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00:00:01
Ricky Overton, Inspired Physiotherapy
20 Plays8 months ago
In this episode, Steven sits down with Ricky Overton, Director of Revenue Cycle at Inspired Physiotherapy
Learn more about SaRA Health: https://www.sarahealth.com/
Check out Inspired Physiotherapy: https://inspiredpt.org/
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Transcript
Introduction to The Disruptors Podcast
00:00:02
Speaker
Welcome to another episode of The Disruptors, where we're arming you with the tools you need to innovate within the physical therapy space by highlighting those who have come before you. I'm your host, Stephen Cohen. Now, let's get into it. Everybody, welcome back to The Disruptors podcast, where we are highlighting people who are disrupting the physical therapy industry for the better.
Introducing Ricky Overton and His Expertise
00:00:23
Speaker
Today, I'm joined by Ricky Overton. Ricky and I have worked together for, gosh, what, six months now, but if you count when we started talking,
00:00:31
Speaker
you're like 18 getting getting closer to did two years. um i I have been so impressed by your determination to get your company paid. um I have been so impressed by just your knowledge of the rev cycle space and how you can do different things across different payers and whether it's motor vehicle, whether it's work comp, whether it's commercial, commercial Medicare Advantage and the understanding. So i I'm extremely excited to have you on today because I want to
00:01:07
Speaker
pick your brain and give others who may be struggling more on the ref cycle side both generally but also specifically for the remote therapeutic monitoring codes a ah chance to hear it from from somebody who as I've seen across ah you know we'll call it hundreds of of examples a a a speaking on a hill, what we'll call it. I hope that doesn't make you blush too hard, but with that, ah Ricky, I'd love if you wouldn't mind giving it a just quick little intro on yourself and and then we'll we'll get into it.
Ricky's Career Journey to Revenue Cycle Management
00:01:44
Speaker
I've been doing ref cycle now for about 13 years, started from the bottom up and worked all the way to the director of revenue cycle. so
00:01:53
Speaker
going through hard knocks to get here and through the trenches. And by that, through those each steps, I've had great mentors and and people sharing knowledge. And that's been the key to the success, is sharing the knowledge and the one-offs to learn from. I'm with a startup right now. We have two clinics getting ready to open two more clinics this year.
00:02:21
Speaker
and hopefully two more by the end of the year we're shooting for. So we're a growing company and building processes and trying to streamline revenue cycle to the best that we can and get ultimately to get patient care. I love that and and appreciate that that's so much. and you know what led you to the world of Revcycle? If you wouldn't mind giving a little bit of of the the why behind it um and i know I know this but I think it's it's worth everyone else knowing as as well. So I come from the hospitality industry. I owned a restaurant in nightclub, sold them and I had a young daughter and decided that I needed a 9 to 5 job and I figured medical billing would be around
00:03:14
Speaker
indefinitely. So I got my foot in the door and started verification, learning that process and took it from there. So, you know, soaked up all the knowledge I could. I had great mentorships. I had great people helping direct me, teaching me different aspects of it. And then I had a few key people that moved me through different departments in revenue cycle.
00:03:43
Speaker
so I could learn the whole life of a coin from start to end, even to the refund in the process.
Establishing Revenue Cycle Processes
00:03:52
Speaker
So that really what led me to revenue cycle. Then I found that it's very interesting and it's never dull and it's a challenge every day. So you get to keep fresh, keep challenged um and and keep fighting you know as As you look at the, as you as look at, okay, you started with a clean slate with inspired, right? Like you got to set the all the processes and in everything from day one.
00:04:27
Speaker
What are maybe one or two things that you, you knew like, I am not letting this part go awry or what are like, what are one or two things that, you know, were the, the submission, what you were called mission statement or foundational things that you you were. So the first thing was to change the mentality of what you do. So we really are a billing company that offers speaking. That's really what we do.
00:04:57
Speaker
um That's unique in the industry to think that way, but that's really what we're doing. um That and then where revenue cycle starts. That was probably one of the biggest points. Revenue cycle doesn't start when it comes back to the billing department. Revenue starts at the first point of contact with the patient. So that's your front desk, calling the patient, getting them scheduled, getting all that critical data.
