Transcript
Kristi Toby (00:00) hello, Annette. How are you? Good. How are you? Good. Happy Friday junior to you? Yeah, I,
Patty (00:10) wish it was Friday.
Kristi Toby (00:12) I know we’re almost there. I.
Patty (00:14) Know. One more day, so.
Kristi Toby (00:20) Awesome. Let’s see. We’re just waiting on Jen from my side.
Patty (00:25) And Patty probably from my side.
Kristi Toby (00:27) Yep. And we can get started. I don’t anticipate this will take the full 30 minutes. But anytime we’re in the process of building a proposal, especially like when it’s the first couple of ones we’re working through, I just want to make sure everything is crystal clear and give you an opportunity to ask any questions as opposed to just blindly sending over a proposal. So certainly we’ll have time for questions if you need them, but ultimately just walking through exactly what it would look like. Good. All right. And there’s miss Patty. I’ll admit her.
Kristi Toby (01:03) Hi, Patty.
Patty (01:10) Must be stuck. Oh… sorry about that. Hi, Patty. Yeah, how are you?
Kristi Toby (01:18) Doing well. Annette and I were just saying it’s Friday junior. We’re almost there.
Patty (01:22) I know. Thank goodness. Is it warm where you’re at? Because it’s hot here?
Kristi Toby (01:27) Yes, it’s very warm. I’m in Atlanta. So, I think our high today is like 85.
Patty (01:31) It’s 85 here in my office. I think, yeah, 78.
Kristi Toby (01:37) I love the heat. I would much rather be hot any day than cold, so I won’t complain.
Patty (01:42) No, you’re right? Our offices just aren’t keeping up with the first warm of the, you know, change of season.
Kristi Toby (01:50) Got it. Awesome. Well, I appreciate you joining us today. I was just telling Annette before you hopped on that, typically, the purpose of these types of meetings is, instead of just blindly sending over a proposal, just walking through very quickly what it looks like especially as it’s the first couple ones we’re navigating together to review what it looks like. The structure of it, give you an opportunity to answer any questions, but certainly, if it doesn’t take the full 30 minutes, happy to give you some time back.
Patty (02:16) Perfect. All.
Kristi Toby (02:17) Right. And hey, Jen. So you hopped on?
Patty (02:20) Hey, guys. Sorry, a couple minutes late here. How’s everyone? It’s.
Kristi Toby (02:24) okay. We’re just relishing in the warm weather that we’re all experiencing. Yes.
Patty (02:28) Couldn’t be happier?
Kristi Toby (02:30) Awesome. So we’ll dive right in just out of respect of everyone’s time, but again, it hopefully will be shared with exactly what we’ve been discussing, right of getting the delegated portion of medallion set up for tenor. So I’ll send this over to you afterwards as well as the formal proposal. But again, can you see my screen?
Patty (02:50) Yes, yep. Okay.
Kristi Toby (02:51) Cool. So at a high level, this was in the appendix of the previous presentation that we sent over to you as a takeaway. But ultimately, this just defines, you know, sort of a you do we do responsibilities as it relates to the delegated portion of medallion. And so understanding very easily what tenor’s responsibilities will be with getting it configured and set up for the payr delegation. And then how medallion operates as far as getting them the providers and facilities credentialed. Any questions about that? No. Okay. Just wanted to have it as a refresh. And then one of the things that we did ask, I know in the email exchanges that we had earlier this week, Patty and we just wanted to double down and confirm as far as the monitoring. So currently tenor health has the sanction monitoring within the platform. And you can see the verifications that are incorporated with that. In order to have that delegation, we do need to upgrade to the ncqa compliant monitoring. And we did just want to verify that the death master and ofac are not required for the delegated agreements that you have in place. Is that accurate?
Patty (03:59) I don’t believe that they are okay. Is that something you normally would see is not part of them?
Kristi Toby (04:06) So most of the time, what we see is that the comprehensive monitoring is what those customers that want to sort of have the full gamut right? For the delegated agreement package that we have. But if it’s not required, then certainly we would be totally fine to move forward with the ncqa compliant. But we just wanted to make sure. So that way in a week or two, if we get into the process and it’s like, no, we actually should have had death master and ofac then we just have to go through another amendment to make sure you have the right type of monitoring. But if you are, you know, confident that it is not included, then that’s fine.
Patty (04:39) Yeah, that’s fine.
