Transcript
Samantha Bouchard (00:00) my lighting is bad.
Jake Shubert (00:02) You’re fine… here’s, Rachel, I’m going to let her in. Okay?
Jake Shubert (00:12) Hey, Rachel. How are you?
Jake Shubert (00:17) Looks like you might be on mute.
Rachel Bregman (00:21) There we go.
Jake Shubert (00:22) There it is. How are you?
Rachel Bregman (00:24) I’m good. How are you are?
Jake Shubert (00:26) You back from vacation?
Rachel Bregman (00:29) Yeah.
Jake Shubert (00:30) Nice. How was your trip?
Rachel Bregman (00:32) I was good. Thanks. I was not totally call it a vacation but it was a change of scenery. Let’s say, yeah, it was nice. It’s always nice to get a change of scenery.
Jake Shubert (00:45) That’s that’s good branding. Yeah, I guess you can’t fully call it a vacation. I mean, you literally took a work call with us. So like we’re part of the problem, but it’s.
Rachel Bregman (00:53) okay.
Jake Shubert (00:54) I’m glad you got a bit of a change of scenery. When did you get back?
Rachel Bregman (00:59) On Friday? Okay, nice. Cool. Yeah.
Jake Shubert (01:02) Awesome. Well, Rachel, we can sort of jump into things just, you know, right into it for today’s. Call. I know we booked 45 minutes for today. Candidly, I don’t know if we’re going to need the full 45, but just in case we do just the full 45 still work for you.
Rachel Bregman (01:16) Okay, great. Okay, cool.
Jake Shubert (01:18) Well, kind of our plan, Rachel for today’s, call was I had sent over some like general scoping estimates to you over email after our last call, I know that you didn’t get a chance to provide any revisions there. But what I thought I would do is just show you what pricing looks like based off of the estimates we currently have, get sort of your feedback on that pricing. And then obviously, if there are updates to make the numbers more accurate, like we’re more than happy to take your direction there. And then just sort of figure out if, you know, we feel like we’re aligned and we should keep chatting about next steps and a path forward or if you think it’s better, we should part ways as friends. That’s totally cool too. But that was kind of our plan for today’s. Call. Does that sound good to you?
Rachel Bregman (01:59) Yeah. Okay.
Jake Shubert (02:00) Okay, great. And then Rachel, were there any, just on your end before we jump into pricing, any outstanding questions, things you wanted to see anything else you wanted to address? I know you’re obviously very familiar with medallion already, but just figured I would ask.
Rachel Bregman (02:16) Yeah, no, I don’t think so.
Rachel Bregman (02:18) I mean, we can talk about more of the particulars. And then I can tell you sort of like my biggest question is sort of like really along the lines of like what happens when there are problems so, which I think we touched on a little bit but I still don’t feel like I have a totally clear answer on like what the process would look like, what the resources are dedicated to that kind of situation. So we can talk about that later. And also, we have some reference calls with other clients that are using it, so they can help describe that to me as well.
Jake Shubert (02:51) Oh, nice. You already have those reference calls set up? Yeah.
Rachel Bregman (02:54) That’s great. Well, it’s in the process of getting set up. So, hopefully.
Jake Shubert (02:56) Yeah, that’s perfect around the topic of sort of like problem resolution for lack of a better term. It seemed like the one of the things that came up most during our demo last week was around panel closures. Would it make sense maybe Sam, if you want to take maybe just like a minute or two and just flesh that out a bit more, Rachel, would that be helpful for each of them in the pricing?
Rachel Bregman (03:18) Sure. Yeah. Things like panel closures or things like documentation missing? I guess that’s like less of a, that seems more like a technical thing that you would sort of be, I guess like messaging us through the portal saying, hey, we’re missing this or we’re missing that. So I think that’s yeah, probably a little less relevant but like panel closures or I… don’t know one of the things we see a lot of issues with is like they’ll load our providers, but they’ll load them at the wrong addresses even though an incomplete set of addresses even though we’ve supplied them with all of the full set of addresses, that kind of thing.
Samantha Bouchard (03:52) And in that case, Rachel, what process do you follow today? Like if they’re like linked to the wrong address?
Rachel Bregman (03:59) So, yeah. So typically, it’s not the wrong address. It’s more like an incomplete set of addresses. So, like we have seven locations, our providers are often, you know, seeing patients at multiple locations. So it might like have one location loaded, but not all three of them. Let’s say, for example. And then I think they go through like the portal and, you know, there’s like, I don’t know some process that they have to go through to kind of update it or they’ll kind of, you know, reach out to insurance directly and say, hey, you know, this provider is incorrect, can you update it? And sometimes there’s a form or there’s some sort of process.