00:05:27
Speaker
their name, their legal name, what's on their insurance, the driver's license, all that stuff is just due to an accident. Getting all that upfront gives your success rate a better chance. um If you don't get that information, you're behind an eight ball and you're getting out of a hole. So if we can get that faster,
00:05:50
Speaker
then we are more successful and we get it clean. So we have checks and balance. So that was the, ah that's the, probably the third thing was that we have a check and balance system. So a front desk gets that information that as we verify the insurance, we're double checking all the data in the system. So we're checking name, date of birth, all of that information that's critical for a claim to get paid. We're making sure that goes through.
00:06:20
Speaker
um And then we parcel that the benefits aspect to it to an authorization team that are specialized in authorizations. That's all their focus is versus doing verification and authorization. They're just focused on there. So we learned that the nuances to an authorization link. Can we really submit this at the eighth visit to keep the patient continually treating?
00:06:46
Speaker
or What codes do we really have to submit to get this off? How fast is time to approval? Then we can move it all out. So all of those were my key factors into the process of revenue cycle as we started. And I built those prior, so that helped.
00:07:06
Speaker
So you have that strong foundation in a a a playbook, if you will, going into inspired, which then when it's you, when you get a brand new team, right? And in a brand new field, it's easier and harder, right? I'm sure there's, there's both things there.
00:07:24
Speaker
And so when the remote therapeutic monitoring codes came out, you would would you mind talking me through just your journey with hearing about them, investigating them, um and yeah kind of just how you thought about it. I would love to hear how how you thought about it.
Remote Therapeutic Monitoring (RTM) Insights
00:07:41
Speaker
So my, my first thing was I just heard about him and then I started researching it. Then I'm thinking of how I interact with my primary care. Now he's a neighbor, so I have a little bit of the interaction with him, but I could text them and say, Hey, we need a refill for XYZ and how that communication worked. Or like on a Saturday said me going on a walk-in clinic. I'd be like, Hey, I have a sinus infection. Can you prescribe me some?
00:08:11
Speaker
That interaction makes it more, you feel more secure with your provider and you feel more at home. um You feel like he's a buddy, in my case, because you have that interaction. Now, not all providers are this way, so don't, but I loved it. It made me feel comfortable and gave me more trust. So when RTM came out, I was like, man, this is amazing.
00:08:35
Speaker
But before RTM came out, you know, you could call your doctor, but no, that could be a $35 charge, yeah whatever, or even more. um Or you had to set up a telehealth visit. And that is the future we saw in COVID. It worked.
00:08:54
Speaker
um So why physical therapy during COVID really jumped into telehealth, because that was our own choice. So why remote therapy, RTM, why wouldn't that work? Like, if I could, me as a patient, I've had a broken collarbone, had physical therapy, I'm not gonna lie, I wasn't good at home exercises. um I'm not that good of a patient. So, but if I had someone holding me accountable versus just twice a week, I would have probably been more likely to do all my home exercises or at least be on top of
00:09:34
Speaker
yep which would have gotten my care better, I would think. Actually, if that's the way to say it, um or it would have shortened it, maybe. And that's the thing. I wouldn't have to be doing eight weeks of care or six weeks of care. I could be doing four weeks of care and being over and done with it. you know For your schedule, it's sometimes it's hard to get into PT.
00:10:02
Speaker
um So with that, I was like, man, RTM, that's great. Then I had to sell it to my team. That was the hard part. It's new. People don't like change. I understood. I felt like maybe 20% of how it works and what it did and what it was for. But then I had to keep researching, keep throwing through. Then I did research with insurances like who's paying this besides Medicare. How are they paying this?
00:10:34
Speaker
What do we have to do? What hoops do we have to jump through to get it paid? um So I started researching this as long as communicating with you, asking you probably a ton of questions and probably picking your brain way more than you wanted it's to deal with me.
00:10:53
Speaker
um Then when I got a good handle of it, gave me a better selling proposal to my leadership team and to to implement this. I see this kind of remote therapy management, the way healthcare care is going. There's going to have to be more hands on, but really hands off kind of thought pattern because like I said, I'm not a good patient.
00:11:23
Speaker
But if I had that accountability, I probably would have been a better patient. And probably I wouldn't have gone eight weeks, I would probably have cut it shorter. But I didn't have that. And I think that was a miss on my treatment. And I'm speaking as a, mark me as a patient. right um But I think the outcome could have came faster if I had done my own therapy and been healthy.
