Transcript
Lewis Elder (00:00) the platform. Awesome. I will share my screen.
Lewis Elder (00:19) Get this up. Okay?
Lewis Elder (00:45) Can y’all see that? Yep? Okay. Perfect. Sorry, now that I’m on Google instead of zoom, I’m like, wow… you know, different, same thing but a little different. Okay. So, yeah, we’ll talk a little bit about delegation and then, you know, Sam and I can answer any questions that y’all have, but we didn’t hit too much on this last time. So I’ve just prepared a few slides to kind of run through that. So I did want to start by asking, have y’all had any conversations with your payers around delegation yet? Like have y’all reached out at all to your payers to discuss delegation, kind of curious where that stands? That’s typically like, you know, best starting point?
Bridget Wolfe (01:29) Yeah. We’ve talked with, I think cigna evernorth, and Aetna and maybe one other one. We have their like minimum provider number and all of the standards that they require that we need to meet in order to kind of get into that level and get approval for that. So we’re opening up those conversations, but it’s definitely not been anything beyond like, hey, give us information about this. What do you require?
Lewis Elder (01:54) Got it. That’s helpful. And my, another kind of introductory question was, I know you have like there’s like 2,500 therapists total, but for the, do you for their provider requirements? I wanted to make sure that you guys feel confident you meet those for the provider minimums?
Bridget Wolfe (02:12) Yeah, I mean, definitely, not in current state, but I feel like we’re confident that we can meet them in the future as we scale the product.
Lewis Elder (02:19) To, so, yeah. Okay. So because that’ll obviously be critical and we won’t spend since this is more of a future state thing, I won’t spend a ton of time, on the delegation overview. But just to give you guys a sense of like what it looks like without medallion, what it looks like with medallion, I’ll kind of, you know, churn through some of these and call out some points here. But that’s helpful. So if you’re not familiar, it sounds like you know, a B. You definitely are basically what getting delegated means is that, the payers would essentially entrust you know, journey clinical, and medallion, or if, you know, journey clinical yourselves to credential your own providers. So the meaningful impact that would have for you all is that you would be able, to reduce your turnaround time to like a day because you’re self credentialing your providers, your payers are entrusting that process to you and you have the authority, to credential your own divider, own providers, and really avoid all of those like, you know, payer delays that you would otherwise normally encounter.
Lewis Elder (03:26) So, without using a medallion, so medallion just, to kind of level set. So, we are an ncqa accredited cvo. So we would act as a sub, delegate to your agreements, the agreements that you have with your payers, which would grant journey clinical, an ncqa certification. So we would allow you all to be delegated with your payers, by medallion being a cvo. Any questions so far? Just on, you know, delegation as a whole and what it does. Cool. Really, the important thing here is, you know, you could pursue delegation with a medallion or without. The reason that medallion offers this service, the reason that we sell it, the reason that we have customers buy it is because without using something like a medallion as a cvo, it is, a, pretty grueling process. So, it’s a very difficult long term process for or for an organization like journey clinical to accomplish yourselves. It, you would need to obtain your own ncqa accreditation. And, and that can take like one to two years at minimum to achieve on your own. And, with medallion, we, you know, we can significantly shorten that. One thing to call out here is that payers require a 12 month credentialing history in order to get delegated, that the path below illustrates what it would look like to go from direct enrollments to delegated enrollments without medallion. So, on average, we see it take about two years for groups, to get it done, start to finish. Yeah.
Samantha Bouchard (05:08) Bea, and that credential history really varies payer by payer. So like there are some that only need three months and that’s really why we recommend you kind of reach out to the payers that you might be interested in as you’re kind of hitting those 100 providers per contract to really see what their requirements are. And then that would give you like better predictability into like how quickly but essentially like with medallion and the payer enrollment. If you were to go with us for that, that’s going to be that really quick value for you. All you can start offloading those enrollments to us, benefit from, you know, us streamlining the onboarding process, getting those applications out the door, turning those applications around faster. And then in the meantime, we kind of work on this a little bit behind the scenes so that if you think about it as a scale, you get all direct, we want to kind of swap those, right? And we’ll be able to do that all in one system. Just, yeah, we just like to share this because obviously doing it on your own, it’s going to take a while. There is still some upfront work that we partner with you on. And then just the payer requirements of producing those files for a certain period. That’s why we like to bring this up now because if it is something you’re pursuing like let’s get started, let’s start working in the background so that you guys can ultimately see that value, you know, as soon as it’s available.
Bridget Wolfe (06:38) Yeah. And I think most of the payers we’ve talked with it’s been six or 12 months of data that they require. And then I also had a question just on like the front end of this as we’re standing it up. And again, I can’t recall, are you guys helping with establishing the policies and procedures and helping us like understand the committee piece of it and like maybe guidance on how to reach out to certain payers or insight on certain payers and what you know, about them is any of that offered as part of this? Yeah.
Lewis Elder (07:09) We have, I’ll start and Sam, you can add in, we have pre built policies and procedure templates and a huge amount of like best practices for committee structuring committee management. And all of that would happen electronically inside medallion?
