Transcript
Cameron McCormick (00:00) hey, Kim. Hello?
Cameron McCormick (00:10) Happy Friday.
Nicole Campbell (00:20) Did your bracket also get busted for your March madness this week?
Cameron McCormick (00:27) I actually haven’t looked at that.
Nicole Campbell (00:31) while I was reading, I was just telling Kyle this because he was saying he picked gonzaga, but 零零零零零零零零零零零零零.
Nicole Campbell (00:50) okay. I have like the new numbers scoped out for her for the yearly, I want to start if like if she jumps on with the win of.
Nicole Campbell (01:50) Hi, Anu, how are you? Happy Friday. How you doing? I’m good, long week. Are you working from home today?
Anu Vora (02:00) Yeah, I’m actually working from my sister’s home. She’s in Cleveland. Oh, good. We have a mindfully office in Cleveland that I try to visit quarterly. So, yeah, just always on the road.
Nicole Campbell (02:13) I mean, I was going to say, I don’t think I’ve like seen you be in one place for a week yet when we’ve.
Anu Vora (02:18) talked, nope, nope, not yet. Maybe.
Nicole Campbell (02:22) Maybe in the future. Well, yeah, happy Friday. Thank you so much for all the feedback this week and the information. So kind of like two things. We’ll start off with one to like lead this discussion. So, first of all, I want to talk about what we were able to get approval from like our finance team on, specifically around that pay or enrollments number. I know we kind of talked about that on the phone. And we re, scoped the deal a little bit now knowing, okay, there’s 100 new providers each, year over year, at least growth for the next potential two to three years. So that we added in to make sure that we have the right scope and we’re not going to have to come back in like four months and be like, okay, we’ve already overused what we had allotted. So, yeah, I think this will be much more accurate, long term and leave no room for surprises for you.
Anu Vora (03:09) Okay, awesome. And.
Nicole Campbell (03:10) Then the one thing we are just waiting on final like sign off for just to be clear is the STC SLA, with the new pay or scope. So want to run through that and hopefully we’ll get a final answer from the team while we’re potentially on the call. Worst case that can be something we follow up with and that’s just because we submitted it later.
Anu Vora (03:31) Yeah. Well, a very like grounding question for me is let’s say that we have, you know, four anthem plans, anthem, commercial, anthem, medicare, medicaid, and anthem EAP, you all charge that as one payer enrollment for anthem subplans, correct? Yes.
Cameron McCormick (03:47) Yeah, yes. Okay.
Nicole Campbell (03:49) Great. Yeah. So that, yeah, I was going to say, but before I jump into my stuff, I know you were able to talk with the team a little bit more after we connected. I think Tuesday, yeah, Tuesday afternoon would love to know what feedback internally there’s been, what other conversations have happened. And then I can jump into, you know, all the good news we have for you.
Anu Vora (04:09) For sure. So there’s kind of three sections that we’ll talk about. One is like the scope of work. So, what does our current credentialing team own? That is and is not included? And some of it might just be like semantics. Yeah. So I’m just gonna pop a screenshot into the chat here. Everything with a red asterisk, hopefully, you can see that is kind of like over and above what the current scope includes. So I guess first things first, can you help me understand which of these items are included in things like medallion, core, ongoing monitoring or other items? And then which of these items are just straight up, not done by medallion?
Nicole Campbell (04:57) Yeah. Cam, do you want to take this one with the screenshot?
Cameron McCormick (05:01) Yeah. So, and I just want to, I might ask a few clarifying questions. So provider directory management, is that referring to the payer like once the provider is credentialed with the payer updating the payer’s directory?
Anu Vora (05:20) I think so.
Cameron McCormick (05:22) Okay. Payer attestation that is attesting that all of the things the provider attesting that everything in the credentialing application is correct? Yes. Okay. And then fee schedule management is, can you say a little bit more about what your vendor is doing for that?
Anu Vora (05:44) I think helping us ensure that we know well… our credentialing vendor is also our billing vendor. So sometimes I’m trying to figure out how these things tie together. Give me one second. I’m going to be furiously whatsappping while we talk to like what do we mean by this?
Nicole Campbell (06:05) Attest? Okay.
Anu Vora (06:08) Yeah. So the list of providers. So provider directory management, list of providers, which shows on the insurance website?
Cameron McCormick (06:14) Yeah. Got that one.
Anu Vora (06:15) Okay. So that’s included?
