Transcript
Erica Lloyd (00:00) and I’m going to let her in.
Erica Lloyd (00:17) Hey, good morning, Nadia.
Nadia Sobe (00:18) Hi, good morning. How are you all?
Erica Lloyd (00:21) Good, good to see you. How was your weekend? It?
Nadia Sobe (00:23) Was amazing. Did an overnight trip in? I think I told you guys, Philly and jersey?
Erica Lloyd (00:29) Nice. What did you do?
Nadia Sobe (00:32) Did a little food tour with my girls and my husband and celebrated my sister in law’s.
Erica Lloyd (00:46) love it. We’re planning a girls’ trip in September. We’re throwing out vegas, so we’ll see.
Nadia Sobe (00:56) Sounds like a good, you had me at food tour in Philly, that sounds lovely. Yeah, Philly cheese steak, all that.
Erica Lloyd (01:06) Cool. I guess we can get down to business. A new face on the call, Sam.
Erica Lloyd (01:12) So Valerie’s on vacation this week, but wanted to make sure that we kept things moving. So I invited Sam to join us. She’s one of our lead solutions consultants. She’s based in Boston and she’s going to run point on the demo. And basically, she helps to ensure that things are running smoothly from both a technical alignment standpoint, as well as designing solutions that will meet your needs. And then Anika joining along, she’s hopefully going to be promoted to the next step soon. So she’s following along. Thanks for letting her stay with us.
Erica Lloyd (01:48) Okay. So Nadia, I was thinking for our time today, I’m just going to do a quick kind of what we heard, make sure I captured the most important things correctly. And then Sam is going to run point on the executive customized demo. And then I think we were also going to hold some space just at the end to do a little bit of light scoping. And that basically is just how we inform the proposal since we are a consumption based model. So making sure we have the right volumes to put together pricing. And then I can also just go through briefly the project plan of like how customers typically evaluate and purchase medallion so that’s kind of what I was thinking, how we spend our time together. Does that align with what you’re thinking about?
Erica Lloyd (02:46) Oh, sorry. Can you hear me? Oh, now we can, does that sound good?
Nadia Sobe (02:50) Yeah, that sounds great. Okay?
Erica Lloyd (02:53) And then, I guess like as I’m just to be sure I’m going to share a slide here, Nadia, as I’m jumping in here, let me make sure you can see that. So if this demo goes really great, can you just help walk us through? Like what a like what next steps would be in your mind?
Nadia Sobe (03:18) Next steps for me would be… to get it going, get things going,
Erica Lloyd (03:29) Yeah, get things going, meaning like.
Nadia Sobe (03:33) To implement your software into our processes. Okay? All right.
Erica Lloyd (03:40) And we can then go, I’ll make sure I hold space and go through the project plan of what that actually looks like on our side. Yeah. Have you been involved on the critical path, in procuring other software products for sobe? Yes. Okay. So give us, we’ll when we get to it, you’ll have to then give us insight into where the hiccups typically are. So we can help there. Okay. So currency kind of what we are solving for here, what I heard kind of in a nutshell is you have fragmented systems, not that leading to incomplete data. You’re growing at a pretty fast clip and not having the correct systems in place is leading to scaling challenges and data inaccuracies which are impacting revenue.
Erica Lloyd (04:31) And you’re kind of unable to track some of these key metrics because of these systems. Did I capture that correctly?
Nadia Sobe (04:39) Yeah, sounds exactly right. Okay.
Erica Lloyd (04:42) And then speed to revenue, is going to be critical. Obviously. Just grabbing a metric there from prior conversations. We understood from the time that you hire provider to the time like a contractor or provider, to the time that you get them to billable status with your payers, whether it’s commercial or government is typically around 90 to 120 days. Is that accurate?
Nadia Sobe (05:08) That sounds right?
Erica Lloyd (05:09) Okay. So we can show you how, and this is across the board. We say between commercial and government payers, we’re typically around 52 days to get completely billable. So probably cutting that in half. And obviously, the value there is the faster accelerated time to revenue, just to align more to your specific use case. I know we spoke about last time turnaround times specifically for medicare, Florida and Georgia. We work really closely with our government payers, medicare very closely with, so, for Florida, our turnaround times are, is 17 days for Florida and.
Nadia Sobe (05:51) For Georgia, Florida and medicare?
Erica Lloyd (05:52) Yes, Florida and medicare, is 17 days right now in our database and Georgia, medicare is 15 days. Okie. Dokie… and just to track the Roi since obviously, that’s typically how decisions are made. Do you, are you tracking how much revenue per day your providers generate?
Nadia Sobe (06:20) I wouldn’t know like, no, we’re not well, I’m not tracking that. But if I had to guess, I would say like each provider… it could be like a 1,000 dollars… that’s that.
Erica Lloyd (06:38) Sounds about accurate for the type of providers you have. Like for behavioral health, we see like 500 a day plus, and then surgeons and urgent care, we’ll see like 5,000 per day plus.
Nadia Sobe (06:49) Okay.
Erica Lloyd (06:50) Because like for urgent care, like they’re doing all those tests, a 1,000,000 different testing, which then is generate rates quite a bit more revenue. But, for the type of providers, you have a 1,000 dollars a day. Sounds right? Do you know? And then use, I know you have 300 providers always growing. Would you say you’re hiring like 50 including organic and backfills? Would you say like 50 per year? Sounds about right?
