Transcript
Stephanie Ryan (00:00) Gail, how’s it going?
Stephanie Ryan (00:14) Hey, Ivelise, hey, Gail. How’s it going?
Ivelise Revett (00:21) Hello? How are you? I’m.
Stephanie Ryan (00:23) good. Thanks. Happy spring.
Stephanie Ryan (00:29) I’m good. You know, I’m in Minneapolis and the high is like 52 today, so that’s like a heat wave where I come from and no complaints on my end.
Ivelise Revett (00:41) We just had a second burst of cold and it went down to 64 last night, so.
Stephanie Ryan (00:47) Ooh, very chilly. I mean, my kids would be in shorts at 64, so.
Ivelise Revett (00:52) Mine still were too. So.
Stephanie Ryan (00:55) We’re headed to San Diego next week for a family vacation and I’m just like excited to be able to be outside and like doing things that are not indoors so… well.
Stephanie Ryan (01:10) Thanks for taking time to connect here. I know we met in January and you guys gave us some feedback just on the partnership and where we could make some improvements. And based on that conversation, I was able to circle back with the team and get kind of more of a concrete update of where things were at and within that. I think that the only outstanding item where you guys shared feedback were on the delegated rosters and we Ivelise, I believe you joined a call with your team, my team and it included our technical solutions team and we were trying to like work through where are the pain points with the rosters and how can we get them to a place where they’re workable? And your team really doesn’t have to touch them? And so your team was going to share feedback with us on kind of what isn’t working. And I don’t think that we’ve received any data at this point. I know the team has been very focused on the audits, and I think one audit just wrapped up maybe. And now there’s another one that they said is priority, which I totally understand audits are definitely a priority item, but it seems like those are taking priority over rosters. And so I just want to make sure that we get to a point where we have the feedback and they’re using them. And like we know that it’s working going into our renewal conversations that are happening now. And then, you know, with the renewal coming in June, so I wanted to number one, take some time to talk through that. If there’s anything that we can do on our end to try to support more, we’re happy to. But at this point you purchase a solution that your team is saying isn’t making their lives easier, and that’s not the goal of the solution that you purchase. So I’d love to hear from you two on kind of where the team’s priorities are, yeah.
Ivelise Revett (03:07) It was my understanding that they were currently working on cleaning up the issue that they were experiencing, that we could then look into seeing how to make that process better or more efficient or anything like that. So, I know that was still happening the last we spoke, right? I think it was just a week or two ago, but I can follow up with them to see what else they were pulling together to send you all.
Stephanie Ryan (03:32) Yeah. And here, let me pull up my notes really quickly.
Dale Aggen (03:37) Ivelise, wasn’t there something that we were going to ask them to do to make our license? What was that?
Ivelise Revett (03:47) Yeah, it was because one of the things that gosh, his name, I’m blanking on his name that they meet with regularly said that one of the issues was is that you all didn’t manage the full dalcrad process and, that would help alleviate some of the misproviders and misinformation that goes back and forth because there wouldn’t be a gap. So, I was curious to see what that would look like and how that would improve the process and to be able to talk more about that.
Stephanie Ryan (04:16) So, based on the notes, I’m, seeing your team was going to finish updating the PPG associations?
Ivelise Revett (04:26) Okay.
Stephanie Ryan (04:28) And then once Jen gives us a go ahead, we would be in a good start to start like a reconciliation exercise. When we met at the end of February, we were told like that following Friday, we would maybe have information, but then audits like an audit popped up and obviously, that took priority. And so we just haven’t gotten your team to finish the PPG associations.
Ivelise Revett (05:00) Okay.
Ivelise Revett (05:05) And Jen is back in the office tomorrow. I mean, the audits, yeah, it’s one then another one. And, yeah.
Dale Aggen (05:14) Unfortunately, we have ncqa happening too, right?
Ivelise Revett (05:17) That’s beginning to kick off. Yes, we just got all of the information for that for our next audit session. So… okay. Yes.
Stephanie Ryan (05:29) Well, I know it’s top of mind. I know James and Jen have been talking through it. I think they talk through it pretty regularly just from like a status update perspective. So, I just wanted to keep you in the loop that we like more action has not been taken since that meeting. And this is why I don’t want you to think medallion is, you know, not taking that to be a priority. We, we take it very seriously. We, we want this to be meaningful for you. So just know that we’re here to support wherever we can. And, when those associations have been completed, we’ll dive right in… go ahead could?
