Transcript
Mike Manson (00:00) what’s up garrison? Yo?
Mike Manson (00:35) I might get the meeting booked with urgent team, which is good. And I think I might have an in with ap derm which is one of the new accounts I’m targeting too, which is good. There you go. Yeah… that was the Guy.
Garrison Goodman (00:51) From family.
Mike Manson (00:53) Yeah, matt got us connected. I’m just waiting for the Guy to give me times, but VP of finance. They were high school buddies, matt sent over a warm intro, spoke highly of us. So, yeah, that could be a good one. He said RCM rolls up under this Guy. So… good. Not a huge account, but they have like 150 providers.
Garrison Goodman (01:18) We need them all right now, man. Yeah, it’s in the book. Take it down. Yeah. Yep.
Garrison Goodman (01:30) I’m just kind of laughing about… essin.
Mike Manson (01:38) Yeah, I don’t yeah, we just need to figure out what’s going on. I mean, I, so John accepted the meeting on Friday. He has his read receipts on. So he read my text, but hasn’t responded. I think I might just, I’ve got some more PG calls to rip, but I think like end of the day today, I’m just going to try and give him another call again and be like, hey, like depending on what we hear from khan. Yeah, there seems to be some serious lack of communication happening internally on their side… and it feels it seems pretty consistent that Akil is like a blocker like why would you not want to… have a conversation with us? Where we’re firming up a proposal? Where we’re this close to a decision like.
Mike Manson (02:35) Yeah, confusing.
Garrison Goodman (02:41) Yeah, I mean, I’ve already shared with you my fears.
Abubakar Khan (02:45) But it’s.
Garrison Goodman (02:47) also, just like… why? So secretive? Yeah, it feels like they want every excuse to just go with the cheapest option and see so they can say they did their best. Yeah… especially from what?
Abubakar Khan (03:14) John was saying… but,
Mike Manson (03:17) John was, yeah, I don’t know John was saying kind of the opposite, right? I mean, he said pricing is definitely a consideration but he said it’s like 30 percent of the problem and, I got the sense of him where he’s like we… can’t mess… this up. Like we can’t just choose, the cheapest option and continue on, cons, here. I’m gonna let him in. Okay?
Abubakar Khan (03:57) Hey, khan. Hey, Mike. Hey, garrison. How’s it going?
Garrison Goodman (04:00) Hey, khan. Hello?
Abubakar Khan (04:02) Hello. How was your meeting with? John? Thought it went well.
Mike Manson (04:08) Yeah, had a good, long, almost a full two hours and he gave us, some good feedback. I think, you know, he was upfront that based on what he had heard from Vesta that, you know, he initially was, somewhat skeptical about medallion. But then after talking to the references and having the meeting that we had with him on Thursday and going through everything, I mean, we left the meeting, he said, you know, after talking to you guys and getting to talk to some of the references, he said he was heavily leaning towards us.
Mike Manson (04:46) Nice. So yeah, just, you know, we’re trying to tighten up on the proposal, because I think some of the numbers that he gave us were different than what we had been talking about up to date. So like, I guess like question for you is, you know, I know John came in late to the conversation, what has your communication been with him in terms?
Abubakar Khan (05:18) Of just.
Mike Manson (05:20) Like, you know, he gave… us 630 providers today. He sort of mentioned that like the growth as far as new providers was probably not, he had mentioned like 40 new providers and then potentially some backfills, which is… so I.
Abubakar Khan (05:41) don’t know. I don’t know where he’s getting that number from. But dr sehgal told me that the number for this year along with our chief people officer who’s sort of tasked with making this happen with this recruitment team is 400 for onboarding this year. Now, given that we are in March and three months have passed, let me check and see. So it looks like from the last committee, the number right now if we minus the lpps is around 606 106. Still. So we’re still around that number. It’s around 600 Ish. Yeah, he.
Garrison Goodman (06:21) Was saying it’s like it’s less new hires and maybe like more rehires too. It can.
