Transcript
Erica Lloyd (00:00) power through. What… what, why is your head hurting? I don’t know. I don’t know. I just took some motrin, I’m just like.
Dave Wallach (00:15) I’m so over it. Good morning. Good.
Mallory Smith (00:19) Morning.
Erica Lloyd (00:20) Charlie’s running point today.
Dave Wallach (00:24) She’s on the lookout.
Mallory Smith (00:27) Dave, did you know that Maggie ran point yesterday?
Dave Wallach (00:30) I saw her. I saw you picked her up a little bit at one point. I forget what call it was, but I saw her.
Erica Lloyd (00:39) Wait, was it one of them? Did you get emailed a Gong?
Mallory Smith (00:44) Yeah, I had a health. Yeah.
Dave Wallach (00:47) No, I was on a call with you when you picked her up. That’s all, I remember. I don’t remember maybe it was the day before. I don’t know. I just remember maybe it was the night before. I just remember, you kind of walked away and you picked her up and sat down with her?
Mallory Smith (01:00) That was an internal.
Dave Wallach (01:01) Call. So we were on with guidehealth yesterday, and.
Mallory Smith (01:05) She does part time grooming. So, of course, I had to pimp out my dog.
Dave Wallach (01:09) Yeah, perfect. Oh,
Josh Hartle (02:36) morning, everybody.
Erica Lloyd (02:38) Hey, good morning.
Josh Hartle (02:39) Josh. How are you? I’m, doing good.
Erica Lloyd (02:43) How was Easter with the kids?
Josh Hartle (02:46) It was good. It rained here in Virginia. So that was a little bummer, but we did everything inside but it was good. It was good. Yeah, it was raining.
Erica Lloyd (02:56) Here too. We, we took the kids to Florida for spring break last week. That was awesome. Yeah, it was a trip.
Josh Hartle (03:04) Just visiting or you have family down there. Yeah.
Erica Lloyd (03:07) So, my in laws have a, they snowboard down there, so we took the kids. Yeah. So, got a little help with the kids.
Josh Hartle (03:14) Yeah, that’s always nice.
Mallory Smith (03:16) And josh, they got to see crocodiles and alligators and they were very happy about.
Josh Hartle (03:21) That, oh, that’s good. That’s good. I know it’s a different topography down there. Then up in New Jersey, you can imagine.
Erica Lloyd (03:30) Yeah… I told my, I told my kids they only eat kids that don’t listen.
Josh Hartle (03:37) Yeah, yeah. But for real, don’t go near the water.
Erica Lloyd (03:40) No, seriously.
Mallory Smith (03:46) Freshwater or saltwater, no, I.
Josh Hartle (03:48) know, I know man.
Erica Lloyd (03:52) Cool. Is, is Paul joining us?
Josh Hartle (03:54) He should let me ping him real quick. I literally just talked to him this morning in the hallway, okay?
Josh Hartle (04:16) His team’s bubble is yellow. So, I don’t know where he’s at… but he’s not in a few minutes, so we can get started. Okay?
Erica Lloyd (04:24) Sounds good. Well, I’ll introduce, I’ll let Dave introduce himself a new face and then we can dive right in.
Dave Wallach (04:31) Cool. Josh pleasure to meet you, Dave Waller, me too, also based in New Jersey like Erica. Nice. I manage one of, our enterprise partnerships teams and I’ve heard great things about your conversations from Mallory and Erica and I’m happy to be here and contribute however I can great, awesome, looking forward to it. Yeah.
Erica Lloyd (04:53) So, yeah, thanks so much for sending over all that information that was really helpful to help us inform the proposal. So, thinking for agenda, why don’t, we just briefly workshop the business value assessment, get it more EVP ready for you. Okay? And then we’ll review the estimated investment. It’s a little bit of a work in progress, but I want to make sure you have some kind of like anchor on pricing and we can just get your feedback and align on, make sure we’re aligned on scope. Perfect.
Erica Lloyd (05:31) I was reordering my slides if Paul joined later.
Josh Hartle (05:36) I.
Erica Lloyd (05:36) was going to do the more, the more… business value ones with you.
Josh Hartle (05:43) Okay. No worries.
Erica Lloyd (05:45) Hey, Paul.
Josh Hartle (05:52) Hi. How are you? There you go, hey?
Erica Lloyd (05:54) Good to see you again, Paul. Thanks for hopping on. Yeah. So quick intro here, Paul. My, my leader, Dave, is joining the conversation, asked him to join. So it’d be helpful to have a little bit of leadership alignment as well as we’re continuing to move through.
Dave Wallach (06:12) Hey, Paul. Nice to meet you.
Josh Hartle (06:14) Good to meet you too.
Erica Lloyd (06:16) So, yeah, let’s just jump right in like as I was saying, so I was saying, let’s workshop the business value assessment, get it more EVP ready, for you.
Erica Lloyd (06:25) And we were talking about doing that from both the, you know, the things you can measure and the things you can’t measure, Paul that we talked about. Let’s review, the first pass at it at the investment as I was saying, given we’re still aligning on some of the scopes, we had a couple of questions. That way you can at least have some kind of anchor on it. And then we can kind of iterate on it and then wanted to hold about 10 minutes or so to review the project plan and really that can anchor us on like who, what needs to be completed by what dates if you wanted to move forward with championing medallion. Does that sound good? Okay. Anything else that you both were hoping to cover today?