Dale Aggen (06:08) We, could we look at that issue by you taking things from a to Z? Yeah.
Stephanie Ryan (06:14) How.
Dale Aggen (06:15) would that a… do we already pay for that B? If not, how much does that cost us in that? You know, we have, what? Another three we’re working on our three of, I’m sorry, we’ve been with you three, four years. I can’t remember. Yeah, but as well, we have to renew the contract, right? Right?
Stephanie Ryan (06:37) Exactly. So.
Dale Aggen (06:39) What, what is the release? I don’t understand it and that’s okay. I don’t need to even this gets it. Well.
Stephanie Ryan (06:47) And I actually would like to better understand because this is the first time I’m hearing that our team said like if we took on everything, we would see kind of better outcomes and that solution. And so I would like to better understand what are we not doing today? That if we were doing, it would make things a little more streamlined. So, I’m going to take that as a takeaway here. I apologize. I just, I’ve never, that is feedback that I am just hearing today. So I’d like to better understand. I mean you purchased our delegated roster solution. You’ve got your ongoing monitoring with us. We do your credentialing. So I just need to understand what piece of the puzzle, are you guys owning that maybe, we could explore owning on your behalf to make it a little more streamlined. I.
Ivelise Revett (07:38) think it was the terms and changes, okay?
Stephanie Ryan (07:46) And I want to say, so in hearing you say terms and changes, I recall a conversation internally, I think it has something to do with your team is maintaining those via spreadsheet. Is that correct? Yes. Okay. And I’m wondering if there is a, I don’t know if we got resistance to managing that differently or if there just isn’t a possibility to do so. So, let me double check with that and I’ll circle back Ivelisse and let you know. But I don’t I do not believe that this should be as challenging as it is. So I want to, right?
Ivelise Revett (08:25) Some things going on that’s making it more difficult and making it having our team do double work because they’re still getting these spreadsheets from medallion and having to review them and clean them up. So, I’m not sure what portion there is. Okay?
Stephanie Ryan (08:42) And I’m listening to you, I’m just reading my notes here because there there is… so what I am reading based on the recap from February is that there was hesitancy from your team’s side on medallion producing updates and terminations. And I, I’m not under I’m not understanding why there would be hesitancy there. So I will, I’ll just make that a little more clear on my side to determine like I can go back and listen to the conversation, or we can talk through it with Jen again?
Ivelise Revett (09:18) And I will do the same would.
Dale Aggen (09:21) James know the answer that Stephanie he.
Stephanie Ryan (09:24) May and I actually have a meeting with him after this, so I was gonna, I was gonna pick his brain on that as well, okay?
Dale Aggen (09:31) Because, this is where we’re at right now, right?
Stephanie Ryan (09:35) Originally we.
Dale Aggen (09:36) were proposing to add another body to our curriculum staff and it got very far but it didn’t get to the point of posting, right? And now.
Stephanie Ryan (09:47) we’ve.
Dale Aggen (09:49) had, some challenges and we’re hoping we don’t have to add an fte. Yeah, we’re hoping that we could resolve some of this. Now, it’s going to be difficult on our side because we’ve got multiple like I may be speaking incorrectly here that’s correct? We’ve got multiple systems. We’ve got multiple spreadsheets. We’ve got multiple everything’s about this thing called process and it’s crazy, right? And, we’re trying to see if there’s any way we could eliminate some of those multiple spreadsheets… and manual inputs. There has to be a way that’s.
Stephanie Ryan (10:37) what I think.
Dale Aggen (10:37) Elise is looking for with pale and tear to help us, but that may be a while in coming and I haven’t heard it recently, but that’s only been about a couple weeks, but that’s… where we’re at Stephanie, we really don’t want to add another person. Yeah.
Stephanie Ryan (10:57) I hear you if.
Dale Aggen (10:59) If we don’t have to, we’ve got two really good quality people. They know what they’re doing, but they’re just inundated, with the mundane… spreadsheet inputs. Yeah, yeah, I.
Stephanie Ryan (11:18) hear you like.
Dale Aggen (11:19) We could stop that or at least I mean, significantly curtail that.