Samantha Bouchard (07:24) Yeah, it’s all audit tracked. And so we do have like an audit support piece. So as, you know, preparing to officially get that delegation, they’re going to want to audit those files that you’ve already produced. And so we support that whole event to just, you know, really make it seamless for you all. Awesome. Cool.
Lewis Elder (07:49) Good question. So, anything else?
Bridget Wolfe (07:53) No, not.
Lewis Elder (07:54) Yet. Yeah. And this is just kind of hitting on we.
Samantha Bouchard (07:59) Kind of went through this.
Lewis Elder (08:00) Yeah.
Samantha Bouchard (08:03) Do you?
Lewis Elder (08:03) Yeah. And Sam, you can let me know if you want to just skip to the.
Samantha Bouchard (08:07) Yeah, I think Bea has like a really good understanding of delegation. So in this slide, Bea, when Louis sends it over, you can see what you own and then where we’ll work together. So, you see in the green, like the policies, the staffing, the metrics, and then even that delegation agreement with your subdelegate, we’ll support. And then you can see where we kind of come in with the policies and procedures supporting the committee, you know, adherence to the rules and the guidelines and the delegation agreements.
Samantha Bouchard (08:41) So like when you get that delegation agreement, you send that over to us, we kind of review it and then we like partner on a plan.
Lewis Elder (08:46) Yep. I think the most important thing that we get questions on is kind of around the agreement negotiation with your payers like that still would be your responsibility to review those contract terms and have that negotiation conversation with your payers to get those agreements in place. That is not something where we would be taking over that scope of the work. But yeah, otherwise I can send this over and, you know, you can always ask questions there, but I think just wanted to at least level set as to kind of what delegation entails, you know, how we approach it and the overall scope of work. But Sam, I can hand it over to you. I’ll pause there. Any other questions from Rekha or Bea? I?
Samantha Bouchard (09:28) Do have a question for, Bea, like as you’re thinking about this and like your, you know, 12 month plan with the business? Like looking ahead, like, you know, is the goal in 12 months to have a couple of these or like, do you think it’s further out?
Bridget Wolfe (09:47) No, I think it’s as soon as we can. Is the response. We’re really interested in being able to, you know, kind of own that and own that turnaround time piece. And I mean, that’s I think probably everybody’s interest at this point in that is like, you know, how do we make that a quicker process? So we can onboard the therapist really quickly? Because again, we’re offering this kind of as an extension of other services. And then too just, you know, we have the same struggles that most practices have where we need to fill gaps in care if somebody has a family emergency and they are out and we have providers who are licensed in other states but they’re not actively working there. And so getting them, you know, turned around and set up really quickly is key as well to ensure that we don’t have interruption care. So… I think that’s the biggest motivator and it’s like we want to start yesterday on just getting everything in order to be able to do this as soon as the payers like, yeah, you can.
Samantha Bouchard (10:46) Yeah, yeah. And that’s something to keep in mind like some might have a six months, some might have a three months. So like in this example, this is definitely on like we were able to move really fast and the payers that they selected were able to move, really fast.
Samantha Bouchard (11:02) But in this case, like they were able to get like three agreements in the first three months. And so this is like an example of one of our customers. And so you can see like, you know, where we come in with the one day on average credential file, turnaround time, you know, plus our onboarding, and then the support we provide for those agreements, just allow you guys to bypass a lot of that initial setup. One thing that’s also important with delegated agreements. And I think we asked this before npdb id. Are you all registered with national provider data bank? I.
Bridget Wolfe (11:39) Think you did ask that and I didn’t know the answer to it. So maybe an Andy question, I’ll have to find out. I do have that flagged in my notes.
Samantha Bouchard (11:49) Okay. We can do self queries like to start, but ideally, we just auto connect with npdb through your npdb id and that allows us to really create that and give you those turnaround times that we talked about and create that compliant file because that is a requirement for an ncqa file. So Lewis and I can follow up with the npdb website and just kind of how you would go about applying for that. There can be some like restrictions and like them offering an id like based on like the type of like facility or practice that you all are, how your organization is set up. So I would definitely recommend just kind of combing through like their requirements as well. Okay?
Bridget Wolfe (12:38) Thank you. Yeah.
Samantha Bouchard (12:40) Absolutely. All right. Well, let’s transition to the demo and kind of show how this really comes full circle with the request process and just how streamlined we really make producing… these files in the system. So let me share, I.
Rekha Philip (13:03) Have one question that’s maybe completely outside of this whole discussion. Maybe it’s because I don’t yeah, I’m just curious. Does medallion have services where you also help us contract with payers? Or is it just?
Bridget Wolfe (13:18) So we.
