Transcript
Mike Manson (00:00) mr. Levitan?
Mike Manson (00:05) How are we doing? Good, man? Putting out some spring fires, but other than that doing good.
Abubakar Khan (00:19) I guess it’s good that you’re putting them out but, yeah.
Mike Manson (00:25) I mean, I think we can, I… think we can resolve them, but we’ve got it escalated… all the way up the chain about what just like a lot of it is like if I were to, I was just thinking about this like if I were to summarize their complaints, most of them are product related and it’s because it feels like to me, we have optimized our software to be really good for our operators to use, not our customers’ admins, fair… like a lot of it is just like data visibility into like how they manage the tasks. And yep. And I don’t you know, I don’t think we have a lot of customers that are the scale of spring and like we can maybe get away with that when it’s a couple 100 providers. But, Somebody is here. I don’t know who this person is, but baker is here. Okay?
Mike Manson (01:36) Hey, guys. Hey… is this khan?
Abubakar Khan (01:43) Yes, sir.
Mike Manson (01:44) Okay. For some reason, your name came up as baker?
Abubakar Khan (01:48) Oh, it might be a previous name setting. I haven’t used zoom on my phone in a while. I’m on my way home.
Mike Manson (01:57) Nice. Yeah, I was like, I’ll let this person in but I don’t know… you on the, you take the subway home?
Abubakar Khan (02:12) No drive. Oh, nice. Subway is going to take me too long. It takes like an hour and a half by subway, but the drive is way more easier so to speak. Yeah.
Mike Manson (02:26) Yeah, you’re in Queens, right? Yeah. Okay. So, this is khan, just in case you were confused khan.
Garrison Goodman (02:35) Baker. All right. Yes, sir.
Garrison Goodman (02:43) Are you on someone else’s laptop or is that a pseudonym or another middle name? Oh.
Abubakar Khan (02:50) No, this was a, very old nickname. So, I guess I haven’t used or signed in from zoom for my phone in a while that’s probably why it came up. No one else gets confused.
Mike Manson (03:08) I’d love to hear the backstory there at some point.
Abubakar Khan (03:12) Yeah, sure.
Mike Manson (03:15) We’re only two minutes over. So, I know. So John, there’s something weird that happens when I send out invites to the Aston team. I get like a bunch of declines and then tentatives and then say, he declined it. But then I texted him and asked, and he said he was able to join, so.
Abubakar Khan (03:33) Yeah, I spoke with him today too, so he will join Akil. I’m not sure if he’s going to join.
Mike Manson (03:42) I took him off just after our last conversation.
Abubakar Khan (03:45) Okay. Nice. Okay. That works. I spoke to John a little bit before this as a reminder as well. So he knows to join. Let me ping him as well. Cool.
Abubakar Khan (04:17) I just pinged him.
Mike Manson (04:19) Okay. Give him a few more minutes here, and that’s the end of the day on Friday.
Abubakar Khan (04:25) Yeah, I’m glad it’s the weekend.
Mike Manson (04:28) Got anything good going on?
Abubakar Khan (04:32) That’s a great question. Good for me is like peace and relaxation. So I’m hoping I get a nice and easy weekend but who knows what date is it? It’s the 20 seventh, right? Yeah, actually, my friend’s coming to visit this weekend, so it should be fun.
Mike Manson (04:53) That’s great. I feel like 60 to 75 percent of the time I ask a married Guy what they’re doing this weekend. They go. I don’t know. My wife needs to.
Abubakar Khan (05:02) Exactly. I’m usually like, all right, depends what she has planned, but I just remembered that, yeah, this is my weekend. So it should be good weather doesn’t look great, but hey weekend should be all right?
Garrison Goodman (05:19) Yeah. We’ve got our go to market team off site in Austin coming up in a few weeks.
Abubakar Khan (05:25) Austin. Nice.
Garrison Goodman (05:26) Yeah. And I lived there for three years and have a pretty good network of friends out there, so she… doesn’t know it yet, but I’m going to be staying that weekend. So, I’ll.
Mike Manson (05:39) have.
Garrison Goodman (05:39) that conversation when?
Abubakar Khan (05:40) I’m ready exactly. Yeah. So garrison you were in Austin? You were in California too, right? You’ve.