Stephanie Ryan (11:24) That would help us out tremendously.
Ivelise Revett (11:26) Ivelise, am I speaking? Right? Yes, yes, that’s correct. And we’re also working on our side to see how best to minimize the multiple logins, these providers need to do because we have providers coming at us from different channels. And that’s something we’re trying to work to minimize as well. But then also, how can we get this information to you more streamlined so that you all can do what you do and do it completely. So then it doesn’t have to come back or we’re not getting the complaints from the plans for things being submitted incorrectly? Because I mean, just as a week ago, two weeks ago, we were still hearing from two plans that things were coming in correctly. So just, what can we do to work with you all better?
Stephanie Ryan (12:13) Yeah, for sure. Who was it? Yeah, I was going to ask what plan it?
Ivelise Revett (12:17) Was careplus and Melina… and we know with careplus, we’ve had some difficulties for a while, so it’s just that every now and then it gets better. And then it pops back up again where I think they’re receiving providers via fax. Yeah, that is, it’s weird that.
Stephanie Ryan (12:36) Is I was going to say the careplus issue? I recall us talking through in January and when Janine was still here and she was supporting your account, she had said that was resolved. I think back in late QB or QB and we hadn’t had any issues since granted. I don’t know that we had submitted anything since then either. And so if there are, if there’s feedback where they’re sharing these are incorrect. And this is where like James may know that your team may be sharing that with him. I have not been as close there, but definitely should be sharing that with us so that we can take a look and make sure that our documentation and our sops are noted correctly, and that the team is following what they should be and.
Ivelise Revett (13:27) James has jumped in right away. He’s very responsive. So he has jumped in right away to even communicate with the plans to be like, hey, we realize this is an error and we’re fixing.
Stephanie Ryan (13:36) It. Okay. Well, I’m glad to hear we’re all over it. I can ping my team to just better understand where the errors were coming from and what guardrails we’re putting in place to make sure that that’s operating as smoothly as it should be going forward here. Too. And then I did just look through my notes here. So what my team is saying is that.
Stephanie Ryan (14:08) we can take over the updates and the terminations after we run through this kind of clean slate exercise, which is where we’re waiting for your team to do some cleanup in the system for us. And then what they’re saying is after that exercise is completed, we’ll be able to provide your team with education on our triggers and events which will give more insight into the delegated roster project process. So, I think if we can get this piece completed, I think we are going to be in a much better place to take on more work and have this be more streamlined based on what I’m seeing here. I will double confirm that and just circle back with you via email, but I think we can do it based on what I’m seeing right now. I’m confident. But I will confirm that as well. Okay. The other thing, you know, I hear you’ve got a team of two, they’re working out of spreadsheets. Their bandwidth is very limited and I know that we had sold you guys on caqh management for this… contract year and your team has turned that off. They have not enabled that for any providers. And I am confused on why that may be. I know there was some caqh issues that have been resolved, but the management piece really is supposed to give you all an automated synchronization of any demographic updates that are happening. And it links to our platform and it’s reflected up to 30 days prior to a provider’s recredentialing deadline. And so that should also be making your team’s lives a lot easier. And the fact that they’re not leveraging that today just gives me a reason to wonder like what isn’t working? And how can we maybe even make that better for you? So.
Ivelise Revett (16:15) From what I heard about that is that it was just pretty much resulting in double work. They were still having to go in and enter these providers anyway. So they were like, why not just do it all because they’re in there anyway?
Stephanie Ryan (16:30) Double work from entering into like entering the data into the platform or can you, do you know more about that?
Ivelise Revett (16:38) That’s what I believe. So from what they were explaining to me is that with a past company, we used, it was very hands off for them. The company did it all. They handled everything regarding caqh and there’s some portion of it here that they’re having to go in anyway and be very manual with it. So, they’re thought process was if it’s we’re still having to be manual, we’re still having to go into all these providers accounts. Anyway, it doesn’t make sense to not just put it directly in there.
Stephanie Ryan (17:08) But is it a time savings to have the majority of the data there and then just have to enter in a like a sliver of information. I’d be curious to know that.
Ivelise Revett (17:19) I can follow back up with them as well to get more specifics on exactly what they were adding and.