Cameron McCormick (06:18) That one, so here’s what is included pcos management is included. Payor attestation is included. I’m assuming when it says payer audit, rejection, denials, it’s essentially if you have a claim that’s denied or rejected, like contacting the payer to understand what the reason is and then fixing that.
Anu Vora (06:40) Correct. We.
Cameron McCormick (06:41) Do that for enrollments that we own. So if we’re doing your payer enrollment and that happens, we will handle that. Okay? And then consultation services is pretty broad.
Anu Vora (06:54) I think that’s like, hey, we’re thinking about adding this location. What do we need to do that? We’re thinking about dropping this payer. Can you help me understand like what the turnaround time is and whether they’re like going to drop something? Do you have any info as to where human is going? Where anthem’s going? Can you help us like make our strategy?
Cameron McCormick (07:25) Yeah. So our engagement manager. So when you become a customer, I don’t know how if Nicole and Jake have walked you through this, but you get an account manager and an engagement manager. The account manager is more focused on commercials. So essentially like making sure that your contract is appropriately sized for the work that you’re doing qbrs and keeping… things kind of moving forward on the right track from a contractual perspective. The engagement manager is the person who is more of a subject matter expert on enrollment.
Anu Vora (08:02) Hold on one second, Cameron, I’m just going to pause here. Can I, do you mind if I record this because?
Nicole Campbell (08:07) Yeah, it’s actually being recorded. So I will send out, I can send this out afterwards.
Anu Vora (08:11) Perfect. Then never mind. Please continue.
Cameron McCormick (08:14) Okay. Yeah. So as I was saying, account manager like these are the people that will support your account. The engagement manager is a subject matter expert on operational and credentialing questions and that is what they can help with.
Anu Vora (08:32) Okay.
Nicole Campbell (08:33) And Anu, besides sending the recording to you in the last deck with our pricing proposal, it does have this laid out. So I’ll when we do a follow up email today, I’ll make sure we re, include this and this kind of has, as I’ve been sharing my screen just the four people who are built in to support your account, long term, and then kind of what their roles are. But yeah, that is also then included.
Cameron McCormick (08:55) Yeah. So to summarize I will need to get back to you Anu, about npes. There are a few limited situations in provider enrollment where M pes comes up. My understanding is that if there needs to be a change in M pes to do an enrollment, we will do that. But I want to make sure I’m not speaking out of school so I can check.
Anu Vora (09:24) With them and send.
Cameron McCormick (09:25) you an email but everything outside of directory management and fee schedule management, medai does.
Nicole Campbell (09:35) And it’s already scoped in to what we’ve.
Anu Vora (09:37) built. Okay. So the provider directory management, sorry, I think I heard earlier that… perhaps, so… who does that? Do we do that using your platform?
Cameron McCormick (09:52) Yeah. So usually, it’s a combination of the… admin of medallion and the RCM team and it varies based on what the requirements for each payer that you’re in network with actually are. So some payers require a lot of information. Some payers require much less information, but it’s essentially on a pair by pair basis. And it’s essentially what that is making sure because I have anthem insurance. And so when I go on anthem’s website and I’m like I’m looking for a physical therapist, yep, that’s what, making sure that you’re showing up in their directory.
Anu Vora (10:43) See, I always thought that was a derivative of caqh, like making sure caqh was updated.
Cameron McCormick (10:50) I think some payers use caqh for that, but there’s a lot of them that have a separate process. Okay? But it is not something medallion does.
Anu Vora (11:01) Okay. So once we get feedback that xyz has been rostered, then a process manually can be completed to ensure that the provider directory management is happening based on the rules of each payer and each plan. Yes. And that work is slightly informed by medallion, but the accountability rests with us. So.
Cameron McCormick (11:25) We can outline for you after the call like async, what the kind of formal process that most of our customers use is. But yes, you will be pulling when you get a notice that your provider is now in network with that payer that would come that will be stored in medallion with the effective date and the, however they communicated that to you. Yeah. And then the roster or the directory management process happens after that… and it can be pretty lightweight but some, it really varies payer to payer.
Anu Vora (12:05) Yeah. Okay. That makes sense. So then moving on, you said payer attestations about what I’m hearing is every 90 days, payer will send notifications to complete attestation to confirm if the data is correct or make changes and complete the attestation. So medallion will complete that for us.
Cameron McCormick (12:24) Yes. Okay.
