Transcript
Noah Laack-Veeder (00:00) good stretch there, garrison our.
Garrison Goodman (00:01) plant bridge day fellas. We got full on war happening in Iran.
Noah Laack-Veeder (00:07) Oh, God.
Kyle Bettencourt (00:08) Wait. What happened?
Noah Laack-Veeder (00:11) Did we blow them up?
Garrison Goodman (00:13) We’re in process of blowing up infrastructure.
Noah Laack-Veeder (00:17) That’s not a war crime. Oh boy.
Kyle Bettencourt (00:24) I delete X for a bit.
Garrison Goodman (00:28) I know it’s like just.
Kyle Bettencourt (00:30) Enough depression all day.
Noah Laack-Veeder (00:43) My God. Oh, hey, good news. My daughter’s no longer needing to wear her helmet… that’s great. That’s it there is good.
Garrison Goodman (00:56) Oh, you said she had a, I understand. I was thinking like on a bike or something. I was like,
Noah Laack-Veeder (01:01) yeah. Oh, no, yes, she’s seven months old riding a bike. It took me a.
Garrison Goodman (01:06) while to get there, but yeah, no.
Noah Laack-Veeder (01:07) It’s okay. Hey, that’s great. Yeah, it’s good news. And then that daycare was like, who’s this baby because I didn’t recognize her. Just funny that’s awesome. Yeah.
Garrison Goodman (01:18) My Diana as an OT has done a lot of work with peds. And so, she was, she’s done a lot of like sizing and like fastening for those.
Noah Laack-Veeder (01:29) So, a lot of work. So it’s cool.
Garrison Goodman (01:31) It’s special. How long was it? Hey, Doris? Hey.
Noah Laack-Veeder (01:34) Doris.
Garrison Goodman (01:39) Doris, are you off today?
Dgprince (01:41) No.
Noah Laack-Veeder (01:42) Oh, okay.
Garrison Goodman (01:44) We’re going to have to get off and let you enjoy your time off?
Dgprince (01:47) Yeah, I was off Friday supposedly.
Noah Laack-Veeder (01:53) Supposedly, yeah.
Garrison Goodman (01:56) Did you get to have any fun?
Dgprince (01:58) Actually, we actually drove down to South Carolina. We have a house down in north Myrtle beach in South Carolina. So, I’m working while my husband’s having fun. So.
Noah Laack-Veeder (02:09) Is he rubbing it into, or is he, like, is he like bringing you lunch? Is he bringing you lemonade or anything?
Dgprince (02:16) He’s actually, you know, we hadn’t been on a few months, so he’s actually getting like the yard ready and all that kind of stuff. Getting the sprinkler system kicked back off and all those things. So all.
Garrison Goodman (02:26) Right. Nice.
Dgprince (02:26) It’s not bad. I mean, it’s like five and a half hours from Virginia. So it’s not bad. Well, I don’t think it’s even that much anymore. Now, I go to 17 and it’s like four Lane. Most of the way, it takes about five hours to get here. So it’s a little trip, but again, fun do.
Garrison Goodman (02:41) You get to spend a good amount of the summer there? We?
Dgprince (02:44) Do kind of hybrid, he retired about six months ago. So I get to work and he gets to see all of his family and everything down here. So we do, we go back and forth a couple years ago. When my mom was really sick, I worked a lot remote and it gave me those last few years with her where I could be here, you know, and then just go at night and spend the evenings with her or take a break and go have lunch with her or if she was having a bad day, just go spend the whole day with her. So this house, lord have mercy. I thought I was going to have a heart attack when we did a second house. I’m like the second house and we weren’t going to rent it out. I’m like, how are we going to do that? But, you know, it’s just those nerves but anyway, it was a blessing because I did get to spend quality time with my mom those last three years of her life. So, very much, very happy. We had this place.
Garrison Goodman (03:38) Yeah.
Kyle Bettencourt (03:39) Yeah, paid for itself there for sure.
Dgprince (03:41) Yeah. So, anyway, so where are you guys at? I don’t think I even asked y’all, where you’re at or located?
Kyle Bettencourt (03:48) I am out of Austin myself, Austin, Texas. Okay?
Dgprince (03:52) Yep.
Kyle Bettencourt (03:52) Yep. And we’re a little bit all over, yeah, in New Jersey. So, oh, wow. Probably close there in Wisconsin.
Noah Laack-Veeder (04:03) Yeah. All over the place. Don’t you think?
Dgprince (04:05) Cold places woo, exactly that’s. Not Texas, but.
Noah Laack-Veeder (04:10) Yeah. Texas isn’t cold, but, yeah, Wisconsin, it’s hey, it’s a whopping 41 degrees this morning. So. Wow.
Kyle Bettencourt (04:18) Short’s.
Noah Laack-Veeder (04:18) weather my.
Garrison Goodman (04:20) My, my wife’s family has a house in the jersey shore here, and my wife’s an occupational therapist in a school. So, so she was on spring break last week and so we went to the jersey shore for a few days, but, you know, you can only be at a beach for when it’s 40 degrees for so long. So, but we’ll be excited because when once it starts getting hot here, it usually stays right around 75, 80 degrees at the beach. Oh, perfect. Yeah, that’s.
Dgprince (04:48) perfect. Yeah, I call, I don’t know. I said the, I said yesterday, I said the weather here is bipolar, because it was on… Friday before we got down. It was like almost 80, and then Saturday was really pretty. And then yesterday was like 60 and today it’s like 54. I’m like what happened?
Noah Laack-Veeder (05:10) Jeez, make up your mind. I’m like, okay.
Dgprince (05:14) But at night, it’s getting down to like low forties, I think it was 39 one night and I’m like what the heck it’s that time of year, that time of year?
Garrison Goodman (05:23) Doris, how far are you from charleston? Not?
Dgprince (05:26) Even two hours, probably an hour and a half hour and 40 minutes, maybe not quite two hours. Yeah, we love charleston.
Garrison Goodman (05:35) Yeah. So, I lived in Austin for three and a half years and every August or July depending on how hot it would get. My wife and I would leave for a month because we just couldn’t take it and we spent a month in charleston and had such a blast, actually got out to the isle of palm there. I think it was called the windjammer which is like this really cool, like, you know, restaurant beach bar right right there. And her favorite artist actually was playing. And so I got to surprise her and do that. So that’s great.
Dgprince (06:11) Like,
Garrison Goodman (06:11) special place in our heart. We love.
Dgprince (06:13) It, yeah, my son during the height of the housing market sold his house had a bidding war on every house he tried to rent or buy. So then he ended up renting for a year. And then at the end of his lease, he still couldn’t really find something without overbidding to buy a house. So he, the lady that he was renting from, she was don’t worry about it. You can just rent another year signed. I was getting ready to sign the next year lease. And then before they could sign, she says nevermind I got an offer. I couldn’t resist. So I’m selling wow.
Dgprince (06:51) So they ended up coming here and staying in our house for three years until the market got a little bit better and they were able to move to Georgia and do what they wanted to do. But anyway, where I was going to go with that is they love charleston. They would get up every Saturday morning and drive to charleston all day, Saturday and then drive back. They loved it there. Like we can’t afford to live there, but we love it.
