Noah Laack-Veeder (20:03) Exactly. And then, with that manual process, how are you then taking this information and then starting to populate the payr applications? Is it like literally copy and pasting information to different portals? Like, what does that process look like? There’s no.
Jared Arnott (20:20) Portal to copy and paste from? Yeah, I mean, some of the, some of the payers obviously have portals themselves. So I can do that. So, all the data and information from, our providers, is one, the basics of it is put on an excel sheet. So again, names mpis, that kind of stuff. So that the basics, is readily available. Everything else, is stored just in a Google folder or Google drive folder from there. So, if I need to go back up and look up, okay, where they go to school at, or what was their work history for the last seven years? I can pull that up on my simple spreadsheet. I’ll have names, date of birth, mpi license number, the, you know, the top six things. But all it, is, again, it’s manually reading that, and typing in it, whether it’s PDF or it’s a portal of sorts for that payer, that’s the process? Yeah. And I think what you’re.
Noah Laack-Veeder (21:08) kind of alluding to is the manual nature of it is just a lot of work like it can get done but it’s just a lot of management. So with medallion so far, what I just want to show is that kind of excel spreadsheet, the share drive, all of that can all just be in medallion here. So if you do need to get that information, it’s available to you, but I do want to jump in and show you given we have this information, how easy and how much time can we save you when it comes to the actual enrollment process? So when you need a new enrollment, the process is pretty much you tell medallion what you need and then we do the rest. So what you could do is say, look, I want Naomi as part of this group contract to be enrolled with all of the payers that are part of that group contract. So if you’re doing that manually today, you might have to go to a spreadsheet, see like which group she’s a part of or which groups or whatever it might be. There’s a lot of work to figure out like who she should be enrolled with a lot of customers of medallion, just say, look, we already know which groups they’re part of. Just enroll them with all the payers here. And then you can also choose which lines of businesses as well. Ultimately, what this is doing is it’s preventing you from having to search for this information. And then if they need to be at different locations, we also can link them to locations in the platform where you just say, look, I just want them enrolled with every location that they’re associated with. And so what this does is it prevents you from having to remember that, put it in the application. You’re just telling us what you need. And then when you click submit, what we end up doing on your behalf, is all of the work like submitting the applications. So what you’re seeing here is a blue cross blue shield, Arizona example where we’re auto populating this via RPA, like a robocrawler on a website and what we’re doing is taking all the information that you’ve already given us in medallion and automatically populating the portal. So we have integrations like this across all of the payers in the us. So whether it’s a portal, whether it’s roster, whether it’s medicare or medicaid, paycoast or medicaid state portals. We’re going to automate that submission for you. So the impact is you tell us what you need. You don’t have to do. The manual copy and pasting of data that’s done automatically. So kind of thinking about that obviously very similar to the manual process, but it’s just automated. We’d just love to hear kind of what the impact of that would look like for you given that this takes a lot of work today.
Jared Arnott (23:45) Sorry?
Noah Laack-Veeder (23:46) Say that again, Jared, yeah, I.
Jared Arnott (23:48) think the impact is exactly what you stated. It’s just time that does not have to be spent on this. If it takes the work process, if it takes an hour to fill out a PDF or a portal application to where it takes five minutes to click the buttons, you know, that’s what you’re looking at from a time save standpoint, without a doubt. I assume there’s obviously some back end work there as far as getting all that information in there, but… significant time. Yeah, with the kind of.
Noah Laack-Veeder (24:18) Manual process today, I know you’re doing the status checking and things just to kind of call it out. A lot of organizations I work with that status like things get missed. We forget statuses, whatever it might be. And the impact could be like look, we missed a revalidation, or we had a provider see a patient they weren’t supposed to and things can show up there. How is that showing up for you at all with the manual process? If at all?
Jared Arnott (24:45) There are plenty of things we’ve missed over the years. Like I said, whether it’s just a revalidation date, whether it’s a God… we’ve had everything along those lines. And again, some of our providers are… spread out across the country, but they’ll have 20 different licenses or 30 different licenses. Which then means that they’re credentialed with whatever X, number of payers. It may be just delta dental, but there’s 14 different delta dental’s in those 30 states type of a deal. So, yeah, there’s a lot of manual tracking along those lines that just simply doesn’t get done. Yeah.
