Transcript
Lewis Elder (00:00) hello? Hey, Sam. How’s it going? It’s going? Oh, yeah. You changed your virtual background?
Samantha Bouchard (00:10) Oh, yeah. I missed it on a trip.
Lewis Elder (00:14) I like that. You’re not sure.
Lewis Elder (00:24) One person in the waiting room. I’ll give it a minute before I add everybody in.
Lewis Elder (00:42) Sounds good. I saw you posted about demostack. So, did your computer go back to being incredibly slow?
Samantha Bouchard (00:51) Yeah, today, it was, but I restarted it and it seems to be better.
Lewis Elder (00:58) Okay. Well, let’s hope, no, we’ll find out later. All right. I’m going to go ahead and add them in since it’s one 30.
Samantha Bouchard (01:06) I’ve given like three demos this week and it’s been fine. So.
Lewis Elder (01:10) Okay. Well, that’s good. Yeah, hopefully it was more of an internet problem than a computer problem. Hey, this is Luz from medallion. Hello?
Samantha Bouchard (01:21) My name is Sarah Sargent. I work in the finance department, and I asked me to also sit in just to have.
Lewis Elder (01:28) A, yeah, that would make sense. Yeah, thanks for joining. Good to meet. You. Are you in Buffalo with the team or somewhere else? No, we’re in, Rochester? Sorry?
Samantha Bouchard (01:41) Yes, Rochester, yes.
Lewis Elder (01:43) Buffalo, what am I thinking? I’m confusing my, not New York City, New York cities and I see Amanda joined and we’re just waiting on a few others. So we’ll give everybody a minute. Amanda. Can you hear me?
Acarter (01:56) Sorry, my audio was off. Chetna is in the room with me.
Lewis Elder (02:00) Oh, perfect. Hey, chetna.
Acarter (02:02) Hi, I’m here… and Tasha said she was going to be a few minutes late.
Lewis Elder (02:07) Okay. We’ll… we’ll give Tasha a minute or so unless we think she’s going to be like, you know, five minutes or so late. I’m guessing it would be, you know, important for her to be on. Yeah.
Acarter (02:21) I think it’s pretty imperative that she’s on this.
Lewis Elder (02:22) Call. Cool. We’ll give her a minute. Are y’all, getting I’m in Pittsburgh, Pennsylvania for anybody who doesn’t know. So, you know, east coast Ish, and we are having a heat wave right now. I don’t know if that’s made its way up to y’all,
Acarter (02:38) yes, with wind.
Samantha Bouchard (02:39) Of course.
Lewis Elder (02:40) Yes, we’ve been, yeah, we’ve had wind too. Anytime I’ve opened my like screen door, the front door to my house, it’s like flinging open as that’s about to like rip off the hinges. It’s scaring the crap out of my dogs. But the weather’s you know, besides that the weather’s been nice at least.
Acarter (02:57) Yeah. But then Sunday, it’s supposed to drop down to like.
Lewis Elder (03:00) I know, I think, oh, I know… it’s not too happy. I know me neither, but I’ll even a few days of decent weather. You know, Pittsburgh is very rainy. I’m assuming it’s probably pretty rainy in western New York as well. So I will take even a small break in the action. Hey, Tasha. Oh, just finished up another meeting. All right. No problem. We’ll give Tasha a moment to finish up before we get going. I guess in the meantime, we’ll just we’ll do some quick introductions since we do have at least one new person. Is there anybody else we’re waiting on from the oak orchard side? Slash? Is there anyone else in the room with you, Amanda, chetna that I should be aware of?
Acarter (03:45) No. So, I think we’re all here. Amanda and I are in the office. Sarah’s also in the same office, but in a different room. So I just wanted to, Sarah’s, our controller and I just wanted to know because this is going to be a big change for the finance team. So I wanted the entire team to be there. So three of us are in finance. Would you want to go first? Yeah, we can ask her. Yeah, I’ll go first. Okay. We’re going to just grab one more person?
Lewis Elder (04:14) Sure. Yeah. Take your time. Thank you again.
Latasha Cutaia (04:36) Sorry, guys.
Lewis Elder (04:38) No, hey, Tasha.
Latasha Cutaia (04:41) I’m sorry, say that again. Oh.
Lewis Elder (04:42) I said, don’t worry and then I said, hey, Tasha. Hi.
Latasha Cutaia (04:45) Sorry. No.
Lewis Elder (04:46) No worries at all. Are you off the meeting?
Latasha Cutaia (04:49) Yeah. Sorry, when the CEO calls, you got to answer the phone. Oh,
Lewis Elder (04:52) yeah. Oh, yeah. My CEO does not call me that much, but every once in a while, I get a text from a strange number that’s claiming to be him and asking for me to send him gift cards and my social security number. But yeah, that definitely takes precedence. Hopefully, everything’s okay?
Latasha Cutaia (05:07) Yeah. All good. All.
Lewis Elder (05:09) Right. We’re just, you guys are back.
Acarter (05:17) Sasha to you and Taylor.
Latasha Cutaia (05:21) Taylor’s on vacation today. So I’m solo, okay. Okay.
Lewis Elder (05:25) And I can, for the folks in the conference room, I may need to ask you to repeat stuff at certain points. I can definitely hear you. It is a little garbled. So if I do ask to repeat anything, I apologize in advance but just wanted to call that out. I think we have everybody then somebody, you know, let me know if not.
Latasha Cutaia (05:45) No, I think this is everyone.
Lewis Elder (05:46) Perfect. Okay. Awesome. Thanks y’all for joining and making time on a unseasonably warm Friday… today.
Lewis Elder (05:56) Yeah, basically, we’re going to go through a couple things and you guys tell me if there’s anything else you want to hit on, but agenda for today will be, and I have like a visual powerpoint that I’ll pull up, but we will kind of recap what we internally call value drivers. So basically what’s the problem oak orchard is facing? What are the solutions you guys are hoping to achieve? How does medallion solve those solutions? And then we will get into the pricing proposal. I’ve put a couple options together for you guys to review. And then from there, we’ll kind of look at potential next steps that’s really all I have on the agenda for today. Anything else that you guys want to cover or add in to that agenda?
