Transcript
Amy Barfield (00:00) hi, Kay. How are you? Hi, how are you?
Amy Barfield (00:08) Good. Thank you. Hi guys. How are you?
Amy Barfield (00:19) Thank you.
Nate Rosenthal (00:34) I will be on camera in just two minutes, just.
Amy Barfield (00:36) Fyi for everyone. Okay?
Amy Barfield (02:06) Hello, Vikas?
Vikas Bhalla (02:07) Hello. How are you?
Amy Barfield (02:09) Good. How are you today?
Vikas Bhalla (02:11) Good, good. So, I think I see Kristen. I see Jeanette. Do you have your team?
Amy Barfield (02:20) We, do we, do we’ve got Kate, Amy and Derek on the call today.
Vikas Bhalla (02:26) Okay. Well, I saw Nate for an introductory call after that. He is missing the action. Here he goes. Oh,
Amy Barfield (02:31) wait, there he is.
Vikas Bhalla (02:34) I’m missing you, Nate. Thank you for joining.
Nate Rosenthal (02:36) Ah, yeah. Sorry, I was flying 30 hours to India last week during our call, so, I would have much rather been on our call.
Vikas Bhalla (02:45) That’s true. Well, thank you for joining. All right.
Amy Barfield (02:50) All right. Let’s go.
Amy Barfield (02:51) Let’s jump in. Okay? So this week we are down a total of 18 overall… but we’ve got some moving this green moving into these buckets. So that’s why it looks a little low. I think we’ve completed a little over 50 at least in total. But these greens are moving into the yellow. So that’s why this is up. And then we had about 22 to 27 that moved over here. And so that’s why that number is only at 18 this week. So overall, these are the numbers as of this morning. So they went down a little bit from Friday when I sent you the report. So at 150 plus, we’re at 314 92 at 121… 87 at 90 to 120. We also included those days that you wanted to see with a total of 18. So we’re at 593 total. And then when we break down to your four states, these did rise a little bit. I’ve asked the team what rose in these particularly, these two states. And that was the amerihealth and the hchsn. And this week, we’re… working to get in contact with the amerihealth. We have contact with the amerihealth rep. So we’re working to set up a call with them to see if we can kind of reduce that and get some approvals on their side and just streamline the process. So it went up from 21 from last week. For those, this is the estimated completion date that you requested last week on our call. So for April, the estimated in this right here is 21 in total right now. I think it was at 477, but that was for like total overall. So I’ll have to get the number of just based off of the 90 plus where we’re at. But I believe that we’re like around the seventies on total completed for the 90 plus. So we’re still ahead of schedule there. So next month our total is going to be around 187 is the estimated. Do you have any questions here? Yeah?
Vikas Bhalla (05:10) Is this for? Okay, this is for 90 plus request completion. Yes, yeah, this is very concerning, very, concerning. Like I just can’t accept this plan. It’s like, I’m so upset that I want to stop the meeting. Now, it’s like these are 90 plus days and 70 percent of those you are saying, it will be only done by August, you know, which is we are talking about April, you know? So we are planning for a scenario that for these to be like 360 days, 400 days.
Amy Barfield (05:48) I think these are just estimates based on past… but the goal is to have a higher number than what’s listed. I,
Vikas Bhalla (05:56) want you to be honest in terms of what it will take. And if this is the honest answer to the question, I’m actually very disappointed and very, I don’t even know what to do because like if you go, if you have like these 500 enrollments go in August, I miss my budget and I definitely can’t see all you as a partner going forward.
Amy Barfield (06:24) Okay. We’ll reevaluate this internally and get you a plan of action.
Amy Barfield (06:36) So, these are the states that we reviewed last week of those higher payers that we’re reviewing for… each of these states with the highest 90 plus. And then here’s the state count that I sent you in your email on Friday. So you can click here and also see that here… and then… still working with Kristen and Jeanette on those term providers, updating group profiles so that we’re getting clean submissions the first time and correspondence New York medicaid. We’re still working to get those completed. I think this number has gone up since last week. Independence. I sent communication to Jeanette and I believe she’s sent those along to those contacts at independence to try to get those 21 providers approved. And we’ll review those again on Wednesday on our weekly sync sunshine health was updated. There’s 55 completed there with 60 remaining in follow up anthem.
Amy Barfield (07:41) We did get those group analysis, our analysis lines requested last week. And so our team is working on those this week so that we can move forward on the anthem and blue cross blue shield 90 plus amerihealth, caritas. We’re working with the rep to set up a meeting this week to streamline that process. MVP as we discussed, we can only submit one tax id number at a time and submitting those demo requests once that one tax id is approved. Cdphp, we were able to complete 37 providers last week and I sent a list of pending signatures of providers that we need to Jeanette on 417.