Noah Laack-Veeder (25:18) And then just from what you said, the things you missed like a revalidation, like there could be instances where we have to write off something. There might be a claims denial down the road are like revalidations being tracked at all today, or is that all being manually done?
Jared Arnott (25:34) Okay. So, with.
Noah Laack-Veeder (25:37) Medallion just highlighting this like the whole aspect of having to manually track status and losing those things we think is critical to a function. So what we’ve done is we automate status checking. So this is just an example of paycos. But just think of like any commercial portal, the email that has to go out to a payer to get a status, the phone call, we’re using all available AI methods today. What you’re showing you here is just an RPA, but we’re using agentic phone calls to call a payer to get an update. Ultimately, the impact for your organization is that when you need to see the status of something, what you’re seeing in medallion is real time. If you’re having to today reach out to payers, do that payer follow up. We take that work on their behalf. All you need to do is say, look is someone enrolled with this payer yet? You can check out the request status here. But also if you need visibility as to who’s effective with who, you can see that in the platform. And this is reflective of the it’s real time. The other piece I’ll say is revalidation dates being tracked manually. What we do as an organization is we typically process revalidations automatically for you around 120 days before they’re due. So that eliminates the risk of a revalidation being missed, which could create that provider access issue downstream. So again, compared to the manual process today, we’re just automating that piece. I typically see the impact being things not falling through the cracks, kind of things like that.
Jared Arnott (27:05) How are you feeling?
Noah Laack-Veeder (27:06) About the status piece here and what you’re seeing, would this be, is this like high up on your evaluation criteria when it comes to a solution?
Jared Arnott (27:21) I would not say it’s high, but it’s something that we’re currently not doing that I know needs to be done. The only reason I would say it’s not high is just because of the turnover we have with providers would not be uncommon for them to not even be around for a revalidation. You know, if it’s a one year mark, they may be if it’s a three year revalidation, they may not be. But again, it’s something that we’ve certainly run into. We’re not doing it. It’s simply our process now is if they send me an email that says, hey pay attention, dummy your revalidation’s due in five days, I say, okay, oh shit. I should probably do that.
Noah Laack-Veeder (28:01) Yeah, yeah. Like that’s.
Jared Arnott (28:02) the process?
Noah Laack-Veeder (28:04) Yeah. Well, the new process would be if they are still around, medallion would say probably wouldn’t call you a dummy, right? But they’d say, hey, Jared, we’re gonna do these revalidations for you. But I think what’s important with what you just said is, yeah, these folks aren’t gonna be around that long. So, I think how I’m envisioning this working is if they’re not gonna be around as long you want them to see patients as soon as possible. And you wanna know that if they see a patient, it’s not gonna result in a claims denial, or write off. So we will also alert you as soon as someone’s par… the other thing that I just wanna mention along that line is the total turnaround time of this process. I’ve talked about automating the application preparation. For your sake. It’s zero time to do, but we do these pretty instantaneously so.
Jared Arnott (28:56) Through all of these.
Noah Laack-Veeder (28:57) Different things, the follow up, the SaaS tracking, et cetera. We’re typically able to reduce turnaround times by at least half. So those things that Mike were talking about earlier in terms of business case, earlier provider access is typically done with medallion because of all of our automations. So with that being said… what would the impact be for you if let’s say we could cut down these turnaround times by like 50 percent?
Mike Manson (29:29) I think there’s something going on with your mic, Jared. Sorry?
Noah Laack-Veeder (29:32) Sorry?
Jared Arnott (29:32) Say that again, get a little too far away from the microphone, relax a little bit. It doesn’t like it.
Noah Laack-Veeder (29:37) It’s like, hey, stop relaxing, Jared. Yeah.
