Transcript
Erica Lloyd (00:00) hi, good afternoon. Good to meet you Robin.
Erica Lloyd (00:10) There we go.
Robin Redd (00:13) I like it’s so funny between the platforms. Like sometimes they start you out with everything turned on. Sometimes it’s all turned off, so.
Erica Lloyd (00:23) Teams, give me anxiety every time.
Robin Redd (00:25) You know, WebEx… to me though, gives me more anxiety because we work on, with teams. And so, while it has a lot of glitchy things, we’re used to them. So, we usually know how to get around them or fix them. We’re like, oh, let me just hop off and hop back on and it’ll come back, but WebEx, have you used that very much?
Erica Lloyd (00:49) Very, like, very rarely, do we use that one teams pretty much zoom and teams?
Robin Redd (00:55) Urac uses WebEx, and that’s one of our first. We’re always, you know, can we please go to teams and get out of WebEx?
Erica Lloyd (01:04) Well, next call we’ll, I’ll have, we can initiate and have you do, teams. So it’s easier.
Robin Redd (01:12) I mean, this is working fine. It’s it’s when we get bumped out a lot, but this is, I mean, the zoom call is fine. It’s it’s WebEx that we have issues with. But anyway,
Erica Lloyd (01:25) good to meet you. Thanks so much, for hopping on. I saw, so just before you do intros, I saw on your LinkedIn that you do dog grooming also.
Robin Redd (01:36) So, I, yeah, I have a, I have a small business on the side, and I’m keep trying to retire and kind of phase it out, but it’s I’ve got some older customers that I have for a long time and I just don’t have the heart to make those old dogs change. So, since I don’t work enough during the week. Now, I work every other weekend to do that. I.
Erica Lloyd (02:01) Just noticed because Mallory, her dog is, she has a very cute little dog that gets groomed, I’ll go get her. I’ll be right back that gets groomed more than, any human, I know. So, I thought that was a, that was interesting. You might appreciate that.
Robin Redd (02:15) Yeah, no, absolutely. It’s, yeah, it’s so funny. My, my own dogs don’t get groomed that much at all but, yeah, everybody else’s dogs are very clean around here. This is Maggie. Aww. So sweet.
Mallory Smith (02:33) She got groomed two weeks ago and I don’t blame you at all. Robin. I’ve been going to the same groomer for six years now.
Mallory Smith (02:40) She’s worked at three different places and I just follow along. I’m like, no, you’re stuck with me for life. I’m.
Robin Redd (02:45) sorry, and I’m mobile. So, you know, a lot of the customers that I have are either older customers or they can’t drive or the dogs are really old and like, you know, they know me and I don’t want to make them have to change. So like I get that, but I have another, you know, I’m like, but I have another job and so, you know, where I used to have over 100 customers now I’m down to like about 20 because I got the other ones all situated with new groomers. So I’ve still got about 20 of these older dogs and I mean, I don’t make any money. At this point. It’s just a wash, but I enjoy seeing them. So it’s okay.
Mallory Smith (03:29) Oh, sweet. You’re making a difference. I think that it’s like volunteering, you know?
Robin Redd (03:34) I mean, wait, well, it, yeah, it kind of actually is, it’s funny, but yeah, I am. I do love my, I love seeing my customers and I love the dogs. So like, you know, it’s there are a lot worse things you could do, as a side job, so.
Erica Lloyd (03:50) Yeah. And,
Robin Redd (03:52) I mean, with the economy, I’m kind of honestly afraid to let it go completely because I’m like, you know, it’s always supplemental income if I need it. So, I hope I don’t but, it’s always good to have that little back pocket thing going. So.
Erica Lloyd (04:06) Yeah. Keep, keep your skill set up. I love that.
Robin Redd (04:08) Yeah, no kidding. So like I’m sure, your recorded demo line is going to love that conversation, but.
Erica Lloyd (04:15) No one listens except us. Well, thanks so much for carving out some time. Robin. I think we could just do some introductions. Sure. I listened back to the call that you had with Nicole, so we can kind of pick up where we left off there. I had a couple clarifying questions… sure. And then, I think, you know, we can answer any questions that you have, and then align on next steps with which probably could be a platform demo, and potentially looping in some additional stakeholders on our side on both sides. So just introduction. My name is Erica Lloyd. I’m an enterprise account executive here at medallion. Been here a little over a year now, and I’m based in New Jersey.
Robin Redd (04:58) Yeah. And you?
Mallory Smith (05:01) Want to go next, Erica?
Erica Lloyd (05:02) Yeah. Go ahead.
Mallory Smith (05:05) Robin. It’s a pleasure already. I can tell to meet with you today.
Mallory Smith (05:08) So, I am based in Nashville, Tennessee. I have been in the provider space for roughly 10 years or so and I’ve been with medallion about two of those great well.
