Transcript
Mira Guha (00:00) we just switched our zoom.
Jessica Bollasina (00:01) Over. So.
Mira Guha (00:03) Hi, can you hear me? Okay? I?
Jessica Bollasina (00:05) Can I, can, I was just pulling up your proposal and our current commitment and all the fun things. And I, thank you for sending over those past few invoices. I was diving into that this weekend to kind of understand like what we’re paying for. And what I’m seeing is we are under utilizing this contract. Yeah.
Mira Guha (00:30) I’m happy to kind of take a look at that right now. That’s one of the things I wanted to go over is the current consumption information. I think that would be really helpful.
Jessica Bollasina (00:39) Yeah. Let’s do it. Okay?
Mira Guha (00:40) Perfect. Anyone else joining from the?
Jessica Bollasina (00:43) No, no, no, Gary couldn’t make it. And so I briefed him before and he gave me some guidance. So it’s just you and me. Okay?
Mira Guha (00:53) That is fine. Just wanted to make sure if there was only one we were waiting for that. We.
Jessica Bollasina (00:57) Yeah, no, no, no, you’re fine. Yeah. So.
Mira Guha (00:59) I thought this might just kind of help paint a helpful picture of what the last almost three years have looked like of this contract. So, this is available in your account usage tab, kind of the meat and potatoes being these kind of columns of the table here. We had this kind of incremental growth over time. At one point. We actually, I think signed an addendum because we were utilizing pretty quickly. So not too long ago.
Jessica Bollasina (01:22) That was what year I.
Mira Guha (01:24) Think that was 20 25. I can go ahead and find that for you and send it.
Jessica Bollasina (01:27) Over in 20 25 last year. Yeah, because we launched a new market that required new, a bunch of new state licenses for clinicians. Yeah.
Mira Guha (01:38) We added a couple providers and some licensing. So that was added in 20 25, first year of the contract. We were really low. We only used about half of what we had contracted however in year two, we, well beyond, you know, we exceeded what was kind of technically contracted. So we carried over some of what was unused from year one into year two. And now in year three, we’re actually tracking pretty on target. The biggest thing being as of right now, three months left on the contract, 23,000 dollars available remaining on the agreement. Okay?
Jessica Bollasina (02:11) So, we have used that up a little bit because like I think when we last met, you said we were getting close to 50 and I’m like that’s bad.
Mira Guha (02:18) Yeah, it looks like we’ve had a pretty good the last few weeks. We’ve had a pretty good kind of, rate of consumption, average.
Jessica Bollasina (02:25) And when you say rate of consumption, I want to make sure I’m understanding our current msa correctly, we are paying for every provider in medallion, we are paying 200 dollars annually to monitor and manage that license. And then we are paying medallion to renew and issue new licenses per use, and that unit we are committed to for the six month window, 75 renewals and 40 new licenses from December to June. Okay. Okay. And then I do see that you do allow SKU translation like let’s say we needed more renewals and we didn’t use as many news. We.
Mira Guha (03:14) Could we’d.
Jessica Bollasina (03:15) come up short? But we’d still have a little bit of wiggle room there?
Mira Guha (03:22) Exactly. Yeah. We call that SKU flexibility. So yeah, just basically kind of allows you to move the funds around. I know we’re not, we haven’t worked on any yet, but, part of this information here is just trends over time based on the current, average based on current contract year. And we do have 4,000 dollars in upcoming consumption. That means something’s been requested, but our team hasn’t done enough work to be consumed against your contract. I can go ahead and pull that up if that’s helpful to review.
Jessica Bollasina (03:50) And that’s requested as in like somebody we get. So, I’ve learned this too since we last met. So, the way that our team is administering this is that all of the administrators myself included, get an email saying this person’s license has come up. And then the person who, that administrator, the person in this group of administrators, who, that, who is the person’s? Leader says this is a medallion renewal or this is a self administered renewal?
Mira Guha (04:19) Yeah. And so, if you put it as an interwell or client owned renewal, we won’t touch it, but you can use the platform to monitor it, but we use.
