Tackling Financial & Operational Challenges When Changing Practice Management Systems

Simone 00:00:00 Welcome to the Flychain Reaction, a podcast designed to empower healthcare providers like you to master the business side of running a practice. Each episode sparks a chain reaction, where actionable insights on financial management, operational efficiency, and growth strategies build upon each other, creating a powerful ripple effect to help your organization thrive.

Simone 00:00:24 With Flychain's financial expertise and insights from industry leaders, we'll dive into everything you need to ignite success. Join us and let the Flychain Reaction spark growth in your healthcare business.

Simone 00:00:38 Hello and welcome back to the Flychain Reaction. I'm Simone Deverall, Head of Growth here at Flychain and I'll be your host for today's discussion. Today's episode brings together two visionary leaders. We have Ethan Schwarzbach, CEO and co-founder of Flychain and Nate Maingi, CEO and co-founder of TherapyiQ.

Simone 00:00:56 We're tackling the challenges healthcare providers face when transitioning EMR, RCM, or practice management systems. So today we'll be sharing strategies and highlight how TherapyiQ and Flychain solutions can work together. We'll be introducing a transition financing program and really with the goal of helping to ease cash flow concerns.

Simone 00:01:19 So let's get started. I'd love to turn it over to Ethan and Nate to introduce yourselves and your company. So maybe Nate would love for you to start.

Nate 00:01:28 Yeah, so I'm Nate, co-founder, CEO of TherapyiQ. TherapyiQ is a practice management platform that eliminates the need for the other seven to nine different point solutions that providers usually need to subscribe to in order to manage and run their practice. And the reason they usually need to do that is because most of the traditional EHR products out there usually see these practices as a clinical operation and not a full business.

Nate 00:02:00 At TherapyiQ, we take a different stance with this, and we think that this is a full business, and they need a business owner needs full visibility through the entire workflows, the entire processes from clinical, financial, and operational, and also be able to also maintain compliance fairly easily. Because that is the core of their business. They're seeing human beings, they're trying to help human beings, and not only is compliance important to them, profitability is also important to them. So we take care of that so that they don't have to worry about that.

Simone 00:02:31 Wonderful. Very comprehensive. Yes, Ethan, maybe do you want to introduce Flychain quickly? I know it's a collective reaction, so artists just know what Flychain is.

Ethan 00:02:42 Most people should know, but really quickly, we're flashing. I'm Ethan, co-founder and CEO here. And thanks, Nate, for joining us. We've built what we call the financial toolkit, the financial operating system, if you will, for small to medium-sized health care businesses. And we're really focused specifically on the health care universe we lend to our customers. And we'll talk a little bit about that and help bridge cash flows in periods of delay from insurance, transitioning, where we will see these things, seasonality comes about.

Ethan 00:03:14 That's where we actually got our origin is lending and wanting to create a very fairly priced working capital solution to folks that are usually not able to get the bank financing. And then that led us down this path to build our full financial platform, which now includes accounting and bookkeeping specific to healthcare where we're doing insurance game reconciliation, multi-location. We then could do things like valuations, and we built like rocket money for your business now that we have this reliable financial data.

Ethan 00:03:42 And we're really excited to talk with Nate today because we kind of view these worlds as while they're fundamentally different companies, one is much more kind of clinical and operational, we're that more financial and operational, they're actually kind of like very related. There are almost two sides of the same coin. And so we're going to dig into that today and talk about how the marriage of our two solutions really does benefit this universe and takes a lot of work off of our customers plates so they can spend more time running their business, seeing patients, doing what they got into this business to do in the first place.

Nate 00:04:15 Exactly. Love it.

Simone 00:04:17 Wonderful. Great. Well, yeah, I think let's jump right into the discussion. I think Nate, would be great if you can start this one off. We want to understand why are transitions like switching an EMR, RCM, or practice management system, why are they often compared to as an organ transplant?

Nate 00:04:38 Yeah, that's actually a great question. I love the analogy as well of an organ transplant. I mean, change in itself for any human being is hard, no matter what you're changing. But when it comes to a change that you're making on behalf of your business, especially a change as far as the software that you're using to run your business. That is as important as any organ in your body. And when you think about it, you need this piece of software in order to operate the rest of your business.

Nate 00:05:07 Even if it's just one piece of software, even if it's just your bookkeeping software, even if it's not even your EHR, think about anything that you use in your business. The moment you want to replace that, now you have to think about quite a lot of things. There's data involved that was in this platform that you need to move over. There's workflows that learned muscle memory, that you're used to doing certain things a certain way because you're used to this software.

Nate 00:05:34 When you decide to make that change, it's a big deal. The organs in your body are essential to the survival and function of the body. These systems are also essential to the day-to-day running of your practice. They manage critical tasks like managing patient records, billing, scheduling, and these are important because you're actually dealing with human beings' lives.

Nate 00:05:57 So it's not just, you're not just running any other business like any other business, this is a very special type of business. So replacing these systems requires a seamless transition to avoid disrupting your workflows internally with your teams and also your customers as well. Failure in transitioning a new system can lead to revenue loss, compliance issues, and even patient care disruptions. So beginning the evaluation early is important.

