EPISODE 348: What Insurance Companies Don't Want You to Know with Brian Capra DC

Hey, chiropractors. We're ready for another Modern Chiropractic Marketing Show with Dr. Kevin Christie, where we discuss the latest in marketing strategies, contact marketing, direct response marketing, and business development with some of the leading experts in the industry.

What insurance companies don't want you to know. And it's a lot. Hi, this is your host, Dr. Kevin Christie. And we've got another interview today that I'm excited about. I have Dr. Brian Capra, who's from Genesis software on to discuss what insurance companies don't want you to know. And some of the things.

Uh, they are doing, uh, this is a common issue. It affects everybody. Even if you are not an insurance based, uh, practice, you really want to know this information and a lot of it isn't just insurance issues. It's coding and other things like that, that we dive into today. And Brian brings a wealth of knowledge, not only from in the trenches as a practicing chiropractor for many years before diving into the tech world many years ago as well.

And so he's got a, a unique. Insightful look into, um, running a chiropractic practice, uh, running a billing company, running an EHR and how it all marries [00:01:00] together and what they're doing to try to, uh, frankly, win the tug of war battle that we all face with insurance companies. And so today's episode, we really dive into things that you're going to be able to apply, uh, to your practice.

Some of the, what AI is able to do on the billing and coding and EHR side of things. And some of the exciting things coming from that. I know you've heard a lot about AI and various things, but it is entering in the EHR world and hopefully makes your life easier and your billing companies or billing person's life a lot easier, uh, as well.

And so, uh, Brian. Uh, I've had the pleasure of having dinner with him, uh, over the last a couple of times over the last year, really get to know him and his company and what they're trying to do to help chiropractors. And as you'll find out today, um, he really, um, is trying to, uh, be of service to the profession.

and help, uh, really chiropractors thrive in an [00:02:00] insurance world and, and non insurance world as well. But we really dive into a lot of great information today. And so without further ado, here is my interview with Dr. Brian Capra.

Dr. Kevin Christie: Hey, Brian, welcome to the show today. I'm really excited to have you talk about a topic that is, uh, fresh to our podcast, not, not necessarily new to our industry as we know, uh, and that's what insurance companies don't want us to know. But before we dive into that, tell us a little bit about your backstory.

Uh, it's a, it's an interesting one. So I like to hear that.

Brian Capra, DC: Sure. I'll, I'll, I'll keep it short. Thanks. Uh, first of all, for having me on. And, uh, It's been great getting to know you and we're, we're practically neighbors here in South Florida. So it's, uh, it's been, it's been great so far. So I, the backstory is it could get long, so I'll try to keep it short.

Um, uh, basically I was probably like most docs listening right now. You know, you're in school, you want to get out there. You want to open a practice, serve a lot of people. And that's just what I [00:03:00] did. I went and worked at, um, a couple of practices for about a year and a half, uh, that were mentors slash practice management consulting type thing just to get some basics under my belt and, uh, um, was super valuable.

And then I went and had my own practice in Jersey and, uh, something very interesting happened. I, I. Was loving practice was making a lot of money. Um, and, but I had this insurance issue, this insurance collection issue where I had hired the outsourced my billing to a company and I was getting paid, but I wasn't sure whether or not I was getting paid the right amount or all everything I deserved kind of thing, because there was no transparency.

There was no control. I'd get paper reports every month in a FedEx envelope. And they were great people. Don't get me wrong. Their customer service is amazing. As far as I could tell. And, you know, it just, uh, kind of continued on. I grew my practice and as my practice really grew real quickly, [00:04:00] um, I had a bookkeeper come into my office cause my practice was actually in a gold gym in New Jersey.

Um, and she was the. bookkeeper for the gym. So she came into my office and she said, Hey, do you need help? And I was like, you know, pulling my hair out, going just like a million miles an hour. Uh, and I said, yes, please. And, uh, she set up my book. She helped me hire, um, staff. She just was really huge, huge help.

Um, cause I got the whole, I knew how to get the message out. I knew how to bring patients in. I knew how to convert patients. I knew how to set them up for lifetime care. That I didn't know. I just didn't have time to do those other things. And never did I ever think I would have time to actually, you know, manage the billing that was supposed to be happening.

It was the last thing on my mind, right? The last thing on my mind in school was creating a software company or a billing company, billing service, which is what we do now. But, uh, this problem was happening. And. [00:05:00] That same bookkeeper introduced me to two gentlemen. One was a PhD in artificial intelligence and came from Bell Labs.

