Episode Transcript
Speaker 1 00:00:03 Welcome to another installment of Revenue Radio, powered by kassouf and Kassouf Healthcare Solutions, where we bring you the information you need to enhance your business of medicine. We want you as practice managers, providers, physicians, uh, healthcare business owners to achieve value through the information we bring to you. My name's Jeff Dance. I am the executive director of he, uh, KAUSE Healthcare Solutions and your host again today for Revenue Radio. Russ, do, Dorsey is on our board today making us all look and sound good. And we appreciate, uh, all you do, Russ. Uh, thanks. Thanks for being a part of this. Our guest today is Shelby Scheer. Shelby is a graduate of Auburn University's Health Services Administration program. I think that is, uh, uh, like a acronym of hadam, is what you call that, right? Shelby, welcome today. Thank you. Uh, Shelby's part of our Kaso Healthcare Solutions Team. Uh, she's on the management services side where she really handles, uh, a lot of, of client, uh, accounts payable purchasing payroll. Uh, Shelby's made a great impact since she's been with us over the past couple years, and our clients, uh, value her. She's client facing. She visits with them and, uh, uh, takes care of a lot of what they need. So, Shelby, welcome to our program today.
Speaker 2 00:01:29 Thank you. It's great to be here.
Speaker 1 00:01:31 Good. I wanted to take some time with Shelby to, uh, visit with her and kind of find out a little bit more about what she does, uh, and especially as it relates now to some of the supply chain issues that we're seeing, uh, as we try to, uh, from a pro procurement standpoint, purchasing, ordering some of those, uh, situations that we're seeing, maybe some practical solutions for the practice manager on how to, uh, look at vendor relationships and some of the other i items that you're, uh, experiencing in your role. And then I also wanted just to, uh, uh, close with how, uh, a practice manager, a business owner in healthcare can take advantage of, uh, a program such as Auburn's, Hadam, uh, we've got some other graduates from other types of programs that work with and for us at at K Hs. But, uh, again, that can go all over the healthcare spectrum.
Speaker 1 00:02:32 And, uh, I want to, I want to hear from you, uh, especially from a millennial perspective. So, Shelby, welcome today. Uh, thank you for your time and, uh, let's, let's go ahead and get started with some questions. So again, uh, you, you see this ordering, uh, situation, uh, you deal with your clients. Kind of talk to us about how that weekly process works, where, uh, the, the client leans on you to get things ordered, uh, office supplies, medical supplies. How does, how does, uh, an efficient process work in that regard? So you're not just getting on a, a website and, and trying to catch something every day? Yeah,
Speaker 2 00:03:13 I think definitely establishing when, as for our clients, the onboarding is just the first step of kind of developing the accounts payable process and how it works best for that practice. Or like, let's say for Kasu Healthcare and how we handle all of our procurement and ordering. Um, for most of our clients, we do kind of, we establish a personalized ordering form mm-hmm. <affirmative> for their clinical supplies and medical supplies. And we have a certain timeframe that they have to get those in by, and that helps the APM procurement team develop a schedule and timeline for getting those orders in and communicating any such delays. But with that order form quarterly, you can also update pricing. Um, and I know with covid and all of the shortages that have happened over the last few years and will continue to happen, you have to look into different vendors and solutions for options. I mean, you wanna get, for companies and hospitals and clients, you want to get the best price for your clients. And so having to do some dynamic pricing between different vendors and staying on track with like, the current market requirements, that's really important. But that all comes down to a timeline as well. Setting it with your clients,
Speaker 1 00:04:51 You, you mentioned onboarding, uh, uh, that would be obviously a new client or a new practice that we, that we manage and serve. Uh, what are some of the kinks or nuances that you try to work through or work out with a new client? They've gotta learn us. We gotta learn them. Yes. And we don't want to come in as some overly strict, you know, here's, if that's the case, we go work for a corporate office. Right. Uh, but, uh, gimme, gimme some insight on how, uh, a practice would want to work with someone like you, uh, in, in, in this space of accounts payable and procurement,
Speaker 2 00:05:35 Let's say. I mean, you come into a client and they are set of how they've done things. Um, I think the first thing that we try to do is compromise. Um, but two is offer solutions that they might not be familiar with. Um, we have some vendors that offer coupons. They offer incentives. They offer gift cards. Um, and some of our clients aren't aware of those. So if you kind of come in and be like, Hey, I have this new vendor. If you, they have good pricing, and if you order through them, also, by the way, you can get treats and you can get gift cards and stuff with your orders. And a lot of times if you provide them incentives to switching vendors that they work with all the time, they're a lot more open to changing.
