Transcript
Derek Kamajian (00:00) hey, Jeremy, how are you?
Jeremy Walker (00:02) Doing good, man. How about yourself?
Derek Kamajian (00:05) All is good in the hood?
Jeremy Walker (00:08) We love to hear that. Hey, did you ever get my, I sent you like a 12 pack. I saw you were sipping on some celsius. I sent you a 12 pack. Did you ever get that by chance?
Derek Kamajian (00:20) I got the email link, but for conflict of interest, I decided to not claim it so.
Jeremy Walker (00:28) Not claim it. Yeah, but I would. Gotcha. Okay?
Derek Kamajian (00:32) 99 percent of my fibers of my being were telling me to just buy it or get it and then drink all of them.
Jeremy Walker (00:39) And then drink all of them. That’s like one of my favorite flavors. So, anyways,
Derek Kamajian (00:48) but thank you very much. That was very nice.
Jeremy Walker (00:50) Of course. Yeah, yeah, hey, Suzanne. Hey, Khaliq.
Derek Kamajian (00:56) Good morning.
Suzanne Foss (00:57) Good morning.
Jeremy Walker (01:00) How are you doing today?
Suzanne Foss (01:02) Fine. How are you?
Jeremy Walker (01:04) I’m doing good. Thanks for being here. Let’s see. I’m just reading. It. Looks like she’s got some note taker in here. You will need to restart the meeting for the change to take effect. So, is this, is Suzanne actually here? Or is that just like her note taker that’s here?
Derek Kamajian (01:25) That looks like a note taker but I thought I saw her also sign on Khaliq. Did you see her? I thought I saw her sign on and then just drop off. I.
Jeremy Walker (01:37) Thought I saw that too. Because it was actually, instead of fireflies, it actually said her name, but oh, here she is. She’s in the waiting room. Let me let her in real quick.
Jeremy Walker (01:49) Sweet. Hey, Suzanne.
Derek Kamajian (01:58) Good morning.
Jeremy Walker (02:06) Suzanne, just a heads up. You’re on mute if you were.
Suzanne Foss (02:12) Sorry about that. Good morning.
Jeremy Walker (02:15) Good morning. I love your background. There’s. A lot going on there. It’s very cool.
Suzanne Foss (02:20) Yeah, thanks of.
Jeremy Walker (02:23) Course. Yeah. Well, I appreciate both of you being here. I know that Derek and I have been working over the last couple of weeks to formulate kind of a value narrative of what a potential partnership with medallion could look like. I do have one more individual, Mallory smith who actually was the one that ran the demo that we recorded and sent to both of you. She’s going to be a couple minutes late, but she will be on the call here any minute now. So in the interim, would love if Suzanne, you’re the new person on the call, if you would introduce yourself, just give your background with insight therapy solutions and then maybe what you’re hoping to get out of the call today, that’ll be a helpful place for us to start.
Suzanne Foss (03:09) Okay. I’m Suzanne foss. I have been at insight for about 11 years. Wow. I’ve done pretty much everything in those 11 years. I continually get moved from whatever just something new right now. I’m currently… doing contracting and I am helping Khaliq get the credentialing department up and going again because we just got he’s new to that position. So that’s kind of what I’m doing now. I also do the licensing when we do new licensing for new providers.
Jeremy Walker (03:54) Yeah.
Suzanne Foss (03:56) And that’s what I’m that’s where I’m at right now. Awesome. And, I think like the… thing that I hope to get is that I hope we end up do getting some type of software because, you know, we are expanding and we have been expanding for about since the end of 20 24. So we’re in the middle of this project and I know that it would be super beneficial and make our lives a lot easier, you know, for tracking purposes and everything. So I’m looking forward to that.
Jeremy Walker (04:36) Awesome. Yeah, I appreciate that overview. And then I see we got Mallory in here, Mallory, just a quick summary. Suzanne was introducing herself. She’s been with insight for 11 years and currently is overseeing contracting credentialing really with the goal of setting themselves up for growth by bringing in a new partner, to assist with that. So with that said Mallory, we’d love for you to, I know a couple of folks on the call have heard your voice when we recorded the demo for them. But if you want to come off mute and say hello and introduce yourself too.
Mallory Smith (05:07) Yeah, absolutely. Thanks, Jeremy, Suzanne first, it’s a pleasure to meet you. I love your background. That is very cute. It’s very personal. Did you do the painting of the two? Is it like two men, the two brothers up?
Suzanne Foss (05:20) There, my sons. Yeah, no, no, I didn’t do that.
Suzanne Foss (05:24) Oh, thank you. It’s like our place is small. So, this room is kind of like taken over all these things that I can’t seem to get rid of, you know, and,
Mallory Smith (05:35) she has personality. Yeah.
Suzanne Foss (05:36) I.
