Transcript
Chris Jones (00:00) Joshua, what’s shaking man? How are we good? You pumped up and ready to head to the islands?
Joshua Levitan (00:10) I am very ready. I.
Chris Jones (00:12) bet, when do you find out?
Joshua Levitan (00:15) Tomorrow morning?
Chris Jones (00:16) Late? Awesome. Yeah, I’m jealous man. Sounds great.
Joshua Levitan (00:22) Yeah, appreciate that. Yeah, it’s gonna be a good time. We’re there for a while.
Chris Jones (00:30) Yeah, that’s the way to do it. Man. If you’re flying that far, then might as well make a trip out of it.
Joshua Levitan (00:35) That’s exactly the thought here. Yeah.
Chris Jones (00:39) Is your wife pretty?
Joshua Levitan (00:40) Pumped, she is very excited. Yeah, we gotta finish packing today though. We gotta get a haircut gotta do all sorts of last minute shit. Gotta drop the dog off at the boarding place. Oh, yeah. And then we’ll finally be off tomorrow morning and staring at 14 hours of travel. Oof.
Chris Jones (01:07) Yeah, I guess that’s about right? I think ours, when we went last year, I think we were like 12, maybe something like that, so.
Joshua Levitan (01:15) Yeah, it’s like 12 on a plane, but then a two hour layover.
Chris Jones (01:19) Okay. Yeah. It wasn’t as bad as I thought it was gonna be to be honest with you. We went through vegas. So, it was, you know, one stop in vegas for, you know, a couple hours, stretch your legs, and then back at it and it wasn’t bad. And then the way back was even better because you got that tailwind and we made up like, I think it might have been like an hour and a half shorter, two hours shorter on the way back. Yeah.
Joshua Levitan (01:40) We actually booked, not through the company. I use my own points, but we have live flat business class seats on the way home. Oh, dude from L a to Boston. Yeah, which is the red eye, which is the red eye leg.
Chris Jones (01:53) Yeah. You’re set that’ll be perfect dude.
Joshua Levitan (01:57) Got a great deal. It was only 30,000 points per person.
Chris Jones (02:00) Okay. That’s not bad.
Joshua Levitan (02:02) Yeah.
Chris Jones (02:03) Yeah. So, that was in addition to, the fare just to upgrade.
Joshua Levitan (02:07) No, that was in place of the fare. I pretty much was just like I pinged Kyle, I’m like, hey, can you just book my flights to L a and then I’ll get myself home from L a because I want to do this.
Dave Wallach (02:15) Oh, wow. It.
Joshua Levitan (02:16) Was on American but booked through Alaska.
Chris Jones (02:19) Okay. So.
Joshua Levitan (02:20) I got like a sweet deal. Cool. Dave. How you feeling?
Dave Wallach (02:25) A lot better? 95 plus percent.
Joshua Levitan (02:27) So nice.
Chris Jones (02:30) We’ve got Kim and Melanie. Melanie’s the director of her credentialing there. Got them both in the lobby here. So I’ll let them in.
Dave Wallach (02:39) Sounds good.
Chris Jones (02:51) Good morning, Kim, Melanie. How are you?
MelanieScott (02:54) Morning. Good. Thank you. Hey.
Kimberly Massanova (02:56) Nice to see you guys.
Chris Jones (02:58) Likewise. Hello. How’s life been treating you? Same?
Kimberly Massanova (03:04) Same. All right. Same one, same one, right? Yeah. How you guys been doing?
Chris Jones (03:08) Good. We’re actually in Austin this week for our QBR. So, oh, yeah. So, so back and digging out.
Kimberly Massanova (03:17) Awesome. Well, I know we’re waiting for Lily and Craig but maybe Melanie, do you want to introduce yourself? And then maybe Chris, you guys can go around real quick and let her know who you guys are.
MelanieScott (03:28) Yeah, of course. Yeah. So thanks Chris first of all, for forwarding me the email.
MelanieScott (03:33) So I did listen to the recording from last week. So hopefully I’m able to get up to speed. But anyway, my name is Melanie. I’m a physical therapist, and I’m the director of administrative services for company clinics.
Chris Jones (03:46) So, oversee.
MelanieScott (03:48) A lot of all the admin portion as well as our internal credentialing team.
Joshua Levitan (03:54) Gotcha. Run.
MelanieScott (03:55) My own business, know about being in the weeds with credentialing. And now obviously oversee credentialing as well.
Chris Jones (04:02) Okay, great. And then are you a physical therapist as well by trade or to me? Yeah, yes. Okay. Gotcha. Okay, cool. Great. All right, you.
MelanieScott (04:13) Probably wouldn’t want me treating any patients, but any more, yes, I still have my license put it that way.
Chris Jones (04:19) All right. Excellent. Okay. Good. Well, yeah, I’ll kick off introductions on our side. So, Chris jones, I’m the account manager that’s responsible for physical… been with medallion for just a few months start of the year, but been in software for quite a while, and then joining me today, we have josh and Dave, josh, do you want to introduce yourself?
Joshua Levitan (04:42) Yeah, pleasure to meet you. I ride shotgun here along with Chris, but in a little bit more of a technical context, I think the demo that you had watched someone was filling in for me, one of my colleagues, but I lead demos, answer technical questions, all that type of stuff. And my wife is a physical therapist. So, PT profession is near and dear to my heart.
Dave Wallach (05:04) I’ll go next, Melanie, pleasure to meet you, Kim. Great to speak to you again, Dave wallach based here in New Jersey. I lead our enterprise partnerships team. Chris is a member of my team and looking forward to the conversation. And Melanie, I was going to ask if you still practice, but you said you’re licensed. So there you.
