So with that, if any AI bots have jumped on to the call, we will remove those because webinars are only for AOE members and paid registrants. And without further ado, I'm going to introduce today's presenters. We have Danelle Newman, who's the Director of Patient Access with OSS Health, and Laura Pata, who is the AVP of Customer Success for Infinix. So I'm going to go ahead and pass it over to Laura to get us started. Perfect. Thank you so much. Danelle, do you have the slides? Or do you need me to share? Got them. Awesome. Did everybody see them? Yeah, we can see them. Let's see. All right, so we can get started. I know I'm going to let Danelle kind of carry this conversation through. I just wanted to briefly introduce you to her. I've known Danelle for, I don't know, over five years. She's been a customer of Infinix. So we go way back. We have a lot of good stories. I consider her a friend. She's the Director of Patient Access at OSS Health. She brings over 25 years of patient access, revenue cycle management experience. I'm not going to steal her thunder. She'll go into further details in terms of what she does and how amazing she is and a rock star she is. I've been with Infinix for over almost 6 and 1⁄2 years now and so oversee customer success. And Danelle has been one of our clients for a long time, part of the AEO community. So super happy to have her here. Thank you, Laura. So I will share a little bit of the agenda with you. And I'll tell you a little bit more about myself. So we plan to go over some of the operational challenges that OSS has had over the years as we grow and how I was able to overcome some of those fears and outsource some of our authorizations with regards to artificial intelligence and all of those fun things. I have been in RevCycle for 25-plus years. I have been at OSS over 10 years. On the RevCycle side, I became more active in the patient access side of things the last five years of my time here. I have the registration teams for all of our physician clinics, our specialty hospital, our ambulatory surgery center, two of our pain centers. I also have the contact center, our scavenger, imaging, as well as our authorization team. So today, one of the things that we will talk more in detail about is the authorization team at OSS and some of the challenges that we've had with our growth. So OSS Health is an organization that is three independent orthopedic practices that joined, I'm gonna say, 20 or so years ago. We built a hospital, a specialty hospital, with 26 beds 15 years ago and have over 10 physician clinics in multiple different counties. We have urgent care centers, as well as, like I said, pain management and ambulatory surgery centers. We just recently opened another physician clinic and are building another ambulatory surgery center. So we continue to grow. We onboarded five physicians just in the last year. And some of the challenges that we've had in the last few years is that we have grown so fast that we have not been able to manage to have enough staff for all of the work. So what originally started the relationship that we built with Infinex was because we had staffing challenges. Back in 2019, we had an authorization team of approximately seven or eight staff and three of them gave their notice within like two weeks. So we had a mass exodus of three staff members that were going to a health system here in the area and they were gonna be paid a dollar more now. And in the grand scheme of things, you think, well, if you like your job and you enjoy the environment, why are you leaving? But you're leaving because financially, it makes more sense for you to go to a place where you can make more money. And we were going to be in a situation where the staff were gonna be working a lot of overtime and I was still concerned with the volumes that we weren't gonna be able to manage those volumes. And one of the big key parts of orthopedics is imaging, right? So patients are gonna come into our office, they're gonna be ordered an MRI or a CT and what is determined is if they're gonna need surgery from these things. So we couldn't say to the shareholders, hey, we're not gonna be able to get all these patients scheduled and get them on the table because we can't get the authorization. So I quickly needed to look into potential ways for us to outsource some of that work. So that is how we came to the recognition that we were gonna need to have somebody else. There was a lot of fears and challenges with that. I was worried that I was gonna lose control. I, what was the, what was I gonna do if things didn't work the way that I thought they would with having a partnership with someone? The staff were worried about job security. Are they gonna lose their job? Are they still going to have work or is Danelle gonna get this company and they're gonna come in and they're gonna help us with imaging and ultimately they're gonna take my job. And honestly, that's a common concern and fear that we have with a lot of our clients. They're worried