Centra Demo

Transcript

Phone Caller #3 (04:12) good morning. Everyone. Good morning.

Phone Caller #2 (04:23) Let me just make sure Mallory’s able to get in. Happy Friday.

Phone Caller #2 (04:31) Yes, happy Friday. I just admitted. Mallory. There she is. Are you all in a conference room together?

Phone Caller #2 (04:48) Can you hear us? Okay?

Phone Caller #2 (04:55) Testing testing… Erica, can you hear me? I can hear you. Yeah, I don’t know if everyone’s in a room together.

Phone Caller #1 (05:04) They’re actually just pranking us. This is a delayed April fool’s.

Phone Caller #3 (05:29) I’ll pop it in the chat. Can you hear us now?

Phone Caller #2 (05:45) Yes, it’s a little bit of like echoing, are you all in one room? Yeah.

Phone Caller #3 (05:50) So, we’re going to have to just join from one of the laptops, and then we’ll fix it. So just give us two seconds, okay?

Phone Caller #2 (05:56) Sure. Okay.

Phone Caller #1 (06:02) You know, I’m on piano there’s this reverb option. So, whenever I want to play like disney music or something that’s exactly what it sounds like.

Phone Caller #3 (06:15) Okay. Can you hear us now? Yes. And there’s no, no, no Healthstream. Okay?

Phone Caller #2 (06:23) We can hear you. We can’t see you.

Phone Caller #3 (06:33) There you are. Yeah. So if we, yeah, if we turn our cameras on, then we won’t be able to see your screen. So it’s going to be either our faces or can we see what you’re going to demo? Oh,

Phone Caller #2 (06:42) okay. Well, we see josh, we have one face, so that’s good. We know we saw what you look like. So that’s great. So, how was it? So, yeah, how was your, before we jump in? How was the vacation, Nicole with the babies? It was good. Yeah, I had a really good time. It was good. It was good.

Phone Caller #3 (07:04) Nice. Okay.

Phone Caller #2 (07:07) I hope you’re able to chime in because I want it to be interactive. So I hope you can come.

Phone Caller #3 (07:13) Off.

Phone Caller #2 (07:13) mute and we’ll be able to ask questions. So what I was thinking for agenda… is why don’t we, I know we carved out an hour and a half. Not sure we’ll utilize the full time but glad we have that. What I was thinking is let me just do a quick recap on what we heard from the last conversation. Make sure we heard everything correctly. I’m going to show one slide on kind of business value, how we’re thinking about measuring this and would love your feedback there. Mallory will run point on the product demo and she’ll frame up the product SKUs that we’re going to talk about and then let’s hold the last like five or 10 minutes, get your feedback on it and make sure we align on the next steps which could be going deeper on the business value or scoping doing some proposal scoping. Does that sound good?

Phone Caller #1 (08:14) Or for what?

Phone Caller #1 (08:22) Sorry, I saw, I had to step out.

Phone Caller #2 (08:24) I’m trying to think how we can get it so that you guys are able to be interactive because I want to make sure we’re not just talking at you for an hour. I’m trying to text.

Phone Caller #3 (08:35) Yeah, we’re interactive. So you just won’t be able to see our face. We can hear you and hopefully you can hear us.

Phone Caller #2 (08:42) Yes, I can hear you now. Sonya, there we go. There’s a little bit of background with Nicole. Okay, great. So I guess first, I know we were socializing this with rob and looking at this from a macro lens with medstaff under him as well. Any initial feedback from him from our last conversation?

Phone Caller #3 (09:09) He just told us to proceed on with our demo and looking at the professional side. And then when we get the quote from you, all you can include both sides, but we are focusing on the payer credentialing and the piece that we directly oversee.

Phone Caller #2 (09:25) Okay. That makes sense. We were actually talking about this yesterday and that big of a change may be a lot at.

Phone Caller #3 (09:32) Once, so, yeah. So we’re going to proceed here with the payer credentialing side and see what comes in with that quote, like I said, and compare that to what we are spending internally and have those conversations and that’s the way that he told us to proceed with moving forward.

Phone Caller #2 (09:53) Okay. Let’s see, you know, what Mallory, I got a new computer and it’s not, I’d have to quit to.

Phone Caller #3 (10:02) Share.

Phone Caller #2 (10:03) Would you mind sharing? Yeah, I can get that pulled up. Yeah, sorry about that. I thought I was, yeah.

Phone Caller #1 (10:12) I was sneaking a look at your laptop holder in Austin and it said delivery. Sorry, I’m a creeper like that.

Phone Caller #3 (10:20) Let me get.

Phone Caller #1 (10:21) It pulled up. Is it the, the one modernized with medallion CMG marshmallow? Yes?

Phone Caller #2 (10:29) So, we’ll start on slide three.

Phone Caller #1 (10:32) Okay, perfect. I’ll get over there.

Phone Caller #2 (10:36) And thanks so much for giving us so much, great information on kind of what you’re looking to solve for it helps us kind of frame out the business case here. Okay? Of course, can you see Mallory’s screen? Huh. Okay. So, current state we understand, and I want to make sure I got this correct. So, right now, the full credential process, it’s a manual process and it’s split into the med staff, cbo, onboarding, and privileging, and then your team with patient accounting. And under that is payer enrollment, the delegation scheduling and ongoing monitoring. Did, did we capture that correctly? Yeah. And.

Phone Caller #3 (11:12) You can actually up that to say payer credentialing, because it is a separate team within patient accounting. Patient accounting isn’t the team and that will confuse our leaders. Oh.

Phone Caller #2 (11:21) Okay. So that should be titled patient accounting, not or patient credentialing, not accounting.

Phone Caller #3 (11:27) Payer, credentialing. Okay. Payer credentialing?

Phone Caller #2 (11:31) Okay. And are those the right product the right like responsibilities that align the enrollment, delegation scheduling and ongoing monitoring? Yes?

Phone Caller #3 (11:43) And they also do re, certifications for the provider. Okay? And we do the paperwork for the 855 updates as well?

Phone Caller #1 (11:57) And when you say re, certifications, do you mean like the revalidation? Okay? Thank you. Yes.

Phone Caller #2 (12:06) Okay, great. And then understand payer mix is about 83 percent medicare because of an aging population here. And then the remaining volume you have is split across commercial medicaid, about six to seven delegated commercial agreements and 10 to 12 non delegated agreements. Is that accurate? Yes. Okay. Great. And then turn on times. Josh. I think you gave us this metric. We’re at around 90 to 120 days from submission. We’re measuring this from submission to effective date. And I’ve identified one of the biggest areas of delay in bottleneck is just the payer follow up, which we can show you in this demo today, how we address that. But did we hear that correctly? Yes, that’s correct? Okay, great. And then, so for the payer credentialing, which I can update that there’s six ftes on that team, correct? Okay. And the goal would be potentially reallocating some of those folks to work denials with a goal to improve margins?

Phone Caller #3 (13:18) Correct. Great. Okay. And then,

Phone Caller #2 (13:21) just like overall, looking at this from a macro level grant goal is for information project is really just to improve the fte productivity, prevent denials and reduce labor costs. Just looking at your annual report, it looks like it was like 44 percent of the overall expenses is labor costs.

Phone Caller #3 (13:39) So,

Phone Caller #2 (13:40) it sounded like a metric was to improve.

Phone Caller #3 (13:42) That?

Phone Caller #2 (13:43) Is that correct? Correct. Okay. Great. Mallory, do you mind just pulling this forward? Yeah. And we’ll just spend like five minutes here. I just want to make sure I think this was something we were looking to measure last time, Sonia, the denials since that’s something that it would be kind of like success metric of this project would be reducing denials. I think you were going to ask it for this data on what the denials looked like last year from like a 12 to 18 month look back. Were you able to get that data?

Phone Caller #3 (14:20) Yeah, I have not gotten that. Do you know where we are with the total for prevention? I have to get a report on that. Yeah, so we can get that to you quickly. I can get Wes to run that because he was on vacation last week and so was I, and so was Nicole, so.

Phone Caller #2 (14:40) Okay. All on vacation? Okay. I hope it was fun. Yeah. Okay. And I guess looking at this just so we can help you if you don’t want to champion this with the business case. I said, look just looking at the annual report. It looked like the overall spend was like 44 percent on staffing… and operational expenses. Do you know, like how this project’s being measured? Yes?

Phone Caller #3 (15:16) So, I would not lean as much on the transformation piece and looking at the annual report because that truly is separate. We are looking at our department and our area and the improvements that we need to make in our team. So, I don’t know that… yeah, because they don’t even know that we’re looking at outsourcing. We are doing this based on the work, the number of ftes and what we need to do for ftes in our department. So I don’t know how that’s being compared to the bigger picture.

Phone Caller #2 (15:54) Okay. And really the just, the goal is there, is to just understand how it would be measured. Yeah, so we.

Phone Caller #3 (16:04) would be measuring it by the time for credentialing. So, the time from submission to credentialing the reduction in denials that have to do with payer, credentialing or any provider denials that’s how we would measure that success.

Phone Caller #2 (16:22) Okay. Yeah, that sounds good. So, yeah, just whenever you have it, we’ll want to be great to know where it is today and then where we could hopefully move the needle and understand that Roi metric.