Josh Hartle (07:08) I think that covers it for me. Sounds good.
Erica Lloyd (07:15) Okay. Am I sharing the right screen?
Josh Hartle (07:19) Yeah, I think rvus.
Erica Lloyd (07:21) Okay. Let me put it in the slide. So, again, so let’s just briefly workshop this. Thanks for sharing those numbers. We understand today. We’re about 700, you said about 700 K in write offs. Not terrible. Honestly, not so great job for a revenue cycle. But I think there’s probably, obviously, you know, as all health systems are going through headwinds and things, how do we get better? I think there probably is, an area of optimization pretty significantly to reduce that by around 50 percent. It’s always like six percent resubmission rate. We can compress that to around three percent so that’s one area. And then let’s see, we were just thinking about making sure we were aligned on like current spend for opex is probably a little over a 1,000,000. We were estimating Symplr software. Okay? Does that feel about right? For, for what the spend looks like for opex?
Josh Hartle (08:27) Possible? The one, yeah, I think that looks correct. I don’t know the specific Symplr one. Yet. We’re still trying to get that information. Me or Paul are kind of not in the loop on that. One thing I guess I would add to this just understanding our structure here at carilion… provide enrollment’s my department, and we have our credentialing department under Paul’s team. And so we both kind of do parallel functions. So that’s correct? I would say probably for our department, but his department, I want to say, correct me if I’m not wrong. Paul, you have like what 14 people that do credentialing and verification services. Yeah. So, I guess that’s where that might get a little change and we’re probably getting to more of that when we talk about what that hybrid outsourcing looks like as far as what our opportunity is there? Okay?
Erica Lloyd (09:19) That’s really helpful. And then that actually piggybacks on another question that Mallory and I had when we were going through this… for privileging do you know the size of the team that’s doing the privileging today.
Pholzak (09:35) I mean, we, I don’t know off the top of my head, yeah, I would.
Erica Lloyd (09:39) Imagine it’s probably fairly similar to, yeah.
Mallory Smith (09:43) And if I could just have a secondary question there, obviously, you have a large network of different medical offices, hospitals, health systems that you currently manage? Is there only one privileging team? One exec, like exec committee that manages this, or do each of your hospitals have their?
Pholzak (10:03) Own, sorry. Yeah. Again, I know we keep going back to the medical staff offices, but I just can’t reiterate enough like it is just not worth our time to talk about that at the moment.
Mallory Smith (10:17) Oh, completely understand. I think josh had previously asked if we could scope privileging. So when we think privileging like joint commission level credentialing, and then privileging to different hospitals. So if we’re just talking about credentialing with ncqa that’s perfectly fine. Just we’ll take your lead by there.
Pholzak (10:35) Well, it’s centralized. So just again, just to reiterate the credentialing process here is signed. Okay. So there is no other credentialing group except for the group that we’re talking about here, which is the 14 people.
Mallory Smith (10:49) Okay. Thank you.
Pholzak (10:50) All of our members.
Mallory Smith (10:53) Okay. You know, politically speaking.
Pholzak (10:56) There’s there’s pushback and things, that are just in the way of it won’t go well, yeah.
Mallory Smith (11:07) No, of course.
Josh Hartle (11:08) Would you say Paul, just for their clarity, we have, what would you say like seven msos, like medical staff offices because of all of our hospitals? Yeah. And then do they all send everything to the committee? Is that how that works? Or do they have their own committees even?
Pholzak (11:23) So, they have their own boards at each hospital. So they all have their own processes at their own hospital. So anything that can be centralized in terms of centralized credentialing, it is, but still, we still have here’s a classic example. Well, I know you credentialed them over at the main hospital, but I can’t understand why you even did that there. Like we would never do that here. I mean, this is the kind of conversations like we don’t have alignment across the board, right? With the privileging side of it for particular specialties, I know, right? We just had a situation just recently where a physician had not been practicing for a few years had gotten passed and on staff at our main hospital, right? Because we did our due diligence to understand why that was the case. And we got to kind of push back from another hot, one of our outside house, outlying hospitals about, they don’t understand why we would even would have even considered doing that.
Mallory Smith (12:28) So, okay. Appreciate the insight there. So I guess when we consider josh, let me have you clarify for me, we can absolutely include privileging like mso capabilities and things because we offer volume based discounting, we would just need an idea of general scope regarding how many privileging applications or medstaff applications. That would be. So if you want to go back and just check numbers and let us know at a later date, that’s fine. But for now, we will let them all operate separately and kill the dream of centralization and move on, okay?
Josh Hartle (13:08) I.
Dave Wallach (13:09) had one very quick question and Mallory and Erica may already know this. I’m just jumping into where we are right now. So I want to catch up. I understand that josh, you said that there’s 11.
Mallory Smith (13:19) People?
Dave Wallach (13:20) Doing PB today, and then you mentioned number 14, I think for Paul and I remember the word credentialing, what are those 14 people doing today? Is that then that’s a different team? Obviously? Yeah.
Pholzak (13:31) It’s all about that’s. All the credentialing aspects that, we provide for all of our health, all of our medical centers. So.
Dave Wallach (13:39) Credentialing meaning medical staff, credentialing, like joint commission or something different than that.
