Transcript
Erica Lloyd (00:00) bye there. How was? So? Mallory should be on in a moment, but how was your vacation? Oh, I think you’re muted.
Robin Redd (00:15) Every time I get on here, it was great. It was wonderful. I don’t think I’ve taken an entire week off in years.
Erica Lloyd (00:26) Oh, no, so.
Robin Redd (00:29) That was really nice. I usually take like a day around. I’ll take a day or two around a weekend, but I don’t usually go anywhere for an entire week. So that was really nice. It’s kind of hard to go through the re entry part. Now. I know, like, okay, my email is full. But it was really nice to get away. Thanks. How was, how was your week so far?
Erica Lloyd (00:57) It’s been crazy, so, we went to, we have like our quarterly business reviews that we do in person since we’re fully remote. And so we pick a location every quarter and everyone gets together and kind of does a almost like a post mortem of the quarter. Yep. And we also had some exciting product releases that they wanted to kind of train us on. So we’ve been in Austin. We got back. We all got back last night.
Robin Redd (01:22) Oh, wow. So you’re kind of feeling like I am today? Yeah. I started out with tech problems right out of the gate, couldn’t get into email, couldn’t get into teams, couldn’t get into my calendar. And I was like, okay, well, and it was one of the things where I had to, actually, they had to do a lot of updates. I’ve never been on with a tech call for two and a half hours before, but I was today.
Erica Lloyd (01:48) Oh, no,
Robin Redd (01:49) Everything is fine now, but like until 11 o’clock today, I was literally just, I couldn’t do anything. I mean, I could do some things on my phone but you can’t really, you know, you’re kind of limited in what you can access from your phone. I could look at my calendar, make sure I wasn’t missing a meeting, but that was about it.
Robin Redd (02:08) So, so I have that said, I did dig into the emails and the attachments and I tried to jot down some questions really just kind of clarifications… and I think it’s probably just me with the vacation brain coming back. But… just want to make sure that I’m reading it correctly. I think it’s probably more… which lens am I looking at this through? Like, am I from the provider standpoint, from the like guidehealth, you know, credentialing department standpoint or like, who am I? Who am I on this slide? I did have a couple of questions and I don’t know if it’s if… some of these like can vary based on whether we’re using you like as a full vendor versus maybe using the platform to do some things ourselves. Hi, Mallory. Hi.
Erica Lloyd (03:05) Robin, good to see you.
Robin Redd (03:06) I didn’t want to just blaze right in. Do you want to, do you want to start Erica and walk through them? I do kind of want to stop at two 30. So, I’m, going to try to stay on task more than I normally do.
Erica Lloyd (03:19) Yeah, same, I think we do as well. So, yeah, let’s I was thinking, let’s hear your feedback on, the pricing. We were able to adjust that. Thank you Mallory for being able to, what we did, was being able to reduce some of, the SKUs per year and smooth that out. So it’s a little bit lower. And then we also were able to just do like a comparison, on and I’ll show you what I’m looking at slide three, which is really to help guide us on. If you were to build this in house. This is how much it would probably cost between software.
Robin Redd (03:52) And, I do appreciate that. That’s you know, that’s always nice to have in your back pocket when you’re presenting an idea because, you know, that’s at some point that question’s going to come up,
Erica Lloyd (04:04) So, so hopefully that landed, we can go over your questions and then I also just put a very rough project plan together with timelines. So, if you’re thinking, what do I need from like a resourcing and timelines and stuff like that perspective in order, to say, when, if Amanda says, hey, what, what’s the timeline? What’s the resourcing? What do we need to actually get this fully launched and implemented? So I put this together, we can go through that after your questions.
Robin Redd (04:35) So.
Erica Lloyd (04:36) That’s kind of what I was thinking for agenda. Does that work for you?
Robin Redd (04:39) Yeah, that sounds good. And the, I think the pricing doing that over four years to kind of show the beginning and then to the, through the recredentialing. I think that’s much better. That’s much more helpful. And I think it kind of, it allows it to kind of complete the cycle a little bit, I think, you know, because otherwise, it’s a little harder to understand the year two and year three, like it’s it just to me that just kind of packages things a little nicer and it makes it easier to follow. So, I think that was helpful. Thank you for doing that.
