Transcript
Scott Everline (00:00) hey, Scott. Hello? Taylor.
Taylor Ryan (00:12) Is your week like insane trying to cram everything in before you leave?
Scott Everline (00:16) Today is, and I think people are just catching wind that I’m gone on Wednesday. So, it’s like tomorrow’s starting to fill in. But… there’s also, I think just a combination of like a lot of rfps coming due. Oh, really? Yeah. So like three RFP related demonstrations today.
Taylor Ryan (00:35) Wow. Yeah, that’s a lot. It is a lot.
Taylor Ryan (00:47) All right. Looks like bramer’s in the waiting room. Cool. Jimmy and Michelle. Both, Jimmy said that he was available, so, and we moved it for him. So I anticipate he’ll probably join, but he didn’t respond to the invite and then Michelle didn’t respond either, but bramer’s probably the one that we need to talk to the most anyway.
Scott Everline (01:11) Yeah, sounds good.
Taylor Ryan (01:12) Okay. I’m going to let him in cool.
Taylor Ryan (01:24) Hello? Hey, bramer.
Bramer Owens (01:28) Hey, how are you doing?
Taylor Ryan (01:30) Good. How are you? Am I saying your name correctly? I?
Bramer Owens (01:32) Am, you know what I’m going to actually ask you, are Adolfo to join us? I mean, he’s free, okay. And he’s not that’s all right. But let me see if I can get him to join. Sorry, I’ve been about 10 minutes behind all day.
Taylor Ryan (01:48) No, you’re good. You’re right on time for us.
Bramer Owens (01:50) And I’m not sure that I’ll catch up anytime soon. Okay?
Scott Everline (01:55) Well, we can try to keep this to 45, but by saying?
Bramer Owens (01:57) No, no, no, that’s good. I mean, there’s a pressure on us to figure this out. So let’s just get it going.
Scott Everline (02:03) There’s a pressure on the universe to figure this out.
Taylor Ryan (02:10) Who did you say you were adding? Raymar?
Bramer Owens (02:13) Dolfo, he actually works closer to some of the process items than I am. Let me actually call him real quick. Okay. Yeah, take your time. That would be helpful.
Bramer Owens (03:00) All right. He may join. I didn’t get a hold of him but let’s just jump in.
Taylor Ryan (03:04) Okay. Sounds good. So, Jimmy, you joined as well. All right. Cool. Well, yeah, this is everyone from our side and yeah, I think that we talked last time about just kind of mapping out the process that you’ve got today so that we can kind of give you an idea of what our recommendation would be. So I’m going to hand it over to Scott pretty quickly here and just jump into things if that’s all right. Yeah, awesome. All right, Scott, the floor is yours?
Scott Everline (03:33) Cool. Nice. Seeing you all again. I have no slides to share and I will probably ask you guys lots of questions and follow up questions because the goal here is to learn and then ultimately the thinking would be I would pull together kind of a process map and then we would walk back through that and talk about kind of the components that medallion feels like we can really support. And then the pieces where we might want to kind of solution around workarounds or for other support features. So hopefully that works for you all.
Bramer Owens (04:08) Yeah, I mean, I think a couple of pending items on my side after this call, when you have what you need to kind of fill out the questions I sent over last week that’d be helpful for us just to kind of like orient around and the answer is no, then let me know what else you need to do that. Yep. Secondly, I thought what I would do is just show you how we work today.
Scott Everline (04:29) That’s awesome. Yeah.
Bramer Owens (04:30) And then it would be great just if one of y’all could pull up the platform and say, like, yeah, okay. Here’s, how that would work in the platform. Is that helpful? Or is that? Yeah?
Scott Everline (04:43) I think a reverse demo is a great place to start. Okay? As you’re talking about. And I guess a big question I had because I know this RFP initiated from the provider side of the org and it sounds like on the payer side of the org, you guys were looking for similar solutions or potentially a kind of consolidated vendor, how much synergy is there between what happens on the provider side of the org? And the payer side of the org? Because I’ve seen them historically kind of split. Yeah.
Bramer Owens (05:15) That’s a fair assessment. I think that, you know, part of pulling together the various parts of harbor is, you know, I do have enterprise solutions across the board, I think today and Jimmy jump in here please. But like today, the interaction is I have a participation agreement with harbor health medical group and vmd. So it’d be one harbor and, you know, the interaction today is I negotiate that with my colleagues and we get, we delegated credentialing to those groups and they are responsible for harbor.
Taylor Ryan (05:53) Health hayvedor?
Scott Everline (05:54) Relief.
Bramer Owens (05:57) They’re responsible for doing ideally monthly attestations or on the rosters that they’re required to produce as part of being having delegated credentialing so I’ll just pause there now. I mean, granted like there’s a 1,000,000 things we do to collaborate, but I’m just, but just the base of the arrangement is that, let me just say it that way.
Scott Everline (06:21) That is exactly what I would expect it to be. So that’s perfect. I wanted to make sure you all didn’t have some de siloing that I have never seen before in this space. And for whatever reason, gemini decided to try to take over my keyboard so I can’t take any notes. All right. That should be interesting. I’m going to real… quick that’s perfect. Okay. We can, yeah, let’s dive into kind of what your process is. And I was thinking like understanding everything from kind of like where pieces of credentialing and I’ll call it a directory or a roster use case, kind of where those overlap throughout the journey. And then as much as we can kind of dig into who’s managing which components of the process would be super helpful.
Bramer Owens (07:13) Yeah, duff is going to join. I want to get him… make sure he gets it. Give me one second just to send it in the link if you don’t mind. Yeah.
Bramer Owens (07:36) I thought I saw that.
Bramer Owens (07:48) Give me one second. Sorry, guys. I can’t copy for some reason. I can’t copy. I can’t forge your meeting, but.
Taylor Ryan (07:53) Do you want me to, if you have the email address? I can here. We.
Bramer Owens (07:58) Go, let me add… yeah, I’ll throw in the chat. Okay. Oh, he got it. No, we’re good. All right. So let me just show, can I share my screen? Yeah. All right. So today, this is a partial list and I appreciate we’re under NDA which is why I feel good about sharing this stuff with you. So today, let me show what happens.
