Transcript
Noah Laack-Veeder (00:00) hey, what’s up, man? I’m just going to be off cam until I join this, get some lunch in nice.
Kyle Bettencourt (00:07) Really getting some late lunches this week? Oh, yeah. I actually haven’t eaten yet today. I don’t know why I have not been hungry at all this week, but I.
Noah Laack-Veeder (00:19) wish I had that problem. I.
Kyle Bettencourt (00:21) Usually don’t I had food poisoning on Sunday, so maybe that has something to do with it. That makes sense. Yeah.
Noah Laack-Veeder (00:27) That makes sense. Dude. That’s the worst.
Kyle Bettencourt (00:31) Door to ask some chipotle when I got home.
Noah Laack-Veeder (00:34) You just want round two of food poisoning? Huh? I’m just kidding.
Kyle Bettencourt (00:37) Deadly mistake.
Kyle Bettencourt (00:42) I was so mad too, because I had some grand plans for a productive Sunday, get ahead of some work. And yeah, I was like the.
Noah Laack-Veeder (00:50) worst dude. You don’t plan on getting sick, you know?
Kyle Bettencourt (00:53) No, I was like, I was so close to ordering something else too. And just last second, I just went with chipotle my go to and then, dude.
Noah Laack-Veeder (01:00) Paid for it. You never know, you just never know dude. I was at spi, I had to go pick up my groceries last night.
Kyle Bettencourt (01:08) You, what? I.
Noah Laack-Veeder (01:10) was late to the game this week. I had to get my groceries last night.
Kyle Bettencourt (01:16) What’s your go to lunch? I’d imagine you’re if I had to guess you’re kind of like a ground beef Guy.
Noah Laack-Veeder (01:23) I am a ground beef Guy, but I just… eat whatever was. I cook dinners and lunches every day. So it’s like I make enough for the next day.
Kyle Bettencourt (01:36) Yeah, that’s kind of my routine, That’s probably the best perk of the Revell, work is being able to eat exponentially healthier.
Noah Laack-Veeder (01:48) And then I always make sure Sophie my wife who works in a hospital, like I always make sure she’s got office friendly meals. So, it’s got down to a science Kyle.
Kyle Bettencourt (02:00) Yeah… that didn’t surprise me one bit. All right. Let me, Andrew accepted. So I’m… sure he’s a busy Guy here getting ramped up.
Noah Laack-Veeder (02:21) Yeah, totally.
Kyle Bettencourt (02:23) I’ll give him a minute and shoot an email out.
Noah Laack-Veeder (02:27) It’s okay. I can just scarf this down while I’m waiting perfect.
Kyle Bettencourt (03:08) Randy. Hey, Brady.
Brandy (03:18) I got to figure out how to unmute myself. Sorry, guys. How are you?
Kyle Bettencourt (03:23) All good. Doing good. Long time. No talk.
Brandy (03:26) Yeah, Andrew should be coming. He had to leave us walking from one meeting to the other.
Kyle Bettencourt (03:31) Okay. Yeah, I figured he’s plenty busy getting ramped how.
Brandy (03:34) Much is my consulting fee guys?
Noah Laack-Veeder (03:37) You.
Kyle Bettencourt (03:37) know, Noah and I were discussing that yesterday. So we’ll send a proposal over after, oh,
Brandy (03:43) wait a minute. Is it after the contract gets signed basically?
Kyle Bettencourt (03:47) Just a blank check. So, you just write your price and we’ll.
Noah Laack-Veeder (03:51) we were literally talking about that yesterday, Brandy. I was just like, how on earth? Can we repay Brandy?
Kyle Bettencourt (04:02) Well,
Brandy (04:02) if you ever need to hire a nurse, you let me know how’s that… I mean.
Noah Laack-Veeder (04:09) Hey, look, yeah, my wife’s did I tell you? My wife’s she was an icu nurse now, she’s a crna, oh, really? Yeah, she’s always talking about how like there is no shortage of nurses being wanted. Yeah. But then the next piece is, how do I get out of actual clinical practice?
Brandy (04:31) I don’t blame her. I don’t blame her. Yeah, absolutely. Absolutely. I.
Kyle Bettencourt (04:40) Will say Brandy if, you know, should we end up moving forward together at one point, we definitely need more customer stories. So, if you were interested in actually kind of partnering with us on that aspect, there’s absolutely an opportunity there.
Brandy (04:55) No problem. Not.
Kyle Bettencourt (04:57) To put the cart ahead of the horse or anything. But.
Brandy (05:00) Well, we want to grow, right? You want to grow?
Noah Laack-Veeder (05:03) Yep. Yeah. And I don’t know Brandy if you’re a steakhouse person, but I know Kyle is. So that could be, that could be something. Yeah.
Brandy (05:10) Yes, steak is always good. You know?
Kyle Bettencourt (05:15) That looks like Andrew just emailed me.
Brandy (05:19) Yeah, he should be hopping on here, hopefully.
Noah Laack-Veeder (05:29) Speaking of steak, Brandy, what’s your cut rib eye? Are you a New York gal? No?
Brandy (05:35) We’re filet people.
Noah Laack-Veeder (05:37) Filet. Okay. You know, I’m not, I mean,
Brandy (05:40) not that I won’t eat a rib eye. I will eat a rib eye. It’s just most of the time. If I go out somewhere to eat steak, I will eat normally a filet or some type of sewer or something of that nature.
Noah Laack-Veeder (05:51) Yum. Yeah, no, I, if I’m.
Brandy (05:53) home. I mean, I’m not as picky. So I’m not really picky at all. Anyhow.
Noah Laack-Veeder (05:59) If there’s a steak made, you will eat the steak.
Brandy (06:01) Yes, it’s really keeping my children away from my food like you got your own food like eat yours first. This is mine.
Noah Laack-Veeder (06:11) Yeah. Well, I can’t do that with my wife.
Brandy (06:13) Yeah, no, no, no, you’ll probably get in trouble with that. Yes.
Noah Laack-Veeder (06:17) So, yeah, yes, always order for two. Yeah, yeah.
Brandy (06:20) I have big linemen boys. So anything I do not eat, they will definitely scruff up. And then the nine year old little girl, she will clean my plate for me. She likes to eat things. It’s my plate and her plate is my plate.
Noah Laack-Veeder (06:32) Yeah. Well, hey, speaking of linemen, I don’t know Kyle, have you told Brandy your football history?
Kyle Bettencourt (06:38) No, I was about to say that it sounds like me back in my younger days. Oh, really as much as I could. Yeah, where do they play?
Brandy (06:46) So, my oldest played up in Milwaukee at Wisconsin lutheran. So he is.
Kyle Bettencourt (06:52) He.
Brandy (06:52) is six five, 320? Wow.
Kyle Bettencourt (06:55) And.
Brandy (06:55) then my middle son is going to Lawrence tech. He wants to major in architecture. He is six three 280.
Kyle Bettencourt (07:04) Wow. All right. Those are, yeah.
Brandy (07:06) So, they are left, one of mine is a left tackle, and one’s a right tackle. So.
