Transcript
Nic Schisler (00:00) hi, Deanna. Good morning.
Deanna Cook (00:03) Hi, there. How are you? Good?
Nic Schisler (00:05) Thanks for supporting me here this morning. Yeah. So what I’ll do is I’ll just tell Tony like let’s just get into the sal redline comments questions he has. And then if we need to talk about anything that’s going on operationally, I’ll just get you off. So then you can kind of get back to your day. So we can kind of make best use of our time and we’ll kind.
Deanna Cook (00:30) of he’s from procurement or what’s his role?
Nic Schisler (00:33) He’s from procurement. I think he gets a little involved in some of the day to day. At times there’s to… take a big step backwards like high level real quick. I think as gabby mentioned, this used to be one company. They’ve separated. Yeah. So now he’s just kind of there has been, there was a migration we had to redo the migration.
Deanna Cook (00:54) Right. It’s.
Nic Schisler (00:55) that’s what kind of caused some of the unforeseen issues with us having to pause requests that were in flight, etc, those are all now back in flight. We worked through the team. The team worked through a lot of it last night and so we should be in a good spot now as we move forward. Okay. Essentially, we’ll let him join. Where are you? Are you on the east coast? Just so I.
Deanna Cook (01:18) know, I’m in Michigan. Oh.
Nic Schisler (01:19) Okay.
Deanna Cook (01:20) How about you?
Nic Schisler (01:21) I’m in South Carolina a little warmer.
Deanna Cook (01:23) Okay. Yeah. Still.
Nic Schisler (01:25) Snow up there? Did you all get like I saw some town after that weather came through earlier this week, they got like 30, some inches of snow it was.
Deanna Cook (01:35) Wild.
Nic Schisler (01:35) oh, yeah.
Deanna Cook (01:36) That’s up north in Michigan. We have a cabin up north. Yeah, we got like two feet that is crazy. But down here, I’m in Ann arbor. So down here where we are, it’s not been bad. It’s been cold and it snowed a little bit the other day, but then it’s supposed to be like 60 tomorrow, so.
Nic Schisler (01:50) Awesome.
Deanna Cook (01:51) I have not been there. You never know what’s gonna happen. Yeah.
Nic Schisler (01:55) I have not been there, but I’ve heard it’s a great little town that you’re in. Yeah, it’s nice. All right. Here comes. Tony. Let’s let him in. Okay? Hey, Tony. Good morning.
Tony Lewis (02:10) Hey, there. Good morning. Can you hear me? All right?
Nic Schisler (02:12) Yeah, we can hear you loud and clear. So we have Deanna here to kind of help talk through maybe some of the red lines, sal, questions you have. I know there’s a few things operationally going on too that you had questions about. And I’m not sure if you saw my update this morning, but I figured we could kind of just start the call off by maybe going through the sal first to make best use of time. That way Deanna can answer any of those questions, you know, live for you or if we need to address some red lines that you’re going to send back, she can do that and get back to you quickly. And then we can let her drop. And then you and I can discuss some of the operational stuff going on at this point. Everything is in flight. It’s being tracked and we can talk a little bit more about that in detail after she drops, but I just wanted to make best use of our time if that’s fair to you.
Tony Lewis (03:01) Yes, it is. And I had the document open ready to share and then somehow got closed. So let me just get repositioned here. I went ahead and accepted a lot of the red lines. Some of them were fairly straightforward, removing some definitions that don’t truly apply… share screen to.
Tony Lewis (03:31) Okay. Do you have my screen with the contract open? Yes. Yep. Perfect.
Nic Schisler (03:35) And let me let Lana in too for us.
Tony Lewis (03:40) So most of these changes were pretty straightforward. Like I said, the first were some changes here to the definitions. So I’m going to just go ahead and delete this. I left it there for just kind of a reference point. Okay… removed all of, you know, the prior scope. It talked about some of the platform and other things. I think what we have is probably satisfactory. I don’t know that I’ll get a ton of pushback from my legal or other folks. You’ll notice one change here. There was still like a section four that was description of services, but it was just left blank. So I deleted that and it changed the reference numbers. So there was actually a reference up here that I think it was originally section eight. You had changed it to section five. So now I’ve changed this to now be section four.