Mike Manson (05:50) been all around, yes?
Garrison Goodman (05:52) Sir. I have been quite a few places. What?
Abubakar Khan (05:55) Place? Have you liked the most so far from all the different states that you’ve spent time in just curious.
Garrison Goodman (06:03) Well, I’ve learned that I can be happy anywhere. I don’t think I need to do another North Dakota winter. I did five of those in college. Don’t need another one of those but, you know, living in extremes like that and then Texas, it gives you, I think appreciation for what you can handle. But I think California’s home. You know, where I’m from. So every time I go in there, you know, when it feels like going home, right? And, you know, that to me is, I think it’s tough to beat. But right now we’re out in jersey where my wife’s family is, we start trying to start a family ourselves. Okay?
Abubakar Khan (06:41) Nice. Thanks. Nice. Congrats.
Garrison Goodman (06:44) Yeah, yeah. We’re working on it.
Abubakar Khan (06:45) How are you liking jersey? Just curious because I absolutely despise jersey.
Garrison Goodman (06:51) You know, like when I moved out here, I took a, so I was in Austin and then I took a role in a series a company where I was leading like all go to market functions and I was commuting into New York every day, Manhattan, midtown. Okay? And we coming from Texas, we had an acre and we have a big, you know, 100 pound dog that likes to bark at anything and everything. And as he’s you know, he’s pyrenees and so part pyrenees. So he’s a livestock guardian and so we tried a few airbnbs, you know, in the city and he was doing what he’s supposed to do and barked at everything. And they were like, all right, we got to get to the suburbs. So this was, you know, door to door. I could get to where my office was before in under an hour. And so we’re out here in maplewood and I know John’s jersey Guy himself too. So we’ve been out here I think two years now. But like I said, my wife’s from, she was born in freehold but grew up outside of Philadelphia. So we’re seeing her family quite a bit and she’s happy and, you know, coming from the west coast, coming from the central. When I first moved here. I’ve eaten so many like cold cut sandwiches and the Italian delis out here. And I put on 20 pounds, very fast when I got out here.
Joshua Levitan (08:13) All right. So here’s, the question, garrison, I’m interrupting you and it’s a question for you and John, I get in my Instagram algorithm, a place called talersios.
John’s IPhone (08:23) Yeah. Down in red bank. That makes these, yeah, that.
Joshua Levitan (08:26) Makes these okay. So you have tried it. The Guy is great on Instagram. But those sandwiches look like something else.
Garrison Goodman (08:35) How do you spell?
John’s IPhone (08:35) It, they’re intentionally ridiculous. Although I’ll tell you guys when you come back out to The Bronx, the next time we’ll do it around lunchtime and I’ll point to a deli that’s pretty close to us. It’s the place, that, what’s his face… my mind just went completely wrong. It’s the Joe Rogan spot.
Garrison Goodman (09:04) That’s exactly right. Oh, yeah. I know what you’re talking about. It was like what a two foot massive sandwich or something?
John’s IPhone (09:10) Well, you can get, you can get a normal like hero… sized version of that. You don’t need to get like the three foot, you know, party size. But anyway.
John’s IPhone (09:25) So,
Joshua Levitan (09:25) that’s on my list. Now, talersio’s is still on my list and I’ve still never been to Milburn deli which.
Garrison Goodman (09:31) all my friends from.
Joshua Levitan (09:33) jersey talk about. Then I need to hit next time I’m in there.
Garrison Goodman (09:37) I am, although.
John’s IPhone (09:38) I’ll tell you like up north. So, I’m from Bergen county originally, and so I’m a central jersey transplant. If such a thing exists like the food down here is so nowhere close to what I grew up with. So, you said you’re in maplewood, you can get some good stuff around there. The further north you go, especially Italian deli, you know, the better it gets. Oh, okay. That’s good to know. Yeah.
Garrison Goodman (10:12) Yeah, we’ve got, I’ll have to make a trip because that’s you know, honestly what my wife and I will do, we’ll go get some cold cuts, some cheese, a bottle of wine that’s a great weekend for us. So, John, I’ll hit you up on some recommendations.
John’s IPhone (10:26) No doubt, no doubt.