Nadia Sobe (07:18) No, we’re probably hiring like… 100 per year.
Erica Lloyd (07:26) Wow. Okay.
Nadia Sobe (07:32) Yeah, cause we’re just, yeah, we’re just always having to add… people.
Erica Lloyd (07:38) Yeah. Okay. Yeah. OT, is it just growth or is it mostly backfills? Do you think? Or is it organic growth? Like opening new locations that you mentioned and scaling into new states? I’d.
Nadia Sobe (07:53) say it’s like 50 50? Okay?
Erica Lloyd (07:57) So either way they need to get, they need to get credentialed and enrolled. So, my math in my head is not great. Maybe maybe I’ll tap solutioning on this one. But just like quick back of the napkin math to frame some of the Roi for you. And where folks find the biggest value with medallion. And for this kind of use cases, the 100 is a 1,000 dollars per day, 100 providers times 52 days on average or sorry, about 50 days faster based on the 9,220 days that’s typically a couple 1,000,000 just, in revenue there that’s not even looking at like the denials or anything like that. So I think that’s kind of important to highlight.
Nadia Sobe (08:38) Okay.
Erica Lloyd (08:42) Anything else on your side on that? Sam? I.
Samantha Bouchard (08:48) was just curious, Nadia, do we have the list of payers yet? Eric? Or on average, how many payers are each of these providers getting enrolled with?
Nadia Sobe (09:01) One… let me pull up this list. I think like six six. Yeah. Okay.
Samantha Bouchard (09:13) That’s helpful. And that will help inform the demo a little bit too. So, thank you.
Erica Lloyd (09:19) Okay. No problem. Great. Thanks, Sam. Okay. So, I’m going to turn it over to Sam. This will be a super interactive demo essentially with this demo flow. We want to make sure that you have an understanding of how the platform works to solve for the fragmented systems, faster time, revenue, some of the expertise that may or may not be on staff and then not needing to hire additional folks as you grow as well as backfilling Carla.
Nadia Sobe (09:53) Yeah. Also a little update on that. Carla rescinded her resignation. We’re going to let her stay. So, just in case that forms this conversation in any way, just wanted to throw that out there. Okay?
Erica Lloyd (10:09) Does that change then your strategy on what you’re thinking about doing here?
Nadia Sobe (10:15) No, because at the end of the day, Carla does need a better system. Maybe she can be used in other areas outside of, you know, what medallion may take over from her day to day tasks. So just in case like, you see a, you know, point in this presentation that like or if this would basically take over her entire role in credentialing, you could point that out to me.
Samantha Bouchard (10:49) So, yeah, yeah.
Erica Lloyd (10:50) Okay. Sorry, go ahead. I.
Samantha Bouchard (10:51) Was going to say, yeah, it’s definitely going to take over a large amount of her time, Nadia. But, you know, it sounds like, you know, I listened to your discovery call with Erica and it sounds like, you know, she’s like a pretty valuable employee who really understands your business and your overall strategy. So the way we think about kind of how you would partner with medallion is typically, it’s around like half of an fte up to almost like a 1,000 providers when you’re kind of thinking about the management piece. And so what that essentially means is, you know, as your provider base grows, you don’t need two, three, four more Carlas, right? You kind of get to keep her, your staff really level there. And then exactly like you said, just really utilize her for some, you know, higher value tasks internally rather than like entering data into a portal which we can take over with the automation. Yeah. So I’ll try to be really clear in the demo, like we give you a lot of visibility. But as far as like a, you, do we really look to you all to own the strategy. We own the execution, but we give you visibility into every step of the way. So not only are we going to be your provider data management solution, meaning storing all of your group, all of your practice, all of your provider data. We’re also going to be able to support, you know, that downstream function, of payer enrollment as well. Okay. So for the demo today, I want to highlight just how we really streamline the provider onboarding time, getting your provider’s data into the system and on average two days, so shortening that. And then we’ll look at we’ll look at, how we process your payer enrollments using our AI and automation, ultimately getting those applications out the door quicker with less errors, accelerating that revenue for your team. And we’ll also look at our analytics function and how, you know, you can kind of come in with a cup of coffee and get a pulse on like where things stand which can be really hard if you’re in spreadsheets or multiple systems. So that’s what I had planned. Was there anything that you were hoping to see that I didn’t mention just then?
Nadia Sobe (13:24) Definitely want to see what therapist onboarding would look like. Okay?
Samantha Bouchard (13:35) And curious on that. Can you tell me a little bit more about that process today and how long kind of that’s taking Carla just to collect the information that she needs before she can even move forward with the payer enrollment?
Nadia Sobe (13:50) It takes her quite a while. We have a good amount of documents. We do it through workbrite. So… we’re able to set up custom contracts through there. And yeah, it’s probably like 40 different line items that they need to complete. So, you know… basic tax documents, contracts, license verification, we have them upload their social security. I think we have them upload their diploma, their like college degree. Yeah. And.