Phone Caller #3 (16:34) And then,

Phone Caller #2 (16:35) doesn’t need to be now, but as we’re going through like I think this demo will be almost like an art of the possible. But just so we have, we’re thinking about kind of what would.

Phone Caller #3 (16:45) need to be?

Phone Caller #2 (16:46) What you need to see in the demo and throughout this pro, this evaluation process to ignite a change because obviously, there’s you know, it can be a short term headache for a longer term gain. But, what would be kind of the catalyst to make you make that change?

Phone Caller #2 (17:05) So just something to think about as we’re going through. And then, yeah, just last question before I turn it over to mal, I’m guessing funding you’re saying that this would be funded through staffing, reallocation, is that?

Phone Caller #3 (17:16) Accurate. That is correct. Huh. Sounds good.

Phone Caller #2 (17:20) And then mal, do you mind just pulling this forward to the next to slide five?

Phone Caller #3 (17:28) Is this it? Yeah, the,

Phone Caller #2 (17:30) Tampa general. Yeah. So just quick customer story as a large health system, you know, we work with over 350 provider groups and health systems and just some, what you could look at from like just anchoring on something. I think yours would be larger because you’re a larger health system. But Tampa general, it’s all two point 4,000,000 just in being able, to move faster in their credentialing process by partnering with medallion. And obviously, we get better over time, but just to give you a little bit of insight there. And really it was just compressing those turnaround times with both delegated and non delegated agreements, as well as improving the provider experience, which was something really important. Reducing some of that administrative lift.

Phone Caller #2 (18:17) And then I’ll just pull us forward to the next one. And then I’ll and then we can go into the demo. Okay? Maddy, am I just going forward one?

Phone Caller #3 (18:29) She said she had to step away. Oh, okay.

Phone Caller #2 (18:33) Let me see. All right. We are good then. Let me just see the next one. So the next one was just, I was just curious the number of providers that you have today. Do you know how many providers you have today and what, the forecasted hiring looks like over the next year or so? I don’t.

Phone Caller #3 (18:57) know the forecasted hiring because that is handled within CMG operations.

Phone Caller #3 (19:02) I could probably get that from Aaron Reid, but he’s on vacation through next week. And then we have approximately about 800 providers. And on.

Phone Caller #2 (19:17) average, we do about 120 new providers a year. Okay, perfect. Okay. That’s that’s exactly the metric. I was looking at the 120 new providers because obviously, you’re the providers that you have today are already credentialed in a network. So basically the work that we would be completing for you aside from the ongoing monitoring, which is a much lower lift would be like how we would price this, which is the number of new providers that you would need us to enroll with the number of payers, and so that 120. And then we also just from an Roi perspective… we look at the number of then… the amount of revenue generated each day per provider. And if we can do an X number of days faster like, you know, 50 days faster, this is how much more revenue and margin that we can increase for.

Phone Caller #3 (20:10) You. So as we.

Phone Caller #2 (20:11) Go down as we go down funnel there, we can get clearer on what that exact Roi would look like. But just rough numbers with 120 providers, minimum of one to 2000 dollars per day in revenue. There’s probably a couple 1,000,000 that we could recoup and like say couch cushion money.

Phone Caller #2 (20:33) Okay. All right now, I’ll turn it over to you to run point on the demo. So really, yeah, just to kind of frame it up. We are going to, we plan to start with the reporting module, then we’ll show you core single source of truth as we call core. But it’s really going to be what you can utilize in lieu of spreadsheets. We’ll do pair enrollment, ongoing monitoring and we’re going to leave off credentialing, and then we can go into licensing. I know that’s something that you said your providers are doing today and get reimbursed, but again, just picking up some time from them doing administrative tasks.

Phone Caller #2 (21:19) Does that sound good?

Phone Caller #2 (21:24) Yep. Sounds good.

Phone Caller #1 (21:27) Awesome. Thanks. Erica, is everyone able to see my screen?

Phone Caller #2 (21:30) Yes, we can. Okay. Thanks.

Phone Caller #1 (21:32) All right. So we have plenty of time. So I definitely want this to be interactive. If you want me to go back and reiterate any part of the platform itself, how the services aspect would work with it, please just let me know. As Erica said, we’re going to kind of follow the flow of reporting provider onboarding and how we get those providers in the system very first of all. And then of course, implementation, we’ll talk a little bit because we have plenty of time for it. From there, we will talk about pay or enrollment and what that will look like for you guys. Okay. So with the screen that you see here, you are able to white label the system. So you’ll see that your logo can be put up right in the top. It’ll be center medical group, everything you would have your full provider directory available here. But I want to start off with first is actually analytics and reporting as a part of the platform. And then we’ll talk about the onboarding experience. So when we think of analytics, this is going to be your visual dashboards that you’re wanting to be able to track all of your forecasting growth and scalability as you continue to grow in the industry, whether it’s the licensing segment, pay or moment credentialing. We have analytics for provider onboarding task summary, just additional metrics that you can track such as how long is it taking our providers to complete tasks? Currently? How long is it taking for them to get onboarded? Where is the bottleneck that we’ve been able to identify? So what that really means is that dashboards means less manual work, which is a big win for your team. So rather than you having to go through and compile all the different manual data points, you are now able to just have it done for you automatically with the analytics that you see here. So when we think of the analytics, the other great aspect of this I’ll show you with open market share. I know that because you do have delegated and non delegated and so forth. I do want to show you what this could look like by enrollments by market. So when you think of an enrollment report depending on how many states that you manage, or if it’s just one state, if you want to look for certain demographics within it, you’ll be able to see all the market, open enrollments, the percentage covered by each payer, the open enrollments by providers themselves… and any of those metrics that you would look to be tracking. So that’s all the analytics piece of it, whether it’s payer, enrollment credentialing. Ongoing monitoring. And then I’ll also show you the report builder. So the biggest benefit you’ll get with your report builder is these reports. There’s going to be standard canned reports that come from the system. There’s about 10 or 15 of them that your team will be automatically set up with. You also have the ability to create and build your own reports. So, I’m going to show you what that looks like here in just a minute. The biggest value that you’ll find with this is that these reports can be automatically scheduled to be sent from the system at whatever cadence you prefer. So if there’s someone that you’re updating on your leadership team, if your med staff team is looking for an update, if you’re billing scheduling teams, anything like that, this system can automatically have that report in their email inbox every morning, once a week, once a quarter, whatever you prefer to see there… when it comes to building your report, I’ve worked in multiple different credentialing softwares at this point in my tenure and this is by far the easiest that I’ve been able to see. So depending on the type of report that you want to build, let’s say that we want to look at pay or enrollment request. With this one in mind, we’ll be able to say in the order that we select the icons or the different data points that’s the report order that it would build. So let’s start with state payor… the lines of business for that payor, maybe the npi and the provider name the… status when it was submitted, how many days it’s been since submission? The effective date. I can take all of these points, transfer them to the right. We now have a report with that required information. So this is really helpful when you think of payor directories, if they reach out to you on a quarterly basis and say, hey, please match your provider directory with our format. And of course, they’re payors. So they’re never going to have the same format across the board. I appreciate caqh’s efforts to centralize all of that, but definitely finding a good fight there… with this report. You’re able to go ahead.

Phone Caller #2 (26:00) Oh, sorry. I’m just going to pause here for a second. Thanks, val, on this report builder. I know this was something we were really leaning into because this is being done on spreadsheets today and we have to coordinate back and forth with the office manager. It’s a lot of like manual effort and dashboards. Is one of the things we wanted to look at. Is this the type of data points that you would be looking for in a system?

Phone Caller #1 (26:23) Yes.

Phone Caller #1 (26:28) Do you now hear me? I said, yes. Oh.

Phone Caller #2 (26:29) Yeah, cool. Okay. I didn’t know if there was any elaboration. Sounds good.

Phone Caller #1 (26:33) Thanks, val. Thanks. So with this report, you are able to go through and filter based on the response or what field you’re looking for, you can export this as an ad hoc or you can just save it. So hopefully you’re able to see the value there. That with these reports, if your team is currently having to spend even if it’s one to two hours per week creating reports, sending them out, finding the data that has now been eliminated, the need for, because this can just be done in the background, set it and forget it mentality. Okay. Before I go and lead analytics and reporting before we talk about the onboarding experience. Did you have any questions regarding the functionality? Any of the value points here? No, that looks good.

Phone Caller #2 (27:19) Okay. Awesome. Now.

