May 27, 2025 • 30 mins
The financial health of your healthcare practice depends far more on what happens after patient care than most practitioners realize. Dr. Christian Robertozzi, physical therapist and co-founder of Total Care PT Billing, pulls back the curtain on the misunderstood world of healthcare billing in this eye-opening conversation.
Drawing from his dual experience as both a practicing clinician and billing specialist, Robertosi challenges the common belief that declining revenues stem from poor insurance reimbursement rates. "The revenue is there," he explains, "it's just good billing is not." This perspective comes from helping numerous practices literally double their monthly income without seeing additional patients—simply by implementing proper billing practices.
Most clinic owners operate in financial darkness, too busy providing patient care to monitor what's happening behind the scenes. They don't realize their billers might be quietly writing off denied claims instead of fighting for proper payment. The solution starts with accountability: dedicating just 30-60 minutes monthly to reviewing basic metrics like accounts receivable reports and CPT code reimbursement rates. This simple habit creates the visibility needed to identify and fix revenue leaks.
What makes this conversation particularly valuable is Robertosi's willingness to share specific, actionable advice drawn from years in the trenches. He outlines exactly which financial metrics matter most, how to interpret them without advanced financial knowledge, and the warning signs that your billing operations need attention. Whether you're struggling with practice finances or simply want to maximize your rightful reimbursement, this episode provides the blueprint for transforming your practice's financial health.
Ready to reclaim what's rightfully yours? Subscribe to our podcast for more insights from healthcare leaders who've mastered the business side of patient care, and share your billing challenges with us in the comments.
📇 Guest Contact & Social Info
Name: Dr. Christian Robertozzi, PT, DPT, OCS
Title: Co-Founder, Total Care PT Billing
Email: doc@thatstheknot.com
Website: https://totalcareptbilling.com
Location: Bentonville, AR
Company: That’s The Knot PT (formerly) / Total Care PT Billing
LinkedIn: https://www.linkedin.com/in/christian-robertozzi
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr Andrew Greenland (00:01):
Hello everyone and welcome back to
Voices in Health and Wellness.
I'm your host, dr AndrewGreenland, and on this podcast
we sit down with practitioners,clinic owners and health leaders
who are doing the real work,and today's guest brings a
unique perspective on one of themost overlooked issues in
private practice billing.
Dr Christian Robertosi is aphysical therapist and
orthopaedic specialist who'sseen the system from the inside.
(00:23):
He's also the co-founder ofTotal Care PT Billing, a company
that helps clinics streamlinetheir revenue cycles and finally
get some clarity on what'scoming in and what's leaking out
.
Christian, thank you very muchfor being on the podcast today.
Dr Christian Robertozzi (00:38):
I started a relationship with
Prompt and Prompt startedsending us referrals, and so
what we've seen in the last twoand a half years of having this
billing company is that a lot ofthese clinicians are very much
(00:58):
like me, at least on the frontend.
They really don't know what'sgoing on in their clinics.
At least on the front end isthey really don't know what's
going on in their clinics.
And so we're going about taking.
You know, we see two differenttypes of clinics.
We see the new clinician, sothey're starting from scratch
and that's easy.
There's nothing that we need totrack down.
But the bigger headaches andissues out there that maybe we
(01:23):
can talk a little bit more aboutis we have these clinics that
are established.
They're seeing a fairly highamount of patient streamlining
in patients coming into theirclinics.
So they figure, since themoney's coming in, everything's
good.
And then usually once theirbiller, their previous biller
(01:48):
starts to taper off in theeffort, they see revenue drop
down.
Then they start to get upset,and so what we see is you know,
people complain aboutreimbursement with insurance,
but my experience has shown methat the reimbursement for the
most part.
There are a few exceptions outthere in the country, a couple
(02:09):
of states that notoriouslyreimburse lower.
The revenue is there, it's justgood.
Billing is not, and because theclinician is just running around
trying to see these patientsand keep his or her head above
water, just seeing thesepatients getting the
documentation done andsubmitting the claim to us so
(02:29):
that they can get paid.
They really don't know what'sgoing on behind the scenes, and
so they assume that when theirrevenue starts to taper off,
it's because insurance isreimbursing them poorly, and
really, to taper off, it'sbecause insurance is reimbursing
them poorly, and really itboils down to they're not paying
attention to the claims thatare not being paid, you know
(02:51):
rejections for whatever reason,and and they're not they're not
staying on top of their staff,and so because they're just
assuming that everybody else isdoing their job like they are,
that everything is the insurancecompany's fault, and really it,
it, more times than not, seemsto be internally.
If they can get their systemsin place, their revenue goes
(03:15):
back up and they're they'redoing better.
So that's that's kind of whatwe're doing in a nutshell and
where we see some of theproblems with clinics right now
got it.
Dr Andrew Greenland (03:24):
So this sort of the genesis of this
business was really out of,perhaps, a sense of frustration
or the fact that there's a bighole in the whole industry in
terms of how this process works,from the billing aspects
through to the reimbursementalthough you say the
reimbursement is not the problem, it's everything else.
But you've really driven to dothis by virtue of the problems
(03:44):
you were having in your business.
Is that a fair thing to say?
Dr Christian Robertozzi (03:48):
yeah and and uh.
I mean I've seen it severaltimes with the clinics that we
we do take over.
You know we're not businesspeople by by trade and so we
really don't know what's goingon.
You know, you just kind offumble through it and then you
know.
I think I just took umunderstanding the revenue cycle
a little bit more seriously thanmost other people do.
It's a headache, it's hardright, Like I have my you know
(04:11):
my staff chasing downpre-authorizations, trying to
get more visits for people, justfiguring out what the actual,
you know like insurance benefitsaren't necessarily listed
correctly in these portals, andso then that leads to the person
, the insurance verificationspecialist, to make a phone call
.
It's a lot of work just so thatyou can get paid.
(04:34):
You know when, once you do yourjob, and so I can see why
people would be hands off.
It's very complicated and umit's, it's very complicated and,
um, it's it's tough tounderstand.
And then finding the peoplethat actually can do it, um, are
, they're out there?
They're absolutely out there,but it it takes knowing a little
bit about that to vet thesepeople before you hire them, and
(04:57):
that's also tough and timeconsuming yeah, so what does
your day-to-day look like now?
Dr Andrew Greenland (05:01):
I mean, are you still involved in patient
care?
Are you fully focused on thebilling operation side of things
?
Dr Christian Robertozzi (05:06):
Yes, I have.
I have my own clinic.