Bramer Owens (08:21) So we have this request to contract. We have to cover, we have to keep for just compliance purposes. But ones we’re actually engaged with are here. And so this is basically how we walk through. And yes, we’re eventually moving to a CRM. So don’t chuckle in our spreadsheet today, but it’s and so we’ve got 34 agreements we’re working on. Based on what we see going forward, this should be about 300 long. Once we get all the expansion markets fully staffed and have our target list. And that’s something that’ll be done in the next 30 days or so. So what you see here, it moves to contract credentialing status, a signed agreement. And so that’s so there’s no, this is all contracting. You know, where are we at? What’s the issue? You know, can we get a signed agreement? So once this, it turns blue, it moves over here and our paralegal. And I realize this is way more detailed, but I want you to understand just kind of like how we function today. Our paralegal is responsible for filling out the orange portions. It’s a shared drive between us and our current credentialing manager. Once that’s done, it tells you is it delegated? Is it an actual like credentialable organization or whatever the current credentialing solution we use goes in. And for, the delegated ones, all they have to do is let us know if their roster’s in or not what notes they have. And ultimately, if they’re fully credentialed, they just pick this up and they run with it. And so it’s a system we devise they look at this twice a week. Any new ones that come in, they either take and do the actual, their credentialing workflow which I believe is just well, it is a set email they send out saying we need a B and C. And I think a and B are like the ncqa face sheets. And then like a lighter touch roster to make sure they cover all the ones that all the providers that should have face sheets. And from there, so let me, so there we don’t do anything… until there one of two things happens. One, there’s an issue with one or more of the providers in the credentialing committee. And so we discuss that and iterate as needed with… that. Let’s assume there’s not a group came in. They’re fully credentialed, they’re all clean files, they got approved by committee. So when that happens, the next time I interact with that group as it relates to credentialing, is I come in here and I see, I get a weekly roster sent to me.
Bramer Owens (11:18) Here is the last one I got was 316. It would have any groups credentialed between 312, the previous one and 316 added to that roster. And then that roster is ingested into our system to do the different things you would expect like go to directory, go to tpa, yada. Yada. So that is my current workflow for credential groups. So let me pause there and answer any questions you have.
Scott Everline (11:48) Yeah. Can you pull that sheet back up? All right, please? Yeah.
Scott Everline (11:56) So when you guys, so there’s the distinction between a delegated group and a non delegated group.
Bramer Owens (12:01) Yeah, I didn’t cover, so I didn’t cover delegated. Yeah, I just want to cover full. Yeah. Okay. Sorry. So, and it says hbp. I mean, y’all know this, you don’t have to credential hbps. So that’s we just have to get there that we treat them like a delegated group effectively. So, but yeah, I was just talking about it’s like this grit, this one. Let me give one, let me give a more recent example of one that this one’s a very recent one. They’re in epic order not date order, but say the sign one, 120 26 that, the process I just described and let me see here. So… they haven’t started their monthly attestations yet. But it looks like if I read this correctly, like and the options are credential incomplete, pdm are complete. So if it’s pdm, I need you to go get the roster to fill it out. But let me put, let me put delegated aside. So I tell them to go credential. It’s like for this one, she’s reached out. It’s a little and, you know, we need to this week we’ll discuss, well, are they engaged or not? Why this is a credential for gastro, and medconet? I’m reading this like, okay, their credential and they’re now on, the roster and I’ll go and verify that. So.
Scott Everline (13:17) Do you guys, so, are they, because these are groups, right? Is, is one cred today going out to those groups? And you’re they’re saying we need the roster of all the providers that are part of the group. And then they’re going out and obtaining the credentialing files for all of those individuals?
Bramer Owens (13:34) So, the way it works today, let me clarify there’s a form email that one cred sends to who we tell them to send it to. Okay?
Scott Everline (13:42) And.
Bramer Owens (13:44) that’s here, the cred contact. Okay? And I could find a copy of that form email. But effectively, it says congratulations on being part of harbor house network, blah, blah, blah, please attach every ncqa face sheet for the individual providers under ncqa under your group that you want credentialing under the health plan here’s. An example of what that sheet looks like. That’s I think de, identified or just or redacted. Sorry, and if you have any questions, happy to meet and talk with you about it. So that’s generally how it works, and then how.
Scott Everline (14:27) are they pulling the actual credentialing application to start the PSV process? I,
Bramer Owens (14:31) understand that all they need is an ncqa face sheet and they can pull everything they need from there?
Scott Everline (14:39) Okay. Are they like leveraging an instance of caqh that you guys have or are they?
Bramer Owens (14:45) I think they have their own… okay… I can find out. I mean, I can find out that’s helpful, not.
Scott Everline (14:57) Necessarily. I’m just kind of curious. I haven’t heard like ncqa face sheets as being like a starting point of an application, but that’s fine. And then they conduct all the primary source verifications, yep, and then onecred’s managing the credentialing committee for you all as well, like they’re making decisions today, whether or not a provider meets network requirements.
Bramer Owens (15:18) Yeah. But one of our, and we discussed this before, but one of our, one of our doctors is on that committee because you have to have someone that’s part of the network. And we just went through our audit with them, our ncqa prep audit with them. And we’re still working through some details. You guys?
Scott Everline (15:36) Are trying to get ncqa accreditation, our?
Bramer Owens (15:40) Survey’s in April. Okay? This year, right? Jimmy? Yeah… sorry. Yes, yes, it is.
Scott Everline (15:57) So, when they, so they’re managing the committee essentially, so they’re kind of helping prep the files for committee. So they essentially function as the committee chair. Are they also staffing committee members? I know you said you had somebody from the network represented, but are they staffing the providers for the committee as well? They?
Bramer Owens (16:14) Are, but I mean, again, I’m not an ncqa expert by any means but, you know, I know what you have to have active participants in your network, right? To be on the committee. And so we set that up as part of this engagement. Where they are, we have some of our network providers that are on their crunching committee. They’re reviewing files for our network, okay?
Bramer Owens (16:44) And.
Scott Everline (16:44) then they’re ultimately just letting you all know at the end of the day, if that provider clears committee.
Bramer Owens (16:50) Yeah, or if they don’t and what the issue is, and then typically there’s issues like they have their required committee responses, they have to provide. But then we’re aware. Yeah.
Scott Everline (17:00) And are they managing the appeal process when there are issues, are you all managing the appeal process?
Bramer Owens (17:05) They’re managing it. Okay? When I say effectively our crunching is outsourced today to one career that’s what I’m trying to communicate.
Scott Everline (17:13) Yeah. That’s why I’m trying to ask the question, right? Because there’s a big distinction between how I would say 95 percent of the cvos in the space would treat this and how it sounds like onecred is treating this.
Bramer Owens (17:27) Yeah. And you may say it’s wrong and they won’t pass ncqa audit. I don’t know if that’s true or not, but I mean, again, I.
Scott Everline (17:38) mean, ncqa audits are so squirrely quite honestly like I’d swear you could go through an ncqa audit with one auditor one day and then go through it the next day and have like clean to issues or vice versa. It’s their, they’re a funny group of folks at ncqa. Now, I would say if you’re getting accreditation, they may have challenges with your cvo not being certified. I.
Bramer Owens (18:08) Don’t know. Yeah, I think well, they’re ncqa eligible and I think it’s so that’s the piece. I mean, we’re off topic here, but they’re ncqa eligible and my understanding their survey’s in July, but that’s I think you’d have a certain amount of lead time that’s correct? And onecred does this for, I would say half 12 to 12 other health plans today… but I think what’s I think important for this discussion is that you understand our process today?