Mallory Smith (05:37) love it. I have a friend like that up in Massachusetts that every inch of her walls around the entire house is covered with like artwork that she’s done or her husband’s done.
Mallory Smith (05:44) I’m just like I love this. Yeah, and pleasure to meet you. I am a solution consultant here. I’m based in Nashville, Tennessee. I’m just here to support the conversation. From a technical perspective. I’ve met with Khaliq and Derek before. Hey guys. So just here to support as I can.
Suzanne Foss (06:01) All right. Nice meeting you and.
Jeremy Walker (06:03) Since we have so much time usually, the structure of the call today to review what we call our business value assessment, doesn’t take a full hour. So, I just wanted to start by seeing if there was any additional questions Suzanne and Khaliq, you guys were really good at.
Jeremy Walker (06:20) I think Derek, you sent over a list of questions. We sent answers back. You guys were really good at being comprehensive with those questions. But based on any of the responses that we gave, is there anything that’s not clear about the medallion platform about how this partnership would potentially be structured areas we would help, we wouldn’t help, would love to start there and kind of settle any potential concerns or comments that you might have.
Suzanne Foss (06:51) I don’t I can’t think of anything that, you know, or any additional questions that I had? You were very good at? You know, answering everything and sending out the information… I don’t think that I had anything.
Jeremy Walker (07:12) Okay. And Khaliq just want to double click and make sure you’re all set as well. Yes, no questions.
Derek Kamajian (07:18) At this time.
Jeremy Walker (07:20) Okay. Awesome. Well, we will jump right in here. Derek, any color that you want to add before we jump in here?
Derek Kamajian (07:26) No, the only thing is the team’s done an amazing job growing a multi 1,000,000 dollar business with excel sheets and manual documentation. And everybody is on the same page, including the CEO and the department leads that we need some software to be able to help whatever that software is, right? To be able to help organizing the providers and being able to help with the credentialing. And it’s not just the credentialing department. Each department is picking their own software that’s going to help them on the expansion efforts. So, we’re all open minded. We’re just here to listen and to kind of pick apart or if we see something that… may need a little more attention in whatever presentation, we can all talk about it now. So then when we present it to Francesca, she can make the final decision.
Jeremy Walker (08:14) Yeah, and that’s super helpful. And I think I want to reiterate that to Suzanne and Khaliq, this truly is Derek and I have put some work into this and we’ve spent time on it but it’s still a draft. And so if anything jumps off the page or seems inherently wrong, or maybe slightly off, would love to get your perspective as we refine this further, there’s going to be a lot of metrics that we have here and again, Suzanne, your response back and, very thorough explanation of the current state gave us a really good launching off point. And then the second thing that I wanted to highlight is to Derek’s point, you guys have all done an incredible job. I don’t think we have talked to an organization that’s made it as far as you have 40 providers, you know, counting, you know, 29 interns currently today, 20 different payers that’s done that well, with spreadsheets and really the goal of today. And the core of the value narrative that we want to present on is keeping everyone that is there happy and in the position that they’re in because clearly it has worked. And really, the value being, how can you scale up your operations and take on additional provider count without having to add 10, 15, 20 people as you continue to grow and scale? So that’s really the story, that we think we can help tell. And again just wanted, to make that abundantly clear before we jump in today. So let me share my screen. Obviously we’re here, to dive a little deeper. But if you take one thing away from the presentation today is that based on the numbers that we have evaluated with Susan, some of the answers and some of the answers that you’ve given us and time that we spent with Derek and Khaliq, we strongly believe that in partnering with medallion insight will be able to rapidly grow while reducing operational costs by 616,000, annually. And also see a net reduction in turnaround times of 26 to 71 days. And that’s what we’re excited to talk more about. So backing up a little bit, right? Who is medallion? We are, a venture capital backed startup company that was founded in 20 20, we’ve you know, received, some generous backing from optum, Google, sequoia, as well as some other VC firms who have all bought into this vision that medallion is fundamentally changing the way that credentialing and enrollment is viewed, right? Historically, they’ve been viewed as cost centers or similar to like a utility, right? But because of the automation and AI first approach that we take, we’ve been successful in using our tooling as a way to generate revenue for organizations. And so we’re trusted by over 400 healthcare organizations, some telehealth, some hospitals, pretty much every vertical you can think of. And we’re not just credentialing, right? We do payer enrollment. We do delegated roster management. We do delegated contract support and setup. We also do some credit alliance. We’re a ncqa certified cvo. So there’s a lot of different things that are within our scope. And so again, excited to translate that into the opportunity that we see with insight. One story that I think is relevant that I shared with Derek, right? Is family care centers, who they came to us. They were in a very similar position to insight today, where they said, okay, we’re at five clinics today, at 125 providers. We’re looking to quadruple in the next two years, right? We want to be 45 clinics. We want to have over 600 providers. We can’t shoulder the burden of that operational lift unless we partner with