Phone Caller #1 (27:21) Let’s go ahead and talk about the provider experience. So of course, you have your directory. This will be where you store all of your providers in the platform. When it comes to inviting providers, there’s two different options. There’s the bulk import where we take the provider’s caqh id, their last name, their npi from there, it automatically downloads the provider’s caqh profile, all their data points, all the documents, it’s going to create a profile for them in the system. It’s going to send them a welcome email. They’ll be able to electronically sign in review, all the information, electronic signature, all the bells and whistles, when you think of the onboarding experience that’s the bulk import option, we also have the individual option. So someone from your team, if you have only one or two colleagues joining, then you can come through and say what is the role? So we do a role based access control. If it’s a provider individually, an admin. This would be someone on your team. So you can have full visibility of the entire platform. And just as a reminder, even though we are a services solution for you, we are able to give you full transparency. So you can see every aspect. So everything I’m showing you today would be your view and your experience in the platform. Once you’ve identified the role of the provider or the user that you’re adding from there, it’s just minimal information, their email name, start date, provider type. What happens next is a welcome email goes out directly to that provider. That welcome email will look something like this. So you’ll see your logo up at the top. This is white labeling capability. So you do have the ability to list everything out in the email. You can have whatever wording or messaging here that you would like to see. The providers are able to do a mobile experience with this onboarding as well as from their laptop or from their tablet. Once the provider receives this email, what they would do is click get started. And when they click get started, they’ll have the onboarding flow of what you see here. So central medical group has partnered with us for licensing, credit payer, enrollment, whatever services as you decide the provider would get started, they would be able to kickstart their profile. There are multiple different data ingestions here. So the first one of course is going to be caqh. We are a participating organization with caqh. That means we have a true bi directional with it. So what that means is we can import the provider’s, caqh without having to have their username and password. We could also push any information back into caqh. So rather than the provider have to keep up the correct data in the Medellin platform. And in caqh, the two now talk to each other and we are the only vendor in this industry that has that bi directionality. So with caqh that’s what 80 85 percent of our customer base currently uses for their providers. Many of those providers that are fresh out of grad school or medical school. We also have a resume scanner. Maybe you have some tenured providers that refuse to use technology. It is reality, unfortunately. So if they do have a CV or resume and it’s 15 pages long, they can just upload that. Instead, we have OCR technology to read that populate the profile for them. And then finally manual or API integrations with a group of your size. I would definitely recommend an API. It is open and bidirectional with your HRIS platform, with your CRM, with your billing scheduling systems. So it can be upstream or downstream… that can happen automatically. So what a lot of our customers will do rather than the provider having to create a whole profile with a medallion and add their own information, they will connect it from their HR platform. It will feed everything in connect all the information and populate it for the provider. That way they can just log in and review it. We use the caqh option three data points. If it’s the provider connecting it, it’s social caqh id and last name. If it’s you connecting it for the provider, their last name, npi, caqh id… once it reaches out and it verifies that the provider does have a caqh profile, it would hit confirm and link. It is now linking their profile. This is going to get the profile completion to about 70 to 75 percent automatically. Due to the complexity and just the length of the caqh application itself. So whenever they go through and link their profile, they’ll now have a view into the system such as this. So they’ll see their information to the left. They’ll see a check mark. If the information is there, if it’s missing, then they’ll know that they have work that they can do there. Now, a few features I always like to point out with the onboarding itself is the external… accounts. They are able to store any of their passwords in this platform. So we are sought to type to compliant. When we think of a privacy and security perspective… we’re also able to see their continuing medical education credits, disclosure questions matched directly with caqh. And then with the agreements themselves, this is where the providers can review the documents and we have electronic signature integration. So if they need to update their signature, they can do so here. When it comes to documents, one of the biggest features that we often hear back from providers when it comes to feedback is the QR Code scanner. Not only are they able to see all the documents, they can track the expiration dates if they take their phone, and they hover over the QR Code that you see here, they can hold it up to the wall, take a picture of their diploma. They can hold it up to the Coi face sheets that’s on the desk. What that does is it saves it as a copy. It saves as a PDF. It even helps name the document. So, rather than them having to take the phone off the wall, untag, everything, find a printer scanner, have it emailed to their admin. The admin puts in the system. However you’re currently doing it today, they can just do all of this from their phone. And then to wrap up that last piece of onboarding, the mobile view. Again, if they’re on the go, they don’t have time to do this from a laptop or a tablet, then they’re able to view all of this information from their cell phone. They can see that they have the agreements left to sign. They can add their signature, and then they can save and finish. And that really concludes just the onboarding experience. We currently have about a two day average onboarding timeline due to these features. Thanks Mel, just to kind of put a bow on.

Phone Caller #2 (34:07) It, I’d love your feedback because I know the provider.

Phone Caller #3 (34:10) Onboarding.

Phone Caller #2 (34:13) Typically, we hear that takes a few weeks, I guess valor’s saying it’s about two days, just that’s the kind of like compressed why?

Phone Caller #1 (34:20) You should.

Phone Caller #2 (34:21) Care about these features here? Do you know how long it’s taking today? I know this is not necessarily your wheelhouse, but how long that’s taking today to complete the provider onboarding? No, because we don’t have any.

Phone Caller #3 (34:36) Insight into that. That’s Whitney and her team. So not really sure how long it takes them to do that. Okay? So.

Phone Caller #2 (34:44) Typically, I mean, we usually see anywhere from a couple weeks to longer just to gather all the data in a manual process. So that’s kind of like what this means for you.

Phone Caller #1 (34:57) Tldr here.

Phone Caller #3 (35:01) So let me ask you this. So let’s say that we decide that we, that we’re moving forward and we decide we want to have the ability for providers to do this even though right now current state… medical staff makes the initial outreach… would that be possible? And would that cause issues if we take in that information in this way? And then if medical staff had access to view this, then they could choose to do with that information what they want. Do you see people doing it that way?

Phone Caller #1 (35:49) Yes, I think that’s a great question. We do see that happening very often. Typically, what happens is that if it’s a bifurcated system, how you have it now where you have credentialing med staff and you have your involvement team, some times, they don’t necessarily cross or have like an overlap very similar to your situation. So for any time that we’ve partnered with customers and they just want to focus on the pay per moment, you are able to give access to the medline platform to anyone that’s a member at your organization, they can have read only access. They can have viewing edit access. So they can be as involved as they want to be. If your med staff team wants access to the platform, they want to be able to treat this as a repository. They absolutely can. And the other great aspect of that is typically, we always see expansion opportunities with that because even if the med staff team is not necessarily on board or vice versa with the pay per moment, they see how easy it is to use the platform and it’s a lot easier now that the data has already been migrated anyway just to get them on the system as well. And.

Phone Caller #3 (36:53) Would they be able to import information from here to their system if they wanted to?

Phone Caller #1 (37:02) Yeah, absolutely. So different import methods. It could be with an API if we wanted to build that out. If that’s not the long term goal. Perhaps if you’re like, hey, I know you guys aren’t necessarily looking in the market right now and you also have the option of just exporting into more of like an excel or CSV file. You can export documents that way. So there’s several different ways of gathering. It just depends on like what they’re seeing is more of a long term vision before I would recommend an API. Thank you. Yeah, of course. Okay. So what we can do next is I’ll just head back into the main platform here and… where we can go next is kind of up to you. So we talked about the analytics and the reporting, the provider onboarding experience. We could talk about payor enrollment next, or we could talk about monitoring. What would you prefer to see next? Payor?

Phone Caller #3 (38:04) Enrollment? Okay. Let’s.

Phone Caller #1 (38:05) get started there then… payors. What I’ll first do is actually show you what the group structure would look like in the system. So please remind me how many practice locations do you currently have as a part of centra. So, for.

Phone Caller #3 (38:22) CMG that’s our medical group, we have about 62 locations, okay?

Phone Caller #1 (38:28) Thank you. Do each of those locations have a separate tax id?

Phone Caller #3 (38:31) No, they have one tax id, but they do have their own npi awesome.

Phone Caller #1 (38:37) So we can definitely go through the system that is so smart by the way to have one tax id I’ve had where they each have like a separate tax id and type two npi. And it’s rough. So with that in mind, they can still all have the same tax id number, but that different factor can still be the type two npi. So you would see all 62 locations broken out here. If I were to go into one, let’s go to community health center, for instance. And I’ll be able to see group detail summary, the overview tab. If there’s any tasks that we need to do at the group level, the profile information. So this can be again a repository where you store all of your group or practice location information. If it’s basic finance operations, the number of individual locations as a part of this group itself. And with the documents, of course, unlimited document repository, you can store everything you would need to here at the document level. Another benefit that you’ll see with this. If you do have to share with other members of your team or even the other members of the department, they can still use this to access the information as well. So rather than you, if they ask you for the information regarding a group or a practice location, you can tell them where to find it in the medaket platform.

Phone Caller #3 (39:52) Quick question about their practice locations. So with the practice locations, are you able to, because… our sub locations, we of course have to have, they have to have an npi for that. So the overarching npi for example, like our cardiology office. So they have sec lynchburg so that’s their main location, and that has one npi. Then they go to danville, and so then their danville location has a different npi. Does it store that information in here for those practice locations, those sub locations as well?

Phone Caller #5 (40:32) It does.

Phone Caller #1 (40:33) So if I were to go into this specific one, then I can see that this is like almost like to your point, a sub location of this type two npi tax id group that you have. So.

Phone Caller #5 (40:45) Yeah.

Phone Caller #1 (40:46) You’ll be able to store all the information right here. At this level, there’s an intake process. You can even see which providers are a part of this specific location itself.

Phone Caller #3 (40:55) Which is because we have some, not all providers goes there’s. Only select ones that may go to those locations. So being able to see where they’re linked to those locations would be good. Absolutely. And actually, let me ask you a.

