Discussion: Rehab Out of Network Substance Abuse Insurance Collections
Jim Peake interviews Ryan Ellison, VP Sales of CollectRx to discuss out-of network billing collections in the addiction treatment industry. The advantage is that CollectRx will not charge upfront fees to generate additional income from past underpayments from previously billed patients. If your addiction treatment center does a lot of out of network billing with some of the big players like United Healthcare, CIGNA and Aetna then it might be worth a phone call to discuss ways to collect on past billings that are basically found profits and revenues. CollectRx takes a commission fee for their services.
Attendees
Jim Peake, Ryan Ellison
Jim Peake: Ryan Ellison is VP Sales with Collect Rx. You guys are doing a lot of what they call Underpayment reviews for out of network claims in the drug rehab business.
Ryan Ellison: Yeah, that’s correct. We’ve been heavily involved and behavioral health for almost 20 years now.
Jim Peake: 20 years.
Jim Peake: Talk to me first off about out of network and in network and why your business is focused on out of network versus in network because then now please.
Ryan Ellison: so, Yeah, I mean I think a good place to start is just, what we do is we focus specifically on out of network claims that have already paid a provider. What the insurance companies have deemed is a quote unquote, reasonable and customary amount. The reason why they do this because the provider does not have a contract with that insurance company for our company to be able to make a difference for a provider.
Jim Peake: OK.
Ryan Ellison: We need to be able to operate in the same gray area to drive revenue. What I mean by that is that if the insurance companies price a claim and say it’s a reasonable and customary amount that is really a gray area or black box that they’re pulling numbers. That’s where we can have an actual impact as opposed to a fixed amount if that makes sense, right? That’s correct. So you’re an in network provider. You’ve entered into an agreement with the insurance companies that your bill charges will be submitted to the insurance company is going to pay you a percentage of those bill charts.
Jim Peake: Right.
Ryan Ellison: That is the agreement and they answer into that agreement, with the understanding that the insurance company will drive patients to their business. When a provider is out of network that agreement obviously doesn’t exist. So the provider can charge whatever they want, but the insurance companies are not going to pay whatever the provider charges.
Jim Peake: So the provider can charge whatever they want, but the insurance company can also pay whatever they want, right?
Ryan Ellison: Absolutely correct. But they have to have some type of rationalization as to why they paid what they did.
Jim Peake: And so they can make up the numbers as they go along and they do that. Through other rehabs in the geographic area?
Ryan Ellison: Yeah, they try to use their pricing. There are literally thousands of different data points that they pull from to come up with these numbers. But the most ones that they have, they rely on heavy as our past experience with providers and a geographic area, What is a national reimbursement for that specific code that was built and then they balance their relationship with the employer groups. At the end of the day, the employer gets the ones that are purchasing the policy. So, therefore, the insurance companies are the bosses, so they are very factor in, how much blowback, they’ll get from one of these employer groups, if they vastly, underpay a claim or they just, don’t pay it all. And then they all look at patient consideration as well. But the three that I mentioned are the biggest books.
Jim Peake: So, if let’s say an out of network claim, the provider charges a thousand dollars and they were only paid for that’s for days worth of treatment. and they only get paid $300. How does your process work to collect the other, maybe $200 or $50.
Ryan Ellison: Or anything, right? I mean It’s going to be very important that the provider has some sort of comparable data to make their arguments. So, if the insurance company is going back to the provider and says we priced you at 30% of your bill charts, which is what to this scenario would be and here the reasons why, it’s based off of the percentage of providers that we’re paying in a geographic area. You can’t go to them and say, hey, I think you owe me more money because you paid me more money on a claim last week that looks similar to this, that won’t work. You need to have, very large pool of, information to draw from.
Jim Peake: So a sample size of, a hundred claims or 50 claims of past clients and maybe with other insurance companies or specifically with that insurance company.
Ryan Ellison: Yeah. The more detailed the more specific the better, So if you can pull in providers in that geographic area, that’s great. Other actual payers is not as effective as focusing on the one that place. They don’t really care what CIGNA is paying you you don’t really care what Aetna is paying you because those are totally different term policies. Right? So you want to be payer specific…
Jim Peake: Gotcha gosh.
Ryan Ellison: you want to try but you need to be provider specific, Obviously, BLOWyou can’t use comparables with a dentist…
Jim Peake: Right.
Ryan Ellison: If you’re in behavioral health. And then you want to try to sync the policies up as much as you possibly can tying it back to an employer.