Deanna Cook (04:36) Yep. That’s fine.
Tony Lewis (04:46) I think that’s just still part of your previous edits. Again. I didn’t make any changes. So then moving forward, I don’t believe there were any other edits yep. Okay. So I invited this to Lana and Christina and I’m not sure if they’re able to join, but essentially the additional service that was added, their team’s already doing a lot of that renewal monitoring today. So that additional service as part of the ncqa, new requirements, the added SKU that you had there, they ultimately said, hey, like that’s not something we need as part of this service. So I have left this out. I took it out and left it as the original. So I didn’t know if you had questions, comments, feedback on that.
Nic Schisler (05:40) Deanna, we can take that back to gabby. I think the reason why we added that in Tony is because that is something that it’s a very similar thing that I think we set up for coverage today. It does add in a little bit of a manual piece of work for Christina and team to do. And I know that’s why Christina kind of originally raised that to Ray and I the other week on the call which is why I proactively reached out to you just kind of flagging, hey, like we’ll work with you on preferred pricing. I think it’s very similar to what was put into place for carebridge. It allows us to do that monitoring for you rather than the team and it’s captured in the platform. So Deanna and I can go back to gabby and just say, hey for now. It sounds like their team is going to handle it. You know, we can revisit this down the road if it’s something that becomes a larger issue. And I don’t think she’ll have a huge pushback there, but I think that was our reasoning for it essentially. OK.
Tony Lewis (06:34) Yeah. And so I just want to make sure we’re keeping carebridge.
Nic Schisler (06:39) Totally separate, totally understand that. Yeah.
Tony Lewis (06:42) So they’re different orgs, yeah.
Nic Schisler (06:45) Totally understand that. It’s just from a, I guess a product perspective of like licenses renewals, et cetera. It’s a very similar workflow, which is why I think she presented it in there for you all.
Tony Lewis (06:58) Yeah, no, no. And I agree with you overall, you know, generally, but there are some initiatives that Christina, Lana, Amy, diversa and team are working on that. OK, are somewhat separate in terms of their org redesign process flows. OK. So again, I know it is a fairly manual process today. I’m not sure that’s going to be the case in the future and ultimately, they were just comfortable retaining that function in house.
Nic Schisler (07:26) That’s fair if we need to revisit it, at a further time because it becomes a bigger manual lift where we can happily revisit that. So, you know, you just let us know we can have that conversation. We’ll share that with gabby. I don’t think it’s a all or nothing thing from our understanding. So it should hopefully be a mute point there.
Tony Lewis (07:46) OK. Fair enough. Sorry.
Nic Schisler (07:50) To interrupt, but I have a five six two number dialing in. Should I allow that? Do we know who that is?
Lmartin3 (07:55) That’s Christina. OK?
Nic Schisler (07:57) Let me let her in as well.
Lmartin3 (08:01) Yeah. We’re both having a hard time with WebEx. I’m sorry, Tony. And.
Tony Lewis (08:05) That’s what I was going to say. This zoom WebEx, whatever it is. I always have to join from the browser. It always takes a time or two to get in here.
Tony Lewis (08:16) But while she gets dialed in again, I don’t know that she’ll have a lot of commentary on the contract. It looks like, hey, Christina, are you in there? Can you hear us?
Tony Lewis (08:28) Well, you’re stuck on mute if you are, but we’re just walking through the contract. Now, we can talk about some operational issues.
Tony Lewis (08:35) Once we make our way through this, we’re through most of the major changes again. I know we called out the dates. I’m going to work with my team. They just have some reservation with the one one contract agreeing to payments for 20 25. And so I’m just working through with ap in terms of budget and other impacts. But at the end of the day, I think I’m fine with calling that out so that we clear any overage from the prior contract. It clears, you know, the gap where somewhat expired while we were working through, you know, the renewal and the migrations. So you cleaned up and capitalized pass through fees, which again makes sense.