Pholzak (13:47) So, we’re talking. We’re talking about like credentialing for, well, I mean, we’re not doing privileging, right? We’re just doing the credentialing side of it, right? With the joint commissions. And then we’re right? But then one of the things that we encountered was that we were slow and on the uptick in terms of providing that credentialing at the courts, the ncqa’s got.
Dave Wallach (14:08) It. Okay. So if I and I will drop it here, just, I guess they’re doing credentialing but not the privileging is that correct? Got it. Okay. Got it. Appreciate that clarification for myself. Thanks.
Erica Lloyd (14:22) And josh, just since you were talking about the staffing, but we’ll go more into this and we have like full plans that we do with our head of implementation, okay?
Mallory Smith (14:32) We have like,
Erica Lloyd (14:34) full staffing plans like, hey, here’s where you could, how many staff you would need with medallion here’s, a reallocation plan. And here’s when throughout the process that we would recommend that reallocation typically depending on the work they’re doing, we would say, okay, sorry, that should be one fte, one fte, per 500 providers future with medallion. Again, that depends on what exactly what else they’re doing. But that’s typically the metric that we’re looking at. Does that feel, does that seem about right to you?
Josh Hartle (15:07) I don’t know, I don’t know, I think that’s kind of what we’re trying to determine here. And obviously you all have done this before. So just helping us understand from your experience, how you guys typically measure that because that’s going to be something that we’re going to do with our business case proposal is our goal. Paul has been very great about communicating this. We’re not wanting to reduce headcount again, that may be a national opportunity that comes about it with a hybrid solution. So they’re going to want to make sure that we’ve really thought through the math on that of what that looks like because we don’t want to get in a position where we’re understaffed, and then we’re you know, we have a great system but we have nobody to use it. That makes sense. And then we’re gunking up our processes that way. So, yeah, it sounds good. I think I’d like to see more of the workforce development behind it, but, yeah, yeah.
Erica Lloyd (16:04) Well, and we’ll yeah, we have like a whole that’s usually like another 45 minute session of just like going through exactly, I think additionally we, and we weren’t sure just based on the growth plans, like if you were planning on hiring additional credentialing and enrollment folks?
Pholzak (16:20) Okay. I guess my question is that I don’t really understand the math on the two, the one fte per 500 because my, I guess my first question is how you cover for pto?
Mallory Smith (16:35) I can kind of elaborate there too. So because we are an end to end services platform, basically, we’ll need an fte to manage inviting providers to the platform, which can be done individually or in bulk and then requesting the appropriate services that are needed. So that fte can then manage analytics reporting capabilities, make sure the team is up to date, but it’s really not too much of a lift from an actual workflow. So you’re inviting and you’re requesting and then you’re monitoring the process of everything else that’s occurring. So medallion is doing the heavy lifting. We’re submitting. We’re following up. We’re getting the effective dates…
Pholzak (17:18) And then what about following up with the providers who aren’t doing what you’re asking them to do?
Mallory Smith (17:22) Yeah. So we typically, we have conversational AI as well as other tools in the platform to follow up with those providers automatically every three days if they have not responded after our third outreach that’s where we would then escalate to that fte and then let someone on your team know that way they can either find them directly in person or try additional routes of communication.
Pholzak (17:50) And then does that take into consideration any recredentialing?
Mallory Smith (17:56) This does factor in recredentialing. Yes.
Josh Hartle (18:02) And my question too because how we kind of have our organization set up with PE credentialing? And then we’re not talking about privileging, but we have that privileging piece over here. Is that per department? Or is that like those three teams combined one fte for all three. So that way, you know, like that way I get like point three of an fte for enrollment credentialing, etc.
Mallory Smith (18:29) Yeah, no, I think it’s a great call out. So typically, when we think of it holistically, sure you could have three ftes to manage it. But I think what honestly makes more sense and more of a sense of reality is that you do have ftes dedicated to each department like you do now. So it might be two or three for enrollment. It might be two or three for credentialing but usually our customers will go through and bifurcate the two and they’ll just have different departments especially since you’re managing the volume of providers that you currently have. Okay?
Erica Lloyd (19:01) Yeah, thanks. And I’ll go through this really quick and make sure we have time for the investment. But these are great questions. Again, it’s like, I mean,
Josh Hartle (19:08) yeah.
Mallory Smith (19:08) Sorry, I don’t mean to belittle.
Pholzak (19:09) The point, but back to the fte piece of it is that 500 providers is that 500 provider credentialing activities. So,
Mallory Smith (19:20) we typically look at it as 500 providers just because you’re inviting requesting you’re monitoring. But we can always explore that more and go into more of like behind those scenes why the math works. So, what we would probably do that would be most beneficial is take a look at your current workflow. I could map that out using lucidcharts, put a visual together and then what the new workflow would look like if you were to reduce staff so that’s something we will typically do with customers of your size just to make sure it’s realistic. You’re able to see where the change management can occur.
Pholzak (19:55) Because we do just so you know, like we have physicians who join, they’re here three, five months a year. And all of a sudden they’re going to pick up a new location. And then we’ve got to send them back through credentialing to pick up a new location. If they’re not depending on where they’re at, right? If they’re only inpatient and we go ambulatory, they need a new credentialing process. They need to go through to go to their ambulatory sites, or if they actually go to a different hospital, same thing, right? So, I don’t know the number right there off the top of my head, but we definitely have, you know, a decent amount of physicians that actually get re, credentialed to go to a new location annually. I.