Erica Lloyd (05:15) Yeah, absolutely. Okay. So, I guess what let’s go through actually let’s just let me if… it’s okay. Is it okay if I just go through, the timeline real quick?
Robin Redd (05:31) Sure.
Erica Lloyd (05:32) Is that okay? I just want to, okay. So, because I think it’s just helpful, I’m only thinking like, okay, how would I actually purchase this if I want to purchase it? So here’s, where we are, we’re kind of in this Roi criteria area… here? Is there any clarification… on timeline or any? Has this, have you started socializing this up with Amanda or anyone else internally? I.
Robin Redd (06:04) Actually, have, I actually am meeting with Amanda this afternoon, but I don’t imagine any of that has changed. I don’t think we’ve got any. I don’t think we’ve got any more details around that, but I’ll clarify that this afternoon and I’ve kind of set an expectation that I’ll send the two finalists and my recommendation to her on Monday. So I think at that point, then, you know, the leadership kind of has the information they need. They have the general pricing and they’ll know, you know, as this moves forward, at least they’ll know what we’re looking at. I’ll see if I can get a better feel for the timeline… but I have, because I’ve been out of office, I really don’t have any information that I didn’t have when we talked last time. Unfortunately. Okay. And honestly, even if I was in office, I don’t think I’d really have anything different because I don’t think anything has changed that much. So I’ll let you just keep on going.
Erica Lloyd (07:10) Okay. Yeah. We don’t have to go through all of it then if it’s still, if it’s status quo, but I think, yeah, it’s probably just helpful for you to get an understanding of, I guess this would be Roger, but like basically how folks usually go through the process?
Robin Redd (07:36) So it looks like so… when you’re looking at that timeline, is that timeline? Is that prior to, are you saying it would take until the end of July to have a signed agreement and then timeline, then that implementation timeline would start.
Erica Lloyd (07:57) Yeah, good question. So, but basically, I just wanted to give us something to anchor on. So I’m saying, if we went through everything and you signed an agreement by may, we would take anywhere from eight to 12 weeks for a full deployment.
Robin Redd (08:12) Okay. So that would be when we’d actually be cooking?
Mallory Smith (08:17) Yeah, exactly. Okay. Yeah.
Erica Lloyd (08:19) So, I just wanted to make sure you had a visibility. So you typically, once you sign the contract, we’re really great about getting an implementation project manager set up really quickly. And then within one week, we’re usually able to kick off the project and then we, you know, obviously we want to go through testing and do everything. But once we will do a full deployment, typically that eight to 12 week mark, so.
Robin Redd (08:39) When you assign someone, is this an existing project manager that you just assign an account to?
Erica Lloyd (08:45) Yeah. So we do our own implementations. We don’t use a vendor for that or we don’t make you a company to do the implementation. So we do have a project manager. Obviously, the more lead time we have on when you would sign the better, so we can allocate resources. This is typically a very busy time of year for us and then you would, they would assign the project and the project team to?
Robin Redd (09:07) Get implemented. That makes sense. Yeah. Okay. All right.
Erica Lloyd (09:14) Okay. Mallory, I will, I’ll turn it over to you, Robin and Mallory to go through some of the questions. Okay?
Mallory Smith (09:19) Thanks. And I just want to add in a really quick note for you, Robin. I did speak to my leader and we did talk about what the implementation timeline would look like. It’s actually looking more like it’s going to be closer to four weeks. The way I explained it is that you don’t have the immediate, I know Erica, we talked about.
Erica Lloyd (09:35) That a.
Mallory Smith (09:35) hero.
Erica Lloyd (09:35) comes.
Robin Redd (09:36) along.
Mallory Smith (09:38) We just, we’ve had so much happen since last week, Erica. Yeah. So yes. So that’s kind of what we’re thinking because you don’t have any of the providers actively hired just yet as you do bring them on because we have caqh bulk import, it’s going to gather that information. So really we would just need your group and practice information. The training on the system is pretty minimal, but we could easily see going live quote unquote within four weeks just because you don’t have any current providers to even do like a data migration for?