Anu Vora (12:27) Fee schedule management. I’m getting clarity on what that means. So besides provider directory management and fee schedule management, everything else is most likely included in the existing pricing with medallion with an asterisk with npez because you have to just confirm.
Cameron McCormick (12:42) I need to check on what exactly the use case for updating npez would be as it relates to what you’re doing. But I can circle back with you later today.
Anu Vora (12:56) Okay. So yeah, this is the fee schedule piece is requesting for fee schedule every year especially for the commercial line of business. So just making sure that we’re communicating with the payers. And typically your other customers are just doing this themselves?
Cameron McCormick (13:13) Yeah. The medallion admin, would, they would already, you know, because you’re you have, are contracted with that payer? Already, there is a point of contact that your team should have as a network manager, usually on the payer side and you can just reach out to them and ask for an updated fee schedule?
Anu Vora (13:41) Okay. Cool. So the batchman and pez on, yeah, on the process like the, you do we do for provider directory management, what your other customers are doing? But other than that, nothing here looks too jarring. Okay. Then then we can talk about the costing. So that’s actually very encouraging because I’m like is this going to add to anything? I do still have to keep someone on my team. So like my cost doesn’t get completely absorbed by medallion, but it’s minimal for a resource to help do that. Additional questions I have are like new locations. So if we’re adding and we’re credentialing a location for one of our business units. And so right now, for example, we have five locations in Austin, Texas, they’re all cash pay businesses. We’re going to take certain suites of those five locations in our new mindfully Texas LLC business that’s going to be has an Aetna contract. We’re adding a united contract. So then we need to credential those five locations, parts of those business locations for mindfully Texas. How would we do that on medallion?
Cameron McCormick (15:00) You already have the contract with the payer. Yeah. So you would be just enrolling under that practice location, the providers that are associated with that practice location?
Anu Vora (15:13) But I can do that with medallion because right now, we’re location credentialing, okay? And there’s no additional charge for that.
Cameron McCormick (15:20) There. Well, so do you have any of those providers credentialed with that payer already in Texas?
Anu Vora (15:28) We’re doing it now.
Cameron McCormick (15:31) And it’s the current vendor that’s managing it.
Anu Vora (15:35) Actually, no, not even we’re just doing it ourselves because it’s like five people. So.
Cameron McCormick (15:38) Okay. Yeah. So we would charge those as enrollments, but we can do that for you.
Anu Vora (15:45) So it would be considered a payer enrollment. Each new location would be charged as though it’s like a person getting credentialed… it.
Cameron McCormick (15:55) Depends on whether those providers are, if you’re adding a practice location to like the provider’s already enrolled with the payer and you’re adding a practice location is different and they’re not credentialed with that payer at all.
Anu Vora (16:09) So, I’m saying providers are credentialed with the payer, the contracts are up and running. We’re adding locations.
Cameron McCormick (16:15) Okay. I believe that is a demo. I believe that is charged differently, but I need to just double check… with our solutions consulting team and confirm that and, we can follow up today, okay?
Anu Vora (16:30) Thank you. Sorry to ask the edge case questions, but that’s.
Nicole Campbell (16:33) no, no, no.
Cameron McCormick (16:34) Worries. Just.
Nicole Campbell (16:35) As we’re like following up so I could give you like correct numbers like you mentioned like, okay, it’s like five people. Is there any like there’s a concrete growth plans kind of with that scenario.
Anu Vora (16:46) Oh, yeah. That’ll probably be okay. It’s not even in my estimates for you. It’s probably going to be like 30 by the, this time next year. Okay? Because.
Nicole Campbell (16:54) Even if we don’t like let’s say we’re not putting it in first round. At least we can show you hey. This is what it would cost if you’re doing it this way. And then.
Anu Vora (17:02) It could be something to add the locations. So, I’m always adding locations, right? I’ve got like 23 physical locations today. So there’s just constant expansion because our in person business is doing quite well. People are tired of teletherapy. And so that’s just an important question for us, okay?
Nicole Campbell (17:23) Good. That’s good to know. And we can get back to you on that. And then that’ll be probably my request for follow up is just the growth model for that one as we just finalize. Okay, what would, where would that line item land?
Anu Vora (17:34) Exactly. I’ll even send you the three questions we have just in the chat so you can reply to those like new location with payr for the group. Is that a new enrollment or part of maintenance, new location mapping with payr for provider, like the provider is getting added?