Samantha Bouchard (13:20) facilitate like the group enrollment, Rika, but as far as like that negotiation piece that would go back to you, we do have, I believe one or two like partner recommendations for that particular service that we could share if you’re kind of looking for like a consulting firm when it comes to the contracts. But yeah, we don’t have that in house. We just kind of facilitate the, yeah, the process for obtaining it. Thank you. Yeah. Okay. So last time with my choppy internet, we kind of looked at medallion as a core platform, how it would organize all of your data from your tins, your groups, your providers. And I know Bea, you know, really thought that aligned with kind of like what she would be looking for just from a data structure. We looked at how we onboard providers integrate with caqh, taking that turnaround time to an average of two days. So getting those providers integrated in the platform faster. And then we looked at our payer enrollment offering how we really take that on end to end and reduce those turnaround times, ultimately accelerating revenue for journey clinical. And so the next piece to this is the delegated credit. So… you can think about this a couple different ways. So the, that first six months that you’re generating files. The way this would look is… you hire a new clinician, you come in here, you request the initial credentialing, you select the provider that you’re looking for or providers you hit submit that’s where your work ends. It’s gonna go into our request modal here. And we’re gonna instantly start connecting with our primary source verifications. So, sorry, was there a question? Nope. Okay. I heard some background noise. No problem. So we’re gonna instantly start connecting with our primary source verifications. Ncqa requires that there has to be like a human in the loop. So we can only automate so much of this. And then we have human for QA. So essentially, we do our instant connections. If anything comes flagged, we let you know about that, and we’re returning this file in on average one day, but we have that three day SLA… you all have visibility here. Once the file has been reviewed with the human in the loop, it’s gonna move into our ready section. And this is where you have visibility into the file itself. So you can kind of page through if anything’s flagged it’s gonna show it to you. You can add any notes. And from here, this is where that committee piece comes in. So before I get to the committee, just wanna pause all this kind of tracking, making sense, Rika, I know this is kind of like a newer area to you but just wanna pause for a second. Do you guys have any experience with like site packed stuff?
Rekha Philip (16:49) Like that where, for example, in the behavioral health world… therapists have this thing called site packed where they’re credentialed with like third fifth team states, but it’s a different type of model than the regular credential or sorry, not credentialing but licensing.
Samantha Bouchard (17:11) I was gonna say I was like, I know site packed but I thought it was related to the licensing. Yeah, licensing. Yes, we do. So we’re gonna get into the licensing. This is a little bit separate but where licensing comes into play is that we’re gonna validate through these primary source verifications that all of their licenses like are up to date, right? So this is doing that check that like when you’re placing like a provider with a patient, once this file comes back green, like you’re good. Like, you know, they are who they say they are, they don’t have any malpractice, things that are coming up that would prevent them from not servicing. So all of this is typically done by the payer, right? They give you that they grant you that par status. You know, your provider’s linked. Everybody is like covered from like a compliance perspective. And so in this case, you guys are actually taking that on from the payer and so that’s where the partnership really comes into play because we’re producing that ncqa file that the payer would typically produce. And so once these files are ready, this is where the committee piece comes in. So essentially you decide like, you know, typically we’ll see people will set up a clean committee and a needs attention committee. So anything that is flagged and needs to be reviewed would go to the needs attention. Anything that is green would go into the green. And then you all are able to form your committee which is typically comprised of like a medical provider, you know, and typically, you need an additional voter especially for those files that are flagged. But essentially, they can come in here. And so have you ever been part of like a formal like credential process in the past, where like doctors literally used to sit at a round table and like review these packets or has it always been a little different for you? It’s always?
Bridget Wolfe (19:16) Been a little bit removed. I’m aware of what you’re talking about. So I’ve worked closely with like the actual when I worked in an office a bajillion years ago with the actual like credentialing committee who had the office and the paperwork and all of the things and we would help them pull their packets and stuff together. So, I’m familiar with the concept there.
Samantha Bouchard (19:35) Are people who still print these out and load them up on like a dolly like wheel them in? Like it is so wild to me that like it still exists. And then, you know, some like less tech forward healthcare organizations like the thought of reviewing them asynchronously or in a platform is so hard for them to comprehend. But I think you guys would adopt this just fine and be able to just build your process around it, which would be great. But essentially you list out who you want the clean committee voters to be, who you want, the needs attention. They can kind of come in here, approve. And where that approval date is really important, is that’s the date that goes on the roster that gets sent to the payer. And so that essentially becomes your par date. So you guys all come through here. You approve, you know, say on a weekly cadence twice a week, you know, we make it easy that you can kind of come in and do that regularly. It will move to a closed state. We’re going to update that recredential date. And then, you know, so you can always track when those recreds are due. And then ultimately, our team is going to take everything from the month output a roster to you all you submit that to the payer because you have the relationship with the payer. We’re just your subdelegate. We give you the roster, you submit it. And then all the payers are going to backdate to that committee approval date. Got it. Awesome. So.
Bridget Wolfe (21:18) There’s work on our side on essentially getting the provider information in that we need and creating like the tasks, right? Like starting this off, there’s work to be done on the committee piece. There’s work on sending the actual roster over. Is there anything else that I’m missing that would be like a substantial amount of I’m just trying to think about how we need to staff internally to, yeah.
