Transcript
Josh Brunell (00:00) hey, Sam.
Samantha Bouchard (00:02) Hey, how’d you get home yesterday it?
Josh Brunell (00:06) Was hectic? She’s in the waiting room now? I’m going to let her in.
Josh Brunell (00:27) Hey, Latisha.
Leticia Stewart (00:29) Hi, how are you guys doing? Doing well? That was a long pause there.
Josh Brunell (00:39) Yeah. I had quite the travel day. Yesterday. We were all together in Austin this week for a company off site and I had like both of my flights, I had a connecting flight going home, but both of them got delayed.
Leticia Stewart (00:55) That’s fine.
Josh Brunell (00:56) Yeah. And then I got home late, and then… my wife spent solo with the kids all week. And so, of course, I get home right at bedtime and then there.
Leticia Stewart (01:10) You go. Yeah.
Josh Brunell (01:11) Exactly. So I ended up sleeping in my twin bed with my three year old last night. So it was just a rough go, but I’m good now. Oh gosh.
Leticia Stewart (01:26) Yeah.
Josh Brunell (01:27) How’s your week going hopefully a little smoother than that?
Leticia Stewart (01:31) Definitely smoother than that, but definitely busy. I’ve been doing a lot of digging and so, I think you remember me telling you that my counterpart for our facility side signed a contract with modio, right? No big deal.
Leticia Stewart (01:46) I didn’t sign it. I’m not involved, but we did have the contract with credentialstream. So, when I went to go term the contract with credentialstream so I could move forward with medallion, we passed the notification date to term, which conveniently… they reached out after the termination, like after the time passed for us to term. Okay? So we’re locked in… I’m going to try to see what I can do, but I don’t know if there’s any potential for me to do anything. I’m sure. When you guys lock somebody in, you don’t let them out, right? Like they’re caged in.
Josh Brunell (02:33) Yeah. I mean, unless they have any sort of like contract language around like, you know, like breach of contract, like if they’ve done anything or if it’s a three.
Leticia Stewart (02:50) Year agreement, and I’m sure I can change that because there’s no way I’m going to deal with that for another three years because.
Josh Brunell (03:00) Was it set to auto renew? I guess?
Leticia Stewart (03:05) So, and I don’t know what the previous person that was doing credentialing, what that looked like, but the bill just goes to the CFO. And so I just got involved with credentialing, you know, like I said in the last few months and so he sent the bill to me and I’m like what is this? And so I’m like, no, we need to reach out. So when I reached out, she never even mentioned that there was an auto renewal or anything. I guess that’s my responsibility to know. But I didn’t know. She never mentioned it. And then when I went to go term and she’s like, yeah, you passed the deadline and I’m like really, but I’m… still sure I can change the terms of the agreement like that hasn’t passed like the renewal hasn’t passed. It was just the notification to term has passed. So I’m going to see what I could do for that. Yeah.
Josh Brunell (04:00) One thing that we may be able to do to get creative, and I don’t know if I probably can’t commit to this until Nicole’s not on this call. So I would probably lean on her. But one thing that we might be able to do is if you’re able to work on the term and get it reduced to a year, we may be able to work with our finance team to make it, you know, whatever, because I mean, I don’t know, I mean, do you have an understanding of what the annual cost is with Healthstream? Is it they?
Leticia Stewart (04:35) Have us listed as renewing with a 1,000 providers? Which is insane. I’m like how did it get to that number? She didn’t have. Like, so when I asked her and I don’t mean to speak bad about anybody. I’m not trashing them or anything. I don’t know them. I don’t know anything about them. Never worked with them. But when I asked her, are we utilizing that number? Because, you know, how we ask you guys all the time, will you tell us if we’re utilizing what we contracted for? She said we would have to pay to get that information. It’s a separate service you have.
Josh Brunell (05:07) To pay to get a report on how much of the service you’re using? Yeah?
Leticia Stewart (05:10) Because that’s an analysis that a separate team handles and they can’t tell us that.
Josh Brunell (05:16) Oh, wow.
Samantha Bouchard (05:17) That’s so easy. Yeah, like with us, we do quarterly business reviews with our clients that is mainly focused on consumption. That’s like the main thing just seeing if you need to right size the contract in any way, right? Right? That’s frustrating Letitia. And.
