Transcript
Jake Shubert (00:00) thank you. Hey, Nicole. Hey, how are you feeling? Just?
Nicole Campbell (00:08) Like half alive enough. I swear like we were with like some of Seth’s friends’ kids over the weekend and I swear, yep, it was gross. I can’t say how gross it was on a recorded line. Yeah, it was just like a, and then I just like can’t ever get rehydrated again? Like when I’m really sick? Yeah.
Jake Shubert (00:32) And.
Nicole Campbell (00:33) I just struggle, but that sucks. Yeah, I would listen. I literally was having like a fever dream about Weston last night, like I woke up thinking about it because I had listened to the call before. I like really just shut everything off and it was just like sticking in the back of my head.
Jake Shubert (00:48) Yeah, like we.
Nicole Campbell (00:49) Are not, I don’t know how to get her where she needs to be to sign this right now.
Jake Shubert (00:55) Yeah, we can talk about that. I think our only move is a reference call, yeah.
Nicole Campbell (01:01) Which I think is totally fine. Yeah, especially right now, yeah, because.
Jake Shubert (01:05) Like the other option would be an stcsla but our turnaround times for them were like not there. So, yeah… yeah. Whenever I’m around my, whenever I go and visit like back home or North Carolina and stuff around my friend’s kids. I get sick every single time.
Nicole Campbell (01:22) We’re just like not used to it. We’re so, you know, like we don’t have those germs exposure as much.
Jake Shubert (01:28) Yeah, it’s exactly what it is. You just build up that like resistance that.
Nicole Campbell (01:31) I know… do we have a call set with Weston or no?
Jake Shubert (01:37) No, she, Glenda like agreed to set up a follow up call after the reference call, but, okay, I probably should have pushed harder to like have that on the calendar but I wasn’t sure how quick I can get the reference call turned around if we would even improve the reference call? So.
Nicole Campbell (01:52) No, you’re good. Yeah. Also Cameron moved our forecast.
Jake Shubert (01:58) So we could just, oh, nice. Yeah, that’d be great. Yeah, and not sure what you think about reference call wise. I was kind of just thinking matt Ortiz at FCC, like I.
Nicole Campbell (02:08) mean, yeah, I think we are setting him up with one other one right now for josh, but I think that’s fine. Yeah, I don’t know who else we would kind of set them up with.
Jake Shubert (02:21) Yeah, I think that’s and we, in theory could find other like more, well, never mind. Here comes matt. So, okay, same time in zoom. I should probably jump into the call, but, yep.
Jake Shubert (02:36) Hey, matt. How’s it going?
Matthew D (02:38) Hey, good. How are you all?
Jake Shubert (02:40) Doing pretty good. How’s your week been?
Matthew D (02:42) Busy but excited. I’m a lot of awesome stuff happening in the RCM land. So this is just part and parcel with that. So this will be great.
Jake Shubert (02:52) Nice. Well, hopefully you’re leaving this call and there’s one additional exciting thing happening in RCM land that would be, yeah, that would be ideal.
Matthew D (02:59) I’m going to be onboarding. I had a teammate Ben who I think was on schedule to come to some of the initial calls who we passed… his promotion in, I think soar history, but he’s we brought him to senior director and he took over two different teams in soar that’s in central ops. And so we’re backfilling him. His backfill will be starting with us in, I think we have a candidate that I’m going to probably give an offer to today. And if they assuming they accept, I think it’s start of June is when they said they’d be available. And so I think there’s which I think is perfect timing for this to kind of get this figured out on our end over the next few weeks as I said kind of like a bit of a blackout and then come back and kind of have the actual more tactical follow up discussions on documentation or contract and whatnot. Yeah. And then like kind of like start we can start in Earnest before then. But then really my view is they’d be driving a lot of this to start. And so I think that timing just on my point the other day like I want to move fast, get this figured out and then kind of get our ducks in a row and then kind of go really hard once we have like the capacity. And so I kind of view it as like that end of may start of June is kind of where I think we’ll try to hit the ground like running really hard.
Jake Shubert (04:09) Yeah, I mean, we’re totally aligned with that. So that sounds great. And also first off shout out to Ben for multiple promotions already. But also, it’s really cool. You guys are already setting an offer today and backfilling someone’s up.