Mallory Smith (20:32) Think that’s a great call out and we would probably need to look at that as if it’s two providers, especially if they have to go through the credentialing process. So we’ll note that and then that can definitely be part of our conversations.
Pholzak (20:42) Yeah. All right. Yeah.
Erica Lloyd (20:44) And that, and there can be again, as you were saying, not necessarily appetite to step down, but sounds like reallocation of some staff into doing different things, whether that’s work denials or revenue cycle or different areas of the business. Sounds like there’s no shortage of work to be done. Yeah. And yeah, like I said, I’ll go through this fairly quickly. I thought this josh when you’re talking about like what’s going to resonate at the EVP level? This is typically the kind of like money slide that resonates the most is, and I wanted to just get like your eyes on it. We were estimating as you were saying, you were saying?
Erica Lloyd (21:28) PE, we can conservatively confidently say about 30 days faster. On average, we’re doing 52 days. And again, we’re being really conservative on the revenue per day. I know surgeons are probably five or 6,000, but we also were talking about the fact that it’s you know, probably quite a bit of medicaid payers that are going to have lower reimbursements.
Erica Lloyd (21:53) So we wanted to be really conservative in this number. So we said you’re on 1,500 dollars per day, equating that to adding 360 new providers. That math is about 16 point 2,000,000 in acceleration of cash flow that we were confident that can happen with as a result.
Erica Lloyd (22:13) Okay. And then I think Paul, like as we’re just going through, I think these are just kind of another important things is like, hey, the things we can’t measure with a dollar and cents that are really important. Paul that we talked about quite a bit. Last conversation is like, hey, you need to reduce the provider abrasion branding. You know, these people are talking. This is really medallion is really going to help you do that from a recruitment lens in a very tough recruiting market for providers to get them to relocate to roanoke or, you know, get them to join, reduce the business impact downstream of missed start dates. And then really like bringing carilion to talk about all these manual processes. We’re using agentic AI and automation to bring carilion into 20 26. So they’re not, you know, snail mailing and everything back. And so just saying, hey, we’re, in the new century, we’re doing things the right way, you know, come join carilion. So I’ll keep moving. But any questions on, these two slides as we keep moving? Are we, are we on point here? OK. So let’s talk about the investment here. I’ll have Mallory kind of go through where we got the math on this. This does not include privileging but this, we just scoped out year one. Obviously folks typically do three years. They’re not three year investment. They’re not going to be changing every year. And three years is obviously when the recredentialing cycle needs to happen, we only did one year priced out one year for now. Just so you have an idea, but I think it’s important just to note also we have skew flexibility year over year. So if you were estimating obviously with the consumption based model, if you utilize more in one year, you can push and pull from year to year as long as you don’t over consume more than 80 percent of the full contract, you don’t need to true up. So I will let Mallory just run through, what each of these are. And then as we get to pay revalidations, josh, it’s going to be fairly impactful on the price, but I didn’t know we had a question there on the volume. So we’ll go with that. We’ll save some time to hear your feedback here. So if.
Mallory Smith (24:25) we look at the first few line implementation onboarding. This would cover the data migration as well as training of your current staff on how to utilize the medallion platform pretty straightforward. With groups your size. We’ll see anywhere from eight to 12 weeks for a full implementation. We do have the ability to prioritize if you want certain functions complete and ready to go live before others. So we’ll have a whole technical scoping call with our head of technical solutions. If we were to move forward to that stage… with medallion core, these are the seats in the platform for the providers. You are able to backfill and reuse these seats. So as you have attrition go through with your providers, you can just put new providers in those seats. No additional charge. How we got this map. You have roughly 23 51 providers right now. And then you’re growing somewhere between 303 60 a year. And we put in a lower attrition rate of maybe five to 10 percent to subtract that amount math. I’m so sorry, I am going through a sinus infection or something this morning. So bear with me. But the core season we came up with is right around 2,500. And then of course, that would also be reflective of the ncqa compliant monitoring for ncqa credentialing. This is for initials as well as recredentialing. So we would take your 303 60 plus about. We averaged about 760 recreds that you may see annually. We can provide this detail to you in a follow up email so you can compare it to your numbers. But that’s what we’re kind of expecting delegated roster generation. Josh, you have about 11 delegated agreements to date. This would be automated roster generation. So the system will do the rosters for you adding providers, terming them demographic updates, have those rosters sent to your team several days before you need to send them to the payer… audit management, the annual payer audits that you currently go through, we would be fully assisting with that as well. Since we are now credentialing your providers to ncqa standards payer enrollment. You let us know about 3,000. My math also agrees with that. It checks out… payer revalidations. So you put 55 and I wasn’t sure if you left off at zero or if there was some magic that you were working. So I did want to dig in there just a little bit. When we typically think of revalidations, we’ll take your current number of providers. Now, the list that you provided was very detailed. Thank you so much for that. We were able to remove the providers and maybe they don’t have their own separate enrollments with plans. And that gave us about 23. I think about 2,200 providers to work with. We would take that by the number of non delegated plans. Now, we know you have about six or seven non delegated, but a lot of those can probably be done with caqh for revalidation. So I took those out and I went with a conservative number of four. So we took your total number of billable providers, times four health plans, dividing that by three since the three year re credentialing cycle. And I got about 300. So I just wanted to pause and see based on your answer of 55 if there was something you were doing differently there. Yeah.