MelanieScott (05:26) Go. I have my license, but I don’t practice. There you go. I could, I guess… I’ve got my hands full. I don’t need to.
Dave Wallach (05:36) You don’t have you have enough going on? I’m sure.
Kimberly Massanova (05:40) All right. And, sorry, and louie’s joined, but he’s wow, echoing for me too.
Dave Wallach (05:46) Yeah, we have enough. I’m on the.
Joshua Levitan (05:48) Road.
MelanieScott (05:49) I’m just saying, I think we all have an Healthstream, yeah.
Kimberly Massanova (05:52) Louis is here as well, but he’ll be off camera and.
MelanieScott (05:56) I don’t.
Kimberly Massanova (05:57) know, I’m sure if Craig’s free, he’ll end up joining, but maybe we can kind of get started. Yeah.
Chris Jones (06:02) Sure. And it looks like you are in twice one of them’s muted. Yeah. So I don’t know. Yeah, one’s muted one’s not.
Kimberly Massanova (06:11) Oh, I am. Let me kick myself out. Oh, wait, can you kick me out?
Chris Jones (06:15) I think so. Which one am I kicking out here? Let’s see. I would think maybe kick out the, Kim, that’s muted. Yeah. Okay. All.
Kimberly Massanova (06:28) Right. Oh, sounds better now. Thank you.
Chris Jones (06:30) Okay. Got it. Okay. Cool. All right. Perfect. Hey, good morning, bluey. Thanks for joining.
Louis San Miguel (06:36) Good morning.
Chris Jones (06:39) Okay. And then Craig did not accept, so we’ll see if, he might be busy. Yeah, fair enough. Okay, cool. We have an hour set aside for this. I don’t know that we’re going to need it all, but really from an agenda standpoint, we just had a few items.
Chris Jones (06:54) So one, it’s been a few weeks since the demo and I know we kind of covered a lot on that one and moved pretty quickly. So I want to just kind of circle back on that and just get some, you know, feedback from you folks, find out if there’s any open questions that we still need to address or anything we need to dive deeper into. So that’s one item. And then next, it’s really just kind of understanding more around kind of your process where we are timelines and then just really what you need from medallion to help support you moving forward as you’re going through the evaluations. And then lastly, and I’m not sure if we’re here yet or not, but if it makes sense to start looking at kind of things from the commercial aspects and helping to build a business case, we can talk through some of the data elements that we’ll need to kick that process off. So those are kind of the three major food groups that we had for today. And really is there anything else that you guys wanted to cover from your perspective?
Kimberly Massanova (07:51) The only thing I would say and Melanie may step in is like just want to make sure that once we get through it all, Melanie has that opportunity to like just ask all those questions, right? That we may have forgotten to ask. And for her understanding, you know, being part of the, you know, overseeing the credentialing team now. So.
MelanieScott (08:07) I have a number of questions and it may not be all applicable to this group and this timeframe, but I have a number of questions… you know, just when I had a look at it, you know, I’ve spent some time mapping out our current credentialing operation against what you showed on the demo. So we can be very thoughtful about that fit. I think it was mentioned that we do currently use qgenda and the team there really fine tune those automatic workflows per Ein, right? Because we work in multiple states. And from listening from the recording from a couple of weeks ago, you have a very similar process looking at that platform. It kind of reminded me right of qgenda, of how that works. So, I guess, you know, whether it’s this time or at another time, a lot of my questions about, are not about a less about, I guess where the tasks can be executed, but more about perhaps how those responsibilities and risk would shift if we partnered. Does that make sense? Because I think the actual system itself seems very similar to what we’re using on qgenda, but it’s all those outside kind of things. And those are really what my questions are based around.
Louis San Miguel (09:24) Yeah, I would tell you guys that given that this is Melanie’s first time speaking with you.
Louis San Miguel (09:29) All I would love for her to be able to, I think the best use of the time right now is to let Melanie pepper you guys with her questions and let you know honestly because she’s probably going to be my best barometer on comfort level there. So, I think that would be, I know Chris, you had three items, but I want to make sure that Melanie feels good. Happy, strong, you know, as this step right now?
Chris Jones (09:57) Yeah, completely agree with that. So, yeah, yeah, Melanie, if you want to, you know, start the peppering, I’d say let it rip and talk to her.
MelanieScott (10:08) So,
Kimberly Massanova (10:09) I.
MelanieScott (10:11) want to start with medicare and paycost governance. But before that and before we go deeper, I really want to make sure that we’re aligning that our immediate focus is in physical therapy and physical therapy operates in a largely non delegated payer environment. So I just want to make sure that we’re all aware of that. And this whole conversation, is about a non delegated payer environment. We have a handful of delegated contracts, but to be quite honest, they’re few and far, and if you’re aware of physical therapy credentialing, they’re few and far in physical therapy, credentialing as it is. So with that assumption, I’d like to focus on how operational responsibility and accountability would be potentially be shared between medallion and us. So moving on to my first question to medicare. So today, our internal team fully owns medicare provider and group revalidations in paycos. So if we partnered with medallion, how would those revalidations be handled day to day and where would accountability ultimately sit? Yeah.
