Transcript
Amy Walsh (00:00) hi, G, Joe. Hey, Chris. Happy Monday. Hey, Amy. How are you? I am doing pretty well. How are you? Both? How are your weekends?
Jijo.Mattamana (00:11) Good.
Amy Walsh (00:14) Busy, Chris. Is that what you said?
Kristopher Nelson (00:16) Busy? We had taekwondo sparring, black belt camp. We had some baseball games.
Amy Walsh (00:22) Oh, yeah. That’s a lot. How many children do you have? I assume these are your children, but maybe I don’t know if you’re doing this for someone else, but.
Kristopher Nelson (00:33) Yeah, my sparring, no, I have a son and daughter, 12 and 10.
Amy Walsh (00:39) Oh, nice.
Kristopher Nelson (00:40) And they’re active in a lot of different things.
Amy Walsh (00:42) That’s awesome. Yeah, keeps you busy. I’m sure. But that’s awesome that they’re super involved.
Kristopher Nelson (00:49) Until they can drive, yeah?
Amy Walsh (00:51) Yeah, yeah, yeah. It’s funny. You say that my husband works with someone, he’s a father of three, and he told my husband recently that, and they live in the suburbs. They only until recently had one car between the five family members, but they just got a second car. Now that they’re two, they’re teenagers can drive. And I just thought that was wild that one car. What’d you say? I?
Kristopher Nelson (01:17) Don’t know how you do that with one car?
Amy Walsh (01:19) No, I thought that was pretty crazy for getting around, but what do I know? I don’t have kids yet, but I thought that was a little crazy… but anywho, I wanted to sync with you both.
Amy Walsh (01:33) I know we have these on a recurring basis today. I want to talk about the additional provider piece, but also want to leave it open to you guys first to see if you have any questions for me. Any thoughts? I know we’ve had good discussions in the past. So just wanted to leave it open to start with.
Jijo.Mattamana (01:47) Yeah, Chris, I’m happy to lead with the go for it. We know we need to add the contracted providers and I guess, I think there’s a little bit of disconnect with what we’re contracted with versus what we need. So, I think, Chris, I’m wrong. My understanding is when we originally contracted, we thought we’d have about 100 new contracted providers a year that would need privileging for the ascs. I think that’s what we have within the contract. I guess what we didn’t understand is for the 100 contracted providers, there’s no seat associated with those within the medallion platform. So, I guess what?
Kristopher Nelson (02:28) Was.
Jijo.Mattamana (02:29) going, I guess where were the providers supposed to live before? If we were just going to be doing credentialing for privileging for these 100 folks, but they’re not living in the platform?
Amy Walsh (02:41) Okay, great. So I’m pulling this up together so we can look at it together. So, okay. So these 215 are the ones you were originally or the medallion core seats you purchased and you’re saying the extra 100 or so, what line item were you understanding fell into the different SKUs, just so I can make sure I speak to this as best as I can. I think.
Kristopher Nelson (03:02) It’s called that credentialing, tjc, yeah, which is like privileging. So facility privileging, I believe is what that was for. Yes.
Amy Walsh (03:12) That makes sense. Yes, those are.
Kristopher Nelson (03:14) Yeah, we’d include the 215, but then on top of that, there would be contractor providers. I can’t remember the math to get to that number, but that’s what that number included. But to jijo’s point that privileges the facilities, but it doesn’t manage those contractors… licenses and everything else that they need to do on an ongoing basis. So, I guess does that coming up with this estimate was the assumption that those would be monitored elsewhere… or is it just we should have put it in and we didn’t I don’t know.
Amy Walsh (03:54) The latter is my assumption just is my guess. I didn’t I don’t know how cliff and you guys came up with this figure. But what I do know is, and what I can confidently say is that the different, it sounds like at the end of the day, you’re going to have 300 providers across these different orgs, correct?
Kristopher Nelson (04:14) Well, no, I mean, yeah, I think so in that math there that 285, I believe it’s like every what two or three years you have to re, privilege? Yep. So it’s a lot higher number than the gap there of 70. I think it was like two, I think it’s every three years, which would make it about 200, something like that.
Amy Walsh (04:39) Okay. That makes sense. So, sorry, let’s like separate the two lines for a moment. So I understand what you’re doing the credentialing piece. That makes sense to me. But what I’m trying to get to the bottom of this medallion core. So that stands for providers at your organization. So right now, from my understanding in the clinical side, you have around 200 and on the asc side, you have another 100 that may not have been properly accounted for during scoping conversations. I don’t know if that was on our end. I don’t know what happened there because I was not part of that conversation but obviously want to make it right now. But between the clinical and asc side, do you have 300 providers at nvision?