Josh Hartle (27:30) So I interpreted revalidations as our core facility revalidations that we do with medicare that we have to revalidate. So I guess can you clarify, like what is the revalidation piece? Is that more that definition that I was acting off of or you guys revalidate that a provider is part of our organization? Or maybe a third definition? Yeah.
Mallory Smith (27:53) No great question. So the facility revalidation for 55 absolutely. Makes sense. That was going to be one of my questions later because you do have so many different offices that you currently manage. So with these payer revalidations, we’re thinking of the individual revalidations they’ll need with each of those payers. So because this is just for the non delegated plans, the standard direct enrollment you’re having to submit. So that’s where our mic is coming from. That, but I can definitely add in 55 for facility reval. That would take the facility enrollment line there. Well, we have a separate SKU line for facility reval, but we can add that in there.
Josh Hartle (28:29) Yeah, because I want to say, to be honest, we don’t get a lot of revalidation requests for even our non delegated payers. I want to say… off the cuff, maybe 100 a year. It’s very… low for us. Yeah, that’s.
Mallory Smith (28:48) fantastic. I’ve been hearing more and more of that in the industry especially as they’re just relying on caqh, Right? Caqh, up to date, they’re good to go. So we will adjust that number that’s great for the price. Let me tell you. Yeah. So we wanted to call it safe. And this was the best possible outcome, what we were hoping for. So we will go back and take payor revalidations.
Mallory Smith (29:08) Make that about 100 for volume. We’ll add in the facility revalidations for 55 and you’ll see that separate SKU line. Okay. Thanks for walking through that, yeah.
Erica Lloyd (29:19) Absolutely. Yeah. So I guess just let’s just get your one. Like we said, we can re, scope it. So, thanks for validating that. Let’s just get like your feedback on, from this price or from the total investment.
Pholzak (29:42) So when you make that adjustment though to what to the 100, what line item? Is that going to hit the?
Mallory Smith (29:50) Very bottom one. So payor revalidations the quantity for 3,000 volume discount, 255, it should.
Josh Hartle (29:58) Go from like 270 to 17,000.
Dave Wallach (30:00) 73. Gotcha. Safe to say it’ll bring it down to around 600,000, assuming everything else stayed the same. And.
Josh Hartle (30:12) From what I’m seeing from the numbers, it looks like the biggest impact is the payor enrollment because that’s where part of this hybrid model is we’re talking about? I think more part of the impact from what I’m seeing on this for Paul and your team would probably be the ncqa and the credentialing. And then so basically lines two three and four affect you and then lines really, the rest affect me on my department. On the bottom. I was.
Pholzak (30:42) Thinking that I thought, well, maybe it wouldn’t be such a good idea to say yours and mine but since you brought.
Josh Hartle (30:46) it up, no, yeah. Yeah. I was like, well, it’s good.
Pholzak (30:52) Though, right? Because this is part of working internally as you guys know, you’ve done it so many times, right? And if you lose budget, does it hit and what’s the?
Josh Hartle (30:58) Impact. Yeah.
Erica Lloyd (31:02) I guess that kind of brings me to… I guess that brings me to the project plan a little bit, but I guess just based on the conversation so far, you know, basically we’ve done the demos. And now we’ve seen what the investment looks like. Is this something that you would want to champion up the chain?
Pholzak (31:28) Looking at this from multiple vendors, yes.
Josh Hartle (31:32) Yeah, yeah, yeah, absolutely. I’m like I.
Erica Lloyd (31:37) gotta ask. I gotta go for it. Yeah.
Josh Hartle (31:40) Well, and like I think the one important piece here too is, I think if we get to the point where we’re champing at like at the end of the day, we’re not going to be the ones that’s like driving the pricing conversation, that’s going to be my boss and Paul’s boss. And then our CFO. And… there’s some good negotiators. I know that will probably be a question they’ll have is like what’s the flexibility on some of the pricing, the unit pricing? Because in full transparency, we have looked at other vendors as well. And some of these unit costs are a little higher than the other ones. And again, we all understand you get what you pay for. But… given the historical context of where carilion’s coming from our symplr experience has been very bumpy to say that we used to at one point outsource enrollment and then it went horribly wrong. So, I know again, I’ve only been here six months. Most of our leaders have been here five to 30 years. Yeah. So this is that’s where the sell and the elevator speech is going to be huge. Like how’s this going to be different? Not only with pricing, the experience, the outcome et cetera. One.
Dave Wallach (32:58) Quick comment. Eric, do you mind going back? One slide and I’ll just make a very quick comment. We can provide a little more in depth when needed. The unit price is the list pricing for that SKU, excuse me, that is showing the volume discount that’s your total savings off of list price, right? So you can see we came in very aggressive, basically a 50 percent discount. We want to put our best foot forward. And then you can see your price, so we can show you what your discounted unit price would be. You’ll see it’s significantly less than that. Okay? I just want to highlight that.
Josh Hartle (33:33) Yeah, that’s good. Yeah, thanks.
Erica Lloyd (33:36) Dave, I also just wanted, so just comparing apples to apples.