Garrison Goodman (10:28) It was, I think my first couple months out here, I went to Milburn deli like two times a week and then our first Christmas here, my wife bought me a Milburn deli hat. I rock it all over.
John’s IPhone (10:42) And I spent this week at our brand New Jersey office, which is much more convenient for me than The Bronx.
Joshua Levitan (10:50) So that’s why I asked and expanded into jersey. So John’s commute was about 20 minutes instead of two hours.
John’s IPhone (10:57) Hey, you know, I won’t say that. That’s the reason we’re here, but I’ll tell you, I took advantage of it.
Mike Manson (11:05) Well, we can come out there next time we make a trip.
John’s IPhone (11:08) Absolutely, absolutely.
Mike Manson (11:10) Very good. Well, I know it’s four o’clock on a Friday for us east coasters. So I’ll get in, I know you guys are both mobile. Are you able to see a screen if I pull it up? Yes. Okay. I think just to kick things off, we’ve got some new faces joining the call, John, it was great to meet with you last week on site. I think we left the meeting feeling really positive about what we can do to partner. So just for the new folks on the call, you know, John runs payr contracting and the network strategy over at essin, and has been brought into the conversation, you know, as we’re at kind of the final stages, he was able to talk to some of our references and I think what we wanted to cover with John today was specifically how we can help them with delegated roster generation, delegated roster audit, support some of the things that he really cares about, but I don’t know josh and Cameron you want to introduce yourselves?
Joshua Levitan (12:10) Yeah, pleasure to meet you, John. The team has kept me up to date here. I had some kidney stone surgery last week and so Hassan, my leader filled in for me that.
John’s IPhone (12:23) Sounds miserable. I hope you’re feeling better.
Mike Manson (12:26) Start with josh.
Joshua Levitan (12:29) Yeah, thank you. I appreciate that, John. I am feeling a little bit better. I will say I might actually go camera off at some point and move to a non desk chair. I’ll tell you though, John, the worst part is I have to go back for a second version of it next week. So I’m in the thick of things right here, but yeah, appreciated the support from my team here. I work for Hassan. He’s my leader. So I fill a similar role on these calls to the role he was filling with you last time, Mike was telling me you’re a big yankees fan, and I had told Mike he needed to put a picture of the bill Buckner as his virtual background, which I see Mike did not do.
Mike Manson (13:12) But I couldn’t bring myself to do it. Yeah.
Joshua Levitan (13:16) I’m also a Boston Guy, so we’re having some fun with it over here, but I digress.
John’s IPhone (13:21) So I think all of us need to be really careful about not putting the moloik on our respective teams this year could go either way.
Mike Manson (13:34) Agreed agreed.
John’s IPhone (13:36) So, so I thought the intent I’m sorry to interrupt. I thought the intent for today was to walk through the actual proposal.
Mike Manson (13:45) We do have, yeah, sorry, I’ll pull up the agenda here. We do have a proposal to go through. I think we’re we need to clarify a couple things on volumes specifically of direct enrollment. And I know con, I know we’ve had conversations about this and you shared some data with us. But I think like the more accurate we can get on that will allow us to give you like, the real number. But we will, we do have the SKUs up with the volumes that were shared with us already and we’ll go through kind of like line by line, of what that looks like and what the service includes.
John’s IPhone (14:22) Sounds good.
Mike Manson (14:24) Very good. So one of the wanted to kick things off with. I know, we went through some of these last week, John, but wanted to just like get a little bit more dialed in on, the bva, as you think about presenting this internally, we want to make sure that we can give you a good number as far as like, you know, an Roi calculation that you feel confident standing behind and I, you know, it might not be perfect.
Mike Manson (14:48) But if we can get close, I think that’ll help the conversations. So we covered kind of the status quo last time, 23 ftes today. We know what the turnaround times are. One of the things I wanted to confirm is the like this is a breakdown basically of what we think you would need to hire as you continue to grow based on what the current fte to provider ratio is. And I know also just to clarify too, John and con would love your feedback on like I know you, John, you mentioned there’s 40 potential net, new providers being onboarded for this year. I think con, you had mentioned you thought the number was closer to 400. So obviously, there’s a pretty big discrepancy there. Like you guys have a better read on what the growth actually is. So I.