Kristopher Nelson (05:19) What’s the right number? G? Joe? I don’t know. Yeah.
Jijo.Mattamana (05:22) So the 215 is what’s like nvision owned like that’s all the clinics and then at the asc’s non nvision, I guess employed contractors that’s another 210 providers. Okay. Yeah. And do.
Amy Walsh (05:37) you plan and let’s just like look at it.
Amy Walsh (05:38) Oops, let’s like look at it at medallion together because I think just like making sure we walk through it fully will help connect the dots here for those 210 that you’re talking about. Are you planning? And it Connor made it seem like you are, but I just want to make sure we’re aligned. You’re going to be adding those 210 to have providers of profiles within medallion. So this two oh three is going to go up to 413?
Jijo.Mattamana (06:07) Yeah. I guess that’s my question is we,
Amy Walsh (06:11) to be able to do, sorry to.
Jijo.Mattamana (06:13) Do privileging right? To do?
Amy Walsh (06:15) Privileging, you need a profile. So I think I answered your question with that answer. So yes, you need to have a profile to be able to do privileging and credentialing for your providers, that’s a requirement to be able to ensure that our teams can do the proper work because all the information that’s needed lives in those profiles ultimately.
Jijo.Mattamana (06:34) Okay. Got it. That. I mean, that makes sense to me. I guess if I could, if I could just share my screen real quick. Yeah. So I think I was going off of this and I think Chris and I have looked at this in the past. So on the credentialing tjc line, it says we accounted for 100 new contracted providers a year.
Jijo.Mattamana (06:56) But what it sounds like those 100 new contracted providers don’t actually have a seat in whatever we scoped initially, right? This just said we’re somehow going to do credentialing in tjc but we’re not going to put them in the medallion platform, I think is what I’m hearing that we contracted for, right?
Amy Walsh (07:15) Based on what you’re sharing with me, that makes sense to me, yes.
Jijo.Mattamana (07:20) Okay. And I think that’s our disconnect is we assumed that the 100 would have been accounted for and it sounds like our gap from our understanding is about 110 because we realize it’s about 210 providers that we need to do this for. We thought this 100 was already included in kind of, you have everything you need in the contract to take care of these 100 new contracted providers, whether that’s seats, whether that’s you know, resources or whatever I think that’s kind of my disconnect. Chris, is that understanding correct? I think that’s kind of where we landed.
Kristopher Nelson (07:54) I think when we went into this, we said that the contracted providers are with someone else. We were privileging them for our facilities. They’re not in vision, right? They’re someone else’s position and, that was managed separately, but it sounds like to do this, they need to be, is that fair to do the privileging? They have to exist in the medallion platform as part of the license expiration monitoring, yes.
Amy Walsh (08:22) And, sorry, just so we’re fully on the same page. It says as part of medallion core, not license expiration. Monitoring. No, no, it’s okay. I know I’m being semantics wise, but I just want to be super clear. So, yes.
Kristopher Nelson (08:33) That’s the gap is that it sounds like we contracted for something that is not possible, right?
Amy Walsh (08:39) Well, I wouldn’t say it’s not possible. It’s you because you have the data to get the providers into medallion, correct? Or no?
Kristopher Nelson (08:51) I believe we would.
Jijo.Mattamana (08:52) Yeah.
Amy Walsh (08:53) So we’ll be able, yeah, we’ll be able to get the provider. It’s similar to what you’re doing now, jujo, with all of the clinical data that you’re working through with Sheldon, you’ll be doing the same thing for these asc providers. So, I’m… wondering why you think it’s not possible the.
Kristopher Nelson (09:11) Way I’m explaining it might be a little confusing. So, I’m thinking.
Jijo.Mattamana (09:14) we’ve.
Kristopher Nelson (09:16) for the privileging line there, the second from the bottom, we have a number of, but that in this quote, we never included the contracted providers within the medallion core, but it sounded like to do the privileging for those contracted providers, they have to be in the medallion core.
Amy Walsh (09:37) Yes. So the way that we would make this possible is having that addendum sent out to just add those providers to your core to make sure you’re fully squared away and all good to make sure you have the right number of lines for your providers to then be able to do privileging.
