Well, good afternoon, how's everybody doing? Good. We ready to learn and talk from each other, right? I'm not the know all, do all, you all are gonna help each other. We're gonna help each other today, right? So I'm very interactive when I talk. I probably talk loud enough, I don't even need a mic. So if I see you with your eyebrows like this, I'm gonna say, what's wrong? And what questions do you have? I think the only dumb question is the one that you don't ask because you came all the way here and didn't get your question asked, right? So if you don't want me to bother you, just sit like this, put a deer to headlights and I'll leave you out, okay? Y'all ready? All righty, I think the clicker's working now. Oh, see, I think these are the things that she said already. There's the check-in code if anybody didn't get it. Okay, all right. Why should you move to a virtual front desk? And do you really need someone at your front desk? We are located in Houston, Texas. I've had the billing company now for 28 years. I've been in healthcare since 1989. I started when I was 10, I know. But I love what I do. I love healthcare practitioners. It's really a passion of mine is helping healthcare practitioners because I've had, I'm all about the dollars. And so I'm great with money and numbers, I've always have been, but my healthcare practitioners, they'll tell me, oh, I just need to take care of Ms. Lucy. I'll say, Ms. Lucy, you don't make any money on Ms. Lucy. And they'll say, but I have to see Ms. Lucy. I have to make Ms. Lucy better. I can't leave Ms. Lucy, right? And that just tugs my heart that you all are the way you are. So I feel like I got to come back for you all or advocate for healthcare providers. That's really what we do all day. We find insurance companies all day long. That's really what we do. So virtualizing the front desk has been shown to save money also. But when you look at that, it also provides a higher patient collection rate. And the reason I talk a lot about patients and patients being a priority now in healthcare, y'all, because they really do, with high deductible health plans, the $3,000, $5,000 deductibles now, we began to notice that a lot of our clients' collections were going down. And that was a major reason is because we sent a claim off and the claim the EOB will come back with $0, right? And it say all patient collection, patient responsibility. And that's hard. I don't like collecting from patients myself. I fight insurance companies all day long. So that is why we started getting more proactive about front desk patients and paying more attention to the patient part and the patient collections. You'll have happier patients because when they get a surprise bill, two or three months from now, that's just not a great relationship. They're called, they're upset. Why do I owe? I thought this was taken care of. Because most patients and most people, period, don't understand their healthcare benefits. You ask them the difference between co-pay and co-insurance, they think that's the same thing. In-network, out-of-network, out-of-pocket, maxes, they don't know what that is, right? So patients are happier, gonna alleviate some of your staffing concerns. You know, it's hard right now. I did a talk for MGMA, and that was one of the main things they're talking about is staffing. They can't even staff front desk people hardly anymore. So y'all nodding your heads. It's hard to find those people now to even staff your front desk. COVID, touchless, you wanna make this as, you know, touchless as possible. It saves time. It will increase your profitability, because one of the main goals is that you'll have a decrease in that, you know, W-2, a full-time employee or W-2 employee, plus you're gonna concentrate on getting, you know, being proactive with the patients and their collections, right? So it does weigh itself off, and it is a great increase in profitability and increase in efficiency. So those are the things that we look at, and that's why we say, you know, you will, you know, it will be advantageous for you. So you do not need a person sitting at your front desk. I get that, I know some of y'all smiling at me already saying, yes, I do, yes, I do. But really, you don't. We see a lot of practices that are functioning, high volume, high traffic, that are functioning without a person at their front desk. It outweighs the times that they need somebody outweighs the time that they really don't. Because you're being proactive, you're doing all of that ahead of time, and a lot of things that were usually being done in the waiting room, it's no longer having to be done in the waiting room. It's being done way before the patient even steps foot into your office, right? So concentrating on patients as being your priority number one. I mean, if you really focus on the patient, we'll see why most, you know, think that insurance is the most important, but really patients are. Patients are the most important because they're the most difficult to get paid from, as far as I'm concerned. So we have to be proactive about them, right? We beat up insurance companies all day, but I just can't beat up patients all day. I just can't do it, I don't have the heart. And so the collection rate to even, you know, trying to collect from a patient, I think is probably seven times more, seven times harder, costly, than it is from an insurance