Jim Peake: And then, how far back can you go? It’s different for each insurance company.
Ryan Ellison: It is for the all types of purpose of what we’re talking about. We would be working within the parameters that the insurance companies put forward, and we would have to look at their timely filing restrictions. Each payer is different.
Jim Peake: Yeah.
Ryan Ellison: Okay, so as I was saying, each payor is different. They each have their own rules. We need to play within those rules. So the big players that we work on are Aetna, CIGNA, United Healthcare. Aetna, has a nine month restriction or 180 days. We’ve push the envelope a little bit further than that. Just we can pull extra claims in for clients. United Health care has 11 months, we push our reviews out to a year, same reason. And then CIGNA actually allows you to go on 18 months, this restriction again is because we are appealing within the concerns constraints of the insurance company’s provisions. There are other avenues to go. For example, you can start involving legal entities and attorneys. They can usually go out much further, but that is a much more aggressive factor. Obviously, you’re submitting demand letter.
Jim Peake: So, let’s say Generic rehab, let’s say California, Florida, New Jersey. Yeah, let’s say a hundred beds and they’re doing. let’s say a million dollars a month and top line revenue just to keep the numbers simple. and they got paid a million dollars a month. I mean, when you go in there, you can. pick up an extra, what 10% in line revenue or more?
Ryan Ellison: And it could potentially be more than forecasting out payments like that is very difficult space and it’s because the claims are so unique and
Ryan Ellison: out of network is a moving target. It changes daily in certain circumstances, but I would be very comfortable saying that, a 10% return on the claims that we dig out of the portals for them, the ones that we identify for them. I should say, is not unrealistic. I think it’s many cases as much higher.
Jim Peake: Okay, so then, let’s talk about the current billing operations at the company and either if they’re using a third-party building, or they’re doing it in-house. How does that work? I mean, they’re already doing the billing. They’re up to speed. Everything’s been paid the last three months. You don’t want to go into those three months that they’ve just gotten paid on everything, right?
Ryan Ellison: I mean, first and foremost, when 90% of our clients help utilize some sort of outside billing vendor, doesn’t matter to us. I mean, we look at the claims through a totally different lens. So in the billing world, the most important part of doing that exercise, getting the next claim out the door, getting it out clean and getting the initial payment in. So let’s say, for example, that billing company sends out a claim for a thousand dollars. They get the 800 Bucks is in their best interest to move on to that one. Next plan, that little 20% delta is not worth the squeeze, then to slow down the entire failing operation. and the reason why is that appealing claims is very time consuming.
Jim Peake: That’s where you, right.
Ryan Ellison: That’s exactly where we come in so that little 20% delta right there, even though it’s not a lot of money because we have the data and analytics that we’ve been compiling over the past 20 years and 5,000 providers nationwide. It allows us not only to meet the arguments on the cases but it allows us to identify multiple so that 20% delta even though a billing company passed on and as they should pass up. We may look at that based off of the data that we have. You make one call to this certain entity and you should get that payout fairly easily. So, our margins are already calculated. In our rates, we can do that work and do it quickly effectively. And, obviously if you scoop up enough of these for providers we are talking about real money,
Jim Peake: Would you consider yourselves in auditor or you’re doing an auditing type of service in some way?
Ryan Ellison: I mean, I would say that It’s a really good question. So I think we’re a little bit of both being an honor and kind of a higher gun for additional revenue. Right? Just finding claims is one part of it. it’s difficult, but it’s not the heaviest lift. the real work comes after, once you start actually working, these claims navigating the system, to make sure you’re talking the right person that can actually make a decision on an additional payment. Making sure you’re speaking the right entity. So it’s not always just the insurance company to go to sometimes it’s an employer group, sometimes it’s different entity called silent PPOs. It’s gonna be important which avenue to take. And then when you get a hold of these people on what arguments to make.
Jim Peake: So you’re essentially a collections agency.
Ryan Ellison: That’s exactly what we are. We are definitely a collections agency, but not your traditional one, right? So traditional collection agencies are going after patients, they’re going after any avenue, where they think they can find money and push that buck, we go specifically after the insurance companies and only on out of place.
Jim Peake: And do they go? Oh no it’s CollectRx again.
Ryan Ellison: They definitely know who we are some very large national clients that we process hundreds of thousands of claims for over the years. So there are certain payers that actually have carved out divisions to deal specifically with us. So yeah, they know who we are and I won’t tell you that. The majority of them don’t like us very much but yeah, we do play by their rules.