Garrison Goodman (07:13) That’s fun that’s fun. Well, I’m sure you’re you know, happy and sad to have your house to yourself back.
Dgprince (07:21) Absolutely. Yeah, because now they’re in coming Georgia which is a long ways. It’s six hours from here. They’re from Virginia. They’re like 10 hours and 38 minutes. So it’s not a quick trip anymore, not a quick trip. Anyway, all right. I have not really had an opportunity to really talk to a whole lot of folks.
Dgprince (07:45) I know it was spring break which I knew it was going to be kind of hard with folks, you know, being in and out and all those types of things. I have been putting my business case together for Ron with my three options just to try to, you know, let them know, you know, what staffing and everything else. And that’s the reason Kyle, I said, you know, I’m also trying to like just skew things out there to see, you know, if our staff were to do this, it’s going to take us this many hours to do it. If you know, you all were to do it, it’d only be this amount of time just to kind of give, I don’t want to say the shock value but the real value of it because sometimes when I tell them it’s that laborious for us. I don’t think they believe it. I don’t mean it to sound that way but like, well, it’s just a form. Well, it’s just a form within a systems application. You know what I’m saying? And some of them do go fast and some of them take a while. Like North Carolina medicaid, it’s a pain in the patookas to do. And anytime you have to do multiple practice locations, you know, it’s you have to do the application not just once but if it’s five locations, it’s five times and we literally have our urgent care which is on my agenda. With senior leadership. They attach every nurse practitioner that they hire for our urgent care division to all 19 locations. So I have to submit 19 applications for every nurse practitioner for North Carolina and for some of those other payers that are site specific. So again, just trying to, you know, the way we’re set up today that’s how it is. So I’m trying to work with some of those payers to say, will you accept a roster? You know, will you accept things even though we’re not delegated, will they take a roster? Is there an easier way to do it? And that type of stuff. But again, just trying to let them understand it’s not a quick answer or a quick fix for us with credentialstream the way it’s set up and the way that they populate our forms. We still have to go in and manipulate every line, almost every line on every form that they auto populate. So all the savings that was promised to us from credentialstream, we didn’t really get it from a manual, not from an application perspective. So bringing it back in house, not having to go direct and fill it out manually. We were promised, you know, all this auto fill. Well, it does auto fill, but then it has spaces or dashes or commas, and then we have to go into that line item and backspace and take them all out. So again, until they were able to literally sit and watch the staff do it, which is what I did. I was like, I would rather and I’m a very fast typer. So for me, I don’t want to say leave it blank. Let me type because I can type really fast but, you know, but then you have mistakes, you have to worry about that, but they’re making mistakes by doing the backspacing by leaving off a letter backspace a little bit too far and you look at it in your mind, it read right? You know, but you left an awful letter. So that type of stuff anyway, got it. Well.
Kyle Bettencourt (10:48) Yeah. I mean, we’re really excited to chat with you because I know we left the last call really kind of focused on the parent enrollment piece, but, you know, I think diving into it further, we realize there’s definitely some huge opportunity to help you guys out on the credentialing front.
Kyle Bettencourt (10:59) So, so yeah, we pulled some information together that we can run through. I guess just out of curiosity, did you guys meet last week in, as a group? Or how did we?
Dgprince (11:10) Met last week. Bryce didn’t come. Linda didn’t come. So it was just dr hooper and dr hooper is our hospital divisional VP over all the msos and hospital privileging because he is leading an initiative. We’ve got a couple of things going on that’s what I told Ron, I said everybody’s getting the lines blurred. So, for Ron and I, because when I spoke with him and he became my VP and I went hello, welcome to craziness. But please understand things that were promised aren’t delivered.
Dgprince (11:45) I said, so we’re struggling and we did, we were struggling hospital is struggling as well. We met our go live deadlines but we are struggling with being promised one thing and having something else that’s the reason you always hear me say, don’t give me a sales pitch, give me the real thing because again, if it’s going to be manual, just tell me it’s manual if it’s not going to work that great. Just tell me it’s not going to work that great. So we can plan for it versus everybody thinking that we got the moon and the stars and really we got a star. So I just need to know how it’s really going to function because this is, was promised a lot of technology and it really isn’t there. It’s very manual, very cumbersome. So meeting with Ron, I was trying to explain to him now that we’re in house and we’re doing this holy moly, what I thought was going to be an hour for all 17 applications. You know, it’s four to six hours for those applications for us to get through it. The delegated rosters, we have to do so much manual work on those still every month. And I’m not sure if it’s the same way. I think we talked about that. And you said it was the same way for you all anthem wants something different than united wants something different than, humana, commercial wants something different than humana military, you know? So it’s like you’ve got eight payers but all of them have their own unique spreadsheets… or rosters with the data that they want in them. And then anthem is just a beast in itself. They want their own type of specialty versus the provider’s true specialty. I mean, it’s really weird how they operate and we have well, the team, I don’t know how much pushback they’ve done that’s. Where I’m at now because I’m like why is it not uniform if I was online, completing the? Application, all the stuff in that application. So why am I having to do it now? You primary source delegated everything to me to do. Why do we have to put all that information? You know, what I’m saying on a spreadsheet, I’m just kind of pushing back trying to get the answer to say, you know, I want to say, sorry, this is what you’re going to get and accept it and see where we go. But yeah, I haven’t had the nerve to do it yet because I’m still trying to understand it all and what does that impact? Because we’re already struggling with them uploading their file. They ask us to give to them. It’s taken them like 60 days to upload the file. After they get it. We’re doing all the primary service work. We’re doing everything for them to me, it should be loaded in 30 days or less. So I’m pushing back on those things too. So anyway, so with Ron I’m trying to explain to him now that things are not as automated as we expected. The staff can’t get through the level of work that we thought they were going to get through. So now we’re at that fte thing.
