Transcript
Mira Guha (00:00) hi Jennifer. Hi Marissa. How are you? Good? How are you doing? Well? Happy Friday.
Marissa Olumoya (00:11) Bye, happy Friday.
Mira Guha (00:14) I feel like we haven’t chatted in a bit. How are you both doing? Doing well. Thank you, tgif. I feel you on that this weekend could not have come soon enough. Well, thank you for your time. I’m hoping this will be pretty quick. I think we’ve kind of been, we’ve been over contract stuff a good bit before. I think we kind of understand where we’re at. So just wanted to go over current state just kind of some of what we’re seeing our kind of next steps here. Our team’s recommendation for kind of how to address the current consumption. So I put this together. I can share it just kind of a nice summary of where we are. So just wanted to kind of highlight a couple of things here. We can also take a look in platform if that’s helpful.
Mira Guha (00:58) But I know we reached out to you. We hadn’t consumed beyond the total contract value. As of today, we are over by just shy of 900 dollars here. All of our SKUs, this was just kind of a fluke in our analytics. So you can see it only consumed 39 dollars when we updated your ongoing monitoring. But over on providers credentialing and the monitoring here. Since we do have eight months remaining on the contract, just want to work with you to kind of right size. What an addendum would look like here factoring in both the current consumption as well as just what we think we’re going to need to get us to that finish line in. I think it’s October getting my or August I’ll go ahead and pull it up. So I make sure I’m thinking about the right dates but our team’s gone ahead and put together a contract addendum here. But kind of what we’re seeing right now. So what we use to kind of create that. And of course, we can always adjust to make sure we’re going off of what we think you’ll actually need based on where we are current term here. We’re seeing about four point five cred files on average per month being used. Obviously, not sure if that’s going to be something we see continue to trend at that level below that level, above that level. I don’t think there’s anything queued up for recredentialing right now. So don’t expect to see anything there unless we add those or a provider who needs that. And we have had a pretty good increase in providers over time. I think when I was looking in platform today at kind of that overtime trend. I was seeing 13 providers added since January, so I think the most helpful thing for us as we get working on this agenda, and since we are over tcv, we’ll need to do that pretty quickly is just any context you can provide about if we do think we’ll need about that four and a half per month through the remainder of the contract on the credentialing file. If we think we’ll need more or less as well as any changes to hiring or just kind of expecting changes in that provider count. So would love to hear a little bit from you if you have kind of any insight or context there or thoughts on how we want this addendum to shape up?
Marissa Olumoya (03:02) Do we have to have?
Mira Guha (03:03) An addendum we do now that we’re over the total contract dollars that’s our policy with the scuflex model?
Marissa Olumoya (03:10) So I thought we were maybe I’m just not understanding it and forgive me if I’m not, but I thought we pay for each license that we do go over.
Mira Guha (03:20) No, that was our former model which was overages. We used to bill overages on a monthly basis at unit rate. We moved away from that model. We had a lot of feedback from clients that it wasn’t working for them. There were also concerns about if someone had 100 overages at the end of the month. That also meant maybe our team wasn’t as prepared as we could have been to do the resource planning for that. So the addendum kind of helps us with our own planning. It helps kind of make sure we’re aligned with what we might be seeing from you. And it just kind of helps with that skew flex piece. It also means that you’re not getting billed at higher rates than like what’s in your contract because the overages meant you could get billed at a higher rate than your actual unit price. So moved away from the unit cost. I can definitely send over your agreement if that is that’s okay?
Marissa Olumoya (04:10) I was just curious, I’m trying to understand and then, are we, do we have to make an addendum every time we go? Like each time? Are we just going to keep making an addendum? So.
Mira Guha (04:21) Our goal with this addendum would be that we’re factoring in how we’re over right now and then try to do the planning like, hey, we know you guys need like greater good needs another 10 files by the end of the year. Like that’s our best estimate. I kind of call it the price is right? We want to guess as close as possible without going over because as you know, the dollars don’t roll over between contracts. We want to make sure we’re getting as close to, you know, what we think you’ll need as possible. And then if we get to the end of the contract, we’re a little bit over. We can just, you know, invoice the difference. But since we have eight months remaining on the contract and are already over, the providers and monitoring will continue to of course, accumulate as far as the cost and then any credentialing you do on top of that. So that’s just our policy with how we address that. So hopefully we don’t have to do this once.
Marissa Olumoya (05:08) That’s what I’m trying to get to. So our CFO prefers to not pay in advance for licenses that we’re not using. Okay? So that’s… where my concern is because I won’t be able to get that approved. However, I know that there’s stuff you can do to like we can figure it out. I think that’s why you have flexible something in the SKU… we are going to have a lot of growth. Okay? I don’t know how much growth we’re going to have through the end of the contract that’s the problem. So I can tell you right now what we have contracted and not all of what is contracted is right now. So we have about 12 coming maybe by June July. But let’s give you total numbers. Jen, can you give them to her? Do you want me to drop it in the chat? Yeah, why don’t you drop it in the chat? Perfect. And this is between now and the next three months, two months, may June, July, three months.