It's been operational now foreight years, but then we started
total care and so we about twoand a half years ago.
And so the clinic is a job forme.
I'm very much in it, working init, seeing patients Monday,
wednesday, thursday and Friday.
On Tuesdays I kind of dip backinto the total care side and
(05:33):
make sure that everything'sgoing well and working with the
staff and seeing what needs toimprove or whatever.
But yeah, I'm in both.
But the total care is more of abusiness for me.
You know, sarah is my chiefbilling officer.
She's been with us for the lasttwo and a half years and she's
a superstar.
She understands the revenuecycle from start to finish.
(05:56):
She understands cpt codes, sheunderstands hipaa compliance and
all that good stuff.
So she's the one really leadingand HIPAA compliance and all
that good stuff, so she's theone really leading the rest of
the team.
And then we have a really greatteam of billers as well as
insurance verificationspecialists, and so, yeah, I'm
in both and enjoy it.
(06:20):
We've been able to help a bunchof clinics go from like being on
death's doorstep to doublingtheir revenue.
They can keep their doors openand continue to grow and
flourish.
That's the part that I enjoy.
I was never quite that faralong in terms of having my
revenue dry up, but I've feltthat pain and I'm sure if any
(06:43):
other clinician is listening tothis right now, whether they
know it or not with probably afew exceptions out there they've
gone through that pain of nothaving money come in like it
should, and they work hard.
You know they deserve it.
They need to pay their staff,so they're dealing with the
stress of making sure thateverybody is paid, so I take a
(07:04):
lot of pleasure in knowing thatthat's one less thing to worry
about.
It really shouldn't be on theirplate to begin with, but it
comes to their attention once itgets bad enough.
So we like to help out got it.
Dr Andrew Greenland (07:18):
So you, I mean, are you servicing other
clinics in this niche or youextended it to the wider sort of
health and wellness um industrywe're, we're, we're pretty
specialized.
Dr Christian Robertozzi (07:28):
So I'm a physical therapist by trade
and so I understand that codingum.
I have a relationship with a um, an emr company, prompt, which
is a really killer uh platform.
It's billing um.
The billing portion of thatplatform is incredibly strong
and so I liked it.
As a clinician, I it allowed meto see everything.
(07:50):
So once my my business partnerwas like hey, we should, we
should go and do this ourselves.
We just reached up to them andsaid, do you do referrals?
And like, yeah, sure, so thatwas those kind of how it got it.
Dr Andrew Greenland (08:05):
I mean, I've done a number of these
interviews um these podcasts andI have to say that everyone
I've spoken to in a unis, a ushealth and wellness space
insurance is the one thing thatseems to be the universal
bugbear in terms of the thingsthat are bottlenecks for their
business, and obviously I'm veryinterested to hear that you
work in this niche.
I just wonder, wonder, what themarket is like for other niches
(08:27):
in the health and wellnessspace.
Are there other people doingthis and to what extent and kind
of?
How do you fit into thatpicture?
Cause it seems like there's amassive demand for this kind of
thing and from what you saidabout what you're able to
achieve for people, it soundspretty amazing.
Dr Christian Robertozzi (08:40):
There there is a demand, so here's,
let me.
Let me tell you at least howphysical therapists work.
Right, like our profits.
Margins even though there ismoney to be made are a lot
slimmer than a private practicephysician or an orthopedic
surgeon or a neurologist, right,their revenue is much, much
higher.
So ours is thinner, and so thatmakes the clinic owners very
(09:04):
sensitive to cost, and sothey're not looking at me as a
money generator.
I'm just another bill on their,on their docket, and so my
competition there's.
There's billing all over theplace, and what's happening a
lot is is a lot of that billingis being sourced overseas, and
(09:27):
the people that are doing that,you know they're in different
time zones.
They might not understand therevenue cycle here as much.
There's lots of limitations, Ithink, that they encounter, and
so they're doing it for supercheap.
But they're doing a poor job,and I've taken over a couple of
clinics that had outsourced itto that, but they're only
(09:47):
charging a very, very smallamount because that billing
company can do that, becausethey're paying their staff next
to nothing.
We charge at, I think, anhonest rate.
It's definitely enough to paygood billers to do a good job,
and what we've done in the pastis we've had clinics where we've
(10:10):
doubled their monthly revenueor at least increased it
substantially, even though theirpatient care is about the same.
So, yes, there's a really bigneed for good billing.
Some people want to have billersin-house because they want to
be able to have thatconversation in real time, and
(10:30):
once a clinic gets big enough,it can be feasible to do that.
It becomes more feasible to dothat.
Some people, for whateverreason, maybe they're not big
enough and so it would be reallyexpensive to have somebody
full-time, and so having afractional biller, kind of like
us, makes more sense financially.
But a good biller will make youmoney.
(10:53):
They should not, and it's takenme years to to see this and
understand it.
There's a lot of need for it,and somebody that really knows
what they're doing will make youmoney.
They'll fight for the work thatyou've already put in and get
you paid, and they're relentless.
A bad biller is going toquietly this is here's an
example of where you seeproblems A bad biller instead of
(11:16):
telling you, hey, I'm gettingthese denials, I need you to do
a peer-to-peer with thisinsurance company they're just
going to quietly write it offand your AR looks great, right,
because that was closed out andso things look like they're
moving smoothly.
That person is probably thisexample here, is probably just
(11:38):
writing stuff off left and rightand the clinician doesn't know
it, until they start to seetheir revenue drop and that's
when the questions start to getasked got it.
Dr Andrew Greenland (11:47):
So, based on some of the things you've
mentioned about, you've beenable to double um the income by
virtue of the service youprovide.
So do you think most clinicowners actually know what their
true billing picture looks like?
Dr Christian Robertozzi (11:58):
no, no, and even you know it's
interesting too because, um, wewill do audits of of people's
billing practices.
Pts is pretty straightforward,I think.
Uh, getting into positions theyhave way more codes and it gets
more complicated, but we'repretty straightforward, um, and
(12:20):
we'll just bring up differencesin billing for their time.
Right, pts are very muchtime-based CPT codes.
You need to spend time withpeople.
So with Medicare guidelines CMSguidelines you can bill up to
in most cases, four units forthe hour.
Ama guidelines you can get fiveunits.
Ama guidelines you can get fiveunits.
(12:44):
And so when we bring that tothe attention of a clinic owner,
hey, your staff arehistorically billing out three
units in an hour for thisMedicare patient and maybe only
four units for some of thesecommercial insurances where it
could be five.
If you just add that extra unit, you could be bringing in X
number of more dollars.
