Transcript
Jordan Tantleff (00:00) hey, Molly. How’s it going?
Chandra Mouli (00:02) Good, sir. How are you?
Jordan Tantleff (00:04) Doing very well. How was the trip out in napa?
Chandra Mouli (00:09) It was good. Very good. I had a chance to meet a lot of folks out there.
Jordan Tantleff (00:18) It’s good to hear. I was supposed to be out there as well. We had a few… last second, some of the health plans I was supposed to go dropped out last minute, and I think we just tried to cut down some heads on our end. So sadly, I couldn’t go out there but heard it was beautiful. I’m sure you guys enjoyed. I don’t know if you’re a big wine drinker, Molly, are you a big wine drinker?
Chandra Mouli (00:48) I drink all.
Jordan Tantleff (00:52) I’m sure it was good. I’m sure it was good. How’s it going? Val? Hello, how you doing? Doing well. Appreciate you guys taking the time to meet late on Friday, especially going into the holiday weekend here. Just had a few things wanted to talk through and then we can kind of take it from there. So our team did review the pass through fees invoice from February specifically, that sample set that you had sent over, val. And from our review, you know, many of these charges were expected based on the work performed, but they stem from areas where requirements weren’t you know, clearly defined upfront, you know, for example, like boards that, you know, we would recognize as a part of the verification process versus not recognized by caresource, you know, hospital affiliations… the educational commission for foreign medical graduates, sorry, Mohit, go ahead. You can chime in at any point here.
Chandra Mouli (01:58) Yeah. Before we go there, I hear fletcher is no more with the company.
Jordan Tantleff (02:05) That’s correct. Fletcher did accept another opportunity elsewhere.
Chandra Mouli (02:09) And who’s going to be the new fletcher? Is it John?
Jordan Tantleff (02:15) So I’ll be the main point. I roll up to a different VP. Now, I can introduce you to him as well if necessary, his name’s Dave, but happy to broker that intro if that’s helpful too.
Chandra Mouli (02:28) Okay. Yeah. It is definitely needed. I need to, I had a good chance to speak with your coo. I spent a lot of time with him as well. I did not know until fletcher himself texted me that he is no more. And I’m going to be talking to him some time from now.
Chandra Mouli (02:52) So we’ve been exchanging some texts. No one told me from the medallion that fletcher is gone. I wanted to say that it should, somebody should have been very transparent and come back and say, hey, fletcher is not because I asked, somebody told me that no, he couldn’t come at the last minute or something like that. I am very unhappy that somebody did not tell me what is going on because he is my first contact and especially we have some disputes that are, I will not say dispute the while we are trying to iron out on this pass through charges. Okay? So, so that is one.
Chandra Mouli (03:41) And then second point I wanted to bring up is you’re the only common thread. I have requested Valerie. But again, through this call, I will also request we had this pass through emails going back and forth and the pass through cost would not exceed more than I think seven, 16 or 17,000 dollars, something like that. That we had some of the emails. I need to take it out, those emails and that’s what was baked in for our, the final cost. When we did the financial analysis, when I asked for fletcher to be added that as part of the statement of work because that was one of the sticking wicket, then fletcher’s comments were that, these… pass through fees since we have ironed out should not go beyond these numbers. I have a leverage of up to about 25 to 27 grand. Not more than that in mind. And this is a defining factor, or a big deal for us on the pass through fee because we go with certain numbers and assumptions and then budgetary provisions that we have. And I will amend the contract to very clearly state that the pass through cannot go beyond certain of this number. Okay? We will, we will look at the past history what you have. And suddenly this is going up as 80 K or 90 K. Something like that. If that is, if for some reason we are not able to come to an agreement, we may have to talk through the different items because no way I can accommodate the three times the pass through cost that is being provided to us because our current vendor, who we are working versus who we are working. We have been working with them for so many years. We have not crossed beyond 30 grand in our, in our budgetary allocation. So whatever the cost gain that you, I will be getting by coming over to medallion that gets sweeped away on this on the name of pass through cost. I don’t know how verisys was able to manage, keep the pass through cost under that. And, I want medallion to go back and then really think through how this can be worked out, okay?
Jordan Tantleff (06:29) Absolutely. Yeah. And, and on the first front, I should have led the call with, the news around fletcher that actually happened. He officially his last day was actually Wednesday this week. So I should have led the top of the call with that and kind of we should have probably been a little bit more transparent about that transitional phase. So I’ll take ownership on that end in regards to the pastor fees if you, if you’re able to find, you said there’s an email thread that there might have been regarding, yes.
Chandra Mouli (06:58) That is one that very able to find that out that email thread which the pass through that we all discussed in one of the emails. So we’re clear. I’m sure John, you will also be rude. I’ve also been there. So just trying to pull that out. And then at your end also which will very clearly say that. So in its entirety, John, I’m.
