Jerry Durham is Out of Network with Everyone! | CashPT Lunch Hour #17

Cool.

Yeah, you can just take a few hours. Okay.

What's up? Cash Cash PT Nation. Cash PT Lunch Hour. This is Aaron Labourer with Levour Consulting. Here we go. Jared Carter. I got him in the background. I got a whole bunch of people here at the APJ PPS conference. We got. Jerry Durham is our resident expert for the day and for the day. Always, man. For the year. All right, so we're gonna get started. This is out of network with everyone. So that's Jerry Dermot. The first person I think of

out

of network is Jerry. So why don't you guys. If you're listening online, let us know if you can hear us by just typing in the chat. Where you're from, where you're listening from. Can you hear us? Is the volume okay? If you guys are here and you haven't registered, you can. You can get the replay by email. Just go to labourconsulting.com jerrydurham up and get the replay and it'll come to you by email. Oh, yeah. Oh, there's Annette from Greensboro, North Carolina. Perfect.

North Carolina. You have people in North Carolina?

I got people from all over the place. Check this out. Oh, here it is. Bozeman, Montana. Amy. Brittany from Washington.

Who's Amy? And Boz? I know.

Bozeman. Jason from Scottsdale, Arizona. Krista from Memphis, Tennessee. Joy. Cornelius. Kira, North Carolina. Beth from Lynchburg. Willie. Awesome.

Jack Daniels.

Jack Daniels from Jack Daniels. And Kelly from the North Pole.

Thanks for Tennessee.

You got someone from the North Pole calling in.

What?

Yeah, yeah, always Kelly's. Kelly's one of my big listeners.

Oh, that's awesome.

Yeah, man. And. All right, great. So my guest today is Jerry Durham. This is the Cash PT lunch hour.

Live from Vegas.

Live from Vegas. And so, Jerry, first off, you know, I'm gonna. Let me introduce. I'll tell you, I've already introduced you, but I'm gonna introduce yourself. But Jerry owns a practice in San Francisco, California, with sturdy McKee. San Francisco sport and Spine. Jerry's huge on Twitter. He's brand new to Facebook.

Brand new, dude.

Brand new. He doesn't even know how Facebook works.

What are all those people doing there?

Yeah, he doesn't know what the like button is.

That thing is so new to me.

Yeah. So, Jerry, tell us real quick, like, how'd you get into physical therapy? Private practice. What. What was that journey from early on to now? In five minutes.

It's my favorite story. I'll keep it shorter than 5. This is my favorite story. And you gotta hear the beginning. Everybody will Appreciate this. So I got outta school, worked jobs, come home and bitch about my job month after month. And after about a year and a half, I'd quit, get it? Tell my wife, hey, my manager sucks my job. This was the PT world, right? Yeah. So my manager sucks, my manager sucks, I'm quitting. I could do this different or better and, and so I'd get another job. And about a year, year and a half in, guess what? My manager sucks. I need a new job. My wife was very patient, said, if that's what you need to do. I said, yeah, I found something else, did that like three or four times. Finally I came back to my wife about four or five years out and said, my manager sucks, I'm quitting. And she goes, very patient woman. She's been married to me for 24 years.

Wow, congratulations.

And she said to me, she goes, jerry, there's only one constant in all those jobs you've had. And I'm like, well, what was that? She goes, you and I. And it was like my brain works a little slow. So it was like I had to process that for about a year. She took it right away, she said, you have to start your own business. And I said, there's no way I'm starting my own business. There was no way I was going to start my own business. And so she slowly but surely pushed me. And then I opened my own practice on my own. I had known Sturdy, Sturdy and I knew each other in San Francisco. He had a practice at the same time. And then about a year in, he came to me and said, hey, I have an opportunity to get more space. And rather than just move my space, I want to grow and I need a partner. So Sturdy and I partnered up about 16 years ago. We just had our 15 year anniversary last June. And then today, how'd I get here? You know, fortunately, tribute to Andrew Burton. Andrew, I'm talking about you. We were using metrics and we knew what our cost per visit was and we knew what our revenue per visit was. And when we got our first insurance contract that fell below our cost per visit. That was about a two second discussion because we, we said, Sturdy said, yeah, I contacted them, we tried to negotiate, they wouldn't negotiate. So we knew we had to cut the contract. And so that was our first out of network foray, shall we say, about seven years ago. So going out of network started. So to bring us up to now, what we're talking about now, the out of network didn't you know, we didn't go out of network. You know, on like June 1st. Yeah. And we did it. It was driven by business and business decisions and business metrics. It wasn't done. You know, now we make a lot of decisions why for the patient, it wasn't, you know, it was done that this is the cost, this is what's going to happen. It's like we can't sign that contract. The good news of what happened is it caused us to focus where we should have been, which was directly on the patient, that healthcare consumer. And so we said we're not gonna sign this. So we both kind of looked at each other and said we have to change the discussion because now we have to convince someone calling in on the phone that they need to pay us $150 when they could literally, literally walk around the corner for $20. So that's when we really start to focus on that customer as the driver and the end, what I call the end user.

Yeah.

And then so slowly but surely right then over the next few years all the out of now are all the contracts started showing up because all the other idiots are signing it when and they don't know their business metrics. So.

So is this like, were you guys negotiating with them? Yeah, yeah, we can do X. You know, we can do X. And they were just like.

And early on we did have some success on that and we got, we were getting more like for United Healthcare because. But then everybody just stopped negotiating with individuals. So finally we went out and networked with everybody about what four years ago? Everybody but Medicare. We're not going to talk about Medicare today because that's its own beast. But yes you do. And, and so we went out in that work about four years ago finally. But the good news was because of going out little by little pulling the band aid off slowly, we were able to build up that patient experience, that customer life cycle I always talk about and really put that customer of which you guys talk about all the time. And you know, and this is my thing about why. And I'm going to throw this out there. I don't like the word in. You know, I don't like saying I have an out of network clinic. I don't like saying you guys have cash business. I don't like saying that in network because we all focus on patient.

Right.

And that's why we're. You, me, everybody is successful.

Yeah.

So I.

So who's your customer? Tell me who's your customer?

Yeah, my, our customer. You know, it's really, it's interesting. So we have three offices in San Francisco, and each neighborhood is a distinct. Different customer. So.

And if you came in patient.

Right. Yeah, I'm sorry. Yes.

Yeah.

But don't tell me about them. But I want. I wanted to make that point that a lot of people are focusing.

Thank you. Yes.

On their customers, either the insurance or the physicians.

