Transcript
Jake Shubert (00:00) hello? Hello?
Nicole Campbell (00:06) I read through that.
Anu Vora (01:44) Hi, Anu. Hey, how are you? Good?
Nicole Campbell (01:47) How are you doing? I,
Anu Vora (01:48) am good. I just shot you an email I’ve been trying to find three seconds in my day to send it earlier. So, I apologize. Hey, Jake. Good to see you, hey.
Jake Shubert (01:58) Great to see you it.
Nicole Campbell (02:00) Hasn’t come through to my side yet. So literally might be in transit.
Anu Vora (02:03) That’s fine. We use outlook. So everything takes. Okay. Yeah… the worst. So, let me start off with the good news which is we can do quarterly payments. Everyone can breathe easier. Yeah, I’m happy.
Nicole Campbell (02:20) For you too. Hopefully that’s weight off your shoulder too. Yeah.
Anu Vora (02:24) Yeah, it’s all good. And so that’s done. And I’ve got a lot of like tactical questions since we’ve gotten through that piece that I want to be able to jump in. That are… the biggest pieces with, of which is as soon as you get that document that I sent it’s an excel sheet of all of our payers. I just, my ask is, can you help me group them into what was become, what would constitute one enrollment? I was hoping to get that to you sooner, but I just got it myself. I think that would be really helpful so that we can essentially manage because our enroll, we might blow through our minimum enrollments. So hopefully we can get that together. Yeah, the other piece for you is no huge notes on the msa either from our legal team. So we were able to get the review. Let me just pull that up. Wait a second.
Anu Vora (03:23) I’m still waiting on these Cameron, do we ever see you smile? I’m giving you good news left and right here.
Jake Shubert (03:27) This is the same question I asked. This is.
Anu Vora (03:30) Yours, this is an exciting question.
Cameron McCormick (03:34) Yeah. No, I am very pleased to hear that. And I am smiling now. I was reading some other messages unrelated to this that make me not?
Anu Vora (03:45) Smile. No, it’s I’m just making fun.
Jake Shubert (03:47) Isn’t that always the response you want, which is I’m smiling now, nothing. Nothing quite warms the heart like.
Anu Vora (03:52) That, no, exactly. Exactly. Yes. All good. I’m just hoping for fun, no.
Cameron McCormick (03:59) Very fair call out.
Anu Vora (04:01) And sorry small thing. It’s Anu, in case it’s my name. Yeah. Oh, sorry. No, no, no. It’s okay. We’re gonna work together for a long time. Yeah, it sounds like. So apologies for correcting.
Jake Shubert (04:14) No, no, thank you for that.
Anu Vora (04:16) Yeah. So the only questions we have from the order form are… well, okay from the msa. Let’s start there because this is truly, I think the only question that I have which is around phi. So let me pull up. So basically, that doesn’t allow for like any phi to be uploaded into the system. I understand that. However, what do we do when there is a denial that’s impacting a client? And so typically our flow is like let’s say… and I’m probably going to misspeak. So I might need to open up my whatsapp again. But if there’s a client that’s impacted, they can’t get into care. There’s a pa that’s denied or there’s a bill that’s denied. We’ve seen something at the end of the funnel, right? Like six months from now and you all did the enrollments. Theoretically this went through. We got STC in the timing that we needed. Everything is green light, go. Why are we getting a denial on the basis of a credentialing issue? Our current flow would be call our credentialing team, and set or send them an email or something that says, hey xyz patient isn’t able to get into treatment. Because, with abc provider, because of this payer, so does it make sense for us to send you a baa so… that we can discuss things with you? We’re since we’re the covered entity we have our baa. Should we do that? Yeah.
Jake Shubert (05:47) Can definitely, if I’m speaking out of turn, but this is a really good question one that comes up quite frequently given the nature of what we do, we are managing PII, but we are not actually managing really any phi inside of the platform. So as a result, I think with like 99 percent of our customers, we do not need to have a baa in place that doesn’t really negate our ability to talk about those things with your engagement manager, with your account manager, or with our team. So… I guess just speaking from like direct experience, I would say we do not need a baa, but.
Anu Vora (06:23) Here’s what makes me nervous if we’re on a call and we’re not uploading anything, but like you’re on your engagement manager is on a call with my like head of clinical and he is like pulling up a spreadsheet as people do in these shared calls and it’s got like client patient information, like you are our vendor. This is going to touch like it might have a, or might be looking into our ehr and saying, why am I seeing xyz or looking into a note? I can’t control what might be screen shared. You’re definitely going to see client names. So we would feel really comfortable signing a baa while signing your msa, that says we agree, we will not upload any phi. Yeah, I.
