Transcript
Lewis Elder (00:00) hey, Jake… they’re in the waiting room. So I’m going to let them in.
Lewis Elder (00:21) Hey, chetna. Hey, Taylor. Let me know if you guys can hear me.
Chetna Chandrakala (00:27) Oh, hello, we can hear you.
Lewis Elder (00:29) Hey, how’s it going?
Tabentley (00:32) Doing well.
Lewis Elder (00:34) It’s warm out where I’m at today so I can’t complain although I think it’s supposed to start pouring rain soon, but as of right now, it’s not.
Chetna Chandrakala (00:45) Are.
Lewis Elder (00:45) we waiting on Tasha? Yeah.
Tabentley (00:48) Tasha is stuck in another meeting, so she said if she gets out early, she’ll join, but if not, we can go ahead without her.
Lewis Elder (00:54) Okay. Gotcha. All right. Perfect. The goal… for this meeting is essentially for Jake and I to work with y’all to kind of quantify some of the… like work that we would potentially do for oak orchard ultimately.
Lewis Elder (01:14) With the goal being that I can put together like a full proposal of like pricing and show you guys how all of that stuff breaks down for you to review. I sent over that document in the email so that’s kind of what we will run through. I have a couple questions before we get started on that, but I’ll pause. There. Is there anything that the two of you want to make sure we cover anything else or, you know, questions, top of mind stuff or feel free to shout it out if so… cool. Awesome. Well, we’ll get into some of the numbers two kind of more base level questions that I have for you guys. Do you that I’m more curious on is, and, you know, let me know if this is, would involve Tasha as well, but do you have an like a kind of a selection of criteria that you’re using to evaluate like a medallion or whatever software, you know, options that you guys are looking at? Nothing?
Tabentley (02:16) Like that, I guess super formal. It’s more like do you check all of our boxes? Do you do everything that we need on both the credentialer side and the player enrollment side, the exclusions, all of that kind of stuff. So there’s like there’s a bunch of different things we’re looking at, but no, we don’t have like a specific checklist we’re sitting here like I guess checking off if that’s what you’re asking?
Lewis Elder (02:37) Yeah. Some people have like a specific like decision criteria that they’re like working off of and it can be helpful because like maybe I don’t think you talk about something and it’s like a big, you know, item on your list. And of course, you know, it makes sense. A lot of groups also don’t have anything formalized. But if we do miss a point or something or there’s something that hasn’t been brought up at any point, feel free to shut it out. We’ll tell you if we do it or we don’t do it. And then what other? I’m curious too, what other options are you guys evaluating? Are you looking at other vendors? Are you considering kind of just keeping doing it manually? Just kind of what the, you know, state of the business is?
Tabentley (03:11) I mean, this is kind of a newer process for us. So we have looked at other vendors. We are looking at other vendors just to kind of weigh our options but nothing is, I guess formal as of now. Sure. That makes.
Lewis Elder (03:26) sense. Are you able to, you know, are you able to share what other vendors you guys were looking at?
Tabentley (03:31) Just, I don’t even remember the one we were looking at earlier. Symplr. I think it was, and then I think there was one more, but I can’t remember the name of it, no.
Lewis Elder (03:42) Problem that’s helpful. Even we have some like, yeah, symplr, you know, and medallion do similar stuff. And we actually have some former symplr folks that work at medallion now. So I’m familiar with them for sure. Awesome. Jake, am I missing any high level questions before we get into the nitty. Gritty.
Jake Shubert (03:58) Yeah, I would just say it makes perfect sense to evaluate symplr and other tools. It sounds like for the other tools you’re evaluating those are probably more of like provider data management tools where it’s you know, places to store all the information, but it’s your team who’s still going to be doing the manual work and having to scale out. But with that sort of tool as the centralized repository, is that kind of an accurate lay of the land?
Tabentley (04:21) Yeah, I would say.
Jake Shubert (04:21) Okay, perfect. And I’m also just curious like when you guys have purchased software before, what is the current process? Are there other folks who need to be involved in the process? Are there like legal and security reviews that we need to go through with you guys, you know, being an fqhc, I just want to make sure that we’re working ahead of time on any like internal requirements you guys have.
Tabentley (04:42) I have never been through the process of purchasing software. Chetna. I don’t know if you have. Yeah.
Chetna Chandrakala (04:48) So, I can just quickly say that we are governed by a procurement policy. So, we have to do an RFP and we have to get the first few votes for anything more than 15,000 dollars. So, we have to do that. Otherwise, we can actually have them sign off if it’s less than 15,000 dollars. Otherwise, we have to get two votes and make it a session. It doesn’t have to go to a poll or anything. I hope we’re not looking at a big number that we have to vote for. Okay?