Joshua Levitan (11:28) We would own that process completely for you. You would make a request to get enrolled with medicare in medallion or to get the revalidation schedule, you know, got a little crazy post covid and is now starting to normalize. So that might be a slightly separate topic, but you would make the requests and then we would handle that completely for you. Our technology works with paycos. Obviously, medicare is probably like the largest payer that we’re enrolling with just based on the national landscape. And in terms of accountability, we have slas in our contract designed to give you that accountability that, you know, we are doing things within certain time frames or there are contractual ramifications… for us. The next piece of this though would be visibility which is while we’re actually submitting the application and following up on the application. As you saw in the demo, you can see every step in that process, what’s the next action that medallion is taking? Who owns this? How much time has elapsed you know, all of that stuff, but we know in the process end to end?
MelanieScott (12:31) Yeah. So who, so when you submit it directly, are you going directly into paycost as a definite? Yes. Okay. So who is the final sign off, right? Because if you look at the application for paycost, right? It’s got all those terms and agreements and someone’s putting their name to that to say that we’re adhering to everything who goes on that.
Joshua Levitan (12:57) So in I’m not like super familiar with the paycost application detail, but where we need sign off, the most common approach is that we’re actually asking the provider for power of attorney, and then we’re asking them to attest in medallion. So they have certified that their data is accurate, and that gives us the ability to sign or submit applications on their behalf. I believe for paycost, we are going to collect your organizational login and you’re going to delegate that to us as well. Like, you know, how there’s the blank on the exact name, but you’re going to fill out the form in paycost to make us like an authorized agent on your behalf as well.
MelanieScott (13:36) So, but ultimately, someone still, you can do it as a delegate, but someone still has to have the authorization. You’ve got two separate accountabilities in paycost. You’ve got a delegate, which could be your credentialing person. And then you’ve got your authorized person and that’s the name who sits there to say, you know, if anything goes wrong. I’m the one who’s paying back the money or going to jail. So, you know, that’s my question. You know, where does that governance sit? Because I would imagine that governance still sits with us. I.
Joshua Levitan (14:07) Will double check on that. We’ve got questions about a 1,000 different payers in the country, and it’s hard for me to keep up on all of them. But I can ask the medicare specific team. I.
MelanieScott (14:17) Think medicare and medicaid, you know, they’re both our big federal healthcare payers, right? They are high risk payers with compliance as well. So we really have to make sure. I just really need to understand the mechanics there of who’s actually accountable.
Joshua Levitan (14:32) Yeah, yeah. And.
MelanieScott (14:34) I do believe through paycost, you can’t do an authorized signature for any of our employees, any of our staff, they have to do it direct.
Joshua Levitan (14:42) Yeah. Well, so that’s the thing even when the employee or like when the provider has to do things direct like our automation can still do that on their behalf. So they are signing like there are situations here where it is, and I need to double check if this is medicaid specifically or not. Could you have a?
MelanieScott (15:01) Look, perhaps, I think when we bunch up commercials and then we bunch up our federal payers, our medicare and our medicaid, from what I’ve understood, you know, I’ve had to sign them as well. You can’t nobody can sign them on anybody’s behalf. It’s the provider that has to sign those. Yeah.
Joshua Levitan (15:19) So, medicare.
MelanieScott (15:20) That would be fine. But I was, you know, my other question was facility, but, yeah, find out some information. I’d love to hear more. Yeah.
Joshua Levitan (15:27) We’ll go back. We’ll get the information. The way that a lot of this process works, Melanie is like we essentially hire people like you who work for medallion who map out all of these processes who are on the operational side and they like train the automation and as well as like oversee it and provide quality control. And while like during this part of the process, you primarily work with us like we obviously have access to those resources that our coworkers, we talk to them every day, so we can go and get the answers from them. And if a written answer that we have from you isn’t sufficient, like we’ll just have them hop on a call with you and go through like the little nitty gritty detail.
MelanieScott (16:04) That would be great. I think it’s probably pay driven though and medicare driven rather than.
Joshua Levitan (16:09) Yeah. And we have different team members that have different specialties, right? So, like there’s one person that knows medicare inside and out who works with the product team on all things Pecos, like that’s who we’re going to bring this question to?
MelanieScott (16:18) Okay, perfect. Yeah. Okay. So moving on to caqh, you shared that medallion can manage caqh updates and attestations, right? Yep, again, from that governance perspective, how do you think about responsibility if an attestation is inaccurate or incomplete?
Joshua Levitan (16:37) So, we ask the provider to attest in medallion, And we then like that is on them if they read through medallion and they don’t and they attest to data that’s inaccurate. There’s nothing we can do. I mean, obviously, there’s certain elements of this data that we are verifying, for example, like licenses, we’re going to go and independently verify that. But for something like that, they are attesting in medallion and signing a form that is legally giving us the ability to then go and use their attestation in medallion and attest in caqh on behalf. So the onus is on that once a year.
MelanieScott (17:13) So, do you have any kind of approval or review checkpoints during that caq attestation or once, it’s signed and you’re going with it or do you have some checkpoints through that? So?
Joshua Levitan (17:25) They’re going to have to read a test in medallion at least once a year or if data changes in a significant way. So, anytime there’s updates to the demographic data, we’re going to ask them to reattest and we’re going to make sure they reattest at least once a year in medallion.
MelanieScott (17:42) Okay. But when they first reattest, you don’t have any checkpoints within there to check that data is correct?
Joshua Levitan (17:48) What do you mean by that? Like?
MelanieScott (17:51) Those approval checkpoints, you know, if they put it into caqh or medallion, however, you know, I know that it can be a hybrid, you can put some of it in caqh and some of it in medallion. Are there any checkpoints in there to make sure that information is correct?