Phone Caller #1 (41:11) Question. Since we were talking about pay our moment, do you ever enroll all your providers with all locations associated with that group to npi or are you more selective?

Phone Caller #5 (41:21) We are more.

Phone Caller #3 (41:22) Selective because what we ran into when we were doing just loading everyone is of course, medicare if you don’t go to that location within that 90 days, then they deactivate you. And so it was just way too much legwork for if they were never going. So we only put them in if we know for sure that they are going to that location. Okay? That was it?

Phone Caller #5 (41:53) Yep. If you don’t.

Phone Caller #3 (41:56) use that in 90 days, then, yeah, they will deactivate that location and then you have to get it reactivated.

Phone Caller #5 (42:04) And when you say?

Phone Caller #1 (42:06) Reactivated, do you have to submit another 855 bar?

Phone Caller #3 (42:08) That is correct.

Phone Caller #1 (42:10) Absolutely. Not. Okay. All right. I understand. Completely. Okay. Not worth it. I appreciate you clarifying that for me. So when we go through and I show you how to make a request for the enrollments in the system, then there’s an option to do an auto, enroll for all those locations. But there is a specific way that you can identify which practice location you want for each provider. So I’ll show you what that looks like instead. Okay?

Phone Caller #5 (42:37) Okay. So let’s go ahead and get into.

Phone Caller #1 (42:39) It, so like I showed you with the groups, you can see the different tax ids and type two mpi sub locations as a part of that each payers list. This will be a part of the implementation process where you’ll go through and basically say we have 15 payers with this type two mpi. We have 13 with this one. We have 14 with this specialty, this provider, type, this group, whatever it may be. So we’ll have that configured in the system. We’ll store that at the group level.

Phone Caller #5 (43:07) Enrollment.

Phone Caller #1 (43:07) Request, what I’ll show you next is actually how you go through and submit an actual request to medallion to process an application. So.

Phone Caller #5 (43:15) Of course, we’re.

Phone Caller #1 (43:16) comprehensive, we do individual group and facility enrollment. We can do demographic updates, revalidations or re credentialing as necessary if I were to select a new parent enrollment, someone from your team would come in the system and let us know if this is an enrollment for a group or a provider, the.

Phone Caller #5 (43:35) Provider or?

Phone Caller #1 (43:35) Providers in question. So you do have the ability to submit multiple requests for multiple providers at the same time. Absolutely saves time at the end then.

Phone Caller #5 (43:45) If I.

Phone Caller #1 (43:45) identify my provider, the group itself, we.

Phone Caller #5 (43:49) can see.

Phone Caller #1 (43:50) Intuitively that we already know that she’s a part of these practice locations. If we wanted to add her to others, I could just click here and then it’ll say it will be added to this group profile. So there’s different ways of adding information in the system just depending on how your team likes to operate best.

Phone Caller #5 (44:08) Care.

Phone Caller #1 (44:08) Of course, this is intuitive. So we’ll know exactly where all the provider is already licensed based on her profile. So if we were to go through and your team was to submit a request for Alabama, she does not have an active license in Alabama. So that request would not go through. So we would give the option to update or upload for Alabama license or we can also apply for it. So, I know at the end of this demo, I’m going to show you the licensing aspect as well to see if that falls within your purview.

Phone Caller #5 (44:36) The big picture.

Phone Caller #1 (44:36) There is you’re going to have safeguards all throughout the platform to avoid making any basic errors or just erroneous errors that you may have when it comes to requesting once.

Phone Caller #5 (44:48) You’ve.

Phone Caller #1 (44:49) identified the state. You will then select the payers.

Phone Caller #3 (44:51) Now, the great thing.

Phone Caller #1 (44:53) About it, especially if you have a different payer list for each of your practices, then with one click, you can click everything that’s enrolled with this practice location and it can highlight all 10 payers at once, all 15 payers. So rather than having to come down here and select one by one, you now have the option of just one click, highlighting all 10 at the same time.

Phone Caller #5 (45:14) Now, this is where it.

Phone Caller #1 (45:16) Gets really specific. And this is where we’ll need the strategy for your team to be behind it. So do we want to use the same lines of business for all payers? Typically, your group executed agreements may look a little bit different based on how.

Phone Caller #5 (45:31) Yours is.

Phone Caller #1 (45:32) Set up with them so we can use all the same lines or you can go through and say, no, I actually want to explore what they could look like. So with the first one here adventist.

Phone Caller #5 (45:42) And they only have.

Phone Caller #1 (45:44) Commercials of where your group agreement, it would come down here to alliance. If I wanted to come back and add, let me see if Linda has.

Phone Caller #5 (45:56) Medicare.

Phone Caller #1 (45:56) Let me do this one, then I can see, okay for medicare, traditional medicare. If there was any additional.

Phone Caller #5 (46:05) Lines of business.

Phone Caller #1 (46:05) That would be needed there as well. So now that these have been identified, we’ll go to the next step here is that area I was talking about enrolling each provider at all associated locations. It sounds like that is not the idea with your team. So, what that would look like instead is for the practice locations, for this plan, you would let us know which practice locations, these two.

Phone Caller #5 (46:29) For the.

Phone Caller #1 (46:29) next one, it could be all.

Phone Caller #5 (46:32) Three.

Phone Caller #1 (46:32) So it would be one, two three.

Phone Caller #5 (46:35) For the next one with.

Phone Caller #1 (46:36) Medicare, it could be one. So you are able to go through and be very specific with your request. That way that when we submit the applications, we actually have a 96 percent accuracy rate which means that 96 percent of our applications that we submit do not get returned for errors and then make it all the way through to completion without having to come back to us for additional information. And this might be seem like a lengthy process of requesting it, but that is how we’re able to go through and make sure that it’s accurate information. You’re getting exactly what you asked for. You have a full system and repository to show you every click and everything that was selected as well as a comprehensive audit history.

Phone Caller #5 (47:16) The.

Phone Caller #1 (47:16) last few steps. Do you want to be seen in the payer directory? Do you want the same answer for all? If not, you get to pick and choose what’s the desired effective date. So the app submission date, if it’s the start date, if you have another date in mind, and then finally, once you’ve identified these, you’d be able to submit the application to us. We’ll be here for just a minute to make sure if there’s any questions.

Phone Caller #5 (47:48) All right.

Phone Caller #1 (47:50) Oh, wait, I’m sorry.

Phone Caller #2 (47:52) Before we keep moving, I know we mentioned a 96 percent accuracy rate of not having resubmissions for manual processes. Since this is very manual work. We’re typically seeing resubmissions anywhere from 10 to 25 percent. Does that track with what your team with what you feel like your team is doing right now?

Phone Caller #3 (48:16) It looks like we have a lot of resubmissions because they take their time with doing the applications. So we’re not really seeing a lot of resubmissions because information is submitted inaccurately the first time?

Phone Caller #4 (48:31) It’s mainly going to be the resubmissions of when we’re not following up and we have to resubmit another application.

Phone Caller #5 (48:39) Okay. So that,

Phone Caller #3 (48:40) that keep up with making sure that we’re checking in.

Phone Caller #5 (48:46) Do you?

Phone Caller #2 (48:47) Thank you for that, josh. Do you know the rate of resubmissions?

Phone Caller #5 (48:53) No, because that would be.

Phone Caller #3 (48:54) manual to track. So there’s no way for us to really give you that number?

Phone Caller #1 (48:58) That’s the chicken.

Phone Caller #2 (48:59) And the egg here so many times with this manual, it’s like, hey, we need to improve some of these KPIs, but we don’t have a way to track these important KPIs today. So, see like how, what’s the incremental improvement?

Phone Caller #5 (49:14) That’s helpful. Thank you. And I know this is.

Phone Caller #1 (49:18) completely unrelated, but Sonia you have blinded me with that ring, I’m going to go. Oh, I’m sorry, it’s.

Phone Caller #3 (49:27) not an engagement ring. It’s just, it’s just a little,

Phone Caller #1 (49:30) Tiffany heart ring. Oh, it’s cute. I like it. Thank you. It’s not.

Phone Caller #5 (49:35) It’s not an.

Phone Caller #3 (49:37) Engagement ring.

Phone Caller #2 (49:38) Fooled us.

Phone Caller #1 (49:41) Yeah. Okay, perfect. Well, I appreciate the insight there. So, when it comes to going through and making the request, what you’ll see next is you’ll get full transparency in the process. So, I appreciate, the intel around that.

Phone Caller #5 (49:55) You see more of a,

Phone Caller #1 (49:56) resubmission, it’s not necessarily due to errors. That is that’s granted if it speaks to the quality that you have internally. So I’ll talk a little bit more about our follow up process with each of these. So as we’re going through, you do have full capability of seeing every single data point you would need to see. So once you’ve made the request, you’ll be able to see it tracked here, you’ll see every email communication that we have with the payers. Any communication we have back and forth with providers, the submitted application will be attached directly to the line that you see for each one. If there’s any specific tags, if it’s available for us to submit, via roster, if it’s out of state just to give you an idea of like the, just details that we can go into it.

Phone Caller #5 (50:40) The other great aspect.