Some people are very receptiveto it.
Some people think that we'retrying to trick them into doing
(13:09):
something fraudulently, which ofcourse we're not.
It's interesting.
There can be resistance to thattoo.
So the owner needs to educatethemselves.
There needs to be a little bitof work on their end to
understand what what they'redoing.
Um, we can only guide themright.
We can't put those units in.
(13:30):
Certainly, if they haven't, thework hasn't been done
interesting.
Dr Andrew Greenland (13:35):
So what do you say are some of the simple
and powerful things that clinicscould perhaps do to get a
clearer financial picture, basedon your experience with working
with um, with these various umclinics that you have done?
Dr Christian Robertozzi (13:46):
a clearer picture.
Um, really, you need to carve.
You know, the problem is andI'm guilty of this too right,
like once your day starts you'rejust seeing patients all day,
carving time out to sit downwith your biller or billers,
depending on how big it is andtaking that time and having them
(14:09):
show things and explain thingsto you would be a game changer
for probably most clinics outthere.
And you don't necessarily evenneed to understand the
intricacies of billing.
But if you pull up your chartof people that you saw last
month, right, and then you pullthat same chart up again this
(14:29):
month and then you start to goline by line of payments and you
see there's a couple blanks inthere, that's a great place to
start.
You don't have to understandanything else outside of.
Like, there's not a dollar signnext to these people's names.
Why don't you explain that tome?
Why didn't we get paid on thesepeople?
That's scary, right?
(14:49):
You're not making moneynecessarily by spending that
time with your staff, and sothat feels like a waste of time.
But I will tell you that wouldbe a huge game changer for any
clinician.
Just taking it I'm sure itdepends on the clinic size, but
like taking 30 to 60 minutes amonth, you know, once a month,
(15:15):
maybe once a week, depending onthe size of the clinic and just
staying on top of your billingonce a week, depending on the
size of the clinic, and juststaying on top of your billing
your biller would be a hugeshift in in positive revenue for
you guys, because now they knowyou're watching and they're
going to start asking.
You're going to start askingquestions to your biller on why
we're not getting paid on thisperson.
It's been three months.
It should have been paid by now.
(15:36):
They're going to work a littleharder absolutely um.
Dr Andrew Greenland (15:40):
So, delving into the weeds a little bit,
are there any um numbers ormetrics that you think every
clinic should be tracking that?
You've found that most aren'tdoing yeah, that's good.
Dr Christian Robertozzi (15:50):
Uh, yeah, like the easiest part is
just looking at your, your ar,right, you?
There's a couple differentthings that we look at with our
clinics that we we talk aboutweekly.
So what is your zero to 30 dayAR?
So how quickly are you gettingpaid on the claims that you
submitted within the first 30days?
Some clinics can be a littlebit different.
My business partner owns a DMEcompany.
(16:12):
He's happy if he gets paid inthe first 90 days.
His timeline is much longer, soyou need to understand your
timeline.
We have some clinics that do alot of workers comp and that
historically takes longer.
So zero to 30 isn't alwaysappropriate, depending on the
type of clinic.
You are insurance and and itpays in a reasonable amount of
(16:42):
time 30 days, 45 days so thatnumber should be pretty good.
It should be pretty high.
You know we shoot for 80 to 90percent, so seeing that number
is is a great first pass test tosee the the health of your,
your income.
The other is understanding theCPT codes that you're putting
(17:03):
out.
Our EMR can print the averagereimbursement per CPT code and
that can be really powerful,right?
You might be billing somethingout that never gets paid and
your biller just never talks toyou.
Because you never talk to them,so there's no reason for them
to have that conversation withyou.
They're doing their job andyou're doing yours, but you've
(17:25):
been billing out this code foryears and don't know that that
code doesn't pay or doesn't paywell, and that there's actually
another option out there.
So once those questions start tobe had between you and your
biller, you start to understandhow insurance is paying you and
and that can help shape the wayyou're coding and that also
(17:48):
boosts Revenue as well.
So having those two thingslooking at your, your AR reports
on a regular basis and then CPTreimbursement that's not
necessarily so much of a weeklything.
That's a pretty standard.
That doesn't change too much.
But seeing if you're getting alot of denials in certain areas
(18:09):
or for certain CPT codes, that'sinteresting information too.
Right Now you can recode thatparticular service to something
else that does reimburse and nowyour revenue goes up.
So those are the two or threethat I would look at Brilliant.
Dr Andrew Greenland (18:25):
I'm guessing what you do is very
much just kind of done for yousolution from the way you're
talking.
But how do you stop the clinicsgetting overwhelmed with tech
and spreadsheets when you startworking with them?
Dr Christian Robertozzi (18:35):
We're having a conversation like this
and we'll point out somethingsuper easy.
Hey, you know they're already,usually when we get them they're
already overwhelmed.
Um, because now this clinicowner has been trying to manage
the billing in the background,why they've been looking for
somebody like us.
So we're really high on service.
(18:56):
You know, usually clinics startto see that something bad is
happening because thecommunication breaks down.
Right, that's like a universalhuman truth.
Right, like if you're a, youcould be the best physician in
the world and a terriblecommunicator.
They, they won't like you notvery much, unless you're like
really amazing.
(19:17):
But the clinician that does agreat job, showing empathy and
listening.
Right, everybody loves thatperson.
It's no different with yourbiller.
Right, like that person, whenyou ask them a question, they
need to respond, and so that'ssomething that we're really high
on with our billing staff isthat you know you're answering
(19:40):
those text messages, thoseemails, those phone calls.
So, just by the clinicianseeing that when they have a
question we answer it and it'sreally a legitimate answer
because we're really doing it,that lowers the stress.
And then we're taking care ofall the billing on the
background.
So once they, there's usually alittle bit of trust that needs
(20:03):
to be built in the first coupleof weeks for them to really
understand that we're differentand we really are doing our job.
But again, you know, whetherit's me or anybody else right
like you, you really need toknow that your staff is doing a
(20:24):
good job.
They might love you and theymight be really doing their best
, but that might not necessarilybe the best work that can be
done and that's where you needto manage it.
Dr Andrew Greenland (20:42):
Brilliant.
So it sounds like you've foundlots of solutions and you're
helping lots of people, but arethere any bottlenecks still left
that you've got left to solve?
If you've got something you'dlike to make, wave a magic wand
over to fix in the billinglandscape for the clinics that
you work with yeah, I mean we've, we've kept our hands away from
doing credentialing.
Dr Christian Robertozzi (20:57):
It's.