Jessica Bollasina (04:26) The platform so that when they do renew, they enter that information. And then medallion maintains and says, okay, like this is correct. Now, I will also say, that this is handy to finish this. Like why we do this? Is this is handy when it comes time for an audit and we have to produce a list of licenses in their current existence. And then we also, generate our Coi with your platform.
Mira Guha (04:54) Gotcha. Okay. Awesome. Great. Any other questions on that? That makes sense? No?
Jessica Bollasina (05:00) I just, that was kind of the information that I’ve collected since like on our end, this is how we’re using it. Okay. So, 25, 20 20 25 was a big year. We expanded into a New York, new market and we issued a lot of new licenses that we are now going to maintain and manage for those clinicians who are with us. And then, but… those won’t be new issues. Those will be renewals in 20 20. I don’t know how long a nurse license lasts 20 26, 20 27.
Mira Guha (05:32) One to two years on it. Okay? That’s.
Jessica Bollasina (05:34) what I imagine so in 26 and 27, like, is that something that you can help with, medallion, like, is that like your expertise of like state license issue laws, like rules, how long they’re good for, or? Yeah.
Mira Guha (05:49) So that is something that our team will track within the platform. One of the things that I thought would actually be helpful today is, just evaluating where we are with the current contract and seeing if we need to do any more, right? Sizing before the end of the agreement. Yeah. It sounds like as of right now maybe not, but we are, you know, still trending pretty healthy right now. So, there is a chance depending on like, it sounds like the focus is mostly renewals, but if there is any kind of push to do any additional licensing, we could factor that in, I think, yeah.
Jessica Bollasina (06:21) I guess like, I don’t see like the, given where our business is over the next year, possibly two years, I don’t see us expanding needing new licenses, okay?
Mira Guha (06:32) At all, like no new licenses whatsoever. No.
Jessica Bollasina (06:37) No. Not 40. Okay. Or what’s in the proposal? Let me see. I.
Mira Guha (06:45) Have that listed here? Yeah, we have 60, which is based on usual kind of growth trajectory.
Jessica Bollasina (06:50) Yeah, that’s I mean, that’s if you looked at our last growth trend, yeah, that would look correct. But, yeah, over the next two years, we’re in a stable state. And so we don’t anticipate also, we’ve kind of covered a lot where our value is available. And so, like we’re kind of licensing wise, we’re where we need to be, the only reason we would cover a new license is if we stood up another img which is the one that had the push last year and that’s live right now. So we’ll be handling renewals and ongoing there. So… let me see here. So, yeah, you’re targeting?
Mira Guha (07:43) And if it’s helpful, I can provide a breakdown under the entire current contract of kind of what like what we were using in each contract year, like how many new state licenses? Yeah, I think last contract year was definitely the big peak we saw in usage. Sounds like we’re kind of slowing down. Would we maybe still want to factor in just a small handful of new state licenses if there’s any providers maybe?
Jessica Bollasina (08:04) Well, that’s what I’m wondering like what’s the a la carte cost for new? Yeah.
Mira Guha (08:10) It really depends. It’s hard for us, to quote unit prices. What we usually do is we just get, your volumes like, hey, can we actually bump that new state license skew down to like 20 and then see what the pricing looks like?
Mira Guha (08:21) Our team then kind of creates a quote and sends it over. So unfortunately, hard to kind of give the a la carte pricing. But if you have like ideas in mind, the good news is we have some time so we can go back and forth with edits and then kind of land on whatever number makes the most sense. Okay?
Jessica Bollasina (08:35) And then your, the 185 per provider per year, that’s the maintenance, the annual, the monitoring.
Mira Guha (08:43) Yeah, that’s just to keep the provider active, be able to do the data management. We don’t have any sanctions monitoring currently enabled for you. If that’s something you’d be interested in, we can definitely add that to the platform.
Mira Guha (08:55) I would recommend license expiration monitoring most likely, and then we can pull a quote for you on that, what that?
Jessica Bollasina (09:00) Looks like aren’t, we using license expiration monitoring in our current, because I get a notification when somebody’s about to expire. Yeah.