Jared Arnott (29:40) Don’t sit back too far. I mean, the significant impact from the standpoint of again providers that we can utilize. And the biggest thing in my world is… necessarily that we would have providers not seeing the right patients. We don’t run into that or not being able to get paid or having denials. But what it does is it opens up. So when we have patients that are calling in, obviously, we’re at 24 seven availability. When they’re calling in, they’re looking and talking to a provider immediately and whether we have a provider available or not is our entire business model. So if we don’t then that’s just somebody that doesn’t get serviced or we have to service them in several hours from now and somebody is available or they find another solution or whatever the case may be. There’s lots of potentialities there. But the more providers that I have available to see that patient, the better chance I can get them taken care of. So if I have, you know, nine providers in California and a patient calls from California, I have a really good chance, you know, and then obviously, you go down the insurance route. Okay? Are they a medi cal patient? How many providers do we have that are lined up with medi? Cal? Okay, of those nine, we have six. All right. Again, pretty good kind of chance we’ll get that patient taken care of, vice versa. If they call in from whatever some insurance I’ve never heard of and we have zero or one, you know, then that chance we’ll get them taken care of is dwindling without a doubt. That’s more. So what we’re looking at in our world is that again these patients aren’t going to be long term. They’re not coming back to us for the next 12 years. We’re going to talk to them for five minutes and probably never again, that’s it that’s the only chance we get, yeah, knowing.
Mike Manson (31:20) That is the goal to put safeguards around that, to have them enrolled with like if.
Jared Arnott (31:26) you’ve got a.
Mike Manson (31:27) Provider that’s enrolled in five states is the goal to just get them enrolled with as many insurance companies as you can in those states… yeah.
Jared Arnott (31:38) I mean, there’s some that we avoid that we’re kind of intentional about being out of network with just because of fees and what they would pay us if we were in network versus out of network. So, there’s a certain ones. We don’t care to say the truth just because the reimbursement structure that they have. But yeah, the providers we have and I have a handful that are quote unquote full time. We don’t have full time employees. There’s. Still 10 99 contractors, but this is what they do for a living. They have 35 40 state licenses. The more those guys are available, patient wise, insurance wise, the better, without a doubt in every one of those states got.
Mike Manson (32:15) It. And are you guys tracking lost?
Jared Arnott (32:20) Revenue.
Mike Manson (32:20) because of exactly what you just mentioned like, hey, we, you know, we had 100 leads last week. They had our website and wanted to see us but we couldn’t because we didn’t have them enrolled. Yeah, we.
Jared Arnott (32:31) definitely track patients that call in that aren’t provided services. And there’s obviously 100 different reasons for that, whether it’s you know, our choice or their choice or something in between and that’s one of them is we just don’t have somebody available at that moment. We may have somebody available in an hour or two or whatever. But again, we’re in a pretty short window as far as how long the patient’s willing to wait. It’s not long. Makes.
Mike Manson (32:56) sense. I’m just trying to put myself in your shoes and feel free to correct me if I’m wrong. But the way I would be thinking about it is the more providers on the platform enrolled and licensed in more states, the better odds we have of winning business the.
Jared Arnott (33:11) Whole model which is again, I think we talked about before need to double the providers in the next, you know, few months is simply because of that. And obviously we don’t require them to be available in a specific time. So even if I have nine available dentists, five of them may be unavailable, whether they’re out to dinner or they’re working another full time job, they’re not required to tell us just like any other 10 99 gig, if you were driving for Uber, like you don’t have to tell them. I’m not available. You just tell them when you are available, same concept. They just tell us when they are available. So if I have nine and only five are available and only two are in the insurance world. Like then again my numbers dwindle down and down. So I need to take that nine to 18. So then if half of them are available, I got 10 and then, you know, so on and down the road. So that’s the whole numbers thing is I have to have enough people on the back end to service the front end, which we match pretty well right now. But we’re in the process of growing that front end pretty well. So we need to have the providers in the back end to match. It makes.
Mike Manson (34:13) sense. I would imagine probably less free French fries for your 10 than the Uber drivers, but no, that makes a lot of sense. It’s helpful to understand where you guys are at. I mean, who on your side cares about this? I mean, I imagine it’s you know, I was looking up, I would imagine Keith probably is pretty focused on availability and things like that. I mean.
Jared Arnott (34:36) There’s only six of us. So it’s a constant topic we have every day we review how many patients came in, how many we were able to convert? Why didn’t we convert them? Is it something in our system as far as we screwed up? They dropped off? Did we do a poor job of whatever? Or was it just the patient didn’t like our service? Whatever the case may be. We certainly have those patients that just want to see an in person dentist or they want the prescription for God only knows what that we’re not going to give them. That certainly happens too. But yeah, there’s also the world where they were ready to go. And we said, sorry, we.