Joshua Levitan (18:07) Where we independently verify information? Yeah. So like we’re going to like if we’re monitoring them from an ongoing monitoring perspective, there are certain things that we’re going to verify from federal databases. Some of this starts to get into like are we doing credentialing or not? And obviously, we’re not doing credentialing for the purpose of delegation. But if you choose to do credentialing for the purpose of verification, then absolutely, we are going to verify all of those sources, you know, and that could be the ncqa standards. It could be less. It could be more we’re going to like independently verify licenses. There’s. Certain information we obviously like. Can’t verify? Like we’re not going to, we’re not going to like pay a data broker to like verify their home address or something like that. I know.
Louis San Miguel (18:48) I guess Melanie, can you give a couple examples of whatever information in your head you would want validated or verified or whatever? Like specific, and then that’ll give josh the opportunity to say what they’re doing there on that piece?
MelanieScott (19:05) Yeah. So obviously, I believe you already verified their license, right? And you ran them against Sam, right? I mean, we do that within qgenda already. Yeah, I think it’s just that caqh. So my understanding is they’re going to fill it out and they’re going to attest to it. So they’ve legally attested to it. There isn’t anybody there’s no eyes on the back end of that. Just kind of eyeing that over making sure that, you know, the resumes matches what they put in caqh or anything like that.
Joshua Levitan (19:43) Well, yeah, maybe we should step back. So we’re going to start by saying, like if you just hired someone, we’re going to start by importing their caqh data to begin to build out their profile essentially to make it easier to build out their profile in medallion. But then they’re going to go through the medallion onboarding process that you saw in that recording. And in that process, they are going through field by field, adding in data, uploading documents to your point about the resume. We have a feature where they can scan the resume like with their phone and then that automatically populates their work history from the resume so that’s validation in a way, right? Like if caqh was outdated when we first suggest they upload a new resume, we’re going to update that to make sure that the work history aligns. Then from that point forward, we are assuming that medallion is the source of truth and all changes to data happen in medallion. And it is from that point forward that we retroactively write back to caqh to make sure that both data sources are aligned as that write back is happening. We’re managing Sam, oig, mpdb is a continuous query. We’re verifying licenses. And if you wanna go so far as like ofac and deathmaster, we can do that too. That sort of depends on where your compliance needs are in the verification space.
MelanieScott (20:58) Okay. So just and then, so moving on from that, right, we’ve talked about onboarding new PTS, right? So many of our PTS, particularly new graduates need a lot of assistance and notification. Yep, you know, they really need context and reinsurance, right? Yep. So question, you know, how does medallion kind of balance that automation component with real human interaction when our providers are somewhat confused and overwhelmed? I mean, even we’ve got seasoned people that don’t even know their ceqh number. They’ve never had to fill it out before. So, you know, is that, how is your, how is that support handled on that end? Yeah.
Joshua Levitan (21:41) And so, to be clear, right? Like we’re not asking them if they haven’t already to go and fill out things in ceqh. We’re asking them to fill out the profile in medallion. Part of this process is that medallion is just a much easier and straightforward tool to use from a UI UX standpoint, right? Where a technology company with, you know, backing from Google and sequoia and all that with, you know, some of the best San Francisco based developers in the world. So usability, right? We find that there’s usually a big tick up especially compared to specifically caqh which looks like it was built in the eighties and takes like nine seconds to load from screen to screen. So there’s that aspect of it. The providers will always have access to our live support based chat in the app and they could get in contact like by calling during us business hours, a support member of our team. What is probably realistically gonna happen though is not that they’re probably gonna go and ask you or someone on your team. Okay? They have access to the chats again, like just in experience though, like they’re gonna feel more comfortable reaching out to you than like putting in a support ticket with medallion. Now, you can see everything that they can see and there’s prompting along the way. So if they are missing documents, we are sending them a task which is in the tool but also via email saying this is the specific thing you are missing and we need you to upload it. Let’s take a basic example like two by two passport photo that’s missing, right? So they’re going to know exactly what is missing along the way. And they’re going to see that summary and their data profile like slowly build. But with those call outs, your team has access to the same thing. So they call you with questions. You just pull up their profile on your side and you see everything and there’s sort of a fallback method in here, right? So if they are not technologically savvy, this does happen and they like don’t use medallion at all and they sort of revert to like just bombarding you with emails and all the information your team can go in and just complete their profile entirely for them. And then all they do at the end is review it in a test. It’s not the ideal workflow because it’s labor intensive, but I think the way we like to look at things here is we never want like single points of failure, right? And relying only on providers to be able to get data in would be a single point. Of failure. So we’ve architected the system that you can do all of the things except a test that the provider can do to help bridge that gap where you have a little bit higher touch providers.
MelanieScott (24:12) So in your experience working with physical therapy groups, how much interaction does potentially someone on the internal side have with medallion for onboarding new staff and things like that?
Joshua Levitan (24:28) Honestly, pretty minimal, Dave. Do you know how many team members confluent has?
Dave Wallach (24:34) Let’s check and find out they’re not an account that my team manages. So.
Joshua Levitan (24:39) The best reference we have here is confluent, which if you’ve heard, I’m sure you’ve heard of them. They’re one of our biggest customers and their coo is like on our advisory panel, we’ll go and pull their numbers. We’ll go and look and ask them and look in our internal system and see of the 7,000 providers across the country that work for confluent brands. How many internal staff members do they have? Yeah, I think it would.
MelanieScott (25:00) help for us when we’re mapping things out, right? To see what support we need.
Joshua Levitan (25:05) Yeah, we could ask, we could ask Ivy as well another big customer of ours about their ratios to provide. Yeah, probably like five of our 10 biggest customers by providers are PT groups?