Abubakar Khan (15:46) sent you the breakdown of providers from our, from Michael pretty much John from that’s what he’s expecting to onboard in terms of providers across various specialties, and it comes out to 400 for this year? Can you pull that up really quickly, Mike? Just that breakdown? Yeah.
Mike Manson (16:05) Let me see here… con.
John’s IPhone (16:07) We have 600 total providers. How are we onboarding 400 new ones?
Abubakar Khan (16:13) For this year? They want to bring on 400 new ones. I mean, providers drop off all the time too, but that’s his goal for this year. He gave me the breakdowns.
John’s IPhone (16:22) I was gonna ask, I was gonna ask like in terms of, and maybe you and I should take this offline. Yeah, that number that, I just don’t know where it’s coming from.
Mike Manson (16:39) So, this was 122 for intention health, which you know, is the new acquisition 72 in behavioral health, 45, nursing home, 22 primary care, 116 specialists. And if we want to be like more conservative on this, we can, but I think we just need like directionally.
John’s IPhone (17:03) Yeah. Look, we can look the number. Well, let me ask this if the number is actually 100 instead of 400. Yeah. How does that impact pricing? So.
Mike Manson (17:18) Our, our finance team looks at two things, the overall size of the deal as well as volumes per line item. So if you commit to like we want to get accurate because we don’t want you obviously committing to something that you’re not going to use. And some of that, we can get into more detail about how we put some guardrails around that.
Garrison Goodman (17:41) If I could just jump in, Mike, sorry to interrupt, John, it’s based upon the number of enrollments that we have to do. So, if you’re hiring less providers, we have to do less enrollment. You’re buying less enrollments from us.
John’s IPhone (17:55) Yeah. So, so we pay per provider on the enrollment side?
Garrison Goodman (17:59) Per enrollment. So.
Mike Manson (18:01) One provider getting enrolled with five plans would be five enrollments.
John’s IPhone (18:07) All right. But what about if they’re what about delegated versus direct? So.
Joshua Levitan (18:15) That’s on the direct side, it’s like per packet on the direct for delegation. Because there’s only one delegated packet per provider. It’s a cost essentially per packet and then a much smaller fee per roster because there’s work that goes into automating each individual roster. So not only is delegation like good for you in many ways, it also really does help drive your medallion costs down. And I think that’s a lot easier for us to estimate because the difference between, you know, 27 delegated contracts versus 30 is like minimal in the scheme of where the quote works out to, but the direct enrollment piece because it is the most intensive process from a technical standpoint for us and because it represents the most value savings in terms of how expansive it is for your or hard and time consuming. It is for your team to do is the biggest cost driver in our pricing, alright?
John’s IPhone (19:14) So maybe let’s jump to the next assumption then. So can we talk about what assumptions are made relative to direct versus delegated?
Garrison Goodman (19:26) Yeah. And if helpful, Mike, I can pull that up, we mapped out per division where.
Joshua Levitan (19:37) you.
Garrison Goodman (19:38) would need direct enrollments. And so it looks like and then where the majority of your providers are assigned to by division. And so with that 80 percent of them being assigned to Ema, you know, various percentages by this, we took a conservative approach that, hey, this actually is like, you know, close to nine, we took seven and a half.
John’s IPhone (20:05) So, if.
Garrison Goodman (20:06) you take 80 percent of 400 providers or rather 80 percent of the total enrollments here and we got to 3,000 enrollments which is basically 400 providers times seven point five or something and we just wanted to get directionally close.
John’s IPhone (20:26) Yeah. So, khan, what seven contracts, what are the seven contracts that require direct enrollment that would touch every one of the 400 projected providers?
Abubakar Khan (20:38) Medicaid medicare?
Abubakar Khan (20:46) Let me see. Give me a second. Do you guys have the list of all the direct payers with?
Garrison Goodman (20:52) You, yeah, it’s on my screen right now. I don’t know if you can see it.
Abubakar Khan (20:57) Okay. It’s broken down to direct and delegated.
Garrison Goodman (21:02) Yeah. So you can see.
Joshua Levitan (21:03) Hold on. This garrison was only the top payers?
Abubakar Khan (21:06) By percent.