medallion, right? Unless we partner with an end to end provider in this space. Since then, they have been successful in growing from 120 providers to 650 providers. And they’ve not had to hire any additional ftes. They started with two. And they still only have two today. That’s the story that we would like to tell with insight as well. Additionally, it’s not just growth without headcount but it’s also the fact that they were seeing 90 to 120 day turnaround times with their payers. Now, they’re seeing 45 to 60 days. So really this kind of two hit punch where it’s yes, we’re going to allow you to do a lot more with the same team that you have today, but we’re also going to accelerate the amount of time it takes providers to be live. So I just want to pause there. Any comments or questions so far? Awesome. Perfect. Well, I will move on. Then second thing I wanted to highlight here before we get into the full business case is that medallion’s not just a software that we’re going to install and get live in your environment. And then say, okay, good luck to you, right? You truly have a full team who is dedicated to your success from the moment the contract is signed and you’re introduced to our implementation team, right? All the way through, you know, on an ongoing basis, having quarterly reviews with your account. Manager who is assigned specifically to your account. Apart from that, right? You’ll always have contact with myself with Dave wallach who’s my manager with Mallory for any escalations or any things that come up in the meantime and then ongoing support. You know, we have a really good onshore customer support team who again can help fill those gaps. So, it truly is a partnership we want you to be successful. And it, you know, it’s part of the operational model that we’ve created at medallion to partner with you rather than just leave you on your own to fend for yourself. Any again, any questions on the model, the team kind of what the partnership looks like from a support perspective? Awesome. Okay. You guys are making this easy. We’ll jump into kind of the strategic focus, right? We understand the big initiative right now that Derek has been tasked with is create a playbook that allows insight to rapidly grow provider account and to replicate the current success that you’ve had with the states that you’re currently operating in across all 50 states. And in return, right? The ultimate goal being how can we grow from 4,000,000 in revenue to eight, 10, 15,000,000 in revenue? The problems that Derek has shared is currently, I know that the hiring freeze was just recently lifted. But as it stands, there’s not systems and software and playbooks in play today. Currently, that will support this operational lift and aggressive growth that’s on the horizon. And so really what you’re looking for is a tool that can I guess do all five of these different bullet points, right? Bring you automation and AI, bring in a software, have a centralized database as a source of truth, right? Replicate current expansion across all 50 states and ultimately free up some of the time that’s spent on manual effort to be used for more strategic efforts. With the ultimate goal being you’re unfazed by turnover, you can scale via automation rather than headcount, accelerating revenue through providers, becoming billable sooner and contracting support and delegation as time is freed up, Khaliq and team and Suzanne, you guys can focus your efforts on, hey, what contracts should we go after next? What states should we expand into next? Is there delegation opportunities that can allow us to really speed up these turnaround times, right? So again, want to pause here, make sure there’s no edits necessary, and that this is all making sense from your perspectives?
Suzanne Foss (16:20) Yeah, I just have a question, I guess about the onboarding part. So, you know, we are, our onboarding software… is getting rolled out in may. So we can totally remove that part from this, correct?
Jeremy Walker (16:40) I’m going to have Mallory answer that. I’m sure she’s going to answer your question with a question first, but Mallory go for it. Jeez.
Mallory Smith (16:46) Jeremy you think you have me figured out? I am though he is right. No. So Suzanne, can you tell me which onboarding software you’re going to be rolling out soon?
Suzanne Foss (16:57) We’ve actually developed our own. I’m sorry, we’ve developed our own. So it is, that is one of the things that’s been in process also the credentialing part, but that’s obviously not, we’re not there yet. That’s why we’re looking elsewhere for that part of it. But the onboarding part is it is getting rolled out the first part of may. So I just had that question of, you know, is that something that we can separate out from this with medallion? So.
Mallory Smith (17:33) The great news there is we can absolutely do a hybrid approach. From a technical perspective. All we’ll need is for each individual provider to see log into medallion at least once and review the information as correct. And then they can sign the agreements, their electronic signature. They can do so from their phone or from their tablet, and then they can be done with the entire process. What we’ll need to be able to collect. And this is something depending on how big your onboarding team is we can have your team complete the information needed. So we can go through, submit the credentialing, submit the enrollments in the medallion platform, or we can have the providers do it. So with those two options, what do you think would be the smoothest approach considering that you built your own onboarding?
Suzanne Foss (18:18) Yeah, not the providers. It would be better for it to be us. Okay?
Mallory Smith (18:22) That’s totally fine. I would probably say we have like 50 50 right now in the customer base, providers link their own, they onboard everything, and then the others, your internal team links it. The good news is that your team can absolutely go through, complete the profile on, the system since you created it yourself. It is proprietary. Are you open to API integrations? Do you know if there is an open ended API available?
