MedallionAI Wiki

NeurAbilities

· 1 Gong source

NeurAbilities

Snapshot

Multi-specialty behavioral health and neurology group (psychiatric NPs, developmental pediatricians, neurologists) with multiple clinic locations; Medallion prospect — product demo given 2026-04-20; decision expected within 1–2 weeks pending CEO sign-off.

Profile

  • Specialty mix: psychiatric nurse practitioners, developmental pediatricians, neurologists, ABA providers. Per Gong call, 2026-04-20.
  • Currently billing under individual NPI; likely should be credentialing and billing under group TIN/NPI based on contract structure — under review.
  • Expansion planned: evaluating 3–4 new clinic locations; in approval phase.
  • Payer contracts historically managed by outsourced billing company; contracts not centrally stored; partial recovery effort underway by billing team.

Operations

  • Credentialing is entirely manual today: email-based provider data collection, spreadsheets, shared drive / SharePoint.
  • CAQH used inconsistently; providers not proactively managed; quarterly attestations not automated.
  • Estimated 30–40 days to collect provider onboarding data; no defined SLA for application submission.
  • Revalidation/recredentialing dates not tracked reliably; CEO has repeatedly requested a visibility dashboard.
  • Claim denials attributed in part to individual-vs-group enrollment mismatch and revalidation lapses.
  • One credentialing FTE (Jen) under the RCM team (head of RCM: Allison).

Key Contacts

Customer — Jonathan Irizarry, Senior Accountant (jirizarry@neurabilities.com); Nicol Hartnett (nhartnett@neurabilities.com); Drew, CEO (no email on file); Jen, Credentialing Manager (no email on file); Allison, Head of RCM (no email on file). Medallion — Kyle Bettencourt, Enterprise Account Executive (kyle.bettencourt@medallion.co); Noah Laack-Veeder, Lead Solutions Consultant (noah@medallion.co); Kirsten Neville, Business Development Representative (kirsten.neville@medallion.co).

Active Work

  • Sales cycle in progress: demo completed 2026-04-20; pricing/ROI model to be built by Kyle.

Open Issues & Requests

Operational pain

  • No visibility into revalidation dates; CEO (Drew) has been asking for a provider-level credentialing status + expiration dashboard. Per Gong call, 2026-04-20.
  • Individual vs. group enrollment mismatch: providers credentialed individually instead of under group contract, causing sub-optimal reimbursement rates (primary care rates instead of specialist rates) and in-network gaps with payer sub-plans.
  • Payer contracts not centrally stored; historical billing-company transitions (two changes in past few years) led to lost contracts; partial recovery in progress.
  • CAQH not proactively managed; providers expected to self-manage, causing delays and payer rejections when CAQH data is stale or incomplete.
  • Revenue acceleration is top board/CEO priority; scheduling delays when providers are not yet credentialed with payers are causing provider reallocation overhead.

Decisions & Commitments

  • 2026-04-20 — Kyle Bettencourt: to send open-items list to Jonathan for Jen and the RCM team to fill in gaps. Per Gong call, 2026-04-20.
  • 2026-04-20 — Kyle Bettencourt: to prepare initial ROI and pricing model; Thursday 10 AM CT pricing call scheduled with Jonathan.
  • 2026-04-20 — Noah Laack-Veeder: Friday 9 AM CT in-depth technical walkthrough scheduled with credentialing team (Jen).
  • 2026-04-20 — Jonathan Irizarry: decision body is Jonathan, CEO Drew, and head of RCM (Allison); will present to CEO after getting credentialing team buy-in. Target decision within 1–2 weeks. Will raise at upcoming board meeting.
  • 2026-04-20 — Group credentialing strategy: Noah assessed that group-TIN billing is likely correct given specialty mix and contract structure; confirmed as action item to verify and standardize going forward.

Source History

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