Mike Manson (35:10) Don’t have anybody. Yeah. Okay. No, it’s super helpful. I think it’s interesting. I mean, I think from, no, unless you disagree, I think from our perspective, it appears to be a pretty good fit. You know, I think we’re going to be able to do what you need us to do and, with the goal, of keeping up with your scale and that, you know, again putting myself in your shoes, like if we can take this work off your hands and you can go out and recruit more people, man, that would be the goal, right? I would think.
Jared Arnott (35:40) The more people I can get on there’s, not a limit like the people that I talk to. I’m not turning them away unless they’re just a terrible fit from either a conversational piece. They, they sound on the phone or they’re just jerks. Yeah, they’re a licensed dentist. I’m cool. Let’s bring you on. And again, nice thing about tenninetynine, if we have a couple phone calls that go sideways or they’re not a good fit, then I just, we can kick them off. We don’t have to, we’re not contractually obligated to keep them on at that point. But yeah, there’s no limit to the point of just saying the only limit as far as the number of providers is just how quickly can we get them on? Yeah, and then keep them busy. So again, if we send them zero work in the next two months, they’ll probably drop off themselves. So, yeah, there’s a balance there, but yeah, there’s no limit on how many I can bring on because more is better, yeah.
Mike Manson (36:32) Outside of this credentialing activity is a lot of your day to day like recruiting and dealing… with current providers.
Jared Arnott (36:43) I don’t want recruiting. We don’t have any real big… again because part of it, there’s a bottleneck as we’ve discussed from an onboarding standpoint, part of it is too, we don’t want to get out of balance for the patients we have. So we’re trying to keep that symbiotic again if I bring on a bunch of dentists and there’s no work for them to do, it’s, not helpful for anybody. It’s just making additional work for no point. So we don’t do a ton of recruiting. We obviously have things out there on websites and our stuff. I probably get five to 10 inquiries a week from dentists that have some level of interest. And then obviously we talk we discuss, is there a match? Is this something that interests them, you know, whatever the case may be? But there seems to be enough interest there that if I wanted to first… from the onboarding process, speed it up. And then obviously, once the front end continues to pick up, there’s enough interest there to hit the gas pedal pretty good. Yeah. Okay. And so,
Noah Laack-Veeder (37:50) so, Jared is thinking about like kind of tying a bow on this demo. Like as you were talking about that phone call with those dentists, they’re like, hey, you’re licensed you’re not a you’re not a meanie, you’re not a jerk. I want to enroll you. Like, how does the experience that I showed you from getting the providers in the system to enrolling them compare with that ideal workflow that you’re thinking of?
Jared Arnott (38:14) Listen to what like, so.
Noah Laack-Veeder (38:16) If you’re thinking about the new process being automated, not manual things that kind of fall through the cracks, getting as much data as possible early on. And then ultimately, the result there being we get these folks billable 50 percent faster. Like was there anything else from the technology that was outstanding that you want to look into? Or do you feel pretty comfortable with what you saw?
Jared Arnott (38:40) Pretty comfortable with what I saw kind of what I imagine again they’re still going to be that quote unquote interview process that’s going to be on my end as far as manual and going through that. But once we kind of hit the yes, we’re going to move forward with it. That’s where I think we pulled in there like, hey, if we can send them a quick link, if all they have to do is hit a ceqh number versus fill out paperwork, they can turn that around to me in a day hopefully or however close they want to get to it. But essentially, if they only have 10 minutes worth of work on their end, hopefully they can do it in the same evening. And then from there, how quickly can I turn around that hit the button to say, hey, yes, I want delta of Arizona. I want blue colossus of Arizona. I want whatever… and then we can start that process. You know, we could be talking about 24 to 48 hours to get from phone conversation to we’re filling out paperwork to we’ve now got an application submitted. And then however quickly delta of Arizona wants to get back to us.
Jared Arnott (39:34) Obviously, we’re on par, you know, whether that’s a week from now or that’s a month from now, we hear back from them that’s you know, obviously the quicker the better.
Noah Laack-Veeder (39:43) Yeah. I mean that makes sense. I think the thing I’d say is the typical provider to admin ratio here is like it usually takes around 500 to a 1,000 providers for this to start being a single fte’s responsibility just because so much admin work is done. So, if this is kind of like how I’m seeing this? I’m not sure who you’re envisioning being the kind of the admin of medallion. But if you’re kind of the person talking to these folks, pressing a couple of buttons that’s definitely something that like doesn’t take a whole lot of effort. But I kind of how are you thinking about this? Like given you have automation like this, would you be thinking about hiring someone still? Or would this still be kind of more a side of the desk thing for you to do going forward? The?