Latasha Cutaia (06:40) The only thing that Taylor asked me is to make sure that you guys can do the vendor exclusions as well.
Lewis Elder (06:48) Sam, I’ll let you weigh in there.
Samantha Bouchard (06:51) Yeah. So the way that our system works for the non clinical checks today is it requires like social security number. So it is really like mainly focused on that individual lookup. So at this time, yeah, the vendor exclusions would not be included. Okay?
Lewis Elder (07:16) Any other questions? And I think I did email that over to Taylor as well because I know she asked that yesterday and I passed along. So I know she’s out of office. Yeah, any other questions or odds and ends? I think that’s it.
Samantha Bouchard (07:33) Okay. All.
Lewis Elder (07:34) Right, perfect. So just to like tee it up before I pull the slideshow, I want to kind of preface what I’ve put together for you guys and we’ll get into this in a few minutes after we kind of recap the problem statements.
Lewis Elder (07:47) But I’ve put together kind of two proposal ideas for you all with my thinking being, I know, obviously, I know you guys are an fqhc, I know budget’s a big deal. You guys have shared kind of like, you know, anything over 15,000 dollars requires an RFP you’ve shared that you have like one credentialing manager currently that you’re that level of salary is kind of like what you’re benchmarking things at. So I’ve taken all that into consideration. I basically put together a proposal that’s essentially like a, that’s you know, a pared down version of what we could do for y’all but that I think would still be very useful considering where you’re at today. That version is cheaper. And then I’ve put together a version that has like we do everything and that version is more expensive. So we’ll go through both and of course, get like live feedback. But, I, I’ve tried to really keep in mind, you know, your financial position, the space you guys sit in, and keep things as like competitive and reasonable as I can. Obviously, that’ll be for you guys to decide to tell me if, you know, there’s no way this will work whatever, but I just wanted to kind of at least preface that. And that’s why we’ll be reviewing like a couple options for today. And of course, you know, we can always like look at a third option or something if you guys want to. But just wanted to say that upfront. Okay. Awesome. Let me share my screen.
Lewis Elder (09:11) All right. Can you all see that? Yes, perfect. All right. So we will move to, so a lot of text on this slide. You don’t you know, you don’t have to read it. All this is all things that we’ve talked about but we talked about quite a bit, right? So I’m you know, trying to fit it all into a slide. I do want to at least spend a minute on this as dense as it is. And I want you guys to let me know, please like make it conversational if there’s anything that I’m missing or if I’m off base on any of these assumptions. But essentially on the left, you have like the challenges that oak orchard is facing today. And on the right, you have like how medallion would hypothetically solve this challenge with the first being, you know, and they’re all intertwined obviously. So first being, you know, looking to transform and scale for growth when we’ve had conversations before you guys have said, you’re looking to, I think Tasha provided these numbers, you know, it’s about a 15 percent growth with, you know, looking to hire ideally like 10 new doctors and about 15 apps for this year. And you guys are doing everything on spreadsheets today. Kind of the, where you sit right now is not ideally, you know, situated for the level of growth that you would like to hit over the next year. Is that an accurate statement there? Yeah. Cool. So what medallion does and, you know, probably for like Sarah or whatever who hasn’t been on these calls. So medallion, we enable your team to support an unlimited number of providers across an unlimited number of applications like credentialing and payer enrollment applications across, you know, all 50 states. Not relevant for you guys. But with 900 plus payers, we have built in knowledge for all the provider and state requirements. We’ve talked about like, the New York medicare medicaid funkiness. And, and we can support an entire credentialing operation without y’all needing to hire. So helping you either reduce opex or keep it flat. So, I know we’ve talked about you have one person that may be, you know, retiring soon? And then you’re also growing at a rate where you’re kind of facing a decision of like do we need to backfill? And do we need to hire additional folks on top of that as well? Kind of, you know, looking for a direction to move to… enrollment turnaround times and par status. So these vary between payers. I know sometimes the government payers can be, sometimes it’s shorter than 60 days, sometimes it’s longer basically vary between like a couple months to three to four months. And one piece that y’all flagged that took that was a real pain point was onboarding new providers and getting the data collection from the providers. That it could take a couple weeks to a month to just get the data from them. I want to make sure that I have that, you know, I’m thinking about that in the right way. I know that’s been kind of a pain so far. Yes, that’s.
Samantha Bouchard (12:08) correct.
Lewis Elder (12:09) Okay. Yeah. So in the way that medallion would address this is, so we would, our average turnaround time start to finish across all 900 payers we support is 52 days. Sometimes it’s shorter. Sometimes it’s longer, but it’s, the average is 52 days. So we, our goal would be to get your providers par faster. So, I know you, Chad and Natasha, you both mentioned, you know, with government payers, you can often backdate your claims so you may not be missing out, on a lot of revenue, but it could be more of a provider experience issue where, you know, maybe they’re sitting on the bench, or just not able to go through the onboarding processes as smoothly as possible. One thing we’ve talked about is medallion has a bi directional API connection with caqh so we can automatically pull in a lot of that provider’s information to populate about 80 percent of their profile, which just reduces the manual work both for your team and the providers when they’re onboarding. So I think that would be a big improvement in the current state as well… provider for sorry, go ahead.
Samantha Bouchard (13:13) No, I just said agreed. Oh.