We're so focused. And I said that yesterday. And the quote. I think I said, it's not the insurance. Yeah. Because. Yeah. We've lost focus on who the customer is. And it's that patient. Right. It's the end. I call it the end user. Who's. Who is that touch point? Who is the person right in the. I'm sitting across from you, and I'm worried about, you know, the principal. Everybody needs to go on Wikipedia and look up the term, the. The term principal agent. And it talks about what occurs psychologically when they're. When you and I have a business relationship and the money flows in from somewhere else.

Yeah.

And you're not handing over the money. So this principal agent thing is really important of that mindset. And it happens on the PT side. Right. You sign an HMO contract, capitated care. It dictates the type of care you're going to deliver, and then your end user is not.

And you're like, this person's only worth 30 bucks for this visit. So I'm not gonna put that much effort into.

Well, right. In the same diagnosis, someone else has is paying out of pocket, and you're treating them different. Yeah, yeah. No.

So tell us, like, who. Tell us, who do you like? All right, let's go back and say now you're out of network. It's not just. I don't want to know just about who your actual real customers are, and your target is. But how do you go about. The big question a lot of people have is how do you go about convincing people to come see you guys and how to network? I think that I want to know. I want to. I know what you do, but I want you to share with everyone because that's going to answer all these questions like, how do you. How do you. How do you convince people to come see you guys?

So step one, which you guys will understand, step one is you have to understand what you're selling. And we're all. That. That's your. That's your value proposition. I think Paul Goff calls it your service proposition. Right. So he calls it usp, come from an older model, and we called it our uvp, our unique value proposition. And our Unique value proposition was we were going to. We were going to create applications. So everything we do is focused around creating a happy patient. And if you think about it, you ever see someone going to in network provider and they'll tell you how great their care was, but they'll never go back to that clinic because of that bill at the end? That's not a happy patient. No. So we feel like that encompassed the whole thing from the first touch to the very end. Not to the very end, but just through the end of their course of care. And so you know, you have to know your bp because when someone calls me and we know darn well what they're gonna ask them first. Right?

Yeah.

Do you take my insurance?

Right.

And I do take your insurance. Right. It's the right. Yeah.

Right.

Then what we do. Yeah, we do. So here's the things. And these two.

But take. What does take your insurance mean?

There you go, dude. So there's the million dollar question that everybody messes up hugely.

That's the term we need to define. What does that mean? Take your insurance.

And everybody needs to listen to this and listen closely. So I'm out of network. So I bill, I choose. I choose to bill your insurance company. So do I take your insurance? Yes, I do.

You take on the responsibility.

You are correct. Now what is the question? They really want to know because they're asking the wrong insurance pay or what

will my insurance pay?

Are you in network? So check this out. Well, no, they're. Well, that's a good. So someone just said, yes, they're asking the wrong question.

Yes, they really want to be asking

is you are correct. So here's what's interesting and here's where I get some. So we had a. We have a dedicated person answering the phone. Okay. So we hired someone and it didn't work out, so we fired them. And before we fired him, I realized we didn't have our system in place very well. So I committed to answering the phone to build the system so we could hire the right next person. So I answered all the incoming phone calls for almost a year. Actually, it was less than that. Sorry. It's about maybe six, eight months. But I went back and figured out I answered over 1000 calls of people calling in. Right. And that that's how I got to the wrong question. Right. And so what I realized is we had put someone in the seat and I didn't even realize what was coming through the other end of the phone. So I sat there, took over a thousand phone calls, called Over a thousand people back with their insurance benefits. And that's where the system really came out about the conversation.

Yeah.

And I'm going to tell you right now, out of that thousand, right, we're saying they didn't ask the right question. And everybody assumes everybody picks up the phone, says, are you in network? I guarantee you not. Five people out of a thousand started with, are you in network? Everybody asked, do you take my insurance? So, as you know, with everything we've done, right, I prefer they ask, do you take my insurance? Because now we can have a conversation, Right? Because if you ask me if we're in network, I'm gonna have to go down that road with you, and I don't want to. Yeah. You know, I kind of like it when people like me and we're not gonna have a good conversation.

So someone calls us. Susie Joanne calls up, well, maybe in California. Yeah.

They only have one name. Everybody.

Everybody doesn't have two names in North Carolina. Susie Joanne. So Astra calls up and she's a Sagittarius. Well, I'm Sagittarius.

Sunshine.

Sunshine calls.

I guarantee you we have a Sunshine, probably.

And, and, and she says, do you take my insurance? Tell us about that conversation.

Okay, so every conversation has to start with, has to follow two rules. Acknowledgement, and then permission based, right? Permission based. And so the first thing I do is I say, what's her name?

Oh, Sunshine.

Sunshine say, you know what, Sunshine? I said, by the way, if you didn't catch it, my name's Jerry, and I say, by the way, Sunshine, we do take your insurance. Now, I have a question. Can we get. Can we talk about that at the end of the call? Because I have some other questions I'd like to ask you first, but I'll definitely get you all that information at the end of the call. 99 of the time, what do they say? Sure. Right, sure. So now we can have a conversation, right? And Paul does this great. Paul talks about the guy sitting in the bar, right? Walks up to, girl, hey, you come here often. It's like, right, that it means nothing to nobody, right? So. So you got to steer that conversation down the path. And don't forget, most people calling don't even know what physical therapy is. I mean, we can get into that. It's some other point. But yet they don't even understand their insurance. So. So we got. A consumer doesn't understand how the insurance works, which they're planning on using for payment, and then they don't understand the product they're Going to buy. So we immediately go down that path to start to build trust, start to build the relationship and build trust and start to sell our UVP unique value proposition. Yeah.

What's the next.

Did you want to hear it?

Yeah.

Yeah. So the next question is. So sunshine, blah, blah, blah. My name is Jerry, in case you didn't get it. So what's going on? What have you done? Yeah. Oh, my team was so resistant to this. They just wanted to ask for database and everything. And it's awesome. They were resistant because they felt like they were. And they told me this. I've got a great relationship with my office coordinators. I spend most of my time with them all on the front end. I don't even know my PT's names, I think. And so they were resistant because they felt like we were asking too much personal stuff. And I said, that's what we want. And so there was some resistance and I got their buy in to start doing it. Every One of my OCs loves the approach now because they're feeling, even my office, I'm sorry, office coordinators, ocs, they're filling that personal connection come through the phone and it's making them feel good.

Yeah.

I didn't, I didn't realize it was going to make myself, staff even feel more valuable. They feel more valued in their job since we start asking, so what have you done? And that leads into what can't you do?

Right.