Erica Lloyd (33:40) So with symplr like obviously you’re just, it sounds like you’ve maybe looked at other like vendors that would be a hybrid model like medallion.
Josh Hartle (33:49) If.
Erica Lloyd (33:49) they’re just if leadership is just comparing to symplr, it’s obviously, they’re it’s just software not no service.
Josh Hartle (33:56) So.
Erica Lloyd (33:57) It’s not necessarily apples to apples, right?
Josh Hartle (34:01) So I would, and I, and again, I think me and Paul that’s something we’ve aligned on because even other vendors we’ve looked at, you guys do a consumption model. They do like a per provider per fee per month. You know… I think where we will probably have to where the discussion is going to have to be.
Josh Hartle (34:21) Because really that only affects the third line from the bottom providing enrollment the 285,000. That still puts us at. What is that like five, five, 20, 520,000? And so again… not saying that that’s I still think there’s a discussion to be had here. It’s just when we looked at some vendors. And while it’s a SaaS platform, not a combination. They’re really going to know what’s like, you know, I’ve looked at this person. It’s 150 a year. Take out my PE piece that’s we’re still at 500,000. They’re really going to want a well thought out explanation of that big difference in it.
Josh Hartle (35:01) Again, I’m not saying that’s a no go. It’s just that’s where they’re probably going to park and really have a lot of questions to see what that looks like and what… are our outcomes going to be for it as well. So again, we’ve been impressed with the conversations we’ve had with you all. So I’m not saying that to scare you all. I’m just saying that’s going to be the hurdle our leadership team is going to have. And again, I used medallion in the last place like I loved it and that’s why we’re here today but… just trying to give you all ways to support us as we’re working to champion and have those future conversations. Yeah. Does that make sense? I’m trying not to ramble, no.
Erica Lloyd (35:45) I think if there was no, if you had no like pushback, no objection, no thoughts. That would be a red flag. So I think you’re talking about it in the right pragmatic way. So appreciate that. And I think what we can do and what we’ve done in the past is help you put the business together in like a one page type consumable way that can help you socialize it up the chain so that when we end up, you know, when we are having those conversations at the executive level, just presenting and they’re you know, talking about price and outcomes and things like that. We can keep it really concise for them. You’ve already, you know, socialized it and they’re not like what is medallion when we get to them.
Josh Hartle (36:24) Right, right. And just from my clarity standpoint with this pricing, so not to confuse things but to just translate between us and you all this does not include privileging. But when we talk about features such as the, what is it called? Like the like we have in our C iv committee, it’s our credentialing committee that votes on the packets that Paul’s team works on. I think there was a feature for like voting or something like our board members. Is that included in this but is separate from privileging. Does that make sense? It?
Mallory Smith (36:56) Does make sense? And I can clarify that as well. So for the credentialing and cqa line, based on the conversations Paul, you were able to bring to my attention today, it sounds like your team is doing both joint commission credentialing as well as ncqa level credentialing. So we’ll need to factor in the files that we need to quote for joint commission level. But then you do have virtual committee voting for both in here.
Josh Hartle (37:22) Okay. So this all right. So that’s what I was asking. So privileging is not included. That’s if we ever wanted to have that conversation which that’s a battle maybe for another day and we’ll not be in Paul’s ballpark… tap it.
Mallory Smith (37:38) Out, in all fairness, all we really do is we’ll take the dop forms. We’ll attach them together. It’s not that we’re actually performing the privileging so that’s my apologies on the confusion on the lingo. So, yes, we’ll just do the joint commission level file. We’ll put all the packets and documents together. Your team can vote. And then the dop forms are just for ease of convenience for those that actually do the privileging internally.
Dave Wallach (38:02) Okay. And the joint commission credentialing is not on this price, correct? Mallory want to.
Mallory Smith (38:07) Confirm it’s correct? But essentially, if I were to do the rough math, it would probably be pretty close to the number of ncqa cred files. Of course, you’re doing ncqa for delegation and then joint commission for the I.
Dave Wallach (38:23) Just know that joint commission is a higher price. I just want to highlight that if they’re not the same price, but we can, so.
Josh Hartle (38:31) Are we talking like it would be a different line item with an additional unit fee? Or it would just increase the unit fee? It’ll.
Dave Wallach (38:39) be a different line item in the unit, your discounted unit cost for a joint commission credit file? Is it’s a more complex file? So it’s a slightly higher cost. I don’t think it would do anything significant to the price.
Mallory Smith (38:52) Okay. For what it’s worth, we do have a five day SLA for it. So it might be worth the money to you if we think about it from the revenue perspective. True?
Dave Wallach (39:03) Josh, I want to clarify. Did you say that you used medallion in the past? Did I hear that?
Josh Hartle (39:07) Right. I did a previous organization. Where did you use it light counseling?
Dave Wallach (39:12) Okay. Yeah, I.
Josh Hartle (39:13) don’t know if you’ve heard of them, but they’re in Virginia, I.
Dave Wallach (39:17) haven’t but that’s good. Okay. That’s good to know. I guess you wouldn’t be talking to us if it wasn’t a solid experience?
Mallory Smith (39:23) Yeah.
Josh Hartle (39:24) Exactly.
Erica Lloyd (39:27) Okay. Well, thank you for the feedback and collaboration here. Again, it feels like we have, so we’ve done quite a bit. We have quite a bit to go but we’re moving in the right direction. So, let me just bring up the project plan here.
