Seldom Talked About Innovations That Boost Your Bottom Line
This week, Paul welcomes Bridget Yeager and Todd Taggart from Athelas to discuss the tools their company is offering clinic owners that can drive revenue in both direct and indirect ways.
Full transcript
Generated from the episode audio and lightly edited for readability.
Good afternoon and welcome to another episode of Paul Martin's Crucial Conversations. Today we are going to delve into our innovation series. And what we're wanting to do in this series is we want to make sure that we equip you with insights so that you can make informed innovation decisions for your business in 2025. As you all know, there is so much innovation out there. I think everything we do now is AI generated or in some way shaped with AI. But we have to be careful and make sure that we choose the right tools.
So in that vein, I am absolutely thrilled today to have two physical therapists with me, Bridget Joerger and Todd Taggart from Athelas. Welcome you guys. Thanks Paul. We're happy to be here. Thank you. So, Athelas is a healthcare technology company that provides AI powered solutions and that includes intelligent medical billing, teleaalth programs, RPM, remote patient monitoring and all of this is to enhance patient care as well as operational efficiencies. So again, Bridget is a doctor of physical therapy and she serves as the clinical consultant and account executive.
And what that focuses on is discussing clinical inefficiencies with practice owners that are choosing to use ais or planning to use athellis who are already utilizing ais. And Todd Taggart is also a physical therapist. He holds the position of regional sales manager, overseeing sales operations within his designated region. So, are you guys ready to go? We're ready to rock and roll. All right. All right. So, if you guys could start just provide an overview of Athelas, what the core services are and how your AI powered RCM revenue cycle management platform diff differentiates itself in the healthcare industry as a whole.
Sure, I can I can start us off, Todd. I'll give you a little bit of a background kind of 90 second overview of who we are and where we came from and then we can dive deeper into you know, some of the specific product lines. But, Ephelis was really born in 2016 at Y Combinator to Stanford students that created what started as a remote patient monitoring device to be used in the home. An atome blood prick device is where we got our origins. From there, you know, physicians loved it, hospital systems loved it, practices loved it, but this was 2016 and it was really hard to build for remote patient monitoring.
Nobody had figured that out quite yet. So, the feedback to the executive team was, you know, hey, we love this concept, we love the product, but how do we get paid for it? So, we took feedback and we said, "Okay, you know, hey, we're going to go acquire medical billing practices, deconstruct them, essentially learn all the ins and outs of medical billing, learn how to maximize revenue, learn how to maximize billing so that we can support our current customers." That's kind of where the RCM motion was founded.
And it's funny, it's kind of continued on that same trend of RCM is now live and deployed to hundreds of clinics nationwide and now we're getting the same feedback of, hey, RCM is great. Now, how do you make an EMR to complement the RCM platform? So, it really you know, the company as a whole grows and innovates depending on the needs of the market. And so when I talk to prospective clinics, physician owners, executive boards, whoever it may be, I like to make it very clear that we are a health tech company, right?
We're not just a billing company. We're here to provide solutions, to provide an ecosystem really of health tech and tools to give power back to physicians, save time, get back with your families, increase revenue, increase margins. So brief overview of kind of where we started. Yeah. No, really interesting. And to think back in 2016, if somebody said, yeah, our clinic is using RPM, I would say, you're using what? Yeah, exactly. So, that was kind of an early innovator of RPM. Is is that fair to say?
I would say so. Yeah. And Todd has a little bit more info on the RPM side, but I think so. And you know now the talk is therapywise specifically RTM right so we're starting to see the pivot to this remote patient monitoring remote therapeutic monitoring and I think a lot of it is falling in the wake of more value based care initiatives and you know moving towards value based care. [snorts] Sure. Sure. So, what's the long-term, you know, the return on investment specifically for physical therapy practices?
Because our audience today, they're all physical therapy business owners. With them using the Ethelis RCM services, and how does this kind of align with current industry trends that buyers or investors are focusing on when they're looking at physical therapy businesses? That's a great question. I think it's a [clears throat] loaded question, right? Because I think when you look at an ROI, certainly there's going to be financial return on investment that can be realized by our partners. But the other component to that as well is the quality of life for the providers, the quality of care provided by them.
And therefore like improvements in patient outcomes as well. All of those things have to be considered when we are having conversations with potential clients in trying to understand exactly what are their needs and how can we potentially plug and play some of our solutions to be able to help them realize those objectives. So yeah, it's a matter of like doing a needs assessment similar to what we as physical therapists do when we evaluate a new patient. We simply meet with clinic owners or clinicians within a clinic and then determine what exactly are their needs and how can we implement some solutions for them.