Lewis Elder (13:14) Perfect. Provider frustration is the other piece. Yeah, it just, and you guys have said it’s kind of been a headache for both your team and the providers both in terms of that onboarding piece and maybe some slow turnaround times. Maybe the revenue collection, some of the groups we work with, it’s like they’re missing out on a ton of revenue if they can’t backdate some claims. Maybe it’s not that’s not as big of a piece for y’all, but medallion’s ability to onboard providers in an average of two days as opposed to your like current status of like two weeks or a month, I think should be, a huge improvement there. And then also, you know, we would be improving your overall turnaround times, and lessening, that provider abrasion by the, you know, with the automations that we have built into the platform. And then also, we’d be abstracting that work away from your team having to do it manually. And then I’ll kind of run through these last two, manual process. You’re doing everything on spreadsheets and in folders. Obviously, that takes a ton of time. You have to update everything manually. You have to do everything by hand and then looking to just kind of modernize your approach to credentialing and payer enrollment overall. And I think we’ve hit on enough of how medallion solves that, right? Like we are a software platform. We also have people that are in the loop when people need to be involved in the loop. But we will automate all of that. All of those like mundane tasks, remove all of that manual effort, and also give you guys a single pane of glass where you can manage all of your providers, track all of your enrollments, track the onboarding process that you don’t have to do it all in spreadsheets so that you have that visibility across all of your providers where they currently sit. And then also lessening that manual burden on your team that you’ve experienced today. Does that capture kind of all of the pain points? Whether you guys go with medallion, you go with something else, that you guys are looking to solve for?
Samantha Bouchard (14:58) Is there anything I’m missing for HR? Yes. Yeah.
Lewis Elder (15:00) Good. Amanda. Yeah.
Acarter (15:04) That for the payer credentialing, I don’t think I’ve asked this before if a provider is no longer here like, you know, now they’re termed, for whatever reason. Is that something that you guys would handle like all of the, you know, forms that need to be completed by all the, by all the payers? Like would you guys do that or is it something that we would do?
Samantha Bouchard (15:28) Yeah. So today, we deactivate the… you would deactivate the provider in our system, which would like still save their data record in case you ever needed to reactivate it. However, those individual term letters would still be owned, by your team.
Acarter (15:50) Okay. And then you guys would maintain rosters to them, correct? Also?
Samantha Bouchard (16:01) Are you referring to like the quarterly like roster, like requests from a payer, like?
Acarter (16:08) Humana, I have that I’m dealing with right now. So like, they want everything done on rosters, right? So, and at like if we’re going to add in a new location,
Samantha Bouchard (16:20) it’s done on a roster, like you guys would do that for us. Say you’re going to add in any one provider or multiple providers that’s on rosters, you guys would do that as well. On top of that. Yeah. So we’ll follow whatever the, we have over 900 payer process guides in the system. So that’s something that you would no longer have to manage. And then whatever that payer’s preferred method is, we will follow that on our side. And as far as like adding locations that would be like considered like a demographic update, which is a request you can do directly in our platform. So, yeah, all that would come over to us.
Lewis Elder (16:54) Okay. Good questions. Though. Any others from Amanda or the rest of the finance side?
Acarter (17:06) No, we’re good over here, great.
Lewis Elder (17:08) Yeah. Just to, and I know, you know, HR, Tasha’s team, you guys handle just the credentialing piece. And then Amanda, you, the finance side, you guys are obviously handling the payer enrollment. I do remember, one other thing that I think is important to call out is that Tasha, you mentioned this on a call, was that in addition to like your own internal growth targets that you guys were getting to a point where, you know, part of what was necessitating the growth is that you were having like a patient waiting list, like you just had a more patient demand than you had a provider availability at the time. I want to make sure I’m remembering that correctly? Yeah.
Samantha Bouchard (17:41) We have more patients than providers. So this is why there’s a huge push. Yeah. So hence why the CEO is like, how are we doing? Not hiring people? So.
Lewis Elder (17:52) Yep. Gotcha. Okay. Cool. I’ll keep it moving then if anything comes to mind of like we also wanted to solve for this. So this is also a pain point, please do shout it out. But I think this kind of summarizes what we’ve talked about in the calls that we’ve had and, you know, if you guys spend the money and buy something like a medallion, this is what you’d be looking to solve for. So, just looking at, you know, timeline comparison right now, it’s two to four plus weeks for provider onboarding and enrollment. I know it takes a while for y’all to get the credentialing packets and submit them as well, you know, anywhere from 30 days to 100, 20 days for pay enrollment turnaround times. And then with medallion, I think the biggest benefit that we’ll have here in addition to just speeding up the pay enrollment turnaround times by a bit. But I think the provider onboarding and application submission part will have the biggest impact on for y’all, because that’s a part of the process that I think is particularly slow with your current state and we should be able to shorten that from like a month to a week basically or a little less. My anticipation is that you’ll be, you know, achieving par status at, you know, the beginning of somewhere around like the beginning of the third month as opposed to what I’m guessing now is either month four five or six from start to finish of the process.
Acarter (19:14) Can you hear me okay?
Lewis Elder (19:15) Yes, yes, I can. Yep. So.
Acarter (19:18) Just going back on that number of days.
Samantha Bouchard (19:21) I.
Acarter (19:23) think I would really focus on whenever you come to the SLA terms. I’ll really focus on the number of days for completion of paperwork because that’s in our control or rather your control than the payers are, you know, that 52, 32, 60 days is all very subjective to different payers and not in our control. And something could be in our control. But I don’t know how it works from your system like you’re really not impacting that. That’s what I understand you’re really not impacting what’s in your control is the prior… the pre work, the verification, the primary source verification piece, the preparing of all the applications and submission. So I think that’s in your control, the balance time is not. So I would really like to see that kind of like is that two to four weeks or is that one week, something like that? Because if it’s two to four weeks, we ourselves take two to four weeks to do that. Then what is the difference will you make to that?
Lewis Elder (20:34) Definitely a couple things to respond to there. So you’re right? In that we can’t medallion, you know, no one has total control over the payers, right? So it is, you know, we can’t I can’t like say, yeah a medallion, can, you know, guaranteed speed that process up? I will say that we do have ways that we can speed that up because we can do things like submit by roster. We have direct relationships with a lot of these payers. Some of them are our customers and we do have certain automations built into the platform to kind of speed the payer process along because we’ve basically tracked how the, what are the fastest ways to get an application through? So we can’t we, while we can’t we don’t have control over it. We can influence it to be a bit faster. But then I’ll actually share this is I’m going to change what I’m sharing and pull up a different thing. We’ve covered this in an earlier call, but I think it would be good to see now. So this is going to be directly referencing… chetna, what you’re talking about… Da?