Matthew D (04:20) Yeah. So I’ll start looping them in if and when they accept on this. So yeah, let’s talk pricing though. I’m excited for this.
Jake Shubert (04:27) Yeah, man. Let’s jump right into it. So just kind of like a review our plan for today’s. Call, like you just mentioned is really just around pricing. So we’re in from the first half of today’s call and we’re going to review two different pricing estimates. So the first one you’re going to see is where medallion will be supporting the entirety of your credentialing needs. So delegated credentialing obviously, but also including the non delegated enrollments, you know, revalidation, caqh, management of your providers, so on and so forth. And then the second proposal that we’ll share is just what it would look like for medallion to support soar, with delegated credentialing. So those are going to be the two different proposals we want to give you both. So you can sort of like see sort of what the ranges are and then figure out what the best strategic path would be for you guys. So that’s our idea. Obviously, we know over the next intervening, you know, month plus like the numbers on your side might change or your growth strategy might change or pair strategy, whatever it might be. Like, these are not final numbers by any means. We can totally iterate on them. But wanted to give you a frame of reference. So that’s a good plan. Yeah, let’s do it. Cool. And then, yeah, just the back half of the call we’d love to talk about like, you know, if we are in the right pricing ranges, sort of like what your evaluation criteria looks like you were talking about sort of next steps, formalizing sort of those timelines and understanding that as well. Great. Okay. Cool. All right. Let me share my screen. Okay. I feel like I always get these like zoom pop ups now that I have to like click 10 different things to get to screen share. All right. I think it, let me in now. Okay. Cool. Can you see this? Matt? Yes. All right. A lot of text on this slide. The sort of tldr here is like we took all of the inputs that you and Brent provided in the scoping questionnaire that we sent over and that’s what we used to formulate the pricing ranges. So everything you’re seeing here is stuff that we gathered directly from your team. Obviously if there’s numbers that have changed since then, let us know we’re happy to make those updates on our side. But these are the general ranges. I also want to take a moment here. Just, I think we’ve mentioned this before, but just to explain big picture like how our pricing model works. So we charge a overall sort of like platform fee, a software fee that we call medallion core, which is to use medallion as a provider data management tool, as well as what powers all the downstream automations that Sam and myself have been showing you in the platform and in our couple of demos. And then we charge based off of the, you know, providers and services we’re going to be supporting for you guys. So, you know, number of delegated agreements, number of enrollments, revalidations, et cetera. Just wanted to give like that frame of reference for the overall pricing model. But any questions on the model itself or on sort of the numbers you’re seeing here on this slide? No, no, this all looks like directionally cracked. Okay, great. And like I said, we can always change that if those inputs do change. Cool want to jump right into the proposal then. So like I said, the first one we’re going to share is for supporting the entirety of soar’s operations. And before I jumped into the actual numbers, I did want to just be like transparent for a second. So, Sam Nicole myself, and like the other medallion team members who we’ve been working on this behind the scenes with like we are really confident that you guys doing delegation with us is like a slam dunk fit. You know, I’d be curious if you agree or disagree, but like that’s something we are really confident in to be transparent. We also think there’s a ton of potential value in medallion taking on the rest of soar’s credentialing needs as well. But truthfully, like, I still think there’s work that we need to do on our side to prove out if there is enough value there, you know, in terms of improving turnaround times in accelerating the current process, like improving the provider experience, saving money from having to add future headcount, et cetera. Like, I think we still need to prove out if the value is there for you guys to do sort of the transition and disruption to move off of like your current state. So just wanted to share like that’s something that we still want to work with you guys to figure out like if that the entirety of the credentialing operation, if that makes sense for us to support or if it would just be the delegation side that.
