Transcript
Stephanie Ryan (00:00) thanks to the conversation today, I know it’s been a little bit since you guys have connected. Hey, David. How are you? Good?
David Zeman (00:08) To see you again, Jen. Good to.
Stephanie Ryan (00:09) See you too. Opening day for mets. Let’s go.
David Zeman (00:15) Should be a beautiful day for the ball game, a.
Stephanie Ryan (00:18) Beautiful day for the ball game. And here you are talking to medallion. So I don’t think there’s any like beating around the bush. David. I know that we’ve been going back and forth via email. It seems like there are still issues happening and I think where we left off the last time we connected was we were going to put together a proposal for what is going to happen, should ent choose not to work with us any longer on the payer enrollment front. So I sent you an email yesterday. I also put together a quick slide with a summary of what we were proposing just so that it’s top of mind that I can pull up and then maybe we can talk through that. Does that sound okay?
David Zeman (00:58) Makes sense? Okay?
Stephanie Ryan (01:00) Perfect.
Stephanie Ryan (01:01) I will share my screen. Just give me a moment here. Okay. So essentially, what we are proposing is that we do another 150 K concession with the stipulation that if we move towards that, you would no longer request any new payer enrollments, any demographic updates, or revalidations, we would issue a 75 K refund directly back to ent. And then an additional 75 K would be issued as a credit against your account to be used for any future invoices, and that would apply to pass through fees or even your next renewal notice. So that’s kind of how we were thinking through should you go this route, but I want to hear your thoughts. What your reaction was. I know that we also did 150 K credit at the end of 20 25. So this really would make up for that total 300 K that you have in your existing contract today. Yeah.
David Zeman (02:09) I guess I appreciate this. Thanks, for sending it along. It’d be helpful for me to see the invoice as it’s broken out… between enrollment services and other. So I get a better understanding of the 75 K credit truly like when and how could that be used? I get it if I go ahead and renew for another year, it could be applied to that. But for the remainder of this contract term, once we… I guess no longer have the enrollment piece, what are the remaining invoice items? And I know there’s like some variable pass through fees that come through throughout the year. Now, what’s left for us to apply that credit to this year? Okay?
Stephanie Ryan (03:15) Yeah, we can work on that for sure.
David Zeman (03:23) Right now. I’m just, and maybe this is not current, but I looked at our two year agreement and in year two, it looks like, you know, 320,000 of the 443,000 annual costs… was payer enrollment related. And then, you know, another five grand or so for demographic updates, revalidation, another 2000. So really, it’s credentialing roster, management, delegated agreement, audit management, and the medallion core. I guess in monitoring, right, those are the remaining SKUs that we apply to.
Stephanie Ryan (04:16) Exactly.
David Zeman (04:18) Okay. So, yeah, I could just, I want to make sure that what I’m looking at is still accurate from a pricing standpoint. Yeah.
Stephanie Ryan (04:27) For sure. So we will, we’ll pull together what your remaining invoices are going to look like and give you kind of an idea of what you have left to owe medallion throughout the remainder of this contract year. I also would be curious to know from a credentialing standpoint, I know you’re very happy with the platform and how that’s running? Is there at all? I know we’ve talked a little bit about your delegated payers. There’s one in mind that you have, but I don’t think that you saw that happening for, I think Q3 is what we said, right?
David Zeman (05:02) We have one right now that we’re working with pre delegation because they don’t have a government plan.
Stephanie Ryan (05:07) So,
David Zeman (05:08) we’re you don’t need to satisfy 12 months of creds, committee meetings. The rest of our payers generally all have that requirement, but we will be hitting 12 months in may of this year. So my intention is to apply for delegated status with all of our large commercial payers.
Stephanie Ryan (05:30) Certainly.
David Zeman (05:32) The top five in may and to try to get us to delegated status by end of the year. So that certainly would be a big win if we can do that. And I would like to maintain the medallion core platform for that purpose. Okay, you know, I know you offered and I’d love to meet Nate and talk to him, hear his thoughts. I, you know, maybe I’m being a little too negative here but I don’t see how him joining can like markedly improve the quality of the product in a few weeks time.
David Zeman (06:22) You know, the conversation I’ll have with him is the same thing I’ve had with you guys like in my opinion, like there needs to be a wholesale re engineering of how you guys like push applications out. Like there’s just so many errors. And I was talking internally with our team and they’re like, we know we’re a little like a little unique but like we don’t think we’re that complicated. And if we are, then that’s another pain point for you guys because it’s we’re a small practice compared to, you know, some of the larger clients you have. And admittedly I’ve talked to your other clients. I got connected with those people and I’ve heard the same thing from them like, yeah, lots of errors, lots of issues. So, I don’t think we’re alone here in that and I don’t want, you know, I don’t want, I’m I don’t want to guys put you guys in an awkward position to like speak about other clients, but I just don’t I feel like I can’t we can’t be alone in this experience and I don’t know how he’s going to rapidly change that. I think it’s going to be a pretty significant build and lift for him. Yeah, I can jump.
Genevieve Seney (07:40) In a little bit there David completely aligned. Obviously we’re there’s no, no hiding here. The amount of sort of like errors and things that have not gone right with ent that we’ve seen across other clients transparently. That was, that is our focus for this year is specific to payer enrollment getting that right? And it’s not just to your point. I don’t weeks is probably a little bit more expensive. The one thing I will say Nate does have an extensive background he’s coming from airbnb for scaled operations. And so I’ve personally been really impressed with what he’s jumped in on so far cause he’s basically dissecting it from the top down. So it’s not just to your point like it’s not solved overnight. But I do think like his background in terms of what he’s analyzing from the perspective of the swim lanes has already been pretty impressive in terms of finding those gaps and finding where things have broken down in the operations perspective. And so I think like with his background and what we’re working on and how we’ve restructured the organization to fall underneath it’s not just operations. It’s going to be sort of everything in terms of the escalation process in terms of how we’re actually scaling the company. I am looking forward to that. So I think your conversation with him hopefully will give you some you’re.