Abubakar Khan (06:29) Be, can be, sometimes providers leave again, provider drop off, right? It varies a lot. So we do have providers that are termed and then they rejoin again, maybe in a different division. That does happen too. But, this I’m going off of the committee numbers that we present. So this is usually highlights the total number of providers that we’re working with. So, I think 606 106, 606 110. It’s probably a good range for our current standing of providers.
Garrison Goodman (06:57) Okay. So that’s current, how, so given that, what should we model? And, you know, I think.
Abubakar Khan (07:04) it should be based off of this, our current let’s do six because again, I don’t know maybe five providers can leave tomorrow. That’s why I felt like 600 was an average number that I’ve been seeing that we’ve been hovering, you know, plus or minus around, like right now it’s six six previously, I saw, a little less. I saw it a little higher than this, but it’s like we’re hovering around the six hundredth so, 605 if you want to put it, but I think 600 is okay for our current provider count. And then 420 number came from our chief people officer. He said that’s his goal for this year actually. And that came from dr. Sehgal, he said to me to, put some cushion in there in case, you know, it’s a little more.
Mike Manson (07:46) So that’s, new providers.
Abubakar Khan (07:49) Correct. So, I think, yeah, I think like.
Mike Manson (07:52) The biggest impact on what the overall cost is going to be is on the… new payer enrollments and the payer revals. So, I think in the past, we had modeled whatever your new headcount would be times six payers.
Garrison Goodman (08:12) On.
Mike Manson (08:12) average. So, like if we’re saying it’s going to be 420 and… they would all be getting enrolled with six payers. Is that a good model to use?
Abubakar Khan (08:26) Wait, say that one more time, please? Yeah.
Mike Manson (08:29) So, I think like the, as far as pricing goes, I think one of the biggest line items is going to be payer enrollments.
Abubakar Khan (08:36) Yep. And this.
Mike Manson (08:37) Would be based on, it could be based on partly existing providers if they are not enrolled with everybody and we would be taking on that work. But I think the biggest volume discrepancy is going to be for each new provider. How many plans would we be enrolling them with? And I think in the past, we had used six, which… would be 420 times six, which would get us to 25, 20, 20, 520.
Abubakar Khan (09:06) Enrolling them with six plans? Yeah.
Garrison Goodman (09:12) Six direct enrollments? Not counting the delegated?
Abubakar Khan (09:15) Agreements, yeah, give me once I can’t so.
Abubakar Khan (09:24) And so, what would fall under that? Would it be? Medicare? Is one medicaid is one, like based on the list that I sent you for our direct payers. And what would that look like?
Mike Manson (09:42) Yeah, each in each plan would… be one enrollment per provider. So, if it’s medicare medicaid, that would be two per provider. And then I’m assuming like, you know, you’ve got several commercial plans. I don’t know if I’m assuming not every provider is going to be enrolled with every commercial plan, right?
Abubakar Khan (10:07) Alright, the math here may be, a… little hard just because there’s smaller plans as well. And for direct it’s also by division. So, let’s see if we start with all the divisions, we have medicaid, we have medicare, railroad, medicare that comes under medicare too. Humana.
Abubakar Khan (10:35) Signa… for their commercial lob, we… have a bunch of these vision plans like vns is here for one division village. We’re in the process right now of also just trying to see if we can get delegated with the one tin that the BTC tin, just because we’re delegated across the other tins but not that one for some of these plans. So, we’re working on that already. I don’t know in regards to, let me get back to you on this one just to see what the main payers would be that fall under this category, for direct that we would be enrolling with. And why did we cap at six? Do you recall, was it because six were like the main major payers or, yeah.
Mike Manson (11:25) That, that was what we used for the last time we did the scoping, if it, if it’s more than that, you know, so, I think like one of the things that came up with John too is he felt like a big portion of our business we are delegated with. We have 27 delegations. So, I think that’s where we need to like land on at least an estimate because essentially, the benefit to getting close on the direct enrollment number is gonna be that the higher the volume is, the lower this unit cost is gonna be like we’re gonna be able to discount more, right?
Abubakar Khan (12:04) But, you know, we.
Mike Manson (12:06) Understand, there may be some gray areas. So, you don’t wanna like over commit either, but if we can get close, this will give us a good idea of what we can, you know, our finance team is gonna be able to offer more discounting…, on the higher volume, if that makes sense, right?
