Transcript
Chris Fagan (00:00) so, he didn’t accept on the invite, but he called me back last night and said that he’s good to go. So he should be on.
Chris Fagan (00:30) You going to Austin? No, you’re on mute… you?
Hassan Zahir (00:39) Would think I’d never use zoom. Yes, I am going to Austin. I will be there again on Monday and then leave out on Thursday. I have to leave slightly later than I wanted to on Thursday because I have to take morning meetings in Austin. I wanted to get out early but.
Chris Fagan (00:55) some deals.
Hassan Zahir (00:58) That we’re trying to get done in April. Yeah… I will… be present… unless you’re going.
Chris Fagan (01:15) Yeah, I’ll be there. I lived there for a while, so I’m probably going to stick around work there Friday, but work there. Like mostly, you know, work there Thursday Friday and then kind of stick around for Saturday Sunday.
Hassan Zahir (01:26) You just pick all the worst places to live. Don’t you man, Austin, Miami? Like all the shitters?
Chris Fagan (01:32) Yeah, just like, yeah, I can’t pick them. I need the nice weather, bro. I need the nice weather.
Hassan Zahir (01:41) I don’t blame you. Yeah.
Chris Fagan (01:43) It’s just like I can’t do the cold.
Chris Fagan (01:47) I tried, I lived with it my whole life and then I tried it again last year up in New York and Boston. It’s just like… can’t do it? Yeah.
Hassan Zahir (01:57) I don’t blame you. Not one bit.
Chris Fagan (02:01) It’s a little easier too when you’re single.
Hassan Zahir (02:07) Yeah, I could imagine. I could imagine. Yeah.
Chris Fagan (02:13) Kind of make those unilateral… decisions just whenever the hell you want to make them, don’t really have to worry about any inputs from anybody else?
Hassan Zahir (02:23) I think that’s a great way of saying it unilateral decisions. Sometimes I make unilateral decisions and they don’t go well. It doesn’t go.
Chris Fagan (02:32) Over. Well. Everyone’s got a chest of waters every once in a while, you know?
Hassan Zahir (02:40) Sometimes I’m hard headed, I’ll try more than once but never has it gone over well.
Chris Fagan (02:46) Oh, shit. I remember why I don’t do this. That… is a fact. Come on Dio… where you at man… check my email and thank you so much.
Chris Fagan (03:30) I mean, I guess I could… consume a text.
Hassan Zahir (03:36) Yeah, I mean, he’s probably busy worst case scenario. You and I sit here and we say exactly what we would say to him. We document it. Yeah, in the email, okay?
Chris Fagan (03:54) And send him like send him the bva, doc? , or? Yeah.
Hassan Zahir (03:59) I mean, essentially just give him an opportunity. Yeah, just the sections that we need to get answers from him on. Yeah… let me just text him real quick.
Chris Fagan (04:43) I sent him a text. I was like, hey, are you still good to jump on the zoom? We’re on it right now?
Hassan Zahir (04:48) Okay.
Chris Fagan (05:06) Tell you what though, man, it does rain a hell of a lot more down here than anywhere else I’ve ever lived.
Hassan Zahir (05:11) Yeah, but it rains and then it clears up. Yeah, summertime showers. Yeah, it’s.
Chris Fagan (05:17) just like, okay, it’s got a couple days a week, you’re just like you look up and you go out and I go out and I try to go in the morning and go for like a little walk and then like, you know, it’s beautiful. And then, you know, you look out the window a couple hours later and it’s just like storm clouds and pouring. I’m like, is that rain? Yeah. Is it raining? Gotta get used to it, man? One of these days I’m gonna get caught in it.
Hassan Zahir (05:42) One day, the only thing that like worries me is, like… for that kind of stuff is just like, do I ruin something?
Hassan Zahir (05:51) If I don’t ruin anything? I don’t care. Yeah.
Chris Fagan (05:54) Yeah… it’s like it’s I have like, I have a jeep, so.
Hassan Zahir (06:01) Yeah, I know we were talking about that. Yeah.
Chris Fagan (06:04) Yeah. So, like, I got a, it’s like half soft top and so can like, the front seats are soft. I can just like pull that back.