Jared Arnott (40:25) Whole team is currently me and that’s the plan forward.
Noah Laack-Veeder (40:28) Okay. Yeah. Okay. So that makes sense. So I think summarizing your responsibilities going forward, chasing providers for things that we can’t automate, which might be a couple things, right? A document or two telling us what you need for enrollments. If we have a follow up that we can’t automate, we’d route it to you and say, look, we need this from the provider. Can you help us out? Other than that, we’re just going to be notifying you when they’re par and the whole idea would be we’re going to be doing that about 50 percent faster.
Jared Arnott (40:58) So.
Noah Laack-Veeder (40:58) With that being in mind, I think as you’re kind of thinking about other platforms, I think some things to look out for is like we have kind of the automation owned outcomes end to end. So when we say these things will be 50 percent faster, like we’ve got slas that will guarantee those performances. So as you’re talking to others, I would definitely inquire about that as well because I think that’s really important. But the other piece is that because this is kind of all, we do around 200,000 plus enrollments per year. That’s how we’re getting those turnaround times so low. But one thing I did want to ask like you’re talking to dentists that are licensed, are you ever having to get them licensed yourself for a new state? Like, is that something that you would do for them?
Jared Arnott (41:44) A few, if there’s a big need, I have done a hand full of state licenses, not many. There’s a lot of times we have reached out to providers that may do it. You know, we say, hey, we have a need in Rhode Island or Massachusetts and they’ll say, cool. I’ll take care of that and maybe something we even reimburse them for. At that point. That certainly happens. There’s some that obviously this is, they work for us and any other telehealth company they can find. So they’ll do it themselves. You know, they’ll have 10 or 1,215 licenses to start with. But yeah, so the process I have done it personally, I think three times for different licenses just when we’ve needed to, I’ve asked providers to do it, you know, kind of because we have a need several times and they do it, see if it takes however long it takes from that point.
Jared Arnott (42:32) And then obviously, there’s ones that just kind of do it on their own because of their own benefit type of a deal. And then they just kind of send it in and say, hey, here we go. But yeah, again, because the way the business works, the more people that are licensed in Texas, the better. And if it happens to be the same Guy’s, license in Arizona, I don’t care.
Noah Laack-Veeder (42:51) Yeah. Here’s like let’s just get you licensed. So, yeah, medallion can do the licenses as well. I know it’s probably not the biggest focal point of this, but if that is something that you need to do medallion can offer licensing, the payer enrollment all in one platform. So just as you’re evaluating others, it’s kind of that’s another reason why organizations choose a medallion versus other folks in the space.
Jared Arnott (43:13) Yep. That makes.
Noah Laack-Veeder (43:14) a lot of sense. We see. I know you.
Mike Manson (43:16) Mentioned verifiable last time we see verifiable a lot, I’ve had the pleasure of moving a few folks off of them recently. And I think the biggest side by side comparison that we do that they don’t is the payer enrollment piece.
Noah Laack-Veeder (43:29) Like they’re if you’re looking for a self.
Mike Manson (43:32) Service software. Their software is not like if it’s just credentialing and credentialing to ncqa, they’re going to look relatively similar to us but that’s still you managing that like they offer some automation, but it’s still you doing the work. What they don’t do at all that we have a clear advantage on is on the payer side, like we’re going to, we’re going to take that completely off your hands. You’re going to say we need this Guy submitted in these five places and it’s set it and forget it until their power status there’s no, we do all the follow up, you know, we own that completely. So it’s that and then it’s the SLA, like we mentioned a couple of times, like, we’re not just saying, hey, look at us. We’re the greatest piece of software you’ve ever seen. Like we’re actually going to contractually commit in our contract that we will deliver on the turnaround times we talked about.
Noah Laack-Veeder (44:26) So that’ll be that Jared like kind of when you’re doing what’s kind of like what’s the like the technical, what’s the technical evaluation look like? I’m sure you’re having demos like what is kind of like, what are the pieces that you’re looking for? And is there anything that like we’ve not talked through yet?