Stephanie Ryan (17:26) Yeah, that would be helpful to know because there… definitely was a need for it at the time when we contracted for it. I would, I’d love to learn more about the user feedback and where things are getting hung up.
Stephanie Ryan (17:44) Okay. Thank you. And then, I know today, like our conversation is really supposed to be renewal focused and these are two important things that are obviously going to play into the renewal, but I wanted to talk with you all a little bit about what you’re envisioning from a like forecasting perspective for the rest of the year. Like today, you’ve got 495 providers on your platform. Are you anticipating a lot more growth that will help me really shape what this proposal looks like and how many different providers you’re expecting to bring on?
Dale Aggen (18:20) How many providers do we currently have Stephanie with you guys?
Stephanie Ryan (18:24) 495.
Dale Aggen (18:26) I know. But how many did you buy? It was like five?
Stephanie Ryan (18:29) 100? Oh, I’m sorry, I believe you purchased, let me just double check, give me a moment… and.
Stephanie Ryan (18:47) So, from a provider perspective, you purchased, come on and load four… 150?
Stephanie Ryan (19:05) So… you’re over, you gotta buy some.
Dale Aggen (19:12) More, yes.
Stephanie Ryan (19:14) You are over. I would definitely say at least 500, but if you anticipate more hiring, I would up that to even six or 700.
Dale Aggen (19:26) Let’s do that?
Stephanie Ryan (19:27) You think seven?
Ivelise Revett (19:33) I would think at least 606.
Stephanie Ryan (19:37) 100, we could go 600 or 650. We can always add in, that’s the good part about this. So, if we go 600 and then you are like, wow, we’re kind of blowing through that we can absolutely add in. So let’s go 600. And then based on that increase. So, Dale, I know you know how this works, you’ve been a part of the contracting process in the past, but Ivelise, the more you buy, the better rate you get. So with 600 jumping up, I should be able to get you a better rate on your core offering as well. And then you purchase 400 credentialing files for this contract year. You’ve used just about 200 of those and you’ve got another 30 re creds coming. I looked at your re, credentialing schedule for the next year and you have about almost 200 re creds just for 20 27 and 20 20, well, 20 26 into 20 27.
Stephanie Ryan (20:47) So to me 400 felt like, it may be the right number, but I would defer to you on what you’re thinking because if you’re doing a lot of hiring, that means even more credentialing as well.
Ivelise Revett (21:02) And so that number is all the files you process per year, re cred, and initial cred.
Stephanie Ryan (21:06) Initial and re cred. Yes.
Ivelise Revett (21:11) I do think that makes sense then to stay at the 400?
Stephanie Ryan (21:15) Dale… make the call. Yes. Yeah. Okay. Pay your enrollments, you only contracted us with for 30. We do minimal pay your enrollment work for you. You have consumed 40. I… was anticipating like when I was thinking through this, you’re at 30, we’ve got you till June. We had a couple more that are scheduled but have not hit consumption to date. Like I thought 50 to 60 may be the right number just to get you through. And if we saw an uptick again, we would be able to add more in if that was necessary. You agree with that?
Ivelise Revett (22:03) Yeah, 50. Yeah.
Stephanie Ryan (22:06) OK. And then… your monitoring solution. So, I was, we’ve changed our monitoring solution package and I put you on our new package called the ncqa compliant monitoring package. And that makes sure that you’re aligned with the ncqa standards. It runs, Sam, it runs oig, npdb medicare, opt out state licenses, Dea license, CSR license, and your medicaid exclusions. Is that, does that seem like the right? Yeah, yeah, of.
Ivelise Revett (22:52) the list of things that you monitor. Yeah, I would have to double check just to make sure nothing was missed, but that sounds okay.
Stephanie Ryan (22:59) I will send that to you via email, what we’re running. And then you let me know. Hey, we actually need this too. And I can see if there’s a better package for you to be on. But if the checks are included and you don’t need anything additional, then I think that we should be good. And what we do from a monitoring perspective is all of your providers on the platform are also monitored. So we would match everything you’re monitoring quantity to your provider account. So we would do another 600.
Dale Aggen (23:26) Right. Okay.
Stephanie Ryan (23:29) And then I wanted to talk a little bit about delegated roster generation. I know that there’s conversation that still needs to be had around the solution. But assuming that we move forward with it, how many payers are you delegated with? Like how many rosters would we be?