Suzanne Foss (18:50) I couldn’t answer that. I’m not sure. I don’t know. Sorry, oh.
Mallory Smith (18:55) That’s completely fine. Just some things we think of the future maybe as like a phase two rather than your team having to like dual entry and make sure the information’s in medallion so we can work and your team can work within your own onboarding platform. We do have an open ended bidirectional platform and that’s typically or an API. Typically, when we work with customers of your size, they’ll have an HR HRIS system that it just automatically integrates into. So we can always create that connection for you as well. So just something to consider. Let’s go back to your original question. I believe the new ehr?
Derek Kamajian (19:30) I believe the new ehr team that’s building said they have the open apis to work with whatever larger organizations we have.
Jeremy Walker (19:37) Perfect. Awesome.
Mallory Smith (19:38) Thank you, Derek. Yes, that’s perfect. So that can be a phase two, we can get it off the ground and up and running. And then something we can consider is going the API route. So if you have your technical team that have the bandwidth to build it, perfect, we’ll give you the API keys, you can build it or we can always build it for you as well so we can scope it out either way you’re looking.
Suzanne Foss (20:00) Okay, great. Thank you.
Jeremy Walker (20:06) Appreciate the questions. Anything else from maybe Khaliq… good to move on? Yeah, no question. Awesome. Okay. Cool. This is the business value assessment, right? So we’re going to kind of break this down in a couple of different parts. The first one is revenue acceleration, right?
Jeremy Walker (20:23) So we wanted to understand if medallion is able to use our slas and averages within your environment, how does that impact the actual revenue that’s generated per provider? So what we did is we looked at your credentialing turnaround time of 45 days that’s about industry average that we see payor enrollment turnaround times 45 to 90 days. Again, pretty good to industry average. We understand monthly revenue today is about 350,000 dollars. So we took the 40 providers. We chose to exclude the interns. I know that Derek was doing, some slack messaging last week to determine, hey, are interns actually billable? Do we submit claims through the interns? And so if we do need to adjust that a little bit here, we can. But we just focus on the core psych D’S and MD providers which is 40. So if we divide, that total revenue per month divided by the 40 providers, and then the number of days in a month, 30 days, that gives us about 291 dollars of revenue that’s generated per provider per day. So when you look at medallion, right? We have a three day guaranteed SLA for credentialing with a one day average. So that means that if we miss that mark, there’s revenue bound implications for us missing that mark which represents a total net reduction of 42 days. And you multiply that 42 days by the value of a productive day of a provider, 291. And you get 12,222 dollars of additional revenue that’s generated per new provider. And then you do the same thing for payer enrollment, right? In some cases, your average is actually better than the medallion average of 54 days because it takes you 45 days. In some cases, it takes much longer with 90 days, right? And that’s okay. So we just took the average of 68 days against our average of 54 days that represents 14 days that’s saved. So the total of those two is that for every provider that you bring on as you grow and expand, you will see an additional 16,200 dollars in revenue because those providers are billable, faster, they’re capturing new patients that would have otherwise given their business elsewhere. And that is a representation of new revenue that would have been missed had that provider been waiting for another, you know, 14 and 42 days. Does this conceptually make sense? Okay? I see nodding, which is good. Yeah, sorry.
Suzanne Foss (23:07) I’m on mute that’s fine.
Jeremy Walker (23:11) And then about this 40 provider count, right? I know there’s 29 interns today for a total of 69 providers. Do we have it correct here in that interns are not being credentialed and enrolled with payers and therefore are not submitting claims or is there instances where that is the case and help give us if anything like a percentage of ones that are enrolled and submitting claims?
Suzanne Foss (23:35) Okay. Well, insights policy has always been, you know, whatever providers we hire, we enroll them with every payer that we have in Nevada, you know, in Nevada. So, yes, there are a few instances where interns are billed under their supervisor or their in house supervisor. So those don’t really require credentialing, but there are also other ones where we actually do credential the interns, okay?
Jeremy Walker (24:08) With the same, like you mentioned, your current average is, I think 12 to 18 payers today, that’s same for the interns that are credentialed as well. Correct? Okay. Cool. Of the 29, how many would you say are fully credentialed and enrolled and how many are maybe billing through their supervisors?
Suzanne Foss (24:28) Well, it’s going to be a combination of both.
Suzanne Foss (24:32) and it would be all of them.
Jeremy Walker (24:34) Okay. Awesome. I would.
Suzanne Foss (24:38) Have to look if you want specifics on, you know, insurances, I’ll have to, you know, like for instance, let’s say, medicaid, it is, can be billed under their supervisor… like anthem, blue cross, blue shield medicaid or, but like Sierra health and life, no, they get credentialed even for the medicaid. So it just depends, okay.
Jeremy Walker (25:08) Mallory, anything that on this call, we need to unpack from that perspective, I know that probably is going to change the scoping a little bit. But is there anything else urgent that you feel like we should run by Suzanne here?