Samantha Bouchard (21:41) So the collecting of information is all going to come from that provider onboarding process which is also going to apply to just one your provider directory. You want that up to date, which is the core platform two. You’re going to still be doing payer enrollment for these providers. So all of that is going to like, you know, apply to those three areas. And then yes, like they send this out. And then from there, you take the committee piece and the sending of the rosters. But rather than, you know, some teams are like manually checking every single one of these primary source verifications or some other self serve tools. They might connect to a couple of primary sources for you. And then you’re kind of responsible for the rest. We’re going to kind of we’re going to produce that compliant ready packet in our system. Thank you. Yeah. Awesome. So that’s kind of the process of like the first six months, you’re kind of just generating these for the tracking purposes. You’re not going to really do much with them other than it’s going to at least tell you that your providers are good and you kind of get to get familiar with the process once you get that delegated agreement that’s when those rosters obviously would start and, you know, the same process continues. But I just kind of wanted to distinguish like that first six months, you’re just creating a file for, the payers audit purposes. All right. Awesome. So just to kind of tie this in, so you’d come in, you’d collect all the provider data. You’re going to request the credential file, move on from that. You’re going to come in to the payers, you’re going to request all your payer enrollments that are associated. You’re kind of done with that piece. And then if there are licenses that’s kind of where the licensing piece comes in. So just want to make sure it’s clear. I think we offer so much visibility into the platform that sometimes I’m finding like as I’m giving demos, it can be challenging like I like how your brain’s already thinking like what do we do versus what do you do? I just want to make sure like that’s also clear from the payer side because I know we kind of rushed through that. Did you have any questions, Bea after the demo of like where you all come in and then where medallion takes over? Yeah.
Bridget Wolfe (24:07) No, I don’t think so. I think I’ll restate it back and you tell me if I interpret it incorrectly, but we would submit basically the enrollment request. From there. The team picks it up. They’re doing all of the follow up necessary things to push it through. I would assume if there’s anything additional needed, we would get that back as a request or the provider, whoever we direct that communication to. And then from there, we would just get the approval and be able to see that had occurred. And I think if I remember correctly, you had an API too that could generate the approval. Okay? And then if the provider terms, then we would be responsible for the removal of them from the roster yep.
Samantha Bouchard (24:49) Okay. Bee, you’re hired… good. Well, that makes me happy. So that messaging did come across. I’d like to say you guys own the strategy, we own the execution and that’s kind of where your click path is. What do you need? Who do you need it for? And then from there, just the visibility into each step.
Samantha Bouchard (25:09) Okay. Awesome. So let’s talk licensing really quick. My understanding with your licensing needs is like you’re taking on these providers, sometimes they have multi state licenses. You place them in the states where their licensing exists. And then you may want to expand a license here or there is that kind of accurate? Because, you know, obviously there’s a cost to these licensing applications. There’s these fees. So, you.
Bridget Wolfe (25:38) know, we.
Samantha Bouchard (25:38) have clients that only manage like the expiration just because they don’t want to take on that cost. But then a lot of our telehealth companies end up taking on the cost because it’s so critical to their business. I.
Bridget Wolfe (25:50) Think it’s TBD is probably the best answer I can give you. And so we have our chief medical officer. We currently he’s licensed and several states and we, I personally actually do all of the renewals for those. And then our lead prescriber is licensed in a handful of northeast region states and I am doing the renewals for her as well and also assisting her with obtaining new licenses in those areas. So like we just went through Pennsylvania, we now need to do Connecticut and Maine. So there’s on the prescriber side, there’s that bit of it of like there’s already this kind of recurring workflow. There’s a need to sometimes obtain license we have offered in the past for prescribers if we have a gap in coverage, like, hey, if you want to get licensed here, you want more hours, we’ll pay for it. But primarily they are responsible for their own licensure and assuring that they have that. We just keep up with like expiration dates and making sure that, you know, there’s no, no gaps there. On the therapist side, maybe somewhere in the far future that’s something that we offer is like to help them, you know, get licensed in multiple states to expand their practice. It’s hard, to say. So I think it’s a question mark but we definitely want to explore like, you know, all of the opportunities and how we can bundle that in for me. And I talk, you know, with my lead about this is where I’m struggling a bit right now is just bandwidth of obtaining the new licenses. The renewals are easy to do. The new license is like the application as, you know, is so long and tedious. And I think it took us a few months to get our lead prescriber through Pennsylvania. And then she’s like, okay, let’s do Connecticut? I’m just haven’t had time and so there’s opportunity. I think right out the gate for that to happen potentially if the Roi is there, okay?
Samantha Bouchard (27:46) No, that’s so so helpful. And the good thing with our pricing model is like if you just want five licenses and five renewals, we can price it that way. So we can just add this in as like a lower, like just a lower volume to kind of take on, you know, the employed physicians that you’re managing as well as, you know.