Dgprince (14:41) You know what I’m saying? We’re winning ftes especially with the 40 percent growth and they want us to take on and be a centralized credentialing team for all of sentara. So with that said, there is no bandwidth, there is no capacity to do that. But meanwhile hospitals are losing money, our enterprises division is losing money, you know, our hospice centers, our pace centers, our dme centers because they don’t they haven’t done enrollment with payers. So they’re losing money. So I’m helping them, but I’m teaching them how to Fish for them to go do it currently. But unfortunately, there’s such turnover in those divisions that the knowledge isn’t getting shared. So here we go, somebody needs to be re cred, or they all of a sudden have denials. Again, they’re coming back to our team and I’m like, okay, it distracts from what we’re supposed to do, but we are all sentara. So I still keep trying to push up my sleeves and help them. We’re gonna need staff if that’s gonna happen without technology without everything else. We’re gonna need people to help. So that’s kind of where he came into it. So the two things that are going on right now is the 40 percent initiative to increase positions. You know, Melinda and Dave Mathis has come down from the top down, saying shorten the length of time that it takes you to bring on a provider period, whether that be talent acquisition, recruitment, HR, credentialing, hospital, mso, whoever it is, start shaving some time off of that because we can’t find a clinician make a job offer and say, well, you can’t start until 120 days. That defeats the whole purpose. So they’re looking for us to get something more like in a 30 60 day range. I don’t know that’ll ever happen just because… we can like I shared with you all the numbers. I mean, we are getting payer enrollment from the time we submit it to time, return back of effective date less than 60, but it may have taken us 60 days to get all the information from everybody to get it out the door if that makes sense. But folks don’t understand that piece. It’s not a matter of provider’s hired. You just need an npi number and roll, it doesn’t work that way. You have to do all of those pieces to get there. And sometimes clinicians are just very slow at responding or giving you information that you need to be able to close the loop and close the file. Like our Coi, our coverage of insurance every year, every may, we do a new, we have only one insurance company for all of sentara. So our coverage of insurance is renewed every may. So guess what you are a new grad season and we’re waiting for the vendor to send us all new cois for our existing providers… because in Virginia, we had to increase the limits every year for I don’t remember how many years like six or seven years. So we’re in that increased span every year. And so that means, you know, risk is doing that. I mean when we have all the new ones coming in, they’re just kind of sitting there waiting for them to get through that mass project. And then they go back to it. I can’t do payer enrollment or update caqh without that Coi. So payer enrollment kind of sits. So we have to make a decision, you can hire them, but we can have loss in revenue, but nobody wants to hear about the loss in revenue because they don’t want the position to start until then, which then creates that gap. So those are two things that we’ve got big initiatives. So dr Cooper is leading the initiative on shortening the timeframe from finding and doing the recruiting and extending the offer to onboarding. They want that time shortened as much as possible. So we have a work group around that. So when we went to our meeting. It was supposed to be encompass of everything and that was only the focus was how are we going to streamline? How are we going to fix things? So I did talk to Bryce a little bit. He was actually in our office on Wednesday and I told him, you know, it’s not all about just pay your enrollment to make things better, which is where everybody’s looking at even for the timeline, you can start a position tomorrow. You’re just going to lose money. So at the end of the day, but they can’t start, they can’t step foot in the hospital if they have privileges and that’s taken upwards of six days. So you got to fix that. And we have 12 hospitals with 12 different committees. They have their own 12 separate bylaws like if we are sentara, fix that, Fix that. And then my team can move things along much faster. But right now, we have to submit to 12 different committees if they’re going to go to multiple, well depends on how many hospitals they’ll only go to all 12.
Dgprince (19:34) But often I have a provider, especially hospitalists, you know, or even your specialists, like your cardiologists, neurologists, whoever it may be, or neurologists, they’re all going to go to, because in Hampton roads, we have three hospitals that are like probably eight Miles away from each other, 10 Miles at most. So those providers can go to all three of those hospitals to render care. So I’m going to have to, you know, have hospital privileges at all three. Well, that means three committees, three macs, three separate applications. How insane is that fix that? Fix? That? That’ll help streamline some of the time. So that’s kind of what that meeting turned into. But we’re talking with Bryce. I told him I said that’s only fixing one piece of it. I said that still doesn’t take care of what my needs are and what we need. And he told Ron, he said get it to him, put it in front of him and let’s start talking about it, what we need. And he says, but you’re not going to get 44 staff. And I said, well, I’m not, I said, I just said everybody got hung up on that number. I said because, you know, I said if we continue this growth, eventually my team would be 44 people. But anyway, I don’t think we need 44 today. I know we don’t need 44 today. But if we continue to grow. And if we take on the whole entire enterprise of sentara, all, you know, the health system of sentara, for, you know, credentialing but not the health plan. But if we take on all other divisions, all the 12 hospitals enterprises, you know, pace and all those other things, yeah, we’re going to need a pretty big team to manage all that stuff. So just trying to get them to see the reality of it, you can’t just snap your fingers and it happens, we’re going to have the staff to do it.
Garrison Goodman (21:23) So that’s where your.
Dgprince (21:24) technology will help go ahead that.
Garrison Goodman (21:27) Tends to be the hardest part where it’s like getting them to realize you can’t just, you know, put more work into the same capacity that you have.
Dgprince (21:35) Correct.
Garrison Goodman (21:36) And folks that haven’t dove into the process and actually understand in and out of it. So, what was kind of their reaction to, you know, what you outlaid as like, hey, with the growth, we’re going to need a bigger team and therefore bigger costs. What was?
Dgprince (21:52) Basically, Bryce just told me to put the case together, present it and let’s start working on it. That’s kind of where he was at. So that’s what I was trying to do. So, I’ve started it. I just hadn’t slowed down to finish it. I’m almost done with it but started doing that case. You know, this is what we were originally told. Again, I need them to understand well where we are today in a crisis just for us to bring in payer, enrollment in house is because this is what we were promised but that’s not what we were delivered. So that’s the number one thing I need them to understand hospital may love Healthstream and it may work really well for privileging, but it is a very clunky manual workflow process for us. Just like yesterday. I was trying to run reporting and because our systems analysts moved just a few fields around to make them more flexible for the staff. But the fields are still the same. But now it’s at the top versus in the middle or at the bottom, my reporting is all jacked up. So, my report yesterday, when I was trying to run numbers, nothing’s working. And I’m like, lord help me because we created dashboards and then reports, but I could go and push the manual reports or queries and I could get the data but none of my dashboards are right. So that doesn’t make any sense. It doesn’t matter if I refreshed it or what I did with it. So she’ll be back today, but I’m like, good luck. You got a lot of work to do. You moved some fields around. Now. We’ve got everything all jacked up which it shouldn’t be because again, the variable is still the variable. It doesn’t make any sense to me but that’s how Healthstream is. It’s very… you can’t mess with it without breaking something else.
Garrison Goodman (23:39) Yeah. Okay. One of the questions that’s high level, you mentioned the two main initiatives which is grow at 40 percent and then improve onboarding, correct? You mentioned a couple of times around like, hey, the hospitals as well as all the orgs are losing money because of this process. Is that just due to time or what are the other factors that contribute to that? Well?
Dgprince (24:04) The other, the hospitals and them are losing money because what had happened was we had someone that had worked for the organization almost 40, three years, 44 years. And she did all the hospital enrollments and all those things for those divisions. So like behavioral health, I guess a lot of the hospitals and, I haven’t been on the hospital side in 28 years. So, again, Kathy Warren was there when I was on the hospital side and now she’s gone, but she managed all the finances, you know, paycos, payer enrollment if needed. And all that for some of those hospital divisions that you had to enroll providers with. So like behavioral health, you may have a behavioral health, inpatient outpatient program. Well, if you have a state funded or state ran program, then you have to enroll in those commercial payers as well as those government payers. Well, she did it all. Well, she retired two years ago. Well, now, all of a sudden the providers are up for re, cred, They’ve added new providers and they’re getting denials that knowledge is gone. No one knows how to do it. So that’s what’s happening there. Garrison is that they just don’t they don’t know until they start getting denials and the Ar, folks are going, let me call credentialing. I know, door server and credentialing, let me call her and I’m like hold on a minute, don’t know what that is. And then the same thing with pace, Pace providers do not get pay or enrolled with anybody but medicaid because medicare is a pace program and they’re paid. But for medicaid, they have to be enrolled. I don’t know, I had to go and read to even know what it was, how does it work? And what, you know, who does need to be enrolled. So it’s that type of stuff and then practice operations or I’m saying not practice but operational leaders within some of those hospitals or like within enterprises, those operational leaders did the credentialing for those providers, but they have now left or been promoted or whatever it may be. And no one knowledge shared before they left, that’s what’s in there yep.