And the other was a computer science graduate from Princeton. So I met them and they had building tech, been building technology in the cloud with artificial intelligence. And when I met them was 2004. And, uh, you know. It's something that you hear a lot about today, the internet, the cloud, right?

Everything is going into the cloud. AI is all over the place, but back then nobody heard about it. Um, or let alone, you know, knew how to. Apply those things to change business operations. So I basically just went, um, met with those guys. They said, Hey, we built this technology. They had actually been contracted to build technology for another billing company in that project got.

Scrapped right in the middle of it. So I, I was like, okay. And they said, would, would you try it? And I did. [00:06:00] And my collections went up 40%. So I was like the Guinea pig. Mm-Hmm. . And uh, we decided to form a partnership 'cause I knew a whole bunch of doctors that were also using that same billing company, . And I'm like, this is a no-brainer, but it was actually more than that for me.

And I won't go too much into it. What I learned. Through that process is I was watching how artificial intelligence in the cloud with automated workflow, totally changed the level of transparency and control over operations in the billing space, um, and got different results, keeping insurance companies accountable.

For example, um, but I also knew that if we can use that same technology, the same methodology and apply it to the overall practice and the practice management technology, um, it would revolutionize how technology was used for chiropractic offices to manage the business. And, and to this day, you know, and we started that company, we built the [00:07:00] whole thing from that.

Um, so today it's, uh, Genesis is not only A system that's in the cloud. We're the first one in the cloud. We're the only one with AI. We've been doing it since 2004 and it's a different. It's like night and day when you compare it to other practice management technology. I don't even think those systems really help you manage a practice or a business.

It's, it's a, it's like the philosophically different. It's a proactive way to manage any business operation. So that's the story. No,

Dr. Kevin Christie: that's great. And I want to set a little bit of context for the conversation with it, because, and that's why I wanted your, your backstory, you know, you're a chiropractor, you're, you're in a trenches.

You're not just a, you know, a fly by night entrepreneur that found a particular niche. Like, you know, the profession kind of like, I always say is like, I'm a chiropractor. I know the profession. I know how to marry marketing. with the chiropractic professions and the realities that we deal with. And so you, you have that background, obviously Genesis [00:08:00] does a lot of things, but just to kind of set a little context, like I said, it's a, it's an EHR, but it's also, you guys are billing specialists as well.

And because there's always that. There can be a disconnect as you know, and so with that, uh, kind of given that 30, 000 foot overview for everybody, uh, that gives us a good kind of runway to talk about the insurance companies because. Uh, not only is your Genesis business now pulling up on 20 years, uh, you've been practicing for a while before that, so you see it all happening.

So let's start that conversation. Like what are, what's going on with these insurance companies, uh, over the last few years here? What are some of the things you guys are noticing, uh, seeing it across the board?

Brian Capra, DC: Um, you know, as, as, as much as things change, they stay the same, right? Is that the expression?

The more things change, the more they stay the same. You know, it's, it's interesting. Cause what you, when you have a different perspective that, and I've learned that over the years, [00:09:00] like I wasn't a guy that came out of school and was. You know, trying to learn the coding and the, you know, trying to put specific modifiers or how to change the code and get paid more for it.

I never cared about any of that stuff. But what I did care about is keeping them accountable. And to do that, you have to understand the game they're playing. And to do that, you got to really understand there's a totally different world out there than what most doctors think. Like, for example, a lot of doctors think, you know, insurance companies are out to get chiropractors.

Um, and that's just not true. They're out to get everybody. You know, they want to get, they're not, they don't, um, discriminate, you know, they're out to get every profession. In some cases, we're a little easier targets. That's true. That's not their fault. They're just taking advantage of the game. And the other way to think about it, uh, I've said this a million times in the past, the way they're doing is playing, you know, you're playing checkers with these little tactics and they're playing chess long term big gains.

They're not, our little tactics are not going to beat their game the way. We've thought about it, right? A little [00:10:00] coding secrets and stuff like that. It's not going to happen. Um, so you have to understand the way they make money to begin with is they make most of their profit more than half, I should say on interest or what's called the float.

The float is you saw a patient today. You just did today. Every second after that, that you're not paid interest is being earned on your, what is now your money. Now, why would I expect that that's my money? I just saw my patient five minutes ago. Well, at least by the end of the day, that's your money. And here's why.