Marissa Olumoya (06:16) So that does the reason why this may not be our last addendum is because if we do sell past that, like we have new clients past that… we would probably need more. And it’s and it’s hard to say right now what that is because we haven’t signed new clients.
Mira Guha (06:39) Gotcha. So sorry, just looking at the number and the hold.
Marissa Olumoya (06:42) On Jen, does that also include Jen? Pocatello? No… yes, that’s yes. Okay. So, I have another question Mira, we have been asked and I think the last time maybe we talked to you about this a year ago, but we have like support staff that need to be credentialed, like medical assistants, lpns, we’re paying the same for their seats as we are our MDS and nurse practitioners. Have you guys created a separate profile yet for mas? Yeah, that.
Mira Guha (07:17) is not something I’m aware that we have on the roadmap as of right now. I think that.
Marissa Olumoya (07:22) That was before because the problem is like they’re we do need them to be enrolled into auto monitoring. So, like the monthly sanctions checks, we do initial verification on any licensure they may hold. And then we do verification of education. Sometimes the mas in Montana, they’re not necessarily required to be certified. But if they have like a.
Mira Guha (07:47) Bachelor’s.
Marissa Olumoya (07:49) degree or something in biology, that is equivalent education. And so their lift, their seat is a lot less than a nurse practitioner. And that pricing of one versus the other. It, it’s substantially different NPS have to submit, you know, a lot more than an ma. And so, I don’t know if there’s additional considerations for the fact that like I don’t know 20 or 30, of our support staff is in there versus like an actual doctor or an actual nurse practitioner. If that’s something you can ask that would be helpful because it’s, it doesn’t make sense that they’re priced the same if I’m being honest?
Mira Guha (08:35) I can definitely check with our team would, if that was something they said, yep, this is on the horizon. This is something we’re planning to do. I haven’t heard anything about this recently, but I can check, would that affect how many providers you would keep active? Like, would you expect to see more providers in medallion, or change anything with kind of how you would expect to use the platform?
Marissa Olumoya (08:54) No, it wouldn’t, it wouldn’t we still, we want anyone that is touching a patient to be in medallion because of the auto sanction checks. And then just, like I said, anything that’s like touching a patient, clinical care, we want to keep in medallion. That’s how we differentiate… like our monitoring internally, I guess, so we want to use medallion for that, but it’s hard for me to justify the cost, for basically just adding a user in there.
Marissa Olumoya (09:28) So, there’s like clinical, and how do I say not clinical licensed and not licensed users in medallion? Does that make sense?
Mira Guha (09:36) Yeah. With the medical assistants being the non licensed?
Marissa Olumoya (09:39) Yeah. And granted, some of them are licensed, but it’s easier to say licensed and non licensed. All that aside that 24 number does include support care teams and that is like contracted essentially to be hired in the next quarter. Okay. If you want, Jen can give you a total count of breakdown by provider type.
Mira Guha (10:08) Okay. I don’t know if we’ll need that depending on what the product team says regarding the provider profile thing. I will see what their feedback on that is. I’m not confident that they’re going to have a change like a change in pricing as of right now. I know we don’t have a change in pricing for that, but I don’t know if they’re working on like having like maybe almost, I don’t know, I want to say bare bones but like a less like.
Marissa Olumoya (10:33) Yeah, ask, because I, we did ask about this, during the last renewal and we said, and you guys said that you guys were working on something. It comes up with us because when we onboard our medical assistants, they’re kind of like all of this stuff isn’t relevant to me. Why do I need to fill it out? And we’re like just ignore that and fill in the parts that are relevant. So, we have even been asked by our leadership internally if we can simplify their applications for them. So anyways, I wanted, I’m glad we had this conversation because I wanted to ask you about that.
Marissa Olumoya (11:12) So that being said, I wouldn’t I don’t think I would make an addendum for any more than what we have contracted at the moment, but I don’t think that’ll be the last addendum we’ll need to make this year.
Mira Guha (11:25) Sorry, when you say beyond what we have contracted, can you elaborate like, yeah.
Marissa Olumoya (11:30) The number that Jen dropped in the chat, I see. Okay. Yeah. So that’s how many more seats we are for sure going to be adding in the next three months got.
Mira Guha (11:39) It. Okay. I can go ahead and show you what I put together and what our logic was behind that. And then we can take that feedback. Do you know if you’re planning to request, do you think you’ll be probably requesting any more credentialing files between now and the end of contract date? Okay. Do you, do you think it will be for those 24 providers or any, anything beyond that?
Marissa Olumoya (12:01) When you say requesting credential files, is that initial anri, credential?
Mira Guha (12:06) Yes, anything, either of those?
Marissa Olumoya (12:08) I don’t think Jen counted the re, credentials through the end of the year, so we can get that to you too. 20 would be 20 would be 24 would be initial, Jen, you owe her a number of re, credentials through the end of the contract, end of the contract. Yeah. Okay.