It's painfully slow, um, andyou're usually having your
contract sent back to youbecause you missed, you know,
one dot here or there, forgot tocross a T?
Um, we've, we've done it likeonce or twice and and we end up
being the bad guys because it ittakes so long and it's it's not
(21:17):
really our fault, it's justit's a gruelingly slow process
and so we've kind of walked awayfrom it because that's like a
nobody wins scenario.
I have a really great lady thatdoes it.
She's in Massachusetts,michelle.
That would be one.
Um, I don't want to necessarilytackle that.
Uh, what are the boogeymen outthere?
(21:39):
Um, a lot, a lot of times.
It's a lot of times like we,we've dealt with lots of
companies across the country, sowe've seen a lot.
So we have a really goodunderstanding of how billing
works.
And sometimes people are justthey've been in the game too
(22:01):
long or they think they knowmore than we do and so they're
not willing to change and theyreally hurt themselves more than
not.
So maybe I need to get a do abetter job of communicating.
I don't, I don't know.
Those are that's.
That's what I can I can see isit's a relationship.
We're trying to have arelationship with them in their
(22:23):
best interest, like Ilegitimately want to see these
clinics thrive.
I know they're working hard, Ido the work myself, and so I
just want to see them win, andsometimes they won't allow
themselves to be successfulinteresting.
Dr Andrew Greenland (22:43):
Um.
So where do you think thisindustry is headed in the next
year or two and wherespecifically do you want to be
in the next year or two withyour operation?
Dr Christian Robertozzi (22:50):
the billing industry.
You know it's interesting.
I heard a statistic the otherday that in the US the biggest
group of healthcareprofessionals are therapists,
and so you're seeing a coupledifferent things.
There are private equity firmsthat understand this and they're
(23:12):
starting to snatch up these momand pop clinics and kind of
grow their team of billers,because there's just so much
billing going on for us, or usbeing the healthcare
professionals physicaltherapists, occupational
therapists those guys Will itturn into a bunch of really big,
(23:38):
uh billers?
I don't think so.
I think it's tough for them todo a good job.
I'm small, you know.
So I know all of my clinicowners by name.
They email me when they have aproblem.
I solve it.
Um, can that be done on a largescale?
I mean Amazon's done it, youknow.
(23:59):
So it's certainly possible.
I haven't seen a big one outthere that's doing it that well,
where do I want to be in thenext year?
You know we're just trying togrow and I enjoy the process.
I, like you know, when we get anew clinic it's a new clinician
maybe not a new clinician but anew business owner and he or
(24:20):
she really doesn't know whatthey're doing.
And I've been through thosepains and so I enjoy sitting
down with those guys and justkind of talking them through
what their next step should be,and that feels good too.
You know, I remember when I wasin their shoes just wanting some
help, and everybody that seemedthat had advice to give wanted
(24:40):
$200 an hour, which I didn'thave.
So I'm happy to hand out somefree advice.
I guess you get what you payfor, but I've done it.
So I think my advice is prettysound.
So I mean just hopefully justkeep on doing this in the next
year, you know, hoping tocontinue to grow our company.
We've got a great staff.
(25:01):
We enjoy each other.
Um, we've got great clients.
We enjoy working with them andseeing them thrive.
So I mean to do more of this isis fun.
Maybe I could take myself outof the clinic a little bit more.
Maybe only treat three days, domore billing stuff two days.
That would be cool.
Dr Andrew Greenland (25:15):
I mean, it sounds like you're doing a
pretty amazing service for amuch more delivering a much
needed service for people inthis industry.
Is there any?
Is there any barriers to growth?
From your point of view, itsounds like there's must be a
huge demand for what you do, butis there anything that's
stopping you from growing to thelevel that you'd like to?
Dr Christian Robertozzi (25:32):
you know, uh, yes, and some of
that's intentional.
So we've had um, you'll seesome billing companies out there
that they'll take anybody, andso that means that their billers
are billing in numerousplatforms and I think that's a
disservice to the clinics thatthey serve, because these
billers aren't becoming ultraaware of how to use each
(25:53):
platform, so they're mediocre ineach one, and I've seen that
from the clients that we'vetaken over where they had these
types of billers.
So we've we've specialized notonly in just physical therapy
billing but just in prompt.
Our billers know that like theback of their hand.
(26:13):
So we've had so many meetingsabout this.
But we are willing to only billin prompt so that we are
excellent at billing in promptand get the results that we
expect out of ourselves.
The flip side of that is iswe're we're not taking referrals
for people that are in othersoftware because we don't want
(26:34):
to learn it, we're not going tobe good at it, we don't.
We don't want to be good at it,we want to be good at working
in prompt.
So that's our limitation.
I guess if there was a sea ofprompt users that needed help,
call me and I'd be happy toassist you.
But otherwise we're kind ofleft to get referrals from the
tender mercies of my friends atprompt and they've been really
(26:57):
generous.
But that's's, that's what kindof uh.
That's the direct uh flow ofreferrals that we get.
How we get them and prompt iswhat?
Dr Andrew Greenland (27:07):
sorry excuse my ignorance, what is
prompt exactly?
Dr Christian Robertozzi (27:10):
oh, it's fine, there's a million,
it's.
It's an emr out there.
It's specifically designed forum physical therapists and other
types of allied healthcare,like I know they they chiros use
it a lot.
Occupational therapists use ita lot.
So it's, it's those there's.
There's some one-offs ofdifferent types of healthcare
perfect professionals that'lluse it, but it's really built
(27:33):
and designed for those types ofclinicians therapists, you know,
chiropractors.
Dr Andrew Greenland (27:41):
Brilliant.
What do you?
Would you say what kind ofclinic owners are best
positioned to thrive in the newenvironment, or where billing is
going in the future?
Dr Christian Robertozz (27:51):
Somebody that's willing to take
ownership of their clinic.
That seems that might seemsilly.
Well, it's my clinic.
Of course I'm going to takeownership of it.
But I will tell you that, eventhough there are a lot of clinic
owners out there, I feel likethey've kind of washed their
(28:11):
hands of everything once theyopen the doors and they expect
everybody else to do it.
And there might be clinics outthere that do just fine with
that.
My experience has shown me thatthe clinic owners that are
involved in a positive way andtake ownership for the clinic's
outcomes are the guys and galsthat do the best.
(28:36):
Somebody that thinks thateverybody else should do it for
them is in for a really roughtime.
You just need to be out therehustling right Like you need to
be the face of the clinic.
You need to have a good rapportwith your staff.