Um, and this is one thing I learned from one of my business partners who first actually started on wall street and originally designed the technology with AI for hedge funds on wall street. There's way more complicated transactions that happen every single day. Without question, way more complicated than one patient, one doctor, one transaction, right?

Multiple parties, all kinds of, all over the world, everything's kind of happening, right? So, by law though, everybody, [00:11:00] by the end of that day, has to be paid. So, it was interesting because what he taught me when he, because he came from Wall Street background first, is, he said, um, there's, this is so simple.

This, this transaction is so simple, there's literally, He said, at first I couldn't figure out why doctors weren't just getting paid. Um, why is there this whole billing industry? Um, it's a whole business built around this, right? Huge, huge multi billion dollar industry. Why does it even exist? Um, so that was first.

So the first thing you need to understand is how they get paid as interest. Um, and, and from there you realize that, you know, you submit a claim, they have something like, you know, a month. To respond to you. Um, the claim form is very complicated. It's got lots of diagnosis codes, procedure codes, 9, 000 different fields that if you put one little thing wrong, they'll reject it, right?

Or if you put three things wrong, they'll [00:12:00] reject it, but only tell you about one mistake and, and so on and so forth. So technology and companies and services have been Kind of coming to this market, making businesses out of trying to help you get paid faster. And so they tout, they have technology, they have clearing houses, or they have, you know, people or whatever.

And every business should have people processing technology. So these are the first two things, how do they get paid interest? Um, and how, if you know that. And that their game is to delay payment as much as possible. Well, how are they allowed to do it? Well, the second thing you need to know about them is how they gain the power to make the rules.

Because somebody made these rules and obviously wasn't doctors, right? It was insurance companies. So the way they did that is they, they, um, what's called create a oligopoly. It's sort of like a monopoly, but in reverse. It's when there's only one payer, as opposed to where a monopoly [00:13:00] is the only one provider or of a, a good or a service.

So they create an oligopoly when there's only one person, , in essence, you know, it's not literal, right? The, the, the, the way it works is most people in the United States are insured by very few insurance companies. And because of that, they have all the power to lobby and make any rules they want across the country.

And, and in most industries, that's illegal. Um, for example, if all chiropractors ganged up against insurance companies, that would be illegal. But it's okay for insurance companies to gang up against... All healthcare, it's actually, um, it's, it's called antitrust law and they're one of the only industries that is mostly exempt from these rules.

Um, so it's, um, so they, they found out a way to get exempt from federal law and rig the system against us. So everything that happens after that diagnosed code, procedure codes, documentation requirements, all this [00:14:00] nonsense is really just nonsense. All they, they should pay you the moment you see the patient.

So. The way technology can help us level the playing field and beat them, or at least come close to beating them at their own game, um, is by leveraging artificial intelligence and leveraging workflow automation. What does that mean? Well, the artificial intelligence. At the end of the day, you're going to submit a claim, it's going to go through a process, um, hopefully, um, with AI, it'll catch any mistakes before, all of them, not the, you know, not the one at a time that they're going to send back.

It's going to be way smarter than just a normal clearinghouse. It's going to pick up all the errors, in some cases correct them, of course it's not going to code or anything like that. But it'll tell you or your staff to fix it and how to fix it and why to fix it and automatically resubmit that claim instantaneously.

And then everything after that's automated as well. So, you know, it goes to the insurance company. It comes back with all the [00:15:00] denial codes and every insurance company has different denial codes of intentionally and you have to know what that means or they'll underpay. Uh, a certain claim or a certain code, I should say, and where your staff person would never be able to remember every single C.

P. T. code insurance company allowable amount and what their normal payment would be. And if they paid 50 cents less this time, they would they would catch it every time. It's impossible for. Humans to do so that I does all of that and finds claims that are underpaid denied for whatever reasons and takes the claim.

And this is one of the most important things is it doesn't wait for you or your staff to find the claim it finds it for you and puts it on a. What's called a workbench and tells you what's wrong with it or why you need to follow up the second it's due so that every day, you know, in real time as fast as possible, right?

You can keep your those insurance companies [00:16:00] accountable if it's a phone call or resubmission or whatever has to happen. It happens the second it's due. And that's the way you drive your accounts receivable numbers down to minimal numbers. Um, so, uh, and that's, if you do think in house, you can outsource.