Joshua Levitan (21:08) Of utilization, I’m looking for the other list, khan, give me one sec. Okay?
Mike Manson (21:18) Yeah. I mean, essentially like the reason why we want to get as close as possible to this is the higher the volume that you commit up front, the lower the unit cost is going to be, that’s how our team looks at it.
John’s IPhone (21:31) So, if we commit to a high volume and then it turns out to be not even close, then what?
Mike Manson (21:36) Yeah. So we don’t want.
Garrison Goodman (21:38) you to overshoot it? That’s for sure?
John’s IPhone (21:40) Yeah. Are there?
Abubakar Khan (21:41) Credits that we get back or something or money that we get back, if we don’t utilize that amount or?
John’s IPhone (21:47) What does that look like?
Garrison Goodman (21:48) We try.
Joshua Levitan (21:49) To be.
Garrison Goodman (21:50) As conservative as possible, so that we don’t do that, but we also will offer like a skew flex to where you can either pull from, let’s say in year two, you can pull from year one or, hey.
John’s IPhone (22:01) So, let’s get this number, let’s get this number, right? Let’s not try and play games with it. Let’s just try and get this number, right? Because again, right? You know, khan, I’m trying to do this reconciliation with our existing delegated agreements. We’ve got a couple of scenarios where some of our entities haven’t been merged into those delegated agreements.
John’s IPhone (22:23) So today, we’re doing them direct. We shouldn’t be, and that’s going to change quickly. And then especially as we look at these new markets, right? We’re going to be leveraging ipas heavily in these new markets and likely be doing, you know, sub delegating sub delegation agreements with those ipas, so piggybacking off of their delegation. So I want to be really careful that we’re not like the numbers that you’re quoting like knock me out of my chair. I just can’t believe that they’re real.
Abubakar Khan (23:03) Okay. Cigna’s, we have cigna medicaid, medicare, humana. And.
Joshua Levitan (23:11) humana.
John’s IPhone (23:13) We’re delegated cigna, we will be delegated through ipani, okay?
Abubakar Khan (23:24) Those are the main ones that I’m seeing the rest are smaller for behavioral health or vision plans.
John’s IPhone (23:30) Vision plans would not be all 400. It would be a handful of optometrists yep. So, yeah, there’s going to be very little by way of direct. So, you know, I would say, you know, if you’re basing it off of 400 providers, I would say max there’s a 1,000, well, four times two for medicaid and medicare… although for the most part with medicaid and medicare, you’re talking about just the linkage you’re not talking about a full delegated, not talking about a full credentialing package for each of them. Okay? So, I don’t know how you account for that.
John’s IPhone (24:14) But I would say, you know, like 1,000.
John’s IPhone (24:20) Well, 50… would be a much more reasonable estimation even based on 400 providers, which I think 400 in and of itself is high. But if that’s what came from HR, then we’ll go with it.
Garrison Goodman (24:42) Okay. So just so we’re following along, it’s 400 providers times three direct enrollments that’s how you’re getting there.
John’s IPhone (24:50) Yeah, pretty much. Okay. All.
Garrison Goodman (24:52) Right. Hey, I can do that math 12.
Mike Manson (24:54) 100, yeah, 1,200. Sounds like a good number to land on.
Garrison Goodman (24:58) Yeah. As long as you all feel like you can stand on two feet, like from our perspective, we care in the sense of getting it right? We don’t obviously want you to buy more than you need. So… we’ll move that to 12.
John’s IPhone (25:14) 100. And then we can, and then we’ll flex. We can flex if that changes dramatically because of the market, we can have a conversation and talk about it.
Mike Manson (25:25) You can flex across the different SKUs for sure, meaning if.
John’s IPhone (25:31) you need more. No, I mean, in year two, I mean, in year two, if, you know, we decide to go into like 30 new markets next year. I mean, I had no idea we were going in, I had no idea we were going into seven new markets this year as of October. So, you know, there is a chance that in 20 27 or 20 28, we’re talking about a lot of new markets, you know, then we flex the volume there. But I think for… you know, second half of 20 26 and first half of 20 27, I feel pretty good about 1,250, you know, 1,500 max the.