Lewis Elder (05:25) That makes sense. And it is a bit hard to hear you, chetna. I don’t know if it’s just on my end. I basically heard that if it’s over 50 grand, you have to do an RFP and there’s some selection criteria if it’s under 50 grand.
Chetna Chandrakala (05:37) Sorry. Is there an Healthstream?
Jake Shubert (05:39) It sounds like mumbly?
Chetna Chandrakala (05:42) That’s so strange because someone else is so bad to me. Was it on the previous call too? What’d you say? Was it on the previous call?
Tabentley (05:53) What the, the amount? Oh, you’re talking? No, it wasn’t actually, no, it wasn’t this is the first I’m hearing of it.
Chetna Chandrakala (06:04) I’m going to hang up and use my phone to call.
Tabentley (06:08) Sure.
Lewis Elder (06:09) Yeah, take your time. We’ll wait for you. Are you in, Rochester as well, Taylor,
Tabentley (06:18) I’m in a town called brockport, but it’s close to Rochester. So, yeah, I have.
Lewis Elder (06:23) Googled brockport, I think because of you guys, I’m like western New York is like, I lived in New York for a little bit, just like a little over a year. And western New York is like a, like an, like a very, like, interesting place to me like, I know it’s like a lot of small towns kind of like big rolling hills and, yeah, so I’ve heard it’s very scenic it.
Tabentley (06:43) Is it is definitely nice, lots of farmland.
Jake Shubert (06:47) Yeah. Did you grow, did you grow up around there? I did, yes, yep. Oh, very cool. That’s awesome. I grew up on long island, which is like the least cool place in New York. Yeah, it’s the most boring place in New York to be from, the city is cool and interesting. Upstate in the west is like pretty and scenic and long island just exists. So.
Tabentley (07:07) Yes.
Jake Shubert (07:14) And actually, I have a random question for you. While sort of we’re waiting for chetna, to dial back in, I’m just sort of curious like with you guys doing so much of this work manually today, like if, you know, medallion was taking a lot of this work off of your plate. Like are there other things that you would love to be able to like focus on, or sort of spend more brainpower doing? Like, I’m just curious if there’s any stuff that you’re not able to get to today that you would love to be able to get to if, you know, the credentialing and enrollment work were taken off your plate a little bit.
Tabentley (07:40) So, I don’t do as much of the credentialing. So, we do have a specific person who does that. I’m kind of on these calls to take her place, like for the calls. At least, I do have a pretty good understanding of what she does, but I’m not the one doing it on like the day to day. Yeah, that makes sense.
Lewis Elder (08:01) I think chetna is back and I think now my internet is giving me trouble. So, let me know if you guys cannot hear.
Chetna Chandrakala (08:08) me. It didn’t work on my phone, but is this better or no?
Tabentley (08:11) Oh, that’s much better. Yeah.
Lewis Elder (08:12) Much better. Actually, I have to drop and rejoin because I’m getting all types of zoom messages. I’ll be right back. I’m sorry?
Jake Shubert (08:23) It’s like a game of like hot potato. I feel like I’ll be next. It’ll just keep going around the loop. Yeah, that’s.
Chetna Chandrakala (08:30) funny. Sorry, is he? Okay? I missed why he had to drop off? Oh.
Tabentley (08:34) He said his internet was just being slow for a second. So he was going to try and drop off.
Jake Shubert (08:39) Yeah. I think chetna, whatever’s going on with you is contagious. It hit Louis. So, yeah, we’ll see if Louis infects me now.
Chetna Chandrakala (08:46) Okay, good. No, it’s not. Sorry.
Lewis Elder (08:51) Yeah, I don’t know. I don’t know what’s happening with my zoom. Jake’s audio cut out for me while chetna was dropped off. So, I have no idea what you asked Taylor, and then I popped back on, but then everybody’s video went black. So I don’t I’m not sure, exactly, but all right. I think we’re good to go. And, yes, chetna, you did.
Chetna Chandrakala (09:06) Sound much better? I think we’re good to go right now.
Chetna Chandrakala (09:08) Hopefully. Okay. So, what I was saying is 15,001 five was the number that we could get icu approval more than that. We have to get three coats.
Lewis Elder (09:19) I see, okay, three coats from just different vendors. Okay? And.
Chetna Chandrakala (09:22) then the procurement policy basically says that we, you.
Jake Shubert (09:26) know.