Jake Shubert (07:02) guess that, that’s a helpful clarifying point there. I guess one more question if you don’t mind.
Cameron McCormick (07:09) Given.
Jake Shubert (07:10) sort of how you express that concern, would an NDA cover that as well where it’s like instead of needing a baa just, we know, that would not cover that for you? No, okay.
Anu Vora (07:20) So, yeah.
Cameron McCormick (07:22) No, thanks for the context. We’ll we will, we don’t do baas, because we don’t handle PII or phi. Excuse me, and we like forbid the uploading of phi as terms of service in our msa. So we’re we can ask our legal team about this specific scenario. But I can just tell you like we’re not going to do review and, or sign a baa. Like we don’t have that with any of our customers and we can talk through like what the best practices are for this scenario specifically around denied claims in phi. And I, we can get an answer back to you on how to handle that. But like we’re not going to make any progress internally trying to go do a baa for this contract?
Anu Vora (08:18) Even if we’re acknowledging that we’re signing and agreeing to an msa that prohibits us from uploading phi, if.
Cameron McCormick (08:24) that’s the case, the response from our legal team would be then why would we need a baa because?
Anu Vora (08:30) We’d be meeting with you and you’d be sharing patient information, we’re not uploading anything. Yeah.
Cameron McCormick (08:36) I will check with them, but, I, this is, this comes up frequently like customers, even though we’re not processing or touching phi will want a baa and we do not execute them. The response from our legal team will be, I can tell you what it will be. It will be, we forbid customers from uploading phi into our platform. Like we’re not going to take on unnecessary restrictions, and like burdens.
Jake Shubert (09:11) Yeah.
Anu Vora (09:12) I think for this case, we’re the covered entity. So I think like there’s the legal argument that you would send a baa which doesn’t make any sense because you don’t have any data that you’re covering. We’re the covered entity, it’s for our protection. And it’s us also signing an agreement. We don’t have an issue with your msa. We’re saying we agree, we will not upload phi. We also agree that you’re a vendor that we may be discussing a client, a client’s, name may come up in a call. You all record every call. Now that has, that is an admission of patient information that I have to be wary of. That might be out there. I can’t get sued with like a hipaa complaint because I’m talking to my own vendor internally with my team about a client, their denial, the provider, the payer that will come up in the ordinary course of business. So, I think I feel safest knowing that we can openly talk otherwise, I have to coach my team not to say anything. The reality is we have a baa with our current credentialing provider, we can email them. This is what happened. This is what’s going on and they help us get to the bottom of it. So it’s a really clear… thing not to upload any data. So, yeah, let’s.
Cameron McCormick (10:32) let’s table this for a second. Let me talk to our GC and we can circle back on it for.
Anu Vora (10:37) Sure. Okay. Dumb question. If an application is denied, let’s say like we apply for all five seven anthems, we have, right? Plans, different plans. We get paid charged for one enrollment or whatever. In that case, let’s say five of the seven come through, completed accepted, enrolled, rostered, whatever you want to call it. Two don’t fine. We’ve paid the 90 bucks. No big deal. What if all of them come back? Denied? For some reason? Do we still pay?
Jake Shubert (11:15) Yeah, I can take this one first. So what we’re what we charge for is the application submission, that goes out, right? So, for the work the medallion is doing is of taking all the provider data, filling out the applications, filling out the forms, submitting to the payers doing the payer follow up, etc, that is the work that we do. So that’s how we charge. So in essence, like we’re not going to charge differently if an application is approved or denied, however.
Cameron McCormick (11:42) Denials.
Jake Shubert (11:43) are obviously something that we need to work on together, right? So if there is a denial that comes back from the payer, the notes from the payer, the reasons from the payer, all that’s going to be locked inside of the platform. If you guys need to work on an appeal or whatever, that might be. That is also work that like we can work on in conjunction. Your team would be the one sending it out, but we can help out with that as well. Sorry, I came, I thought you go off mute.
Cameron McCormick (12:06) Go ahead. I’m just gonna add one thing when you’re done, yeah.
Jake Shubert (12:09) And I was gonna say in addition, obviously, like if we know ahead of time that a panel is closed for whatever reason, we would share that information with you, but, you know, panels can open and close on a pretty random basis, but.
Anu Vora (12:21) Okay. We’re gonna charge regardless and if we see denials and we’ll work on them and we’ll stop applying.
Cameron McCormick (12:26) Yeah. And what I was gonna say is the thing I was gonna add is if it is a medallion like air, which is, yeah, not what we’re expecting but like we, you don’t repay, we will fix, we will fix the enrollment and get the enrollment process. Got.
