131- Maximizing Your Personal Injury with Perry Rickel

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Hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langmaid. This week we have a great episode which is an interview with Merrick Medical CEO Perry Rickel. @ the last orthopedic group I worked with, we used Merrick extensively to improve our cash flow and reduce our risk related to personal injury. So this is one you definitely want to check out. And if you have interest in learning about their passport system, visit us at the evidence based chiropractor.compi that is the evidence based chiropractor.compi and we will make sure that we show you how you can reduce your risk and improve your cash flow related to PI cases. This episode is brought to you in conjunction with Rock Tape and Rock Tape is revolutionizing the soft tissue world again with new Rock Blades Mohawk. They are available for 175 bucks. You can learn more and get access to educational courses featuring mohawk@rocktape.com Mohawk without further ado, here's Perry Rickel.

If you're a doc listening and you are any bit involved in the personal injury space, I think Merrick is a name that you really need to know. And Perry, if you don't mind, give a little background on Merrick as a whole. What do you guys do just and a little bit about yourself as well. How did you come into this and what does Merrick do for docs as we sit here today?

For sure. Thanks Jeff. What we do? Well first off my background is in finance, real estate finance specifically. And what happened in Colorado and how I got into this business about in 2003 we had a law that changed in Colorado and we went from a no fault state to an at fault state. I know you're familiar with that but in a no fault state when there's an auto collision then it doesn't matter who's at fault. My insurance take care, my insurance takes care of me, the other driver's insurance takes care of them and you go on down the road. And what we did in Colorado as we shifted from a no fault state to an at fault state or a tort state and that is how we exist today. And at the time of that change, my business partner was working for Liberty Mutual Insurance as an adjuster and what had happened was he had a client that Came in that was injured in an accident. The guy didn't have health insurance or was underinsured, and he was just trying to get scan shot of his back. I mean, the guy was in the emergency room. They said, you need to get an MRI of this. I don't have health insurance. So my business partner's meeting with him and saying, hey, don't worry about it. You know, he's an industrious guy, right? So he says about it, I'll take care of this. And so he starts going through the yellow Pages, which, you know, we don't have anymore. But he started going through the yellow pages looking for an imaging provider that would just shoot a scan of his back. And what he found was no one would do it. And he started thinking, gosh, I've got to figure out a way that this scenario doesn't happen again. I've got to figure out a way to take care of this patient to where they can have and they can access health care. And I can make a margin on that. And I can take the, one, the risk away from the doctors for treating him. And two, get the patient coverage whenever they've been injured in an accident that wasn't their fault. And that was the beginning of the conversation with he and I around building our company, Merrick Medical. So now what we have done is we have created a network of providers across the country that will take our patients, that will treat them, send me their invoices, and then we effectively we purchase their invoices from them, and then we wait the, on average, 20 months to collect on those invoices from companies like Liberty Mutual, where Null, my business partner, used to work, or, you know, State Farm, Geico Farmers, Allstate, those kinds of companies, because it takes so long for those cases to settle. So we take all the risk off the provider. The provider's paid up front, and we don't add any interest or anything like that to the. To the invoice. We present the invoice at the end of care, and then that's when we get paid.

I love that. And for some of the docs out there that are doing a pretty high level of personal injury, my understanding and what we talked about a little while back was, you know, you even have the ability to do that kind of behind the scenes for some of these docs that are really heavily vested in personal injury. And maybe they have multiple clinics, multiple service offerings that you guys are even, you know, again, able to offer that, you know, kind of invisibly in the background and that was something I thought was, was great. Talk a little bit about, about that.

Yeah, that's right. That's something we rolled out, Jeff, in the middle of 2016. You know what? That's not right. It was the middle of 2017 when we had a large multi specialty clinic that just needed help. And so we came in and said, look, why don't you let us take over all of the back end, all of the technology that's required to run a company as efficiently as ours. You go out and practice and let us handle all of your loss mitigation, let us handle all your risk. So we mitigate the risk and then we take over, we take over all the perfection aspects of that and then we act as their back office for all of their lops. Or you say lop in your neck of the woods and up here we call it liens. But liens or lop, it's the same thing.

I think that's cool. And from a provider perspective, doing that work is so valuable, right? Because you guys have the efficiency, you know what you're doing, you've gone through it, and you're able to really advocate in a way that many providers probably either feel uncomfortable or unable to do themselves while maintaining a great relationship with all parties involved. I think that is a really important element of this and I want to dive into the weeds a little bit. So if a doc says, hey, you know, Merrick is a company that I want to utilize, this seems like a good use case for it. How does that go then from the provider perspective? Who's making phone calls?

How does that process work?

Where are the notes kept? I'd love for you to dive into the weeds for the providers that are saying, hey, this sounds good on the surface, but let me see if it makes sense for me in my office.

Yeah, for sure. There's different levels of implementation with this product offering, but the most common use is the provider comes in, we establish a workflow, and then we handle that entire workflow from start to finish, meaning we compile all the records and notes and bills chronologically. Provider doesn't have to do any of that. And then when someone calls in, let's say a law firm patient, what have you, all that communication goes through our communication hub. Everybody has access to it. You can see everything that's going on in real time. And then at the end of the case, all of the information comes through our technology to the attorneys or other providers, whoever is involved there. And once they get that information, then they would have a contact on Our staff that would handle that entire process for an individual provider.

