Transcript
Samantha Bouchard (00:00) I’m muted. Hey, Nicole.
Leticia Stewart (00:02) Hi, Sam.
Samantha Bouchard (00:03) How are you? I’m.
Nicole Campbell (00:05) good. How are you doing? I’m.
Samantha Bouchard (00:07) officially on an antibiotic and a steroid as of nine 30 this morning. So it’s only up from here. I mean, the.
Nicole Campbell (00:15) antibiotics like, I know, we people may talk some ass about them sometimes but they are wonder drugs.
Samantha Bouchard (00:22) I know when.
Leticia Stewart (00:23) she said the.
Samantha Bouchard (00:24) steroid too. I was like you’re an angel, thank.
Leticia Stewart (00:27) You?
Nicole Campbell (00:28) You’re like let’s go, I got a vacation to get to.
Josh Brunell (00:31) Exactly. I’m gonna admit her before I do.
Josh Brunell (00:41) Do you think Nicole, we avoid the pricing and just try to show bva and then ask if she has more time later to review price or?
Nicole Campbell (00:49) I think that’s what we have to start anchoring on and then being like, hey, like we need more inputs from you before we do pricing and be like, do we have like a scale? Do we have a range that we want to present? But like.
Josh Brunell (01:02) Yeah, I think I’m going to just tell, yeah, I think I’m just going to tell her like range wise. We’re probably looking between, you know, probably around 500 K. Yeah.
Samantha Bouchard (01:11) With hospital applications and then if she,
Josh Brunell (01:14) without hospital applications.
Samantha Bouchard (01:16) Oh, without, okay, but.
Nicole Campbell (01:17) I think this is where we can say like we are, we’re ready to be really aggressive though, and work with you on that, we just need more inputs and like a timeline for the contract. Okay, that’s what we can ask. Cool. Okay, you’ve got this.
Josh Brunell (01:45) Yeah. Hi, Leticia, how are you? Good?
Leticia Stewart (01:54) How are you? Sorry, my information is really choppy because like I mentioned, everything is done in spreadsheets, random people’s computers. So, one of the reasons why we need a system is because there’s no tracking.
Josh Brunell (02:10) Yeah, that’s okay. I think we got a fairly decent starting point and we can reiterate on this. I know you just want to move fairly quickly though. So I just wanted to at least… you know, get together kind of run through our initial business case for you, like what the Roi comes out to and then kind of get your head around like kind of where we’re sitting on pricing today, however, yeah, there are a couple of other items we’ll probably want to need from you especially on like the privileging side just to get you a quote for that specific product if you were to choose us to be doing that work for you?
Leticia Stewart (02:49) Yeah. And I don’t have any of those answers so.
Josh Brunell (02:53) Yeah, I’m going to coordinate with Melissa and Lisa on that. Yeah, perfect. Following this meeting. Cool. And I know we have 26 minutes. I know you mentioned you had a hard stop at the top of the hour. So I’ll be respectful of your time before we dive in. Obviously, we ended the call yesterday. We sent over some videos both to your team to share with Caleb and Lisa on the pay enrollment side that Caleb missed and the privileging side. Happy to have one on one calls with them too. Either today, tomorrow, at any time. I know you’re looking to make a decision quickly. So just wanted to throw that out there. What were your overall thoughts coming out of the meeting yesterday?
Leticia Stewart (03:41) I don’t actually do credentialing. So I don’t have a whole lot of.
Josh Brunell (03:44) Thoughts. What were the team’s impression? I should say?
Leticia Stewart (03:48) I didn’t talk to them. Actually. It sounded like Marie liked it, but Marie is doing credentialing and she wants to get out of credentialing. So she likes everything. So we… definitely need something. We had a person that is no longer with us. And so we only have two people doing all of this work now, not counting Lisa and her facility thing.
Leticia Stewart (04:17) We have two, Melissa and one other person who’s doing credentialing. And Marie is trying to get out fast. So we basically have two people. So we definitely need that support. So that’s all I can tell you. I don’t have any more thoughts. Yeah.
Josh Brunell (04:33) When I got the data, I did want to validate some of this with you. So I’m going to pull it up real quick before we dive in just this piece here. So forgive me, I’m going to zoom in a bit. Okay?