So with Genesis, we have clients that are all cash. They're smaller, you know, their new practices, they're all cash. There's more established cash practices. There's insurance based practices that do their own follow up, but they leverage the artificial intelligence. To make, to help them not be, you know, wasting time looking through reports.

Um, there's doctors that, or practices that outsource that work to us as well. There's doctors that actually keep their, their practice management system and still leverage all the billing automation and all the dashboards and all the workflow with the, with the Genesis billing engine. So, um, we have. You know, we run the gamut really on, um, types of clients.

But, um, so those are, those are some of the things [00:17:00] that, uh, insurance companies don't want, you know, another one that they don't want you to know. Yeah. Let

Dr. Kevin Christie: me, um, before I forget, cause there's something that I really wanted to. Kind of touch base on, cause you said a couple of great things there. Um, there's kind of the early problem where let's say a chiropractor is putting in their charges and they forget to put the modifier 59 on manual therapy and they build a spinal manipulation as well.

Um, I'm assuming the AI catches those mistakes. Or let's say they build a three to four region manipulation, but they only have a diagnosis code for one region, probably catches a mistake like that. So those are a lot of the pre submission mistakes that chiropractors are making. And I think they're, they're having a hard time keeping up with all the different diagnosis codes and modifiers and all.

Are you, are you seeing chiropractors make that mistake? And then obviously the AI catches that.

Brian Capra, DC: Absolutely. They make that mistake. Um, and again, I'm not a coding guy, but I mean, I know enough about, I know a lot about coding, I [00:18:00] should say. Um, so one thing you want to be careful about is a system automatically fixing something for you.

Um, for many reasons that you might understand, but, um, what the next, the next level of that is, is. Um, not only do you know what you did with your patient and is the coding, uh, accurate, but is your documentation supporting that? So, um, the next iteration of that is the documentation system. For example, in Genesis, um, you, when you document, it tells you what is in your documentation, not only You know, what you are putting, picking codes from out of your brain.

It's what's in your document. Um, so if you want to add stuff, obviously, or just to say, I want to have this on every visit or something like that, you can, you can do that, but, um, you, you want to make sure that not only do you charge correctly for what you did, but your documentation also supported that.

So the next level of that is, well, how does AI make your documentation even faster? Um, I don't know if you heard about this, Kev, but, um, the, uh. There's new [00:19:00] AI coming out. Actually, we're, we're working with it now, not for clients or anything like that, but behind the scenes and beta testing and whatnot, but it actually listens to your interactions with your patients and documents the visit.

Obviously it's a little weird for chiropractors because you're not typically saying everything you're doing. Um, but in, in some specialties, in some circumstances in a chiropractic practice, it's. Going to be pretty amazing.

Dr. Kevin Christie: Yeah, that'd be pretty fascinating. And so, um, moving on to the next phase of it, it seems like there's then, okay, we've submitted a claim and, uh, for whatever reason, the insurance company denies it under pays, do they do the things they do?

So there's a, the AI is going to catch some of these things that look off after the claim has been submitted in the insurance company as. Let's call it rendered a decision there. Uh, is that accurate? The AI is going to catch those things as well. Yeah,

Brian Capra, DC: absolutely. Well, there's simple things, right? Like, um, they have 30 days to pay.

If it's not paid, it's going to take that [00:20:00] claim and put it on your, what's called the workbench, uh, for either you or, or our team to follow up on and say, Hey, it's been. They didn't even respond, right? We didn't even get an EOB back or what was called an ERA. But the ERAs are basically electronic EOBs, electronic remittance.

It's going to go right into the system. The AI is going to parse it out and line item post everything perfectly, right? And with the denial codes, and it already knows all the denial codes, but it's also looking for those sneaky things, like you mentioned, like an underpayment, which, um, is. You know, you would think I have a contract, right?

And so they can't do that and they can't, but sometimes you would miss it because you're too busy, right? You just post it, you know, just taking checks or, you know, the, the deposits happening and you're just, it's just posting and it's an ER and you don't, it doesn't look like it's underpaid. It just looks paid.

Um, the allowable amount is a tricky one, right? They could just start lowering the allowable amount. Well, why can they do that? The reason they can do that is because they know you typically won't call about [00:21:00] it. Um, so you have to have something that keeps them accountable to every little sneaky thing

Dr. Kevin Christie: they do.

