Transcript
Mira Guha (00:00) hey, Nicole. How are you? I’m alright. How are you doing? Okay? It’s Wednesday I.
Amy Frana (00:08) Was looking through that slide deck again.
Mira Guha (00:10) The one we’re presenting today? Yeah, yeah. Let me just slack it to you. Thank you. Yeah, I knew the problem.
Mira Guha (02:29) Hi, Richard. How are you?
Richard Wagner (02:31) Hey, Mira. I’m good. How are you doing?
Mira Guha (02:34) Well, thanks for making the time. I know your time is precious. So I thought we would just jump in today. This is everyone we’re gonna have from our side really just gonna go ahead and share my screen here. Been having some WI fi issues. Let me know if I disappear… just as far as kind of what we wanted to cover today. Really wanted to use this time to align on some of the feedback that’s been discussed recently and that’s been shared especially on the last call I had with you and Kelly. So I wanna make sure you know who all of us are on this call first and foremost. Then discuss the feedback. We’ve kind of reviewed and basically grouped some of the items that were discussed and we’re looking to kind of address those today and just get more feedback from you, clarification, and then just kind of align on next steps and your strategic priorities to see what we can do to best address those going forward. Make sure we’re aligned on all sides. Do you have any questions before we jump in?
Richard Wagner (03:31) No. Let’s go for it.
Mira Guha (03:32) Awesome. Okay. So, you know who Nicole and I are? I’m your account manager here, kind of high level strategy, contract pieces, stuff like that. We had that ebr the other week to kind of chat through some of these pieces. Nicole, kind of your day to day in the operational weeds. I know she’s meeting with Kelly pretty regularly here to kind of also provide some more context given she has those frequent touch bases regarding the actual operational pieces. Always have our customer support team for any questions or general assistance that you need in between any meetings you have with Nicole. And then new faces on our call today. We have Genevieve sini, she is leadership on our account management side. So I work very closely with her. And then we have Amy frana from our engagement management team leading there. I’ll go ahead and let first Jen introduce herself and then Amy real quick.
Genevieve Seney (04:21) Yeah, yeah, yeah. It’s great to meet you Richard. Thanks for taking the time today as Mira mentioned manager on the account management side of the partnership. And so connected with her briefly regarding your feedback and what we heard from you today. And want to just sort of obviously iron that out and make sure there is a clear path forward for the partnership. And, you know, closely work together on how we can sort of reroute the feedback we’ve been hearing. But, yeah, just a pleasure to meet you and looking forward to today’s, call.
Amy Frana (04:52) Yeah, and hi, Richard, Healthstream, what Jen said, it’s very nice to meet you, Amy, frana. I am very closely connected with Nicole.
Amy Frana (05:01) She’s a member of my team and here to help support and work through some of these challenges that you’re having as well. So appreciate the time to be able to review.
Richard Wagner (05:10) Nice to meet you guys.
Mira Guha (05:13) Great. So we’re just going to go ahead and jump in here. So like I said, kind of bucketed or categorized into really kind of three main focus points here. I’m just going to go ahead and run through them. And then we can kind of leave it to like more of an open discussion or make sure we’re just addressing any questions you have. So I wanted to start with this first piece which is enrollment ownership, kind of medallions part of that ownership versus ravens as far as responsibilities expectations when it comes to requesting and how consumption works since I know those were some big ticket items in our last call. So wanted to just confirm, I believe we mentioned this. But consumption against any managed requests such as an enrollment occurs once intake is complete and any request is put into a workable status. Like we were able to start working on the application, work towards submission. Basically means that it is charged against your contract for the work medallion is doing. And the time that is put into it, I know there has been some feedback about submitting application and seeing that the panel is closed. Unfortunately we don’t have control over that piece on the payer side. So we are still going to consume that request based on the work we’ve done. And then Nicolle and team can kind of regroup with you on next steps about, you know, that enrollment if we want to look into next steps months later. However that works for that particular enrollment. So really just wanted to reiterate that piece and Nicolle and team can kind of chat more about workable versus non workable statuses for clarity. There other pieces as far as requests that have been stopped, I know Nicolle and I have chatted about some requests that were made for enrollments based on particular kind of service lines, medical versus behavioral that maybe then had to be stopped because that was not the correct route for that payer. And then new requests submitted and how that has affected consumption if we worked on those. So really just wanted to reiterate that we’re asking Raven to really ensure understanding of what your needs are with those enrollments when it comes to your clients and their payer contracts and their ultimate goals to avoid kind of having to create those, stop those and then create new lines. So just really wanted to reiterate that piece there and see if you had any questions on that.