about, okay, this is my team. Things are run this way. I understand we have to save money. We have to outsource, okay, but am I gonna lose control? Am I gonna lose my job? Or is my team gonna lose my job? And I feel like you've done a really good job in terms of coaching your staff and understanding who Infinix is and we work for them, right? We're there to help them become more efficient. We're there to help your patients be seen sooner to make them, their jobs easier. But it's really about how you kind of played that out internally, which helped us in the end. Absolutely. And the other fear too is, when you're losing control, is it going to decrease the quality? Is it going to increase the denials or are we gonna have reimbursement issues that we have an authorization on file but maybe it was for the wrong CPT and so we're not gonna be paid and losing control of those things. And I also didn't want to make any non-rash decisions just because I was short-staffed, right? I didn't wanna go into different vendors and say, hey, I'm short-staffed and then be like, oh, this is gonna be an easy sell, right? She needs somebody, you know? So I needed to also really discern over what made sense for us as an organization and how could I find somebody who was going to be a partner and not just a company who is helping, right? A partnership, you're looking for the partnership. Yeah, right. I think that was really, really important. Some of the strategies or things that I had to overcome then is also I needed to be open and transparent. I mean, not only did I need to communicate and be transparent with my team, I also needed to be, we are an independent group, right? So I needed to be transparent with my shareholders, right? They're trusting in me to make good judgment on, okay, Danelle, this is your world, we're trusting you, right? So I needed to make sure that I was making a sound decision not only for my department, but for the organization. I had to continue to reassure my staff that, hey, you guys are still gonna be essential. Like, I can't just say, there's no way for us to just be like, okay, there's no, we don't need an off team anymore, right? And I felt secure in that I had regular touch points with Infonex. So once I made the decision that we were gonna go with Infonex, we had weekly meetings, just to this point, we still have lots of touch points with it, but I needed to feel comfortable and confident in my decision. And I was- It was more like you were just training like a new FTE, like how would you, the whole onboarding experience, right? So that's like, there's different ways that people can do it, there's different approaches, but the best I think for you is just like, you're my team member, you work for me and I'm gonna train you how I would train someone who would be sitting right next to me. Right, and I think that that was also important in that transparency with my staff members, for them to see that, look, we have standard practice and standard work, right? And Infonex is going to follow that too. And we are going to teach them like, just as it's a new staff member, it's gonna be on my team, you look at them as an extension of our team, right? So if you see that your peer has questions on this, what do you do? You help them, right? It's not about like, oh, that's Infonex and you know, we needed to set Infonex up for success. And I will tell you that one of the things that helped me to make the decision was that Infonex said to me, we have a pilot program, right? We know we can do the job, but give us the opportunity to put our money where our mouth is, right? Give us your orders, show us, you know, let us show you we can do it. And that helped to really, you know, mitigate the risk, right? I felt more comfortable with them. Infonex said, after 30 days, if you don't like it and you don't want us to do anymore, great. We can walk away, right? Go find somebody else or, you know. So that really made me feel comfortable with the decisions that I made. In that 30 day pilot program, we really did a lot of training with the Infonex staff. Like I know I've talked a little bit about how important it is for them to be a partner. Just like if I was onboarding staff members, we trained them. Infonex gets into our EMR, they pull the clinicals, they upload them. So it was important for me to build that rapport, build that relationship and expectations. The other piece is that we are, you know, for profit and we have shareholders and some shareholders like it this way, some shareholders like it that way. And we were able to share that with Infonex and they were able to, you know, do what they needed that if I needed these to be done this way, Infonex could do that. If I needed those to be done that way, they could do that. It wasn't like, oh no, if you hire us, this is how it has to be, right? Yep. Yeah, exactly. It's truly tailored to the client. Like it's really what the hell they want. It's like, I've never onboarded a client the same exact way. Every, doesn't