In this episode of The Lead Climb, host Steve Donai welcomes Christopher Wolfington, serial entrepreneur and Chief Revenue & Strategy Officer at FinPay, for a candid and enlightening conversation on one of the most overlooked issues in healthcare: the broken patient financial experience. Christopher shares the personal story that inspired the founding of FinPay and how his background in consumer payments helped him recognize the glaring dysfunction in how patients are billed and engaged around the cost of care.
Together, Steve and Christopher explore how the behavioral health industry—particularly SUD (Substance Use Disorder) treatment—has historically neglected compliance and transparency when it comes to patient financial responsibility. From outdated CRM systems to a long-standing “wink and wave” approach to billing, Christopher breaks down the domino effect that left patients confused, providers vulnerable, and revenue on the table. He also offers solutions rooted in consumer protection, compliance, and technology that can dramatically improve both patient experience and provider sustainability.
If you’re a treatment center owner, revenue cycle leader, or just someone who’s ever been baffled by a healthcare bill, this episode is a must-listen. Tune in for sharp insights, real talk, and a refreshing perspective on why fixing the money side of treatment isn’t just a financial issue—it’s a mission-critical one.
Below is a transcript of the show:
3
00:00:09.230 –> 00:00:18.210
Steve Donai: all right. Welcome to this episode of lee climb. Podcast. Today I have Christopher Wolfington with Finpay. Christopher. Why don’t you tell us a little bit about yourself?
4
00:00:19.420 –> 00:00:24.920
Christopher Wolfington: So today, yesterday was my birthday. So let’s start with that. I yeah.
5
00:00:24.920 –> 00:00:25.570
Steve Donai: Birthday.
6
00:00:25.570 –> 00:00:28.820
Christopher Wolfington: Yeah. So another another year survived.
7
00:00:30.330 –> 00:00:35.330
Christopher Wolfington: I’m most proud of the fact that I have. I’m the father of 4 great kids.
8
00:00:35.890 –> 00:00:38.870
Christopher Wolfington: and that’s the most notable thing.
9
00:00:39.040 –> 00:00:44.240
Christopher Wolfington: really. It’s the only thing that matters. In my opinion, everything else is what we’re doing while we’re trying to be good parents, right
10
00:00:45.620 –> 00:00:52.179
Christopher Wolfington: As you mentioned, I’m the founder of Finpay. My day job at Finpay is chief revenue and strategy officer.
11
00:00:52.620 –> 00:00:55.470
Christopher Wolfington: and back in 2020
12
00:00:55.820 –> 00:01:02.269
Christopher Wolfington: we hired a real seasoned CEO, a guy named Tim Kowalski, to run the business
13
00:01:02.400 –> 00:01:10.439
Christopher Wolfington: which has really given me the freedom to focus on revenue growth and strategy, and which is the stuff a. I’m good at. And BI find fun.
14
00:01:10.880 –> 00:01:16.043
Christopher Wolfington: And Finpe is my 7th startup little fun. Fact.
15
00:01:17.160 –> 00:01:20.740
Christopher Wolfington: I’m sort of an entrepreneurial junkie startup junkie.
16
00:01:20.840 –> 00:01:24.049
Christopher Wolfington: I just love the notion of building something from nothing.
17
00:01:25.540 –> 00:01:49.089
Christopher Wolfington: prior companies have had as many as 9,000 employees. That was probably the craziest one we went from Concept to Ipo. I was with a bunch of other people involved. It wasn’t just me we did Jp. Morgan’s 1st ever Ipo back in 1996. So I’m showing my age a little bit there. But I’ve always been in businesses that have been around engaging with consumers.
18
00:01:49.820 –> 00:02:01.260
Christopher Wolfington: And so if there’s 1 common theme between the 7 startups that I’ve been involved in, it’d be that most of them have been around consumer payments and the current Finpe business
19
00:02:01.680 –> 00:02:07.239
Christopher Wolfington: really came about. As a result of my 35 plus years experience in consumer related
20
00:02:08.039 –> 00:02:15.579
Christopher Wolfington: businesses, I was ran into some scenarios in healthcare with some family members. It was just absurd to me
21
00:02:16.000 –> 00:02:20.370
Christopher Wolfington: the way the financial experience was handled in health care
22
00:02:20.490 –> 00:02:23.660
Christopher Wolfington: and coming from a consumer payments background.
23
00:02:24.290 –> 00:02:37.600
Christopher Wolfington: I thought, there’s no way. This is how the largest economy in the United States, you know, engages consumers around cost. It turns out I was right. It was as crazy as it seemed, and so I knew there was a had to be a solution for it. And
24
00:02:37.820 –> 00:02:39.479
Christopher Wolfington: that’s how Fimpy started.
25
00:02:40.230 –> 00:02:42.045
Steve Donai: Awesome. Well, glad to have you.
26
00:02:42.770 –> 00:02:52.710
Steve Donai: one of these. I think this is actually where we’ve met before this. But we really started to know each other was about a year or so ago at a conference, and you and I were on a panel together.
27
00:02:52.960 –> 00:02:53.930
Steve Donai: and
28
00:02:54.120 –> 00:03:10.799
Steve Donai: you for the 1st for the 1st time brought up something that I think probably should have been common sense for me, and it never really hit. So I’m assuming, for the people listening is probably very similar. It was the the role and depth and breadth of compliance and patient
29
00:03:10.930 –> 00:03:19.560
Steve Donai: responsibility for their collections, for their part of a payment for treatment. I think that there’s a misconceptionist industry where.
30
00:03:19.680 –> 00:03:30.080
Steve Donai: if you send them 3 letters, or you text them twice, or all the crazy stuff that I’ve heard about. If you do these 3 things, it’ll it’ll mean you’re you’re meeting needs of compliance.
31
00:03:30.948 –> 00:03:34.310
Steve Donai: Can you talk a little bit about that? Because I I think, from
32
00:03:34.460 –> 00:03:49.360
Steve Donai: from all the guests we have on, the conversations usually lead to compliance in one way. So I kind of want to kick today off with compliance, because that one has always struck out struck me as a topic that isn’t discussed nearly as much as it should be, and is, is wildly important for treatment center owners to understand.
33
00:03:50.500 –> 00:03:55.499
Christopher Wolfington: So the 1st way to start about it is realize that whether it’s fair or not is another debate on another day.
34
00:03:55.700 –> 00:04:01.210
Christopher Wolfington: But behavioral health, specifically, specifically, sud
35
00:04:01.540 –> 00:04:11.550
Christopher Wolfington: has multiple compliance requirements as it relates to how they engage the patient around cost. So number one is what every business has.
36
00:04:11.720 –> 00:04:35.969
Christopher Wolfington: and that’s consumer protection laws, right? So it doesn’t matter if you’re a big bank. If you’re a credit card company, if you’re a healthcare provider, if you’re engaging with patients taking payments from consumers, you have to comply with consumer protection laws. This is something that’s most commonly overlooked in healthcare, and part of the reason is because for a long time nobody cared if the patient paid what they owed
37
00:04:36.260 –> 00:04:59.289
Christopher Wolfington: right the revenue model in prior years, I’m saying prior, meaning 5 years or longer was, hey, look! The reimbursements are strong enough in the sud space, you know. The out of network model was dominant in the beginning, and the reimbursements were so high. Why would you ever alienate a patient, or potentially lose a high revenue admission by talking to a patient or family about money?