Robin Redd (05:18) I’m Robin Redd. I’ve I’m a, currently, I’m the manager of accreditation and regulatory affairs, but my background is in credentialing ooh, like old days, credentialing like back in the nineties and 2000. Oh, yeah. Yeah. Back when we were pushing paper in and out of the door to get letters. Huh. So, yeah, back when we were really excited if we had like an off the shelf software package to just support the credentialing process. You know, I remember getting tape loads and, you know, sometimes actual like floppy disk and things like that coming in the door from the different sources to like, yeah, get uploaded. So, so things have come a long way. The automation’s fantastic. I actually have been on the network side of things. I’ve been on the managed care side of things. I’ve had delegation coming in for credentialing. I worked for a cbo that we got. At the time, it was a 10 out of 10 certification. I think now there’s 11. So I’ve been on all sides of it. So I understand the process pretty well. I know that there are always, newer and greater things to offer. But, what I do know from my experience is that, until you hit kind of a critical mass, it doesn’t make a lot of sense to build it internally when you can have an outsourced partner that can do it well and quick and generally more cost effective than you hiring a staff for an uncertain volume.
Robin Redd (06:54) So that’s kind of where I am. We have, we’re… a growing organization. We have always ongoing relationships with different payers. But our most immediate need will likely be, and I say that because we don’t have the contract signed at this point, we’re looking at probably about 2,500 providers, at this point, probably in a single state that can change it, can spill over into surrounding states, you know, how that works. But I’d like to have identified a partner and a cvo that when those triggers hit, I know who I’m reaching out to. We already understand the pricing structure and we’re ready to sign an agreement and hit the ground running. So that’s kind of why I’m going through the due diligence right now. I can’t guarantee a set number. I can just give you the estimate that for purposes of comparing the, I guess the finalists and the cvo selection process, I’m going with 2,500 providers and a single state. So, I just want to make sure that I’m kind of comparing everybody in a level playing field, things that could be important as differentiators are more in the broader solutions versus just like the primary source verification process, I guess is a given. I mean, I kind of, and I know that you’re ncqa certified. So, I already know at a base what you can do in that arena. If you have any, like functionality that would provide either hybrid access or some kind of a solution surrounding like provider enrollment, provider roster generation or any kind of contract management, that would be interesting to me as well. But I definitely need to understand the, I guess the entirety of the per provider per year cost. And I know that everybody, it’s funny. I’ve realized that I think it’s intentional. I think cvos make their pricing complex by design so that’s a little bit harder to compare one to the other. But at the end of the day, as long as I know which of those services it checks off. And I know what the price at the end of the day is divided by 2,500, then I’m going to have a provider per year price. That said, I will make that distinction. So, if one organization can give me everything on my wish list and the price is higher at the bottom, that’s understandable versus someone who only checks off five of the boxes and the price is lower. So I… will definitely make that, you know, make that call out in the leadership summary. So, okay. Questions for me? Yeah.
Erica Lloyd (09:57) Yeah, absolutely. Thanks so much for sharing that. That’s really helpful. I think just like backing up, for a few minutes here. So you mentioned the con, your, this initiative is tied to having a contract signed. Can you just help us understand? We were trying to kind of piece it together of how, as a managed service of like, I guess how your revenue stream comes? Is it through signing up new customers? Like how is that?
Robin Redd (10:31) It’s a great question. So, the network piece that we would be talking about building a provider network would be not a separate entity altogether, but would be almost like… a subsection of our business. That would be a new business initiative. Whereas our primary business, exists around value based care, utilization management, delegated services. We have, we do claims processing. A lot of what we do on the value based care side is supporting physician practices, and that’s basically an extension of the office. It could be things like reaching out to members to make sure that they’ve had their blood pressure reading done for the day, doing follow up calls for colonoscopies. So, we, it’s a services organization in terms of what we offer our different customers, but that can look very different. Like, for our utilization management business… we’re delegated to perform those services. Usually, the payers delegated it to an ipa and an ipa has sub delegated it to us. We’re urac accredited for, we have a lot of business in Illinois, primarily because the department of insurance in Illinois requires you to have an accreditation in order to do business there for. And we do so that’s creating a lot of delegation coming our way. So that’s a big part of, our business right now, this.
Erica Lloyd (12:15) Provider.
Robin Redd (12:17) Network is something completely new and separate. So that isn’t right now, we do have contracts with customers but we are not delegated for credentialing in those arrangements. So the current level of, I don’t even use the word credentialing. I’ll say, the current work that I’m doing is more risk management because from your act standpoint, if you look at the credentialing in your act, it’s not, it’s make sure they’re licensed and board certified. I mean that’s about it. So I would still consider what we’re doing to meet the, your act requirements really just a robust risk mitigation process. So there’s a handful, a small handful of providers that I’m doing that like myself manually. It’s not ideal. And if we’re talking about building a network of 2,500 providers, it’s definitely not scalable or sustainable. And I’m not really interested in trying to do that. So that’s the reason that I’m looking for a partner because that would be an actual full scale ncqa level credentialing process to meet that requirement. So while we do have relationships with payers to perform different functions, we’re not delegated for credentialing at this point with any of those. So we don’t have a credentialing department, I guess is the bottom line. Okay. Yeah. So my goal if.
Erica Lloyd (13:57) memory.
Robin Redd (13:59) serves, and if pricing holds true, it probably makes more sense to outsource as much of that process as possible so that I can just have minimal staff to do the things that like a cvo or solutions organization can’t so if provider relations is something that I have staff for, but I don’t have to build a platform because as a cvo partner, you can provide us some functionality through the platform that you have. That would be nice. Otherwise I’ve got to go to my technology team and we have to build something to house all the data that we get back from the cvo. Don’t do that. Yes. Thank you. And even on the front end, I mean, we currently have a system for contract management even for some of the other arrangements we have. But it seems kind of silly to me to have that information housed in one system and then have to send it over to a cvo and have multiple systems going and be siloed about it. It’s possible can be done and we can certainly pull the data out of there to then upload it over to a cvo to provide like the mpis, the whatever’s required to get the network process started the network credentialing process. But ultimately, I think as a baseline, we would plan to require the providers to use caqh so that everybody’s provider data is going to be housed in one spot. And it seems like most cvos are just have a relationship with caqh anyway, just to pull that data over. I’m assuming you guys do too. Yeah, absolutely. Yeah, that is kind of a.