Josh Brunell (04:51) Oh, that might be a little too much. Okay. You all see my screen? Okay. Yeah. Cool. Yeah. So 1,800 providers unknown… on the provider growth piece as far as just like making a best guess here just to make sure that we’re putting together a pricing proposal that makes sense?
Josh Brunell (05:18) Would, I don’t know throwing a number out there like, you know, 10 percent growth, make sense? Or I guess what do you, what would you typically see as far as like overall?
Leticia Stewart (05:30) We would have to bring on a whole new client. So it’s not just a provider growth, right? Like say, maybe a client we already have adds a provider. I don’t know when they’re going to add a provider for us to have meaningful growth, it would have to be a whole new client that brought on a group of providers. We don’t add providers. You know, we’re just a billing company.
Josh Brunell (05:56) Yeah. I think my question where I’m trying to get at is like what’s the team usually see as far as their workload of like doing new enrollments? Like is it hey the team is doing across their customers that they see collectively, you know, five a month, 50 a month, new providers starting across the various clinics for the clients they support. And the reason why I ask that is because the pricing which we’ll get into is really baked off of a couple of factors. It’s obviously how many overall kind of like licenses you need for those providers. And so if that is either, you know, going up or going down, we just want to take that into consideration because the discounts that we apply to our contracts are based off of volume. So obviously, if you’re planning to add new providers and grow your client base, then we just want to take that into consideration. So you have better per unit pricing on the.
Leticia Stewart (06:56) No, I get the reasoning behind it. Yeah, I’m just saying we don’t add providers. Our clients would add a provider and we don’t know if they need new providers. We don’t totally. And usually when one comes on, another one leaves, they’re usually replacing providers. They’re not just adding. And if, like I said, if they add it’s like a provider here, a provider there, it’s not going to be like a big influx of new providers unless we add a whole new group.
Josh Brunell (07:27) Got it. How often does that happen?
Leticia Stewart (07:30) It’s random, like we just got a new group starting for one, but it’s one doctor. But you know what I mean? Like usually when we add a group, you know, a group has 20 30 40 doctors. I don’t know why we added this one doctor… and so, or we go out, you know, after bigger projects and so then it’ll be like 50 doctors. And then I think at that point, you know, we will probably have to do some kind of amendment to the agreement, but we would know well in advance. I don’t know if anything in the pipeline, I can tell you that, but I don’t know if they always tell me, you know, what’s in the pipeline until it gets closer to, you know, they have to have a signed contract for them to really let us know what’s happening.
Josh Brunell (08:22) Okay. So it varies, it can be random. Sometimes you can have spikes when those big projects come up. Sometimes it can be like a little pit phase that’s okay. Yeah.
Leticia Stewart (08:35) I think the last three, one, two, we have two, we have two new clients this year and they both were one doctor groups that’s it.
Samantha Bouchard (08:47) So, Latisha, I’m just curious like if you looked at how many providers potentially that were added just like across your partners, like would like just so we can estimate something like we have some flexibility in how we do pricing. You can kind of like pull from different years and things like that. But like would 10 new doctors? Like does that seem reasonable to you 15? Just trying to get like a general estimate for josh? So we can kind of put a number in front of you and help you? And,
Leticia Stewart (09:18) what happens if it’s not 10 though? Because I can’t tell you because I don’t always know when the doctors join because like say we have a client, we have northstar as a client. If they add a doctor, I don’t need to know that information that’s not important information for me. Whoever’s doing the enrollment will know, but I don’t know if they keep track of, okay, they added a doctor this month, but they didn’t add a doctor for six months. I don’t know that it’s not even important information.
Josh Brunell (09:48) Yeah. I would imagine if the team’s tracking this in modio, it may be.
Leticia Stewart (09:55) We’re not, we’re not using modio yet. Okay. Got it. That’s what I’m saying we have spreadsheets.
Josh Brunell (10:02) Got it. I thought, so, my understanding was that you were up for renewal with modio and they have a contract out for you for renewal. We.
Leticia Stewart (10:10) Have a contract for the facility side of our business that we don’t manage. We have a different person who manages the facility side. Lisa is like an exception that’s why I just kind of forget about her. But we have a whole nother business that’s using modio. They have a signed contract, they’re using. Well, they’ve been having meetings and they’re supposed to be uploading their data. That contract is signed. They want to know if we want to amend the contract to include the payr side because when the person did the enrollment for the facility side, she did not include us at all. We found out. So they’re using Healthstream. One person is… but I don’t see any tracking in Healthstream about, you know, productivity number of doctors. I don’t see anything like that. Okay?