Mike Manson (26:11) Nice part, is that we would structure this as a three year deal where you basically have a total sum. So, if we did just a flat rate of 1,200 over three years, you’d have 24, 3,600 total enrollments. And if all of a sudden you spike in year two, you can just draw down against that 3,600 number. And then we wouldn’t be sending you a new invoice. If you blow through that, then yeah, we would have a conversation about just adding on.
Garrison Goodman (26:37) Yeah, I think, yeah, if you guys know, hey, growth plans change. We’re going to triple double like come to us and we’ll you know, renegotiate it and another contract.
Mike Manson (26:51) Like the other question there too?
John’s IPhone (26:53) Khan khan before we move on, khan, don’t, let me steamroll you. So if you think that I’m way off base, push back.
Abubakar Khan (27:00) No, I think you’re fine, so far? Okay?
Mike Manson (27:06) For payor, revals, you know, we typically see about 25 percent on the gross number of direct enrollments do you guys have a strong opinion on what the volume would be for payor revals for meaning providers that you have that are already enrolled, that would require a revalidation because they’re in their third year?
Garrison Goodman (27:31) If we use that same math, 600 current providers times you?
Mike Manson (27:38) Know three direct.
Garrison Goodman (27:40) Enrollments, divide that by three because you’re only having to revalidate… every three years. Does 600 sound right?
Abubakar Khan (27:50) Yeah, I think we can go with that same number… and do the revals include medicaid revalidation and medicare as well?
Joshua Levitan (28:01) Yes, they do. Obviously, the landscape with that got wacky during covid, right? And now the government has normalized it a bit more. So we’re absolutely tracking for that. I know this was also a question that had come from Melody. So we’re absolutely tracking for that. Like for anyone going forward, we know we’ll be back on the set five year timeline. There is obviously a little bit of variance with anyone that should have been revalidated, like in that post covid craziness, right? Right? But yes, to answer your question directly, a revalidation would include medicare or medicaid, revalidation. Okay?
Mike Manson (28:45) Cool. And then on for hospital applications, con, I know you shared the hospitals that you’re affiliated with. So I think what we need, I guess what I’m unclear on is like would we be saying that all 400 new providers would need to be no?
Abubakar Khan (29:02) So I put the numbers in there for the number of providers as well. Okay. If you refer back to that email, rose gave me the number.
Mike Manson (29:12) Okay. Yeah.
Mike Manson (29:21) So, we had bronxcare montfiore and st Barnabas as the hospitals.
Abubakar Khan (29:27) I think you should say like two to three providers.
Mike Manson (29:30) Two to three providers per year. Okay. That’s a total provider count, correct? So we’d be saying like we’d be saying nine hospital applications then essentially. Yeah. Okay. All right. That’s easy. Okay. Yeah… I think that’ll help us dial this in and then actually give you a proposal with the total cost… while we’re… here. I wanted to bounce back to the bba question real quick. Are you guys able to see this? Yes. So we were, I know we were talking about this last time John khan. You’ve been super helpful on trying to help us get accurate here. But again, I think this is important to get at least directionally close to as you have your conversations internally. I think the biggest adjustment we made is we were coming in, assuming, you know, probably more of the business was direct enrollment than it actually is. So we had this revenue acceleration as like 10 point 5,000,000. I think based on the conversations we’ve had, we got this down to one point five… it sounded like John based on your feedback was like the biggest revenue drivers for this project is actually on accuracy and claims that are getting sent back and, or denied. Do we feel good about these two numbers?
Mike Manson (31:06) You know, I think at one point, we said it was maybe closer to five, but it’s like 4,000,000 dollars in revenue leakage due to claims denials. Is that a number you feel confident in John?
Abubakar Khan (31:27) 4,000,000 annually due to credentialing only, is what you’re saying, right?
Mike Manson (31:33) Yeah… and, or para enrollment application errors?
Abubakar Khan (31:41) I feel like it’s half of that.
Abubakar Khan (31:51) Give me a second, yeah.
Mike Manson (31:53) And I know, you know, it sounds like a lot of it or at least a significant portion of it is because of operations jumping the gun on getting providers, seeing patients before they’re actually credentialed, right?
Abubakar Khan (32:07) Yeah, that’s usually the issue… that’s why I’m trying to gauge how to give you a number here because it wasn’t until more recently where we started separating out the actual denial reasons based on if it was because of ops or if it was actually because of a delay on our end. Yeah.