Kyle Bettencourt (07:11) Very cool. Yeah. So, I played at willamette, university. A smaller school sounds pretty similar size. But, yeah, we played a game in Wisconsin. It wasn’t whitewater, I’m trying to, I’m drawing a blank on who we played at this point so long ago, but, yeah, I was a left tackle in high school and I played D line in college. So.
Brandy (07:31) Oh, OK. Oh, you were a D line Guy. See, my oldest would have been the great D line Guy. My middle son, he’s too much. I mean, I hate to say it like he did play a little bit of a defensive nose tackle, OK, a little bit. And like the last game, he got really into it, but I’m like dude, you got to hit somebody like, you know, like you got to bust through. He’s like mom, it’s a little harder than what you think it is. It’s.
Kyle Bettencourt (07:57) definitely not easy. Yeah, I was at nose tackle for a couple of years and, yeah, you’re just kind of there to like take up bodies for the most part. And it’s just, yeah.
Brandy (08:05) That’s what he’s like, it’s like I’m just taking up space, mom. Yeah.
Kyle Bettencourt (08:09) I.
Brandy (08:09) expect you to take somebody out like hit them. Yeah. So, but my daughter, now, she, I say she’s a boy trapped in a girl’s body because like she wants to be like out playing football, basketball, volleyball, like she probably has a better spiral than some of the boys do it in the elementary school. So, I’m like… honey, I’m so sorry with your brothers. Well, you grow.
Kyle Bettencourt (08:33) up with, you know, two linemen that’s kind of.
Brandy (08:35) Yeah, it’s like she’s the ping pong ball between them two. Like, you know, the house shakes. It’s like, okay, guys, you need to stop. Yeah.
Kyle Bettencourt (08:43) I was the younger brother. So I was just kind of used to defending myself.
Brandy (08:46) Yeah. You were like on the defensive. Yeah, that’s her. That’s definitely her, I’m like don’t swing your sister, don’t bang her head into the wall like let’s you know, let’s be a little bit gentle here. Yep. So tomorrow at three o’clock is the big.
Kyle Bettencourt (09:05) Yes. Okay. They, Susan and Maren haven’t accepted the invite yet. So it would be worth confirming with them.
Brandy (09:13) Yeah. Let me send that out.
Kyle Bettencourt (09:15) Here, I’ll throw Andrew on as well while we’re waiting here. He said he’s going to hop in probably any minute now.
Brandy (09:21) Okay. That’s fine. Yeah.
Brandy (09:28) I am driving home from Atlanta tomorrow because of the tsa lines. So I might be on the phone meeting depending on what time it is. So, just okay.
Kyle Bettencourt (09:40) That sounds good. And.
Brandy (09:43) I’ll send out on that invite. I’ll just confirm with them. Well, I’ll send Maren a message.
Kyle Bettencourt (09:51) Okay. I just added Andrew as well. Okay?
Kyle Bettencourt (10:02) Have you chatted with them much this week or last?
Brandy (10:07) I chatted with Maren on Friday and then a little bit today.
Kyle Bettencourt (10:15) Cool. How is she kind of feeling about everything?
Brandy (10:19) Well, when I was on that other meeting, I just pretty much told her and she’s like, well, you know, I think honestly, I think Maren wants to do probably what’s best for. I don’t want to say for me, but she understands where I’m coming from and Maren has the best interest for that. I think Andrew, will, you know, definitely come on board with that because just today, we were talking about our referral program out with mendola and that we bill for that, and it’s per code and we’re billing under the supervisor again. And so he understands, and I said, well, this would be need to take care of because this would happen with credentialing and then it can go out underneath the MP and the pa. So.
Kyle Bettencourt (11:04) That makes sense. Yeah, definitely understand. Maren’s perspective is kind of a inherited problem and unexpected expense. So, if you want to work with them, on a few options that make the most sense from dr.
Brandy (11:18) Kenzie, if you want to talk to her, I’m in the meeting. So, hey, garrison.
Kyle Bettencourt (11:25) Hey, sorry. I’m late. Did I miss the party?
Brandy (11:27) Sorry, Tammy’s behind us. We’re at the apartment just fyi. All right. Hello.
Kyle Bettencourt (11:35) Cool joining as well.
Kyle Bettencourt (11:43) There he is. There we go. Hey, good afternoon, Andrew. Hey.
Andrew Sowerbrower (11:48) How’s it going? So, sorry about that?
Kyle Bettencourt (11:50) Not a problem. Garrison actually just hopped on from our side. Oh, you blew my cover. Awesome.
Kyle Bettencourt (12:00) How’s the day going? Andrew? I’d imagine busy getting ramped up here.
Kyle Bettencourt (12:13) Thank you, my man, mute.
Andrew Sowerbrower (12:17) I love talking on mute. I do it all the time. No. So it’s just drinking from a fire hose, you know, but Brandy’s been great on kind of getting me up to speed on these types of things. So I’ve been super appreciative of her.
Kyle Bettencourt (12:30) Absolutely. Yeah, we would Healthstream that as well. She’s been super helpful kind of helping us map out your guys’ credentialing process and in current state. So yeah, we’re definitely excited to chat today. And yeah, I think really the goal of the call today is kind of getting you up to speed so far in the conversations between allcare and medallion. And then just kind of introducing you to sort of like some Roi projections that we put together based on some different scenarios and then general high level pricing, but I guess just kind of before jumping in, when did you actually start with allcare just out of curiosity?
Andrew Sowerbrower (13:06) Yeah. So I am in week three, I started March ninth, I believe.
Kyle Bettencourt (13:14) Got it. Okay.
Andrew Sowerbrower (13:18) That.
Kyle Bettencourt (13:18) Sounds good. Yeah. And Brandy, so she got me up to speed on your guys’ conversation yesterday. So I guess I’ll just kind of start out with kind of recapping like kind of where things stand. And then we’d just love to hear from you sort of like what’s piquing your interest to kind of get involved with the conversation here and what you’re hoping to cover on the call today as well. But, you know, essentially, you know, we understand that allcare has some pretty aggressive growth targets and there’s a fairly complex branching operation today that’s entirely managed by Brandy. And so Marin actually reached out to initiate conversations with us about, I guess roughly a month ago, and what we thought was a relatively easy fix turned out to be a little bit more complex than we initially realized as we began to kind of dig in and learn more in working with Brandy. And so, you know, ultimately what we’ll do today is kind of walk through like what the current process looks like for allcare when it comes to credentialing and enrollment for providers, we’ll kind of walk through the different scopes that we’ve identified as sort of what we believe you guys need from a volume perspective and licensing perspective for medallion. And then like I mentioned, we can walk through sort of what that Roi would actually mean by utilizing medallion to automate some of these functions. So, I guess before just jumping headfirst into processes and background on medallion and all that, we’d love to just kind of hear your take on sort of where things are today with credentialing at allcare and what’s driving your interest on getting involved here. It looks like we lost him, yeah.
Garrison Goodman (14:58) Yeah, I cut out as well. Do you think he’ll be able to run long?
Andrew Sowerbrower (15:06) I don’t know if you asked that, Kyle? Sorry?
Kyle Bettencourt (15:08) I didn’t I probably will probably clarify if he jumps back in here.