Jijo.Mattamana (09:56) And I think Amy to be transparent, right? We went into this and we have this budget, we budgeted what we’re going to spend on medallion for the year. And if we have to go back and add 285 to medallion core, that’s going to completely blow up our budget for the year. It’s going to be way more than we expected to pay within this first year. We had imagined that we had contracted everything that we needed to get this 285 within year one. I think that’s the main disconnect. We understand that we’re going to need to pay for license expiration monitoring. That’s not something we originally scoped and we understand that’s something we need to pay for these providers moving forward. But we didn’t we weren’t aware that, you know, we’d have to pay for seats for this 285 as well. I mean, it doesn’t to Chris’s point, it doesn’t make sense why it’s in the quote. If it wasn’t actually added to the medallion core, right? Like what does this 285 really entail then?
Amy Walsh (10:49) So hold on, let’s take a step back because it wouldn’t be 285 more. It would you have 410 providers, right? Across all across the asc and the clinical side. Yeah. So.
Jijo.Mattamana (11:05) There’s 210 on the contracted side. And then, yeah, I think we assumed about 215 on the.
Kristopher Nelson (11:10) nvision side on the clinic side as well. Okay?
Amy Walsh (11:12) So two, I’m just doing the math quick because… 210 plus 215. Okay. So that’s 425 total providers. And then for the credentialing tjc privileging side, you’re not going to have to add anything to that because you’re well accounted for because well… then it sounds like only 215 of those providers would need credentialing. Is that correct? Because the 210 on the clinical side don’t need that.
Jijo.Mattamana (11:46) Correct. For the 210 on the asc side, all they’ll need is, you know, privileging a seat and then we’re going to need to do the license expiration monitoring.
Amy Walsh (12:02) For the clinical side, they don’t need privileging or they do, correct?
Jijo.Mattamana (12:06) Yeah. On the clinical side, they don’t we don’t do privileging. Yeah.
Amy Walsh (12:10) Got it. Okay. Yep. So clinical side, we don’t need to change anything. And then the cred piece… I mean, because you probably only need 215 if you have 215 providers on the asc side. So maybe I’d have to see internally what we can do, but maybe we could do something to like reduce that number of it in the contract. So it’s a bit more reflective of what you’re actually doing while increasing the core and the comprehensive monitoring. That might make the head a little less, okay.
Jijo.Mattamana (12:45) I mean, I think that’s just what we’re trying to figure out, right? Like obviously we need to make this happen and.
Amy Walsh (12:52) Yeah, no, absolutely. Yeah. No. Now, I have a full picture of what’s going on. I just need to internally talk to my manager about, you know, it sounds like you need 70 less cred files than what you were signed up for and you need 210 more core and comprehensive monitoring, credentialing tjc again, I have to check internally if that’s something we’ll be able to credit you back on. I just have to talk internally to see what we can do that’s more expensive than those other two services. So it’s not going to be quite as big of a hit as if we were only adding the first two lines and then not reducing one of the others. So I think we have some ways to work around this and make it right? But I hope that makes sense.
Jijo.Mattamana (13:37) No, yeah. I mean, I appreciate it, Amy. And.
Kristopher Nelson (13:39) understanding.
Jijo.Mattamana (13:40) I think on our side, we’re just trying to understand, you know, are we thinking about this, right? Is this, are we missing something? So it’s helpful to talk through it? No?
Amy Walsh (13:48) Yeah, absolutely. And I apologize that there has been some, you know, confusion at the beginning. It’s you know, the last thing I like to get from a client who enters the account management phase of the lifecycle. So I just want to apologize on behalf of, you know, the team on, you know, some of the confusion that’s been coming up, but I’m doing everything I can to make it the most right for you guys moving forward.
Kristopher Nelson (14:10) Okay. So just on the math on the privileging, so that’s not one to one with the core, right? Because I mean, the way I’m thinking about it, there’s 215 nvision providers every three years. So that’s roughly 70. We have a third of our contracted providers which jijo just mentioned is 200. So that’s another call it 70 that’s 140. We have 100 new contracted providers every year.
Amy Walsh (14:37) That’s basically.
Kristopher Nelson (14:39) 100 to that number that’s like 240. And then we have our new providers that we add for each esc. So that’s I’m coming up with something closer to what we’re showing here. Okay?
Amy Walsh (14:52) I thought though that we just said the clinical side wouldn’t need credentialing services. That’s why I was coming to the smaller number.
Kristopher Nelson (15:00) The existing 215 do not need re privileging every three years, they would still need to be re privileged with the name jijo. I guess.
Jijo.Mattamana (15:09) I’m thinking about it just from the asc perspective, but I guess, well, our.
Kristopher Nelson (15:14) Existing 215 providers go to our ascs or go to nasc when they need to be re, privileged every three years. I mean.