Jared Arnott (44:48) The main pieces coming into that I’ve looked at is one is the onboarding process is, can we make it Symplr for myself? One to get that information to them and then Symplr two for the providers. It’s certainly almost called a bottleneck, but filling out manual paperwork takes them whatever 30 minutes. It’s still something they don’t want to do. So, it kind of gets put in the back burner and maybe they don’t do it for a week or two. So, that was a big again front end as far as, hey, how do we shorten that? And then the next one was with all the payers. We talked about it. It’s how do we get that provider networked credentialed with the folks we want them with? Whether it’s again delta of Arizona or blue cross, whatever the case may be. How do we get that done… one quicker? Two – without manually doing it ourselves. Those are the two biggest things without a doubt. The tracking of everything. Again. Good. Now, it’s functional. By all means. The information’s there, it’s stored. We have it, it’s not being updated. It’s not being tracked. It’s not being proactively, you know, hey, your license expires in six months. Do you have a new one? Hey, your credential expires in 60 days? Do you have a new one? It’s there again manual. We’d have to look through it to do those types of things. So that’s kind of the last thing as far as just, do we have some place where all this stuff is stored and tracked and kept on top of that’s. The biggest things I was looking at kind of going into it. And then like I said, there’s additional things that could be nicest to have whether it’s the state licensures or things like that?
Noah Laack-Veeder (46:21) Yeah. And so again, I’ll just ask the question directly like how are we doing with the evaluation criteria there? Do we think? Do you feel like we hit the mark?
Jared Arnott (46:30) Yeah. Okay. Yeah, you’ve checked all the boxes as far as… hey, there’s nothing missing that says this is a big red flag that, you know, is not going to provide what I need it to… we’ve got about.
Mike Manson (46:47) 13 minutes left. So ideally we can break early on a Friday afternoon, but I guess my question is what happens next? You know, we have a typical process that we follow. Usually we would get back together after this call. Assuming you’re interested, we kind of try and dial in that bva a little bit more so that we have an accurate representation of, you know, where we’re going to end up from an Roi perspective. I think it’d be good to just dial in the scoping to like really understand like how many providers you have now, how many do you plan to hire in the next 12 months? How many enrollments do you think you’ll need so that we can get pricing dialed in?
Jared Arnott (47:28) And then from there would be,
Mike Manson (47:29) you know, pricing conversation and, you know, if you need to review legal and all that stuff. So, yeah, just curious how you’re thinking about it, timeline, all that good stuff.
Jared Arnott (47:38) I mean, I’ll let you kind of lead as far as the next steps. But that’s where my brain goes to as the next things is what information do we need to exchange to really get a firm grasp on this? Is, what exactly the portal will look like? The functions we’ll have. This is what the cost is going to be of that. And then from there, we can, you know, do a present and future state of, okay, this is, I currently have X number of providers with whatever minimum of offices. We have all that kind of fun stuff that information exchange wise. And then how does that roll into? This?
Jared Arnott (48:14) Is what we’re looking at from a cost standpoint. And then obviously, we can go into the, what changes in future state as far as, hey, if we’re expected whatever 20 30, 40 new providers in X timeframe, what does that do? Does it change our portal? Does it change the cost? Do we grow from this? How does that go? So I think that’s the logical next.
Mike Manson (48:31) Stop. Yeah, I think that makes perfect sense. I think we should put some time on to go over that. We probably only need 30 minutes. I can send you a doc that has like kind of the inputs we would need from you, but I will say like you may not know all the information and it’s worth getting together and to go over it live because, you know, we, me and Noah do this every week but, you know, most people we talk to don’t so I would love to just kind of like be clear on everything so that we’re giving you an accurate proposal.
Jared Arnott (48:59) Sounds good?
Mike Manson (49:00) Yeah, I am actually on pto, all of next week. Is that what’s your timeline? Like, I mean, I can get someone to fill in for me if you’re close to a decision or I wouldn’t say I’m close.
Jared Arnott (49:16) To a decision. We’ve not set a timeline for him. So, obviously, I don’t want this to drag you for the next two years, but we’re not in a time crunch either.
Noah Laack-Veeder (49:30) Yeah, I guess when’s the next like cohort of providers coming in?
Mike Manson (49:35) I.
Jared Arnott (49:36) mean, I’m doing one or two a week currently pretty steady.