Leticia Stewart (05:35) she, and so I was like, so you don’t know if we’re utilizing this and she’s like, well, we don’t know that would be, you have to pay to set up a call and meet with them. And I’m like I’m feeling a little dirty right now. I’m just gonna be really honest like I feel like it wasn’t handled properly. And the way they handle it is not the way I would handle anything. It’s not upfront. It’s not the way things should be done. But I haven’t gone back to them after the renewal.
Leticia Stewart (06:04) We kind of just ended the call and now… I have to go back and see for one, it has to be a one year agreement for two. We cannot be… enrolling or doing whatever. We don’t even use their enrollment, but they’re charging us for enrollment, a 1,000 dollars, a 1,000 providers. So I have to get all that fixed and I just don’t know what that’s going to roll out to be. So I can’t have three different and you guys kind of alluded to this when we were talking before you’re like three different credentialing products. And my thought was that we were going to get rid of one of them and just have the two. Okay. And now, it looks like I might not be able to get rid of that one immediately as I had hoped. And so I did discuss that with the rest of the team and they’re very disappointed and they’re like, well, how long do we have to put this off? And I’m like, I’m not sure yet and I just kind of found all this out in the last little bit.
Josh Brunell (07:05) So, Nicole, just to get you up to speed since I saw you just join. So Leticia said that she reached out to credentialstream to essentially give them notice that they were going to be renewing and that credentialstream kind of sat on that and then got back to them after the fact of like saying, hey, well, sorry, you didn’t give us enough notice. And so you’re set to kind of auto renew here in, you know? And so it sounds like the team’s unhappy with the situation. Leticia’s trying to dig into it more. And so she just wanted to share that at the start.
Nicole Campbell (07:40) Of it all, Leticia, did the like auto renew already happen or were they just trying to push back?
Leticia Stewart (07:44) No. So they said there’s a 90 day like you have 90 days to term. Totally. We noticed that till June. So I knew I had time. So I didn’t what I didn’t know was that I needed to give notice to term in 90 days and they didn’t tell me that.
Nicole Campbell (08:00) I would, if you’re open to a suggestion and like if you don’t want to take this on also, I.
Leticia Stewart (08:06) Don’t mind. I don’t know.
Nicole Campbell (08:08) I would say like engaging with your team’s lawyers because the contract is not renewed, having worked in software for many years, like obviously clauses are in place because they’re trying to secure the renewal. But if they also didn’t notify you of that, normally teams have to notify you that your 90 days is like coming so that you have the opportunity to renew, like make that decision. Also, it’s very hard for a company to like force you into an additional contract that you’re not wanting to be in yet, especially since.
Leticia Stewart (08:40) you would think you would.
Nicole Campbell (08:41) Think so. I would touch base with your lawyers. Like if the team is really unhappy with this motion and it is going to be like affecting how your workflow works and also how effective the business is. That is something I would encourage the team to push back on especially if we have like CEO initiative on this. You know, I would loop in your team so they can maybe handle some of that communication with credstream for you. Yeah.
Leticia Stewart (09:09) The other thing is we do have one person and I don’t know if we talked with, her name was Lisa smith. She did the facility credentialing and I think we said we were going to put that on the back burner and just move forward. Well, she uses Healthstream heavily and the client has access to see what she’s doing and what she does is she, they have access to view what she’s doing and like if she puts a note that says, you know, we’re working on this or we’re working on that, the client can see it. And they also, she downloads everything like all the documents into a shared file and the client has access to that shared file.
Nicole Campbell (09:54) So,
Leticia Stewart (09:55) I don’t know if you guys have anything like that because she works out of citrix. So the client can be able to view all her stuff, which I didn’t know that either. I learned that in the last couple of days as well because I was explaining to her, you know, moving transitioning, she’s like, but wait, are they going to be able to do this? This and the other? And the client will not release control of that account to like anybody else they want her doing it? It’s in our contract that she has to do it.