So now I'm going to find out. Exactly. Right. You're not calling me. Think about. And this is the other important thing. You're not calling me. I made this point yesterday. You're not calling me for low back pain. Right. You're calling me because when you sit for 20 minutes in your car, you get pain in your back and your commute to work is 45 minutes. That's, that's why you're calling me. That's what we have to get to. On the first phone call, we're going to start making that connection. And by the way, back to. Let's spin it all the way back to the beginning. This is why out of network. In network, cash pay doesn't matter because we're going to build a relationship and I'm going to take care of you. And yes, we're going to have to deal with finance, but you're going to want to see me regardless of in network.

Yeah.

Right.

Yeah, yeah.

So we go down that path. Right? What have you done? And then there's one more question. Sorry, I totally lost it. But it Follows that path.

How's it limiting you?

Yeah. Thank you. How's it limiting you? You know, so you get their goals, and then you find out what. What's limiting. So then that goes. Yeah. And then that makes it down the path to the physical therapist. So when they show up, the physical therapist already knows. So, yeah, that first phone call is where the trust, I would say, is established.

All right, so now I know you call it the benefits callback. So how do you get from those questions. Questions to answering the. Do you take my insurance question? And the best.

So then at the end of that first phone call, and I say, so. Oh, yeah, your insurance. What do you have? Oh, you know, I. Blue cross Blue shield. Okay. I say, this is what we'll do for you, sunshine. I will get all this info. My team, who's awesome. My team will check your benefits. Your appointment is next Friday. I will get you your cost and your insurance benefits at least 48 hours before that Friday appointment. Will that work for you, yes or no? And some people say no because they want to know that cost, and they're going to make their judgment on cost. 95% of people say, yeah, that'll be fine because I'm offering. And think about it. Anybody call your doctor today, ask them to check your insurance benefits and get you your cost before your next visit. It ain't gonna happen. Right? So we, you know, by the time you hang up the phone, you're like, wow, this isn't like any experience I've had. Right. And we're starting to create that happy ratio. Right.

And then the insurance payment becomes secondary to getting better and what this guy can do for me. Yeah.

So now all of a sudden. So the benefits call back. And Aaron, thank you for bringing that up. Aaron knows my life cycle. So the next step is the benefits callback. Right. So now what's beautiful and what I have figured out, and my team's great at doing all that info we collected on the first call, that's the conversation we start with, right?

Yeah.

So it's in your. Yeah. Benefits callback. And then if you start to get objections, you know, then you start to say, well, you know, we do have the appointment tomorrow. You know, you want to get this better. You got, you know, so you can have a conversation about what you're Holes are not about low back pain. Right. So you're having more of that personal conversation. And people do that, you know what? And they say, yeah, you know what? My time is important, and I do want to stay because I have that appointment tomorrow. And a lot of times we'll leave the appointment on and let people call around and try to see if they can find an appointment tomorrow. They call back, no, I'm just gonna keep it. So we're okay with that? Yeah, yeah, I'm gonna keep you on. They'll say, well, I want to cancel. I'm not too sure. And we say, oh, we'll just leave it on for you. It's not that big a of do. Just call us back before 5. Yeah, yeah. And you know, a lot of times they'll stay. Yeah. So. So how do we. So again.

Right.

The conversations on Facebook, everywhere else, everybody wants to talk about a model in network, out of network. It's like, let's talk about the person in the center, the cons, that healthcare consumer. Which is.

Yeah.

Probably my favorite term for the patient.

That's cool. That's so good. All right, so I want to lateral.

Oh, I'm done.

Yeah, I want a lateral to. Let's. I want to talk about your definition of what's out of network, what's in network, and what's cash based. I know you say that.

No, no, that's fine.

Yeah, tell me, what are your differences?

So an in network, that means you signed a contract, you put your name on the dotted line with Blue Cross Blue Shield. So you are bound by that contract. And by the way, I've read all our contracts in the past because I battled with just about all of them.

Yeah.

So you've agreed to a lot of things that you don't understand you've agreed to. So that's in network.

Yep.

Slash contracted out of network. Non contracted is. No, you don't take the contract, you don't sign it. Now, the way the system is set up, you don't have to sign the contract for them to be able to use their insurance card with you. Right, Right. So. So you are under no obligation. Now, remember this, you sign in network, you can't collect the term balance. Right. So if you balance billing balance, I've seen that pop up. And it's an important term. If you're in network, you can't balance bill. So if I want to collect 150 a visit and your insurance in network pays me 75, I can't bill you. The other 75, I can't collect.

You can only collect what your contract says you can collect.

If you're.

You can collect $500 a visit.

Right. My insurance covers for $50. Hey, you'll always, you know, so. And that's the way we do it by the way out of network, we figure out what we want per visit and then you get balance bill. For lack of a better term, the difference. Yep. Everybody's benefits. And this is key, and this is key to the conversation that brought this to fruition and is if you're not checking benefits then it's very hard to have a conversation about super bills and billed and paid and collected and co insurance and co pays if you've never checked insurance benefits. Now the key is you need, you need to figure out what kind of practice you want to establish so based around your customers.

Yeah, right.

Your healthcare consumer. Because I've been having this discussion a lot about okay, these people come to me, I want to be out of network and I say okay, okay, you're gonna bill insurance, you're gonna give them a super bill. They're like, what's the difference? Well there's a huge freaking difference.

So what is it? Let's tell it. So like where's, where's ca. Like, well, I would agree, I would say that cash based is what you do. But you get the super bill. You don't take on the.

Yeah, you're right.

The, the responsibility of filing the claim and checking claim.

So and when you do that correct you, you say you know the insurance company, you get to deal with them.

Yeah.

Because you now you also give up. You also give up if you're going to pass over a super bill.

Yeah.

You also give up if an insurance. So if you pay me 150 bucks and I give you a super bill for 150 bucks, I'm affecting the way that you're going to get reimbursed by the insurance company. Yeah. And I have to be okay with that.

How so will they get, will they get less by sending it in themselves?

Yes. How come? Because they're always going to. This is what came up in this building. Paid are two different things. Right.

So what's build? What's paid?

Yes. So build is the amount that gets sent to the insurance company and we all know the game and we all have to play the game and it's, it's, it's like the 900 gorilla. Because you know there's like that thing. Right. What everybody thinks is, well I give a super bill for 200, they're gonna get reimbursed 200 and that's the correct use of reimbursement. Right. Because they paid me 200, I give you a bill for 200, you're going to get reimbursed I'm not sure they're going to get.

They're going to get minus their co pay or co insurance whatsoever reasonable and

customary for that insurance carrier. Right, right. So that's the key point there. I hand you a super bill for 150. It doesn't mean you're getting 150, and more than likely you're probably going to

get less or because you've never met your out of network.