You need to make sure thatyou're having those touch points
(28:57):
with your staff.
They like you.
They like working there.
If they don't, why?
That's your job to you knowsolve it.
You need to be out there makingsure that your relationships
are strong with your referralsources, the physicians that are
supporting your clinic, makingsure that they're happy with you
.
It's hard.
I mean it is much harder thanbeing a staff clinician anywhere
(29:20):
, but it's very doable and it'svery rewarding.
It's exciting.
I think it's way better thanjust working for somebody.
So you just need to be willingto put in the work.
That's the you know outside ofwork ethic.
I think anybody can get it done.
You just need to know thatthat's the life you're signing
up for and it's and it's a lotdifferent than just punching the
(29:42):
card and being a nine to fiveemployee.
Dr Andrew Greenland (29:47):
Christian, thank you so much for your time
this afternoon.
It's been a really thoughtfuland eye opening eye opening
conversation, and you've beenreally generous with your
insights.
I think it's lots of actionableinformation that people
listening to this will findhelpful.
So thank you for your time.
Hello everyone and welcome back to
Voices in Health and Wellness.
I'm your host, dr AndrewGreenland, and on this podcast
we sit down with practitioners,clinic owners and health leaders
who are doing the real work,and today's guest brings a
unique perspective on one of themost overlooked issues in
private practice billing.
Dr Christian Robertosi is aphysical therapist and
orthopaedic specialist who'sseen the system from the inside.
(00:23):
He's also the co-founder ofTotal Care PT Billing, a company
that helps clinics streamlinetheir revenue cycles and finally
get some clarity on what'scoming in and what's leaking out
.
Christian, thank you very muchfor being on the podcast today.
Dr Christian Robertozzi (00:38):
I started a relationship with
Prompt and Prompt startedsending us referrals, and so
what we've seen in the last twoand a half years of having this
billing company is that a lot ofthese clinicians are very much
(00:58):
like me, at least on the frontend.
They really don't know what'sgoing on in their clinics.
At least on the front end isthey really don't know what's
going on in their clinics.
And so we're going about taking.
You know, we see two differenttypes of clinics.
We see the new clinician, sothey're starting from scratch
and that's easy.
There's nothing that we need totrack down.
But the bigger headaches andissues out there that maybe we
(01:23):
can talk a little bit more aboutis we have these clinics that
are established.
They're seeing a fairly highamount of patient streamlining
in patients coming into theirclinics.
So they figure, since themoney's coming in, everything's
good.
And then usually once theirbiller, their previous biller
(01:48):
starts to taper off in theeffort, they see revenue drop
down.
Then they start to get upset,and so what we see is you know,
people complain aboutreimbursement with insurance,
but my experience has shown methat the reimbursement for the
most part.
There are a few exceptions outthere in the country, a couple
(02:09):
of states that notoriouslyreimburse lower.
The revenue is there, it's justgood.
Billing is not, and because theclinician is just running around
trying to see these patientsand keep his or her head above
water, just seeing thesepatients getting the
documentation done andsubmitting the claim to us so
(02:29):
that they can get paid.
They really don't know what'sgoing on behind the scenes, and
so they assume that when theirrevenue starts to taper off,
it's because insurance isreimbursing them poorly, and
really, to taper off, it'sbecause insurance is reimbursing
them poorly, and really itboils down to they're not paying
attention to the claims thatare not being paid, you know
(02:51):
rejections for whatever reason,and and they're not they're not
staying on top of their staff,and so because they're just
assuming that everybody else isdoing their job like they are,
that everything is the insurancecompany's fault, and really it,
it, more times than not, seemsto be internally.
If they can get their systemsin place, their revenue goes
(03:15):
back up and they're they'redoing better.
So that's that's kind of whatwe're doing in a nutshell and
where we see some of theproblems with clinics right now
got it.
Dr Andrew Greenland (03:24):
So this sort of the genesis of this
business was really out of,perhaps, a sense of frustration
or the fact that there's a bighole in the whole industry in
terms of how this process works,from the billing aspects
through to the reimbursementalthough you say the
reimbursement is not the problem, it's everything else.
But you've really driven to dothis by virtue of the problems
(03:44):
you were having in your business.
Is that a fair thing to say?
Dr Christian Robertozzi (03:48):
yeah and and uh.
I mean I've seen it severaltimes with the clinics that we
we do take over.
You know we're not businesspeople by by trade and so we
really don't know what's goingon.
You know, you just kind offumble through it and then you
know.
I think I just took umunderstanding the revenue cycle
a little bit more seriously thanmost other people do.
It's a headache, it's hardright, Like I have my you know
(04:11):
my staff chasing downpre-authorizations, trying to
get more visits for people, justfiguring out what the actual,
you know like insurance benefitsaren't necessarily listed
correctly in these portals, andso then that leads to the person
, the insurance verificationspecialist, to make a phone call
.
It's a lot of work just so thatyou can get paid.
(04:34):
You know when, once you do yourjob, and so I can see why
people would be hands off.
It's very complicated and umit's, it's very complicated and,
um, it's it's tough tounderstand.
And then finding the peoplethat actually can do it, um, are
, they're out there?
They're absolutely out there,but it it takes knowing a little
bit about that to vet thesepeople before you hire them, and
(04:57):
that's also tough and timeconsuming yeah, so what does
your day-to-day look like now?
Dr Andrew Greenland (05:01):
I mean, are you still involved in patient
care?
Are you fully focused on thebilling operation side of things
?
Dr Christian Robertozzi (05:06):
Yes, I have.
I have my own clinic.
It's been operational now foreight years, but then we started
total care and so we about twoand a half years ago.
And so the clinic is a job forme.
I'm very much in it, working init, seeing patients Monday,
wednesday, thursday and Friday.
On Tuesdays I kind of dip backinto the total care side and
(05:33):
make sure that everything'sgoing well and working with the
staff and seeing what needs toimprove or whatever.
But yeah, I'm in both.
But the total care is more of abusiness for me.
You know, sarah is my chiefbilling officer.
She's been with us for the lasttwo and a half years and she's
a superstar.
She understands the revenuecycle from start to finish.
(05:56):
She understands cpt codes, sheunderstands hipaa compliance and
all that good stuff.
So she's the one really leadingand HIPAA compliance and all
that good stuff, so she's theone really leading the rest of
the team.
And then we have a really greatteam of billers as well as
insurance verificationspecialists, and so, yeah, I'm
in both and enjoy it.
(06:20):
We've been able to help a bunchof clinics go from like being on
death's doorstep to doublingtheir revenue.