So, yeah, and I guess we could probably venture a guess that they run the numbers and they say, Hey, let's screw with this percentage of people by doing things the wrong way. X amount of percentage won't even catch it. The other ones that do and they resubmit, fine. We'll pay it, but they've know there's a percentage that just didn't even catch

Brian Capra, DC: it.

Yeah. And that's how they find you for audits too. They're looking at your profile. When I say they, it's AI, they're just profiling doctors. And they, you know, you kind of bubble up to the top because you're so far out of an outlier. It doesn't mean you're actually doing anything wrong. You might have documentation to support that, but there's an eight to one.

This is another one of the things in the book, the ebook is they have an eight to one return on investment for every audit they do by the time they get you to that point and they send you the letters. They already know. Um, for all the audits they do, they're going to get an invest in, they're going to have 8 back for every [00:22:00] one they've, uh, invested.

Um, so audits are another, another way, right? They don't, that people don't realize it's just another numbers game. So you have to have, you know, one of the way we used, uh, ways we used AI and automation, uh, workflow in the past. Another example of this, um, I don't know if you know about this, but in New Jersey for years, they, uh, Blue Cross Blue Shield was not paying for extremity adjustments.

For years and years and years. And, um, luckily New Jersey got well organized the docs, you know, the, the, uh, organizations got pretty well organized and they fought and fought and fought, fought and they won. And so Blue Cross, um, was basically like, okay, just resubmit the claims and we'll have to pay them.

And then it's like, well, you know, you think about 5, 10 years of claims for some docs. They have no, some of them had no technology, right? Um, to even remember who they saw and all this stuff. So, but for the clients of, of [00:23:00] Genesis, we had all the data and we automated it and you had to submit claim forms.

You had to mail claim forms with a letter or this whole thing, right? It's just nonsense. So, um, what we did is we built an automation that actually cranked out all the form, all the submission for our claim forms with the letter. All that and sent it. We sent it FedEx it to the doctor. The doctor just had to sign it and drop it in an envelope and went to Blue Cross Blue Shield.

Now imagine Blue Cross Blue Shield with, you know. Genesis clients just getting stacks of FedEx envelopes. And we found out they had one person to process all those claims because they never expected them to organize or have any technology or automation that would get anything to them anytime soon.

Dr. Kevin Christie: That's wild. Yeah, it's just the games they're playing. Now let's take it to like kind of the third phase. Uh, they send something back. They don't pay on something. They, you know, do their thing to try to take money from you. You know, AI or the doctor or whoever [00:24:00] catches it, sends it back, they still fight it.

So now let's say we're in this battle and we as a chiropractor know we're right in this particular claim. Insurance companies playing tough. Yeah. What's a typical process to continue fighting that? When, when do you potentially cut your losses on that or, you know, what are some of your just thoughts? I know it's, it's so variable, but it just would love your input on it.

Yeah.

Brian Capra, DC: That's, that's, um, And it's specific case by case. But basically, if you know you're correct, you wind up going through an appeals process, which we as much as we can automate, meaning that we can create appeals letters in an automated way, um, send them to the doctor for signature, receive them, submit them for the doctor with the claim.

All the history and everything. So there's, there's ways and usually it's not going to go that far. If you're very correct, you know, well, most, most things, um, then you're, you're not going to wind up in a too, too tough a situation like that. [00:25:00] But then there's secondary, you know, secondary coverage and automating all the steps as fast as possible is, is the key, the biggest thing that's going to change collections in the biggest way.

Dr. Kevin Christie: That's a big one. You know, and obviously it's a numbers game there. And I think, you know, conceptually chiropractors that are listening to this, I think we all can relate to it. Even if we're now like, uh, I'm more of an out of network cash practice than I used to be a network. Obviously, as you know, in Florida, American specialty health really put it to us pretty good down here, but, um, it's just that sense of overwhelm of being able to, um, track it, organize it.

Like you mentioned, I think, uh, a work desk, um, functionality. Yeah. Workbench. It seems like, um, there's now some structure, some organizational structure of, okay, these are the ones that are still outstanding. I know there's being a process to work through this. Uh, so there's probably a [00:26:00] level of, you know, peace of mind that that's happening here.

Is that what you're trying to accomplish for?

Brian Capra, DC: Yeah, absolutely. So you think about that. You have one. number every day that you want to know is how many claims that the system find that need attention and are they finished? Did somebody attend to them? Um, and how many need to be done in the future? Cause you might take an action today and you need to take another action within a week, call again, or something like that.