Matthew D (08:39) Is that is something I was like over the weekend even just like thinking about just I like I, for some reason it was like very top of mind, but it was, it’s because we’re starting some projects in the payer enrollment side. That like it sounds like you guys just do it well and have a machine, but I also feel like we’ve like I don’t want to have like because we’ve sunk time and we can’t change but like, it works well. There’s all these like nuances that pop up like for example, just to give you one on that, we have a rule set that like we have two or three payers that require us to use the center npi that the people support. And so we do like center. I say my team always tell me that’s not what it’s called, but it’s like central level credentialing versus like the group like store level credentialing, and, you know, we found out, well, hey, like our psychologists, it’s all remote. The kids aren’t at a center. Our contracts have this and there’s like a nuance based off of like where the contract is for psych, that we, that’s kind of like the center we bill at, like the facility that we use and the billing like facility. And so we have to modify the rule set to appropriately in the credentialing app. And it ties to our authorizations, checks. And it changes what the team actually gets as they’re like kind of like hit list of priorities each week to do. It changes the automations that go out and even like nuances like that, like it took us 30 minutes to fix everything versus like working through with you all. And like how I think the question that it’ll come down to is that like the biggest thing for me is like the yes or no is like the flexibility that the system provides to a layer of this rule set in. And then also like the turnaround time to adjust for these things. And is it self service or do we have like an account rep we work with? And that to me is like, as we kind of like learn the nuances, especially the new markets that’s where the pay or enrollment side. I think it’ll kind of, I know maybe the argument is like we do some pay or enrollments with you all.
Matthew D (10:29) So like our big national contracts, like, you know, for example, I think it’s optum or united. I know they’re like the same. But like, optum, like united behavioral or optum, for slpot, whatever the split is like with our contract, one of them takes a week to credential, one of them takes nine months. And so, like is there a, for those ones that do take a really long time? Is there a value in working with you all on that? But then we have like these split systems that from a onboarding perspective are really crappy for the clinician. How do we merge those together? So that to me is more of like the nuance. And so I fully agree delegation is the focus pay or enrollment. I’m fine. If like even if it has like a cost implication for like for, if it’s an annual contract for like first year, I’m like doing that one separately and then merging them down the road if we go there. But just so you’re aware like that’s on my mind on the payroll side?
Jake Shubert (11:13) Yeah, it sounds like we’re thinking about this the exact same way matt, and like we can obviously keep working on answering those like nuanced questions that are gonna determine sort of that fit. And also like we can always keep iterating here on like what that pie chart looks like, right? Maybe it’s like you said, we take on just a few priority commercial payers as you move into new markets. Maybe it’s us taking on everything like, you know, I think the point of me bringing this up before actually pricing which is to share like, yeah, we’re thinking about this the same way as you, we’re not just like blindly gonna tell you like, yes, 100 percent, we should take on everything right now. Like we wanna prove that out if that’s the right decision.
Matthew D (11:46) For you? Yeah, on the same page, cool.
Jake Shubert (11:48) And then just on the delegation side, I know it’s a priority, but do you kind of agree that like from where we are right now, like that delegation is a really strong fit with medallion.
Matthew D (11:56) That delegation, we will be doing delegated credentialing. Like there is no doubt about that. We will be doing delegated credentialing?
Jake Shubert (12:02) Yeah. And do you feel strong about where medallion’s positioning is with delegated credentialing? I.
Matthew D (12:07) Frankly, just like through this process, we are one of our board members introduced us to like one other company and I’m like literally, I mean, it’s like to me like a very shortlist conversation. I haven’t even engaged with the other company yet because we mentioned we were engaging with you all. And they brought that up. But like this to me is ultimately like it’s already kind of like a shortlist finalist round. I don’t want to like overdo… this. It seems like I feel like we can get to a good answer on this with like just a good kind of like sow with like kind of very clear expectations in there. And if we can do that and pricing doesn’t break the bank, I think the value is there.
Jake Shubert (12:44) Awesome. And are you able to share with that other vendors that you recommended?
Matthew D (12:47) Yeah, it’s assured. Okay, cool.
Jake Shubert (12:49) Yeah, we’re familiar with assured. Cool. Yeah, always happy to talk to.
Matthew D (12:52) You. We just had the intro like last week or so because we had a board meeting and we brought this up and they had worked with that for one of their other, they have like three portfolio companies and this was the other one that they had. Yeah, they had worked with them on so nice got.
Jake Shubert (13:04) It, yeah, we’re always happy to talk about sort of the differences there, but that could be on.
Matthew D (13:07) A future call. Yeah. And that’s where like I need to kind of like bring back. This brings back. And I’m like this is where I like it’s like consider this more of like a final, like we’re kind of in the throes of a final round RFP, if you want to think about it that way that.
