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Transcript

All Things PMI, Payments and Getting Paid Faster with Ben Morfoot (Effra) · No Appointment Necessary

• 0:00
  Michael: Welcome to No Appointment Necessary.
• 0:02
  Michael: Today we have Ben Morfoot from Ephra.
• 0:05
  Michael: Um, Ben, we became aware of Ephra, I don't know, probably about a year ago now.
• 0:10
  Michael: Um, something like that.
• 0:11
  Michael: Yeah, and we sort of met online and we met in person recently.
• 0:15
  Michael: Um, I'm gonna do this one differently because normally I don't let people sort of talk about their products too much or or sort of promote in any way.
• 0:22
  Michael: But I really want to get into Ephra a little bit.
• 0:24
  Michael: Um we'll get into Ben's background, but I really want to get into Ephra because we've had whenever we've put it out to to clients, we've had so much positive feedback.
• 0:32
  Michael: Um, one actually said it's changed his life.
• 0:34
  Michael: I'll tell you who that is after this after this pod.
• 0:37
  Michael: But it is a product that I think is sorely needed in the industry.
• 0:40
  Michael: So I want to kind of explore the product and what you do, and then we're gonna have a really good chat around lots of controversial topics around uh PMI and and so on.
• 0:48
  Michael: But let's start off with your background and tell me what Ephra is.
• 0:53
  SPEAKER_00: Fantastic, sounds good.
• 0:54
  SPEAKER_00: Yeah, so um my name is Ben.
• 0:56
  SPEAKER_00: Myself and the other Ephra co-founders all came from Go Cardless.
• 1:00
  SPEAKER_00: So we're all product builders and we built large parts of that product, as as you and your your listeners probably know.
• 1:06
  SPEAKER_00: That's a payments product helping people to small businesses to get paid really easily.
• 1:11
  SPEAKER_00: So that's our kind of background, that's where we we came from.
• 1:13
  SPEAKER_00: This kind of we really like building software for taking payments and billing and helping businesses to get paid easily.
• 1:19
  SPEAKER_00: And we came into health and sort of saw the way that clinics and other types of providers were working with particularly health insurers, and all of the hoops they had to jump through, all of the steps they had to take, all of the kind of messiness of that interface.
• 1:33
  SPEAKER_00: And we thought, this is kind of mad.
• 1:35
  SPEAKER_00: Like this is the sort of thing that should just be automated end-to-end.
• 1:39
  SPEAKER_00: Bits of it were automated, you know, you've got some APIs for submitting invoices, things like that.
• 1:43
  SPEAKER_00: But there are large parts of it that aren't, and lots of the kind of rough edges, lots of the things that go wrong aren't.
• 1:48
  SPEAKER_00: So we thought we should go and build this.
• 1:51
  SPEAKER_00: Uh, and so that's basically what Ephra is.
• 1:53
  SPEAKER_00: It's it's end-to-end automation for getting clinics paid by health insurers.
• 1:58
  SPEAKER_00: And the thing I think that it's interesting you mentioned that you know the positive feedback, which is great.
• 2:03
  SPEAKER_00: Obviously, that's the thing that really drives us and we love.
• 2:05
  SPEAKER_00: Back when we were looking at different ideas and different sort of areas that we wanted us to start a company, the thing that really drew us to this particular problem was that kind of emotional aspect of it.
• 2:16
  SPEAKER_00: That's what they always say to look out for when you're starting a company.
• 2:18
  SPEAKER_00: Keep trying things out until you find people who are really pissed off about something.
• 2:22
  SPEAKER_00: And when we started talking to clinics about this, that's exactly what we heard.
• 2:25
  SPEAKER_00: People were really annoyed and really excited that something better could be coming along.
• 2:29
  SPEAKER_00: So that's what convinces us to stick around, and that's what yeah, continues to make us stick around every day.
• 2:34
  Michael: So you're you're essentially a tech nerd.
• 2:36
  Michael: Absolutely.
• 2:36
  Michael: You're a you're a techie nerd, you're a geeky developer.
• 2:39
  SPEAKER_00: How the fuck do you end up in healthcare?
• 2:40
  SPEAKER_00: So, yeah, we looked, and like in complete transparency after coming out of Go Cardless, we knew we wanted to start something.
• 2:47
  SPEAKER_00: And it's kind of a it's kind of a relatively trodden path in tech to go off, know you want to start something, but you're exploring different ideas.
• 2:55
  SPEAKER_00: You've got some hypotheses, but you don't know which one exactly is going to be the company that you start, and you go through and you you just sort of test them and and and see which one has legs.
• 3:03
  SPEAKER_00: We tried a few different industries and we we have a few links into healthcare.
• 3:08
  SPEAKER_00: One of my co-founders, his wife is a doctor, one of my other co-founders, he used to work at a big health tech company in France.
• 3:13
  SPEAKER_00: And so we thought, well, have a little look at have a little look at this.
• 3:16
  SPEAKER_00: And we realize, maybe particularly private healthcare in the UK, it's obviously not a huge market, nothing like say the US.
• 3:22
  SPEAKER_00: And therefore, there just seems to be this dearth of good tech here.
• 3:26
  SPEAKER_00: And there are some, you know, there's some great new companies coming through doing all sorts of things, which is fantastic.
• 3:30
  SPEAKER_00: But it does mean that you just have uh a real kind of gray zone of good of good tech solutions.
• 3:36
  SPEAKER_00: And so that got us really excited.
• 3:38
  SPEAKER_00: And then that along with the emotion is what we thought great, let's let's stick around and let's see what we can do in this industry.
• 3:42
  Michael: And I suppose you also scope out a market and you see the size of a problem and the severity of a problem, right?
• 3:48
  Michael: So when it comes to PMI and so on, you saw that there was a gaping hole to fit into where you could fix something that hurt a lot.
• 3:56
  SPEAKER_00: Yeah, exactly.
• 3:57
  SPEAKER_00: It's super easy, I think, when you're starting a company to see, great, I can go in and do this thing 10% better.
• 4:02
  SPEAKER_00: And that might get you some of the way, that might be quite good.
• 4:05
  SPEAKER_00: But there are so many, I guess, headwinds, so many things that can mess you up and ruin the company that in order to give you the best chance of success, you need to be starting with something that feels 10x better than the alternative.
• 4:17
  SPEAKER_00: You know, it needs to feel like shit, this is gonna change the world, this is gonna change my life.
• 4:21
  SPEAKER_00: People need to get really excited because there are gonna be a bunch of things, you know, you're gonna find a bunch of reasons that it's really hard to actually build that product, you're gonna find a bunch of reasons that it's really hard to sell to people, you're gonna find a bunch of things that are gonna be against you.
• 4:32
  SPEAKER_00: So the initial idea you start off with has to really like really feel like you could make a meaningful difference to the problem.
• 4:39
  SPEAKER_00: And that's what we saw, and that's what we got excited about.
• 4:41
  SPEAKER_00: And yeah, there are plenty of headwinds, but that kind of core problem is still there.
• 4:44
  Michael: So let's talk about the problems.
• 4:46
  Michael: So give us the for people listening, watching, like what are the core problems that you solve?
• 4:51
  Michael: Like, give it what's the biggest one and then give us a few more.
• 4:53
  SPEAKER_00: Yeah, so I think I guess that the the sort of simple way of putting it is that when you come to taking insurance, what you really want is an experience, I guess like taking a card.
• 5:02
  SPEAKER_00: You know, the the ideal is the patient has something like a like a card they can authorize at that point.
• 5:06
  SPEAKER_00: You the money doesn't actually change hands, right, when you when you take someone's car payment, but you know they're good for the money.
• 5:10
  SPEAKER_00: That's kind of an authorization.
• 5:12
  SPEAKER_00: At that point, you know it's set, you know where the money's coming from, that's it, it's done.
• 5:15
  SPEAKER_00: But actually, the entire insurance process has very little in terms of upfront assurety.
• 5:21
  SPEAKER_00: You have, you know, this auth code, so it's a it's a code that the patient's been given, but the provider has very little detail about what that auth code is, what it means.
• 5:28
  SPEAKER_00: They have very little information about what they're actually gonna get paid off the back of that.
• 5:32
  SPEAKER_00: And really everything just happens after the fact.
• 5:34
  SPEAKER_00: So the kind of core problem is it's all happening after the patient has left, and it's all the responsibility of the clinic to make it all happen.
• 5:41
  SPEAKER_00: So unless the clinic is really on it and keeping on top of this process, they're just gonna end up with gaps, right?
• 5:45
  SPEAKER_00: They're gonna end up with bad debt and they're not gonna get paid everything they're owed.
• 5:48
  SPEAKER_00: Obviously, we all know PMI doesn't pay as well as self-pay either, so that adds to the problem.
• 5:53
  SPEAKER_00: You know, you're already not getting paid as much, and then you're having to do all of the work to make sure you get paid.
• 5:57
  Michael: Yeah.
• 5:58
  Michael: And it's interesting you talked about experience there as well.
• 6:00
  Michael: That experience, I suppose from both sides though.
• 6:02
  Michael: Um the experience of the patient, like you did to pay me by card, but also then the experience of the clinic as well, right?
• 6:11
  SPEAKER_00: Yeah, completely.
• 6:12
  SPEAKER_00: Yeah.
• 6:12
  SPEAKER_00: And this is one of the things that I think we found surprising.
• 6:15
  SPEAKER_00: When we set, you know, when we set Ephra up, we knew we were going to be solving this problem for providers, and we thought, I mean, patients, you know, patients don't don't patients don't really have much of a problem here.