Jijo.Mattamana (15:25) Yeah, I guess that is a fair point.
Kristopher Nelson (15:27) So, I think that number based on how I’m thinking about it, I think that number is good?
Amy Walsh (15:36) Yeah, no, based on that, I?
Kristopher Nelson (15:38) Guess the only thing I question is, I know we came up with 100 new contracted providers every year. Does that seem reasonable, jijo, given we have 200 today, is there that much churn? I?
Jijo.Mattamana (15:47) Don’t think there’s that much churn?
Kristopher Nelson (15:49) Okay. So there might be some opportunity there because I’m just thinking about it now, that seems like a high number, but we were only looking at privileging when we’re starting to think about the core. I mean, if we’re adding 100, I guess if there’s enough churn where you’re losing 100 providers every year, I mean you only have that many in the core. So I guess it won’t matter as much, but I guess we need better numbers to come up with a realistic estimate for that.
Amy Walsh (16:21) Yeah. Okay. So let me know. These are the numbers I’m thinking and just let me know if this aligns with what you’re thinking. I think you only need to be increasing. And… I sent this last week but I’ll reshare my screen.
Amy Walsh (16:44) Sorry, give me one second.
Amy Walsh (17:00) Okay. So right now, I only added 100 each. I only added 100 medallion core that’s the number of core seats. It sounds like though we need to get that number up to 210 to make it be four… 125 total across the orgs. And then each of those providers needs comprehensive monitoring for credentialing purposes. So you would be at 425 total for each of those. So change this number to 215 ultimately for both of these. And based on what you’re saying, I don’t think we need to be adding any credentialing tjc because it sounds like some of the providers that you’re uploading are already fully credentialed and don’t need to be re, credentialed every year because it’s that every three year window. So we don’t need to do anything with that number. I think we just leave it right at 285 based on the number of providers that you may be adding based on, re, privileging based on all of that. Like I think the number that you shared is good for that.
Amy Walsh (18:09) Got it. It makes.
Kristopher Nelson (18:10) sense to me. Was this the number you showed before the 93 dollars?
Jijo.Mattamana (18:15) Yes. Okay.
Jijo.Mattamana (18:26) And then I guess, so that I think that’s 100 percent accurate, right? Like for these 210 providers, we know we need to add them to medallion core, and we know we need comprehensive monitoring, right? Yes.
Amy Walsh (18:37) And I don’t think we need to touch the credentialing tjc based on… how the providers you have at your clinics are working to then be credentialed slash, how you’re bringing in the providers on the asc side and making sure that they’re fully credentialed. Like, I think that number makes sense to me. I don’t think you need the full four or 10 to have all of your providers need to be credentialed each year because it’s like Chris, you said some are going to need to be recredentialed, some one year, some are going to need to be recredentialed another year. If you have a new provider coming in that needs to go through the full credentialing process, that provider will need to go through that at the beginning. So, I think that’s why just kind of staying at that number almost like an average among all of your providers would make the most sense?
Jijo.Mattamana (19:22) I think the, I guess I’m just trying to understand like we obviously thought about these contracted providers in.
Kristopher Nelson (19:29) Some aspect.
Jijo.Mattamana (19:31) In the initial contracting, right? Where does that live? Does that live in that 285? Is that delta of 70, like 215 to 285? Is that what that is Chris?
Kristopher Nelson (19:41) The delta, it’s all because it’s only every three years you’re doing the privileging. And so, yeah. So you have the delta, you have the existing providers, you have the existing contracted providers, and then you have new contracted providers, then you have the ascs, where a facility equals a provider. So that’s where the gap comes from.
Amy Walsh (20:02) Okay. That’s that, and.
Jijo.Mattamana (20:06) Then, I guess those we never had, I guess assumed those re, credentialing or credentialing didn’t have a medallion course to meet previously, right? And that’s what we’ll need. Obviously, we’ll make it happen. We just need.
Amy Walsh (20:25) To be adding a seat for all of that based on what I’m hearing. And I know again, I wasn’t involved in the sales cycle. So if I’m wrong, I apologize, but what it sounds like to me is that the asc side of the business needing all their providers to have profiles, I think just was not properly scoped out. So those kind of got felt to the wayside. And the only side of the business that was fully being considered for needing a provider seat, was the clinical side, which makes sense because right now you have about 200 providers uploaded into medallion. You’ve only uploaded a clinical profile. So I think that’s probably what occurred. So we just need to make sure we’re fixing this to get the asc side fixed… and having that provider count uploaded into medallion. So then they can be credentialed fully. Bye bye. I think I summed up that’s what I’m hearing. But yeah, open to your thoughts on that. So then is.