Richard Wagner (07:24) Yeah. So maybe it’s helpful for me to just boil down kind of the big concerns on my end. I know that, you know, Mira, you’ve been taking notes but here’s the thing I see three big challenges for us right now. The first one hasn’t really even been mentioned, but that’s like 80 percent of the problem. Maybe more is we haven’t seen a single successful enrollment process. Now, I know in your dashboard and I think I saw your response Nicole that you guys had one at the time and now it’s like two. But those were providers that have already been enrolled. So like before medallion.
Richard Wagner (08:01) So these, like as I look at it today, again, the whole reason we brought you guys on is to help us enroll providers. We’re now over four months into the engagement and haven’t seen a single one process. And when it was promised to us that we were looking at 60 to 90 days, right? With the emphasis on the 60, when part of the sales process, it’s something that we have relayed to our customers. We have a lot of angry customers, a lot of people who have left us as a result of this. And it’s just a huge headache. I don’t see any way out of it. So.
Genevieve Seney (08:41) If.
Richard Wagner (08:42) you guys have clarity into that. I would love to hear it. Number two is what you just talked about. The consumption model that you guys have. This was not discussed in the sales process and it’s been infuriating for us. The fact that we can have a provider again, this is like I’m looking at it from my customer’s perspective, we can have a customer who comes to us as love to use your service to enroll. We go through that process. We charge them, we get down the line, you know, a month and then told that network’s closed by the way we still have to charge you. By the way, you know, that we lost the time of that month that they took to try to enroll with someone, right?
Richard Wagner (09:26) That prolongs our period to revenue, prolongs when a customer can get up and going on the platform. Like there has to be a better process for this than just sorry, you know, throw up our hands in the air. It’s like you guys have to take that and eat the cost. It’s not acceptable. And then the third thing it’s like, I think it’s by far the least important of the three. But I think it’s symbolic of the relationship so far and it’s just been a nit for me for so long is that we were promised as part of the sales process that you guys would be there to provide sales enablement resources, help us like market this product to the market, right? And it’s been like, I haven’t heard a single thing since we started the relationship, right? This was again sold to us as like a value add that you guys have a full sales and marketing team that can help us like position this in the market. Nothing. And we’ve been kind of left to our own devices. So, I don’t see a product that’s working. I don’t see the partnership support around it. And I see this like lack of faith it’s led to a lack of faith and trust in you guys as a partner. When, you know, again, it’s even… the things like you got to eat. The number two thing that I mentioned, I think it’s symbolic of where the partnership is at. So just, very frustrated. And I felt like we were sold something that wasn’t there. And I’m not sure if that’s in your, in the feedback here. It doesn’t look like you have all of that, but I wanted to make sure that I got that here on the record. Yeah, yeah. And.
Genevieve Seney (11:05) I can jump in first. So Richard understood, I think like just speaking for all of us, we obviously were not involved in the sales process and your pre sales process and what was promised, what was not. So I think like to take a step back, what I can speak to is sort of what you’re seeing today and what you know, contractually and what all clients are sort of held to with the partnership.
Genevieve Seney (11:24) I think that the first piece just to kind of take a step back in terms of the completed enrollments, right? So first things, first onboarding typically takes like 12 to 16 weeks. I think you guys started in maybe December January. So, I think like in terms of where we are today with the partnership, you can definitely holistically look at like the timeline and what work’s been completed, and how we got to the point where we are today and what work is being done. I think from our perspective, right? Like in terms of the completed enrollment. So we do have two completed enrollments. And obviously, there’s a lot of back and forth with what it takes for us to start an enrollment. What it takes for us to submit it to the payer. Really, all we’re processing, right is the requests that are submitted. And so if you’re stating that the two requests that were submitted were enrollments that were already done, we have no control over that, right? Like if you guys are submitting requests, we’re working the requests you submit. And so anything in terms of the data that’s submitted, that’s what we’re working towards in terms of the turnaround times on this slide, it does mention you have full access into the state and payer breakdown of the turnaround times and those actually break it down by the different statuses. So obviously workable versus non workable meaning if we’re waiting on any piece of data such as a task that’s open for a social security card document, whatever it is, we can’t work on that file until that’s provided, right? So that’s considered a non workable status. And really we’re trying to get this submitted to the payer as quickly as possible. That’s obviously what we’re trying to do. If I look at the platform today, we have 39 requests that are waiting on some sort of action from riven out of the total of 120 or 100 requests. And so like I think just to sort of like break it down in terms of the turnaround times we are aiming to have, you know, the shortest window possible, a lot of that as, you know, is out of our control. So once it’s with the payer, we have no control over how long that will take for them to complete it. What we’re doing is just following up via email via direct contact et cetera. To get that across the finish line. Yeah. But again,
Richard Wagner (13:29) like, you know, the two let’s take those off the scoreboard because those did not happen, right? Like those, you guys, what is that? What?