Well, right. And if you got a deductible, like we talked yesterday, you're going to get reimbursed nothing. And so, so then again, we're back to that. What responsibility? And it's up to every. I don't judge this. Judge a lot of things, but not this. What responsibility do I want to take above and beyond collecting money? Right, right.

Well, that's the service you're providing to your patients.

Exactly. And so that's what we decide. That's what we decided a while back when we went out in network is no, we're going to continue. We're going to continue to offer this service. And the service we offer is we will bill your insurance. And what's nice is my team's gotten so good at checking benefits. We know how much we want per visit. Not, you know, so not everybody's walking in paying $150. Yeah, pocket. Some people are paying. By the way, when you check benefits, you'd be surprised. Sometimes plans are exactly the same. So I call you back on the benefits callback, I tell you you're out of network. But then I tell you, by the way, regardless, interrogative network, you have a $50 copay, so there's no reason for you not to come.

Yeah.

So can I just ask. So in that, let's take that as a, an example. Someone has a 50 copay, whether they're in network or out of network. That's what their benefits are. That's what when you called and verified that's what they told you.

Correct.

So you call them back and you say, look, whether you go, someone who's in network or out of network, you're still gonna have to pay 50. Now, in the case that they come to see you, does that mean that you guys are collecting 150 from them and then sending in the bill on their behalf and then they get 100 back.

Guess what the answer is.

The process.

Guess what the answer is. Depends. Because. Okay, so, so I'll give you an example. And this is how deep we have to go. And this is why my billing team Is so good. And again, why I trust them too is Blue Shield insists on reimbursing the patient directly. And this is where we. This is where we found a lot of this stuff out. So we send a bill. Oh, and we collect 150 per visit. You collect 150 no matter what. You're going to get reimbursed from Blue Shield.

Okay.

Just for Blue Shield. You're gonna pay me $150. We get the elvs that you get. We bill what? 250 for an eval. 275, whatever. And the follow ups are like a little over 200. Right. So we can get whatever we get. Right. And we, we know all the math. Well, some plants. Hold on, hold on, let me finish. Some plants will reimburse you more than 150. So we see the EOB. So our financial policy actually says no, you owe us 150 plus whatever the above and beyond your reimbursement. See, this is the conversation and this is where. This is where things start to get muddy.

Yes. So let's. I want to back up and like when I talk to you about this. I did we on the phone two months ago. We went over this a couple times the.

And that's only Blue Shield. So that's the depends thing. So just riding that up. Everybody's different. Remember I'm in San Francisco, so I get plans. I got people walking in. I got plan plans from other states. So nothing is ever the same. So I swear to God.

So let's just.

I'll show you. Then I'll send you the next 10 benefits. I check just the next 10 people are calling and it will be all over the board. I'll send you just the next ten blue crosses and they'll all read different.

So Jerry, tell us like define what is balance billing and then let's go over. I want to go over this process one more time just to make sure

it's also balanced billing, which I can do, you can't do when you're in network. When you sign that contract, you cannot bill above whatever the amount. By the way, what's interesting too if you think about this. So I'm in contract, I'm in network. I get 75 a visit. Right. Just argument's sake, your co pay is $50. How much is the insurance company paying me? 25 bucks. Yeah, yeah. It's just. It's so bad.

So balance billing is. I want 150 a visit. Your insurance is going to pay 75. So you owe us the other 75

and we tell them. Yeah. And so everything's totally transparent.

Will you still collect the 150 upfront from the patient and then.

No.

Because. No, no. And that's the other. That's the other thing I do. So I'm agreeing to take 75 from you and then dealing with the insurance

and then deal with. So they will. Unless it's blue shield, most of them will pay you directly because then you

get a check in the mail.

Okay.

With an EOB that I get so I can see. And we've had people. We don't have a lot of cases. Billing issues at the end. But we've got a couple cases where people were paid. They cash the checks and they don't think they owe us anything.

Yeah.

Yeah.

So.

So they actually think about this for a second. They actually made money.

Made money.

So that is. Yeah, that's. And we wonder what's wrong with healthcare in America. Right. And they're making money. And so that can be an issue with the super bill. And so I think that original one was if you pay me 150 and I know your insurance benefits, I'll give you a super bill. Build, build, build. Now pay build 200 so that you will then get the 150 back from. Or as close to our amount.

Whatever amount is in the contract.

But if I say I build 150 potentially they're going to discount.

So just so I'm. I'm clear and makes sense. Depending on the contract, depending on the.

The payer.

Sometimes you might collect the full 150 from the page.

Remember it's not on contract because I'm not contractor.

Right. Okay.

Venture.

Okay.

Seriously serious. Because I don't want to mess those up.

Sometimes you collect the full 150 from a patient.

Yep.

And sometimes you might collect if you know.

25.

Yeah.

25.

Because I know I'll get. You'll get 125 from the. So that. That's the commitment I'm making is. Is I'll collect the balance from these guys. And then. And then some plans have no out of network benefits. Right. So you have an EP then it'll

be a full 150.

They become a cash full cash.

Okay now what happens when the insurance reimburses 175 so we is in the

financial policy says it you get billed the extra $25. Yeah. Because you paid us 150. Right.

Wait, I missed that.

What happened?

So. So insurance. So the rate's 150. He bills 200 and insurance reimbursed is 175.

Okay. What do you do?

How does he get the next 25 if it goes to Sunshine or Jared Carter?

Yeah. We build them.

We bill them at the end of therapy or as you get the information back.

As we get the information back, yeah.

So they pay it, by the way.

Trying to gather that, like, six months down the road is a disaster. Yes. Yeah. Because they've cashed it, they've spent it, and then they don't really want to own the fact that they, oops, I owe you money. Right. It's kind of weird. It's. I don't. You know, I got. Some people think everybody's trying to cheat us, but, you know, I'm like, you know, nobody understands the system anyway. You get a check, you cash it. You can't read an eob. Somebody tried to read anything. And they're all different. Right. And there are times when I sit down with my billing guy and I. I've read them for 15 years and I still have to go away. Take me through this one. Right. So I don't really. If someone gives pushback, they don't owe us the money, then, yeah, we got an issue. But if someone cashed it and didn't send it to us, I don't see that as someone trying to cheat us. Yeah. I just see that as someone going, well, they said I'd be reimbursed. Question for you. Let's take the example. January 1st, got a brand new policy, reset their deductible to check their benefits. They've got a $5,000 deductible. No code. You set your metrics that you need to expl. You're going to bill 250, 275.

Did you.

Out of that. Are you required to build in the balance between the 150 that you set as your nun versus what you're billing? So here's the deal. I'm gonna answer.