company. So we really talk about pre-care for the patient, you know, making sure that everything is in the chart, everything is done before the patient, like I say, is put in your office. So as a billing company, we know what we need to get paid. We know, you know, doing the prioritization, the benefits, we do all of that. You want to have that done, all of that done before the patient gets there. You know, some people, I'll tell them, you know, you have your patients try to do everything at the front window with other people back there listening. That's just not a, you know, not very HIPAA compliant anyway, as far as I'm concerned. And you're trying to have those conversations at the front window. And then by the time they get to the exam room, their blood pressure is high and the doctor's wondering why they have high blood pressure, right? So we don't want, we do not want that. So that is what we want to cut out. That is the goal of what we want to really cut off. And patients are now, did you know the patients are now, this is from, they don't have the sources down, I guess they took all that off from TransUnion, but patients are now the third largest healthcare payer behind Medicare and Medicaid. Patients pay more than some insurance companies. And it's because of the high deductible health plans. And our premiums are going up higher and higher. And they're pushing more and more of the financial responsibility of our healthcare onto us. So we're finding that patients are really the third largest payer behind Medicare and Medicaid. So when we look at the deductible breakdown for families and the coverage by employer health, 7% have no deductibles, 3% have a deductible under $500, 11% have a deductible between 500 and 999, only 29% between 1,000 and almost 3,000, 2,999. The last two, 26% have a deductible between $3,000 and $4,999. And now 23% of America have deductibles that are $5,000 or higher. So that 23% and 26% together is 49%. That's almost half of America have deductibles that are $3,000 or more. Do y'all feel it? You do, right? We're feeling it. So that's why I'm saying the patient is priority number one. It is. It has to be. They have to be priority number one. So they're pushing more and more of our healthcare responsibilities onto us. Right? And then patients want to know sometimes we have to have that conversation as to, well, why do I still owe? We have to let them understand you wanted a lower premium each month, right? And they say, yeah, I did reduce my premium. Well, when you did that, they increased your deductible. And having those conversations and helping them to understand their healthcare improves the relationship that you do have with your patients. Because it's not that they don't want to pay. They do want to pay, but they just want to understand. So when we think about front desk duties, what all do we have to do at the front desk? We're scheduling appointments. Those are inbound and outbound calls or scheduling appointments, answering the phones, the registration and check-in process for patients. The whole intake, the email triage, if they have a referral, if they have images, if they have whatever, that whole email triaging should be done before. And I'm talking about all this needs to be done before the patient even gets there. I mean, I know if you take walk-ins, you can't do all of this before the patient comes. But if you have scheduled appointments, these things should be done before the patient gets there. Insurance benefits and verification. Of course, prior authorization should always be done before the patient gets there. We work with a lot of ambulatory surgical centers. I'll never forget one said, oh, they would get up at three, four in the morning, ready for the first surgery like at five or six in the morning. And they get there and the patient come to swipe their credit card and it declines. Because they're waiting until, you know, what do you do? Go ahead and do it. And then hope and pray, you know, it won't decline tomorrow. Proactive. So a lot of patients, I call it patient financial counseling. Educating our patients on what their healthcare benefits are. We have to educate them. Or some of us need to be educated, but at least our front desk and whoever's handling the front desk duty should be educated on those things to help the patient understand. And then collect the patient estimation, collecting patient estimation payments. The key word is estimation. You always, always, always want to say estimation, okay? That's the key here is saying estimation. Handling any type of referrals, uploading, downloading information into their charts, EHRs, forms, of course, signed consents, PCPs, retrieving voicemails, following up on no-shows, ensure all patient information is in the EHR and surveys. I'm a huge advocate of surveying. I survey everybody. We survey just to see what did we do good? What did we do bad? What can we do better, right? So I'm a huge advocate of surveys as well. And hopefully you are too, just to see how can we do better. So all of these are our different front desk duties. I may have even forgotten some. It may be some, you know, that you're saying, okay, we do this, but this is most of them. But these are all front desk duties. And all of this, y'all, can be done before the patient gets there and should be done before the patient even gets there. Are anybody doing