Samantha Bouchard (28:06) And if you wanted to have a handful of slots, you know, for those other potential use cases, you know, we can estimate that as well. Cool. So with our licensing, it’s going to be very similar to payer enrollment. You own the strategy. We own, the execution licensing is actually our core product which I believe you all know because you were on it a few years ago. But essentially you come in, you select the provider, you select the license type and the states that you’re looking for. So we do highlight, I know Rika, you were mentioning the SCI pack. We do highlight the imlc, I’m going to get you more information on SCI pack and how that’s supported because I know that it is, but I just want to make sure I’m giving you like the most recent up to date information on that. But essentially, if you need Dea controlled substances, you really move all that over click request and we are going to take on the work from there. So as you mentioned B, these applications are tedious. There can be a lot, they can be very task heavy. They can require fingerprints sometimes need E notary. We really work to make those pieces as simple as possible. So we’re going to run the primary source verifications that are affiliated with those trying to see if there’s where that I think it’s we have a lot of columns up here, but we’re going to run the primary source. Yes, you can see like it’s with the PSV team. So we’re going to run the primary source verifications for that. We’re going to highlight any additional tasks that are needed which would come to our go to the provider. But then you as administrators have insight into that. And then we help facilitate the E notary, we have that directly in the platform. And then we also do a partnership with printscan where providers have to get their fingerprints done once. And then I think like 38 out of 50 states accept them. So we keep those fingerprints on file for a year and then those can be reused for like other state applications. So that really streamlines the process quite a bit. We’ll flag if anything needs your attention. And then another cool thing is this is a test environment, but you’ll see this issue? In CTA, so I heard you say Pennsylvania took quite a long time based on the data that we have for all of our licensing customers across medallion platform. We’ll actually give you an estimated date that you can expect that, which allows you all to plan your business. And then we surface these metrics on our analytics tab down here so you can see time with the board by state, by provider type. And if you have additional provider types, we can pull that data for you from the backend. And ultimately, what this does for you is allows you to apply for it, know when it went out the door and then say, okay, dr. Smith, like we are going to be able to place you in that state in on average 47 days from this point. So just kind of better prepare.
Samantha Bouchard (31:47) Any other questions about licensing? So as soon as we’re going to follow up with the board, we’re going to surface that to you as soon as it’s available, we’re going to note the renewal date for that license. And then another cool thing about renewals is you can select auto renew. So for your providers that, you know, aren’t going anywhere, you can click auto renew. So that automatically starts. And we have the time… we have the time listed with the like when that window opens, trying to see… yeah. So like when the window opens, so like each board, you can kind of submit for renewal. Sometimes it’s 90 days in advance. Sometimes it’s 60. Sometimes it’s 30. And if you go too soon, they’re like they’ll bump out your application. So we pay attention to that window. Once that window opens, that’s when we can auto generate the renewal. But we’ll also notify you if it’s not on auto gen. So just like another way to kind of track all that. That sounds great. So curious bee like from what you’ve seen is this kind of aligned with like your expectations from, you know, kind of passing licensing on. Was there anything that you were hoping to see? But didn’t no.
Bridget Wolfe (33:15) I’m familiar. Like I think we were at the tail end of using medallion for licenses when I came in to the organization and it was just a cost decision and that’s how I ended up managing it. So I’m familiar with it because I managed a piece of it as it was in here. So it’s pretty.
Samantha Bouchard (33:31) Straightforward. Okay, cool. And then, yeah, I just wanted to show you this expirables tab. So anything in our system that has an expiration date, you’re going to be able to see it all when it’s expiring. When it’s coming up, this will go down to licenses, passports documentation. So we’re going to kind of automatically track a lot and just kind of take that mental burden off of your plate or out of your spreadsheets.
Bridget Wolfe (33:55) Awesome.
Samantha Bouchard (33:55) And then lastly, we just have analytics and report builder. So we looked at licensing… payer, enrollments. This is really that 30,000 foot view. You’ve already seen the granular data that we’re providing line over line. This is a place you can go get that high level view. All the data is really rolled up really showing you like new enrollments, volume and turnaround time. So new enrollments, month over month, new licenses, what state those enrollment requests or licenses are in? And then like as they’re completed, you can see those completed enrollments here, potentially get that ping from the API or you’re going to get also get an email update letting, you know… do you all have any type of like analytics or doing any pivot tables on any of your dashboards today? Or is a lot of this detail kind of varied?
Bridget Wolfe (34:52) A lot of the detail is varied. We do have like some tracking dates as far as the time from submission to like there’s a formula, you know, in the spreadsheet that counts how many days it’s been since we submitted. So we can easily see when we need follow up. But we don’t at this point in time have a good way to say, okay with Aetna in this state, it’s taking us X amount of days versus, you know, this payer or whatever. And the other piece is we don’t have, we often get the question of, you know, when will this provider be credentialed or is anticipated to be credentialed with this payer in this state? And it’s always kind of a best guess or somebody has to get on the phone and actually call and check on the status of the application. So it would be nice to be able to clearly see like where providers are coming up in the states and where they are in the process. I know Rekha sometimes will have questions because the therapists have questions about, you know, like did you submit? So for her to just be able to go in here and look would be really great. She’s not stuck waiting on us to go through our spreadsheets. So, yeah, I mean any visibility is going to be better than where we’re at today?
Samantha Bouchard (36:00) That’s great. Yeah. And then lastly report builder. So where this I think is going to make you light up be as much as it’s like a simple thing is like for any additional like rosters or things that are needed. Like right now, you’re kind of like compiling those manually here. You can kind of come in select like the payer that you’re looking for. You can select, you know… tons of information like address, any information about the provider, you move it over to the right hand side. We’re going to auto generate the data down here below. So you can filter as needed and then you can export that if it’s a one time thing or you can save it if it’s something that needs to be sent regularly. And you can kind of set the cadence here so simple. But you would be surprised how many teams come to us and love this feature because they’ve used tools in the past where like getting the data out is like a request to a team member, and then a five business day wait and like a turnaround and things like that. So all the data in our system, you can pull it from here, all these tables, you can export and you have the ability to kind of like customize the columns to like your view. So we really do make it super simple for you all, to access your data and do with it what you wish. If you’re doing something with it consistently, we’d want to know about it because we can likely make you a custom dashboard in here, and surface that for you. Cool.