Anu Vora (12:41) It. So if I send you a packet of information, you type something in wrong, it submits exactly.
Cameron McCormick (12:46) That’s counted as a consumed enrollment, but you’re not going to be counted. You’re not going to be double.
Jake Shubert (12:52) Charged. Yes.
Anu Vora (12:53) Okay. Sweet. Do we pay caqh, monitoring on a per person basis? This is a very technical point or a per seat basis. Meaning when I have an intern that comes in and leaves after one semester and another intern comes into that same seat, I’m technically paying for one seat for the year or are you going to charge me? They’re.
Cameron McCormick (13:17) transferable? So if somebody leaves, you can reassign and yeah, and,
Jake Shubert (13:23) out of that also, I know why they asked specifically for cqh management, but just so you know, that also applies to core and ongoing monitoring as well. Okay?
Anu Vora (13:31) If we don’t want you to manage the caqh for our interns because it’s literally, they’re only on medicaid in Ohio, then… can we do it? Can… we monitor their cqh? Because I have 80 interns and… I make like no money on them? Yeah. So to pay 100 bucks per intern would be hard. Yeah. So.
Jake Shubert (13:59) The question there would be, is it possible to do cqh management for some providers but not for the interns? Is that correct?
Anu Vora (14:06) Meaning we would still have to do it for our interns, but we would take that on rather than medallion doing it because it’s just not worth it. They’re like not they’re baby clinicians, yeah.
Jake Shubert (14:17) The use case, I definitely understand there I guess just from like, a technical feasibility level of cam, do you think? Is that something that we can have on the platform? Because obviously, typically that’s more of a, of an all or nothing skew. So I’m just curious cam, if you know the answer to that one, if not, I can.
Cameron McCormick (14:32) We’ll have to ask Noah, I believe that you, I mean, obviously, you can manage those providers caqh yourself if that’s something that you want to do. But, what we need to check on is like, is that technically possible? And I believe it so, but yes. Well, meaning.
Anu Vora (14:52) Like we can use medallion. We can get all of our reporting. It’s just that those providers we are managing ourselves, we’re still using medallion for those interns. We’re just saying these guys will do the updating, yeah.
Jake Shubert (15:04) The, the ask makes perfect sense. We shouldn’t make sure that’s technically feasible in the platform and not something that’d be either all or no provider. So I can get the answer to that for you.
Anu Vora (15:13) I would prefer that you guys do everything and you just discount by 25 percent because there’s no work there. So, if you prefer that and you get more seats at a lower cost, then let me know. Otherwise, we’ll just manage the interns ourselves. Yeah, I.
Jake Shubert (15:30) think that makes sense. I think the issue with my run to there is we’re already at like, I think 60 or 70 percent discounting on that skew in particular, because.
Anu Vora (15:39) we know.
Jake Shubert (15:39) This is, you know?
Anu Vora (15:41) Yeah.
Jake Shubert (15:43) Yeah. So I think that, that’s where, that issue might arise. So, yeah, we can get an answer for you on if there’s a way to like, you know, get the more happy medium and if not, then figure out what it looks like from there, got it.
Anu Vora (15:55) Next question I’m just rolling through. So thank you. No.
Jake Shubert (15:58) No, these are great rapid fire is perfect.
Anu Vora (16:00) So, so the company I started is called mindfully behavioral health, that’s the parent company. So it’s evolve health LLC, doing business as mindfully behavioral health, that is not an operating entity. It’s a parent company. It’s a holding company. It owns 100 percent of mindfully LLC, which is what you’ve written as a contracting entity, which is the counseling business, as well as a separate entity, mindfully psychiatry LLC, as well as mindfully Texas LLC, which is just getting started and doesn’t even have anybody in there, but we’re hopefully growing as well as ignite counseling, Colorado LLC, as well as a few others. I would like all of these businesses to be covered in our contract. That will only increase the number of seats with you right now. I’m only starting with and scoping out for mindfully LLC and mindfully psychiatry LLC. So my ask is, do I need anything special? Can I label each sub organization?
Anu Vora (16:57) So I can at least like do searches and filtering off of what the sub org is. And also can I do the contract at the parent level? Was that the intention or did you specifically send me a contract for mindfully? LLC?
Jake Shubert (17:09) The intention was to do at the parent level. So this is a great call out. So Anu, we’re on the same page on this. So I can, I’m sorry, Anu, so I can… switch that in the order form language to be for evolve, right? That’d be that’d be accurate to make it evolve as the.
Anu Vora (17:24) Evolve health LLC. Okay, doing business as mindfully behavioral health. Yep. And if you could write in there and it’s subsidiaries, like just in case I ever have an issue where I need to show that I have a credentialing partner for a sub entity, it’ll be covered. Just, yeah.