this now? Some of the, at least some of them, right? Okay. At least some of them. So these are the seven tools that are needed for a successful virtual front desk. And this is not all of them. This is just seven of the major ones that I say that you really should have. And I'm surprised, like I call them my dinosaur doctors. I do have some dinosaur doctors is what I call them. They're still stuck some, they still have paper. Like I cannot do paper. We've gone paperless long time ago. So even just helping them to get from, you know, all that paper to paperless, you'd be surprised. They're still practicing out there. They're still on paper. Okay. So number one, we're gonna talk about the voiceover IP phone system. You cannot have a regular phone system anymore. You do need a voiceover, at least a voiceover IP phone system. Website set up for efficiency. Intake registration process with digitized forms. Have some type of EHR PM system. Patient financial counseling set up at your office. Online payment system and automated check-in and checkout process, at least. And when we talk about phase one, the patient pre-arrival process, I call it pre-arrival or pre-care, the voiceover IP phone. You wanna get e-faxes to send and receive, referral management for HMOs, scheduling appointments, confirming reminders, email management and triage, and answering the phones and voicemails. And again, my surveys. This is just one of the ways that the patient will be able to reach you. So you need to be able to give them options. Options to be able to reach you for their specific needs and not waste their time. So the phone needs to be able to say, at least press one for appointments, right? Press two for billing, press three for the office manager. And most of the time, those are these type of voiceover IP phones. I'm not gonna name any, but we have a lot of them. It's a lot of them out there, of different voiceover IP phones. So number one, you wanna make it easier for the patients, at least to be able to reach you in contact and communicate with you. And you're probably saying, duh, but no, it's not duh. I mean, some people don't even, don't have this. And number two is the website. Having a functional, good, updated website for efficiency. It can integrate even with your EHR PM system and your appointment scheduling. If all of these things talk to each other and they can integrate, that is awesome. Payments, everybody should be able to pay you easily. Easily be able to pay you. And I cannot believe how hard it is sometimes to pay your payer, to pay y'all. It should not be, that should be the easiest, that's the easiest thing you can do for my clients. Oh, I'll make it real easy. A lot of different ways that they can pay. And the number one is on my website, just go to my website, there's a big old button right now that says Pay Now at the top of my website. And it should be for yours too, Pay Now button. So having that merchant provider, they'll be happy, ecstatic to set that up for you on your website, to be able to take payments online. Having the resources, how-tos, even a chat capability and making sure that your website is mobile-friendly because most people use what nowadays? Our phones. So you'd be surprised how many people, they'd say, I did a website 10 years ago and it's still just original from 10 years ago and it's not mobile-friendly and it just doesn't work. So make sure that you have made your website mobile-friendly, okay? So, I'm sorry. So this will be your hub for a lot of things. And with marketing, you should be pushing patients to your website. You should be pushing patients to your website to schedule their own appointments. Hopefully we're doing that. And like I said, it's integrating with your EHR so it's there. You have to set everything up. Even a chat capability and the chat features. A lot of them are using that chat GPT right now too. Chat GPT is almost a living thing. I mean, it's amazing. But your virtual response, they're ready to assist. So live with Zoom or anything that we can do, even to be able to talk to them over the phone, you can incorporate all of this into your website, okay? All right, number three, the intake registration process. That's you gathering all of the patient demographics. Anything that they would do in a waiting room should be done before they get there. So once they make their appointment, you immediately send them their forms. Digitize all the forms, send in those forms. And it's really done like automatically. Appointment made, if it's a new patient, automatically they should be getting forms. Uploading and downloading the forms and their IDs and take pictures, all of that good stuff. Mobile or tablet or desktop capability should be available. Okay, so that's the intake process. Number four, the patient financial counseling. That's verifying, these people will be verifying benefits. Now this is where you probably will need someone to do this, but they don't have to be at your front desk, right? They don't have to be in your office at your front desk. So verifying those benefits, once those forms and everything come back, verifying benefits, doing any type of prior authorizations, helping patients understand the benefits and their financial obligations and giving them payment options. So having that conversation upfront. I often say I love the idea of being proactive and not reactive in