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Access Medical Clinic

· 2 Gong sources

Access Medical Clinic

Snapshot

Active Medallion customer in implementation phase; delegated credentialing setup underway with Humana, Devoted, and Centene sub-delegation pending; expanding toward UHC and BCBS Arkansas delegation.

Key Contacts

Customer — Kim Waters (kimwaters@amcmedicalclinic.com); Monia York (monyayork@amcmedicalclinic.com); Monia Hunter, SVP Human Resources and Credentialing (monyahunter@amcmedicalclinic.com); Matthew Punches, Punches Advisory Group (matthewpunches@amcmedicalclinic.com). Medallion — Naomi Denson, Sr. Implementation Manager (naomi@medallion.co); Adalee Arreola, Sr. Technical Solutions Manager (adalee@medallion.co); Jason Zednick, Engagement Manager (jason.zednick@medallion.co); Peter, Account Manager II (peter@medallion.co).

Active Work

Recurring cadences

  • Bi-weekly implementation sync (ongoing); platform walkthrough for credentialing team (5–6 people) scheduled next Monday at 10am; payer process scoping call scheduled next Wednesday 11:30am central — per Gong, 2026-04-20.

Implementation in-flight

  • Custom provider invites: Adalee working on custom provider invite flow; custom welcome email in progress.
  • CAQH management: CAQH PDQS credentials pending from Pete at CAQH (not blocked by AMC); once received, Naomi runs imports from AMC roster on CAQH; provider email list needed for bulk-enable — AMC to identify exceptions (PRN providers who manage their own CAQH) and send list of who to enable vs. exclude.
  • Enrollment data load: AMC data team reviewing import template (expected by end of week 2026-04-25); Adalee actively building delegated rosters; non-delegated rosters mapped in platform by Jason (some payer links still missing from payer process doc).
  • Delegation agreement: awaiting Naomi’s ops director to add comprehensive monitoring details; then going to Tony (at AMC) for DocuSign signature; Kim to be CC’d — per (Gong 2026-04-20).
  • CMS preclusions setup: confirmed all 3 (CMS preclusions, OFAC, Death Master) needed in credentialing files for delegation; Naomi submitting tickets to EPD team to configure these into file workflow — per (Gong 2026-04-20).
  • Comprehensive monitoring package in use: OIG, SAM, Medicare opt-out, NPDB, Medicaid exclusions, license verification monitoring; comprehensive add-on adds CMS preclusions, OFAC, Death Master.
  • Sub-delegation notifications: AMC needs to notify Humana, Devoted, and Centene to designate Medallion as CVO; conversations not yet started as of 2026-04-20.
  • Credentialing committee configuration: clean file committee + needs attention/review committee; Kim to confirm voter names; provider access to files held until AMC communicates partnership to providers.
  • Group/practice profiles: 77% complete; 67 facility/RHC profiles loaded but only need full completion for facilities with active work.
  • Provider access: providers to be granted file-view access only after AMC announces partnership; Naomi to enable when AMC gives the go-ahead.
  • Beta providers: AMC targeting beta group first, then broader rollout; go-live June 1 defined as first enrollment request + first credentialing request submitted + providers invited + CAQH enabled.
  • Volume: 20–40 providers over next 2 months (primarily turnover, not net-new); potential acquisitions in discussions — Kim to update Naomi as details emerge.
  • Transfer enrollments: to be loaded close to June 1 go-live (not before); requires submission dates, tracking numbers, and payer info for any in-progress enrollments.
  • RHC custom workflow: Kim and Naomi discussed tracking facility readiness (surveys, letters) in platform; Josh Levitt referenced a custom workflow scoping discussion from sales; Naomi to follow up with Josh on scope and right team.
  • Training plan: 3 one-hour sessions — general platform overview; credentialing + ongoing monitoring; payer enrollment + CAQH management — to be scheduled.
  • Delegation expansion: AMC wants to expand delegation to UnitedHealthcare Arkansas and BCBS Arkansas; exploring whether Medallion has existing contacts there; payers won’t work directly with Medallion on delegation setup.
  • Provider-by-state reporting: open ask to Medallion reporting team to find way to pull provider counts by practice location/state (needed to meet payer minimum provider requirements for delegation); no easy platform report found yet; also exploring Athena as data source.

Open Issues & Requests

Operational pain

  • Group NPI blocking issue: platform requires group NPI entry when updating group profile, but AMC’s setup was configured without it; blocks Kim from saving changes to group profile (e.g. adding lines of business, medical records email); escalated to Medallion EPD team for configuration fix as of 2026-04-20 — per Gong, 2026-04-20.
  • CMS preclusions list source: Humana is responsible for sending the preclusions list to the delegated entity (AMC); when Medallion is designated as CVO/sub-delegate, Humana should route that list to Medallion; process not yet set up — per (Gong 2026-04-20).
  • Payer portal credentials / attestations out of Medallion scope: payers requiring password updates every 30 days or provider attestations every 90 days (e.g. CAQH attestations) cannot be efficiently handled through Medallion; AMC retaining those workflows internally — per (Gong 2026-04-20).

Feature requests

  • Provider-by-state report: AMC needs a report showing provider counts by practice location state (not license state) to evaluate payer delegation minimum requirements; no current platform report supports this — per (Gong 2026-04-20).

Decisions & Commitments

  • 2026-04-20 — All 3 comprehensive monitoring add-ons (CMS preclusions, OFAC, Death Master) confirmed required in credentialing files for payer delegation; Naomi to submit EPD tickets — per Gong, 2026-04-20.
  • 2026-04-20 — Provider file access held until AMC communicates partnership to providers; Kim to notify Naomi when ready to upgrade provider access — per (Gong 2026-04-20).
  • 2026-04-20 — Medallion delegation agreement to go to Tony (AMC) for DocuSign once ops director adds comprehensive monitoring details; Kim to be CC’d — per (Gong 2026-04-20).
  • 2026-04-20 — Transfer enrollments to be imported close to June 1 go-live, not before; AMC to compile submission dates, tracking numbers, and payer info for any in-progress enrollments — per (Gong 2026-04-20).
  • 2026-04-20 — Payer portal password and attestation management (e.g. 90-day CAQH attestations) to remain with AMC internally — per (Gong 2026-04-20).
  • 2026-04-20 — Kim to send collaborative agreements to Naomi after call — per (Gong 2026-04-20).
  • 2026-04-20 — Naomi to follow up with Josh Levitt on RHC custom workflow scoping (facility readiness tracking, surveys, letters) — per (Gong 2026-04-20).

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