Valerie Lewis (07:27) I’m still looking Jordan, but I can let you know a lot of it stemmed from us sharing that cost right now. We’re not sharing any PSV costs with any of the other mcos, right? That you’re with. So this is what I asked you before. Where are we on the sharing of the cost with the psvs? I could just tell you various is the reason that we were able to keep it low, is they paid for any PSV of 25 dollars or less, right? Right? So that’s all the npdbs that’s all of the caqhs, right? So, and that can be a lot when you add it up especially with the amount of providers that we have.
Valerie Lewis (08:06) So I’m just kind of throwing some ideas out that, you know, you could take back or something like that. But let me find the email. The reason why we came up with the amount that we had is because I think we were looking at it based on the shared cost of the PSV right? Right now? One verification conversation?
Chandra Mouli (08:24) Too. Yeah.
Valerie Lewis (08:25) Yeah, that was kind of part of the amount we came up with and that’s why we have way less than what we’re paying right now for PSV. But I can definitely find the emails and send the email and send it over to you. Yeah.
Jordan Tantleff (08:40) And I remember we went through that exercise as well during the evaluation process where we took the number of creds did like a projected pass through fee estimate based on no overlaps. And then if it was like a 50 percent overlap, what it would look like. So let me get an update on, the pass through fee portion. The one thing I’ll note on that is we did contract to if you remember the 88 percent overlap, which was… more of like the benefit of the doubt of like ongoing conversations within the alliance even though the true overlap might have been a little bit less, but I can get an update on where we are with sharing pass through fees. The one thing I did want to call out in regards to why the pass through fees are, you know, a little bit more higher than what we’re worth we’re expecting here, is that right now. And I think we’re working towards this dial with the specialty piece as well. Because as we kind of map where the specialties are that’ll inform kind of the boards that we’re looking at. Because right now in the sop, it’s saying pretty much if you find, if we find an additional board when verifying one of these provider types, we’ll add it to the platform and verify even though it might not be a board that you guys all recognize. So that’s where some of these additional costs are coming in. And you might see like two valid boards being verified for a provider. And that’s something that we’re trying to work towards. I’m curious if there’s a kind of one of the biggest unblocks would be if there’s a definitive list that we can get from you all in regards to the boards that you do not recognize, and then add those to our sops. Yeah.
Valerie Lewis (10:14) So, Ray has it, we’ve been sending it to her every time I’m looking at the invoice that comes over, right? We’re identifying it, we send it over. We’ve been talking through it in our meeting. So you should have the list of what we recognize. And then what’s not on the list is what we don’t.
Jordan Tantleff (10:32) I think Ray only has like one like a couple that have been just flagged in the invoice. Is that let.
Valerie Lewis (10:39) Me look, but I thought we sent her our list of all of the care source approved boards… licensing boards, board certification boards, right? I think we sent her that. So let me check with my TLS to make sure that we sent her the full list. But I do believe we did.
Jordan Tantleff (10:57) Several times. Okay? I can check with her on that as well. Let’s see. And then in parallel with all of this, I’m working with leadership to also add potential credits to the account.
Chandra Mouli (11:12) Who is your operations VP level person who can be engaged in one of the calls? Because I don’t know whether he’s hearing this or not or understanding what our challenges are. And Valerie’s team had to suck up a lot of manual work which after moving on and every time this is being relayed to Ray… with a little to no support and we continue to eat up some of those manual work on the re creds that we needed to do, which none of those that we were doing while we were working with verisys, I still want to go support medallion to take things forward and try and do it, but I am not getting a feedback from my team that the work is not going down. We are, we continue to backlog. We missed one of the state SLA, I told you, but the biggest lingering effect is this invoice which has to come down. I have simply no budget of 90 grand to approve. I just do not have, I don’t know how verisys was doing that they were doing.
Chandra Mouli (12:41) But if you think that this is what we need to do, then I need to think through my options. What I have in front of me because right now, from the pricing standpoint, when verisys was so high, they have come down to the same levels. Okay? But still I just wanted to do it and I don’t want to do it as kind of a chicken and egg jargon. So I want to work with you and maybe you need to bring your operational VP or something. Or maybe Nate sent me a note this morning. Also maybe I will drop a note to Nate and have that individual come back. Okay? Yeah.
Jordan Tantleff (13:30) I’ll try and I’ll go up to food chain operationally to see what needs to be done here. I know a lot of the manual work was being caused from the kind of state import issue, and I know you guys were in napa for the call this week. Sheena sent us over the list of state entities and the contiguous states this week. So we’re working to propose a solution for the state import issue that will hopefully free up a lot of the manual and rework that’s being done today in regards to the re, creds, but I know we got that this week. Okay?
Chandra Mouli (14:03) No problem. So, on this, how… is our March invoice looking like if it is going to be upwards of 30 K more, do not send the invoice. We will have to really talk through all these invoices and come to an agreement. What is the number that it is going to be? So, please advise your accounts receivable team just to calculate and please provide this feedback to your business team. Also that caresource is pushing back on these invoices. In the meantime, we will lay our hands on our, on the email chain and then identify and share it with you, Judd, so you can show it to them that this was discussed and this is what it is. And then they cannot go beyond X dollars.