00:11:51
Speaker
And that would have saved up time. You know, time is money for you all that life itself. So that's kind of how, and then I started diving into insurance. That's the crazy part. How do we do it? Who's going to pay for this? Why aren't they paying for it? Is it experimental in these plans? Like, can you get a letter of determination if they're covered? Can you do all these little steps to see if you can get them paid?
Challenges with RTM and Insurance Companies
00:12:20
Speaker
some for Some insurance companies act like they've never heard of it. Whatever the case scenario there. So it's just moving the pieces. as It's a slow process, but just filtering. It's trial and error, basically. It may work, it may not, but can you shuffle to make it work? Or is this one is a loss, you can't do anything. And you've got to be able to make those decisions right then and there, because it may not be worth keep trying. So that's kind of the process. Yeah, I mean, the submit and see, right is, unfortunately, the the best way. It's a, it's not a statement I like making. But like, it's like, what happens if they have like $100 left on their deductible? Like what happens then? I'm like,
00:13:14
Speaker
for what payer, like blue cross between Tennessee, like, okay, well, what's, I get, there's so many other questions. Like, I don't know. I don't know. Um, and I think that's where a lot of people struggle. That's was one of our struggle. Like, is it going to cost the patient more money? And that's a huge factor, but I'm revenue psychoanalytic clinician. So I don't have that thought pattern. My thought pattern is I go to see my primary care and he says, Oh, you need a shot. I don't say how much is that shot. I get the shot.
00:13:45
Speaker
So in this industry, I find that's a hard sell because they are worried about like, is this going to cost the patient? But ultimately most providers that I've found in this space, they're communicating with their patient outside of the work. So you don't get paid much in physical therapy and And I think I've told you, I use this as my negotiation tactic is that can you get a, a restricted rate of repair man for that rate? Yeah. And good luck. When you get that person to come out to your house, then I'll take that rate, but you can't, you know? Um, so we've got to get these therapists paid what they deserve. And I'm not saying they got to make half a million dollars or anything like that. So you can get paid for what you're worth.
00:14:41
Speaker
um So if you're already doing this, you should be getting paid for. A doctor's not doing it without getting paid. 99% of the time. So therapists should have the mindset, they should be getting paid for what they do. And RTM gives you that asked that piece that was missing. In my past life, I've heard you know therapists giving out their cell phone number, giving their email address, and they are spending an hour and night texting back patients or emailing patients. yep Well, there's no charge to that. I mean, I think some have made it where it's a charge, the next visit, but do it legitimately. yeah know Don't cross the line or walk that line. And this gives you that opportunity and you still get to maintain
00:15:36
Speaker
do the maintenance care or not, I shouldn't say maintenance care, but the care that the patient deserves and you can help them on the spot. So twice a week, at least three other days, they're wide open doing their own thing. And this way it kind of gives them a communication piece that they can react to the therapist can react to. So, well, I think you nailed it. Uh, you hit the nail on the head there with,
00:16:04
Speaker
And what we've seen in in our own outcomes research, right, is there is a likelihood that there will be fewer visits required. And if your co-pay is 40 to 60 bucks, right, which is probably the average for a commercial plan these days, like, hey, there's a chance that you will have that you will need one or two fewer visits. All of a sudden you're like, oh, okay, well, if this if this service, this additional modality is only going to cost me potentially like $12 with my coinsurance, but I could save a visit. like when what When do you not want to play the game of you give me 12 and I'll give you 50? Not even including like all the other resources required to go to a physical therapy appointment.
Patient Experience and Financial Burdens in PT
00:16:51
Speaker
right we We talk a lot about the willingness to resource curve, which is which is basically the willingness to pay curve,
00:16:57
Speaker
but a willingness to resource in terms of going to a physical therapy appointment. And um you gotta think of, okay, not only is there driving, parking, depending upon the person's job, you know, carving out the, what needs to probably be 90 minutes can be difficult, right? Sometimes even 120 depend upon traffic and and everything else. And then do they have a family? I know this is more me speaking as a patient, then I appreciate you giving your patient experience as well.
00:17:26
Speaker
like if I do it in the morning, which is easiest for work, well, then my wife has to take my son to daycare or our son to daycare. And that's like, that's kind of my job, especially when I'm in town is like, I take care of the morning. So now I have to ask her to do that. So there's a unit of value that I'm having to trade or, you know, expend, uh, to, to be able to go to that appointment. Or it's okay. Now I got to block off two hours in my afternoon. Right.