38
00:04:59.510 –> 00:05:05.129
Christopher Wolfington: Just wink, wink. Come on in, don’t worry about it, and to be fair to the providers
39
00:05:06.410 –> 00:05:10.920
Christopher Wolfington: like it’s reasonable they didn’t care because the payer didn’t care
40
00:05:11.720 –> 00:05:27.769
Christopher Wolfington: right, and so, if the payer doesn’t care, why should I? As the provider care? And then the domino effect was, well, then, the patient’s not going to care, and the the patient gets in the habit of not having to worry about this money. Oh, the bill came in the mail. Just throw it away.
41
00:05:28.700 –> 00:05:35.259
Christopher Wolfington: the last domino to fall was the technology providers didn’t care.
42
00:05:35.560 –> 00:05:47.770
Christopher Wolfington: So you have crms and emrs and revenue cycle technology that provides no functionality whatsoever around patient financial responsibility.
43
00:05:48.160 –> 00:05:53.569
Christopher Wolfington: anything to help be more intelligent and transparent about how you engage patients about cost.
44
00:05:53.670 –> 00:05:58.750
Christopher Wolfington: And so it was like the perfect negative storm.
45
00:05:59.360 –> 00:06:05.930
Christopher Wolfington: Payer doesn’t care. Provider doesn’t care. Patient doesn’t care. Technology providers don’t care, and all that was great
46
00:06:06.200 –> 00:06:07.910
Christopher Wolfington: until 2,018
47
00:06:08.580 –> 00:06:15.570
Christopher Wolfington: and in 2,018 the elimination and kickbacks and Recovery Act, which is commonly referred to as Ecra
48
00:06:16.720 –> 00:06:20.870
Christopher Wolfington: was a Federal law passed that said, If you’re in the sud business.
49
00:06:21.630 –> 00:06:26.410
Christopher Wolfington: it is now a criminal offense criminal go to jail
50
00:06:27.020 –> 00:06:39.540
Christopher Wolfington: for waiving or reducing out of pocket costs, even for commercially insured patients. So I want to make it very clear. Cms for Medicaid and Medicare patients have always had that rule.
51
00:06:40.140 –> 00:06:56.870
Christopher Wolfington: Right Cms is a way to prevent fraud and inducement has always had a rule that says you’re not allowed to reward patients to induce them to come, get healthcare services through you. That’s why healthcare is one of the few industries that doesn’t have a rewards program.
52
00:06:57.560 –> 00:07:01.030
Christopher Wolfington: I bet most people never even thought of that. Hey? That’s right. Like.
53
00:07:01.030 –> 00:07:02.180
Steve Donai: There’s no Punch card.
54
00:07:02.180 –> 00:07:19.650
Christopher Wolfington: Right. I got right. I get no, I get no free gift cards. I get no. And the reason is is because it’s specifically you’re not allowed to give any type of inducement, rewards or otherwise, for someone to get their healthcare services through. You know your specific medical practice. So in 2018,
55
00:07:20.070 –> 00:07:26.100
Christopher Wolfington: the Federal Government expanded that to include commercially insured patients.
56
00:07:27.150 –> 00:07:29.940
Christopher Wolfington: Right? So what that means is
57
00:07:30.060 –> 00:07:33.010
Christopher Wolfington: that. And think about this. If you’re the provider.
58
00:07:34.250 –> 00:07:49.009
Christopher Wolfington: if the payer hasn’t cared. I haven’t cared. The technology vendors haven’t cared. That means I don’t have any subject matter. Experts that work for me. I never hired someone to be my patient financial management? Vp, or director.
59
00:07:49.470 –> 00:07:55.030
Christopher Wolfington: Because why would I spend money on a part of my business? I don’t care about what’s really interesting
60
00:07:55.530 –> 00:08:00.580
Christopher Wolfington: is, it’s sort of a really double negative.
61
00:08:00.880 –> 00:08:09.710
Christopher Wolfington: So at the same time you had this heightened compliance, requirement put on the provider coincidentally.
62
00:08:09.840 –> 00:08:12.199
Christopher Wolfington: was right. In the middle of this
63
00:08:13.340 –> 00:08:24.139
Christopher Wolfington: rate. Reimbursement, rate compression. I’ll call it right. And the best analogy that I could probably give you and I show this to people all the time.
64
00:08:24.780 –> 00:08:27.470
Christopher Wolfington: Look on your screen, and you compare
65
00:08:28.180 –> 00:08:31.850
Christopher Wolfington: what an admission was worth in 2013,
66
00:08:32.470 –> 00:08:38.390
Christopher Wolfington: and what portion of that revenue was due by the patient. It was less than you know. Roughly, 2%.
67
00:08:39.830 –> 00:08:46.639
Steve Donai: And so for spotify real quick. Just so, everyone knows. In 2013 the patient financial responsibility is at 2.3
68
00:08:46.880 –> 00:08:52.989
Steve Donai: now 25.6. That’s 10 x. That’s that’s pretty significant. Yeah.
69
00:08:53.770 –> 00:09:12.660
Christopher Wolfington: Now that’s not unique to substance abuse, right? Like all throughout healthcare, when the Affordable Care Act sometimes referred to as Obamacare was passed, it really was the 1st time you started to see these high, deductible health plans come into the market, and then employers started to
70
00:09:13.220 –> 00:09:15.249
Christopher Wolfington: employers started to
71
00:09:15.360 –> 00:09:30.349
Christopher Wolfington: offer multiple plan choices for their employees. And you know, let’s think about it logically. You’re an employee. You’re signing up for a health plan, and one of the plans, takes out $500 a month out of your paycheck, and the other one only takes $200 out
72
00:09:32.280 –> 00:09:35.980
Christopher Wolfington: your paycheck like I don’t know. Simple math says.
73
00:09:36.860 –> 00:09:48.759
Christopher Wolfington: Do I want to spend 500 bucks that maybe I’m going to need to use my insurance, and that higher deductible applies as opposed to. They’re definitely taking $500 out of my paycheck. And so you saw this explosion
74
00:09:48.980 –> 00:10:04.799
Christopher Wolfington: using this strategy. This is how employers saved healthcare costs because they let the employee decide which plan they wanted, and think about it. Most people are going to say so. My choice is $500 out of my paycheck or 200. I’m picking 200,
75
00:10:05.100 –> 00:10:09.899
Christopher Wolfington: not realizing that meant when they go to use their insurance
76
00:10:10.620 –> 00:10:17.109
Christopher Wolfington: instead of maybe owing a thousand dollars for whatever care they got now they owe 3, $4,000 for that same exact care.
77
00:10:17.530 –> 00:10:41.470
Steve Donai: Yeah, and a lot of people I know, myself included. We’re fine with that. That sort of mindset is less. We know we have a surgery or a birth, or something that could cost a lot of money that you’re coming up. But for people for substance use treatment, it’s usually not that thought process like, you know what this November we go to treatment and need to spend 30 or $40,000. Right? Is that friend of mine. $200. It is what it is. And then
78
00:10:41.570 –> 00:10:45.300
Steve Donai: boom! Oh, that decision was not the right decision, because now we’re in crisis.
79
00:10:45.800 –> 00:10:50.730
Christopher Wolfington: So now now take that a step further to get back to your original question, that I’m long-winded answering
80
00:10:51.400 –> 00:10:52.430
Christopher Wolfington: compliance.