Josh Brunell (10:30) That’s a good question. So we do have ways to collaborate in a similar fashion with clients in medallion now, Sam, I’m going to kind of lean on you here. When it comes to the privileging hospital application piece. We don’t have that in scope today. I guess… if we’re talking just pure from an administrative standpoint and document sharing like I feel like we could support that, but I’m not sure if that would be like the ideal workflow with how they’re doing it. I would kind of want to lean on.
Leticia Stewart (11:02) You.
Samantha Bouchard (11:03) Yeah. So they would have like the providers would have their own individual portal. We could explore potentially like an instance situation where you could give them like read only access as an administrator. I’m trying to think and then like from like an application review perspective like we do create individual tasks for that. So I definitely think that there’s a way that we can, you know, be on parity with the experience you’re having today. So.
Leticia Stewart (11:38) The, it’s the client, not the providers but the client like their joint commission Dean… status, the hospitals that she, this client is with and they just did their joint commission. So the client wants to be able to go in there and pull up a document at a moment’s. Notice if they’re in joint commission things like so that’s why they have this access to everything she does and all her documents… she has to load everything real time. They see everything. And so there’s this shared communication that they have that I don’t know of other companies that are, you know, are that involved, you know? So that’s why? And I think they have like some kind of dashboard where they could see like where each provider is and they could see the notes and the statuses of like through her workflow, they could see, okay, she did this. She did that. She’s waiting on this. Does she, they could see the whole workflow? Yeah.
Samantha Bouchard (12:40) So, the way that would mirror in our system, Leticia, she would have like role based access permissions. So like your main administrator would have the ability to like edit lines kind of clarify. But then she could have like a view only role into that. And.
Leticia Stewart (13:00) Then all the documents could be stored there, forms could be automated, filled out. But she would be the one managing all that. It wouldn’t be like a relationship where we would want your team to manage any of it. I think. Yeah.
Samantha Bouchard (13:14) So in our case, we would be end to end. So we would take those requests on time. So I think that would be definitely a change there. Yeah.
Josh Brunell (13:28) You know, I mean, like you say, I want to get your thoughts here.
Leticia Stewart (13:33) Would obviously.
Josh Brunell (13:35) As you’re trying to navigate the, what’s happening with credstream on the contract piece? Like do you think it would be valuable for Sam and Lisa to have a one on one to where we can actually have her kind of walk us through the end to end workflow with this customer today so that we can make sure that we can there’s parity between what we can accomplish in medallion. Because every, when it comes to like joint commissioning credentialing, privileging, like, every customer has a kind of unique workflow. And so I just want to make sure that like we can support that and that you feel confident in it as well. So would that be something you’d be open to as we’re kind of working through the credentialing contract? Yeah.
Leticia Stewart (14:16) I mean, like I said, we just did that. So I was able to really see her workflow. And I know if there’s any communication or thoughts or talk about her not doing the work, she’ll go to the client and tell them that we’re trying to get rid of her. Like it’ll be, yeah. So… we couldn’t present it in a way that she wouldn’t be doing it honestly. We could say she could be assisting our oversight or something like that, but we couldn’t say we’re giving it all away and somebody else is going to do it.
Josh Brunell (14:52) 100 percent. If the client has a good relationship with her and wants her to be like the core administrator like that is still something that like we would support, it would just be, yeah… I think we just need to have her kind of walk us through. Like what she is actually producing like, is it a credential file to joint commission standards and then a hospital application as well? What does that kind of document, the… documentation look like? If we can yeah work with her and get a better sense of that, like have her going to do a show and tell of her current workflow. I think that would be a good exercise to work through as we’re as you’re trying to navigate the legal discussions on credstream.
Leticia Stewart (15:43) Yeah, I’m happy to do that. I’m sure she’d be happy to do that. I know she wants to be more efficient, but she definitely wants to own it. And so we just have to be very clear when we’re having that discussion that she still has complete oversight and control of everything related to this client, like it’s this one client. But the client has, I think she mentioned 25 different hospitals and 98 different doctors… that she handles. And she was saying she had to review all the cois and she is doing all the, I don’t know if she called them revalidations. I don’t think she called it that she called it something else. I don’t think it’s revalidation. I don’t know what she was saying but, and she was saying, I have to do that for 100 doctors and I have to do this and she very much owns it like to a point that I’ve never seen in my life honestly. So that would be my only caveat to, if we meet with her, we have to present it in a way that we’re just trying to help her with her flow. Okay? I.