Genevieve Seney (13:36) Do you mean by that? The,
Richard Wagner (13:38) two enrollments that I’ve been told have been successfully processed, they have not, right? Those were previously enrolled payers or providers in networks who, you know, that was their mistake to tell us. They would like to enroll in a payer, you know, for a given payer in their state, they didn’t know that they were already enrolled. But those were, you know, I don’t want to, we can’t claim those as like medallion assisted wins, right? Because they were already in place. So.
Genevieve Seney (14:04) Take those.
Richard Wagner (14:05) Off the scoreboard and, you know, granted, yeah, there’s a number of like these are probably new customers in the queue that we’re working with them to get new information. But like you take the 36 off the side. I look at 71 that have been processed, right? Or 70, whatever it is. 80. Now that.
Genevieve Seney (14:24) we’re.
Richard Wagner (14:25) o, for 80, right? Like not a single one has processed in four months more than four months now. So I match that up against the timeline that we were sold on, promised, right? Is what is typical and I don’t understand what value I’m getting especially since these providers could have tried to enroll with their networks and, or do this on their own and see similar times in terms of processing time. I don’t I just fail to see the value you guys are providing. Yeah, I think.
Genevieve Seney (14:57) Maybe also too, right? So out of the remainder, the 40 that are with you guys, we have 21 that are with the payer. And then we can dive into the remaining because again, we’re talking about that workable versus non workable status. So if a provider doesn’t log in, if they don’t do their attestations for 10, 20 days, like we have no control over how we can submit those.
Genevieve Seney (15:18) And so I think like that’s maybe the parse piece that’s missing for your side is like, how can we get your providers to do these action items so that we’re not held up in submitting these applications? And so I think like that’s the part where like our value add comes from obviously relying on your side that you’re getting the data and you’re getting the information needed that we can submit these to the payers. And then from that piece, right? Like we can definitely look at if there’s anything medallion’s doing that’s not processing these applications right away, but we are held to those automatic standards for again, our slas are tied to request to submission to the payer is 10 days, 10 business days. So anything outside of that we would obviously be, you know, held to. But again, from what I’m seeing in the platform, there’s just a lot of sort of, I think misunderstanding of how everything works and how we can submit to the payers.
Richard Wagner (16:12) Okay. I… the value as I was told was you guys take a byzantine process, simplify it and it translates into faster enrollments for providers. I can’t we can’t quantify what that is right now because there have yet, there has yet to be a single one that is processed of all of those that are in process of being worked even under the best case scenario, all of like the 70 that are in process go through tomorrow. We’re still behind industry average in terms of how long it takes. And so I don’t understand how medallion speeds that process up, right? That’s the problem I’m facing. And again, can’t even quantify that because we have yet to have a single one go through. Yeah.
Genevieve Seney (17:07) I mean, I think we’re kind of saying the same thing, right? Like the reason why we haven’t had a single one go through so to speak, is all the time it’s taking to get the data up front. And again, I do think like to your point, there is a lot of friction in the beginning because of all the data and all the work it takes to get sort of the amount of information needed to submit to payers. So I don’t know, I mean, I’m not as close to what the process does look like for you guys. For once you invite a provider to the platform, sort of what is the expectation that they’re completing the profile or adding the data needed to get the enrollments submitted to a payer? But I think that’s maybe an area that we can definitely dive in together to shorten that time up and get you everything you need upfront. So that when the provider is invited to the platform, ideally profile is completed in one to two business days, and then that application can be submitted back to the payer. But I think like that’s where we’re sort of stuck and where we can’t really move things forward and we can’t deliver that value. So to speak, if we’re not getting the required information upfront in order to process the applications. But Nicole, you’re obviously close to this as well. I’ll sort of lean on you to see if there’s any feedback or anything you’re hearing from the team that is causing any delays? I.