Bridget Wolfe (37:39) And then can we go back to like if today, I have a view that the state and… they’re over each other. Then they have all the providers for each state. And then the payers are along the top and I can see who’s effective or who’s processing. Is there a quick view of that on the payer enrollment side where we can see like, and I think this is where we talked about lining it up by the group and the states and how our PCS roll up. But like being able to see an overview as an organization of where people are. But then kind of zooming into the state and understanding, okay, I have two providers who have united and two who are still pending and so on and so forth. Yeah.
Samantha Bouchard (38:23) So, that was kind of like this example that I put in here. Yeah, which we didn’t show you last time. So good. Thank you for reminding me. This is like an example of like a market coverage from another client. So we can certainly like reuse this template or make some modifications. But, yeah. So it’s like letting you know like open enrollments by state, open enrollments by market, and you can kind of like define like what those markets are. And then like by payor as well, not with payor total et cetera. Let me see what else we have in here, open enrollments by provider, which I think would also be like a helpful kind of quick summary for you. And then you can see we’ve… yeah, just kind of like summarized all of that and like where things are, weekly enrollments by update. And then, yeah. So this is like a very custom metric, advertised employed and clinical experience. So there’s you know, depending on like what is most important to journey. We can certainly kind of tweak a dashboard like this to really give you like those key metrics as they relate to like your expansion plan. Awesome. Can something like this be like, what would the value be for you all? Like if you were able to see all of this? Just like better planning or it’s.
Bridget Wolfe (39:56) that, but also understanding where we are because some of our states have, you know, maybe two or three providers, it’s pretty small. And so again, if we lose one to vacation or family emergency or something like that, we’re left kind of shuffling and so being able to prepare and say, like I understand in the state of California, I have, you know, 12 providers who are with united right now and three are in process. And like if I’m going to have a gap somewhere being able to quickly visually identify that. I think it also just helps us with understanding of like if somebody’s application gets stuck in the process which happens right now because there’s one person doing all of it, you know, and something sits for a bit, then we can see like everybody else is effective with this payer in the state and this person still processing like what happened? How did we miss this? So there’s probably a lot of use cases and maybe some of those would be solved by just having a platform. But I also think the other thing that comes to mind is just our support team. They like that high level overview because if they have a patient who maybe the provider needs to cancel and they need to rebook manually with another provider, they can go to that and see which providers are in network in which state. So great.
Lewis Elder (41:12) I saw you speak. I don’t know if your audio is working. We can’t hear you.
Samantha Bouchard (41:20) She wrote that she had to step away but maybe she’s back, no.
Bridget Wolfe (41:25) She’s back, she was starting to say something but we can’t hear her yeah.
Lewis Elder (41:28) I just noticed she came off. Yeah, I see her off mute. I don’t know why.
Bridget Wolfe (41:33) Maybe mute, maybe it’s.
Samantha Bouchard (41:34) your headphones. All right. Well, while Rekha’s working on that just kind of wrapping up here. Bea. Rekha, what I hope I got across to you in these kind of two demos is really like how medallion can help you all move faster, get your providers onboarded billable, sooner, get some of those licensing move into a place where you’re in more control when it comes to the delegation all without adding that additional operational burden. And then in the same breath, you’re kind of creating a better experience for your providers as well as Bea, you and your team. So if there’s anything that you felt like you want to see more of or if you ever, you know, we can dive back into the platform at any point. So just appreciate the conversation and your time so far. So, thank you.
Lewis Elder (42:30) Rekha, put a question in the chat. Can we see the view of the by provider by payer status of credential?
Samantha Bouchard (42:38) Provider by payer status? Yes. Let me… see here. So that would be just in, our standard payer enrollment, which is what we looked at last time. Sorry, one second.
Lewis Elder (43:07) I also, I wanted to ask a general question or I know obviously you guys are at like an inflection point now, obviously with accepting insurance, are you, this is more of I guess like a strategy question for your team. Are you considering when you think of like solving the problem, whether it’s like purchasing medallion or some other solution or like hiring people? Are you guys, do you feel like confident in one camp? Like are you for sure gonna just buy a solution or are you considering, hiring more people kind of curious as to how you guys are thinking about it? Yeah.
Bridget Wolfe (43:36) I mean, I think as an organization, we again are like very, you know, automation AI forward and leaning towards doing more or doing the most that we can with less. I think doing more with less sounds bad, but, you know.
Samantha Bouchard (43:49) Yeah.
Lewis Elder (43:50) Increasing.
Bridget Wolfe (43:50) efficiency. And so hiring individuals is always going to be the last option. So, it’s very much like what can we do platform wise? What can we do with integrations? What can we do with automations and AI? And then from there, where do we need to plug in the people? Which is again, why I was trying to figure out like, what work would be left for us to do in these different buckets so that I can appropriately understand like how do we need to staff this? I.