Garrison Goodman (15:21) Hey, Andrew, can you hear us?
Garrison Goodman (15:31) Might be on mute again.
Kyle Bettencourt (15:56) Can you guys hear me? Hello? Yeah, there he is. Okay?
Andrew Sowerbrower (16:01) Sorry, I think I got kicked off for a second. I had to rejoin.
Kyle Bettencourt (16:06) Not a problem. So I’m not sure how much of that you caught but I guess maybe just to pivot like love to just kind of hear sort of what you understand today about kind of the credentialing function at allcare and what’s driving your interest to get the introduction to medallion. I know I connected with Brandy yesterday and she got us up to speed at a high level. But maybe just as a jumping point, we’d love to just kind of hear from your own words.
Andrew Sowerbrower (16:28) Yeah. So big thing is I prior, in a prior life, I worked with a company that was joint venture with piedmont on their contracts and had to, I was in the RCM team and so we had to do the same credentialing process. And I know I kind of got how big of a headache was there? We had a team. I mean, it was bigger but we had a team of about four or five people that all they did was credential for piedmont because of all of the issues. And one of the things I wanted to do here is we currently only have providers credentialed with all of our payers. And so it creates that supervising problem and all the problems with billing. If someone goes to a different location, how does that look? And so it just creates a lot of problems with billing. And so I’d like to get all of the NPS credentialed so I can start billing under them just for audit purposes and everything else. You know, don’t really want to mess with medicare too much on those types of things. But in essence, I’ve done the piedmont process before and I know how big of a headache it has been. So when I got here and, you know, we are looking to grow and grow rapidly. And I mean we’re hiring, we have three physicians, three NPS onboarding next month. One might be an MD. And so, I know Brandy’s going to be, you know, way underwater very quickly if things go as they’re planned.
Kyle Bettencourt (18:01) Got it. Yeah, that’s super helpful context there. And as far as the call today, so kind of our plan was just to walk through sort of in depth with you sort of the current state of the allcare workflow that we kind of mapped out with Brandy. And then we can show you sort of medallion like where we would step in and help to automate those areas and make it more efficient. Is that kind of what you were hoping to get from the call? Or is there anything else that you want to make sure, that we get to? Yeah.
Andrew Sowerbrower (18:31) The only other piece would be the integration with piedmont itself, right? So just to ensure even if we load all of our NPS with the payers that, how are we ensuring that we are still getting the piedmont contracted rates because it’s under their cin. So just from your perspective, how that process would be one and the same?
Kyle Bettencourt (18:58) Okay. Andrew.
Garrison Goodman (18:59) Real quick. We’ve got about 10 minutes scheduled left. Can you run over?
Andrew Sowerbrower (19:04) Yeah, I’m good.
Garrison Goodman (19:06) Could you go to the top of the hour by chance? Yeah, I got as long as you guys need. Okay. So, yeah, just to Healthstream what Kyle was saying.
Kyle Bettencourt (19:16) You know, we, you know.
Garrison Goodman (19:18) Started the engagement, with Marin and, you know, as allcare has broken off to allcare Georgia. And you guys have a lot of exciting things going in the relationship with piedmont. You know, the goal was just like, hey, get a credentialing service in place. Marin and Susan have familiar coming from a customer that was using medallion. So they’re familiar with us. But through this process, there was, you know, two things that I think, you know, kind of came to light that maybe they weren’t expecting which is the total number of enrollments that you all will need, to do based upon your relationship. It seems like that was a maybe an inherited bit of a surprise. And then also the other like sticking point is just how much work that is to do in enrollment. Cause one of the things that they were suggesting is like, hey, why can’t we just, you know, throw a person at this? And so we want to confirm with you what we understand is like the number of enrollments that you’d have to do based upon your business model and your relationship with piedmont. That’s like the first thing we, you know, coming from our perspective, we don’t really care how many enrollments you need, you tell us kind of thing like, well, we’ll do the work and so, but I think that’s like kind of maybe the problem that was inherited that wasn’t necessarily known upfront. And then the second piece is just walking through how much work it does to, actually takes to actually do an enrollment. So that they understand like, hey, we can’t just throw one or two people at this. It’s actually going to require a bit more than that. And then from there, we feel like we have the best cost efficient solution and also some value add on times from how fast we can do things. So that’s what I think we want to orient the call from and hope you walk away from, and that we align with you on how many enrollments that you actually need as well. Is that, is that fair? Yeah, no, that sounds great. Okay. Cool.
Kyle Bettencourt (21:16) So, no, I’ll let you kind of jump in here but you basically Andrew, the options that we have sort of initially scoped out with Brandy are sort of twofold, right? We have kind of like an entry level option which is sort of what we thought was going to be the requirements when we kind of initially started the conversations here. And then, you know, as we kind of learned more, we prepared a second option, a volume for basically accounting for re, enrolling the entire existing provider base… again. And so Noah and Brandy can probably speak to sort of where we got, these numbers a bit better, clearly clearer than I can. But that’s kind of the two volumes that we’re working on here. Yeah.
Noah Laack-Veeder (22:00) And Brandy, I can take a stab but definitely don’t want to steal your thunder because you were super instrumental to creating this. And just,
Brandy (22:07) no, you go ahead. You talk better than I do.
Noah Laack-Veeder (22:10) I don’t know if I agree with that but, you know, I’ll you know, I’ll see what I can do. So ultimately, it kind of when we were talking to Brandy about the initial option a, is there’s going to be around like three pas, three NPS, let’s say for this year? And from what we understood is that piedmont really only today is handling the MDS and not everything for an MD, but kind of just high level. They’re just doing majority MDS, but they’re not doing either the pas or the NPS. So with that being said, if we want to get all of the pas and NPS enrolled with all 50 plans, this would be net new work that would have to be done. So if you see that multiplication be, you know, this three times 50, 150 enrollment events. And then as we kind of go through the hiring plans for the following years, that’s how that math works out. Brandy also kind of mentioned that and Brandy again not to put your, put you on the spot here. But, and I won’t but is we aren’t necessarily confident that the pas and NPS that are currently on the team are enrolled. So that option B is saying, look, if we wanted to enroll everybody including those that are going to be hired in future years, this is what that volume could look like. So kind of option a would be let’s just get the pas and NPS enrolled, that we’re hiring this year. Option B is, look, we don’t necessarily trust all of the work that piedmont’s done. Let’s just make sure we do this, right? And that’s how we got to those numbers. Anything Brandy that, you would add there? Did I do a pretty good job of covering it? No?
Brandy (23:54) I think that’s a great job. And Andrew, like I said, before, we had a major problem with credentialing when I first came on because of what was going on with the providers not being credentialed where they really needed to be credentialed and the multifaceted sites that they were going to. So with that being said, like,
Noah Laack-Veeder (24:16) it.