• 6:24
  SPEAKER_00: As far as they're concerned, their insurance is paying for it and that and that's fine.
• 6:27
  SPEAKER_00: But actually, some of the feedback we've then had from clinics is patients prefer, you know, when the when the process is really smooth, whether that's using Ephra or however you're doing it, when the process is really smooth, patients much prefer it.
• 6:36
  SPEAKER_00: Because actually the worst thing is when you're getting chased for money you don't think you owe, especially if you actually don't owe it, right?
• 6:42
  SPEAKER_00: And that's because of a mistake in the process, either from the insurer has has made a mistake or because the clinic's made a mistake, you can end up with a really bad patient experience because you haven't got the process smooth and sorted.
• 6:53
  SPEAKER_00: So actually it's really good for them if the the clinic's you know got their got their ducks in a row as well.
• 6:57
  Michael: So can you give me a walkthrough just as an explanation of an end-to-end patient comes in, what happens, how does Ephra work, how does it link up, what does it do for the clinic, and so on.
• 7:07
  Michael: Just give me an end-to-end experience.
• 7:09
  SPEAKER_00: So patient will register with a clinic, they'll provide their insurance details ahead of time.
• 7:14
  SPEAKER_00: Typically, that's you know, a policy number and an auth code.
• 7:17
  SPEAKER_00: With um Ephra, I don't want to you know just just just talk too much about our platform, what we do, but but I could sort of give it the way we work.
• 7:24
  SPEAKER_00: Uh with Ephra, we'd also take a card on file ahead of time.
• 7:27
  SPEAKER_00: So we take a credit card saved for that for that patient.
• 7:30
  SPEAKER_00: So we've got everything we need then.
• 7:32
  SPEAKER_00: We've got insurance details we we believe are correct, and we can do some validation on those.
• 7:35
  SPEAKER_00: We've got a credit card we can use to collect any patient liability.
• 7:38
  SPEAKER_00: Then the appointment happens, and what we do is pull all those details immediately, pull all the details about the invoice as soon as the appointment has happened, or even during the appointment in lots of cases.
• 7:48
  SPEAKER_00: We submit them straight to the insurer really quickly, getting really quick feedback in many cases on whether that's likely to get paid or whether we're seeing these signals it won't get paid.
• 7:56
  SPEAKER_00: We are dealing with all the messages and remittances and things that come back from the insurer, so knowing what you've been paid, pushing information back into your practice management systems, clinical, for example, to keeping that all up to date with you, dealing with the patient excesses.
• 8:09
  SPEAKER_00: So if a patient owes some money on their policy because of an excess or a copay, uh, we deal with that, we collect that as well.
• 8:15
  SPEAKER_00: Using the card of file that we collected at the beginning, if we've got that.
• 8:18
  SPEAKER_00: And then we reconcile the whole thing all the way through to your bank account.
• 8:21
  SPEAKER_00: So we're also connected to your bank, we're looking at a fee of the bank transactions, so we can make sure you're paid everything that you should be and that you should be owed.
• 8:28
  SPEAKER_00: So it's kind of like end-to-end from the information collected to the patient at the beginning right through to it hitting your bank account and knowing you've been paid.
• 8:35
  SPEAKER_00: And we automate the whole thing.
• 8:36
  SPEAKER_00: Obviously, we're adding in more and more automations of of different bits of it and other edge cases as we as we go, keep going.
• 8:41
  Michael: So it's pretty hands-off for the clinic owner in other words, taking away lose.
• 8:45
  SPEAKER_00: Yeah, they're all yeah, for the most part, especially for like the majority of your invoices, like we all talk about the problems, and and the invoices that go wrong are the ones that you know the most painful.
• 8:55
  SPEAKER_00: But for the majority, they do go through fine, the deep the insurance details are all correct, they get paid fully, and those basically become kind of a zero touch.
• 9:02
  SPEAKER_00: Those are completely hands-off, so you know, no time needs to be spent on those.
• 9:06
  SPEAKER_00: And for those where they do have some edge cases where things go wrong, gradually we can automate more of more of that.
• 9:12
  SPEAKER_00: We can use um all sorts of smart ways of the ones that look like they wouldn't necessarily get paid, we can automatically get them paid in various ways, and that varies by insurer on exactly what the case is.
• 9:22
  Michael: And and uh sort of that brings me on to another topic, which is someone mentioned it to me, which was age debt.
• 9:27
  Michael: Because when whenever we look at clinics, there's always so much age debt all over the shop.
• 9:31
  Michael: It's it's it's kind of scary actually when when you look at it objectively.
• 9:35
  Michael: I think censors have got have got very used to having a ton of debt there and it will be collected, hopefully maybe someday.
• 9:41
  Michael: But I think it's it's obviously a huge huge problem.
• 9:43
  Michael: I'm sure you saw that as a problem yourself as well.
• 9:46
  Michael: Is that something you've seen and can help solve as well?
• 9:49
  SPEAKER_00: Yeah, exactly.
• 9:50
  SPEAKER_00: Yeah, so age debt, but it's it's very common for us to talk to clinics where they've got a you know an age debt they're not happy with.
• 9:57
  SPEAKER_00: I think it's common for a lot of businesses, but in particular, you know, the insurance, the way insurance works, everything being after the appointment, so many things that can go wrong to lead to that, it's a real problem that falls out of PMI work.
• 10:08
  SPEAKER_00: I think the key thing for that is speed.
• 10:11
  SPEAKER_00: Like this is kind of obvious, right?
• 10:13
  SPEAKER_00: It's an obvious point, but the quicker you, the quicker you deal with things, the less likely they are to become age debt.
• 10:18
  SPEAKER_00: Right?
• 10:18
  SPEAKER_00: If you in extreme cases, if you wait six months until after an appointment, for most insurers you can't build them, right?
• 10:24
  SPEAKER_00: If you wait till six months after the appointment, bill booper, they'll say, sorry, that's obviously far too late.
• 10:28
  SPEAKER_00: Not many clinics get to that point.
• 10:30
  SPEAKER_00: But even things like waiting until the end of the patient's treatment.
• 10:34
  SPEAKER_00: So you give your five booper appointments, the patient's gone, then you go and submit those, and there's an excess the patient has to pay.
• 10:40
  SPEAKER_00: And what a surprise, the patient's now gone.
• 10:42
  SPEAKER_00: As far as they're concerned, their treatment is over.
• 10:44
  SPEAKER_00: You're now having to chase them, re-engage them, bring them back on board.
• 10:47
  SPEAKER_00: Not bring them back on board to be like a self-paid patient or something.
• 10:50
  SPEAKER_00: That would be a really great thing you're trying to do.
• 10:52
  SPEAKER_00: Instead, you're just having to waste time trying to get hold of them to collect that excess payment, as opposed to submitting, you know, submitting that invoice as soon as possible, ideally as the as the appointment is starting, immediately submitting the invoice.
• 11:03
  SPEAKER_00: And if it's with Booper, actually they give you really quick feedback.
• 11:06
  SPEAKER_00: So you can know by the time the patient has left clinic or is even leaving clinic whether there's an excess to pay.
• 11:11
  SPEAKER_00: You can stop them as they're walking out.
• 11:12
  SPEAKER_00: You can stop them as they're walking out of the clinic and go, sorry, we've just seen there's an excess come up on that invoice.
• 11:16
  SPEAKER_00: Can we stop you and take that card payment right now?
• 11:18
  SPEAKER_00: If you've got your ducks in a row and you've got that process down, that's the way to reduce it.
• 11:22
  SPEAKER_00: It's just it's speed and getting that inform, you know, getting remote in as soon as possible, getting the information back as soon as possible.
• 11:28
  Michael: Yeah, and I think it thinking, I just the the thought as a marketing person of um having to call up a patient a month later, a week later, a few days later and ask them for money kind of ruins all the goodwill you've built, right?
• 11:40
  Michael: No matter whether they owe us or not, the last thing you want is to get a call saying you owe us cash, um which isn't good for the clinic either, right?
• 11:47
  Michael: That that patient is not coming back, whether that's your or anything else, that they're gonna see you in a quite negative light and certainly probably not getting any decent word of mouth.
• 11:56
  SPEAKER_00: Yeah, exactly.
• 11:56
  SPEAKER_00: Yeah, and it part and part of that, you know, you you you can do a lot of that, right?
• 11:59
  SPEAKER_00: You can set expectations up front so they kind of understand that rather than this being a kind of a slightly nasty surprise, especially if it's coming after they kind of consider this treatment to be done.
• 12:08
  SPEAKER_00: Letting them know up front.
• 12:09
  SPEAKER_00: That's one of the things when we do when we take car and file, you know, that comes with look, you've got insurance, that's great, that's fine, but you may have an excess to pay, there may be other liabilities, you may think you've paid your excess, but actually do you know when your anniversary date is on your policy, especially it's a work policy, so you might not know when your work renews their contract each year, so your excess may reset, you know, these types of things.
• 12:31
  SPEAKER_00: So you just say, look, this is the expectation, there may be something to pay.
• 12:33
  SPEAKER_00: We're letting you know well in advance, we're taking card on file.
• 12:36
  SPEAKER_00: Um, so this doesn't become a negative conversation down the line.
• 12:38
  SPEAKER_00: You're sort of setting expectation earlier.
• 12:40
  Michael: Just much better experience.
• 12:41
  Michael: And and I think people don't mind that.
• 12:43
  Michael: So when you get hit with something afterwards, you feel like you've been conned.