They can keep their doors openand continue to grow and
flourish.
That's the part that I enjoy.
I was never quite that faralong in terms of having my
revenue dry up, but I've feltthat pain and I'm sure if any
(06:43):
other clinician is listening tothis right now, whether they
know it or not with probably afew exceptions out there they've
gone through that pain of nothaving money come in like it
should, and they work hard.
You know they deserve it.
They need to pay their staff,so they're dealing with the
stress of making sure thateverybody is paid, so I take a
(07:04):
lot of pleasure in knowing thatthat's one less thing to worry
about.
It really shouldn't be on theirplate to begin with, but it
comes to their attention once itgets bad enough.
So we like to help out got it.
Dr Andrew Greenland (07:18):
So you, I mean, are you servicing other
clinics in this niche or youextended it to the wider sort of
health and wellness um industrywe're, we're, we're pretty
specialized.
Dr Christian Robertozzi (07:28):
So I'm a physical therapist by trade
and so I understand that codingum.
I have a relationship with a um, an emr company, prompt, which
is a really killer uh platform.
It's billing um.
The billing portion of thatplatform is incredibly strong
and so I liked it.
As a clinician, I it allowed meto see everything.
(07:50):
So once my my business partnerwas like hey, we should, we
should go and do this ourselves.
We just reached up to them andsaid, do you do referrals?
And like, yeah, sure, so thatwas those kind of how it got it.
Dr Andrew Greenland (08:05):
I mean, I've done a number of these
interviews um these podcasts andI have to say that everyone
I've spoken to in a unis, a ushealth and wellness space
insurance is the one thing thatseems to be the universal
bugbear in terms of the thingsthat are bottlenecks for their
business, and obviously I'm veryinterested to hear that you
work in this niche.
I just wonder, wonder, what themarket is like for other niches
(08:27):
in the health and wellnessspace.
Are there other people doingthis and to what extent and kind
of?
How do you fit into thatpicture?
Cause it seems like there's amassive demand for this kind of
thing and from what you saidabout what you're able to
achieve for people, it soundspretty amazing.
Dr Christian Robertozzi (08:40):
There there is a demand, so here's,
let me.
Let me tell you at least howphysical therapists work.
Right, like our profits.
Margins even though there ismoney to be made are a lot
slimmer than a private practicephysician or an orthopedic
surgeon or a neurologist, right,their revenue is much, much
higher.
So ours is thinner, and so thatmakes the clinic owners very
(09:04):
sensitive to cost, and sothey're not looking at me as a
money generator.
I'm just another bill on their,on their docket, and so my
competition there's.
There's billing all over theplace, and what's happening a
lot is is a lot of that billingis being sourced overseas, and
(09:27):
the people that are doing that,you know they're in different
time zones.
They might not understand therevenue cycle here as much.
There's lots of limitations, Ithink, that they encounter, and
so they're doing it for supercheap.
But they're doing a poor job,and I've taken over a couple of
clinics that had outsourced itto that, but they're only
(09:47):
charging a very, very smallamount because that billing
company can do that, becausethey're paying their staff next
to nothing.
We charge at, I think, anhonest rate.
It's definitely enough to paygood billers to do a good job,
and what we've done in the pastis we've had clinics where we've
(10:10):
doubled their monthly revenueor at least increased it
substantially, even though theirpatient care is about the same.
So, yes, there's a really bigneed for good billing.
Some people want to have billersin-house because they want to
be able to have thatconversation in real time, and
(10:30):
once a clinic gets big enough,it can be feasible to do that.
It becomes more feasible to dothat.
Some people, for whateverreason, maybe they're not big
enough and so it would be reallyexpensive to have somebody
full-time, and so having afractional biller, kind of like
us, makes more sense financially.
But a good biller will make youmoney.
(10:53):
They should not, and it's takenme years to to see this and
understand it.
There's a lot of need for it,and somebody that really knows
what they're doing will make youmoney.
They'll fight for the work thatyou've already put in and get
you paid, and they're relentless.
A bad biller is going toquietly this is here's an
example of where you seeproblems A bad biller instead of
(11:16):
telling you, hey, I'm gettingthese denials, I need you to do
a peer-to-peer with thisinsurance company they're just
going to quietly write it offand your AR looks great, right,
because that was closed out andso things look like they're
moving smoothly.
That person is probably thisexample here, is probably just
(11:38):
writing stuff off left and rightand the clinician doesn't know
it, until they start to seetheir revenue drop and that's
when the questions start to getasked got it.
Dr Andrew Greenland (11:47):
So, based on some of the things you've
mentioned about, you've beenable to double um the income by
virtue of the service youprovide.
So do you think most clinicowners actually know what their
true billing picture looks like?
Dr Christian Robertozzi (11:58):
no, no, and even you know it's
interesting too because, um, wewill do audits of of people's
billing practices.
Pts is pretty straightforward,I think.
Uh, getting into positions theyhave way more codes and it gets
more complicated, but we'repretty straightforward, um, and
(12:20):
we'll just bring up differencesin billing for their time.
Right, pts are very muchtime-based CPT codes.
You need to spend time withpeople.
So with Medicare guidelines CMSguidelines you can bill up to
in most cases, four units forthe hour.
Ama guidelines you can get fiveunits.
Ama guidelines you can get fiveunits.
(12:44):
And so when we bring that tothe attention of a clinic owner,
hey, your staff arehistorically billing out three
units in an hour for thisMedicare patient and maybe only
four units for some of thesecommercial insurances where it
could be five.
If you just add that extra unit, you could be bringing in X
number of more dollars.
Some people are very receptiveto it.
Some people think that we'retrying to trick them into doing
(13:09):
something fraudulently, which ofcourse we're not.
It's interesting.
There can be resistance to thattoo.
So the owner needs to educatethemselves.
There needs to be a little bitof work on their end to
understand what what they'redoing.
Um, we can only guide themright.
We can't put those units in.
(13:30):
Certainly, if they haven't, thework hasn't been done
interesting.
Dr Andrew Greenland (13:35):
So what do you say are some of the simple
and powerful things that clinicscould perhaps do to get a
clearer financial picture, basedon your experience with working
with um, with these various umclinics that you have done?
Dr Christian Robertozzi (13:46):
a clearer picture.
Um, really, you need to carve.
You know, the problem is andI'm guilty of this too right,
like once your day starts you'rejust seeing patients all day,
carving time out to sit downwith your biller or billers,
depending on how big it is andtaking that time and having them
(14:09):
show things and explain thingsto you would be a game changer
for probably most clinics outthere.
