Transcript
Kyle Bettencourt (00:00) hey, Brandy.
Brandy (00:05) Hi, how are you?
Kyle Bettencourt (00:07) Doing good. How are you doing today? Good. Another crazy week on your hands or is it settling down for you? Finally? Never? No, I don’t even know why I bothered asking to be honest. Yeah.
Brandy (00:26) I just had my one on one that I have weekly and got about five other tests to do. So, we’re resting.
Noah Laack-Veeder (00:33) Nice. Well.
Kyle Bettencourt (00:34) I think this should hopefully be a relatively quick call. I know you had a chance to kind of look over everything already.
Noah Laack-Veeder (00:40) Yeah.
Kyle Bettencourt (00:42) Seems like it should be good, but I’ll give Noah a quick second to hop in. Did you hear from Andrew or no?
Brandy (00:49) I did not hear from him. No. Okay. Just to let you know in… my job duties today, he said that Tari will be taking over medallion. So that seems pretty promising.
Kyle Bettencourt (01:05) Oh, okay. That sounds very promising.
Brandy (01:09) Yeah, I looked at that, and I’m like, Okay.
Kyle Bettencourt (01:12) Interesting.
Brandy (01:13) Okay. In my org chart. So, yeah, I was like, Interesting. Who?
Kyle Bettencourt (01:19) Is that that’s taking over?
Brandy (01:21) It’ll be the director of operations. It says moving Tari to VP of ops, who will oversee medallion omega. So.
Kyle Bettencourt (01:27) Okay. Hopefully, that’s the medallion that we’re thinking of here.
Brandy (01:31) He came out in March. So.
Kyle Bettencourt (01:35) All right. Excellent. Yeah. And I think just kind of looking through the updated numbers now that we finally have gotten to the bottom of the enrollments. Like, it seems, I don’t know from our biased perspective, it’s you know, more of a no brainer for them, you know, the cost is probably less than adding on an employee. So it’s like either do this or get somebody new to it. So, yeah.
Brandy (01:58) I got to figure out how to add a facility to CMS. So, I’m trying to figure that out now because I have, okay. So I’m trying to figure that out. So, I’m watching all my educational videos, you know?
Kyle Bettencourt (02:13) Yeah.
Brandy (02:15) It’s not so easy. It’s not user friendly.
Noah Laack-Veeder (02:18) Yep, to CMS. Yeah.
Brandy (02:21) There’s Andrew?
Noah Laack-Veeder (02:22) Hey, Andrew?
Andrew Sowerbrower (02:24) Hey, how’s it going?
Kyle Bettencourt (02:26) Good, good. How are you doing?
Noah Laack-Veeder (02:27) Doing all?
Andrew Sowerbrower (02:28) Right.
Noah Laack-Veeder (02:30) Awesome.
Kyle Bettencourt (02:31) How was week? What week is it now for onboarding for you?
Noah Laack-Veeder (02:36) Four.
Noah Laack-Veeder (02:44) Brandy, Andrew, what’s going on? Hello? Does it feel like it’s only Tuesday? I feel like I’ve had a whole lifetime already this week. I’m not sure.
Brandy (02:57) I kind of wish it was Friday right now. So, yeah.
Noah Laack-Veeder (02:59) Wasn’t it the wish like every day? No.
Brandy (03:03) Not really. I mean, you know?
Noah Laack-Veeder (03:06) Yeah, I guess I have kids. I mean, I have a kid now. So, like weekends, are they’re not really like a relaxation time, but, you know?
Brandy (03:12) I got three, you can adopt.
Noah Laack-Veeder (03:14) Let me get through the first year and then we can, oh,
Brandy (03:19) I got a six year old, a 19 year old and a nine year old. You can have a great time with me.
Kyle Bettencourt (03:23) There you go.
Noah Laack-Veeder (03:25) Andrew, do you have any, do you have any kids? I’m not sure if you’re on mute. Yeah.
Andrew Sowerbrower (03:32) It muted me, of course, I actually have a six month old.
Noah Laack-Veeder (03:36) Oh, wow. We are in.
Kyle Bettencourt (03:37) The same boat we’re in the know.
Brandy (03:39) We’re in the probation area. Yeah.
Noah Laack-Veeder (03:42) Andrew, is it a boy or a girl? It’s.
Andrew Sowerbrower (03:44) a boy? Okay?