MelanieScott (25:20) Okay. So.
Joshua Levitan (25:21) We have a lot of data points we can provide there.
Louis (25:24) Guys, would we also be able to do a reference call with one of them? Absolutely or two of them? Yep. I think.
Louis San Miguel (25:31) That’d be good for Melanie and Kim to also do. I mean, I’ll gladly be on but for sure for Melanie.
MelanieScott (25:42) Sorry, I think I’m just bombarding you with questions.
Joshua Levitan (25:44) No, keep going.
MelanieScott (25:45) But bear with me, but sometimes these questions open up more questions right? As well. So, when we talk, we’ve mentioned a little bit before about signatures and that you have an attestation, and you can sign on behalf of a physical therapist with that attestation, something that is already there present in qgenda, however, there are cases, there are obviously nuances that could be that payer won’t accept that kind of signature. They need a wet signature. So to speak. How do you manage those?
Joshua Levitan (26:18) Yeah. I love to pick on New York medicaid here even though they did just release a portal to finally get away from this. But for years, I’ve been picking on them as the wet signature example. It was also fun because they needed a wet signature that was notarized. So we will.
MelanieScott (26:34) There’s always those nuances, right? Yep. So.
Joshua Levitan (26:37) Actually the nuance is a good point, right? So the team of people that I was describing before that have like the very nitty grits, right? So we keep essentially a database. We call it a directory, but there are 1,100 payers currently, and that number goes up every day and we’re talking your major payers, your government payers, and even like regional ipas and stuff like that where we map out their process and keep that up to date. And that informs everything we do down the line. So we’ve already put in the legwork to understand again 1,100 payers, what that process is and then tune around it specifically for this process of a wet signature. What we do is we map the data into like the form like the PDF essentially that’s an automatic process. We then send that we can send it to two places. But let’s just say right now we’ll send that to the provider and we will send them pre return postage or prepaid postage, I should say, and they will get a task which will be via email. They’ll be notified every three days until they complete it. And it will be in the medallion app that says, please print this out. Please sign it if you need it notarized, you know, here’s your local bank to get it notarized. And then there’s a label already paid for them to then mail it directly back in sometimes or if you have like a, if that’s a situation specifically with the notary, if you have a notary, like in one of your offices and the provider is already going into an office, we could actually just have them print that out like in your office and notarize it all right there, as opposed to them doing it at home. So a little bit of variance in like how we make that process as easy as possible. But that’s the outline of it. Okay?
MelanieScott (28:12) So what you’re telling me if I’m understanding correctly, you guys are responsible for following through with that and making sure that the provider gets that taken care of and signed?
Joshua Levitan (28:23) Yeah. I mean, as much as we can, right? So we’re going to follow up every three days via email. We have the option now, it’s an add on, but we have the option to follow up on any of these tasks that you hear me reference with phone calls and text messages. We’re using an AI phone calling agent to do that. We’ve had really good luck and sort of seen high numbers with that at the end of the day. Like we are not guaranteeing that your provider is going to do that next amount of time. That’s a very hard guarantee for us to make, but we have tried to fine tune the right level of squeaky wheel, gets the grease. We want them to ignore our emails, but we’re going to annoy them until they do it. The other part of this is you have visibility into those tasks and how long they’ve been sitting out there for. So if your team sees a task that’s 30 days old, medallion’s emailed them 10 times and they haven’t taken action, your team can then step in and in whatever method you get in contact with them.
MelanieScott (29:18) Okay. Follow up. Okay. Yeah, I know it’s always a challenge, right? We have the same thing as well, right? Trying to get people to sign stuff or, you know, understand the importance of it and that’s what I’m saying as a clinician, right? You’re just like I’m just here to treat patients. I don’t need that. Yeah.
Joshua Levitan (29:33) And the more, I think the more fun challenge is like what’s the right level of annoying them? But where they don’t then like block the email, right? Like there’s a very like we have a lot of data. I mean, there’s 100,000 providers that used medallion last year. So we’re constantly looking at the data and trying to fine tune like that outreach cadence so that we are the right level of annoying without them, you know, just blocking every email that comes from us.
MelanieScott (29:56) Ultimately, right? They want to be able to see all the patients that are coming through their door at that clinic, right? So they need to be credentialed… with them. Okay?
Joshua Levitan (30:09) Yeah, actually that’s a great point. I want to stop you there for a sec. So I’ve been answering these questions a lot more in respect to like corporate physical, but I think it’s important to note that if we start talking about franchises every time I’m describing like your team can see something to help move an action along in the franchise model, your team could be the franchise owner, like who would have just the providers in their franchise? That wouldn’t be able to see any other physical stuff, right? But just their people. So they can be the person saying, hey, you know, because they’re the business owner in that context, right? So they want to see, hey, if you have this task outstanding, I need you to go and do this, right? So we can segment that access on the franchise side or even on the corporate side, like by region or by, however you have it split up and sort of localize those escalation points to people that have the closest relationship with the provider themselves. Okay? That.
MelanieScott (31:07) Makes sense. On the recording that I listened to, I know there was a bit of a conversation about apis and coming in with prompt about an API. So… the current situation is and I presume that this isn’t going to be forever. But currently, our credentialing… team will go in when a… provider has been accepted with a payer, and they can go in and change the different type of rules, right? Can they co sign? Do we have to hold claims back? Can they just not see the patient called spot, right? So there’s like various buckets depending on the rule of the payer, depending on depends on what that PT can do. Can they see the patient? But it has to be co signed and they… can they not see the patient or can they see the patient? And the claim has to be held back, right? So we’ve got kind of three buckets and.