00:17:56
Speaker
ah That that's that's tough, especially where our business is today. And oh anyway, that's yeah enough on that. But I completely agree with you on that pieces. And where I get where yeah I really scratched my head is when I onboard a practice, and I hear that like, Oh, well, you know, I don't want the patient to pay more. And then I see a laser and a sign that says $50 cash for laser. I'm like,
00:18:26
Speaker
Uh, help me, help me understand this, which I think is to the point where people are still, clinicians are still coming to the conclusion that this is, like this is helpful, right? They've read the research, they believe the laser works. Okay. And now I think it's really just a belief, right? Um, on, uh, a belief. It's not a, um'm are they really afraid their patients are going to pay more?
00:18:56
Speaker
potentially because they might hear about it or is it, I don't know if they'll get the ah ROI, the patient will get the ah ROI on their money. I think it's more of the latter, but that's just a nonpatient taking a ah wild guess. Right. and And I think that is a struggle because physical therapy, because you do do so many treatments, it becomes, it's a heavy cost to a lot of patients. Yep. And, um,
00:19:25
Speaker
that out front, that out of pocket money, they've had surgery, they've already spit out a bunch of money now that they're coming to PT and they may not have a high deductible. So they have more money. So you lose, you lose that patient because of financial, because they think they're spitting out all this money. And I get that thought pattern, but I'm, I'm really a believer after multiple surgeries I've had because I'm old, but, um,
00:19:55
Speaker
Uh, and seeing the outcome that I've gotten from PT has made my life better, but it's a hard sell and I'm in the industry. So I see it with patients. Um, but what I'm, what it's hard to do is to get that person has never had PT.
00:20:17
Speaker
and they're doing it and they're like, I'm at five visits and I feel, I'm at 60%, I feel pretty good, I can move my arm, da da da, I can do the rest of this at home. Really? Probably not, because they're not gonna do it. They may do it the first week, but after that, they're probably gonna fade off like a normal person. So they need that interaction with the therapist, they need that skill for them to get better and to get there,
00:20:46
Speaker
You have to sell this, but this is another tool in the toolbox. So RTM is your it another tool you can use to get that patient better. And that's a plus. As more tools that we have at our fingertips, ultimately it's the better care. And that's the goal for any practice. There's no secret sauce to what we do. It is you're trying to get a patient better.
00:21:14
Speaker
trying to get them back to a normal standard of living. And if I have three tools or I have a hundred tools, what, I'd rather have a hundred tools and give patients options than have three tools. And this is the only options you've got. Not everything works for everybody. So you don't have that flexibility. And this is gives you that point. And that's where I was a huge believer in it.
00:21:44
Speaker
And looking at the studies, looking at our conversations or picking what we've we've shared with each other and putting it all together, it was a no-brainer for me. Like, this is something we have to do. And we're small, but we want to grow big. So eventually this is going to come more prevalent across the industry, I believe.
00:22:11
Speaker
I would rather ah have all our bugs worked out and we've got it fine-tuned and we're doing it, then coming later on and 20 of our competitors or three had this is one thing. The second thing is that our reviews are outstanding. And I think part of that is the care we offer and the the personal touch, but our team gives us that personal touch.
00:22:38
Speaker
ah i I appreciate that very much and as we see ourselves evolving as a company and learning, um yeah we have started to to put this out there and it's resonated quite well, which is Sarah is a a relationship operating system,
Sarah Health's Role in PT Practices
00:22:53
Speaker
right? You have your EMR, you have your Revcycle tech, you have your ERP for knowing what your you know what money's going out coming in and all that, then you need a relationship operating system, right? because that's It's what you, that's what your clinicians develop with their patients. And so, yeah, I, I, that's, that's what we're, we're seeing is like, what, what does Sarah do? And I, okay, well, text patients like, go okay, well, that's not fun. Like, I mean, that's cool, I guess, but like, Oh, well, they make RTM really easy. Like, okay, well, that's, yeah, that's nice. Like, we'd like to do that. um But I think more and more, it's coming down to,
00:23:32
Speaker
we help make a stronger relationship with less effort on the PT. Yes. So I was always told when I, cause I was new to PT than my previous life. So it takes about three visits to get a patient to buy in and trust the therapist. So that's based on that, those touch points at their appointment. So now if you have those touch points outside of the appointment, the text message, um,
00:24:02
Speaker
does that increase the buy-in from the patient? Because ultimately that's what it takes. um And they have to be complied to the plan of care and all that. So if we're pushing more touch points in the office and outside the office, that's more buy-in. So our outcomes, so ultimately that benefits the patient, of course, yeah for getting better.