Samantha Bouchard (04:29) Yeah. No, that’s helpful. And I think things would operate similarly today with medallion except for the fact that you all wouldn’t be doing the direct follow up. So I did get some more information on the closed panel from our operations team because I just wanted to make sure I was providing you with information the most up to date information. And I think it sort of goes hand in hand with the scenario that you’re mentioning as well. So when we are the ones that initiate the request with the payer, we’re always going to do that direct follow up. So in the scenarios that you mentioned additional documentations needed, you’re spot on that’s going to be a task that gets created to the provider. If we need it from them. You know, if we don’t have it in the profile, it’s not something we can obtain. You as an administrator, have visibility into that. Once we have that information, we close the gap, the closed panel scenario, you know, while we can’t control, nor can you like whether they’re going to close a panel or not. We do support the operational follow up with that. We’ll clearly identify the rejection reason we’ll track the decision. We’ll help you all coordinate next steps, which is typically preparing an appeal or a reconsideration letter that really outlines the network, need the access gaps, the provider qualifications or market justification. Likely, it just makes sense for you to have that letter on file, right? Because it’s internal medicine. So you’re likely going to just be able to reuse that letter and it’s probably something that your team has already developed today. So we can’t force them to accept you into the network. But we do manage that process for you in a very organized and timely way. And so that would also be the same with, okay, you have an enrollment that goes through, you requested these three addresses, and then we get the par status back. And then you guys find out that for whatever reason, like it’s set up incorrectly, that line would just live in the system. And so you all would kind of like reopen it with essentially the challenge that you’re having. And then our team would like take that back to the payer and coordinate. Okay, you know, this is the application we sent through. These are the addresses we requested like we’re having this challenge would.
Rachel Bregman (06:56) Your team notice that? Or would that be on our team to pick up that problem? Like is that the kind of thing that like gets flagged by medallion or?
Samantha Bouchard (07:11) When is your team? Like is your team noticing it with the par status letter or are they noticing it when you go to do the initial billing?
Rachel Bregman (07:21) They’re noticing it. When many of them don’t provide a par status letter. They’re just providing, I guess some sort of an update through evalidate. Let’s just say they’re searching again. I think it’s through evalidate. Mostly that they’re doing. Is that right to check par status?
Samantha Bouchard (07:37) It’s through the, it can be through the evalidate. It can be through the individual payer’s website. Sometimes it’s like an email notification.
Rachel Bregman (07:45) Right. So, like for example, they, the way that they do the process now, I believe is they like let’s say for a provider, they submit everything and then they have their timeframes and let’s say it’s like 45 days later. Then they’re checking like, okay, you.
Samantha Bouchard (08:00) know, let’s.
Rachel Bregman (08:00) say they haven’t gotten any notification that there’s any problem which they usually do get. But let’s just say they haven’t gotten anything. Then they would check and then let’s say they’re like, okay, I see that, you know, Rachel bregman is now par with united. Great. Now, I’m going to look at like the locations where she’s par. And then they’ll say she’s par at three locations, but we submitted an application with four locations. So she’s missing this.
Samantha Bouchard (08:22) Location. Yes, we would absolutely notify we would absolutely notice that that’s going to be because every individual location line in our platform gets an active status. And so it’s not like they’re just saying this application’s par, like we go down to the location level, excuse me, and that’s how we do this submission. So if that wasn’t lining up with what was submitted, then that would absolutely be something that we would proactively follow up on.
Rachel Bregman (08:53) All right. Sorry. And.
Samantha Bouchard (08:55) I think some of like the additional requests that your team might be getting is in the middle of the process. I think a lot of that would really decrease with medallion because we know what all of those requirements are. So we’re not going to submit the application until we have everything that’s needed. And so it’s possible that potentially your applications are going out the door a little bit sooner. And then there’s that need to kind of close yeah.
Rachel Bregman (09:22) Yeah, I think that will definitely be an improvement. And okay. So let’s say, so that’s noticed on medallion’s end. And then is there a process that medallion would go through to sort of fight that or then does that fall on us to kind of fight?
Samantha Bouchard (09:35) That we would continue the conversation with the payer because similarly to the close panel, we were the ones that initiated the request.
Rachel Bregman (09:45) Got it. And then if let’s say they approve you for united or for oxford with these two plans but not the third plan that you had applied for same sort of thing like you would say, hey, this provider was not credentialed… with this particular plan that they requested what’s the reason send the letter or that is something that we would do. So.