Lewis Elder (21:45) So we have a… one day average turnaround time for an ncqa committee ready file with a three day SLA. And then we have a five day SLA for a joint commission ready file. And I know you guys, I believe you’re credentialing to joint commission standards. Is that correct?
Lewis Elder (22:10) Oh, sorry. I can’t.
Latasha Cutaia (22:12) say that again, Louis. Sorry, you cut out on my side?
Lewis Elder (22:14) Oh, I’m sorry. Hopefully my internet does not give up on me. We have a three day SLA for an ncqa committee ready file. And then we have a five day SLA for a joint commission ready file. And I wanted to verify that you guys are credentialing to joint commission standards.
Latasha Cutaia (22:31) Yes, we are.
Lewis Elder (22:32) Yeah. So, yeah, we SLA that to five days and can often get it done quicker. But just to call out the specific SLA, and then for the enrollment turnaround time, it’s a five day average to submit the applications to the payers with a 10 day guarantee. So we should be saving a material amount of time off that process for you. Chetna? Does that answer your question and anything else you want to call out there? Yeah.
Samantha Bouchard (22:59) And chetna, the other thing I’ll say too is just from like a volume perspective. So one thing we heard from you all is like, you know, if that volume kind of increases at that point, you know, like your team is doing those applications, one application at a time, right? So it’s going out the first one’s going out, the second one’s going out. And you can, you know, that could, you know, take a couple of days or longer, right? To get through with medallion, you’re kind of submitting all of those at once regardless of the volume that are coming in. And so that’s really happening in a like everything’s kind of happening in parallel rather than like in the linear fashion that you’re following today. So when you look at that with the provider onboarding and the caqh decreases, add in, you know, that parallel submission process that’s where a lot of the time savings happens in addition to, you know, what Louis said about some of the special relationships we have with payers where rosters are accepted, et cetera.
Latasha Cutaia (24:11) Louis, I did think of one question that I do have because this just came up recently when doing the background stuff with credentialing for a provider, will you guys be able to flag if they can’t submit to a specific pharmacy or is that just kind of a unique thing?
Samantha Bouchard (24:28) Yeah. So I wanted to talk a little bit more about the background check piece. So one of the things that you all, you know, I know you’re running a background check with a different vendor. It sounds like there’s some additional primary source verifications that are included in that, and that’s really a separate service from our, you know, the tjc file that we would submit. So, I don’t know Louis if we want to dig into that this now or just table it, but I will say that in the proposal that Louis has put together, we haven’t included like there’s no cost from like the background check perspective. We do have an integration with checkr and we can share like their direct pricing for background checks and that can integrate into our platform if you’re considering changing vendors, but we wanted to hear more about that and like would you all want to stay with your current background check vendor and then have medallion really just take over the primary source verifications for the joint commission file? Or how are you all thinking about that? We?
Latasha Cutaia (25:37) Would like to move away from them just because they’re super slow and unresponsive. We haven’t because we really haven’t been able to find anyone else that can do what they do… if that makes sense.
Samantha Bouchard (25:52) And when you say do what they do like, are they running some of the tjc psvs for you in addition? Yeah.
Latasha Cutaia (26:02) Okay. So I.
Samantha Bouchard (26:04) think what we’d want to do Tasha, is just have a separate like just maybe you and I like a 15 minute conversation where we kind of look at all the primary source verifications that make up a joint commission file and like what medallion would take over? And then what those additional psvs are that you’re looking for? We can add custom primary source verifications. It would just depend on like do you want those in the joint commission file? And then we also have the background check option, but right now we just don’t have that in this price. So it just would be something that we would want to kind of circle back on and follow up? Sure?
Latasha Cutaia (26:44) I’m fine with that?
Samantha Bouchard (26:46) Okay, awesome. And.
Lewis Elder (26:49) Chetna. I want to make sure in addition, did we answer your question fully, do you have any additional questions or lingering questions there on kind of the provider data collection, you know, submitting the application timeline piece? Yeah… cool. Would this would shortening it to, you know, five days? Would that be a material for your business currently?
Acarter (27:22) I mean, someone else is doing it. So, yeah, we try to do within five to 10 days as well, but at least, you know, from the point of view of what tananda said about the scalability, I think that makes sense. Scalability would be much more easier than someone like you and I are supposed to be doing in house. If we have to do five applications, we will probably take, you know, that many days to do it because that person’s home yet. So that certainly helps. But in terms of just one application, probably not.
Lewis Elder (28:00) Sure if my memory serves even one application though, wasn’t it taking you guys like two to four weeks even just to, you know, get the provider to get the information from them and get the process started or I could be misremembering, you know, we’ve had a lot of conversations. Please correct me if I’m wrong, no.
Acarter (28:19) I feel like it kind of all just depends on when we get the information. Like all of the credentialing information from HR as well. I see, you know, and then every application is different. So some like that you actually need the provider to sign some, you can sign on behalf of the provider. You know, what documents do I have? Every pair is different. So some pairs, they want proof that they have admitting privileges. Some don’t want that. So honestly… they all just kind of vary. So I try to just get them in so at least they can get processed. And if they need something else, then they can reach back out to me and I can try to obtain that. But rather than just having multiple applications, just sitting here, you know, all these to get in and get the ball going.
Lewis Elder (29:05) That makes sense. Yeah, absolutely it.
Acarter (29:07) Just kind of varies. Yep.
Lewis Elder (29:09) That makes sense. That makes sense. That’s a good call out as well. Yeah, I think the hopefully the yes, the ability to kind of scale in addition to, you know, the caqh integration. So the providers have to do less work. I do hope that, you know, would have a meaningful impact for your timelines but that certainly makes sense. I can understand the variance there. Any other questions on that piece? Otherwise I’ll keep moving through the proposal. Okay? Let me switch my screen sharing back.
Lewis Elder (29:53) Okay.
Lewis Elder (30:01) All right. Moving on. So getting into the pricing proposal. So, these are basically the inputs that we got from you all. So we had a call where we met with, I think it was chetna and Tasha. Maybe, yeah, some additional folks, maybe Amanda, I don’t remember if you were on that call or not.