Garrison Goodman (26:03) So, that makes sense. So, it’s hey, you’re going to have to grow. And then if you were going to, you know, backfill this woman who left a couple years ago, you have to get the right experience, the right knowledge. And then you add management layers. Those managers also have to have that experience, correct. And so that becomes a lot of enablement and overhead for I’m assuming you right, and.
Dgprince (26:28) that’s the part that I tried to explain here by the way we just didn’t roll them. I said it’s not that simple. So, it was like pace, I must have done research. I can’t tell. I called so many payers spoke to so many people. They’re like we don’t know what you’re talking about. So then I went to medicare. Thank goodness. I have her last name’s. Temple. I can’t think of her first name right now, at medicare and she is very, she’s very direct. She says don’t call me unless your life depends on it because I have too much to do. So, I called her and I said my life depends on it. I’m calling and she goes it better. She just so direct, but I guess that’s how she keeps people from calling her all the time.
Garrison Goodman (27:06) Yeah.
Dgprince (27:06) And she goes, I’m gonna send you the link, read that tonight for your bedtime story, not a problem. Thank you. And she sent it to me and I was like it’s a freaking contract but the pace people couldn’t even explain it to me. They could not explain their service. So I started backing into it. Well, how do you get paid? Well, we do this log. Well, what kind of a log, you know, what I’m saying? So I went from, how do you bill, how do you get paid? Then I went to I’m gonna remember her name here in a moment. Her last name’s temple. But anyway, Dawn, her name’s Dawn temple. So I called Dawn and I’m like help me, she says it’s a contract do this tonight for your bedtime reading. So I read and I’m like son of a gun. It is a contract. I don’t need to pay or enroll with medicare, but you do need to pay or enroll with medicaid. So anyway, it just takes a lot of research and you can’t just go out and do an application. The way I do provider enrollment. It’s not the same. It’s not the same. And that’s what I tried to explain to everybody, a facility is not a provider group.
Garrison Goodman (28:05) Yeah.
Dgprince (28:06) Okay.
Garrison Goodman (28:08) Okay. Yeah. This is really helpful insight and I think it makes sense. And so when we hear, this is like the exact, I would say ideal scenario for us where, you know, you’ve… got great leadership but know that there’s a problem to solve and know that adding people won’t fix the core won’t be a core long term solution, right? If I’ve learned anything about us working together, Doris, like you want something that’s like a real fix that, you know?
Dgprince (28:39) Absolutely. Long term, long fix. Yes, true. And,
Garrison Goodman (28:42) the other thing you said too that I think is actually a great fit for us is the fact that the hospitals can keep their privileging set up the way it is and doesn’t have to change anything they don’t want to. And we’ve got capabilities and we work with health systems that have that exact setup and it works great.
Dgprince (29:02) And.
Garrison Goodman (29:03) we also have health systems that use our privileging but it’s like we can tackle that in a year or two or three if you guys want to. But we don’t have to. And so I think Kyle and Noah put some things together that we want your eyes on. And one of the things that you mentioned was, hey, we got to build this case. So we try to partner very closely. You probably got a sense of working with us right now. This is a workshop for sure. So we want you to correct everything here. But we’re hoping that we did some of the work for you so that, yeah, you can stand on two feet. I think when you go to, I think you had to go to Ron and Bryce and probably ultimately Michael too because the one thing I want to know is like as part of onboarding, where do you want medallion to own versus, you know, whatever you may be doing over there. So we’ll you know, table that for a second and we’ll walk through this. So I’ll let Kyle introduce it. But the high level is we’ve added in the PSV function of production as well.
Dgprince (30:10) Good, very good. Yeah.
Kyle Bettencourt (30:13) And so, you know, just kind of like walking through, you know, that table that you sent us and just comparing current, you know, current times to medallion, right? Like there’s some pretty significant opportunity here to reduce, you know, everything across the board, right? So, you know, starting off with the pay or direct enrollments, you know, you mentioned four hours on average… realistically, you know, we’re like 10 to 15 minutes per payroll day. I think the big one though is going to be the primary source verification. So you mentioned 15 day average turnaround time. We’re doing that one day on average, but we actually have a three day guarantee written into our contracts. So, I know you mentioned, you know, the idea of saying it’s all going to be great and automated but not actually having any sort of proof. So we can actually back that up for you which I think will go a long way in getting some confidence from your team there and being able to relay that internally and the.
Dgprince (31:10) primary source verifications. And I assume, I mean, even though we’re in cqa, like I said, anthem is our biggest one, that is just nitpicky as I don’t know what, I don’t know if y’all have had experience with that. I think we talked about that a little bit the other day but my goodness because they’re saying that we can’t we’re not only are we required to follow ncqa, but we’re also required to follow all compliant regulatory guidelines of anthem. And it’s like this little tiny wording at the bottom of our big contract language, but… it wasn’t in our delegated agreement. So again, I push back on Lisa every year and I’m like we are ncqa. We’re following the guidelines here are, you know, and she’s like, yeah, but you don’t have this, you don’t have that. And I’m like we’re not required, you know, but she keeps pushing back on it. So again, I didn’t know if y’all encounter that or not with any of the delegations that you have.
Noah Laack-Veeder (32:05) Yeah. I mean, you’d hope that they kind of go with the efficiencies with ncqa, but look if there’s custom requirements that are going to be part of this, we can add those in, I think, and that’s something that we can kind of scope out. But generally speaking, there’s a little bit more complicated psvs with joint commission if you think of those. And our contractual SLA with that is five. So all I’m saying there is like huge.
Dgprince (32:32) Savings.
Noah Laack-Veeder (32:34) and so, yeah. So just wanted to call that out. Yeah.
Dgprince (32:39) I mean, even prior vendor, you know, to the, to Healthstream, we were six days. We were literally at six days with advantum, we’re at 15 with, you know, one click cvo within Healthstream. So again, I know there’s opportunities what I’m trying to get to. So again don’t doubt it. So, thank you. Yeah.
Kyle Bettencourt (33:03) Cool. Yeah. And then just kind of walk through the rest here, right? So new provider set up, you know, we can, you know, utilize auto sync, so greatly reduce, that time for your staff and the pay or follow up and status tracking. You know, I don’t know that we have numbers… but, you know, I think like conservatively we’re you don’t have to do that anymore, right? With your team. So that’s going to save you guys a ton of time. I know we have two and a half to four hours here, but I mean, curious, is that, what would you estimate from like.
Dgprince (33:31) a time period? Probably that, yeah, I mean, because right now we’re just, I mean, we’ve only been doing it for three months. So I haven’t really because they’re still learning, you know, what I’m saying, the system and the processes and everything else. So follow up they are doing it, but probably, yeah, that’s probably about, right?