Nate 00:06:22 Again, this is actually the point I want to make really, really clear because just like an organ transplant, I mean, most of the time you get an organ transplant because it's last minute, it's an emergency, and you need to live, and you need to do it. As opposed to an organ transplant, when you're switching your software, you don't want to be in that spot. You don't want to be in a spot where you have to do it. You want, you know, that's an emergency at that point. And it's almost too late to start investigating.

Nate 00:06:49 And then you're probably likely to make an emotional decision or bad decision. So what you want to do is you want to begin evaluating replacements six to 12 months before your either contract expires or before your desired goal life. So you might think, I want to start, you know, I want to, I want to launch, start using an EMR in the summer. The best time to look is today. Is you need to start to be starting, you know, immediately.

Nate 00:07:08 So how do you do this? You participate in demos with other products and cover inefficiencies in your current system because you don't know what you don't know until you start looking. And then also you're gonna discover new technologies. Like, have things changed since you last looked? Because the world is moving.

Nate 00:07:23 Your peers are moving into systems that are more robust and they're getting more value and they're shrinking their overall payroll expenses because there's systems now that are more efficient out in the world today that are not requiring too much manual workflow. But you don't know that unless you start looking. And so before, rather than waiting until things are tight and think it's an emergency, you wanna start looking as early as possible. So that in a nutshell is how I think about migrations.

Nate 00:07:50 And just to give you guys a quick overview, I'm a CEO of a tech company, and it might sound like I'm talking about switching to my tech, but before I was, in my previous life, I was actually a consultant for providers in private practice. And for over 10 years, Amy, my co-founder and I, that's what we did for over 10 years. And it's how we discovered the gaps with the traditional EMRs. But we also have experienced moving hundreds of practices from one system to another, from one platform to another, even from websites from one host to another. So we have plenty of experience with this. And we've seen this is not something you want to rush as an emergency.

Simone 00:08:34 That's so fair. This is not something that you do last minute. This really takes a lot of planning. And I think what would be interesting also for Ethan, maybe you can speak a little bit to like the financial or cashflow implications during that system change.

Ethan 00:08:51 Yeah, absolutely. And we've seen this firsthand time and time again across our customer base. And when we think about switching, you know, EMR, practice management, billing, even payroll, to a certain extent, it often causes breaks in the action, as we like to say. So we're using that EMR billing as an example. When we see switches occur, it takes a while for that new system, A, to get people retrained on it, et cetera, but also the migration and getting all the things that you were doing historically there and transferring that over here.

Ethan 00:09:27 And now you're going to have new kind of people maybe you're working with, new processes in place that can cause issues. Even the best billers, the best practice management software, like there's always problems. We know this healthcare is kind of broken. And so, you know, you have to understand and bake that in. And so we'll often see cashflow issues arise in this transition kind of in a few ways. Like the first would just be, you know, delayed reimbursements and billing interruptions. That's the kind of stuff that may be using a new platform as we're getting used to it might cause a little like friction day one.

Ethan 00:10:00 But working with the right partner, we're going to talk about how to kind of put yourself in the best position for success there. So you don't have those cashflow issues and you're working with partners and looking out for things that are going to make that decision easier and transition process easier. I'd also say there's just this notion of like accounts receivable that all of our customers generally have in the form of those outstanding claims and kind of two things can happen there. So there's this notion of making the switch, right?

Ethan 00:10:27 And you're going to be switching from a system that was doing billing and they're kind of responsible for that like outstanding AR. And so when you're making that transition, it's really important to know like, who's gonna tackle that outstanding AR? Is it gonna be them? And then, you're now gonna be taking over with a clean slate or are you gonna transition that AR and what's the process of transitioning that kind of outstanding claim that was submitted through this system, but now needs to be like reimbursed through this one.

Ethan 00:10:56 So that is all generally thought through. And we see on average, I would say like anywhere between four and six to eight weeks is, and be like the whole transition process beginning to end, sometimes shorter, sometimes longer, but just know that it will take some time as it relates to getting these new things stood up. So, Flychain just really quickly will help and kind of help finance those cashflow gaps because we'll have a line of sight into that outstanding AR.

Ethan 00:11:23 So, it's we see it all the time and by partnering with the right folks that can do a really good job in that transition, like TherapyiQ, we see less cash flow issues. Granted, we're there to help, but it just minimizes the window and it minimizes the amount of potentially uncollected claims.

Nate 00:11:40 Yeah, and actually, just to piggyback on that, just a quick comment on that point as well. That scenario also applies whether you have an in-house biller or you have a third-party biller. They're using some kind of system to run your AR. So they're running your payments through some kind of system. So whether they're responsible for it, for managing that process, it's something that you, as a provider, as a practice owner, you need to be clear on what's outstanding, first of all.

Nate 00:12:11 Where do we draw the line? And then how are we gonna collect that money? Because it's money that you've served, definitely money that's owed to you, and you cannot leave that money, just let it disappear. So definitely a great point there, Ethan.

Ethan 00:12:22 Awesome.

Simone 00:12:25 Yeah. And we'll definitely get into that also later and talk about that transition financing. We have some exciting news for you there also. But just to dive into really the heart of this discussion, and I think, Nate, you would be the most qualified person to be answering this question. But what are the key questions that practice owners should ask a prospective practice management provider before deciding to switch?