• 12:46
  SPEAKER_00: Yeah, it's amazing what I I mean, I find this just as running a business generally, you sort of fret about something you know, with a customer or kind of something you might need, you know, like a something you think might be a bad experience.
• 12:56
  SPEAKER_00: But as long as, you know, as long as you set the expectation, as long as you communicate it early, people are actually really happy with things, right?
• 13:01
  SPEAKER_00: As long as you're providing a good service, people are happy to go, yeah, that's fine, that makes sense.
• 13:04
  SPEAKER_00: You explain the reason why.
• 13:05
  SPEAKER_00: Just let them know it's coming.
• 13:07
  Michael: Yeah, and actually that applies for everything.
• 13:09
  Michael: When you uh always say to the team, like, when you make a mistake, just tell people.
• 13:12
  Michael: It's not a problem.
• 13:13
  Michael: One minds, Ben, listen, we screwed up here, we're gonna put it right, but this is what we did.
• 13:18
  Michael: You're like, you know, well, that's fantastic, they're honest.
• 13:20
  Michael: Yeah, yeah, completely.
• 13:22
  Michael: And I suppose in tech it's a little bit like we are gonna have some downtime, get prepared, we're gonna do it at the best time, we're very, very sorry.
• 13:28
  Michael: That's very different to we're down, right?
• 13:30
  Michael: It's like do it the right way.
• 13:31
  SPEAKER_00: Yeah, yeah.
• 13:32
  SPEAKER_00: Communicate in advance, and if anything does go wrong, you know it's gonna happen.
• 13:35
  SPEAKER_00: Just yeah, communicate early and transparently, and people accept it, you know, people understand nothing's perfect.
• 13:41
  Michael: No, exactly.
• 13:42
  Michael: Quickly, I want to just jump onto healthcode and clinic code because for us it's a really important topic.
• 13:48
  Michael: Um, it may not be relevant to everyone here, but I constantly get we cannot leave product X for product Y because it doesn't have health code, and often these are very complex, I'll be nice, shit systems that they shouldn't be on.
• 14:03
  Michael: Um and they should be moving to something much, much better, let's say Clinica, whatever the case may be.
• 14:07
  Michael: But the excuse is always healthcode.
• 14:09
  Michael: Is that still the case?
• 14:11
  SPEAKER_00: So we we're we obviously we we'll deal with a range of practice management systems.
• 14:16
  SPEAKER_00: We've got opinions on which are better than others, but uh we're happy to kind of we're happy to deal with with lots of them.
• 14:21
  SPEAKER_00: But specifically on healthcare, no, so uh we've got you know a large number of clinics uh using using Clinico um and we can um bill for them in some cases, depending uh yeah, healthcare in some cases, depending on the way you've got set up, but you can also just bill uh directly and all the insurers have different ways you can you can do this.
• 14:40
  SPEAKER_00: Booper is kind of like a lot of a lot of clinics we speak to are already billing directly through Booper, and that's really common because they've just got a really good system for it.
• 14:48
  SPEAKER_00: Um but they've all got different ways of doing it, so there are always alternatives.
• 14:51
  Michael: Yeah, that was I gave you a little bit of a put that on a platter for you, Matt.
• 14:54
  Michael: It's like, no, listen, if you want to use Clinico, you don't need to worry about healthcode as much as you might think you do.
• 15:00
  SPEAKER_00: So Yeah, we're always happy to talk through like there are you know there are pros and cons to every approach.
• 15:06
  SPEAKER_00: Um, you know, the stuff the healthcodes that the health code is really useful for does does does really well.
• 15:10
  SPEAKER_00: The reasons that you might want to use other systems.
• 15:12
  SPEAKER_00: We're always happy to chat through uh any of the options.
• 15:15
  SPEAKER_00: We've obviously seen it all really uh hands-on, all the kind of details about the different ways of doing things.
• 15:19
  SPEAKER_00: We can talk through all of them and we can advise what we can help you do, or even what you can do directly.
• 15:24
  SPEAKER_00: And if you don't want to use Ephra, we can we can talk you through what your options are.
• 15:26
  Michael: So let's um get off of Ephra a little bit.
• 15:29
  Michael: Um I'm interested always when when people are kind of involved in the in the um sector and things they see, particularly when they come from outside.
• 15:37
  Michael: Us corporate people often have very, you know, we see the the industry and we're like, oh my god, this this is kind of strange, and sometimes in a good way, sometimes in a kind of this is crazy way.
• 15:46
  Michael: So I want to sort of talk to you about, you know, you you have now seen a lot of clients, you walk in and they say, look, this is our process, I think we've got it pretty, pretty well put together.
• 15:56
  Michael: And you look at it and you go, oh my god, what are you doing?
• 16:00
  Michael: I'd love to hear some sort of examples of problems that you see, experiences that you've had.
• 16:04
  Michael: Funny if you if if you want, um, but it'd be kind of interesting to just get some idea of the kind of things you see.
• 16:11
  SPEAKER_00: Yeah, I think generally the biggest, I guess the biggest problem is so much is still being done manually.
• 16:18
  SPEAKER_00: And this is kind of a boring problem to raise, I guess.
• 16:21
  SPEAKER_00: But one of the like one of the issues is so many of the bits of software being used in this industry just don't talk to each other that well.
• 16:28
  SPEAKER_00: And so you end up making these bridges between them, like something happens here and you need to go and act over here, and that happens based on a person, and fine, you can say that only takes them, you know, sort of two minutes to do that thing.
• 16:39
  SPEAKER_00: But uh, what about if they're doing other things?
• 16:41
  SPEAKER_00: What about if it's delayed?
• 16:42
  SPEAKER_00: What about if they forget to do it or do it wrongly, or they're way on holiday?
• 16:46
  SPEAKER_00: So, like in theory, they sort of lay out this big smart system, and you're like, that's great, but then like what's your bad debt rate?
• 16:53
  SPEAKER_00: And why is your bad debt rate like that?
• 16:55
  SPEAKER_00: Like, if this is all working so perfectly, or okay, what's your average time of going from uh the appointment, the appointment starting, through to money in your bank account?
• 17:04
  SPEAKER_00: That's what we that's what we measure, that's what we really that's the sort of metric we really care about.
• 17:07
  SPEAKER_00: And they often don't know, and then then when they go and they you used to go and look it up, it's it's really long, and you go, but I thought you were doing things like this.
• 17:13
  SPEAKER_00: I think I thought you were billing like every day.
• 17:16
  SPEAKER_00: Uh and if if you were, that that doesn't make sense for it to for it to be that number.
• 17:20
  SPEAKER_00: So I think it's it's this sort of like you theoretically you've got a process, and it's like a theoretical process, but actually large bits of it are being done by hand, and therefore things just things and it's I don't know, like everybody, you know, everybody, every business has flaws, and we all do, I'm sure we do things as well that we think we've got this sorted, and actually there are gaps.
• 17:38
  SPEAKER_00: And so it's you know it can be sort of sensitive to talk about.
• 17:40
  SPEAKER_00: But I think it's really important to reflect on and go like, okay, that's what you're you're saying, but actually, is that actually what happens?
• 17:46
  SPEAKER_00: Like if I go and ask you about how often does that not work, do you know what that number is?
• 17:51
  SPEAKER_00: Do you know where that where it falls through the gaps?
• 17:53
  SPEAKER_00: And like what are you doing to fix that?
• 17:55
  Michael: Yeah, and I I I think there's two things.
• 17:57
  Michael: First is uh my favorite geeky, nerdy topic is open APIs.
• 18:00
  Michael: I think the industry isn't helped by so many systems, software vendors providing systems that simply don't have open APIs and can't talk to each other.
• 18:09
  Michael: So you have to do a lot of manual work.
• 18:11
  Michael: I mean, it seems crazy to me that in 2026, I had to look that up, I was about to say 25, in 2026, we are still kind of sat there with systems that won't talk, and these are central pieces to a business's um infrastructure and and the way they operate.
• 18:25
  Michael: Yeah.
• 18:26
  Michael: Again, it's crazy.
• 18:27
  Michael: So I always say to people if you're gonna if you're gonna buy a system, make sure it talks to something else, even if it's got a fucking webhook or something, like you've got to do something here so you can do some things.
• 18:35
  Michael: Um I've probably just gone over everybody's head there, but um, it is important to have that.
• 18:40
  Michael: So you you've got to give um people an excuse for that because sometimes it's just the case.
• 18:44
  Michael: And then of course got the other problem, which is you don't know what you don't know.
• 18:47
  Michael: It's all well and good me um walking and going, oh, if only you did it that way, or you know, uh if you don't know, you don't know.
• 18:55
  Michael: And and I've certainly been that situation where I think everything's going pretty damn well, and someone else comes in objectively with a bit more knowledge, kind of looks at it and thinks, yeah, it's not.
• 19:03
  Michael: What are you doing?
• 19:04
  Michael: How the f did you set this up?
• 19:06
  Michael: This is crazy.
• 19:06
  Michael: And I'm like, oh, okay.
• 19:08
  Michael: So it's yeah, it's not a criticism, but I think the manual issue is a big one.
• 19:12
  Michael: And I think one other thing that that um you missed is that the more manual work you have, the more mistakes you're gonna get.
• 19:19
  Michael: 100%.
• 19:20
  Michael: And you must see a shit ton of errors from when people are doing things manually.
• 19:24
  SPEAKER_00: Yeah, we what one of the things I think that really surprises us with actually no first thing I gotta pick up on the open API API thing, that actually is is mad.