Tony Lewis (09:20) Changing this reference. Now back to section four since we’ve modified the numbering. And then I accepted all of your changes in terms of consumption, tracking the skew flexibility essentially saying that we’re committing to this dollar amount and it can be spread across any of the skews as necessary if I read that correctly.
Deanna Cook (09:43) That’s right? Yep. Okay.
Tony Lewis (09:53) I don’t think that was a good typo. So again, there was some clarification around the reports. There was some reference to compliance reports. So I don’t know what the reporting is today. I just want it to be consistent with the same reports that we’re not restricting or limiting and I assume that’s the expectation, right? The current reporting suite is going to be available. Yep. No.
Nic Schisler (10:19) Changes there. Yeah, that’s right. Same platform go.
Deanna Cook (10:22) Ahead. We just don’t have anything that’s actually called a compliance report. So all the reports you have been getting in the platform that you’ll be getting the same stuff. We just wanted to make sure that what’s reflected here is actually reflecting what’s actually being provided.
Tony Lewis (10:35) Okay. Fair enough. I’ll clean that up and accept it. And there’s going to be some formatting issues that I won’t bore us with. So there… should be a note here. I would like to essentially just modify this section to say the addition of any subcontractors if any will require written notice. I think at the end of the day, we just want some continuity in the operations and that if you’re going to go out to a competitor of ours and employ them as a subcontractor, we want to be notified. I understand we’ve already given acknowledgement and approval to your current subcontractors and so one, I wanted to clarify if that’s like external resources that you’re hiring and not making them full time as subcontractors or if there’s an element, it’s like your finance and billing departments, which I’m not overly concerned about at the end of the day. We want this to be tied to the operational subcontractors if any. And if there’s changes we want notice. So are you fine with reducing this to just this one sentence?
Deanna Cook (11:45) Yeah, I’m fine with that in concept. Could we also add a sentence just confirming here in this agreement that our existing subcontractors have already been approved so that it’s clear on the face of this document that there are existing subcontractors elevance has already approved those. But the addition of any new subcontractors would be, are you asking for prior written approval or prior written notice? Because those are two different things.
Tony Lewis (12:10) One I would like approval depending on again if you’re talking operationally for the example I gave, like if you’re going to employ optum or some of our competitors in providing services, we’re not really in that business like we don’t directly employ with optum or change wherever possible for a whole host of reasons. So one we like awareness at a minimum that there’s an acknowledgement that you’re shifting, but ideally it’s approval that you’re giving us notice and we’re giving you thumbs up. And so one, I want to better understand the… subcontractors that we have already approved. And if there’s a list and how they impact operationally, like again, I know you outsourced your billing at one point. I don’t know if that’s still the case, if that’s what we’re referencing or what operational subcontractors… you utilize for delivery of these services.
Deanna Cook (13:10) Sure. Right now, we have an arrangement with it’s basically like a supplemental staffing arrangement with an external entity, but they provide staffing resources that help support our licensing and credentialing operations. So those personnel are technically, you know, considered contractors to us because they’re not directly employed by medallion, but they are essentially like staff augmentation. So they are subject to all the same training onboarding, you know, same monitoring and oversight that we do of our own employees. So they, we treat them for all intents and purposes as medallion employees, just on paper, they are employed by different entities. So that’s why they’re considered subcontractors.
Tony Lewis (13:56) Okay. Yep. And that was my expectation that’s fairly common when providing some of these services. So, okay, I will add some language here in terms of.
Deanna Cook (14:09) And then on the like, it sounds like your main concern is really us utilizing a contractor that may be a competitor of yours. So would you be open to us saying that we will give you notice of any new subcontractors and that in the event you know, such subcontractor, is deemed a competitor of elevance, or carillon, then you would have the option to, you’d have approval rights basically? Okay?
Tony Lewis (14:38) Yeah, I think that works. And again, I’m less concerned about the staff augmentation perspective where it would be as if you’re outsourcing some of your development of the software or where our data is housed and stored, the subcontractor component I’m comfortable with. And again, that’s where we’ve given you approval in that aspect. So it’s more data… control for one and just awareness as to who’s touching our data?