Samantha Bouchard (14:32) From like a timing perspective, sometimes we, you know, obviously there’s the a plus provider that has this stuff readily available which is far and few between. And then it’s the, you know, provider that needs a little bit more hand holding and could take upwards of like 30 days. Do you have a sense of where your providers kind of fall on average?
Nadia Sobe (14:53) I would say probably like 20 days?
Samantha Bouchard (14:57) 20 days. Okay. Perfect. That’s helpful. All right. Well, let’s get into it here. So what you’re looking at here is our provider data management platform. You know, as we move forward to pricing, you’ll see this referred to as our core offering, which essentially is just all of your data storage in addition to analytics and reporting. So each provider listed here is going to have their own profile. We’ll look at what that looks like, streamline the data collection. And then as you know, for payer enrollment, the tin and the npi of those different locations is extremely important as that relates to your contract. And so we store all of your tin information as well as the practices that roll up. And then we go a layer deeper and we’ll link the providers that are associated to those practice locations, associated to those groups. So sort of this three level data structure which allows us to really effectively submit payer enrollments accurately. But then also gives that layered visibility to our clients which sometimes can be a little bit lacking. So we have multiple ways that you’re able to really see which provider is par where and you can kind of see that from like the provider’s view or you can see that from like your group and practice view as well. So curious just with workbrite and kind of how that data is stored today. Does this seem like on par with your current solution? Or is this a data structure that is something that you all are looking for?
Nadia Sobe (16:48) Yeah, this is pretty much how they present that information as well. Okay?
Samantha Bouchard (16:52) That’s helpful. Great. And so we’ll switch, we’ll look at analytics just to give you that 30,000 foot view. And then we’ll kind of walk through provider onboarding through payer enrollment submission so you can get a feel for what that looks like. But essentially, I like to start here because it really shows all the data we’re collecting behind the scenes in that granular fashion. But then how we roll that up to executives like you so that you all have a pulse on what’s going on behind the scenes. And then ultimately can make, you know, decisions for your business, you know, as a result. So we really focus on volume and turnaround time. So we’re really going to show you the enrollments issued month by month, kind of where those are in the process when an enrollment is completed and that par status comes through. We’re going to highlight that here, but you’re also going to get an active notification to an email. And then we do have a way for you all to integrate via our bidirectional API into your billing system or your emr. So you get that status instantaneously that this provider’s par with this. Payer, can start to see patients and is ready to be billable. And I heard in the previous call that you have a way in your emr to kind of like block a provider before they see a patient. If they’re not par. How are these systems talking to each other today? Or how are you like knowing? Okay, this provider is now able to see, you know, patients in xyz plans.
Nadia Sobe (18:36) That’s Carla. So when Carla basically completes the credentialing, gets notification from the payer that’s when she’ll notify all of our team that deals with providers, and they’ll update it in the system and it’s all pretty manual and fragmented. Okay?
Samantha Bouchard (18:57) That’s helpful. Do you ever have situations where somebody might have been par, like two weeks prior? But maybe Carla like didn’t get that notification by? And so there was potentially like two weeks of somebody sitting where they could have been seeing patients with that payer?
Nadia Sobe (19:16) I haven’t heard of that specifically, but I would not be surprised if that happens yeah.
Samantha Bouchard (19:22) We can hear that happens quite a bit especially where, you know, Carla’s managing 300 providers today may not have time in her schedule to necessarily like scrape the portals or call the payers for the follow up statuses. And so sometimes, you know, those notifications from payers can be a little bit lagged. And one thing I’ll highlight is how we use our AI and our portal scraping as well as AI phone calling to check in on the status so that the second it’s available to the payer, we’re kind of notifying you of that. And then that’s where those integrations obviously can be really powerful. So that data is like streamlined. But we have additional ways like downloaded reports, things like that can get you that information too. If you all, you know, didn’t want to pursue like an integration right away? Awesome. And so these dashboards are customizable. If there are certain metrics that you all are looking for, we would be, you know, kind of happy to build that out. But just curious, are there any metrics today that you specifically look for that you don’t have access to or, you know, how does this, you know, having access to this data? Is this something that would be an improvement from your current platform?
Nadia Sobe (20:55) Yeah, this would be a helpful view, just like a single view of the status of everything. I know that would be very helpful. Awesome.
Samantha Bouchard (21:09) Great. And then I’ll quickly show report builder. This is like, you know, some of the, our prospects that come over really like this feature because they’ve worked with vendors in the past where you have to like make a request. It’s five business days to pull your data. We really make it as streamlined as possible for you to export all that out of the system. So with a couple of clicks, you can build ad hoc reports. You can save those. If there are one time you can export it and send it on a… you know, a cadence of your choosing as well. And then all of our tables here, which you’ll see our data structure throughout the platform is able to be filtered downloaded? So we really do try to, you know, all the data that we have available, you have access to as well. Amazing. Awesome. Okay. Amazing. Erica. Yeah, any questions before I transition? Yeah, I’ll just pause there for a second. Amazing. Let’s dig in a little bit more there. How would you think about using this report? I.
Nadia Sobe (22:16) don’t know a lot about Carla’s process. So, I can’t think of it like from… I don’t know like a processes standpoint, but I know generally this information just to be able to see things in a snapshot is helpful. And we don’t have that in our, this area of our business, we have it in every other area of our business except for credentialing. Okay?