matter if you guys live in the same neighborhood, you know, work in the same neighborhood. It's really just a matter of how you guys do things internally and we're there to help replicate it to make sure that we can make it more efficient. Obviously, you know, the bots help, you know, some of the automation efforts that definitely helps with making sure that things get processed quicker. You know, you get more real-time results versus, you know, reminding your staff, oh, we didn't follow up on that prior auth. It's like, it's, you know, there's a lot of automation involved that's helped on both ends, but for sure the pilot I know is key for you guys. It's key to a lot of, because it's actually giving you guys the opportunity to say, all right, I'm not going to be locked into a one-year contract, two-year contract, whatever it is. I'm getting the ability to see the capabilities, to test out the system, to see if it works and then decide if we move into a full contract. So, you know, we're giving you the option. We want to show our capabilities. Yeah, and in that first 30 days, we could already see the benefits, right? You know, I talked about how we had a smaller group, you know, eight people, seven or eight people that were on our staff, right? And if we had 40 or 60 imaging orders a day, we were booking patients out at least seven days because we needed time to be able to get those authorizations approved. Because you guys schedule without the auth, right? You know, you just based it on, we didn't have the auth at the time of schedule, you cancel or reschedule, right? Yeah, so that's a pain. If we didn't have the auth, we would have to cancel that patient and put them on at a later time. So in that first 30 days, some of the key, right, we were already seeing results in that, oh, if I'm booking a patient out seven days and I'm giving the order to Infonex, the AI that they were able to utilize to be able to bring back an authorization in, you know, 24 to 48 hours was amazing because then we were able to say, okay, we can set different parameters now and we can get our patients from our clinics on the imaging table in three days or five days instead of seven or ten days. So even in that first 30 day pilot, we were seeing results and the integration really was seamless, you know, I said we talked about a partnership, we met, we would have meetings, we would talk through, okay, you know, just here's some things you're doing great, here's some things that we need to give you more guidance or this is where you need to look for this or you're going to this portal and you need to go to that. Yeah, I mean, because Pennsylvania is different than Texas, it's different than Maryland, right, so what commercial plans are popular and what, you know, in essence, the third-party carriers that they're using to give the authorization and revenue to clinicals is going to be different depending where you're at. Yep. Well, we might have talked some about this, but some of the gains, internal team now could focus on our urgents and our stats, so us transitioning some of our routine standard orders to Infinex gave us the ability that we didn't, I mean, Infinex will do stats and orders, not stats and urgents, not a problem, but I didn't need to send those to them because I had internal staff that could manage the stats and urgents, so that gave us more efficiency. Also, that gave us the ability that we could cross-train, so when we had our small team, right, I'm doing imaging, I'm doing surgeries, I'm doing physiatry, right, and we didn't have a whole lot of, like, if somebody left, I hired somebody and they learned imaging. It gave me the autonomy that as I push things to Infinex, or let's say I have three people at FMLA, right, it gave me autonomy, I can push more orders to Infinex, I can keep orders in-house if I need to. What would your hiring pool look like, though? I mean, is it hard to find specialty-specific prior-off people or patient access people, or is it like some of them may be coming right out of high school? Like, what is that like? I will tell you that the hiring pool that we have is, sometimes it's college students who, yeah, that can't get a job in their degree, right, sometimes it might be somebody who was a high school student and just, it picks things up quickly, right, you know, the right person can be taught how to do it, but again, it goes back to and those types of things, so sometimes the hiring, I mean, it's not an easy job and it's right. Well, and that actually goes back to even when you started, because I know, I don't think we touched on this, but when you started with the pilot, we were just doing imaging, we were only doing a couple modalities, and now we're like multi, multi-specialty, we're almost like in everything for you guys now. You are, right, and that was where, you know, again, going back to we knew that we needed it for imaging because there's huge high volume, right, then we knew that we needed to do AFC or outpatient surgical cases because