Phone Caller #1 (50:42) Of this is as the application is in process, we also use the gentic AI to assist with the follow up. So what I’ll say first especially when it comes to medicare availability portals, things like that, we do have portal auto population. So if you have any applications you currently submit via portal, we’re able to go through and pre populate that via surrogacy access. So we’re able to complete the application immediately. We also have portal scrapers. So the great thing about that is that it scrapes the portal every single night at midnight to make sure that we have the latest status on file. So the biggest benefit there is if you submit an application to medicare, three weeks goes by, they actually have an effective date on Monday, but your team hasn’t checked until that Friday that’s potentially five days that you could have been billing for this patient already. And that’s only because we’re able to check it every single night at midnight. So a lot of great benefits. When you think of the portal submission, the other aspect, we’ll never be able to get away from making phone calls to payers, they’re always gonna have someone payers are using AI. We’re using AI. Everyone’s using AI. So we do have a gentech AI to assist with those follow up calls. The best benefit that I would say is that as they’re making these calls, we can now perform thousands of follow up calls per day because of this tool. And when they do bring back a welcoming date or an effective date, then that’s where we actually have someone from our team call and confirm that. So we’ll always have that human confirmation. It’s just.

Phone Caller #5 (52:11) I’m a 98.

Phone Caller #1 (52:11) Percent advocate for AI, but I don’t think we’ll ever fully replace humans at the end of the day. So we’ll always make sure that we have someone from our team confirm that information when it brings it back and.

Phone Caller #5 (52:22) Then when the welcome letter is.

Phone Caller #1 (52:23) received, you’ll see it attached directly to the payr line.

Phone Caller #5 (52:28) I actually want to show.

Phone Caller #1 (52:28) you, once these applications go through and they’re processed under existing enrollments. You have the ability to be so specific when it comes to billing. So let me ask you this question really quick. When you get an effective date back for a provider. Is that effective date? Do you ever have to track it as a different effective date per practice location or per provider or anything of that nature?

Phone Caller #5 (52:52) Sometimes if it’s.

Phone Caller #4 (52:53) like an additional location app, like say the provider’s already been with us and now they’ve started to go to one of our other practices to help out there. Then, yes, we would see that two different effective date.

Phone Caller #5 (53:04) Okay. Thank.

Phone Caller #1 (53:05) You, josh. And then do you see that with lines of business as well? I know sometimes like with medicare medicaid, dependencies, you may have a later medicaid or medicare date.

Phone Caller #4 (53:14) Yes, I have one provider where they were like board certified in emergency medicine, but they were doing like family medicine work and there was a payer that wouldn’t credential them based upon their boards. So they had to be not.

Phone Caller #1 (53:28) Listed with.

Phone Caller #5 (53:29) them. Okay. Thank you for letting me.

Phone Caller #1 (53:32) Know that. So I think this piece will be very valuable to your team especially when we think of those nuances. So, what I’ll show you is that right now, with existing enrollments first, the biggest benefit you get here is just a system of truth for all of your enrollment information, the provider enrollment, if I were to look at this Aetna line at this practice location, I would be able to open it up. And this is where your team can be very specific if they want to. So first you’ll see lines of business that are a part of this, if it’s direct enrollment, and then enrollment details across the bottom. Right now, we have one effective date for this provider, across all locations and lines of business, we can do it.

Phone Caller #5 (54:11) Varied by the.

Phone Caller #1 (54:14) Location and the line of business. So for this specific practice location and this line of business, if they are active or inactive, when it comes to billing, if they are par or non par and linked to the group, what is the specific effective date for the medadvantage line with this practice location? And then maybe you have additional documents that you need to track. So you’re able to see very specifically if it’s an active or inactive, we see a lot of value with this especially with billing and scheduling teams. So a few weeks ago, we built out a report.

Phone Caller #5 (54:45) Especially.

Phone Caller #1 (54:48) with practice locations, we built out a report for a customer that they had 15 different states. They had over 100 different practice locations. With this report, they were able to type in the zip code of the patient themselves, find a provider within a 15 minute radius of that zip code, and then see the list of providers that are par and participating with those plans with that line of business with that practice location. So we are able to build reports such as that. If you’re needing that level of granularity, and again, that can always be a future conversation with your billing team or scheduling or anything of that nature. But the important thing is that you are able to see it as a part of that process. You can now see that with dr Morgan with Aetna. We have two active one inactive, so that’s another way to view the information as well.

Phone Caller #5 (55:38) And one of our.

Phone Caller #4 (55:38) Other biggest challenges that we have too, like for example, say unitedhealthcare when we enroll the provider, you know, we’re assuming that they’re linking them to all lines of business, right? But then when we get denials that it’s maybe the commercial plan of that and their provider is not linked to the commercial, but they have all other lines of business. I assume with this, you’re able to check with the payer that all lines of businesses have been added for that provider?

Phone Caller #1 (56:06) Yes, yes, we.

Phone Caller #5 (56:08) Absolutely do.

Phone Caller #1 (56:09) Yeah. And I would even take it one step further because, you know, how payers are sometimes that you’ll submit the application, you’ll get an effective date, it’ll say for all lines of business, three months down the road, they’ll say, no, you were never enrolled with the medicare advantage line for this one. And then you have to go well, per the submitted application, per this welcome letter, if it is an application that medallion submits and they’re saying, no, this wasn’t effective, then we will do the history and we’ll look up and we’ll talk to that payer for you. If it’s something that we need to resubmit, we will at no additional charge. But typically, what we’re able to do is just provide them with the submitted application, the documentation tracking number or even the welcome letter and just let them know like, no, please, you have it here. At one point. I did get escalated to a manager’s manager when having one of those conversations. So I’m sure you’ve seen those issues before too.

Phone Caller #1 (57:06) I’m going to pause there for just a minute and I’ll reiterate the value point. So when it comes to pay our enrollment, we have a 10 day SLA from the time that you make your request to get in the application out the door. But really we get the application out the door in three to four days. We have an intake process for each application. We have auto population. We have submission via portal or PDFS, emails, things like that. We’re averaging about 54 days right now for all payers across all providers in all states. If you want to share your payer list with us and let us know what you’re currently getting back as like average turnaround times, how long it’s taking the payer to process, I’m more than happy to compare that to our internal system and show you how we’re processing when it comes to that as well. Of course, nine six percent accuracy rating on the applications going out the door, not needing anything before we go through and get the existing enrollment.

Phone Caller #5 (58:00) And specifically, can you talk?

Phone Caller #4 (58:02) A little bit about the medicare enrollment process? Are you guys doing paper applications? Are you using pay codes?

Phone Caller #1 (58:10) What does that look like? Of course. So we do use pay codes unless it’s a specific stipulation from a customer that they prefer paper applications. We do have those mapped if needed, but we’ll use the identity and access surrogacy system. So we’ll basically be registered as a staff and user with that provider with pay codes. And if we do need them to authorize something, we’ll actually get them a call and say, hey, can you please check, can you send us the text or the code that you just received? So we’ll do the Ina system for pay codes, okay? And for that,

Phone Caller #4 (58:43) how does that work on our side as the healthcare system for the authorized or delegated official for signing that?

Phone Caller #5 (58:52) Yeah, of course.

Phone Caller #1 (58:54) So, we kind of see it as a couple of different ways since we would be staff and user, you could grant us an authorized and the ability to sign on it or we could also just send it back to you as a task, it’s completely different per customer. So we would basically follow your sops on what you would be most comfortable with.

Phone Caller #3 (59:12) Okay.

Phone Caller #3 (59:19) And that if you text it back to us that I could go in and sign electronically just like the providers can and give that back to you.

Phone Caller #1 (59:26) Yes, that’s accurate.

Phone Caller #5 (59:30) Is.

Phone Caller #2 (59:30) that the workflow you’re doing today?

Phone Caller #5 (59:33) We use paper for the.

Phone Caller #3 (59:34) Majority and then I sign and then the team submits.

Phone Caller #1 (59:38) Yeah. Do you have any other applications that for.

Phone Caller #2 (59:44) instance, you?

Phone Caller #1 (59:45) Probably don’t have California groups, but with medi cal, for the longest time, they had triple ink signature required on the applications and we would have to send a prepaid envelope directly to the provider, so they could just sign and then pop it back in the mail. Do you have any situations like that?

Phone Caller #5 (60:04) So we currently do that.

Phone Caller #4 (60:05) For our medicare enrollment right now?

Phone Caller #1 (60:08) Okay. So, since we are doing.

Phone Caller #4 (60:10) paper applications, but, you know, now hearing that you guys are do have the capability to use payco, so that’s definitely probably the route we will.

Phone Caller #1 (60:18) Go moving forward. We.

Phone Caller #4 (60:20) Just had a hard time, you know, due to the volume of staff due.

Phone Caller #1 (60:24) To the volume of.

Phone Caller #4 (60:25) Payers and managing their login information and making us the surrogate and everything. It just was too much to manage at current time.

Phone Caller #1 (60:35) I hear you loud and clear. Yep. Absolutely. Okay. All right. Well, I appreciate the feedback there guys. So where we can go next in the platform. So we’ve already talked about analytics and reporting the onboarding, the payer enrollment experience. Let me ask, are there any final questions when we’re thinking of PE in the platform or how your team would be interacting with it?