Robin Redd (10:07) Yeah. I figured that most of that is usually a data migration that seems, yeah, that seems much more kind of in line with what I was thinking. And again, I’m trying to kind of build a lot of wiggle room into this flow. But I just didn’t want to, you know, I didn’t want to underestimate. And then, you know, have someone make a commitment where they think that our, you know, 120 day process starts like from the time they have a handshake agreement like, no, no.
Robin Redd (10:44) And, you know, we have to allow our, the recruitment and the contracting to happen before that even begins. Exactly. That sounds good. Yeah, I’m going to let you, do you just tell me when you want me to pop in or if you just want to, I think the, that middle attachment that had the, a lot of the slides, the slide deck?
Mallory Smith (11:09) That’s.
Robin Redd (11:11) kind of what I had some questions going through that, okay… part of it started. I think my first questions were like under the provider overview and there were, I guess there was things that would say like… what we do, what you do, a lot of the roles and responsibilities. But I guess my question is if the contact information, when… you reach out to like caqh and you get, you know, you have the few pieces of key information you need on a provider and you’re pulling that information over, is that a like one time thing? Or do you have a constant flow of data where as information’s updated at caqh for that provider, does it auto populate into your system?
Mallory Smith (12:04) Yeah, that’s a great question. Like.
Robin Redd (12:06) If they change their address with caqh, is that going to be updated in your system or, and what happens if we find out about something before they’ve made a change to caqh, like how do we, how do we manage? Like, you know, new office or new primary office or those kinds of things?
Mallory Smith (12:25) Great question. So, when it comes to caqh, part of the core platform is that we are able to re sync with the provider caqh at any time. Now, on the flip side because we do have that bi directional integration with caqh. If you purchase the caqh management SKU, which I don’t think we have quoted, correct? Erica? No.
Erica Lloyd (12:46) We did not the caqh, no, just the no.
Mallory Smith (12:50) Okay. So with the caqh management SKU, we are actually able to automatically and proactively push the, any information from caqh or medallion back into caqh. It happens behind the scenes. It reattests the profiles on behalf of the provider. It makes the updates and the address changes and things like that. So what we sent to you because we know that you’re looking at this is a new initiative. We don’t know if we need the comprehensive scope. We left it out of that, just because these could be contracted providers, independent providers, do they want us managing their caqh? There were so many unknowns there. So to answer your question, when we import from caqh, we can re, sync that data whenever we need to now pushing it back into caqh that’s with the caqh management service that we could offer that’s not currently included in the quote?
Robin Redd (13:41) So, I don’t mean to sound ignorant of this process, but I’ll just put myself out. There. Is there a reason that we would take on that cost versus a provider just having to own that responsibility themselves to keep their profile updated with caqh? That’s.
Mallory Smith (14:03) a fantastic question. Typically, when we work with provider groups, they hold their provider’s hands and they are very much white glove service. And a provider typically is just like, well, my admin has been updating my caqh for three years now. I don’t even know the login information to it. So what we, the reason we offer it is because status quo for a lot of our customers as they’re coming on board, is they’ve just been managing the provider profiles in caqh to take the lift off the providers. If you start out the gate and you say, hey, welcome to our network. I don’t see you running into any issues. So that’s kind of the other thinking is if you let the boundaries be known from the start, then you won’t like sure, we’ll handle that. We’ll renew your license for you. We’ll renew your Dea, like you just it’s like a snowball effect.
Robin Redd (14:52) I mean, it’s good that you brought it up because honestly, I hadn’t thought about that. I can see their office staff handling that for them sure. But I honestly didn’t realize that some of like a network would offer that up as a perk, which is funny because we’re value based care and we do that extension of the office service all the time. I just didn’t know, you know, but I will say even some of the medical directors, like they’ve really, kind of… looked to me to like, can you help me get my license? And I’m kind of like… no, I can show you how to do it but no, that’s on you or your admin plus it’s like the fox guarding the hen house. Like in their case, I will be the one doing the credential exam. I’m like, no… no, but that was a good try. Yeah.