Jake Shubert (17:41) And, and just your, other question, that was, there is like, yes, inside of the platform, you can, you know, sort of label out subgroups, you can do reporting and stuff like that. So, you know, we have a lot of customers who will be like a manager organization who have like, you know, eight different fqhcs roll up under them, or different health systems or whatever it might be, right? So, that has to be like a part of the platform. So, yeah, that, there, there’s like a certain level of reporting, you know, access and controls, permission sets, et cetera, that you can do there. So.
Anu Vora (18:13) Got it. I am not clear if I need ncqa compliance monitoring for interns. And so, so sorry, that was, did you guys freeze or can you hear me no?
Jake Shubert (18:26) We can hear you.
Anu Vora (18:28) You were focusing and I was like, no.
Jake Shubert (18:30) Yeah, we’re just, yeah, we’re just, very focused so.
Anu Vora (18:33) The, the minimums for ncqa monitoring probably need to go to 200 because we don’t need you to do that for interns. And if we do, then we need to do that ourselves, same thing for caqh, are we able to, is the question? So, again, there’s not much to monitor because they’re only accepting medicaid in Ohio, yeah.
Jake Shubert (18:58) For the monitoring specifically, that is not something we could toggle between providers. We would do the same level of monitoring for all your providers. So ncqa monitoring seems to be the requirements based on our, off our conversations with Tiffany and prod, if you want to lower that quantity amount from, I think, is that 250, I could check, but 250, let’s say, yeah, so, from 250 down to 200, that is totally something we could do, but we couldn’t do, ncqa monitoring for this cohort of providers, and then a different level of monitoring for a different subset of providers. No, what?
Anu Vora (19:33) If we just did no monitoring for the interns, can we have them in the system? And then just say we’re turning ncqa monitoring off for interns. Yes. So, pretty much I.
Cameron McCormick (19:44) Guess, can’t really know if?
Jake Shubert (19:45) I’m thinking about this the wrong way, but the way I’m thinking about this would be, yes, you would, purchase like 200 seats for ncqa compliant monitoring, that would cover the providers whose monitoring you actually want to do. And then for the interns or whoever it might be like, you know, you then just would choose not to purchase more seats for monitoring there. But I guess cam, am I thinking about that the wrong way? We’ll.
Cameron McCormick (20:10) just have to double check on whether because I think.
Jake Shubert (20:14) there might be some issues with consumption tracking with that approach, but we’ll double check. Okay, let me write that into double check.
Anu Vora (20:20) Understood. I’m sorry, our intern program is, very, large and is definitely unique.
Anu Vora (20:32) We’re more of a training practice, so, but it’s good because they usually like 90 percent of the time stay with us, become dependently licensed, and then you can benefit from their credentialing, and monitoring. Okay? So the units, once you get that confirmation, assuming that we can just like toggle it off for ncqa, we will do that for, and change the seats to 200, and then same change for caqh monitoring. Because I confirmed that we can probably do that ourselves. Now, there’s a chance that we’ll say we don’t want to do it ourselves and we’ll come back to you. It’s just like that’s. Imagine… someone’s doing five sessions a week for you for 10 weeks and that’s all the revenue you’ll ever make for them. And for that, you have to pay somebody for their supervision. There is nothing like there’s nothing left at the end of the day from that.
Jake Shubert (21:32) Program. Yeah, the economics of why you’re asking these questions makes perfect sense. Yeah, correct.
Anu Vora (21:36) So, let’s see. Okay, demographic updates. So on your response, Nicole, you said in one of the 100 emails, there was something about a demographic update. So, if we change or a location. So let’s say we change an address for a location, and we add a suite number and we have to update that location’s. Credentialing, that would be a one time 70 dollar demographic change, or if we add a new location that we need to get all of our providers credentialed under or located, sorry added to our practice, and all of our providers would be then credentialed to that location that’s not a new enrollment for 300 providers or whatever that’s a one time demographic change for a new location. Let me know if I can clarify that question. Yes.
Nicole Campbell (22:30) You are correct. I’m like I’m just trying to make sure I’m like taking off all of these Cameron and Jake jump in if I’m wrong here. But, both of those scenarios that you laid out are correct in terms of what the demographic update is applied to versus like a full new enrollment? Okay?
Anu Vora (22:47) So, we wouldn’t be charged 70 dollars for every provider who works at that location. Okay?
Nicole Campbell (22:52) Correct. It’s the demographic update, SKU price, which is the 70 dollars are there any?