Noah Laack-Veeder (03:45) So, you’re a boy, dad, I’m a girl dad. So, hey, if you ever need to vent about, you know, the six month age, let me know. I can be your Guy. I’m looking at you right now.
Kyle Bettencourt (03:55) He’s a month ahead of you.
Andrew Sowerbrower (03:56) Oh, you’re month seven right now?
Noah Laack-Veeder (03:58) Yeah, technically, she was, so, she was a month early, so she’s really six months old, but seven months officially I.
Andrew Sowerbrower (04:06) guess, oh, man, we’re in the same exact boat. We were a month early too. So we’re you know, it’s like, oh, this is the milestone. And then the wife’s like, oh no, but really, you know?
Noah Laack-Veeder (04:16) Exactly. Everybody’s like, oh, my seventh month old is crawling. I’m like, oh no, but I’m like wait a second. She’s still got a month. She’s fine. We’ll get there, you know?
Kyle Bettencourt (04:24) She’s.
Noah Laack-Veeder (04:25) fine. She’s got it. She’s fine.
Kyle Bettencourt (04:26) Yeah.
Brandy (04:27) Let’s.
Noah Laack-Veeder (04:27) just start.
Brandy (04:28) crawling and walking. It’s over guys. You’re going to be.
Noah Laack-Veeder (04:30) Running exactly. I’m in no rush. I’m in no rush because grandpa came over and helped us baby proof. So, you know, now, I’m just like see.
Andrew Sowerbrower (04:39) We haven’t baby proofed yet. We got to get through that stage. We’re still, so he’s not, he’s still just doing his tummy time thing, but as soon as he starts moving, I’m in trouble.
Noah Laack-Veeder (04:50) Well, that’s from.
Brandy (04:51) School and tell you everything and you’re like, did anybody talk to you today? Like I love you, but… then they tell you things you do not want to know what was said on the recess. It’s like my.
Noah Laack-Veeder (05:04) Oh boy. Well, I coach high schoolers, so I’ve been hearing, oh, yeah, you know, that. Yeah, I had to institute a rule yesterday. I was like guys, I don’t think I can control your swearing. So, what we’re going to do is if I hear it, you’re going to have to do 10 push ups after practice and I’ll keep track. And so yesterday, I had a circle of boys do like 40 push ups. So we’ll see if, and the girls were great. The girls didn’t swear at all. Yeah. So, yeah. So anyways, yeah.
Kyle Bettencourt (05:30) Noah’s even copying the high school insults to me and garrison this morning.
Noah Laack-Veeder (05:35) Yeah, pretty simple universal like repeat whatever someone said in a different voice and it’s like, ah, that’s how you sound. It’s still funny you.
Kyle Bettencourt (05:45) know.
Brandy (05:45) I.
Kyle Bettencourt (05:46) know… well, cool. So we can jump into it and kind of chat through the price and stuff here as I’m sure you both have a jam packed afternoon, but, yeah, Brandy, we were obviously chatting before everybody hopped on and you had a chance to look over the updated numbers. So we appreciate you getting that information back to us. I figured I’ll just kind of run through like the updated version of the deck that we talked from the call from last week. And then we’ll just kind of pause and, you know, allow you guys to ask any questions or clarify anything that we have here. But does that sound good or anything else that you want to get to Brandy or Andrew? Any questions that maybe came up that you wanted to cover on the call today since last week?
Andrew Sowerbrower (06:33) I don’t have any guys, no, I think we’re.
Noah Laack-Veeder (06:34) good. Okay.
Kyle Bettencourt (06:36) Cool. So just to kind of really quickly recap, right?
Kyle Bettencourt (06:39) Allcare is growing. This is putting a lot of pressure on the credentialing operation. And, you know, ultimately it seems like the problem boils down to either adding an fte to solve the near term growth constraints and likely additional ftes, you know, after the initial year here to keep up with the projected growth or partnering with a tool like medallion to help future proof your provider network which we believe can, you know, support you guys up to 500 plus providers pretty easily based on the current processes. So… the other areas of value, right? We can help you accelerate revenue, which we’ll kind of talk through some of the numbers that we pulled together there. And then we can also help you guys eliminate claims denials by… you know, having more accurate files as well by leveraging the medallion AI to ensure that you have up to date information. And so as far as the updated numbers after… the feedback from piedmont, this is kind of what we have here, right? So we revised some of the initial counts kind of based on your feedback, Andrew to account for a higher provider count over years one through year three. But essentially, what we’re understanding is that it’s essentially two plans per provider that needs to be enrolled. And so that’s sort of the overall volume that we have scaled out for all care for years one through three. So I’ll quickly pause here. This, I know Brandon you already mentioned this. This looks good in your eyes. But any questions on the numbers that we’re coming up with?