Phone Caller #5 (60:57) I think we have.

Phone Caller #4 (60:58) A quick other question here on the screen that you’re showing here. This is like our dashboard where we would see if there were any tasks back to us that we would have to manage. We would see that here.

Phone Caller #5 (61:09) Great question. Let me show you.

Phone Caller #1 (61:11) Two different areas in here. So we have several large groups that work with us. They have about 4,000 providers each. So how they’ll use the system? Just because they come in, they can see tens of thousands of open enrollment lines that are processing. We have a status bar along the top right here under enrollment requests. So we know that something needs your attention that you need to get back to us. They’ll click into this area and they’ll be able to see, hey, something is needed from the provider or from the admin itself. They’re also able to see if anything is on hold what has currently been stopped? Why has it been stopped? So you’re able to see every single note that’s available for the payor line. So there’s this option to have this command center right here. And there’s also.

Phone Caller #4 (61:56) Tasks which.

Phone Caller #1 (61:57) are available up here. So two different ways to view the task information task could be anything from the onboarding experience to payor enrollment specific applications. And under this is where you would be able to see all of your tasks clearly demographic just like demo environment, but these can be automatically assigned to you. We do have ways to auto motify you within the platform itself. You’ll see the task, the notes itself. You can communicate back and forth here. So rather than have to email your providers back and forth, you’re assigned to send an email to a provider, but you’re out of vacation, you’re going on a cruise next week by the way to the caribbean. So, you’re out this cruise and then you get an email back from the provider, but you’re not checking it because you’re in the middle of, you know, of the water, right? So, someone from your team is not notified because they sent an email back to you. If you use the task management in the platform, then what you’ll actually see is that they can see the provider responded, and you can then have someone else respond to the provider on your behalf. So another great way just to track communication back and forth, it has a time and date stamp. You’re also able to track metrics such as how long is it taking providers on average to complete things? How long is it taking our internal team to complete things? Just examples like that?

Phone Caller #5 (63:14) Makes sense.

Phone Caller #1 (63:16) Yeah, I guess.

Phone Caller #2 (63:17) Just to kind of compress everything and connect the dots here in payr enrollment. Thanks so much, mal. I think really the main thing is that we want to show you and what we want you to walk away with from showing these modules is as mal was saying, like everyone’s going to be using AI and automation. It’s just a matter of how and when, and so, because we have all these processes and automation and these programs in place, that is where we are able to compress those turnaround times from the 90 to 120 days down to the 52 to 56 days and some places even shorter. So that’s kind of like the net there?

Phone Caller #4 (63:57) Thanks, Erica. And just to confirm too, one other question for like medicare specifically, you guys would handle the group revalidations?

Phone Caller #1 (64:06) As well?

Phone Caller #5 (64:07) We.

Phone Caller #1 (64:07) would, yes.

Phone Caller #5 (64:08) Okay.

Phone Caller #1 (64:09) Do you have any facility revalidations?

Phone Caller #4 (64:12) Yes, we do.

Phone Caller #1 (64:14) Okay. Well, the good news is that we are comprehensive. We’ll do individual group and facility enrollments as well as revalidations for each of those.

Phone Caller #5 (64:26) Actually, I’ll show you the facility.

Phone Caller #1 (64:27) In here just because whoever suggested an hour and a half for this demo, I’m just the biggest fan of because I just got to click around the system.

Phone Caller #2 (64:36) Josh… what’s awesome. You said that’s awesome. I’m going to unpack what’s awesome there?

Phone Caller #4 (64:46) I’m going to manage that because currently, right now, you know, even though I’m overseeing billing right now, I still have oversight of the facility, a 55 enrollments for medicare. So, if that is something that, you know, potentially we could offload here, that would be a huge.

Phone Caller #5 (65:01) Win. Okay.

Phone Caller #2 (65:06) Let’s see the.

Phone Caller #1 (65:07) Smile. So.

Phone Caller #2 (65:08) Huge win. Okay. Does that mean huge win?

Phone Caller #3 (65:12) Okay.

Phone Caller #1 (65:15) All.

Phone Caller #2 (65:16) right. Josh, I’m going to, I’m going to go even direct huge win. Tell us more about what a huge win means for you?

Phone Caller #5 (65:28) Can.

Phone Caller #4 (65:28) utilize that for something else in my purview right now? So great. Yeah.

Phone Caller #1 (65:35) He has quite a bit on the, we haven’t been able to.

Phone Caller #3 (65:38) Offload it that’s.

Phone Caller #5 (65:42) the other piece is having.

Phone Caller #3 (65:42) Individuals being able to focus on their area because since he used to manage it. And then Nicole’s coming in and stepping in and taking care of some of the day to day, some of the stuff that just didn’t make sense to transition like the ability to do the 850 fives, and with the signatures and all of that like, that was just too much legwork when we had in our mind that we may be making larger changes. So that’s why josh still owns that piece, but really needs to offload so that he can focus on the denials and follow up work for the acute billing. So that’s a huge time savings for him. Okay?

Phone Caller #5 (66:31) Thank you so much for unpacking.

Phone Caller #2 (66:33) That, and that’s those are some of the really big metrics again if you want to champion this, being able to do revenue generating work like working denials aside from following up, you know, having your team and you following up with payers is really, we’re really going to see this significant Roi here? Yeah.

Phone Caller #3 (66:51) And those are the things. So our plan after this and why I was kind of in the beginning saying, you know, if we can get an initial estimate of what we think this lift would be because we’ve already put together the cost that we’re paying for our current software for each employee. And then we’re going to do an S bar so that I can present to rob to say here’s, what we’re requesting and what we would like to do because, we know we.

Phone Caller #5 (67:26) know that there’s.

Phone Caller #3 (67:27) value and that the.

Phone Caller #5 (67:32) dollars.

Phone Caller #3 (67:33) Are gonna make sense, we think, so, it is definitely… high ticket high priority item.

Phone Caller #3 (67:47) This week, just because we, we’ve done some things this week and things that will be happening over the next month with ftes, and things of that nature that we really need to have people focused internally on revenue generating processes and the things that we can all flow that we all flow.

Phone Caller #5 (68:09) Okay. That’s really.

Phone Caller #2 (68:10) helpful. Thank you for that. That kind of. So let’s understand so great that. Did you the to the business case you’ve already put that together or you’re gonna, you need the estimate or have you like already started putting, the background together there?

Phone Caller #3 (68:26) We’ve already started putting together the background as far as internally with our ftes, their salary, how much we’re paying out yearly with the salaries. And then also what we pay in costs for our software. We already know what that is because we pay per year. And then the other pieces we will be putting in the case after we finish this call as to.

Phone Caller #3 (68:58) Improvements where some of it is, the dollar isn’t going to really be traceable or you’re not going to really know the true Roi of some of the pieces because we don’t have a way to measure it because of the manual piece of it and because it’s time, you know. So there’s no really way to put the time on josh. Like, yes, I can take what he makes per year per hour, break it down and say he’s spending X amount of time, but I don’t think I’ll need to get that granular, but being able to have some of these pieces that you can not only do individual but also group facility management as far as the 850 fives, because that is an arduous task and it takes time. And then not only can we reduce the cost of the, even the small piece of sending an envelope prepaid envelope to a provider that’s a cost, right? So you have to send that to the provider, they have to fill it out, send it back. And then that’s time. And then I have to sign it. Then we have to submit it. So it’s all those pieces that we’re going to put in the S bar that may not necessarily have an overall dollar that we can put with it, but our CFO can add two and two without seeing two and two. Okay?

Phone Caller #5 (70:21) That’s super helpful.

Phone Caller #2 (70:22) And I think one of and you’re right? It is hard to qualify time. What we can do, is, and you probably have this data is okay. What is, the amount of denials that he could be working? And like how much are you bleeding right now with that? And if he could, if he could come, you know, recoup 10 percent, 20 percent, 30 percent, then we can quantify it in that way. So just a, an idea of what we’ve done in the past with these helping build out some of these S bars so that’s helpful just so we can have an anchoring point. Do you know what the like total is that you’re spending today between software, and fte credentialing?

Phone Caller #3 (71:10) Bring up our spreadsheet that we work on yesterday. So for salaries, it is estimated about 383, or if you can say 384 K. And then cost for our software is about 63 K. Okay?

Phone Caller #5 (71:30) That’s annually. And then,

Phone Caller #2 (71:35) is that, are you including benefits on salaries that’s.

Phone Caller #5 (71:39) with benefit? Okay. That’s.

Phone Caller #2 (71:44) just helpful just so we can have a, an idea if I need to, because obviously our value property, you know, one of our main value drivers, obviously the revenue piece, but reducing opex. So if I transparently, if I put everything in our calculator and it doesn’t it’s not a savings. It gives me, the ammo, I need to talk to our CFO and say, you know, let’s make sure this fits here because I think this could be a really important, it could be a really strong partnership to, initially and then obviously growth opportunities there, right?

Phone Caller #3 (72:15) So,

Phone Caller #2 (72:17) I guess from, a timing perspective, it sounds like it’s kind of accelerated and we can like, so we’ll get a proposal together pretty quickly but from a timing perspective, when would you want to kind of make some kind of decision?