Anu Vora (22:58) I didn’t see a pricing for that anywhere. So then it got me thinking about where are all the other? Like where’s the full price list of things that aren’t in our, yeah. And the,
Nicole Campbell (23:08) reason we don’t include everything like there is so much more scoping that like is not needed for this org and kind of is aligned with more hospital systems. This was something that then why we like asked so many detailed questions up front because otherwise, it would be like very overwhelming in terms of what is potentially possible but this was not included. Yeah, because we kind of hadn’t brought this up at all in conversations. But I don’t think there’s anything else that would be relevant to the mindfully team that we have not scoped. Yeah, the other?
Jake Shubert (23:39) Excuse, like if you want, we can absolutely share them but haven’t been told that we needed our like licensing. So, you know, if you wanted us to get a new license for your providers, do license renewals for your providers or those kinds of things like aren’t in scope because, you know, that’s just has, so.
Anu Vora (23:54) I saw that in the contract, it’s listed as like a pass through. Is that a pass through or is that a price somewhere in your price list?
Jake Shubert (24:02) Yeah. So you’re referring to the pass through fees? Yeah?
Anu Vora (24:06) It was like in that you even wrote for example, like licensing for a provider whatever like the fingerprints and everything else and the application costs would be a pass through. So, I guess… I’m wondering if there’s like if there’s an add on that, is that like a specific price, then I should, I definitely want to see the price list for everything else just to know where we could get a… bill, but it sounds like what you’re saying is so, well, let me stop there and let you respond. Yeah, so.
Jake Shubert (24:36) Just to call out what we refer to as pass through fees, are, this is not like a revenue driver for medallion through the course of getting providers credentialed. There are certain fees that come up that medallion has to pay upfront to get a provider credential. There’s gonna be the same fees that you guys are already paying today to get providers credentialed. So we pay for those pass through fees upfront. That way we don’t slow down the process of getting your providers enrolled and credentialed. And then at cost, we pass those down to our clients. So we don’t upcharge or something like that. There’s no delta there. It’s just any fees that we have to pay as part of the process for mindfully to get providers enrolled. We would pass those down. That being said that’s pretty much only applicable or mostly applicable to licensing for payer enrollments, which is what we’re talking about. And cbo credentialing, which isn’t part of the scope either. But for payer enrollments that doesn’t really exist. So, you guys shouldn’t have like a pass through fee motion as part of your relationship with the working group medallion. If we were talking about licensing though, that’s why that exists in the contract. So if I.
Anu Vora (25:43) got all 300 of my providers licensed in like one new state then it would be the licensing, pass through costs, but I’m not going to get a surprise fee on credentialing. Like I’m not going to get an application fee on top of my enrollment. Okay? No, that.
Jake Shubert (25:59) Wouldn’t exist again? Yeah, the pass through fees are for licensing, not in scope for what we’re supporting and cvo credentialing when you guys are like a delegated entity, not in scope for what we’re supporting. So, yeah, there should not be pass through fees included here. Do.
Anu Vora (26:13) You, do, I feel like we talked about this many moons ago. Do you do make us a designated… yeah, whatever it’s called?
Jake Shubert (26:24) Yeah, that is something that we do support. There’s obviously legwork that goes into that. That would be on the mindfully side though. So you guys will need to reach out to your payers and figure out if they want, you know, you guys to go down the path of delegation if they do though we are an ncqa certified cvo. So we handle all the work of actually, you know, processing the credentialing files, helping with their committee setup and support policies and procedures. We help like tremendously with the delegation process. So we totally could talk about that. But the first step would be figuring out if your payers are open to that or not. Okay?
Anu Vora (27:02) We have only like three minutes left. So last quick questions. We have a clinically integrated network with a local hospital here. I’m not sure if you’ve worked with any companies that are part of clinically integrated networks, have.
Jake Shubert (27:20) you? Yeah, I guess so.
Anu Vora (27:22) Essentially, we’re like one step above a referral partner, one step below like embedded. And so essentially, our providers need to become credentialed with mercy hospital to be part of their clinically integrated network. How does it work when there’s a hospital system you get credentialed with? Is that something we can do on medallion? Yeah, great.
Jake Shubert (27:48) Question. So this is commonly referred to as like a privileging use case of getting providers credentialed and have the necessary privilege at a health organization that is absolutely something that we do support. However, that is something we would want to scope out with you and have be included in the proposal if that is a necessary requirement for your providers. So I guess let me pause there. Yes, we do support that. The follow up question would be… is this something that’s necessary for your providers right now? I’d love to understand a little bit more about what this workflow entails well.