Mike Manson (12:27) So maybe that’s something you can shoot over an email and I can just lay it out like, what are the inputs that we need? Yep, that works,
Abubakar Khan (12:38) Let’s do that. And then for the payor revalidation, what is this one? So?
Mike Manson (12:46) This would just be, this would be existing providers who… have already been enrolled if you want us to.
Abubakar Khan (12:54) This is just medicaid and medicare, right?
Mike Manson (12:59) Yeah, it’s whatever. If you want us to take on the work of doing the revalidations, right? I think it’s like every three years. So, yeah… however many of those existing providers are three years in, we.
Abubakar Khan (13:17) Would, I think for medicaid, I believe it’s and for medicare, I think it’s five years if I’m not mistaken at least in New York for medicaid, I need to confirm medicare, but I think medicaid’s five years.
Mike Manson (13:30) I think like the standard math that we’ve used in the past for organizations like yours is about like 25 percent of whatever the new enrollments is. We would use as a kind of a standard template for what kind of revalidation we need. But yeah, if got it.
Abubakar Khan (13:47) If, yeah, we can also.
Garrison Goodman (13:49) Flex on that. If you know what I mean? I think we’re that’s what we see as standard. But if you guys have different numbers, we can change that.
Abubakar Khan (13:58) Okay. It’s just like, you know, like,
Garrison Goodman (14:00) Mike’s saying general rule of thumb is every three years, you have to revalidate as.
Mike Manson (14:04) A provider and,
Garrison Goodman (14:06) so, it’s going to be some percentage of existing providers that you have, that have to revalidate if there’s a percentage that you’d rather us use like we can do that. Okay.
Abubakar Khan (14:21) That works.
Mike Manson (14:23) Let’s take that?
Abubakar Khan (14:25) Through email as well. I would say, yeah… hospital applications, okay, ask me this question?
Mike Manson (14:34) Yeah, this would be how many providers… wait?
Abubakar Khan (14:41) I think I sent this one over. I believe, right? By email. I think when I spoke with rose.
Mike Manson (14:47) You may have, yeah, yeah, yeah, I’ll look back through it. The one with josh if I can’t find it. I’ll put that in the email, ask as well. So then we can get to what… we need there. Okay? So I think we can do this async and I’ll get this out to you this afternoon con. I think like what would be helpful at this point is just understanding what the process is looking like on your side. So like we, yes, we have that meeting that and candidly, like we had a really good call with John. We went through a lot. There was a lot of discussion. We left the meeting with a next step of, hey, you know, I’m the representative from finance on our side. So like, you know, he mentioned that there would be some definitely negotiating that’s going to happen, but he would want to sort of have the first pass at the proposal. And I think there’s also from like what we can do for the team, you know, as a solution. He was hoping to look more into how we can help with audit support, roster generation. So there was like some follow ups that we agreed to for our next step. So, I guess I’m garrison feel free to step in here. I’m a little confused on like Akil wanting to not have that call on Friday.
Abubakar Khan (16:10) Yeah, just.
Garrison Goodman (16:10) To summarize, John said he wanted to walk through the business plan and the numbers and the pricing, and also like make sure he was firm on how he would help through delegation. That’s how he left the meeting. And then we went to go schedule that. And then, you know, we’re just a little confused as to Akil saying like, hey schedule like cancel that meeting. So I think we’re just trying to better understand the dynamic. And then also like what are the specific next steps? And how do we get John totally wrapped around this and feeling comfortable, got it.
Abubakar Khan (16:41) So, I didn’t know there was, that he requested a follow up on some items. I spoke with Akil when I messaged you or right before I messaged you Mike. So he followed up with me. I asked if he attended when you guys came on site and he said no, he didn’t get a chance to. So, I told him that, he said that he spoke with John and John said, you know, we can continue going about how we’re going about it. He didn’t I don’t think he mentioned to Akil that there’s a follow up items that he requested from you guys. So, I think that’s more of an alignment issue internally on our side because Akil told me he’s like, no, so get, why are we meeting for another hour? Why don’t we just get the proposal? Let’s sit down internally and review with leadership first. And then we have that conversation, because I think who else is on that call for Friday?