Erica Lloyd (15:52) Bespoke medallion feature… not to get into feature functions, but yes. So we have a direct integration with caqh to automatically pull that over. I had another question. So just kind of going back to the way you’re thinking about this partnership, would you, then, would you, I guess purchase credentialing… or primary source verification from medallion and then kind of like use it as a pass through and mark it up for new customers?
Robin Redd (16:27) No, we would own the network, okay?
Mallory Smith (16:33) So when you say you would own the network, would you perform the credentialing and enrollment function? And then would you be billing under your tax id?
Robin Redd (16:44) That’s a great question that I can’t answer but we would do whatever we would, we need to do. I don’t really handle that part of things, but we would essentially contract our network with different payers and of course, they can repeat the credentialing process if they want. But generally speaking, they would delegate credentialing to us because we’re going to be credentialing our own network anyway to keep them up to ncqa standards, right? With the goal of hopefully having enough different contracts to make that a cost effective venture. I mean, as you guys know, that’s the whole business model of a cbo is, you know, you credential them once and you sell it multiple times. And that makes it make sense. Because if you only credentialed each provider in your repository one time and then move into another market, that really doesn’t make a lot of sense for you. So agreed. I just.
Mallory Smith (17:51) Have a clarifying question with that. So when I hear mso, I immediately think third party what you’re describing to me sounds more like you’re going to own these providers, whether they’re tin, I nine or W, ii. Yeah.
Robin Redd (18:03) Because it will be a separate that’s what I’m saying. It’s not part of the mso, okay services. Yeah, it would be guidehealth, okay network, LLC, kind of thing, right? Perfect. Thank.
Mallory Smith (18:15) You. Then I think for our conversations moving forward, we can just treat this like it’s a very typical medical provider group where you own all the providers who have the network, right? And then to answer your question with the cvo and delegation, yes, we would essentially be a sub delegate for you and that’s how you’d be able to maintain ncqa certification, credential providers, everything of that nature.
Robin Redd (18:36) Absolutely. Yeah. So I mean in my ideal world… we would handle contract management with or without access to some kind of functionality to make that easier with you. We would outsource the credential verification process to you all the primary source verification. Hopefully, we would be able to log in and track the process going through like the committee process and then generate directory rosters and handle provider enrollment. That would be my perfect world so that we do the very minimum required outside of the platform by our staff. So we would handle that, obviously have a credentials committee and handle all of that, the peer review. But as far as the process goes, as much of, that could sit on a different platform from our own internal would be ideal, absolutely.
Mallory Smith (19:36) Eric, I know we’ve got 11 minutes left if you wanted to maybe go into like an overview of medallion and I’m thinking Robin, that we.
Robin Redd (19:45) can.
Mallory Smith (19:45) house, we are the full system like one source of truth. We can house every one of the aspects that you’ve mentioned.
Robin Redd (19:52) And then we.
Mallory Smith (19:52) of course, are open ended bidirectional API. So if we do continue conversations, I’d love to have just a technical call to determine if you wanted this to be automatically pushed back and forth or what that would look like. But that can be several calls down the road. There doesn’t need to be anything there.
Robin Redd (20:09) So I will say just to be transparent about the timeline because I know that I’ve been in discussions with other cbos so I’m really at that final stage with them of tweaking the pricing and being, I’d like to get this right recommendation and information to leadership in the next two weeks. So whatever demos and pricing and back and forth we want to do, I’d like to kind of fast track that. And I’m actually going to be out of town Thursday through Wednesday of next week. So I know that really cuts into that timeframe. I know that we kind of lost a week on the front end. So if we can make good use of the next couple of days and then the end of the following week, that would be great. I don’t know how much back and forth you guys usually do at this point. I’ve done it with three other cbos. So I’m pretty clear on what I’m looking for. Hopefully that can cut down on that. Yeah.
Erica Lloyd (21:09) Let’s well, I don’t want to get ahead of myself too much, but yeah, appreciate you kind of sharing that. Why am I sharing the right screen here? Partnering together? Yes. Okay. But I think, but thanks for giving us that. So I want.
Mallory Smith (21:28) to make sure you.
Erica Lloyd (21:29) Have visibility into what that looks like. Like. Again, we’re fast tracking what that is. So we’re here, in kind of solution discovery. It sounds like you’re pretty aligned on what you need, I guess just to give us visibility in order for you to make a recommendation on a specific vendor. What is it that you need to see aside from price?
Robin Redd (21:52) That like, what?
Erica Lloyd (21:53) Is it that you would really want to see to make the recommendation? Like, the ncqa certified that we can handle the services? So.