Andrew Sowerbrower (08:17) No, I think we’re good there. I’m just looking at the providers Brandy we kind of talked 55 is high year one, but we re, enroll all of our current NPS so that’s right? Even for the medicare. So that’s where that number is really coming from. Yeah, it’s fine. Yeah.
Kyle Bettencourt (08:40) And then as far as the provider growth for years two and three, I mean does that seem reasonable in your eyes Andrew?
Andrew Sowerbrower (08:49) 30 30 might be ambitious, I mean, 30 total. But at the same time, I, it’s not out of the realm. Like I think that would be the goal target would be around 30. So I’d probably keep it.
Kyle Bettencourt (09:08) Okay, cool. And yeah, I think like the other thing to note here which we can talk about later as far as just like how the contracts work. But we do have flexibility like in between years one and three. So if you have, you know, a higher provider onboarding one year, you can pull from, you know, a further year in the agreement. So there’s this kind of flexibility over like the three year picture that we look at there. So yeah, usually best to, you know, account for all possible growth there. Cool. So yeah, I mean if those counts look good in your guys’ eyes, you know, we can kind of just quickly recap sort of what the current state is. So I know we kind of touched on this high level on the last call but, you know, I think like there’s a lot of areas that we can help you guys accelerate the process right? When you kind of break down all the different steps involved here. We’re seeing it’s anywhere from 10, upwards of 44 hours per enrollment of staff hours that’s required. And then when you take into account the amount of time that it takes for payor follow up, you know, it can take upwards of 120 days, you know, 60 to 90 of those days are spent on just waiting for manual follow ups for the payors to get back with the provider information. And so using medallion, we can automate pretty much every step along the way in that process, reduce the actual time that it takes for Brandy or the credentialing staff to manage these enrollments down to, you know, less than an hour per enrollment. And then in the meantime because we’re able to automate the payor follow up, we’re averaging that we can, or predicting that we can reduce the actual turnaround time by 57 days… compared to the previous 120 that we had scoped for the end to end process. So I guess quickly pause in here, Brandy, does this all sound accurate or fair in your eyes as far as where… we’re helping and what we’re able to automate.
Andrew Sowerbrower (11:24) I’m saying, yes, sorry, I’m just talking to myself on mute. So, yeah.
Kyle Bettencourt (11:30) No problem. Well, cool. And then just kind of pivoting to, you know, the other areas of value that we can provide all care. Obviously, I think like the main thing is alleviating the fte additions and future proofing the need to hire full time employees for this. But we also think there’s like some really significant revenue acceleration opportunity by being able to reduce that turnaround time per enrollment. And so this is kind of the breakdown that we had here, you know, two point 2,000,000 dollars worth of potential revenue acceleration in year one alone. The numbers are based on adding eight providers this year. You can kind of see the breakdown of sort of the revenue per day by each provider that we’re estimating that you guys would look to add this year. But ultimately it comes out to 35,000 dollars a day of, you know, potential loss revenue. And, you know, when you equate that to a 63 day reduction in time savings. You know, that comes out to, you know, two point 2,000,000 dollars in revenue acceleration that we can help provide. So pretty significant number there. You know, Andy, we’d love to hear your thoughts on this. If that resonates if, you know, you see this as an accurate number that you’d feel comfortable… speaking to.
Andrew Sowerbrower (12:50) Yeah. I think, I mean truly in the grand scheme of things, I don’t know that this is the revenue number truly makes sense, right? All my MPS are built under a supervising provider whether they’re enrolled or not. So that 4,200 that you have for a majority of them is a wash, right? Like I’m not losing any time for them. The MDS are a big deal. And Brandy as you know, with our last two enrollments kind of went sideways. And so I’m going to lose, you know, just on those two providers, I just sunk costs of the delay. And so all those times all those plans are gonna be timely and out of network is roughly like 200,000 and not delayed but lost revenue which I think is probably a bigger picture than delayed revenue. Yeah. Yeah.
Kyle Bettencourt (13:51) That’s that’s definitely significant and good to know. And yeah, I’m happy to kind of adjust the, some of the numbers here. So it sounds like these mid levels not necessarily going to have an impact but potentially more impact, on the MDS and dos with some of these delays here that you’re experiencing. Yeah.
