Transcript
Brendan Cherry (00:00) at least… hey, good morning, Angie.
Brendan Cherry (00:16) Hey, Angie. How you doing today? Can you hear me? All right? I think you’re on mute?
Angie Prietofelix (00:26) Yeah. So that’s my phone number. I was trying to connect it. Oh, gotcha. Yeah, give me one second. Sure.
Angie Prietofelix (00:45) There. Okay. That way, I don’t hear an Healthstream. How are you?
Brendan Cherry (00:50) I’m doing really well. Thanks. How about yourself? How was your weekend?
Angie Prietofelix (00:53) Good, good. It was pretty good. Actually, I did not start the week off. Well, I had a pretty bad stomach bug at the beginning of last week, so much better now.
Brendan Cherry (01:07) Yeah, no, it seems to be going around a little bit. My wife was kind of feeling that yesterday and some other folks. So I don’t know, I don’t know what’s going on in Miami, but hopefully it goes away.
Angie Prietofelix (01:21) Yeah, that’s what I heard, you know, after the fact, it’s like it’s going around. I’m like.
Brendan Cherry (01:27) Yeah. But then again, I feel like people always say that when something happens, maybe it’s just the way it is though. Who knows? Yeah.
Angie Prietofelix (01:34) Well, I kind of believe it though because I’ve heard of some people even like a cousin of mine, I hadn’t heard from her in a while and she was like, I’ve been sick with this stomach bug and I’m like, oh, so it’s a thing?
Brendan Cherry (01:46) Yeah. Well, do you have any good plans for the summer? Anything good coming up?
Angie Prietofelix (01:53) No, I have a bunch of family stuff going on and weekend trips and stuff like that. So, I have a pretty big trip coming up in the fall and so we’re holding off for that all.
Brendan Cherry (02:06) Right. Excellent. So, fall big trip and then a lot of weekend stuff excellent.
Angie Prietofelix (02:11) Yeah, yeah, yeah.
Brendan Cherry (02:12) I, yeah, I just want to say, thanks for.
Angie Prietofelix (02:14) Finding some time. I know you had some questions on like what Sergio’s team and his role is for your presentation? I think next week.
Brendan Cherry (02:25) Yeah. So I’m glad we got that sorted out. It looks like there’s you know, like a number of people invited. I have a couple of questions but, you know, broadly speaking between, you know, I’m just going to list like folks like Miriam Barbara. Of course, Ashwin, I’ve met before Sergio, you know, yourself, Talisa is like just wanted to kind of like get a broad sense of like if there are any, you know, expectations, you’re aware of anything. Anyone have anything in particular of particular interest that they want to see, just kind of get your lay of the land, so to speak. So we have, you know, so we prepare, you know, a good conversation for next week.
Angie Prietofelix (03:08) So, I know that it’s split into it’s, one department as a whole. But I know that it’s split into the hospital and then the pro fee side. And so the hospital does the contracting obviously for all of our facility locations and services and they work together with our billing team to determine how are we going to bill this? So that they know how to credential it? So that’s one piece of it. And then there’s another team like I said, that does the pro fee side of it. And the same thing. They want to know the types of specialties that we have and the providers, their locations on where they’re going to be, and making sure that all of our locations are credentialed with the payers and they negotiate some contracts and stuff like that for our reimbursement. And what… else was I going to tell you they do that? And then they obviously enroll and disenroll every single month based on whoever leaves and onboards. Jackson. I don’t know how big that team is. That team is probably about four people. Maybe the managed care team is probably about the same on the hospital side, probably about the same. So in total, probably like 10 people, I kind of want to give or take right? A little bit sure. I know that they have challenges in enrolling our Ed group. I don’t remember the specifics behind that, but some of the payers don’t want to enroll the Ed. So that might be something there, but I know that team is evolving and they’re doing quite a bit and looking into like value based care. And… there was something else I wanted to talk about. It was value based and I don’t know why I’m drawing a blank right now, but I know that they’re evolving. They’re making a lot of changes. Yeah, I’m sorry. Oh.
Brendan Cherry (05:04) No, I’m sorry, go ahead. I didn’t mean to interrupt.