Kristi Toby (04:40) Okay, perfect. And so with that, the recommended solution moving forward is of course, the ncqa credentialing and sort of bulleted out there. I won’t belabor the point as far as, you know, we have a pretty clear alignment on what’s included with that, the ncqa monitoring with all the verifications that we just spoke to.
Kristi Toby (04:57) And then you mentioned there were two rosters, two unique rosters that are required for the payers that you already are partnered with. Is that correct?
Patty (05:05) Correct. Okay. So.
Kristi Toby (05:08) I think we’re on the same page as far as that goes. So as far as what the investment would look like, so, for the 170 providers that you mentioned that would need that ncqa credentialing, we have the unit cost at 110 for that, and we have it prorated through let’s say, activating it within this week, through the current end date of the agreement, which is March 20 fourth, 20 27, the upgrade of the sanction monitoring to the ncqa compliant monitoring. And so as I mentioned, there is the sanction monitoring included today in tenor’s agreement. So it would update you to the ncqa compliant. And then for the two monthly roster submissions, it’s an annualized cost. And so again, because it is prorated and not the full 365 days, that would be the total cost that you see to the right. So I’ll pause there to see what questions or reactions you have to that.
Patty (06:01) No, I’m just looking over what you have there. So the year in total to add it, does that bring, the year one total to 52,000? Or is that to add the ncqa piece? So.
Kristi Toby (06:18) This is, this is the portion to add to. So consider the agreement that we already have in place. You know, sort of out of sight out of mind. But in order to add the ncqa portion to the services, this would be the year one total in addition to and on the next slide, I have what the, since we’re in a multi year agreement, what it looks like for year two and three, but it will be less because once we have the 170 providers credentialed this year, we only are accounting for 10 over year two and year three to be proactive about the growth that you mentioned?
Patty (06:48) Okay. And then.
Genevieve Seney (06:51) One thing to call out too is we would credit you back your original sanction monitoring package. So you guys originally purchased sanction monitoring, which is just again, the less verification checks. So that entire package from the original agreement would be credited back, knowing that you’re upgrading to sanction monitoring, just wanted to call that out yep.
Kristi Toby (07:11) Exactly. And so I think the annualized total for that was just over 12,000. And so you can anticipate approximately that much. And certainly when it gets to the invoicing, it’ll be spelled out very clearly what that would look like. So, the contracted value of what we’re adding is 52, but understand, it would be about 10 to 12 K less based off of, you know, the upgrade and getting the credit back for the sanction monitoring that you’ve already paid?
Patty (07:37) Okay. So.
Annette Craig (07:38) Christy, I have a question. So if.
Kristi Toby (07:41) we.
Annette Craig (07:42) didn’t do the death master. So this is for everyone. So this is just for pay enrollment, right? You would still do the death master for your medical staff, credentialing, correct? Or is it all includes I’m just because we do currently now run a death master?
Kristi Toby (07:58) Yeah, great question. So if you wanted to incorporate the death master, then, yes, we would update you to that comprehensive monitoring which I think was on the previous slide. And so if that’s what you wanted for all of the providers, then yes, we would just go ahead and update this proposal to include that comprehensive. And then you had the death master covered for everyone because we can’t segment it right? Where only certain people have one type of monitoring and everyone else has, okay?
Annette Craig (08:24) That’s what I was asking. Yeah, because I thought we had that in the original, okay. That’s what I was asking. Great.
Kristi Toby (08:34) Question. So based off of the agreement that we have, it’s just the sanction monitoring. So it would be that column to the far left. So it would just be the Sam, oig, npdb and medicare opt out.
Kristi Toby (08:50) Are you saying you were under the impression that the death master was included with the, yeah.
Annette Craig (08:55) But, you know, I wonder if they’re going to get that for certify now? Okay. Yeah, because that was included in checks we have now and that’s what I thought David was getting.
Annette Craig (09:11) Okay. So if it’s.
Kristi Toby (09:13) helpful, obviously, we can update this to give you a comparison of what the ncqa compliant monitoring would look like or if you wanted to upgrade to the full sort of comprehensive. And then, you know, moving forward, you have all the verifications and monitoring that could be potentially offered through medallion and have that comprehensive. And that way you can sort of compare and decide which monitoring makes the most sense. Or if you like you mentioned, if you want to double check and see if you have those death master through another service, then that’s fine. Yeah.
Annette Craig (09:43) Because that’s I know we currently do and they’re looking to, okay. All right. So.
Kristi Toby (09:49) I can update this when I send it over to you to include what it would look like if we included the comprehensive and that way you can compare.