• 19:31
  SPEAKER_00: When we came in, like in tech, the default is you know, you have an API, your developer documents are public, or your support documents documents are public, everything's out there, anyone can build any kind of integration, and you just go for it.
• 19:43
  SPEAKER_00: And that's what makes your product better because it's part of an ecosystem.
• 19:46
  SPEAKER_00: And that's how you know big tech platforms have become really big because it's really easy to go and build integration with them, and it's not this kind of closed, closed world.
• 19:54
  SPEAKER_00: And this kind of like closed off, oh, we want to negotiate commercials before we open up an API, all this kind of stuff.
• 20:00
  SPEAKER_00: Is uh yeah, I w I mean we've we find it painful, it's really unnatural to us, and it's not the way that you know most of the tech world has like boomed or become really successful is through that kind of collaboration.
• 20:08
  Michael: Um just on that, I want you to explain something there.
• 20:11
  Michael: Um two things actually.
• 20:13
  Michael: One is um what do you mean by commercial arrangements before opening things up?
• 20:16
  Michael: Because I think that's really important for people to understand what that actually means.
• 20:20
  Michael: And secondly, in terms of the tech world, um it's not just not how it works, it's also how businesses businesses only become successful and become optimized when they have access to best of breed products and they're able to to use what they need that's gonna get the job done.
• 20:37
  Michael: And I think in this industry, that isn't recognized.
• 20:40
  Michael: It's like I want one system that does everything, I don't want 10 that do different things, but actually the old standardization thing, you you want to have 10 products that do different things.
• 20:49
  Michael: So speak to the the commercial arrangements thing, because I'm not I I'm not I don't think people know about this.
• 20:54
  Michael: This is interesting.
• 20:55
  SPEAKER_00: So I mean it right, you can understand it.
• 20:58
  SPEAKER_00: So you if we go and talk to, for example, a practice management system, right?
• 21:03
  SPEAKER_00: And they say, look, we've got a customer base, you have a product that you want to sell to that customer base, you want to integrate with us in order to make that experience for the customers really good.
• 21:13
  SPEAKER_00: We therefore, you know, we therefore want some money for you for you for that.
• 21:18
  SPEAKER_00: And this is something, you know, this is this is something that happens, this does happen in, you know, in this sort of wider tech world as well.
• 21:24
  SPEAKER_00: Um, but I think there's kind of two flavors of it, right?
• 21:28
  SPEAKER_00: There is one is we want some money out of you before we're even gonna like let you see our you know our API docs, you know, before we're even gonna sort of suggest that that we could do something here.
• 21:38
  SPEAKER_00: And the other version is like, no, okay, go and have a crack and do something.
• 21:42
  SPEAKER_00: If you want us to promote you or if we want to work more closely together, let's look at some money, you know, look at some numbers and see if money, you know, money kind of needs to change hands.
• 21:50
  SPEAKER_00: That sort of second version is more reasonable.
• 21:52
  SPEAKER_00: Uh, you know, it's it's it's yeah, you you you know, you you do have some customers, but by integrating with your platform, we hope we're making it better for them, but also it's benefiting us.
• 22:01
  SPEAKER_00: So, like let's work out, we'll promote you, you promote us, you know, kind of quid pro quo, let's see, let's see how this can work.
• 22:05
  SPEAKER_00: I'm gonna disagree with that.
• 22:07
  Michael: Um, I actually think that's really problematic because, and let's just put the opposite example in place, which is a, and I don't want to keep mentioning Clinico, they still haven't paid me any money, they should.
• 22:17
  Michael: But um, you take someone on Clinico, you as a developer, me as a we go, right, we're gonna build something.
• 22:23
  Michael: Uh, you don't have to pay anyone any money, you don't have to ask for permit for permission.
• 22:27
  Michael: Of course, if you do something dodgy, I'm sure Joel switch you off.
• 22:29
  Michael: But generally, like there's your product, go and go and build into it.
• 22:32
  Michael: We don't want anything, which means that the customer is only paying you, you're not having to charge a fee on top to cover the cost of the system.
• 22:39
  Michael: And I think people should realise that if if if if they have an open API, if they have a system that doesn't have an open API and they're using you, I don't want to get in too much trouble here, but you are likely charging on top, which is giving money back to that uh initial system.
• 22:54
  Michael: Not always, not not always, but but that can happen.
• 22:57
  Michael: But but here's my problem with this kind of oh, it's fair enough, it's commercial arrangement.
• 23:02
  Michael: That's fine if we're talking about opening up, you know, chat GPT and tokens for Twitter and whatever.
• 23:07
  Michael: I I kind of get that.
• 23:09
  Michael: But it also means that you're in and I go to that vendor and I say, hey, listen, that PO, that practice management system, I say, listen, I've got a competitive product, I'm gonna pay you more, but only if you get rid of Ben and his silly product.
• 23:21
  Michael: You see, there is a risk there.
• 23:22
  Michael: And I don't care about your risk, you're a geeky nerd that makes lots of money in your product guy, but there's a risk to the customer, right?
• 23:28
  Michael: Because if I have spent all this time and effort and energy building everything out properly and and and integrating you with my practice management system, and then they say, Yeah, I don't want this guy anymore, I'm kind of screwed, aren't I?
• 23:40
  SPEAKER_00: You are, yeah.
• 23:40
  SPEAKER_00: And obviously the other yeah, the other thing is even if even if they don't turn you off, right?
• 23:44
  SPEAKER_00: If they're promoting, oh you should use product X versus product Y, is that because it's better or is it because the kickback is larger?
• 23:50
  SPEAKER_00: It's most likely the latter, right?
• 23:51
  SPEAKER_00: That that that's just just just the way of the world.
• 23:54
  SPEAKER_00: Yeah, I think the thing I don't have a problem with it in principle.
• 23:58
  SPEAKER_00: I think the thing that is really concerning is that it's kind of hidden and it's kind of an unknown thing, and it's like secretive behind the scenes.
• 24:05
  SPEAKER_00: Certainly, I mean, like, Clinico are fantastic.
• 24:08
  SPEAKER_00: As you know, their their philosophy is just, you know, like we're gonna make sure you're doing things safely, the right things with data, and all those kind of things, and they're super careful on that, which is brilliant, they should be.
• 24:18
  SPEAKER_00: But you go and do what is really good for our customers, and that'll be really good for us.
• 24:22
  SPEAKER_00: Um we don't want money to change hands, that's not how we work.
• 24:25
  SPEAKER_00: We just want to get the most integrations with the most high quality products, and obviously that's how they built a really good product.
• 24:31
  SPEAKER_00: And people when people move to move to Clinico is because of that, right?
• 24:33
  SPEAKER_00: Because of the range of integrations, and we hear that all the time.
• 24:36
  SPEAKER_00: And it's a really powerful job.
• 24:38
  SPEAKER_00: So you're like, sure, we would love it if everybody was like that.
• 24:40
  SPEAKER_00: But yeah, sadly, it's not always the case.
• 24:42
  SPEAKER_00: Some are more protective than others, and certainly you get to you get to kind of like the extreme end that's a bit more old school where they're super protective and they won't even they won't even sort of talk about integrations unless the the numbers are right.
• 24:53
  SPEAKER_00: Uh yeah, it's it's just not how uh yeah.
• 24:56
  SPEAKER_00: I mean, it's it's it's it's quite short-termist, I think, right?
• 24:59
  SPEAKER_00: It's not it's not how you're gonna build a big and effective company long term.
• 25:01
  Michael: I think it's you're right about the secrecy side of things.
• 25:04
  Michael: Uh it would be good for the customers to know.
• 25:06
  Michael: Like I imagine if um all those, and I'm not gonna name any systems, but all those customers of TMS ABC were told, by the way, all these lovely features that everyone else has, you can't have them because um we aren't willing to pay the money, or or you know, we're gonna charge those people money and they're not willing to pay it.
• 25:27
  Michael: Like I think they would have uh a bit of a PR price.
• 25:29
  Michael: So I think it's important to expose it and say, look, why can't we?
• 25:32
  Michael: There's there's and and you're right, someone like Clinico, I I think Splose are doing it now as well.
• 25:36
  Michael: Um I haven't seen much of Splows, but I think Splows have got rest and it's all open and you can just do what you like.
• 25:42
  Michael: And and um, yeah, I think it's great.
• 25:44
  Michael: I I think the problem is most of these PMSs they think that they can build their ecosystem.
• 25:48
  Michael: They all think they're Apple or four trillion in the account, and we can do everything, and we can do everything better.
• 25:53
  Michael: They've got three developers with about 200 quid in the bank account, and they are not keeping up with people like you who are being innovative and and have funding and are just going for it, right?
• 26:03
  SPEAKER_00: Yeah, I mean we obviously we've got we're super opinionated here that we think like we are really focused down on this one problem.
• 26:08
  SPEAKER_00: We're not trying to make a platform that does everything because we're like, I think you know, we're good.
• 26:13
  SPEAKER_00: Like we're we're I'm we're gonna be sort of quite direct about that.
• 26:16
  SPEAKER_00: Like we're very good engineers are very good, product builders, and we can see a lot of really challenging problems just in the PMI space, just in this one thing.
• 26:23
  SPEAKER_00: We could be developing really smart stuff for for years and keep making it better and better.
• 26:27
  SPEAKER_00: And so, yeah, it doesn't really make any sense to us that you could come and have something as large as the surface area of uh PMS and do a good enough job of this, let alone all the other things you're doing.
• 26:38
  Michael: Well, so yeah it's it's not just that your view, it history has shown us, you know, the the biggest software companies in the world and hardware companies, the oracles, the SAPs, they've never managed to build a single system that just operates perfectly through a through an organization.