David Zeman (09:07) in the weeds right now, like you’re in the, you had like a rapid growth stage, right? You picked up a bunch of big clients, you bought, you got through a few seeds, you got a ton of investment money and you built a core product. And then, and now you need to deliver on the quality and service side of it, right? So there’s like building the tech, which is great. You can hire a bunch of really smart coders and engineers and pay them a lot of money and they’ll build you good tech. And then you’re gonna rely on your people to use that tech to drive the product and service out. And that’s where he has to focus his time. It’s that layer of hiring and quality assurance that just hasn’t come to fruition and it’s possible that it has to do with how quickly you brought in clients and just your inability to scale the service to that client population. I’m theorizing based on my experience and what I’ve seen in my personal experience with you guys, but it’s not like you’re the first startup tech company to deal with this. It’s the growing pains of an early stage organization like you all are… I think that’s.
Genevieve Seney (10:43) exactly, right. And I think like there’s so much too that we start to get better at. And then I think our challenge is closing the loop on that of like what did work? And can we replicate that? So, I think a lot of that is to come. And I think as we start to get obviously more down the rabbit hole of this sort of automation and working with payers to say, hey, we are doing this for this client as a roster. Let me do the same for ent, right? And so that’s what I sort of want to come back to this with as well is not, and you’re aligned with this, we don’t want to do custom work like we understand this is how our clients have been doing it for years with their reps, but if we can automate it and the payer is saying, yes, let’s do that because that’s where we’ll really cut down on the enrollment times and minimize errors. So that’s what I’m excited for. And yeah, hopefully you’ll see that in your conversations with him as well.
David Zeman (11:41) Yeah. Listen, I’m always open to re, envisioning partnership and… it’s got to be done in a way that one there’s really true demonstration of change in your org and then like economically, it would have to work so that there’s downside protections because at this point and I appreciate what you guys have done in terms of credits and rebounds and concessions, but I don’t want to have to like fight for that every time I run into issues. So there’s got to be a structure where I’m not just paying you guys and getting a shitty product. It’s got to be there’s. Got to be some level of two way street absolutely.
Genevieve Seney (12:27) And we don’t want that either, right? We don’t want these conversations. We want trust and we want scalability.
David Zeman (12:32) No, because if I’m happy you’re going to get more clients, I have a big network exactly in this industry. So if I can help other clients come to you, that’s the way you guys will continue to grow. But I hear you. So let me digest this with the folks internally here. If you could send me that invoice detail so I can have that with me. I’ll come back to you with some answers and then, you know, look forward again to meeting with Nate when he’s available.
Stephanie Ryan (13:03) Yeah. I’m working on that piece right now. David. I would also just say like you’re super great at being transparent like don’t let that stop with Nate. Like I think he needs to hear your true pain points in order for us to make a difference.
David Zeman (13:17) Trust me, I’m not shy. Yeah. At the end of the day, like I believe in what you’re trying to do, I think like the friction between provider groups and insurance companies is all consuming across all levels of competition, connectivity between those two stakeholders. If we can try to like improve one area of it which is this exchange of information, everyone wins. Yeah. And you know, so I believe in that, but, you know, I got to stand behind a product that I can actually stand behind we.
Stephanie Ryan (13:56) Hear you. And we appreciate that you’ve been such a great partner with us throughout all of this. You’ve given us a lot of chances and we have not been able to follow through on expectations. So, I think, you know, number one, I will get you that spreadsheet and you can mull it over internally to determine how you want to move forward regardless of how you move forward. We will get you a conversation with Nate. And then again, if you choose to not do PE with us right now.
David Zeman (14:28) I’d love to.
Stephanie Ryan (14:28) Be able to come back even in the summer and just say like here’s some of the changes that we’re making and just keep you up to date on that product front because we.
David Zeman (14:38) are already doing a lot. You know, I’ve enjoyed being part of the advisory board piece and hearing on your dev and like even if I, if we do drop this side of the business, like I’d hope to continue to do that because I’d like to understand where you’re taking the company and add my value to that. But yeah, totally, like I said, I’m open to re, envisioning this. It’s just a matter of how we do that absolutely.
Stephanie Ryan (15:05) Okay. I will get you that worksheet. I will get you just this slide, but you have that email as well. And then we can regroup again next week, assuming that you have kind of an answer of how you’d like to move forward. And then in the meantime, I will get Nate’s availability, and I will connect with, I believe it’s Jen on your side for scheduling.
David Zeman (15:28) He’s probably swamped with starting and et cetera. So just whatever works we’ll make it work on perfect. Thank.
Stephanie Ryan (15:36) You so much. Again. Thank you for your partnership. We appreciate the patience and we’ll be in touch here hopefully by end of week with that… invoicing kind of what’s remaining throughout the rest of the contract, 70 degrees.
David Zeman (15:51) Out today in jersey, Jen. I.
Genevieve Seney (15:53) know, oh, you’re telling me I’m pumped to get out.
Stephanie Ryan (15:55) There. Oh, my gosh. We’re supposed to get snow tomorrow, I think so. We’re having some opposite weather right now?
David Zeman (16:03) Don’t get cold here again soon. All right. Take care. Bye.