Mira Guha (09:08) So, based on the data we have in medallion, we will just, you know, track license expiration date based on, you know, like last license we issued for you, just to make sure I am fact checking myself, the license expiration monitoring kind of takes it to a next level. Let me pull up the exact frequency. So, if we do the license expiration, it’s, any licenses we have in a platform to you’ll, get the same emails you do. Now. That says the license is expiring here’s, the expiration date two weeks prior to expiration. We’ll send you an update. And then, until we know if it’s actually been renewed or if the license expired, we’ll do weekly follow ups after the license expiration date, with the current?
Jessica Bollasina (09:48) Are you fact checking? So the, that service in addition to what we’re currently getting is that you’d actually be validating what’s in our, what’s in your system versus what’s in the database? Like the national data provider database? Yeah. And I can send more details and that’s not something that we’re currently doing. We’re relying on what that date says, okay, which so far it’s working.
Mira Guha (10:09) Okay. Yeah. If you’re not interested, that’s fine. But after today’s, call, I can send some details about how that works, just, to be like extra sure, we often do recommend that for folks using our licensing solution. Yeah.
Jessica Bollasina (10:21) I understand. Okay. So 185 is more that’s reflective of the amount of providers we have active in the system today.
Mira Guha (10:30) Okay. Correct. That’s kind of a good faith. Thanks for continuing to work with us as far as our finance team.
Jessica Bollasina (10:37) And then year two is anticipating additional 15, providers.
Mira Guha (10:43) Being added. Yeah.
Jessica Bollasina (10:46) And then,
Mira Guha (10:51) And I can tell you, I went ahead and checked, what we have in a medallion and between, six, seven, 20, 26 and six, 620 28, which would be the new contract term. There are 280 licenses expiring in that period. Not sure if you’d have us be renewing all of them. Sounds like you’d do some of them. So this was kind of with the assumption that we would be handling some, and.
Jessica Bollasina (11:13) Not all. Yeah. The way our benefit is set up or sorry, it’s not a benefit. The way our administration is set up. It’s been this way forever. And I’m just not learning about it. Is that like if a nurse comes in like to our team, let’s say a nurse joins our team and she lives in Texas, then she maintains her Texas license, but let’s say we need her to work on. We need her to take on a caseload in New York. We would pay for her expansion, which is the new that we pre funded. And then we would handle that renewal as well. Okay? And fund that renewal. And so, that, from what I’m understanding that’s the pass through fees we’re getting so like we, you so like if you, we say medallion you facilitate the renewal of that license, then you take 100 that’s the 150 dollars credit, That we pre funded or that we committed to. And then we pay whatever fees go into that renewal through the pass through fees, correct? Okay. I understand. Yep. And those are.
Mira Guha (12:23) at cost, we don’t inflate those at all. We just, we cover as many as we can up front. And then we ask for reimbursement essentially.
Jessica Bollasina (12:29) Yep. And I see that we, because like we have historically because I was like if we commit to this and it’s billed quarterly, then why are we getting monthly fees? And then I looked at the type of invoice. I was like, oh, this makes complete sense in the fee.
Mira Guha (12:40) Section of the contract. Yeah.
Jessica Bollasina (12:42) Okay. So then… I guess from there, I… you need from me to continue? This is the… headcount is the headcount it’s in there right now are?
Mira Guha (13:03) We expecting any kind of increase and it?
Jessica Bollasina (13:05) Sounds like not in the next year?
Mira Guha (13:06) Not in providers at all, not whatsoever. No. And.
Jessica Bollasina (13:10) Then new licensing, I don’t see that in our forecast for the next year… renewals, is the one that I need to dial in a little bit more. Okay? And so here’s my question about SKU flexibility. Is what is the translation? Like how many renewal units equal one new? Yeah.
Mira Guha (13:36) And that’s really going to depend on what the ultimate quote ends up looking like. Yeah, because as of right now, it would be pretty easy to do that math with the unit rates that we have here. Yeah, it.
Jessica Bollasina (13:45) would be like four units of a renewal plus one, yeah, five. And then you’re wasting 100 dollars, but that’s the cost of under quoting yourself, right? Right?
Mira Guha (13:58) So, and if we do significantly reduce here, I might recommend we still keep a couple new state licenses even if it’s only like five or 10 per year. But if you feel strongly, I can see if we can adjust.