Niccole Russell (18:21) Have heard from Kelly that it is hard to have the providers log in to have whatever request is out there. I do know that we have a product enhancement update or ticket in for an update to the system because I know Kelly should not be receiving those admin tasks as well. So, I know there’s a lot of back and forth between her and the actual provider that should be receiving those.
Genevieve Seney (18:50) But… a lot.
Niccole Russell (18:54) Of the issues have been as far as the enrollment process again, just not knowing really what to enroll. So, I did give her a list of BH payers.
Richard Wagner (19:03) So she would.
Niccole Russell (19:04) kind of know how to enroll those or how to request those enrollments. I.
Genevieve Seney (19:09) Think during our.
Niccole Russell (19:11) communications, I’m not hearing a lot of negative things other than, hey, I’m reaching out to providers, not getting a response, things like that. So on my end… everything seemed fine. Obviously we’re taking a while processing, but I know it’s a lot of back and forth due to a lot of those tasks needing client attention, yeah.
Genevieve Seney (19:37) And I think like just from our perspective too, if we look at the platform again excluding everything that’s needed from the Raven side to process the requests like, these enrollments have actually only been sitting with the payer for less than 60 days. So just to give you an idea like I understand how you’re from your side Richard that like this doesn’t look like anything’s happening or any movement. But again, it’s all has to do with the upfront data that is required in order to submit an enrollment, whether you did that or we did that data is not, there’s no way around it. And so like I think if we had a clearer path into, how do we get your clients to give this data upfront or have it prepared upfront could be a better way to escalate, and to make this more efficient for the partnership? I just.
Richard Wagner (20:21) don’t agree with that 60 days comment. Though we started aggressively selling this even before we signed the partnership, knowing that we were close to signing. Those providers were entering data in December. And again, I haven’t seen a single one process. And I’m not going to throw this on. My customers say that like they’re eager to get this, get their enrollments up and going like they have gone through that process. They’ve submitted information. I’m sure there are some that are slower than others, but we’re talking about business owners who again understand that the enrollment process takes a long time and they work like hell to get these in. And now we’re just like in limbo. So I, yeah… I.
Genevieve Seney (21:12) get it. I mean, I understand your frustration. I think like from our perspective, all we can do from our side is show you that data and maybe tell that story a little bit more because again, we obviously want this to work. We’re not in the business of making things slower and making payrollment more of a delay that’s not what we’re looking to do at all. So I think like as an action item for us for that particular piece, like we can certainly give you some data of what we’re seeing and how we can.
Richard Wagner (21:38) Obviously remove.
Genevieve Seney (21:39) Any blocker that we see on our side… yeah, if you want to.
Richard Wagner (21:44) Put a report together. I’ll take a look. The other challenge I forgot to mention before is I heard from Kelly recently, it appears that you guys do not have a caqh kind of integration and that was what was promised to us as well, which is leading to additional documentation on our side. Is that true? We do have?
Mira Guha (22:06) A caqh integration. I was emailing her about this because my understanding was there was some confusion about invoicing on that. And we do have a caqh integration for the use of helping populate the provider profile. Nicole. I don’t know if that’s something that is currently being used in medallion right now. We are able to populate if the caqh profile for that provider is up to date and fill it in as possible. It’s a decent portion of the profile, but it won’t complete everything. There are certain things that will still need to be added even if we pull everything from caqh but we do have an integration. It sounds like that is being utilized at least for a few providers. We.
Richard Wagner (22:47) still have to… I’m looking at some of the comments internally that was provided on this. So.
Richard Wagner (22:59) It says medallion supplied us with a complicated workbook that suggested to email back and forth captured data. There’s a big red flag. So, Richard.
Niccole Russell (23:12) Just so I can speak on this a little bit, Kelly had received a task for caqh. So at that point, I kind of went through and reminded her where to check that box. She did respond back that was only going to be for new providers. And then she had a question the other day about consumption. So it’s literally the click of a button. She could have responded back to the task stating you.
Genevieve Seney (23:34) know that.