I'd love to hear a little bit more on patient outcomes and how the products because I know it's an array of products. It's not simply one product. But how any one of those individual products would assist a company in being able to very boldly state what, you know, clinical outcomes they're achieving. Yeah, I think value prop is an interesting question too just in and of itself because it differs, you know, depending on who you're talking to. One practice their goal might be, hey, we need to reduce admin bloat.
I need my admin team to be more efficient. I can't have 12 billers for five PTs. Somebody else, right? You go down the street and they might say, "Hey, admin wise, billing-wing wise, we're doing great. We have no trouble there, but my clinicians are complaining that they're documenting until 11 p.m. You know, what can we do about that?" And so, I think that's where the power and the depth of ais comes in is that it's not just one solution. It is a health tech ecosystem of where are you struggling?
What are those quote unquote pain points? If it is admin, great. Let's talk operational inefficiencies. Where can we plug and play some of these solutions to streamline your admin team? If it's clinicians complaining about documentation, let's talk AI scribe, right? I mean, that's the hot button in 2025, it seems. If it's patient outcomes, you know, what specific feedback are we getting from our patients daytoday that, you know, is repetitive that we haven't been able to adjust to, right? And and how do we then help that patient interaction?
Sometimes it is just a scribe tool so that you can spend more time with your patients. Sometimes it is better billing processes so your patients aren't blindsided by, you know, hundreds of dollars worth of bills three months after they come see you. So, I think, you know, it differs and that that's where I think Athelas has really done well is putting clinicians in these positions because we've been there. We've been in the trenches. We know what you're talking about when you when you talk about these pain points.
And so, you know, our goal is really to help give you the tools to succeed. [snorts] Yeah. Yeah. So if you look at a typical practice you know from startup and you know growing out through that first year second year and whether it's clinic count or revenue at what point do you think it makes the most sense to integrate some of Athella's solutions what are some of the key indicators that would suggest a practice has reached the stage that some of these solutions would make sense?
Yeah, it's [clears throat] a great question, Paul. It's it's changed over the years. So, I've been here for two and a half years [clears throat] and what we were able to do for smaller clinics initially. We've we've since moved up market a bit. So I think the sweet spot from a physical therapy standpoint would be like practices that are doing about 2 to four million a year in revenue. But understanding also that we have partners that are doing 20 to 30 million a year. And beyond.
So there's I would say kind of that minimum bar though is probably around that million and a half to two million a year would be kind of the sweet spot to explore our solutions and that they might [clears throat] excuse me might make sense from a financial standpoint. And at that point is it typically you know a you know a menu of you know things that aelis can offer and a company would choose one maybe two and start with that and then gradually grow. It can be.
Yeah. And I think you know to go back to your question for a second, I think some of these practices that we talk to, it's time to implement new technology. Maybe it is just because denials and rejections are starting to get out of control. You know, it can be as simple as revenue. On the flip side, you know, I think 2025 is going to be, you know, all we've heard is it's going to be a big year of M&A, right? So if you can streamline finances, if you can get everything in one spot, you know, then, you know, private equity and acquisitions and all of that fun stuff is a whole different conversation.
But I think that businesses looking to scale really clinics looking to scale and streamline operations is kind of the sweet spot there as well. So, you know, it can be singular problems of just we're stuck on billing or we're stuck on documentation, but oftentimes it's, you know, hey, we're looking to grow, we're looking to hire more, we're looking to streamline operations. Now, where in this process do you fit? But, but yes, I mean, just because you use RCM doesn't mean you have to use EMR or Scribe.
But the goal is really to give you the option to have all of that under the same singular umbrella, the same ecosystem versus all of these add-on integrations and you know kind of alocart options [snorts] and how does typically you know utilizing the resources from ais how does it typically weigh out on you know bodies that are working you know billing collections admin is there a body reduction? Staff reduction, let's call it. Is there a staff reduction? Is it to complement what the current staff is already doing?
Is it do you guys do full outsource? Kind of walk me through the different stages of that. Yeah, I think we have a very unique approach to like if we just focus on RCM for a second, we have a very unique approach to RCM. Because we're not your traditional third-party outsourced biller. Our goal is to give your team the tools to have more transparency into what's happening financially at the practice. So we estimate that we automate about 80% of the revenue cycle process but there still has to be a human touch point a human living and breathing in our software that's at the practice.
So just because we've automated 80% of the revenue cycle you know process does not mean that we can eliminate humans completely. I don't think any of us want to eliminate humans completely in healthcare but we do make it very clear to partners that we do need somebody on site to work with us as a partner. It's a true partnership moving forward. It's daily, weekly conversations of what does our revenue look like? What are some of these, you know, billing rules that we've implemented? What needs to change in order to maximize revenue?