Lewis Elder (30:18) But we basically got kind of your current numbers of providers and your, the amount of applications, your hospital applications, you’re submitting, got an idea of your pay enrollments, revalidations, et cetera. So these are all the inputs that we got from that call. So just to give you an idea of some of the numbers that are going into the pricing proposal, which will be next… we’re you know, you have 170 current providers looking to hire, you know, 10 new doctors, 14 or so new apps over the next 12 months. You’re commissioning credentialing to joint commission standards looking to, you know, have medallion take over ongoing monitoring, caqh, management, hospital applications. I couched that at 18. I got that number because your, the estimate was between 10 to 15 new providers in total across, you know, doctors, new apps. So I just did like and you guys said it was about one to two applications per provider. So I just took like a conservative estimate of like 12 providers times one point five applications is like 18 hospital applications. Obviously, that number could change but I wanted to be a little more conservative there and then pay enrollments based on what we talked about you’re doing like 15 to 20 new providers annually. So it was about 225. And then revalidations were about 375. Any questions there on the inputs that we got from your team?
Acarter (31:49) No, I think that looks okay.
Lewis Elder (31:50) Okay. And then current state and this is kind of what I, the way that I’m thinking about it. So, you have one full time credentialing manager that’s making about, you know, 45,000, you know, plus salary benefits. I don’t know. I’m just couching that at, you know, between 55 to 60,000 dollars in total spend for oak orchard. You know, you’ve mentioned that person is probably nearing retirement. And just with the volume you’re doing you’re in a position where obviously that’s why you all reached out, you’re looking at, hey, can we outsource this to like a software vendor or should we, you know, either backfill this position and hire new people, hire new people. So that’s kind of how I’m quantifying the problem right now. And obviously, you’re having the credentialing manager handle just the credentialing part while the finance team is still doing the pay and enrollments. So, is that a correct kind of state of the state of where things sit today?
Acarter (32:45) So, I think we have time for some notes. So I would just put a cost of say 50,000 total for the entire work that we’re doing.
Lewis Elder (32:54) 50,000 for the entire work that they do. You said 50,000 China?
Lewis Elder (33:05) Can y’all hear me? Okay. Am I cutting out?
Acarter (33:09) No, I heard you. I can hear you Louis.
Lewis Elder (33:15) Okay. I think China just said couch it at 50,000.
Lewis Elder (33:22) China, Amanda, we, I don’t think we can hear y’all right now. I’m not sure.
Acarter (33:26) Sorry, what, sorry, was there a question? Yeah.
Lewis Elder (33:30) Sorry, I just wanted to confirm, I understood what you’re saying to just to benchmark that number at about 50,000?
Acarter (33:39) Yeah. So, so we have a part time person doing the insurance credentialing, and a part time person doing the privilege in the front end. And both could be like a full time together. Yes. And I don’t think the cost of the total is 60,000? What I was saying is that, I would put a cost of say 50,000, but that’s okay. 50 to 60 ballpark is good. But it’s not one person. It’s like two people, but part time, I.
Lewis Elder (34:10) See, I see that’s helpful. Yeah, I thought it was just one full time. So I try to add in like, you know, an estimate on like benefits and stuff, but obviously, if it’s part time, that changes the math a little bit. But I’m glad to hear I at least wasn’t totally off base. That’s.
Acarter (34:22) why I didn’t want to say it’s one full time person with that full salary. So, my rough estimate with loaded with benefits and all of that was 50,000 dollars of could be cost savings on a, on the personnel part. Got.
Lewis Elder (34:38) It, that makes sense. That makes sense. And that person would just be handling the credentialing work, correct? Not the not the pay enrollment work.
Acarter (34:48) No, there are two people they’re doing the front, the privileging portion, with the provider.
Lewis Elder (34:56) Yep.
Acarter (34:56) Onboarding. And then there’s another person whose part time job is to be a care adult.
Lewis Elder (35:03) Yep. Right. Understood. All right. So that, those are kind of the inputs that we’re considering. And then, it sounds like if you were to hire, you would just be looking at hiring one F fte as opposed to the part time, correct? Like one full time employee. Is that what you just said? Chetna? Yeah.
Acarter (35:28) Yeah, I don’t know. I mean, I don’t know what we would hire.
Lewis Elder (35:32) Okay. Understood at the.
Acarter (35:34) Gauge of, what we have right now? Sure. So parent enrollment, we don’t have a need for full time.
Lewis Elder (35:42) Got it. Understood that’s helpful either way. Just helps me understand kind of what you guys are, the options y’all, are weighing, and how, you know, medallion intersects with those. Yeah. Any other, any other questions or call outs here? Otherwise, I’ll move into some of, the pricing.
Acarter (36:01) No, I’m good, Louis. Cool.
Lewis Elder (36:03) All right. The first of the two proposals that I put together. So the first proposal is just is going to be reviewing what it would cost to just do credentialing only. So it would not include pay enrollment. So this would be the cheaper of the two options and it would just be us doing essentially the, you know, the credentialing. So doing, the psvs, you would also get access to medallion’s core platform, which is our provider data management platform. So you’ll still have that single pane of glass to manage all of your providers through to hopefully move y’all off of a spreadsheet based workflow. But this, the first proposal that I’ll review here is going to be just credentialing. And then the second proposal that I’ll review will be credentialing plus the pay enrollment. Any, any questions there before I jump in? Nope. We’re good. Okay. Awesome. And all medallion contracts are three years, three year terms. So I’ll run through both like year one, year two, year three and costs for both. And we’ll just kind of we’ll go through those and of course, ask any questions, as they arise. So this is for credentialing only that your total year one cost would be 58, 590. You can see the cost breakdown here. You can see like the unit price and then what I’ve discounted it to.