Mike Manson (17:36) I had it as I had it as, you know, us, you and Akil, if Akil feels like, hey, he’s got what he needs. I mean, we could just have the conversation with John. Yeah, I think, what we got cut off with was like, we talked about a lot and we sort of started from scratch because he was coming into this new, but what to garrison’s point? Like there were some things around how we support roster generation, audit support that we didn’t get to, that I think would be valuable to walk through with John, cause it seems like that’s what he cares most about?
Abubakar Khan (18:15) Okay. So, wait, which items did we not get to discuss? I guess for the roster generation? What specifically just?
Mike Manson (18:24) How, how we would go about it?
Abubakar Khan (18:30) Generating the rosters? Yeah.
Mike Manson (18:32) Generating rosters, and then what we would do for audit support? Like, you know, if there’s an audit that comes through, on your rosters, how we support?
Garrison Goodman (18:40) That, yeah, there was, a couple of things.
Abubakar Khan (18:44) Delegated, you know?
Garrison Goodman (18:45) Credentialing, how we think about that for going into new states, how we support that, versus, you know, the.
Abubakar Khan (18:53) Strategy piece, I guess. And then also, okay, I mean, in that case, it might make sense to, I don’t know, let me talk to him again.
Abubakar Khan (19:06) So what he told me was that, let’s get the proposal and then let’s have another internal discussion among ourselves first. And then once we finalize, we present that to dr sehgal that this is the vendor we want to finalize with. And then we have the conversation, to meet as a group to go over the proposal and discuss what we can do there. I think that’s that was his, what he was trying to relay is that, is this call to discuss the proposal in detail and go through it because I would rather us just receive the proposal. He’s like we don’t need to spend an hour to see the proposal. Just send it to us first. We’ll review it internally. We’ll meet internally. We’ll present to dr sehgal. And then once we get the full green light, then we can move forward with the conversations. You know, I think that’s where he was coming from. Yeah, no, I.
Garrison Goodman (19:56) Mean, I think but.
Abubakar Khan (19:57) Again, none of us, I think had any follow up with John since he met with you guys. I was out on Friday and Monday as well. I didn’t get a chance to touch base with him. Either. He just sent an email to us that was pretty just sort of a generic statement for us to just move forward with whatever we’re doing. So, I don’t know if there was a follow up that he requested from you guys.
Abubakar Khan (20:18) I think go forward, go ahead and schedule it. I don’t think probably Akil probably doesn’t need to be in that meeting then I’ll just relay that to Akil that, hey, John had some follow up items that he wanted to get clarification on from them. That’s what that meeting’s for. Totally fine. Keep the meeting. And then I think in the meantime, he does want us to receive the proposal. So if you can send it prior to that great, if not, if you want to use that time again, I’m just being transparent if you guys want to use that time to present it to John first or whatever, or talk through it with him and go through some of the items from my end. I think that’s okay. I can let Akil know that, hey, I’m waiting on the proposal still. So they’re probably going to send it after Friday once they have the final discussion with John. I think that’s fine to say up to you guys, how you want to go about that. Yeah. Okay. Nope. Thanks for.
Garrison Goodman (21:06) That context. Yeah. And then I think one of the things that we wanted your input on was on the bba in regards to the revenue acceleration, John’s biggest pushback was like, hey, as soon as we hire people, they go to committee regardless of where they’re at from a credentialing status. And so his, and he was like that’s more like an operational he’s like that’s more how we operate internally than anything you can influence. Yeah. And so he was pushing back on like a lot of the revenue acceleration numbers and saying, like, hey, actually, you know, the denial is… actually much higher and so kind of wanted your take on that and how we should best align the value or change the value numbers to align better to how you all are operating from the way in which ops will send over, you know, new providers to committee regardless of their credentialing status. Yeah, that’s.
Abubakar Khan (22:12) one of our biggest issues. Sometimes they don’t even wait till the committee, they just have a provider that they need to see a patient somewhere that.