Speaker 1 00:06:27 Right. I think Russ <laugh> right now might be a good, uh, opportunity for us. Full disclosure, uh, whatever vendors we, we do recommend that's, that that's purely for the client's benefit and we don't, uh, correct. We don't get anything out of it other than client satisfaction. So, uh, and, and good pricing. So from a value perspective, um, again, whether they get treats or gift cards, uh, it's, it really boils down to service, I think, and, and pricing.
Speaker 2 00:07:00 I mean, it, it comes down to where can I get this product in the fastest method, but along with the best price. Right. And quality too. I mean, with all of the shortages and supply chains we're having to find alternative substitutes, but we also need to make sure that those substitutes that we're providing are of good value.
Speaker 1 00:07:23 So have you seen where a physician says, Hey, get me the cheapest thing you can find, then once it shows up, it's probably not exactly what, uh, he or she was expecting. Yes. What, what was kind of the anecdote or scenario along those lines?
Speaker 2 00:07:40 Um, mask, for example mm-hmm. <affirmative> during Covid. Right. People like to stock up on those. And so those are very hard to find. Well, you would find, I mean, an unimaginable number of vendors for mask. Well, if you order certain kinds and that was what you were accustomed to and you couldn't get them mm-hmm. <affirmative> during covid, you would buy the ones for the best price or super expensive. And I mean, some of them were just almost like a piece of paper. Right. Of cloth. Yeah. And weren't functionable in a practice that you're having to wear all day. And so those substitutes along with, I mean, lidocaine, for example, when Lidocaine was so hard to find, you had all the different substitutes of Marcaine and some of those weren't feasible mm-hmm. <affirmative> in some of the practices. Right. So that was a big hurdle getting through. Good. In the past year or two,
Speaker 1 00:08:37 Uh, in your role, you know, you're focused on that space, that procurement. So you, you really are watching all the different options and ways to get product to Yes. Uh, to the client. And, and again, from a practice manager standpoint, that's a lot of time. Can you talk us, talk to us a little bit about, um, maybe how your day goes, uh, time that you spend really researching products and, and availability, capacity, pricing all, what, what, what does that entail
Speaker 2 00:09:15 As far as time? I mean, you're looking at a few hours a day, um, definitely spread out over the workday. Um, but if an order comes up or if you have a client that's wanting to research a certain device, I mean, you're having to go through all of the vendors that you know of, as well as you might need to look into other venue vendors mm-hmm. <affirmative>. And then that comes with, if you want to purchase something from them, then you have to fill out contracts, and then you have to look at price analysis and cost compared since. And so it's definitely, it's not a easy one or two step process. They're multiple steps involved in it.
Speaker 1 00:09:56 Sure, sure. Uh, as far as now we've ordered it, we've received it, kind of go through how, and, and again, I, I used this question for a practice manager, um, to, from a, I guess you would call it compliance and control standpoint. Talk to us a little about, uh, about some of the controls that we have in place that are, uh, necessary, such as the, the invoicing, the, the packing slip. How do you, how do you do the check off to make sure when you're gonna write, get ready to write that check that you know that you're spending the, the client's money appropriately? And that would be the case again, whether you used a an M MSO such as KS or not. But for a practice manager, what are some controls that you might recommend to a practice manager? Before I write the check, I want to make sure this is in place to use air
Speaker 2 00:10:56 Quotes. I would definitely start, like, the first thing with the order form, uh, a lot of our order forms, we require signatures from either the practice manager or the doctor. So let's say someone, your staff, your MA or something is placing the order. The doctor, the practice manager has to sign off on that order before I even place the order mm-hmm. <affirmative>. So that gives the practice manager or physicians control of what they're ordering in their practice weekly. The next step would be, as soon as I place the order, they get email confirmations tracking information, and I continue to provide updates in the shipping process, knowing that they're familiar of when the product is supposed to arrive. After the product arrives. Typically, a lot of our practice managers will get those packages they go through and see what they receive, and then kind of send us back, um, packing slips is what we suggest best for our method. And that allows me to do a check and balance of what was ordered, what was received. And then from there, as soon as I receive the packing slip, that is when I go and it will proceed into the payable for the following.