Kyle Bettencourt (33:47) Cool. And yeah, just, you know, applying that scale, right to a 1,000 projected hires, right? We’re looking at 7,500 to, you know, potentially 13,000 hours of labor that we can save sentara, right?
Dgprince (34:00) Okay. From.
Kyle Bettencourt (34:01) Utilizing medallion. So that’s just kind of how we’re thinking about initially on some of the operational capacity impact, you know, as far as reducing just the overall time to onboarding providers, right? You know, I think there’s just a huge opportunity when it comes to onboarding caqh, and just the primary source verification. You know, on average, you get the payer enrollments submitted. I think we’re about three days, correct me if I’m wrong there, Noah, but we also contractually will guarantee five days from being those providers, you know, enrolled with your payers?
Dgprince (34:34) Okay. Awesome. So, yeah.
Garrison Goodman (34:38) But I really like this slide because it.
Dgprince (34:40) kind of paints.
Garrison Goodman (34:41) A picture of like, hey, a lot of the pain is actually before the enrollment piece as well. And so even if that’s like near… even which I know we were working on only a couple months of data. I mean, there’s so much time saving there. So like what, you know, what do you think the team’s reaction to this will be? And, you know, where do you think we need to detail out in the future to help, you know, kind of paint this picture. I.
Dgprince (35:10) Think they’ll like this very much because again, that was one of the things in our, you know, provider onboarding sooner or quicker than they are today. Well, like I tried to tell everybody, they can set a date. I’m just gonna make up my story. So if Doris prince is moving from California to Virginia to work here, doubt that would ever happen. But if it were to happen then, you know, you can set a date out further than you expect. But then why don’t we have some good news for once and say, you know, dr prince, we were able to get your provider, you know, your payer enrollment done. If you’d like we can start you 30 days earlier, that type of thing. So like I was trying to explain to some of the executives in the room, I said I can’t guarantee what payers are gonna do, but I can tell you that some of these payers, we can get through pretty quick and our delegated payers, we should be able to hire them, get them through primary sourcing on that month’s committee. And that’s eight of our 17. And if you saw, you know, my medicare and my medicaid folks are getting things done less than 30 days for approvals for those. So now you’ve got, you know, 10 of your top payers that are less than 30 days. So if you can get them to complete their application, get them to provide us their information, we can get this piece done. We could easily have a provider start in 30 45 days from time of offer… but only see those patients with those plans and only publish to the world that they’re seeing these patients and these plans when they first start. And then we can add the other zone, you know, saying there’s other ways to do it. But I can only speak to payer enrollment. Like I told them, they gotta clean up the hospital privileges first and make that move faster because I can’t change that piece, but this would help us streamline the payer enrollment side of the house. And I.
Garrison Goodman (37:09) Would say, you know, in that first part, you typically get people to be like, there’s no way you can do it in three to five days, and that’s where we’re like actually we’ll contractually commit to that. The one thing that, you know, to caveat is you need a provider to log into the system and we’ll message them, you know, but once they’re in, our average time to profile completion is like two and a half hours, right? Because we just make it super easy for them. Plus we’re doing a lot of the integration of work from caqh. So we’ll see that and be like this is already somewhat completed for me. So that’s the only part that like, you know, to caveat with you is, but once, they’re in and we’re fast, but you’ve got to get them to log.
Dgprince (37:52) In, so, right, and those will be all the pieces that, you know, and I’m probably saying too much, but… actual is so much better than what we had because we had nothing from the medical group side. The hospital was using Healthstream. They were using the provider hub. So they did a lot of their communications and all the work within Healthstream via the provider hub. And it was a one stop shop for them. They had, you know, electronic application, everything built within Healthstream. It worked very well for them. So let’s say if the provider forgot to add something or mistype, something, our specialist on the hospital side could go in and update it and just resend it and the physician could sign it and then send it back. And then they’d move on. Well, they added a layer of actual, it’s very slick, very cool product. And for us, we like it from the medical group side because we had nothing, you know. So we really like it. It’s it’s an E wallet that literally, all I need is their mpi name, the mpi number, their name, and I think date of birth, I think there’s only three things that we really have to have. And then we push it to them. And then once they do that identification with their driver’s license, or some other type of form of official id, like you said, it goes out there starts pulling everything. It just auto populates a lot of the application for them. And then it asks all the additional questions and things that we need from them. And then their attestation, they sign, they give us their caqh login and all that. So that is the piece that, you know, the hospital like we don’t need axuall. Why are we paying for this? We had all this in Healthstream. It’s another layer, get rid of it. But those are some of the things that we are going to have to figure out how do we do that? Because everything that we do in axuall is for us and the hospital. So my team for every provider that works for the medical group, we are the conduit and that step one for all that data gathering. And for all those pieces within axuall which then flows into Healthstream. And then the hospital starts their piece and then we break off and start our payer piece. If that makes sense. How I describe that?
Dgprince (40:03) So, again, I know that’s more down the road, but just want to throw that out there. We’re going to have to, but, the organization is looking to say is axuall really, do we need to keep it or not? Our opinion is those who are in the weeds? The answer is no, okay. We can pretty much get everything that we already need with Healthstream. From a hospital perspective. From that application perspective, the provider hub is there, the provider hub is an E wallet as well in its own essence. So again, I feel like we have two E wallets and the hospital uses both because when they go for their recreds and everything they don’t use axuall, they use the provider hub. So the hospital team has fragmented workflows and processes.
Garrison Goodman (40:49) Okay.
Dgprince (40:51) Anyway, anyway, but now I think this is going to be really good. I think this will be very good for Bryce and Ron to help push it up to the next level. And then again, you know, we’ll have to go to it and everybody else to make sure because Healthstream has become the single source of provider data today. The repository that, that’s what they’re trying to do. Because again, the health plan uses Healthstream but their own instance. And then we… the hospital and us use the same instance of Healthstream. And then Casey, you know, he was participating in our calls as well. He’s over for managed care contracting. And because of the things that are changing in 20 27, he’s looking to use Healthstream to help him manage the 200 plus applications he’s got to do per payer. Now moving forward for all of those offsite hospital locations underneath his hospital managed care contracts.
Garrison Goodman (41:54) Yeah. Okay. Doris, what, I would recommend? And what we do for pretty much all of our customers is let’s you know, help you with the business case and get, hey, yes, this is something we want to solve.
Dgprince (42:08) And then what.
Garrison Goodman (42:10) Noah and team are experts at is mapping out like, hey, here’s what your current system and workflows are. And here’s where it would be in the future and.
Dgprince (42:20) That one.
Garrison Goodman (42:21) Helps everybody see like, hey, where’s the efficiency gain? But also gives like confidence like, hey, no, we’ve actually mapped this out and we know how it’s going to work.
Kyle Bettencourt (42:30) And.
Garrison Goodman (42:31) to your point on like, hey, do we want to consolidate any systems? Like how would that architecturally look? We, I think in a, you know, good hour or so session, we could map everything out current state and put together a good future state for you?
Dgprince (42:46) That sounds great.
