Business Solutions: Balancing AI and Human Talent in Medical Practices
Download MP3Well, hi, everyone, and welcome to the MGMA Business Solutions Podcast. I'm Daniel Williams, senior editor at MGMA and host of the MGMA Podcast Network. Today, we're talking about a topic on every practice leader's mind, how to balance AI and human talent so you can run a smarter, more trusted operation and practice. Today we have a guest that I had an opportunity to work with on a recent webinar, and we're going to link to that webinar so you can capture that own demand as well. But we have Doctor.
Daniel Williams:Rihan Javid today. He's president of EDGE and CEO of Renova AI. So Doctor. Javid, first, good to see you again.
Dr. Rihan Javid:You too, Daniel. Thanks for having us on. It's a pleasure, as always. I know we've been working with MGMA for a couple of years. It's always great events.
Daniel Williams:It really is. So a couple of questions just for clarification, because I keep going back and calling you guys Edge Health, Renova AI. Help us understand a little bit about the organization that you're the founder of and bring us up to speed of what you guys do and how those two different titles sort of mesh together there.
Dr. Rihan Javid:Yeah, definitely. So, you know, a few years ago we started Edge Health, which is, it's kind of an employer of record where we have people in multiple different countries. So Pakistan, Peru, Costa Rica, and a couple other smaller countries throughout the world. And what we do is we provide remote talent for medical offices, dental offices, and insurance companies. So we've been doing that for a few years.
Dr. Rihan Javid:We have about three fifty healthcare customers And you know, we have everything from solo practices to the largest physician owned hospital in the country. And for those groups, you know, do everything from billings, we do billing, we do staffing, we do front office, back office, so pretty much everything across the board. And so one of the things we heard from our customers is that, you know, this is going really great, but where's AI? Where's, you know, how are you guys gonna do this? You know, we're still wanna grow, but it's still hard to find billers.
Dr. Rihan Javid:It's still hard to find people who are able to do all of this. So how are you gonna do that? And our CTO from Edge, he's actually a PhD in AI machine learning. You know, we sat down and was like, know, look, billing, a lot of it's repetitive, lot of it's really easy stuff and AI is able to fix a lot of it, right? So when we first started, we with Renova, we were trying to offer maybe like a full solution where we take over your whole billing, but obviously these companies and healthcare practices, they've been doing it for years and they're like, man, that's just too much of an ask, right?
Dr. Rihan Javid:Because if you mess it up for a month or two months, you can't pay your staff, right? It's just not going to happen. And so, we worked with them and we used our existing solution and we really enhanced into something called an AI agent. And so with the agents, it's just a software that does, you know, maybe ninety, ninety five percent of your billing, but you still have your human team that supervises it. So your workflow stays the same, but you just have the AI that does most of it.
Daniel Williams:Okay. You were walking me through some sort of a demo on YouTube. You had some videos up there that were fascinating. I'm hoping we can get into those in just a second. But first, you do have that doctor in front of your name.
Daniel Williams:So tell us a little bit about your healthcare background.
Dr. Rihan Javid:Yeah, so I was actually a lawyer beforehand. I went to law school and did some healthcare litigation stuff. But I really want to go to med school. I think even when I was in law school, was like, man, I should have, should have done that. But at the same time, you know, I was in there.
Dr. Rihan Javid:So, you know, I went to med school, I'm a psychiatrist and worked on administrative side for the past three or four years, chief medical officer at one of the hospitals here in California, and you know, same problems, lot of billing, a lot of compliance issues, under billing, over billing, miscoding, And so we've been able to work with the hospitals, the different stuff, use my experience from this, and really apply it to the different aspects of both Edge Health and Renova.
Daniel Williams:Okay. Now you have been talking about those challenges with billing. You were talking a lot about it to me offline. Just looking at it, because you have really studied this topic, why are there so many issues with billing? Then it provides an opportunity for organizations like you to come in and fill those gaps.
Daniel Williams:What's going on with billing that seems so problematic in healthcare?