Samantha Bouchard (10:09) We would note everything in the line. If we need to coordinate directly with you, it would be an administrative task. So in the task section of our platform, you’re going to have access to the administrator? It’s possible that there may be some coordination that needs to be done with like the owner of medallion. So we do recommend like a,
Samantha Bouchard (10:37) but either way that’s.
Rachel Bregman (10:39) the point two five to point five, it?
Jake Shubert (10:41) Just, it’s speaking to like the amount of time like your HR supervisor might have to spend on medallion whereas, you know, they might need to every once in a while manage an escalation or a triage with our team.
Rachel Bregman (10:51) So, what does two point two five mean?
Jake Shubert (10:54) We’re saying it’s kind of like point two five of a full time employee of a person, I see of a person, yeah.
Samantha Bouchard (10:59) Sorry, Rachel. No.
Rachel Bregman (11:00) No, I thought that’s what you meant but I just wasn’t.
Samantha Bouchard (11:02) yeah. I was just thinking like, you know, sometimes it’s a full person, right? Depending on like if they have a 1,000 providers, right? Right? So based on the size of your organization, so I knew you were on the smaller side, so I kind of tried to come in the middle. Okay? Just kind of thinking that through. But yeah. So essentially like we’re still going to be doing the coordination. If we need anything from you, it’s going to be flagged directly in the platform and by email, but, we are going to like manage that particular line all the way through until we have that final resolution from the payer, got it. And.
Rachel Bregman (11:36) Then, is there a person that we’re dealing with at medallion? Like on that back end? Is it like one person that’s assigned to us? Two people? Like how does that?
Jake Shubert (11:45) Yeah, that’s a great question. I can touch on this and then Sam, what you used to like manage implementations here. So I’ll let you speak to that. But yeah, Rachel, you’d have a dedicated account team here. So you’d have an account manager who really is like your person for all things commercial. You’d have an engagement manager who’s like the person running your day to day operations. So these kinds of questions would be you and your engagement manager working hand in hand. And then during the actual like onboarding implementation project, you have an implementation manager. So they’re the ones who are running point for you and getting you guys onboarded onto the platform. And then obviously, you know, you have, our 24 seven support and things like that. But in terms of like dedicated personnel to the account, it’s really like your implementation manager, your account manager and your engagement manager would all be like the west side points of contact.
Rachel Bregman (12:32) Got it. Okay. So, there’s account manager, engagement manager, and who?
Jake Shubert (12:37) Was the other one implementation manager? Every blank manager you can imagine is included?
Samantha Bouchard (12:45) Yeah. I think the one that’s like.
Rachel Bregman (12:47) someone who engages us.
Samantha Bouchard (12:49) Someone like an implementation would get you. Yeah, implementation is going to get you onboarded, get all your data in the system. Make sure you’re trained, make sure, you know, you guys understand the platform engagement manager is going to be with you throughout that process. But then once you kind of graduate from implementation, that’s where your engagement manager is like that day to day operational contract contact. So like they have been credentialing specialists in the past licensing specialists, payer enrollment, like they are able to understand these processes inside and out and so they can meet with you on whatever cadence you prefer. So if you’re seeing something come in the platform that you have questions on, you can set up a meeting with your engagement manager and kind of walk through it or, you know, you might have weekly touchpoints post implementation or biweekly or monthly. And they are really that single point of contact for you to kind of like look at the application.
Rachel Bregman (13:47) Got it. And just to get a sense how many clients does each one of these engagement managers handle?
Samantha Bouchard (13:53) Usually it’s around 12. I believe. Okay. Yeah, I know that’s a good question. Sometimes it’s a good one to ask because if I said 60, you would be like, okay. And.
Rachel Bregman (14:06) you said they’re all like us based Americans. They’re.
Samantha Bouchard (14:09) all us based yep, and they all have backgrounds like, you know, some actually came over from our payr enrollment operations team. Others have just like been in the industry for a really long time. Jake and I go to them for operational questions and expertise all the time.
Rachel Bregman (14:25) All right. Okay. I think that pretty much like answers this.
Jake Shubert (14:31) Perfect. Well, I will jump into pricing then, but obviously, Rachel, if any more questions pop up, feel free to ask away. Sure. Okay. Can you see my screen here? Yes. So this next slide, these are the same inputs we talked about last week, Rachel, that we reviewed. So we’ll spend a ton of time on these. Like I said, if there are ways to make these numbers more accurate, me and Sam, we’re all ears. So after this call, Rachel, if you have feedback based off of the enrollments and validations from our providers, whatever it might be, let us know. So we can make the proposal as accurate for you as possible. But just so you know, like, well, what you’re about to see pricing wise is based off of these numbers here. So third existing providers adding 10 Ish per year, doing monitoring and caqh management of those providers, obviously. And then the revalidation or sorry, the enrollment numbers was dictated by the number of payers you guys have. So about 15 payers each provider is getting enrolled with, and the revalidations is based off of that same framework on a three year term. So that’s the average timeline for enrollment revalidation for providers again, just.