• 26:54
  Michael: You're gonna have to plug bits together, and many of them also don't allow you.
• 26:58
  Michael: This isn't like a thing only in the MSK space or in the health space.
• 27:02
  Michael: I remember once um for you to get your data out of a certain uh data warehouse, they charge you 250,000 euros.
• 27:10
  Michael: Uh essentially you had to cut a cable at the back.
• 27:12
  Michael: An engineer came in and cut a cable to allow the thing to uh actually export data.
• 27:16
  Michael: I mean, it was that ridiculous kind of thing.
• 27:18
  Michael: So it's not it doesn't only happen here, but it is disappointing in this day and age where things are much more open and much more transparent that um that this sort of stuff goes on.
• 27:27
  Michael: So it's just slightly annoying for me.
• 27:29
  Michael: Um and we got you and and yeah, you as well.
• 27:32
  Michael: And I think it's uh you know, I I think maybe it's I don't know if it's our generation, I have a feeling I'm like 30 years older than you, but um I I think it's like maybe the tech crew, like I I said to you before before this call, I I want you to offer HMD customers a little discount.
• 27:47
  Michael: And I was very clear, right?
• 27:48
  Michael: Do not give me any money, I don't want money.
• 27:50
  Michael: And we've never taken money for recommending things, and I think it's important to be transparent.
• 27:54
  Michael: If I ever did, I'd say Ben's just paid me a load of money to promote this product, but then I probably wouldn't promote it.
• 28:00
  Michael: It's like interesting funny.
• 28:01
  Michael: But but yeah, I I think um it it's an interesting it's an interesting thing that that one of the things that you find is one of the biggest problems, which is the manual nature of things, has to happen because of the systems that are uh uh prevalent in the industry.
• 28:14
  SPEAKER_00: Yeah, which is a real which is a real shame.
• 28:16
  SPEAKER_00: Yeah, you know your other point was around which you can talk a bit around if it's interesting is human errors.
• 28:21
  SPEAKER_00: Yeah.
• 28:22
  SPEAKER_00: Yeah, which is kind of it's quite wild actually.
• 28:24
  SPEAKER_00: So we I think again, like I think we are naturally sort of quite low ego.
• 28:31
  SPEAKER_00: And I certainly well, we you you go into an industry and you kind of assume sorted, you look at people what people are already doing, you think, oh, they've you know they've got their house in order, they've got a really good s solution.
• 28:40
  SPEAKER_00: Uh there are a lot of kind of, you know, there are a lot of companies you can use to outsource your billing if you want to.
• 28:45
  SPEAKER_00: And we thought, okay, well, like these guys seem to have this lockdown and they're doing a really good job of, you know, they're they're specialists, and we probably can't beat them, but maybe we can do something else, we can have a little look.
• 28:55
  SPEAKER_00: I think one of the things we found on quite early, for example, was um because of the fact that everything, you know, lots of stuff needs to be manual.
• 29:03
  SPEAKER_00: We went in and we would we would talk to clinics who were who'd been using billing companies.
• 29:07
  SPEAKER_00: And we realized that behind the scenes everything's being done manually, right?
• 29:10
  SPEAKER_00: You're just outsourcing it to to often to sort of somebody um offshore, or you know, it's just not in your clinic, but it's but it's somebody else.
• 29:17
  SPEAKER_00: And like the manual errors that were happening were insane, and they were much bigger than in the clinics who were just doing it in-house and didn't have specialist staff and were just keeping on top of it.
• 29:25
  SPEAKER_00: Like in mad things, like you know, like small operations being charged out at sort of like 10 pounds and and you know, this this kind of thing.
• 29:33
  SPEAKER_00: And you're like, and again, if in like if you're the clinic and you're not keeping on top of it, it's really easy for this stuff just to go through and you get beyond your six months, you can't correct it.
• 29:41
  SPEAKER_00: Boob or whoever say, like, look, sorry, you should have corrected it within six months because you know that that that that's been and gone.
• 29:48
  SPEAKER_00: And like these these mad things that go through.
• 29:50
  SPEAKER_00: And like if you're in MSK, right, you're putting through a lot of smaller invoices compared with, you know, it's like a hospital or something.
• 29:56
  SPEAKER_00: And so it is really hard to keep on top of all of them.
• 29:58
  SPEAKER_00: And then as soon as you've got manual parts in that process, you just get you just get all sorts of like underbilling and other errors slipping through and like things slipping through the cracks.
• 30:06
  SPEAKER_00: I think we were really surprised at how much of that was going on, and particularly how much clinics weren't spotting it, or they were they were getting to a certain point and then spotting it and going like, shit, like I've got it, I've got a year of of underbilling here and I've just noticed, and now I need to do something about it.
• 30:18
  Michael: Um it's one of those problems as well that it it's it's consistent across the size of the business.
• 30:24
  Michael: When you're a small business, there's only one or two of you, you don't have the time to do it properly, right?
• 30:29
  Michael: So manual errors creep in.
• 30:31
  Michael: But then it's the same as you get bigger, you have more stuff, but you've got so many more um things to deal with, and and suddenly you get just as many mistakes.
• 30:38
  Michael: So it's not like only this stage of business has issues, it's literally every stage of of the business's evolution.
• 30:45
  SPEAKER_00: Yeah, it never stops.
• 30:46
  SPEAKER_00: And yeah, as you sort you're right, it's like it's never fixed at any scale, just the problem looks slightly different.
• 30:50
  SPEAKER_00: We see the same, we see the same problems in like a you know, like a two two physio clinic at a at a much larger one.
• 30:56
  SPEAKER_00: They just present slightly differently and they've got sort of different processes around it.
• 30:59
  SPEAKER_00: You're like, it's the same set of problems.
• 31:00
  Michael: Yeah, and it may be a different amount of money, but to a smaller clinic, it's still a lot of money, right?
• 31:04
  Michael: So it is, yeah, it is interesting.
• 31:07
  Michael: I think um I've also heard uh the moment you start going either multidisciplinary but also multi-clinic and multi-location, it starts becoming an even bigger problem.
• 31:17
  Michael: Um, particularly that multi-location piece.
• 31:19
  SPEAKER_00: Yeah, yeah, it does it complicates.
• 31:21
  SPEAKER_00: And especially this is where you know the practice management system you're using needs to also support that really well, otherwise you can end up in a in a bit of a mess.
• 31:28
  SPEAKER_00: And you know, you are you're doing things per clinic or have you got a central um accounting team, you need to get those kind of things worked out.
• 31:34
  SPEAKER_00: And yeah, multidisciplinary, especially if you start to, and this is not not all physio clinics, but but some will be you know registered as a hospital, they'll be charging facility fees as you go into sort of sports doctors and those types of things, then it it takes a step up in complexity and you're billing, you know, you're sending in multiple different bills for the same appointment, and it just starts to grow in complexity, and you need to become more sophisticated because of that.
• 31:55
  Michael: Yeah, isn't it one criticism I have heard?
• 31:57
  Michael: Um, and we can give clinically some criticisms.
• 31:59
  Michael: One criticism I have heard is for multi-location clinics, they find the clinic code really difficult to use.
• 32:05
  Michael: Is that something you've seen as well?
• 32:06
  SPEAKER_00: Yeah, people have mentioned that.
• 32:07
  SPEAKER_00: Yeah, I mean, we've not like I don't run a multi multi-location clinic, so we can only report what we've heard.
• 32:13
  SPEAKER_00: People have said that, and they've said, you know, when you get to multiple sites, go on and use, you know, this other, this other different PMS.
• 32:19
  SPEAKER_00: And I think uh yeah, we've definitely seen that kind of transition.
• 32:21
  SPEAKER_00: But then we do know, I mean, we've got we've got customers who've got, you know, 10 different locations and they're still using Clinico and they're making it work and it's fine.
• 32:29
  SPEAKER_00: Ultimately, every like every every PMS, every PMS has like a trade-off, right?
• 32:33
  SPEAKER_00: Every everyone has like, oh, it's really great apart from X.
• 32:36
  SPEAKER_00: And if you're waiting for the perfect one, you've either got to pay through your nose for something insane and custom, or you're just never gonna change, right?
• 32:42
  SPEAKER_00: And you're gonna be every few months you're gonna be looking at other PMS and going, mm, I know that one's got something missing.
• 32:46
  SPEAKER_00: You've kind of just gotta you've kind of gonna pick a trade-off.
• 32:49
  Michael: Yeah.
• 32:49
  Michael: I'm uh journey listening, I'm smiling because it just reminds me of the story of a very big PMS.
• 32:54
  Michael: You like this as a tech person, a very big PMS.
• 32:58
  Michael: I think what they were doing was they were running the credentials for all their different clinics off of a single server.
• 33:05
  Michael: So I was doing testing, website testing for one of our clients, and I noticed it already had my details, even though it was a different clinic.
• 33:11
  Michael: So clinic B.
• 33:13
  Michael: So I'm in clinic B and I'm putting my details like, oh, we know who you are, and I'm like, Do you know who I am?
• 33:18
  Michael: And when I logged in, it was it was the same credentials.
• 33:21
  Michael: And then I looked at it, I was like, my god, I can see my appointments for another clinic.
• 33:25
  Michael: This was a major player, and I was like, Yeah, this is so bad.
• 33:30
  Michael: This is so bad.
• 33:31
  Michael: So I let them know, and and and to be fair to them, they did fix it, but they also kind of went, they dismissed it.