Deanna Cook (15:07) Yeah. Understood. Yeah, I don’t anticipate us bringing on like a true third party subcontractor especially one that would pose a conflict to any of our existing customers. You know, the one thing that gives me pause about giving one particular customer a right of approval or refusal, is we use these subcontractors across all of our customers. So, you know, it makes it sort of operationally difficult to carve a certain customer out of utilizing those resources… that’s not to say it couldn’t be done. That’s why I want to try to limit that approval, right? As much as we can just to, that situation where you’re really concerned about which is if it would be a competitor or, you know, some other entity like that would really pose a concern?
Tony Lewis (15:53) Okay. I think I can consent to just prior written notice, okay? And we can carve out again. I don’t know, I don’t necessarily need notified every time you added some associate that’s deemed a subcontractor to you to do the work, right? If you have ebbs and flows on your resourcing staffing, I’m not concerned about that. It’s more like you said true third parties that may be accessing the data for which you have a separate contract with. And I want to make sure that all of our regulations standards that flow to you are then they’re held accountable to? Yep. Okay.
Deanna Cook (16:34) Yeah. So do you want to take a stab at proposing some language back then that you’d be comfortable with and we can review?
Tony Lewis (16:39) Yes. Okay. And I should get that over to you this afternoon. Like I said, I have my legal office hours this afternoon, so I will bump them up against this. Again. I don’t think they’ll have a concern with approval at the end of the day. We’re more concerned about the notice of material third party operational changes.
Deanna Cook (16:59) Sure. Okay.
Tony Lewis (17:05) All right. And then I think that’s really it in terms of contractual feedback.
Nic Schisler (17:13) Okay, great. All right… Deanna. I don’t think we need any more from you. Once I get that from Tony this afternoon, I’ll just drop it in our internal channel for review from you.
Nic Schisler (17:24) And then once we get a clean version back, Tony, I’ll send it back to you. Probably hopefully maybe Danny, I think for the weekend you think. Yeah. Okay. So we should have this turned back around to you, Tony, before the weekend, as long as we have it from you. Okay? Awesome?
Tony Lewis (17:41) Sounds great. All.
Nic Schisler (17:42) Right. Thanks, Deanna.
Deanna Cook (17:43) Yep. Take care.
Nic Schisler (17:44) Bye. Hi, Lana. Hi, Christina. Hey, oh, Christina may have dropped. Okay. So, Tony, where can I? Maybe? I know I sent some emails late last night after bedtime sorry, it took us a while to get the girls down. And then I gave you an update this morning. So happy to add some context there. Ray will be in touch with the team today. I think kind of just going back to my email earlier. Some of the things that happened due to the migration, which were unforeseen. Like I didn’t you know, originally if I’m going back several months ago and we worked with Christina to get her blessing. If we would have known then that we were going to run into sso issues and all the things I would have said, whoa. Like let’s press the pause button. Let me go to Bob and Melissa and get on board with them, right? And so at this point in time originally, I think Ray and I don’t think she was trying to do this purposefully, she was trying to work with Christina and team to have them go back into the system and re, request.
Nic Schisler (18:56) And I said let’s hold off on that. Like let’s try and be better partners there essentially. And so we worked internally with our team to have them re, request all of the renewals that were originally in flight and put into a stopped pause position because of the migration. So those are all now back in flight. They’re all on the platform. She’s able to view them. As I mentioned in my email, some of them have either been renewed or they’re in the process of being renewed, and we will meet the termination date. Anything that is of high priority right now, our team is aware of they flagged and they are pushing to ensure that those are completed ahead of the expiration date. Essentially, the new license request, very similar to what happened was, is they had to be stopped because of the migration. Our team worked through the night last night to get all those put back in platform. Ray has a spreadsheet that she will share with Christina and we can loop you into the email thread as well, Tony, if you wish for visibility. So they have that. So now everything is back in flight. Our team are working new requests as normal. Essentially, everything is back in platform. I think we’re only going to share the spreadsheet that way. If Christina has questions or Lana or team and they need to reference the spreadsheet, they can bump and compare against the spreadsheet for whatever reason essentially.