Joshua Levitan (32:12) those, and this is in your scheduling and RCM system. You’re just right?
MelanieScott (32:15) Yeah. And in prompt, currently, we can put those rules in so that when the provider gets there, they find out they can’t sign it or their claim has to be held back at the moment. In prompt, there’s not a feature that would in an ideal world in prompt, it would be lovely to say, you know, you go and schedule a provider with a patient and it pops up and says, hey, you know, this patient can’t be seen or a patient would need a co, signature and stuff that isn’t available in prompt as we talk now. So as of today… I’m presuming that would be on our team. How would that workflow from you telling us when the provider has been acknowledged and accepted by the payer? How does that workflow go to our team? I’m presuming that would then need to go into the emr and update the email. Yeah, a.
Joshua Levitan (33:11) Couple different ways. And sometimes if this is, we want to try and do all of these ways to be super thorough. Sometimes this is like a crawl walk around approach. You can give read access to anyone in your organization to medallion. So you could have someone on, you know, the scheduling team directly in medallion, not the best approach because they have to remember to log in. But they could have that. The next approach would be, we would send like through our reporting feature function of medallion, we could build a report. Let’s say in this case, it would be like the provider’s name the plan, the location and the par, effective date and status, and then we can have that report emailed to anyone on a cadence. And you could choose the cadence. So daily, weekly, monthly, whatever… best approach. But there needs to be the technical ability to do this on the other side as well would be connecting this via API where it would be instant. The second that we have record of that in medallion, we push that into prompt. We.
MelanieScott (34:13) Can.
Joshua Levitan (34:15) send you our API docs. We have a team that builds these integrations. You can also use your own team to build these integrations. It doesn’t matter. Obviously, there’s a cost associated if we’re doing the work… and we can, you know, take a quick look at the prompt API docs, and sort of help give you a determination of what’s possible. The limitation with any API integration is that like we know what we can do, but it is always dependent on another party. So, based on the fields that you were describing, like I’m hopeful that we probably can get information into prompt in some way shape or form. I know prompts a very modern platform as well. We would obviously need to validate that. But, but those are your three options. And in terms of like the flashing red, hey, don’t, put this on the schedule because the provider can’t see the patient like great idea, promptly put that in and they could use our data to do that. I mean,
MelanieScott (35:10) they already have the data, right? Because we’re already in there and saying, is this a co signature, the claim needs to be held right? Or they just can’t see that type of thing? And we obviously have a master copy, right? That kind. I would envision the report that you’re saying we would want it on a daily basis because the number of therapists we have like every day we’ve got one filter through and it says, you know, they can see we can see that patient. Yeah.
Joshua Levitan (35:34) And depending on how you break this up, there could be three versions of that. It could be three reports for each region or like one report for corporate, and then 50 reports for each franchise that go out to the like, there’s different ways to break those down and like filter the reports and then send those to the necessary party. Like we don’t need to try and catch too much information in a report. We can make it hyper specific. Yeah, I was.
MelanieScott (35:57) Just kind of at this moment, just kind of focusing on that corporate level, right? Yeah.
Joshua Levitan (36:01) Yes.
MelanieScott (36:02) I would imagine someone on our team, you’ll send that report and someone from our team then still needs to go into to prompt as it stands as today. Yeah, state that, and also our internal spreadsheet that actually tells the scheduling team who, and who they can’t yeah. Okay. Yeah.
Joshua Levitan (36:24) What?
MelanieScott (36:25) Have I got here when we talk about like therapists has a name change? They get married? Such like do you manage all of that? Do you pay costs and pay assistance or, you know, just, is that all part of your program? Yes? Okay. And I guess we just really commented right? How the downstreams like that emr internal credentialing tools are notified. So basically, it’s report driven from you guys. Yeah.
Joshua Levitan (36:57) I mean that we should read like especially at your volume, like we should reach for the apis if we can, but we don’t need to start there. Yeah. I mean, I don’t you can start with the reports and then, yeah, that’s probably not.
MelanieScott (37:09) Going to happen overnight with, yeah, right. Yeah.
Joshua Levitan (37:14) Josh, josh, do you… have any clients who?
MelanieScott (37:20) Use prompt and?
Joshua Levitan (37:21) And have.
MelanieScott (37:22) apis built by any chance?
Joshua Levitan (37:25) I believe Ivy uses prompts to be honest. I’m not sure if I’m we’ve talked to prompt about larger partnerships in the past. Pretty recently, they had a lot going on so that those conversations were put on hold. So… we can talk about that. The closest one might be, I know Ivy uses prompt so we can ask about… that. Yes, I can look real quick at their API docs too. I think, the important thing I want to stress here too is like if you don’t have the resources to do this in house, like we will build this for you too. Like we do this regularly. There’s. Obviously, it’s like it’s a one time cost, but it does cost money. So you don’t need like as long as they have the open apis on their side, which I would imagine they do in some way shape or form like you don’t need your own developers and you don’t need any input from them, we can do that engineering work for you. But to the qualrock crawl walk, run like we could start with reports for the first three or four months and then decide, okay, like we’ve migrated all the data. We’re in good shape here. Now, let’s build the API integration. So.
MelanieScott (38:38) You know, it’ll be a question to prompt, right? Do they already have that? As far as I know they don’t have that feature? So, but, you know, things are changing all the time. All right. I’ve got a couple more questions and then I’ll be done. So contract renewals, repapering, and things like that. I’m presuming all of that would keep it with an internal team.