81
00:10:53.710 –> 00:10:59.270
Christopher Wolfington: So now our rates are coming down as the out of network model is, continues to be under attack
82
00:10:59.530 –> 00:11:08.699
Christopher Wolfington: by rates coming down and payer audits increasing on on a alarming level. I personally have sat in
83
00:11:09.750 –> 00:11:11.120
Christopher Wolfington: twice as many
84
00:11:11.350 –> 00:11:18.439
Christopher Wolfington: payer audits in 2024 as I did in 2023 literally those actually more than twice as many.
85
00:11:18.620 –> 00:11:28.160
Christopher Wolfington: So now I’ve I. My consequences of not collecting this money are potential criminal, you know consequences.
86
00:11:28.660 –> 00:11:35.790
Christopher Wolfington: But the more practical exposure for waiving or reducing these costs?
87
00:11:36.110 –> 00:11:42.869
Christopher Wolfington: Or is payer audits where a payer comes in, audits you and says, Oh, by the way.
88
00:11:42.980 –> 00:11:50.160
Christopher Wolfington: you’ve induced patients because you can’t prove to me that you have standard operating procedures around patient financial management.
89
00:11:50.310 –> 00:12:02.460
Christopher Wolfington: You can’t show me your 3 regular and customary collection efforts, and, you know, show me where your good faith estimates are, and when you show up with spreadsheets and paper to substantiate
90
00:12:02.730 –> 00:12:05.079
Christopher Wolfington: the answers to those 3 questions.
91
00:12:05.240 –> 00:12:17.120
Christopher Wolfington: it really puts you in a position where you’re going to lose that audit, and therefore is a basis by which they may claw back claims. And that’s the more practical risk. Exposure, right? Don’t get me wrong
92
00:12:17.230 –> 00:12:19.250
Christopher Wolfington: if you’re referred to.
93
00:12:19.380 –> 00:12:21.580
Christopher Wolfington: Mostly it’s from the payers. Right?
94
00:12:21.820 –> 00:12:29.070
Christopher Wolfington: The payers refer to the Justice Department, a particular provider. There was a huge Aetna lawsuit
95
00:12:29.330 –> 00:12:44.690
Christopher Wolfington: in the end of 23 for a quarter of a billion dollars, trying to claw back 5 years of claims inside. That lawsuit was of the 6 complaints inside the lawsuit. 4 of the 6 complaints were around inducement.
96
00:12:45.020 –> 00:12:55.990
Christopher Wolfington: The other 2 were around some bad marketing practices, body brokering the normal bad actor stuff, but it tells you how the payers think right. They’re going after where they assume
97
00:12:56.310 –> 00:12:59.220
Christopher Wolfington: that you stink, and the myth in the business
98
00:12:59.690 –> 00:13:01.860
Christopher Wolfington: to really answer your question originally
99
00:13:02.050 –> 00:13:15.859
Christopher Wolfington: is sending 3 statements does not count as a regular and customary collection effort. And I’m using those words very specifically regular and customary collection effort is the actual language in the statute and is statutorily defined.
100
00:13:15.990 –> 00:13:41.169
Christopher Wolfington: What counts. So a phone conversation, a face-to-face conversation, a text message, email efforts simply sending someone. A statement of services rendered does not count on its own as a collection effort. So you can send out 3 statements. Good for you. I’m happy for you. But that’s not meeting any of the compliance requirements in this area of the business that would expose you
101
00:13:41.650 –> 00:13:45.509
Christopher Wolfington: to those both payer audits and regulatory enforcement.
102
00:13:45.650 –> 00:13:52.589
Christopher Wolfington: But more practically, Steve, because compliance always happens to the other guy.
103
00:13:53.400 –> 00:13:53.970
Steve Donai: Hmm.
104
00:13:54.240 –> 00:13:59.900
Christopher Wolfington: Right. And I, you know fib pay, I said, is my 7th startup. I’d be lying if I didn’t say
105
00:14:00.250 –> 00:14:10.619
Christopher Wolfington: historically, when you’re building a business, and you’re trying to scale it and grow it. Someone comes to you and says, Oh, we got to spend all this money over here for compliance for something that might happen
106
00:14:10.870 –> 00:14:21.740
Christopher Wolfington: right? It’s really tempting when you’re really growing, and you’re trying to meet the the financial demands of growing a business to invest in a part of your business for something that might happen
107
00:14:21.990 –> 00:14:22.890
Christopher Wolfington: right?
108
00:14:24.120 –> 00:14:33.529
Christopher Wolfington: and right. You see it with hipaa compliance. Right? You see it with other areas in healthcare Compliance. But here’s the real reason, in my opinion, that this is a big issue.
109
00:14:35.990 –> 00:14:38.449
Christopher Wolfington: The rates have come down significantly
110
00:14:39.170 –> 00:14:45.850
Christopher Wolfington: so with the value of an sud admission 10 years ago
111
00:14:45.980 –> 00:14:51.979
Christopher Wolfington: was here. You know, it was 20 grand, 22,000, even in network. If you’re out of network, double that number.
112
00:14:52.090 –> 00:14:52.820
Christopher Wolfington: right?
113
00:14:54.000 –> 00:15:01.360
Christopher Wolfington: And today it’s 30% less typically.
114
00:15:02.030 –> 00:15:05.839
Christopher Wolfington: And the payers aren’t stupid. One of the interesting things
115
00:15:06.200 –> 00:15:09.519
Christopher Wolfington: the people don’t realize this. So I’ll I’ll share it with you.
116
00:15:09.970 –> 00:15:20.300
Christopher Wolfington: The biggest impact Covid had on this industry. In my opinion, this is strictly my opinion. I don’t have any quantitative data to support this, but the logic really makes sense.
117
00:15:21.670 –> 00:15:31.409
Christopher Wolfington: The payer community was so indifferent about behavioral health, and even more specifically sud that many of them
118
00:15:31.860 –> 00:15:35.799
Christopher Wolfington: carved out the management of the claims
119
00:15:35.930 –> 00:15:39.680
Christopher Wolfington: to 3rd parties like I have Independence Blue Cross in Philly.
120
00:15:40.570 –> 00:15:44.470
Christopher Wolfington: For as long as I can remember, Independence Blue Cross carved out to Magellan
121
00:15:44.740 –> 00:15:48.690
Christopher Wolfington: the management of their, you know, behavioral health claims.
122
00:15:50.200 –> 00:15:53.869
Christopher Wolfington: and so did a lot of other payers, a lot of different states, a lot of different markets.
123
00:15:54.430 –> 00:16:00.710
Christopher Wolfington: And because if you’re the CEO of a blue Cross payer.
124
00:16:00.880 –> 00:16:03.140
Christopher Wolfington: or united, or Aetna, or whoever
125
00:16:03.870 –> 00:16:19.729
Christopher Wolfington: you look at behavioral health claims as a percentage of your overall business that you do. And it’s this small single digit percentage. And you’re like, let’s be honest. Isn’t it reasonable for that person to be like, well, who cares like. Let Magellan have that. I’m going to focus on this other stuff. So now Covid comes along
126
00:16:21.120 –> 00:16:24.279
Christopher Wolfington: and all over the media. I don’t know if you remember this, Steve? But
127
00:16:24.490 –> 00:16:33.409
Christopher Wolfington: you couldn’t turn on the radio or the TV where somebody wasn’t talking about the behavioral health consequences to everybody, including children
128
00:16:33.620 –> 00:16:44.359
Christopher Wolfington: on the lockups and Covid, and what it meant to everyone’s mental well-being and suicide rates and drug and alcohol abuse Yada Yada Yada.