But from the attorney side, you touched on something, on the decrease of the work of an attorney to create a demand letter and talk a little bit about that.

Yeah. So if you have a patient, it's a great question. If you have a patient that's treating, let's say, with a one point of service doc, let's say it's a chiropractor that is seeing them, but the patient has gotten outside of the chiropractor, let's say they have imaging all the way through something as intense as a complex back surgery, we would be provided there in the network, the Merrick network, we would be compiling all of those notes and bills in one place for that attorney. So instead of them having to make five or six phone calls to every doc that has treated this patient on a lean, they're still only making one. And that chiropractor or another specialist, maybe it's a frontline specialist, maybe physical therapist would be the person that would be almost the keeper of that information. If you think about it that way, they really wouldn't be. But that's where the contact would start. And then everything else behind that, we, we handle all the compilation of those things.

Love it. And that makes things so much easier, in my opinion. Not only, not only from the attorney side, but the provider side as well.

100%. No, you're 100% accurate. And think about this. If you're in our network and you are a, let's say you're a treating physician and you want to see what that scan looks like, you want to see what that MRI looks like from that patient, you can log in through our portal and you can see that as well. So it's a communication tool for all the providers within that continuum of care for an individual patient, it's really slick. And we've picked up the ball and run with it where a lot of people, even insurance companies, don't have the technology that we have.

And with that taking it to the next level, something that I got a quick look at when I was out your way, was your passport tool. And you know, from a conservative care provider perspective as a chiropractor and chiropractors listening, this is something that I think is really applicable to the day in and day out and the instant authorization process and how that works. Talk a little bit about passport and how that's utilized in provider offices.

For sure. It's a great question. So if you have a provider that, let's say it is a chiropractor that needs to refer out for imaging, let's say imaging, or maybe they need to refer them out for us to a spine surgeon. Let's say that care can be coordinated through our passport application. So they would just roll onto passport, enter some information there, and we would kick back almost an instantaneous authorization to treat with a specific provider in our network, which means the provider will see the patient immediately. They've been scripted to that provider already. The provider knows they're going to get paid. So now if you think about all those things, now you've got a patient who feels great because you've got them into a continuum of care that's ongoing and there's not gaps in care. And then you have a provider that's willing to see the patient whenever they can get them scheduled. And that you, if you're the chiropractor on the front end of that situation, you can actually print out and hand that patient, right then the phone number, contact information for that imaging or imaging provider or orthopedic surgeon, you can hand it to them in your office and say that's who you're going to treat with. Expect a phone call from them or reach out to them. There's their contact information and they'll get you scheduled to treat.

But when you say that instant, you know, near instant authorization process, what does that, what does that mean? What does that entail?

Yeah, so we have, over the years, Jeff, we have been working on this auto authorization idea. I mean, can we take some of the touches that our underwriters do on a daily basis or some of the touches on an account by account basis? Can we automate that? And we realize there's about four touches that we've automated from, let's say, five years ago till now. And five years ago is probably when we started having the idea of this Passport app. So those four touches, provided that the information comes in and ticks off all four of those touches, then we will automatically authorize that first course of care. And that that means, look, if we've missed something, we're still on the hook, right? If we miss something, we're still taking the responsibility for missing something. But what we found over the last five years of going through this automation process, that we have figured out a way to automate those first four steps, and it's done with that initial application in that checklist. So when you fill in that affirmation, that information, provided that the four things, and I say four, there's probably more than that, but four Big ones. Provided that those four things are met and that criteria is met and that authorization hits us, hits the next provider in line, meaning the provider that we've referred out to and also is given to the referring provider.

At the same time, you guys actually also built in kind of an internal provider mapping system system which touches on providers that are comfortable using the software that are already working with Merrick that make it super, super easy. And I just would kind of commend you on that and talk a little bit about that provider search function.

Yeah, that's great and that's awesome. That's actually done by modality. So if you're needing a podiatrist. Podiatrist is probably a bad example, but let's use it. If you're needing a podiatrist and I'm familiar with our zip codes better than you are, 80207 here, Colorado. And you're gonna find, excuse me, a listing of all the podiatrists in that area and you can expand that geographic search. But what we're trying to do is we're trying to get the patient one, to a doctor they feel comfortable with. Number one, they have to feel comfortable with the treating physician and two, in a location that they can get to easily. So one, the comfort with the physician and two, the location. If you tick both of those things off now, you've got a patient that is going to show up for their appointment and that doesn't have to drive all the way over town to see a podiatrist. I mean our number one priority is patient first and you can look at and see our patient feedback. Google reviews things of that nature. The patients see us as that compassionate arm of the healthcare in a very unique situation to them and a very stressful situation as you alluded to earlier.

I can't say enough. I was so impressed and happy to come out and meet you in person. Spend some time with the team and learn more about what you guys are doing. Because to me it's exceptionally important. And with patients being injured looking for help and then docs not having to feel like they're compromised in multiple ways, I think you guys provide an exceptional service and make things even easy for the attorney on the backside. And I thank you for sharing some time and talking about it here today.

You got it, Jeff. Anytime. Thanks so much for having me and look forward to seeing you face to face soon.

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