Brandy (24:17) hurts my soul as a revenue utilization management nurse to see things get wrote off. And I can’t tell you how much we wrote off. So that’s what my concern is with these guys, they will make sure that we have our pas and MPS credentialed multifacets across the clinic. So we don’t have to have those write offs of saying, hey, we moved Rachel Daniels from Reynolds town to northside but she’s not credentialed for that clinic or something of that nature. And like also if we lose a doctor of moving those seven supervisors to another doctor that we necessarily don’t have right now, I mean, if we would lose two doctors right now, that would be 14 MPS and pas, and we’re MPS and pas heavy that we may not have a supervisor for which means and you know, that with that supervisor role, we can’t send those bills out. We can’t get paid because we don’t have a supervisor that we’re billing under. So I think, Andrew, you see that aspect because we even talked about it today with mandula that we’re billing underneath a supervisor. So if we lose two docs just by chance, for some reason, we’re kind of up a crick at that point. So… what I really do like about this system and what’s been presented to me on my aspect is the revalidation, the timelines they’ve given me and how fast their team can do this. So hear me say if I was to do this, I would probably need a whole month or two by myself. No one talking to me, no one calling me for anything additional to even try to enroll all the pas and the MPS, through all of the multifacets that we need to do it through our payor mapping. So, and what I also want to look on the perspective Andrew is, if that was, if we’re ever looking to take medicaid, that can be done as well through this facet too. So it’s probably a quicker process than actually hiring because we know with, human form makes mistakes and that happens. But these guys back that up more than us needing three or four ftes. And that’s where it really coincides like they guarantee their work and for us to bring three or four people in to do the credentialing that we would need to do. It just doesn’t seem feasible on our end, with the state that we’re in at this point in time with how many that we need to be done. So that’s why Andrew, when you told me yesterday about how big of an uplift would it be? I was like medallion, he would be the perfect thing for that uplift and it would be in a timely manner effect, a manual uplift for us. Yeah.
Noah Laack-Veeder (27:23) Andrew just love to hear kind of any feedback initially based on that. Yeah.
Andrew Sowerbrower (27:29) I mean, just looking at these charts, I would think if anything, the even option two is still probably low on the estimates just based on growth. And, you know, if we’re going to re, enroll all MPS that we currently have, because, I think Brandy, you said none of them are credentialed currently?
Brandy (27:47) Nope, right.
Andrew Sowerbrower (27:48) Because pnot wouldn’t let us.
Brandy (27:50) Pnot will not even let, will not even credential them MPS and pas for blue cross blue shield. And I did get that confirmed yesterday, Andrew.
Noah Laack-Veeder (27:57) Yeah, and just really quick Brandy. Do you know why they won’t credential them?
Brandy (28:03) Well, what I’ve gotten is that they don’t recognize MPS and pas for whether it’s our, us being a part of their aco or when we came into their aco, but like Andrew said, like before I think Andrew, you had said that they would credential MPS and pas for us. We’ve been told absolutely, they will not credential for us, our.
Andrew Sowerbrower (28:27) MPS and pas. Yes. So just so you guys know, I did urgent cares and we were a joint venture partner with pnot and we were under the pnot contracts. Obviously at urgent care is heavy pa, and I was billing under my pas with some credentials. So I know it can be done. So it would be so that’s where I get in the question of, okay. So if we, if pnot says no, if we just go in credential, anyway, what does that look like? Essentially like do that’s where I’m more concerned because the pnot rates are very lucrative. And so I don’t want to lose those just because I want to bill with an NP.
Noah Laack-Veeder (29:16) Yeah, that makes sense. Just so I’m hearing that correctly. It’s we kind of like conflicting information whether or not they can bill for or they can do credentialing for these folks or it’s kind of like will they, is kind of the question? I think Brandy or Andrew, do either of, you know, like because you said the lucrative rates in your past or maybe Brandy, you know, this with the current, do you know anything about the pnot contracts? Like are they allowing NPS and pas to, yeah. So.
Andrew Sowerbrower (29:46) They definitely allow. Like I said, I know they allow NPS and pas because I was doing it at the last place, but I don’t know if that, because I do remember, it was maybe a slightly different enrollment and maybe we credentialed the site and loaded everyone’s npis to that site. And so I don’t again, I don’t know how necessarily how it was being done. I could make some calls and try to dig it out, but ultimately, I was billing under NPS and pas to the same exact contracts that we are on.
Noah Laack-Veeder (30:25) Today. Yeah. And that makes sense. So I think ultimately, the way that I’d look at it would be medallion can absolutely do these provider linkages to a particular group contract. If piedmont is the one that owns the contract, we just got to make sure that we’ve got all the associated details for that enrollment. So things like tin, you know, a couple there’s like there’s as, you know, Brady, there’s gonna be a couple things, but we just got to make sure that we have the basic information that’s gonna be required to link that provider to that. So whether or not it’s us doing it or piedmont doing it, that doesn’t necessarily matter as long as we get the data. The second piece that’s most important that you called out is look if piedmont with blue cross, blue shield doesn’t have a contract that allows for reimbursement for NPS and pas, then the option would be, I mean, and it doesn’t sound likely, but then that situation, you would need to have a contract in order to do that, right? It’s just not gonna just happen, right? If you did try to credential it’s just not gonna work, right? It’s gonna be out of network. So, yeah. So I think something to figure out is if we go, hey, piedmont contract information, are you able to bill for NPS and pas? Yes, great. Our providers, it seems you asked earlier, Andrew, they’re already associated with that cin with piedmont. It’s just more or less just getting the information that we need to process those. And that seems like the likely scenario how I think about it would be you would just be kind of offloading the work that piedmont does is doing to medallion and you’re kind of getting a fast pass for the work that they’re doing. So if it takes them 120 days normally with NPS and pas, then the timelines that we’ll walk through later are the ones that you’ll get through. The ones that medallion’s submitting. Does that make sense at a high level and kind of what the next steps need to be there?
Andrew Sowerbrower (32:18) No, that does make sense. I’m just Brandon, you know, this better than I do from doing the MDS. Do you know if, because obviously like medallion, like you guys can go straight to the payers, but are we required to use piedmont? And so essentially, medallion would take place of what you were doing for the prep work of piedmont and then funneling it to them, or are we allowed to go around?
Brandy (32:50) That’s a good question. I think for us to stay in the aco, we have to go through piedmont for that aspect. As far as I understand for us to be able to stay in that aco. Yeah.
Andrew Sowerbrower (33:04) So, I would imagine that it would not be necessarily all replace the piedmont part. It would be all be replacing the Brandy part where it’s the prep, it’s getting everything in and making sure they’re enrolled in every, and then the follow up after piedmont supposedly enrolls and takes, you know, 60 days plus, you know, whatever other timelines they arbitrarily give. Yeah.
Brandy (33:29) So what we do is we send that application over and then it goes in front of the credentialing board Andrew right now. So it’s whenever that credentialing board decides to meet. So it could be next month, it could be in 60 days. It could be whatever we’re at that. So we had an application that we submitted in January and that person’s finally going in front of the board in April.
Andrew Sowerbrower (33:53) Yeah. And see that’s yeah, I mean that’s not a medallion problem that’s you know, a problem. We got to get in front of piedmont because we can’t be doing that. And the other piece to this is I do know on their blue cross, they only load it twice a year. So I’m not missing their credentialing, like your example. Maybe in April, I hired this person in January. They’re not going to load that person until July, the blue cross. And then on top of that, I’m going to have to wait two months to pull the claims again or 90 days, whatever they make me do. So, I’m not going to bill until Q full of this year for someone that was started in January, right? And so that’s where I was hoping we could streamline… here is, you know, if I don’t have to use piedmont, but I have all their information. Can I just do it myself through medallion or is?