Annette Craig (09:57) Yeah. Let’s do that please.
Kristi Toby (09:59) Absolutely. What other questions do you have?
Patty (10:05) I don’t have any right now? Okay?
Kristi Toby (10:09) And this was just an example of the difference between the year two and three, right? Because we’ll go ahead and just co term the entire agreement. And so the year two and year three investment will be less because again, we’ll already have the 170 or so credentialed through medallion in year one. And then we’re just proactively accounting for the approximate 10 provider growth, year over year that you mentioned. Okay. So it’ll be less each year after the first year.
Patty (10:38) Okay. Understood. So.
Kristi Toby (10:42) What are our thoughts? I know you need time to digest and send this over, but are there any initial thoughts or reactions? Because I know this was something that we wanted to move forward with while we’re in implementation, right? So we can sort of cut, you know, measure twice cut once as far as implementation goes. But what are your thoughts on sort of the budgetary aspects of things? My?
Patty (11:05) Gut is for two payers, it’s probably not worth it.
Kristi Toby (11:10) Okay.
Patty (11:10) I’m going to talk to our managed care… tenor just hired a managed care director and I’m going to talk to him tomorrow, and we’ll run this so if you could send us the formal proposal or these slides so that we can review it with tenor and our managed care team that would be great. But I need 52,000 dollars to do a lot and probably not delegated credentialing is one of them. Okay?
Kristi Toby (11:44) That’s definitely fair. Was there a number in mind specifically that you were anticipating this falling around just for a ballpark?
Patty (11:52) Honestly, because it was something that CHS did and it only impacts two payers for us. I really had no idea what that cost was going to be.
Kristi Toby (12:03) Okay.
Genevieve Seney (12:05) Yeah. I think one thing just to kind of consider, right? Is like, I think in your mind too, Patty, right? Like the 950 is way inflated, right? Because you only have 100 or sorry, go back to the last slide. Christy. I think it’s 150 providers 170.
Genevieve Seney (12:19) So I think that piece is probably also is you have to think of that more holistically for the entire partnership as opposed to just the credentialing function because ncqa compliant monitoring is a one to one. So that’s why we need all 950 for your, the core platform even though you’re only doing 170 of those providers as cred. So we’ll lay this out via email. I just want you to have that context.
Patty (12:44) Yeah, that’s great. And.
Genevieve Seney (12:46) Then we’ll lay out like the credit function. And then again, and that seems like separately, we might have to update to comprehensive monitoring regardless. Curious. Just want to ask a question on that for the checks. What were, was that just for your ongoing monitoring checks? You’re running death master?
Annette Craig (13:04) We were doing, yeah, the reappointment, so, and, it was included in our background checks which I believe you are running a background check, correct? Yes.
Genevieve Seney (13:15) And so, are you just talking about for the you’re just talking about for ongoing monitoring, not for payer enrollment or reappointment, correct?
Annette Craig (13:22) Correct. I’m just talking medical staff credentialing, yeah, not, and it’s independent physician. So at the time of reappointment or initial appointment, we would run a background which would give us the death master.
Genevieve Seney (13:34) Okay. So, yeah, let us check with the tjc cred function. If that’s running the background check, and.
Annette Craig (13:39) I’m almost, I thought Mallory said it would. Okay. Yeah.
Genevieve Seney (13:45) Let us just check the tjc cred that you purchase, but we’ll make a note just again separate from this discussion to check on the death master and background check and just make sure we’re all very clear with what you’re getting. And then, yeah, obviously, Patty, Christy will be in touch with anything additional you need.
Patty (14:02) Okay. I appreciate that and thank you for getting all of this so quickly. Okay?
Genevieve Seney (14:06) Thank you. And.
Kristi Toby (14:08) So, we’ll get this over to you and updated before your meeting with the team tomorrow. And then should we just follow up with you later tomorrow or Monday on sort of the direction that tenor wants to take with it?
Patty (14:21) It’s probably going to take a couple days. I’m only with our managed care person tomorrow. So probably give us till the middle of next week. Okay.
Kristi Toby (14:32) Sounds good. Is there anything else that you have questions about or that we can clarify for you? We’ll look into those two items that Jen mentioned and get this over to you.
Patty (14:42) No, that would be it. I appreciate it all.
Kristi Toby (14:45) Right. Well, thank you so much for your time and we’ll talk to you next week.
Patty (14:48) Okay. Bye bye.