Jim Peake: It’s just the cost of doing business for them?
Ryan Ellison: You got it and I will also mention this too, we’ve been around a long time, but in comparison to have those insurance companies, we are a tiny little player. There’s our massive, multi-billion dollar corporations.
Jim Peake: Okay.
Ryan Ellison: We can get it. I’m done. But we’re not beating the company over the head of the sledge hammer.
Jim Peake: Talk to me a little bit about EMR’s. And where do you see them going in the billing space? And how are they playing a role?
Ryan Ellison: I mean, I can’t really speak to EMR’ too much, we don’t interact with, that part of the business specifically where we do the majority of our work is going to be in what are called online, pay your portals, which are these repositories of electron, or explanation of benefits, which is really where we grab Our data, we’re familiar with, most EHRs and billing platforms out there. Yeah. So unfortunately I can’t give you a ton of insight into the future of this.
Jim Peake: The clearing houses.
Ryan Ellison: So You get your billing platform is used to create the claim which is then sent out to the insurance company once it gets there. Then you’ve got a clearing house which is basically going to house the information and electronically and can potentially then branch out that information directly to the insurance company and then send feedback information back to the provider. The EHR is more of a records management system which links to exactly that entire thing together.
Jim Peake: Inside.
Ryan Ellison: So, in the behavioral health space, we typically don’t use a lot of information that’s stored in medical records. Because remember, we’re looking at claims have already paid something.
Ryan Ellison: So that type of information is very valuable in the working at denials.
Jim Peake: Right.
Ryan Ellison: You’re gonna need to actually look at the medical record. That was sent a lot of times. You’ll have to redo them and then resubmit them based off of what the feedback from that clearing house. Which is something that we can do.
Jim Peake: Right.
Ryan Ellison: It’s just not our core business.
Jim Peake: So we were talking about underpayment reviews versus payment or post payment recovery services, where they are basically denials where they are?
Ryan Ellison: Yeah.
Jim Peake: How often does it happen? Where? I’m sort of like the complaint department for the rehabs.
Ryan Ellison: Right.
Jim Peake: Jim we had everything right, we had the right CPT code in there, we got the VOB done, and everything was right. She had the policy and we did everything right, and they denied the claim.
Ryan Ellison: We’re like medical necessity so that is something we see all the time.
Jim Peake: Yeah.
Ryan Ellison: So that really, is a delay tactic that the payors deploy. So, United Healthcare is famous for this, especially in the lab space. They will repeatedly ask for medical records over and over and over and over and over again. And they know that what these poor labs that the likely have them getting that information from referring position is very difficult. So it’s a way for them to basically just get away without paying a claim. Now they’ll do the same thing and behavioral health too. and this is pure speculation. I don’t know this to be a fact, but it would make sense.
Ryan Ellison: We believe that the payers are doing this and an effort to recoup payment,…
Jim Peake: Right.
Ryan Ellison: What I mean by that is that they can deny a claim, 90 days out, requesting the same medical record over and over again, and what happens that claim the money’s sitting in their bank account. So, it’s still accruing interest and interest and interest. So, it’s covering any type of payment that they would make. And we do know that.
Jim Peake: But…..
Ryan Ellison: insurance companies, use it as factoring for payment. So take it with a grain of salt. What it is that’s just kind of our inside speculation.
Jim Peake: So when you work with the rehabs, so far as your contractual setup goes if there a big deposit. Are you charging it by the hour? Or you take a commission?
Ryan Ellison: Yeah, total contingent base and it’s true a sense. So no upfront cost no technology downloads on the provider side, there There’s no monthly maintenance fees, cancellation fees, no long term, binding commitments. None of that stuff is a true contingent arrangement. We only get paid if we are successful.
Jim Peake: That sounds like a pretty low risk way to do business with you?
Ryan Ellison: That’s the idea, is to live and die by our results because if we don’t live up to expectations a client can walk whenever they want. So we keep this honest.
Jim Peake: Gotcha. how about other insurance companies like Anthem or Blue Cross or I guess TRICARE is all in network, right?
Ryan Ellison: TICARE is a difficult one that we TRICARE, Blue Cross & Blue Shield, Humana, Kaiser, there are various different reasons why we don’t work with these payors, which is the longest short of it. The success rate essentially is half of what it is for the other players and just to be straightforward, we do live and die by our results, So we do have a pure contingent relationship. So we’re absorbing all the risk with those payors because a success rate is lower. Right? We don’t have the appetite for that type of a risk. And then also, you’ve got companies like Blue Cross Blue Shield that will punish a provider for going the extra step and getting that additional payment. They’ll just send it to the patient or say I’m sorry to the patient.