Dr. Rihan Javid:I think there's a few different things. The The insurance companies, that's probably one big part of it, right? They don't wanna pay what the contracted rate is, right? They're really making it hard on practices. I think that's one thing.
Dr. Rihan Javid:The other thing is it's hard to find a good billing and coding team. If you have someone, you pay them, you know, some places $25 an hour, they stay with you for six months, they learn your systems and they go across the street to, you UC San Diego Scripps where they're paying $35 an hour pension, all this stuff. And so it's really hard to compete. It's really hard to keep a talented team together. So I think, you know, those are two parts of it.
Dr. Rihan Javid:The other thing is billing and coding, it's such a large expense for most medical practices. Anywhere between four to 8% we've seen. And so, you know, if you have 10 doctors, maybe your annual revenue is 10,000,000, out of that you're paying $500,000 for billing and coding and it might not even be right. And so we just think that's too much, It's just putting too much of a burden on your team and on your practice to pay that much. And so really our goal is to bring that down from 5% to less than 1%.
Daniel Williams:Thank you for that. Now, one of the things that was so interesting in the webinar recently and what we're going to talk about here, is really peeling away the layers of understanding the AI human balance. We all hear about AI now, and then some people go, Well, does this mean I have a job anymore? And you've got some really interesting take on here. So what are some of those operational tasks out of practice where AI is excelling, but then where do we still need those human beings to be part of that production cycle as well?
Dr. Rihan Javid:Yeah, great. So I think there's a few things on there. I think the main area where AI really excels is in repetitive tasks, simple stuff, right? Just copying, pasting, like coding, like, you know, coding a note, right? So it's an algorithm, right?
Dr. Rihan Javid:It's just like step one, step two, step three. Do you have these criteria to send it over? Also, you know, when you're when you code the note, then you gotta submit it. A lot of times you're copying and pasting data from one software to another and then you got the payment or the check and then you gotta pay to, you know, go back and paste that, right? So it's very simple stuff, but you know, do you really wanna pay someone $35 an hour or $20 an hour?
Dr. Rihan Javid:And do they really wanna do that? You know, think a lot of times, no. Sometimes you know, people love it and you know, that's great, but I think those things are really easy and easily, you know, helped with AI And some of the stuff that's not is, you know, I know there's like agents or chatbots that will answer the phone call. I mean, I have Verizon and man, even like calling my doctor's practice and they're like, oh man, press 1 and we'll send you a text and you can communicate with that. Oh, it's hard.
Daniel Williams:Yeah.
Dr. Rihan Javid:Right? You just want to get on there, you want to talk to someone and yeah, I know like my parents, my, you know, like in laws, everyone, right? They're sixties, seventies years old and they don't want deal with that, they just want to just talk to someone really quickly. And what this does is it really helps you transfer people from these repetitive tasks back office where they're not seeing anyone to really your patients and really giving your patients the attention that they need.
Daniel Williams:Okay, thanks for that. Now one thing that you were walking me through before we went live here is an AI agent. You showed me a little bit of a demo on YouTube and hopefully you can let me know if we can share that link with our audience. I don't know if that's proprietary. Definitely.
Daniel Williams:Okay. Oh, good. Good. So let's talk about that and define it. What is an AI agent?
Dr. Rihan Javid:Good. So let me get the exact definition. Sure. An AI agent, it's basically a software that acts as a human and does whatever a human can do, right? So it's usually a combination, so I know, you know, pretty much everyone's probably heard of ChatGPT at this point, ChatGPT will be the brains of the agent and then there's a memory and then there's tasks, right?
Dr. Rihan Javid:So the tasks can be, you know, logging into the EHR, pulling up the schedule for the day, finding the first patient's note, coding that note and submitting it. So the agent will be trained on those things. So it can do all of those things as well as payment reconciliation, whatever you want. And so the agent is basically a computer program that asks acts as a human to do all of those different tasks. And so it could be something as simple as just logging into the software to, you know, running your whole revenue cycle.