Jessica Bollasina (14:08) That, I would imagine it would be safe to do that just to make sure the SKU exists in our, okay. Yeah. But, yeah, that’s I would like that quote down to like five.
Mira Guha (14:20) Okay. Gotcha. Okay. Yeah, I’ll go ahead and come back to our team. Obviously, that’s going to significantly.
Jessica Bollasina (14:25) Five to 10. Sorry, that is going to change five to 10. That’s going to change how we’re built. But, yeah, make it 10. Sorry. Okay. Like 10 seems to be the.
Mira Guha (14:31) Right. 10 to four years. Okay? Because the.
Jessica Bollasina (14:33) thing I’m thinking about is like, what if it’s not a compact license? Then we’d do like, so let’s say it just takes to add somebody.
Mira Guha (14:42) It would be like let’s.
Jessica Bollasina (14:43) say, we did take on a new hire, And they were in a non compact state, Like they would need probably five licenses. Gotcha. That’s the math I’m still trying to navigate and I’m learning really quickly.
Mira Guha (14:59) So,
Jessica Bollasina (15:00) what’s… our timeline here too?
Mira Guha (15:04) We have some time, okay? So just wanted to keep track. I find this is really helpful especially just to make sure we don’t miss. Yeah. So we’re about three months out which is good. I’m having conversations with folks whose agreements are ending in a week. So we’re in good shape. We just are trying to really avoid that. And I’m going to be out at the end of the month for about a week because I’m getting married. So I’m just trying to thank you. I just want to make sure I’m not missing anything. We’ll have people covering while I’m out. This is just kind of a tentative timeline. This would obviously get us well ahead of that June sixth deadline, but it means we’re not going back and forth and our finance team isn’t threatening to do any like access shut off. So here’s, just kind of a general recommendation if in the next like I’d say maybe two or so weeks, we can start finalizing those volumes. I’m happy to hop on another call if that’s helpful. And we can kind of go back and forth, look at anything in plan and maybe aim for like end of April, early may to kind of start getting finalized numbers, make sure the terms look correct. I think that will put us in good shape. We can continue tracking consumption as of right now. But it sounds like we’re really slowing down. So no need to add extra funds at this time. Yeah. But does that?
Jessica Bollasina (16:15) Sound, and right now you said we’re at… yeah. And,
Mira Guha (16:18) I also made a note there are currently 28 licenses expiring between now and June that haven’t been requested. Sounds like some of those, your team will be renewing, some of those you might have us renew, but wanted to flag that there’s one CSR license that has been requested that’s a scheme we haven’t been historically doing for you, but it looks like we’re happy to do.
Jessica Bollasina (16:38) It, can you remind me what a CSR is it’s.
Mira Guha (16:41) one of the controlled substance licenses. I think.
Jessica Bollasina (16:44) What’s the provider name? Do you know?
Mira Guha (16:45) Let me see. Here I go. We’ll pull this up. I like.
Jessica Bollasina (16:51) download every report you can download to try and figure this out. But yeah, no worries service request.
Mira Guha (17:00) This one for Bianca Blanco. So if you click on that, it should take us to who requested it. Well, that’s weird. Hang on. No. Sorry, probably because I’m in as the wrong person, I’ll go ahead and do some digging for you.
Jessica Bollasina (17:16) I can, I have the active request… up? I did see that CSR and I was wondering what that was? Yeah, controlled.
Mira Guha (17:29) Substance registration is what that stands for. There’s. Dea. And CSR one is kind of Dea is more federal. CSR is more state specific. It looks like that was requested by Shira Simpson, interesting, but that was requested a really long time ago. So, we haven’t actually touched it. So, I don’t know if we’re even moving forward with that. It’s been stuck in intake for.
Jessica Bollasina (17:50) a very long time. When was it requested? What day? Sorry? Okay.
Mira Guha (17:53) 10 seven, 20 24. So that will show in the upcoming consumption. I see.
Jessica Bollasina (17:57) It, I see it. Sorry. Yeah, no.
Mira Guha (17:59) Problem. If you don’t want us working on it, I can let our team know to just put it on hold. It is almost two years old, so I understand that.
Jessica Bollasina (18:12) Yeah, why hasn’t it been worked? I’m curious.