Joshua Levitan (39:05) What do you mean by that? So.
MelanieScott (39:07) For example, contract renewals, like a contract comes through and they’re like, okay, we need to repaper this contract or?
Joshua Levitan (39:13) Your contract with the parent?
MelanieScott (39:14) Yes. Okay.
Joshua Levitan (39:18) So we, yeah, I would keep managing your renewals internally. We, we do help get new group contracts to an extent like we will do the paperwork process associated with that, but we’re not going to negotiate rates. But my guess is if you’re having to renew that contract, most of the conversation there is going to be around terms and conditions and rates that we’re not going to want to touch and you should continue to run that as you do right now, no.
MelanieScott (39:46) Okay. And then… this one was interesting.
MelanieScott (39:52) Correct me if I’m wrong. Did you share on the last meeting that medallion is ncqa certified? Is that correct? Yep?
Joshua Levitan (40:00) We’re an ncqa certified cvo? Okay?
MelanieScott (40:02) So, with, that… certification, how does that help or does it help someone like a non delegated physical therapy? Yeah, because, you know, currently, Q gender follows the ncqa workflows, right? So we’re not certified, but we’re following the exact same workflows. But I was just wondering, you know, in that non delegated PT environment, how does that ncqa certification if it does impact day to day operations? Yeah.
Joshua Levitan (40:40) I think the truth is that the direct answer is, on the parent enrollment side, it really doesn’t it applies much more to the credentialing side. What I will say is, I think it is though a sign of organizational maturity going through that and maintaining that costs time and money and needs expertise. So not just following the procedure but actually going through the accreditation process. We believe is a big value just in terms of the maturity of our organization. Yeah. But the day to day like it really only matters, on the delegated side. Yeah.
MelanieScott (41:14) So, okay. So, so have you come across a, in, even in a non delegated environment, where are there any PT specific players where that certification is helpful?
Joshua Levitan (41:32) I’m gonna say no, like there are, we have PT groups that are delegated. It’s hard. It’s very hard to do as a PT group, you need to have an MD or a do on staff running your committee. Even with that, there are still some challenges. We have helped both confluent and Ivy actually go through this process. We, you know, it is not an easy process, but it is possible… I think the only other way that this would matter is if you chose to run a delegation, a credentialing process as sort of like an HR compliance check, pre hire or at the time of hire. To be honest, most of the groups that do that purely just for the sake of doing it and not for the sake of delegation are not PT groups. They tend to be, you know, more higher level practitioners that have more risk and, you know, in like an asc setting or something like that. Yeah.
MelanieScott (42:32) Okay. I bombarded you there, I’m sorry, no relevant questions. I kind of pulled them off.
Dave Wallach (42:41) Melanie, I’ll just say this is exactly what you should be doing, right? This is, you know, so I appreciate the due diligence, and we’re more than happy to answer 100 more questions I have.
MelanieScott (42:53) One and I don’t think I asked it. So, for example, you know, we’re obviously really cautious around eft and banking changes in the medallion workflow. Would these updates remain internal or do you ever submit address changes like mailing address changes and eft updates on our behalf or are they internal?
Joshua Levitan (43:19) Yeah, we’re not going to touch eft updates. There are, yeah, we’re not, we really don’t want to touch that. There’s some like… for example, very, specifically with New York medicaid. We will track E 10 expiration, but we will not submit anything on.
MelanieScott (43:36) Your behalf that’s the answer? I was presuming I was just kind of circling around and confirming.
Joshua Levitan (43:43) Yeah, yeah, yeah.
MelanieScott (43:50) I don’t think I’ve got any. I know I will have more questions, but I think that was a good start. Yeah.
Chris Jones (43:58) Happy to set up another session, dive back into the product. If you like, I know you just saw the one demo. So just let us know what you need there to help check boxes.
Joshua Levitan (44:07) On your end. Yeah.
Chris Jones (44:12) Okay, cool.
Louis San Miguel (44:14) So,
Chris Jones (44:15) I guess where do we go from here? I know you guys will obviously need to regroup internally, but.
Louis San Miguel (44:23) I would say Chris, from my perspective, yes, we’ll regroup internally obviously, but getting that reference call or the two reference calls would probably be really good for us to get on the phone with a couple other PT clients that use you guys. I think, yeah, let’s have that be the direct next step here. Yep. Okay. Melanie, do you want a live demo? I know you weren’t able to attend the last one but do you want yourself maybe 30 minutes of a live demo with them?
MelanieScott (44:55) Yes, why don’t we set that up and I’ve probably got some more questions as follow up as well.
MelanieScott (45:00) Yeah, as I kind of map things out from, you know, sideline with both together and see where we go. I think probably the biggest impression I’ve got from this conversation is we literally… can’t kind of and this is kind of sounds a little bit rough around the edges literally. Can’t just give everything to you. We still need to keep quite a lot of processes internally. Yeah.
Joshua Levitan (45:28) I think our general philosophy is like we want to take away the lowest hanging busy work possible. We don’t want to replace the strategy and sort of like strategic element of your team. And we’re also like, you know, to your question about the intents, like we’re just not really at this time going into anything related to how money moves or billing. But our role is very specific. What is the lowest hanging most repetitive, lowest value work within the credentialing realm, which is like submitting applications and calling payers to follow up and doing psvs. And that’s the work we want to take on. But we are not here to take away the strategic or the in house knowledge or the value, like the reason why Melanie is a superstar. What we want to do is make you even more of a superstar because you don’t have to worry about the little things. So you have much more time to focus on the strategy and the higher level pieces. And.