Erica Lloyd (22:46) Let’s and let’s just upload a little bit for you, Nadia. It’s just not even thinking about the credentialing side of like what Carla does, but the type of reporting that is more relevant for like on an executive elt level, I want to make sure that we’re capturing that type of reporting for you also. Yeah.
Nadia Sobe (23:02) Yeah. Dr sobi works closely with Carla on this. So he’s big on data. Everything he does is looking at numbers and reports. So I know for sure he would be crazy about this. Okay? Is.
Erica Lloyd (23:16) there. And, and that type of data, I guess I’m thinking maybe how fast they’re getting to par status when they can be scheduled. So that when he’s trying to forecast where we can, where we can open or where we can grow different networks, like thinking of that more from the executive level. Is that what you’re thinking about exactly?
Nadia Sobe (23:34) Okay. Yeah. That’s exactly operates.
Erica Lloyd (23:37) Perfect. That’s like a really core use.
Samantha Bouchard (23:39) Case.
Erica Lloyd (23:40) At the elt level for medallion because obviously, like most, the value drivers are going to land a lot more at that elt level.
Samantha Bouchard (23:51) Awesome. Great. Well, let’s look at the provider onboarding flow. I’ll try to make this as I mentioned Nadia really clear on like where Karla comes in versus where medallion comes in. So you kind of see me refer to that a couple different times. But essentially a new provider is ready to start with you all Karla would come in, fill out five pieces of information about the provider and then a welcome email would go out. So we can customize this with your logo with your, you know, your onboarding language. So it really fits that overall kind of hiring package that you’re working with. And then from here, we would take them through a customized onboarding flow. And this is really where our integration with caqh makes a really big difference when it comes to the speed by which we can get this data. So you mentioned their diploma, their license information, all of this data tends to be stored in caqh. They do require a 120 day attestation from the providers, right? So we, this is a really accurate tends to be a really accurate data source mostly by the legwork of administrators that support them. But sometimes from the providers themselves. And so with this data integration, it’s bidirectional. And so we’ll talk about that in a minute and how that can be valuable. But this, you know, at this step, we’re just pulling the information in. We can supplement that with a resume. So pull through OCR technology kind of upload that resume, take any missing fields, put it where it needs to be. And then of course, we have the option to manually fill out which we, you know, try to avoid where our integration is different. Is we just need the caqh id, social security number and last name. A lot of these integrations will tend to need username and password. Those can be pretty tricky to track down especially if another administrator set them up. But caqh id is usually readily available and something that providers have. So with this information, they can verify their details. And then we’re ultimately going to pull in like up to 70 percent of their provider profile. And what this does is it ultimately reduces the amount of manual entry from a provider.
Samantha Bouchard (26:29) It allows us to see a completion time of their profile in on average two days. So you mentioned sometimes up to 20 days, we really drastically reduce that, which ultimately allows us to get those applications out the door faster. So when you think about your total payer, enrollment turnaround time, you know, you have that 90 to 120 days plus the 20, any transition time in the meantime to get those applications out the door. So with the decrease down to two days, we have an SLA to get the applications out the door in a set period of time. And then with our 52 day average turnaround time, which it looked like it was 17 for a couple of your medicare payers, you can kind of see how streamlining this flow up front is so valuable in the long term turnaround times and that revenue acceleration.
Samantha Bouchard (27:29) I’ll pause here given what you know about your current onboarding experience for providers, kind of a checklist function. How does this really kind of compare to that process today?
Nadia Sobe (27:46) Let me see here. So I see you have existing licenses. Is that something that you would have them upload their license?
Samantha Bouchard (27:56) Those typically pull in directly from caqh? Okay.
Nadia Sobe (28:00) So caqh actually houses the provider license? Yes. Amazing. Okay. So that would save them some trouble. Yeah.
Samantha Bouchard (28:10) All of their basic information, their personal information, a lot of their professional history will come over professional information certifications and then any documents they have. So, sometimes, malpractice insurance is a requirement in there that will come over. And then any other documents. So say we do need an additional document. Do they upload that to workbrite today or is that typically like sent an email?
Nadia Sobe (28:42) Yeah. So that’s what I was just going to tell you. We do have like company specific documents that they have to sign, like our handbook policies and procedures. So they do that in it’s housed in workbrite. And then they can just sign it electronically.
Samantha Bouchard (29:01) Okay. Cool. Yeah. So likely that’s like your standard HR system, too, right? Workbrite?
Nadia Sobe (29:08) Yeah, exactly. Yeah.
Samantha Bouchard (29:11) So likely that flow could potentially stay today if you’re looking to streamline it, we can talk about like what can come over to medallion? What can kind of be pushed back? This data set is going to be primarily focused on the pay or enrollment data requirements, but we do have the ability to store all of these additional documents. So if you were interested in kind of doing a total replace of workbrite, we can certainly talk about what that would look like to have some of those other documents stored here as well?
Nadia Sobe (29:47) Yeah, that would be a huge thing for us to be able to get our workbrite forms over. Some of them are custom and… they change per provider, but like we have the W9, we have their direct deposit form that they fill out.
Samantha Bouchard (30:11) Is the goal to end your contract with workbrite?