Anu Vora (17:50) Is that considered a new enrollment, new location addition with provider and caqh? So we have to update caqh. Seems like that one is simple. You’re saying all caqh management is 102 dollars no matter what for the year for each average person. Okay, correct? So then my last sort of like substance item before we talk about numbers is we have a lot of interns, social work, counseling interns. These are like people doing five, six seven sessions a week to get their hours to graduate from the programs. They’re usually not fully credentialed, I mean, with medicaid, maybe because it’s all they can do, but they don’t count as full time employees and they don’t need full caqh management, but they, I’m unclear as to whether or not they need to have a caqh profile so that we can even like get them rostered… or whatever with medicaid so that they can do their minimal sessions. I mean, they’re like point two five fte. So I don’t want to be in a situation and I have 100 of them. I mean, we have the largest intern program in Ohio. Yeah. So I don’t want to be in a situation where I’m getting 100 dollar charge for someone who’s like barely making me any money as an intern. Do?
Cameron McCormick (19:13) They, do, you know if they have caqh profiles now?
Anu Vora (19:18) To whatsapp, I go, it turns out.
Anu Vora (19:38) All right. We’ll find out. So that’s kind of where I think the caqh fee needs to be discounted to account for that depending on where we land here. Yes, they have caqh profiles. So definitely, I mean that’s like a fourth of my work third of my workforce. So these are people who have like they’re not ftes. Most of my people are not ftes. I would say of the 300 people, 30 are qualify as ftes. So we have a large part time workforce. So I’m going to need to work on the caqh part and the monitoring, and then… we can get into some other topics. So why don’t, I let you guys present what you have? I’ve asked a bunch of questions and then we can go.
Nicole Campbell (20:26) No, I think these are all. Thank you for bringing these. I think there’s like we’re going to follow up and like also review and have very like clear answers for each of these in our follow up email as well as then the question might be the location mapping and kind of understanding location growth a little bit more because I feel like we’re still not final scoped in for what you need. And I just want to make sure like that’s like before we kind of like put those final contract in front of you. We talked through that. But on the good news, I think what I wanted to start with was what we talked about on the phone around like, hey, what is finance going to approve for us? So scoping in now especially the larger numbers of growth year over year, like thinking 100 providers year over year while that will now increase the scope size of the total contract. What we’ve been able to do is get approvals to bring that payer enrollment line item down to 90 dollars per payer enrollment, which where we started was the last, just like also reviewing the last payer enrollment number, we were at 157. So a huge cut down per payer enrollment line. And we have new math for you. In terms of obviously how we thought about 100 providers, we kind of scoped that out as assuming the largest number is probably in Ohio with like maybe 70 of those payers being in Ohio, 15 in Colorado, maybe 15 in Texas. Those numbers can be fluid. But now we’ve scoped you out for and we’ve gone through those eight payers for Ohio, five payers for Colorado, four payers for Texas. So now you’re scoped in for 695 payer enrollments each year. And we’re going to send those numbers over in the math but first want to pause there with that big hopefully win that you see on your end as well from us getting that number substantially down for you for the.
Anu Vora (22:13) Life. Yeah. I mean, I think I was pretty transparent about our numbers of growth and I think in my email, if I remember correctly, I meant to put at least like I don’t want to build for that and increase my minimums because I need to have a minimum that comes hell or high water. Let’s say we have 100 interns this year. Let’s say next year the regulation changes and we don’t we can’t have an intern program right? So now, if I’m backed into X amount of enrollments because, you know, we want to make a commitment but I can’t run that program and I can’t enroll them in medicaid. My enrollments are going to suffer, plus those interns then convert into being dependently licensed, which is a fresh application. So, for the same person, I’m going to do a medicaid enrollment, and then I’m going to do another few payor enrollments and then they become dependent independently licensed. I’m going to do all of this again in three years. So that’s why I’m trying to figure out how to make sure those risks are put in. So I’ll be curious to understand what you want the minimum commitment to be. Yeah.
Nicole Campbell (23:15) That’s fair. And I think with the 100 just understanding from my side with that 100 person potential growth year over year, are those including the interns? Or was that just fully like full time providers that’s.
Anu Vora (23:29) inclusive of interns? That’s inclusive?
Nicole Campbell (23:30) Of interns? Okay. That’s good to know. I think we can once again, like I said, seems like scope, we’re still working together to finalize, but I want to just get your feelings and commitment maybe from that 90 dollar number, for the PE line at.