129
00:16:45.050 –> 00:16:51.039
Christopher Wolfington: So you know who else was hearing those messages was the Ceos in the C-suite of all these payers.
130
00:16:52.540 –> 00:16:56.640
Christopher Wolfington: and if you hear someone on the news over and over and over again, telling you
131
00:16:56.960 –> 00:17:06.789
Christopher Wolfington: that there’s a 3 to 7 year tail of the mental health consequences in behavioral health meaning.
132
00:17:07.460 –> 00:17:09.960
Christopher Wolfington: if Covid ends in 2022,
133
00:17:10.440 –> 00:17:17.279
Christopher Wolfington: that means it’s 2029 that they’re still going to have residual impact of mental behavioral health in the United States.
134
00:17:17.880 –> 00:17:20.840
Christopher Wolfington: So if you’re that c-suite of that payer, you’re saying to yourself.
135
00:17:21.160 –> 00:17:23.510
Christopher Wolfington: holy crap! I better get ahead of the curb.
136
00:17:23.859 –> 00:17:45.099
Christopher Wolfington: let’s you know. Let’s get Joe or Mary into my office, whoever it is that’s in charge of that. Joe and Mary get in here. Tell me what’s going on in our behavioral health business, and Joe and Mary go. Well, we don’t handle that you? You decided to carve that out to Magellan. It’s like, Well, okay, we’ll get someone from Magellan in here, and Magellan comes in. And all of a sudden this CEO finds out. Wait a minute.
137
00:17:45.230 –> 00:17:49.260
Christopher Wolfington: We’re paying $3,000 a day for resident. What?
138
00:17:49.500 –> 00:17:55.439
Christopher Wolfington: Wait we’re paying. We’re paying 4 grand a day for Detox. Wait, wait! Who the hell approved that.
139
00:17:55.610 –> 00:17:58.450
Christopher Wolfington: And now, all of a sudden, this huge spotlight
140
00:17:59.470 –> 00:18:02.400
Christopher Wolfington: gets put on the business. Now, if you’re the payer.
141
00:18:03.430 –> 00:18:09.639
Christopher Wolfington: Let’s just be honest. They’re not an insurance company. Everybody calls them insurance companies. They’re arbitrage companies.
142
00:18:10.350 –> 00:18:17.950
Christopher Wolfington: and their arbitrage is I always have to make sure my claims paid is less than my premiums in
143
00:18:18.890 –> 00:18:27.220
Christopher Wolfington: right. As long as my premiums that are coming in the door are more than my claims. Going out the door. My arbitrage, my profits, the difference. So all of a sudden.
144
00:18:27.220 –> 00:18:38.509
Steve Donai: Even more so than that they’re very big into the investments, right? So taking that delta of claims in versus payouts out and investing into the market. So for this year my larger concern for the smaller programs that we work with is
145
00:18:39.170 –> 00:18:55.459
Steve Donai: if there’s market volatility, payers don’t want to pay because they want to be able to maximize the lows for buys, and sell the highs and go from there. So I think that’s for me. I think that’s the other part of the payer concern that we have right now for the rest of this year in particular, is the uncertainty.
146
00:18:55.710 –> 00:18:58.859
Christopher Wolfington: Now take that logic. So now this is the
147
00:19:00.170 –> 00:19:06.409
Christopher Wolfington: I said. I don’t have any quantitative data to support my theory. But let’s take exactly what you just said.
148
00:19:06.920 –> 00:19:12.950
Christopher Wolfington: What you just discussed and is very true is evidenced by
149
00:19:13.070 –> 00:19:17.870
Christopher Wolfington: the attack on the out of network model, because the best way
150
00:19:18.620 –> 00:19:23.350
Christopher Wolfington: to put that pressure on the provider community like you just articulated
151
00:19:23.560 –> 00:19:34.920
Christopher Wolfington: is to force you to go in network. And if you’re in network, I have a managed care agreement with you, and that managed care. Agreement has very specific guidelines and rules about when I do, and when I do not pay you
152
00:19:35.110 –> 00:19:45.350
Christopher Wolfington: for claims that you submit to me, not even as granular as the details in which the claim has to be submitted and what needs to be included in it. So I’ve empowered myself as the payer
153
00:19:45.610 –> 00:19:54.819
Christopher Wolfington: to inflict a level of influence on you, the provider on what I am, and I’m not willing to pay, based on those highs and lows that you just referenced. So
154
00:19:54.970 –> 00:19:58.960
Christopher Wolfington: that so now that makes sense in that context.
155
00:19:59.110 –> 00:20:06.000
Christopher Wolfington: it makes all the sense in the world. Why the payer community is under is attacking the out of network model. And here’s the other evidence
156
00:20:07.330 –> 00:20:11.219
Christopher Wolfington: that I’d love your opinion on if I simply
157
00:20:12.070 –> 00:20:15.010
Christopher Wolfington: would just didn’t want to pay you more.
158
00:20:15.400 –> 00:20:19.580
Christopher Wolfington: If my goal is a payer was, I don’t want to pay $4,000 a day.
159
00:20:20.700 –> 00:20:25.289
Christopher Wolfington: I would simply pay you less all the time.
160
00:20:26.200 –> 00:20:29.360
Christopher Wolfington: Right? I’m only paying you $400 a day. I’m making that number of them.
161
00:20:30.920 –> 00:20:35.480
Christopher Wolfington: The problem with that is the provider can adjust
162
00:20:36.030 –> 00:20:37.909
Christopher Wolfington: both in staffing and other things.
163
00:20:38.250 –> 00:20:46.920
Christopher Wolfington: But what the payer community is doing is they’re not paying consistently low. They’re, I believe, purposely
164
00:20:47.160 –> 00:20:54.380
Christopher Wolfington: paying high on some claims low on other claims, high on some claims, low on other claims. And what does that do to you as the provider?
165
00:20:54.940 –> 00:21:00.809
Christopher Wolfington: The thing I can’t handle the thing I can’t tolerate running a business, especially
166
00:21:02.720 –> 00:21:07.890
Christopher Wolfington: the treatment facility is the unpredictability of my revenue stream, and if I
167
00:21:08.710 –> 00:21:13.929
Christopher Wolfington: I have a payer mix and a patient population where I have no clue.
168
00:21:14.090 –> 00:21:38.320
Christopher Wolfington: What my revenue is going to be. How can I possibly build an infrastructure and a staffing model that allows me to provide quality care, make a profit. So I have a sustainable business. So to me, the biggest evidence that everything you know what you just said, and what I said is the fluctuating rates that they pay on the out of network model, the heavy push to force people to go in network, and once I have you in network.
169
00:21:38.830 –> 00:21:57.749
Christopher Wolfington: the good news is, I’m selling you on the notion that. Oh, you’re going to get more patients because I have a you know, I as a pair of a dominant position in your market. So you’re going to get more patients, even though I’m paying you less, and it’s more predictable revenue. You know what you’re going to get, but what comes along with that is a whole lot of compliance
170
00:21:58.110 –> 00:21:58.790
Christopher Wolfington: and.
171
00:21:58.790 –> 00:21:59.550
Steve Donai: And the
172
00:21:59.880 –> 00:22:05.260
Steve Donai: and hey, and sorry, I think the challenge with that, too, is. And now that that payer has
173
00:22:05.370 –> 00:22:12.589
Steve Donai: 6, 7, 8 in network, same level of care, same billing code programs that in that same market.