Speaker 1 00:12:01 Okay. Timeframe, can you use, uh, use, uh, the software QuickBooks? Uh, I know there are others out there, but that's one that, that is, uh, readily available. I know, Russ, you, you help us out on the online versions of that. I think there's a desktop, uh, application, but, um, you know, we prefer the, the online piece. Online QuickBooks. Yes.
Speaker 2 00:12:25 Good.
Speaker 1 00:12:27 And, um, again, it should be available to all the owners, all the, all the interested stakeholders from a full transparency standpoint. The owners should be able to see what the purchasing person's doing and the check writer and all of that. Right.
Speaker 2 00:12:43 And speaking of transparency, um, we highly suggest too, to be transparent with our physicians. And I mean, sometimes they like to keep track of pri of pricing. And so, um, we like, it's, it we allow, I mean, all of our physicians have access to all of the vendors that I have access to. And so they are, have the ability to go in and do price com mm-hmm. <affirmative> comparisons themselves. Right. And so that helps too, cuz if a doctor is looking for a certain piece of equipment, and I haven't, I'm not, haven't been made aware of it yet, they can come to me and be like, Hey, I found this price with this vendor. Can we look into that? And we're happy to do so.
Speaker 1 00:13:25 Right. Right. So it's a team effort, regardless, again, whether you're using, uh, an MSO such as ourselves or if it's contained within the practice, you know, as practices grow, there's sort of that administrative, uh, office and, uh, and such that everybody wants to be coordinated and transparent through the whole processing of the orders and the paying of the bills. Uh, real quick, uh, before we get into this other little piece, uh, from a supply chain standpoint, what, what are you seeing right now as the, the big hangups? Any, any major supplies, uh, that, that you're experiencing delays?
Speaker 2 00:14:10 Lidocaine is still, um, in the substitutes with it, mark and pca mm-hmm. <affirmative>, those are still hard to come by. We have had to, from our typical vendors, we have had to find vendors out in smaller pharmaceutical companies out in California. There are some in Montana and Wyoming that are shipping to some of our smaller clients here in the south in Alabama. Um, but also two I would say is ibuprofen and acetaminophen. Hmm. Um, that has been very, very hard to come by.
Speaker 1 00:14:47 Wow. Uh, tho those are, we think of those are just, just kind of regular stock items. Shelf, yeah. Mm-hmm. <affirmative>. Mm-hmm. <affirmative>. Yep. Um, you mentioned working with the physicians. Uh, again, uh, it's the communication pieces. There you actually are client facing. You go to a physician's office to their practices and such. We've got some clients that where you meet with them on a regular basis, uh, to report. What are some things that you, or tools that you use, uh, to communicate this purchasing the expense side of, of the business? So maybe we, we might have a, a physician listening today that's wanting to start their business, uh, or go out on their own, or maybe they want to enhance some of the information flow. What are some of those tools that you use to communicate what the expenses are, uh, for that particular reporting period Mostly, or usually a month? Um, so kind of give us a little flavor or insight into those discussions you have with, with those physicians.
Speaker 2 00:16:03 I would definitely say when communicating with the physicians that I have built relationships with over the years, transparency and constant communication have been the number one tool. Um, offering quarterly updates on items that they order all the time, um, is a big factor because that builds their trust. They know that, okay, although I order this item every week, you are still getting the best price. Not just because you're comfortable with one vendor, but you are re you are researching and keeping up with the latest market trends. And that helps that not only establishes the relationship with them, but it helps them trust that you are taking care of their money and still trying to find them the best deal possible, even when they're not mentioning it.
Speaker 1 00:16:58 And if they see on a transaction list, uh, that there's x, y, Z vendor, well, I've never recognized that one. You gotta be prepared with maybe invoices and such. Remember, that's the one we had to switch or we had to substitute with.