Amy Barfield (08:26) So I’ll check in with her on Wednesday to see where we’re at with those signatures for the qaqc reporting that you requested. I did list here just so you can see week after week, what was mentioned in our email? But I know Kate and Derek are working together with Nate to get you some additional reporting. Do you want to talk on that, Kate? Yeah?
Kateland Sanders (08:53) So a couple of things we’re working on is to be able to share what QC files are funneling in weekly, just right now that’s an internal report. So we’re working on somehow setting that up. So you will see that weekly. I know we talked about the percentages that are funneling in. And to your point, you can’t see what is a new hire, what is medicaid? And then the other ones that we’re adding in. And so Jen and I are working on that with Nate on how we can get that to you weekly. My thought was we would just send it on Monday for the week before of what lines went through QC for the QC piece?
Vikas Bhalla (09:25) Yeah, that makes sense. And then just a couple of things Janet was telling me earlier on the call about the, you know, last time you all mentioned that the time for us to complete the provider application is about 50 days and apparently the report got changed and now it says it’s eight days. So which one is it?
Amy Barfield (09:49) So before it was based on an average over entire time and so they updated the analytics to where it gives a median date. So now you can change it to like the last six months or the last 12 months. And so when we were looking at those analytics on Wednesday, it’s come down. And so we have like I think in the last six months, it’s like eight days.
Vikas Bhalla (10:13) It’s okay. So eight days is pretty good, right? When you compare to your other clients.
Amy Barfield (10:17) Would you say, yeah, yeah, yeah. So.
Vikas Bhalla (10:20) I would like to, also, once you have that file, I don’t know if it’s Kate, you or Amy like to see the second part of that, like how long does it take? You know, once for the new hires only, how long does it take to get enrolled for the one which we already have received enrollment, right? Like, so essentially, so that we can calculate our average… time to revenue?
Amy Barfield (10:44) Right.
Vikas Bhalla (10:46) For new hires? Okay. All right. And then second, Janet, you want to talk about the email issue we were discussing earlier today?
Janette (11:01) Well, Amy, I know that you were going to get back to, we talked about last Monday, you getting back to the team, finding out if we could have someone dedicated to our account. Do we have any progress on that? Any feedback? Well?
Amy Barfield (11:18) Our director was out with Nate. So last week and so she returns tomorrow, I believe. So I plan on setting some time up with her to discuss like how we can get, maybe have a dedicated person right now, the account specialist though she understands this is an issue and she’s been monitoring the email and trying to catch what she can.
Amy Barfield (11:40) So she is reviewing those daily. If there is something that you see you’re more than welcome to shoot me an email and I can get have her jump right on it.
Janette (11:51) Yeah, I’ve sent you a few already and optum I’m working directly with now they’re sending the contracts directly to me because they’re time sensitive. So I’m forwarding them to you as I get the contracts, right? So that you can file and know that you can change the status on it. But right now, it’s an additional workload for myself because I’m having to take on, you know, that role of making sure that the contracts get signed. But at the end of the day, you know, I just need to make sure that it gets done timely. And so I agreed with optum that, you know, this was another alternative to we get the email under control.
Vikas Bhalla (12:31) Yeah, sure. And but let me let’s just talk about the issue that you’re trying to address Janet.
Vikas Bhalla (12:38) You know, what, the reason why Janet is asking that is because she has seen a pattern of payr sending you emails and you are not responding in a timely manner. And because of that, we are missing the filing deadlines. It goes back to the start of the tapes and which is probably a root cause of some of these issues. And it is continuing. today. Even apparently last two weeks, you have got emails from payr that nobody responded in a timely manner. So I would like to understand who is responsible for this. You know, is it people on this call or somebody else? And, you know, and why is that happening? And what’s you know, like. And Janet’s idea was we should like shouldn’t go into like a generic inbox and it should at least for the time being to resolve it, make it dedicated to PM pediatrics so I don’t want to design a solution for you, but I’m really concerned if that’s still happening with what Janet told me?
Amy Barfield (13:38) Yeah, we do have a dedicated email box for pmps and we have a triage team that adds these emails as they come in to the specific requests. But there is a gap somewhere and I do have some ideas of my own, but I have to discuss that with Nicole and maybe even Nate on how we move forward with having a resolve to this issue. Yeah.
Nate Rosenthal (14:02) We are, also, we’re doing some work on the engineering side to improve the visibility and the consolidation of multiple kind of responses to a single thread because we have an issue right now within the system where the visibility is not quite there. It’s not easy as the team member to actually see what’s a new email coming in and what’s an outbound that we’re sending. So that should help in one way. But then we also should dig in with the team to understand what the workflow looks like and how we can ensure that they’re staying on top of this work.