Mike Manson (32:31) And if you don’t have it in front of you, I know you guys are both on your way home today, but I think what we’re trying to get to is a number where when you go to dr Segal and have your conversation with Ron John, and you’ve got your price from medallion, it’s like this is medallion’s costs.
Mike Manson (32:47) This is where we think we can have an opex reduction impact. And then here’s where the Roi comes from because we’re going to reduce that claim denial number. Yeah.
Garrison Goodman (32:56) It’s also the number that you will stand on two feet and say, hey here’s what we can expect to deliver to the organization of this project. And I’d say, let’s be conservative, but let’s not just discount it too much to where it doesn’t look like we’re delivering good enough stuff to the business that warrants this initiative.
Abubakar Khan (33:19) Right. Okay. So, let’s see for the last year.
Abubakar Khan (33:30) It was for credentialing specifically.
Abubakar Khan (33:38) 40 plus 20.
Abubakar Khan (33:50) Give me a second.
Abubakar Khan (34:23) Oh, you see this 100 K? I wonder if we use the… 80 40 that’s 120 that’s 220. What do you see in specialty?
Abubakar Khan (34:56) One point one… one point one plus 40? Yeah. So, one point one, one point two.
Mike Manson (35:13) Okay. That’s claims denial specifically due to cred errors. I.
Abubakar Khan (35:17) Want to say yes, but I think this is also including some of the ops issues, but for the most part, I think it’s a good estimate hovering around a mil. Okay. Yeah, plus or minus one to 300 K, but around one point one to one point three, I would say.
Mike Manson (35:35) Okay. Yeah. Okay. Yeah. Well, we can update this. And then as far as the rev acceleration, we were going off a 30 day reduction that’s additional billable days for 400 new providers. Yeah, that works for me. I understand. Yeah, I mean, is that a realistic number to go off of or do we think because of the percentage of delegated business that should be lowered?
Abubakar Khan (36:07) It’s… a good point just because you guys are also doing the follow ups for delegated. So we are saving time with submission and with receiving participation for delegated as well. So if we do 15 there and then for direct enrollments, yeah, we can save 30 there. I think this is still an okay estimate. I don’t think I would base it off of 400 providers. I think I would probably do… half and leave the 30 days that might be a more accurate number. Okay. Well, hold on. My concern is, you know, what is the,
John’s IPhone (37:00) a good portion of that 400 estimate whether I believe it or not is related to expansion, right? And so… so I just want to be really careful that we’re not like over. Well, I guess you and I need to be aware that we’re not overselling this thing, right? Like at the end of the day, like the actual time savings and the time to be able to see a patient.
John’s IPhone (37:36) I don’t know. Yeah.
Mike Manson (37:38) I mean, so we, I mean, we had it at 12,000,000, right? If you just look at this math, 30 times a 1,000 dollars a day, times 400 comes to 12. We lowered it significantly based on the feedback last week, John. I think, I mean, we could try and represent it like break it into direct enrollment versus how we help with delegated speed.
Abubakar Khan (38:01) I think that would be better. I.
John’s IPhone (38:03) Think the other look my, I see the number and my reaction is that, this… is nowhere close to being real that’s all… and I don’t know how to get more comfortable with it, but I’m just as uncomfortable with it as I was when we first talked about it. So.
Mike Manson (38:27) What if we took, if we tabbed the 12,000,000 dollars and then just took a percentage of that for direct enrollments? Like I think I can go back to the sheet that garrison had up earlier, and then we can pull your percentage of direct enroll, you know, direct payers and how much of the business that is and take a percentage of the 12,000,000 based on that.
John’s IPhone (38:47) And then I think that’s probably the right answer. And then we’ll get, yeah, again, like John, we don’t wait, we don’t wait at Essen for anybody to get credentialing anyway today.
Garrison Goodman (39:00) Yep.
John’s IPhone (39:01) So, so any reduction in any reduction in denials, I feel good about reduction in turnaround time leading to cash flow, right? That I don’t feel as good about. Yeah, I hear you… because.
Joshua Levitan (39:21) of the operational issues, your point there, John, we’re schedulers, we’re just getting people out there regardless.