Dr. Rihan Javid:And instead of taking ten or fifteen minutes per patient, it can do it in twenty seconds.
Daniel Williams:Wow. Wow. And you walked me through it and I saw it live and we'll share that link with everybody. So what we keep hearing about AI is it is rapidly evolving, rapidly changing. So what are the roles of agents in the future of AI as that continues to grow and evolve?
Dr. Rihan Javid:Yeah, think we spoke about a month ago
Daniel Williams:maybe, know,
Dr. Rihan Javid:agent was like very early, right? We didn't even mention it, I think in the webinar, since then when you came to market, we've gotten like multiple different agents that we've applied to different parts of it. So yeah, I think the roles of the agent at very beginning, probably revenue cycle management's really easy to do. AI scribing, I think is hit or miss. You know, think some of the better ones can get maybe 95%.
Dr. Rihan Javid:So you still have to go through, so spending time on that. I think those are probably, you know, maybe the two easiest to do. And then obviously there's like phone agents and stuff like that, which I think, you know, we already discussed. I think it seems like both of us agree that's a challenge, right? If you've got a call, you can't get ahold of them.
Dr. Rihan Javid:Right. I think that's a challenge. So I think that's maybe further down the road, but definitely, you know, the billing, the prior authorizations, the eligibility, where you just log into a computer, figure the stuff out and then post it. So I think those are, that's probably the feature, the media feature, maybe like one to three years. AI scribing is kind the same thing.
Dr. Rihan Javid:It's, you know, it's already here, but maybe not quite where it needs to be. And then I think the answering services that are AI, I think those are, I don't know if they're ever gonna be like 100%. I don't think they're ever gonna be 100% because I just wanna talk to someone. Right?
Daniel Williams:Right.
Dr. Rihan Javid:And I like run into a machine and then go back and forth. Think yeah. I like talking to people and I think that'll be limited.
Daniel Williams:So I'm asking you a question. You have that legal side of your background that may not be muscles you're exercising all the time these days, but this is a general question. If you know it, please share with us. But when we as a consumer are talking or interacting with someone in a chat room, do we know, or is it legally bound to tell us that it's an AI, or is it fine that we don't know? We could be talking to a chatbot.
Daniel Williams:We could be talking to a human being, but we don't really know. Is that something that you have knowledge of?
Dr. Rihan Javid:You know, I'm not sure. There's no, I don't think there's any federal guidelines. Think even states, like, I live in California, I haven't seen anything in
Daniel Williams:California. Okay.
Dr. Rihan Javid:And, you whenever I call, like, insurance companies or, you know, Verizon, T Mobile, whatever, I've never heard anyone say this is a chatbot, so I don't think there's anything on that. Unfortunately, I think it would be better if there was, but unfortunately not there.
Daniel Williams:Yeah, I was just curious about that. Let's go a little bit deeper then when we're really talking about the benefits of bringing together both the AI and that human element. When you're using those AI agents, you've talked to me previously and in that webinar about reducing cost. Talk about that. Where are those costs coming down and how low can the cost go for a practice?
Dr. Rihan Javid:Yeah, that's a great question. I think it really depends on the practice. So we use an average primary care practice where the doctor bills about a million dollars a year, about $80,000 a month, plus or minus, know, some places higher, some places lower. And so right now, if they're paying about four to 5%, maybe 6%, that's about $50,000 a year, which is quite a bit, right? Imagine you can take your, you know, put in your four zero one ks, take your kids on, you know, summer camp, Acacia, whatever it is, right?
Dr. Rihan Javid:Save for your family or your staff or whatever it is. So that's, you know, a significant amount, right? So say if you have 10 doctors, that's $500,000 and a lot of that's just wasted time that you can take those people, your staff members, put them patient facing whatever you want, right? So I think we can bring that $50,000 we already are, that $50,000 per doctor down to about 5 or 6,000.
Daniel Williams:Okay.