174
00:22:12.740 –> 00:22:28.000
Steve Donai: The problem is that you used to get with going in network was, you’ll get our referrals for your treatment. It’s not happening anymore. There’s many programs that work with or in network with lots of payers. And they don’t get a single phone call. And that’s unfortunate, obviously, for them. But the second part is.
175
00:22:28.130 –> 00:22:42.190
Steve Donai: and this is actually on another conversation I had. That will also be on on our pod here, either right before or right after this one is the diversification of revenue streams for treatment centers is paramount. Given what you just said, there is that
176
00:22:42.490 –> 00:22:44.040
Steve Donai: unpredictability
177
00:22:44.230 –> 00:23:05.939
Steve Donai: that then compounds with seasonality, and then compounds with the competition increases that are going to these markets, that compounds with increased cost of goods sold increased labor due to inflation, so you can either continue to take your contracted payments that are varying, or late, or slow, or fast, or high or low that you have really no control over.
178
00:23:06.230 –> 00:23:30.770
Steve Donai: and and you can’t. You can sit there and take it, or you can do something about it which is diversifying revenue streams increasing the length of engagement with clients, improving patient financial responsibility. There’s there’s a lot of different ways of of approaching that, but doing nothing is not a strategy. And that’s far too often what we’re seeing, even from a lot of the big organizations that we tend to do some work with is the doing nothing or the status quo strategy.
179
00:23:31.170 –> 00:23:36.730
Steve Donai: And that’s a concern to me, because it’s not like we’re having a shortage of patients who need our help.
180
00:23:37.080 –> 00:23:52.689
Steve Donai: But we are having a shortage of proactive treatment centers who are saying, Let’s let’s understand what this looks like. It won’t get voluntarily better. How do we mitigate this and still continue to provide great patient care, because to your point something’s got to give.
181
00:23:52.930 –> 00:24:16.200
Steve Donai: you can have a worse facility if you need to cut costs. You have worse food. You can have lower level employment, you have less employment, which means, you know, higher turnover, which ends up costing you more. Anyway, something has to give in the budget of a treatment center. Unless you’re, you know, pay. It’s all cash. Pay is 6 figures a month, and then that’s a whole different conversation. But if you’re relying on payers.
182
00:24:17.020 –> 00:24:36.239
Steve Donai: either you have to diversify your revenue streams, create longer tail, improve patient responsibility. There’s a handful of things you can do, or you have to make a cut. That’s uncomfortable. I don’t think that’s that’s the best idea for the patient, because I’m I personally believe that patients should enter recovery. Feeling is punitive, and sometimes that’s what those cuts can do.
183
00:24:36.750 –> 00:24:39.429
Christopher Wolfington: And the biggest. This is my opinion.
184
00:24:39.670 –> 00:24:40.200
Steve Donai: Hmm.
185
00:24:40.870 –> 00:24:43.489
Christopher Wolfington: The biggest challenge is if you ran
186
00:24:44.620 –> 00:24:47.090
Christopher Wolfington: an out of network model for a long time.
187
00:24:48.350 –> 00:25:01.019
Christopher Wolfington: and I’m not picking on the Ceos of these companies, but many of them were able to make money despite themselves. In other words, there wasn’t this innate pressure. You know the old adage that necessity is the mother of invention.
188
00:25:02.060 –> 00:25:10.820
Christopher Wolfington: There wasn’t a requirement to have very efficient workflows and processes and automation inside a business right? You could still make a really good margin
189
00:25:12.190 –> 00:25:21.139
Christopher Wolfington: what you just said. And also, as rates are coming down, as you know, Google is getting more. Let’s just call it interesting
190
00:25:21.270 –> 00:25:39.300
Christopher Wolfington: in how they’re bidding for the pay per click and the positioning on the searches is going. So Cpas are going up, I mean, tell me, what could be worse for a business model when your gross revenue rates are coming down at the same time. Your Cpa. And cost per emission are going up. I mean.
191
00:25:39.420 –> 00:25:45.953
Christopher Wolfington: what’s gonna happen is, and I’ll quote one of my customers. It’s a really smart guy, Rob Harrison. He
192
00:25:46.810 –> 00:25:51.470
Christopher Wolfington: He’s a coo, and one of the owners of recovery unplugged, and
193
00:25:51.710 –> 00:26:06.599
Christopher Wolfington: he says the future is the companies that are going to survive and thrive are the ones that are able to have a care delivery model that has the lowest cost, care, delivery model without sacrificing the quality of the care.
194
00:26:06.720 –> 00:26:10.599
Christopher Wolfington: And the only way to really do that is literally to search out
195
00:26:10.750 –> 00:26:26.450
Christopher Wolfington: ways to automate everything that you can so that you can become more efficient, including in your staffing model, so that you’re spending your money where the where the care is, and less on manual tasks, and then as part of that.
196
00:26:27.790 –> 00:26:35.960
Christopher Wolfington: it also. If if someone agrees with my point, and what what Rob thinks I happen to subscribe to what he thinks. By the way, for for what that’s worth.
197
00:26:36.750 –> 00:26:44.369
Christopher Wolfington: I personally believe that I think quality of census should always have been everybody’s goal.
198
00:26:45.330 –> 00:26:49.699
Christopher Wolfington: But now you’re going to be forced to be focused on quality. What I mean by quality of census is
199
00:26:50.550 –> 00:26:57.109
Christopher Wolfington: pick programs. You know. You can deliver very efficiently in a cost efficient basis at a high quality
200
00:26:57.590 –> 00:27:08.749
Christopher Wolfington: and then target. Have a good balanced lead Gen. Strategy right? Outreach, biz, dev digital right? Have some balance.
201
00:27:08.930 –> 00:27:10.900
Christopher Wolfington: Understand your market.
202
00:27:11.190 –> 00:27:26.350
Christopher Wolfington: So you have know what that balance should be. Right? It’s not accurate to say, well, California should be, you know 20% digital. And you know, 25. Whatever the math is, the market really dictates what that is based on the demographic of the market. But once you figure that stuff out.
203
00:27:26.700 –> 00:27:30.389
Christopher Wolfington: then it’s a question of sort of what I do
204
00:27:30.670 –> 00:27:35.010
Christopher Wolfington: is the patient financial responsibility, this thing that nobody cared about forever.
205
00:27:35.210 –> 00:27:40.990
Christopher Wolfington: Well guess what this thing that nobody cared about forever now can make the difference between you making money and not making money.
206
00:27:41.370 –> 00:27:44.849
Christopher Wolfington: If the patient owes 20% of all your revenue.
207
00:27:45.260 –> 00:27:47.829
Christopher Wolfington: And in an in-network model, that’s a fact.
208
00:27:49.200 –> 00:27:55.230
Christopher Wolfington: Well, I don’t know how many businesses that you know of that can have 20% of their revenue not pay them
209
00:27:56.350 –> 00:28:00.329
Christopher Wolfington: and still be a sustainable business. And the challenge to most
210
00:28:00.560 –> 00:28:03.309
Christopher Wolfington: operators is they manage from the bookends
211
00:28:03.470 –> 00:28:06.640
Christopher Wolfington: right? What do I know. I know how many admissions I did last month.
212
00:28:07.020 –> 00:28:11.950
Christopher Wolfington: and I know once my claims have adjudicated what I got paid.
213
00:28:12.600 –> 00:28:19.129
Christopher Wolfington: Well, there’s a whole lot of stuff that happens in between those 2 time periods. I mean a whole lot of stuff. And so
214
00:28:19.470 –> 00:28:21.730
Christopher Wolfington: our logic at Fimpe was.