Mallory Smith (39:43) Let me all.
Erica Lloyd (39:46) Right. Can we see my, can we see the screen here? Yeah?
Mallory Smith (39:54) Let me,
Erica Lloyd (39:55) make it a little bit bigger. Okay? So, all right. So we are basically here. We’re basically here. So we’ve done quite a bit, but I guess, yeah… we’re looking at business value. We’re almost done with scoping. I guess we would love to, we’ve kind of gone through some of it, but criteria, I guess the criteria to partner, which would be kind of up the chain. Can you give us any kind of guidance there?
Josh Hartle (40:34) On what? Again? I’m sorry, like.
Erica Lloyd (40:36) What would be, I guess the criteria as you’re going, I know you’re talking about like looking at other vendors, like what would be criteria to move forward with a partnership with medallion?
Josh Hartle (40:49) I’ve been talking a lot. I’m going to tap you on that poll and then I’ll answer… what are your thoughts with that I have?
Pholzak (40:59) A meeting tomorrow with the person I report to. We’ve had some, we had a first area conversation about looking at this as an option. So I need to have that conversation about the fact that we did look at, right? So we interviewed like four vendors, right? So we’ve interviewed four people who do it. Okay. So one’s out. So we got three in the mix… and we haven’t gotten to this level with the other two vendors yet. So we’re going to have to get back to them, you know, and then to evaluate where we are from an organizational standpoint. Really, I report to the CHRO, we have implemented workday as of October. We still haven’t stabilized there. And, you know, we just need to make sure that if we look at this, it is accomplishing what we talked about, which is, can we improve the, you know, candidate and provider experience? Is it going to impact, you know, our workflow in a very positive way, our experience again, being part of the really of the conversation, it’s not just about money, right? It’s about the experience, you know, understanding, you know, how we and from the credentialing team, if or where we’ve had problems recruiting? Does it make sense for us to, you know, how is this going to be structured in such a way that we can impact that as well? Is that we won’t be challenged with the hybrid side of it which is, you know, how do we can, we are we worried about, you know, having people, you know, leaving us immediately if they catch wind of a process like this, right? So, these are all the conversations that we’re going to have, right? So that’s really kind of the next steps. I do need to involve some other people in this who are not on this call or have not been involved in this yet. But because we do not want to tip our hat to them because we don’t want things to go sideways on us if we don’t move forward on anything with any vendor. So this is really kind of where we’re at, right? But josh and I need to come in informed. We need to know that we’ve done our due diligence that we looked around. We do not have to have a final like, hey, this is who we’re going with recommendation tomorrow. We’re not at that point yet. We’ve got some internal business processes that I understand josh has been here a few months longer than me. Right? There’s a few business processes that we would actually have to go through to actually even get this up to the next level in terms of. Scope our evaluation what our goals are for making a move like this and we’ve already got a draft of that sitting in front of us. So really that’s where we’re at.
Josh Hartle (43:58) Yeah, I agree with that. I think what we’re doing right now is we’re just doing our due diligence without bringing the whole party to the party. Like one thing I think Paul’s referencing to is like before any decision we’ll have to loop in our internal it team just to look at from a risk standpoint, they manage our ehr systems as well. So our current platform symplr does integrate with it’s. Called like an SCR record, but they basically will match epic ids in our symplr system. So it’s like it’s a custom like text field or number field. So they’ll want to make sure that’s not going to disrupt their processes, whether it’s onboarding providers, transitioning between practices, et cetera. Et cetera. So… I think again to reiterate what Paul said, they’re just wanting to show we’ve thought through stuff. We’ve really, we have a well rational piece with it. We’re not just trading one software for another.
Pholzak (44:58) And.
Josh Hartle (44:58) then getting that buy in, I think everyone is ready to improve it. It’s just they want to make sure we’re just not doing a repeat. And then we’re going to be in this for three five years. Yeah, Paul and me have egg in our face because we’re the ones that brought it to the table.
Erica Lloyd (45:18) No, exactly. It’s risky to, you know, there’s big risk, big reward. So.
Josh Hartle (45:25) Correct, right? We totally.
Erica Lloyd (45:27) Understand that if you’re a champion, you want to make sure that it’s something that is going to make you look good. Yeah.
Josh Hartle (45:33) And improve.
Erica Lloyd (45:33) Processes and not do so. Absolutely. That totally makes sense.
Josh Hartle (45:39) And just to wrap that up, I think where we are right now is getting this proposal. What my leader has asked is we’re creating basically an sbar right now where we are state of our union. And then what’s the business case, whether it’s medallion or another vendor.
Pholzak (45:58) And then,
Josh Hartle (45:59) me and Paul will be taking that to her. Our CHRO, and our CFO to basically like, hey, this is what we think kind of get the green light on it. That’s when we’re going to start bringing others to the table to kind of maybe doing some more demos like, hey, this is how this might impact your department, improve your department. This is how we’re going to bring it in and all that stuff. But I think that’s kind of where we’re about to start going into, we just need those pieces there. And that’s where we’re going to need help from you all to kind of build that business use case proposal.