Hassan Zahir (06:14) Yeah. Yep. Just like where the freedom panels normally would be.
Chris Fagan (06:17) Yeah, exactly. Exactly. And I’m thinking about doing a full, thinking about getting it switched to a full soft top at some point. I don’t know though. We’ll see. Yeah.
Hassan Zahir (06:28) Bestop has some really cool like automatic ones. Yeah, you know, you closed a couple of a couple of nice ops, man. Yeah.
Chris Fagan (06:36) Yeah. All right. He just jumped on them at 11, okay?
Chris Fagan (06:46) So, I’m so sorry, I lost my train of thought. No worries. Okay. Sorry about that. No worries. Okay. Perfect. I appreciate you jumping on Neil. Thank you. Yeah. So like we talked about yesterday, right? Need some information from you in order to give you an accurate quote. And we think the best way to do it is just to kind of share that bva doc that I was talking to you about. And there’s a, there’s just inputs in here that we need, to get from you. And that way we’ll be able, to fill something out for you today and get it, ideally get you something back tomorrow. Okay. Sounds good. Thank you. So I’m just going to share the screen and we’ll run through it. Yeah. And.
Hassan Zahir (07:24) Leo, some of these questions like we felt like it was just getting directly from you. We know we talked about, okay. Are we considering the physicians not considering the physicians? Should we do this both ways? And so just trying to figure out like what are the best inputs here? Yeah, to get you the best number? And so figured we’d do it on the fly. And so, yeah, so.
Leo D’Agostino (07:43) With that, I’m sorry, go ahead. I was actually thinking because I, you know, initially their thought was not to do any of the medical folks and just do the behavioral health side. So I think it’d be good to see like the vote like maybe if they just decided to do the behavioral health side, because on the medical side, I feel like they have eventually covered, I think from a long term perspective, it makes sense for there to just be like one sort, but I don’t know if that’s where they’re going to go right now. So I think it’d be great to get like sort of an idea of both, if that makes sense?
Hassan Zahir (08:23) Yeah, no, that makes sense. And we can put both numbers in here. We’ll just put the first number, then the numbers and slash. Okay, I know we got some preliminary numbers like what are the numbers including the physicians and the number? Not including the physician?
Leo D’Agostino (08:39) Yeah. So let me pull up. Basically what I sent you was the, but let me, I can pull it up and here it is okay. So if I, if we don’t include?
Leo D’Agostino (09:02) Let me do just a quick.
Leo D’Agostino (09:10) Let’s see.
Leo D’Agostino (09:41) Okay. Just give me a couple minutes. This looks like this is.
Chris Fagan (10:21) I have some from my notes too, Leo. I,
Leo D’Agostino (10:24) have, yeah. I’m just actually trying to, I’m creating like another list that it’s probably going to be around the same, but I’m trying to divide up. Okay? I think I have it. Okay. So if I… so, in terms of folks that need credentialing on the behavioral health side, I’m going to say there are approximately like 519 people. And then if we include the clinic, if the clinic would have approximately 109 people.
Hassan Zahir (11:02) So, row 11 will be 519.
Hassan Zahir (11:09) And then we’ll say 111 for we’ll just put those under doctors for the clinic. 111. Was it? Yeah.
Leo D’Agostino (11:18) 111, one, one, nines.
Hassan Zahir (11:21) One nines. Sorry.
Leo D’Agostino (11:22) Okay. One nines.
Hassan Zahir (11:25) And then forecasted growth year over year. The.
Leo D’Agostino (11:30) Company has stayed pretty, there… hasn’t been much growth. Sometimes programs close, sometimes programs reopen but they’ve pretty much stayed consistent. So, you know, I guess we can anticipate some growth but not very much. Okay. Should.
Chris Fagan (11:51) We keep it at like a percentage, maybe keep it at like a five percent year over year growth or something or is that high? I mean, that’s what?
Leo D’Agostino (11:58) Yeah. I mean.
Hassan Zahir (12:03) That would take into account churn as well where someone leaves and needs to be replaced because then we would need to credential them. And so we typically see a five to 10 percent but looking for your direction here.