Jake Shubert (13:18) Makes sense. Cool. Well, let’s jump into the proposal for the all in. So including the entirety of enrollments you guys need. So here’s sort of the pricing estimate that we prepared. So, you know, we don’t need to get bogged down to like individual SKUs or line items. So obviously it’ll change over time and there’s no like unit based discounting built in here yet, but here’s kind of the range. So to support the entirety of source credentialing needs from what we scoped out, we think it’d be in the ballpark of about 300 to 400 K annually. And then the next slide I’ll show will be the just delegated credentialing piece. But yeah, curious for any feedback here on like this sort of pricing range for the quote unquote like all in proposal, no.
Matthew D (13:57) No, I mean, I think, I mean honestly like my question is like what’s split of delegated versus the rest. Actually, my only question then is like that I do have on this view is… like I tell me if I’m wrong, but like I, you can obviously do like a payr specific piece potentially but then that would be like the syncing of systems that we’d have to think through and work with you all on. But like medallioncore down to ncqa credentialing or maybe involvement like validation, whatever like that is all kind of one package, right? You can’t it’s like you’re not like cherry picking like we just went caqh management, right?
Jake Shubert (14:33) Yeah, to be honest, you could cherry pick like medallion is pretty a la carte in that way. So, yeah, I mean, again, that’s something that we can talk about in the future.
Matthew D (14:44) Of like what that?
Jake Shubert (14:45) Looks like. So I think there’s maybe more flexibility there than maybe to be assumed. But in the next slide I show you which shows the just delegated piece, it’ll narrow down the skews of what is just needed for delegated credentialing. So maybe that’ll help sort of provide there. But, yeah.
Matthew D (15:02) And I will say like caqh management is annoying because you have to like people have to reattest we’re waiting on them. Like that is like a pain like I figured out what you guys had showed with the API exactly. But like, yeah, like you’re pulling out the necessary info from there. Like that is actually like I view like highly value accretive even within like if we keep our current system. And so I actually view there’s like delegated. Yes, there’s probably some like a la carte cherry picking. And then there’s like the overall and it depends on how messy we want to make this. But that’s cool. That’s good to know.
Jake Shubert (15:30) Yep. And then caqh management like we’re the only vendor who kind of has like a what’s called a direct partnership with caqh. So, yeah, that’s kind of a unique thing for us to tackle. Great. And that’s helpful feedback. So then, yeah, just the delegated only estimates. I wanted to share that here as well. So you’ll see the SKUs narrowed down. So for delegation based off what you guys have shared, looking at about five or six payers in year one, we would estimate that to be about 150 K to support the delegated credentialing needs for soar?
Matthew D (15:59) Okay. I mean that frankly feels reasonable like I think the value is super high there. I’ll have to come back with obviously more of a… like more thoughts on that, but I mean to me like right off the bat, I’m like that. That seemed very reasonable.
Jake Shubert (16:17) Cool. Yeah, that’s great feedback. And I can also just share these slides with you over email. So, so you have them.
Matthew D (16:22) Yeah, but.
Jake Shubert (16:23) Yeah, that’s kind of where we wanted to pause here. So those are the overall pricing estimates. I guess the one question I had was like, matt, I think it was a couple of calls ago. You mentioned that for some projects, you kind of have like, a personal budget set aside for things like, you know, RPA automations, offshoring, et cetera. I was curious, were you able to figure out sort of like what that budget looks like? And if medallion would be able to apply to some of those conversations?
Matthew D (16:49) Yeah. I, what I can tell you is this, I actually like this is where like I want to talk, I need to, it’s like kind of a, my boss is the CEO and like, I want to talk to him on this. But like ultimately, this kind of, I, I’ve gotten the sense over the last he was out. I was out. I know we haven’t talked. He and I have talked about it in a bit. But like my last conversation I had with him on this is like this is, this goes beyond, my budget to some extent. And so my budget that I really that I got is actually lower than I expected. I actually got the final feedback. I’d asked for something around this and I got like half that, but I think that, but I also think that I also think that, we don’t need to rely on that like very strongly, I feel very strongly. This is gonna be like we’re just gonna like instead of hiring people down the road, we’re just gonna do like we’re gonna use this and it kind of offsets that. And I can work with him on that separately. So that’s where I’m saying I don’t view this as like outlandish at all. I think it’s I think it’s I like, I think it’s fair. And I’ll kind of go talk with him on that. And, and one of our board members who has a bit more experience on this but, and I can give that feedback based on those conversations?