Josh Brunell (16:54) totally. Yeah, totally agree. And yeah, maybe at the end of this call, we can send you some of our availability. And then if you want to connect with her and see what makes sense there, that’d be great. I also kind of want to talk to you on the modio piece. So I think just make sure I heard you correctly at the beginning. So modio is being capped regardless… correct? And what was the reasoning behind that? Well?
Leticia Stewart (17:21) Because I didn’t enroll, I didn’t do anything with modio that’s a whole separate person and she signed that agreement with them and she just signed it like in the last couple months. So I don’t think there’s a way to get out of that one because she just signed it. I haven’t seen the agreement. I can ask for a copy of it and see what she agreed to, but I don’t know if it’s a one year, three year and they just were doing the implementation and the training. So I don’t think that they’re going to be like, okay, you can go. Now. That’s why that’s the only reason not because well, because it’s not mine to decide on but also it’s… new. So, yeah, yeah, on.
Josh Brunell (18:08) The, on the modio piece, do you know the specific like functions they’re doing?
Leticia Stewart (18:14) It’s just a database, the whole stuff honestly, that’s all I can tell. It’s just a, it’s a database that’s what that is just like credentialstream although credentialstream says they have other things and we’re paying for other things, but we aren’t using it for other things.
Josh Brunell (18:30) Understood. Yeah. Understand. Modio, is much more of just like a database for and document kind of tracking system. I was just wondering if like a specific team is using that just to track provider data and then like documents around, you know, payer enrollment or.
Leticia Stewart (18:47) Well, they, no, not payer, just facility because this is the facility lady for our facility. We have, a whole different department that’s just doctors and these facilities that we do the reads for and, they aren’t part of what I do. They’re not part of civie. They’re part of a different company but they’re all under one umbrella, got it. And she owns that piece and she had got modio before I really start looking into making any changes like we were talking about it. But we had never like made any moves and she decided to go with them. And so I did have Lisa meet with them. That’s what I’m saying. So I saw her workflow and I saw everything she was doing and she was asking them questions because I was like, the thing that would make the most sense was just everybody go to modio and we get out of the Healthstream in a year. That’s what my thought process. But then when I had her meet with them, they couldn’t mirror the, where the admin could have or where the client could have access and see like the status and the notes and the workflow. That wasn’t something that they present to the client. It would only be if you’re an admin. And then she didn’t want them to have admin level access because then they can make changes. So it was like all these different things. And then I don’t think they were storing all her forms and some other things they couldn’t do. And so she was like it wouldn’t make sense for me to move to them because they’re not going to be any more efficient than what I’m already doing. So that’s how that all that’s what I’m saying. So the last few days I’ve been digging into this a lot more than when I thought I could just get rid of Healthstream like she can keep modio and do whatever she’s doing. And then I can move to medallion and Healthstream will be gone and it’s okay if we have two because it’s really two separate companies. It’s under two separate budgets books and everything. So I thought that was fine. But I can’t have three or two myself. You know what I mean? So that’s where when I reached out to term, they were like, no, you can’t and I’m like, okay. So that’s kind of how that all happened. So I was doing some, you know, deeper dives on what’s available. What are our options? What else can we do kind of thing? So that’s where I wanted to share with you guys kind of where I came up with in the last couple of days?
Josh Brunell (21:23) That was helpful and outside of like, so it, yeah, it sounds like the only path here then is if we’re able to resolve what, you know, the issue with Healthstream and be able to back out of the contract. I imagine that the like that’s our only path here.
Leticia Stewart (21:45) Yeah. And I think if I can’t back out of it, well, regardless, I’m going to do, I’m going to reduce it to a one year contract for sure. I’m going to reduce it to the lowest volume that we can have that we need to keep going… and I might try to see if we can just do like month to month instead of being in an agreement. I mean, I don’t know what my options are because honestly, she wasn’t very forthcoming with what, you know, my options were, she was just like, no, no, you’re stuck. You got three years at this rate. And I was like, okay that’s not going to happen. But I couldn’t get into it with her at that moment because I didn’t know everything else I needed to do at that time. So that’s why I had to get with Lisa and have her go through some things. And I started with modio because we already have it, but I think it would be a good idea to make sure that, you know, her needs can be met through medallion and then I can decide if they’ll let us just go month to month and then we can term it at any time. You know what I mean?