Anu Vora (28:26) Anytime we add a new provider, we have to like in Ohio, especially in Cincinnati, we have to put them on this list and get them credentialed with mercy hospital. And that’s… because we’ve got like minimums, you know, they have a lot of flow that’s in our way. It’s a very meaningful referral partnership. It feeds our clinicians. They typically will. Then I don’t know if you care about the workflow afterward, but once you’re credentialed, then they’re essentially like giving… it. If you go to your doctor’s office and you fill out your phq nine and they say, my gosh, you’re depressed, you need to go to a therapist. Usually, they send you to somebody in your network otherwise they’ll say, hey, actually go to my, that’s like a partner organization of ours and they’ve been vetted and they’re like, you know, making sure they’re looking at our organization. And then the client says, okay, great. That referral gets faxed to us. We scrape it. And then we can like reach out to the client. So they’re sort of doing one two step of avoiding the client having to take, do anything. We can reach out to them. In order to have that privilege, we have to get credentialed into the mercy system that’s super helpful.
Jake Shubert (29:35) Do you have time to just dive a little deeper into this? Or do you have? Okay?
Anu Vora (29:39) Couple of follow.
Jake Shubert (29:40) up questions there first. Like how are you guys handling that process today? Is that your current like verifiable ipc? Okay. Got it. And then when talking about sort of like being added, to the staff having those privileges? What’s that actual process? Like like are you guys filling out like, a hospital application? Is there, is there a paperwork process? Like what is actually, what is the verifiable ipc group doing to get your providers, what they need to provide care? No clue.
Anu Vora (30:11) So, I have to, I have to find that out with my team. I’ll take that as a follow up for me.
Jake Shubert (30:19) Yeah, cause we want to understand, we just want to understand if this work is already scoped in this proposal and we’re all set or if this is more of a privileging use case. Yeah, in which case, we have to understand, you know, what is the volume of this? What does that entail? And then make sure that we’re scoping that accordingly. And I’m also getting you discounting in line with discounting you’ve seen with other SKUs to make sure this is again economically viable. Yep. What does the data.
Anu Vora (30:44) important transition look like? So ipc has already started credentialing for several people, you know, how do we transfer? So that’s question note one. Yep. And then for the existing folks, how do we move that in? Is there any cost to moving the already credentialed folks in too?
Jake Shubert (31:04) Thanks, Cameron. Yeah, thanks cam. Good question. So what the process looks like is we have a data import template that is, really straightforward. We just need like five or so data points, name, social security number, caqh, id, things like that. And from there, we’re able to begin sort of the bulk upload of pulling all providers data from caqh from other data sources to get provider profiles about 80 percent complete. We then share that template as well with your team to help fill in any historical information that’s really important, right? You know, historical information on enrollments, your relationship with payers, whatever it might be. And then medallion, we do all the work of taking that data, cleaning it up and then creating all of the provider profiles for all the mindfully providers. So we do all of that work overall to be like a complete go live. So all historical information is included, typically takes about eight to 12 weeks. But to start doing enrollment work to start bringing in new providers, things like that could be done in the first week or two. So if you guys have a batch of enrollments or work, you need us to do whatever it might be, that can start pretty much ASAP. But to get all the historical data in, we would go through the import template that we have, and that would take about eight to 12 weeks to get you guys fully live, alright, then I.
Anu Vora (32:22) have a little bit of a fun curveball for us to navigate. So, ipatientcare are aware that we’re looking to replace them on the credentialing side with medallion. They are up for renewal on their verifiable contract. They’re not going to renew if we move to medallion. Yep. So we may not have eight weeks to… be looking at historical data we may have.
Jake Shubert (32:53) Yeah, very.
Anu Vora (32:55) Little time that, sorry.
Jake Shubert (32:58) I didn’t mean to cut you off. I would say that’s a really important call out. It likely wouldn’t be too much of a concern because verifiable is pretty reliable with getting data exports. So, what would happen here is you guys should be able to pull all the exports you need from verifiable in this period of time until, you know, that contract terms, the ipc and then you guys will have all that data that we need to sort of populate the import templates. We can start the import template ahead of time. We also, I could talk to Noah the SC, and get any other best practices, but yeah, you guys don’t need like a live instance of verifiable, you just need to have that data somewhere. So just pulling out those exports ahead of time would mean that you’ll be in good shape.
Anu Vora (33:37) Okay. Sweet. I’m like, oh crap. No, that’s.
Jake Shubert (33:40) really, I’m happy you didn’t bring that up and we didn’t talk about that and you’re like, well, it’s gone now. So what?