00:24:30
Speaker
but also that benefits the therapist because we're learning stuff from the patient through that text message that we may never again, unless you're doing it on all the side, you know, it's a personal phone or email. Which shouldn be doing shouldn't be doing yeah for a variety of reasons. and But this gives you those extra touch points to make that sale and that buy.
00:24:55
Speaker
Thank you for listening to this episode. This would not be possible without the sponsorship of Sara Health. Sara is the relationship operating system for physical therapy practices, driving better patient outcomes, improved of arrival rate, and improved financial margins. If you'd like to learn more, check them out at Sara, S-A-R-A, health dot.com.
00:25:16
Speaker
Sarah health comm and if you'd be interested in advertising with us and helping us produce even more great stories Please let us know at Steven at Sarah health comm now back to the episode buts Let's take a a shift more to the the nuts and bolts on the rev cycle side, right? So so you've done the submit and see the letter of determination and had some discussions around the experimental right and and then being deemed experimental. I'd love you to walk me through the general process and then let's take just for the RTM codes and let's take a couple examples that's ah you know that that that
Navigating RTM Billing Challenges
00:25:57
Speaker
differed. right so I'd love you to to walk me through a couple. so Basically, when I started this process, I started looking at how do we get it paid?
00:26:08
Speaker
There wasn't, there's not a ton of information out there that says, oh, we're going to pay this. Um, no, it's not like they post on their website. Hey, we pay RTM. Um, if they do, it's in the fine print on page 1001. And usually it's blurred out for whatever reason. You're never going to find it basically. So now you have to do your research. Um, and some of it's just trial and error. Do we bill it?
00:26:38
Speaker
and see what they do. Like, do they leave the patient fully responsible, full bill of charges? Then you start thinking that process through, like, what are you going to do with the patient? Like, are you going to bill them? That's your internal decision making. But then you go to the insurance and say, okay, they came back, they left the patient responsible, or they did denied. One of the two factors. So why did they deny?
00:27:08
Speaker
code, it's not listed, it's not on a fee schedule, whatever. But then you take it from there. So painters have experimental codes sitting out there all the time. And I experienced this lesson through a personal experience with my daughter. So, so it was trial and error in that situation, but this taught me a lot in the process. So what I did was I got hold of a medical director.
00:27:38
Speaker
went to them directly and I start saying, okay, I need a letter of determination. And so I get the codes and they'll be like, well, you can't do this. You can't do that. And then they'll say, they'll come back and be like, well, we're not going to cover this because it doesn't fall in this scope, which whatever reason it may not fall in physical therapy scope, but does it fall in your health benefits?
00:28:06
Speaker
like Where does it fall? Like does it fall anywhere? So then you have to dive into the policy. Now that's difficult because the people you talk to read a script. So then you have to push it up. So you have to go to, you may go through the benefits team, then you may go through authorization team, then you go to the medical director, and then you basically go and keep pushing, pushing and pushing until you get to someone that may know something,
00:28:35
Speaker
ah or can interpret a little bit of a piece, then you have to go back and fight that. So if you get the answer you're looking for or a piece of the answer, you just take that piece and then use it to fight for that code per se. So like with the initial setup code, that's pretty easy to bill for, um but What are you setting up? So like some payers look at it and like, what are you really setting up? You're not setting them up. Medicare says anything. I mean, basically, it's kind of a wide spectrum for Medicare. So you have to use what Medicare says to Blue Cross, but Blue Cross may say, are you setting them up on video? Are you setting them up? What are you setting up? Oh, you're just putting their number in the system. That doesn't count. You know, that's what I heard at first.
00:29:33
Speaker
But then when I started going off of what Medicare was saying and talking to Blue Cross, they were like, yeah, we pay that guy. And it was like, oh, so you're telling me this? I've been through hours of going through on the phone with everybody. I think I even talked to the janitor. And to get to that point and they're like, oh yeah, Medicare sees it this way, we pay it this way. So learning their terminology, that's the other key thing.