Josh Brunell (11:05) So, I think what could be a good solution here then? So if the team’s not using modio today, using Healthstream to some degree, you had mentioned that there’s a goal for?
Josh Brunell (11:23) Obviously, you don’t want to hire more people. I imagine the organization doesn’t want to have to backfill some of the folks that have left and hire and staff up the credentialing team. You’d rather have technology to help automate the.
Leticia Stewart (11:33) Process, correct? Right? And.
Josh Brunell (11:35) then also just free up some capacity of the current team as well because it sounds like people whose core jobs like Marie, like you have mentioned, she’s.
Leticia Stewart (11:43) better.
Josh Brunell (11:45) Suited to be doing other things than credentialing, correct?
Nicole Campbell (11:48) Right, right. And.
Josh Brunell (11:50) when we’re looking at like overall, how many, where does it?
Nicole Campbell (11:54) Say this?
Josh Brunell (12:00) So, you have two people today and all, and they’re responsible for. And then plus Marie and any other, they’re responsible for 1,800 providers and doing their revalidations.
Leticia Stewart (12:12) Yeah. The one person just left on Friday, the person that left, she just left on Friday. And then we have a person who’s like a temp helping… okay? But she’s not our employee. She’s a temp. So that’s why I just say two employees, but we have a temp that’s helping out until we find a better solution. Okay? It’s very disjointed. I understand your faces.
Josh Brunell (12:41) It is, yeah, no.
Leticia Stewart (12:43) I get it. I’m telling you that’s why we were like,
Nicole Campbell (12:46) yeah, we.
Leticia Stewart (12:47) everybody’s doing their own thing.
Leticia Stewart (12:51) even the spreadsheets don’t look the same.
Josh Brunell (12:54) Like, yeah, I.
Leticia Stewart (12:55) mean, I can’t tell you how insane this is. Yeah.
Samantha Bouchard (12:59) No, Leticia, I like, I hear you. And if you’re seeing our faces, it’s like my gosh, like we can help here. We can help here. We’re kind of just like thinking of ways that we could, you know, allow like really implement our technology quickly, allow you to not have to rely on a temp person kind of take on this work for you, streamline it, have all these analytics and this information that would be really valuable to you. So that’s kind of what I’m thinking is where we’re talking through it. And I definitely feel your pain.
Leticia Stewart (13:30) I’m kind of looking at, you know, we… get into it, we start seeing what the numbers are. You guys have some analytics and I mean, not that I want you to come back and try to say, well, this is way more than you told me it was going to be. Now, it’s three times as much. But until we really start getting some data, I can’t really give you a whole lot of data because I don’t know what’s happening.
Nicole Campbell (13:53) Yeah, and sorry, Leticia, I don’t think I got to introduce myself. I’m actually josh’s manager here. Hi.
Samantha Bouchard (13:59) Sorry for.
Josh Brunell (13:59) that.
Nicole Campbell (14:02) Wanted to make sure we’re brought in so that we’re like cutting out a little bit the middleman, and I think this is where like we always want to be as transparent as possible. So, we’re usually not trying to have it be like, okay, you know what? In six months, let’s right size? This, we didn’t.
Leticia Stewart (14:15) no, I know. And.
Nicole Campbell (14:16) So, if, but if we’re okay with that mindset too of like, hey, we want to get this in a system, find a best working process and we know we might need to revisit something in the future. I think as long as we are both comfortable from that from like a partnership aspect, it’s not something that we’re not willing to. Also do. We just never want anyone to feel like it’s like a surprise. I got.
Leticia Stewart (14:38) You, yeah, I get it all set up. And now I got you now, I got to leave. And what I’m thinking more is more like a range kind of thing. Give me all the ranges up front. And then if we fall into another range, at least we know what that range is. Yeah, yeah, that.