Angie Prietofelix (05:08) Oh, no, no. That’s okay. I thought you were going to give me the clue of what I’m missing for that word?
Brendan Cherry (05:12) No, I wish I could. I wish I could be more helpful.
Angie Prietofelix (05:18) Oh man. What is it called though anyways? They, and so we also hold like our monthly meetings, with our payers like our provider reps and stuff like that. So they coordinate that and that team and I know we’ve been kind of maybe making a bigger push towards that. So, I don’t know if this would help them and they’d be able to kind of get away from like the paperwork or having to do the individual one offs and stuff like that. I don’t know, but I think it would be good for them. I work with them closely but I don’t do their work. So, I don’t know 100 percent. I know that they are dependent on when we do a new location, the mpi, medicare and medicaid. So when my part is over, that’s when they kick in. Okay? So it kind of would be great, right? To do a little cohesiveness and kind of work it all together. But that’s pretty much it, it’s just of what they do. Okay? From my perspective, from what I know, so.
Brendan Cherry (06:19) You were saying there’s like, I don’t know if I heard you correctly, like pro fee?
Angie Prietofelix (06:25) Yeah, like the professional, like the professional billing for the fee. Oh.
Brendan Cherry (06:31) Okay. Got you. All right. I just wanted to make sure I understood the term. Yeah, it seems like, you know, the team that’s assembled would probably touch or overlap on like a lot of the things that we do. I guess, you know, when you think of like right now we’ve been very focused on like the facility enrollments for medicare and medicaid, you know, we do that for commercial payers, and then we do these sort of provider centric things licensing ncqa or tjc credentialing, hospital applications and payer enrollments. Is there anything in that sequence that maybe you have some understanding is, you know, taking longest or where things kind of get tripped up or something there that we should, you know, kind of pay particular attention to as we, yeah.
Angie Prietofelix (07:18) I know that they, so we just opened up a diagnostic center and some payers kind of gave us some pushback on that and we had to kind of figure out which taxonomy et cetera. And I think there’s still one or two payers that are still like stragglers that still have not even credentialed that location. So, I think that if there’s something in your workflow that can assist with that and kind of make life a little bit easier, that might, you know, kind of be a good selling point for them. Yeah. But that’s pretty much what it is. It is the facility enrollment with the locations we do have. We are expanding our footprint, you know, in the ambulatory world. So there are going to be quite a bit of locations that are going to be coming up that will need to get enrolled. And I don’t think that that’s just like a one time thing. I think that’s just going to be ongoing, sure. So I think that would be able to help. Yeah.
Brendan Cherry (08:16) You know, I was thinking about it like south Florida is growing in general. So the hospitals… that support it must be as well. And it seems like you guys are experiencing that. So out… of maybe one thing that will help me kind of get a sense of the dynamic, you know, obviously working with you and Ashwin in New York, it seems like there’s been a lot of focus on the facility side. Is there anyone attending that’s more focused on like the physician credentialing as well or physician enrollments and so on, who’s that?
Angie Prietofelix (08:50) Yeah. Let me see and remember, they’re all in the same team. They’re just kind of broken out a little bit sure. It’s on the 20 seventh, right?
Brendan Cherry (09:02) 28 27. Yeah.
Angie Prietofelix (09:03) What?
Brendan Cherry (09:04) Date?
Angie Prietofelix (09:04) Is it, it’s.
Brendan Cherry (09:06) like Wednesday or Thursday, something like that? Yeah.
Angie Prietofelix (09:08) It’s Tuesday, actually, it’s Tuesday? Oh.
Brendan Cherry (09:11) Tuesday? Okay.
Angie Prietofelix (09:13) Yeah. So, okay. I don’t see anybody from the facility side though there, I see. So it looks like they just gave you. So they gave you Ileana Alvarez. And so what she does is that she does the corporate credentialing and that is credentialing our providers to be able to work at Jackson. So that’s we use the word credentialing, but you know what I mean? It’s a little.
Brendan Cherry (09:41) It gets used for a lot of things. Yeah, sure.