Brandy (34:52) This, it could be a possibility if piedmont. So I mean, this is my thing. I don’t know exactly what that, but what I can do is I can definitely reach out to eve because I have that relationship with her and have a conversation with her, say to eve. We’re looking at a credentialing company. We’re part of your aco, do we have to credential our MDS? Or can we go through medallion and use the contracts that we have with you for the aco with piedmont and do our own credentialing?
Andrew Sowerbrower (35:24) Yeah. And I would, it should be pretty straightforward. Yeah, yeah. And I would just allude to the time it’s taking to get these people credentialed, right? Because truly, I think that’s where, you know, I’m looking at the medallion to really step into like if we can do that, then great. If not, it’s just a problem… right?
Noah Laack-Veeder (35:51) Yeah. And just so I’m clear your organization doesn’t have active contracts with payers, it’s just piedmont, correct? Yes.
Andrew Sowerbrower (36:00) We’re in the piedmont network. So all of our contracts are piedmont contracts.
Noah Laack-Veeder (36:05) Yep.
Noah Laack-Veeder (36:11) So just give me a second here because I’m just trying to give you just, I know we can write these up as like the best next… steps here. But I think number one is, do they allow NPS and pas that’s like number one? And then number two, if… like the scenario Brandon you said is, if we have all of their group information, are they willing to just have medallion do the work? Like, is there any requirement against medallion us doing that? Like we would pretty much be, because we work with organizations like piedmont and we do the work for them. It’s just, it’s very similar. You have a group, you have a group relationship with the payer link providers to that that’s absolutely something that medallion can do. I think you just have to understand is they’re like, is there, so given they have really lucrative rates, is there a unique agreement where they have to do a little bit different process to do payer enrollment? That one I think would be something we’d have to work through. But if there’s really no requirement, then I don’t see an issue with medallion handling this. If piedmont needs to get the information around enrollment finalizations and things like that, we can absolutely send that via report. Brandy. We could give them all of that information that they might need, which I’m sure if you’re handling those other enrollments today, you’re kind of having to do similar things today.
Andrew Sowerbrower (37:37) Yes.
Noah Laack-Veeder (37:40) Maybe Brandy, you can just help illuminate a little bit. So the work that because there were enrollments that piedmont’s not doing today, correct that you’re doing?
Brandy (37:49) Right. They’re not doing the medicare, they won’t do the medicare and.
Noah Laack-Veeder (37:53) So, how is that different? Are you going end to end? Like are you going into Pecos and then doing all that work and entering in piedmont’s group information?
Brandy (38:04) Okay. Facility information. I’ve added our facilities in there, we go through palo mento. All of that is being done by me.
Noah Laack-Veeder (38:15) Yeah. And so you have to use, you have to use piedmont’s group information and contract information when you do that process. Okay?
Brandy (38:23) It’s all linked to the account that was set up. Okay? And then I’ve had to change the medical director. I’ve had to change the routing. I’ve had to change… information, who it goes to. I’ve had to delete people from it. Yeah. So I am the main person that’s maintaining that Pecos and CMS and assigning and approving signatures and things like that that’s going through that system.
Noah Laack-Veeder (38:48) Yeah. So I feel like that’s a positive sign. It seems like it’s possible Andrew, but it’s just something that we definitely want to double check and.
Brandy (38:56) I’m going to send it as we’re talking. I’m typing up an email to eve. So she’s pretty respondent to me. So I’ll try to set up a time. Maybe I can talk with her, just have a phone conversation with her if not get some of my questions answered for that.
Noah Laack-Veeder (39:16) That makes sense. Okay… Andrew, I think I did want to comment or understand a little bit more. So maybe Kyle, do you want to go into that process map a little bit? Yeah… let’s assume that we can do all of this. I think it’s still important to kind of call out what the vision is here and I just want to get any comments from you in terms of things that maybe we’re not thinking about. But Brandy and I helped put this together, right? It’s just what the model looks like today. So if any MD or do leaves or there’s a single point of failure where NPS and pas wouldn’t be able to bill or you wouldn’t be able to bill until that supervisor relationship is there. And then just kind of highlighting some of the revenue and compliance risks that we see is just kind of obviously the claims and aisles, but also that missed revalidations, right? So that’s something that we can take care of. But then if we go into the future state just kind of seeing how we’re thinking about the future process here is because your NPS or pas are credentialed, there wouldn’t be claims and aisles because they’re not in network. So ultimately, I just want to just talk through this because there’s definitely benefits here. But Andrew, from your lens, I think there might be some compliance things that you might be thinking about or wondering about. I just want to make sure I just understood from you other challenges besides the claims in ielts that you could see with kind of the single point of failure today.
Andrew Sowerbrower (40:51) Yeah, I think truly compliance is always the thing. I think the… maintenance is probably the biggest part of that. And then the other piece on the claim denials is just… you know, there’s so much unknown. Like I will have a doctor at a random site, just get denied for an open access cigna plan. It’s like I’m enrolled everywhere and I don’t have a point of content. So that’s where like I was really hoping, you know, if all this goes well, you guys could be the source of content, be like, hey, they’re saying they’re not enrolled. What’s going on? Yep that?
Noah Laack-Veeder (41:27) Makes sense. So, I’m hearing it’s just like that because it sounds like with piedmont, we kind of have like a black box. It’s like if there’s any issues, it’s hard to understand what the root cause was. So with a vendor or partner just being like, hey, if we do need to like even if we do everything perfectly, sometimes payers make mistakes. So, it’s like if we need to do that appeal or grievance process, can we do it really quickly? And ultimately, I think Andrew just kind of thinking about that a lot of times, it’s that visibility that’s challenging. But the impact is that we’re not able to drop claims or things are still being denied because we don’t have that information like what’s the, what are you seeing in terms of the impact of that today?
Andrew Sowerbrower (42:09) So the two biggest things is one, the denials for just, you know, time and time they’re like, okay, they’re enrolled and then I go to bill. It’s still denied, you know, so I’m holding, I still have claims held from November that I keep resubmitting. So I don’t hit timely filing, but I keep getting denied for it.
Andrew Sowerbrower (42:27) And then the other piece is that patients are, actually, when we go to verify with certain doctors, they’re being like turned away because they’re scared that it’s going to hit 100 percent out of network and they don’t want to have coverage. So they just won’t even, you know, step foot in the clinic because they’re you know, they’re getting some sort of kickback on when they’re inputting all their information. So, I just like it’s just things like that. That are the common occurrences. You’re exactly, right? Piedmont is a black box. So when it’s cigna, open access, I have nowhere to go to even, you know, I can that’s where I would really like to understand like for me for saying the odd, like I don’t even know where to start? You know, how do I re, enroll? Do I have to go back in front of a board? Like can I just have you guys update something in the plane that’s you know, just because it is a black hole right now? Yeah.