Rachel Bregman (15:37) To be clear when you talk about a payer, like for example, is united, a payer with multiple subplans?
Jake Shubert (15:46) That’s correct? Yes, united would be like going to those subplans would be one enrollment with united.
Rachel Bregman (15:51) That’s one payer. All right. Okay. Yes. So basically, we’re looking at essentially… like, the big like blue cross is going to be one payer, or is blue cross going to be multiple?
Jake Shubert (16:08) Yes. I mean, on your experience, we typically see that blue cross would be one payer, but Sam, any, anything that I’m missing there?
Samantha Bouchard (16:15) Yeah, it would just be one pair with all of the different lines.
Rachel Bregman (16:20) Got it. Okay. Yeah.
Jake Shubert (16:21) So, yeah, Rachel, if that changes the equation at all in terms of the number of payers we have here on the slide, then definitely let us know. But that is the way our structure of enrollments work, got.
Rachel Bregman (16:31) It. And I guess the pricing is going to be based on like the number of existing people, we have, the number of new hires, we have the number of payers.
Jake Shubert (16:41) And.
Rachel Bregman (16:41) those are some of the three. Yeah.
Jake Shubert (16:43) You nailed it. So, so all the numbers you see here are going to be what you’re going to see on the next slide with pricing. So, yeah.
Rachel Bregman (16:48) Got it. So I can sort of figure out if I’ve if I go up or if I go down in any areas like what that would look like.
Jake Shubert (16:54) Yeah, exactly. Yep. So, you know, if we’re like directionally on the right path, Rachel, then, you know, the next call you say, hey, actually, this should be 100 enrollments or 200 enrollments, right? That’s how we can toggle it is.
Rachel Bregman (17:04) It also the kind of, well, I guess you’ll get to that, but I’m just wondering, is it the kind of thing where let’s say I anticipate 10 hires and so that’s my pricing. I mean, is there like, are there like levels of pricing or is it like just literally like per provider? So if I end up credentialing 15 new people, it’s just like five more than what we thought.
Jake Shubert (17:22) Yeah, that’s a really good question. So it’s kind of two different pieces to that question that I’ll try to answer. The first is like the way we price. So the unit discounts that our clients get is definitely dictated by volume, right? Like we are able to offer, you know, a group who’s doing 10,000 enrollments super discounting on a group doing, you know, 100 enrollments, right? That’s just the nature of the beast. But to your point, like we obviously understand that predicting credentialing outputs a year in advance or two years in advance is like an inexact science. So the way our contracts are built is we have what’s called skew flexibility, which means that across lines of the contract and across years of the contract, you’re able to move around or pull forward or push out spend to allocate for that unpredictability. So for your example, right? Let’s say you guys bring on instead of 10 new providers, you bring on eight new providers over the next 12 months, right? That gap in spend that delta, you then can push forward to year two of the contracts. You have that extra spending room because you didn’t consume it in year one. And the opposite is true too, where let’s say you bring in 15 providers instead of 10, you can pull forward some of the pre allocated cost in year two and year three to cover that change in year one, to make sure you’re not having to pay unexpectedly out of pocket upfront. So we try to build in as much flexibility within the walls of the contract as possible?
Rachel Bregman (18:49) Right? And then discounts come in. What sort of levels like you gave the example of 10,000 providers, but are there other like lower level kind of breaking points? Yeah.
Jake Shubert (18:59) There are lower level breaking points. Typically, you’ll most often see that in like the increments of 100. So like 203 104 105 100 et cetera. Like that’s typically where the break points are, is around like just the round numbers. Yeah. Got.
Rachel Bregman (19:13) It, so if I’m at 40, basically, I’m not really looking at any discounts until I get to something like 100.
Jake Shubert (19:18) Yep. You nailed it. I will say not to like get ahead of the game here, but we did get approval on a little bit of higher level of discount thresholds than we would typically get here. So you’re going to see like pretty much a 25 percent discount across the lines of your contract here. Rachel to try to be as aggressive as possible, right? Yeah, the idea of that just to be transparent is like sort of we’re coming into end of quarter right now and beginning of the next quarter. And as we’re reporting out to our board and stuff, getting earnings earlier in the year is pretty important for sort of our valuation and eventually fundraising that kind of stuff. So we have a little bit of extra wiggle room right now to offer higher discounts. So, OK, cool. Any other questions before I jump into the proposal?