Anu Vora (23:46) Least, I think we’re depending on where we land with the caqh cost. And let me pull up my notes on the quote, hold on.
Nicole Campbell (23:56) And here I can show my screen and to be like also this number is inclusive of us including 100 providers every year. So, yeah, the new scope line you?
Anu Vora (24:06) Basically made 278. Sorry, what you made the unit 278 from 178, probably. But we’ll see in a second. Yeah.
Nicole Campbell (24:18) Can you see my screen? So you can see the discounted line item prices? So caqh management is 102. And then the line item for pair enrollment is 90.
Anu Vora (24:30) Yeah. Okay. And.
Nicole Campbell (24:33) This is where, okay, we’re gonna focus on and revalidate some of these numbers from a standpoint. Also understanding where you were thinking the 100 people weren’t just the, we didn’t account for them being interns as part of that. So not full time FTS, correct? Yeah, that being said, I think our biggest want to take away is if that 90 number works and then we will work with you.
Anu Vora (24:55) It’s, it’s definitely part of the conversation because if we don’t do anything else, then like, no, but if we reduce some of the other pieces, you know, so my ask was gonna be that we take caqh management and either we do a calculation for interns, where we do point two five X the cost or we refactor the whole thing and bring it to 50 dollars, right? And so, the, there’s a net impact. And then separately, so there’s two asks really, it’s like caqh, we need to figure out what to do because I like 100 people are interns last year was 150. And like this is a major program for us because we’re the largest training academy in the state then we’ve got the payer revalidation. So if an enrollment is going to be 90, which is the bulk of the work, then basically a revalidation doesn’t make sense to me to be more expensive than the enrollment. So we need to then adjust that to be a similar cost. So those are my two asks. Yeah.
Nicole Campbell (25:57) I would say like also being up front, the likelihood of us getting caqh management down to 50 dollars is not going to be an ask that I believe will be.
Anu Vora (26:07) Fulfilled that’s why I’m like, the math behind it, maybe.
Nicole Campbell (26:10) That’s where the scoping we can.
Anu Vora (26:13) It lacks context, right? The number lacks context. The reasoning for the number is because I’ve got so many people. Yeah.
Cameron McCormick (26:19) One quick question on that is of the 300 and Nicole, how many?
Nicole Campbell (26:25) Right now we have 350 scope for caqh management of?
Cameron McCormick (26:29) The 350 Anu, how many of them are interns? 100?
Anu Vora (26:34) Okay. So.
Cameron McCormick (26:35) You’re essentially looking for the price on those 100 to be reduced? Yeah. Okay.
Anu Vora (26:42) Well, I’m looking for the net price to be reduced for the caqh management total on its own and also for the 100 to be recognized basically as like baby social workers. So they have, no, they have no real profile. They’re only allowed to be in medicaid and mcos. They’re point two five fdes. And they only work for us for like four months or one semester, maybe two semesters. So there’s constant churn, right? So, yeah. Okay.
Cameron McCormick (27:13) So let me let’s just get the pros back up here. So it sounds like, your main feedback is the caqh management and the revalidation cost, is that correct?
Anu Vora (27:25) Yeah. I also think 350 is incorrect. So we’re gonna need to redo that number to probably guarantee a minimum of 275 because, I’m already not at 350 number one. So that’s like a number we maybe can grow into. It accounts for a zero impact if there’s like a problem. So maybe it makes sense for me to take this updated quote and send back what I think is possible.
Cameron McCormick (27:52) Just one clarifying question. Where did we get 350 from?
Nicole Campbell (27:57) Yeah. Let me pull. And here is what we kind of sent over. So let me go for with the updated numbers from.
Anu Vora (28:05) It’s the Texas number that’s throwing us off. So, number one people in Texas are not on insurance like they’re not, they’re currently all cash pay. We’re building an insurance company, okay?
Nicole Campbell (28:18) That’s that’s good feedback. So I will send over those like our calculations. Maybe you can give feedback on that calculation sheet as well so that we can make sure that like once again, I think the bigger thing too is that we felt like maybe it was underscoped for growth. Now, we may be a little too over scoped for your growth. It’s almost like we’re going to find something well.
Anu Vora (28:38) Yeah. And this is the thing that worries me is these are fixed costs. So I have to have margin somewhere in case my business experience is shrinkage. So I’m not baked into a fixed cost.