Chetna Chandrakala (09:28) Being in fqhc and not having the freedom to spend money the way we would want to. They, the focus is on the lowest price of course, quality as well. But if the quality is about similar than the lowest price, which is normal, got.
Lewis Elder (09:46) It, yep. Yep. That makes sense. That’s that’s really helpful. I think that’s all my questions then on that piece, Jake, anything else?
Jake Shubert (09:57) No, I think that was it.
Lewis Elder (09:58) Awesome. And then, so, I’m, going to kind of run through some of these questions on this document and anything you guys don’t know, the answer to, we can just take as like a follow up and you can either, you know, try to bring it to our demo on Thursday or just email it over to me. But the more answers that I have like, the easier it will be because I have to like essentially like I’m literally plugging all this into like a big spreadsheet and it, you know, spits out like a price and the, you know, SKUs and all that stuff or whatever you guys are looking at, you know, looking at evaluating us for, and the number of providers, et cetera. So.
Jake Shubert (10:30) I’m, going to,
Lewis Elder (10:31) start at the top total number of providers, 170, I know Tasha gave me that number previously.
Tabentley (10:36) It’s about 160, 170 because, we have to credential, a lot of people, the pay or enrollment side, they don’t have as many. But as far as like the privileging side, we would have more.
Lewis Elder (10:51) Got it. Okay. And then you guys only operate in New York? Obviously, I’m assuming there’s no, sometimes I’ll talk to kind of regional health centers like you, and maybe there’s like expansion plans to like a neighboring state? I’m assuming that’s not in the cards for oak orchard or I.
Tabentley (11:06) Don’t believe so.
Lewis Elder (11:07) Okay. Yeah.
Lewis Elder (11:10) What, what primary source verification are you guys running? I believe it was hrsa standards. Yep. Okay. And then one follow up we had that. I don’t think we’ve gotten from y’all was a, a, like a example credentialing packet.
Tabentley (11:32) If you’re ever, oh, yes, I can get that to you.
Lewis Elder (11:36) Okay. That’d be great. Next question would be, do you have an, npdb established as an organization?
Tabentley (11:46) Like do we run? It, is that what you’re asking?
Lewis Elder (11:50) Yes, Jake, I also will lean on you there. Yeah.
Jake Shubert (11:55) Chetna. It sounds like the answer to that, was, yes. Yeah. I mean, if you guys are doing primary source verification work today, I imagine the answer would be yes. So,
Lewis Elder (12:03) Yeah. Okay. Do you know what, psvs, you’re running on an ongoing basis, so example could be like Sam, oig, ofac, etc, all of?
Tabentley (12:19) Those, yes, but I can get you like a complete list so you have everything. Yeah.
Jake Shubert (12:26) And it sounds like medicaid exclusions is a priority. Is that, is that accurate? Taylor?
Tabentley (12:30) Yes. Okay. Cool. Yeah, we.
Jake Shubert (12:33) Support that as well. I want to make sure you called it out as one of the main things.
Lewis Elder (12:40) Sorry, I’m typing, do… you know on what cadence you typically recredential your providers? It’s usually like every two or three.
Tabentley (12:49) Years. I believe it’s two years every two years, okay?
Lewis Elder (12:51) Cool. How many payers on average? Is each provider enrolled with?
Chetna Chandrakala (13:00) 1,515?
Lewis Elder (13:02) Okay. And then how many enrollments are submitted annually, so.
Chetna Chandrakala (13:10) Annually, I, depending on how many providers we hire in new providers, could it be what 20 Taylor or 15 or 20 new providers? I.
Tabentley (13:27) Thought, yeah, and then we have to do money for recredentialing?
Chetna Chandrakala (13:32) So, for re, credentialing for payers, I don’t know how much of that like that’s a renewal, but something new packet, the new packet would be, I would say 15 to 20 providers. So, times say 15 to 20 applications. So about okay, 200 to 25, yep.
Lewis Elder (13:58) So, if I’m making sure I heard that, right? So, 15 to 20 new enrollments? And then what was the number for recredentialing? Or revalidation? Revalidations?
Chetna Chandrakala (14:10) It all depends on how many, how, since I don’t have the number?
Jake Shubert (14:14) Yeah. Sorry, I didn’t mean to cut you off. I was gonna say like from what we typically see, so you mentioned let’s say about 15 new providers across 15 payers. So about 225 new applications per year. Since the average payer across the country including the state of New York does re, credentialing on a three year term to get a best estimate there, what we would typically see is just dividing that total by three to get that average. So.
Chetna Chandrakala (14:39) If it’s just.
Jake Shubert (14:40) ballpark sound, right? Probably about 75 revalidations needed per year for oak orchard. Yeah. Yes.