Mallory Smith (15:54) No, I think that’s the issue is that you do push back as you should and other people should push back more is what I’ll say. I mean.
Robin Redd (16:03) I feel like at the very least if that’s the service that you offer, you should probably build that into your pricing scope because I mean, I know you do, but I’m thinking for myself like I don’t want to take on that cost for something that’s really not our responsibility in this process.
Mallory Smith (16:22) Exactly.
Robin Redd (16:24) I mean, I feel like they’re already doing something to keep that profile updated to keep them from having to do all the many applications that they used to have to do back in the day. So, I guess if we were trying to take them from one network to another and that was a deal breaker, I guess, you know, I don’t know how that. I still think that’s probably not that’s a really big ask that’s a lot of work. Yes, and they’re not the most compliant group of folks like, yeah, I don’t want to do that. That’s.
Mallory Smith (17:04) what we assumed but we can definitely roll it out. I.
Robin Redd (17:08) Mean, well, what I will say is that, I know from past experience with the network that you will find out that, you know, they’ve they’re moving to a new office location or they, their primary is changing or they’ve got a new phone number. And I know that like my provider relations team spent an inordinate amount of time keeping all that information updated in the database we had. So I guess that’s kind of where I’m coming from is like… if you found out about something through some kind of, I don’t know how you would find out, but like, is that something where you… we go in and update it? Do we, I’m sure. Not because it’s your system. Do we notify like how does that work? Or do we just send them back to the caqh and say you need to update that through that profile. Is that the right thing?
Mallory Smith (18:04) No, I think it’s a great call out. So there’s multiple ways and there’s multiple ways for a reason because most of our customers prefer a different route than the other. So a handful of our customers will say, yes, our providers will go into caqh, they’ll upload their new practice locations, and then they’ll let us know when to re sync that data. Other customers will update the medallion system on behalf of their providers. They’ll put in the new practices. So it is our system. But to your point, we do give you the ability to go through and add information for the providers. You can edit the information. Okay? Yes, I.
Robin Redd (18:40) could see like once they’re credentialed and they’re in the network, I could see like a provider relations or cross frame part of my staff going in and making those updates… partly just so that they’re not, you know, I mean, I think in conjunction with that, it would be a kind of we’ll make, thank you. We’ll make a note in your profile here, right? And you should also follow up with caqh, yeah.
Mallory Smith (19:11) I think that’s a great.
Robin Redd (19:12) That’s my personal feeling about it. But that way, I know we’re covered on the front end quickly in a timely manner. And then hopefully they’re backfilling it so that, you know, when we go to pull a recredentialing file or whatever. We’re all clean. So does it overwrite what happens if you sink down the line, you pull on a caqh profile and there’s a change. There’s a conflict with information. So.
Mallory Smith (19:45) We have an internal like a data import table for the information that comes over from caqh. And that is where your engagement manager would be involved. So you would let them know like we’ve asked these providers to update their caqh. We’ve already updated the medallion platform for them. So our team is able to go through and pick and choose what information so that it doesn’t override if that’s the information because nine times out of 10, the practice information put in by your admins and your team is going to be more accurate than what the provider’s putting in. So, yes.
Robin Redd (20:18) What I would say, you know, you should go and do that. I don’t trust that they will. So I just wouldn’t want their whole file to overwrite the new information that we’ve taken the time to put in.
Mallory Smith (20:28) Okay. Exactly. So.
Robin Redd (20:30) That’s great. That was one of my questions.
Robin Redd (20:40) So in some of the slides as you go down, I couldn’t tell when I was looking at it which slide I was on. I should have looked at the pane… there’s. One that has like a band to the left, it’s like roles and responsibilities.
Mallory Smith (20:58) I’m looking for it now.
Robin Redd (21:01) Oh, is this the one go down? One more… keep going. Yes. So the part where it’s like your team will, is this specifically for enrollment versus like we’re not doing all that for the credentialing process, right? No.
Mallory Smith (21:28) That’s correct? So this is.
Robin Redd (21:29) Just giving you enough so you can make the match for caqh and pull it in, right?