Jake Shubert (17:57) Yeah, that’d be great. Cool.
Matthew D (18:00) I’m not worried. And, I kind of, I’m like happy that I think I can like I can flex up as needed cause this is more of like a strategic priority than like a, yeah.
Jake Shubert (18:08) Yeah, that tracks. Cool. And then I just want to chat about next step. So like, I guess I kind of built out this what we call like a mutual action plan. And this is just mostly because I’m like a type a person who needs direction or else like I, you know, I don’t know what I’m doing. So, I guess I wanted to ask matt, like for your internal steps like what are the things, that need to happen for your evaluation process from here on out? Yeah,
Matthew D (18:37) I view this as it’s kind of like that and I’ll kind of go up until like implementation of this. The first thing is kind of like strategic like credentialing the strategic roadmap with like, matt and CEO, and again, this is already like in there, but it’s more like let’s extend this out beyond like, and look ahead. There is the from there there to me is like, the actual like sow msa discussion that we could have with you all. And I think in my mind, I think there’s kind of like we share a niche. I mean, I guess you guys are like, I don’t know you guys, I assume have like a pretty off the shelf sow components that you can put together based on our scope. So maybe this is, it, it’s like a strategic roadmap. And then it’s plus like, so on that first line, you put it’s credentialing, strategic roadmap, plus like scoping plan, cause that applies to like what do we start with? Where do we go with? And so I can take that? And then based on that, we share that back and there’s a kind of you all share the sow and msa. And there is a discussion around that, which is inclusive of like the pricing side of things. And then there’s there is the I’d say kind of like, the project kickoff and then that would be something that we would do. I would kind of coordinate with my new teammate joining, which I think we can say June, if that works, I know it’s a little bit further out but like that’ll be great just to have them kind of tied into that. And then from June, you all kind of like, yeah, I know you guys had had, those timeline slides based on stuff, and maybe if you could kind of share back like full implementation kind of like is complete by based on the start date?
Jake Shubert (20:24) Yeah. So I’ll call that like go live. Yeah, cool. That’s helpful. Okay. So we’re going to dig into a couple of things here. So this first step credit strategic roadmap and scoping plan, that sounds like it’s more of like an internal soar conversation, right? Okay. Yeah, that’s let me just write that down. Okay. So that makes sense. And then for the sow and msa discussion, I did send over, excuse me, I did send over the msa over email after our last call.
Matthew D (20:55) I actually did see that it’s in my to re review folder. So, thank you for sending that.
Jake Shubert (21:00) Yeah. Do you guys have like an internal legal team or what does that look like for you guys? Yeah.
Matthew D (21:04) We, we have our means, okay?
Jake Shubert (21:07) Would you be open to like in conjunction while you’re doing sort of this step, the strategic roadmap step, also having the legal team review the msa. So those are just being knocked out in parallel?
Matthew D (21:17) Sorry, can you say it over time?
Jake Shubert (21:18) Yeah. I was saying, would you be open to as you guys are having the internal conversations on the strategic roadmap? Just sharing the msa with your legal team. So those are being knocked out in parallel?
Matthew D (21:30) Yes, yeah. That’s that’s fine. Okay?
Jake Shubert (21:34) Cool. So legal can start reviewing the msa. You guys have these internal conversations figuring out sort of like where do you start? Where do we go with on the sow? I imagine that’s something we’ll put in place after you’ve had that roadmap conversation, right? So we know.
Matthew D (21:49) Yeah, because it’ll kind of be like the a la carte piece part. And then there’s probably like a, this is working with you all more like the, how would like if this is kind of what we’re looking for? Like is it feasible? And what would be like the proposed cadence to support that?
Jake Shubert (22:01) Yes. Okay. That makes sense. I guess like not trying to put a timeline on you guys, but is there kind of like a date you’re targeting to just try to have the strategic roadmap conversation?
Matthew D (22:12) Like that sort of internal, I would say like in like this would be like by end of April. Okay? And then, and then that would kind of give us like the month of may to get things like buttoned up and ready to rock? And then, and then I don’t know if it’s a project kickoff, like how long of a turnaround from like signing everything ready to kick off? Do you guys typically need? Yeah.