Mallory Smith (25:21) That seems pretty standard. We’ll of course, follow our standard operating procedures with each payer. We have the directory based on medical behavioral health, dental vision. So I think we’re fully covered here.
Jeremy Walker (25:33) Okay, awesome. And then Khaliq, I saw you come off mute. Did you have a comment? No, no, Suzanne cleared that. Thank you. Okay. Awesome. Well, I appreciate the color and we’ll continue to unpack that. I think one of the next steps that I wanted to schedule before we get off the call today is to actually formally sit with both of you and scope this out in detail both from a, hey, what kind of integrations do we potentially need to think about as well as confirming the scope of what we have. So we’ll definitely get that scheduled before we hop off today. The next thing I wanted to do, right? And this was Derek’s request is, hey, let’s take a look at how long it’s taking the team today to submit payer applications, right? What’s the labor time associated with payer application submission?
Jeremy Walker (26:20) So we talked with Khaliq and we learned that the average was about 15 to 20 minutes to submit a payer application. Right now, you’re averaging about 18 payers per provider or really that’s the forecast of where you want to be, right? At the end of 20 26 is about 18 payers per provider, which means that the total labor minutes per provider is about four point five hours just to submit the payer applications. So if we’re assuming a 50 K annual spend, right? That means that 112 dollars per provider is being designated towards payer application submissions. So when you look at the future state with medallion, you guys have all seen the demo, we’d be happy to revisit this. But because of our user experience and user interface, a lot of the times the payers for a given provider are going to be auto populated based on groups based on different criteria. But beyond that, even if you have to manually select all 18 payers for a given provider, that kickstarts all 18 of those applications at the exact same time. So really what we’re getting at here is instead of it taking 15 minutes per application, it’s going to take less than one minute to fulfill all 18 applications. And so again, when you look at, you know, comparing today to where medallion could take you. That means that, you know, there’s 111 dollars in labor costs that’s saved and it’s freeing up for payor application labor time, 99 point eight percent of time.
Jeremy Walker (27:50) So really what we wanted to do beyond this is what does that mean for the team and their strategic focus? Right? With this time that’s freed up couple of things that this would mean that you could have the time to do is focus on new contracts with payors, right? Think about expansion. Do contract negotiations with your current payors? Focus on, hey, is there national contracts that we should go after delegation opportunities, right? Once you reach about 100 providers, is usually when delegation is a realistic option and then further departmental growth and insulation. Some of the outcomes of that leads to is just additional revenue streams by bringing on new payors, busier and happier providers, right? Obviously, you know, these providers, most of them are probably W2 or sorry, are 10 99 with other organizations. And so the more payors you have, the busier, you can make them within insights, platform provider billing within 30 days. Once delegation is set up, and just ultimately this further catalyst for state by state growth. That’s been the big theme that you guys have been targeting this whole time. Any, again, any comments on this slide?
Jeremy Walker (29:05) Does this excite you, Khaliq, go ahead, Derek? Yeah.
Derek Kamajian (29:10) Real quick, Suzanne and Khaliq, you guys have a deeper understanding of the organization than I do. But to you, does this look like, say… Francesca says we want to get in those 50 states and we set up a roadmap for three to four states per month after recruiting opens up those positions which they stated that they don’t have issues filling. We just need to be able to open them. And after we review the obviously legal parameters into expanding into those states, once that’s greenlit, and we hire those providers, we get all their licensing information. We manually put it into medallion or through an API, have it placed… in there. Then we’re all saying I’m not hallucinating that in five or 10 minutes, we can take that provider and get them credentialed with every payer we need to that we actively have in that state. Is that correct? Or is that not correct?
Mallory Smith (30:10) When you say five or 10 minutes, Derek, can you elaborate there? So?
Derek Kamajian (30:15) After we have all the providers’ information, they’re clean, they’re good to go. We did the license and background check. They’re ready to go in that state. We’ve hired them. We have their information, their credentialed information or we have their licensure information? We place it in medallion. It’s only going to take a few minutes to go through medallion’s system to get that provider credentialed in that new state.
Mallory Smith (30:37) It’ll take a few minutes to go to the medallion platform to make the request. And then from there, it’ll take three days for the ncqa level credentialing. And then right now we’re averaging, I think 54 days to get them enrolled with the payer. So making a request takes less than 10 minutes each time, but we will need time to actually send to the payer process the application with them.
Derek Kamajian (31:01) Okay. So that was my mistake. So that 54 days they’re good. But there’s no other labor on our end after we submit that request. So we’re done, and we can just basically have that in a status holding and kind of move on to something else.
Mallory Smith (31:15) That’s correct. Yes, we are end to end comprehensive. In that way your team will be monitoring the request. You’ll be looking at the more higher strategic areas that Jeremy just mentioned. So we’ll do all the legwork if you will.