Mallory Smith (21:34) Yes. Okay. If this is just scoping for the credentialing and cqa committee process, then you can disregard this slide. But because you did after pricing, we wanted to include that as.
Robin Redd (21:44) Well, okay. That’s what I thought when I was looking at this, I thought, okay, this may be more like we’re trying to do an in house with some support or something or we’re going from an application in that doesn’t involve caqh as a point of entry, correct?
Mallory Smith (22:01) Yeah, this is definitely just more on the provider enrollment side. Erica, did we include the credentialing responsibilities? Yes, because I.
Robin Redd (22:12) think those made sense to me because it was like there was a great little, yes that perfect. So, yeah… essentially, once we get the information to you and make the order and you’ve got what you need to pull the caqh, then we’re kind of out of the process until everything’s completed and we put our eyes on it, take a look at it. Take it to committee, get a decision. Okay. Perfect. Okay. That was… the centralized expirable tracking where… it said alerts to, does that alert come to like my team or is that alert going to the provider?
Mallory Smith (22:59) It can go to both. So completely configurable. If the provider does not want to get the alerts, then we can turn it off… like how you’re setting the precedent with caqh and making sure that they’re independent. In that regard. I would recommend that they get their notifications just because it’s either your staff gets a notification, then you reach out to the provider and say it or they just automatically get the notification from us anyway. So, yeah.
Robin Redd (23:24) I think that would be better. And then if I want to see what’s going on, I can always look at a report or dashboard, right?
Mallory Smith (23:30) Yes, we have a task dashboard. You can see how long they’ve been open. If the providers responded. If they posted any questions for you, all of that’s visible, okay… right? Moving right along.
Robin Redd (23:45) When we’re talking about background checks, I think like the oig I think is in there, I just want to make sure because I don’t want to, I don’t want to misuse that term to mean two different things. So when I think of a background check on one hand, I think of like the sanctions and everything. But on the other hand, I think of like we have a, we have a vendor who does background checks for us, like on everyone that we hire. And it’s like the criminal background check. The whole thing. Okay? Before anybody works for our company, they have to go through a background check. So when we’re talking about a background check, are we talking about that plus the sanctions and everything? Or are we just talking about the sanctions and things?
Mallory Smith (24:32) It’s really more of the sanctions, okay?
Robin Redd (24:35) That’s what I thought.
Mallory Smith (24:37) Perfect. Yeah, there is an integration that we have with checkr. I don’t know who your current background servicing company is, but we do have it that can automatically get kicked off via API with checkr. But it is not the criminal background check that is not what we’re doing unless you want to do the integration with checkr and set up a subcontract and things like that.
Robin Redd (24:58) Yeah. I think that we would just stick to ncqa in terms of these physicians.
Mallory Smith (25:04) Right.
Robin Redd (25:08) And it may be that we have some kind of a little in between thing. We still, I don’t know, I want to talk about those 12 providers. They’re making my life crazy. But anyway, we may still need to run them through or it may be at some point where we say we’ve got our network. But now we have this little pot of 12 guys that we’d like to fold together into our contract somehow and see what we can do. Let’s just keep that off the table and not complicate things. But, okay, I was just thinking about like what are we doing for them and background check… site visits? So they’ve kind of popped up in my brain now. So if we contract with a provider, we need to do a site visit. So do you have any kind of, is there anything built into the system for tracking those results, tracking that information? Or like housing some kind of a site visit tool or platform? Like I saw the facility credentialing, but that’s you know, a little different from like the provider has three offices. We need to make sure that it’s you know, passes muster before we would send patients there that we’re not sending them in. Yeah, that it’s Ada compliant that it has, you know, all the things.
Mallory Smith (26:28) I am looking now… just a minute… checking group level. Let me check facility level. Yes. So facility site visits, we are able to see who performed the site visit, the site visit date, the documentation can be uploaded and then you can, yeah, you can track that as a date. So that is available at the facility level for any notes or documentation you would need to store. Do you?
Robin Redd (27:01) Have some kind of a site visit tool built in? Or is it just kind of where you can upload, you can upload a tool and just like track like a document or a date or something like, okay?