Jim Peake: Patient. Yeah.
Ryan Ellison: You got it and the situations obviously it’s a massive loss for us.
Jim Peake: So when they sign into the patient, guess what? The patient goes out to party.
Ryan Ellison: You got it. Yeah, that’s a whole other story, right? There’s a certain point where the insurance company should be liable for any damage that is done to the patient especially and the addiction space. They know the medical records of these patients better than anybody else to give them a check for, 30, 40 50 thousand dollars while they’re still in recovery is just terrible.
Jim Peake: So, what other questions should I be asking about behavioral health and what companies should be thinking about before they hire you? I mean it’s a running their business, the way they should be and doing everything the correct way? What’s the best way that they can run their business? So they don’t have to hire a collections company like you or I don’t know if that’s a right question to ask?
Ryan Ellison: I think that’s a good question valid. So what we do on the back, end of the billing cycle, we feel was the most difficult part of it when you’re out of network. Obviously, I have a vested interest in saying that you should use more company or someone like us to do that type of work. the other side of it though, that’s just as important as the part of billing, meaning the verification of benefits process and you are Very complicated.
Ryan Ellison: We can only do our work successfully if it’s set up in the beginning. So what I mean by that is if you admit a patient that has no other network benefits, no one’s gonna be able to help you get that payment. No one’s gonna be able to help you get those additional dollars as dad on a ride or if you admit a patient that has adamant or benefits but they reimburse to Medicare rates nothing that really anyone’s gonna be able to do for you. And you’ll probably be able to argue for additional payment. You’re talking about rounding errors at that point.
00:20:00
Jim Peake: Right.
Ryan Ellison: That part of it is just as important as what we do on the back end. One other thing we haven’t talked about too are what we call prepayment negotiations. And these are scenarios where companies like Multiplan or Mars or Zealous or namely the other 600 of these vendors There are going to reach out to a provider looking for a discount on their bill charges before the adjudication happens. So before any type of decision has been made on that plane, So in this scenario just think of it this way. No payment has been made, no EOB has been generated. Typically providers don’t have visibility on this because they go directly to a billing company. The billing company is in their best interest to sign off relatively low, meaning if they get an offer at 50% of build charges, that’s an absolute win for billing company. And, they don’t have to report that back to their clients at a grand granular level. It goes into the monthly reports and I’m 50% return on network claims actually pretty good, right? So to the billing company, They can get a daily summary from one of these companies like Multi-plan, where all these, offers to negotiate are on one spot and they can just click down the line except for tonight except and at the end of the day, that’s really not negotiating. We would highly recommend, and this is a service that we offer to you, but even if you didn’t use us for this, I would highly recommend reaching out to your billing company and asking them. Hey, how many of these are we getting a month? What is the average allowable that we’re signing off on?
Ryan Ellison: Really important the service that we offer would obviously be to negotiate on behalf of the client and we would leverage the same data and analytics that we have on the post payment of things, to drive the ALLOWABLES or those build charges, the payments up to the highest point possible and really knowing that you’re getting the most out of each one of these claims that you can possibly get. So again, I would say, one of the biggest takeaways from this conversation is definitely ask your billing company about MultiPlan offers is another one too, ask them, if they signed a contract on your behalf with Multiplan, that’s also, completely another potential major downfall but yeah I mean yeah we can talk about that.
Jim Peake: Down.
Ryan Ellison: Another time that gets a little bit complicated but yeah it’s a big part of that we’re going.
Jim Peake: Okay.
Jim Peake: So, I know a billing company that has pre-negotiated rates with Multiplan.
Ryan Ellison: Yeah.
Jim Peake: And they can get some pretty good numbers.
Ryan Ellison: So let’s talk about that. So understanding who Multiplan is very important Multiplan. Kind of plays themself off as an advocate for the providers in an advocate for patients. We’ve seen this a lot in the behavioral health space, they come to providers with these amazing offers, they’ll say, hey, we’ll give you 80% of your build charges or the allowed amount or 80% out of network pricing. What they don’t tell you is that they work for the payers and that the payers that you’re getting this contract with. don’t have to access that contract if they don’t want to, so you start to think it through you’re like, why would an insurance company ever access? One of these agreements? They’re not in the business of losing money.