Mira Guha (12:24) And, I can take a look at that in platform too, like as long as the data’s in medallion, we should have that. I didn’t see anything queued up for uncom, upcoming, but I’ll double check. If nothing else, it sounds like we need 24, we do it.
Marissa Olumoya (12:35) We do it like month by month. Basically. Okay. I’ll.
Mira Guha (12:37) take a look at that to make sure I’m not missing anything. As far as next. Okay, this is really helpful. I’ll definitely check on the ma, thing and I’ll let you know what their feedback is. So.
Marissa Olumoya (12:47) What we used to do before too, Mira, and maybe we can get back to this is like… when we sign a new contract, if it’s substantial, we usually give you guys a heads up.
Mira Guha (13:01) Okay. That makes sense to me. I,
Marissa Olumoya (13:03) think we did it sometime last year when we had a bolus, coming in like 15 at the same time. We were like, okay, we got 15 people coming in here’s. What’s coming up? I know that you guys are also limited on capacity. So, I think it makes sense like to give you a heads up when we have a big contract, but we’re gonna have a big incoming. So, Jen, I’ll ask that you update her going forward. We.
Mira Guha (13:27) Appreciate that. I know our team like if we are expecting like an influx, like definitely helps. Just for this, I want to be conscious of your time. This is what our team put together. This was just based on where we are currently with the, I think we’re over by like I’ll go back to that other slide to keep myself honest. We’re over by 21 providers right now. So we want to factor in that current additional 21. I just budgeted in like an extra nine, but what we can do is budget in those extra 24 kind of staggered. I can kind of mess with the numbers since that’s a prorated software. But we can kind of mess with the numbers a little bit based on what you expect to see trickling in over the next couple of months here. The sanction monitoring, it’s the ncqa compliance. You just might see a terminology change, but it means you’re still getting the same type of monitoring. We factor in 36 based on that four point five average. Sounds like we’ll be at 24 plus those recreds which I’ll take a look. But if you can confirm for me, that would be great. This is just called unallocated spend it’s meant to just cover that current overconsumption we’re at right now just kind of clean slate there. And then everything above that is just what we expect upcoming through the remainder of the contract which is, yeah, the eight months. So… yes, because I know we realigned to a January first start date. Sorry, getting my brain back in order. So it sounds like we have some good thoughts on where to kind of start with the projections. Do you have any questions for me as far as next steps?
Marissa Olumoya (14:51) Can you ask about the licensed and unlicensed.
Mira Guha (14:56) yes, absolutely. That’s the first thing I’m going to do after.
Marissa Olumoya (14:58) our call and I will say I would be more… whether it’s on the roadmap or not, whether it’s something we could do or not. I would be inclined to add even more unlicensed folks into the system. If it was a different cost, okay, it would make our lives easier in many ways. So, you know, I could even add all the clinic staff, Jen, you know, like and then we keep clinic and then admin separate. I would, I could feel comfortable increasing that number if it was something that was a different price.
Mira Guha (15:32) Absolutely. I’ll go ahead and follow up on that and get you our feedback as soon as possible. Perfect. Okay. This is just as far as just making sure we’re on a timeline. We don’t have a deadline for you right now, a hard deadline for you right now, but we will probably need to act quickly since we’ve gone over that total dollar amount. So here’s just kind of a track of where we are right now. I reached out a few weeks ago, had our call today? Sounds like we already have a good idea of where the addendum will probably land roughly. So over the next couple of days, I’ll send it over to you so you can review it and then you can just based on the current number. And then, of course.
Marissa Olumoya (16:07) Right.
Mira Guha (16:09) Size it there. Let us know if you have any feedback like, hey, actually, can we adjust this up or down? Whatever? I’ll hopefully have some feedback for you on the licensed versus unlicensed providers. There. Once we have that final kind of terms and numbers, our team goes in to review it, we go ahead and send it out to your team for signature. I think, was it Mike who was the one who signed it last time? Well, same sign I was about to say, he comes.
Marissa Olumoya (16:33) Back from paternity leave the last week of April. So I think if you could give us through five one, that would be ideal. Yeah.
Mira Guha (16:43) I think that will probably be fine.
Mira Guha (16:44) I’m actually out that entire last week of April. So I’ll just make sure that works for our leadership team. I think since we’re having this conversation now, we have a plan of action. Hopefully that won’t be an issue. So I’ll go ahead and give them that update. So I could just go ahead and update the timeline here based on that.
Mira Guha (17:00) But any other questions for me? I think I have my follow up items being that one major piece for the licensed versus unlicensed. But.
Marissa Olumoya (17:08) Yeah, no, that’s it.
Mira Guha (17:10) Perfect. Great. Well, this was extremely helpful. I’ll go ahead and send a follow up email after this call. Hopefully you didn’t lose me just there my internet’s being kind of funny today. Yeah. And I’ll feel I’ll go ahead and send over that information as soon as I have it. And fantastic both of you have a wonderful rest of your Friday. Thanks. Take care. Bye.