You need to kind of like a tickler system that makes sure you know, um, you know, you, um, quantify how much work needs to be done. Cause we're not, you know, Most of us are not expert billers, right? We're not, we're not billers at all. We're doctors. That's why we went to school and we probably didn't learn anything about billing and coding or in school.

Probably learned that as some seminar, you know, on a weekend to see you or something like that. So it's not your business. It's not your, it's not the type of business that you should manage. You really should focus on what you do best and that's building your practice. [00:27:00] And now the problem is if you want to.

Partner with slash outsource to a provider of, um, like a billing service. Well, you, you feel typically like you lose control. You lose transparency in those things, which is true, uh, for Genesis clients, whether you're using your own software or you're using our complete platform, you're 24, seven real time access to all the dashboards, the number of how many claims need to be followed up on.

You can drill into it. You can see what's being said to insurance companies, everything that's happened on that claim. Since the day it was created, how much money you've collected so far this month? What's the total outstanding aging you can drill into anything, sort filters, sort filter by payer by patient, but you name it, you cannot get more control with other technology in your own office.

Um, so it basically, um, the way I have tried to position it or word it sometimes for docs, it's like. I never wanted to [00:28:00] deal with insurance either. Um, I'm not an insurance guy. I was going to be perfectly happy doing more cash, you know. And I did a lot of cash because I had families that, you know, long, longer term cash plan, uh, care plans, which were a majority of cash.

But, um, so with Genesis... What we're aiming for is to help you practice where you can still accept insurance, but you feel like you have a cash practice because the work is so minimized, you're not feeling able to manage a billing department and, you know, determine your performance of your billing department based on collections, which are up and down and all over the place.

When you know, with one number, every single day that everything was done possible to get you paid every penny as fast as possible, that alleviates a lot of the headache and concern.

Dr. Kevin Christie: So what would you recommend? And I know it's variable because someone could have a practice where they see 300 people a week and they could have a practice to see 100, but in a week, but what would you recommend they do as far as either them, [00:29:00] the owner, or let's say they have a really good practice manager to look at the dashboard, look at the claim.

Like, is it an hour a week? Is it at the end of each? Day is it, uh, tip is it could be a range, like, should they sit down and carve out a period of time each week or each month to just like, look over that dashboard. Where are we at on certain things just to get a, a beat on it without, you know, digesting it all the time, like being consumed by all these claims, right?

Brian Capra, DC: So there's two, there's two types of practice as far as Genesis. Full, full system, right? One that actually calls the insurance companies when they're when when they need to and the other that allows us to do that work or post paper claims and EOBs in some cases and that manual stuff there is that manual work is what Genesis is trying to do is whittle down that manual work to something that's almost nothing if possible, right?

And Show you what it is. This is the manual work, right? So, um, if you're doing your own stuff, [00:30:00] that's one thing, and that should be done on a very regular basis. If you do it on a very regular basis, um, that followup work, then it's. It's not over never. It doesn't become overwhelming. The problem becomes when you let it snowball and it's just worse with other systems.

But even with Genesis, I mean, at some point you have 100 calls to make. I mean, it helps because you can filter by payer and call on for five patients with one phone call. But still, they're gonna make you sit on hold. Um, so if you're outsourcing, there's, um, to us, uh, you have Another, what's another workbench, which is only the, you know, small number of instances where we need more information from you, your practice, you know, something about the patient, maybe specifically, or a question about coding where it could be this, and we want to get verification in writing from the doctor that it should have been something, stuff like that.

And there's, it's another workbench, it's called the provider's [00:31:00] workbench as opposed to the biller's workbench. And it's just another way to. Communicate and keep that claim in a closed loop doesn't escape. It doesn't get closed. It doesn't get lost, but that's just doing that again. It's a daily basis is best, but there will be days where there's nothing to do.

Um, but if the, Oh, the only problem we've ever had, uh, with customers is when they don't do that piece. On a consistent basis. So even if it's three times a week, whatever it is that you say, it has to be done consistently. If it's done that way, you'll never get overwhelmed.

Dr. Kevin Christie: That makes a lot of sense. And you can punt this question because it's a little bit of a sidebar, and it may not be something that you're, uh, you, you have an answer for, but insurance verifications, is there a particular strategy or workflow that chiropractors should be using or that you guys offer or anything that, you know, like to optimize that?