healthcare. And one thing that's pushing us that way too is the No Surprise Act. I'm not sure if anybody's doing a session, okay, on No Surprise Act. One thing that's pushing us this way is the No Surprise Act because it should be transparent. Healthcare should be transparent. How much it costs for me to have this service done should not be a mystery. Even if I go to the restaurant and for that lobster it has market price, you're gonna ask what? Well, how much is it tonight? Before you say I want that lobster, why can't we do that? Why can't we have that in healthcare? It's a mystery. You go and go home, get a bill and saying why? No. And then they'll say why, okay, I'll give you $1 a month. Am I serious though? Very. So with them being the third largest payer, collections, cash flow, all that depends on this. It really does. It depends on it. So, and it's not that they don't wanna pay, just give them the payment options. If they can't pay, then say, okay, give me a credit card on file every three months, this, this, this, or I need at least half, whatever your rule is for your office, but get something, right? Get something and letting them understand. One patient I remember having a conversation and he said, well, I paid my co-pay. So he was in exam room and so we even have kiosk client and they have them in the exam room. If they want a procedure that day in the office, we have that conversation. This is what it's gonna cost to get this procedure done. Are you prepared to pay that today? And we have that conversation before the service is done. And he was like, well, I paid my co-pay. I'm like, your co-pay was only to get you seen by the doctor for them to tell you what's wrong. Now, if you wanna fix it, that's a different price, right? And cause a lot of time they don't understand and he was very serious. I paid my co-pay, why I have to pay again? That was just supposed to tell you what's wrong for the consultation, you know? So it's just important to have those conversations. That's all I'm saying. We should be having those conversations with our patients and hopefully you are. All right, so important questions to ask. Oh, here's a lot of them. From co-pay to benefits to out-of-pocket policies, lifetime max, I mean, when we do billing, I mean, we need all of this information in order for us to be able to get paid, right? In order for us to be able to get paid and increase our revenue and our collections, we gotta go through all of these questions. There's a lot of stuff, yeah, it is. So do you have time to do that while the patient is in the office? You wanna do that while they're in the office? Right, no, no. We don't wanna do it while they're in the office. Having price transparency will help your patient swallow the bit of bad economic news. So news about our economy impacting a lot of our patients, the state of economy affects how often they come to seek medical care. So we don't want them not to have care. We want them to come have care. It's just having these conversations. And one in four won't come have care because they're afraid of getting a bill later and not understanding. We have to change that, y'all. We have to change that mindset in healthcare. We really do have to change how we do business. This is business, your practice, this is a business, right? We have to change that business model that we have regarding healthcare right now. So 75% of patients research costs and that information impacts their decision. 49% of the patients are still not clear of their out-of-pocket expenses. 62% of patients said knowing out-of-pocket expenses in advance impacts their likelihood of pursuing care. They wanna know, they wanna know. And it also increases their rate of pay and you getting paid and it not being a mystery. And you having that conversation up front, set up payment plans, whatever that is. So payment, the patient is priority number one. Four out of 10 adults said they would have to borrow money, sell something, or skip paying an unexpected bill of $400 or more in 2018 Federal Reserve Report. So medical bills are, you know, that are several hundred dollars or several thousand dollars especially when the patient isn't prepared for their costs or unlikely to be paid. So the Black Book Revenue RCM survey found that 83% of clinics with five or fewer physicians struggle with delayed payments from patients with high deductible health plans. So as healthcare consumerism increases, patients are looking for clear information about what their costs will be for healthcare services. So a recent study in 2017 showed that the average out-of-pocket exceeded $1,800 and are climbing by double digits year over year. And that was 2017, that was six years ago. So I'm pretty sure it's well over that now. Okay, so hopefully you're paying attention to your AR. You know, we look at our AR buckets hopefully every month and not just the insurance AR buckets. Sometime when you pull that AR report for your patients, AR buckets, it will scare you, it's frightening. Right, I know, it's frightening. So only 51% of patients in the TransUnion survey said that they received clear information, have received clear information about costs before getting treatment. But 65% said that they are more willing to pay when they know the cost up front. Providers should really provide an estimation, and that's the key word, always say estimation. I'm like