Nate 00:12:52 100%. That's a fantastic question. So like I mentioned in my previous answer, you know, over 10 years of experience migrating practices from one platform to another, or just different technologies to a new technology. And I usually break this into three categories. So I'm going to go through them in my own, I'm going to tie them to our analogy of the organ transplant, and hopefully it'll all make sense.

Nate 00:13:21 The first thing you want to make sure about anything that you, any platform, any resource, any vendor, that you're trying to use to integrate as a partner into your practice. One is current and future business compatibility. So just like an organ, the new system must be compatible with the body, the body being the existing infrastructure and your processes in your practice today. So you shouldn't have to make a massive change in your workflow just because you're switching system.

Nate 00:13:50 So does it, is it compatible where you are today? And migration, just like tissue compatibility in transplants also must be handled with precision to ensure a seamless transition. So in 2025, what questions do you need to ask a vendor? So here's some examples.

Nate 00:14:06 One, does a system support efficient group charting, group scheduling and group billing? Because if you're gonna scale your services, you wanna be able to offer group services as well. Does the system have integrated telehealth and e-prescribing? To be honest with you, in 2025, they don't have that, just walk away. Does it have integrated lead management and waitlist functionality? Every single provider we're talking to today has a waitlist. How do you manage your leads?

Nate 00:14:30 You're capturing your leads from your website. How are you managing those leads all the way to the EMR? Does the EMR think about that or are they not even considering that yet? Another question you wanna ask is do they have modern patient engagement tools? Because you wanna engage your patients, you wanna make sure people are feeling like they're being seen and being heard. Do they have automated payment, sorry, patient appointment reminders?

Nate 00:14:50 Patient appointment reminders, in this day and age, they don't have it, just walk away. Do they have a patient portal and a check-in kiosk? You wanna automate as much of your practice as possible. You have someone at the front desk who's already overwhelmed with the work that they're doing. Everybody in your practice is overwhelmed. So where you can use technology, you can leverage technology to simplify those workflows, you want to do that. So a patient portal is a simple way to do that.

Nate 00:15:15 So you can actually have a portal where your patients can actually, you can communicate with the patients and you can also help serve them through the treatment process. The check-in kiosk is obviously a no-brainer. You want to be able to have people, there's an iPad at the front desk, people can come in and self-serve and check in and the therapist in the back room is notified to say, hey, your patient is here. Those are simple things that actually make your life easier as you're operating a business.

Nate 00:15:46 And this goes beyond now clinical documentation and scheduling, which is what most traditional EMRs have. Now, the other set of questions you wanna ask is billing capabilities for the new system. Does it automatically run eligibility checks to verify benefits for your clients on day one? Like you want to have\... When you're migrating from one system to another, you already have eligibility figured out on the previous system. Or maybe you have a process, maybe you call in or whatever.

Nate 00:16:14 But when you're moving on to a new system, the Vista system, is this system gonna help you verify the thousands of clients you have on day one, so that when you're starting to make appointments, you already know what's coming up? Does the system have the ability to seamlessly bill secondary insurance? This is a huge feature that helps practices avoid leaving money on the table.

Nate 00:16:32 Does the system have an auto pay feature that you can enroll your clients in? So auto pay is where you can run automatic payments so that you don't have to manually click and bill and charge your clients. If you don't want to do the automatic payments, does the system have the ability to offer batch payment processing for those who are not enrolled in auto pay? Because some clients might not want that.

Nate 00:16:52 And then scheduling capabilities, you want to find out, do they have multi-time zone support? We're finding a lot of practices now that are spread out across multiple states. But you also, most traditional EMRs out there, they can't manage multiple time zones. So you wanna be able to manage your entire practice in one instance. You don't have to have an instance for Chicago and have another instance for California because your practice is spread out across multiple time zones.

Nate 00:17:19 And then as far as scheduling as well, you wanna find out the resource availability search. So can we enter, can the provider enter a criteria that can find all the availability that can work for your client. So this goes into like self scheduling for the client. Can we find a way to quickly schedule this client and show all the availability fairly quickly and fairly easily so that we're not spending time on a call with a client for 30 minutes trying to figure out how we're scheduling the next appointment.

Nate 00:17:51 Payroll capabilities, you know, payroll actually, this point I really want to stress on this point. If you plan, this is how you can actually tell if a platform views you as a business or just a clinic if they're thinking about how you pay your employees. You know, do they track how, do they understand how your payroll works? Are they tracking the KPI that matter to you so you can pay your clients, your employees? You know, some practices use a pay for service option where they pay their providers based on the service that they provide.

Nate 00:18:18 Does the EMR even have a way of tracking their KPI? No, are they making managing your team easier for you or more difficult? Because your provider\... you also have your own case load as a practice owner. You also have your own case load. So, and then you're managing a team as well. Does the technology you're going to be using in 2025 help you manage that? Does it make it easier or more difficult?

Nate 00:18:40 If not, this shows a lack of understanding that your job as a healthcare entrepreneur doesn't end when the session ends, right? So your job as a healthcare entrepreneur is nonstop. Do these guys understand that? So yeah, Ethan, any comments on any of that?