Andrew Sowerbrower (14:10) I think that’s the risk, right? Is, I think when you’re going to speak to these numbers, the, you know, I would remove the MP and ap numbers out of it. But your exposure on the MDS, right? Because they’re my supervisors. So every, I don’t have them enrolled is a loss for that clinic essentially. So yeah, your average daily could be higher and I wouldn’t even call it revenue postponement. I would call this true revenue loss. You know, anything… because we can’t always backdate especially with piedmont, I can’t backdate, their effective date. So any delays on that first getting the paperwork is just sunk cost.
Andrew Sowerbrower (14:57) If that makes sense. Yeah.
Kyle Bettencourt (14:58) No, absolutely. And then, so you mentioned that happened with two providers recently. Is that, I mean Brandon, I guess in your experience, is that kind of like a corner case, or is that something that consistently happens, with hiring the new MDS and dos? No?
Brandy (15:14) What happened is we lost the person that was doing revenue cycle, that was doing credentialing. That’s why it ended up in my seat. So, we had a doctor that came on in August and she never credentialed them at all with anywhere. So she started seeing patients come. When she leaves, we find out she’s not credentialed. So then we start the process with piedmont finally get them on the board. And then her, when she goes to credential, her license was not renewed or nor did she have her cmes done. So that became that issue. And then by the time what we were doing is when dr williams would come on, which was in, I think the middle of November by the time we got her credentialed with piedmont, it was almost February because.
Kyle Bettencourt (15:59) they only.
Brandy (16:01) meet once a month for a board meeting to credential providers.
Kyle Bettencourt (16:07) So, yeah. Okay. Yes, let’s definitely get to know. So, yeah, I’ll kind of revise these numbers here to reflect that instead… of the revenue law or sorry revenue acceleration and also revenue loss for, you know, potential delays that we’re experiencing for MDS and dos here. Well, cool. I appreciate that info. And so then just to kind of pivot here to sort of the overall investment, right? So, I think that year one Roi we’ll want to take another look at, but, you know, regardless, I think with the updated counts, right? It’s pretty on par, honestly probably less expensive than adding an fte to handle the credentialing function for all care. So year 161,450, year two would be 49,150, year three, 58,450, you know, average cost is 53,000 over that three year period.
Brandy (17:08) And so,
Kyle Bettencourt (17:08) what’s included that includes your core seats for medallion comprehensive monitoring across, you know, licensing and stations along with peer enrollments, and, you know, really kind of the rest of the scope of work that we work through here with Brandy and the team. So I guess just initial thoughts on pricing.
Andrew Sowerbrower (17:28) So after year three, what do we go through this whole process again or is there like a more maintenance fee based or how does after year three work?
Kyle Bettencourt (17:44) Yeah, that’s a good question. So, I think typically how we would handle it is we would work to start understanding your like volume projections beyond year three and then just work on a renewal contract with allcare. I don’t know garrison or Noah if you might.
Garrison Goodman (17:59) Yeah, I can tell you, I mean, like Andrew, if you guys decide, hey, we’re going to grow like crazy or we’re going to acquire a company or, you know, hey, it’s actually just year end. We have an account manager. We have an engagement management team. We have a support team. They’ll be with you through the entirety of the solution. So if you need to make any additions or revisions, and then again, if it’s coming time for renewal, we would engage those conversations then, is that what you were asking Andrew?
Andrew Sowerbrower (18:24) Yeah. That makes sense. I was just thinking from the back end, you know, because the auditing functions and everything else. So, like even if we weren’t growing rapidly, it’s the maintaining of those features and whatever else is on that. Okay?
Kyle Bettencourt (18:44) Cool. That makes sense. And then, yeah, just as far as kind of like the further breakdown if you guys want some more, you know, granular information on sort of where that pricing comes from. We have it detailed out here. So, you know, happy to go through anything in depth. And then just as far as our standards cues that we have included on the pricing also… have that included.
Brandy (19:05) I didn’t mean to.
Kyle Bettencourt (19:05) Include a slide which I’ll be sure to have for Thursday, but I did want to mention that this does include implementation along with your ongoing support team. So this will include help getting this stood up for all care. But you’ll also have a full account management team like garrison mentioned along with, you know, support and product work with you guys to, you know, ensure that the engagement is going well. Everything is working as it should, you know, as things come up, you’ll have a dedicated resource team to, you know, to help you as you go along and grow.