Scott Everline (18:35) Yeah. For sure. I’m putting it together. Yeah.
Bramer Owens (18:38) So it’s and Adolfo joined, he can jump in because he does this a lot too. But any questions about the, like… the groups that we’re responsible for credentialing?
Scott Everline (18:53) No, no. And, there’s no interface. Everything’s happening on this spreadsheet. So like this is a shared document or a document that you all send to?
Bramer Owens (19:01) Yeah, we don’t have a system to interface it with, right? So like it’s just, they have a system and so, I just want to make sure that the right groups are being reached out to and there’s responsiveness on both ends. And we meet weekly to discuss any escalations or concerns for credentialing yep so, but you don’t.
Scott Everline (19:23) have access to their system. This is like their system is their own tooling that.
Bramer Owens (19:26) They, I guess I could if I asked for it, but I… haven’t had the need. We haven’t had the need to yet. I don’t think. Okay, okay. Delegate it. So same thing… moves here. It goes blue. And then, and you can also once it goes blue, new line, new lines created here, the signatory. And by the way, while this is not populated, we just started this process about six months ago. So the ones that are already done and incumbent, we didn’t go backwards. We just moved. We just moved forward with net new agreements and credentialing. Com. There’s Jimmy’s name how funny, but the we’ll put in the credentialing contact for the delegated group. We’ll note on here that it’s a pdm group or, and they’ll go and share out the roster template. And as we discussed before, one of two things happen, some groups actually fill out the roster template. The way we did. We’ve I think I showed it with you last time we were together more times than not. It’s like here’s our roster, you figure the rest out. So onecredit will take that map, what it can… based on the roster template, we discuss any variances and kind of go from there. And then ultimately the same process. Once they’ve fully verified the roster that has been provided by the group, it gets on our master roster which has been ingested into our systems.
Bramer Owens (21:07) Okay.
Scott Everline (21:09) And so you all aren’t doing anything other than kind of putting a name and a contact in here, right? Yeah, onecredit essentially is picking that up.
Bramer Owens (21:17) That’s right? And we just deal, we deal with issues. So non responsiveness, lack of, you know, lack of, we don’t have we don’t have enough data to actually complete the process? You feel me? So I can say, you know, when things are not working as planned, then we then an offer, I intervene and figure out what we can do to get them to work as planned.
Bramer Owens (21:55) And then does.
Scott Everline (21:59) onecredit do anything with the least network component? I know this is credentialing focused.
Bramer Owens (22:04) They do. Yeah. And I mentioned that. So they do so similar.
Scott Everline (22:08) Process like it’s a spreadsheet and they’re pulling that in or no?
Bramer Owens (22:12) Yeah. So the way we were delivered that today, hang on a second. There are first right now, we use first health… and I think it’s here. So we get what’s called a geofile looks like the last one was March six that comes monthly via sftp. They take the geofile and it’s not in our, the same format that our first health gave us an initial run of the data. But since then, we’ve had to like take their geofile format and they mapped it to like our spreadsheet, like, our template that I shared with you last time we got together and that shows up. And this is at the request of, our database team that shows up as a combined roster here. So, when it says first health pdm, so it’s both the first health data and the pdm data. Oh, I can show you an example of that if you want to see it, but let’s go to 316. It’s a very big file. So it takes a while to load. And for whatever reason, our database team preferred it to be in like an excel format. I think that’s where they map it into the database. And so you can see just there’s.
Adolfo Carrasco (23:37) adt.
Bramer Owens (23:37) Information here. But this is a full run.
Adolfo Carrasco (23:40) And there’s a network source. You can see whether it’s pdm?
Bramer Owens (23:49) Would be a.
Adolfo Carrasco (23:49) Delegated group one.
Bramer Owens (23:52) Cred, first health, new ones, one cred.
Adolfo Carrasco (23:55) Dupes.
Bramer Owens (23:55) Because there’s deduplication. Requirements. So, the main three categories are first health, one, cred, means credential. And pdm means delegated. Does that make sense?
Scott Everline (24:12) It’s similar one cred’s getting that file and then they’re massaging it, manipulating it yeah.
Bramer Owens (24:18) Well, it doesn’t come in this format. So they’ve built.
Adolfo Carrasco (24:21) A tool.
Bramer Owens (24:23) That actually pulls in this format and let’s just say that for instance.
Adolfo Carrasco (24:27) I’m.
Bramer Owens (24:28) just making this up but telemedicine is not populated.
Adolfo Carrasco (24:34) What.
Bramer Owens (24:34) they’ve also done is they’ve built.
Adolfo Carrasco (24:36) A.
Bramer Owens (24:38) directory of other like incumbent payers like united and blue cross blue shield, the two most dominant ones and they go and they check and see if there’s parity of both united and blue cross blue shield. Say that?
Adolfo Carrasco (24:50) You know this?
Bramer Owens (24:51) Doctor here?
Adolfo Carrasco (24:52) Takes.
Bramer Owens (24:54) telemedicine, like they flag that as a potential you.
Adolfo Carrasco (24:58) Know, data.
Bramer Owens (24:59) Point to add into the roster. I think they also do website searches too. They have a website… it’ll go and test certain things on the provider’s website if they have it, but I’m getting ahead of outside of my.
Adolfo Carrasco (25:11) Comfort zone.
Bramer Owens (25:13) Explaining what they actually do.
Adolfo Carrasco (25:15) Yeah, but they’re doing, go ahead. I was going to say.
Scott Everline (25:18) They’re augmenting whatever’s coming in on this template with other sources. Yeah, that’s right? Other people’s directory in.
Bramer Owens (25:25) Pez, other, you know, united’s directory, blue cross, blue shield’s directory in Texas or… and then I think for not, I want to say about half the groups. They have a verified website.
Adolfo Carrasco (25:38) And so there’s a web?
Bramer Owens (25:39) Scraper that can go and say, okay, is this is dr Angela’s CD still on there?
Adolfo Carrasco (25:44) You know, is there any?
Bramer Owens (25:45) Data points we can, so.
Adolfo Carrasco (25:47) There’s that component too. Yeah. But to be clear that information,
Bramer Owens (25:57) goes back to those monthly attestations. We talked about. Any found information, goes back to the group to attest to. And if they attest to it, then it becomes like data that’s actually used in the spreadsheet. Does that make sense? Yep? Okay. And I think you saw earlier February, we’re still missing February attestations for some of them?
Adolfo Carrasco (26:16) March, those are trying.
Bramer Owens (26:18) To kind of roll in.
Adolfo Carrasco (26:20) Yeah.
Bramer Owens (26:21) As you can see, and so we go, is.
Scott Everline (26:23) There an access requirement for monthly attestations?
Bramer Owens (26:25) When you say access, what do you mean?
Scott Everline (26:27) I said Texas specific requirement for no?