Josh Brunell (22:46) Yeah. Another option here. I’m just going to throw this out here. Probably need to get well, not probably we’ll definitely need to get financial finance approval on this Nicole. But, you know, one thing that we can consider doing Leticia is if you’re able to share what the annual commitment is, say you’re able to reduce it from a three year to a one year, if you’re able to share what that commitment looks like or what that cost looks like, we may be able, you know, in the spirit of partnership to reduce some of the year one costs of medallion to offset that. And me and Nicole and Sam can go to our leadership and advocate on that on your behalf so that if you did have to get locked into that contract, say for another year, the cost essentially we could try to get as much of the cost pulled out of the medallion contract in year one. So you don’t have to feel that.
Leticia Stewart (23:38) Yeah, and.
Nicole Campbell (23:39) Also, what it gives us too is that okay, let’s say we’re just you’re locked into a year at the minimum like basically like minimal rate that it can be at. This also gives you a little bit more flexibility in terms of just implementation. Like you don’t have to worry about data disappearing, right?
Nicole Campbell (23:56) Like, so we’re happy to do that. I think like from, a strategy standpoint, it would make sense if like you, me, josh and Sam met with you and your CEO just to make sure we’re making like the right path from a strategy standpoint for the business and then giving you the power and like kind of like words to go back to credstream with as well as like an executive team.
Leticia Stewart (24:19) Yeah. I’m free to do whatever I need to do with that. Trust me, he’s okay with it. And I did get approval for, to move forward with medallion. So that’s when I set up the meeting, this was before I knew about Healthstream, not termi. He gave me approval to move forward with medallion. So I sent him the deck, I sent him the proposal and everything, and he said let’s go forward although in that same vein, he says, ooh, that means we can get rid of staff. So that was another piece of him wanting to move forward. So, you know, he always has, a motive or agenda behind when he gives me approval to do something. So, I did get that. And then I was like, okay, great. And then I found out about this. I’m like darn and so he didn’t say you can’t do this. I just know it doesn’t make sense from a, you know, a workforce kind of perspective to have three different companies. So, yeah.
Nicole Campbell (25:17) Just a quick clarification question, cause I know with like PE, with payer, enrollment, the team was working mainly off of spreadsheets and not selling in credstream. So, I guess then my question would be like, it still would make sense even if understanding like credstream financially is taking up a piece of the pie, but you’re still would have a workflow gap if you didn’t bring medallion in terms of?
Leticia Stewart (25:41) Like, okay.
Nicole Campbell (25:43) So there might be like,
Leticia Stewart (25:44) yeah, that’s what I’m saying. Okay? So that was.
Samantha Bouchard (25:48) My question too. Leticia, like with the, with all of your staff primarily being on spreadsheets. My understanding that they weren’t utilizing modio, each staff had their own individual process. And so, with this new modio renewal, like, is there a new plan that, that’s going to be moved into there? Cause I know you liked kind of like the,
Leticia Stewart (26:06) multiple, so we don’t use, we don’t use modio at all that’s a whole separate team that’s different people. They don’t report to me. I don’t have anything to do with that, the modio piece, like they, that’s a whole different company, it’s under our umbrella, but it’s a different company. Okay? So we have a different person who manages those credentialers she purchased that or got into that agreement with modio. I have nothing to do with it.
Samantha Bouchard (26:32) Okay. So your PE team, the three girls that you have are not going to be utilizing modio like they’re continuing in their spreadsheet process.
Leticia Stewart (26:40) Right now, until we figure out what our next steps are, I’m not going to, I don’t think I’m going to have them move to modio, then move to medallion. I want to figure out what we can do and how quickly we can do it before we make any of those changes then.