Anu Vora (33:45) Do we do? I feel like I’m like I always joke with the team. I’m like hungry hipaa, I’m just like knocking things like all the time, just like finding things under rocks. So, okay. Is there any, is there any cost we have not talked about that we are going to get charged outside of this like that is if you can’t help, I’m just like, I hate surprises. So the only.
Nicole Campbell (34:11) thing I would say is like we’ve scaled it back a lot and that is my only like word of caution is that if you do overspend in terms of like we over exceed what your minimums is that’s the only area where it might be okay, we’re either pulling in from year two, which would then change if your year two continues on the same growth pattern. But no, like we’re not trying to hide costs. We’ve only scaled back. And that would be the conversation that potentially happens where we actually are exceeding your minimums, I think.
Anu Vora (34:44) We will, and that’s what I told you is, I’m like I really.
Nicole Campbell (34:47) Don’t want that to feel like in the future for you hitting costs, cause like I want us to be able to like that’s the only thing we would then.
Anu Vora (34:53) I appreciate that. That’s where I need a lot of clarity on that group, the groupings. So whatever goes together. I’m sorry, I wish I could have taken more time to make it prettier for you, but in the interest of time, I just decided to send you this ugly spreadsheet. There’s seven different anthems in different places, the bcd here and anthem there. Like, are there seven of them that count as one enrollment? Where am I going to get charged? That’s probably the biggest risk at the last mile for us is if I feel like we’re going to have to do 15 enrollments or 30 enrollments. Now, what we’ve also done is be very transparent about percentage of the business yeah.
Nicole Campbell (35:32) Which.
Anu Vora (35:33) is why as many of those plans that have like no encounters and no patients that we can lump in somewhere else with the payr group is very valuable for us because we have to have some of these groups to be able to get access to it’s. A marketing issue. It’s a, you know, being able to be on these different panels and lists. It’s sometimes a contractual obligation. So then we’ll have to start being really creative about which payers or which providers we yeah.
Jake Shubert (36:03) Yeah. Do for us, that makes a lot of sense. Do you mind if I just regurgitate stuff back to you real quick just to make sure I do it? Yeah. Okay. So things that we need to do, we need to do exactly what we just talked about. The assignment with payr is figure out what the groupings are. So, you understand what one enrollment covers for each payr, that’s very clear. There’s a caqh management, ongoing monitoring pieces of what that looks like, if that can be sort of broken out based off of the amount of interns you guys have, how that reflects pricing. Those are two other action items. And then on your end, is this privileging potential workflow that just came up? We need to understand a like, is this a privileging use case? We should understand like in as much detail as possible, what’s required for these providers, you have this relationship with or for this health organization you have this relationship with? And then if that’s a privileging use case, understand what scope of that looks like to your point, that way, there is no surprise of costs that come down the line. Is that clear? Is that accurate? Anything else that we missed here? That?
Anu Vora (37:05) Is accurate. And I have one last thing. Sure. We left medicare off of our list of the top eight payers. So here, it has sent us nine payers that represent like 75 percent of our volume on encounters… we removed humana. So now it’s eight payers, yup, humana, Ohio medicaid. I would like to see if we can add medicare on there only because that is a big payer for our psych group. And since this is a mindfully behavioral health contract, I just want to make sure that it can still come in at that 74 day STC. Yeah. And this is just to.
Jake Shubert (37:45) Have this is just standard Ohio, medicare, right? Or is there a more specific, I was going to say I?
Nicole Campbell (37:52) See humana, medicare on the payer list? I don’t.
Anu Vora (37:56) I’m going to search medicare on this list.
Nicole Campbell (37:58) I’m just looking it right now and that’s like number 23 on your payer list? I’m not seeing it.
Jake Shubert (38:05) Yeah, because that’s just going to be like our analytics team is going to ask us like, okay, medicare, is there a specific medicare? Yeah.
Anu Vora (38:13) There’s… give me 30 seconds. I know I’m taking up a lot of our time. I’m sorry?
Jake Shubert (38:17) No, you’re fine.
Nicole Campbell (38:18) No, this is important. So, yeah, we want to make sure we get it.
Anu Vora (38:23) Psychpayers.
Anu Vora (38:28) Student health care self pay, united… medicare of Ohio medicare.
Jake Shubert (38:35) Of Ohio. Okay. Yes, that is, let me write that down too.
Jake Shubert (38:38) Okay. So I lost my there. It is okay. So also look up adding medicare of Ohio to STC. SLA. Okay. Cool. We could put in a request for that too and let you know. Cool. Sorry, Nicole, I was gonna ask.
Anu Vora (39:00) If we could do 70 days, not 74, but if you can add medicare and keep it 74, I’m a happy camper. Okay?
