Experity — Salesforce bootstrap (2026-04-19)
Bootstrap — initial state
This is the first fetch for this account; every record below is reported as initial state, not a delta.
Account
- Name: Experity
- Industry: Software
- Type: Customer
- AnnualRevenue: 95862000.0
- NumberOfEmployees: 600
- ARR__c: 1375124.25
- Customer_Coverage_Tier_Calculated_by_ARR__c: Tier 1
Opportunities
- Experity - Core, CAQH mgt, PE - Year 1 of 2 (006PO000009M1xxYAC) — Closed Won — $615000.0 — closes 2024-06-30
- Experity - Core, CAQH mgt, PE - Year 2 of 2 (006PO00000BGeMXYA1) — Dead - Replaced — $612500.0 — closes 2025-06-30
- Experity Renewal 2026 (Y2 of 2) (006PO00000BHhewYAD) — Closed Won — $1375124.25 — closes 2026-03-31
- Experity_Expansion to Full Client Base + PAR Analysis (006PO00000C6pc1YAB) — Dead - Duplicate — $1631875.0 — closes 2025-03-14
- Experity_Expansion into full client base for PE (006PO00000DURmTYAX) — Dead - Duplicate — $600000.0 — closes 2024-12-20
- Experity Early Renewal 2025 (Y1 of 2) (006PO00000IxyDtYAJ) — Closed Won — $2750248.5 — closes 2025-03-15
- Experity - Renewal - 2027 (006PO00000JFqkwYAD) — 1 - Pending Renewal — $2750248.5 — closes 2027-03-31
Cases
- None (500PO00000a7EazYAE) — Committed - Future Quarter/P2
Create request prompts for bulk demographic updates when a user changes information that requires a demograhpic update.
- None (500PO00000XeCqjYAF) — Committed - Future Quarter/P2
If a new group enrollment request is in process, automatically make the provider enrollment requests dependent upon the group request
- None (500PO00000NBF1kYAH) — Committed - Future Quarter/P2
Current flow:
Payer line: IPA-NY is one enrollment application that can be submitted that covers at least four payer networks. Example: IPA-NY (Humana, Aetna, UHC, and CareSource) is par and effective as of 10/01/2024. This now means that Humana is effective 10/01/24, Aetna is effective 10/01/24, UHC is effective 10/01/24…. etc. For easier viewing/ingestion of the data, Experity has requested that when the IPA application payer line has been marked Complete, there will now be five payer lines under Existing Enrollment when there was just one payer line that the internal Medallion team had to process under Enrollment Request. [~accountid:712020:aa742bcd-f8a6-4274-b488-f9327672035e] has suggested that instead of our internal team having to add four additional lines each time to accurately represent the plan lines under the IPA, this functionality would reduce the workload to a Medallion specialist now just having to add in four effective dates rather than entire payer lines.
- None (500PO00000NBEAXYA5) — Closed/P2
Currently you are able to export from any of the payer lines being managed by Medallion. Experity has requested that you’re able to report from the existing enrollments, regardless of Medallion submission or Experity internally.
- None (500PO00000NB3JzYAL) — Closed/P2
CAQH “Ready to link” email notification | Can it include the provider’s name within the email notification? This can help reduce the provider abrasion and onboarding experience.
- None (500PO00000NBGSQYA5) — Closed/P2
Once a provider’s enrollment application is accepted at the payer and PAR, we will send an email notification to both the Experity Admin team & the provider. Marley asked if we could add a third email - the client admin - to that automated email. Is that possible today? For additional context, there would be 1 ‘client admin’ associated with each group in medallion, so the workflow would need to reference what group the enrollment was tied to, pull the ‘client admin’ associated iwth that group, and include them on the email notification stating that provider is PAR.
- None (500PO00000NBGQoYAP) — Closed/P2
EPD has been able to bulk enable CAQH Management for Confluent in the past. We often get this request in Implementation and would like the TSMs to be enabled to bulk enable CAQH Management for customers.
- None (500PO00000NBGPCYA5) — Not Doing/P2
Experity is wanting to expand the services to include par analysis. They currently perform this for their customers by 1) having an outlined/confirmed payer list and 2) gathering the billing information as a part of the enrollment process. When Madeline conferred with Kate S. on this possibility, Kate responded “We cannot collect that information during par analysis. Payers will not send us copies of their contracts because we are third party vendor. We do not house Billing set up or store executed agreements in our platform. The items listed above are not standard public information that the payers give out.” Experity is curious that if we can’t do the full billing/contract/enrollment with par analysis, which elements could we perform? It would seem duplicitous to have the Experity team call for the billing component while the Medallion team calls each payer for the enrollment/par piece.
The potential here is to explore the best way to perform market analysis rather than working from a confirmed list. Marley at Experity has been giving great feedback on how to perform this function as a third-party vendor, but it does not currently fit into our business model.
- None (500PO00000NBDXmYAP) — Closed/P2
This was originally flagged in a request doc, so I apologize for not getting this on the RR Tracker sooner!
Intuitive Request Modals
I would like to see where we move to more of an outcome-based model rather than an individual request submission.
Example: CHS gave us group enrollments and then the providers associated with the group and expected us to map out the provider enrollment requests based on this desired business outcome.
Example: Currently, in VerityStream, Experity is able to dictate which payers are allowed to be requested for each provider based on the practice location, group, and provider type.
Ideally, they would like this to be automated, as they are flagging the current request workflow is creating a large amount of extra work on their end.
- None (500PO00000NBCzyYAH) — Committed - Future Quarter/P2
Currently, you can only select a single provider for demographic updates. When a customer opens up a new location, they need to be able to add multiple providers for multiple payers to cut down on the amount of individual requests needed as the current process is time consuming.