Mike Manson (22:21) was, yeah, yeah. Sorry. I didn’t mean to cut you off. That’s what I heard was like, he’s like, not only did they not wait to go to committee, they don’t wait like they just have them go see patients before they’re immediately.
Abubakar Khan (22:33) Enrolled. Yeah, yeah. So the accountability I’ve been trying to flag this since I joined. So it took about a year to get doctors to call and finally point the finger to the right team, right? So that’s where now they’ve been taking accountability for that. But we’re still seeing it. So a lot of our denials are because of that provider will be non par. They try to push it towards a credentialing issue, but it’s because they’re seeing providers before they even see the status is par with that plan and they’re not going to stop doing that either. So we’re trying to like separate buckets internally for how these denials are organized or which buckets they should go to just for reporting purposes. But that’s our biggest issue is that ops decides to see patients wherever, whenever, even if we’re not contracted with the insurance, we had a case that came up where I think the number was like upwards of 300 K. That was a complete write off for 20 25 just from one insurance that they would just keep seeing. And I flagged it throughout the entire year with the dollar amounts from one from March till December. And they continue to see that those patients till this day. So that just gives you an idea like we’re still losing that money… even if we don’t have a contract with that payor there, they’ll see whoever they want to see, right? That’s that’s one of our biggest reasons. The other reason is they want credentialing to be done in a second. Sometimes it takes a while again those pain points I think we’ve discussed already mainly with collecting documents. If the provider is missing something fresh grads, you know, no experience filling out caqh or old grads, don’t know where the documents are. Lost, it in a house fire, blah, blah, blah, whatever the cases are, you know, those months cases, but those pain points you guys are already aware of regarding the denials, ops is a major issue. I think something that may help will be speaking on the integrations with ecw, whatever capabilities that are there. That would be honestly a huge problem solver on our end. I know Melody didn’t respond to that email. I don’t even know if she got a chance to read it honestly. If you can bump that one where you gave the explanation of like the statement of work, whatever that would look like. I’ll remind her as well just to get a response out of her. That’s what would help better? Because right now our current system doesn’t speak with ecw, the mapping isn’t correct. With ecw. It doesn’t come out accurately in our reports right now. That’s one of our biggest pain points because we read through the reports and we’re like this isn’t mapped correctly. This says E, instead of east, this says that instead of that blah blah blah. So we’re having a lot of reporting issues which leads to a lot of Ar issues. And then if we are getting rejections for some of our direct enrollments, for example, maybe this is a good point too from metroplus recently, they sent us a bunch of rejections because the applications weren’t filled out correctly or there was some missing information or we didn’t attach collab agreements or blah, blah, blah, it wasn’t a complete packet… committee. Still an issue for us, right? We’re manually like racing in the last week of committee to gather all the files, make sure the checklists are completed, make sure everything is actually verified, who’s able to be presented? We’re still missing a bunch of documents and we’re still presenting them to committee, still getting approved, where’s the visibility on which ones were approved. Are still missing documents that we still need before we can submit them. So, it’s a bunch of different issues. But I would say the bulk is ops seeing patients when they’re not supposed to. And the manual prep work for a lot of these files is what I think our issue is because our team works at, you know that.
Garrison Goodman (26:13) Makes sense. And what John was saying is like, look like you guys having this data and moving faster like will give me the information that I need to be able to like… present to ops like, hey here’s how much your decisions are affecting us. But like what we were looking to understand is like, hey, this 10,000,005 number that we originally aligned on was 400 providers getting brought on 30 days faster if they’re going direct to committee before credentialing there’s not really anything that we can do about that, but it seems like, hey, the, you know, claims write offs is a bit higher.
Garrison Goodman (26:55) So it’s some percentage of this number. This is probably a lot higher. This is probably a lot lower. We’re kind of asking for guidance as to like, you know, if we were to get things to, you know, basically have a file to, you know, ready to go before committee significantly faster. I guess what I’m saying is like, what is the factor that speed plays into this? Been those parameters and like what percentage of additional revenue? Do you think we can see?
Abubakar Khan (27:36) That’s a great point. So I’m trying to think of something that stands out. So, one thing I would mention is Vesta.