Nicole Campbell (14:56) That makes sense. So I think like we can kind of make some low conservative estimates on all on these numbers to start the team on board, kind of walk you through. Hey, this is what it’s going to look like with medallion. Also what we hope to see in the first couple of months as we’re implementing you so that if we’re like looks like, we forgot about the spreadsheet and like what impact this might have that’s then where we can be like we’re just going to be open from both sides of like we’re going to need to work through this together potentially as we onboard, if that, if that’s like a comfortable position and also helps us move quicker for you to get something in front of you that’s tangible, right? That makes sense.
Leticia Stewart (15:39) Okay. As long as there’s no huge surprises because once I give the proposal to our CFO, he’s going to want to know like if it triples, he’s going to ask me, what did I, do, you know what?
Nicole Campbell (15:51) I mean? And I think that’s where we could call out like, hey because we don’t have exact estimates here. Where are the risks of increase, right? And hopefully that would be something that the CFO can understand that like we’re moving quickly, but this is where and why we could see this is in the paper. Would that kind of give him a better like understanding? Okay. Yeah.
Leticia Stewart (16:12) Tell me where those, where that happens. Like if we make a change here, this is going to impact this because I don’t know if there’s a baseline where there’s just a monthly cost. But then if this happens then that cost could increase. But sometimes there’s a baseline that doesn’t change based on this or that, you know, yes, and,
Nicole Campbell (16:34) that’s something we do like, yeah, like the new provider growth of you guys signed a new customer and they brought 100 providers?
Leticia Stewart (16:39) Right then that’s a whole conversation and we get that it’s just and we would have to tell you up front, we would have to have a discussion. How do we add this? How do we move forward? And if we got 100 provider new group, we’d be so excited. We wouldn’t really care that it costs money, right?
Nicole Campbell (16:57) Best case scenario. Yeah, that’s not a big problem.
Leticia Stewart (16:59) Right. That’s what we want. That’s a good problem. Yeah, that’s a problem we want to have. But if it’s like one doctor here, one doctor there, it’s like, are you going to nickel and dime me for every one doctor or this one? Basically, it’ll be like usually a doctor comes on because another doctor left or we have locums, oh, locums. Yeah. Does that have anything to do with this?
Nicole Campbell (17:20) Yeah. Well, we can touch on that in a second, but also want to say, like with Leticia, like you mentioned like bringing one doctor on, let’s say we had set up for 10 new doctors and then it ends up being 11.
Leticia Stewart (17:31) We also have.
Nicole Campbell (17:32) a few flexibility inside of this. So that means, hey, if we’re pulling from year two or year three dollars to help cover an additional one or two, there’s flexibility built into the contract to.
Leticia Stewart (17:44) Build stuff like that as well, right? Right?
Nicole Campbell (17:47) But, sorry, josh want to pass it back over to you. Just wanted to, we were on the same page, like thinking about this as a strategy.
Leticia Stewart (17:54) Process. Yeah, yeah, yeah, absolutely. And.
Nicole Campbell (17:56) It sounds like we are. Yeah.
Josh Brunell (17:59) Yeah. Sorry, I was just, I’m trying to play with some numbers here on my side because like, yeah, originally, I think we came in with an assumption of like, hey, you have 1,800 providers, maybe you’re bringing on 200 in a given year. And so I put together.
Leticia Stewart (18:14) That’s a lot.
Josh Brunell (18:15) That’s a lot and that seems like a lot, right? So like, I kind of want to come back to you Leticia with like maybe a couple different options like, hey, what does it look like to add 20 providers versus 50 versus 100 in a given year? Would that make more sense? And then also like from a, when it talks to the different products, like having it clearly stated what the per unit pricing is, and then kind of once you hit that threshold of hitting like, hey, say we grow to this amount, the per unit price goes down by this much having like a pricing table to show that for, if you were to grow, right? Would that make the most sense? As far as how we’re putting together the proposal? Yeah.
Leticia Stewart (18:55) Okay. And,
Josh Brunell (18:57) I’m going to give you a range if that’s okay with you for now? And then I’ll put this together in an actual deck and then a contract? Yeah, sorry.
Leticia Stewart (19:09) Go ahead. I wanted to say our company is not looking to grow the RCM business… that’s not their goal. They’re looking to grow their software business. So, I don’t know how much they’re really trying to get new providers. Like they’re not trying, like I said, a new provider to me is new business. And I don’t know if that’s their goal. They really are trying to get into the software, more of a software company as opposed to a billing company. So, I don’t think we’re going to see that any real growth we’re just trying to maintain what we have. And I don’t even know like we have a client leaving. Like I said, March 30 first, they’ve extended twice that’s why I didn’t say anything before. So, I didn’t know if they were going to extend. Again… they have over 200 doctors and they’re leaving, so.
