Transcript
Mike Wills (00:00) hello? Mallory?
Mallory Smith (00:11) Just let me know when he gets here. Come again. Did you say, okay, or come again? I.
Chris Jones (00:20) said, come again. Oh, he’s in the lobby. Here we go. That’s what I needed to know.
Mike Wills (00:27) That works too. All.
Chris Jones (00:29) Right. Well, luckily.
Chris Jones (00:35) Hello? Hi, Mike. How are you? Good Friday. You got it.
Mallory Smith (00:42) It is Friday. I go on vacation all next week and I think every fire in the world has happened today because that’s how it goes.
Mike Wills (00:52) Where are you going?
Mallory Smith (00:54) May president’s club. So I’m going to be going to Maui and we’re going to be staying for three days, and then we’re extending it a couple of days because I’m not going to travel to Hawaii again for another 10 years. So why not?
Mike Wills (01:04) Yeah, that’s been on our list for a while. It’s a big trip it.
Mallory Smith (01:09) Is, yeah, we’re going to go to oahu, first couple of days, Maui. For the rest. We were thinking about going to the big island, but really, it’s just a volcanic national park and it’s going to be closed off anyway. So just whatever.
Mike Wills (01:22) Have fun. It’s good.
Mallory Smith (01:24) To see you again though. Thanks again for connecting on LinkedIn. I saw your name with, I think I was like reviewing something of Chris’s account and I was like mpac, I’m like that hold on that rings a bell.
Mike Wills (01:36) We’re still here?
Mallory Smith (01:38) You’re still there? That’s good. Well, have you met Chris yet?
Chris Jones (01:43) We have not, okay.
Mallory Smith (01:45) So, yeah, Chris, if you wanted to introduce yourself, he is my account executive, so he would kind of be like the Jessica if you will.
Chris Jones (01:52) Got it.
Mike Wills (01:52) Yeah, so.
Chris Jones (01:53) Hey, my pleasure to meet, you know, like Mallory said, I’m a account rep here at medallion fairly new to the company started at the first of the year, but I’ve been in technology for 20 years, so based out of Columbus, Ohio.
Mallory Smith (02:10) And Mike, are you still in California or over in that way?
Mike Wills (02:13) I’m in Chicago. We had business in California but not much anymore.
Mallory Smith (02:18) Oh, good. Okay. Chicago’s, nice. We did our last qsr there. I think last quarter, we just got back from Austin though, and I’m just waiting to see how many like we got back like two days ago from Austin. So, I’m just waiting to see how many people get sick next week. Yeah.
Mike Wills (02:34) That’s how it goes.
Mallory Smith (02:35) Yeah, of course.
Mike Wills (02:37) Exactly.
Chris Jones (02:39) Well, yeah. So I appreciate the time and Mike just to kind of level set here a little bit. So I know that you looked at medallion a couple years ago and I think that evaluation was largely driven by, you know, just kind of slow enrollment times. And if I remember correctly from the notes, the, you know, kind of maybe less than ideal customer support from symplr. And I think that evaluation got moved to the back burner and you just had other priorities that needed attention first. And then I’m not sure if it, if you heard or not. But back in February of this year, I had a discussion with Joe McDonough and he indicated, you know, I reached out to him cold and he just indicated that you guys were, you know, always looking for ways to reduce enrollment times. So he and I had a brief conversation. He mentioned that you were over the entire credentialing process, but I was going to share some information with you and who knows if that made it to you or you looked at it or not. But really that was it just going to kind of pick up on things, understand where you are today? You know, obviously Mallory is in a unique position having spent time with both organizations. So maybe you could do a little bit of compare and contrasting but really just wanted to kind of get a level set from you and see if or when it makes sense to evaluate medallion.