215
00:28:23.020 –> 00:28:29.479
Christopher Wolfington: well, if it’s 20% of your revenue. The 1st step to getting paid, what you’re owed is knowing what you’re owed.
216
00:28:29.930 –> 00:28:36.560
Christopher Wolfington: So we build a 1 of a kind estimator tool that is meant. So the admissions team can say, what is this patient going to owe
217
00:28:36.910 –> 00:28:42.240
Christopher Wolfington: so? And then I can balance between all right. If I think this admission is worth $15,000.
218
00:28:42.550 –> 00:28:45.550
Christopher Wolfington: How much is coming from insurance? How much is coming from the patient?
219
00:28:45.810 –> 00:28:53.490
Christopher Wolfington: And if if a significant portion is coming from the patient. I better collect some of it now, like
220
00:28:53.990 –> 00:28:54.720
Christopher Wolfington: right like.
221
00:28:54.720 –> 00:28:58.429
Christopher Wolfington: Yes, and say there’s been no visibility in the past.
222
00:28:58.770 –> 00:29:12.659
Steve Donai: So let’s talk a little bit more that we’re running out of time on this one, and love to have you back to continuous Cox. These are. These are dense talks. There’s a lot of information on on financial, patient financial responsibility. But the one thing I did want to make sure we addressed is
223
00:29:13.030 –> 00:29:16.234
Steve Donai: so here. What I love about this industry is
224
00:29:16.860 –> 00:29:34.519
Steve Donai: People are truly passionate, and, generally speaking, the extreme majority of people who run treatment centers really care about the patient outcome. You know, I worked in general surgery prior to coming to behavioral health, and I can’t say everyone truly was super passionate about Hernia repair, you know. It was like no one ever.
225
00:29:34.520 –> 00:29:37.980
Christopher Wolfington: I can tell you. I’m not passionate about Hernia repair.
226
00:29:37.980 –> 00:29:53.569
Steve Donai: I was passionate about my 3 hernia surgeries. But but other than that, when I when I worked in it, no one ever asked me like, Why are you doing this? Did you have a hernia? Does a relative a hernia like? No, no, it people just did their job. It was what it was. But here people care right it matters, and
227
00:29:53.860 –> 00:29:56.420
Steve Donai: and for better, for worse. That leads to a lot of people
228
00:29:56.590 –> 00:30:09.309
Steve Donai: with a high level of passion, but probably a lower than general for a healthcare company. Level business acumen coming into a role of an executive and treatment center, sometimes like and like you said earlier. They were successful. Kind of
229
00:30:10.000 –> 00:30:15.250
Steve Donai: you know, without getting out without getting their own way or despite themselves. They’re successful. So
230
00:30:15.470 –> 00:30:27.709
Steve Donai: here’s what I’m getting at is the the biggest push, like I’ve gotten over the last decade, and change of doing this line of work is, if I ask the patient to pay me. They’re going to relapse. There’s this like this underlying.
231
00:30:27.840 –> 00:30:34.299
Steve Donai: I would say, self-fulfilling prophecy lie. We tell ourselves, misnomer, that
232
00:30:34.620 –> 00:30:40.439
Steve Donai: a normal business practice that is very common from your dentist to your optometrist, to
233
00:30:40.750 –> 00:30:49.749
Steve Donai: a hernia surgery. In this one specific case, if it’s for treatment, it could lead to negative outcomes. Can you talk on that for a little bit?
234
00:30:50.800 –> 00:30:53.880
Christopher Wolfington: So first, st the best way to dispel.
235
00:30:55.400 –> 00:30:57.640
Christopher Wolfington: in my opinion that crazy thinking
236
00:30:59.070 –> 00:31:04.689
Christopher Wolfington: is so I’m going to ask some rhetorical questions, but feel free to answer, what’s the goal? If I’m
237
00:31:05.500 –> 00:31:08.000
Christopher Wolfington: a treatment facility
238
00:31:08.280 –> 00:31:13.599
Christopher Wolfington: and I have a patient come in the door. What’s my goal for that patient? What’s the ultimate goal.
239
00:31:14.330 –> 00:31:15.290
Steve Donai: Recovery.
240
00:31:15.290 –> 00:31:16.739
Christopher Wolfington: Recovery. They stay sober.
241
00:31:18.350 –> 00:31:22.249
Christopher Wolfington: So we already talked about that you have
242
00:31:22.870 –> 00:31:25.619
Christopher Wolfington: the obligation to collect these out-of-pocket costs.
243
00:31:25.740 –> 00:31:29.419
Christopher Wolfington: and we’ve talked about the myth that people send 3 statements
244
00:31:29.910 –> 00:31:34.559
Christopher Wolfington: just because they think that makes them compliant, which it doesn’t. But that’s not the point here.
245
00:31:35.200 –> 00:31:41.230
Christopher Wolfington: So my goal is to help you be, get sober and stay in recovery. So here’s my strategy.
246
00:31:42.150 –> 00:31:44.060
Christopher Wolfington: I’m going to let you enter treatment.
247
00:31:44.580 –> 00:31:53.230
Christopher Wolfington: I’m not going to talk to you about cost. I might mention your deductible. In fact, I might even try to collect a deductible, which is even worse than doing nothing, and I’ll explain that in a second.
248
00:31:54.200 –> 00:32:00.549
Christopher Wolfington: and all of a sudden I go through my 30 days, 20 days, whatever it is.
249
00:32:00.870 –> 00:32:03.050
Christopher Wolfington: and I get home. And 60 days later
250
00:32:03.910 –> 00:32:07.769
Christopher Wolfington: a $4,500 Bill shows up in my mailbox.
251
00:32:09.280 –> 00:32:11.460
Christopher Wolfington: and then it shows up 3 months in a row.
252
00:32:14.470 –> 00:32:17.340
Christopher Wolfington: Now, would you argue with the fact that
253
00:32:17.750 –> 00:32:21.100
Christopher Wolfington: financial stress is one of the top 3 leading causes of relapse.
254
00:32:21.310 –> 00:32:23.920
Christopher Wolfington: Would you debate me on that right? You wouldn’t.
255
00:32:23.920 –> 00:32:24.550
Steve Donai: I only.
256
00:32:24.730 –> 00:32:26.320
Christopher Wolfington: You would not, nobody would.
257
00:32:26.910 –> 00:32:28.430
Christopher Wolfington: So here’s the model.
258
00:32:28.640 –> 00:32:36.919
Christopher Wolfington: I’m in the treatment business, and I have a business practice that specifically is triggering.
259
00:32:37.410 –> 00:32:41.379
Christopher Wolfington: One of the most common causes of relapse
260
00:32:41.630 –> 00:32:44.650
Christopher Wolfington: within 90 days of when I treated the patient.
261
00:32:45.910 –> 00:32:46.750
Steve Donai: Which.
262
00:32:46.750 –> 00:32:51.159
Christopher Wolfington: Most absurd thing. Now now let me go one step further.
263
00:32:51.610 –> 00:32:58.970
Steve Donai: I was gonna say, and that’s that time period in particular also is where you see the outcome studies start to dip right? That 90 day is that dip.
264
00:32:58.970 –> 00:33:00.849
Christopher Wolfington: So watch. Let me take it a step further.
265
00:33:02.590 –> 00:33:05.600
Christopher Wolfington: So I’m in the treatment business, which means I want to provide treatment.