Robin Redd (22:03) I’ll tell you when I made my selection for my due diligence, everyone I’m looking at is ncqa certified for the same number, of processes. So you’re at a baseline, I’ve already filtered anybody else out. So we can just go with that. I’m assuming the primary source verification. I mean, I’m taking that for granted because you’re ncqa certified. So I really don’t need to see the details of how you do it. I honestly don’t that’s you’re doing it to ncqa standards. So I really cared, I mean, I don’t mean to say that bad, but just like I trust that, but I need to know if there’s an implementation fee. I need to know if there’s a pass through fees. I need to know what the provider. I mean, it’s the pricing is a huge piece of it because everybody I’m talking to, I feel like has a certain level of quality because they have the ncqa seal. So pricing is a big piece any additional solutions surrounding that contract management or provider relations functions is big. But beyond that, really, it’s just kind of the, I mean, really that’s what it comes down to functionality and price.
Erica Lloyd (23:22) Okay. Let’s let’s, again, this is typically how people evaluate medallion this process. You know, we’re in solutioning right now, making sure that there’s actual alignment, in basically what we have to offer with what you’re looking for. We usually typically would do a product demo, which, I recommend, I think, we should do that and we can kind of do that in tandem with a business value assessment. I also scoping as you’re talking about pricing because it is a consumption based model. It’s not intentionally, like we’re not gatekeeping it or anything. It’s just in order to say how much you need us to do. So, it’s completely on your behalf. We can go through, some scoping, which we can send you some over emails to cut back on a little bit, of the time together and we can work on that async, and then we typically would go through a proposal we, and do that from an in on. Typically, this is when we have exactly back alignment as well. We typically like to bring them in. I’m sure you, these are team sports. Usually, they like to be involved a little bit earlier than pricing. It’s always awkward to ask for money on the first conversation. But, many times like they’ll have questions about the pricing, what’s involved, implementation, timelines, things like that, and then move into an agreement. So the.
Robin Redd (24:39) demo sounds good and I do care whether it’s user friendly, whether it’s visually appealing, whether it’s easily navigate all those things. You will not have our executive team on this call. I can tell you because that’s my job. It’s to, they don’t know anything about credentialing. I am their subject matter expert. So, they’re looking to me to get the information, select the one that I recommend and give them the reasons why and what that would provide. So, we’re not going to have our CFO on a call. If we get to the point of, you know, legal documents being signed and some particular questions, then legal and our CFO may jump in on something, but I don’t see that being a need in the short term. So, I mean, and in terms of like the specific questions about technology, like we have a robust technology department. So, whatever format we would need to get things through to, we can, but because it’s really going to come through caqh.
Erica Lloyd (25:44) I don’t.
Robin Redd (25:45) know, unless it’s like on the backend, like how you, how we would access like the credentials files, whether that’s something that we definitely download or we send electronic. I mean, that’s I guess that’s more of the question. But again, I don’t think that needs to involve leadership. They don’t get involved in that level. No, yeah.
Erica Lloyd (26:07) That’s that’s true. Yeah, we wouldn’t, we can go through some of that in the demo. We definitely wouldn’t go into some of the features functions there.
Erica Lloyd (26:13) This is really typically they like to have some kind. They usually have some kind of questions on the pricing and things like that. Obviously, I hear you price is important. It sounds like you’ve done quite a bit of research on where you’re thinking about budget for this. What would?
Robin Redd (26:31) The cost?
Erica Lloyd (26:32) Per provider, it sounds like that’s how you’re thinking about this from a pricing perspective. Can you give us some guidance on kind of where you need to be from a pricing lens?
Robin Redd (26:42) I can’t really to be honest with you without really divulging pricing from another cvo. I mean, at the end of the day, it’s really just a justification that it’s better to outsource than it is to build it in house. And I’ll definitely be costing that out. I just that’s not my preferred that’s not my preferred route. I really don’t think it makes sense with, I think we have the potential to triple the number of providers that we’re discussing now.
Erica Lloyd (27:14) But, but.
Robin Redd (27:17) Until you have that and you know, that it’s you know, that, you know, you don’t want to build it, you can’t turn on a dime to do the credentialing without lead time of hiring and training, but you also don’t want to do that too far ahead of the business being at your feet. So that’s you know, that’s why I’m looking for a partner. It’s not because I don’t think we could do it in house. It’s just because I don’t think that’s probably the smartest route at this stage. So.
Erica Lloyd (27:50) You know, there may.
Robin Redd (27:52) Be a point at which it makes sense. But I really honestly as long as outsourcing to a cbo is cost effective. I think that’s still probably the best route to go.
Erica Lloyd (28:07) You know, I.
Robin Redd (28:07) don’t think we have any interest in building a cbo ourselves. And short of that, it’s you know, if you’re going to different markets and you’re building networks that’s not the most financially lucrative way to, you know, to move into the market. So I think it just kind of depends… it depends on there’s just so many conversations going on at the company right now at different levels like if everything hits then things look very different. But that’s why I’m starting at the low end on the 2,500 because that to me, that’s the assumption of one network hitting in one state. And I assume from that point, any additional business or volume would just be less expensive because usually people have tiered pricing. So that’s something that would be important to know too. Like if 2,500 is going to be roughly this much per provider per month on year one, then what does it look like if we hit, you know, double that or triple that or, you know, wherever your tiers are, that would be good to know too. Yeah, we.