the volume is just intense, right, and so as we felt comfortable, and attrition, right, so just like staff members were saying, oh my gosh, I'm going to lose my job, sometimes there's staff members that would transition to another position in OSS or they would leave. I wasn't like stressed about having to, oh my gosh, I need to recruit, I need to retain, I have, this gives me the flexibility that I need, and also as a patient satisfier, you know, going back to patients, I can put patients on the schedule sooner, I can, I'm having solid positive turnarounds on these authorizations, so, you know, we're, we onboarded five additional physicians this year, and we are on track to onboard five more physicians next year, and as you are, are hiring, that can be scary, right, you're like, am I going to be able to find MAs, am I going to be able to find, you know, people on the contact center, so at least for my departments that I oversee, this gives me a little bit of like, I know I got it for authorizations, I'm just going to push more to Infinex, right, and we have a monthly meeting with them, and I can say to them, hey, I got three positions that are coming on in, you know, the spring of 2025, that gives an opportunity to be able to manage their staff, and do they need to put more people on, on, on my, uh, on, on my account. Account, yep, yeah, we, we definitely, you know, based on volume, that's how we figure out how many you guys need, how many people you need, we want to make sure they're trained, they understand your SOP documents, make it scalable, I mean, I think that's super important that you hit on that, because people don't realize we're a multi-specialty, it's like, oh, we are in the ortho world, so yeah, it's not just radiology, it's DMEs, it's PTOT, you know, it's the surgery, it's pain management, there's, like, so much that's, it's not just one specialty, it's very multi-specialty, so it's, it's great for ortho groups, because they can scale, we can scale with them, right, and I think that some of the lessons that were really learned for me, it are really that this is a partnership, I can't, I can't stress enough, um, that I have a, I hired a manager, uh, for the authorization team two years ago, one of the things I said when she started is, like, you look at them as your team members, right, you don't look at them and, like, oh, I gave that to Infinex, right, they are part of your team in every aspect, if we get bulletins that there's new CPTs that are going to require authorization come July, then push those bulletins to Infinex and make sure they're aware of it, don't be just assuming, right, um, build that rapport, build that partnership, I can't stress enough the relationship that I've built with Infinex, that if I need to call them today and say, oh, my gosh, something's wrong, or, oh, my goodness, right, help us, right, um, or if they did something incorrectly, there's always positive reinforcement, there's, like, I don't, I don't send an email and wait five days to get a response, I send an email, and it's, like, you know, 10 minutes later, someone's, someone's responding to me, right, or taking the phone and calling me, like, how, what do we need to do, how can we help, so. Yeah, it's, it's very important for us, I mean, because one, we know it affects the patients, I mean, bottom line is, it's, like, if things get delayed, or your physicians get upset because everything's going to peer-to-peer, or, like, you're, like, oh, you guys sent the wrong doc, well, you know, there could be so many different nuances, it's humans, right, there is automation, there's tech in play, but there's still a lot of human touches. Yeah, um, yeah, I can, and it goes back to, you know, putting that effort into onboarding, that's the other thing I really can't stress enough, is equipping any vendor, whether it's Infinex or somebody else, with the tools to be successful, right, like, so that's an important part of it, and, and continual process improvement, and aligning and evolving our operational needs at Infinex's operational needs, so, you know, I think our staff are super, super happy with the relationship that we have with Infinex, they now feel, you know, more secure in their job, they recognize that they still play an integral role and a part in the organization, and that Infinex is their partner, and is really, like, you know, helping them. Well, and so, since you're going to add, you added five physicians recently, you're going to add five more, have you had to scale up on your side of things, or have you been able just to scale with just Infinex on the back end using us? We have scaled on both sides of things, the things that, I know we've talked about this in the past, but the one thing that Infinex does not do for us is hyaluronic acid injections, the reason that, you know, if we bring on three sports medicine doctors, we're going to see way more VSCO or HA injections, right, and because of the complexity, not saying Infinex wouldn't do it, keep that