Ryan Ellison: The short answer is, they’re accessing that contract because it’s benefiting them, they’re basically taking money out of your pocket to do so meaning that if that contract wasn’t in place the claim, what a higher pursuant, to the contract that they have with the employer group, does that make sense to you?
Jim Peake: Yeah, I make sure and insurance companies. they’re more profitable than banks. they’re the most profitable financial concerns in the country……
Ryan Ellison: Absolutely.
Ryan Ellison: Yes, they are. And so I think that with that in mind, there’s no scenario where they’re going to be entering into an agreement, what that does not benefit them period. I can tell you without a doubt that even some of the largest healthcare providers in the country, we work with them don’t have in network contracts at 80% of bill charges. so, if something looks too good to be true, it most likely is.
Jim Peake: So, they don’t have in network contracts with multiplication.
Ryan Ellison: so, Multiplan is not a payer. They do not process claims, all they do is price them. And they work directly for the insurance companies. So if you get a contract with MultiPlan and MultiPlan, what they tell providers all the time, sign this piece of paper and you’ll be in network at 80% of your build charge, whatever the rate is with all of these payers, it does not work that way. That contract quote, unquote, contract is a cap of your payment. It is not a guarantee of your payment. I cannot emphasize this enough that…
00:25:00
Jim Peake: Gotcha.
Ryan Ellison: if you have a contract that name a number, Without the contract in place it most likely would have processed higher or it may have processed lower to begin with. But the opportunity to appeal the claim at a higher rate exists.
Jim Peake: It’s not there.
Ryan Ellison: you got it, it would actually be there without that contract in place. You put the contract in you’re done.
Jim Peake: Gotcha.
Ryan Ellison: Yeah, follow me. You’ve got the contract with Multiplan I don’t know. 80% of bill charges, It processes goes straight through. You get that 80% of bill charges, everyone’s happy. What they don’t realize it without the contract in place. Let’s say it goes to the insurance company and processes at 40% of bill charges but because you’re smart provider, you find that 40%. You say, Okay, I’m going back to the payer, I’m saying, I want 100% of my billed charges and certain circumstances, they will pay just that.
Jim Peake: Okay, 100%.
Ryan Ellison: Ninety nine, ninety percent, they’ll pay higher than whatever that contracted rate is.
Jim Peake: Really okay.
Ryan Ellison: That’s the only time those payers will access. Those agreements is if it benefits them, right?
Jim Peake: Got you? Wow, it’s
Jim Peake: It’s a strange world or living in right now. I mean, they’re
Ryan Ellison: To give this a little credence to just, you…
Jim Peake: and it’s a moving target. Yeah.
Ryan Ellison: people that’s it. Always is. And it changes daily too. I can tell you that’s being in this business. It definitely. Keeps your on your toes?
RRyan Ellison: one thing that I think is important to mention here too, is that I’m not just speaking about this from, personal experience I’ve been doing this a while. I know a good bit about an American, how it works. But our company was actually started by the same guy who started the original MultiPlan, way
back in the 90s. it was a guy named Don Greenberg. He’s actually famous for creating the original nine databases which insurance companies would use to calculate what reasonable customer actually is, he had a company about health ended up. Getting sold to a company called Concentra. Became Viant. Vinant is now MultiPlan.
Ryan Ellison: And the start of it was all this guy, Don Greenberg, who ended up starting Collect Rx after he sold his first company. So, we have a very, very deep understanding of how these companies operate because we used to be them, we still staff very heavily from repricing and negotiation companies like MultiPlan, our headquarters are both in the same town. Negotiators, almost all of them previously worked for MultPlan are co-founders of dining Mr. Sunny Bloom. He actually ran the operations for Multiplan for almost 10 years. He’s the one that actually drafted the templates for the agreements. We were just talking about So we’ve, again a deep understanding of how this stuff works.
Jim Peake: And so, the other guys, like you said, Mars and Zellos, I mean, they’re smaller players In this space.
Ryan Ellison: They are, but I would say, that’s interesting. You bring that up The majority of those little companies that I just mentioned, are actual subsidiaries. And multiply So Multiplan is a large umbrella company, they own Mars, they own violent. They own a lot of the other guys. So PMCS. Yeah, I mean, Multiplan is notes, no small company, they’re publicly traded, he backed by the Carlisle group there there, you…
Jim Peake: Yeah. There are MultiPlan for Multi-billion Dollar Company.