Nicole Campbell (26:54) It makes sense like even we want to help support the credstream piece, but I think it makes sense from an argument standpoint of even if there was a year where there’s an overlap of two systems for your team because we’re still taking on all of that PE work and then we can slowly roll off the work off of credstream on to medallion. Maybe we can put together and josh and I can work together to kind of put together what that path looks like.
Leticia Stewart (27:20) And why?
Nicole Campbell (27:21) There’s still, you’re going to still see immediate value? Like with medallion getting off of those spreadsheets. I know in theory like I understand you being like, I don’t want three systems or two systems, but it’s kind of like a short term overlap and then still a huge big value in change for the PE side.
Leticia Stewart (27:41) Right. And so that’s why when I met with our credentialing manager and she was like, no, and she was like we really need to move to medallion. So I asked her, do you want to move to modio? In the meantime? She’s like, well, I don’t know. I’m not sure how much more it’s going to improve other than having more organization that’s what it would give us. It would have us have a little bit more insight in some organization we have been setting up like organizing our information to get ready for a move, you know, updating all the spreadsheets and stuff to get ready to move to something. So we have had a team just organizing and moving stuff around trying to get ready. But yeah, maybe there’s an opportunity where, well, first we need to make sure that you can meet Lisa’s needs because that’s a non negotiable honestly with that client that’s a non negotiable. So we need to make sure you guys can meet her needs. And then if we have to, you know, maybe and then I need to find out if I could do a one year agreement with credentialstream and we can plan, you know, you guys can help me work out a plan to do like a transition over a period of time and that you would need to do that for the big client. Where we need this. Anyway, it would have to be a transition. We couldn’t do it all at once. And then something’s missing kind of like you mentioned, we need to make sure it goes smoothly and everything is available and that kind of thing. So we don’t want any mishaps with that because… that’ll be an issue with the client. So a.
Josh Brunell (29:23) 100 percent. Yeah, I think that sounds like a great idea. We should reconnect with Lisa, make sure that she feels confident in the solution long term. And then, yeah, if you’re open to sharing the details, I know you said a 1,000 providers, but if we had like even a ballpark range of what the annual cost is with credentials, then take that back to our finance team and see what we can do to work down the year one cost of the contract?
Leticia Stewart (29:55) Here, hold on one second. I got another call but let me see if I can grab that. I remember looking at it going, what in the world? And I’ll just give you a range. So it’s not like I’m sharing like proprietary information. I don’t want to look like I’m doing something that, who’s that lady I was talking to? I definitely don’t order form msa brochure…
Leticia Stewart (30:35) Renewal draft. Okay. Hold on… proposal. Oh, I can’t see.
Leticia Stewart (30:52) So, it says year one annually. I’d say it’s between 70 and 80 or 65 and 80,000. Okay, year one and it has us listed for a 1,000 providers, 36 months. So, I don’t know if that would change if it wasn’t 36 months. I would assume… you know, that kind of thing. And then she has us enrolled in a few different products, but we don’t know what any of those products are because nobody uses them. So. Okay.
Josh Brunell (31:24) That’s helpful. And then, so I think the plan on your side then is going back and seeing like, hey, how can we reduce the scope of this if we are locked into that one year term? Okay.
Leticia Stewart (31:36) And then you guys just send me some times your availability and I can set something up with Lisa. Yep. And then after, if she says we’re good to go, yeah, you guys can meet my needs and the client’s needs, and we’ll be able to see everything that’s really important is they need visibility into what she’s doing and have access to all the forms and everything she pulls.
Leticia Stewart (31:59) That I’m just upfront telling you so you can be ready. And if she says it’s a go, then we’ll move forward with trying to do all these other things that we were talking about and you guys can help me develop a plan on how we can transition smoothly safely, you know, and we don’t have to rush now. Obviously, yep, yep. Sounds good. Okay?
Josh Brunell (32:23) I’ll get those available dates sent over here this afternoon.
Leticia Stewart (32:26) Okay, perfect. Thank you so much of.
Josh Brunell (32:29) Course. I know you have another meeting to jump. Thank you Leticia for the time and the context. I’m sure we’ll find a we’ll find a way to work through this.
Leticia Stewart (32:36) Thank you so much. I appreciate it. Awesome. Bye bye.