266
00:33:06.020 –> 00:33:11.020
Christopher Wolfington: So normally a patient that goes through my, my, my facility
267
00:33:11.420 –> 00:33:19.609
Christopher Wolfington: assuming my care is good, my facility is nice, my food is high quality right? My like the experience. The clinical experience was awesome.
268
00:33:20.700 –> 00:33:28.380
Christopher Wolfington: How would you feel if a bill showed up in your mailbox for 3 to 4? Grand that nobody ever told you about? Nobody ever helped you with. In fact.
269
00:33:28.780 –> 00:33:37.869
Christopher Wolfington: if me and this is what I meant about even worse. When I spoke to them they said my deductible was a thousand dollars. Maybe I even paid them that 1,000. So I actually thought I was done
270
00:33:38.110 –> 00:33:48.700
Christopher Wolfington: because you told me my deductible is a thousand. I paid it. You didn’t tell me about coinsurance. You didn’t tell me about copays. You didn’t tell me about this other stuff. Now, this $2,500, $4,000 Bill shows up
271
00:33:49.220 –> 00:33:50.820
Christopher Wolfington: if I relapse.
272
00:33:51.530 –> 00:33:53.420
Christopher Wolfington: I don’t know where I’m going.
273
00:33:53.590 –> 00:33:55.680
Christopher Wolfington: I only know where I’m not going.
274
00:33:56.700 –> 00:34:05.249
Christopher Wolfington: I’m not going back to you, and not only that if I have a friend or family member that needs care, there’s no better brand ambassador in the world than a happy alumni.
275
00:34:05.510 –> 00:34:06.360
Christopher Wolfington: none.
276
00:34:07.000 –> 00:34:24.539
Steve Donai: And let me tell you about that. So my my former doctor, my former primary care physician, sent me a bill is years ago. At this point, 18 months after a service for $25 and 36 cents. Clearly this left impression me, I can absolutely pay a $25 bill, but it was the
277
00:34:24.969 –> 00:34:49.819
Steve Donai: the audacity to send this bill 18 months after saying, Hey, you got to pay us this money, or we’ll ding your credit if you don’t pay it. I don’t know, with no explanation that said, you know what I’m done with this practice. If that, if you can’t have that conversation with me. You can’t have a well run practice. I don’t trust you have a well run clinical medical product right? So for me personally, that happened on such a small scale. I can only imagine, from the patient standpoint to you, saying I’m done.
278
00:34:49.929 –> 00:34:56.599
Steve Donai: I’m not going back. If if 4,000 $5,000 hits my mailbox, and I’m expected to pay it, and there’s never brought up, and you can’t tell me.
279
00:34:56.600 –> 00:35:25.649
Christopher Wolfington: Well, not only that. Think of the stress. Someone’s 30, 60, 90 days out of treatment, probably maybe not even back into an employment scenario yet, or if they are, they’re recently back in, and a statement shows up. Now remember, the provider just wants to be compliant. There’s not even follow up on the statement. They’re not even let me help you with this. Let me answer any questions. No, figure it out on your own like that is so absurd to me. So
280
00:35:25.800 –> 00:35:27.650
Christopher Wolfington: the I and here’s the irony.
281
00:35:28.420 –> 00:35:31.120
Christopher Wolfington: So we did a study we were at.
282
00:35:31.590 –> 00:35:40.300
Christopher Wolfington: We were at about 200,000 patients on our platform. So and about a half a billion dollars of patient financial responsibility risk that we’ve managed.
283
00:35:40.430 –> 00:35:41.920
Christopher Wolfington: And we wanted to know
284
00:35:42.240 –> 00:35:52.599
Christopher Wolfington: to dispel that myth about if I talk about money they’ll relapse, or if I, the more common one is, Steve is, if I talk about money they’ll go to the competitor down the street
285
00:35:52.910 –> 00:35:53.690
Christopher Wolfington: right?
286
00:35:54.500 –> 00:36:01.079
Christopher Wolfington: And, by the way, 10 years ago, without a network with the huge $20,000 bill, maybe you could, you know.
287
00:36:01.670 –> 00:36:03.340
Christopher Wolfington: Show me there’s that.
288
00:36:03.720 –> 00:36:06.800
Steve Donai: Yeah, they’re they’re definitely legacy beliefs based off of that time, that time period, for sure.
289
00:36:06.800 –> 00:36:12.839
Christopher Wolfington: But here’s our data patients that were engaged prior to admission.
290
00:36:13.430 –> 00:36:18.650
Christopher Wolfington: And we had 200,000 patients of data ready for this myth.
291
00:36:19.440 –> 00:36:26.210
Christopher Wolfington: They paid 76% of what they were owed. What they owed the industry average today
292
00:36:26.660 –> 00:36:29.660
Christopher Wolfington: is 13 to 15% collection rate.
293
00:36:30.450 –> 00:36:33.759
Christopher Wolfington: So you have 20% of your revenue that you only collect 13% of
294
00:36:34.450 –> 00:36:43.400
Christopher Wolfington: patients that were engaged prior to admission paid 76% of what they owed their patient satisfaction. Score
295
00:36:43.700 –> 00:36:48.860
Christopher Wolfington: was 97.2 when the process was done right?
296
00:36:49.410 –> 00:36:53.460
Christopher Wolfington: Right? And our that’s 1 of the things our software does is empower.
297
00:36:53.640 –> 00:37:01.320
Christopher Wolfington: The employee at the treatment facility to be more intelligent and transparent and upfront and and empathetic about how they discuss cost.
298
00:37:01.800 –> 00:37:04.570
Christopher Wolfington: And so the satisfaction scores show that.
299
00:37:05.960 –> 00:37:25.010
Christopher Wolfington: and the average length of stay for inpatient was 3 days longer and outpatient was 5.1 sessions longer. And here’s the logic I couldn’t quantify. Why, but it makes sense. If I go into treatment with any concerns about cost in the rearview mirror because I was helped. Somebody helped me work through that.
300
00:37:26.000 –> 00:37:27.330
Christopher Wolfington: Why would I leave early?
301
00:37:29.050 –> 00:37:32.669
Christopher Wolfington: Usually it’s the fear and anxiety concern about cost
302
00:37:33.550 –> 00:37:37.850
Christopher Wolfington: that. And patients in 2025 families. They know they owe money
303
00:37:38.290 –> 00:37:56.700
Christopher Wolfington: just because you don’t bring it up doesn’t mean they don’t know. It’s this big pink elephant, this big gray cloud that follows them through treatment. And the reality is, you know. Look at ama rates. Right? Most Amas are financially related, not just clinically related, right? And so
304
00:37:57.460 –> 00:37:58.920
Christopher Wolfington: it’s complex.
305
00:37:59.330 –> 00:38:02.680
Christopher Wolfington: This is why electronic financial records are so important.
306
00:38:02.860 –> 00:38:09.700
Christopher Wolfington: 90. Some odd percent of the treatment facilities do not have electronic financial records. Think about what
307
00:38:10.310 –> 00:38:14.369
Christopher Wolfington: the world would be like if Emrs Ehrs didn’t exist.
308
00:38:14.880 –> 00:38:21.599
Christopher Wolfington: If people were still using paper and spreadsheets to manage clinical charts and getting claims paid, it’d be a nightmare.