• 33:37
  Michael: They were like, What are you talking about?
• 33:38
  Michael: This isn't a big thing.
• 33:39
  Michael: I think internally they were like, Fuck shit.
• 33:41
  SPEAKER_00: Yeah, I'm sure trying to downplay it, but internally, yeah, losing their mind.
• 33:45
  SPEAKER_00: Yeah, that's the nightmare.
• 33:46
  SPEAKER_00: That's when you've got yeah, if you've got cross-contamination between uh yeah, between different customers.
• 33:51
  Michael: Oh, the other funny one, this would be in music for people.
• 33:54
  Michael: I got a call personally, it was from a client at about 8 p.m.
• 33:57
  Michael: on a tw, it was a Tuesday evening, and she's going mad.
• 34:01
  Michael: She's like, what have you done?
• 34:02
  Michael: You've hacked my system, my customers are going crazy.
• 34:05
  Michael: I'm like, oh my god, what's going on?
• 34:06
  Michael: Like, we've just embedded her clinico basically into the website.
• 34:09
  Michael: And she's like, all my patient data is out there, I'm getting complaints, it's all I'm like, oh my god, like this is not, I do not want to what have we done?
• 34:17
  Michael: I'm thinking, hold on a second, we've got embed code.
• 34:20
  Michael: Like, what's going on?
• 34:22
  Michael: Anyway, after about two hours of furious screaming and blaming, whatever.
• 34:26
  Michael: I was like, Can I don't suppose your patient who's put in their details has auto-complete on their browser?
• 34:31
  Michael: And she went, what do you mean?
• 34:32
  Michael: I said, Well, when they put their details in, you know how the details appear?
• 34:35
  Michael: Maybe that's the autocomplete and not and she went, yeah.
• 34:38
  Michael: Anyway, it was a very funny moment, which I couldn't gloat over too much.
• 34:42
  Michael: I was actually more happy that we weren't releasing patient details onto the Yeah.
• 34:47
  SPEAKER_00: We've uh we've we've had exactly the same problem with uh yeah, again, with with sort of like patient-facing forms we've got, where um yeah, they report it, they're like, but they've they've yeah, they've we've already have you already got their payment details.
• 34:59
  SPEAKER_00: And yeah, it's exactly that.
• 35:00
  SPEAKER_00: It's uh auto autocomplete on or um like save save save card from Stripe system where you can save across multiple yeah, things are getting too easy, I guess.
• 35:09
  Michael: Yeah, we had a a funny conversation with another person who does some allows you to link up your clinical API and one of the questions, one of the first questions that first started going out to to new clients on the uh physios, it was a physio, said does this give you access to my credit card?
• 35:23
  Michael: It's like no.
• 35:25
  Michael: Yeah, I I do want to one day, I was gonna do this years ago, but I I I I wanted to do a uh a secret diaries of someone working in the world of um healthcare and just come up with all the really funny things that happen, then we'll do that someday.
• 35:38
  Michael: Not yet.
• 35:38
  SPEAKER_00: We've got some, I'm sure we've got some, yeah, so we've got some stuff that I wouldn't yeah publicly say, but we can we can submit anonymously.
• 35:44
  Michael: Yeah, yeah, exactly.
• 35:46
  Michael: Um all right, here's uh here's another interesting one.
• 35:49
  Michael: If you did own a clinic, let's talk more about gen generally general work on my if you owned a clinic and did have to work with an insurer like in order, because we always get this question like which insurers are good, which ones are bad.
• 36:01
  Michael: But let's say you owned a clinic, what would you do?
• 36:03
  Michael: Which ones would you go with in in order?
• 36:05
  Michael: And are there any without getting yourself into trouble, are the any are there any way you're just like do not go near?
• 36:10
  SPEAKER_00: This is a really good question.
• 36:11
  SPEAKER_00: So I think it what's I think what's what's funny about this is we obviously speak to clinics all the time, and their view on different insurers is wildly different.
• 36:20
  SPEAKER_00: Like we'll talk to somebody and they'll say, like, avoid boober at all costs, it's it's terrible.
• 36:25
  SPEAKER_00: I much prefer you know working with the vitality, and then somebody else will say the complete opposite.
• 36:29
  SPEAKER_00: So I think the first thing to caveat is so much of it is a clinic, and that could be lots of things, right?
• 36:35
  SPEAKER_00: It could be the way you're set up, whether you're billing as a provider, because you can bill as like an individual physio, you can bill as a clinic, you can have different payment timings set up, you can have different ways you're getting remittances.
• 36:45
  SPEAKER_00: Like your experience can vary wildly.
• 36:47
  SPEAKER_00: You should like there are ways you can optimize all of them, but we but we we hear wildly different things.
• 36:51
  SPEAKER_00: But if we assume that you've got kind of the best possible experience that you've kind of optimized things with each of the insurers, I think I would actually no, I'm gonna first caveat.
• 37:01
  SPEAKER_00: The other thing is all the insurers I think have their pros and cons, and the people behind them are generally good, right?
• 37:08
  SPEAKER_00: They want the right thing, they want the right thing for patients, they want the right thing for providers.
• 37:12
  SPEAKER_00: So I don't think any of the insurers, you know, some people think that oh, they actually don't want to pay and they're trying to like throw sand on our face.
• 37:18
  SPEAKER_00: I don't think anything that's true.
• 37:19
  SPEAKER_00: I think it's just like big company stuff, things end up happening and things get in the way.
• 37:23
  SPEAKER_00: So I'll caveat with that.
• 37:24
  SPEAKER_00: Like none of them I think are actively trying to be difficult.
• 37:26
  SPEAKER_00: But if I was, if I had everything set up perfectly and wanted to go with the other insurers, I think I go for different reasons to different insurers.
• 37:35
  SPEAKER_00: Um UPA across the board tend to pay the best rates.
• 37:40
  SPEAKER_00: Um they um they're quite expensive insurer, you know, for for patients, but they offer really high quality treatment.
• 37:47
  SPEAKER_00: You can kind of go anywhere, they offer, they offer really good rates.
• 37:50
  SPEAKER_00: That's kind of part of their deal.
• 37:51
  SPEAKER_00: So if, you know, obviously insurance doesn't pay as well as self-pay, they're they're really good for that.
• 37:55
  SPEAKER_00: That's particularly good.
• 37:56
  SPEAKER_00: For like for like knowing what's going on, things being controllable, things being predictable, uh, I'd go for Bupa.
• 38:02
  SPEAKER_00: Booper are there are they can be stringent on details.
• 38:05
  SPEAKER_00: Like if you get the information wrong, they'll pick it up.
• 38:08
  SPEAKER_00: But they've got lots of automated systems, lots of things happen automatically behind the scenes.
• 38:12
  SPEAKER_00: There's some human input, but a lot of it, as far as we know, is not.
• 38:15
  SPEAKER_00: And therefore, things happen really quickly, things happen predictably.
• 38:19
  SPEAKER_00: And if you've got your abduction row, if you've got your information right, you're gonna get paid and you know where you're gonna get paid.
• 38:23
  SPEAKER_00: Um, then I think the other one for acts are kind of sort of different to Booper in that things can still go wrong in ways they they wouldn't with Booper because it feels like you know, maybe more behind the scenes is done a little bit more manually, but also means they're a bit more forgiving than Booper.
• 38:39
  SPEAKER_00: Um so if you, you know, get your your patients say surname wrong and and it's because they've got remarried or something, we quite often see they'll correct that for you, for example.
• 38:48
  SPEAKER_00: They'll just as long as, depending on how you're submitting to them, um they'll just correct that for you, it'll go through and it'll it'll it'll get processed.
• 38:53
  SPEAKER_00: Um so they're they're kind of far more forgiving.
• 38:55
  SPEAKER_00: But it does it does mean sometimes um sort of more mistakes can can slip through.
• 39:00
  SPEAKER_00: So I think I'd sort of trade off between those three.
• 39:04
  SPEAKER_00: If I absolutely had to pick one that I would just go with, it probably would be booper.
• 39:07
  SPEAKER_00: But maybe that's because I'm a nerd, so I like to, you know, I like sort of systems and processes and and like I know that my ducks have been a row, so I'd happily, happily deal with that.
• 39:14
  Michael: So if you're not efficient, don't go with pooper because you're gonna run into problems.
• 39:18
  SPEAKER_00: Yeah, I think that's yeah, I think that's that.
• 39:20
  SPEAKER_00: You can yeah, that if you if you yeah, if you if you just sort of like yeah, submit bad data, they're gonna let you know and they'll be like, yeah, obviously we're not gonna pay this, like that doesn't make any sense what you what you've submitted to us.
• 39:29
  Michael: Yeah, I've heard that it's an administrative burden, but I think that's partly you're you're doing so much manually again and making the odd mistake that maybe you shouldn't be.
• 39:38
  Michael: Um what are your thoughts on just generally about the insurance industry and the the amount of money they pay?
• 39:43
  Michael: As an outsider, there's now an insider.
• 39:45
  Michael: But what what do you think?
• 39:47
  Michael: Um, you know, getting paid forty quid an appointment for for a patient.
• 39:50
  SPEAKER_00: Yeah, it's obviously really tough, especially when especially when like uh the numbers haven't changed.
• 39:56
  SPEAKER_00: I mean, we've not been in the industry, we've only been in the industry a few years, but from from from what we've seen, people People are getting paid those sort of numbers for appointments, and it hasn't changed.
• 40:03
  SPEAKER_00: And it's actually gone down in regards to uh inflation.