Rachel Bregman (20:02) OK.
Jake Shubert (20:03) Great. So like I said, you’re going to see here the exact quantities that you saw on the last slide. So again, like as we toggle if you want to move up, move down, we can totally look at revised proposals here. But what you’re looking at is a year one contract value a little bit less than 73,000 dollars annually. Just to foreshadow a bit, this is the most expensive year of the contract. You’re going to see the reason why is because of that upfront implementation fee. So year over year, what you’re looking at in terms of spend ratio is like an annual spend in the high 60,000 is more where this contract is going to land. I’ll show you what year two and year three of the contract look like here. In a second, this is a three year contract term. That is both an industry standard and a medallion standard. Given the amount of resources they dedicate to each account to stand them up and to manage your credentialing end to end. So this is a three year contract term. Like I said, we have extra discount incentives here based off of sort of timeline and sort of what’s important to medallion right now as we look to raising in the future, but I’ll sort of pause here. Any overall feedback, sort of curious like how this pricing lands with you?
Rachel Bregman (21:10) Yeah. I was just wondering about the like existing third year providers who already are in medallion. Yeah, being priced as the same as if they weren’t or, yeah.
Jake Shubert (21:20) That’s a good question. So this is being priced as if those providers were not in medallion, from a profile perspective. We are obviously not counting any enrollments that have already been done for those providers. So what I mean by that is like we’re only counting net new work that we’re doing for those providers. So we’re not charging you based off of enrollments or any requirements that they already have in place. We’re only charging off of the work we need to do for those providers, moving forward. If we are able to figure out that these providers all have existing medallion profiles and there is no additional work that would need to be done to get them into the profile. This 75 dollar received the discounted price on the right for medallion core. We think we would have flexibility to move that down further because there’d be less work that we have to do on those providers behalf. So if we are able to prove that out, that is where you would see the difference in cost would be in that first line item called medallion core.
Rachel Bregman (22:15) Right. So that’s basically like the 75 times 40?
Jake Shubert (22:18) Yes, that’s 75 times 40. Like I said, like.
Rachel Bregman (22:20) Whatever it is times 30 discount.
Jake Shubert (22:23) Yeah, exactly. Right. Will.
Rachel Bregman (22:25) You share any slides with me after?
Jake Shubert (22:27) Oh, yeah. Yeah. Absolutely. I’ll share this over email. Yeah, you don’t need to take like furious notes while we’re talking. I’ll send it all over email.
Rachel Bregman (22:34) Okay. So just so I understand what I’m looking at. So basically, you’re saying 8,000 is the implementation and then there’s the 40 times 75… the 20 times 40, which again, I guess that would, I guess remain?
Jake Shubert (22:52) Yeah. The only one that would change would be the core. So we still need to do the ongoing monitoring for the providers, whether or not they have caqh or sorry, whether or not they already have medallion profiles.
Rachel Bregman (23:00) Right. And then… the enrollment you’re doing 10 times, yeah. So 10.
Jake Shubert (23:11) New providers times 15 payers gets us the 150, right?
Rachel Bregman (23:17) And this revalidation happens in year one, even if there’s no revalidation needed. Like even if these are all new, yeah.
Jake Shubert (23:23) So, the revalidation number we’re actually calculating based off of your existing provider account. So, what we’re saying here for revalidation is we’re saying there’s 30 providers who already have been credentialed with about 15 payers, which takes us to 450 total enrollments. And then since providers need to be revalidated on a three year term, we’re dividing that by three to get our average, which would be, we would see that westside would have to do around 150 revalidations per year for your existing provider base. So that’s for the 30 providers you already have employed and credentialed.
Rachel Bregman (23:58) Got it. Okay. Yep. And then partnership… spend real good.
Rachel Bregman (24:14) And when you say across SKUs, that means like does that basically mean the whole spend can get moved around into any of these categories or is it just within a category?
Jake Shubert (24:23) Within any of the categories and it’s 20 percent of the contract value each year can be moved forward back across SKUs? Etc? Okay. Yep.
Rachel Bregman (24:32) So, if it’s more than 20 percent that you don’t use that sort of gets lost, let’s say, and if it’s.
Jake Shubert (24:42) right. Yeah. If it’s more than 20 percent doesn’t get used, then, that would be like, I mean in essence like wasted spend, yeah, right.