Phone Caller #5 (72:35) By… so I.

Phone Caller #3 (72:39) hope to get a report back if not today early next week for the denials to be able to get that information to you. I’ve already sent that email to our it person, a different it person to see if he can pull it for me. And then ideally, I would want to be able to present at least a soft case to rob on.

Phone Caller #2 (73:12) Pivoting over to the, I shared with you, the project plan.

Phone Caller #5 (73:19) What the hell? I don’t know what you’re saying.

Phone Caller #5 (73:28) Did you share your drawing?

Phone Caller #2 (73:30) Yeah, I can slack it to you also.

Phone Caller #3 (73:37) I would like to get something to rob within. I would say the next two weeks at the very most.

Phone Caller #2 (73:54) Okay. Thank you. I, we’re we’ll we’re all okay?

Phone Caller #5 (74:00) So, just to give.

Phone Caller #2 (74:01) you some visibility on pulling forward a little bit. You’ve bought many softwares before. I’m sure for different processes.

Phone Caller #3 (74:09) This is typically the.

Phone Caller #2 (74:11) the process that prospects.

Phone Caller #1 (74:15) And customers go.

Phone Caller #2 (74:16) Through when they’re looking at and this is a living document. I can share this with you as well so you can look at it. But just so you have an idea on timeline, I’m going to move pull this forward if you wanted to get his forward. If you wanted to review a proposal sooner within the next two weeks or so, put in just a placeholder of four 30, be in.

Phone Caller #5 (74:41) Typically.

Phone Caller #2 (74:42) obviously, you were going through a proposal. Will we talk about implementation? What, what it looks like there? We usually allow. And I put in six 30. It sounds like I should probably move that timeline up for how to actually solidify something we typically would within one week of a contract being signed. We can assign a project team. We do our implementations internally and then we estimate a full deployment within a conservative eight to 12 weeks and that would include, and we’d want to deep dive a little bit more into your current software. What are you using? Because obviously, we’d have to do a cutover. What are you using today from a software side? So.

Phone Caller #5 (75:29) We currently.

Phone Caller #3 (75:30) Use healthstream. Okay?

Phone Caller #2 (75:38) Great. No. Sorry. Again. And.

Phone Caller #3 (75:40) then we use.

Phone Caller #4 (75:42) MD-Staff is what the medical staff office uses.

Phone Caller #5 (75:46) If we’re looking to.

Phone Caller #4 (75:48) Have any, you know, integration between the two systems.

Phone Caller #5 (75:56) Is.

Phone Caller #3 (75:57) as far as the baa, so I will tell you that most of our projects get held up in the legal side on centra because vendors try to change our baa. I will tell you that our baa is our baa and you can redline it to death and centra is not going to accept it. So, does that typically cause a problem for you all or?

Phone Caller #2 (76:27) What? Not to get too deep in the weeds with it? But what?

Phone Caller #5 (76:35) Typically?

Phone Caller #2 (76:35) Because I haven’t seen that what it looks like, are there indemnifications or like are there any sticking points that typically come up in those vendor agreements? Whether it’s like insurance requirements or indemnification, or term termination, it’s.

Phone Caller #3 (76:49) usually small sticking points that once a vendor realizes, okay, their baa is their baa. We haven’t had anyone come back and say, yeah, we can’t do business, but it usually has to do with, I think coverage amounts and things of that nature. But we, we’ve yet to have someone say, okay, yeah, no, we can’t absolutely, can’t accept your baa. It’s just that typically people try to give us their baa and legal’s not going to use your baa, they want their baa used. Yeah.

Phone Caller #2 (77:25) I mean, ideally ours, ideally, our legal wants to use ours just because it’s a really bespoke offering of software and services, but.

Phone Caller #5 (77:37) We’re going to be.

Phone Caller #2 (77:38) Amenable for that’s. The only path forward that, that’s the only path forward would you use? Would you use, your baa? I haven’t, usually we use the term msa, I’d be, is that business agreement Erica?

Phone Caller #1 (77:50) Erica, can I just jump in there really quick? So Sonia, we actually don’t typically need baas. So it’s not something our legal process finds just because we’re not dealing with any hipaa information or privacy, patient information. What we’ll normally do is like we can do an NDA, we can use yours.

Phone Caller #3 (78:07) You can use.

Phone Caller #1 (78:08) Ours, but because of, the nature of the data itself, there’s no need for us to sign a.

Phone Caller #3 (78:14) Baa. Okay. Sorry, I.

Phone Caller #2 (78:18) Thought you’re talking about our master service agreement. I mean, there’s NDA.

Phone Caller #1 (78:22) Msa baa. Now?

Phone Caller #3 (78:24) The msas of course, go back and forth to get redlined because there’s amounts that’ll get changed as far as like, you know, what’s the coverage amount if a breach happens or things of that nature. So that is normal for the msa to have red lines and go back and forth with that with our legal. So that is normal case, normal business. But I just know when it comes to the baa, yeah, if there was one, but if one, since we’re not doing, you know, patient information, if there’s an NDA that’s required or whatever the case may be, the legal will jump in and, you know, take care of that piece and do whatever needs to be done, okay?

Phone Caller #2 (79:12) That sounds good. Would do these steps look accurate. I’d love, your feedback. We can, you know, this is a live document so I can change the dates and process the.

Phone Caller #3 (79:31) Procurement process. Yeah, the only thing I’d like to put in there or what we would request is if we could have a current client probably maybe two clients that we could speak to that are currently engaged on the payer enrollment provider side, so that we could speak to them and just get feedback from them on how their implementation and how their use of the system and how it may have improved their workflow. That would be the only thing that I would say would happen before we get to scoping?

Phone Caller #5 (80:11) And things.

Phone Caller #3 (80:12) Of that nature or not scoping, but aligning and the execs and all that, because that’s going to be a question that rob asks. Okay, yeah, happy.

Phone Caller #2 (80:22) To, to do customer to provide a customer reference… just to looks at, happy to provide that usually like to make sure we’re aligned on budget ahead of that, just.

Phone Caller #3 (80:38) Saving.

Phone Caller #2 (80:39) Some bandwidth on, our customers ends because pretty much everyone asks for a reference. So as you can imagine customer, the reference fatigue is real, but, yeah, happy to provide that.

Phone Caller #3 (80:50) Okay. So.

Phone Caller #2 (80:52) Let’s do that. I think something because it, we are a… function based model. So we need to make sure we’re this when I say scoping, just make sure we can have the right volumes approximately to inform our proposal. So let’s I actually have a couple of questions in these last couple minutes here. Why don’t we gather some of this information from you? And then we can validate it going into, so we can start to get an idea of price.

Phone Caller #5 (81:26) But,

Phone Caller #2 (81:27) I guess other than that, so we’ll do the we’ll do scoping, but other than that, these timelines, they look, do they look good or should we adjust the, should we adjust like contract execution date for go live to move that up? I think right now leave it where.

Phone Caller #3 (81:48) It is because I’m not sure.

Phone Caller #3 (81:56) That’s the goal piece because like I said, that’s the piece that usually takes the longest and then the it engagement because it is going through some changes and transformation just like everyone else. So I think to be on the safe side. And also our contract with our current vendor does not end until October. So that go live date would line up perfectly for us to be able to not be paying for two services or to have to terminate a.

Phone Caller #5 (82:32) Contract early. So.

Phone Caller #3 (82:33) I think your dates where you have them right now are safe.

Phone Caller #2 (82:35) Okay. That’s good. A good data point. I want to make sure it’s clear the implementation plan. So we’ve done a significant amount of displacements of healthstream… and both MD-Staff and healthstream, our head of implementations and technical solutions. Sammy, he… can walk through a program, a project plan on what that cut over would look like from a data like a data strategy and both data strategy as well as staffing plans. So, when would you start to reduce staff? When do we start doing the data import? How do we do the data import to minimize disruption and what those milestones are going to look like throughout the project from it, during implementation and then fast following implementation over the next couple months? Like here’s the milestones that are going to be occurring. And here’s the resourcing that you’re going to need to retain. Okay?

Phone Caller #3 (83:41) That would be perfect.

Phone Caller #2 (83:42) So, I think that would probably be a good, fast. A good next step also is that meeting, with Sammy, would anyone else from your side be involved in the data strategy, for a cut over conversation?

Phone Caller #3 (84:02) I would say Wes Morgan, who is our senior director for I recycle it. So they handle, he handles the team that does everything. It, I think we start with him and I can let him know, that would be coming. And then he would then include like our boots on the ground, the Guy Jimmy that I just sent the email to. They, they do the in the weeds work, but Wes knows what projects are going on, assigns them out, puts them in order for us based on what our priorities are. So he would be the next person that I would include. Okay?

Phone Caller #2 (84:45) Perfect. Thank you. Let’s Mallory, let’s just gather a couple, we have a lot of these data points, to put a proposal together from just all the discovery that you, we’ve done so far which is great. Mallory, I put in the, in our shared document, the last tab, scoping work in progress. Do you want to just make sure we’re good on that so we can start to get a straw man put together. Yeah, absolutely. Gonna just stop sharing my screen so I can get that. Okay?