Jordan Tantleff (15:00) Okay. Let me just make note here.
Chandra Mouli (15:03) Sure, sir. No problem. Your medallion note taker will send us these minutes, right?
Jordan Tantleff (15:11) I can also send the recording here as well. Okay? Sometimes?
Chandra Mouli (15:16) What happens is these recordings? Since we are not in your network, we cannot hear so unless otherwise, it is in black and white. I tried in one of the calls. It did not let me… for.
Jordan Tantleff (15:29) One of our recordings or I remember for the intake one, we could not access yours. So maybe there is a firewall. So if it needs to be the transcript or the note taker, I can send that over as well. Okay? While we are on the topic of re creds here, val, I know you are out and it sounds like this is pretty manual across the system but we still have not received the July re cred universe and… we just want to make sure we are able to plan and execute ahead of kind of the turnaround times and escalators that we have kind of laid out in regards to those. I’m curious like, can you help us understand? I guess why the process is manual today to pull those, the re cred universe and whether there’s a way to streamline it. We’re happy to partner with you guys on this and try and help kind of alleviate some of this issue.
Valerie Lewis (16:21) Yeah. So right now… we have some automation to pull it but it’s not going to pull all the licenses. It’s only going to pull the entity, right? And so we’ll still be right back in the position that we’re in. And so right now, I have to pull it manually because I have to pull a new field to pull the licenses and remove the non contiguous states. It’s a lot of manual that I can’t get the automation to do, right? So they can pull it. But then I would still have to pull a piece of it, add it to and send it over. And so, and it is dependent on us working out that process, right? Caresource and medallion that way, then I can get the RPA team to pull it automatically based on this criteria. But right now, they’re not going to be able to, right? So it’s ready. It’s just waiting for me to add the additional fields that we need. But then again, I kind of stopped doing that because we will be updating our system too, right? So the minute that I get the RPA team to pull the old data now, I got to go back and say, okay, we’ll pull something different now, right? So that’s just why it’s so manual. And the other piece is, can I just send y’all, July right now that’ll help me? And then I’ll work on sending all the other state months right this month as well. But right now, it’s a huge file because it’s all of our regrets for the rest of the year. Yeah.
Jordan Tantleff (17:47) Are you asking if you could send, if you could send July? Yeah, that’d be great, but.
Valerie Lewis (17:51) then I can send you July probably before Monday over the weekend that’d be perfect. It’s a huge file and between vlookup and concatenating and trying to get all of this, it’s making it even bigger and slows. It kind of gets stuck. And then I’m sitting here watching it twirl. So, yeah, let me pull July out. And then I’ll probably send that over soon but still continue to work on the other months and then send that over as well. That’d.
Jordan Tantleff (18:18) be perfect. Okay, perfect. So we can get going on that. I think either Sheena or Sherry had also mentioned recently some license monitoring needs. I believe?
Valerie Lewis (18:34) It was, they misunderstood my question, right? So my question is, does we need to go move medallion back to verifying all the provider licenses. And I was just wondering if you used fsmb as the initial pull to determine all of the state licenses the provider have, or do you just use caqh? Not the monitoring piece, just identifying all the licenses at initial and recred, right? Gotcha. That way, when you return that information to us, it goes into our system automatically, I don’t have to touch those and then they will get caught up in our monitoring internally. Gotcha.
Jordan Tantleff (19:16) So that was the question.
Valerie Lewis (19:18) I was asking.
Jordan Tantleff (19:19) Gotcha. I’m going to have to circle back internally. I think I missed, we missed on this there, but I know it’s a part of our ongoing monitoring feature. I’m curious if we can bring that into like the actual initial, you know, the cred packet or, you know, cred process we’re going through today as well. So I’ll circle back with merit and get an answer on that. Okay? Because I know it’s a combination of, you know, automation and manual review and we do kind of do those fsmb based queries. So I’m curious what it would look like from a cred standpoint. But I’ll get an answer on that as well.
Valerie Lewis (19:50) Okay. Thanks.
Jordan Tantleff (19:53) Okay. I believe… that was all the kind of areas on my end. I was hoping to cover here. I know I have some marching orders to do here and I’ll send over this recording as well. But is there anything else that you guys were hoping to flag today? I know it’s late on a Friday.
Chandra Mouli (20:12) I think it is good. We will continue to see first and foremost is this invoice issue needs to be solidified. And then we need to clear these journals. Okay? Feb, March and whatever the future invoice, the quarterly invoice will get approved. I’m not going to stop that. Okay? So that will get approved. I will approve them. But this one we need to solidify and then take it forward, okay?
Jordan Tantleff (20:48) I hear you. I’m not 100 percent sure when the March invoice goes out and whether or not that’s automated, but I’ll try and get ahead of that as well.
Chandra Mouli (20:59) Perfect. No problem.
Jordan Tantleff (21:04) All right, guys. If that is it, I’ll do some digging on my end here and get some answers for us. But I hope you guys have a great weekend and after celebrating Easter, happy Easter.
Valerie Lewis (21:15) Thank you. Take care. Bye.