Cause I know a lot of people get. You know, they got one front desk person, I got a busy practice and they're, [00:32:00] they're worried about their front desk be on the phone, trying to verify insurance. I know there's some online portals, but that can be, uh, do you have some thoughts

Brian Capra, DC: on that? Yes. I have a lot of thoughts.

Uh, um, nobody loves that. Everybody hates it. And that's number one. Yeah. It's just, and that is one of the things in the book, by the way. Um, you know, it just sucks though. Life and productivity out of your office. Um, if you have, if you're not busy, or maybe there's a time frame or time of day, you're not busy, you know, and somebody's in your working in your office and they have nothing else to do, it makes sense to put them on it, you know, uh, make a couple, uh, what we try to do is just make it flexible for docs when they need it, it's there.

Um, so, and there's different tiers, right? So if. If you want just the what's online, what's on the carrier's, insurance company's, um, website for that patient. You can get that, of course, you know, that's gonna be generically what's available for that patient without the details [00:33:00] of what they've used so far this year.

Or, you know, have they hit their deductible or in some cases not enough detail about certain codes. Um, so that's one thing. It's a click. Type thing, you know, you get that information if you want it to be more manual, like do the call like you would have done it. We have services for that. Where as part of your setup with us, we'll kind of look at your insurance verification forms and determine, um, to what level they are.

Uh, meaning some can get very in some practices, they get super complex with it like they want 9 million questions answered, um, and or they have multi specialty and it gets more complex and it takes more time. So, but we have three different pricing tiers. And what's nice is you're, you're doing that in the patient account in Genesis.

So you're clicking on a button, say, saying, I want to have manual verification. It sends us a task with all the patient information, obviously. We're calling, we're documenting in that task or documenting in the document [00:34:00] itself within the patient account. And we'd let you know, um, when it's complete. So you're able to outsource it when you need it, basically.

So if you have, uh, another, an example might be, you have a big event and you have, you know, 50 new patients, I don't know, whatever it might be, that's another case where it might make sense to do it this month, it'll always be cheaper than doing it yourself. Um, because we have the resources to do it

Dr. Kevin Christie: and the opportunity cost is something that I've, I've dove into with some chiropractors on different things.

Uh, I'll tell one story and people can extrapolate out from there, but I had a, you know, particular chiropractors where they're getting, and this is obviously something that EHR can help out with when you do it right. But they're getting so behind on their notes that they've subconsciously had a barrier to grow their practice.

Cause they say this, I was like, well, shit, if I. Doubled my new patients in a month, or I went from 150 to 200 offices in a week. Like my head would explode. I'd have anxiety. My, I [00:35:00] couldn't keep up with it. So they have this subconscious block of growth and there's many of those little things. And it's even things like, uh, you know, I see, we see 40 new patients a month.

Now, if I saw 60, there's no way I could keep up with the insurance verifications, but I don't want to pay someone to do like, like they have this thing. It's like, but imagine if you could actually just. Um, have a clearing and you pay a little bit extra money to someone or some other entity, a third party, but now you were able to clear that and you could see 20 more patients that would easily pay for that.

And there's a lot of those little things. It could be, I mean, there's probably a hundred little things in some people's practices that give these blocks to, to growth. And I've seen insurance verification be one of those

Brian Capra, DC: for a chiropractor. It's really interesting. You say that. Yeah. Cause, um, That's not just for the doc, it's for the staff, it's for any business.

Um, I believe it's like. Where there's those barriers to growth and a lot of times what, what will happen in, in the doctor's mind in the [00:36:00] team meetings is they'll give all the reasons why they can't do something, um, rather than the reasons, um, a solution to how you can do something. So in other words. You, you look, if, if insurance verifications were the only thing that were keeping everybody back from growing the practice, you'd say, well, why is it?

Well, we do 20, it takes three hours, whatever, however long it takes. Well, okay. How can we do that in less half that time? And double our new patients. Well, we can't. We don't have resource. We don't have people. Well, that alone might be a reason why somebody switches the Genesis, right? Because, well, if we just got Genesis or some, if there were just another service that offered just that, right?

If we just got this service and it was, it was reliable and transparent and accountable and, and we just did that. And we were able to outsource it when we needed it. How much more would that increase our capacity? Oh, well, then we could see a hundred new patients. But then you got to go down your line, right?