Ethan 00:18:56 Yeah, yeah, just two questions that are a little less, I would say tactical. Everything that you said there is just, it's just the truth, for lack of a better term. You need to be asking those questions. You mentioned things that are table stakes that we agree with, right? They need to have that. Otherwise, they're not a legitimate partner for you guys, in our opinion. But two questions we always like to kind of say first.

Ethan 00:19:20 One is, ask your team. So I think it's really important because they're going to be the ones in that all day, every day. And you want to get buy-in, you want to get buy-in from your team, have them meet, have them do downloads. I know we're going to talk about support down the line, but what does that mean from me being a clinician who's super busy and the last thing I necessarily want to do is like retrain how to do everything, have them buy into this and so it's a group decision because sometimes maybe the owner makes that decision doesn't really get permission and it causes friction and unhappiness and maybe even attrition. So that's the first like buy in from an organ, the people that are going to be using it.

Ethan 00:20:00 The second is, as you're making these decisions, ask that platform for references. And I always say this, but when I say ask them for references, I would also take it a step further. And don't just ask them for references, because as we know, you're going to get the best people that are going to be evangelists. Obviously\--

Nate 00:20:19 Exactly. like when you

Ethan 00:20:20 Yeah, go and try and find their customers and reach out to those customers that aren't the ones that they've listed because you're going to get a very, very handed answer. And I think doing that a few times just to check boxes and do for their diligence is really important because you're going to be sold something and they're going to say, it's great, blah, blah, blah. But they're going to probably sugarcoat or cover up some of the bigger issues that their actual clients might be experiencing and see a mixed bag there.

Ethan 00:20:49 Sometimes they have it all and sometimes it really leave something to be desired or it's an inch deep, mile wide and for multiple industries. And therefore it's not going to be as specific for a therapy business. For example.

Nate 00:21:03 Exactly. And that's how you uncover those things that you wish you knew after the fact.

Ethan 00:21:08 Exactly. Right. Exactly. Right. And then if it doesn't work, yes, start the process all over again. And then use the term organ transplant.

Ethan 00:21:17 Yeah, exactly.

Nate 00:21:19 It's that important.

Ethan 00:21:20 Right.

Simone 00:21:21 Yeah, and Nate, I have a question also. I mean, everything that you mentioned here, it's incredibly comprehensive, right? You have telehealth, you have billing capabilities, schedule, payroll capabilities, just to set expectation. And I think even just like out of interest, is this something that most practice management systems to date offer as a comprehensive solution? Or is what TherapyiQ is offering?

Simone 00:21:46 Is that very unique to your company and you guys being one of the most comprehensive practice management systems out there? Just to set expectations for when these providers go and ask these questions, if most of the time it's just going to be, no, we don't have that yet, no, we are, yeah, we have a partnership with this person who does that, or we have a partnership with that person who does that.

Nate 00:22:12 Yeah, that's a great question. So when I was consultant and before we built TherapyiQ even for one practice, we were looking to solve certain problems. And the biggest problem we found, no matter what system you use, if you're not able to completely have full transparency and visibility to all the workflows in your business, those silent workflows are basically going to kill your business eventually. You can't you can't scale with those silent workflows.

Nate 00:22:38 So to answer your question, no, there's not a platform that we have found that can give you full visibility on the entire business, clinical, financial, operational, and also keep you compliant. We haven't found that, and it's why we are growing as fast as we are. We are seeing quite a dozens of providers of practices moving to us every month. It's because they can see that, they can see that.

Nate 00:23:04 This is a platform that was built by people who understand them, understand what they deal with on a daily basis. And it's also why we don't write one line of code without speaking to our customers. We don't because we don't think we know more than they do. We think they're the boots on the ground, they're the feet to the fire, they're the ones who know more than we do. So we collect ideas before we ever build anything. And everything we built in TherapyiQ is an idea that's come from the providers, not just us.

Nate 00:23:31 So yeah, in a nutshell, that's the biggest gap is pilot workflows. You're gonna, if you use a traditional EHR, you're gonna end up with seven to nine different point solutions. And so you have to make a decision if that's what you want for your business.

Simone 00:23:44 Yeah, no, because I was thinking it's incredible that you were able to put all of this into one comprehensive solution. And from our time, you know, talking to partners and other options out there, this just seems incredibly comprehensive. So, yeah, just it's very impressive.

Nate 00:24:03 Thank you. It took quite a bit of work. Yeah, that's the only way we felt that's the only way to do it. It really is. I think if any other practice, provider had the talent and the skills and the knowledge that we had from the tech standpoint, they would have ended up with the same type of product because they get it, yeah.

Simone 00:24:21 I think, so earlier you mentioned there are three key points to look out for. You said first, current and future business compatibility. And then you mentioned there are two others.

Nate 00:24:33 Yes, correct. So yeah, let's have-

Simone 00:24:34 We'll just hear the other two.

Nate 00:24:37 So yeah, great question. So the second point that I always like to make, even when I was working with my own consulting clients, is this team's expertise and planning, right? So these guys, the vendor you're going to, has got to know more than you do. I mean, if you think about it, with an organ transplant, you need a team of specialists with meticulous planning because they should know more than you do, because they're here to help you out, right?

Nate 00:25:01 So switching systems demands experts in implementation and training and troubleshooting to ensure a smooth transition with minimal disruption. And they also have to understand your practice the way it is today. Because they have to be able to move you from where you are to where the promised land where you're trying to go. So they need to tell you stuff like, what's the migration timeline? Can they outline a detailed day-to-day process so you know what to expect?