Lewis Elder (37:28) These are, these are discounts. I haven’t gotten approved yet just because, you know, I don’t know you guys have to tell us, right? It’s a transparent conversation like, you know, if this is totally out of scope for you guys, I understand, if it is somewhat reasonable and warrants further discussion… then I will basically go back to my finance team and make sure I can get this level of discounting to prove. But just so that we can put like our best proposal forward for y’all, I just, I added in discounts, that I believe I would be able to get approved to make it as competitive, as possible. So this would be your year one cost. You have an implementation fee that falls off after year one. And then you have your medallion core cost, tjc credentialing hospital applications and ongoing monitoring. And I’m not including the pair enrollment pair revalidation and caqh management piece there. So this is kind of a paired down version. I’ll pause here. Give you guys a chance to look. And of course, I’ll send this over after the call as well. Any, any questions? There or thoughts.
Acarter (38:32) Credentialing or are you giving credentialing for free?
Lewis Elder (38:35) Sorry, say that again, it.
Acarter (38:36) Doesn’t this proposal does not have credentialing at all or are you including it for free? So.
Lewis Elder (38:42) This, this proposal would be us would be just credentialing. So we would not be doing the payer enrollment piece. We would just be helping you create the credentialing packets, as well as providing the provider data management platform. But, it does not include enrolling into payers. So this would be the cheaper option where we would, you know, because you guys are doing both today, and looking for a solution that does both. So, this is just a credentialing only option here. What?
Acarter (39:12) Is the next one then the?
Lewis Elder (39:14) So, okay. So just to kind of work through, this is year two. It gets, it’s down to 52,000 because the implementation fee falls off in year three. Now, one thing I want to call out before I get to the next proposal is, the quantities change a little bit because it’s you know, there’s the cycle that your providers need to be like revalidated on.
Lewis Elder (39:33) So that’s why some of the inputs change. But then I’ll pause here before I move, I can move to the next proposal. If, if the proposal that includes the payer enrollment as well, if you’d like, but I want to give a chance for any questions.
Latasha Cutaia (39:44) Yeah, I would skip this proposal, go straight to the other one. Okay.
Lewis Elder (39:49) Then the, sorry that’s the three, this is for medallion does everything. So it’d be 113,000 for the year includes the implementation fee, and this includes everything, you know, caqh management, payer, enrollment, payer, revalidation, this is basically like you outsource everything to medallion. So you guys don’t have to handle any part of it… because.
Acarter (40:12) I don’t know if these quantities are exact. I know Taylor had given some numbers once we have the final numbers, would they change in terms of the rate unit price go up or down? If the quantities are less or more, yes.
Lewis Elder (40:32) Yeah, it would change the price. Yeah, because it would essentially.
Acarter (40:36) Multiplier would change, but would your rate change?
Lewis Elder (40:40) I, could you mean, the I’m it depends on what the quantities are, if it’s sorry, Sam, I saw you come off mute. Did you want to? Yeah.
Samantha Bouchard (40:48) I know I was just gonna say, yes, chetna, we do have like volume based discounts. And so if the volumes change drastically, there is a potential for that unit price to change, but, you know, Lewis is happy to update this with, you know, any quantities, that you have. And one thing I do want to call out too is we didn’t include the non clinical like oig, and Sam in here. We, when we did our initial scoping, we just didn’t have a number of what that would cost or a number of how many non clinical employees you would be running through that. I assume it’s a small number and pretty minimal, but just want to call that out. And then, you know, the background checks as I mentioned, Tasha are not included in here.
Latasha Cutaia (41:46) Which I think we can add on once we have another meeting, we can add it in and just update this proposal number before we send it.
Lewis Elder (41:52) Up. Yeah.
Samantha Bouchard (41:53) Absolutely. Yeah.
Lewis Elder (41:55) And, yeah, and chetna to your question, like we’re flexible, right? Like this is our, my best estimate based on the medians I’ve had with y’all but we can always update the numbers. And, yeah, like Sam said, you know, like any software vendor, it’s like, if you want to update them, of course, if they get, if you add in, if the quantities are going to go up significantly, we have additional volume discounts that I can get approved, but we can adjust this however is appropriate, you know, whatever the numbers should be, for your side.
Acarter (42:24) The 113,000 is just because I don’t see the math here. There. Is that’s like column one times column, three quantity times discounted price. Is that how you’re calculating?
Lewis Elder (42:40) Yes, exactly. Yeah. And I can add that. I can add that column in as well when I send this deck over for y’all, but that’s it’s exactly. It’s quantity times discounted price.
Acarter (42:48) Because there’s fair enrollment and I don’t know what you counted, fair enrollment. So revalidation is revalidation. So fair enrollment could be it’s not 225. We don’t do 225 fair enrollments every year. The revals will not be 375. We only have 70 or 80 providers that need to go through credential, so they need to build it. So these numbers are high. So I just want like, I mean, if you ask me what do I feel about this pricing? Of course, it’s way too high. My first gut reaction is that I don’t know if we can afford this. We could hire two people and get it done. And the second piece is that I’m not understanding the calculations or maybe the value column to see what each section is costing us. And maybe that’s what is throwing me off. So implementation sure. I understand 15,000. Thank you for doing that. But the others, I’m not seeing that final number. So maybe we, maybe if you can send me that over with that column added, then I can see what it is because those numbers could be wrong because like I said, payrollment is probably how many new hairs in a year? The.
Lewis Elder (44:19) Way that we got that number from your team was, you know, it’s the amount of providers that you’re enrolling times the total number of payers you would need to enroll them across. So it’s like unique instances of a payer enrollment. And then it would be the same for, you know, for payer revalidation, that was what we got from the team as well. It was like, I think it was like 15 payers each. So we were doing some the multiplication there. But of course, I can change any of these if you think they’re inaccurate. This is just what we got. When we sat down with your team, we filled this sheet out together.
Lewis Elder (45:07) But I can add in chetna, I can, I’ll add in the column that just has the total price for each line item as well. And I’m sorry, I was taking a note. You said you would the payer revalidation, you think would be between like 70 to 80?
Acarter (45:25) How soon… do they get revalidated every year or every two years? We don’t know. So depending on how, what that revalidation interval is, maybe based on that, we have all the payers that are credentialed like providers that are credentialed with payers are about 20. And so, even if they were to do an annual turnaround, that would be 120 maximum, 150, if there are some who are in and out kind of thing. So 150, not 375. Okay?
Lewis Elder (46:02) Maybe we can go ahead and.