Chetna Chandrakala (14:46) So we, so the active credentialed providers at any time would be 75 to 80? Okay?
Jake Shubert (14:56) So, yeah, yeah, that makes sense. So that’s 75 to 80, and those 75 to 80, are enrolled with 15 payers, right? Okay. Yeah. So that’s that gets us to 1,125. We divide that by three. So maybe it’d be more on like 375 revalidations per year. Okay? That makes more sense. Great.
Chetna Chandrakala (15:15) Yes, because what I’m looking at and that’s why my number of providers would be different from Taylor’s because Taylor’s includes pas, nurses, and other, you know, not pay or credential providers. So I’m from my perspective finance perspective, anything that goes into billing is my provider. So that’s that number is about 75 to 80 and 15 to 20 new providers coming in either to replace mostly to replace, we don’t grow. We’ve already grown as what we had to. So maybe the growth will also happen, but I think there’s we’re talking about status quo and turnover. Yeah. So.
Jake Shubert (16:01) It’s replacing that attrition. That makes sense. Yeah, that’s super helpful. Thank you. Do you.
Lewis Elder (16:07) Guys process any facility enrollments? Yes. How many per year? Do you know?
Chetna Chandrakala (16:17) So we have 10 10 locations?
Lewis Elder (16:20) Yeah. So.
Chetna Chandrakala (16:22) I don’t again, I don’t know how frequently they happen but medicare, we just completed one round of medicare enrollment. So… I don’t… know about the pairs. I haven’t seen many come through though. So probably it could be a three year. I don’t know. Do you know, Jake, if that’s a three year cycle typically? Yeah.
Jake Shubert (16:46) Typically can be, I would say like considering your number of sites, the facility enrollment volume is going to be really low and probably isn’t much of a lift on the current team today.
Jake Shubert (16:55) So, I don’t think we need to focus too hard on scoping that piece of it out given the information you guys have provided. So, I’m not too worried about the facility enrollments. Okay?
Lewis Elder (17:04) Yeah. And then just two more questions. Do you know, I know we’ve talked about hospital applications. Do you know how many hospital applications you guys submit per provider?
Tabentley (17:18) I don’t I would.
Chetna Chandrakala (17:21) I would.
Tabentley (17:22) Say maybe one or two. I don’t think, I don’t think it’s a lot. Yeah.
Jake Shubert (17:31) Do all your facilities have like the same delineation of privilege form? I?
Tabentley (17:37) Believe so. Okay.
Jake Shubert (17:38) That’s great. That’s helpful. And is it all of the new providers you guys hire who need to be privileged at your facilities? Yeah.
Chetna Chandrakala (17:48) Yes. Okay. Cool.
Jake Shubert (17:51) Okay. So, is that 15 or so new providers? And it sounds like it could likely just be one application for those facilities? Yeah.
Chetna Chandrakala (17:59) I.
Tabentley (17:59) don’t think it’s anything more than two, if that, yeah.
Jake Shubert (18:03) That’d be good to know. And like we also review the packet you guys send over, but that’s helpful for scoping. Okay?
Lewis Elder (18:11) I think that’s it. Then those are all… the questions that I had to go through. Any questions from you guys that we can help with about the demo on Thursday? Go ahead, Jenna? Sorry, yes.
Chetna Chandrakala (18:27) I think is the, well, I mean, I think maybe we can wait to get your proposal and then ask those questions? Because I mean, of course, I would want to know.
Lewis Elder (18:42) Sure. Yeah, implementation.
Chetna Chandrakala (18:44) And then ongoing fee, and is it based on number of users? Is it based on, like I mean, like you said that the providers will get access to as well. So, so it could be like a lot of users to this system. And then from the security point of view, I don’t know, I mean, if you have any to type to kind of high trust for our it department, I would want to collect some information on that as.
Lewis Elder (19:17) Well, yeah, yeah. Absolutely. We have, I’ll send you over our, we have like a security trust page. So we’re high trust and sock too. And then if have any additional questions or like a form to fill out, I’m happy, to work on that. And then, yeah, I will put together the proposal. And yeah, the way the medallion price is, it’s like we have kind of like a base level kind of like a platform fee for like managing your provider data that’s kind of like the base level. And then on top of that, it’s essentially like how much, you know, what level of work are we doing for you guys, how many providers are we enrolling with? How many payers? And, you know, how much credentialing or so it depends on, you know, kind of the, you know, pieces of medallion, you’re looking to use that’s why we’re going through these. So that and that’ll all be like broken down into like a proposal that we can review with you all. Have you, have you gotten a proposal from like symplr or any of the other groups that you’re working with?