Can you kind of reframe?

Yeah. So here you go. So it's the beginning of your year.

Yeah.

The beginning of the year is actually a good. It's funny being out of network, obviously. I know a lot of. In network people. In network, people hate January through March and April because everything, everything reset now. Love it. Out of network. Fucking A smile. January through March, because I know you're in and out of network. Benefits are now going to be the same. Yeah. And my conversion rate will go up, so I'll get more people to show up. So, yeah. So I love it. So the question is. Yeah, the question is so your benefits reset. So here's the deal. I. I'm just gonna say I think you made it a little more complex than it is. So let me go back and answer something that I thought I heard and you can tell me if I answer. So benefits reset. So you have a. Which is argument's sake, a thousand dollar deductible. So we'll do the math when I call you back with the benefits callback. Your evaluation is going to be 175. You're going to pay me every on day of visit $175. Because your deductible is a thousand dollars and you have to hit a thousand dollars before any of your other benefits kick in. Okay. 175 at time of eval, 150 for the follow ups. We do the math. Now here's the kicker. On your question, we collected our 175. We collect 150. The insurance company is only going to. So if it's like some of the Blue Cross plants out of that 150, only 25, only 50 is going towards the deductible. So it's not the full paid amount.

Why I don't see that's, that's the

agreement Insurance industry faster.

I know.

Well I just got to notice remember they only apply. So. So right. So for in network and you're giving me 75 bucks. Right. It's like $75.

Right.

But if I'm out of network, remember the whole balance billing thing and everything, you're only submitting up to that amount.

That's crazy.

The format. So by the way, as did I answer your question? So let's say in my example they actually allow child. Okay, so they allowed the 275 deductible. I don't have any requirements to the patient for the difference. No, no. So in some ways you're helping the patient meet their deductible. Yeah. Yet. Yeah. So if we. Yeah. Hypothetically. Oh no, no, because, because, because there is a. There is an amount per visit they're going to cover. It's remember it's not on bill. That was the other problem with this group is everybody was using build and paid interchangeably. And that's why I got out of that conversation. And I really want someone to submit that. You guys saw it. I want someone to submit that as a fraud. As a fraud complaint. Let's see what happens. It's not gonna go through. Oh, did I say that? Did I say that?

What did you say? What Fraud.

Yeah, I want someone to submit that as a fraud complaint. Remember I said I didn't want to say.

Yeah, so that was one of the questions.

Fraud is intent. Fraud is. Fraud is intent. You know, isn't.

It's intended game, the system.

Yeah. Right. And so there's just there. There was no there there in that story. And the longer it went, then people started putting up new scenarios. I would go back up and read it for the 300th time and go, there is no fraud.

The original scenario. Here, let me go back.

Those who don't know.

Yeah. So in the Cash PT Nation. This is, this is the question here. Here it is.

All right.

This is from Jesse and she said, hey, I'm hoping someone can shed some light on the insurance versus cash based billing for us. We came out of a practice that tried to combine the two concepts. The price for a one hour visit was 150 as cash rate.

Okay. Price, that's.

That's the price.

Theoretically, that's billed.

Yes.

So now we're using price and billed. Right, the same thing.

However, they had a medical biller and would bill the insurance companies for 300 per visit as an out of network provider. So the insurance company would reimburse and then the patient would be responsible for the difference between the reimbursement and 150 if it was less balance billing. Yep. If the insurance paid 140, the patient would be charged 10. If the insurance company.

Right, yeah.

If the insurance company reimbursed more than 150, the clinic would keep all of it and not charge the patient at all.

What's wrong with that? What's wrong with that? There's zero. Wrong.

Right. And they're in network.

I'm sorry?

They're in network.

They're out of network.

There's zero.

And so now she says now, now we are competing in the same market using a true cash based practice, which in discussion. It's hard to understand what it is, but we've defined if we. If it's the same definition of cash based. And I'm providing a super bill and it's me versus you and we charge 150 and give the patient a super bill for 150 to submit to insurance companies. Some patients who've been to both clinics are now wondering why they are paying so much less at the former clinic that has a medical biller which is the same price. And we are both out of network providers.

Yeah.

Because there's the difference between out of network and cash based.

Yeah.

Based on who takes the check, I mean.

And good, because. Good questions going in because our conversation now leading up to this has answered that. Yeah. Even more, I think thoroughly. Yeah, yeah.

It seems much more clear now exactly how you guys.

So you guys, didn't everybody love the deductible story? So when you guys go, right, so yeah, when you go, if you go out and network, right. You're paying me 150 bucks. We make, we make sure that they understand that.

Yeah, but you're also important employing people and paying to collect on that. And, but you're providing a service. So if you get a little bit more than me and you know, it's like two things.

This is back, you know, I don't even mind about the customer, the healthcare consumer. We have to decide what kind of service we want to offer. And some of the service we offer, we may leave money on the table if you don't have to employ three extra people.

Right.

Then you know, my 150 and your 150 whatever.

They could be different.

Yeah, yeah, yeah.

What do you think your percentage? If you know this, what is your payroll, what is your percentage of your payroll going towards? I got thrilling.

I got three full time people fully salary, fully benefited.

So I don't know, three out of how many employees?

20. So it's a, it's a good hit, dude.

Yeah, it's a good hit.

Yeah. Yeah.

And, and so don't think, I don't look, I look around sometimes and go, man, yet what we would give up at this point, it's not worth it

in terms of not billing on behalf of the patient.

Correct.

So you feel like.

No, no, you're so guess why. I guess why we do this? No joke. Why?

To make happy.

It's. Yeah, it's for no joke, dude. Yeah. And I'm serious. I look back, it's a value add. So you know, I'm. You're gonna call my place, we're gonna have a conversation about not your low back pain. We're gonna talk about your, you know, you can't sit for 20 when you call my office. So. So I look at the. We'll check your benefit. You know, look at everything. Cost transparency, everybody screaming about it. We do it right. We're the only people I know who do this now. You guys, do people know what they're paying when they come in the door? So in our model, we're the only people that I know that does it and does it. Well, my team is dead on. And actually I've, I've even Looked at using my team to help other people because like, so people in the group who maybe say, well, yeah, I do want to check benefits and stuff. It is. It is. You want to talk about an art? There are no science behind checking benefits. The only science is dialing the phone.

Wow.

You could sit in the room and listen to what I need a check benefits for four different. She knows the. So to get the same exact information that we put on the paper to give you the callback, she'll have to ask it four different ways, dude. And how did we find out? Because we weren't getting the proper information. And finally one day it's like, oh, I have to use this word with these guys to get this. This word. This word. This word.