Tony Lewis (20:23) And do we have a prioritized list of those renewals in terms of expiration?
Nic Schisler (20:27) Dates, we have a list the team has that I don’t know if I’m pretty sure Ray had shared a list a couple of days ago, but I can get with Ray and make sure if we need to reshare that we can reshare that. And then I think the last outstanding thing was… Christina just the auto renew feature and how it works and I know you all have capability to utilize it. We should have an update there for you by the end of the day and that should come with Ray. We’re just waiting on feedback from engineering essentially.
Lmartin3 (20:59) I’m not sure she can get off mute. So I told her to let me know if she has anything she wants to say. I’ll let you know.
Nic Schisler (21:05) Okay. Thanks.
Tony Lewis (21:07) So first, I just want to recap everything we touched on. So starting with the.
Tony Lewis (21:21) And now have since been re uploaded. Is there activity required of us for those to be processed by you all the?
Nic Schisler (21:31) Only activity that would probably need to be required is if we need some type of additional information from a provider that we would need to task out to and that’s just when the team would be in touch.
Tony Lewis (21:42) And that’s part of your standard that’s.
Nic Schisler (21:44) part of standard workflow. Yeah, with every customer, yes.
Tony Lewis (21:47) Could have already taken place.
Nic Schisler (21:50) Yeah, if we don’t have an npi number, if address isn’t correct, whatever it might be, that’s just standard operating procedure for every customer.
Tony Lewis (22:00) And so my question is of those 120, did some of those initial outreaches where they already started and then put on pause.
Nic Schisler (22:08) That’s a good question. It probably could have happened. But from my understanding, they’re all back in and applicable tasks should be there. I know Ray is actively having those conversations to draft up a bigger email by the end of the day. So there are no outstanding lingering questions from their team. So it’s all packaged up nicely. So I can confirm that with her and just make sure that’s a part of the messaging, but to my knowledge, everything is back in flight. If things need to be tasked out, they’re tasked out and we’re just pending responses at this time.
Lmartin3 (22:35) Is that the same situation we’re in with the 180 renewals? Not the new ones but the that.
Nic Schisler (22:42) Is correct. Those are all back in platform as well too. Everything that was either stopped or paused because of the migration is now all back in platform and in flight?
Tony Lewis (22:52) So essentially just starting over day one. So there could have been some activity that happened. These migrations took place interrupted all of that. And now we’re starting over day one today with all of the previous renewals and the correct.
Nic Schisler (23:08) That is my understanding. Okay. Again, Ray is much closer to the operational in and outs of it. But from my high level conversation with her and team and the internal conversation, I’m a part of that is my understanding.
Lmartin3 (23:22) Sorry, Tony, I got a question about the 180 renewals. So for those, is the auto renewal automatically turned on or is that something that we’re expected to go in and start the auto renewal for those? I?
Nic Schisler (23:35) Would start to enable that based off of the conversation that we had yesterday with Andrea and Christina essentially. Yup. And I believe, I don’t think Ray had sent it yet, but we have screenshots and a walkthrough that we will share. So just moving forward, your team has documentation about how to enable that if needed?
Lmartin3 (23:54) Yeah, yeah. You were saying that yesterday, you were going to put the, oh,
Nic Schisler (23:57) sorry, Alana. I didn’t realize you were on that call. I’m so sorry. Okay, great. Then you’re aware? Okay?
Lmartin3 (24:02) Yeah. I just wanted to confirm that, that’s what we’re saying here for the 180 renewals, because I think there was a little bit of an understanding that the auto renew was on for those. But anything else we needed to do was go in, so I wanted to confirm.
Nic Schisler (24:17) Yup. And I’ll make sure that we reconfirm that with Ray and that’s crystal clear in our communication back out to you all so.
Tony Lewis (24:23) Just from my understanding, the 180 renewals, they’re all going to be auto renewed. Are there any activities required of us for you to start processing?