Bramer Owens (26:30) That’s our.
Scott Everline (26:30) requirement? Okay. I was going to say because I think the standard’s in 90 days, right? Well, our.
Bramer Owens (26:35) Attitude is we want to attest monthly, hoping that we get one every 90 days. Okay. Yeah. So you can see, January, we’re still missing a few.
Adolfo Carrasco (26:47) You can see.
Bramer Owens (26:47) There’s some, what happens if?
Scott Everline (26:49) You guys do like any directory suppression if they don’t attest after 90 days, like what are you doing in those cases? Yeah.
Bramer Owens (26:56) You can see some are passed. And so that’s actually on our list to discuss like the ones in red are ones we have?
Adolfo Carrasco (27:02) To begin… to engage?
Bramer Owens (27:06) Because some are even more than 90 days at this point. So we have there’s work to.
Adolfo Carrasco (27:11) Do… okay. And,
Scott Everline (27:15) those attestations are coming in form of somebody just signing off on the spreadsheet. Is there like an, whoever, is it like an email response? How do you guys receive the actual attestations?
Adolfo Carrasco (27:25) It’s an email response that’s provided by the provider group. Okay? And unless there are any additions or like terminations or deletions, then, you know, that’ll be kind of noted as well. And that is for.
Scott Everline (27:39) All groups, right? That’s not just for delegated groups that.
Adolfo Carrasco (27:41) Is correct.
Bramer Owens (27:42) Okay. Yeah, both.
Adolfo Carrasco (27:42) On the directs and the rental network or the, you know, rap network?
Bramer Owens (27:47) And the deleg, okay? Rap’s not attested to because we auto get that information, correct?
Adolfo Carrasco (27:55) Correct. That’s.
Bramer Owens (27:56) Right. So, the delegated.
Scott Everline (27:57) delegated and direct, right? Direct. Yeah, right. Assuming the rap is doing all the same stuff because they’re correct? Correct?
Bramer Owens (28:04) Which, which?
Adolfo Carrasco (28:05) You know, how that goes? It’s ironic.
Scott Everline (28:08) Because a lot of times I’ll see payr hold them, not you all because it sounds like you guys have it pretty buttoned up, but like having worked over the years like Aetna, I’ll pick on Aetna, like what they did to manage their, these requirements versus what they pushed down to their raps was completely different, right? So, like if you work with, yeah, on behavioral health, like they’re held to like such a granular refined process, it’s like, I guarantee you having worked with Aetna. They never do any of this stuff. So, it’s just kind of funny, they’re holding a higher standard, but.
Bramer Owens (28:37) Yeah, that’s been our experience as well… that’s our process today.
Scott Everline (28:44) Yeah.
Adolfo Carrasco (28:47) Yeah.
Scott Everline (28:51) Do you have like visibility and timing on like how long it’s taking one cred to do these things like let’s just talk about PSV for the directs, like what’s that turnaround time look like?
Adolfo Carrasco (29:04) You know, I don’t I was going to say they’re pretty quick bramer, as long as they got their stuff in order, you know, things… go pretty quickly. Sometimes what you find is if it’s outsourced, then they need to contact, you know, some of these small little cbos and then they kind of populate all the information for them and get them over to us, things of that nature. Just, it just depends how the office is structured. Scott, is what I would say. Okay?
Bramer Owens (29:30) Yeah. I would say the one credit process is assuming the information is complete.
Adolfo Carrasco (29:36) Yeah.
Bramer Owens (29:36) It’s less than 30 days and I think because their committee only meets twice a month, okay? So.
Adolfo Carrasco (29:43) And they have other.
Bramer Owens (29:44) Clients they’re working on behalf of.
Adolfo Carrasco (29:47) So, but if.
Bramer Owens (29:50) we’re waiting two or three and four weeks for the ncqa information to come in then.
Adolfo Carrasco (29:56) Clearly.
Bramer Owens (29:56) It’ll elongate the process.
Adolfo Carrasco (30:02) Makes sense. Yeah.
Scott Everline (30:02) I was going to say like if they’re doing end to end all the way through committee, they can only be as fast as the committee meets, right? Yeah.
Bramer Owens (30:08) I think it’s twice a month. Yeah. Okay. So, I haven’t seen this happen but best case scenario would be 14 days, I guess.
Adolfo Carrasco (30:17) Because, you know?
Bramer Owens (30:18) But typically, it’s about 30.
Adolfo Carrasco (30:20) days.
Scott Everline (30:24) And you mentioned you guys are looking at getting a CRM tool. Yeah, I.
Bramer Owens (30:28) think it has to be on our roadmap just as the network team grows, but it’s.
Adolfo Carrasco (30:34) something?
Bramer Owens (30:35) That will probably not. I’m not looking for any more change in the next few months, but that way.
Adolfo Carrasco (30:40) Yeah.
Bramer Owens (30:40) We are getting a contract management solution called ironclad. So, a lot of the contract pieces that first tab you saw will probably move to ironclad for management. And then we’re going to, so that’s not a CRM that’s contract management. But our plan is for that to auto message certain parties once milestones are met. So, contract signature that would send an automated email response to whoever their credentialing partner is and say, okay, contract’s executed here’s. A summary and then it would, we’d follow up a process we define.
Scott Everline (31:22) And so that would basically kick off like the second half of that spreadsheet.
Bramer Owens (31:24) Yeah, right. So, I wouldn’t worry. I’m just saying that you can’t at scale, manage the business on spreadsheets. I have to acknowledge that, I mean, but so ultimately, we’re going to get this figured out, get contract management figured out and how the two will interplay. And from there, we’ll see what’s left from like a prospecting or CRM standpoint, yeah, yeah, Scott, like.
Adolfo Carrasco (31:47) The way it works today, essentially, once we get a contract executed, a ticket submitted, that ticket notifies various parties, one of those being onecred and that kicks off the credentialing process.
Bramer Owens (31:57) I didn’t cover that. That’s a good point. Yeah, I’m sorry. So there also, we have a ticketing system because we have to load the contract with our tpa as a secondary like notification, the onecred, our onecred what?
Scott Everline (32:15) Do you call it?
Bramer Owens (32:15) Relationship manager is copying on all those tickets. So they’re aware that this one’s coming and they go to the spreadsheet and they review the information and we typically touch base weekly to discuss.
Scott Everline (32:28) If there’s any issues.
Bramer Owens (32:30) with what they’ve seen come through in the tickets versus what’s in the spreadsheet and go from there. So that’s right? I forgot that there’s the ticket. They’re copying the tickets to the tpa. They review that we have a shared spreadsheet. And then we also iterate via slack. If there’s something in the interim we need to address. And then is there a?
Scott Everline (32:55) Pdm system behind all of this? Like where’s all this provider data that’s not getting stored in spreadsheets. So where’s all this provider data?
Bramer Owens (33:05) On their side or our side or both on your?