- None (500PO00000NBE0tYAH) — Committed - Future Quarter/P2
The current process for many payers to fully close a line out is to wait for the letter of approval from the payer. In the meantime, we check the portal and add notes if it has been approved. This slows down dependencies and billing. We should add a new status that finishes the line to move dependencies forward and allows billing to bill but also allows Medallion specialists to not lose track of which requests still need official letters.
!image-20241218-205938.png|width=1116,height=112,alt=“image-20241218-205938.png”!
!image-20241218-205916.png|width=761,height=760,alt=“image-20241218-205916.png”!
- None (500PO00000NB63IYAT) — Needs More Market Signal/P2
Attached is a sample report that has all the contract details that I would love to have a spot to populate in Medallion for each payer for each of our clients.
If we had this capability, along with internal notes that we can attach to a payer and track internally- this would solve us being 100% in Medallion and eliminate the need for us to stay in VERITY. This would also be an opportunity for Medallion to extend this capability to all customer types because the contract drives and defines what provider types must be enrolled with what payer. The contract holds the rules for enrollment specific to Urgent Cares, and the contract details would be an opportunity for any PM API to be able to connect, pull the contract details to set-up payer fee schedules in the PM to allow for automation in building of the payer to submit claims correctly.
- None (500PO00000NBG0zYAH) — Needs More Market Signal/P2
Government Revalidation dates are hard to get throughout the enrollment process. The reval dates for Medicare are random and only arrive via email/letter which can be hard to track for our customers as it could go to multiple places. In order to find out if a provider is up for reval, they have to go to the cms website and check each provider to ensure they are up to date. This is a challenge for a lot of our customers to keep track and can result in lapsed enrollments if they don’t have a process in place.
CMS has a API that I believe we may be able to tap into and provide revalidation dates for providers based on NPI. [https://data.cms.gov/provider-characteristics/medicare-provider-supplier-enrollment/revalidation-due-date-list|https://data.cms.gov/provider-characteristics/medicare-provider-supplier-enrollment/revalidation-due-date-list|smart-link]
- None (500PO00000NBG10YAH) — Needs More Market Signal/P2
Experity is asking for Medallion to automate Revalidations prior to revalidation date for all active provider enrollments. The idea is that Medallion would automatically start the revalidation process a pre-defined (maybe customer defined) number of days prior to revalidation date. This would also move the Revalidation into the “Enrollment Requests.” The expectation is that it would work similarly to how Recredentialing does today.
- None (500PO00000NBFzNYAX) — Not Doing/P2
Prospect internal team currently manage CAQH reattestation on behalf of their providers and track the upcoming reattestation date in their current system (veritystream) - so they want to ensure they can continue to do so in Medallion. They may ultimately choose to leverage our services for CAQH management in a later phase of partnership, but initially they are interested in continuing to manage this piece. Can we expose the reattestation date in platform even if they have not contracted with us for CAQH mgt? Until CAQH reattestation date is available to port over in the API, the customer would be responsible for updating/managing this field.
- None (500PO00000NB46KYAT) — Closed/P2
When Experity is completing a group profile in the platform, the same information applies to the Facility profile. They will still need to submit two separate requests for enrollment (facility and group); however, since the group and facility demographic is the same, this would save a lot of time for the Experity admins.
- None (500PO00000NBFuYYAX) — Closed/P2
This is considered a low priority, but Marley asked if this is a feature we can offer.
- None (500PO00000MJHtJYAX) — Committed - Future Quarter/P2
Moving over RR 177 from Jira - Group Profile Data - Ability to copy to Facility Data - When Experity is completing a group profile in the platform, the same information applies to the Facility profile. They will still need to submit two separate requests for enrollment (facility and group); however, since the group and facility demographic is the same, this would save a lot of time for the Experity admins.
- None (500PO00000MJ6BYYA1) — Submitted - Needs Review/P2
Moving over RR - 179 from Jira - Experity shared a sample report that has all the contract details that I would love to have a spot to populate in Medallion for each payer for each of our clients. If we had this capability, along with internal notes that we can attach to a payer and track internally- this would solve us being 100% in Medallion and eliminate the need for us to stay in VERITY. This would also be an opportunity for Medallion to extend this capability to all customer types because the contract drives and defines what provider types must be enrolled with what payer. The contract holds the rules for enrollment specific to Urgent Cares, and the contract details would be an opportunity for any PM API to be able to connect, pull the contract details to set-up payer fee schedules in the PM to allow for automation in building of the payer to submit claims correctly.
- None (500PO00000MJ2MSYA1) — Committed - Future Quarter/P2
Current flow: Payer line: IPA-NY is one enrollment application that can be submitted that covers at least four payer networks. Example: IPA-NY (Humana, Aetna, UHC, and CareSource) is par and effective as of 10/01/2024. This now means that Humana is effective 10/01/24, Aetna is effective 10/01/24, UHC is effective 10/01/24…. etc. For easier viewing/ingestion of the data, Experity has requested that when the IPA application payer line has been marked Complete, there will now be five payer lines under Existing Enrollment when there was just one payer line that the internal Medallion team had to process under Enrollment Request. @Mitchell Thompson has suggested that instead of our internal team having to add four additional lines each time to accurately represent the plan lines under the IPA, this functionality would reduce the workload to a Medallion specialist now just having to add in four effective dates rather than entire payer lines.
Exec touchpoints
- 07/2025 - Exec. Touchpoint - Experity - EBR (a5BPO000000CXY52AO)