Erica Lloyd (29:19) Can obviously the cost per provider could go down as we go. You know, the more volume you give us, it does our because each provider is basically, you know, a seat on the platform. It doesn’t that’s not as much as where we can compress it’s more like the services and where it’s probably going to make more of a difference. And so I guess just giving you a little bit of… insight into kind of what it is. So as mentioned provider data management platform. So we would house all of your data here. We’ve been around for about six years now backed by some of the really big players in the VC space like… Google ventures, Salesforce, really making investment in automation to move faster. And they said as you mentioned Robin more cost effective. And so I think it’s also really important as you’re looking at other vendors to highlight. We do have service level agreements. So we have contracted outcomes, meaning we will contractually commit to specific timelines, you know, specific timelines for you.
Erica Lloyd (30:27) So I think that’s going to be important to highlight as well. And again, it’s both the software and the services we.
Robin Redd (30:35) Do what is your current turnaround time on average for PSP process? So.
Erica Lloyd (30:41) For the primary source verification, we in our contract, we will contractually commit to a three day SLA.
Robin Redd (30:49) on that.
Erica Lloyd (30:50) We typically will do it in one day, one business day. Obviously, there’s X factors, but I think that’s because we have that direct integration with caqh, there’s a lot of information we’re able to glean really quickly up front, a lot of automation that we have. I won’t get too deep in the weeds on it, but that, you know, automation to help fill out the paperwork. So we’re not doing it manually… and that’s all just going to be able to enable it to do extremely fast.
Robin Redd (31:21) Did you get kind of a chart from me? That kind of outlines what I’m looking at?
Erica Lloyd (31:28) Did not. Okay. I’ve got.
Robin Redd (31:31) Kind of, and I think it would help you like understand kind of what I’m looking for and what I’m looking at and I can share. I don’t know. Can I share my screen? Do you mind? Yeah, go ahead. Okay. Can you see that? No?
Erica Lloyd (31:49) I you.
Robin Redd (31:50) know the,
Erica Lloyd (31:51) on the bottom, the little arrow on the bottom?
Robin Redd (31:55) The share? Yeah. So it’s I think it’s because it’s on screen too. Oh, I have to move it over. I was,
Erica Lloyd (32:08) when I share on teams, I have to practice ahead of time, does?
Robin Redd (32:11) Can you see it now? No, nope. So I’ll drop that to you in an email, go that route. But essentially, I’ve just kind of got the line items down there’s. A I’m looking to see like things… like, you know, do you do follow up to make sure the information is complete in the beginning? If so, is there a charge for that? Is it included in the pricing… then the obviously credentials initial credentialing, recredentialing, ongoing monitoring, sanctions checks. If there’s a match with a sanction, do you follow up… expiring credentials? So like continuous monitoring. And at the end, like do you designate the files like clean versus having issues so that I don’t have to go and open and look through 2,500 different files? Does it like, is there some kind of an alert that would let me know you need to take a look in detail at these before you dig into the rest of them. And then I guess, yeah, just the seeing if there’s a provider enrollment and directory option and whether there’s any kind of an ease in on the contract management.
Robin Redd (33:35) But I do have them kind of all broken out. So I can send that to you. And I did put the assumptions at the bottom which were just a network size of 2,500, like… an average of no more than two licenses for focus. Sorry about that. And a single statement. I would say an average of two licenses because, you know, let’s say we have I’m in Georgia. So let’s just say we have a Georgia network. We may have some providers that practice on the boundaries with other states. So they may have a license in more than one state… that kind of thing. Does that make sense? I know that was running through a lot of… questions. But like what I’m trying to do really is just kind of go down that list and just green check everything that you satisfy. So I mean everybody should at least green light the caqh profile and the initial and re credentialing. I mean, I think that’s probably a given. And if you’re ncqa certified, you know, the sanctions check. I’m sure is an option even if it’s not included in the bundle pricing on the files. So… and I know it’s broken down that a lot of people have like an implementation fee. And then there’s an extra charge for different things or access to different modules. And that’s fine. I’m just going to add all that up for what it would look like for year one of 2,500 providers. And I’m going to divide it by 2,500 to find a provider per year cost and that can be provider per year. Year one might look different than the other years. So we.
Erica Lloyd (35:23) do three years. So that’s helpful because in year one implementation costs, and then year two. And I think you said in the call with Nicole, so year three, you wouldn’t need to do recredentialing until year three. So year two will probably be the lightest year three. We would include recredentialing.
Robin Redd (35:40) With three year?
Erica Lloyd (35:41) Agreement that we do, what’s helpful is that you can push and pull from year to year. So if you have a, like I said, it sounds like you could need some additional, so additional in year one or year two, you can push and pull the volumes from year over year and they don’t make you true up unless you’ve consumed. I think in our contract, it’s like over 80 percent of the full contract. Okay? That’s.
Robin Redd (36:01) a great point. And I’m glad you made it because, you know, while we may have a commitment to build a network of 2,500 providers, you know, it does matter that they meet the HSD, the access, you know, we have to look at their membership is what it comes down to. So, if you’re you know, we have to see where the members are and that’ll dictate how many providers and in what area. And as membership shifts, that could mean year to year, that we have to add a few more providers or that it ends up being, you know, just under 2,500 year one and the balance of them comes straggling in over year two or something. But… like I’m trying to get away from like a minimum for year two because I don’t know what that would look like without knowing what the membership looks like. Going into year two. Does that make sense? Yeah, yes, that.
Erica Lloyd (37:04) Does, and that’s it is really difficult to forecast business that far out. I.