00:30:03
Speaker
is learning their terminology and how they perceive this code to work because it's black and white. What you offer us from Sarah health, it's pretty black and white. And that's pretty the common, but to another payer, it's foreign to them. If they'd never heard of it, some people have never heard it. I mean, we went through an authorization, so American specialty, I'll put it out there on the podcast. They're awful.
00:30:30
Speaker
and let that be known. And um they never heard of the codes. They acted like we were making stuff up. And we went to three medical directors, and then one one out of the three knew what the code was, the codes. And I actually emailed him Medicare, all Medicare's information. And they never heard of it.
00:30:59
Speaker
So we're, we're still fighting that. Yeah. So a lot of, again, is trial and error. A lot of it is determining how do you jump through that hoops for the payer? That's a letter of determination. Is it just push experimental codes? So do you push it towards the experimental? We know in this industry, dry needling was looked on like, Oh, we, we're not paying this. A lot of people can pay it. It's just going to take that time.
00:31:28
Speaker
to get people on board or get it added to their fee schedule. And that, that's a tough battle in this industry. Um, but I think we're seeing it. We're seeing more people jump on board with this payers. yeah It's just finding the right terminology, how to jump through the hoops and what codes do you really want to use? Like out of those codes, like you may not always hit the 16 responses. So,
00:31:57
Speaker
Press on the the initial setup code and try to get that out yeah as much as you can of anything.
The Benefits of RTM for Revenue and Patient Care
00:32:05
Speaker
And in the 16s, I call it icing on the cake. Do you hit that code? Great. The other codes, that's just a birthday present you didn't expect. um And those are harder to hit. Yeah, they require clinician time. Like it's a whole other yeah whole other thing. So,
00:32:25
Speaker
Those two codes are your your your bread and butter. And your initial setup is really your bread and then the 16 responses is your butter. But if you can get one out of the two, you're doing better than you were because that's a little bit more revenue coming in, but ultimately it's leading to the better care of the patient. So if you can get the buy-in and get the 16 codes,
00:32:54
Speaker
It's a plus all the way around revenue cycle and patient care. So you're getting a two for one, basically. You're winning in revenue, you're winning in the care of the patient. Absolutely. and And as you know, there's no shortage of need for PT, right? you're not no one No one we work with is having trouble filling their schedule. In fact, most people have one, two, six week wait list to be able to get someone in. And that has all sorts of,
00:33:23
Speaker
negative impacts both patients and business side of of things. And so i whenever I hear anyone say like, oh, but like that could, they may be done in fewer visits, like, is that really a problem? Like you can't say I'm worried about fewer visits and then say I have a two week wait list. Those can't, the those exist. So ultimately, you know, a lot of it's fake because of the rates is volume. Yeah.
00:33:52
Speaker
so If you free up your schedule and you have someone to fill it, you're not losing. Yep, exactly. You're winning on that piece. On top of that, you're filling that schedule, you're getting someone in faster, getting them care, but you also you're bringing in extra revenue with the RTM codes. So if the next patient does the exact same thing, you're shorting your wait time. so your' as ah rem So you're processing your patients faster and getting them better.
00:34:23
Speaker
and having better outcomes at a shorter period of time, which means you're seeing more patients in the long run. yeahp And it's not over the volume. Let's just say you say average 11 patients. That's the match you you can handle. So you're not pushing to have 16 patients to meet the volume you need. You're still getting that volume, plus you're getting extra revenue that you didn't account because we know the rate of state.
00:34:51
Speaker
um So this just builds your cash flow coming in to help, even though it's a small amount, but you can do that every patient, that your net per visit, NPR and MPD, whatever it is, radiation, you're increasing that instead of having a $88 one, you may have $100 one because you have that RTM coming in. yeahp So that only,
00:35:21
Speaker
gives you more benefits than that may mean extra staff, another table, you know, a new D-STEM, a laser.