Mike Wills (04:01) Yeah. I think, you know, I think that just at a high level, mpac has always struggled with enrollment. It’s been a just, I think given, the nature we operate in the snf setting, we go in, we don’t always know all the payers from the get go. We’re all we’re in like eight, nine different states so, you know, state to state and service line to service line. I think enrollment’s been a challenge just on the payer landscape. And also just like what I’ll consider visibility as somebody who’s sat over credentialing. I still to this day don’t have… like a way to be like, are we doing well? Like we, you know, what is what’s the timeline look like? Where status is at? I just feel like there’s typically there’s always information moving from one group hand to hand and things get dropped and timelines slip and, you know, we did a good. We’ve done a good job of improving it, but it’s you know, it’s still been a pain point and this comes at a time too where we’re evaluating like our, all of our vendors right now. So revcycle, emr, those are likely going to change and it’s kind of an opportunity just to pick our head up and just look at what’s out there on the credentialing side. And as Mallory knows, like one of the last time we had our big thing was like, I don’t know everything that symplr does still or you guys do. So there’s very like to me there’s just like so many different products out there. I just think of like general enrollment like I’m just like person comes in, they need to enroll the payers, it gets done. But there’s all this other stuff like the cvo platform and expirables management, all these things. And we’re also we’re looking at like looking at just the software and bringing the work in house. And so all that to say we’re just, I’m saying at a very high level, we’re just, we’re open to looking right now. I don’t have a timeline for a change. I don’t even know what we’re going to do but it would be good, excuse me just to get kind of like a tour of like what you guys do, how it compares to symplr, maybe some examples of like how you work with other companies, whether it’s on the managed side or on the software side. And then like I said, I’ll be very transparent. We are also when we’re switching our rep cycle, the rep cycle groups often want to do the credentialing for us because it’s in house. It’s right next door. And so would really be, I need to be looking at that very critically from both a pricing perspective, vendor management perspective, and also like what can you guys do better than the rep cycle team? So, that was a mouthful, but that’s where I’m at right now.
Mallory Smith (07:22) Yeah. Do you mind if I jump in and ask a few questions? Yeah, go for it. So with, since you’re in the snf space, I immediately think of facility enrollment. Are you still doing individual provider enrollment with payers or is it more at the facility level with like a per diem at the patient level?
Mike Wills (07:40) It’s all individual patient?
Mallory Smith (07:43) Okay. All right. Per pair. Yeah, I got you well, as far as I could compare and contrast, I hear you loud and clear that there’s all different products that symplr offers. There’s different things that we’ll offer. There’s a 1,000,001 vendors in this space. It is funny that you mentioned that rcms and your revcycle, that they’re also offering credentialing and enrollment because we’ve partnered with a lot of rcms in the space that they’re like we want to start offering credentialing and enrollment because you want to have one hand to shake at the end of the day. So have it all consolidated. It makes the most sense. If your billing team is going to be handling the claim submission, then why can’t we be accelerating revenue so they can submit claims faster. So that business model works very much hand in hand with what medallion sees in the space. And I would say that from a product perspective, we’re proprietary. So we were built from the ground up in 20 20. So you’re not going to have the kind… of call it the frankenstein’s monster effect of what you would see with symplr currently. And I think the other aspect that was a breath of fresh air when I first came to medallion is right now you have no visibility. We track every single data point and we give you full transparency to see everything our team is doing. So it’s not just a spreadsheet that you get every two weeks anymore. It’s you can log in the platform and you can see the emails from the payers. You can see the submitted application date metrics at the highest 30,000 foot view level. So if you’re open to it, I think a demo would definitely be worth your time just so you can get a visual on what your experience would be like from that one. But of course, you know, with you being a CFO, we always want to keep the conversation focused on revenue and metrics at the end of the day too. So it sounds like it’s a great time for an evaluation process and you’re looking for a vendor that maybe can do more than just one area. So whether that’s expirables, management, onboarding of providers and so forth. I think we could definitely have an open conversation about it.