Anu Vora (28:49) And right now we’ve built this to be actuals actually more than actuals. So it’s going to feel like a big step down, but that’s because I’m hoping to pay you more. I’m hoping we pay what we use and that we’re constantly growing, but I can’t be locked into a number that I’m already at because what if we reduce our intern program, for example?
Anu Vora (29:08) Yeah. So let me take a, you’re going to send this to me but I’ll send you my thoughts on this. Yeah, we.
Nicole Campbell (29:18) will send this to you. We’ll send over answers to the message too. I mean, to the questions that we had scoped here. I think like as we’re kind of like finalizing details here, I think our ask from our end, I know Jake sent over the msa and we’re going to send over final numbers for the, or final information for the STC SLA, but can that be passed on to your legal team while we’re finalizing financials so that this piece can be all done quickly. But obviously, we know legal can have a couple of days turnaround.
Anu Vora (29:49) For sure. I think I’m trying to make sure… I have the msa.
Nicole Campbell (29:56) And I’ll follow up with it. I’m like, I know it.
Anu Vora (29:58) Probably, yeah, he hasn’t sent the msa. So I would love to do this in parallel?
Nicole Campbell (30:02) Yeah. Okay. Great. We’ll make sure that’s sent over as well, so we can do things in parallel next week. And then, yeah, because once we have the final numbers contract getting sent over to you, that’s the quickest piece from this financial side. Does it make sense for us? We’ll send it over should we set some time on Monday to reconnect? And once you’ve had time to review, okay, let me pull up. What are you going to still be in Ohio or somewhere else?
Anu Vora (30:30) I guess we’ll see on Monday, okay?
Nicole Campbell (30:32) Cool. I was like time zone wise, just want to make sure I’m making this correctly for you what time works for you on Monday?
Anu Vora (30:40) Well, okay. First, let’s do this. So out of an abundance of caution and because we’re moving quickly, I’m not trying to speak out of both sides. I would like you to redo the proposal, okay? To change the total numbers. So it would be 250 for core ongoing monitoring and caqh management. Because again, like I have to factor for shrinkage when I’m making minimum commitments, yeah. And this is probably more than I want to do. I just recognize the number is shifting up and shifting down and you were adding Texas when they have cash pay and all this stuff. So, and then payroll enrollments that number I think needs to be 350. Okay. I think we’re going to hit to be clear 600. Yeah. I just don’t want to commit to that when I don’t know what’s going to happen. So for us, that’s a doubling in what it previously was. Yes on the quote and I want to make sure that number goes up for you. And then payer revalidations. My ask is that number meet or beat your payer enrollment cost, right? And as long as we see an impact to caqh cost and an impact to payer revalidation cost, then, those units are what I can agree to 250 for core monitoring, caqh, 350 for payer, re, enrollment and call it 350 just for ease of stake or whatever. If you want to keep it 392. I don’t really care for payer revalidation so that’s the unit side, the cost side. We’ve got to see an impact to caqh. I’m open to like the interns are free and you pay 100 for the other side. Fine. We can give you a list of all of our interns I’m fine with like we’re going to make the total price. You said 50 is going to be possible. Let’s call it 70, whatever you think makes sense. And then payer revalidation you know, below 90. Yeah, those are the things that like we would be able to get a deal done really quickly if we hit those. I.
Nicole Campbell (32:48) Think like the one piece of pushback we’re going to get because like we’re kind of like presenting our finance team with potential growth but not committable growth like if we’re keeping it flat year over year, that’s where we’re going to get pushback especially because there is clear growth and expansion inside of your business plan especially for just like next year.
Anu Vora (33:06) If I don’t beat my first year cost projections at the end of one year, you can go ahead and increase my cost by five percent for year two. Like that’s how confident I am that I’m going to beat the minimums. I just can’t sign a contract. I just had a board meeting Wednesday and they’re like, why are you replacing your very affordable credentialing team with this super expensive one? So I need to have the proof in the pudding. So if you guys don’t meet your slas, we’re obviously going to like back out of the contract. But if you do meet them, we’re going to totally surpass these minimums. I just don’t have approval to sign this big of a contract. I have approval to pay what we use for the unit prices. And so that’s why I’m managing kind of.
Nicole Campbell (33:51) All these.