Nadia Sobe (30:16) That would be nice. I would love to have everything in one place. A lot of these are just things that they could upload their CPR certification, TB, or it’s something like that’s. Not customized that they could just, I don’t know if you have a place where we can have them just sign off on different policies… because if so, then we really could… probably house… everything in medallion. I could show you my screen so you can kind of get it.
Samantha Bouchard (30:53) Yeah. Let’s.
Erica Lloyd (30:54) see that. I’m thinking also, would you want to do it for? Is it cost savings or is it wanting everything in one place or a combination of both?
Nadia Sobe (31:03) Combination, yeah. I mean, more convenience than anything, but obviously cost is always a concern. Okay. Let me just show you what this looks like so you can get an idea that’d be great. Do.
Erica Lloyd (31:16) You know, when you’re up for renewal with workbrite?
Nadia Sobe (31:20) I think like July? Oh.
Erica Lloyd (31:24) Okay. So, good timing then, because we would want at least three months like eight to probably a little bit more, but like eight to 12 weeks ideally for a cutover.
Nadia Sobe (31:34) Okay. So this is 47 different forms. Most of them are pretty. You probably do handle the aca background checks, right? And oig, yeah, I would imagine medallion handles those because they’re a big part of credentialing. Yes.
Samantha Bouchard (31:53) We have, yes, we do run ncqa standard primary source verifications. We can kind of customize that to what you run. And then we do have an integration with a vendor for like more of the formal background checks. Is this just checking oig or what’s included here?
Nadia Sobe (32:15) One of them, we check oig, and then we’ll upload that response in here. But this is, we also run, I don’t know you guys aren’t in Florida. So we have something the agency for healthcare administration. They require us to add them add the therapist to our roster and run their level two background check, which they always, they have it on file. Usually the therapist will run it and then just download the background check and upload it ourselves here. So I’m sure if you do credentialing, I’m sure you have something built in that deals with the Oca background checks already. So that’s like a big part of the process. Yeah. So this is the, everything else is just like general information that they just have to sign off on. You see he just like puts his signature here, saves… his IP address, and it’s not really custom. So if you had a place where like we could upload a form set that every therapist has to sign off on, then… most of these forms could be moved over to medallion.
Erica Lloyd (33:34) Okay. Is there anything else that you’re doing in workright?
Nadia Sobe (33:41) The only other thing that I don’t think we could move over to you all is our contracting agreement because it’s very customized like it’ll pull in his name. It pulls in like whatever rates we put here. So, yeah, that’s all custom data that is based on the information we enter… but that’s fine. We could figure out another way to work with that. But if we could get the majority of our forms over into medallion that would help us have everything in one place.
Erica Lloyd (34:18) Yeah, that, I mean, thanks for sharing that. I think that gives us just like an idea of like what you’re looking to solve for, and is that helping to design a solution in that aspect? It may be, you may have to keep some level of an HR system. I’d love to say we could do everything, but I just want to, we’ll just need to double click a little bit more and make sure that nothing’s missed there.
Nadia Sobe (34:44) Do you?
Erica Lloyd (34:44) Know like what the spend is on that on workbright?
Samantha Bouchard (34:48) Today?
Nadia Sobe (34:50) It’s about 650 a month.
Erica Lloyd (34:55) Oh, 650 dollars a month. Yeah. Oh, okay. So it’s not like a, okay. So it’s not like a material cost.
Nadia Sobe (35:03) Yeah, I mean, it would be nice. It would be nice to get rid. It’s you know, it’s a big cost our, I mean, our greatest expense is our emr, so anything compared to our emr is like, not nearly as much so, but it’s nice to save money.
Erica Lloyd (35:21) Yeah.
Nadia Sobe (35:22) Always. Yeah, it’s a little chunk, okay?
Erica Lloyd (35:27) It would.
Nadia Sobe (35:29) Definitely make a difference to be able to get that off of our books, okay?
Erica Lloyd (35:35) But we’ll but yeah, thanks for sharing that. We’ll, we’ll come back on that.
Erica Lloyd (35:43) Okay. That’s good to know. Okay, I’ll.
Nadia Sobe (35:47) let you take over.