Leo D’Agostino (12:15) Yeah. So essentially, so it’s not that like if someone leaves and someone’s replaced, that’s not the same seat or like same, it’s.
Hassan Zahir (12:25) the same seat, but we would still have to run like their primary sources, they will replace the seat as far as a seat in the platform and a person going through ongoing monitoring. So that counts as the same seat, but we would have to run their unique primary sources to be verified. So that is like what the delta would be.
Leo D’Agostino (12:48) Okay. So that makes it a little more complicated. I don’t know off the top of my head what their like turnover rate is, but it’s probably like on the higher side? Okay? So that is a factor then.
Hassan Zahir (13:05) The only thing that’s a factor again is like how many additional psvs need to be run? Like I said, the seat remains the seat, the ongoing monitoring remains the ongoing monitoring because that’s just based upon the total number. Yeah.
Leo D’Agostino (13:20) Every time.
Hassan Zahir (13:20) We run, you know, a license check or, you know… a board check or a certification check, like we count that like as a PSV and so that’s the only reason why that comes into play.
Leo D’Agostino (13:34) Okay. Yeah. I don’t know. I mean we can put five for now, but I think that if the model is, I mean, it sounds like there has to be a conversation around like turnover rate, right? Because that means sort of new checks need, how frequently are positions being replaced… within a year? Yeah. So the turnover rate is much higher than five percent. So I don’t know how do you normally, how do you normally sort of go into that back into that number?
Hassan Zahir (14:16) Yeah. And so again, normally for year over year, we do it like in total, year over year, like what’s the new growth plus the churn and then try to get to a percentage just to give us an idea of how many additional of these checks run? The reason being honestly is like the more of these we run then the rate actually, you know, the kind of the cost can drop, right? Economies of scale come into play.
Leo D’Agostino (14:43) Yeah, yeah, yeah, yeah, certain.
Hassan Zahir (14:44) Numbers, and that’s why I was like if you say it’s 519, but we actually end up getting to 600 total individuals who had like psvs then and the existing providers, obviously, they’re not getting new checks then just.
Leo D’Agostino (14:56) use that as an.
Hassan Zahir (14:57) Example, but, we can pick any number, let’s.
Leo D’Agostino (15:03) just say, okay, let’s just say 15 percent.
Hassan Zahir (15:07) Okay. We’ll say 15 percent and that’ll drive a number. And then that way it’s just the goals that you and then obviously, they understand what that pricing ends up being at each interval. Okay? We’re not talking about payers, we’re just talking about credentialing. Okay? So cvo, we’ll go down to the cvo section. And I had a question here, Leo, because I did see that on the website. Two of the centers, I think san Mateo and San Francisco were fqhcs. What level of credentialing are we thinking here? Because we’re going to talk about, we’ll put it two ways. We’ll put it if we’re including like the physicians and not including the physicians. But also, I had a question like since those are fqhcs, I’m imagining at those facilities privileges are required. Is that the case only at those facilities? Though only at those two?
Leo D’Agostino (16:01) So, we do privileging at sort of our, all of our medical sites. And so those are two fqhcs and there are some, there are additional clinics that are not, that do privileging as well. And so those would only be for the staff that work in that like clinic setting, And.
Hassan Zahir (16:25) So, like that was, the thing is like we can do like standard credentialing, but if we needed to do it to hrsa standards because they were fqhcs then the amount of time we’re looking back, you know, for, you know, for, you know, for verifications of, you know, education, all those sorts of things. Sorry, it’s the end of the day for me over here.
Leo D’Agostino (16:46) No, no, no worries. No worries. I.
Hassan Zahir (16:48) Just want to make sure that we’re accounting for like the proper amount that needs to have the more comprehensive credentialing. And then the ones who don’t need the more comprehensive credentialing to hrsa standards, so that we get the most accurate pricing. Like, is there an?
Leo D’Agostino (17:02) Idea. Yeah. Let me see. I can look up the two clinics that, and see how many people are at those clinics.
Leo D’Agostino (17:19) Super food.
Leo D’Agostino (17:38) Let me see. It might not be as straightforward as I want it to be. Yeah. And I think this is.
Hassan Zahir (17:45) Directionally correct as possible.