Derek Kamajian (31:29) Okay. I went from almost having a heart attack with the expansion in 50 states to I don’t feel as it’s not as scary with having some type of software. So thank you.
Jeremy Walker (31:39) No, of course. Appreciate that.
Suzanne Foss (31:44) Awesome. I mean, yeah… you know, right now currently we are, I want to say in all, but I think in our last phase which we actually have not started yet, we, I think there’s maybe 10 states in that phase which includes the Virgin Islands, guam, and Puerto Rico. So… we’ve you know, and I’m talking about like that, we’ve you know, done research to see like which insurances are the main insurances in those states. So I’m talking about most of, the bigger type insurances. So I feel like, you know, a lot of that’s them, but we definitely are always interested and we have been talking about delegation opportunities and being able to, you know, move forward with that. So that is definitely something that we would be interested in.
Jeremy Walker (32:51) Yeah. One thing that I didn’t mention on the family care center story apart from opex reduction or, you know, scalability, apart from the accelerated turnaround times, we were also successful in getting them six delegated contracts in the first year of a partnership with medallion. I will say that’s pretty ambitious, right?
Jeremy Walker (33:12) We like to focus on maybe three a year. And that is a pretty conservative estimate of what a partnership would look like with medallion. And the good thing about that, is as you’re delegated roster volumes, increase, your volumes of credentialing actually decrease, right? Because you’re doing those within delegation. And so that’s a way that you can actually hedge some of the growth cost of medallion is by adding delegation to offset some of that growth. So we’re doing less and less credentialing each year. So definitely an opportunity and definitely something we’re aligned on as you guys continue to grow and we’ll definitely look to get that set up maybe in the second year once you guys are eclipsing 100 providers.
Suzanne Foss (34:00) Okay. Sounds good. And then.
Jeremy Walker (34:03) I think one thing I’ll make as an edit on this is, you know, catalyst for replicable state by state growth. Maybe it’s you know, replicate the success found in Nevada across all 50 states or something like that. Because what you guys have done in Nevada, you know, I know you said, hey, we’re kind of, you know, we’re officially in pretty much all states at this point. So maybe the wording is replicating what you’ve done in Nevada with all 50 states. So I’ll kind of take that as an edit here. Okay. All right. Jumping into right? The fte to enrollment ratio. So again, this needs a little bit of refinement based on, you know, if we’re looking at those 29 interns, but if we just focus on the providers for now because that’s the math that we have here, right? You’re your current team is, you know, has been successful in enrolling 40 providers with 12 different payers, that’s a total enrollment volume of 480, right? Across three full time employees. That means that about 160 of those enrollments were handled per fte, which is pretty good when you’re looking at the expansion, right? You’re hoping to see each provider enrolled with 18 payers. And so what this symbolizes is in order for insight to scale and add providers and enroll those providers each with 18 payers for every eight point eight providers hired insight’s going to need to hire one full time employee. So when you think about the math, right? Of the forecasted enrollment volume, right? 35 new providers, right? I know that some people have said we want to hire 80 providers. Some people have said maybe it’s less than that. So we kind of hinged on 35 as a safe conservative estimate, 18 payers plus the 40 current providers that you have today with new payers, which was an edit that I made based on Suzanne, your notes that you sent kind of how things are structured today, average wise, and what you’re hoping it to look like a year from today, which gives us a total forecasted enrollment volume of 830. When you look at your current, you know, enrollment per fte ratio, that would mean that if you do add 35 providers, you would need to hire five full time employees to support that growth. So what we would like to propose is, you know, with the three full time employees that are there today, not needing to hire any additional full time employees all the way up to a 1,000 providers again without any operational costs. And so there’s two parts to the equation one is again scalability and the other is time given back. And so this is the scalability… portion of that, right? What does the team look like today? How will it look like a year from today? If we hire 35 providers? And what’s the alternative if we bring on medallion?
Derek Kamajian (36:59) And then, you know, Jeremy, we’re taking your communication stating from these other use cases, scalability from other businesses that have had three to five credentialing… specialists and been able to scale to 500 to a 1,000 providers. Suzanne, does that also make sense in your perspective on the labor and teammates that you’re using to run your department? For example, if you were to stay on the current path now, would you have to hire more heads if you got another 50 providers, or if you got another 30 providers, or would everybody be kind of pushed to the limit, or what would that look like if you didn’t have a tool?
Suzanne Foss (37:45) Well, that’s… I mean, I would probably say that we would need somebody else. Yeah, because literally, it’s really only been Khaliq… and Abhay, so, you know, and we’re just getting the other one from billing right now. It’s just coming over. So, yeah… I would say that we, yeah, we would definitely need at least another person.
Jeremy Walker (38:21) Yeah.