Vikas Bhalla (14:31) So, who’s so, who, so do these people, Amy report up to you or there’s a separate team?
Nate Rosenthal (14:39) This reports into our payor enrollment director. Nicole. So Amy works directly with Nicole and her team.
Vikas Bhalla (14:47) And so, Nicole, she has a team of people who’s responsible for all clients.
Nate Rosenthal (14:56) Correct. But individuals that are focused on your account as well.
Vikas Bhalla (15:03) How many people do we have focused on our accounts dedicated?
Nate Rosenthal (15:08) I don’t have to get, I would have to get that data. I don’t know how many people, yeah.
Vikas Bhalla (15:15) So, I’d like to know that because apparently we don’t have anyone. And if there are people dedicated to our account and there is a dedicated email, then yeah, system can improve the visibility, but this issue should not be there. Then, you know, if somebody has a direct email and then they are dedicated to PM, then we shouldn’t be facing this issue.
Amy Barfield (15:40) I’ll get a number.
Vikas Bhalla (15:41) Yeah. Again number is less important to me. I just ask to see the gravity if you have one person or 10 people, but all I’m saying is, you know, like, you know, like it’s unfortunate, I have to have so many of senior leaders of Derek on the call including Derek, sorry of Medellin on call including Derek and these issues keep on going on. You know, we are not even addressing today, you know, and I don’t see a way out of this, you know, help me help, you know, like I’m very frustrated. I’m sorry… sure.
Amy Barfield (16:17) We’ll work this week to have some internal calls now that everyone’s back. Yeah. And.
Vikas Bhalla (16:23) let me just be very clear, Amy, this is not your issue. I’m just, I want to highlight that and I think it’s a process issue. It’s an ownership issue from my perspective. And I’m like, you know, you have been extraordinarily responsive whenever we send out anything, right? So it is, I am just questioning if, you know, like we are number one, you know, as a medallion or as an organization have the right processes in place to meet the commitment that we have made. And second as PM, as a client, you have your right attention. I see Derek on call every week. No other CEO does with me, but I don’t know if that follows through the organization chain.
Nate Rosenthal (17:06) Yeah, I would say that’s my main focus right now is like, you know, coming in understanding and that’s why we went to India is like understanding all the detail of what’s happening based on, you know, on the ground versus what the expectation is here and diagnosing across the organization, those opportunities to streamline improve, ensure people are following the process, ensure people have clear responsibilities, clear owners and that we’re holding them accountable to it. So this is my top focus across the company but also on your account specifically.
Janette (17:39) Nate, I think it’s important to also reiterate the training and them understanding the fundamentals of who we are, what we do, who the owners are, so that they don’t fill out erroneous information such as again with Optimus, the most recent one that I have that one of the support team members used one of the providers as an owner, filled it out incorrectly. And it got to the point where the optum rep doesn’t even want to deal with medallion at all. And so, I think that, you know, it’s an educational opportunity, you know, for them to even reach out and ask questions if they’re unsure before they fill out a form. So as of right now, Amy and I, we agree that any kind of doo, forms need to come directly to me to avoid any, you know, potential hiccups.
Nate Rosenthal (18:32) Yeah, fully aligned with you on that too.
Vikas Bhalla (18:35) So, thank you. And I don’t want to add more meetings, you know, because I would rather have you all spend time solving this.
Vikas Bhalla (18:42) But Janet and I talked about it. You know, we are meeting as a group every week but Janet is available to set up like a daily call with you, Amy and Nate, right? Like almost to go through issue by issue because we have a lot of issues we cannot discuss in these 30 minutes calls. And I know you meet on Wednesday. I doubt if those Wednesday meetings are enough or you come up with an action item that weighs for another meeting. So what I’ll encourage you all to think about Nate, you know, it’ll be good if you can be there. Maybe you and Amy and whoever else you think is needed. And from our side, we’ll have Janet and maybe Christine as optional whenever she’s needed and be on a daily call, you know, to solve these issues like the optum one got escalated to me, you know, this is strategically, so important for us. You know, in behavioral health, we just had an acquisition. We are expanding in new states and optum is the pair we are going after. And then I found and I was asking about why it’s getting delayed. And then I’ve and the first response was provider has not completed information. And then we dig deeper. It was, it went to the wrong person. You know, it went to the wrong. The form was completed incorrectly by medallion. So, so those things really frustrating. And then I would rather not wait for the week to discuss this on this call. I would rather have, you know, people who can resolve this with Janet and Christine from our end and whoever Nate you think from your end, you need to solve this, you know, make an issue log, do it on day by day basis. Yeah. So, you know, Amy, you’re going to take that up and set up a daily meeting. Please keep me as optional. I’ll join whenever I can, but don’t have to wait there with me.