Scott Everline (33:08) Side more so than their side, I think. Yeah.
Bramer Owens (33:11) So we use snowflake. So we call it cleansed because there’s a lot of issues with provider data. We get the cleansed text tested to provider… data from them weekly. It’s in those little spreadsheets. I showed you that information is consumed into our database, which is snowflake. And then that’s where the outputs to tpa search.
Scott Everline (33:39) Other analytics.
Bramer Owens (33:41) It goes from there. Okay. That’s helpful.
Scott Everline (33:49) So, it’s weekly that it goes into snowflake. Yeah, we’re.
Bramer Owens (33:52) filing some plans right now. So I’ve had them do it like I’m having like bi weekly because we’re trying to get them to like for instance, just an example, the first half the rat network data is terrible. I’m like, hey, you’re missing 600 facility license dates. I need you to go find those and populate them. And so that’s a project they’re working on right now. And so I’ll get one. I’ll get two this week. The routine one I get on Monday is I’ll probably get one on Thursday with that updated licensure information because as, you know, you can’t submit a facility without a valid license date to tdi. So there’s projects in between. I mean, we’re not going to talk about like special like projects and things, but because that’s not for the scope of the conversation that would require more often, I guess provision of spreadsheets, but that’s.
Scott Everline (34:43) a different.
Bramer Owens (34:43) Conversation for a different day. I feel like.
Scott Everline (34:46) okay. Yeah, fair enough. Okay. This is super helpful. I mean, I can jump into the platform and talk a little bit about kind of how medallion approaches the cvo and kind of the pdm use case. And then, you know, we can take that conversation and leverage it into kind of answering some of the Q a documents that you had, or the Q a document that you shared last week, if that works for?
Bramer Owens (35:11) You guys? Great. Yeah. Oh, yeah. So, you know, we, do we’re right or wrong? Yep, I guess ncq will ultimately tell us both how right or how wrong we are in the coming months, but.
Scott Everline (35:22) Well, I think ncq probably won’t have, I could be wrong, but I don’t think they’re going to have a ton of opinion on like the cleansing and the attestation exercise as much as we’ll have an opinion on like the primary source verifications, credentialing, cvops. Sure. Yeah. So, yeah. So the medallion platform, right? So this is tooling that you all would have access to and interact. So when I think about potentially how that spreadsheet works and that kickoff initiates things that you guys use today on that contracting template, it could be migrated… into an intake form that comes into medallion to kick off credentialing events, right?
Bramer Owens (36:08) So, and,
Scott Everline (36:09) whether that’s somebody on your side initiating that or whether that’s like an sftp drop, right? That we would then kind of pull from that process. What we, something that happens today is like we don’t go and pursue the rosters from the customers, right? So typically in the contracting process, when we work with customers are getting that roster during the contracting process. So we know specifically what providers we need to be going after. So the process would be that essentially a request would come in, it would essentially initiate a bulk import, right? And we could talk about like how the bulk import would need to be designed that was totally hands off or that was something somebody on your team would actually generate this template. Until then that import file essentially kicks off like a like pulls in a ceqh id, pulls in the provider, the individual practitioner, mpi, and the provider’s contact information, right? So first name, last name, email. And then if we need a credential in contact. So this is a template that most of our customers are loading via API through an sftp site. You know, we can map typically from another format into this document to kind of kick things off. It initiates a credentialing workflow. What we do. So potentially well, it does sound different from this ncqa sheet that you, all that onecred is obtaining is we have a linkage directly into caqh and we pull Texas. Has you guys are exclusively in Texas? Yeah. Okay. So tdi has its own unique state required application. We pull that directly from caqh. If you’re in other markets, we would pull either the caqh app or the state app depending on where you are. Assuming you go into neighboring states. I don’t think any of your neighbors except for Arizona have a mandated app. My geography is wrong there. So, but we would pull that provider profile in from caqh. And then we would essentially store the provider information and the subsequent data that came in off of that credentialing application kind of in this directory. So you would be able to see kind of the providers, the breakdown, the groups that they’re at the practices that they affiliate. And so that’s all either going to come through cleanse data on your end, cleanse data that you know, potentially medallion cleanses or data… that’s coming directly out of the provider’s attested caqh profile… gives you kind of like all the provider profile components that you would expect to see, right? Like basic information, demographic data, personal information, history, you get practice information loaded here, right? By group breakdowns, all that fun stuff and that, and just.
Bramer Owens (39:08) to be clear that’s coming right off of the provider caqh profile today?
Scott Everline (39:14) Yeah. So it comes off the caqh profile. So the way one of our customers is doing this is they’re selling telling us these are the groups, right? Because if I have a caqh profile, I might have a lot of groups that you don’t contract with. I might have 10 groups in my caqh profile. We, we get the 10 in the type two mpi on that intake form and then we pull specifically just those groups into the platform versus pulling everything and somebody going out and scrubbing out contracted groups. I don’t know how familiar you are with like caqh and how their profiles are structured and how much extra data they have in them, but that’s a way to kind of reduce some of that location noise that comes out of it. Yeah.
Bramer Owens (39:52) Yeah, I’m not. I guess your point is it needs to be specific to the group you’re contracting with. You would want to, if.
Scott Everline (39:58) you’re going to go downstream and feed it, right? Because like if I have five groups, say two of them are in Louisiana, they’re… groups that you’re not going to be contracting with. So then you wouldn’t want those pulled into your pdm system because those wouldn’t be relevant groups. And then you run the risk of them getting pushed to the directory and then that runs into a whole other.
Bramer Owens (40:17) So there’s Geo specific, I guess a fence around what you’re pulling in from?
Scott Everline (40:22) Caqh. Yeah, we actually do it by the group’s tin and the type two mpi. So being able to tie those specifically to the contracted elements around the group tin and the mpi number, I understand. And then from there, things move into the credentialing queue, right? So we’ll kind of start this credentialing process. So, and you’ll see files that are in flight, we contractually commit to a turnaround time of three days for credentialing files. So we will do all the primary source verifications, prepare the packet and then move that file into a ready state. This is going to be a difference between us and onecred. Right? Onecred keeps this ball moving forward. This is where medallion is going to give it back to you all. Somebody internally is going to be making the determination as to which credentialing committee this file needs to go to. I’d imagine it’s kind of you have a clean committee where it goes off to a medical director that gets signed off. Typically, you see that kind of happening on a weekly process of files with no issues, quick routing. And then you have files that need to be reviewed by the credentialing committee. We don’t staff the credentialing committee. So that’s something you all would need to do. I’ll be interested to understand like when you go through this process with ncqa, what their determination is around onecred managing that committee, and if it’s supporting their efforts or supporting your final efforts, typically, these files kind of come back like clean files, right? So quick hit, we can auto route these to a clean committee. So you’re not necessarily touching them. So they come through, no issues. Land on the desk of a medical director to sign off on files with issues would come back and somebody would review those and then make a determination as to like this does need to go to committee. Sometimes it might come back with an issue might be a seven year old mpdb hit you’re. Like we only follow up to five years. We’re going to take this to committee, right? So this would be a change where you all would have somebody kind of in the mix kind of playing traffic cop on some of these files to make a determination as to where they go. I suspect you guys probably aren’t even seeing these, right? You’re not seeing credentialing packets today.