Nate 00:25:25 Will there be overlap periods where I'm running two different systems in order to ensure continuity for my clients? If that's the case, if I'm gonna have to run two different systems, how much will that cost? Are we planning ahead for that? And then third, okay, if there's a cost, is there any assistance available from your new vendor to cover this cost? And that is a problem we had to tackle. It's a problem we have actually solved. And we've solved that by partnering with a partner like Flychain.

Nate 00:25:53 And I don't know, I'm gonna pause for a little bit, Ethan, if you could just introduce, just give us a little preview of what transition financing is gonna do for not only our partnership, but also our customers.

Ethan 00:26:03 Yeah, absolutely. And so just kind of taking a step back on the on Flychain where we got our origin, you know, we realize that there are a lot of capital cashflow issues, I should say, specifically in this space where our customers don't really have a lot of other financial options, namely like banks don't really lend much to our customer or our universe.

Ethan 00:26:24 And so what we've done in this notion of transition financing, we've mentioned that there are often breaks in the action some payments stop, there's new processes happening. That can be a couple weeks, two months, what have you. And so what we've built and the way that we can kind of finance customers is we look at your outstanding AR and that's really what we care about.

Ethan 00:26:45 And so we're gonna value that outstanding AR and then bring that money forward so you have a couple of payrolls in your bank account while you're making that transition. We know those claims are out there, we know they exist, they will get paid at some point. And so what we're saying is by partnering with the right entities, we can trust that that money is going to get repaid. Therefore, we're comfortable as you're making this switch to provide you with that capital.

Ethan 00:27:12 So that gives our customers peace of mind and the transition and just to double back on the one point around migration timeline. So that is so critical. And if you're not feeling that level of comfort, right? And have a line of sight in a detailed plan, that two, three week process could be a five month process. And we've seen that. And so I couldn't stress enough that having a partner that tells you this is exactly the sequence of steps, here's our go live date, this is when we guarantee things are gonna be up and running, that does wonders for us.

Ethan 00:27:51 Because now we can rely that this is gonna be back, money's gonna be flowing, you're gonna be able to repay as soon as possible. And that's also a great litmus test for a business, right? If you're making a decision to move there and they're kind of like flying by the seat of their pants, like I wouldn't have a lot of comfort to then hand over kind of like the heartbeat of my business to this entity. So I just talk about that and can always, as I mentioned, get more in the weeds on transition financing, but it's something that we do all day every day and it's been working quite well.

Nate 00:28:23 Yeah. And you know, even with the best laid plans, you could plan a four week, like, for example, in TherapyiQ, we have our transitions usually run between four to six weeks. So best case scenario, you know, it's four weeks, we're getting everything we need from the from the practice and we're able to get things going. However, there are things that are always outside your control.

Nate 00:28:44 For example, big one is insurance enrollment. So you're using a clearinghouse over here from the previous EMR. Now you're switching to TherapyiQ. And now we're enrolling your practice into a new clearing house. That timeframe right there is about, sometimes it takes about two weeks just to get everything completed. So we could have done everything ready to go and you're ready for you to go live, but you're not enrolled yet and you're not making money. And now there's that blip. And that's where flighting comes in with the transition finance.

Ethan 00:29:16 There's this other notion too, where as there is sort of like this transition that's happening, you know, it can take four to six weeks. We see that to be a very good timeline, right? But there is also an onus on the business themselves, right? And so it's a lot of times we find ourselves, I imagine you do too, like we can only move as fast as the customer is giving this information. So I think it's also as you as the TherapyiQ or that entity is providing all the insights on timeline.

Ethan 00:29:47 You have to be very clear that like this timeline can only exist if you are actively doing the things that are required of you because that can get kicked down. Our customers are busy. They might not have all the time in the world to set this stuff up. So making it very clear, like this is going to require X amount of time. This is your responsibility and link front also then gives them a little, a little nudge to make sure that they're, you know, swimming in the same stream.

Nate 00:30:13 Exactly, exactly, exactly. And that's the kind, you know, actually, that brings me to the third point I was going to make, which is support to the adjustment period. Like, you know, even after an organ transplant, the body takes time to adapt to the new organ. And there's always risk of rejection. And this is what Ethan was talking about, your team, like involve your team from the get-go as early as possible, because that's where the rejection is going to happen, right?

Nate 00:30:40 So if there's a problem, you know, there's going to be a workflow, wrinkle or something that you just can't overcome. Maybe you just have someone just does not like change at all. You need support from the team that's onboarding you to mitigate even that guy who is gonna give you a headache due to because of the change. So similarly, staff require time to adapt to the new system. There can be resistance, just personality resistance.

Nate 00:31:07 There can be errors that cause people not to learn the system effectively as quickly as possible. So what you really wanna know is what level, everybody says they're gonna support you, but what level of assistance do you receive from the prospective vendor in the migration process? So you need to know that. You have to absolutely know what that is. Do they allow for custom content, like creation of forms, email, SMS templates, or are you limited to out of the box content from intake and clinical documentation?