Abubakar Khan (27:43) So that consultant I think that you guys are talking about that kicked you guys out or whatever. I wonder if her name was Amy.
Mike Manson (27:52) It is Amy. Yeah.
Abubakar Khan (27:53) She’s a pain in our butt too. So she is still a consultant right through the acquisition with us too. And so we’re using her for any out of state enrollments and licensing applications for providers. Communication is not great with her. She doesn’t even update our platform yet. I don’t know. It’s just a mess right now in dealing with her for out of state enrollments. So, I think if it’s all centralized in one system through one vendor, you know, that’s also a big plus because right now it is a shit show. Even the billing team is like what is perfect health? This is other. And then everyone’s like just, we still need to do the plan mapping for the insurances for that. And so it’s just sitting in the, on hold right now, a lot of those claims are sitting on hold under an other category until the billing teams align with what to do with that stuff. So, I think just for better organization for our expansion plan to other states, it would help to have a centralized platform and centralized workflow. Like you guys are aware of doing enrollments all over the place. You’re not just coming in with the mindset that, hey, we’re in New York. And oh, this is another state for us since we’ve been in New York. This is a little new right now with the out of state enrollments and we’re dependent on this consultant. All.
Mike Manson (29:10) Of the states that you mentioned going to, we have thousands of enrollments done. Yeah. And this woman, Amy, not only was she a problem at Vesta, there was actually another customer that fired her because we were in the account, she wanted to move forward and get us stood up and she was feeling pressured that she was losing control over the process and was a problem. They fired her. And then as soon as she was gone, it went into hyper speed. Interesting. Yeah.
Garrison Goodman (29:44) Akhan, is there a sentiment of like it seems like it’s like, hey, for out of state using medallion that no brainer out of state meaning state expansions. Is there a world in which you guys would like self serve for New York and use us for all?
Abubakar Khan (30:01) The rest, I would say, no, okay, take it all over, okay? Because, you know, it’s broken in pieces, right? I can’t just pinpoint and say, oh, this whole thing is messed up. No, like we’re still functioning. We’re still passing a lot of audits, you know, we’re doing things right? But there are a bunch of gaps in the middle in terms of the connection department itself. Like offshore team, caqh issues. I had to painfully watch someone fill out a caqh application and it took a half hour and they still weren’t completed with it. Document collection, no follow up if you’re not on top of the offshore team, we don’t hear from them and we don’t know if they’re actually working on something. There’s a bunch of little issues that are spread out that are enough to create a big issue and cause these denials. And, things unfold. And again, not just from the credentialing department, it’s also the platform, right? Platform breaks. We did a whole historical import, might not be fully up to date yet. Still, there might be something in there that’s still really old and the team hasn’t had the time to go in and clean up the data. So, it’s a bunch of little issues that add up to create this whole issue with the process. And so, that’s where I like to say the process is broken and we need a centralized solution for this. And that’s where you guys come in. So, do.
Garrison Goodman (31:16) you think that we should model the revenue acceleration just upon new… states then? Does that give us the most concrete way to be like this is directly where revenue can be impacted? I just,
Abubakar Khan (31:30) I guess.
Garrison Goodman (31:31) One thing is, I know it’s a number. I just don’t know what it is given the way you guys operate?
Abubakar Khan (31:38) And what did John say about this number and why it’s wrong? He?
Garrison Goodman (31:42) Said it’s wrong because he’s like, look if we waited to go to committee before we credentialed or, excuse me until after we credentialed. Yes, this makes sense. But the fact, is we just go to committee right away and doctors start seeing patients right away.
Mike Manson (31:59) It’s yeah, it’s not even that they go to committee, like even before they send them to.
Abubakar Khan (32:03) Committee, even if we go to committee, like the provider is still missing documents after, you know what I mean? So even if they’re getting approved in the meantime just to push them forward and give them a start date, they’re still missing stuff. They still should not be presented to committee. They shouldn’t be part of that. They shouldn’t be approved by the committee until we have everything for them and they’re able to be presented. So, it’s more about, and that is the issue across the board with a bunch of practices. I don’t see that getting resolved anytime soon. I see it getting a little better. So, I do agree maybe the number can be a little smaller and you can add in the out of state in here to really show what do you call it? How much you’re actually going to help save us. But I think the.