Mira Guha (18:16) Let me see. It says intake over 21 days. I’m checking to see what tasks there might be for it. I’ll go ahead and check with our intake team to see if we can get some information. Would you still like us to move forward with it if we can? Doesn’t.
Jessica Bollasina (18:30) sound like it’s something that we need if we haven’t done it. I need to talk to her leader to understand what… her… plan is,
Mira Guha (18:48) I’m gonna check with Retta and see if she can help me figure that out. Have you, I can’t remember, have you met with Retta yet? I?
Jessica Bollasina (18:53) Have not. Okay. It’s on my list that’s fine. I was sitting there. I was like trying to like mess around with those analytics and I was like, it’d be really nice if I would, it’s gonna take a little some time. But first, like this just keeps ending up being things I need to figure out first.
Mira Guha (19:09) It’s all good. She’s actually out of office today and tomorrow anyhow.
Jessica Bollasina (19:11) So, okay. Yeah. And I’m out for the rest of the week. So maybe we can meet next week.
Mira Guha (19:16) Yeah, no worries. She’s awesome. And she can kind of get into any of the nitty gritty with the licensing, if that will be helpful, but I’ll go ahead and just ping our licensing team and see if they might be able to provide some insight here. I won’t have us move it forward unless you tell us that we should.
Jessica Bollasina (19:32) Yeah, because the thing, is, that was requested when she was on a different team, Bianca. Okay. And she’s in a different capacity in her current role, got it. Okay?
Mira Guha (19:48) Makes sense. It looks like all the other ones have been marked stopped anyhow. So, maybe this is one that was just missed.
Jessica Bollasina (19:54) Missed. Yeah. Do I have to stop it? No, I can.
Mira Guha (19:57) Go ahead and let them know to stop it. I’ll see if we can find out what happened. I mean, obviously, it’s a year and a half old, so it’s maybe just one of those things. Yeah. But I’ll go ahead and ask them to stop it, okay? Maryland?
Mira Guha (20:25) If you want us to work on any of those, we can, it sounds like it’s not necessary, but we do other types of licenses as well. Yeah.
Jessica Bollasina (20:30) Yeah, I see that. I’m… trying to, I, that’s the person the team she’s on now is my next meeting to understand how they’re using medallion. Because like, yeah, basically, I understand the value of the service is that it monitors our licenses and then facilitates and then facilitates renewals. Yeah. But that’s still a manual trigger on our part. We say, hey, this is a client self renewal or this is a medallion, please make this happen renewal.
Mira Guha (21:02) Yeah. And I don’t know if we’ve discussed our auto renew setting, if that’s something that would be interest, of interest to you, that’s something you could toggle certain licenses into, if, you know, like for this provider, we absolutely need us to renew.
Jessica Bollasina (21:15) I like low key wish that existed because then I could actually like monitor or could actually like manage. I wish that existed like three years ago, because then I could actually look at like which renewals, like we’re doing. But now, I’m like literally with a manual comb, like going through them and like, was this correct? Was this right? You know, that kind of thing, absolutely?
Jessica Bollasina (21:33) so TBD on how we monitor this service will change. And so I do foresee some like leveraging more of those. Yeah, absolutely of those like, I think, you know, there’s two sides of this. We’re underutilizing the like full suite. And we’re also… like we’re manually doing things that we shouldn’t have to manually do. And there’s not a lot of like for lack of a better word control. Like like anyone can, anyone who’s an admin can go in. From what I can see in here, anyone who’s an admin can go in and request any renewal whether it’s part of our policy or not. Yeah. And there’s no second point of approval. Like, there’s no oversight of like this is a two signature thing kind of a thing. It’s all a one signature thing. And I get it. You know, we give people admin privileges because they are authorized to make that decision, but we all need checks and balances. We all slip up. Yeah, absolutely. And so I’m trying to figure out is that a feature that’s available like a two point escalation? Or, I don’t know about.
Mira Guha (22:47) A two point escalation? We do have a couple different roles and every once in a while, our team is like taking that type of feedback and implementing it and creating new types of permissions and privileges. So, I think that’s something I can look into internally almost just kind of like what?
Jessica Bollasina (23:01) About like just like teams, where like we do have.