Robin Redd (37:13) Said you want?
Erica Lloyd (37:13) To make the recommendation within two weeks and you’re waiting on potential contract signature for this to be greenlit?
Robin Redd (37:20) Is that?
Erica Lloyd (37:22) Accurate.
Robin Redd (37:23) I mean, I don’t expect that to happen within two weeks. I would like to make a recommendation about who we should use as a partner in the next two weeks so that I stay ahead of that signature on a contract.
Robin Redd (37:37) Because once that’s signed… I’m going to be scrambling to try to start this process. So, I… think at that point, you know, leadership needs to see what the pricing looks like. See what that off, you know, see what that provides us, you know, hopefully confirm that the outsource CDO partner is the way to go and agree, hopefully agree with my recommendation of which CDO that should be. The reason I would say that it could come down to two different ones is depending on these, these kind of surrounding functions to the credentialing process, whether they decide they want to do that in house or how they want to handle it. Like contract management would not be under me. That is under I.
Mallory Smith (38:31) Had there’s a,
Robin Redd (38:31) different director that handles that? And I have invited him to the demos, but obviously, his schedule didn’t permit him to come. But I am sharing the results with him kind.
Mallory Smith (38:42) Of a.
Robin Redd (38:43) the feedback I’m getting and what the pricing looks like. So he could very well, you know, say, hey, instead of using the current platform that we’re using this could be a solution for us for a lot of things as well, so that, you know, that could kind of tip somebody in that direction versus another platform… that was more confusing or helpful, but.
Mallory Smith (39:09) No.
Erica Lloyd (39:09) That’s that is, I think, I just, yeah, I think we’re just trying to understand when.
Mallory Smith (39:14) You.
Erica Lloyd (39:16) think the contract would be coming in for?
Mallory Smith (39:19) This.
Robin Redd (39:20) I mean, that’s you?
Mallory Smith (39:23) Know that?
Robin Redd (39:23) Conversation that they’ve been in conversations with this group for months. So, you’re asking me to project something that’s out of my control? I don’t know, I think they wouldn’t have asked me to do the due diligence and start giving them the process overview and the pricing if they didn’t feel like it was coming.
Mallory Smith (39:43) Down.
Robin Redd (39:43) To the like.
Mallory Smith (39:45) Reality.
Robin Redd (39:45) that it was like one likely to happen and two, that it would be likely be in the next few months, so.
Mallory Smith (39:53) I mean, definitely.
Robin Redd (39:55) This year and I would say much more likely before the end of the summer. I mean, that could mean next week or it could be in August. It’s hard to say, you know, those conversations can tend to have a life of their own. So I… can’t really say for sure. I mean, what?
Mallory Smith (40:15) I don’t want to.
Robin Redd (40:16) Do is assume it’s in August and have my CEO announce tomorrow that we’re building.
Mallory Smith (40:22) A network.
Robin Redd (40:22) And we have to have it done in four months like and may not have any idea how we’re going to get that done, so.
Mallory Smith (40:28) Yeah, no, that.
Erica Lloyd (40:31) Makes sense. Good to be proactive, right?
Mallory Smith (40:35) Okay. So.
Erica Lloyd (40:36) I think I’m going.
Robin Redd (40:38) To, since price is really?
Erica Lloyd (40:40) Important. I think maybe we do scoping and I’m thinking maybe we do scoping first before the demo so that we can do the pricing.
Mallory Smith (40:50) Yeah. Does that?
Robin Redd (40:53) Just because I know that’s really.
Erica Lloyd (40:54) important. How do you, what is your, what do you think Robin do you want to do?
Mallory Smith (40:59) I think the sooner.
Robin Redd (41:00) We can get the price, the sooner you can put some pricing in front of me because I’ll likely have questions. Yeah, then we can have this, that back and forth and those conversations can be ongoing while we schedule time to look at a demo, okay?
Mallory Smith (41:17) If we,
Robin Redd (41:17) wait until the tail end to start those conversations that’s going to drag it on forward and I, you know, I don’t I do think medallion is a strong contender and I don’t want just the timeline to end up being what, you know?
Mallory Smith (41:33) Pulls it out of the.
Robin Redd (41:35) mix? Yeah. So I’d like to go ahead and get those discussions started. Yeah.
Erica Lloyd (41:41) What would, I guess, yeah, I don’t see how a timeline could pull us out of the mix. So, let’s yeah, just certainly.
Mallory Smith (41:49) Try to,
Erica Lloyd (41:49) make sure we’re meeting that.
Robin Redd (41:53) Let’s do.
Erica Lloyd (41:54) Why don’t we send you some questions async, so that we make sure for the correct volumes. If you can send us that email that has the, what you, the matrix that’s really helpful. Yeah. And then let’s schedule some time and we can go.
Robin Redd (42:11) Over we can walk through it.
Erica Lloyd (42:14) Go through any questions you have, on, the scoping and then walk through, like, what a pricing would look like. How about we… have we’re could we have?
Robin Redd (42:29) Open? Let’s see?
Mallory Smith (42:32) I mean, we could.
Erica Lloyd (42:33) Do.
Erica Lloyd (42:38) would Wednesday at?
Mallory Smith (42:42) One?
Erica Lloyd (42:44) 30 work for you?
Mallory Smith (42:46) It?