Erica Lloyd (46:29) Yeah, that sounds good. Thank you for that. Let’s workshop that together because we’ve done so many of those. So we have a lot of the assets. So let’s not recreate the wheel and then you can kind of put the carilion lingo and spin on it, but we can give you the bare bones and we have a lot of AI tools here to help make it easier, to do it fast and easy. So, yeah, I put that kind of that and also just understanding like internally what you’re saying. Okay, our, this is our top goal for making wanting to do this project. Okay?
Josh Hartle (47:03) So if.
Erica Lloyd (47:04) we understand that we can kind of work backwards and help you build that up to, you know, Armita and Don and Paul and everyone else internally and anyone else that will need to be there. All right? And then I guess for timeline, are we trying to line up the timeline? Like if you end up moving forward with any type of solution? Are we trying to line that up with the renewal for Symplr?
Josh Hartle (47:34) Would say, probably, yes, but I don’t know what that is right now, so.
Pholzak (47:38) Yeah. Okay.
Erica Lloyd (47:40) I thought from the, I thought Armita said we.
Josh Hartle (47:42) Might have said because I think we have some initiatives with them that are due this summer and I think that’s might be where that October date came from, but I’m not 100 percent sure that aligns with our renewal. Okay? Do.
Erica Lloyd (47:55) You know what? Like I guess if it’s not that, what timeline should we be anchoring to?
Josh Hartle (48:05) I think, that those target dates are fine, for me just right now is like a at least having something on our calendar. Do you think that’s okay, Paul, or do you think that’s rushing it?
Pholzak (48:19) I mean, my answer to that is, you know, it just, so here’s two thoughts, right? One of my thoughts is right during the busiest time of the year in terms of adding new providers to the organization, right? Probably not a good idea to start it at that peak time, but in the same respect too, you know, I don’t know. I mean, maybe you guys are really good at this and it makes perfect sense because it’ll actually be better if we just jump on it and, you know, and do it, you know, with our highest volume time, right? Which is going to be, you know, the fall, right? We got a lot of people who are going to be starting in the fall, you know, I mean, you know, we, with our residency and fellowship programs and, you know, that all ties into volume as well. You know, this is our least busy times right now, but it’s going to kick up pretty soon, you know, it just kind of depends on that, right? Or do you just say, hey, you know what? We can actually launch this? We can take three individuals that are currently on your team and we can send them through the medallion process. You can continue to do everything manually with the rest of the team, right? And then we just, we wait them in. Do we just flip a switch and say we’re doing it this way manually today? And tomorrow we’re going on percent medallion… whatever the implementation plan looks like? Yeah.
Erica Lloyd (49:34) Let’s let’s.
Pholzak (49:36) Just so you know, I’m a pilot Guy. I’ve seen it work really well when you pilot things right? Rather than just telling the whole team tomorrow, you’re going to be doing it this way and you’re doing it this way for so long. So that would be another discussion as well. Yeah.
Erica Lloyd (49:53) We can, we can talk through different options there as well. Okay. So, this is, this has been a really productive conversation. I hope it was for you both, as well. So appreciate, the feedback and collaboration here. We will adjust the scope and send that over to you so that you have kind of right sized as far as next steps are concerned. Let’s what do you, so one, I would love to meet you guys in person if that’s possible, grab lunch or something, if.
Pholzak (50:32) we can look.
Erica Lloyd (50:33) To I’ll, I can send over some dates. Maybe we could look to like end of April, early may if that works for you both. Yeah?
Josh Hartle (50:41) For… you. Yeah, that works for me. I’m flexible sounds.
Erica Lloyd (50:46) Good. Why don’t we just pencil something in then? And I’ll look at everyone’s calendar. I’ll do maybe like the may seventh or eighth go that?
Mallory Smith (50:59) Is my wedding anniversary?
Erica Lloyd (51:02) Okay. It’s.
Mallory Smith (51:04) fine. I’ll just bring him back something from Virginia.
Josh Hartle (51:06) There you go. If we need the seventh, that’d be preferable if we could, okay?
Erica Lloyd (51:12) All right. I might.
Mallory Smith (51:17) How cute would that be like a day trip to Virginia, like?
Erica Lloyd (51:21) For our anniversary? So, all right. So let’s do that. And then what should we, I guess, should we work on the business case? We could have a meeting with Sammy to talk through staff staffing and implementation. What I’ll take your guidance? What do you think we have? We have quite a bit to do, but what do you think is a good, the best next step?
Josh Hartle (51:45) My thought and feel free to pitch in Paul. I say we could kind of get a proposal to us and then have that updated pieces with like jco and everything. And then, yeah, let’s maybe start looking at the business case creation and going from there. I know that’ll probably take us a couple weeks a week or so to get done, get in a place we’re all happy with. So.
Erica Lloyd (52:08) I’ll send, I’ll just send an invite then for the week of the 27, for us to all regroup on that. Okay, great. And then if you need to adjust, I’ll just do like the thirtieth perfect. Yeah, I’ll do same time like nine 30 on the thirtieth and then if we need to adjust it, we can, okay?
Pholzak (52:26) That’ll work. Okay? Cool.
Josh Hartle (52:29) All right.
Erica Lloyd (52:30) Well, appreciate the time. Yeah.
Josh Hartle (52:32) It’s nice to meet you, Dave. Yeah.
Erica Lloyd (52:34) You as well. Take care guys. Thank you.
Mallory Smith (52:37) Thanks, everyone. Bye.