Nicole Campbell (39:06) I was gonna say like that’s what we’ll aim for there and that was gonna be my only thing. The only other ask I think from your end if we can, is getting the redlined msa over. Just so as Cameron goes to talk to our legal team about the other, ask with the baa, we just have that piece as well.
Nicole Campbell (39:29) Ask about other. Yeah, just other pieces of the contract. And I don’t want us to leave them out.
Anu Vora (39:34) No, I think you just need to update it with your updated SLA language because it’s not correct. The, we had talked to, you had sent me new terms yesterday after you sent me the SLA a few days ago. So y’all knew to update it. So.
Nicole Campbell (39:48) There’s no other red lines.
Anu Vora (39:49) No. Okay.
Nicole Campbell (39:51) That’s that’s good. That works for us. I just really.
Anu Vora (39:55) Really, really want to be aa because I am so scared of a hipaa complaint and everyone records their meetings and everybody has these AI bots on their calls and that’s great. But somebody’s going to mention a patient and there’s going to be a record somewhere of that in your system. Yeah, I will let.
Nicole Campbell (40:15) We’ll we’ll get information from Cameron for that piece. But I will also put the ask in for us to make the like formal updates with the language we sent over now that like it’s been approved from your end as well. Yep. So that’s the piece we can work on too. But, okay, in terms of turning this around, just want to give us another stop gap. I think it makes sense to give us a day to work on all of this and just come back hopefully Thursday with the final kind of hopefully we’re bringing everything. And if there is any scoping we need to do, we get ahead of it. Does Thursday around the same time still work for you at like four four 30 eastern?
Nicole Campbell (40:55) Or we can make other. Yeah. Okay, great. I’ll send over a meeting for all of us again at that same time and then we might communicate async before then with any other questions or information we get before then. Okay?
Anu Vora (41:08) And at, I just noticed on my notes, I missed one thing. Yeah, I was supposed to say we can do quarterly payments and we’d like net 60 terms on.
Jake Shubert (41:23) Terms. Okay. Yeah, we can ask about that. Kay Mckinney promises on that just out of my control. And also Nicole’s control. But we should be able to answer for you on that by Thursday.
Anu Vora (41:38) And I just want to confirm that the implementation, whatever the annual cost for the first year is inclusive of the implementation cost is what’s being broken up into quarterly payments. It’s not like that’s correct implementation plus the quarterly of the row. Okay. Yeah, yeah.
Nicole Campbell (41:53) That’s all included for that. Okay?
Anu Vora (41:57) I think I have said everything I can think of. So, thank you so much. Yeah. If there’s.
Nicole Campbell (42:03) anything you remember after, feel free to shoot us over. No, I.
Anu Vora (42:06) don’t even want to do that.
Nicole Campbell (42:07) Yeah, just.
Anu Vora (42:08) Like so much other work to do. I.
Nicole Campbell (42:10) Hope you get home before like eight when you click, when you call, no?
Anu Vora (42:15) Chance. No chance. So we have a big event tomorrow. It’s 20 years of celebrating since my family founded their fund.
Nicole Campbell (42:26) My God. Wow.
Anu Vora (42:27) So, the, all the companies, are coming together. We’ve got people flying in from India, California everywhere with 250 people coming governor, kasich, who ran for president, if you remember his speech.
Anu Vora (42:40) Yeah, we have this like, I don’t know what I feel like. We’re throwing a wedding tomorrow, and I haven’t even written my speech guys. So that’s my night. My.
Nicole Campbell (42:53) Gosh I can’t wait for Thursday. We’re just gonna need a recap of this or like the first 10 minutes, how?
Jake Shubert (42:58) Do we know? And me and Nicola flew out, hyped you up?
Nicole Campbell (43:00) Yeah.
Jake Shubert (43:01) I.
Anu Vora (43:02) should be like, hey guys. Sorry, I didn’t write my speech, but I should tell you about the software. I.
Nicole Campbell (43:06) Mean, look, we would not be upset about that like, no, I’m just kidding that’s amazing. That sounds so fun. Well.
Anu Vora (43:13) Yeah, it’s gonna be great. We even have this ex chief medical officer of kaiser coming. He’s an advisor, on our healthcare company boards. So, it’s like just everyone’s coming. And I’m like 20 years baby. That’s amazing. Yeah, I was just 10 years old. Thanks everyone. Well.
Nicole Campbell (43:36) Good luck with the event tomorrow. I hope you can have fun after your speech, you know, get it off your shoulder and enjoy it. Can’t… wait to hear about it on Thursday absolutely.
Anu Vora (43:46) Appreciate the time. Have a good.
Nicole Campbell (43:48) Night. Thank you.