Nate 00:31:37 Why is that important? Because if you're limited to out of the box content, what if the out of the box content does not look like what you're using today? Guess what? Your staff will hate you for that. So the more we can replicate exactly what you're using today, the better. Because that's a smaller adoption curve for your team.

Nate 00:31:55 Secondly, does a vendor support customization of content? Who does that fall on? So even those forms, right? Okay, I want to create\... hey, we have these forms that we're used to, we love these forms, and they're like, okay, here's a form builder, go build it yourself. Do you really have the capacity or the time to do it, or are they gonna help you? That's huge, because you need to factor that into your decision of whether you're gonna go with this vendor or that vendor. If I'm gonna, here I'm gonna get help, over here I'm not gonna get help. So that's a big decision point.

Nate 00:32:27 You know, third, what type of training will you receive? Does the vendor provide live training, or just give you access to a knowledge base and some tutorial videos over here, go figure it out. Do you receive a dedicated implementation team to support you through the process, or is it just whoever, you're sending support tickets or whoever shows up, today's Jane, tomorrow's John, and you don't know who's running the process.

Nate 00:32:54 Number five, do you receive assistance with data migration? Most of the providers we work with, I'm not saying that\... I don't want to knock them and say they're not tech savvy, but they don't have time for technology, right? I know, you know, most of the clients I work with through my consulting days, they're good at what they're good at. They don't want to be good at that thing that you're good at. So they want someone who's going to take this and make sure they don't lose any data because they're required to hold this data for six years, some of them seven years, and this is a requirement by law.

Nate 00:33:24 So they cannot lose data. So who's going to help with that process? Do you feel confident enough that someone inside your team can do that? Because if not, you need to be asking the vendor that question. The other point is, do they provide assistance with clearinghouse enrollments? So when you're enrolling for insurance, who's keeping track of that? Who's the quarterback for that process? Who's making sure that nothing fell through the cracks, you didn't miss a vendor, and now you're having to wait another four weeks because someone forgot to do it?

Nate 00:33:56 Who's managing that process? And then from that point, this is the most important part, more than anything else when you're switching vendors is because a lot of people don't, the dating phase for any relationship is always fun, right? But it's when the relationship actually, rubber meets the road, that's when things get tight. So the biggest question you wanna ask is what level of ongoing support should I expect?

Nate 00:34:20 I have heard some really strange things in this industry. I've heard of vendor, I'm not gonna name one but they actually have something called support quotas. So the quota basically means that there's only two or three people in your practice who can send in a support ticket. That means everybody else is funneling all their problems through these three people. When do they get their work done? I mean, that's ridiculous. But this is actually a major vendor.

Nate 00:34:42 We're actually winning a lot of deals from them right now, but they're a major, massive vendor. And they say that you have, you can only send support tickets to two or three people and you can only send support a certain number of support tickets. Now think about that. What are you really telling a healthcare provider that when they're in the middle of serving a human being, they can't ask you a question, they get stuck, they can't, they have no one to support them at all.

Nate 00:35:06 So it is hugely important that you need to find out what level of support you're going to get, how the support is going to be delivered to you. Is it live chat? Is it screen share? Is it phone calls? What is it? You need to be completely clear on that because that is what is going to give you peace of mind when you're providers in the middle of a telehealth session and they're remote and you have no idea what's going on and they just got stuck. So that's exactly what you need in that scenario. So I'm gonna pause there and see if, Ethan, you have any comments or Simone?

Ethan 00:35:36 I agree with everything that you're saying. Like these are, it's like, we always say the, you know, the best offense is a good defense. And what we really mean by that is doing all of your homework so that\... the defense is like doing your homework, doing your diligence. And then you can go into offensive mode and grow because you have a stable foundation under you. So no comment, you covered it. And I actually wanted to like that.

Simone 00:36:02 Yeah. I just wanna like reassure everyone listening that we will be sending out a checklist after this. I know that we're throwing a lot of content at you. So there will be a checklist summarizing these questions that Nate is sharing because everything here is so relevant and so important. So that will be shared. So rest assured, I know it's a lot of content, but we will be summarizing this in that checklist.

Simone 00:36:33 Perfect. After talking about what questions we should ask a prospective vendor, what's interesting to ask also is what are the questions providers should ask their current vendor, practice management system, RCM, before making the switch? Maybe I'll hand this over to Ethan to talk a little bit about what are these questions that shouldn't be asked.

Ethan 00:36:55 Yeah. I think it's the opposite perspective in a lot of ways versus what Nate was talking about. And what we mean there is you're making a switch, right? You're telling this business, we're not going to be working with you anymore. Well, there will be outstanding claims. So the first is get a pulse on exactly what's outstanding because that's money that you're effectively owed. Right? That's the first. Have a really clear understanding. And then it's, how are, who's going to support this? Is it going to be that company? I kind of referenced this earlier, but is it going to be them?

Ethan 00:37:26 Because there's that kind of uncomfortable area where it's like, we're leaving you but you still have to collect on this. Some people, some of those folks are just like, eh, you're not a customer anymore, I don't care. And that's worrisome because you could be left in the dark and just lose that money. So developing that plan of who's gonna handle the outstanding AR, because that is, that could really sink your business if that doesn't get collected.