Brandy (19:43) Sounds good, Kyle. So, yeah, I.
Garrison Goodman (19:47) think we’d love to understand like, hey, I know Maren and Susan need to get on board. Do you have everything that you need here? You know, any gotchas. Any concerns that you’d think that you’d have presenting to them? Do they want to hear from us? How do you envision kind of next steps going? And how can we best support?
Brandy (20:07) So.
Kyle Bettencourt (20:07) You may not have been in the loop. So we actually have a call scheduled with Susan and Maren for Thursday afternoon. Okay. Oh, I apologize. Sounds like we’ve already.
Garrison Goodman (20:14) Covered that, yeah.
Kyle Bettencourt (20:15) It’s been a bunch of back and forth. So, yeah, I guess just to, I don’t know, ask off that question.
Kyle Bettencourt (20:22) So, I mean, based on the call, Thursday, I don’t know. Is there anything that we maybe didn’t cover on this or anything that we should be sure to include or address in your guys’ eyes? No, my.
Andrew Sowerbrower (20:33) Big thing is, I think it’s going to be more Brandy on your end on just trying to get them to understand too. Like now that again now, I think that last Thursday was 180,000. So, right? Sizing that down to 60,000 is going to be a lot, I think in their mind, probably more in line with what they were thinking. And then two, it’s also the, what?
Kyle Bettencourt (20:57) Went.
Andrew Sowerbrower (20:59) Wrong last year and how this would avoid that, right? Right, right. I think is the big sell because essentially this pays for this, three years pays for those two providers, right?
Brandy (21:12) Absolutely. So.
Andrew Sowerbrower (21:13) Yeah. And then I saw some leftover. Yeah.
Brandy (21:18) So, I don’t think it’s going to be a hard sell if we put in the aspect of the fte, what went wrong and how much time it really does take to do it and the turnaround time with it, so.
Andrew Sowerbrower (21:29) And the audit piece of it like the, you know, the follow ups and everything else. It’s not just the one and done thing, right? You know, Susan being newer to this enrollment. Like I just want her to understand like credentialing is not a, I do it once and I’m done.
Brandy (21:44) Right. Exactly. The revalidations, and then also the caqhs and the deas. Like today, I got a bunch of Dea renewal licenses. So.
Andrew Sowerbrower (21:54) Yeah. So that’s just one of those that I would just make sure I like, I know you speak to it in the present, but I would also just like highlight those like, it’s not just enrollment of the new providers. It’s also like here’s, the risk adverse things that we do, right?
Noah Laack-Veeder (22:12) Do you think it’s also worth Brandy? Like articulating what happens if those things do fall through the cracks? Because we were talking about like, you know, claims and aisles and things like that are happening? Like, do you think they, do you think they’d be receptive to that? Yeah.
Brandy (22:27) Absolutely. They’re and Andrew correct me if I’m wrong, they’re going to understand the money aspect of it.
Andrew Sowerbrower (22:34) To be honest with you, yeah, it’s the.
Brandy (22:36) Money aspect of it. Yeah. And,
Andrew Sowerbrower (22:38) I think at this point, we’re just, you know, it’s really just Susan that you’re trying to sell and stuff. Yeah, I think it’s more of like, the worry free of 60 grand in year one is well worth it than, you know, everything else. I think that’s the big thing yep.
Noah Laack-Veeder (22:57) Yeah, that makes sense. It’ll be unified front for sure. Just, I think, you know, we just want to make sure we’re helping as much as we can, and it’ll be a team effort. Yeah.
Brandy (23:07) Absolutely.
Kyle Bettencourt (23:09) Yeah, we can be sure to provide some more detail around, those workflow and process slides.
Andrew Sowerbrower (23:16) Well, cool.
Kyle Bettencourt (23:19) Well, guys, I really appreciate the time and kind of giving us, some guidance here on how to best handle Thursday. Anything else that we could that we could help with while we’re still on?
Brandy (23:30) I don’t think so. I don’t have anything.
Andrew Sowerbrower (23:33) I think we’re good.
Kyle Bettencourt (23:36) Cool. Well, that sounds great. So we’ll yeah, we’ll plan to connect on Thursday afternoon and yeah, if anything comes up in the meantime, just let us know and again, appreciate your help.
Andrew Sowerbrower (23:47) Thanks. Thank you all. Thank you guys.