• 40:07
  SPEAKER_00: Um and it's really tough.
• 40:09
  SPEAKER_00: I think what's really weird about the UK industry is the, I guess, this imbalance where you've got a small number in general of like large health insurers, so they have a lot of weight.
• 40:21
  SPEAKER_00: And then, particularly in physio and MSK, it's a really sort of like fragmented market.
• 40:26
  SPEAKER_00: You've got a lot of small players.
• 40:27
  SPEAKER_00: So you've got you know the kind of bigger ones where they've got a bit of clout and they can negotiate a bit harder and they can get better rates, and that can definitely be done.
• 40:33
  SPEAKER_00: But you've just got this real difference between the small number of powerful insurers and the really long tail of small providers.
• 40:41
  SPEAKER_00: It's quite different to um, you know, in the US, like there is, you know, there are loads and loads of different insurers, and it's it's a lot more kind of um different policies, it's a lot more variable.
• 40:49
  SPEAKER_00: It's just a very concentrated market here.
• 40:51
  SPEAKER_00: Um, I mean, I think look, there isn't there's no you know, there's nothing I can say that's gonna kind of change that it that it is tough.
• 40:57
  SPEAKER_00: I think you like rates, there are there are ways obviously you can negotiate your rates, you can do smart things.
• 41:04
  SPEAKER_00: If you are shown over the long period to be treating patients really effectively in a small, small number of treatments, you can you've got a better chance of increasing your rates, that type of thing.
• 41:13
  SPEAKER_00: As long as you're doing the right things for patients generally over time, you'll be able to build up your relationship your relationship with the insurer and and especially if your volume's growing as well and get more.
• 41:22
  SPEAKER_00: But it's not easy.
• 41:23
  SPEAKER_00: You know, there's no way to sort of suddenly make it like a really effective way to get paid.
• 41:27
  SPEAKER_00: I think you've just got to kind of think about insurance in the right way, insurance work in the right way, and you know, it being an add-on to your self-pay.
• 41:35
  Michael: Okay.
• 41:35
  Michael: I was gonna say in which way.
• 41:37
  Michael: I think yes, yeah, I've seen people negotiate better rates, but they are I mean, better is probably a a strong term for it.
• 41:43
  Michael: Um slightly improved marginally is is yeah, it it's not making a massive change to your bottom line.
• 41:50
  Michael: I I think uh also it that's an interesting point, is it's how you see insurance because there's a lot of clinics that that that rely heavily and they want yeah, and I say heavily, for me heavily is 60-70%, but um, I think that's that's that's heavy.
• 42:04
  Michael: But it's interesting that there are clinics who are really trying to reduce but are struggling to reduce their reliance.
• 42:11
  Michael: And we spoke just earlier about this, and I think one of the ways of doing that is really simple.
• 42:16
  Michael: There are some really simple solutions.
• 42:17
  Michael: One is not to um allow insurance patients at your premium time.
• 42:22
  Michael: So if you know you can fill out you can fill out 8-9 a.m.
• 42:25
  Michael: easily, or why are you giving insurance patients um that time?
• 42:28
  Michael: So give them in the off-peak time sustainability or reduce the availability of your top clinicians to those people.
• 42:34
  Michael: You know, there are there are ways of doing it.
• 42:36
  Michael: Um another thing is sort of thinking through the the the it's that I don't know how to explain it, but I suppose you could look at it as lead generation.
• 42:46
  Michael: I hate that term.
• 42:47
  Michael: I actually hate that term, but in this case it does sort of work, right?
• 42:50
  Michael: It's to lead.
• 42:51
  Michael: A patient has come in, you're not getting paid a lot, but it's a free person.
• 42:56
  Michael: In fact, not a free person, you're getting paid to see this person use that person as a conduit to generate more business.
• 43:01
  Michael: And I think when you look at it like that, um insurance can actually be quite profitable because if that person gets three or four other people that aren't insurance patches, right?
• 43:09
  Michael: Now you're making money.
• 43:10
  Michael: And who knows, you can upsell them, upgrade them, cross-sell them into something else.
• 43:14
  Michael: If you're if you're doing Pilates in on the side and they don't you know, you can move them into that or whatever.
• 43:19
  Michael: There are things that you can do.
• 43:21
  SPEAKER_00: Yeah, I think it's a really yeah, that's a really good way of looking at it.
• 43:24
  SPEAKER_00: Yeah, you've all you've got that relationship, you've been able to give as long as you obviously give them an excellent, you know, excellent treatment, you can you've built that relationship, as you say, and in a kind of you've been paid to have that lead come in.
• 43:33
  SPEAKER_00: I've done that myself.
• 43:34
  SPEAKER_00: I've got um one of you know, I've I've had uh a PMI treatment previously for a for uh for a leg problem.
• 43:40
  SPEAKER_00: And then that was fine.
• 43:42
  SPEAKER_00: It was kind of back to, you know, back to like fine health, and I could go back to running, etc.
• 43:46
  SPEAKER_00: But actually, it could do with topping up, you know.
• 43:48
  SPEAKER_00: I I could I could do with, you know, maybe going in for however offer a sports massage.
• 43:51
  SPEAKER_00: It just completely completely makes sense.
• 43:53
  SPEAKER_00: As long as you offer that really good experience up front, yeah, people will stick around.
• 43:56
  SPEAKER_00: Some people won't, right?
• 43:56
  SPEAKER_00: Some people see it very transactionally, they're gonna come and and they're gonna go.
• 43:59
  SPEAKER_00: Um, but a certain percentage, yeah, completely will.
• 44:01
  Michael: But I think particularly in London, this is an interesting one, let me think through this as we're chatting.
• 44:05
  Michael: You've got um a lot of people in London, they've got insurance, and they tend to be those people that have insurance tend to be relatively I don't want to say wealthy, but they're certainly not on the breadline.
• 44:15
  Michael: And those people, someone like you, for example, a struggling tech founder, you're probably not wealthy at all.
• 44:20
  Michael: Um, but you you you get the point.
• 44:22
  Michael: You're going in, you go and see your your physio, um because you're a runner and you're really struggling, and then you see that they actually have a running club or a running program or an old G, and you're like, you know what?
• 44:32
  Michael: I I kind of I fancy that.
• 44:34
  Michael: And so you've gone away from being just this transactional PMI thing into they offer a lot more, they do some really cool things, and you know, you're South West London, aren't you?
• 44:42
  Michael: I know a brilliant physio, um Paul Goss, who earns Body Logic in South West London.
• 44:47
  Michael: If you haven't gone to see him, brilliant with runners and so on.
• 44:49
  Michael: But a lot of what he does is like really high-end running stuff that that people would absolutely go to see.
• 44:55
  Michael: Um he's spent a load of money on five or six sessions doing some stuff there as well.
• 45:02
  Michael: So yeah, I think you you don't have to see insurance patients as just like this is my 40 quid and that's all.
• 45:06
  Michael: Can you use it in a s in a slightly better way?
• 45:09
  SPEAKER_00: Can you yeah, can you make it more than just obviously the you know the PMI is for for medical, like can you make it more than just medical, right?
• 45:17
  SPEAKER_00: It's it's sort of, you know, is this a an ongoing, almost like more of a lifestyle thing, right?
• 45:22
  SPEAKER_00: Like it's it's like am I not just fixing the problem, but I am maintaining your ability to like perform at the sport you want to perform at.
• 45:30
  SPEAKER_00: I am you know maintaining you know part of your kind of like active and sporty lifestyle, all of the things that fit around that, and physio is is part of that, but it's not just like this is a medical fix-the-problem transaction.
• 45:40
  SPEAKER_00: It's like where else, where else can we go with that?
• 45:42
  SPEAKER_00: I think people are quite receptive to that.
• 45:44
  SPEAKER_00: There are there are we've seen around you know, businesses who are doing physio mixed with other types of you know, other types of treatment around it and subscription models and all these all these kind of smart things.
• 45:55
  SPEAKER_00: I think you can do some pretty innovative stuff rather than just seeing it as episodic medical care.
• 45:59
  Michael: All right, so uh give us some top tips for making insurance easier, because uh I don't think anyone sees insurance as easy.
• 46:06
  Michael: Um, but give some tips.
• 46:07
  Michael: What have you seen?
• 46:08
  Michael: What what advice would you give to people?
• 46:10
  SPEAKER_00: So I think, I mean, I guess I've I've sort of touched on these throughout, so they're probably not gonna be this surprising.
• 46:15
  SPEAKER_00: But one is getting so if we think about, let's sort of think about it as the patient journey, but first of all, getting information up front as early as possible and validating it as much as as possible.
• 46:29
  SPEAKER_00: So there's only so much, you know, you can't, it's back to the kind of like paying with a card analogy, you can't get somebody to kind of um uh you know put in their, put in their pin so you absolutely know up front exactly that all you know all that all the details are gonna be perfectly accurate and you're gonna get paid everything.
• 46:44
  SPEAKER_00: But you can do quite a lot up front validating that, yeah, those details look correct.
• 46:48
  SPEAKER_00: You can do uh various ways, you can check the validity to make sure they've got a policy that's live and active, and you can do that in different ways to different insurers, and you can do quite a lot up front to know that patient's good for it, they've got that insurance, and actually that's that's gonna cover us, and that that's that's correct.
• 47:02
  SPEAKER_00: So doing plenty up front.
• 47:03
  SPEAKER_00: The second thing I think is raising your invoices and generally, I guess, doing your whole billing process as quickly as possible.
• 47:11
  SPEAKER_00: This is back to the bad debt thing, but the quicker you can get invoices to insurers, the quicker they're gonna come back to you.