Ethan 00:37:52 The other thing I would say is the data migration. You mentioned this before, more on the tactical migration, but like are they okay giving you that historic data? Once again, you're telling them that we don't wanna work with you anymore. They're not that incentivized to really help you anymore. And so oftentimes, like before you make the switch, like start asking these types of questions. Hey, how is my data captured today? And can I export all of that? Maybe do that exercise before you tell them you're leaving, right?

Ethan 00:38:21 These are the types of things that you wanna insulate and protect yourself and plan for because any little issue there can really sink your business from a cashflow standpoint or from a lack of data standpoint. So I'd say like those are the things that we really like to look out for other things like contractual obligations, key points of contact that you can actually then go back to.

Ethan 00:38:43 Once again, kind of awkward, but it's important to check those boxes so that gives you a little bit more peace of mind and say like, look, we're leaving, but you know, we enjoyed our time together and you need to help us kind of make this transition.

Nate 00:38:56 And just to piggyback on just a quick comment on that, migration of data and platforms holding practices data hostage is so rampant, especially in our industry. We have competitors who will not allow a file to be migrated out in bulk. You literally have to go one by one, client by client, and export your files. Now, the sad part is, this data actually belongs to the practice. It actually is owned by the practice. And the fact that you have no way to extract that data out is actually inconsistent.

Nate 00:39:36 I don't even know how these businesses operate, restricting people from grabbing their data when they need it. So that is huge. You've got to ask that question before. And if you're the EMR today, reach out today that does that, you need to start having a plan. And this is why you start looking six to 12 months ahead of time, because you need to have a plan for what's gonna happen when you scale off of that. And it's any platform, you could scale off of any platform. Then go for a business owners to grow. And if your growth is also gonna create a new problem because you now can't move your data in a system that's a cookie cutter system, then that's gonna be a problem for your business.

Simone 00:40:12 Yeah, it's shocking to hear that even in this day and age, I mean, they make it so hard. So it's good to kind of just get everything checked before even confronting them about making a change because at that point, they're gonna completely shut their doors to you. It's really navigating this carefully. I think Ethan also just to talk a little bit more about that financial impact upon transitioning systems. What are some practical strategies that providers can use to manage that those financial implications?

Ethan 00:40:46 Yeah, I think it's honestly not. I wouldn't call it rocket science. It's just like putting some time and thinking through this and budgeting, right? So there are always going to be disruptions. This is usually like a singular disruption when you're transitioning, but we also see disruptions where insurance just takes long to pay, et cetera. So budgeting, do you have three payrolls in your bank account, which is like what we typically recommend just for kind of a healthy business. So budgeting and understanding that of cashflow forecasting and planning, what kind of cash flow break can I actually digest, right? So these are the kind of things. And if you maybe don't have those three payrolls, like, there's access to credit that we provide.

Ethan 00:41:29 So it's really just an understanding of where am I at today? What is my financial situation today? And how might that change or get a little rocky in the next couple of months and then just developing that plan. So I think it's really just around like setting up the capital, budgeting and having a line of sight into all of the different things that could potentially go wrong and having a little bit of a buffer either in the form of a cash balance or access to fairly priced working capital. And once again, that transition financing which we alluded to earlier is a kind of a great option for that at this stage.

Simone 00:42:03 Totally, and it's also the idea of, maybe don't hire that additional staff just before you're about to change systems. It's all those just practical things, lay it all out, assess all the upcoming milestones, budget for everything, have that cash reserve, a line of credit, do your forecasts before you make such a big pitch.

Ethan 00:42:29 We always say, think about running a business as under Murphy's law, everything that possibly can go wrong is probably going to go wrong at some point in time. And so once again, it's that offense is really requiring a good defense and that's all the planning and things and it's honestly daunting right like planning and stuff is the pain in the butt and everything but we just see it so necessary because the folks that don't do that will find themselves in problematic scenarios down the line. Bad patient outcomes, lack of money and then\--

Nate 00:43:01 Losing staff.

Ethan 00:43:02 And so it's just planning and that's what we're here for for sure.

Nate 00:43:08 Yeah, I mean, that's spot on. If we don't plan ahead, we will fail. We're planning to fail.

Ethan 00:43:16 That's literally it.

Simone 00:43:19 Yeah, perfect. And I know we talked about the transition financing program. I don't know, Nate, if there's anything else you wanted to talk about that.

Nate 00:43:28 Yeah, no, actually I do. So for us, the way we see the transition financing program, we actually see it as more than just a transition, right? So, if you think about it, like Ethan just mentioned about, having a rainy day fund, a line of credit, just in case. Usually in business we say, whatever plans you have, they're gonna cost twice as much as you think, and they're gonna take twice as long as you think. So planning ahead, if that doesn't happen, that's best case scenario, but usually, that's what you wanna plan ahead for.

Nate 00:43:56 So for us, we've seen disruptions, even midstream with clients who are already in on a platform, right? So like early last year, we have that massive clearinghouse hack, which fortunately was not, yeah, change healthcare, which fortunately we were not affected at all, but those practices got impacted. Most of these practices, they don't have a line of credit that's already sitting there waiting.

Nate 00:44:22 So what most of them got some funding from change, and then all of a sudden they were required to pay it, and most of them went out of business. So that's what we're talking about here. Planning ahead is huge. So for us, we are planning to offer this transition financing from Flychain, even to our existing customers. Because having a line of credit in your back pocket, it's always a good thing to have because you never know what tomorrow is going to hold.