Louis San Miguel (46:24) Melanie, I mean, another aspect of this is franchisee support services. Remember our franchisees that aren’t PTS, I’m not a franchisee and I’m not a PT myself. Don’t know what the exact process of credentialing is. So then when we tell them, hey, you’re you have to credential your PTS before you can start getting paid. They have no idea what that means being able to offer them a service that is plug and play for them should.
Joshua Levitan (46:50) help them.
Louis San Miguel (46:51) As.
Joshua Levitan (46:51) well, I’d argue even your franchisees who are PTS don’t know.
Louis San Miguel (46:55) Yeah, sure.
Joshua Levitan (46:57) When I took this job, I was telling my wife about it and she goes what’s credentialing? I’m like, you know, all those emails and forms you have to send every time you take a new job that’s credentialing. She’s like, I hate that… all right?
Kimberly Massanova (47:12) So then I think, I don’t know if it’s Chris who’s going to organize that call with Melanie, but if you wouldn’t mind just like looping me in on that one as well because I’d love to hear what Melanie continues to ask, right? And just get a reminder of what the demo is, you know, it looks like.
Chris Jones (47:26) Yeah, for sure. Melanie, if you want to look at the calendar and find some times that work for the both of you to shoot them over and we’ll accommodate.
Joshua Levitan (47:33) Yeah.
MelanieScott (47:34) Awesome.
Joshua Levitan (47:35) So, it sounds like we’ve.
Dave Wallach (47:36) got a few next steps. So time with Melanie, there were several operational questions.
Dave Wallach (47:41) Josh, you can take lead on that one just to follow up on that please. Yeah. And then the reference requests to louie that you had. So here’s my initial reaction. First of all, you guys have been great to work with. So that goes a long way. Our references are typically senior executives, C level execs, cfos, you know, senior VPS of RCM and such as yourself as you can imagine, we do get, we have a lot of conversations similar to the conversations we’re having with your team right now where references are requested. We typically prefer to wait till we’re a little bit later in the sales cycle. Like we want to move forward with medallion. We think you’re the right fit. We’ve already reviewed commercials, you know, we know the budgets aren’t planets away from your investment. We want to do a reference or two and make sure that you’re the right fit with that. Said, I also want to be sensitive to your request and know that it’s a big decision. So, I guess Louis, can we work on getting like one reference set up now just to keep the process moving and then maybe another one maybe with, you know, confluent down the road if you think we’re the right fit as a final?
Louis San Miguel (48:55) Reference. Yeah, that’s fine. Dave. I think look in full transparency to you all. What I, we as a team are trying to evaluate… is medallion better than our current process right now? I can certainly say with, I can say with absolute certainty on the franchising support side, medallion’s going to be better because we don’t have, that doesn’t exist. So, is there an avenue where for our company clinics? Maybe we don’t deploy medallion because we don’t feel that it is much better or different than what we’re doing today? That’s what I’m trying to evaluate, but we still actually get you guys signed on under a master service agreement that we deploy it out to our franchisees to assist them potentially. But that’s what I’m trying to evaluate. So, I appreciate, you know, later on in the sales cycles when usually references are there, I think we’re not speaking with other credentialing third party credentialing providers. And honestly, this came through like I told you guys from Wayne with his, you know, super high… opinion and thoughts of you guys given your success that you guys all had together at his previous employment.
Louis San Miguel (49:59) So I think the feedback I’ve heard from Craig and Melanie, and directly from Craig is that we’re trying to figure out, is this better than our current process? And that’s where I kind of want to talk with a current PT group to say, hey, did you guys see that dramatic improvement that Wayne saw in his prior job? And we’re trying to figure out here?
Kimberly Massanova (50:21) Yeah. And.
Louis San Miguel (50:24) Spirit of partnership. I’m being honest with you guys. So that’s where we’re at right now. Look.
Joshua Levitan (50:28) Not as good as actually talking to people on the phone. I did post in the chat here. We recorded a video with Ashley from Ivy, who is their, what’s… her position? Senior director of provider relations, who is like one of the main people from their side that owns the medallion contract. This is a recent recording we did with her like literally three months ago to try and help today’s. Point sort of serve the need of like we want you to hear from customers. But, you know, we want to also respect their time so not as good as talking to them live, but you can review the case study from Ivy and a recording of one of their key contacts at the link that I posted and.
Kimberly Massanova (51:09) Are they a PT group?
Joshua Levitan (51:11) Yeah, they have 700 clinics, Ivy, Rehab. Yeah. Okay. Yeah.
Kimberly Massanova (51:15) We’ll definitely listen in there, but the actual reference would be great too.
Joshua Levitan (51:20) Yep.
Louis San Miguel (51:24) All right. Okay. So, yeah.
Chris Jones (51:27) We’ve got our action items. We’ll work on those… Melanie. If you want to shoot some times back, we’ll get another call on the calendar to jump back into the product and then answer any additional questions that arise. And then obviously, I’ll circle back when we have.
Dave Wallach (51:44) Reference availability.
Chris Jones (51:47) Okay.
Kimberly Massanova (51:47) Thanks, Chris. Really appreciate it.
Chris Jones (51:49) Of course. Thank you. Thanks.
Dave Wallach (51:52) Guys. Any last questions?
Chris Jones (51:53) Comments before we close?
Kimberly Massanova (51:56) I think we’re good all.
Louis San Miguel (51:58) Right. Have a great weekend. Thank you.
Chris Jones (52:00) All for your time. Bye bye.
Louis San Miguel (52:02) Bye bye.