Chetna Chandrakala (20:08) I have you have, okay. Yeah, one of them, that was the other one that the one that, yes. Okay. Yes, I do. I forgot about that one. Yep. That.
Lewis Elder (20:16) Makes sense. Yeah. And one, one thing that may be different. I, my understanding of symplr and Jake will have to gut check me here is that they, I think they sell kind of like a standalone solution where it’s like you staff it. And you have, would still need to like hire folks to kind of manage it. Medallion is really purely like we do all of the kind of outsourcing the work to us. So we do all of the stuff. So that may be different in terms of the kind of the proposals as you evaluate. My only other question was do you guys have a specific budget allocated for this? I.
Chetna Chandrakala (20:51) mean, most of the budget is going to come, from the elimination of the fte. Yeah.
Lewis Elder (20:55) Yeah, that makes sense. Yeah.
Chetna Chandrakala (20:57) So that’s so definitely, I think that’s a good point. If you can let us know what kind of work effort that we would have at our end. Yep. So that would help us with the decision making. And when you send the information, can you also send a draft template contract? What it would look like? So we can get that reviewed ahead of time? Yeah?
Lewis Elder (21:20) We can definitely do that and we can sit down at a certain point and look and I don’t out, you know, if you’re interested, we can look at like what because Symplr is a big company and, what they’re offering you compared to like what medallion’s offering you? What, you know, is it a totally analogous comparison or is there stuff we’re doing that they wouldn’t be doing? Or stuff they’re doing that we wouldn’t be doing? So we’re happy to kind of review that too just because sometimes, it can be like different, slightly different offerings. Like maybe, you know, medallion is you’re we’re off, you know, you’re offloading all of it to us versus for Symplr, it could just be more of a data management platform. But then you’re still staffing and managing it yourself. So of course, that’s going to be like cheaper than like medallion, if we’re you know, handling all of it ourselves, etc, but we can always like, you know, compare them side by side, and look at what’s the same and what’s different. Have.
Chetna Chandrakala (22:06) You heard of provider passport? Yes, I have.
Lewis Elder (22:10) Yeah, I, I’ve only recently heard of them, but Jake may know, I don’t know Jake if you are more familiar with them, but I just heard them a couple weeks ago.
Jake Shubert (22:17) Yeah. They’re kind of a new player in the field. They don’t I’m sure the offering, is great and really strong. I don’t think they have a pretty big client base because they’re new so far, but they’ve been coming up in some conversations. Yeah, I guess just for my own knowledge, like what was sort of your experience with them so far and your feedback for them?
Chetna Chandrakala (22:38) Yeah. Okay. So, yeah, that they were the other that we.
Jake Shubert (22:43) Looked at. Yeah, what do you think of them as a solution? I mean as.
Chetna Chandrakala (22:47) A solution, it’s really, that’s the ultimate thing that I would want that there were definitely there was some lags… in their processes, and the pricing was a lot more than what we could replace an fte and they, I think needed a point to five fte from our, and to support the work that they couldn’t do fully.
Lewis Elder (23:16) Yeah. And when.
Jake Shubert (23:17) we’re thinking about the FTP fte replacement as budget, how much does that fte make per year today? Yeah, that’s.
Chetna Chandrakala (23:25) very low because credentialing, it’s almost like a very… I would say 45,000 something. Yeah, that’s what I was gonna say. Yeah.
Lewis Elder (23:35) Yeah. And the only thing I.
Jake Shubert (23:38) would call out is just chatting you asked about users in the platform. We don’t charge based on off of users. So you guys can have as many folks as admins or providers coming in the profile. So we don’t charge in that way.
Lewis Elder (23:47) Okay, cool. Okay. Any other questions? Those were good from either of you? Thank you for.
Chetna Chandrakala (23:58) Being flexible from yesterday, no problem.
Lewis Elder (24:04) At all.
Chetna Chandrakala (24:05) I wanted to be on the call but I was like if Tasha and Taylor could do it, but then they were like, no, I think so. I’m glad that’s the reason I wanted to be on the call to give you the information.
Lewis Elder (24:16) Yeah, no, super helpful. Yeah. And appreciate, you being willing to reschedule for today. And then on Thursday, we will go through a demo of kind of, the payer enrollment process. And then I think from that, I’ll have everything I need to kind of put together a proposal and then we can maybe grab time next week early next week to review and talk through, you know what that would look like. Okay?
Chetna Chandrakala (24:38) All right. Thank you.
Lewis Elder (24:39) All right. Thank you guys. So much. Take care.