Lewis Elder (44:20) See. So. Yeah. So, so, you know, using a tool first and foremost, ideally avoiding hiring additional folks, but then last resort if there’s just still some work left, maybe scaling the team, some, yeah. Yeah. Okay. Understood that’s helpful and Sam Ray kaput. I see your type and put another question in there.
Samantha Bouchard (44:42) Yes. So in their provider profile, Reika, they are going to have visibility into their payers. So they’ll be able to see where these enrollment requests sit. This isn’t a good example. This doesn’t have any. They’ll also be able to see their existing enrollments. We cannot see your.
Lewis Elder (45:01) Screen if you’re.
Samantha Bouchard (45:02) well, that would be… that would be a key need here. Wouldn’t it as I’m just talking. All right. We’re good. Okay. Now, I’m getting a weird thing from Google meet, but you guys can see it. So in their profile, they have access to payers, so they can see any enrollment requests, they can see all their existing enrollments, so anything in flight. And then they will get a notification as well as the administrators. Once that car status comes in. They can additionally see their licenses if they have any requests, but in general just like what their active licenses are, and then where their expiration is. So we’re going to kind of track that for them too and give them those notifications. And then in their overview tab is where the task lives. So your question is saying if anything else is needed, can we bypass the team? Yes, like for a licensing request, we’re going to layer on anything. We’re going to task that out. If there’s anything additional needed for PE, we’re going to task that out. So providers are going to have individual tasks here. They’re all going to have like detailed information associated with it. They can add notes and you can kind of communicate back and forth. And then the administrator, so be team is going to have visibility into all the tasks that are outstanding. And so if there is anything that you could fill in for a provider, you do have that opportunity to complete it.
Bridget Wolfe (46:38) I really like this too. Rekha, just thinking about some of our use cases that come up where we don’t get all the things that we need or we get expired information and Brittany has to reach out and we don’t know that she’s reached out because she’s done it in email. And then you’re asking her where it’s at. And then she’s like I got to reach out. You could easily just log in and see like the task is with the provider and nudge the provider because I think sometimes those come from like the provider going what’s going on with this? Because they overlooked the request. So I mean it really gives a level of visibility that we just don’t have today into like the communication and the asks between Brittany who’s executing all of this and the provider. So I think that’s really nice. Nope. No, we can hear you.
Samantha Bouchard (47:32) Awesome. All right, Louis. I’ll turn it over to you and we only have a few minutes here.
Lewis Elder (47:38) Yeah, I guess, sorry, Rekha, if you have any other questions, drop them in the chat now or you can try, I know we have like five minutes. So if you want to drop real quick and come back, I just want to make sure while we have a couple minutes that, you know, get your questions, if we can’t hear you. Otherwise, I can chat next steps. But in the meantime, Bea, any other questions from you?
Bridget Wolfe (48:02) No, I don’t think so. At this point, okay?
Lewis Elder (48:09) Navigations to the platform, would that generate an email to them? Yes. Yep. And I.
Bridget Wolfe (48:15) thought, correct me if I’m wrong, but we can set it up like multiple ways, right? Like we could have notifications go to the provider or just to the admin, if we have providers who are non response because I know some of our providers are like, they don’t get it through one avenue. They just never respond. So that’s right? I think we can customize kind of how they get the, and they can too, right? Like.
Samantha Bouchard (48:35) How they get the, yeah, they can set their notifications. You all are going to get like summary administrative emails, like on a weekly basis, kind of like letting you know what the status is. And then, you know, just your, you know, you would make it kind of part of your weekly process to just like log in, kind of look at the tasks, see, you know, if you need to give like an additional kind of ping because sometimes, you know, they just need that human touch. So.
Bridget Wolfe (49:02) And did we say that you guys could customize some of those notifications? Like if they’re approved, can we give you a template of text that goes in that email notification out? Like for example, the therapist, once they get approved, their next step is to log into our portal. And now they have some things that they do operationally in order to be able to like flag that they’re now available to see those patients? And maybe the API would take care of that. But just thinking like we probably need to give them next step. So, is that an option we can?
Samantha Bouchard (49:34) Customize the onboarding flow. I can look into that. There also might be a way that you could like, we could auto generate a task for you in their task profile because we can like bulk generate tasks and things. So I’ll just write that as is that like a hard requirement fee that you guys are absolutely looking for? Or just something you’d like a nice to have?
Bridget Wolfe (49:59) I don’t know. I don’t know that it’s a hard requirement. I think it would be a nice to have, I think there’s a few variables at play, right? Like we get the product piece up and running, and we have an API and they’re flagged directly in our portal that’s better because then they just kind of have a one stop shop and then maybe in there, we can generate something to, you know, internally to have them take the next steps. So I think it just makes our lives a little bit easier and like keeping them going because then at the point where they’re approved, we sometimes find that we either lose communication with them for a minute and then they come around and go. I have a patient and I saw her yesterday and what do I do now?
Samantha Bouchard (50:40) And.
Bridget Wolfe (50:41) all of the process is completely lost or they are asking, I saw I was approved, what’s my next step? So we’re trying to just bridge that gap so that they can seamlessly move through. Yeah.