Samantha Bouchard (35:53) Awesome. Great. So we get the providers to kind of we’re going to populate 70 percent of their profile from caqh and administrators. So Carla or the provider can fill in any gaps, sign their agreements. And from there, you know, on average, in that two day timeframe, we are then ready to begin those payer enrollments. And so what that would look like. And, and Carla can do this at the same time that she invites the provider. So essentially, she invites a provider. And then she knows from a strategy perspective that this provider needs to be enrolled in these six payers, right? So she’s going to come here, submit a payer enrollment. She’s going to select the provider or multi select the group or multiple groups. We’re going to surface the licensing states that they are have a license in. We’re going to surface the payers that are associated with that particular group. She would select practice locations, and then there’s a couple other just quick application details that are optional. Once she hits submit that’s where her work ends and medallion takes over. And so what she’s typically doing likely doing today, Nadia is she’s saying, okay, what’s the process for medicare? I need to look at my sheet. I need to go ahead and submit this form or this portal. She’s kind of typing all this information in one at a time, kind of going through line by line, getting those applications out the door with, in that, there’s a manual component. There’s a copy and paste component as in like there’s room for error in some of that transition. And so with medallion, we store all 900 payers and these payer process guides across our system. And so essentially, these requirements are really baked in whether there’s prerequisites, what the process looks like, how to submit the application, what documents are required? And we have a whole payer process team that uses automation to kind of scrape those… payer websites for changes. We’re always keeping the most up to date process. And then we use our AI and automation to… populate these portals automatically. So here’s like a quick example of where our RPA technology really comes in and takes, you know, under a minute really to populate a profile that as you’re kind of looking at these fields, you could imagine, you know, I’m sure Carla’s got a system down but could take her, you know, some time to complete. So we’re submitting this. We’re also at the same time pre populating those forms and then most importantly getting those applications out the door and on average, five business days and then we’re doing all of the tracking the rest of the way. So following this is a medicare example of a portal scrape. We’re going in, we’re checking status, giving that status to you as soon as it’s available, but also giving you visibility each step of the way so you can really see or Carla can see, okay, what’s open? Does anything need my attention? Where is this? Is the request complete? Etc? So I’ll pause there. I kind of just threw a lot at you. Any questions around like what Carla does versus what medallion does or how our technology really comes into play? No.
Nadia Sobe (39:56) That’s super clear. I see exactly. I mean, yeah, I see what you mean. Like it totally takes over what she does, but it’s I think her oversight would still be nice to have. Yes, yeah, for sure. Yeah. And knowing like when it’s time to follow up or, you know, click a button, reprocess any of that stuff. She’s still that knowledge I think still applies.
Samantha Bouchard (40:23) Yep. The strategy perspective certainly applies. We’re going to note all of the effective dates, all of the revalidation dates, we can automatically submit these revalidations. So for your providers that are with you for long periods of time, they’re never falling out of par, which would be you.
Nadia Sobe (40:40) Know you have.
Samantha Bouchard (40:41) To start the process all over, we never want that to happen. And then this is that key look up from the billing perspective. So really letting you know what payer is active, what locations are active for which individual provider. And so this is where I was kind of speaking earlier where a lot of clients will ingest this data into their emr so that as soon as that active status is there, it’s kind of automatically triggering those other systems to go ahead and schedule bill, etc, does it?
Nadia Sobe (41:18) Alert like certain users, could we have it? Like when they, they’re in this active status? Could it alert our billing team?
Samantha Bouchard (41:29) Yep. So we’ll create there’s like weekly summaries that will kind of give you a sense of like anything that’s outstanding. Anything that’s open from like a license expiration that’s coming up. So really help you kind of manage your provider base overall. And then these active statuses as soon as they’re available, they’ll it hits our system. You’re getting a notification as well. So those notifications can certainly suffice, you know, where you all can consider kind of a daily export of this data via like sftp that we could automate that would go to your billing system. So there’s a few different ways that we can get that status over, but certainly email would be available from day one. And then we have unlimited administrative access to our platform. So you could have your billing team also have like view only access potentially of this page if that would be helpful for them.
Nadia Sobe (42:29) Very good.
Samantha Bouchard (42:35) Great. So, Erica, any other questions for Nadia before I kind of wrap up here? Yeah?
Erica Lloyd (42:44) I guess just based, on the demo and what you’ve seen so far, is this, you know, is this a platform cost aside that you’d want to move forward with?
Nadia Sobe (42:54) Yes. I think my biggest question is simplifying… the therapists… onboarding process. So… I think this simplifies it for them in one way, but we have to figure out how to make sure they’re not having to work out of two different portals to get onboarded. That’s kind of where my thoughts are lingering now. And then obviously the price, but besides those two… yeah definitely would like to move forward with a program like this. Okay? Great.
Erica Lloyd (43:34) Well, thanks for the feedback. So I think a couple different things we want to do there then well, obviously, we can go a little further on like.
Nadia Sobe (43:41) Making sure because.
Erica Lloyd (43:42) You know, value driver is making it easier on your providers. So I want to make sure that it would actually make it, which I am confident it would, why don’t, we spend a few minutes on our scoping. We have a consumption based model and I want to make sure we’re scoping for both this business value as well as informing the proposal.
Nadia Sobe (44:02) I think.
Samantha Bouchard (44:03) Thinking about this.
Erica Lloyd (44:06) Not only the cost of software but it’s software and services. So it would eliminate the need to hire additional folks. You mentioned the bpo costs, and then also like reallocating some of Carla’s work into some more revenue generating whether she’s working on denials a lot of times.
Samantha Bouchard (44:23) That’s you?
Erica Lloyd (44:24) Know where she’s making a better experience for recruiting providers or, you know, onboarding denials, things like that. So that’s kind of where we’re anchoring on where people folks find the budget for this.
Nadia Sobe (44:41) Sam.
Erica Lloyd (44:42) Do you want to go through, do you want to go through the scoping information?
Samantha Bouchard (44:48) Yeah. Let me go through some of those.
Erica Lloyd (44:53) Yeah. So as you’re planning, I’ll just do the first. So we have 300 providers and you’re adding 100 per year. So for year one, it would be 400 providers?
Erica Lloyd (45:08) Is that accurate? Yes. If we’re.