Garrison Goodman (42:47) Okay. So let’s chug along. Okay? I want to again make sure that this is accurate and what we need to change, we can change in the fly as we go. But yeah, we’ve got.
Kyle Bettencourt (43:01) Like three more slides. We can kind of run through and get your take on it. But, you know, I think, you know, kind of like we mentioned, right? Like the home run is the PSP guidelines, right? We can guarantee three days on average, we do one day. Okay? And then not only that just the amount of days that we can accelerate from provider onboarding, the amount of, you know, labor that’s going to be required from your guys’, team that’s all automated there’s just, you know, a ton there to that we can dig into and really show some value. And then, yeah, again, like on the revenue acceleration piece, right? You know, we’re pretty comparable to your guys’ current in house times as it stands. I know you mentioned it’s a pretty small sample size, but, you know, one thing I guess I was kind of curious about is like kind of where you see things going, you know, if you stay with, on the current projections, like with your guys’ parent enrollment turnaround times, like do you think the advantum times are a more accurate representation… of sort of what your team will achieve? Or just kind of curious your thoughts on that?
Dgprince (44:10) I think it’d be somewhere in the middle. I mean, if, you know, I would hope it would stay pretty close to what we’re doing now, but again, it’s going to become a juggle, you know what I’m saying? Do I do the follow up or do? Because again, when the volume is coming in, they’re going to be focused on the new applications and getting them out the door because if you don’t submit the application, it’s definitely lost in revenue. So, and the follow ups, I think the follow ups would be what would kind of lag behind, but the new application would stay going out the door. So again, you know, if 90 percent of those automatically get approved, you only have a 10 percent fallout, then that 10 percent is where I think we would get in trouble if that makes sense with the follow up, but I think they all know because the ones that are doing, payroll enrollment used to be Ar folks. So they get it. It scares them to death. I have Amber, Megan, and Jennifer who all three, if they have, they had like 22 providers assigned to them like in one day and they were all freaking out because they couldn’t get all 22 out in one day and they’re like I didn’t get it out yesterday. I just want you to know if you go in there and look, it’s not a lot. And the next thing I’m like, well, we got 10 more then we still got 12. I’m like take a breath as long as you get them out in the next five days. I’m good. So take a breath. It’s okay, you know, but they were like freaking out. They didn’t get out day one. So, yeah. And I, I’m hoping to be better than advantum was because they would not work it as soon as received, you know, say it’s like they would work it. I want to say like once a week or however, how they, I couldn’t really figure out their rhythm. I really couldn’t how they were working it. It wasn’t a consistent day by day where our staff were literally doing it every day and staying on top of it. Yeah.
Garrison Goodman (45:57) And Doris we were, I mean, even if we’re conservative and say like look even if we’re just even on the enrollment side, if we solve the psvs that’s exciting because it’s significant savings across all providers not, and payers, not just those that are direct.
Kyle Bettencourt (46:15) Correct, correct?
Garrison Goodman (46:17) So, we wanted to kind of ask you is like what is the best way you think to model out the revenue acceleration here? And what, you know, do you think that you would want that you could stand on, stand behind? And so we didn’t want to like put a number out there because like we just wanted to build it with you because our thoughts are like, hey, a 1,000 new providers, 15 days across all.
Garrison Goodman (46:41) And then obviously, there’s some savings on, the direct enrollments too, right? And… we kind of modeled out those four points that you gave us. Hey here, the hour savings that we see there’s probably more right? What is the right way, to show that impact, to revenue?
Dgprince (47:00) Because to me, again, it’s not necessarily well delegated… payers, not necessarily loss in revenue, but it’s expediting revenue if that makes sense. Because typically we can get those approval dates. It just takes us longer to get them where your direct enrollment, it is loss in revenue. Because if you don’t get the application out the door, then it’s loss in revenue.
Dgprince (47:28) Let me think on that one.
Garrison Goodman (47:30) Okay. Well, if we just take that where it’s like revenue acceleration across all. And then new revenue across direct enrollments of, you know, 14 days or 13, 13 days if you want to be conservative, right?
Noah Laack-Veeder (47:44) Okay. I can.
Dgprince (47:46) Tell you just like I said, historically, I, you know, I’ve already committed that with, even with my team as manual as we are, that we would be able to save a 1,000,000 dollars this year. And I do believe that just because again we can control it, it’s in house, you’re saying we have better control. We have better insight into it where with the advantage system, I want to say, I don’t want to say we were the blind in that we were blinded with our vendor, but you could only see certain things. You know, what I’m saying you could see some of the notes but they weren’t always consistent with their notes. So we were constantly had an outstanding tracker that we would say what is the status of this? Or we would go to the payers ourselves and there would be no new application on file. Then we’d go back and say there’s no application on file, you know, that type of stuff or, you know, I found myself logging into paycos all the time and tracking, where was the application for medicare? And I’m like it’s sitting out here for E signature for 90 days. Why the heck are you not asking me for it or saying something that, that’s easy money that we’re losing? You know, because the provider hasn’t signed their E signature, that’s just not acceptable. Let’s go along that type of thing. So. And.
Noah Laack-Veeder (48:57) Doris, like thinking about just your team like they’re highly effective, but like with all this work on their plate, it’s a ton of work to log into paycos and do the status tracking. So what we feel what we believe is like across the board here, by offloading that work, the automation like going directly to paycos, going directly to medicaid portals. Like we’re going to be catching these things way up front leading to, and you kind of mentioned it, if you’re missing these things, it’s leading to delays, correct? And every delay is going to be some utilization of revenue that we’re missing. And so how we typically think about it, Doris, is there’s going to be a utilization for these providers? And there’s going to be a total revenue per day that we could be capturing if you, if we can kind of get those numbers that’s typically how we think about revenue acceleration. And it kind of based on that 1,000,000 dollars that’s the similar model that you were using to quantify that or like, what were you using, to create that 1,000,000 dollars?
Dgprince (49:57) So what I did was I went back and to look again like at some of the payers, that advantage was taken upwards of 90 to 120 days. And again we’re able to.
Noah Laack-Veeder (50:08) To do.
Dgprince (50:08) it much faster than sooner. And then the follow up, we were doing the follow up where they were not doing the follow up. So that I took our write offs, I took our little losses that we did last year and I was not going to commit to half of it or even more than that because I think last year overall because again, we have three phos that I cannot control which I’m hoping that someone that’s part of our win discussions, they’ll dissolve them because anytime you have three separate groups also mixed into payer enrollment, it’s confusion for the clinician, we have lost in revenue because they don’t do things they’re supposed to do timely. They don’t do the follow up. But then everybody comes to my shop because we own credentialing and I own credentialing denials. From a revenue cycle perspective, everybody thinks we didn’t do something that we should have done, but it’s a third party vendor, a third party company that sentara partnered with for the community physicians. So again, it was like three point 5,000,000 last year, but I do feel like with all of the medical groups that my team manages for 100 percent, we could easily do a 1,000,000 just based off of the write offs that we had for that last year. So I was my, I went into this saying we’ll reduce last year’s write offs by a 1,000,000, you know, saying by bringing it in house and then we’ll go from there and start backtracking into because I think it’s going to be more than that, but I’m not going to commit to it because I can’t control, those phos, and if I don’t have enough of staff, I’m nervous about that too, the timing, you know, saying if we don’t have enough of staff, but we could easily get to like you said the per day revenue? Yeah.