Leo D’Agostino (17:52) Yeah, I have addresses here. So what’s not true? Is that like all, you know, the 109 clinic or medical folks, they’re not all fqhc clinics. And so… why don’t we just let’s put an estimate that they’re like half of those. Let’s just say it’s 50 of those people are fqhc.
Hassan Zahir (18:27) Okay. And so we’ll say 50, and then we’ll take the remaining 59 or so and say nine fqhcs?
Leo D’Agostino (18:37) Yeah. And.
Hassan Zahir (18:38) so, we would just put them through the standard credentialing process. Yeah. Okay.
Leo D’Agostino (18:44) And if, I can probably give you an update of that, if we need to later.
Hassan Zahir (18:59) And those other ones, do, you know, like what level of credit? Is that joint commission level of credentialing is that non joint commission, just standard ncqa? Just want to know like for our edification, how many psvs, how many of those would be?
Leo D’Agostino (19:14) I honestly, I don’t know, what I, and I know that this is where, if we get, if we dive further into like the clinic, which you know, initially, their thought was like we don’t want to do anything with the clinic. So, I didn’t I don’t have that much detail in terms of.
Leo D’Agostino (19:40) Or sort of like, the credentialing for the clinic though because it wasn’t really in the scope. So that could be a follow up. Okay?
Hassan Zahir (19:50) Yeah, that’s fair. We’ll we’ll just do it to like standard credentialing and if something needs to change, then we can do it, but this allows us to get directionally correct with what this will look like, how we’re able to do it.
Hassan Zahir (20:01) And then the last piece that I wanted to ask was, is the ongoing monitoring of non clinical employees for like Sam and oig, is that still in scope? Yeah.
Leo D’Agostino (20:13) Yeah, I’d like to see what that looks like.
Hassan Zahir (20:15) Okay. And so that was 550 or so total employees. Is that still out?
Leo D’Agostino (20:24) Well, for those checks, actually, it would be everyone. Oh, yeah. So actually, it would be everyone. So that’s around the 620 people… all together because essentially… though they’re using another system to do those checks for all of their employees.
Hassan Zahir (20:47) Which… you.
Leo D’Agostino (20:51) know, actually, it includes non clinical employees too, right? So, which is around 1,300.
Hassan Zahir (20:58) Right. And so that’s what I was assuming my assumption would be like we would do ongoing monitoring to standards on these employees. And then these would be the remaining. And that’s why I said 550.
Leo D’Agostino (21:11) Yeah. Oh, yes, yes. Yes. Okay.
Hassan Zahir (21:14) Perfect.
Hassan Zahir (21:23) Okay. I think that this gives us what we need. We know the total employees, we know which ones will go through credentialing in this require like the base ongoing monitoring, we know the clinical ones would require like the comprehensive ongoing monitoring. We have to break down, how many, at least the estimate of how many would be fqhcs and then standard credit and then the anticipated growth as well.
Hassan Zahir (21:53) So, yeah, I think that this gives us what we need to get directionally accurate, Leo will be able to put some things together and share it with you. Okay?
Leo D’Agostino (22:01) Cool. And my call tomorrow with them is at 10 a M Pacific Time. So, if you before then any time would be great.
Hassan Zahir (22:07) Yeah, for sure. We’ll get off here and work together on this?
Leo D’Agostino (22:11) Okay, great. Thanks for your help.
Chris Fagan (22:12) And from your and post that call tomorrow, Leo, what’s the, what are the next steps internally for y’all?
Leo D’Agostino (22:20) I don’t know. I’ll find out after the call so I can check it out. Okay. Yeah, yeah, yeah, awesome. Perfect. Okay. Cool. We’ll get this out to you before 10 a M pacific tomorrow. Okay. Sounds good. Thanks guys. Thanks, Leo. Bye cheers. You want to stay on?
Hassan Zahir (22:38) Yeah. I was going to say if you want to pull up like the, do you have like in the plan? Is that still in there? Yep pulling it up right now? Okay?
Chris Fagan (22:49) Or this is actually, this is probably still being recorded.
Leo D’Agostino (22:51) Let me, let me just.
Hassan Zahir (22:52) Know, let’s kill this. We probably need to trim the first half.