Mike Wills (09:38) Yeah. I mean, I think a demo at the very least would help me understand, you know, yeah, it would. And I’d have Kendall who’s our practice manager to participate in that chat and demo. But this is something that we’d probably want to tackle by one one of 27. And I say one one because that’s probably when we’re switching our emr, probably when we’re switching our RCM, and I know we’re like locked into probably some agreements with symplr and there’s probably whatever. I mean, we’ll figure that out across that bridge, you know, when we get there, but that’s probably the lead time that we’re looking at.
Mallory Smith (10:23) Absolutely. I would say that falls well within our window. We know that this won’t be a decision that you make in the next three months by any means, but I am curious.
Mallory Smith (10:32) I think when you’re leaving symplr, we’ve transferred several customers. We’ve displaced symplr a few times now and they said that I think symplr requires like a 90 day notice. So that might be something you have to.
Mike Wills (10:44) Get in writing. Yeah, I mean, a couple things there. I mean, like I think we have like we might have a three year term with our last one and then it’s like, you know, whatever. But at some point I’m just like I don’t care warp the band aid off and we will deal with it. It depends on, you know, how dire the situation is. But I don’t like being this Guy but I’ll just be like, look like this thing fell apart and we’re not paying and, you know, we’ve given you enough notice.
Mike Wills (11:15) So, yeah, that’s something I got to look at. I mean, like I said, our focus right now is first and foremost is emr shortly behind. That is going to be repcycle. And then when I say repcycle, the billing and collections piece, you know, because I would consider this part of repcycle. And then it would be, you know, if we do not use the repcycle company for credentialing, then it would be potentially making a switch. Yeah, I mean, like I haven’t been, and especially recently I’ve not been, I’m just being honest, I’ve not been impressed with symplr. We’ve had a lot of issues with them over the last six months and we’ve had somebody come to us and be like, yeah, we like restructured our apartment and I’m like, yeah, I get that. I’ve been there. Listen, I have been there. We restructured mpac 24 months ago, but like the quality just like fell off a fucking cliff.
Mallory Smith (12:09) So no, of course, we’ve unfortunately, we’ve heard that a number of times. So we’ve come into several situations where what I’ll say is we’re very familiar and comfortable with doing a data migration from symplr. And I’ll leave it at that, right. I am curious though when you say with emrs that’s kind of your first priority P0. If you will, do you have one identified or would you be open to like an API conversation just to see how we can streamline?
Mike Wills (12:39) So the product we’re looking at right now is called pacer by cysystems. It’s a post acute. Yeah. So that would be, that’s our leading candidate right now. So I don’t know we’ve got, we’ve been in discussions with them. They’re eager to get us to move over soon. We are like maybe let us get through the year because we’re participating in an aco and there’s quality metrics reporting. And, you know, we might be, we might change acos next year and it might just be good to have like a one one cutoff. So I don’t have to smash tracking reports together and all this stuff. So, but yeah, that’s who we’re looking at.
Mallory Smith (13:22) Okay, awesome. So you’re thinking about switching acos, we’ve actually, we’ve partnered with a few pcas and acos in the southeast and northeast recently. So if you were to switch an aco, is that going to disrupt anything with the current credentialing? Is there just more on like the admin side?
Mike Wills (13:41) I mean, it just means we have to enroll our providers in one more, you know, and well, it… depends we have our own tin set up for aco. So really just the aco tin would have to be re, whatever aligned with whatever new aco we’re moving to. And all the providers would come over to if we are participating. Yeah… no, it shouldn’t. It really shouldn’t. I don’t think it should have a… tremendous impact. I mean, one of the challenges that we do face is, but I’d say it’s pretty immaterial. Well, I say pretty immaterial. It might be immaterial. Is for the aco tins. We really only enroll in medicare and medicaid and every other secondary we’re just like whatever because it’s secondary insurance is typically, it’s rare and we’re chasing like five dollars and it’s probably not worth it. So that might be something where we do new enrollment, but I don’t think it should be a problem, no.