Samantha Bouchard (50:55) Let’s I’ll definitely make note of that. That’s something we want to dig into further and maybe we can explore something through the API or potentially like a bulk task creation or something like that. Okay?
Lewis Elder (51:07) Any other questions from the two of y’all, okay. I see Rekha is going to be typing while Rekha is typing up her question. I think now you guys tell me typically, what I would recommend is the next step from here? Is it would meet with either the both of y’all or just be the two of y’all and Andy. And what I would want to do is we would put together what we call like a business value assessment. It’s essentially how I create pricing for you guys. So we kind of sit down, go through some inputs questions that I need inputs to of like how many providers for X y Z.
Lewis Elder (51:40) I would get those numbers. We’d kind of have an open discussion about that. Then I would turn around and kind of create a formal pricing proposal that we would then review. So that’s what I would recommend as the next step. But depends on, you know, how interested you guys are timelines. I’ll pause there and you guys tell me if that sounds like the right next?
Bridget Wolfe (51:59) Step. I think that’s a great next step. We’d like to do it sooner rather than later for sure. And I think we can just do it with myself and Rekha.
Lewis Elder (52:07) Okay. We can, I can do it as early as Monday, Sam and I will just have to like spin the questions up quickly, but that’ll take us like 10 minutes. And then if you have your calendar right now, we can, you know, grab it for early next week. Yeah. Well, I.
Samantha Bouchard (52:22) think Louis, we probably want to send the questions, give Bea a little bit of time to outline those. And then Bea, we may need just like a validation quick touch point with you that’s what I’m.
Lewis Elder (52:36) talking about, Sam. Sorry, I’m talking.
Samantha Bouchard (52:37) About.
Lewis Elder (52:38) a call to… kind of talk through the questions, make sure we get the answers and, yeah.
Bridget Wolfe (52:45) Yeah, it looks like we have some availability like 12 30 central on Tuesday for 30 minutes, if that time frame works. Yes.
Lewis Elder (52:55) That would be 11 30? No, one 30 central, my time, I bet.
Bridget Wolfe (53:00) One 30 eastern. Yeah, 12.
Lewis Elder (53:02) 30 eastern. I can do that, Sam, you are booked, but maybe I can, Sam, we can just meet. Is it? Well, I.
Bridget Wolfe (53:14) also, we also have two eastern from two to two 30. I have a meeting but I can move that if that time is better… do you?
Samantha Bouchard (53:23) Have anything in the morning Abby?
Bridget Wolfe (53:27) Yes, we can do a morning. Let’s see. We also go ahead. I don’t know if that might be too soon if you’re sending over the questions Monday morning or well.
Samantha Bouchard (53:43) Monday morning, we could go through them live if you want. We can just have them prepared and just kind of, and then that way anything you can’t answer live, you can take back.
Bridget Wolfe (53:52) Yeah, I think that’s fine. Let’s see what time works best for you guys on Monday we.
Samantha Bouchard (53:59) Could do nine 30 10 10.
Bridget Wolfe (54:04) Eastern? Yeah.
Samantha Bouchard (54:06) Let’s see… or 11 30 or 12 eastern. So let’s.
Bridget Wolfe (54:16) do the 12?
Lewis Elder (54:19) Eastern 12 eastern? Alright, that’s perfect. So.
Bridget Wolfe (54:21) 11 central. Yeah.
Lewis Elder (54:23) Okay. Sorry, I’ll send that over.
Lewis Elder (54:25) And then, yeah, what we’ll use that time for is Sam and I will just put together some questions and we will just like talk them through with ub and try to get inputs for them. And then anything we don’t know, you can take as a follow up as well. Okay? And then that’s what I’ll use to like build up a whole pricing proposal.
Bridget Wolfe (54:40) For you, that sounds great.
Lewis Elder (54:42) Sorry, if I missed this because the provider wants to look at specific payer rates that we determine and pick the payers, they want to get credentialed with directly and then move to the credentialing process… so that.
Samantha Bouchard (54:53) would be something that you would handle outside of the system. We’re not going to surface those rates. And then we’re also not going to let the provider generate those credentialing requests since that would go to your consumption. And so we really want to make sure that since like there is a fee associated with that request that your team is owning that.
Lewis Elder (55:20) Any other questions?
Samantha Bouchard (55:23) If you guys had like a spreadsheet or like a page made of that, we, in the welcome email, we could have some sort of linkage that like opens that up. So it’s like something that they could start thinking about. And then, you know, potentially there could be some sort of task that says like select the payers that you want to credential with and so that information could be trans transitioned through the platform. So, I think there’s a couple different ways we could solution to make something like that more seamless for you all.
Samantha Bouchard (56:00) And Rick, if.
Lewis Elder (56:01) you have any other questions, make a hand signal, if you’re typing. I just want to make sure I’m not.
Lewis Elder (56:11) Is that a no, no. Okay. All right. Nope. Okay. Good. Just making sure. All right, I will send out that invite for Monday, Sam and I will come with a list of questions and we’ll just talk them through live and try to get as many of those inputs answered as we can.
Bridget Wolfe (56:25) Awesome. Sounds great. Thank you. This has been really helpful. I really appreciate it.
Samantha Bouchard (56:29) Yeah, thank you guys. I hope you have a great weekend.