Robin Redd (42:47) Would be better for me if we could do it. I have a meeting right before that, if we could do it from.
Mallory Smith (42:55) Two.
Robin Redd (42:56) 30 to three 30 or at four to five or earlier in the morning. I’ve kind of got a block from about 10 o’clock until about two o’clock actually, I don’t have a meeting. So about 10 to two 30. Erica I could do, I could do two.
Mallory Smith (43:13) 30 eastern on Wednesday?
Erica Lloyd (43:15) Okay. Yeah. Let’s do two 30.
Mallory Smith (43:18) Is that the correct time? Robin? You’re on eastern?
Robin Redd (43:20) Time? Yeah, let’s.
Erica Lloyd (43:22) yeah.
Robin Redd (43:23) I’m on central.
Mallory Smith (43:24) So, I have to like do the math in my head yeah.
Robin Redd (43:26) Half of my half of my company’s on central actually, and some of them are on pacific. So, yeah, well.
Mallory Smith (43:34) It’s this and then I,
Erica Lloyd (43:36) guess, just as I’m sending this out, what, how did you hear about medallion?
Mallory Smith (43:42) I.
Robin Redd (43:42) literally looked up who I thought the top four were, said ncqa certified cvos, and I said who were the top who were the top cvos? And medallion pops up in the top four.
Mallory Smith (43:56) Oh, I’ll tell our.
Robin Redd (43:57) marketing. So kudos to you, Robin. That’s how I.
Mallory Smith (44:00) chose my graduate program. When I got my mha, I went to Google and I said top 10 mha, programs.
Robin Redd (44:06) Yeah. I mean, that’s I think we all do that now. It’s you know, I’m I mean, we’re in the midst of our second accreditation process right now and, you know, there’s.
Erica Lloyd (44:19) there’s.
Robin Redd (44:20) a lot of,
Erica Lloyd (44:21) AI involved.
Robin Redd (44:23) In everything. So, yeah… I apologize for, I can tell, I’m like putting you in a kind of an uncomfortable fast track, process. I just, in fairness and, I know it’s unfortunate that our ptos lined up instead of overlapping, that would have been great. But I got the request for a two week turnaround and that was three weeks ago. So, I have a grace week because my,
Mallory Smith (44:54) boss is out.
Robin Redd (44:55) Of town at the same time I am, but as soon as I get back, I’m going to have a couple of days to kind of try to wrap things up so that’s part of the reason I’m pushing is let’s try to at least get enough information in even if we have a couple of questions remaining so that I,
Mallory Smith (45:12) can, you know?
Robin Redd (45:15) Say, I am leaning, I just need to get some questions answered versus, you know, just having too much blank space in the comparison chart right now,
Mallory Smith (45:27) And the, as far.
Robin Redd (45:29) as the demo goes, I mean,
Mallory Smith (45:32) we can, I don’t I know.
Robin Redd (45:35) You guys are probably busy. I have a lot of open space tomorrow if it’s possible to do that. Otherwise, I’m only going to be in office two days next week.
Mallory Smith (45:45) Which would be.
Robin Redd (45:46) Thursday and Friday?
Erica Lloyd (45:50) is it possible to do? Because we, we’re going to be traveling again, we have an off site.
Robin Redd (45:58) We, oh, you said you’re going?
Erica Lloyd (45:59) To be out on Friday, tomorrow?
Mallory Smith (46:02) Is a little, yeah, I’ll be out.
Robin Redd (46:05) This Thursday and Friday, and then Monday, Tuesday, Wednesday of next week. So I won’t be back in the office until next Thursday. We can.
Mallory Smith (46:12) Also do something a little different, Erica, Robin to your point, I hear you loud and clear about not needing a full demo.
Mallory Smith (46:18) You don’t need to see how the sausage is made. So, maybe just like a workflow instead on like what your team would be responsible for versus ours, that wouldn’t take more than 30 minutes. I mean, really.
Robin Redd (46:30) Kind of the piece that I’m most interested in are the parts that would involve like my staff. Like, so I… don’t necessarily need to see how you get it from caqh or what you do with it in the interim, but where I would kind of be interested to see would be like, I don’t know how you’re I don’t know how it works for y’all, but like if we have a login to see our providers sitting on your network and then we have a way to enter, you know, to interact with that information for purposes of moving on through the committee process and, or some provider functions like roster generation or, you know, payer enrollment. It’s kind of at the point where we pick it up from you at the end of the PSV process. That’s kind of the piece I want to see is from there to the end. What does that look like? Like? How easy would it be for us to get involved? Is it easy to see status? Is it easy to see reports… or to run reports? You know, those kinds of things? How would I know if there’s an alert? How does that look on the screen? You know, what does it leave like if you find? And this is, I guess I should ask this specific question up front because it is one I know I’ll have. So if you’re verifying a license… for example, if you find out through continuous monitoring, like I know that I use the ama master file right now for this risk mitigation thing. I’m doing. So it pops nonstop. Somebody’s always renewing a license or, you know, letting one go inactive because they don’t use it anymore. I’ve got one provider with 31 licenses because he has a compact license. He’s making me crazy. But so I’m constantly getting, you know, those reports and then I have to cross reference them and look and sometimes even that it’s even if it’s not an active license where he’s doing something for us if.
Mallory Smith (48:39) I.
Robin Redd (48:40) find out that… there’s a finding on another one. I’m going down the rabbit hole because I want to see what that looks like. Like. I’m going to the license board and.