a parrot in my estimate, estimate, estimate. Because they'll say, no, you said it was $100. No, no, no, I said estimated. You always wanna say this is an estimation. Okay, always. So listen to the, you know, and that's one good thing about the voiceover IP phones too, you can listen. As a manager, you can listen to those calls. You can listen to, you know, what your people are saying. A lot of different advantages to that. So front desk staff should be trained to collect as much as they can at the time of service. That's the bottom line. We have different EHRs, PM systems that can store. Of course, hopefully everybody has an EHR PM system here storing all of the patient's clinical records, accessing the patient's scheduling and keeping the patient's financial history inside the EHR or PM system. That was tool number five. Tool number six is the online payment system. And that is where you collect your deductibles, co-pays, co-insurances, any patient prior balances due, collected any estimated payments. So making sure that you have one that's easy to use, that is simple to use, to make sure that the patients are not struggling trying to find a way to pay you. That's the worst thing when somebody wants to pay you and can't pay you, right? All right, phase number two is the automated patient check-in process. So also, and so everything I just talked about before in phase one, all of that's before the patient comes in. All that's pre-care. All of that is, you know, before the patient is being seen, before the patient comes to your, sets foot in your office. All those tools that I just talked about are pre-coming in, before they come in. That's the proactive part. Another way to eliminate, you know, someone at your front desk is going to be phase two, which is the automated patient check-in process. So when patients come in, what we generally see are QR codes everywhere. Because of COVID too, and like I said, making it touchless, you may have a QR code on the door. Flash that QR code. Let's them know that you're here. You can wait in your car if you want to. You know, we'll alert you when you come in and go straight to the exam room. You don't have to wait in the waiting room anymore. So if you can automate a lot of, there are a lot of, you know, ways out there that you can actually automate the check-in process. QR codes, it could be kiosks. Some offices now, some larger clinics in the Houston area, they have geolocators. So if you have the app or something on your phone, as soon as you make it to the parking lot within so many hundred feet, they know you're there. So you have those out there. A lot of your EHRs already have this. You may not be utilizing it, but a lot of them already have this. Schedule the follow-up appointments and rescheduling. So when it's time to check out even, the whole checkout process is virtual as well. Making that, scheduling any follow-up appointments and rescheduling, following up on even no-shows and cancellations, sending patient e-statements. Not statements, not paper statements. We only do e-statements. It's so much cheaper. If you're still mailing out statements, you're laughing. If you're still mailing papers, statements, you're losing so much money from the paper to the envelope, to the ink, to the stamp. E-statements is so much cheaper. Most all EHRs are doing that now. And if not, the clearing houses are. It's cheaper, look into it. I promise you, it's cheaper than what you're doing now. And even for the manpower, for whoever's sitting there stuffing, whoever's sitting there stuffing, envelopes, look into that. That's a huge one. And a lot of doctor's offices are still doing it. I don't understand why. So electronic check-in allows the patients to view and double-check their own data before the appointment and correct any errors or typos as well. So again, that's why I say patients are the number one priority, making sure that we're treating them with the care that they need, but being very proactive about their care, not just their clinical care. So most may think that the insurance company is the most important or difficult to get paid from. That's why I say, no, it's really the patients. And that's why we have to pay attention to them. So we got to stop thinking about the patient last when it comes to reimbursement because of these high deductible health plans, it's caused a paradigm shift in the way we view our reimbursement now. It really has. So reducing inefficiencies in the revenue cycle starts way before the patient comes in to get care. Do y'all agree? Yeah. So we got to see a difference. So to keep pace with the change to healthcare reimbursement, we must be proactive and not reactive, making change all the way from pre-care to us having a zero balance. That's the goal, is having a zero balance after we've seen that patient and we get paid. That's crucial for our healthcare environment today, and these things must be done now. Whenever I see some clinicians and not more of a business, because y'all very nurturing, right? Caring, and like I said earlier, most of them care about the care of the patient than they do getting paid. But how are you going to keep your doors open to care for them if you can't get paid, okay? So if you can't do it, you need to hire somebody who can. If that's not your forte as a clinician, we all have weaknesses, we have strengths and we have weaknesses. We have that... I love reading StrengthsFinders and all those different discs and the Colby assessments and all of that, because I love to know what my weaknesses are, because I find somebody to handle that. I'm not concentrating on my weaknesses, I'm concentrating on my strengths. I'll find somebody to help me with my weaknesses and lift them. That's their giftedness. My giftedness is over here, right? So consumers are demanding more from us too. So 92% of consumers want to know. They want to know what their patient responsibility is prior to their visit. 