Through the whole process. All right. The doc has his [00:37:00] documentation thing too, right? His or her documentation thing. So you got to get over that. Well, it takes me one minute to document. Well, Well, how long would you have to document to see double the number of patients, assuming that if you can do it in half the time, it was as compliant, you know, you felt as comfortable and all that.

So that's some of the stuff we talk about with clients. Well, if we can get not only your document done, but your diagnosis, procedure codes and the claim created and sent. In that amount of time or half that time, how would that change things for you? What kind of return on investment is that in terms of time, in terms of money, in terms of peace of mind?

You got to think about every step in the process, um, all the time. I would love

Dr. Kevin Christie: people to start doing an audit of their practice and like, where are these little hidden subconscious barriers or even. You know, conscious barriers and even like going back, people don't want to want to realize this, but, uh, I remember learning this from the scheduling Institute and they talked about part of the reason why they like to bonus the front desk on new patients.

Like, you would set a goal and then if you hit that goal [00:38:00] for every new, you know, you get money when you break these new patient goals. And part of that is because. They found out like as they did, they've worked with so many practices, the front desk didn't want more new patients coming in. Cause guess what a new patient.

Yeah. It's only more work. That's what a new patient means to a front desk person. Right. More work. Yeah. And so they found that front desk folks, even subconsciously or consciously were like, uh, not really going out of the way to get new patients in. When they were calling, they were kind of aloof on the phone or dismissing them, not wanting to answer some of the questions because it's like, shit, this is going to be more work for me.

I got to verify this insurance. I got to, you know, Do this. And if they do some of the billing too, they're gonna have to deal more billing. There's just a lot around it. And so I want chiropractors to start looking and uncovering the rocks there that, that, that's in their practice. That's a hindering them, frankly.

Well,

Brian Capra, DC: the same stuff we were talking about with AI and automated work. flow applies to patient relationships too. And I shouldn't [00:39:00] skip over that. I mean, uh, it's no small thing, having a system that finds every time a patient relationship is at risk and sending it to your staff. So, you know, exactly how much work it takes.

They know how much work they need to do every day. And they're not wasting their time looking through all the different reports about care plans and you know, missed visits and expired, you know, credit cards on file or inventory. They got them at everything just comes to them and they just need to knock it out.

Right. And now they know how to be. productive for you and what, for what you expect in your office and they feel good about it. And it's one number that they can see every single day. And what it really does is it optimizes the patient's experience. Um, so they tend to stay longer and it increases retention, patient retention.

They stay longer, they get more better results. Obviously they're going to refer refer because of that. And the, you know, over time you can demand a premium for your care in that way. [00:40:00] That's

Dr. Kevin Christie: awesome. Well, Brian, is there any questions I didn't ask you, uh, regarding some of the insurance company's, uh, tactics or traps that they're, they're putting chiropractors in?

Brian Capra, DC: Um, we could probably go for three hours on it. Uh, but one of the best things you could do is, uh, go to Genesis chiropractic software slash ebook. Um, that's the first book is what they don't want, you know, and the second book is how to leverage AI and automated workflow to beat them at their own game and level the playing field.

Um, so that's the easiest thing to do. It's a, they're quick, I shouldn't say quick reads, they're pretty quick and easy reads. Um, and there's others. Um, more content coming to, to follow that when we really dive into the real power of AI and, and the cloud, uh, with real, um, patient experience automation. So that's, that's the real power.

Yeah,

Dr. Kevin Christie: that's awesome. I really appreciate your, your time and wisdom today. Yeah, many, many chiropractors are fighting the. The good fight and it's an uphill battle, [00:41:00] but at least they have some, uh, you know, it's kind of like a, uh, you know, it's an arms race, uh, right. And we're trying to give our, give our side a little bit of a fighting chance.

Brian Capra, DC: Absolutely. Got to level the playing field any chance we get now, there's never been a better time with AI. Well,

Dr. Kevin Christie: yes. To that point is like the human plus the AI actually gives us a chance now to, to combat the, the like

Brian Capra, DC: Terminator, I don't know if it's, I don't know if that's the best analogy. It's a good

Dr. Kevin Christie: one.

It's a good one. They're trying to be the Terminator. That's for sure. Right. Yeah, they are. Well, I really appreciate your time today and I know we'll talk soon.

Brian Capra, DC: Yeah, absolutely. Great to great talk to you again, man. See you soon.