309
00:38:21.940 –> 00:38:24.279
Christopher Wolfington: Yet. Here’s 20% of their revenue
310
00:38:25.800 –> 00:38:36.620
Christopher Wolfington: right that they’re using paper and spreadsheets to manage across multiple departments where the Admissions department doesn’t know what the facility people are doing. Facility people in the back office. Don’t talk. And there’s no
311
00:38:37.190 –> 00:38:43.290
Christopher Wolfington: electronic financial record that crosses over multiple departments on my little thing there, my little love. And
312
00:38:45.510 –> 00:38:50.909
Christopher Wolfington: there’s just like, if I go like this, the it’ll float up the the other thing so.
313
00:38:50.910 –> 00:38:52.089
Steve Donai: Oh, no! We got ours.
314
00:38:52.300 –> 00:38:53.330
Christopher Wolfington: Yeah. So
315
00:38:53.770 –> 00:39:15.899
Christopher Wolfington: the beauty of electronic financial record is, it follows the patient for their duration of their experience with their treatment provider. That means pre-admission. That means during care. That means post discharge. That means, even if it’s a collection conversation, right? That everybody in the organization across multiple departments can always see what’s going on. The compliance is automated
316
00:39:16.000 –> 00:39:40.179
Christopher Wolfington: right? So if you have a payer audit, you literally could flip up a laptop, show the auditor all your standard operating procedures. Show them all the the good faith estimates that you provided for every patient. Show them the 3 regular and customary collection efforts, whether or not. It’s mobile engagement, whether if it’s a conversation and email, whatever it might be, it’s date and time stamped in the system. So and here’s the beauty of it.
317
00:39:41.060 –> 00:39:47.399
Christopher Wolfington: By simply using an electronic financial record, you become compliant number one.
318
00:39:47.510 –> 00:39:50.610
Christopher Wolfington: and if you use it the way you need to to be compliant.
319
00:39:50.770 –> 00:39:55.599
Christopher Wolfington: you’ll get 70% of what you’re owed paid instead of 13%.
320
00:39:57.560 –> 00:40:03.999
Christopher Wolfington: And interesting if you handled all your payment concerns upfront.
321
00:40:04.930 –> 00:40:09.770
Christopher Wolfington: What’s now? Your last experience with your healthcare provider clinical.
322
00:40:11.500 –> 00:40:18.459
Christopher Wolfington: and today, for most people the last experience is financial, the cares, first, st the bill’s second. But if I already took care of it.
323
00:40:18.770 –> 00:40:25.150
Christopher Wolfington: And now I if I relapse, or now, if I have a family member or friend that needs care.
324
00:40:25.590 –> 00:40:28.929
Christopher Wolfington: I’m going to refer them back to the place that I had a great clinical experience.
325
00:40:29.050 –> 00:40:39.670
Christopher Wolfington: and if I had a great financial experience on top of it, even more so. Hey, these were the guys. I couldn’t afford it. I didn’t have any money. This was the place that helped me out. They made the unaffordable feel affordable.
326
00:40:40.090 –> 00:40:41.910
Christopher Wolfington: I’m referring my friend to them.
327
00:40:42.150 –> 00:40:43.699
Christopher Wolfington: And here’s the test.
328
00:40:44.550 –> 00:40:49.930
Christopher Wolfington: Will you agree that the relapse rate in the United States is over 50% like, definitely right?
329
00:40:51.120 –> 00:40:55.820
Christopher Wolfington: Right? So I use 50. I agree it’s way more than that. But I’m saying 50, so nobody can debate this fact.
330
00:40:56.900 –> 00:41:04.180
Christopher Wolfington: The best test to know if your patient financial management strategy is failing you
331
00:41:06.220 –> 00:41:10.540
Christopher Wolfington: when your census is less than 20% alumni.
332
00:41:11.620 –> 00:41:13.180
Christopher Wolfington: you know, you have a problem.
333
00:41:14.460 –> 00:41:15.870
Christopher Wolfington: And here’s the irony.
334
00:41:16.260 –> 00:41:17.649
Christopher Wolfington: And here’s how I’m saying that
335
00:41:18.190 –> 00:41:25.140
Christopher Wolfington: if 50% of the people you admit are relapsing in my example, I think it’s closer to 65%. But let’s just say 50.
336
00:41:26.330 –> 00:41:29.450
Christopher Wolfington: And I have a good facility, and I treat my patients well.
337
00:41:29.600 –> 00:41:32.619
Christopher Wolfington: Why wouldn’t 50% of my census be alumni.
338
00:41:34.760 –> 00:41:55.020
Steve Donai: We’ll see. I appreciate this one, and it’s a great one to end on, too, because the one thing from grow sharp, as we always. For most cases we’ll say 20% is the target for that. Because you do hope your and you hope through outcome studies, that your population is doing better right? And and not coming back. But yeah, 20 is our target. So that’s spot on
339
00:41:56.270 –> 00:42:05.000
Steve Donai: Hey, Chris, hate hate that we have to run out of time. But we we are today. Unfortunately, let’s do a second one sometime soon, though, I like this. I think we have a lot more talk about on this one.
340
00:42:05.000 –> 00:42:08.659
Christopher Wolfington: I? Yeah, I would love to continue the alumni conversation. I had some really.
341
00:42:08.660 –> 00:42:09.500
Steve Donai: Let’s let’s do that.
342
00:42:09.500 –> 00:42:10.869
Christopher Wolfington: Data around that, too.
343
00:42:11.460 –> 00:42:16.280
Steve Donai: Absolutely well. Tell everyone how they can find you and find Finpeg.
344
00:42:16.980 –> 00:42:28.999
Christopher Wolfington: So well, the easy way www.fimpay.com. There’s an obvious one. My direct email is cw, my [email protected].
345
00:42:29.640 –> 00:42:32.480
Christopher Wolfington: And they’re the 2 easiest ways.
346
00:42:32.690 –> 00:42:41.500
Christopher Wolfington: If you’ve ever used financial, electronic financial records, you thought of it. You need a patient financial responsibility estimator tool.
347
00:42:41.800 –> 00:43:06.910
Christopher Wolfington: You’re looking for the ability to have better visibility into this part of your revenue, and who’s paying you, and how they paying you, and where and why. And you’re looking to create automation. That’s that’s what we do. But, like you described, I have a as you could probably tell, a kind of crazy passion about this space, because I think there’s so much good work being done. And there’s going to be some really interesting opportunities
348
00:43:07.010 –> 00:43:18.049
Christopher Wolfington: as a result of everything we discussed today with what’s going on with payers and out of network and in network. And I think we’re going to see a lot of change in the space. And I’m really excited to see you know.
349
00:43:19.890 –> 00:43:24.840
Christopher Wolfington: who are the people that are going to come out on top. I think you’re gonna see a big consolidation wave as the less
350
00:43:25.110 –> 00:43:31.869
Christopher Wolfington: sufficient operators get kind of squeezed out of the space. Because if you’re not efficient, you’re not going to be able to be profitable, and if you’re not profitable, you won’t last right?
351
00:43:32.020 –> 00:43:39.060
Christopher Wolfington: So I love this space. I eat, you know, breathe and sleep it all day long, so I really appreciate you taking the time to chat with me.
352
00:43:39.480 –> 00:43:58.179
Steve Donai: Awesome thanks so much. And if you listened or watched this entire thing, thank you sincerely. I appreciate that. Do the like type thing that I always say to do. Do the touch the buttons, and share with your friends and all that good stuff. If you want to be a part of the lead climb, podcast, ping me, I can easily be found. Chris, thanks so much. Talk to you soon. Man.
353
00:43:58.180 –> 00:44:02.049
Christopher Wolfington: Dave, you’ve been great dude. Really appreciate it had a lot of fun.