73% of providers report that it takes one month or longer to collect from patients. 74% of consumers are confused by their EOB. They don't understand their EOB or medical bills. And then it costs four times more to collect from a patient than it does from an insurance company. So all of this will help us to virtualize the front desk, the tools that we've talked about and increase our revenue by also increasing our profitability and efficiency. So being proactive is the key to sending clean claims and getting paid faster. Cost savings through embracing technology is just to have a positive impact on technology and healthcare is clear. We have got to switch over with, I love automation. I absolutely, I do another talk just on automation, how we can automate it within the revenue cycle management, the AI, the RPA. I love that kind of stuff, the predictive analytics. We have got to embrace technology in order to see savings because a lot of us are struggling, but these are ways that we can, you know, turn our practices around and be more profitable. And it's through efficiency. It really is through efficiency. So we have to make the digital transition experience different benefits of healthcare technology trends and innovation. Embracing the move promises a higher caliber of care across the board also. So embracing digital healthcare services facilitates a happier patient, cutting edge platforms, improved operational efficiencies, integrated approach to patient care, and greater reimbursement potential. I'm in revenue cycle management, I'm in billing. So for me, it's all about the dollar and getting paid from the insurance companies and getting paid from our patients and being proactive with that. So significant cost benefits are going to be less FTEs, the FTE is full-time employees. Reduce office square footage. We've seen a lot of offices that don't need as much, you know, waiting room space. Some people would use to have waiting rooms as big as this room. Remember that back in the day, we don't need all that space anymore. So that's going to reduce your rent because you don't need all that space for waiting rooms anymore. If you implement this, specialized services, reduce employee training, W-2s versus 1099s, the tax benefits of it, the time managing your staff, and then even being able to be multilingual. I mean, if you can virtualize this thing and have 1099s do it, you can actually, you know, probably bring in more patients and be able to, you know, communicate with more Spanish-speaking or Italian-speaking or, you know, multilingual different type of patients, which will just improve. So a happy doctor, we like to say you E everything, electronic everything, as much as we can. From E appointments to E registration to E verification, prioritization, patient financial counseling, E payments, E check-in, you know, see your doctor, and then we got to do the coding, the billing, the E reporting, sending those to you, payment posting, collections, appeals, and E statements. So as much as you can have electronic and automated as possible, it's going to make a happy doctor, happy practice, right? With my clear visit, the patient will make their appointment via the website. Once the appointment is made, the patient will receive a text or email with a link to fill out their paperwork. All paperwork will be done electronically through my clear visit. And it does all of that. It does all of the virtual office and everything for you. This is what I just finished talking about, upload the IDs, paperwork, E verification. It does all of that. Okay. Our mission is that we get you paid, you care for your patients. That's what we do at PMB. And that's it. Any questions, comments? How much time do we have? We're out of time. Any questions? Y'all want to talk? Any questions y'all might have? Yeah. I think we need to talk about this. Okay. not having anybody at the front desk. I've been, LabCorp's been like that for a while, and it's really stale. I hate it. You hate it? I love it. I love it. Well, I like tech, but it seems like it's always the person in front of me who can't figure out how to put their insurance card in there. And then I got this window closed that said, don't knock on the window. And then the person's sitting there going, what do I do? And knocking on the window. And have you seen it? Is that what you see? Yeah, so my little LabCorp place, it's two kiosks, one on each side. And yeah, I just put my code in, so I was getting my appointment ahead of time. So when I go in, if I have an appointment code, or I have a scan, QR code on my phone, and I just do that and go sit down. And they call me. That is where I live. A lot of people can't figure out how to use kiosks. And it backs up. Every time I go in, hardly anybody, when I go, I don't see it back up like that. But is that what