Nadia Sobe (45:11) just talking billable providers, it could be, I’m sorry. So when I said 100 providers, that also includes like assistance. So it could be, it could be less, let me see. Let me just run a report really quick on our active billable providers?
Nadia Sobe (46:07) Just give me a number, oh 282 active billable therapists right now. Okay? So… that’s a good guess. And then we probably would add like 50 billable… therapists in a year. So, yeah… two.
Samantha Bouchard (46:29) 82. Yeah, Nadia, and that’s just another thing to think of when you’re kind of thinking about eliminating the like the HR system is we do have like we’re going to charge like a per seat amount in our platform as well. And so that can kind of be why some people will still maintain the HR system just really where like their overall employee list is different than just like their billable provider list. Yeah. So just kind of as you’re kind of thinking about that onboarding experience just kind of wanted to throw that out there.
Samantha Bouchard (47:08) But, you know, as Erica said, we’ll kind of think through that flow a little bit more and, you know, provide you with some more solutions there as well. Okay?
Nadia Sobe (47:21) Okay. That makes sense. So I have, if we could just estimate based off of three 32 for the first year?
Samantha Bouchard (47:32) And then what’s that looking like kind of over the next three years? Do you have a sense like consistent growth? Do you expect that to double? This would just really be like your best estimate. We know it’s kind of hard to really know what those numbers look like? Year two and three?
Nadia Sobe (47:52) I think it would probably keep going up maybe incrementally like 30 percent. Okay?
Erica Lloyd (48:03) Do you have planned like, do you think it’s just going to be continuing? Is it going to be opening new centers or organic just like organic growth within the centers?
Nadia Sobe (48:13) Organic.
Nadia Sobe (48:19) Thank you. Okay.
Samantha Bouchard (48:23) And then just looking at like your current spend on credentialing and enrollment, we know there’s like that 650 a month cost for workbrite. If you needed to add another credentialing specialist, you know, what would that cost like look like for you?
Nadia Sobe (48:47) I’m sorry, can you repeat that one more time? Like?
Samantha Bouchard (48:49) If you were going to add another Carla from a cost perspective, not saying that you need to, but if you were like, as the business continues to grow and say you stayed on your current path, what would that cost look like for you?
Nadia Sobe (49:06) So, we, when we were going to add another Carla with our bpo, that?
Samantha Bouchard (49:10) Was going?
Nadia Sobe (49:13) To that’s about 27,000 a year, right? Oh, that’s low, yeah, because there we were outsourcing our administrative team now. So we’re using staff in the Philippines rather than the states, so.
Erica Lloyd (49:34) Gotcha. Okay. Yeah.
Samantha Bouchard (49:42) And then in the states that you operate in, is it just Florida and Georgia today?
Nadia Sobe (49:47) Florida, Georgia and Alabama?
Nadia Sobe (49:57) Sorry. Did you hear me? Yep. Sorry, you’re just.
Samantha Bouchard (50:00) Typing away back here. No problem. Thanks for bearing with us. I know this can be a little bit of like just a barrage of questions, but it helps Erica and I just like understand the total scope so that, you know, we’re accurately giving you, the best price. Exactly. Okay. That’s awesome. So, I think that’s a good understanding of… kind of like the general scope. And then these, this next series of questions is really focused on payer enrollment. Do you have any sense of like how many enrollments Carla’s submitting on an annual basis today, I know you might not know that off the top of your head, but I didn’t know if you have access to data around that at all?
Nadia Sobe (50:48) I don’t I know she credentials every new therapist with blue cross and medicare off the bat? So, you know, if we hire 50 billable therapists every year, that would be like 100 for the year just for those. And then now we have the six additional payers, yeah, that’s exactly how we can total. Yeah, times six, okay?
Samantha Bouchard (51:18) So, we can total that then based on like your new growth and then similarly for revalidations, some payers are every two years, some payers are every three years. So typically, what we would look at is your current number of providers times the six payers. And then we’d like divide that by three to get a sense of your revalidations. Does that seem reasonable to you? Sometimes we can lower that number to just like with attrition, right? Because like, you know, you’re not going to have to revalidate some of those numbers. So we could like reduce that by like, you know, 15 percent, which is like an average attrition rate.
Nadia Sobe (52:09) Yeah, that sounds accurate. Okay?
Erica Lloyd (52:15) Sorry, I just.
Nadia Sobe (52:16) Thought of a side question if we can just pause really quick that I wanted to make sure I asked when we do terminate… a contract with a therapist, is it just like a single click of a button in medallion? And then you guys update it with all the payers from there. So.
Samantha Bouchard (52:34) Currently, right now, just because that’s strictly related to your contract, we do have the ability for you to kind of like notate in the system how that’s handled, but we would look to Carla to.
Nadia Sobe (52:50) Remove.
Samantha Bouchard (52:50) those therapists from the contract. And then once you deactivate the provider in medallion, all of their data goes away from the system. But if you ever needed to reactivate them for any reason, you can reactivate them and all of their data does come back.
Nadia Sobe (53:06) Okay. So that’s something that Carla will still have to do is remove them from the payers. Yes. Okay. Also.