Bramer Owens (42:33) If there are issues they bring to our attention, we talk about them.
Scott Everline (42:37) Okay. Thankfully, that’s like the review committee, right? Yeah, I.
Bramer Owens (42:41) mean, I would say.
Scott Everline (42:44) That’s a stretch.
Bramer Owens (42:45) Because we, you know, the committee has to act independently as I’m sure you all know. So it’s just more of a heads up and, yeah, but I understand the flow. Okay.
Scott Everline (42:57) Yeah. So the packet gets delivered, right? You have all your verification evidence. All that documentation is here. Sounds like your committee’s potentially working virtually, which is great. Sometimes committees are pretty old school and they like paper documents, so they can get a PDF of the packet, right? Jump to sections in the packet and review it manually without having to kind of go through the platform. And then there’s an opportunity for people to make notes. So whoever on the harbor side is kind of reviewing these packets, if there’s a note that they want to make on the file, not sure if onecred is adding any kind of notes or commentary on individual documents, but it’s a way to do that. You can make them private. So they don’t live with the file if it’s audited, but you can also make them part of the file itself so that message goes along to the next person.
Scott Everline (43:47) And make the decisions on the platform, right?
Scott Everline (43:54) Individuals get assigned to the committee, then they can in platform same thing, review the packet, look at the results and then make that committee decision. So they’re voting directly here within platform.
Adolfo Carrasco (44:09) But,
Scott Everline (44:09) again, like we’re not staffing that, right? These would be harbor health, assigned individuals.
Adolfo Carrasco (44:16) And.
Scott Everline (44:16) then we move those files to closed.
Adolfo Carrasco (44:19) You know?
Scott Everline (44:19) Audit record of all your files that have been processed, whether they’ve been approved, rejected, you can go back and pull those. When your ncqa reviews come up, right? They’re going to ask for a select number of files. You’ll jump into the system, be able to pull those out. We are ncqa certified. So we’ll support kind of end to end that audit process, the review process surveys. But they’re also familiar with us because we go through our own surveys, right? So they’re familiar with the medallion process. They have their policies and procedures and we kind of keep a steady track with them. And then for re creds, we essentially just reschedule for 36 months down the road, rinse and repeat, right? So unless that provider terminates from the network and you no longer need them, you’ll have the full kind of schedule as to when we start that process.
Scott Everline (45:06) Typically, we start delivering files 60 days prior to the re, credentialing deadline. We start working 120 days in advance. So for that, you don’t need to notify us unless for whatever reason, we don’t need to be running that re cred. Otherwise we’ll just run it, reach out to the providers, gather the information, pull caqh, chase missing.
Adolfo Carrasco (45:26) Data deliver.
Scott Everline (45:29) The packet and then just kind of rinse and repeat, somebody reviews, it goes through committee vote, etc.
Adolfo Carrasco (45:37) What about? Well, okay. I think.
Bramer Owens (45:40) That’s a crunching workflow. It makes sense. I heard you guys about four times. And so it’d be helpful in the, when you answer the questions later on just kind of articulate kind of how you see this played out with other payr clients. And so, for context, Michelle asked me for some information. So I said, hey, we have 31,000 unique mpis today that we’re that are either in network in one of three statuses via rap, via direct relation, direct agreement, which is either going to be credentialed or pdm and about 85 percent of the directs are delegated. So I can give you this. And if you need it in like a email after this call, I fully expect that we’re.
Adolfo Carrasco (46:32) going to,
Bramer Owens (46:32) be two times that number. Oh, and about 2000 facilities that’s about… we’ll cover facilities in a second. So, I fully expect we’ll be at least two times maybe three times that number when all of our current markets are much more mature than they are today. But I just want to point out like that’s the workload we’re dealing with. And so, it’d be helpful to understand like, yeah, it’s like half a person like we have plenty of health plans that just you have half a person doing that or that sounds like three people in our platform using our platform. Ultimately, that’d be really helpful for me to understand?
Scott Everline (47:08) Yep. I can break that down on the response.
Bramer Owens (47:10) Yeah.
Adolfo Carrasco (47:13) So you said?
Scott Everline (47:13) 80 percent are delegated?
Adolfo Carrasco (47:15) I mean, yeah.
Bramer Owens (47:17) Of the mpis, I can give you an actual number if I need to.
Scott Everline (47:21) No, I mean, it’s all park is good enough. I think about.
Bramer Owens (47:23) 85, maybe 85, maybe even 90 percent of the mpis are delegated… about 10 to 15 percent are directly.
Adolfo Carrasco (47:34) Credentialed so that.
Bramer Owens (47:38) Creates its own issue, right? Because you have to audit all those folks. And that’s also something we’re planning for the future anyway.
Adolfo Carrasco (47:47) But then our.
Bramer Owens (47:50) direct agreements, our rap network is I.
Adolfo Carrasco (47:54) might I might include those?
Bramer Owens (47:55) Numbers in the rap network separate, but it’s you know, we ultimately delegate those responsibilities to Aetna to your point who has much different standards depending on which network you’re accessing from that, from Aetna?
Adolfo Carrasco (48:08) Okay.
Scott Everline (48:10) So, that would be, this workflow really applies to a relatively small population that you guys are working with?
Adolfo Carrasco (48:16) Right. When it comes to.
Scott Everline (48:17) The direct providers.
Bramer Owens (48:20) It is, yeah. But I would, it is for sure. But I’m more, one of the more things I’m more nervous about is the delegated groups because it’s less of a, it’s a less of a workflow but also the attention is as, you know, harder sometimes harder to manage of those delegated groups.
Adolfo Carrasco (48:40) Yeah. And, and,
Scott Everline (48:42) like in full transparency on the delegation side, ultimately, it would be the delegates sending.
Adolfo Carrasco (48:49) Files?
Scott Everline (48:49) To us and us then working through that data migration process.
Bramer Owens (48:55) That data could get pushed into.
Scott Everline (48:58) Medallion, so like you could have providers in here that don’t go through the credentialing process necessarily like not the end to end cvo process, but.
Adolfo Carrasco (49:08) Data is.
Scott Everline (49:09) Stored here and as a, in a platform and you’d be able to access those individual providers, but you could also include them as the groups and you’d have the providers kind of roll up underneath those groups. What we don’t do today is we’re not,
Adolfo Carrasco (49:24) we’re not.
Scott Everline (49:25) Doing any of the validation work that it sounds like onecred is doing?
Adolfo Carrasco (49:29) So, like going out.