Jeremy Walker (38:27) Awesome. I mean, so it sounds like there’s maybe there’s a little bit of a disconnect here because… based on the, I guess based on the numbers that I’m seeing here and your current efficiency of the team, right? I’m proposing that you might need five.
Suzanne Foss (38:46) Yeah. I mean, five, I think five is fabulous, right? But I don’t I mean, it’s hard for me to be able to judge like because of where I feel like, where we’re at right now, we’ve done, you know, a lot and we’re looking really good currently, but, you know, five people. I’m sure that could make it. I mean, Khaliq may be better to answer this question because, you know, I’m not working directly like I don’t do a lot of the credentialing myself. So, yeah, basically, I’ve just been working on medicare contracts, so he might be better judged as to what their caseload or what their workload looks like. In terms of the credentialing. I know that… it’s it actually has really been fabulous to see like, all the recently, all the credentialing that’s been completed basically by him and one other person. So, you know, I’m sure that they would appreciate and really love the extra people.
Derek Kamajian (40:01) To.
Suzanne Foss (40:01) help that move along. And maybe, you know, it wouldn’t be so stressful. So, you know… sorry, I’m I have to apologize because I’ve been really sick lately. So my, I have this like brain fog thing going on. So I apologize if I’m coming off like don’t.
Derek Kamajian (40:27) Apologize. It’s like it’s been.
Suzanne Foss (40:30) Four weeks now and I can’t get rid of it and it’s just like I, sometimes I feel like I can’t think straight but yeah.
Derek Kamajian (40:39) The dayquil, does that to me. I can’t remember.
Suzanne Foss (40:43) Yeah, if I’m on the.
Derek Kamajian (40:44) heavy dayquil, baby, it’s.
Suzanne Foss (40:46) crazy right now. So, anyways, but… so, I think, you know, the more people obviously would be better for the department and, you know, and, it doesn’t just affect the credentialing team, like it affects, you know, the front desk. It really affects our front desk team where it makes it super difficult for them to see like who’s in network with what insurance and what state, who’s licensed, where, whatever, so that part of this too, it would be so beneficial for, you know, for the agency overall, I.
Jeremy Walker (41:23) Guess, let me first of all, don’t like Derek said, do not apologize. I think it’s like season we’re all like I have an eight year old daughter. She’s been sick like do not apologize. It made it made a ton of sense. What you said. I think maybe what we’re asking here, right?
Jeremy Walker (41:38) Is if we show this to Francesca, right? Would, would you feel comfortable saying, hey, yes, based on the efficiency of the team today? If we were going to go and hire 35 providers and enroll each of them with 18 payers? This is what that volume would look like. And in order to get there based on today’s efficiency, I would need to go and hire five full time employees, right? And that’s kind of the story, that we would like to help, you know, help you guys tell and have you guys be able to tell with confidence, right? And so that’s kind of what we’re ultimately asking is, does that math check out? And do you feel confident kind of backing that up, if necessary?
Suzanne Foss (42:20) Sure. Of course. Okay.
Jeremy Walker (42:25) Anything else? Derek, I saw you pop off mute real quick?
Derek Kamajian (42:29) All set. No, that’s perfect.
Jeremy Walker (42:32) Okay. Cool. Awesome. And then really last slide that I have for us today is kind of the summary of the value, right? Again hinging on that first point of if you add 35 providers and enroll each of them with 18 payers after the cost of medallion insight’s, going to see a 616,000 dollar net Roi. And that’s coming from these three buckets of, hey, we’re going to accelerate the turnaround times from an end to end perspective from the moment a contract is signed to when a provider is actually billable and seeing patients, we’re going to free up labor time and costs to be more strategic with time and focus on other insulationary opportunities for the organizations. And then finally the forecasted opex reduction which we just spent time and detail talking through. So this is, you know, Mallory and I talked to a lot of organizations. We put a lot of these together. This is a really compelling story and really an opportunity for us to execute as we have for over 400 customers. And we’re very excited at the opportunity. And yeah, I think that’s why we’re here today is because we believe in what you’re doing, the mental health of children and we want to support that however we can. So with that said, any questions or comments?
Suzanne Foss (44:05) I don’t have any, oh, sorry, go ahead.
Derek Kamajian (44:08) Not just kids. Yeah, not just mental health of kids but of everybody. Yeah. And the only other thing I’m going to say just to get the team pumped is… whatever software we pick. I think Francesca’s identified that the… individuals on the team that have built the business, including herself, she set up a system to replicate. I’ve seen this with other providers that have built this system for primary care, and they built the staffing market on the marketing machine. I think she sees that she can plant five to 15 providers in every state, load them up and pump them through a system and just grow. So, even though we’re saying we’re at four point whatever, and we’re getting to six to seven, I think she’s starting to see that this is probably going to be a 15, 20 30, 40,000,000 dollar business once we pick that. So we just need to get the right fit for the business. Sorry that’s the only thing.