• 47:17
  SPEAKER_00: Make sure you've got the way that you are working within the insurer optimized as possible, make sure you're on as quick, you know, quick a remittance cycle as possible.
• 47:24
  SPEAKER_00: So you're gonna have information as early as possible.
• 47:26
  SPEAKER_00: You know, worst case is, as I said at the beginning, you're invoicing a patient that's well, you know, they've gone and left, they've left your clinic, they've left their treatment, and then you're trying to get hold of an access payment from them.
• 47:35
  SPEAKER_00: So doing things really quickly, getting information as quickly as possible, really good.
• 47:38
  SPEAKER_00: And you we just see like such increased uh collection rates from the clinics who are doing things really quickly versus those it you know it drops off sort of precipitously as you do things more slowly.
• 47:48
  SPEAKER_00: And I think the other couple of things, one is be it it's kind of I guess it's it's sort of a general piece of advice, but it's like be on top of this.
• 48:00
  SPEAKER_00: There are so many cases we see where invoices just don't get paid, right?
• 48:04
  SPEAKER_00: Invoices go to an insurer and they just never get back to you.
• 48:07
  SPEAKER_00: Or they think they've processed it, but they've not they've not let you know.
• 48:10
  SPEAKER_00: And this happens routinely with some you know, some of the big insurers.
• 48:13
  SPEAKER_00: And you need to be, you need to have either a process or something automated or something in place where if they're not paying it, if they're not getting back to you or you just never hear back or you get ghosted, you are finding out about that in a reliable way.
• 48:24
  SPEAKER_00: It's not relying on you checking, you know, you know, once a year or once a month or whatever.
• 48:27
  SPEAKER_00: You are, you know, you have a sort of you know, a timeline and you know and you're acting on that.
• 48:31
  SPEAKER_00: Like there are some insurers where um automatically reissuing an invoice, if you haven't heard in a certain number of days, we know if you automatically re-inissue an invoice after X days, the chances are you know, 70% that it will then get paid within four days.
• 48:45
  SPEAKER_00: These, these, these, these types of things.
• 48:47
  SPEAKER_00: A bit of that is kind of our secret source.
• 48:48
  SPEAKER_00: But in general, being on top of it, having a way that you're noticing if you're not getting paid is super important.
• 48:54
  SPEAKER_00: And then I think the final thing is it's this is kind of a tactical thing, but it's it's like cardophile.
• 48:58
  SPEAKER_00: Cardophile is is is the best way to deal with patient excesses, setting that expectation up front.
• 49:03
  SPEAKER_00: There's gonna be uh there could be an excess to pay, there could be a patient part of the bill that needs to be paid, getting the cardophile, having that conversation then rather than it being a thing that you have afterwards is super important and a really good way of cutting off your your bad debt.
• 49:15
  SPEAKER_00: I think they're the they're the key things.
• 49:17
  SPEAKER_00: There's lots of kind of little smart things you do as well.
• 49:19
  SPEAKER_00: But if you've got those those four done, you've you've gone a long way.
• 49:22
  Michael: So when you say quick, I mean you've got to deal with things quickly and and well uh how quick do you mean?
• 49:26
  Michael: Like what are we talking?
• 49:28
  SPEAKER_00: So I mean it depends on how you want to do it, right?
• 49:31
  SPEAKER_00: Like you just blow up blow our own trumpet.
• 49:33
  SPEAKER_00: Obviously, we we we submit invoices within minutes of them being raised, and then we're dealing with the information back from the insurer uh as soon as soon as we hear about it.
• 49:41
  SPEAKER_00: Our record time of going from an invoice being raised in, say, Clinico, through to the patient having paid their excess is 25 minutes.
• 49:52
  SPEAKER_00: So in that time, we've pulled the invoice, submitted to the insurer, the insurer's told us there's an excess, we've invoiced the patient, the patient's seen it pop up on their phone, they've paid by Apple Pay as they're leaving the clinic.
• 50:00
  SPEAKER_00: That's like end-to-end, you've been paid for that, 25 minutes from appointment to getting paid.
• 50:04
  SPEAKER_00: In that case, they've probably submitted the invoice at the beginning of the appointment, and therefore, you know, they're getting paid right as the appointment's ending.
• 50:10
  SPEAKER_00: Like that's what you you know, that that's obviously like the ultimate end of it, but but that's what you want to be aiming for.
• 50:15
  SPEAKER_00: Certainly, if you are billing anything other than daily, I would say see if you can move it to daily, at least, at least once a day, you know, all your invoices going in.
• 50:25
  SPEAKER_00: Even if you think you're doing it once a day, are you actually how often do things run over?
• 50:29
  SPEAKER_00: How often are you actually doing things?
• 50:31
  SPEAKER_00: Oh, it runs, you know, like we we miss a couple of days, it gets to the end of the week.
• 50:34
  SPEAKER_00: Oh, we need to chase up that patient for that information.
• 50:36
  SPEAKER_00: It's very easy for things to kind of like run on and snowball, and before you know it, you're you're you're a week or a couple of weeks behind on your on your invoices, which is a meaningful amount of time, right?
• 50:45
  SPEAKER_00: In cash flow.
• 50:46
  SPEAKER_00: That's all just pure cash flow that you're you're losing every every time you do there.
• 50:49
  Michael: You find a lot of clinics are doing that, leaving it a week or two.
• 50:52
  SPEAKER_00: Honestly, yes.
• 50:53
  SPEAKER_00: Yeah.
• 50:53
  SPEAKER_00: I mean, even even clinics who I guess this is my my point earlier around your processes, like how often are those processes actually running and how often are there are the gaps in them.
• 51:04
  SPEAKER_00: Even if you think you've got a process where you're billing earlier more often than they think, and when they actually go ahead and measure it and look at it, they go, actually, we're not we're not billing on that cadence we thought we were.
• 51:13
  SPEAKER_00: And actually we're yeah, we're we're doing it much more slowly.
• 51:16
  SPEAKER_00: Um yeah, I think it's super common.
• 51:17
  SPEAKER_00: Like a lot, you know, the kind of default payment cycle for a lot of companies is they just do everything monthly and fine, but you don't need to.
• 51:24
  SPEAKER_00: Like what like you could be getting paid 30 days late or 30 days later for an invoice.
• 51:29
  SPEAKER_00: And if you then need to go and pay your physios for their for their cut edits, like either you're paying out of your pocket or you're making them wait.
• 51:36
  SPEAKER_00: Like, why why do that?
• 51:37
  SPEAKER_00: Just get it, just get it straight in.
• 51:39
  SPEAKER_00: Insurers were super happy with you billing on the day of treatment, just do it then and there.
• 51:42
  Michael: Yeah, money in the bank is always better than uh money on account.
• 51:46
  Michael: Yeah.
• 51:47
  Michael: Cool.
• 51:47
  Michael: Okay, listen, let's leave it there.
• 51:48
  Michael: Uh uh, that was really, really, really interesting.
• 51:51
  Michael: I think uh the next bit is how do we get in touch with you?
• 51:54
  SPEAKER_00: What's your email?
• 51:56
  SPEAKER_00: Yeah, so uh if you just um best ways if you head over to just Ephra E D F R A dot Io and there's a big button there, and you can just you can just get in touch.
• 52:05
  SPEAKER_00: And the next the next step is uh yeah, have a chat.
• 52:08
  SPEAKER_00: Usually with me actually, so I can I can talk you through it or one of our one of our sales team and uh we can give you more information on how it works.
• 52:14
  SPEAKER_00: We like to make sure we get to to chat to every customer.
• 52:18
  SPEAKER_00: Um so you can't just go and you know sign up online and settle up, and that's because we want to uh make sure we can talk through.
• 52:24
  SPEAKER_00: There's still a lot of nuances here, right?
• 52:25
  SPEAKER_00: With all the different insurers.
• 52:26
  SPEAKER_00: So we we we get to talk to everybody and we're happy to speak to people, even if you don't want to become a customer, we're always happy to chat through, share uh you know, the sort of secrets we've learned about.
• 52:34
  SPEAKER_00: Insurers share any tips, help you get to a better setup if you want to improve anything or you know, talk more about any of the stuff we talked about today.
• 52:41
  SPEAKER_00: Where does Ephra come from?
• 52:42
  SPEAKER_00: It's the name of an underground river in South London.
• 52:46
  SPEAKER_00: So if you've ever been to uh Brixton, there are a few places around there.
• 52:50
  SPEAKER_00: There's a slightly grimy but good fun pub called the Ephra Social, and there's a few roads around Ephra Parade and things for this this underground river that runs through there.
• 52:58
  SPEAKER_00: Um, one of my co-founders used to live there, and he likes the name of it.
• 53:01
  SPEAKER_00: Say what you will, you know, make whatever connections you want around money flowing and rivers and and that kind of stuff.
• 53:06
  SPEAKER_00: It's nothing is nothing is that that's where it comes from.
• 53:09
  SPEAKER_00: Good name.
• 53:10
  Michael: Well, I actually reason I ask, I live next to Ephra Road in Wimbledon.
• 53:13
  SPEAKER_00: Ah, there you go.
• 53:14
  SPEAKER_00: Maybe it's the same yeah, maybe the same river around through there as well.
• 53:17
  SPEAKER_00: All right, thanks again for coming on.
• 53:19
  Michael: And uh yeah, if anyone wants um Ben and Ephra, go visit the website.
• 53:23
  Michael: Thanks again.
• 53:24
  Michael: Awesome, thank you.