Scott Everline (49:30) And checking and like we check mpez to validate that the mpi is valid, we’re not going to mpez to fill in gaps for like provider specialty if it’s not on a document, right? So, it is, we’re not filling in some of those holes, that it sounds like onecred is doing on those roster files?
Bramer Owens (49:48) Is that because it’s something that you feel like is inconsistent with ncqa or just, it’s something that hasn’t been a need in the past for the business?
Adolfo Carrasco (50:02) It.
Scott Everline (50:02) hasn’t it’s so, our focus on the payer side has been mostly around cvo services and.
Adolfo Carrasco (50:12) I haven’t.
Scott Everline (50:12) seen cvo services and some of this like directory data augmentation work being combined within the under the same roof.
Adolfo Carrasco (50:20) So, like,
Scott Everline (50:21) in my experience working with a lot of the payers are hiring partners to manage that kind of data cleanliness data accuracy as one piece. And then working with a cvo to manage the credentialing volume and,
Bramer Owens (50:35) you will have been the.
Adolfo Carrasco (50:39) delegated.
Bramer Owens (50:39) Groups in that first group you talked about?
Adolfo Carrasco (50:41) We don’t.
Scott Everline (50:43) no. So, I’m saying.
Bramer Owens (50:44) What you described, they, you work as a cvo solution, but since you’re not since.
Adolfo Carrasco (50:53) You’re you’re.
Bramer Owens (50:53) not credentialing delegated groups, you’re saying that most organizations you work with use another firm, to manage that piece of the business.
Scott Everline (51:02) Yeah. And then they’re pulling that all together at the other end.
Bramer Owens (51:08) The other plans.
Scott Everline (51:10) Correct. Yep.
Adolfo Carrasco (51:12) Yeah. It’s like we work with.
Scott Everline (51:13) Caresource, right? Good example, right? They’re probably 40 percent delegated, but those delegated rosters are managed outside of the medallion relationship. And then they’re bringing those back in to their final data source. They’re like they’re so medallion is a source of truth for all of their directly credentialed providers.
Bramer Owens (51:33) We’re running through. We’re.
Scott Everline (51:35) functioning as their cvo and then that feed that data is feeding into their ultimate final pdm platform. The delegated workflow is being managed with.
Adolfo Carrasco (51:47) the like as.
Scott Everline (51:49) Like whatever cleansing vendor, I think they work with hylab. So they work with hylab to cleanse the data. And then that comes back to, and then those two systems come to or those two sets of data come back together and then feed the downstream systems. So like feeds into a platform called onbase, and then onbase feeds, like all the subsequent, like the directory and qnext and, or facets and all that stuff.
Jimmy Price (52:09) But you’re saying if.
Bramer Owens (52:10) we wanted to, we could manage delegated groups inside the medallion platform. You just don’t have many payr partners that do that today, the.
Scott Everline (52:18) Data can be stored. We’re just not doing a lot of the augmentation that you guys are looking at today. So we don’t do like, we’re not going to go out to uhc’s database and say, look provider X is in uhc’s network and they’re showing they went to school here, but we didn’t have the school on the roster file. So we’re just going to grab the education from the uhc platform.
Adolfo Carrasco (52:39) I understand.
Bramer Owens (52:40) And we don’t and just, you know, we don’t do that. They don’t do that either?
Scott Everline (52:44) Oh, okay. I got the impression they were going in and filling in, no.
Bramer Owens (52:47) No, no, it’s things that are on the template. I sent you. It’s not because we’re again things related to.
Adolfo Carrasco (52:54) Crunching process. We’re.
Bramer Owens (52:56) delegating to that group and obviously auditing them, you know, based on that relationship. But what I was sharing is in, that sample roster template that I shared with you. If one of those columns is completely blank, I’m saying, okay, I either need to get the group to fill it out or in this case, one cred, you go find it and fill it out and have the group attest to it that they agree with it. And so I think it’s more depends on which field is empty because there’s some fields that like we have to mpi, you have to have, I mean, there’s no, and I’ve never seen a roster without it, but I’m just making, but there’s some things that are clearly not, you know, and groups like we don’t track that. Okay. Well, in some cases, there’s a tdi requirement that you do, you know, there’s an example. And so one of us has to fill in the gap. And so I think that’s these data cleansing firms talk about, they’ve they found a niche where they can fill in those gaps potentially. Yeah. And we’re not set up to be.
Scott Everline (53:52) That data cleansing institution?
Bramer Owens (53:54) Today. Got it.
Scott Everline (53:57) It is like we will, we can bring in and house the data, but the cleansing component is going to exist outside of the medallion platform.
Bramer Owens (54:04) Yeah. I guess the same thing is true for facilities too. I mean, same concept like you can receive a facility roster and house it, but really, there’s not much. I mean, I guess you could credential facilities, but we do.
Scott Everline (54:16) Credential facilities. So I could be a directly credentialed facility, right? So we’ll go through and check the clia and the site visits and primary resource, verify the state licensing, we’ll.
Garrison Goodman (54:26) do all that through.
Scott Everline (54:27) The facility workflow. But if you’re delegating to the facilities?
Bramer Owens (54:33) It’s not really delegation. I mean, we, it’s just like.
Scott Everline (54:36) Texas.
Adolfo Carrasco (54:36) The way Texas.
Bramer Owens (54:39) Does it, and I’m out, I’m not a credential expert, but like the way Texas does it is, they require you to have a valid license. And we actually pushed back with tdi on this recently and they’re like it can be a state license. It can be a clia license you’d have, you cannot put a facility on your roster without it having a valid license within the last three years, and it depends on the facility type, right? So, like hospitals, either joint commission or state survey imaging centers have like a Texas X Ray, like there’s all kind depending on the facility depends on the licensure and the licensing bodies. That makes any sense yep.
Adolfo Carrasco (55:17) Yeah. So we.
Scott Everline (55:17) have like a whole rubric of like depending on the facility type and the state that they’re in what requirements need to be present in a credentialing file and then validate it or verify.
Bramer Owens (55:27) Got it… running short on time.
Garrison Goodman (55:33) Brand, we wanted to map, get a better understanding of how you’re doing things today. But as we kind of work through this, I just want to kind of get your, I guess sentiment or the team sentiment. If we.
Adolfo Carrasco (55:46) can’t ourselves do the data?
Garrison Goodman (55:49) Transformation or some of the pieces that we talked today, would you be comfortable with like a multi vendor approach to this overall solution?
Adolfo Carrasco (55:57) You.
Bramer Owens (55:58) know, I, I’m not sure how I would, I don’t know if everyone organization would be, let me say it that way. So, I mean, I think I have to go back and connect because connect with the, some of the team members, and,
Adolfo Carrasco (56:14) get back with you all I.
Bramer Owens (56:15) Mean, Jimmy, I don’t know what your thoughts are, but I’m just trying to do one of two things. Okay, go ahead, Jimmy. Sorry.