Noah Laack-Veeder (51:55) That makes a lot of sense. I mean, these are kind of the pieces where, you know, those when we’re going back to the demo, we’re talking about there’s some mundane tasks that take a lot of time and if they’re missed, it leads to really big downstream impacts. But there’s other things that we want the team to be doing as well that are higher value. So kind of thinking about that pay your follow up caqh, the onboarding and primary source verification. Like these are the timelines are going back to Kyle’s kind of end to end time frame like that’s something that we’re really excited about mostly because even if, like we said, this check mark, if we’re at par with your current turnaround times, right? It’s going to be less resource intensive and we’re going to be reducing that primary source verification from about 15 days down to one, right? Right? And that’s the minimum benefit, right? Right? So, I think we’re all aligned there. Okay?
Dgprince (52:47) Okay. Yeah. I think it should be revenue per day. So that way we can calculate it that way, okay?
Garrison Goodman (52:51) Yeah, we’ll.
Dgprince (52:52) follow.
Garrison Goodman (52:52) up.
Dgprince (52:52) With some.
Garrison Goodman (52:53) Estimates and allow you to make some adjustments, okay? Yep.
Kyle Bettencourt (52:58) And then just, you know, kind of last slide or, you know, point here on the fte capacity, right? You know, I think we’ve talked about this pretty thoroughly together at this point, right? But, you know, with the 40 percent growth, we can just absorb that with your current headcount, right? So, I think like that alone is a huge win, you know, without the new tech, you know, we’re we were estimating about 30 to 34 ftes that would be required over, this growth period. And then six immediately this year. So, you know, just on the fte front, I mean, we’re looking at a 1,000,000 dollars plus and correct potential savings for you guys.
Dgprince (53:36) The fte savings alone is going to be huge, I mean, again, and.
Garrison Goodman (53:40) we, you know, we took conservative here, Doris given your, you know, kind of guidance from last time because we don’t I don’t think we like drilled down into the, to the credentialing team and PSV team who’s doing what. So we kind of modeled this on just like avoiding future headcount plus, the natural attrition like you mentioned before… curious if that’s the approach you want to take or if you think we need to go more aggressive in regards to.
Dgprince (54:06) Capacity, no, I think this is where we need to go for now because again, we got to get through everything. So again, there’s a lot of things that my team does that no one else understands. There’s a ton of projects. You know, that sentara medical group. I can’t say medical group, medical groups are doing and we’re pulled into all of that because again, it is like it could be a new line of business, new line of service. It could be we wanted this telehealth, we didn’t do it before but we want to have a hub versus a, you know, location and all of those things. So again, my team, when I say my team, Kristen and I will definitely get sucked into all of that from a higher level. But then from that then becomes project meetings where, okay, now we’ve stood it up but they want those handheld meetings where we’re providing reporting to them to say, okay, we had 15 providers for this location. What is their status? So in order for us to get through all that, Kristen has several of her credentialing specialists who runs those meetings who have a half an hour to an hour meeting with those practice operational leaders going. This is where we’re at. This is what we’re doing. I’m trying to change that mentality for because like I keep telling them, there’s 350 of you all as practice operational leaders, but there’s only, you know, a handful of us on our side of the house if you take just the every team member, just 21 of us, 21 to 300 plus is nothing, you know, to be able to meet with all of them individually.
Dgprince (55:39) So I’m trying to teach people to understand, right? Teach, but share with them that they need to understand a report is a good tool. Read it, look at it if you have a question, call me, but I need to sit in a meeting with 300 different people, you know, consistently. And that’s the hand holding mentality that they have today. So I’ve got to change it. But they are doing that today, there’s a lot of stuff that the team is doing. We still have edit management in epic that we’d have to do. You don’t say, and we still have a customer service box and a phone line that we answer questions from either a credentialing perspective or it could be emails that are coming in truly from a customer service staff, which again, I’m trying to educate and train them that’s not a credentialing that’s a billing go to billing team for Ar, follow up that kind of stuff. But if we don’t have it there, then the poor patient gets moved around to 50 different directions and never gets an answer. And then everybody says it’s credentialing. So we do have some of those little pods. So again, we’ll be able to reduce the staff as far as doing the credit true, heads down credentialing, but my 21 staff do all those other busy things as well as what they’re doing today. Okay. I think we’ll still need. I don’t know that we’ll need everybody that we have today. If we’re able to do this. I really don’t but like I said, I’ve got three people that are very close to retirement age. And as they phase things out in my denial management, I have one person working my denials, I could really use two to work those. OK, that type of stuff we can move people around.
Garrison Goodman (57:18) OK. All right. So we’ll keep this here and we’ll create just like an overall one summary slide based upon, what we learned here. OK? We’ll send that to you.
Dgprince (57:33) You.
Garrison Goodman (57:33) Know, in terms of next steps, sounds like you’re building the case and going to have that conversation, with Ron and Bryce, I.
Dgprince (57:42) Plan to do that. Hopefully on Thursday of this week, like I said, I’ve pretty much done, you know, my take on, you know, what I was originally recommending which is pretty much in alignment. What we’re talking about here. Today. Again, they asked me for three different models again fully in house which we know is not going to work with our current vendor. That’s just not going to work. The second was a hybrid with caqh and direct enrollment, but added a new solution and vendor. And the third was it’ll always be hybrid because onboarding, I can’t give my onboarding team. You know, what I’m saying I can’t give it. I will still have to have a credentialing team to do all those other things outside of this, but again, still have hybrid. But with caqh payer enrollment, you know, full payer enrollment with direct and primary source verifications, you know, being added with a new solution and vendor. So again just kind of painting that picture with everybody to let them know that, yes, we’re fully in house today. I don’t think that’s the right solution, not with this vendor and technology that we have or technology that we have. But I think we need to go to number two like sooner than later. And eventually, you know, if possible, I would like to go with number three where you do it at all the primary source and all of it. Okay?
Garrison Goodman (59:03) And again.
Dgprince (59:04) If it’s a partial again, where we do the follow up, I’m okay with that too because you guys have done the heavy lift, you know what I’m saying? Pushing everything out the door. And if we have to work the fallout stuff, I’m perfectly good with that. Okay? Because again, the staff, most of our staff are very skilled and they’re used to doing follow up. Okay. Is there.
Garrison Goodman (59:24) anything else that we could put together that would be helpful for you in that conversation? Yeah, I don’t.
Dgprince (59:31) think so. I think the biggest thing where I can come back is going to be how much is it going to cost? And I know we haven’t even talked that yet because we haven’t even gotten that far yet. But I know that’s where it’s going to be. I’m like, well that’d be step two. Well, I.