Mike Manson (32:43) number, I think John’s biggest pushback unless you disagree garrison, was, it was that the like this number is assuming direct enrollment and the direct enrollments is actually.
Abubakar Khan (32:55) The one point five, the 10 point five, 10 point five is assuming direct.
Mike Manson (32:59) Enrollment. Like he was actually, he was saying like, hey, a lot of our business is delegated. So like once we get them through the credentialing piece, the delegated pay enrollment is actually fairly fast.
Garrison Goodman (33:12) Got.
Abubakar Khan (33:12) it, that’s where he.
Mike Manson (33:14) Was like, you know, I think this number is probably smaller but we’re still a little gray on what that looks like. But he was saying the revenue leakage is probably closer to 5,000,000, which is kind of in line with what you had said, khan when we first started talking, right?
Abubakar Khan (33:30) If you want to bump up this, the revenue leakage number, I think garrison go for it. And honestly, did he ask you to update this? Or is this something you guys are just doing to make sure you have it up to date, we just want.
Mike Manson (33:43) to give an accurate picture. So that when you take this to dr sehgal and to Ranjan and to the committee, it’s like, hey, these are realistic numbers based on what we’re seeing medallion is going to cost us X, but there’s a clear path to an Roi and I.
Garrison Goodman (34:01) Think too. The other part khan is like, what are we actually delivering to your business, right? Like this is why we’re doing this. We don’t you know, if this number’s skeptical, then kind of the rest are too, right? It’s like at the end of this, when we onboard and we are successful, what do we expect to deliver to the business? And what can you hang your hat on? What can the business hang their hat on as to deliver to the organization?
Abubakar Khan (34:25) The number on the left assumes current spend on confirmed volumes. What is that number or where is that pulled from this?
Garrison Goodman (34:33) Is your current opex? This is the?
Abubakar Khan (34:35) Current opex, is that accurate? Or is that supposed to be 100 more that’s what we?
Mike Manson (34:40) Got from you in one of our previous conversations, I think that was assuming like some of the maintenance spend on parks plus the current team?
Garrison Goodman (34:50) Let me double check.
Abubakar Khan (34:51) I feel like this was 100 more. I.
Garrison Goodman (34:55) Believe people, and I think this number was people plus software.
Abubakar Khan (34:59) So it’s actually different. Let me send the updated number here to the chat.
Mike Manson (35:11) Are you taking, oh, so.
Abubakar Khan (35:13) This is based on current counts onshore. We have seven right now. I’m not counting December, I believe. And then we have 18 offshore. This is including parks. Oh, sorry, this is including the pass through numbers. Let me remove the pass through fees. This comes out two, four, six, seven. This is the number. This is fte plus parks, approximate annual cost.
Abubakar Khan (35:53) We got to refine this based.
Garrison Goodman (35:54) Upon the head count, we think we can get to, but, John was a group John aligned on our admin costs, and he’s like that seems conservative. I’m good on that. So he was good on that part. So, you know what I don’t mean to keep coming back to this. But what is a number that we think that we can influence from like a revenue perspective… 1,000,000.
Abubakar Khan (36:20) Two.
Garrison Goodman (36:21) You know, do we think 20 percent of this? Like I guess what I’m saying is like, does you know 100 percent of new providers that you hire?
Abubakar Khan (36:31) Are they not, like… what percentage?
Garrison Goodman (36:35) Of that is going through direct enrollments? And then what percentage of that would be positively impacted by our speed?
Abubakar Khan (36:42) So, if we go to the payer mix, I think you’re right with 20 percent, but I would also add the… out of state enrollments. And for those, I would add, cause let’s see. Okay.
Garrison Goodman (36:59) We’ll work on that, but that’s included in the 400 provider headcount, right? Yeah.
Abubakar Khan (37:04) It is, it is, yeah, it’s part of the 400. Do you know how.
Mike Manson (37:09) much? I think that’s part of the follow up questions I would ask over email is like, what is the number that you think you’re gonna have for out of state providers getting hired this year? Like out of?