Rachel Bregman (24:56) Okay. Quantities can be drawn. And what does no termination for convenience mean? Yeah.
Jake Shubert (25:04) That’s a standard for software contracts. It just means that when you sign a contract, if things are going well, you can’t just break the contract because you want to, but we do have termination for cause. So, if we are chronically missing our slas, if, you know, if there are reasons for you guys to be able to break the contract, the termination for cause exists, you just can’t break a contract just because you know, nothing’s going wrong, but you don’t feel like it.
Rachel Bregman (25:29) So, yeah, that’s.
Jake Shubert (25:30) a standard across software?
Jake Shubert (25:36) Thanks, Rachel. What’s like your overall just feedback? Like, do you feel like we’re directly on the right path? And it would make sense to sort of iterate on the numbers and figure out a path forward. Do you think this is way out of bounds, just sort of curious, you know, where your head’s at?
Rachel Bregman (25:50) I mean, you know, as I’m sure, you know, it’s very high for what we are currently spending, the… might you show me how it breaks down to year two and year three. I mean, the sales, the initial sales Guy was like, it’s going to be like around 50,000. So like 72 is a bit more than what we thought to begin with anyway. But, you know, I’m still interested in hearing a little bit and seeing maybe where we can, yeah, if there’s any, you.
Jake Shubert (26:19) Know. Yeah, yeah, totally happy to work with you on that. And yeah, I know David shared we had like a 50 K minimum, which is true, but obviously, like your volumes come out a little bit higher than the minimum. So this is year two of the contract. You’ll see we honor all the discounts throughout the duration of the contract. The price goes down because there’s no implementation fee. And here we’re factoring in adding 10 providers, right? So, you know, in year one, you’re adding 10, gets you to 40. Now we’re adding 10 more on top of that. So we’re looking at around 50 providers who’d be inside medallion. So that’s where these numbers come from. And then again across year three, same unit discounts. But now we’re adding 10 more providers, getting us to 60. So the enrollments and revalidations will stay flat. It’s only the top three SKUs, we’re factoring in the new provider count.
Rachel Bregman (27:08) Okay.
Jake Shubert (27:10) Yeah. And then I guess just speaking on sort of, you know, pricing flexibility that we have, right? If we were able to get more aggressive on discounting like let’s say, Rachel, you decide your reference calls go well, you do want to move forward, but cost is like the barrier to entry since March is our end of quarter. I know we have like a lot more approvals and flexibility from our finance team to get aggressive,
Rachel Bregman (27:39) Not.
Jake Shubert (27:40) trying to rush you, but like would making a decision in March be realistic or is that just way too fast?
Rachel Bregman (27:45) Are we at March 20 fourth? I mean, it’d.
Jake Shubert (27:48) be a week? Yeah, it.
Rachel Bregman (27:50) Might be a bit fast, but I guess it depends on how much the pricing could be. Yeah. And,
Jake Shubert (28:00) do you know when you’re gonna have like roughly when you’re gonna have the reference calls?
Rachel Bregman (28:04) No, but I hope, I mean, I imagine the person’s gonna get back to me today, probably so, you know, hopefully within the next day or two, okay, they have not responded to me yet, but I don’t… know, I don’t know the person. So I can’t say exactly how close they are, but I would hope within the next day or two, no.
Jake Shubert (28:27) That makes sense. And also just like decision wise, is there anyone else like?
Rachel Bregman (28:32) On your team? That, no, I’m pretty much the I’m pretty much the decision maker cool on this kind of stuff. I have a, I have a question what is go for it?
Rachel Bregman (28:45) Would there be a scenario where let’s say we left off the current providers who are already in there and just wanted to sort of start fresh with new providers that were hiring?
Jake Shubert (29:02) Interesting. So it would be like sort of going back to year one here for a second. Yeah. So it would kind of be like only.
Rachel Bregman (29:07) totally new let’s say, I want to say like all those people for now anyway that we have on credential that we blah blah, forget them. And then we’re going to put everyone every new person that we hire, do it through medallion.
Jake Shubert (29:23) Yeah. I mean, that is something we can certainly explore. I think the question there would just be around… like your team’s day to day operations. We don’t want them to have to manage two different sources of truth across your providers. So we definitely could look at just new providers onboard to medallion. But new providers is where the bulk of the cost is going to be because that makes up the enrollment line. So I think what I’m definitely open to exploring that, but I wonder if the best path forward would just be seeing how aggressive we can get on discounting for the total package. That way you guys are having one source of truth. Every provider is managed the same way, like every profile looks the same. There’s parity across all providers. I think that would probably be the most healthy path for westside if we can figure out a way to make the pricing right? All.