Ivelise Revett (23:49) Let me take a look James.
Stephanie Ryan (23:51) Said, he thought 14, but I don’t know if that’s right?
Dale Aggen (23:57) 14 sounds high.
Stephanie Ryan (23:59) That’s what I thought.
Stephanie Ryan (24:23) So we have about between.
Ivelise Revett (24:26) What’s coming? 14 does not sound like a lot. No. Okay. No… I think we’ve submitted rosters to about 30 plans. The way we’ve set up with them may be a little different. So it doesn’t always go through the standard delegated process especially with some of these smaller off plans. But no 14 sounds for what’s consistently done about, right? If not low, considering what we have in the pipeline.
Stephanie Ryan (25:03) Okay. I’ll start with that. I just do want to preface. So when we contracted last for the delegated rosters, we contracted based on the number of providers, and we have changed that to the number of payers. We know that rosters can be super payer specific. Each payer requires different templates. And it’s actually like a much bigger lift than I think we initially anticipated when we rolled out the solution. So the quantities are going to look different last time we contracted based on the volume of providers that you had, which would have been 450. Now it will be by payer. And the pricing is, I believe 4,500 dollars per payer, I’m going to see what I can do on that price just based on the volume that you have today. So just know the list price is 4,500, but I’m going to try to get you a better rate there, just on your volume.
Stephanie Ryan (26:10) And then… I will include the caqh management on the initial proposal. Again, I know that there’s going to be conversations internally on if you move forward with that, but again, that is, you have the ability with caqh management to turn it on by provider. So if you don’t think all of your providers need that management, just some, we wouldn’t have to go with the 600. We could, we could scale that back if needed.
Stephanie Ryan (26:48) Okay. So I will include that on my initial proposal. I’m going to run some numbers just based on what we’ve talked about today. Does it work to connect again in a couple weeks just to review a formal proposal based on these numbers?
Ivelise Revett (27:04) Yes, please. Okay.
Stephanie Ryan (27:05) Awesome. Do we want to get that scheduled now? Sure?
Stephanie Ryan (27:13) Let me pull up my calendar… and we’re looking at the week of April twentieth. Do you have a better day of the week that works?
Ivelise Revett (27:29) It looks like… Thursday late morning, okay?
Stephanie Ryan (27:38) Like 10… 30 eastern? Yeah.
Ivelise Revett (27:46) Yes, that looks like it works.
Stephanie Ryan (27:49) Okay. I’m going to get an invite out right now, Dale. I’ll include you as optional… and we’ll plan to review at that time. Do you have other questions right now, again, I’ll circle back on the roster piece and make sure that we feel confident once we get through this piece, we can handle it end to end. But, any other feedback that you’re hearing the?
Dale Aggen (28:18) Only thing that kind of irritates me and it’s small, but it irritates me is the penalties we would receive if we didn’t pay within a certain amount of time, and it’s insignificant. I think there’s like three dollars that we’re charged. It’s.
Stephanie Ryan (28:41) a pain point though. It’s just like we.
Dale Aggen (28:43) Pay our bills. We pay them slowly, but we pay our bills. And if we agree to it, you know, the terms I mean, and if it’s the term is that we probably pay within 60 days, 30 days, whatever, and it winds up being 70 days, 75, 80 85. And then we’re charged, you know… it’s just irritating.
Stephanie Ryan (29:12) I hear you. It’s.
Dale Aggen (29:14) just a pain point. I.
Stephanie Ryan (29:15) Will share that. I know that you guys, I saw you were kind of going back and forth with our finance team, but I’ll just reiterate that to them as well. That, that is an irritation point for the team. We pay our bills. You do, yes, and you’re a very good.
Dale Aggen (29:36) Partner maybe so.
Stephanie Ryan (29:39) I hear you. I will share it. Okay? I will get a summary doc of what is included in monitoring for you. Ivelise, let me know if there’s any other checks that you need run and I’ll make sure that we get those included or if we’re good to go, we’ll connect here again on April 20 third and then I will circle back on the roster piece as well.
Ivelise Revett (30:04) Great. Sounds good. Okay?
Stephanie Ryan (30:06) Thank you so much. Talk to you soon.
Ivelise Revett (30:07) Thank you bye.