Jijo.Mattamana (21:22) that I guess quote that you shared, Amy, is that accurate? Like, is that what we, I,
Amy Walsh (21:28) need to update it… now to be the 215? Because that’s how many you said are on the asc side, right?
Jijo.Mattamana (21:38) Yeah. There’s 210 on the asc side.
Amy Walsh (21:40) Okay. 210. I need to, I need to be updated. So then you’ll have the 425 total across both sides of the business.
Amy Walsh (21:59) So I can get that updated and sent out right now. If you want it in front of you, that takes no time at all.
Kristopher Nelson (22:11) All right. And where are we at in the implementation? I’m sorry, I haven’t been able to join a lot of these meetings. They’ve been pulled in other directions. Are we, is everything up and running outside of the par?
Amy Walsh (22:19) Are we?
Jijo.Mattamana (22:20) Almost there. What are we waiting on? We’re waiting on like all the providers to log in and attest. I think we’ve invited all the providers. Yep, I think once that happens or where are we at after that meeting? Yeah, once.
Amy Walsh (22:33) That they’re all logged in, then any, if there’s any recredentialing that needs to be done, that can start. Sorry, I’m just thinking it’ll be your contract to refresh my memory on services. I know par is being worked on heavily. I’ll have Connor reach out with an update on where we’re at with that process. I think he was saying he’d get that to you. So, I’ll have him send an update about that to you today, G, Joe, just so you can have an idea of where we’re at with that. Then I’m just checking one other thing here.
Amy Walsh (23:09) Okay. And then payor enrollment. So, I know we’re doing par. But once all your providers are logged in and attested, your team can start to submit payor enrollments for any new payors that those providers are trying to get enrolled with. So that’s something that I think our clients see immediate value in to start to get those submissions done. So that should be done when your providers are fully, you know, logged in have completed their profiles, have signed their required forms, etc. So can.
Kristopher Nelson (23:34) we do that with providers that have already signed their attestation, or do we have to wait for all of them? I, oh, you.
Amy Walsh (23:42) Can do it before all of them sign. I just don’t know if gijo, have you, has your team completed the signing the policies and procedures? So our team fully knows the different processes for your payors?
Jijo.Mattamana (23:55) I thought they sent across our policies and procedures on how we do.
Kristopher Nelson (24:00) But I.
Jijo.Mattamana (24:02) I don’t know maybe that was on the asc side. I know.
Amy Walsh (24:04) Sheldon, yeah, I’m not seeing all the enrollment data uploaded yet. So that can’t happen yet. But to answer your question, Chris, once we have all the enrollment data uploaded, then a provider like I can show you, Julie Wong is a provider. She has 100 percent profile completion, requests could start to be submitted for Julie, if that’s like an example, because she has this little green dot so I can show you really quick.
Amy Walsh (24:34) This means her profile is completely done. So, any, payers once we get all the data uploaded here, requests can start to be submitted for Julie for example, to have her enrollment done.
Jijo.Mattamana (24:45) And I guess Amy, what was, what are we still waiting on that needs to get uploaded? Like for Amy for example, or I guess for, was it Julie Wong that needs to get uploaded? So.
Amy Walsh (24:54) And again, Connor, would, I don’t want to like step on implementation’s toes because I don’t know if there’s a reason why all the payr data hasn’t been loaded, but we do need to get that data from your team. So, I assume Sheldon, but I, it sounds like credentialing is the primary focus right now and par. But once we get all of your existing enrollment data and payr data, we need to upload that into medallion. And then requests can start to be submitted for payr enrollments. Got it. Okay?
Jijo.Mattamana (25:24) I assume we have all this. I think Sheldon shared it or we haven’t uploaded it yet or something. But, yeah, that should be no problem.
Amy Walsh (25:32) Okay, perfect. Yeah. So I’ll have Connor send a quick follow up about the par status. He’s just closer to that than I am.
Amy Walsh (25:40) So we can at least give you an update on that, but I think it’s great progress. All the providers got invites last week. I think that’s a great step. So should be really moving and grooving soon with all the services. Cool. Thank you. I appreciate both your time. I’ll send that update. Now. My manager needs to approve it then I’ll email it to you. And then, yeah, if you have any other questions for me about it, please don’t hesitate to give me a call. I think you have my cell number. I’m happy to hop on the phone. So… thank you, Amy. Okay. Thank you. Both. Have a great week. You too. Talk to you soon bye.