Noah Laack-Veeder (43:24) That makes sense. And Brandy kind of from what you’ve seen with medallion, I mean, do you think the visibility and everything that we share is going to be able to help with that? Yeah, absolutely.
Andrew Sowerbrower (43:34) Absolutely. I think so.
Noah Laack-Veeder (43:37) Yeah. And Andrew, if it makes sense, we can always kind of show you what it looks like at some point as well because it could be helpful but typically kind of the claims and aisles and things. And also kind of like the hesitancy to get in the clinic because of being afraid of being rejected. Those are things that you know, transparency and visibility is going to help. And also just a more streamlined appeals and grievances process. So with medallion having that data in one place is typically going to aid in that process and ultimately reduce those claims and aisles and hopefully not have something in January, not being able to be submitted for six months, right? We’re giving you the real time data. So if that does come up, you have it to defend your case and resolve things a lot faster. Awesome. And so maybe… Kyle, does it make sense to kind of just talk through kind of the just the high level vision here in terms of where we think we can help from like a dollars and cents perspective?
Kyle Bettencourt (44:38) Yeah, we can definitely pivot here. So, I know kind of one of the other areas that we mentioned earlier is just like the time it takes to actually manage this process. And like what that lift would look like to try to manage this for all care today based on your guys’ growth. And so this slide here just kind of walks through like the actual hours it takes per enrollment. And, you know, we can go into the details but like ultimately, like on a conservative side, it’s roughly about 10 hours of staff time per enrollment. And that’s being, you know, extremely conservative that’s not even really factoring in follow up that Brandon needs to do with the payers, which you know, can be, you know, five to 10 hours easily. And, you know, oftentimes we’re looking at a 30 to 45 day wait time, you know, to get information back from them. And so when you kind of extrapolate that out to like what the requirements would be for adding full time employees, these are sort of the estimates that we came up with based on your… guys’ expected volume, right? So it sounds like even these numbers that we’re kind of referencing here are still conservative, but at, you know, 10 hours per enrollment at 1,320 enrollments. You know, that’s 19,000 hours, close to 20,000 hours worth of staff time, which would be eight employees for year one on the lower end. And then year two, year three, you know, at a minimum four employees to manage the lift that you guys are going to have to process here when it comes to credentialing and enrollment. And then, you know, kind of the other area that, we haven’t really hit on yet, but is actually one of the biggest drivers in why folks actually look to partner with medallion is just reducing overall turnaround times to accelerate revenue and just ultimately get your providers billable as quickly as possible in generating revenue. And, you know, when we looked at just sort of the year one revenue acceleration for all care based on just adding eight providers… the revenue per day for your MDS and dos. We referenced 5,000 dollars per day worth of revenue that they can generate nurses and aps in the mid levels, about 4,200 dollars per day. So, 35,000 dollars per day is ultimately sort of the daily revenue exposure for every day that, these providers have to sit to get ultimately enrolled in billing patients. And when you look at that across a 57 day or sorry, a 63 day reduction, which is ultimately the turnaround time savings that we’re kind of calculating based on our averages with the payers. That you work with it’s over 2,000,000 dollars in revenue acceleration that we can actually provide for all care in year one. So, you know, between, the revenue acceleration, you know, what we think we can alleviate as far as fte, you know, additions in the future here, you know, we’re looking at two point 6,000,000 dollars worth of Roi by partnering with medallium, and that’s not even really factoring in claims reduction in claims in Niles as well. So I’ll kind of pause here. Does that one I guess make sense from a high level or two? Do you have, any questions on any of those numbers?
Andrew Sowerbrower (47:58) The only question I have is, so you reduce the days from, you know, 160 to 54 or whatever the two numbers were, but pretty drastically after you enroll, is it still the holding period of 60 days for the payers to update their systems or did you all find a way around that?
Noah Laack-Veeder (48:19) Yeah. Typically, like our, what we think of is like that like the process is completed is that the payer has that provider on their roster as a network? Okay?
Andrew Sowerbrower (48:32) Perfect. So essentially, you reduce the front end time down and so it’s we get credentialed faster, still hold claims afterwards over here. Okay. Yeah, I.
Noah Laack-Veeder (48:45) Would say like just so I’m hearing you correctly. So how I would phrase it is like because of the volume that medallion, does I’m, not sure if I mentioned this, but we do about 200,000 payer enrollments a year and that number is growing like we have economies of scale. So we shorten the process up front, but also we have automated follow ups and things like, that speed up the other.
Andrew Sowerbrower (49:07) Kind.
Noah Laack-Veeder (49:08) Of waiting period. So ultimately like the impact to an organization like yours is look if you’re not getting par status for 120 days, we’ll cut that in half.
Noah Laack-Veeder (49:20) So they are in network and by in network, that means that they are added to that payer roster. So they are in network. So you’re not going to get a claims denial due to them not being credentialed that payer. Does that make sense?
Andrew Sowerbrower (49:32) That makes perfect sense. All right. Thanks.
Noah Laack-Veeder (49:35) Yeah, really good question.
Kyle Bettencourt (49:39) Yeah. And again, we maintain over 99 percent accuracy with your credentialing files as well. And then again you get full visibility into your entire provider network along with auditing and reporting so you can have that ongoing confidence that your compliance risk is pretty minimal.
Kyle Bettencourt (49:59) And then, so pricing wise, it sounds like we’ll maybe need to revisit some of the numbers that we have prepared here. But this is essentially the investment for option a and option B here with medallium. So again, these are based on three year terms, but 87,454 for the option a estimate would be the year one cost. But again that’s projecting an Roi of two point 6,000,000 combining that revenue acceleration, full time employee cost avoidance then not factoring in what you guys would gain from denied claims reduction as well. And then option B for that higher volume, that sounds probably closer to what we’re thinking, but that would be 248,560 comes in with a built in 10 percent discount, for the higher volume. But again, you’re still getting almost a 10 X return, for Roi kind of based on what we’re estimating here.
Kyle Bettencourt (51:05) And then, so just to kind of break these down annually, what it would look like, this is sort of the option one and option two side… by side. But curious… your thoughts here from this initial feedback on the numbers here?
Andrew Sowerbrower (51:25) So, I mean it makes sense… per enrollment that’s okay. No, I mean it makes sense. The first year is always going to be the heaviest with all the increases.
Andrew Sowerbrower (51:43) And then so obviously, it’s a flexible plan, right? So like if we hired more or less, you deviate to the total enrollments as a price per enrollment or is it plants?
Kyle Bettencourt (51:59) Yeah. So it’s kind of twofold basically you would have a license in place for your providers. And then, yeah, it’s usage based on your enrollments. And then what’s also nice is we have flexibility across three year terms. So if you do need more enrollments in year one, you can kind of pull from those later terms or vice versa. But the enrollment aspect is sort of usage based. And then you just have sort of a baseline cost for enrollment platform fee for your provider.
Noah Laack-Veeder (52:28) Group, yes.
Andrew Sowerbrower (52:29) I gotcha. Sorry. Go ahead as you.