Niccole Russell (23:35) She wanted our team to pick that caqh management up, but it was my understanding it was only for new providers.
Richard Wagner (23:44) Okay. And I can go ahead.
Mira Guha (23:46) And put that in our write up. I think we’re going to be sending over a couple of items including like that data we just discussed as far as current state of work data. We’re seeing about profile completion time. We can go ahead and provide some more information. The caqh integration I was talking about is just built into the platform for providers. Caqh management is a different solution that you purchased in your contract. Like Nicole said, last check, there was not an interest in using that right now, but we can, I can go ahead and send a breakdown of kind of the distinction between those two. Okay. That’s helpful. Yeah, happy to get in the weeds right now. Just not sure that would be the most helpful right now.
Genevieve Seney (24:27) And I just want to touch on, I hear your feedback like regarding some sort of the sales enablement I think was mentioned sales enablement support. I am going to be pulling back in. I think josh Burnell is who you worked with on that because that’s again, I’m just unfamiliar with what maybe he’s referring to there. So I have asked him to reach you directly Richard regarding that piece and how he can support you.
Richard Wagner (24:52) That’s great. I’m not looking to double down on any sales efforts with this because I’m again concerned that we’re not able to fulfill promises made to our customers. Frankly, we’ve had to go through our website and change all the sort of like verbiage that said as little as 60 days enrollment because we have pissed off customers right now. So, you know, at some point it would have been great to have that early on if we could Rehab this at some point, that would be great. But as of like as of right now, it’s like that’s the furthest thing from my mind.
Genevieve Seney (25:39) Yeah. Understood just wanted to address it. I think like I completely agree. I don’t we obviously want this to be successful and want to do everything in our power to help support you and help sort of drive back the partnership. I think for us what would be and for you maybe is providing where we’re seeing the breakdown. How can we sort of support you in whatever, what is the message delivered to the customers today? I know that obviously, right now we can sort of work with what we have in the platform. Obviously, you’re not looking to add more clients to this sort of moving forward. But maybe just a breakdown of here’s the 40 requests that are waiting for Raven’s attention here are the exact items we need to move those forward by the different providers so that we have like a clear line forward of getting at least these 40 50 completed so that we at least have that data to give to you and show you in the platform of the, you know, submitted to pay or to enrollment completed timeline. So that again you at least have real data to work off of for sort of I guess re pitching this and re inviting your clients to the platform.
Genevieve Seney (26:49) I think we touched on everything on this sort of what we have Richard. I know that again your feedback is most important here so that we do have that sort of clear path forward. I guess with the few minutes left, I think for us, like I said, we want to give you a breakdown of the data in the platform as well as what can we do to push forward these enrollments to completed? So we can at least have a starting point of maybe a post analysis and how we can better support moving forward. What else I guess from us, you know, could we do to sort of help right? Size and right track the partnership?
Richard Wagner (27:26) I mean, it’s simple, right? Just get enrollments processed that’s it like most important. And here’s the thing it’s… not just fulfilling a promise to our customers but… to understand our business. We, once… customers are credentialed, they get on our platform, they start billing claims. We can start charging them. So it’s affecting our business as well, right? So… if… it was, it’s we’ve had to restate budget for this year as a result of this because the like the Raven financials, because the, we had to materially change our onboarding time, right? Built that assumption built in the model for these early stage customers. Because of this, right? It’s driving a wedge. So… process enrollments and do it quick, do it as promised that’s the only thing.
Genevieve Seney (28:40) Yep. Yeah. Again, we’re happy to break down the data and show, where it’s processing with the payers still under 60 days. Again, it’s a lot of the upfront stuff that is driving the longer turnaround times. But again, we’ll follow up with these pieces and see how we can again come together, to shorten that window and get this back on track to where obviously it was originally pitched to you guys. Great. Well.
Mira Guha (29:11) Richard, we appreciate your time and your feedback. Like Jen said, we’re going to go ahead and start putting that together. Hopefully have that for you either today or tomorrow at the latest. I know we have our monthly sync. So hopefully by the next time I’m meeting with you in may, we have kind of like Jen said a good way to get back on track and a clear vision of what’s ahead. And yeah, seeing how we can be more efficient. Well, thank you everyone for joining and Richard just let us know if you have any questions we’ll be following up shortly.
Genevieve Seney (29:39) Thank you.