Noah Laack-Veeder (49:39) Okay. Got it.
Jared Arnott (49:41) So, there’s not like a,
Noah Laack-Veeder (49:42) big like week of 10 or 20 coming in soon that you’d want to get ahead of. Okay?
Jared Arnott (49:48) There’s not, so again, my process is I get five to 10 inquiries a week. I have some pretty generic emails that go out that give us a short spit of this is what we do. If they have interest, after that, we have conversations using my five to 10 turn into two or three that have some serious interest of those two to three, one to two become, you know, hey, this is, you know, paperwork type of a deal so that’s fairly steady. Some weeks are more, some weeks are less, but there’s no, you know, hiring period or something like that. We have. Okay.
Noah Laack-Veeder (50:20) That makes sense.
Jared Arnott (50:22) I’ve got calendars up.
Mike Manson (50:23) In front of us, do you happen to have 10… 30 a M open on the 20 eighth?
Jared Arnott (50:31) 10 30 to 1,120. You said 20?
Mike Manson (50:35) Eighth. Yeah. Okay. That’s fine. Okay.
Noah Laack-Veeder (50:42) Can you believe it’s already the end of April. I don’t know, man. I’m just like that’s. So nuts. I’m like, oh, it’s green grass and I’m like wasn’t it just winter it’s.
Jared Arnott (50:50) I’ll say send that.
Mike Manson (50:53) Out. I’ll get a recap and like I said, I’ll get that kind of preliminary doc that’ll help us dial in a little bit ahead of time on scoping last question I have, and then we can break is assuming we’re selected, you feel good about it? Have you purchased software before? Like what happens on your end? I know it’s a small team. I’m sure you guys are constant communication, but does it go up to your CEO? Like who kind of ultimately signs off?
Jared Arnott (51:22) To see if it was going to be the final decision on all of it especially when it comes to a finance standpoint, I have a technology… officer too that from a software standpoint, I usually run everything through him. Just to get some eyeballs. He usually has some more intelligent technical questions than I would ever even begin to think of my technology is if I hit this button and it works, we’re good. He’s obviously a lot more on the back end loves it and he’s built all of our own portals and back end host and that kind of stuff himself. So he’ll do that scrutiny from that end of things. But that’s kind of where we’re at.
Mike Manson (52:00) Okay. Yeah. And I can provide some information that you can share with your CTO too, just about like data security. And like, you know, we’ve got soc two type two compliance and all of the stuff that he’s probably going to want to post check, including our API documentation. Like there’s a future state where you want us plugging into some of your other portals. You know, we have options. We have options to do that as well. So I can share that ahead.
Jared Arnott (52:23) Yeah. So what we’re going to be interested in is we’ve run our own patient software, essentially patient management software that if you’re running whether it’s curve or dentrix or anything other system that’s out there in the world, we kind of host our own one because it’s a, very simple service. We’re not treatment planning. We’re not charting teeth, we’re not future state planning for, you know, what’s this patient going to do? We have notes, we have prescriptions, and we have patient information that we have to share with insurance companies. And then we have data we have to store. So our system is basically just that, but it is nice that we, if we have the ability as something to integrate. And again, that’s we’re getting to a point where obviously future state. But I can see a world where that can make some sense, cause that’s where we put all of our providers in that’s where prescriptions go out of that’s where all of our claims will be heading out of that’s where all of our claim verification goes out of all that kind of stuff. So if it communicates somewhat with onboarding and payer providers that they’re in par with or out of par with there, there’s a state where that can make some sense.
Mike Manson (53:20) That’s a, that’s a common use case like I was, if Daisy Romero on the RCM side like pushing an effective date into your system, I would imagine would be helpful for her.
Jared Arnott (53:32) Something we can.
Mike Manson (53:33) Do. Cool. Great to connect you again. Jared. I’ll send the invite out. You’ll hear from me with the recap. If things come up, don’t hesitate to reach out and we’ll, Noah will jump on any questions while I’m out right now. Yeah.
Noah Laack-Veeder (53:45) Of course, my email is easy to remember Jared, Noah at medallion co, I guess the hardest part is remembering it’s not com, but it’s on. So, yeah, if you have any technical questions, feel free, but it’s a pleasure meeting you and just let me know if anything else.
Jared Arnott (54:01) Comes up. Enjoy the weekend yep.