Dr. Rihan Javid:So all of a sudden you're seeing, you know, 5% to about 0.5, 0.6%. They're seeing about an 88% savings on your billing costs overnight. Wow. It's pretty substantial. Someone came to my hospital and they're like, man we can save you tens of thousands per doctor.
Dr. Rihan Javid:That's amazing.
Daniel Williams:Really is. It really is. So I want to ask you, just shift a little bit in some of our final questions here, and ask you about this is what I found so fascinating in your webinar, where you were talking about preserving empathy and trust in patient care. There are surveys and studies out there where there is some distrust of the health care system. It might not be the individual practitioner or clinician, but it's that system.
Daniel Williams:So you want to preserve that empathy. How do you do that while also introducing so much of the AI and the technology out there?
Dr. Rihan Javid:Yeah, no, I agree with that. So I'm a psychiatrist and a firm believer that without the empathy, without that doctor patient relationship, it's just not going to work. I think there's countless studies out there that show, you know, that power, the kindness that doctors and nurses and the staff show is probably the most important part in the healthcare system. If you don't have that, it doesn't matter what medications you give, people just aren't going to trust it. They're not going to believe in it.
Dr. Rihan Javid:They're not going to take it or they're not going to have that mind body, I think, connection that we really need to heal. And so if you don't have that, if you just have, whether it's just like a machine, an AI, an agent, a bot, whatever you want to call it, That's all you have. And there's no two ways. There's, there's no listening. I think to the patron, there's no understanding or there's no eye contact.
Dr. Rihan Javid:There's no touching. Even just shaking someone's hand makes a big difference. I think if you don't have that, it's just not going to work. You really need, you know, you need that human touch, you need that connection, because we are social animals and you do have to do that. If you don't, it's just not going to work.
Daniel Williams:Right.
Dr. Rihan Javid:And I think, you know, so AI can help back end, you know, really great, brought in talking to your patients, treating your patients, you know, maybe like, you know, one day, but I think not future. We're social animals, we need that connection.
Daniel Williams:Yeah. Final question then, I'll give you a blank slate here. Is there anything I didn't ask about AI and that human connection here, that balance there, that you'd want to share with our audience that maybe I didn't bring up?
Dr. Rihan Javid:No, think we talked about a lot of it. I think it's ongoing, it's changing dramatically. I think it's, you know, it's a pendulum. I think what's really important for most practices, trying to keep your core, kind of keep your essence of who you are and bring in, you know, little bits here, like whether it's the AI agent to help with billing or this or that, but don't let AI or computers or anything change who you are. Don't let it change your practice and don't let it change your connection with your patients.
Dr. Rihan Javid:But at the same time, use it, maximize it to increase your, you know, your staff satisfaction, your patient satisfaction, and ultimately your bottom line. That's what's going to help your staff, treat your patients, make sure they're not overworked and use this to minimize that stuff. I think, you you'll probably succeed and you'll do pretty well.
Daniel Williams:All right. Well, Doctor. Javed, I want to thank you so much for joining us on the MGMA podcast. Great seeing you again.
Dr. Rihan Javid:Yeah, no, great. Thank you. Are you going to be at Orlando?
Daniel Williams:I sure am. Are you going to be there?
Dr. Rihan Javid:Yeah. I'll be there. Yeah. Alright. You guys there.
Dr. Rihan Javid:You know, if anyone's, you know, on the fence, it's yeah. We've been, I think, three years in a row. It's a great event.
Daniel Williams:Right. I'm looking forward to getting to shake your hand in person there, so that's gonna be fun.
Dr. Rihan Javid:Yeah.
Daniel Williams:Well, everyone, I have mentioned the webinar on several occasions. It's on demand. So what I'm going to do is provide a direct link to that. I'm also going to provide some other resources, as Doctor. Javed was showing me earlier today, a short demo on YouTube of what this AI agent can do.
Daniel Williams:And it's pretty impressive of how quickly it can analyze all the information out there, a great time saver. So I'm going to provide those resources as well. So until then, I want to thank everybody for being MGMA podcast listeners.