Nic Schisler (24:34) I couldn’t tell you that, that’s I mean, I just don’t have the visibility into the intake team. I think if you have that question, if you want to send that back once Ray reaches out, Ray and team can do some investigation, I’m sure there’s going to be some needed pieces of information for us to potentially still push things through. But if it’s a, if it’s a renewal and there hasn’t been a big change to the provider, then no, we wouldn’t need anything.
Tony Lewis (24:56) But they’re in process. I think Christina’s challenge yesterday was that, you know, the auto renew feature didn’t trigger and then she wasn’t able to like submit them for renewal. She was struggling to get them. So I just want to make sure gotcha,
Nic Schisler (25:11) okay. Let me just make sure we clarify that with Ray and her outreach back to you all that might be what she’s pending confirmation on from our engineering team. And then we can clarify that with you all as well.
Lmartin3 (25:21) Yeah, sorry, Tony. Go ahead.
Tony Lewis (25:24) I was just going to say that seemed to be like a potential reoccurring issue that the auto renewal feature wasn’t triggering like a new submission for you guys to start your work.
Nic Schisler (25:34) So, I’m wondering if it was just the cart because of the migration though essentially that’s probably the big reason why it happened again. I know we have a slew of engineering folks working on the ticket for us. They promised me an update by the end of the day. So we’ll make sure to clarify that I’ll get with Ray and make sure that is crystal clear when we communicate that back out to you all as well.
Lmartin3 (25:54) And I have two other questions I want to clarify. There’s five urgent requests for Michigan, excuse me that are expiring in six days. So just want to have eyes on that yep.
Nic Schisler (26:04) I think Ray has already sent an email back about that this morning, just making sure that we have that prioritized and we’re staying on top of it. And whenever we have an update, we’ll be in touch with you all.
Lmartin3 (26:13) And then the updated expiration dates, has that been done as well? Because I know we were talking about them not updating yesterday and the expiration dates weren’t updated. So, is that the?
Nic Schisler (26:30) License expiration dates? Yes, I have to confirm with Ray on that piece that. I think… it sounded to me like Tony when we also began this conversation, that would be something that the team internally there was going to continue to handle moving forward, right?
Lmartin3 (26:49) We’re talking just two different things. We’re talking about the expiration dates that were in there, the upcoming the.
Nic Schisler (26:56) First ones. Okay. Yeah, yeah. Yeah. Let me confirm with Ray. I don’t want to misspeak there. So let me just circle up with her again. I mean, she’s just closer to it from an operational standpoint, day to day. So let me confirm with her and we can circle back with you.
Lmartin3 (27:09) Okay. All right. Great. Okay.
Nic Schisler (27:11) We will have updates for you before the end of the day. Okay, fantastic. I don’t know what we’ll do. I don’t know if I’ll have Ray just start a new email thread because I know we have a couple going on right now. Maybe we’ll just do that. We’ll start a new thread. We’ll put this team on it. So we all have visibility. And then if there’s follow up questions, we obviously can address those.
Lmartin3 (27:33) Okay, great. Thank you.
Nic Schisler (27:35) You are welcome. Okay. Anything else this morning? I appreciate the time. Tony will be on the lookout for those red lines and I’ll get them over to Deanna pretty swiftly?
Tony Lewis (27:47) Sounds good. Yeah, it’ll probably be about two or two 30 after I connect with legal don’t.
Nic Schisler (27:52) Watch too many games today.
Tony Lewis (27:54) I’ll try not to.
Lmartin3 (27:55) I think that’s all Christina had as well.
Tony Lewis (27:58) Awesome. All right.
Nic Schisler (27:59) Thank you all for your partnership. I know there’s been some bumps because of the migration typically, not what happens. So, you know, as we hopefully earn the right to redo next year, I think this would be a lot swifter. We won’t have a lot of, these bumps in the road very soon. The caremore mosaic providers will be out of the carelon, instance. Things will be a lot cleaner. You will only see palliative providers. So we are making much progress. It’s just, I know it’s taking some time, so I appreciate the patience. Okay? Sounds.
Tony Lewis (28:28) Good. Just keep us updated. We.
Nic Schisler (28:29) Will, thank you, everyone talk to you soon.
Lmartin3 (28:32) Okay. Bye.