Ryan Ellison: Massive big boys.
Ryan Ellison: Multi billion dollar. Yeah, that’s saying that range for sure. Yep.
Jim Peake: Really. Wow.
Jim Peake: And so, Gonna ask you to forecast. so, looking at the rehab space in the next Three to five years. Where do you see it going as they’re more in network?
Ryan Ellison: I think that’s fair. I mean, we had this conversation recently all about a network in general. And hey, is there a tide turning? Is it less than there was before? And, is out of network going away? We don’t think so and The pure fact that the amount of revenue that they generate off of selling out of network, benefits is nothing. They’re gonna back away from anytime soon. So they love selling those policies and look at patients.
Ryan Ellison: People like you and me, I want to have other benefits. I want to be able to go see what doctors I want to go see what happens. If I drink my leg and I’m skiing in a different state. that doesn’t have coverage for my insurance. You need to have those benefits so I know we don’t seem going anywhere. I don’t necessarily think it’s gonna be, a cakewalk to get reimbursements. Never really has been. And then there’s a constantly coming up with new ways to basically screw over providers or under pay them. It’s going to be really important for providers that cannot get in network or, specifically, a choose to be at a network to beef up their collections effort, to make sure that they’re on top of the state.
00:30:00
Jim Peake: so is the behavioral health space, more of a target with denying or short-changing….
Ryan Ellison: I don’t think so I know it feels that way. I think the insurance companies that basically just started to deploy the same tactics that they’ve been using for, decades with other providers, when we compare the behavioral health space to say the emergency medicine space, it is night and day. Those guys are really getting wild. So, no I don’t think that they’re picking on behavioral health and in general, I think that’s just par for the course with it for the payors.
Jim Peake: Yeah, I’ve got a great story on the emergency medical space, but I’ll save that for offline conversation. The amount of money that they charge was it was astronomical for one hour’s worth of work.
Ryan Ellison: Okay.
Ryan Ellison: that’s a whole other story and those rates aren’t gonna go down. Anytime either it’s like this perpetuating circle that just he gets and we get to the guys.
Jim Peake: so, Yeah, I mean, so five years from now, you think they’ll still be kicking the can down the road with the other network stuff and a lot of the providers are still going to try to go in network because they can project. What they’re Earnings and…
Ryan Ellison: I think that that’s definitely a possibility.
Jim Peake: Revenue are going to be.
Ryan Ellison: It depends on who’s financing these providers. I know that, there’s a lot of private equity in behavioral health space currently, and that doesn’t seem to happen. Trying to slow down private equity, guys like the forecast there, they’re financials as tight as they can, so that definitely could drive more in network. As far as the providers out there that are not PE backed, I do think that they’re still and, an opportunity in the outer network space. Again, it’s just as long as you’re savvy, and I mean, this is gonna sound obvious, but I’m continuously surprised by providers that don’t do this, pay attention to your billing,
Ryan Ellison: This pay attention to the way, learn about how, the claim gets processed, stay on top of the monthly reports that you get how ask full transparency from your billing company start there. Because you don’t know what you don’t know. And that can be very dangerous and we talk about your money.
Jim Peake: so, the billing companies are really turned into collections agencies also. Right.
Ryan Ellison: if they’re good they should be right, I mean that back in the day and we first got into this space It was on an exercise, you bill they will pay or what they thought, right? So that’s exactly where billing companies focused was just to get that claim out the door and get that payment and move on to the next one. They have gotten more savvy over the past, ten years. So Yeah,…
Jim Peake: Yeah.
Ryan Ellison: I would tell you absolutely Jim, you need to have a very strong collections are with RCM or billing.
Jim Peake: and so, some of the better billing companies and others
Ryan Ellison: yeah, I do I do and there’s ones that we would recommend. Yeah, there’s some good ones out there. There’s also some very bad ones too.
Jim Peake: So another quick question for you and I think we can wrap this up. So let’s say I’ve got a client that Is about to sell their company and they’re selling the assets. So new co is buying old co old co still is going to get some billings complaints that are going to get paid. They’re coming back in. Can they? Use your services. Even though they are no longer in business and that transaction has come about.
Ryan Ellison: Absolutely. Yeah. So that AR still live as long as it falls within the parameters that we discussed earlier. eighteen twelve or nine months. Absolutely. Yeah.
Jim Peake: Okay.
Ryan Ellison: I’ll still get the payments. Sure.
Jim Peake:
Jim Peake: that’s great. I want to shut off the recording