Nate 00:44:46 As a business owner, do you want to control as much as you can control because you won't be able to control most of it. But this is something you can actually control. The partnership with Flychain for us was super high value. In fact, I'm still super excited even though we did this. Finally, the partnership a few months ago, I'm still super excited about this because of what I think is gonna bring to our, not only our new users coming onto TherapyiQ, the prospects coming onto TherapyiQ, but also existing users, existing customers today. So yeah, that's why I'm still super excited about this.

Simone 00:45:21 Yeah, totally. Okay, perfect. I think we're just wrapping up now. I think just a final thing, I guess, key takeaways and how do TherapyiQ and Flychain work together to support providers through system transition. So we'd just like to know a little bit about how you know TherapyiQ is currently doing this and how then yeah with Flychains you know bookkeeping systems, capital, access, analysis, etc. How we can work together to really support providers.

Nate 00:45:54 Great question. So again, back to the organ transplant analogy, if you're looking to do an organ transplant and you're shopping for a specialist, you want a specialist who has experience. So the collective experience in TherapyiQ, even though we're a young company, we have over a hundred years of collective experience from the sales team all the way to onboarding and implementation. Most of us have worked together for years on different projects, even from the consulting project.

Nate 00:46:22 So we are experts at what we do. We know what we do\... The first thing we had to do is build a platform that does what we're saying it's gonna do. And then it's a question of helping these providers move over. So how do we help with that? We consider ourselves operational transition experts, because of the level of support that we provide. So for example, we provide tailored onboarding and data migration support.

Nate 00:46:46 We provide adaptable workflows and real-time reporting, and we actually are able to configure those for you while you're onboarding into the platform. We provide live training, of course. We provide ongoing support, of course, live chat, email, screen share, phone, whatever the practice needs. We don't ever want to see anybody stuck when they're in the middle of serving another human being.

Nate 00:47:08 Patient communication, continuity of care while you're transitioning, we wanna make sure you're transitioning from, if you are using a patient portal somewhere else, you're transitioning to TherapyiQ, which has an inbuilt patient portal. So we wanna make sure that migration, even for your clients, is seamless and easy, right? So that when they're moving over, they're able to continue to receive the care that they need.

Nate 00:47:32 And then, of course, we have scalable solutions for growth. So, for example, we think about your business the way you think about it, like a business, right? So we have a feature, for example, called Waitlist IQ. Waitlist IQ helps you manage your leads right from your website, triage them on your website, drop them onto a Waitlist on TherapyiQ and then you can move them on into clients and all the way to discharge. So we are a platform that actually thinks about your business from your own client journey perspective.

Nate 00:48:00 So we look at from when they meet you on your website, all the way to when you discharge them successfully, hopefully, because that's our goal. It's a shared goal that we have with the providers as well. And in the meantime, of course, our bottom line is to make sure your bottom line is as large as possible.

Ethan 00:48:18 Yeah, I love that. And just to kind of tie a bow on everything is, you know, we've got TherapyiQ, which is above kind of this line, as we like to say, where it's like practice management, RCM, clinical workflows. And for us, we sit below that line where we're finance, accounting, you know, lending, banking, valuation, savings. But it is imperative that we partner with the right folks because we need to get a version of this data and that data interoperability so we can pull things and map your payroll expenses against billing data to understand profitability and things.

Ethan 00:48:52 And so it's really cool to see, when our companies come together, this handshake of data all swimming in the same stream with the same goals of improving the bottom line for the practice and making things more efficient, easier, less time intensive. That's why this marriage of kind of EMR, practice management, billing, and Flychain tends to work really well.

Nate 00:49:14 And it then enables us to do cool things like lending and advancing payment on claims. We couldn't do that without a partner like you because we wouldn't know what their claims are or could rely on them. So it's been cool and we're excited to really kick this off in 2025. So yeah, really appreciative of your time, Nate. And thanks. Like I said, I learned a lot and I'm sure the audience did as well. And we're going to follow up with that checklist.

Ethan 00:49:37 And it's kind of a summary of all of the questions that we've addressed here today and making sure that as you make these decisions, you're not making any missteps and you're going through the right process so that you're giving yourselves the best chance of success in perpetuity.

Nate 00:49:53 Perfect. Yeah. Look, in closing for myself as well, guys, thank you so much for your time, for hosting this, for having me on. I always love to have these conversations. I'm very passionate about providers succeeding in their business. This is why this partnership is important and these conversations. And I'm really looking forward to having more and more of these. I'm definitely open to having more of these.

Ethan 00:50:13 Oh, yeah, yeah. We'll get on the books in the near future. And, you know, with that, I think we're good and appreciate it. Simone, thanks for kind of posting and moderating.

Nate 00:50:24 Yes, Simone. Thank you so much.

Simone 00:50:23 Always a pleasure. Thank you.

Ethan 00:50:28 All right. Cool. Thank you, everybody.

Simone 00:50:30 Thanks for tuning in to the Flychain Reaction. If you'd like to keep the conversation going, feel free to contact us at info@flychain.us or schedule a demo through our website at www.flychain.us. See you next time!