Jake Shubert (22:31) I mean, Sam, you can add more color since you used to be on the implementation team, but matt, the average is like to be fully going live is typically between like eight to 10, maybe 12 weeks for like giant enterprise customers, but that’s but.
Matthew D (22:45) That’s like that’s like go live, not just like starting the work, right? Correct?
Jake Shubert (22:49) Starting the work would be instantaneous and you guys, yeah, and then you guys can start doing like new enrollments onboarding, new providers. All that stuff can happen within the first one to two weeks of medallion. So you wouldn’t need to wait to be fully live. You can start seeing value pretty much immediately there. Cool.
Samantha Bouchard (23:04) Yep. Yeah. Matt and I think just circling back to like the two action items that you can start now, right? Which would be applying for npdb which Jake sent you instructions on that, and we can resurface and then reaching out to your payers, letting them know you’re interested in delegation. So we would definitely just like even the emails out to your payers, like it’s a quick one liner. Hi, we’re interested in delegation. Can you send us some information on it? Yeah, I would definitely start those two things now because that’s you know, one of like the bottlenecks for the delegation. So the sooner that you can get those two pieces done, the better. And we can certainly put together like an implementation timeline and kind of outline like what that delegation layer kind of looks like in between too. Great. Yeah.
Jake Shubert (23:55) And is sort of that npdb and payor outreach, matt, is that something that you guys think you would start the process of this month as well?
Matthew D (24:03) Yes. Yeah. I would say so. I think that’s given what y’all are saying here, yes.
Jake Shubert (24:08) Okay. Cool. And then I think maybe my last question is just if we are like in the hypothetical scenario, if we do end up being the vendor that you choose to move forward with, would this be just like sort of your sign off and the CEO’S sign off? Would there be other people who get involved as well? Just us?
Matthew D (24:26) Two. Okay.
Jake Shubert (24:27) Cool. That’s great. I guess Nicole, anything that we’re missing on our side? No?
Nicole Campbell (24:34) I don’t think so. I think we have a good plan here, matt, and we’re excited to keep this process going with you.
Matthew D (24:40) Cool. Yeah. Appreciate it. So, like I said, it’s like a bit of a blackout for the next two, three weeks just so we can kind of get our stuff to throw and everything else that’s rolling. I’ll kind of start that process with our payor contracting team about, do you guys actually recommend? So we have like contract points of contact and we have credentialing points of contact. Is there like a point of contact you recommend reaching out to? I think you had mentioned credentialing teams like typically don’t even know what exists for like they don’t even know this is a thing. It’s typically like a higher up conversation. Yeah.
Jake Shubert (25:09) Sam, I think we’ve mostly seen it’s. Been like the contracting point of contact. Is that your experience too? Yeah.
Samantha Bouchard (25:13) Okay. Yeah. I would start there, matt, because it’s yeah, it’s essentially an arrangement that you all are going to make to take that on.
Matthew D (25:21) Okay. Yeah, great.
Jake Shubert (25:23) I guess matt, should we schedule a time for maybe the first week of may to reconnect?
Matthew D (25:28) Yeah. Let’s do that as a forcing function. That sounds good to me. I can, I mean, Fridays seem to be the.
Jake Shubert (25:34) Yeah. Let’s stick with that. All right. So, Friday may eighth, I’m.
Matthew D (25:40) good. Anytime after 10 30 a. M. Okay?
Jake Shubert (25:43) Yeah. Can we do 11 a M? Pacific? Yeah.
Matthew D (25:45) Let’s do that. All right?
Jake Shubert (25:46) Sweet. So I will send over that calendar invite. I’ll just do it for like 45 minutes. If that works for you? Sounds good? Okay. 11 a. M, Pacific Time, five minutes. And then I, if it’s helpful, I can sort of reshare the npdb information, I can reshare our msa in case that’s needed. And if you guys have any questions or there’s any updates on your side? Whatever it may be, just feel free to reach out and we’re happy to help async.
Matthew D (26:11) Sounds good. I appreciate it. Y’all, cool. Thanks, matt. Cool. Thanks. Y’all, have a great day. You too. Bye.
Jake Shubert (26:16) Bye.