Mallory Smith (48:57) It’s you.
Robin Redd (48:57) Know there’s this interesting gray area that I know that cbos don’t seem like they check the fsmb anymore. That’s not a thing.
Mallory Smith (49:05) But that, do you,
Robin Redd (49:08) I know with sanctions… like if there’s an actual sanction revocation or suspension, you’re going to catch it with the other places you check however.
Mallory Smith (49:21) If.
Robin Redd (49:23) it’s a rep, if it’s a reprimand or a fine, it’s not reportable to those databanks. So you’re not going to catch it like through an oig or Sam gov, or anything like that. So, I’ll.
Mallory Smith (49:38) just say I’ve.
Robin Redd (49:39) had a situation where two inactive licenses both had some activity on them. So I went down the rabbit hole because to me, that’s a pattern too, especially if it’s more than one in different states and it turned out that it was reprimand and a fine. And so that’s that matters to me because.
Mallory Smith (50:03) I mean, it.
Robin Redd (50:05) Depends on why, right? I mean, if it’s because somebody didn’t do a documentation in time, that might not be as important to you as a quality of care issue, right? But sometimes.
Mallory Smith (50:19) I know.
Robin Redd (50:19) That I’ve seen where an alert pops up and says, you know, basically, there’s a hit.
Mallory Smith (50:24) But it doesn’t.
Robin Redd (50:26) give you, I’m not going to get the detailed report back without. So, what I don’t want to have to do is take 2,500 providers and get just enough back to have an alert, but then still have to go myself back to the source to get the information. So, if.
Mallory Smith (50:43) there are scenarios.
Robin Redd (50:44) Like that, I definitely need you to let me know because that would mean I need more staff.
Mallory Smith (50:49) Okay. So, I think it’s just around it is automated. You’ll get alerted immediately. You’ll have the explanation or the reason as well. But I think.
Robin Redd (50:59) I put together.
Mallory Smith (51:00) like a pamphlet for current customers on what that would look like if a sanction comes back so we can share that with you. Okay?
Robin Redd (51:06) That would be great. I appreciate.
Mallory Smith (51:07) The call out. I agree. Yeah, thank.
Erica Lloyd (51:11) You for that? Okay. Well, yeah. Why don’t we do then? Mal, why don’t we do a workflow more of like a workflow demo and we can go, we can go into like a little bit more on what?
Mallory Smith (51:24) A staffing?
Erica Lloyd (51:25) Requirement could look like when you see that?
Mallory Smith (51:27) And we can also give.
Erica Lloyd (51:29) You like our guidance on how, you know, the 350 plus customers that work with medallion, what they do from a staffing because sometimes they’re letting they’re right? Sizing staff. Sometimes they’re deciding not to hire staff, right? Typically where they’re finding budget to.
Robin Redd (51:44) Procure sure man that’s that would be helpful. That would sound good. And I’ll go ahead and accept this. I just saw that pop through.
Erica Lloyd (51:51) Let’s see tomorrow. We, we… could do, we have a 11 a. M tomorrow. We have four 30 eastern.
Robin Redd (52:05) I have 11. Oh, sorry, you cut out there. I have two o’clock.
Mallory Smith (52:16) sorry, what did you say?
Erica Lloyd (52:18) What time is it? I said, I’m.
Robin Redd (52:19) I’m pretty clear from 11 to two o’clock tomorrow.
Erica Lloyd (52:22) All right. Let’s do. Okay. Let’s do 11.
Mallory Smith (52:25) Okay. All right.
Robin Redd (52:29) And I really appreciate you guys jumping into this quickly. I’m sorry, we’re I’m putting you on the spot with it, but I do appreciate it. We’re we’re good.
Mallory Smith (52:40) Yeah… Eric, I can move my 11 30 if we need an hour. Okay? Why don’t I just,
Erica Lloyd (52:50) push it, book us to 45 minutes. So we have it.
Robin Redd (52:53) Okay. I’ll get the other one moved. Oh, yeah. It’s just my, when I’m.
Mallory Smith (52:59) on, with my manager, he’ll understand… I have to do that.
Robin Redd (53:04) Too, I have to look at the detail of somebody’s calendar and go, okay, that can be moved exactly?
Mallory Smith (53:10) Or my own and say.
Robin Redd (53:12) Yep, that can be moved or nope that’s external, I can’t.
Mallory Smith (53:15) can’t move that one? Okay?
Erica Lloyd (53:20) Okay, great. We’ll send that and you can send, that matrix that’ll be helpful and then we compare it to do that for you, the workflow demo for you tomorrow.
Mallory Smith (53:31) Absolutely. Thank you.
Robin Redd (53:32) Both. And, I look forward to talking with you tomorrow, and I’ll get that, do I have your, both your emails? Do you want to shoot me an email just to make sure I can send it to the right place.
Mallory Smith (53:48) Can you get that email over?
Erica Lloyd (53:50) Yeah, I’m sending it right?
Robin Redd (53:51) Now, okay. And then I’ll send that little snapshot over to you?
Mallory Smith (53:59) Okay.
Erica Lloyd (54:00) Sounds good. All right. Well, we will see you tomorrow then.
Robin Redd (54:02) Sounds great. Thank you guys. Thanks, Robin. Take care.
Mallory Smith (54:06) Bye.