you're seeing with other practices that you've seen also? A lot of QR codes. I think COVID brought QR codes back. That was like a dying thing. That was really going away. And now with COVID, it's back. You got QR codes everywhere. Are you seeing it successful in rural areas? We have, we're in rural North Carolina, where some of our people don't even have a cell phone or their services. Yeah, I literally have people come in. We don't even have running water for some of our patients. Yeah. Oh, wow. Yeah. Um, no. Maybe we're the outlier. Yeah, maybe. And then a lot of times I hear people say, oh, if I have a larger population of Medicare patients, oh, my Medicare patients can't, you know, do all that automation. So my mom was 80 when they had 80 kids, and they do it. So it just depends, I think, on the person. And they want to do it. They want to be all tech, and they really not. But they want to be all tech, right? And so they want to be able to do those type things, and they do. Yeah. I've been trying to implement it. I'm going to say what I see is that it's in your office, it's your people, they have to believe, they have to buy in too. So it's not the technology, sometimes it's our people that may say, they're taking my job away, I'm not going to do this. You know, maybe those are things that you're being combated with, but it's not the technology itself, a lot of times it's the people. I'm getting ready to start to try to implement this as well. You almost have to look at it like when you go to Walmart and they have eight registers and one person there to help each person that needs help. But that's the seven list staff that they have. So that's kind of how I'm going to try to do it to see if it works for all of us. I'm sorry, she had to hang up. And then that too, you were actually the light. Well, you're welcome to go to the other practice in town who also has online You're all patient right now is facing the new patient. They'll have a problem, but it's your salary Yes The next step is to, let's say, you need to put a credit card in a file. If you don't have it the first time, the second time, you're requiring it. And we tried this a year ago, and what happens? The doctor's not allowed to see it. And now it's one that's discovered. But it's just a rule that you have to follow. We have what's stated here. If we don't do that with some of our practices with late fees, and no shows, and same-day cancellations, $20, $25. Or if you want to get seen again, you have to pay that before you come again. I mean, you have to introduce your rules and money. That's a slot that goes on to somebody else. And you have to explain that to the patient again and have these conversations, too. Yes, ma'am? Has anybody started putting the credit card processing thing back on the patient? She said, has anyone started putting the processing fee back on to the patient when they do pay with the credit card, like 3% or whatever from Visa, MasterCard? Anybody done that? You all do that? If we have patients who use American Express just because their rates are much higher than everyone else's, we do put that on them. Look, I do that to my clients. That budget says pay now. They can pay now. But if they pay with the credit card, they're paying 3% on top of whatever's being imported. I do do that. Yes? To the point of having a helper, so I did it with a different type of practice. We're about to implement it in our orthopedics. But we'll have a staff member who's kind of like a direction track person. And they'll have little jobs, but they won't be behind the desk. They'll be answering questions if someone wants to pay cash. They have a cash box. They'll be able to help them with the kiosk if they need it. So you're kind of having a helper and then giving them other little jobs. So they take photos. They check the parking lot. They move the wheelchairs back. And it's an entry-level position. You can get into health care. So it's super easy to see all the employees from every other industry. I call them a greeter. You call them greeters. We call them patient support. So they feel, but then it just kind of gets them in. Yeah. And so you do have those one-offs that can't do it or want to pay when they get there. Sometimes I'll see the MA. They'll be trying just to do those things, swipe a card, take a payment, or something like that. But it's nothing that you need a full-time person to be at your front desk for. OK? Well, thank you. I'm sorry. I'm up. The traditional process in our clinic. Because it's all done in the exam room. So another, so I always call it MCD, the fact that the doctor doesn't have the phase 1, 3 care, phase 2 check in, phase 3, in the exam room, their kiosk inside of the exam room. So even if they want to have that procedure that day, they're talking to us through the kiosk, we let them know how much it is, take the payment, write the name there, and we go ahead and the doctor, because the doctor will inform us before they walk out. They don't want to talk about pricing. They'll go see another patient. We'll talk to the patient, and they'll say they already have it in their notes. We can see the notes returning in two weeks, and we'll go ahead and make the payment, make the follow-up appointment. And when the patient's done, we'll put it up. Okay. All right. Thank you all. Thank you.

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