Angie Prietofelix (09:45) Right. So, Ileana Alvarez only does the credentialing for Jackson, you know, ensuring their licensure, things like that and getting them access and set up credentials with Jackson so that they can work with Jackson. You know, who Barbara is. And so she’s overall, she’s the chief experience officer at the moment. But before that, she was over the managed care team. There’s someone else there now. So she may have extended the invite or not to him. His name is John harkins. And so Sergio and Viviana that are on the invite, Viviana works for. Sergio works in the managed care department. And so they do the provider credentialing every single month with the payers in addition to credentialing locations to add locations to certain contracts as well.
Brendan Cherry (10:42) Okay.
Angie Prietofelix (10:42) Whenever we set up, but they do only the prophy side. So they work on the individual doctors and enrolling them with the contracts. And then they work with our contracts and then adding new location, new prophy locations or a Jackson location. But to our prophy side, if we’re going to do any prophy billing out of it.
Brendan Cherry (11:06) Okay.
Angie Prietofelix (11:08) Did you remember? No, that makes sense. And then the location we do the facility billing and prophy side, sometimes we only do prophy. Sometimes we only do hospital billing. So that’s kind of where the team kind of breaks up like that. But let’s say it’s a location where both the facility and the pro fee is gonna be billed. So Sergio will take on credentialing that location for the pro fee side of the house. And then the other side of the managed care team takes care of credentialing for the facility side. If it’s only, you know, facility, then Sergio is hands off if we’re not gonna be doing any billing out of there.
Brendan Cherry (11:48) Yeah. But.
Angie Prietofelix (11:50) If, well, actually I might take that back.
Angie Prietofelix (11:53) He may just do it all only because the facility side may also get some denials. If a provider’s not credentialed for a specific location. I take that back, you’ll get that specifics directly from them on Tuesday.
Brendan Cherry (12:09) Yeah, no, that’s fine too. Yeah, it’s good to know who may be, you know, most interested in what, and, you know, a lot of like a lot of times, you know, customers work with us for, you know, like maybe a handful of reasons. Typically, it’s you know, getting providers billable quicker. And ultimately, that means, you know, getting them through whatever process like the actual internal credentialing, the payer enrollments, getting them assigned to the right groups of facilities, in some case, hospital applications. And, you know, a lot of times this is driven by like, you know, growth whether it is provider hiring or churn or, you know, new facilities. So, you know, this is maybe information that comes later in working with you guys, but getting a better understanding of what those timelines look today, what the payer mix is. And so on, more importantly, I’m just kind of curious like, you know, who kind of oversees what, and what may be most interesting.
Angie Prietofelix (13:07) To them. Yeah. And sometimes we’re told like, yeah, we’re opening something starting like may first and today is April twentieth.
Brendan Cherry (13:16) Yeah. So you,
Angie Prietofelix (13:19) know we have that because sometimes it’s like, well, hey, you know, we’re going to try and we’ll see if we can get it in but, you know, and they’re normally pretty good about it, but I don’t know what burden that puts on their team. Yeah, right. But that might be something because sometimes we know ahead of time and we’ve tried to get the information ahead of time, but there’s sometimes that we just don’t.
Brendan Cherry (13:42) you know, yeah, I remember you saying that, yeah, is there any kind of centralization of this information today or anything that, you know, systems that you guys are using to track?
Angie Prietofelix (13:52) We’re trying really hard but it’s not. And the way that I suspect and I don’t know for certain is like when we start our piece with you guys, I’m probably still going to be like the central person that it gets funneled through and I’ll be the one forwarding and feeding you guys the data.
Brendan Cherry (14:11) Yeah, very possible. Yeah, that’s still to come. It seems like maybe we’re getting pretty close to getting like the red lines and everything. So, hopefully we’ll see something back this week.
Angie Prietofelix (14:23) Yeah, there’s just a lot going on I.
Brendan Cherry (14:26) Would imagine.
Angie Prietofelix (14:27) Every department, every area is just being pulled a 1,000,000 different ways. So.
Brendan Cherry (14:32) Yeah, I would imagine. It sounds like, I think, yeah, I think I saw is your CEO leaving you’re. Getting someone new.