No joke.

Yeah.

So it's just like calling Medicare.

It's a game. At least, dude.

At least.

At least. So did you guys see my tweet when I left the post office the other day? No. So I go line up at the post.

You tweet far too much for me to keep up with.

Actually. That was. Yeah, I should have just made that retort. So I'm standing in line at the post office. It's about 11:30. There's about 12 people in line. I'm like, it was like that scene in A Christmas Story. Oh. And. And so there are three windows open. I get in there, I'm not in line 30 seconds. One of the people stands up, looks at her co workers and says, I'm going to lunch. And so she yells it so everybody in line can hear it. And you can see everybody in the last half of the line just go,

yeah.

So I waited in line and I left. And then I'm walking out the door and it kind of hit me and I went, just left the post office. Think about this. The management of the post office is in charge of health care for all of America. The government.

Right. Yeah.

I'm like the same people that manage that place I was just in is in charge of Medicare.

Yeah.

I was like, oh, just baffling. Yeah, I digress.

I got a question. Well, there's a question in the chat and people are starting to answer. I just wanted to ask you this. So this from Jesse. They say, so one question is that when we check benefits for of a period patient, the insurance agrees to pay 80% and 20% is the patient responsibility. There's more like a co insurance.

That's called co insurance.

That's called co insurance.

Co insurance. And that's of expected.

Yep.

And do we have an Obligation, Remember,

it's not 80, 20 a build, it's 80 of 20 of what they allow. That's key too.

Yes.

So when people are saying, well your benefits are 80, 20, it's of allowed. So back to our example.

Allowed for PT per visit.

Yeah. Right. So if they're allowing $75 per visit and the patient has to cover 20 or 80. Yeah. So they're only covering. So the balance bill. Right, Dude. So let's say it's just 35. So now you're getting balance billed. My math is not good. 1. Yeah, whatever. Yeah, 1, 115.

So the follow up is like, do we have an obligation to build a patient for the 20% that's their share?

Yeah, yeah. You have an obligation to bill the patient for their especially.

You're in network or both. If you're in network or.

Well, no, I think out of network. No, you're making a choice. It's your choice.

You're leaving money off.

Yeah. I don't know why you.

Was Jesse in network? Jesse, if you can type in the chat, are you in network? You guys in network?

Yeah, that's a good question. Right.

So we talked about waiving CO pays. You guys know about that? People with co pays that you can't do that if you're contracting.

So. So that's called copay forgiveness. When you say, oh no, I know you can't afford your $40. We're gonna get 85 and we're happy with it. You just go on and use your physical therapy. I mean that, that does do that. That does two things in my mind. But what I mean, yeah, if you're in network, that's what that's.

Yeah. And by the way, it's in the corner contract. Yeah. By the way, I went after UHC for a bunch of money one year and I read that contract 30 Ways to Sunday. And the. That was in there because then when I'd get on the phone with them and they tell me, I, you know, we, we broke the contract and I would read them back parts that they broke. So I said so what are we going to do about this?

And sorry, no. So as a follow up here, Jason had said, but how do you know what the insurance will allow? And that's where your billing people come into play. They're on the phone and they're having to figure out different ways to ask the same question. And so it's really just a matter of getting.

Because if you end up without asking those questions, they won't tell you that stuff. Right. And I'm dead serious.

I hope that answers your question by

the way that that's their business model.

Yeah.

And don't forget people, every single time you call an insurance to get your benefits, what does the conversation conversations start with? Every single insurance company in America starts every conversation the same way. When you call the check on benefits, what's the opening phrase?

Does anybody know what's the date of birth?

Good question. That's probably second. That's second. This call is no, is no guarantee of benefits. So they are washing their hands of every bit of information they give you. So when you built so when you see this person 10 times and then bill and they deny the whole thing or they give you erroneous. I just had to deal with the poor guy. He's got over a two thousand dollar bill. His insurance told him he was fully covered. Told us. Yeah, we called them twice. So we called him at the beginning of the year. Both times they told us he's covered 100% and then denied the claim claims like four months later. Like I got stuck with the two thousand dollar bill.

So what do you do with insurance companies that refuse to pay?

Well, first find out. Well, it's always so if you're going to focus on the customer and the healthcare consumer.

Yeah.

Then it should. It's all down to you. It's as I like to say, it's your insurance, your insurance card. Right. You are responsible and actually I worded it that way on the financial policy. The words you and your are probably show up on the financial policy an insane amount of times. But I want people to understand. People hand over the insurance card like it was that first credit card your parents ever gave you.

Yeah.

No idea what the balance is. They have no idea what the. They just hand over the insurance card like it's gonna like it's a credit card. I'm like what the is that?

Yeah.

I've got real quick questions, a really good one and I, I think we've kind of started to answer it. I but I think it'd be great to read this one out. So April asks if I've been verifying patient or I've been verifying patients benefits since the start of my practice in 2010. I'm wanting to go out of network in the past however, I find that so many plans where the I find so many plans where the out of network benefits and in network benefits are so, so different from an 8020 split to a 2080 split.

Yeah.

What I want to do is have a flat daily rate of $150 and then bill the insurance company the elevated fee schedule amount of three manual or two or two theorex and one manual which would come to say a total of $180.

There's going to be a max no there that sheet. So the answer is you're going to have to find out from every insurance you take what they're allowable.

Is okay.

By the way, you can bill even out in network. I could build Blue Cross a thousand dollars. Most Blue Cross plans are going to pay me 25. Yeah, 80, 20 everything. Remember it's. Yeah. So it's the build. It's all about allowable.

It's what's allowable. Okay.

And then she finished 80 20s off the allowable.

Okay.

Off the build.

And she said, then she said then. So they sent in a bill for 180. She wants her daily rate to be 150. Then their out of pocket expense would be the applied out of network benefits to the 180, not 150 that I build them.

Yeah, that's correct. So we're back to the balance billing. I believe what she just described is what we do.

Okay. Yeah, that's what I thought.

Right.

That's what it sounds like to me. Is that what it sound like to you? Yeah, it sounds like. So I'll just balance bill for whatever they pay right now. Here's the, here's here's the thing you got to do out of network. You've got to collect every visit what you need because you're still going to be stuck with the cash flow from the insurance company.

There's no benefit. Yeah.

Yeah. If you don't collect at each visit, you are exactly right. And we take in, I think we take in almost 70% of our gap of our revenue over the front desk. Yeah.

Yeah.

Think about that. So if we didn't. Oh my God. Think about the monthly cash flow issue.