stuff in-house complexity of that, and does it need to come from a specialty pharmacy, what medications are approved as preferred drugs, those types of things, it's one of the things that we do keep in-house, and we have not, you know, dipped our toe into giving those to Infinex. And I actually don't recommend that, you just keep those. Right, exactly, we'll keep pushing you after the cases. Give us your imaging, your surgeries, all that, but yeah, keep those ones. So, I think that that's, yeah, the artificial intelligence that Infinex brings to the table, and that I can lean on them as a partnership, is, has built, has just really been awesome, not only for our relationship, but my shareholders believe in Infinex too, which is a piece that's important too, right? Very much so. I do thank you for your time, just, do you have some questions? Anybody have any questions or or want to, yeah, share positive or negative things that are going on in your areas? I had a question that came in, so while others are thinking and typing in any questions in the chat, somebody sent me a note, how do you juggle outsourcing while making sure your team stays on top of urgent or high priority cases? Okay, so I did share a little bit about that, that we don't send stator urgents out, so what happens is when those orders come in, we keep them in-house, but we also, Infinex has like a portal, an IPA portal, so all of the cases that we turn over to Infinex, we have access to a portal to see where it is in the process. Did they start it? Did they have an authorization? Did they ping already? So I, my team, if I'm owning imaging, I still am responsible for all of my imaging orders, whether Infinex has it or I'm personally working it, that's how we divide and conquer. So like I said, stats and urgent stay inside, but all standard, all the standard cases typically are sent to Infinex, and we document in our EMR that it's sent to Infinex, pending Infinex, once the auth comes back, we load in the authorization number, so we manually do some of that work, and we pull that information from Infinex's IPA, if that answers the question. Yeah, and it's actually very common that a lot of our clients, especially during initial onboarding, they'll keep all the urgents, the stats same days in-house, knowing that they have the option to send it down the line if they wanted to, but we staff up, because if we know you have a lot of stats same days, and we have to add more people just because of the urgency of the request. Yeah, awesome, thank you. Anyone have any other questions? I know we're coming to the end of the time, too. I haven't seen any other ones come yet, so please feel free to drop them in as I'm kind of going through any closing, and I also definitely utilize the contact information on the screen as well, if you have follow-up questions for Danelle or for Laura. As a reminder, this was recorded, and so the recording should be available in the AOE Learning Center, and you'll be notified once that is the case, and feel free to share the access to the recording with anybody on your team who is considering outsourcing and could benefit from this information as well, you know, especially as you're sort of closing out the year, and if any staff has extra time on their hands. We have a lot of material in the AOE Learning Center, and a lot of things that are free resources as well, so this is always kind of a good time of year to think about some professional development, and this will be there along with a lot of other materials. I want to take a moment to thank Laura and Danelle, number one, for being flexible with us as we were having some technical issues. We really appreciate you guys jumping right in. You did an awesome job, and for such a thoughtful presentation. I always really enjoy hearing case studies, and hearing your personal experience is always so great, and thank you to all the attendees as well for being flexible with us on the technical issues as well, so it was great to have everybody attending this webinar. We have a couple more left before the end of the year, so you can check out aoe.net slash events for any other opportunities to join us in the future, and just as a reminder real quick, if we're not going to see you before the end of the year, there is a discount that ends on December 31st for the annual conference, so if you're considering going, we have a current discount happening, and if you are thinking about it, make sure to take advantage of that pricing before the end of the year, and other than that, I think we're all set. Any final other words from you, Danelle or Laura? No, just for your attendance today. Yes, thank you so much, Danelle. Thank you, Jessica. Thank you, AOE. I appreciate you guys. Yeah, thank you so much, everybody. I hope everyone has a great holiday season coming up, and we'll see you the next time around. Thank you, guys. Thanks. Bye.

Patient Access

Staffing Shortages

AI Authorization

Operational Challenges

Partnership

Healthcare Efficiency