And you don't necessarily evenneed to understand the
intricacies of billing.
But if you pull up your chartof people that you saw last
month, right, and then you pullthat same chart up again this
(14:29):
month and then you start to goline by line of payments and you
see there's a couple blanks inthere, that's a great place to
start.
You don't have to understandanything else outside of.
Like, there's not a dollar signnext to these people's names.
Why don't you explain that tome?
Why didn't we get paid on thesepeople?
That's scary, right?
(14:49):
You're not making moneynecessarily by spending that
time with your staff, and sothat feels like a waste of time.
But I will tell you that wouldbe a huge game changer for any
clinician.
Just taking it I'm sure itdepends on the clinic size, but
like taking 30 to 60 minutes amonth, you know, once a month,
(15:15):
maybe once a week, depending onthe size of the clinic and just
staying on top of your billingonce a week, depending on the
size of the clinic, and juststaying on top of your billing
your biller would be a hugeshift in in positive revenue for
you guys, because now they knowyou're watching and they're
going to start asking.
You're going to start askingquestions to your biller on why
we're not getting paid on thisperson.
It's been three months.
It should have been paid by now.
(15:36):
They're going to work a littleharder absolutely um.
Dr Andrew Greenland (15:40):
So, delving into the weeds a little bit,
are there any um numbers ormetrics that you think every
clinic should be tracking that?
You've found that most aren'tdoing yeah, that's good.
Dr Christian Robertozzi (15:50):
Uh, yeah, like the easiest part is
just looking at your, your ar,right, you?
There's a couple differentthings that we look at with our
clinics that we we talk aboutweekly.
So what is your zero to 30 dayAR?
So how quickly are you gettingpaid on the claims that you
submitted within the first 30days?
Some clinics can be a littlebit different.
My business partner owns a DMEcompany.
(16:12):
He's happy if he gets paid inthe first 90 days.
His timeline is much longer, soyou need to understand your
timeline.
We have some clinics that do alot of workers comp and that
historically takes longer.
So zero to 30 isn't alwaysappropriate, depending on the
type of clinic.
You are insurance and and itpays in a reasonable amount of
(16:42):
time 30 days, 45 days so thatnumber should be pretty good.
It should be pretty high.
You know we shoot for 80 to 90percent, so seeing that number
is is a great first pass test tosee the the health of your,
your income.
The other is understanding theCPT codes that you're putting
(17:03):
out.
Our EMR can print the averagereimbursement per CPT code and
that can be really powerful,right?
You might be billing somethingout that never gets paid and
your biller just never talks toyou.
Because you never talk to them,so there's no reason for them
to have that conversation withyou.
They're doing their job andyou're doing yours, but you've
(17:25):
been billing out this code foryears and don't know that that
code doesn't pay or doesn't paywell, and that there's actually
another option out there.
So once those questions start tobe had between you and your
biller, you start to understandhow insurance is paying you and
and that can help shape the wayyou're coding and that also
(17:48):
boosts Revenue as well.
So having those two thingslooking at your, your AR reports
on a regular basis and then CPTreimbursement that's not
necessarily so much of a weeklything.
That's a pretty standard.
That doesn't change too much.
But seeing if you're getting alot of denials in certain areas
(18:09):
or for certain CPT codes, that'sinteresting information too.
Right Now you can recode thatparticular service to something
else that does reimburse and nowyour revenue goes up.
So those are the two or threethat I would look at Brilliant.
Dr Andrew Greenland (18:25):
I'm guessing what you do is very
much just kind of done for yousolution from the way you're
talking.
But how do you stop the clinicsgetting overwhelmed with tech
and spreadsheets when you startworking with them?
Dr Christian Robertozzi (18:35):
We're having a conversation like this
and we'll point out somethingsuper easy.
Hey, you know they're already,usually when we get them they're
already overwhelmed.
Um, because now this clinicowner has been trying to manage
the billing in the background,why they've been looking for
somebody like us.
So we're really high on service.
(18:56):
You know, usually clinics startto see that something bad is
happening because thecommunication breaks down.
Right, that's like a universalhuman truth.
Right, like if you're a, youcould be the best physician in
the world and a terriblecommunicator.
They, they won't like you notvery much, unless you're like
really amazing.
(19:17):
But the clinician that does agreat job, showing empathy and
listening.
Right, everybody loves thatperson.
It's no different with yourbiller.
Right, like that person, whenyou ask them a question, they
need to respond, and so that'ssomething that we're really high
on with our billing staff isthat you know you're answering
(19:40):
those text messages, thoseemails, those phone calls.
So, just by the clinicianseeing that when they have a
question we answer it and it'sreally a legitimate answer
because we're really doing it,that lowers the stress.
And then we're taking care ofall the billing on the
background.
So once they, there's usually alittle bit of trust that needs
(20:03):
to be built in the first coupleof weeks for them to really
understand that we're differentand we really are doing our job.
But again, you know, whetherit's me or anybody else right
like you, you really need toknow that your staff is doing a
(20:24):
good job.
They might love you and theymight be really doing their best
, but that might not necessarilybe the best work that can be
done and that's where you needto manage it.
Dr Andrew Greenland (20:42):
Brilliant.
So it sounds like you've foundlots of solutions and you're
helping lots of people, but arethere any bottlenecks still left
that you've got left to solve?
If you've got something you'dlike to make, wave a magic wand
over to fix in the billinglandscape for the clinics that
you work with yeah, I mean we've, we've kept our hands away from
doing credentialing.
Dr Christian Robertozzi (20:57):
It's.
It's painfully slow, um, andyou're usually having your
contract sent back to youbecause you missed, you know,
one dot here or there, forgot tocross a T?
Um, we've, we've done it likeonce or twice and and we end up
being the bad guys because it ittakes so long and it's it's not
(21:17):
really our fault, it's justit's a gruelingly slow process
and so we've kind of walked awayfrom it because that's like a
nobody wins scenario.
I have a really great lady thatdoes it.
She's in Massachusetts,michelle.
That would be one.
Um, I don't want to necessarilytackle that.
Uh, what are the boogeymen outthere?
(21:39):
Um, a lot, a lot of times.
It's a lot of times like we,we've dealt with lots of
companies across the country, sowe've seen a lot.
So we have a really goodunderstanding of how billing
works.
And sometimes people are justthey've been in the game too
(22:01):
long or they think they knowmore than we do and so they're
not willing to change and theyreally hurt themselves more than
not.
So maybe I need to get a do abetter job of communicating.
I don't, I don't know.
Those are that's.