Samantha Bouchard (30:20) Right. Yeah. Rachel, and the other thing I’ll add is just with medallion core, right? Like that’s the provider data management solution that’s the reporting and analytics. So you really get that single planet glass visibility across all of your providers. So kind of to Healthstream what Jake said, you’re having that same, you have that same storage capability and then you have that consistent source of truth and then the caqh management also kind of plays into that as well.
Rachel Bregman (30:52) Right. Do you, did… you show me last time? I can’t remember what the like provider view of the system looks like?
Jake Shubert (31:05) We did watch that. Would it be helpful to briefly see again?
Rachel Bregman (31:10) Yeah, yeah.
Jake Shubert (31:12) And what are you sort of, I guess looking to see from the provider view?
Rachel Bregman (31:15) I’m just sort of wondering like what… I’m just sort of wondering like what it would look like for our providers, you know, I’m sort of like trying to think through a number of different scenarios in terms of who I would have managing… this because, you know, the current people.
Rachel Bregman (31:37) I mean, the other thing that I have to factor in is the current people that we’re using like they charge us a flat fee. So I’m not like even though it might just be like one quarter whatever fte kind of person I’m still going to end up having to pay them the same flat fee. So, you know, perhaps at some point in the distant future if they really have to do so little, then maybe I would stop using them or maybe I would you.
Jake Shubert (32:02) Know, I don’t know. Yeah. Is your HR supervisor, someone who you’re paying a flat fee for or is it just the two it’s.
Rachel Bregman (32:08) not the HR person. It’s the credentialing team. So really like they would be the ones who would be managing it. She sort of supervises everything, but they are the ones who are managing all the credentialing now. So I’m envisioning like that they’re going to continue to be the point people let’s say, and they would be the ones kind of interacting with medallion for the most part.
Jake Shubert (32:29) Okay. So it would still be those two credentialing folks who are like kind of the medallion liaisons.
Rachel Bregman (32:35) I mean, that’s sort of what I’m thinking if I have everybody on, but I’m thinking like if I potentially were to start with just the new people, then perhaps I would hire a different person or assign a different person to be the medallion kind of point person, which would also give me a better sense of sort of comparison, which I imagine is going to be much better, but it might be harder for me to see that if I have to continue to carry both of these same yeah.
Samantha Bouchard (33:10) Would you still have them do all of the revalidations? Rachel? So you’d still be outputting… a cost. I.
Rachel Bregman (33:18) Don’t know. I mean, I guess that’s what I’d have to see sort of like how I would sort.
Jake Shubert (33:22) Of use?
Rachel Bregman (33:24) Them, but certainly at the beginning, I think I would have to continue to use them until we kind of understood a little bit better what, you know, how exactly the process worked and who exactly would do that work instead of them. So that’s sort of what I’m thinking if I move to a model where I’m just going to like, you know, it’s.
Samantha Bouchard (33:45) a little bit. Yeah, I think you’re yeah, I know I hear what you’re saying. You’re kind of thinking through all the options and I think with your engagement manager as well like they can facilitate some training in that regard. And I’m sure, you know, maybe your partners that you have today could also facilitate some training. It’s like how they like approach the overall strategy. But essentially… what you need from the medallion operator, is someone that’s really going to own the strategy and then medallion is really going to own that execution on your behalf. Yeah. And those?
Jake Shubert (34:21) Two folks, are they like outside consultants?
Rachel Bregman (34:25) You want to call them consultants? I guess you could call them outside consultants. I mean, they’re.
Jake Shubert (34:29) because they’re not full time employees, right?
Rachel Bregman (34:31) No, no, no, they’re not full time employees. Got it. The other thing is actually, I had a question that I meant to ask but I just, it’s occurring to me now, the, how do you view like… a ipa… in terms of like a payer status? So if like one of the things obviously that our people are doing now are doing the enrollment for this thing called ipani which they have to do through medallion. So would that be kind of all built in? Yes.
Samantha Bouchard (35:06) We do have the ipas like kind of broken into like a payer on our portal selections. And so we would store that and then follow that individual process like for that particular ipa.
Rachel Bregman (35:23) Got it. So… so basically, you would have kind of like ipani as like a checkbox as like a payer so to speak?
Samantha Bouchard (35:35) Yep. Exactly. And.
Rachel Bregman (35:36) Do you have like a list of ipas that you do this with? Or is there like any ipa that I’m a part of that would be applicable?