And, you know, increase efficiency. Now, we get asked all the time, does that mean I should cut my staff, my admin staff? Right? And I never, you know, advise on that specifically. I think that track record-wise, practices have the option to after they implement our revenue cycle product. That being said, some people have admin staff that have been with them 20, 30, 40 years, right? In no way, shape, or form are we trying to oust them. Really, we're just trying to, you know, supercharge them with these tools to make their dayto-day a little less mundane, a little less repetitive.
Are you assisting them in that decision based on an ROI? You know if we're keeping the same people and then we're adding additional cost we have to also show business owner what are they getting back that's going to now give the ROI unless we start you know and I can tell you 20 you know 30 years ago there were it's amazing in physical therapy there's days that you say oh I love my staff I would just keep them forever there's days where I would say oh my gosh how can we, you know, maybe lose a couple people.
So, kind of walk me through that. Yeah. How you go through that? Yeah, absolutely. I think I think it it's critical for us to really customize all of our conversations based upon the needs of the client. And so one of the things that we typically will do with practices that we're having conversations with is to do an analysis of their current financials. See where there are some potential holes in the system. Understand are they in-house? Are they outsourced? You know what does that look like from an in-house team?
Is are they happy with the team? Do they want to retain everybody? And then as we look at that analysis and [clears throat] then look at a cost breakdown, kind of a current cost versus future cost projections. We will plug into that conversation of, you know, do you plan on having a headcount reduction? Are you planning on retaining everybody? There are some instances, Paul, where we can get fairly creative with sites. You know, if they want to retain everybody. But from a cost standpoint, that doesn't make sense.
We can get a little flexible with how we make that work. And, Sure. But I think I think, you know, just to piggy back on what Bridget said is that the [clears throat] key to what we're doing is utilizing AI to supercharge humans. Humans will always be a part of the equation and should be. But humans without AI will never be able to do what humans with AI can do. And so if we can put those tools in the hands of a practice and practice owners and their staff, we now can get exponential gains in productivity and return.
As businesses grow and it sounds like you're working with growing businesses, you know, if it's, you know, 20 to 30 million of revenues, those are those are businesses that are growing. How does the solutions that you guys utilize support expansion to new locations? Looking to at that point then maybe reduce the administrative burdens of a business. Yeah, I think that's one of the more you know attractive markets for this software in particular is getting all of the financial data into one platform. So we have partners that have, you know, one, two, three admin or billing staff that are running five, 10, 15 clinics because you don't have to have somebody doing all of those same repetitive tasks dayto-day.
They've deployed AI in a way that frees up their staff to work on the things that need those human touch points. But if you're the practice owner, if you're the executive board, whoever it may be, you want numbers, right? You want data. And speaking from experience, oftentimes you get that data on a delay, right? So bec just because January is over doesn't mean I have my financial data for January. It's March now and I'm still twidding my thumbs waiting for admin team to get back to me on the reports that they're pulling from our EMR that was developed 30 years ago, right?
So I think it from a scaling perspective, having a singular platform that gives you real time data, so we're pulling from EMRs, we're scraping paid u portals, payer portals, clearing houses all day long to give the most up-to-date info to these practice owners and exec boards. You can see exactly how much money you made yesterday. You can see exactly how much money you made last week, last month. So I think that that's the most attractive thing as far as a scaling business goes. Yeah. So instant access to very current information as you said as opposed to looking at you know what happened in January.
Today's March, you know, we're late in March right now and like I don't even remember what happened two weeks ago, let alone back in January. In January and you don't know until March. I mean, you know, now what? Now you run into timely filing issues and you're, you know, trying to claw back those misclaims. Absolutely. Yeah. Yeah. So, you mentioned early, Bridget, and this must be your background with NovaCare and, you know, as a kind of a seeing the M&A, the merger and acquisition side of an industry.
You mentioned that 2025 is going to be a good year and so far yes it absolutely has. So to both of you and your experience, how does partnering with Athelas utilizing your tools, how does that influence of physical therapy practices appeal to potential acquirers and partners? Yeah, I think I mean [clears throat and cough] go ahead. Go ahead, Bridget. I'll follow. I was just say yeah I was just going to say goes back to real time data real time insights. So insights is the name of the RCM platform to allow practices to make real time decisions.
I mean, if you are, you know, in the business of M&A, you want to know exactly what you're getting yourself into, right? The goal of these acquisitions is to scale these clinics and to scale them quickly, right? So, if you have a way to do that is not heavily reliant on admin costs and admin bloat, and you can scale a clinical team without having to scale an admin team or a billing team, right? I mean, there's your ROI right there. So, you know, you're increasing the amount of revenue generating FTEES and, you know, either capping or reducing the non-revenue generating FTEEs.