Garrison Goodman (59:41) Think that what you can tell is like look, we just want to align on like what the outcome to the business is. And if that’s the case, we’re going to come under that because it’s got to make sense to change. So, whatever the, you know, you probably captured this from working with us already. Like if we’re you know, within current opex, we want to be below and if we can, you know, pull some value from revenue acceleration like to grow that Roi great. But we don’t approach deals unless we understand that there’s a business case that we can stand behind, right? So that’s kind of where we’re putting a lot of focus on this and love that y’all are thinking that way too.
Dgprince (60:18) Absolutely.
Garrison Goodman (60:19) So, so, you know, we’ll figure it all out but just know from us like, it has to make sense for a business case. Otherwise it’s going to get turned down, by Melinda, which is oftentimes why we start in the financial world.
Dgprince (60:32) Exactly. So.
Garrison Goodman (60:33) We’ll we’ll make sure that as long as the business case is there, we will put together, we have very transparent pricing and we’ll go through that. But we just want to validate business case and we’ll come back to the proposal that ties it all together absolutely.
Dgprince (60:47) And I just need, you know, that was like, you know, at the end at the very first page that I put together a price and then was like, I need an answer, you know, what I need to know what is your preferred operating model? Are you asking me to stay as is, then cough up some ftes because we’re not going to survive. But if that’s not the case, authorize next steps and tell me what those are. Page one. He knows how direct I am. So that was just, I was like, where am I going? Because everybody’s getting the two confused and like the hospital leadership is so focused on Healthstream, you know, they’re I feel like we’re in a, you ever seen the old, what was it? Was the rubber doll where people would just stretch. Was it stretch Armstrong or whatever?
Garrison Goodman (61:32) I definitely.
Dgprince (61:34) Feel like that? Yeah, because last week, I must have had four two to four hour sessions of how can… we optimize Healthstream? And I’m like I’ve spent three years trying to optimize this, leave me alone. Sorry, but it’s like on the hospital side, yes, it works well for them but I think they would be blown away if they stepped out and saw another solution other than Healthstream. It’s Healthstream for them and it’s what they’re comfortable with. I’m used to epic. I’m used to Ge centricity, I’m used to Ar systems and I’m going. Okay, what a piece of mess. Oh, Ge, was old, but boy is this old?
Garrison Goodman (62:27) Anyway, well, Doris, this has been great. It’s been fun partnering with you so far. We’ll make the edits you’re having your conversation Thursday. In terms of assuming that goes well, there’s probably gonna be some questions that come from it. We’ll work through. I think the two tracks coming from, that would make sense is let’s work through pricing and then work through like, hey, what does a current state future state look like? And my guess is that we’ll probably have to at that point kind of bring everybody else in and say, like, hey.
Dgprince (62:57) Oh, absolutely. We’re gonna have to bring, yeah, as soon as Bryce tell me which path then it’s gonna start down, that gotta bring in it. We gotta bring in everybody else. We got, you know what I’m saying? We gotta get the powers to be to say, yes, this is on the path or yes, this is something that we can move forward with and all those things. So, yes, we can’t everything has to go into a wave initiative and go through all the resources for those two or three levels of approval.
Garrison Goodman (63:22) Yes. Okay. And for an org, you’re well at sentara, is that something that’s gonna take us, you know, a quarter to do six months to do? What should we orient in terms of time towards like, you know, you solving this?
Dgprince (63:41) I’m hoping sooner than later again, I don’t really know until I talk to Ron and him, tell me the timeline. You know, I know we have some other things that moved pretty quickly. Matt, who’s my counterpart on the revenue cycle side. He did a presentation and it got approved pretty quickly. So again, I think it’s the reality of it, what is the benefit of it? And this one there’s a lot of eyes on this. So I really think if we can show its value guys, I think it’ll move fairly quickly because again, they want these clinicians to come on fast and to bring them on fast, you know, it doesn’t do you any good to hire them and bring them on for them to just lose revenue. It does in some ways because you still have the revenue that it’ll generate for the hospital and other divisions, but the medical group will lose money and the goal is for no one to lose money. So again, I think they’ll hear it and I think they’ll move pretty quickly, okay?
Garrison Goodman (64:45) I.
Dgprince (64:46) hope we know more than five to six months for us to go through negotiations and be live but that’s it’ll be six months of a lot of manual work for us to do until.
Garrison Goodman (64:57) Then, yeah. Okay. Well, I think just to add on that too, one thing I find really helpful is like we’ll just kind of map everybody out who all needs to be involved, what they care about. And then that way we have like all kind of the talking points assuming we’ll do multiple meetings but know what we need to address for each person and kind of a game.
Dgprince (65:19) Plan. And I’ll ask matt too because he just went through it all and he’s our senior director over the revenue cycle side and he does most of the, anything revenue cycle project wise. I just fall off. I’m just that one outside person from the rest of that. So I’ll just ask him, you know, what are all the different steps that we have to do? I think initially, it’s an idea that we have to submit. But even before I submit the idea, I have to get executive approval. So again, if I can get Bryce and Ron to agree, the next will be that idea and then that starts pulling everybody together. And then we go from there, it does move fairly quickly even though it feels like it’s slow as a snail if they can see the value in it.
Garrison Goodman (66:04) We’re used to it. It’s you know, it’s one of those things that it’s like people, you know, want to change credentialing, like they want to go to the dentist, but it’s one of those things where it affects everybody. Oh.
Dgprince (66:15) Yes, if you don’t do it, right, you can really mess things up.
Garrison Goodman (66:19) Yeah. So that sounds great. We’ll map it out and, you know, we’ll put together a really strong presentation together, but thank you again for, all the help and we’ll get back, you know, something to you tomorrow at the latest?
Dgprince (66:33) That’s fine. And I want to be transparent with you guys. I have hand surgery next Tuesday. I shouldn’t be out but a few days, but just want you to know next Tuesday, Wednesday, Thursday, I’ll be out of pocket. I have horrible carpal tunnel. So I need to get it fixed.
Garrison Goodman (66:47) I’m so sorry, is it a procedure to hopefully the pain will go away? It should.
Dgprince (66:53) It should boy if it doesn’t oof.
Kyle Bettencourt (66:56) My mom just had that, she just had that about a month ago and she’s going to be golfing by the end of this month here on a trip. So, she said it was definitely worth it. Oh.
Dgprince (67:06) Thank goodness because I can tell you right now, like, I feel like I’m on like my third, I only drink a half a cup of coffee, but I’m on my third half cup of coffee because last night, I don’t think I went to sleep until four a. M. Oh, I’m sorry because it just, I don’t know how to describe it. I feel like my hand’s on fire. Yeah, it is the weirdest thing and it went from being fine to like, hello, I’m here.
Garrison Goodman (67:29) Oh, man, that well, that affects everything. Oh, it does, that burn feeling affects your sleep and that’s tough. Yeah, it’s great. Hey, you wouldn’t know that you were exhausted so well, good, trying to.
Dgprince (67:43) Hide it. Well, all right, guys. Thank y’all so much for your support. I appreciate it.
Garrison Goodman (67:48) Yeah, it’s been fun. All right. I’ll.
Dgprince (67:50) keep in touch then. Thank you all.
Garrison Goodman (67:51) Right. Yep. Thanks.
Kyle Bettencourt (67:52) Joyce.