Phone Caller #1 (85:20) Well, Eric and I work together a lot all.

Phone Caller #5 (85:22) Right. So.

Phone Caller #1 (85:25) I’ve got it pulled up. Okay? So we’ve got the general scope. We see the yes bar.

Phone Caller #5 (85:36) I’m curious because you.

Phone Caller #1 (85:37) Do have six to seven delegated agreements that you currently manage, who is currently performing the credentialing services for the delegation? The.

Phone Caller #5 (85:46) Medical staff.

Phone Caller #3 (85:47) Office. Okay?

Phone Caller #5 (85:48) And do.

Phone Caller #3 (85:49) they, so.

Phone Caller #1 (85:51) The difference here would be that we are able to manage your delegated agreements. We’re able to keep up with roster management. It’s completely automated. We’re able to add remove term providers as necessary. But part of that, if you take us on as the ncqa certified piece of it, we would need to perform the ncqa level credentialing. So, would that be an issue with the med staff office? Or would it be something off of their plate that we would want to consider?

Phone Caller #2 (86:16) So,

Phone Caller #3 (86:18) I would have that with rob. And if the dollars make sense for us, then I think he would make… the necessary decision.

Phone Caller #2 (86:30) Okay, perfect. So then the other aspect here?

Phone Caller #1 (86:33) Because the good thing is you can still use the medallion platform to store your delegated agreements. But if you’re wanting more like that full service offering, we’re doing all the rosters, we’re doing everything for you that you currently have to manage besides the credentialing piece of it then, yeah. So we can definitely send you more information regarding that. So we’ll leave that off for now. How many non delegated enrollments do you currently manage?

Phone Caller #3 (87:03) Okay. We’ll do.

Phone Caller #1 (87:05) Six to eight. We’ll keep it pretty conservative with that. Okay. And then we have that, oh, you’re right here. Can we download this?

Phone Caller #5 (87:15) Information?

Phone Caller #1 (87:18) Josh, you had mentioned facility enrollments earlier, you know, about 62 locations. Are they set up as facilities or just as groups or do you have a separate number of facilities?

Phone Caller #4 (87:29) So, they are set up as under the medical group 10. And then outside of that, we have.

Phone Caller #4 (87:41) Ids that we have facility enrollments?

Phone Caller #5 (87:45) With.

Phone Caller #4 (87:49) there are six tax ids total that we would look to list with you one being a medical group, and then two being medical group cvi. And then the other four would be hospital enrollments.

Phone Caller #1 (88:07) Two med groups, four facilities. And then typically, I’ll go through and give you an appropriate volume for facility enrollments. You mentioned revalidations, do you add a certain number of facilities each year or are you pretty stagnant right now?

Phone Caller #4 (88:26) We’re pretty stagnant. Okay. Perfect. How many?

Phone Caller #1 (88:29) Revalids do you normally need at the facility level that you see year after year?

Phone Caller #4 (88:36) Two, depending on when they’re due for revals?

Phone Caller #5 (88:40) I.

Phone Caller #3 (88:41) think that’s very standard for facilities.

Phone Caller #4 (88:43) Yeah, we do. We are very adamant about making sure every year though that the board members are listed accurately and correctly on those enrollments. So we are doing that at the beginning of every year going in and changing out the board members because that is a requirement listed on the apd vis.

Phone Caller #5 (89:03) Okay.

Phone Caller #1 (89:07) You can track that information in medallion that can be part of your authorized official and boards there? Okay? So, I have a general idea there, Erica, do we know how many providers are adding number of providers out of?

Phone Caller #5 (89:20) The next?

Phone Caller #1 (89:22) Should you add about 120 providers per year?

Phone Caller #4 (89:25) Yes… that’s been pretty consistent the past few years when I pulled that data a.

Phone Caller #1 (89:32) Great quote.

Phone Caller #3 (89:36) That last piece?

Phone Caller #1 (89:36) With the final minute here hospital applications, is that something currently handled by your med staff or are you guys in charge of that? If you have any external and many arrangements that you currently perform for your providers, the?

Phone Caller #4 (89:49) Medical staff obviously handles all?

Phone Caller #1 (89:51) That perfect. And we can leave that out so it can.

Phone Caller #5 (89:53) Happen. Erica… I think I have everything.

Phone Caller #1 (89:57) I need to make sure that we can get a proposal for them, okay?

Phone Caller #2 (90:01) So, let’s do I’ll follow your lead? Do you want to do review the proposal first or do you want to do the implementation conversation?

Phone Caller #5 (90:11) First, I think the implementation?

Phone Caller #3 (90:15) Call first so that we can understand that and can include that in our S, bar to raw. I think that would be helpful just so he can kind of get an understanding of what that I hate to say offload, but what that reallocation of potential ftes would look like in the timing. So if we could do that first, that would be helpful. Okay?

Phone Caller #2 (90:44) Let’s do that.

Phone Caller #5 (90:46) I.

Phone Caller #2 (90:48) think everyone is going to,

Phone Caller #5 (90:50) be,

Phone Caller #2 (90:54) we could do, I can actually, I don’t want.

Phone Caller #3 (90:57) to do it without I want.

Phone Caller #2 (90:58) Sammy to be involved? Is it, can we look to week the week of the let’s?

Phone Caller #5 (91:08) See, could we do?

Phone Caller #2 (91:14) On the 20 eighth or we have pretty open on the 20 ninth also?

Phone Caller #3 (91:26) Is better on the 29? I’m not sure about.

Phone Caller #3 (91:34) It’s better for me. The 20 ninth works best for all of us.

Phone Caller #2 (91:37) Okay. Would three 30 or four work for you?

Phone Caller #3 (91:42) Three? Good. Yeah, three 30 or four would be good if it’s an hour, I would prefer three 30 to four 30 because I try not to keep these people here too long because they get your.

Phone Caller #2 (91:55) Yeah. What’s that I’m going to send it via zoom and then I can set how we can add teams to it after. But just so I can hold the time for us. And then async, what I’m going to do then is send it’s just once we have it all scoped out and just say, are these volumes correct? And that way we can make sure we’re accurately scoping the proposal.

Phone Caller #3 (92:15) Okay. And we can also.

Phone Caller #2 (92:17) With the sbar, I usually help with those. So if you wanted to, if you, I can put notes together, I can give you a first draft and we,

Phone Caller #3 (92:26) can that would be perfect. We can collaborate on that. Yeah. So if you want to give us a first draft, and then we can plug in, that would save Nicole and I, if you could see her face? Yeah.

Phone Caller #3 (92:38) Yeah. If you can do that, then that would save us a ton because then we don’t have to start from scratch and then we can plug and play from there. I think that would be awesome and very helpful.

Phone Caller #2 (92:50) Okay. I’ll do it into Google docs so we can do it. We can collaborate on it live.

Phone Caller #3 (92:54) Perfect. All right.

Phone Caller #2 (92:56) Sounds good. I’ll send this invite out and I will see you over email too.

Phone Caller #3 (93:02) All right. Well, it was a pleasure speaking with y’all, we definitely appreciate we’re looking forward to seeing how we can make this beneficial and how we can make it work and the Roi and definitely keeping our fingers, toes, and eyes and everything else crossed that we can make the numbers work. So definitely appreciate the time and it seemed like perfect timing that, we got together. So, yeah.

Phone Caller #2 (93:30) Absolutely. And just throwing it out there, we’re going to another very large health system on may seventh that’s only an hour away from you guys. So, if.

Phone Caller #3 (93:40) uvn, no, cabrillo.

Phone Caller #2 (93:43) Cabrillo, rhymes with pavilion. I didn’t say that.

Phone Caller #3 (93:52) So you didn’t say that? Yeah, I don’t even know what you’re talking?

Phone Caller #2 (93:55) About, yeah, it’s a nice area. How about that? It’s very, it’s not easy to get to. So while we’re there, if, we would love to come on, say we can, you know, we could have breakfast or coffee or lunch or something like that. So hopefully.

Phone Caller #3 (94:10) We’d love that. Yeah, yeah, we’re like once you make it to the roanoke area, if that’s where you’re going to be, we are about 45, 50 minutes west, east, I always get it. We’re we’re about 45 minutes east.

Phone Caller #2 (94:27) Perfect. Okay. So if you’re around, yeah, if you’re we’re gonna be there like midday.

Phone Caller #2 (94:32) So if you’re around like morning or after morning or afternoon, we’d love to get to meet you in person. Yeah.

Phone Caller #3 (94:38) So, typically, if people are here like sometimes it works out better for dinner or whatever the case may be.

Phone Caller #2 (94:47) Great. Actually.

Phone Caller #3 (94:48) Probably do that. So then that gives you a little bit of time because then driving and all that. So, yeah, we would love that.

Phone Caller #2 (94:56) Yeah, that sounds great. Why don’t I just put out, why don’t, I put a placeholder on the calendar for us to grab dinner together that.

Phone Caller #3 (95:01) Day. Okay. All right. Sounds good. I’ll get these invites out. All right. Thank you so much. I hope you all have a great weekend.

Phone Caller #2 (95:10) You too. Thank.

Phone Caller #3 (95:12) You. Bye.