Josh Brunell (20:01) Does that take it down from 1,800 to no?
Leticia Stewart (20:05) It’s at 2000 right now. It’s taking it down to 1,800. But as clients are leaving, I don’t think we’re trying to replace them is my whole point.
Josh Brunell (20:16) Okay. Yeah. I mean, I understand that. And then on the just curious, the way that your business model works too, like are you making much margin of any? Like are you charging your customers like on a per enrollment basis? Like how does that we?
Leticia Stewart (20:40) Don’t charge our clients for credentialing?
Josh Brunell (20:44) At all at all? This is all on like.
Leticia Stewart (20:47) It’s built into the billing.
Josh Brunell (20:48) It’s built into the billing as part of that cost. Okay?
Leticia Stewart (20:52) Yeah. So we don’t charge for this. So it’s not like for facility. I think they did like for facility you want us to privilege a doctor at this hospital? I think they were charging for that, but for payor, enrollment, payor, credentialing, they don’t charge for that. It’s just a service that’s included for billing.
Josh Brunell (21:13) Understood. Okay.
Josh Brunell (21:24) Yeah. I think based off of everything that you just shared, Leticia, I’m going to go back and make adjustments to what we had planned to show on the proposal because I think the number we have right now is just, it’s going to be much higher than what you would be expected to pay. And I just don’t I don’t want to mislead you by, saying this cause, yeah, I was thinking 200 plus providers being added annually. And so that sounds.
Leticia Stewart (21:55) amazing.
Josh Brunell (21:56) Yeah, one day, but yeah. So, but like directionally like just based off of like the total things that won’t change which I know we’ll probably be close to like is this probably gonna range between like probably 303 150 K annually. And I know we come in higher than modio. And the reason being because we’re actually doing this end to end. So with modio, I’ll put together the analysis but obviously, with modio, they don’t have automation in place that where you click, hey, we’re going to request this enrollment and then our team takes it. And then our automation takes, I should say and runs it through to completion. And so it is an end to end offering. I know you called that out earlier on the demo asking if about that. So I just want to make sure like one, are you comfortable with that model of us kind of owning the submission all the way through to completion of these enrollments? And then two, like price range wise, if we can build out the Roi behind that. And obviously, that’s just like kind of a starting point from a pricing standpoint, like we can work with it, work with you on that on the per unit pricing once we get it in front of you. But like initial thoughts on those two things like price wise, yeah.
Leticia Stewart (23:16) I think that is more than like three times as much as what modio charges, I think even more honestly. Okay.
Josh Brunell (23:26) And is in thinking about that too? Like are you also looking with as you’re going with modio having to backfill the resource that you left and then also hiring an additional one to support or I guess what?
Leticia Stewart (23:43) Well, that’s what I’m trying to determine. So when you say you guys handle it from end to end, I guess I wasn’t clear on how much of the work our team would have to do because like you were talking about yesterday with the white glove service, we do when you’re saying the doctor could just scan this or he could do this. We do all of that. So you guys wouldn’t be doing that piece. So how much of a white glove service would you be providing? So I didn’t understand when you say end to end. Yeah, I didn’t feel like you guys are doing it to completion. I didn’t get that part. Yeah.
Josh Brunell (24:19) So when we say that we mean more so on the onboarding white glove onboarding experience, so like you could essentially have either an administrator on your team kind of invite the provider and then they go through the instructions of like, hey signing their attestation, clicking a couple buttons or your team can do that on their behalf. But that is like a very small amount of the overall workload that we’re impacting like as far as like the overall time goes that like when we’re thinking about caqh management in particular, like your team’s doing that today, we reduce that by at least 75 percent because we’re actually taking over all the attestations.