Mira Guha (23:03) A teams management feature?
Jessica Bollasina (23:05) Yeah, like where it’s like this admin can only monitor these teams. Yes, we do.
Mira Guha (23:09) Have that. I can go ahead and send some information on that. And then maybe that’s something Reda can help you set up if that’s something of interest, but then, yeah, it gives only visibility to certain providers under that team. Yeah, we can customize it in certain ways. I’ll send some information on that. Yeah.
Jessica Bollasina (23:22) And then also, what I’m seeing is an admin can self renew? Yeah… as.
Mira Guha (23:30) In like an admin can create a renewal request or a, yeah, exactly. Yeah, and an admin provider, same thing can request their own licenses. We also have an auditor role. They can see information, but they can’t change things or go in and make requests. So I can send some information on the different roles we have. And then, and the team setting, if you’d like us to change anyone’s roles that’s something you can ask our support team to do. They’ll just go ahead and toggle that change, but it sounds like that will be helpful for you. And then if you have other feedback of something you’re looking for, we can kind of have a quick brainstorming session and I can see if our team maybe has some sort of enhancement underway or is open to that in the future?
Jessica Bollasina (24:10) Okay. Yeah. And just like I said, I’m literally, just like seeing it. I’m like that’s not how our policy is written. Yeah.
Mira Guha (24:16) Anything we can do to help with that, I think makes a lot of sense. Obviously we want it to be as streamlined as possible for you and avoid, you know, duplicate work confusion or anything like that. So, I’m happy to make that kind of a go forward project. Once in the next few weeks, I think it would be helpful as well to just do like another. I know we had one a while ago like a business review. Yeah. So I’d love to get one on the calendar for like every month. I’m happy to schedule one for April.
Mira Guha (24:40) We keep it on the calendar. Yeah. Let’s do one for April. Perfect. I can go ahead and schedule that with you now.
Jessica Bollasina (24:45) And then can you send me Retta’s contact information so I can send her some information for next week?
Mira Guha (24:49) Absolutely. Retta’s also happy to set up a recurring meeting with you and that one will be specifically operations. Yeah.
Jessica Bollasina (24:56) Yeah. And then I’m not asking you the operations question, okay?
Mira Guha (24:58) Perfect. I will not be as helpful for that. Awesome. Is there days and times that tend to work well for you? I’m just looking at the next few weeks this?
Jessica Bollasina (25:06) Is a good time? Awesome.
Mira Guha (25:08) I think next Monday is a little crazy for me, but I.
Jessica Bollasina (25:12) could next Monday is not a good day for?
Mira Guha (25:13) Me? Okay. How about Monday the thirteenth?
Jessica Bollasina (25:18) Perfect. Awesome. I will.
Mira Guha (25:19) Send that over. I will send over the deck from today and any additional details, take that feedback on the contract to our team. I’ll check in with you ahead of our next scheduled call to see if there’s anything top of mind we want to use the time for. Otherwise, it’ll be kind of our usual overview consumption operations stuff, pain points, priorities, anything else? Jessica? No?
Jessica Bollasina (25:41) That’s all. I really appreciate this. Yeah, sorry, it’s taking me so long to jump into this that’s okay?
Mira Guha (25:47) I appreciate you coming and knowing what’s going on, I don’t usually get to see that.
Jessica Bollasina (25:51) Yeah, I’m like so full transparency. I’m over like all of the vendors that support healthcare operations. And so it’s like I cover everything from this to like transportation vendors to like drawing a blank. But there’s a,
Mira Guha (26:08) lot transportation has.
Jessica Bollasina (26:10) Been very front of mind lately and I’m like focus on medallion. Well, no.
Mira Guha (26:14) I appreciate it. You’re crushing it already. I know we just started working together but you’re on top of it so that I think is going to make this so much easier for all of us. But if there’s anything I can or reddit can do to help in the meanwhile, just let us know I.
Jessica Bollasina (26:26) Appreciate it fantastic.
Mira Guha (26:28) All right. Well, Jessica, have a wonderful rest of your day and I’ll be checking in shortly.
Jessica Bollasina (26:32) All right. Thank you so much. Have a good week. Thanks you too. Bye bye.