00:35:32
Speaker
Yeah, a laser. I mean, more continuing ed, right? Like, oh, instead of doing this thing virtually, now we can actually afford to bring in somebody in person or send people out to conferences. Like, yeah, you know what? Like, Lauren, we can send you to CSM now because it's like, this has been great for everybody. And so, yeah, we'll actually pay for your travel to to go out there. You know, whatever that is. Yeah, so there's tons of benefits in it. And there's tons of the way you look at it you've got to refocus your thought pattern of how you're looking at it. Yes, there's a cost to it. There's a cost to everything, but you're also getting a two for one. You're getting more revenue in, you're getting patient care and you're getting them better sooner. So that only frees up your schedule to bring in more patients and getting care. And as your demographics grow and your population grows,
00:36:28
Speaker
that only servers your community back. Absolutely. And you know, in the last three to five minutes here to together as, as you think about, you know, some of the folks who thank you so much for being willing to to talk with them, whether you know, customers or potential customers on the Sarah side, that they're worried about the the rev cycle piece, they're worried about it counting as a visit, right? They're worried about all of those things that,
00:36:57
Speaker
shouldn't it shouldn't be a concern you know once they experience it, right? It's like a fear of the ah cold water before you get in. um what What are maybe one to two things that you're hearing a lot of that are just misunderstandings that if you could wave a magic wand, you'd wish everyone would just stop believing about RTM. So one of the biggest thing is that you have max visits in a lot of policies or you're off Authorization has 12 visits whatever the case scenario that RTM if you build it outside of the visit counts as a visit it does not um Because you're not physically having to live in the office does not go against them your EMR system may count as a visit But it's not a visit towards the paper. So that's one misunderstanding completely
00:37:52
Speaker
And so that hampers a lot of people aye on the revenue side and psychoside and the therapist side. We don't want to go against, they may need that visit. The second thing is it's difficult. Like if you go with the right people, so like we chose Sarah, it's not difficult. They make it easy for you.
00:38:19
Speaker
Basically, it's an email for them. It's the simplest form you can possibly do. And it doesn't make it hard on revenue cycle or billing in itself. It's really simple. And that is where I think people, those two things scare people. And it's going to be hard to bill. I'm going to fraudulently bill. I'm going to be in trouble. No, they make it simple.
Encouraging RTM Adoption and Future Outlook
00:38:48
Speaker
um And then the visit, it's not going against your visit count yet to the patient's policy or the authorization. If you can get over those two things, ultimately you're going to get better here. You just got to bite the bull and jump in. And yes, you're not going to get paid every time.
00:39:09
Speaker
But you're not gonna get paid every visit either. um So that's part of it. And just that that's part of the industry. It's part of dealing with insurance. And you just got to go in it and get everybody by hand. And it's not that hard. It's really easy. I i appreciate that so much. um You know, you've given a a lot of very good tactical advice. So um understanding the, especially learning in your terminology by payer and knowing that you've sometimes got to ping, you know, kind of like pinball around within the organization to get an answer. um Yeah, I share your, um share your, ah call like lack of love ah for, for Ash.
00:39:59
Speaker
Um, yeah, very, they they're, they're, they're on the the naughty list as well as ah a couple of the blues plans and in some others that, uh, luckily Tennessee is a a really solid state for, uh, for, for RTM, um, based on well what we've seen across the the state for, for reimbursement. And I, I think they just get it right. Like, you know, United is one of the best payers for this across the nation as, as we see, and I don't think it's a coincidence that United also owns an orthopedic surgery center or two and a physical therapy group and they're paying for it. like I don't think it's a coincidence um that agree ah they did that. um And so so to to finish up, I think
00:40:51
Speaker
to bring back one of your earlier points, there's a lot of reason for optimism on adoption being full blown at some point, right? Because that's just the process, right? Medicare puts it out. And it takes a bit from there for everyone else to to adopt. But in general, there's a likelihood of 90 plus percent adoption, I think over the course of the next, you know, it's ah April of 2024. I'd imagine by 2026, that we see the the laggards adopt.
00:41:21
Speaker
um Now, granted, I'm optimistic by nature. But Ricky, anything else before we call it a day? No. I mean, I think it's worth the trial. And once you do it, it's worth it. yes If it's not just financial, it's worth for the patient care. I mean, ultimately, that's what it's there for. And it does serve that purpose.
00:41:48
Speaker
i I appreciate that. Well, Ricky, thank you very much for for being on today. I appreciate it. All right. Thank you. Thank you for listening to another episode of The Disruptors. I hope that you were able to take one or two things away that you can apply immediately to your own innovation journey. As always, I'm your host, Stephen Cohen, sponsored by Sarah Health. Let's keep moving.