Acarter (46:06) Then the payer enrollment is, I’m understanding that should be new. So we don’t add more than 20 25 providers every year could be 30, maybe 40 maximum 50, not 225. Okay.
Lewis Elder (46:20) The.
Samantha Bouchard (46:23) the there though, it’s looking at the number of providers you’re adding times the number of payers that they’re contracted with. So if you add, you know, five providers and you have 10 payers that’s 50 enrollments. So that’s where that 225 is coming from. Yeah.
Lewis Elder (46:43) So if you’re adding, you know, 1,520 providers and you’re doing it across 15 payers, that alone is 300, you know, individual enrollments that you would have to do or that medallion would have to do… so. That’s how we’re getting that quantity there.
Acarter (47:08) Yeah… which is a pretty big number 100 dollars for one application. Okay. Yeah, the numbers are pretty big. I’m sorry?
Lewis Elder (47:22) Sure. No, of course. I appreciate the candidness like we’re you know, we’re here to basically get feedback, you know, and we understand, you know, I certainly understand the position you guys sit in and, you know, it’s my job to try to make something as compelling as I can for y’all, and, you know, I can certainly understand that maybe it would make sense following this conversation to sit down and redo some of the inputs with the team for 15 minutes or so to make sure I have kind of an accurate count. I, I’ve taken some notes here today but I’m just wondering if that would be maybe appropriate just to make sure that I have all the numbers correct as I, you know, put in addition, you know, kind of redo some of, the work here.
Latasha Cutaia (48:09) Lewis, is there a sheet you can send us that we can sit down and have a meeting?
Lewis Elder (48:14) That’d be perfect without?
Latasha Cutaia (48:15) Sending back because, I don’t think that we as a team right now are on the same page. So… I don’t want to, I don’t want to waste your guys’ time either. So.
Lewis Elder (48:26) No, that makes sense super common. Obviously with the groups that we work with. I can definitely send you a sheet where you guys can meet, talk things over and plug in numbers and then I can take it back and update.
Latasha Cutaia (48:37) Okay. I appreciate that.
Lewis Elder (48:38) Yeah. Any other questions? Good, good questions so far? I know obviously, you know, pricing, is a dense subject. I appreciate the engagement and the questions here… you know, chetna from your side. Any, any other questions here? I will definitely regardless, I will create the extra column here that shows the, you know, the math, that adds everything up and I’ll send that over today but questions beyond that?
Acarter (49:06) No, okay.
Lewis Elder (49:11) I’ll move to that just shows. Oops, clicked on the right thing. Year two, the implementation fee falls off. And then year three. Now, like I said, these are different because it, you know, it follows the cycle of like when you need to, you know, recredential revalidate, but obviously, these numbers, once we get new inputs from you guys, I will update all of this and you’ll have new numbers but year one would be the most expensive of the bunch because it includes the implementation fee. And then year two and year three would be pretty stagnant at about 100,000 dollars annually.
Lewis Elder (49:46) Any questions there?
Latasha Cutaia (49:51) I don’t have… any.
Lewis Elder (49:55) Other I’m also interested like obviously, chetna, you’re like, you know, your initial impression was kind of you weren’t sure if the numbers were right? And also, it seems expensive any, you know, I’m here to, you know, take all thoughts that you have. I’d be interested in just kind of, you know, what’s going through your head or what you’re thinking in this moment?
Acarter (50:27) Yeah. I mean, I think… it looks pretty expensive to us. So that’s my feeling especially, you know, that we’ve gone through, we’ve seen provider password that wasn’t it was probably half of this. Yes. And then it appeared what I understood, there was a lot of automation behind the scenes. So, but medallion, I understand. And, it’s a manual process but behind the scenes, someone else is doing it, not us. Yeah.
Lewis Elder (51:03) The difference between provider passport is always going to be cheaper because it is, they are medallion and provider passport are both automating parts of the process. But provider passport will require more work from your team to manage. Basically as medallion is really like, you know, you’re kind of offloading all of it to us. So, we have software and automations that handle all of that, the pieces that provider passport does. But then we also have, you know, humans on our side that are handling the additional pieces that a provider passport won’t handle that your team will have to handle. And, you know, I’m happy to also if you’d be interested in it, I can like put together a kind of compare and contrast, you know, a few bullet points on how we differ from provider passport, but I would say it’s like it’s a fundamentally different offering. There is overlap of course, but, you know, medallion is doing, you know, a lot of parts of the workflow that provider passport wouldn’t be in that you guys will be still managing in house?
Latasha Cutaia (52:04) Yeah, Lewis, if you can just give us that, I know it’s apples to oranges right now in comparison. But if you can just provide a bullet sheet that’d be great.
Lewis Elder (52:14) Definitely can do that. Yep. I just want.
Acarter (52:17) to confirm that price does not include disenrollment. So that is something that we would still do on our own, correct? So you guys would only do the enrollment for that price and then we would just still like somebody here would have to handle that disenrollment part.
Lewis Elder (52:32) Yeah, that’s.
Samantha Bouchard (52:34) correct. So what we’re doing is, you know, you all own the strategy we take on the execution, all of the, you know, all of the submissions through all of the follow up so that as soon as that par status is achieved, you all are instantly notified of that for, the payer enrollment piece and the revalidations.
Acarter (53:04) Okay. All right. I think that’s good. So we’ll look forward to your details. And then we can see what internally we can look at the numbers and those make sense, the accounts and you can meet Natasha and Taylor to figure out the front end part and the psvs et cetera, kind of, and we start with those verifications, and then we can reconnect next week that.
Lewis Elder (53:32) Sounds like a great plan. And just to kind of recapture where we’re at this is like a screenshot of like an internal timeline thing that I keep for myself to make sure I’m doing everything that needs to be done anytime we’re working a deal and making sure that we’re completing all the steps in the process. So today is this kind of what we call a business value assessment. So we go through like, hey, here’s, what you’d be buying here’s. What it would cost here’s, the problem it would solve. And then next is like as you can imagine, it’s going to be you guys like taking an internal review. I will, so a couple of things that I’ll do from today, Tasha, I will send you a sheet that has those questions on it that you guys can take a little bit of time and fill out. You will send that back to me. I will update a proposal and we can meet to review. And then I will also put together kind of some bullet points on how we differ from provider passport as our takeaways. Do we want to schedule a check in next week… while we’re on the line right now?