Yeah. Yeah. Any stories certainly you don't have to tell me the name of the company but any stories that you guys may have on when you guys have joined a company they're using your platform and they've had an opportunity to grow topline and also bottom line absolutely I'll chime in here about a practice that physical therapy practice here in Utah they have four locations And early on partnering with them, one of the things that we looked at again with that analysis that we do is we look at your CPT codes, combinations of CPT codes, how those relate to peers.
And one of the things that we noticed with them is that pretty substantially different billing practices compared to their peers within this market. And specifically not billing therapeutic activity at near the same rate as some of the other clinics did in the area. You you know you know as well as I do that we can bill pretty much any of the CPT codes based upon whatever we're doing in the clinic. They all dependent on what our goal or our aim is with what we're doing with the patient.
And so I can build neuro reed or I can build therapeutic activity dependent on what my goals and objectives are. So with this practice we let them know this is how you compare to your peers. They had just an internal meeting and talked with their clinicians and kind of educated them a little bit about that nuance. And within I believe it was two or three months with partnering with us, they were seeing an $8 per claim increase, which you know, again, billing 20,000 claims annually, that's a pretty substantial chunk of change.
Absolutely. Absolutely. No, that that's awesome. Now are there any you know when you build therap let's say you build therapeutic or exercise is there anything that would remind are there any reminders either on the side of billing more aggressively or whoa you're over you know are there reminders in the system that will at least give a red flag to clinicians as they're you know billing those codes in the EMR side. Yes. So, when I ran my clinic, I we always told our clinicians that billing is the one thing you want to be really average at.
You don't want to be on the very low side. You don't want to be on the very high side. You want to be very average in your units build. But I think that you know in the EMR space at least is where we have the opportunity to have a lot of fun because the EMR that we have built now allows us to make configurable customizable compliance checks within the note to say you know it might be you need to make sure you document prior level of function but it can also be you know we've written in Medicare 8 minute rules whatever you know specifically this practice needs to flag before those claims go out.
So that we can ensure that we maintain that less than 2% denials across the partners which is where we sit now. Yeah. That that's very minimal. Very minimal. That that's all. Just to just to add to that, Paul, as well, one of the other things that the system will do, the EMR specifically, is as a clinician is documenting if they're using the ambient scribe device, it's going to give suggested CPT codes and ICD10 codes. And then it will also utilize the large language models to suggest you know adding modifiers or other things that may potentially add some benefit to that specific encounter.
And so your clinician again is not having to think through these things as much. They can utilize the technology to give those prompts to help them build more effectively, more efficiently and within compliant rules. Yeah, absolutely. You guys, anything else that you want to add for again physical therapy business owners out there that are struggling with, you know, they've had a platform, it's been on, you know, they they've had it for a long time, their staff is used to it, changing would just be a nightmare.
Anything else you would share for those companies out there that are kind of struggling with, you know, should they bring some new technology in at this point in time? Yeah, and I think yeah, we get that question all the time and I make the joke of if I were to walk into my clinic and tell my clinicians that I were changing their EMR and you have to start using a scribe tool and billing is going to happen differently, my house would have been egged, I mean, for days.
So it's not in today's market. Too expensive. Yeah. Yeah. Exactly. No one can afford a mirror. But I think that approaching it very specifically to each practice is important. And so we have an entire team that sits down with you and says, what is what is the best way to move forward? Oftentimes it's, you know, hey, we're going to start with the back end and we're going to plug RCM into the current EMR so that your clinical team doesn't have to change their workflows, but then we can start seeing that ROI and we can start seeing the increase in revenue.
When we're happy with that, hey, how about the clinical team starts to use the scribe tool. Now, they're used to a, you know, a one-click documentation system of go in, record the note. Sure, we can still, you know, integrate into the current EMR, but then, you know, now you're still having those alocart or tackon options. So, it is oftentimes still a step-wise progression. But I think really by the end of the year and into the next two, three years, the ecosystem that we build is going to continue to be more and more attractive because right now, you know, you tack on a scribe product onto an EMR, it's kind of like going through Expedia to book your flight, right?
If that scribe tool malfunctions, you can't just go straight to your EMR company. Now you've got kind of a middleman. So you know, goal is obviously to streamline operations, increase revenue, give clinicians time back in their day so they can actually treat their patients, and the most efficient way to do that is to have a technology suite that communicates perfectly with each other versus all of these, you know, ad hoc integrations. [snorts] Yeah. No, it sounds like you're providing a methodology to kind of ease into this.
Kind of one tool at a time so that staff and their heads don't just blow up, right? Yeah. [snorts] look, you guys, Bridget and Tom, you guys have been awesome and I think you've given a lot of value to our listeners today. I want to also thank all of you who are participated in this session. And if you have any questions about the content of today's crucial conversations, either for myself or for Bridget and Todd, just click below and let's talk. Thanks and have a great day. Thank
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