Jeremy Walker (45:06) Yeah. And that’s again in the theme of operational insulation, right? We’ve got, you know, Mallory and I brought on a customer a couple months ago that has nine providers and we also have, you know, some massive healthcare organizations. I’m not sure who I’m allowed to share, but 10,000 providers plus as customers of medallion, right? So really, it’s an opportunity for everyone in the space. And when you think about telehealth as well, that’s its own little subcategory where we’ve seen a bunch of success. So, we believe again that there’s a short term opportunity in the next year to provide an impact, but there’s also a long term partnership that leads to again as Derek said, continued growth and opportunity for all of you associated. So we’re excited. And yeah, thanks for the time, everybody.
Derek Kamajian (45:56) And I think Susan, before I rudely interrupted like an animal, Susan, what do you got?
Suzanne Foss (46:03) No, I was just going to tell them that we appreciate it and we look forward to, you know, seeing how this is all going to play out. I don’t know, we’ll see, so it’s a lot of information and I think it would be fabulous. So.
Jeremy Walker (46:21) Awesome. Well, we’re excited as well as stated, we’d love to get some time for us if you have the availability this week to kind of further scope this out, figure out the numbers in more detail with regards to, you know, these interns as well as just run all of the numbers by you to ensure that we’ve correctly scoped out the partnership.
Jeremy Walker (46:44) So, if you guys have calendars availability, this would be mainly for Suzanne and Khaliq Derek, you’d be welcome to join, of course, but I’m looking at Thursday of this week, Mallory and I have some availability in the middle of the day.
Derek Kamajian (46:58) Suzanne’s only here Monday to Wednesday, and it may be more useful possibly if you have any of those updated numbers, maybe we send to the team on say on Wednesday if you have them or Tuesday and then let’s give Suzanne and Khaliq time. So Monday, Tuesday, next week, and then maybe Tuesday or Wednesday next week, we can set up the meeting so we can review it privately.
Suzanne Foss (47:25) Yeah, because honestly, I’m only doing this meeting and one more meeting today and then I’m out for the rest of the week, good.
Jeremy Walker (47:32) For you, I.
Suzanne Foss (47:33) have to get better. I can’t take it anymore.
Jeremy Walker (47:36) Okay. Well, I’ll send a refined kind of like as we know it questionnaire, you all can make some edits to it. We are actually at onsites all next week, however, of course, we can make time for you all. So if we look at let’s just see here, it looks like we’re presenting on Wednesday Mallory?
Mallory Smith (47:57) I think so. Yeah.
Jeremy Walker (48:00) Let’s look to Tuesday, what’s everyone’s availability for Tuesday to kind of review the scope?
Suzanne Foss (48:06) I’m available Tuesday. Okay?
Derek Kamajian (48:09) If we do Tuesday at the same time, I like having these at the kind of almost the same time every time we meet, if.
Suzanne Foss (48:17) We could do nine 30 because I come on at nine and then it gives me some time to check my emails and all that instead of nine. That would be great nine.
Jeremy Walker (48:26) 30 Eastern Time, right?
Suzanne Foss (48:29) Pacific Time?
Jeremy Walker (48:31) Pacific Time? Pacific? Okay. So 12 30 Mallory, I think that works. You’ve got an internal call but I think that can be moved, right?
Mallory Smith (48:39) Or.
Jeremy Walker (48:40) Tuesday at 12.
Mallory Smith (48:41) Terrible conversion. So, it’s 11 30 central 11.
Jeremy Walker (48:45) 30 central on Tuesday. Yeah, you got a one on one with Jacob, I’m going to.
Mallory Smith (48:48) Cancel that call right now. Yes.
Derek Kamajian (48:50) Why haven’t Google or zoom or somebody have a live add on to these calls? Because this happens every time I’m in Pacific Time. I’m in Eastern Time. People are Pacific Time. You have people in different countries. I can’t do basic math. It makes my brain want to blow up. There should just be an add on where somebody says a time, and then it lists all the times in the different time zones. They have our VPN. They know exactly where we’re calling from. Why isn’t this done?
Jeremy Walker (49:16) That’s so funny. Yeah. Maybe… once we get this partnership settled, we can all quit our day jobs and go start that startup, Derek.
Mallory Smith (49:28) Yeah, there.
Suzanne Foss (49:29) You go. Yeah.
Jeremy Walker (49:32) Awesome. I will send that invite shortly as well as a kind of a questionnaire highlighting what we have today as the numbers you guys can first of all, enjoy your time off, make some edits on Monday, and then we’ll connect on Tuesday of next week to collaborate.
Suzanne Foss (49:48) That’s great. Thank.
Mallory Smith (49:50) you. It was nice meeting you.
Jeremy Walker (49:51) Thanks so much. All right. Looking forward to next week. Take care.