Mallory Smith (14:40) I hear you loud and clear on that. I’m thinking with the aco, if you do a tax id, ownership change like a change of ownership with it, then it should be fine. There was a group we partnered with in Alabama that they acquired. They left a hospital system down there and they just bought the tax id. And that way they could just do like a group roster and not have to submit 120 separate applications. So there’s definitely ways around that, but that’s exciting. So let me talk to you a little bit about provider growth. How many providers do you currently have to manage today?
Mike Wills (15:10) We’re at 85 today.
Mallory Smith (15:13) I think that’s an increase from when I first talked to you, right?
Mike Wills (15:16) I don’t know, I don’t know. I don’t remember when we talked because we went through, we went through hell and back between probably between the time you and I talked and now. So we’re yeah, we’re at 85 providers. There’s about 30 NPS. The rest of them are licensed mental health clinicians. And then, you know, I think we’re expecting to be, I don’t know. We’re going to be north of 100 by the end of the year. So most of the growth is coming from Texas right now.
Mike Wills (15:43) And then would be Maryland and Maine as well are the next markets that we’re going to be in. So, yeah, and, you know, new providers, new payer landscapes, those are things we’d be looking at too in terms of like how can our vendor help us with those sort of evaluations? Yeah, no.
Mallory Smith (16:04) Of course. And just so you’re aware we are comprehensive with the enrollment, the way the medallion, the model itself is, we are a software and services model. So with the software, you’ll see full transparency. But then our team is the one that’s pushing the applications out the door. We have agentic AI for follow up. We’re comprehensive for facility or group enrollment establishment. So if you are expanding to new areas that’s no issue at all. So it sounds like the steady level of growth that’s awesome. I am curious. Do you have any telehealth going on since you mentioned licensed mental health? We don’t we.
Mike Wills (16:40) Do we have some telehealth but it’s for very specific use cases? Typically, we’re not, you know, it’d be like for call, overnight call if we need to bring a physician and do attribution for the aco, but we’re not, we don’t I wouldn’t consider us to have like a true telehealth service line.
Mallory Smith (16:59) Okay. I hear you loud and clear and that would be, it’ll be a difficult concept anyway. Like medallion really got its big start when in 20 20 covid happened. And then the basically the federal like federal level said, hey, you don’t have to have an active license in Maryland to see patients, just see the patients. We just need to see it. Oh, yeah. So we had a huge boom between 20 20 and 20 22. When, the market exploded. There’s, cross state licensure, there’s all kinds of telehealth opportunities, but we’ve seen a decline with that and I think mostly because payers have just been like, listen, you can’t all just be telehealth. So I think payers have been putting restrictions anyway.
Mike Wills (17:37) Okay. Yeah. I mean, they keep extending those waivers so, you know, but… yeah, limited use case for us.
Mallory Smith (17:45) Okay. Awesome. Okay. I appreciate that. I’m just trying to think there’s anything I know that you mentioned customer support hasn’t been great. I think the big difference I’ve noticed here with medallion is there’s multiple different support options, but you would also have your own account manager and engagement manager. So two different people, your engagement manager would be a day to day contact someone you can email if you need something escalated if it’s a high priority. And that would be like an actual person that’s here in the stateside. And then of course, your account manager for expansion upsell, opportunity, things like that. Did you have a similar experience model like that with symplr? Or is it more just like?
Mike Wills (18:22) I do not know. Like it is like I said, right now, we’ve been fuming, it’s all over the place. We don’t know who to talk to, whether it’s the person we’re working with on a regular basis. We’ve been assigned a new account manager who won’t reach out to us. We’ve got invoices that we can’t explain and that have been outstanding for six months that we’re saying we’re not paying them until we get an explanation and we haven’t gotten shit. So I have no idea. I have nothing to compare to.
Chris Jones (18:46) Okay. That’s insane. Yeah.
Mallory Smith (18:49) Now that I’m remembering one of those invoice incidents actually that you mentioned that. So, yeah, no, I hear you loud and clear on that. Okay. Well, I appreciate, you know, you kind of running through the current state. I would love for you to be able to just look forward, put all of that mess behind you. And maybe we could consider an evaluation. We’ll of course, move at your speed. So if you want a demo as a next step, then we could look a week out. We could look a month out what would be kind of a better timeline for you as you’re going through.