Abubakar Khan (37:21) That four, 20, yeah, out of the four.
Mike Manson (37:24) 20, if you’re hiring four, 20, like is it 100 that are in new states?
Abubakar Khan (37:31) Okay. Let me double check that. Yeah, we’ll follow up with everything. Yeah, and what other questions come to mind for this number, send them over as well.
Mike Manson (37:45) And I guess just like last question or maybe not last, but, I appreciate you khan, I know you’re dealing with, some personal stuff too, so I appreciate you continuing to work with us on this. Like are you planning to see proposals from, or?
Abubakar Khan (38:02) A proposal?
Mike Manson (38:02) From provider passport as well and then take that like take both proposals to, yeah.
Abubakar Khan (38:08) So, we’re gonna get one from them as well. But so far, I think it’s all like, so you guys, it’s going towards you guys so far, I would say because their references weren’t the best so far. And so that sort of dug them a little hole right now. So, they’re not really the front runners right now, right? You guys are, so conversations, even John’s satisfaction, I guess after coming out of that full session that you guys did for him, also meant a lot like that was good that you guys got the chance to walk him through everything and to address any of the issues he had, because I brought up what those potential issues could have been for those people, and then come back full circle. Akil’s, agreeing with me now on exactly what my assessment was based on, like why there could have been issues, whatever issues I brought up for you guys,
Garrison Goodman (39:02) So,
Abubakar Khan (39:04) that is to say, like you guys are still on the front running right for this. That’s why I was, just looking at the presentation.
Abubakar Khan (39:09) I wasn’t sure if this was for John or if this is for dr seagal, but, if you’re making it any way, just update the numbers for that presentation on Friday. Great. Go for it. I don’t think that I’m going to use this for the, dr seagal one, but I think for John, I think it’s fine. I don’t he hasn’t seen this previously, but with dr seagal, I did pull out some of these slides from your presentation to present to him. So, he did see some of these, numbers already, and he was like, all right, yeah, but whatever, we don’t know what they’re including, blah, blah, blah, you know what I mean? It didn’t seem like it really affected them. He knew, the need and what we needed. And so, the specific asks from him were in terms of process, and like the conversations we had, right? What that process map looks like, what’s the handoff going to look like, what’s the implementation now looking like, and just so he can gauge what the actual savings would be, but,
Mike Manson (39:56) yeah, I guess, John.
Abubakar Khan (39:59) Yeah, because I know he spoke to dr Segal as well on his own about this. I don’t know in what capacity or how long the conversation really was, but probably did speak to him for a little bit.
Mike Manson (40:08) I think, yeah, it sounds like he did. I mean, I got to, we were on our way to the conference room, and I,
Abubakar Khan (40:14) have seen.
Mike Manson (40:14) Dr Segal’s, profile quite a bit. So, I was, I recognized him right away in the hallway and shook hands with him. And, he mentioned that he was meeting with John later that day, so, I think he, you know, he knew that we were on site, I guess like, my concern would be.
Garrison Goodman (40:29) I have to jump guys, but thank you so much khan.
Abubakar Khan (40:31) Really?
Garrison Goodman (40:32) Appreciate it. And, like Mike was saying, hope, you know, hope everything’s okay. And what’s going on? I love you, man. But,
Mike Manson (40:39) Alrighty. We’ll see, y’all,
Abubakar Khan (40:41) alright.
Garrison Goodman (40:42) I’ll wrap it.
Mike Manson (40:43) Up too khan, I’m sure you gotta go. I know we’re over but I think, I guess my concern would be, if it’s just price versus price. You know, us versus provider passport, like, I assume that they’re gonna… and try and undercut us. And I just, I hope that so.
Abubakar Khan (41:02) I don’t think that’s I don’t think that’s gonna be a deciding factor for us to be completely honest, you know, because, they kind of dropped the ball with, the reps, with the referrals so far while on the flip side, like we actually got a lot of insight from your referrals, right? We had a conversation with them in detail and just, you know, even regarding like their business and like what type of operation they’re running. And it was a very different conversation versus the ones we had with them. So it was very evident that they are very new in the space because one of them.