Scott Everline (56:21) No, I didn’t I really.
Jimmy Price (56:22) Didn’t have a whole lot to add because I don’t I’m in the same, I’m in the same boat. I’m not quite sure what everybody how everybody else would feel about that, but obviously, we can take that to the board and see especially if this will make things go a little easier for bremer, yeah.
Bramer Owens (56:36) All I’m trying to figure out is, you know, what? And this is where I need y’all’s help, like what?
Adolfo Carrasco (56:44) Is going to be needed?
Bramer Owens (56:45) On the, on the payer side, on my side to effectively use the platform. And this, like I mentioned from day one, just be honest with me like this is what we do really well and where you’re going to benefit and see Roi, this is where you need a third and Scott’s done that, I think. So. I appreciate that by the way, like this is where you really need to think about someone that’s not medallion at least at this point in time. And it’s like that’s what I’m there’s questions trying to get at that. It’s not like I didn’t understand that because it helps determine everything else we decide if that makes any sense.
Adolfo Carrasco (57:19) I’ll.
Scott Everline (57:19) say, on the payer side, the big value add is medallions cost savings and efficiencies on the cvo piece. Yeah, like our cvo files are typically.
Adolfo Carrasco (57:29) Pretty.
Scott Everline (57:29) Low compared to other partners, other cvos in the business. And then a lot of orgs appreciate having a platform to really manage that process from an end to end perspective, particularly if they’re managing the committee in house that’s the big value add. Particularly if we’d start talking credit alliance. It’s a whole different story. It’s a,
Bramer Owens (57:48) credit alliance. I’m sorry. Yeah.
Scott Everline (57:50) So, it is us leveraging… shared credentialing. So essentially like Texas medicaid actually does it on the mco side, but it’s basically like there’s a single credentialing event that applies to multiple payers, and that reduces the cost, right? So, the idea is if you united and Molina are all credentialing the same provider and we’re all leveraging medallion, then we’re not sharing that file.
Scott Everline (58:16) We’re not sharing, we’re sharing the cost against the three different organizations. So you’re basically theoretically paying like closer to a third of what the rate would be because we’ll be able to reuse the work. So that definitely reduces a lot of the costs on the cvo side and that’s where our biggest footprint on the payer side is, right? As you can imagine like you’re looking at cred files going from 100 dollars a file down to like 15 dollars a file.
Bramer Owens (58:37) And we.
Scott Everline (58:38) can certainly dig into that a little bit more. But that’s really like our foothold in the payer space more so than like a lot of this data acquisition cleansing type process. And we look to partners to solve. I.
Bramer Owens (58:48) Think, I mean, just thinking out loud, it’d be great to say, hey, we’ve got, I don’t know these four payers and they want a fifth to join them to create whatever it’d be, wouldn’t be 20 percent yeah 20 percent you.
Adolfo Carrasco (59:02) Know the cost or?
Bramer Owens (59:03) Whatever on the cvo side, harvard, are you interested?
Bramer Owens (59:08) And so I think that, yeah, I mean, what’s going to challenge for us for a regional plan? They’re probably all statewide plans. So I guess it really, so I’m sure there’s well, we can cover that in a future time. But what I heard just to make sure I’m in which I’ll tell me the last night we have. So what I heard was harbor you need to plan on having someone man it, get your own Christian department, which is fine. We probably need to anyway as we scale and have someone designated to manage that on the health plan side, you know, manage that. And our job is to give you really good ncqa compliant clean or not clean files but files for that committee to review on the data management side. Most of our health plan clients at this point in time, have other solutions that they manage outside of our platform… that work inside the organization to create a unified roster. Is that correct?
Scott Everline (60:11) That’s a pretty accurate judgment.
Scott Everline (60:17) Based on your volumes, from a staffing perspective, other than staffing the committee, you probably only need three quarters of a human to manage the like the file prep and pushing through like that individual like credentialing committee piece. And I know pretty.
Adolfo Carrasco (60:32) Sure you do that.
Scott Everline (60:33) On the provider side of the provider org side of the house.
Jimmy Price (60:36) Yes, I do.
Scott Everline (60:37) And it, depending on the volume, potentially not to sign Jimmy up for work, but potentially something that might be able to be managed in that workflow and him kind of be a user across the two platforms as long as that wouldn’t necessarily violate, any modeling. And I don’t know Jimmy if you guys do that, on the provider side of the org today, you guys or if it’s similar with onecred?
Adolfo Carrasco (60:59) No.
Jimmy Price (61:00) We actually, I personally work for, I just moved over from villagemd, so I’m very familiar with what you guys provide so, but just not, on the health plan side.
Jimmy Price (61:12) So, this is good for me to know and interesting for me to know. So I pretty much know exactly what I’m getting from you guys from that standpoint, because we’ve been, I think it’s about two years now that we’ve had villagemd so.
Bramer Owens (61:32) A chance to answer the questions for me that’d be really helpful because I mean, Michelle and others want, you know, I think want us to like get to a decision point pretty quick on this to be helpful. Yeah.
Scott Everline (61:44) We can get that cranked out for you. I think it’s like 90 percent completed anyway. So we’ll get that fired off.
Bramer Owens (61:53) I know we’re past time. Any other information y’all, need from Adolfo Javier myself?
Adolfo Carrasco (62:01) What.
Garrison Goodman (62:01) we talked about here, bramer, sounds like you understand, it sounds like you’re gonna have some conversations internally? I guess just gut check. Does anything you hear from us?
Bramer Owens (62:10) Today, like.
Scott Everline (62:12) You know, kind of preclude us?
Garrison Goodman (62:14) From, from moving forward, is there any like thing that you heard that was like a major red flag or anything?
Adolfo Carrasco (62:21) I, the red flags for me?
Bramer Owens (62:24) Are not related to medallion. To be honest, it’s more okay. How are you going to manage the other 80, 90 percent of your network? Like that’s? What I’ve got to figure out. And so that’s something I need to sort of like internally in terms of what you showed is where the platform manages as a cvo. I mean, it is as good if not better than our current process today. And probably, I mean, I’m no insecure expert, but probably our.
Adolfo Carrasco (62:51) destination has.
Bramer Owens (62:52) To be to manage our own, our… in house as we scale, so that’s going to be the destination, I would imagine. And so that’s something.
Adolfo Carrasco (63:03) That, yeah.
Bramer Owens (63:04) That’s something that we’ll have to work out internally, get back together. Okay? All right.
Jimmy Price (63:09) We’ll send a summary.
Garrison Goodman (63:10) And we’ll stay close and we’ll so like Scott said, we’re almost ready to send over the rest of the information. So, thanks so much for the time and partnership helping us understand your business and we’ll follow up here shortly.
Bramer Owens (63:20) Great. Thank you so much, all.
Jimmy Price (63:22) Right.