Josh Brunell (25:00) It’s really just the initial invite to the provider that your team is handling. From there, we would be submitting the enrollment application or we will be handling the enrollment applications from the moment your team clicks a button saying, hey, I want, you know, Jane doe enrolled with these five payers, go do a medallion. Our team takes that end to end the follow up all the way through to completion. And then also the revalidations as well. So like anytime they’re up for revalidations, we would handle that. And so your team, we typically see a team, I would say based off of your volume, probably only needing like one or two administrators to manage this. So you won’t have to backfill that resource that you mentioned or hire additional resources moving forward. And then Marie could also be taken off and kind of doing her own thing in the function. Whereas with modio and I’m, running into this a lot. I’m working with a couple other customers who are looking to make the switch. And I know Sam has helped customers make the switch from modio or kind of like more solutions that are just built for tracking versus execution. We have the automation. But we have a team also that’s going to be doing this work on your behalf. So it’s like if automation falls short where we, you know, maybe we submit the automation, the application with automation through our platform.
Josh Brunell (26:21) And our team will make sure that if the like up until it gets completed, we’ll handle the follow up and the email. Any a lot of the manual burden I would say anywhere from like 70 to 80 percent goes away for your team. So that’s the different story than modio, whereas you would still need a team of people to do the actual work, not just administrate the platform.
Leticia Stewart (26:45) Right. And so that I understand that. But the person who we would need to backfill didn’t make 350,000 dollars.
Josh Brunell (26:54) 100 percent. And that’s why I kind of want to also like hold off on showing you that like that was like our kind of like initial starting point. Like I wanted to put together like a, the three different proposal options for you with some of the feedback you shared because I think we’re going to come in even lower than that number was my, I hope so because the… volumes you shared are much lower than what I had anticipated for 1,800 providers. So.
Leticia Stewart (27:26) The new growth but the,
Josh Brunell (27:29) yeah. So.
Leticia Stewart (27:30) The only thing I got to jump to my other call. They started to call like 10 minutes ago. I don’t know why I’m like I’m not coming but I wanted to ask, can you provide like all the slas that come with this to like because I know we talked about it, but if we’re going to hand it over to somebody, I need to make sure like.
Josh Brunell (27:50) What’s.
Leticia Stewart (27:51) going to happen with that? Because I don’t I knew that there was some automation and that you guys would be able to do some things but I did not think of it as an end to end system. I didn’t I don’t think I caught that. I thought there was still a lot of things that our team would have to do and we would still need all the staff. So that kind of changes it a bit for me and we may need to run back through that again a little bit. Yeah.
Josh Brunell (28:18) Yeah, I’ll put that together for you, Leticia and one thing I’ll create, we have to make this easier to track all this. I have some obviously videos of the platform to share but like when it comes to like the slas… we have slas for how quickly the work gets out the door like submission wise, and then also through to completion. But, that is going to be that’s going to vary based off of your payers and I know, your payers are your customers payers, and everyone’s different, but we’ll put together a number on both the submission to completion that we feel confident in and then I’ll share it with you and what we’ll commit to on the contract.
Leticia Stewart (29:01) Do you have like a roles and responsibilities grid that like says, this is what your team does. Now, this is what medallion will be doing in the future. Can you share that with me? Because that will help a lot for me to kind of understand because, you know, Sam was going through the platform, but I was thinking everything she was showing us was something we would be doing as opposed to, you know, your team. So just trying to understand that a little bit that would help with me to be able to present this to our CFO yep.
Josh Brunell (29:34) I have a couple of things to share where it’s like, hey, what is automated today? What gets automated at medallion, right? Right? And kind of a, you do versus we do, yes, walkthrough of the work of the future work?
Leticia Stewart (29:50) Okay. That’d be great. So I’ll have that ready.
Josh Brunell (29:55) By tomorrow, sounds like you wanted to review it with your CFO? Is it okay if I run it with, by you the proposal that you would then kind of share with them in advance? Okay. I know you got to jump, but do you have like any specific time of day tomorrow that might work?
Leticia Stewart (30:12) I have a meeting at 10 eight eight tomorrow. Okay. Wait, now, somebody put more stuff on there. I have an 815. I have a nine 30 and I’m free after that. Okay. Specific standard. Okay?
Josh Brunell (30:30) Can we do, would one 30? Be okay? Sure. Okay. I’ll send that over. Thank you, Leticia. Appreciate your time. Thanks. Bye.
Leticia Stewart (30:38) Nicole. Bye, Sam. Bye bye. See you tomorrow.