Yeah. Are there, I mean I'm assuming there are a lot of practices that have. Did have like a problem of not collecting everything at the time of. I'm assuming there's a ton of practices that don't collect at the time of visit and have the hardest time collecting six months after as patient care is over.

Guess who used to do that? Us. Yeah. What a disaster. What a cash flow issue. And then I got to tell you, someone walking in the door getting better, knows Zoe well, loves her PT. Jason doesn't have the same issue handing over 150 that day than they do eight months later.

Yeah.

When their life has gone another direction and you know it now. Now it's a bill. Now it's a bill in a pile. Yeah. So you want to talk about the mindset and all the technology on the other side. Yeah. And it's just kind of gone now. Matt Watkinson, I did a podcast with him. He's. He wrote a awesome customer experience book. We had him on my podcast. Talks about the. Oh, shoot. Something end, rule, peak, and rule that basically they've done this study psychology. Psychology. Say basically your whole experience you're going to remember based on the last thing that occurs. So that's what you know. And healthcare is notorious for that. Yes. My PT was great, period. And then three paragraphs of the building before we. Before we put the customer life cycle in place, before my team, before we knew what we needed to share with

the people, there's a. You know, can we keep going? Yeah, we can.

Yeah. We can do some more questions. I got one other question that. No, like, I want to. I want to ask.

Because now you got me scared.

Nice. All right.

Want to do yours or these?

Yeah, let's go off of there.

Yeah, let's go off of this. All right, we'll do this stuff.

We'll save yours. So. Okay. 1.

Dimitri asked, can we get a script for the perfect benefits call to find out what is allow.

Oh, yeah, dude. Yeah.

Do you have that yet?

Are you creating that account, Demetrius Money, bro. No, I'm. I'll. But you're.

You're working on that, aren't you?

Yeah, See, that was part of my thing. I think I started saying that went away. What I found. And I only found this after, like, having conversations. Like, this is. My team is really good at collecting benefits. Like, really good. And I'm running into. I'm running into some cash pay out of pocket. So let's. Out of pocket practices, like your guys is where they want to do what's right for the patient, and they're going to their billing people and they're telling them, oh, you can't do it this way. And I'm sitting across from them going, your biller told you that? Yeah. And what I believe the issue is the biller doesn't want to do the work. And I'm hearing this over and over because it is hard work. How do you think we got to those four conversations? Yeah, because we had the wrong conversation for months and months. Tweaked, tweaked, and tweaked.

And your own billers are in house.

Yeah.

So they're your employees versus contracting or percentage.

We have had. I. I've almost had as many billing services as I've had CPAs. CPAs and billing services services, man, I can't keep them. And I'm dumping my CPU again.

So I hope he's not watching the. Jason said, I'll pay you for the perfect script, but did you guys.

Are.

Were you talking about doing like an actual kind of setting up a billing or call center for.

What do you.

What's the plan there? Because, I mean, there's got to be a lot of practices like ours that want to be able to do this

as Google Doc, man.

We have the whole setup and actually probably going to drop it here. Yeah. So if you want to. Beanie asked about that. Yes. So here's two things. Here's two things. I can share that stuff with you. You can take it to your staff. You can do whatever you want with it. I can share with you, train your staff.

Right.

And then make sure you have. So you get that training and then it's all yours. And we're going to do some videos, too. And then we are. I'm going to. With some other people in direction of. For making a call center. Okay.

So all those things.

Yeah. So that would be, you know, Jared Carter, physical therapy, your number. They would dial you. A new patient off of Facebook would dial your number and believe. This is my goal. Believe that they've called your clinic because we know your uvp. Right. So all the stuff I'm preaching.

Okay.

Yeah. My goal with the call center is they walk in and ask for the person that answers the phone because they had such good, you know, so Zappos thing. Right. In Vegas with Zappos. So that whole. They have a Zappos experience, right. And they come in wanting to meet this person. You're like, oh, they're not here. And they're like, what?

Yeah.

Right.

Okay.

But that's all right. We have a whole. I've got a whole thing in place to transfer the relationship. Yeah.

Okay.

We've got. We're a little too close to the pool. I'm going.

Okay.

So.

Very good.

So let's. Let's move on to the final questions.

Yeah. If they. You guys have any questions here for Jerry?

Yeah. So a lot of people are becoming more savvy, so maybe they know they've done something things. So by the way, I call it. I call it the race for the deductible. Because the first four months someone will come in who's maybe Had a hospital stay and an mri, and they're deductible. So what? I educate people that your deductible is when it's processed, not billed. And this is the other thing. When that bill leaves my office, it doesn't get applied to the deductible until the insurance company processes it. So it's kind of hard to tell someone, you got a $5,000 deductible deductible, and they just spent like $5,000 out of pocket. So as the happy patient will usually, you know, if you say this, that, and this, then we'll let that work. I've got nothing to lose. If I say, okay, we're going to charge you 50 bucks and just. And I tell them it's a race, I say, whatever gets processed first. I said, there is the chance that mine might get processed first, and then you owe us the 150. So, again, full transparency before you arrive. So you can't go wrong. Right. So we have all those conversations. Yeah, yeah, yeah. And it's part of the service. Right? Part of the service and the value add and everything else.

Yeah.

We'll let it flow and say, okay, we'll just collect the 75 per visit. But just know bars get yes first. Yeah. And by the way, I feel good most of the time because then I hang up the phone. And now you're more savvy about your insurance. So I feel like we teach more insurance education over the years. I've talked more people about their insurance.

Yeah.

So usually it's when they're yelling at me.

Yeah, it's.

It's a Sad situation is 99 of the time, it just. They just didn't know. There's nothing else. There's no other reason. People hear what they want. Like this gentleman said, if you're not asking the right question. So it's important that we help people to understand. And I'll tell people you said you took my insurance, and I say we do. So now, are we in or out of network? You know, people still mess up the terms all the time.

Jerry, got a few more questions from the audience, and then we'll wrap up. There's a great question from. From Jason, and this is. And I. Do you need a referral from a physician to get out of network benefits or. So let's just back up and say in California, you guys have.

So we have direct access.

So.

Yeah, just to clarify.

Yeah.

So he asked about insurance. So you do not need a referral from a physician to treat anybody.

Right.

In California, now, each insurance has its own requirements. Some do, some don't. More going away from it. So again, it's plan specific. So this is the other thing, right? If you hand someone a super bill without checking their benefits and they need a referral from the doctor, and they never went to the doctor. Now you're back on the patient, so you're putting it back on them to go get a referral and stuff like that. So again, it's just, you know, what service.

And that's going to be state specific and plan specific.

Plan specific and state.

Well, it's like in our state is that is never. That's never an option. I mean, it's never an issue because we've had direct access for 30 years.