Amy Barfield (20:25) Yeah. I’ll meet with everyone, see what times work best and we’ll find a time to connect. Yeah. And.
Vikas Bhalla (20:32) The goal there is not to again go through the same report goal is to create an issue log just like we discussed and like who’s the following up? What’s the action item? I expect to see a very detailed spreadsheet of, you know, at a payer level at a provider level and somebody just for, you know, like addressing those on a day by day basis. Sure. Okay. Perfect. Anything else? Janet? No?
Janette (21:02) I think, you know, Amy and I have the weekly meetings and, you know, we try to cover as much as we can and if I don’t I just send her emails on a daily basis as well.
Vikas Bhalla (21:13) Yeah, no, that’s right. I think those are good, but I think we are at a crisis stage.
Vikas Bhalla (21:17) Daily meetings, don’t weekly meetings won’t work because we are meeting at a weekly level. I would have people meet daily, you know, to just increase the frequency of interaction. So, and get the focus back on the people who can solve this.
Janette (21:33) Okay. Yeah. And.
Derek Lo (21:36) Then I guess just fyi, I’m looking, I was already messaging some of our team to look into why the projection report is saying we’re going to have so many, you know, back weighted into August because I, yeah, to your point, I mean, I don’t think that should be the case based on, you know, what I’m seeing in terms of how many have been, you know, what the distribution is in terms of 90 plus, you know, to 150. So, yeah, we’ll get that hopefully midweek for you in just a couple of days on why that.
Vikas Bhalla (22:05) You.
Derek Lo (22:06) know, math was showing that and what we think is whether that’s realistic. And if it is why, and if not, you know, what the reason is. Yeah.
Vikas Bhalla (22:14) No, thank you, Derek and I encourage you to maybe include even 60 plus there because very soon 60 will get into 90, right? So that you can start if you add those 304 100 enrollments. I think the number adds up to close to 1,400, which is a lot, right? So, so because it’s, I think if I remember correctly, I mean, you’re right? It is like close to 1,000, which is 90 plus. And there’s another 354 100, which is in that 60 to 90 bucket. So.
Derek Lo (22:41) Yeah, technically, I mean the ones that are at least work that we are working, it adds up to about 600. And so then if you add in the 60 to 90, then it’s a 1,000. There’s there are some lines that are in statuses that are not technically currently owned by us. So either with the payor or in statuses that where we’re waiting for something from pmps. Typically, I think like an on hold status. So I think the 1,000 is the core of what is workable in the 60 plus bucket. And then if you look at, if you look at, you know, completions on a monthly basis, we’re just pulling that. I think that still is looking, you know, fairly healthy. So, yeah, I was just looking at the completed. So.
Vikas Bhalla (23:36) I’m confused. I thought payr’s bucket is your bucket also, right? Derek, like if you’re following up with payr, it is your bucket.
Derek Lo (23:43) That, yeah, 100 percent that is correct. There’s just this other bucket that we have. There’s only 100 lines in it. And so we should go and we can figure out, what makes up those. But Kate, maybe, you know, it’s just in our age line chart right there. Yeah.
Vikas Bhalla (23:58) I’m just pulling up this spreadsheet which Amy you sent on Friday, which is actually a very good spreadsheet. And this is what I’m using and I encourage you all to use that if you’re doing the daily meeting. So this has all the aging by payer status and, you know, and state, right? And this is what Derek, I was looking at, the total was 1,396. This is 30 plus days. If you take 30 to 60 out, it still goes to 1,000.
Vikas Bhalla (24:28) Because we’re including the 60 to 90 as well. In that, yeah, that’s what I was saying. If you take 60 to 90, you’re right? So if you include 60 to 90, then it is close to a 1,000.
Derek Lo (24:39) Yes, correct. Yeah, that’s right? I misspoke.
Vikas Bhalla (24:44) So, that is 60 to 90 includes 1,000 without 60 to 90, it is close to 600, right? Yeah. So, yeah. And I also wanted to pull this. I actually like this spreadsheet a lot, right? So this is what I meant by going through each line item so that we don’t miss any, and making sure we have the right sale.
Vikas Bhalla (25:02) So it has state level status, pair name, and then aging by each of the states, right? So… so again, I’ll be, I have, one of the reasons why I requested Janet to set up this call is because I, in my internal meeting with Janet, I am requested her to provide me update of this spreadsheet every week, you know. So, so anything that you need from me or from our team or anything that you see a progress, please make sure she’s up to date so that we can review this internally. So, and we are following and we are, we’re using the same spreadsheet and not two different spreadsheets. Okay? All right. Anything else from anyone? No. All right. Thank you so much. Thank you. Okay.
Derek Lo (25:55) Thanks a lot. Thank.
Vikas Bhalla (25:56) You.