Mallory Smith (27:14) So you can track, you can upload documents and you can track the dates, but I would say the site visit itself, there’s nothing that stands out about it. I would say it’s pretty elementary, just a place that you can track which facility where the site visit was performed, what date? And then any documentation you want to track?
Robin Redd (27:30) That’s perfect. Okay. Yeah, I just, I was like, yeah, we need to be able to track that too. And since you had everything set up to like connect them to the like practice locations, I figured there was probably a way to do… that. Yeah, I just wanted to make sure I wasn’t assuming something. And then I noticed that you had the option like there’s the ability to do facility credentialing, although I hope that isn’t part of my world. I know it could be at some point. So it’s nice to know that it’s there. So.
Mallory Smith (28:12) When you say facility credentialing, do you, are you referring to more like the accreditation primary source or the facility credentialing at the payer level for per DM at the?
Robin Redd (28:22) Payer level? And like I’ve never been in that world and I really, I’m happy not being in that area. I hear you. You’re comprehensive. Yeah. I mean, a site visit for a doctor’s office is one thing but I’m happy to just leave it at that. Me too. I’m good with never being involved in that. It just honestly, it just always seemed like it was if we were delegated as a network, we just, it seemed like the payer always did that like it seemed like it was part of their process for, you know, for contracting that they just, yeah, so good.
Robin Redd (28:59) I’m glad that hasn’t seemed to change. So those were all my questions and I know we’re like a minute to time, so, yeah.
Erica Lloyd (29:09) Let’s thanks for calling that. Let’s after you. So you said you’re going to meet with Amanda tomorrow. I’m.
Robin Redd (29:16) meeting with her later this afternoon, I’m just going to say, I don’t know that I’ll have anything new to share, but if I do, I’ll certainly share it. Okay?
Erica Lloyd (29:26) I guess let’s I know Mallory’s going to be out next week, but I don’t want, so, let’s communicate over email. And if not, I’ll put a placeholder for us to reconnect the week of the 20 seventh?
Robin Redd (29:38) Okay. That sounds good.
Erica Lloyd (29:40) But obviously reach me over email if anything accelerates.
Robin Redd (29:44) Of course. I mean, I know how to reach you. I think at this point really, I mean you guys are in my top two. So really what I’m going to do is just, I mean as far as services go, you’re really there’s not a huge difference. I’m going to point out the pros and cons. The way I see them and a lot of it is, I don’t really have an unchecked box from talking with you guys. I feel like anything that I could envision that we would need to do you’re able to accommodate or do it. So, I think, you know, you’re I mean, it’s there’s not a huge, you know, there’s not a huge question mark for me. I mean, I’m feeling really confident and really comfortable with you guys. So if I get to like my final calculations or my final presentation in pros and cons, and I have a question or I can’t remember something I’ll just reach out to you.
Erica Lloyd (30:34) Also, I just really want to recommend like not to try to not to go it alone. Like when you’re presenting to Amanda, we’re happy to support that conversation because there’s always questions that come.
Robin Redd (30:46) Up. She’s more my support with elt, I mean, like she’s been doing this forever. So she just doesn’t you know, she trusts me to do the legwork but I’m going to go through it with her first. And if she sees any flaws in the logic and same with my chief compliance officer, we work closely together and she’s done this a bunch too. So I’m just going to put it in front of both of them, you know, ask if they have any questions or if they see anything missing. And if so, I’ll reach out to you. Otherwise, I think they’ll probably just say, yeah, it looks good. Let’s you know, share it and let them know where we stand. Okay? Yeah.
Erica Lloyd (31:24) As we get started later.
Robin Redd (31:26) Now, as we get farther along though, I’ll totally take you up on that. Okay?
Erica Lloyd (31:29) Yeah. Especially even just from the procurement process and what would go into that we can totally support you, don’t feel like you have to go it alone.
Robin Redd (31:37) Thank you so much, all right?
Erica Lloyd (31:38) I’ll put time for us for the week after, and if you need to adjust the time, just let us know.
Robin Redd (31:42) Okay. Thank you. All right.
Erica Lloyd (31:44) Thank you. Bye bye.