Mike Wills (19:21) Let me talk with Kendall who’s you know, I get on these calls and talk a big game. And then she’s got to be the one that does shit. So let me talk with her. I just put it on our agenda for a meeting next week and just see, you know, when it makes sense and, you know, I think it makes sense to evaluate concurrently with our RCM and yeah… we’ll take it from there. So I’ll reach back out to you guys.
Mallory Smith (19:50) Okay. Thank you. I appreciate it. And the other thing that we can always offer too is like a business value assessment. So rather than you having to recreate the wheel, we can look at potential Roi, how we can accelerate your revenue. And that could really help you especially as you’re deciding between having your RCM do the cred, or what it would look like to have a standalone vendor.
Mike Wills (20:09) Okay. Some of this too, and, you know, this is early in the game, but like even a basic pricing structure helps, I think that’s also been like a, and it doesn’t necessarily need to be the final values. But even just how you structure the services, you know, like I get three different invoices from symplr. I don’t know what they relate to and how to split them from costing the new vendor that we’re looking at the pacer, they do everything based on a percentage of collections, which as opposed to like a I’m used to paying like a per user per month or per provider per month situation for these type of services. So even just to get a high level comparison on like how you structure them and like the terms, like at a super high level, I don’t need to draft just like even just a fucking bullet point list that would help me understand like when I’m comparing these two, how I’m comparing apples to apples in terms of in apples in terms of service and price because that’s been a it’s actually been difficult to compare vendors across the couple vendors we’ve talked to because everything’s structured differently.
Mallory Smith (21:19) No, of course. And when you think monthly invoices right now, are they different amounts each month? So you’re not really able to forecast how much you have to pay?
Mike Wills (21:26) I mean, yeah… for the credentialing, they shouldn’t for symplr, it shouldn’t be, it shouldn’t be. But like we started getting overages and we’re not sure why, and so there’s some sort of variable in there. And so, yeah, I mean, if it’s per user per month, I would expect it to be the standard thing, right? And then it gets updated, you know, maybe in, I don’t know once a year based on the number of clinicians that are in the right practice or if it’s a percentage of collections. Like obviously, those two are easy to forecast less about forecasting more about just like understanding what we’re paying for and making like a comparison on a whatever unit economic basis, I’m going to be evaluating absolutely, yeah.
Chris Jones (22:14) As we say, we can definitely dive into that, you know, just at a high level though they’re annual in advance. It’s based on number of providers and then number of requests. So think about request as, you know, number of enrollment requests. So, no.
Mike Wills (22:28) Surprises.
Chris Jones (22:29) Coming through there, but we’ll dig into it and.
Mallory Smith (22:33) I think the biggest differentiator that I noticed is that we have SKU flexibility here. So if you say we need 200 enrollments for the first year, but you don’t use 200 enrollments, you’re not just paying for it automatically, you can push and pull from year to year.
Mallory Smith (22:46) So that was a big difference that I noticed when I came over that way that as your business shifts as it changes, then the invoicing or not the invoicing itself, but the, how you use each product can change. Okay. Well, hey, Mike, appreciate the time. Really appreciate you reaching back out.
Mallory Smith (23:05) We can wait for you for next steps. Once you connect with Kendall and then obviously, I’ll be out next week. I will let you know how it goes so that you can add it higher up on your list. But then I’ll probably be the one showing you the demo the next time that we meet. So I’ll make sure that we have it built with snfs in mind enrollment and so forth.
Mike Wills (23:24) All right. That sounds good. Thanks for the chat.
Mallory Smith (23:28) Yeah, of course. Thank.
Chris Jones (23:29) You. Likewise. Nice meeting you, Mike. Have a good weekend.
Mike Wills (23:31) All right. We’ll see you. Bye bye.