Erica Lloyd (53:20) I’m just thinking like transparently as a new yorker person, if… she rescinded her resignation, it’s probably, I mean, you’re probably wise to think of like a succession plan because if it, you know, if it’s hinging on, that it may, there may be some kind of flight risk there which I’m.
Nadia Sobe (53:42) sure. You’re thinking about, oh yeah, for sure… always. Yeah.
Samantha Bouchard (53:51) Okay, awesome. And then do you have any sense of like estimated error resubmission rate or any kind of claims denials that are tied to pay or enrollment? I know you said you kind of hold in the emr and so that’s on like the lower side, but typically, we still see there could be some that trickle through as well as that like resubmission rate, but that could be, I think harder to track as well?
Nadia Sobe (54:20) Yeah… it’s low. I mean, it’s not often that we get hit with… billing issues based on credentialing, but if I had to throw out a number, I’d say like five percent.
Samantha Bouchard (54:44) And what does that equate to Nadia, just in like a cost perspective?
Nadia Sobe (54:51) Let’s see. I would say max like… 5,000 a year. Okay?
Nneka-Shay Grant (55:05) That’s helpful. And then last question for me, do you do any facility enrollments?
Nadia Sobe (55:14) Facility enrollments? Can you explain?
Samantha Bouchard (55:19) Yeah. So that would be if you’re like directly owning the facility and you want to get the facility fee like billable? Do you, do you all manage any of those today?
Nadia Sobe (55:31) Not yet, but that is on the horizon that’s great to know that you guys do that.
Samantha Bouchard (55:36) Yes, we do support facility enrollments, and then we also support a group enrollment submission. We didn’t hit on this. So as you’re looking to expand new contracts where our system can come in is we can submit the application to the payer requesting the new group contract. Once we get the information back from the payer with the terms and conditions, the fee schedules, et cetera. We create a task in our system that you have access to. We look to you all to do the T’s and C’s, any fee negotiations that you might want. And then we kind of facilitate that back. So we can support that from just an overall tracking and visibility perspective and just really streamlining that process for you all as well. I know you have six contracts today. Are you looking to expand?
Nneka-Shay Grant (56:26) Yes.
Samantha Bouchard (56:26) More contracts?
Nadia Sobe (56:27) Yeah, we definitely want more contracts, do?
Samantha Bouchard (56:30) You have a sense of how many group enrollments?
Nadia Sobe (56:34) One… I know for sure, one that we would love, to tackle, which is united. But, let’s say two. Perfect. Okay.
Nneka-Shay Grant (56:53) Awesome. All right, Erica, that’s everything that I had. Do you have any other questions… I?
Erica Lloyd (57:02) Think, since we’re at time here, let’s use our next conversation to go through the evaluation plan and we can go through the proposal as well. So that’s all I had on my side, so, why don’t we do that? Does that sound like a good next step to go through the proposal and the project plan?
Nadia Sobe (57:25) Yeah, on my end for sure. Okay?
Erica Lloyd (57:28) And I may just over email just make sure we got the scope, completely, correct?
Nadia Sobe (57:33) Since we’re consumption.
Erica Lloyd (57:34) Based model. I’ll move at your pace. We can do, we could do like this week. We could do Wednesday, Thursday or Friday sometime or do you want to look at next week?
Nadia Sobe (57:44) No, I’d love to get an understanding of pricing sooner than later. Okay.
Erica Lloyd (57:51) Let’s just, I just want to run it by finance. Let’s do, could you do, I could do like we’re pretty much open from nine to 12 on Wednesday, the 20 second and then again, from one to two. Do either of those? Do you have like a 30 minute actually? Let’s just carve out 45, just in case. Do you have a 45 minute window? Any of those? Yeah?
Nadia Sobe (58:14) I like to do first thing in the morning for my meetings. So nine o’clock would be great. Okay?
Erica Lloyd (58:19) Let’s I’ll put it for nine. Is that good for you, Sam? Okay. Yeah. Was that this Thursday?
Nneka-Shay Grant (58:27) Did you say the?
Erica Lloyd (58:28) Wednesday, the 20 second? Yep. That works. Okay. I will send the invite with a zoom link. And like I said… we will, I will also just, I might just over email, just confirm the scope so that when we’re doing the proposal, we’re making sure we’re on lockstep there and then we can go through the project plan and the proposal then.
Nadia Sobe (58:48) Awesome. I was going to ask one more thing. Yeah.
Nadia Sobe (59:00) Okay. I forgot. I’m sure it’ll come back by Monday. I’ll make a note to ask.
Erica Lloyd (59:05) Oh, I’m putting this for Wednesday the 20 second this.
Nadia Sobe (59:08) Wednesday. Yeah. Okay. Yeah.
Erica Lloyd (59:11) Yeah. Feel free to catch me over email or my, I’ll put my cell phone in there. Feel free to give me a call if anything comes up. Okay? Perfect. All right. Looks.
Nadia Sobe (59:25) Sounds good. Looking forward to it. Yeah.
Erica Lloyd (59:29) Sounds good. All right. Thanks so much. Thank you, Sam. Thanks, Anika.
Nneka-Shay Grant (59:33) Thanks, Nadia. Nice to meet you.
Nadia Sobe (59:35) Thank you all. Talk to you later. Bye bye bye.