Acarter (54:33) Can you give me just give me one question? I have, yeah, please, what does the implementation look like if everything goes through and you decide to go with you, what does the implementation process look like? Yeah.
Lewis Elder (54:45) That’s a great question. Sam. I’ll let you answer that one. You’re probably best suited.
Samantha Bouchard (54:50) Sorry, can you repeat the question? Louis? I was just getting things.
Lewis Elder (54:53) So.
Acarter (54:53) If you decide to go with you, what does the implementation look like in terms of effort from our site and funding? Yeah.
Samantha Bouchard (55:03) Jenna, so I actually came over from our implementation team. The way that it works, we can send you a copy of our import template. Since you are all in spreadsheets today, it should be pretty simple for you to kind of transition some of that data over. But data is the key here, right? Once we have that data, we can move and it’s clean. We can move relatively quickly. We typically see an implementation taking anywhere from eight to 12 weeks, but you can start to see value as soon as four weeks for any of your net new enrollments. So essentially, what that means is we get your instance set up. You all get administrative access while we’re loading in the data. You can still create profiles through that process that we looked at for any net new providers that are coming on and you can start getting those enrollments out the door through us while we kind of get all of your existing data up and running in the system. Happy to send over some materials on that. And then also happy to put together a couple slides and, you know, carve out 10 or 15 minutes of an upcoming conversation to make sure you all feel really confident in what that looks like.
Latasha Cutaia (56:21) I do have one question as far as like if we do go with this as far as billing, is that monthly annually quarterly?
Lewis Elder (56:29) Yeah, annually. Typically, if we.
Latasha Cutaia (56:31) can’t swing annually, is there, do we have another option? Yes?
Lewis Elder (56:35) Probably, I can advocate for that internally. It’s a case by case basis but I will advocate for anything that you guys need. And certainly I can work on that. Okay… good question. So, any other questions here on, you know, implementation questions, general questions, I know you guys have decisions to make and stuff, but just want to make sure while we have a couple minutes.
Latasha Cutaia (57:06) I don’t Sam, if you want to email me a couple of dates and times that you’re available, I can check where Taylor and I schedule, we can get something going.
Samantha Bouchard (57:18) Okay. That sounds great, Tasha. I will do that right now.
Lewis Elder (57:23) All right. Do we want to, so we have a couple, I want to make sure I’m kind of recapturing because we have a few threads open here. So, Sam is… going to meet with Tasha to discuss implementation. Sorry?
Samantha Bouchard (57:42) Lewis, we’re going to talk about background check and employee monitoring and scoping. Yeah, thank.
Lewis Elder (57:46) You? Sorry. Okay. Sorry, I’m just writing things down. I would like. Is there a way we could grab time next week to, basically, so I will send over the sheet to add the inputs to, but if we could maybe grab like a time for a check in on, I don’t know Thursday or Friday of next week? Would that work for the team?
Latasha Cutaia (58:09) Sure. Let me just pull up Taylor’s schedule. Okay?
Lewis Elder (58:12) That’d be great. So make sure we’re pushing things along. I can also meet earlier too. I just wanted to give you guys some buffer time to like make sure you have all the inputs hammered down and whatever, you know, whatever conversations need to happen internally, but I can be flexible.
Latasha Cutaia (58:24) Thursday’s probably better. Okay, perfect.
Lewis Elder (58:28) I can do, I can do anything up until I can move. Most of my meetings that day are internal. So honestly suggest something and I can make it work.
Latasha Cutaia (58:42) It looks like chetna is out of the office, Wednesday through Friday next week. So, can we do the week after that? Sure?
Lewis Elder (58:53) Do you want to look at Monday or Tuesday? Let’s.
Latasha Cutaia (58:55) go with Tuesday next week or?
Lewis Elder (58:58) The, or the 20 eighth? Yep? Okay. Perfect. What time would be good? Let.
Latasha Cutaia (59:06) Me pull?
Samantha Bouchard (59:06) Up, we.
Acarter (59:08) have to do this better.
Lewis Elder (59:12) You said afternoon is better?
Acarter (59:16) Yeah, I could do like if we’re going to do after two, I could do like three.
Latasha Cutaia (59:22) Actually three works for us too.
Acarter (59:24) Okay. I could do the tlt too. Yeah, so.
Lewis Elder (59:29) Three eastern on Tuesday, the 20 eighth. Yeah. Okay. And then Sam, you’re going to reach out directly to Tasha and probably hopefully, you know, next.
Samantha Bouchard (59:42) Week? I was just thinking if Tasha has the calendars up for her and Taylor, Tasha, do you want to just look at something for next week?
Lewis Elder (59:49) Yep. Hold on a second.
Samantha Bouchard (59:55) Pretty free Tuesday and Wednesday morning and free three to four, Wednesday afternoon on the 20 second.
Samantha Bouchard (60:12) Also one to two on the 20 second, but then like, yeah, like nine to 12 on the 20 second. I’m open what’s.
Latasha Cutaia (60:19) Tuesday, 20 first.
Samantha Bouchard (60:24) Nine to 12, I have open and then one to one 30.
Latasha Cutaia (60:31) Let’s do nine a. M on the 20 first. Okay?
Samantha Bouchard (60:38) Perfect. I’ll get that set up. Okay?
Acarter (60:45) She had to get on another call, but then, yeah, we’re all set if you want to do three o’clock on Tuesday, perfect.
Lewis Elder (60:51) I’ll send that out and then, Tasha, I will send you those kind of input questions to fill out. I’ll send you that right after this. And then I will also put together some kind of compare contrast versus provider passport as well for y’all to review.
Latasha Cutaia (61:06) Okay. Sounds good. Thank you very much, Louis. All right.
Lewis Elder (61:08) Yep. Thank you guys so much. Take care, folks. Bye talk to you next week bye.