So we have. Yeah, all the plans are different.

It's not. It's, you know.

But yes, I'm in a dream addressing his question. Like, you gotta, you gotta check plants, you gotta check your state. You gotta know what's going on. There's another question. Where'd it go? Wow, there's a lot of questions. All right, this is awesome. Okay. Oh, here's one. Here's another good one. And I think this is, I think I know the answer too, but this is from Damon said all my clients and have an out of network deductibles of 5,000 or more. Am I correct in assuming that neither I nor my client would be reimbursed into the out of network deductible is met?

Correct. The answer is correct. So, yeah. So that's why, again, that's why it's important.

And in that situation, like say with you guys, you're pretty much taking the 150, you're sending in the bill, and

then whatever gets, whatever piddly amount gets

applied to the deductible.

That's how much it goes down.

If they get nothing and you get nothing from that insurance until that deductible is good.

Correct.

And the patient's just paying you basically a cash rate.

Dude, it is.

Yeah. 10 visits, 20 visits, it's still straight up cash.

You know, I know enough. I call people back, you know, and just say, you're not going to hit this deductible. And I always tell people, you know, you're not going to hit. And I use it as a value add conversation. I say, you're never going to have enough visits to hit the deductible. And if you do, then you got other issues because we're overdue treat there. So putting it in his head that we're Going to take care of him. Right?

Yeah. Yeah.

So I use it as a value.

I see one on here.

Yeah. I mean I can. Joy asks, isn't and. And this is a pretty simple one to answer. Is an out of network provider a covered entity? This would be. Would this be different from a true cash based provider? And I can just say like you guys are still sending in. You're still sending in claims. So remember, you definitely are on a covered.

Yeah, yeah. So we're still sending in claims. But like I said, now this is where this point really comes in. We collect 70. We collect 70% over the front desk. So 70 of my revenue is cash over the front desk. So that, that's why I get caught up in the terms. Right.

Yeah.

I'm just as much a cash PT as anybody else.

If insurance stopped paying tomorrow, you would have this huge.

Yeah.

Huge issue.

Like that's why we don't have an issue just here. We have to chase down some money.

But you are a covered entity because you are doing covered transactions.

Yeah.

Okay. Gosh.

Let's see what else.

All right, we can.

Can you save those questions?

Yeah, there I'll have. I'll be able to save the questions and I can send you like all of them easily.

You categorize them first.

That's you, that's on your. That's your ELM cache base. That's your responsibility.

So I know that. Sorry, we don't.

I don't take on the responsibility of organizing your documents. All right.

You didn't tell me that on the phone. Thanks for the great. Remember peak and roll, dude. Yeah.

So let's go. Let's just go with one more and then. Oh yeah. Okay, here's a good one. This is one from Krista and this is a little different. But what do you do with clients? Patients who want to keep attending after skilled therapy is no longer needed just because they think they are paying the full fee for service.

Nope. Yeah, I mean that, that, that's a, that's a PT patient relationship discussion. So. No, I mean we. No, it's all about the plan of care. I just wrote a blog for clinician about the plan of care is the ultimate metric in there. I mean we all. You guys, not me. You guys went to school for three years and coming out with all this debt. Use the skills you got in school. And our greatest skill is the ability to listen and then develop a plan of care.

What, what other advice or wisdom do you have for people who are trying to do this out of network and file on behalf of their Pat,

I think the big thing that maybe has come out of this and came out of that is you got to commit one way or the other. And what I see and what I believe now after just our last hour is there's a lot of people with a foot in. Not in network, but kind of a foot in each camp. They kind of want to be out of network, but they kind of want to just hand the super bill. But they kind of want to know the benefits, but they kind of want to pretend like they know this other stuff. You got to go one way or the other.

Full board.

Right. We went out of network, full board and, and chart right in one direction. So now I know everybody's benefits regardless. And I would say if you could get the right team or the right person, if you can find the right person, and I, you know, I'll help do some of the training, if you can find the right person, then it will, it will pay for itself and more. Yeah. And don't forget, most people still call. It changes the conversation. Right. Because I can say don't forget. What can I say at the beginning of that phone call right off the bat? Yes, we take action.

Yeah.

Yeah. That's awesome. So it sure makes that phone call. Sure makes that entry point a little less, you know, because I do. I listen, you guys. Julie doctor in Arizona, man, when I first got in Paul's work with her, she was awesome. The way she answers the phone, I wouldn't have the courage to answer the phone like that. I love it. And she gets it out of the way and I, I think she does it right and it'd be tough for me like that.

Any last things from you, Jared?

No, I mean, I think, yeah, it

can't be one foot and one foot out. And I don't mean in and out of network. The one last thing is go full bore in whatever direction, collect the money and the super bill. And then you have to just say there has to be that barrier. If they get more money, no money, whatever. That can't. It's. You sell your value, say, I will give you a bill.

Yeah, that's awesome. So if someone wants to get in touch with you after the show today, where do they find you? Online? What's the best way to get in touch? So

I just got my website up so you can email me at Jerry.

He doesn't want to say.

No, no, I'm saying it real slow. He's watching jerry@jerrydurmpt.com and spell your last name foR-U-R H A M and then pt.com, so jerry.com.

all right.

That's awesome. Congrats, man.

So jerrydurmpt.com is my website. It just went live. And by the way, this first time I've told anybody beyond, like, Paul and my wife.

Yeah, that's awesome.

So it's live. And, yeah, you might be a little rough. There might be things missing, but you can go there and you can get on my list. And I'm happy to. You'll see there. Every page is something about. I love to talk and I want to meet people. So, yeah, just sign up there and there's some resources there and stuff.

Awesome.

And thank you all for coming.

Thank you, guys.

Thank you guys for showing up, coming and everyone.

All those tuned in.

Yeah. For everyone tuning in. Thanks. You can find more about Jerry at his website. I'll post information.

Yeah, we can.

And more information about Jerry and where to contact him when I post this to the blog in a few weeks. And, guys, check into the Cash PT Nation. If you're not there on Facebook, Jerry's there, too. Jared, a whole bunch of other people.

Yeah.

And we're almost at a thousand people.

Yeah. That is cool.

So hopefully today. Hopefully after today, we'll get over a thousand people.

That is just cuckoo. Yeah. Yeah. Good. We were talking about that today.

Yeah. So thanks, y'.

All.

Thanks so much.

That was really good. That was really good. Because the questioning at the beginning really started to. By the time we reread that thing, it was. Everybody understood was kind of went through each step and said, oh, balance billing. Oh, how to network. Oh, right. That. That is the thing that's really what came out of this.