Angie Prietofelix (14:42) Yes. Well, he’s not new. He’s been part of Jackson for over 15 years and he’s worked his way up through the ranks. So he’s already here and he’s been here in another capacity.
Brendan Cherry (14:52) Yeah. I think I had seen that. I forgot where he was coming up from, but yeah, new to the role. Sure. Well… Angie, maybe you’re next or maybe another 15 years, who knows?
Angie Prietofelix (15:06) We’ll see.
Brendan Cherry (15:09) It’s probably a stressful gig. I’m sure.
Angie Prietofelix (15:13) I’m sure I got offered at a prior organization, something in the C suite and I was just like, I wasn’t ready. I don’t know if I’m still ready. Sometimes I’m in that phase of like, I don’t know what I want to be when I grow up, yeah.
Brendan Cherry (15:28) I hear you. How long have you been with Jackson?
Angie Prietofelix (15:32) Seven years?
Brendan Cherry (15:33) Seven years? All right. Well, I’m coming on four months or so here, but it’s been exciting. It’s a good team not.
Angie Prietofelix (15:41) Going to lie. I kind of thought it was your own thing. I thought it was yours already. I thought it was your company.
Brendan Cherry (15:48) No, no. Far from it. Far from it. That is a gentleman… by the name of Derek. He’s pretty sharp. But, yeah, we’ve been around for a while but it’s you know, it seems like over the past couple months, it’s really started to grow. So it’s been exciting to join at this time. Yeah, what?
Angie Prietofelix (16:10) I would say. And I think having Jackson at, you know, join in. I think it’s a great thing, right? It definitely gives you guys a lot more exposure as well. And then just the possibilities are just endless. So… I think honestly just get to the meat and potatoes, the simplicity of your app, you know, how it’s all like centralized just the forms are here. If something new or any updates, then, you know, provide them to us but you won’t have to provide them again. You know, you just tell us hey this location address and you guys take off from it. Yeah, if you keep it with that, I think it’ll be okay. No.
Brendan Cherry (16:46) That’s really great advice and I appreciate it. I think, you know, with a large group, it’s good to kind of, you know, to your point kind of like cut to the chase and then, but, you know, it’s helpful to maybe get an understanding of what, you know, from my mind different folks might have. So I appreciate you taking some time and that’s really it that’s all the just, you know, insight I was looking for. So I really appreciate you taking a couple minutes. Hopefully, I know like my colleagues really want to come to Miami. So, hopefully, you know, this goes well and we can come visit you guys in the not too distant future. Yeah.
Angie Prietofelix (17:20) I mean, I’m sure if they do, they’ll probably want you to go to river landing because it’s our newest office space and it’s really nice over there, but it takes away from like being on campus and really seeing and this is just our main campus, right? It’s just one location, but you’re here and you’re like, wow. Okay. Got it. You know, because everybody kind of knows Jackson city, you check it online. There’s nothing like when you’re on campus and just seeing all the buildings, all the different stuff going on and just to even just walk the campus just a little bit, I think it takes away from that.
Angie Prietofelix (17:52) So hopefully, I’m sure they’ll have you go to river landing, but hopefully they do a quick tour here just so you can kind of understand the dynamic of it and why there’s not a centralized, you know, it’s too much.
Brendan Cherry (18:04) Yeah. Well, hey, you know, river landing, I’m sure, you know, we can maybe make a case for the campus but maybe it’s mostly for patients. So I don’t know we’ll see. Yeah.
Angie Prietofelix (18:16) Well, I’m here now, so.
Brendan Cherry (18:18) Yeah, we.
Angie Prietofelix (18:19) come in every now and then, so.
Brendan Cherry (18:21) Excellent. Awesome. Well, Angie, like I say, thank you again and I.
Angie Prietofelix (18:27) suppose we’ll see you next week. Any questions at all that you have? Yeah, any questions at all? Anything that you have? Just feel free to shoot me an email. Don’t worry about it. Just tell me, hey, you know, want a quick question or follow up then that’s fine. I’ll find time.
Brendan Cherry (18:39) Absolutely. That’s awesome. I appreciate it. All right. Have a good one. All right. Take care, Angie.
Angie Prietofelix (18:46) You too. Bye bye.