That's what I can I can see isit's a relationship.
We're trying to have arelationship with them in their
(22:23):
best interest, like Ilegitimately want to see these
clinics thrive.
I know they're working hard, Ido the work myself, and so I
just want to see them win, andsometimes they won't allow
themselves to be successfulinteresting.
Dr Andrew Greenland (22:43):
Um.
So where do you think thisindustry is headed in the next
year or two and wherespecifically do you want to be
in the next year or two withyour operation?
Dr Christian Robertozzi (22:50):
the billing industry.
You know it's interesting.
I heard a statistic the otherday that in the US the biggest
group of healthcareprofessionals are therapists,
and so you're seeing a coupledifferent things.
There are private equity firmsthat understand this and they're
(23:12):
starting to snatch up these momand pop clinics and kind of
grow their team of billers,because there's just so much
billing going on for us, or usbeing the healthcare
professionals physicaltherapists, occupational
therapists those guys Will itturn into a bunch of really big,
(23:38):
uh billers?
I don't think so.
I think it's tough for them todo a good job.
I'm small, you know.
So I know all of my clinicowners by name.
They email me when they have aproblem.
I solve it.
Um, can that be done on a largescale?
I mean Amazon's done it, youknow.
(23:59):
So it's certainly possible.
I haven't seen a big one outthere that's doing it that well,
where do I want to be in thenext year?
You know we're just trying togrow and I enjoy the process.
I, like you know, when we get anew clinic it's a new clinician
maybe not a new clinician but anew business owner and he or
(24:20):
she really doesn't know whatthey're doing.
And I've been through thosepains and so I enjoy sitting
down with those guys and justkind of talking them through
what their next step should be,and that feels good too.
You know, I remember when I wasin their shoes just wanting some
help, and everybody that seemedthat had advice to give wanted
(24:40):
$200 an hour, which I didn'thave.
So I'm happy to hand out somefree advice.
I guess you get what you payfor, but I've done it.
So I think my advice is prettysound.
So I mean just hopefully justkeep on doing this in the next
year, you know, hoping tocontinue to grow our company.
We've got a great staff.
(25:01):
We enjoy each other.
Um, we've got great clients.
We enjoy working with them andseeing them thrive.
So I mean to do more of this isis fun.
Maybe I could take myself outof the clinic a little bit more.
Maybe only treat three days, domore billing stuff two days.
That would be cool.
Dr Andrew Greenland (25:15):
I mean, it sounds like you're doing a
pretty amazing service for amuch more delivering a much
needed service for people inthis industry.
Is there any?
Is there any barriers to growth?
From your point of view, itsounds like there's must be a
huge demand for what you do, butis there anything that's
stopping you from growing to thelevel that you'd like to?
Dr Christian Robertozzi (25:32):
you know, uh, yes, and some of
that's intentional.
So we've had um, you'll seesome billing companies out there
that they'll take anybody, andso that means that their billers
are billing in numerousplatforms and I think that's a
disservice to the clinics thatthey serve, because these
billers aren't becoming ultraaware of how to use each
(25:53):
platform, so they're mediocre ineach one, and I've seen that
from the clients that we'vetaken over where they had these
types of billers.
So we've we've specialized notonly in just physical therapy
billing but just in prompt.
Our billers know that like theback of their hand.
(26:13):
So we've had so many meetingsabout this.
But we are willing to only billin prompt so that we are
excellent at billing in promptand get the results that we
expect out of ourselves.
The flip side of that is iswe're we're not taking referrals
for people that are in othersoftware because we don't want
(26:34):
to learn it, we're not going tobe good at it, we don't.
We don't want to be good at it,we want to be good at working
in prompt.
So that's our limitation.
I guess if there was a sea ofprompt users that needed help,
call me and I'd be happy toassist you.
But otherwise we're kind ofleft to get referrals from the
tender mercies of my friends atprompt and they've been really
(26:57):
generous.
But that's's, that's what kindof uh.
That's the direct uh flow ofreferrals that we get.
How we get them and prompt iswhat?
Dr Andrew Greenland (27:07):
sorry excuse my ignorance, what is
prompt exactly?
Dr Christian Robertozzi (27:10):
oh, it's fine, there's a million,
it's.
It's an emr out there.
It's specifically designed forum physical therapists and other
types of allied healthcare,like I know they they chiros use
it a lot.
Occupational therapists use ita lot.
So it's, it's those there's.
There's some one-offs ofdifferent types of healthcare
perfect professionals that'lluse it, but it's really built
(27:33):
and designed for those types ofclinicians therapists, you know,
chiropractors.
Dr Andrew Greenland (27:41):
Brilliant.
What do you?
Would you say what kind ofclinic owners are best
positioned to thrive in the newenvironment, or where billing is
going in the future?
Dr Christian Robertozz (27:51):
Somebody that's willing to take
ownership of their clinic.
That seems that might seemsilly.
Well, it's my clinic.
Of course I'm going to takeownership of it.
But I will tell you that, eventhough there are a lot of clinic
owners out there, I feel likethey've kind of washed their
(28:11):
hands of everything once theyopen the doors and they expect
everybody else to do it.
And there might be clinics outthere that do just fine with
that.
My experience has shown me thatthe clinic owners that are
involved in a positive way andtake ownership for the clinic's
outcomes are the guys and galsthat do the best.
(28:36):
Somebody that thinks thateverybody else should do it for
them is in for a really roughtime.
You just need to be out therehustling right Like you need to
be the face of the clinic.
You need to have a good rapportwith your staff.
You need to make sure thatyou're having those touch points
(28:57):
with your staff.
They like you.
They like working there.
If they don't, why?
That's your job to you knowsolve it.
You need to be out there makingsure that your relationships
are strong with your referralsources, the physicians that are
supporting your clinic, makingsure that they're happy with you
.
It's hard.
I mean it is much harder thanbeing a staff clinician anywhere
(29:20):
, but it's very doable and it'svery rewarding.
It's exciting.
I think it's way better thanjust working for somebody.
So you just need to be willingto put in the work.
That's the you know outside ofwork ethic.
I think anybody can get it done.
You just need to know thatthat's the life you're signing
up for and it's and it's a lotdifferent than just punching the
(29:42):
card and being a nine to fiveemployee.
Dr Andrew Greenland (29:47):
Christian, thank you so much for your time
this afternoon.
It's been a really thoughtfuland eye opening eye opening
conversation, and you've beenreally generous with your
insights.
I think it's lots of actionableinformation that people
listening to this will findhelpful.
So thank you for your time.
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