Anu Vora (33:52) Different things. But, you know, I’m willing to sort of put a penalty. Like if we don’t beat this in year one, I would be shocked like feel free to charge me a penalty, maybe not five percent, maybe call it a 5,000 dollar, 10,000 dollar adjustment… right? For year two, but it sets us off on the right track page where my fixed costs are something in my control. And if I don’t beat those fixed costs because of growth, I know my next fixed cost is a five or 10,000 dollar penalty payment, which then you guys collect to help make up for that.
Nicole Campbell (34:31) Let’s take this. Like I don’t want to commit that, that’s the way they’re going to present it back to.
Anu Vora (34:36) Us, I’m just giving you a bunch of ideas so that you can present those ideas to your finance team and we can get something done so that we don’t have to have so many. You guys are being very generous with your time. I just know what those units are, what those prices are, and that I’m going to beat them. So whatever I can do to help.
Nicole Campbell (34:53) And then I think like my last question then too, just as we’re being super transparent, is there a number of total overall costs? Because like we’re kind of fluctuating around numbers and changing line.
Anu Vora (35:04) Items, it’s not possible because this is fluctuating it’s like if.
Nicole Campbell (35:07) I just want to make sure there’s not something where the board was like, okay, 121 unacceptable, 120 acceptable kind of no.
Anu Vora (35:14) What they’re saying is it’s all unit economics, which is why I’m pushing on the unit economics. If I then deliver to my board, 200 new providers, they have no right to tell me why does your credentialing cost double? Well, I hired twice as much as I was going to, right? So it’s only a unit cost that we have to talk about because I’m trying to have as many people in this company as possible. Yeah. And they are too.
Nicole Campbell (35:39) That’s super helpful just to want to clarify and make sure that that’s not for sure. Okay?
Cameron McCormick (35:45) One last question Anu on the structure of the proposal is, are you, Nicole, is there growth baked into year two and three at this point, in this contract?
Nicole Campbell (35:56) This is where, what I think she’s saying is no. Okay. So.
Cameron McCormick (36:01) You want it to be flat year over year like no increase in committed volumes in the second and third year? Well?
Anu Vora (36:08) One, we’ve talked about a two year contract because I’m doing all, we don’t do three year contracts. So that’s number one, number two. I’m happy to bake in five percent growth, okay? On all the numbers. Okay?
Cameron McCormick (36:20) So, yeah, we will take this back. I think the challenge for us is going to be that the volumes are going down in conjunction with requests to reduce the unit cost. So we will get the best possible… unit prices at those volumes from our finance team and come back to you. Okay? But I can’t I can, you know, I’m very hesitant to commit that we can achieve both reductions in volume and unit costs at the same time we’ll do our best.
Anu Vora (36:58) I just don’t have this many employees today, and then this gives me no margin. So like the units are genuinely what they are. I’m already uncomfortable like I’m uncomfortable with sharing like what our actual volumes are of humans. Because now, like if I lose 10 people, like I’m screwed, I’m paying 100 dollars a year for those 10 people no matter what, even if I don’t have them. So that’s like meaningful because that’s just taking from my EBITDA.
Anu Vora (37:27) I get what you’re saying but we don’t have this many people and I think we were clear our Texas business is all cash pay. So like those shouldn’t have been added into those quantities anyway, which I want to clarify. And then on the payer, enrollments, I just, I think we will surpass 350, but I cannot guarantee it. And so… I’m happy to even to… just alternate. So let’s see what you guys come back with. I can be endlessly creative. And once you send me the msa, I’ll have legal review it in parallel so that we can meet your timeline, perfect.
Cameron McCormick (38:07) Yeah, sounds good. And Nicole as a follow up, let’s just try and understand for… the Texas… location ad.
Cameron McCormick (38:19) Let’s just try and make sure that we figure out exactly how that will be accounted for. Yeah.
Anu Vora (38:24) So, Anu?
Nicole Campbell (38:26) Let’s put a stopgap meeting for maybe Monday.
Anu Vora (38:30) Yeah. To your question about when works?
Nicole Campbell (38:32) Yeah, when works just so that we can at least like do a check in after we’ve sent information over for you to review, and it’ll be a.
Anu Vora (38:39) Two eastern.
Nicole Campbell (38:41) Two eastern that works for me. I can do that. And I think that works for… okay. Okay. I will throw that on the calendar and we’ll send over something this afternoon. And hopefully, if you have any async questions follow up on that, and we can also go back and forth over email.
Anu Vora (39:02) No, y all were super helpful today, so, thanks so much. Thank.
Nicole Campbell (39:05) You so much have a great weekend.