Garrison Goodman (52:32) Say, yeah, most of the cost is based upon, the provider enrollment. So as you know, you sync internally and get, we need your help on understanding how many enrollments that we actually need to model out here. But you can think of it like a utility where you’re you know, rather than paying for an employee who’s got, you know, pto and downtime and where you’re going through hiring, you know, peaks and valleys. You can think of it as in that sense when, hey, you need to hire a bunch of people. You’re not having to bring on staff when there’s down periods, you don’t have to have people with, you know, excess capacity. So that’s kind of how the model is a benefit, to our customers.
Andrew Sowerbrower (53:13) Yeah, that makes sense. But this is also assuming start to finish currently, right? So if option two is or, you know, plan B because piedmont has to do the enrollment with the payers and you guys do the front end prep, it’s a different price or is it one one shoe fits all? Yeah, let.
Noah Laack-Veeder (53:34) Me. So one thing that I think is going to answer that question is whether or not because I think earlier like you know, from your experience, Andrew piedmont doesn’t has allowed NPS and pas to get credentialed. Ultimately, I think the question would be let’s say piedmont comes back and says, no, we won’t do this. Like would you all explore getting your own group contract that would allow NPS and pas to bill? No?
Andrew Sowerbrower (54:03) There’s just no way we’re not big enough for the market, to leverage anywhere close to what we’re billing if we just use the supervising like it, it’s well worth the risk at that point to just use supervising. So.
Noah Laack-Veeder (54:18) Sorry. So I’m hearing you saying that if piedmont says look like we’re not going to allow you to do NPS and pas, you would just say look like we’re just gonna keep with the supervising physician piece. Yeah.
Andrew Sowerbrower (54:33) Essentially, we would have to just because the piedmont is so large in Georgia that their rates in the Georgia market are, you know, probably two and a half to three times what the market rate is. So, you know, if we were to go out our own, it’s such a haircut just to avoid some risk on physicians leaving that, you would always take the risk. Yeah.
Noah Laack-Veeder (54:56) So actually had what about like a hybrid approach where you would use piedmont for the MDS, but maybe have your own contract for the NPS and pas, would that be something you?
Andrew Sowerbrower (55:07) Would explore, no, I’d still want to bill under the MDS of them, right?
Noah Laack-Veeder (55:10) Yeah, fair enough. Yeah.
Andrew Sowerbrower (55:12) Yeah. So, but I will say like when piedmont, because I’m assuming people are going to come back and say, no, we can’t do MPS. I’m going to keep fighting them because I know we’ve done it. So, I want to figure out how we did it at the current, which is 85 clinics in Georgia. Like, so, I know it’s I know it’s being done. There’s 300 MPS on well street’s roster that they currently have credentials for billing. Yeah. So that’s you know, I’m just not gonna take no for an answer on that one. Yeah.
Noah Laack-Veeder (55:45) That makes sense. Like I just wanted to kind of ask that just so we can kind of narrow down the path. So I think like what, to get to those numbers that we’re kind of talking about, Andrew. There’s kind of two different lens like one. If piedmont is like, no, you can’t do this work. You have to let us do it. We think of that as kind of like a, and maybe Brandy, you can kind of talk about this press a little bit more like typically, it’s like you send one provider packet to piedmont. And then what they do is they kind of create, they do all the applications like Brandy’s not creating those applications. Piedmont’s doing that. And so, it’s the question, is piedmont gonna like let us do the application creation or is it that medallion is going to be the one that pre packages that provider data to piedmont? Both are areas that we can absolutely help with and expedite it’s. Just a matter of like which one is piedmont gonna allow? Does that make sense? Yeah.
Brandy (56:45) And that’s the question I’m posing over to eve as we speak with an email I have out to her. I gave her scenarios of like, you know, are we sure that the MPS and pas can’t be credentialed? Why can’t they be credentialed? Can we use the contracts that piedmont has to credential the MPS and pas on our own? And also, can we still use the contracts that piedmont doesn’t do our own credentialing, even using the contract information? So that’s all the questions I have posed over to her in that email that I just sent out yep?
Noah Laack-Veeder (57:19) And so, Andrew, I think the kind of the proposal we showed is probably closer to that situation where we can handle all the credentialing on behalf of piedmont. And then those are also that’s where we’re going to see like just those huge benefits that Kyle was mentioning around revenue acceleration. We’d see that. But on the flip side, either way kind of Brandy, as you’ve talked about, it’s going to be a ton of work to get this information over to piedmont. So we’d be able to do that with much less resources that would be needed when all this stuff happens.
Andrew Sowerbrower (57:56) Well, and the other piece that I would be interested is, you know, if piedmont does have to do the enrollment and not just do the packaging, is the audit feature still available? So like I could quickly see, so, yeah.
Noah Laack-Veeder (58:11) By audit feature, you’re like, can we still get like the proof of enrollment and all this other stuff in our system? Yes. Yeah, absolutely. Yeah.
Andrew Sowerbrower (58:21) Okay. Cool. Because that’s essentially like truly the benefit, I see like Brandy completely understand, but like for my benefit, it’s the back end where I can very quickly see where the problems are and not the black hole there’s. The visibility into the total package. Not necessarily the prepackage, you know, I could.
Noah Laack-Veeder (58:41) Yes, we.
Andrew Sowerbrower (58:43) can hire some contract labor and, you know, Brandy, you’d have a team of 20 that would just work really hard for a month to get everyone, yeah, package, but it’s the back end that I really care about. Well.
Brandy (58:53) And my back end thing is it’s like Andrew, is that like we had a doctor that didn’t do her cmes. And it was, thank goodness I was on top of it looking at it because we literally had to take her off because the medical board didn’t renew her license, which… slowed down her credentialing, which slowed down everything else as well. Yeah. And that’s what medallion will do they’ll check those licenses, they’ll check the deas, they will do all of that for us and also do the caqhs too. Yes.
Andrew Sowerbrower (59:26) Yeah, that’s the big pieces that I really am interested in, right? So then make sure we’re enrolled everywhere. And then also the more regulatory pieces on the back end just being smaller, you know, that’s always the first thing to follow.
Noah Laack-Veeder (59:39) Yeah. And it sounds like piedmont isn’t really doing that at all at.
Andrew Sowerbrower (59:44) All? No, piedmont will never they.
Brandy (59:46) Will not.
Andrew Sowerbrower (59:47) Care, you can lapse every doctor you have, and they still won’t tell you that.
Noah Laack-Veeder (59:52) That’s really interesting, right? Because like, yeah, because I mean, we know that if a sanction or something happens and you keep doing this like they’re going to get rejected, the payer is not going to let this happen. So it’s important to capture that. Also the caqh piece. So, Andrew, kind of if a priority for you is also that traceability and the ongoing monitoring and that caqh maintenance, we will absolutely be able to do that regardless of the piedmont piece, I think we just need to understand how this process is going to have, to work and we can adjust accordingly but I’m bullish on either end that would be able to help your organization with those pieces you’ve highlighted. Do you feel the same way Andrew, kind of after you’ve sat through today?