John’s IPhone (39:26) Yeah, they don’t wait, they don’t wait. Yeah, like the docs aren’t even employed yet and they’re being scheduled con, am I wrong? No, you’re right? It sounds like I’m being hyperbolic, I’m not like that’s reality here.
Joshua Levitan (39:42) Yeah. Look what you’re saying I hear and it might make the next point I say moot, but I want to raise it anyway. I think something we also tried to cover which admittedly is hard to represent is even if you’re delegated with an mco look, con, there were certain mcos that we had talked about where you needed a medicaid member first,
John’s IPhone (40:04) Right.
Joshua Levitan (40:05) So, there was a scenario here in these projections, John, just to explain like how we’re trying to think about this with that 12,000,000 and all that we’re like, all right, cool. Even if, you know, we’re certainly speeding up the time to get the delegated stuff and speeding up data collection and all that stuff. But for anyone who’s on a delegated contract with an mco, we can’t even submit their roster, submit them on a roster until their medicaid is either realigned to your group or they get their medicaid number in general. So even though it’s only one medicaid enrollment, it affects, I think it was six of the delegated contracts.
John’s IPhone (40:42) But, again, that would impact… the denials… that’s not you’re basically double counting by accounting for it in the denials because we are not waiting, there is no one at Essen that is waiting for anybody to get them on a schedule they, you know? So, yeah. Okay. I hear you on the other side of this on the other side of this is we’ve got to clean up that process and that’s actually going to slow down cash flow to some extent because we’ve got to do it the right way going forward. So, I just, at the end of the day, I would almost feel better about, you know, take 20 percent of that number, take 100 percent of the denial number. And that’s probably the benefit.
Joshua Levitan (41:40) Okay. That makes sense.
Mike Manson (41:42) Okay. That’s still significant. Yeah.
Garrison Goodman (41:47) Yeah, no, this is good.
Garrison Goodman (41:48) Yeah, we want to, you know, because you guys are going to get, you know, in rooms that we’re not on.
John’s IPhone (41:53) Challenged. I also know my CFO and if somebody tells him he’s going to get 20,000,000 dollars back like he’s taking that to the bank.
Joshua Levitan (42:03) Yeah, yeah.
Garrison Goodman (42:06) I think, this is really good. We want you all to be able to stand on two feet when you’re having these conversations and not be on the hook for fictitious revenue as well. So, yeah, thanks for helping us understand that.
Joshua Levitan (42:21) Okay. Yeah.
Mike Manson (42:24) I think we can probably let you guys out early. I think, I guess what would be helpful is just to understand next steps like we’re going to revise this and share it with you.
John’s IPhone (42:36) So, are you going to send us? I mean, I don’t know if we have it already khan, do we have an agreement with pricing in the agreement? No?
Abubakar Khan (42:47) Just the previous proposal, but we’re waiting on this proposal to review.
Mike Manson (42:51) We had a proposal from July of last year, so, you know, the scope has changed quite a bit. So we just need to go back and update these numbers. All right?
Garrison Goodman (43:03) And then, so we can get that to you early next week, probably… might be worth spending 10, 15 minutes to just run through it. Khan with you. So you understand it and can relay it back to John before presenting, but yeah.
Joshua Levitan (43:20) We.
Garrison Goodman (43:20) feel like we’re in a good spot.
Garrison Goodman (43:22) We’ll get that to you early next week… going from there, what is going to be your guys’ internal next steps?
Abubakar Khan (43:31) We’re going to review internally. After that, the proposal, we have to schedule a call with Akil Melody and the team and then we’re going to take it.
Joshua Levitan (43:40) From there, I think.
John’s IPhone (43:42) A decision is going to be made very quickly and we’re going to run.
Joshua Levitan (43:49) Okay.
Garrison Goodman (43:51) Well, thank you all for the partnership. We’ll let you guys go. Enjoy your Friday, and then we’ll see you next week. Maybe we’ll get some time scheduled with you khan next week to run you through the proposal.
Abubakar Khan (44:02) Sounds good. And likewise, enjoy your weekend, guys you as well.
Mike Manson (44:06) Take care, everybody. All.
Garrison Goodman (44:08) Right bye. Thank you.