Samantha Bouchard (35:46) We have many in the system if you want to send us your list, we can validate and confirm if we, there’s.
Rachel Bregman (35:56) only one other, it’s the it’s called cap. It’s the columbia associated physicians.
Samantha Bouchard (36:02) So it was cap.
Rachel Bregman (36:05) It’s cap. So columbia associated physicians.
Samantha Bouchard (36:09) And then what was the first one you mentioned it?
Rachel Bregman (36:12) Is ipany a P a N y, independent physicians associations of New York, I think, and they are the ones who are currently using medallion already? Okay? Yeah.
Samantha Bouchard (36:25) So then we definitely have them in the system. I can check the cap one as well. I don’t.
Rachel Bregman (36:31) think cap is, I mean, I don’t know what cap is using. Maybe they’re using medallion, but I guess it wouldn’t matter necessarily if they’re using you as long as you can use, yeah.
Jake Shubert (36:39) And even if it’s an ipa or a payer even that we’ve never worked with before, we would still map out their processes and support them for enrollment. So there wouldn’t be any concern there, right? I guess Rachel, with the last like five or seven minutes we have left just wanted to talk through next steps. So, I know you’re working on setting up your reference call. It sounds like there’s some thinking and iteration we could do on the proposal itself. What would be the best next steps? Or do you want to connect to, you know, end?
Rachel Bregman (37:08) Of the speaker? Yeah, I would say like if you could give me pricing on like, I guess a, if there’s any kind of pricing even as is, I will get you like more specific numbers although I can just sort of crunch the numbers with what they are now specific numbers. Yeah. And then maybe… if you can also see what it would look like if we, we’re thinking about just doing the new providers, yeah.
Jake Shubert (37:32) I can try to run the math on that in the meantime while I’m working on that, you said, you know, for sending over hopefully like better pricing, would you be open to me trying to send or sending you pricing, that would be higher discounts but contingent on moving forward by the end of the month.
Rachel Bregman (37:52) I mean, sure. We can try. I mean, I don’t there may be like a limitation that even if you give me like the best pricing in the world, I just might not be able to make much.
Jake Shubert (38:01) Work. Yeah, the sorry, I was like the I.
Rachel Bregman (38:05) Would probably say like if you’re working on a quarter by quarter basis, right? Or you’re working on?
Jake Shubert (38:11) Yes, quarter by quarter. Yeah.
Rachel Bregman (38:12) I would say like reality… is if I couldn’t get it done by March 30 first and we’re looking at like, you know, June?
Jake Shubert (38:20) Yeah, I mean, we would still, you know, execute a contract, it has.
Rachel Bregman (38:25) To be at the end of a quarter to get a really good discount. No, yeah, that’s why it’s June.
Jake Shubert (38:29) Yeah, sorry, I didn’t mean to interrupt you. I was going to say that to be transparent, my idea for sending you March pricing isn’t for us to move forward with a contract in March. My idea is that’s going to get us the best discounting possible. And then if you look at that proposal and you still think, hey, this isn’t going to work, then we know we have to look at alternate models or whatever it might be. But if you look at that proposal and you say, hey, actually for that all in makes sense. Then I would at least have the ammo to go to our financing and say, hey, listen, like for reasons X y and Z, we couldn’t do this with Rachel in March. But now, if she’s still interested, like, can we hold this offer for her? So that just so you know, like behind the scenes that’s what I’m trying to do, I understand.
Rachel Bregman (39:13) Okay. Yeah, sure. So, yeah, why don’t you do that? And then also send me what it would look like for… you know, just the new providers and then I can evaluate both.
Rachel Bregman (39:25) And then we can hopefully make a decision quickly that.
Jake Shubert (39:27) Sounds great. So I will work on both those and send you a follow up email. Do you want to set up a check in call for us maybe sometime next week?
Rachel Bregman (39:37) Sure.
Rachel Bregman (39:46) Do you want to say like same time next Tuesday?
Jake Shubert (39:50) On Tuesday? So that would be at 10 a M pacific, right? Yeah, that actually works great.
Rachel Bregman (39:57) Okay, great. Okay.
Jake Shubert (39:58) Cool. I’ll send over that invite. I’ll get you pricing today or tomorrow, hopefully the latest. And then if you have any questions, let me know. I’m looking forward to chatting on Tuesday.
Rachel Bregman (40:08) Okay, terrific. Thank you. Cool.
Jake Shubert (40:10) Thanks so much, Rachel.
Samantha Bouchard (40:11) Okay. Rachel. Bye bye.
Rachel Bregman (40:14) Bye. Thank you.