Andrew Sowerbrower (60:41) Yeah, no, yeah, yes, I feel a lot better with the, you know, because I think of the front end was always up for a question. Piedmont’s very strange. But if we still get out the traceability, I feel a 1,000,000 times better on the back end. And the regulatory piece like that’s essentially what I see the massive benefit is from you guys is, you know, is that, yeah.
Noah Laack-Veeder (61:06) And not to make you rehash it again. But just so we make sure we kind of like put this in there. This is so valuable because of the things like appeals and grievances and other pieces that you’re having to kind of play needle in a haystack to fight. Is that kind of what it relates to directly?
Andrew Sowerbrower (61:22) Yeah. Well, that, that’s the, that’s the RCM piece. You know, the RCM side of me is that, but the other side is exactly what Brandy just brought up. It’s the insurance of making sure the providers are on top of it and we’re not lapsing anywhere and, you know, it’s if, you know, if Brandy doesn’t check it, we have a backup.
Noah Laack-Veeder (61:44) Yep.
Andrew Sowerbrower (61:44) Yeah, absolutely. And so I think that it’s like the security blanket along with the RCM benefits. That makes.
Noah Laack-Veeder (61:51) sense. So, yeah, that makes that. Yeah. And I, again, we, I think what we need to do is finalize these numbers that are going to make the most sense for the organization. And Brandy, I think you’ll be able to uncover where we need to go forward. But maybe Kyle talking about the conversation tomorrow kind of like what are we? What are we thinking? Well?
Kyle Bettencourt (62:15) I was going to, I guess maybe ask the group on what might be best. It sounds like we have a little bit more work to do to scope out more accurate pricing for all care.
Kyle Bettencourt (62:25) I mean, I guess just like even from a higher level in like a budget perspective, like is that two to 300 K like number? Is that even like, is that a realistic like price point for this problem? Your your opinion, Andrew, I’d imagine it’s considerably higher than sort of what Susan and Maren were anticipating. But yeah, I mean, it does sound like the significant… raise towards all care. Yeah.
Andrew Sowerbrower (62:51) It’s definitely, it’s definitely higher than probably what they’re expecting. But at the same time, I think they’re really underestimating what they’re trying to do. And I think, in their minds right now, we’re not reloading on the MPS, right? They, they are just looking for future mbe onboarding. So, you know, it would be the much lower end of the spectrum so that 90 K would make a lot more sense to them. But I’m you know, just part of my massive tenure here of three weeks, I’m really pushing that we do all the MPS because just, it just makes life so much easier. So I think we can get them across the, I can get Susan across the 250 mark. If, if everything else comes into play, right? And let’s also be like 250 for the entire process, start to finish. I, it’s not a bad trick for.
Kyle Bettencourt (63:48) For, okay. Yeah. And we’re happy to work with you as well on pricing. Like I mentioned, these are kind of just, you know, initial numbers based, on the conversation so far. But yeah, I mean if that’s in the ballpark and you think that’s realistic, then, you know, don’t want to just present something that will completely.
Andrew Sowerbrower (64:06) Shock them.
Kyle Bettencourt (64:07) Well, I.
Andrew Sowerbrower (64:07) would, so, my only suggestion and Brandon, you could be completely different is until we get confirmed just confirmed answers from Yvonne like the packets first, you guys doing the applications and.
Noah Laack-Veeder (64:21) Really honing.
Andrew Sowerbrower (64:22) That in, I would hold on that meeting about pay, right? Because no one one way or the other, no one’s going to agree tomorrow that, yes, we’re going forward with it with the other questions still up in the air. Yeah, right. So I would wait until we get those confirmed and then let’s circle back to it and, we can agree on that call. Yeah. Okay. Let’s go forward here’s. The process and we have a definite process down not, you know, three different options with two different plans.
Kyle Bettencourt (64:57) That sounds, that sounds good to me. And.
Brandy (65:00) I expect eve’s normally pretty good at getting back with me. I would know something to you guys by the latest Friday morning.
Noah Laack-Veeder (65:08) Okay. Yeah. And again, it’s totally based on your comfort. Like if, do you want me to chat too just to kind of talk about the possibilities? Like I can be a resource just, yeah.
Brandy (65:20) Yeah. If, when, if she has questions or anything like that, let me see what she brings back in the responses and I can let you know, I can put it into an email between us and Andrew and stuff like that. If everything seems kosher and stuff like that. And then if there’s some questions that need to arise, I can introduce you and then you can ask, you know, eve with that, but.
Noah Laack-Veeder (65:43) So, yeah, that sounds good. Yeah, I just want to make sure I will, as soon as you email me, I will respond to you. Okay?
Brandy (65:49) No problem. And normally, I don’t I will probably won’t get a response from her today, but by tomorrow sometime, I will get a response. And if not, I don’t have a problem picking up the phone call on eve.
Noah Laack-Veeder (65:59) I know for sure. I do know. Yeah.
Brandy (66:02) I’ll be like eve, what’s going on here? So, yeah.
Noah Laack-Veeder (66:05) No, exactly. And, and look, I think that if there’s really only two scenarios that are going to happen, it’s one, they say, well, you’re going to have to follow the process that we do today and you’re going to send us this provider packets or no two, you can actually have medallion do it like depending on that, we like, we will very quickly be able to tell you what we think you need, so.
Brandy (66:24) Yeah. And Kyle, just from perspective, what I would do is with that meeting just, I would say, hey, we’ve got, we’ve you know, got some more information that we’re digging into. Let’s try to see what everybody’s calendar since Susan hasn’t accepted it. And Maren told me that that’s Susan’s call just to let you know. So what we’ll do is I would just say, hey, you know, we’re digging up some, a couple more information, what’s your calendar look like possibly later next week by next week? We should have an idea.
Kyle Bettencourt (66:56) Okay, perfect. That sounds good. Yeah, that’s.
Brandy (66:58) what I would do because I got that response while I was sitting here too.
Kyle Bettencourt (67:03) Perfect. That, that sounds like a plan. So I’ll yeah, I’ll update the group there, and then, yeah, we’ll wait to hear back, from you on some volume updates and then.
Brandy (67:12) Yeah, yeah, absolutely. So what I’ll do is I’ll get the update from eve, and then we can go from there. And then I would just check with Susan just and say, you know, just looking at the calendar, I know you didn’t accept it, but how about, how does next week look sometime in the later week? Cool?
Kyle Bettencourt (67:31) Yeah, maybe I’ll just propose the invite for same time next week as a placeholder. And then, yeah.
Brandy (67:35) Maren, Maren’s, pretty open. It’s just, you know, with the departure, she’s probably going to let Susan make that ultimate decision between her and Andrew, so.
Kyle Bettencourt (67:46) Yep. Perfect. Well, that sounds like a plan.
Noah Laack-Veeder (67:48) Great.
Kyle Bettencourt (67:49) Great to meet you. We appreciate you staying on here long and, yeah, Brandy. Thanks again as always.
Noah Laack-Veeder (67:55) No.
Brandy (67:56) Problem. All right, guys.
Andrew Sowerbrower (67:58) As soon.
Brandy (67:59) As I hear something from eve, I’ll let you guys know. Yeah, sounds good. Okay. Sounds good. Thank you guys. Bye bye. All right.