Speaker 2 00:17:16 Correct. And I mean, sometimes they, you have physicians who have, let's say they're wanting to, you're wanting to start somewhere new. Um, you're getting out of a hospital contract or you're just wanting to open your own practice and you have vendors that you've worked with in the past. Uh, we're always welcome to bring those on. But too, as a management company in mso, we are would also like to offer you kind of new ones that we see. And then that's where you can go and be transparent and be like, yes, I know you like this certain vendor with these odoscopes or this certain brand, but here's another one that is similar, but it's also gonna save you a few thousand dollars a year.
Speaker 1 00:17:58 Right. And we look for that group purchasing, correct. Organizations power, uh, those GPOs, uh, there are several out there and, and we, uh, we can work through those again to get the best, get the best pricing instead of just trying to do it all on your own. Uh, is that pretty intimidating to go meet with a group of business owners and physicians and such when they're, you've got expense that they're, uh, wanting to see how you're managing that for them?
Speaker 2 00:18:30 It can be. I think if you go into it as we treat our physicians money, like it is our own, it's not, um, it is more so, I mean, we are looking out for our clients mm-hmm. <affirmative>, we, and I think going into it, it's almost like exciting. It is. And it's, it can be challenging at times. Mm-hmm. <affirmative>, but I mean, going into it also too with it's, it's not even a negoti, it's not like a negotiation. Right. I mean, with vendors, at least for me and what I do with procurement, we're having to do contract negotiations. I mean, we are having to, I do price matching. So I mean, Amazon business offers price matching. So not only are you seeing, I mean, they offer transparent prices, but I, I mean, I have to negotiate with them mm-hmm. <affirmative> and be like, well, this is offered at Staples for $20. Right. You're offering it for 25, I'll, I'll pay $20. Right. And so I think going into it, I know that I've done what I can to save them the most money. And so most of the time, no, it's not intimidating. It's
Speaker 1 00:19:45 Exciting. Yeah. Good. Yeah. When you, I mean, you, you've lived it, you know it. And, uh, and they're expecting you to help them make through or think through the right decision process. Uh, that's a great asset and a great resource for them.
Speaker 2 00:20:00 And I think if I can save, I go into it. If I can save them $7, if I can save them 10 cents between each transaction mm-hmm. <affirmative>, that builds up over time. Yep. And so as much money as I can save them, that is my
Speaker 1 00:20:13 Ultimate goal. And I think a lot of people don't realize some of the compensation models and such that are built around these practices, these expenses, you know, there's the general expense where all the partners, uh, take, take that on and, and whatever the, the, uh, denominator is in how they divide that out. But some of these are then, uh, applied directly to, to that physician's, um, compensation mm-hmm. <affirmative> bonus, however you wanna say that. Uh, and, and it, it matters how you code that, how you track it, how you present that information. From a practice manager standpoint, it's very important to understand how your physicians are compensated and how that fits in and how they gotta work with the accountants to, to make sure that that's tracked properly.
Speaker 2 00:21:07 I agree. And I think tracking your overall expenses, I mean, even from the start of you're opening a new practice, or let's say you've had a practice for a few years, I highly suggest, I mean, going through and just looking at what you're spending and your expenses, because I mean, there's things that you wouldn't even realize that, I mean, are just stacking up over time. Right.
Speaker 1 00:21:34 And I think that's one of the things you do well, Shelby, is, uh, communicating and developing those relationships with those physicians on the front end, that they, if they've got a question, should I, is this a general, is it a, you know, a direct kind of expense? Um, how are some ways that they communicate with you, the, on the business owners, the practice managers, the physicians themselves, all the stakeholders as we would say? How, what are some ways that they communicate to you and some of the expectations you need to, to be able to, uh, track it properly?
Speaker 2 00:22:11 I have a, an open door policy. I mean, the email, text, call, um, at any time, some of the physicians that I have built stronger relationships with, I mean, it's a simple text. It's a, it's a simple call, um, in our meetings that we meet with them monthly. For some of my clients, it's mentioned then. But I think to kind of keep up with that communication, they, I mean, they just let me know.
Speaker 1 00:22:43 Yep. Just being open and available.
Speaker 2 00:22:46 Right. Being open and available. Yep. And I mean, they, even, I think the goal is you want to establish a relationship with your clients and the physicians that you're working with, so that they come to you and ask you questions. Right. And they trust your opinion. And that is the biggest thing, is trust with them.
Speaker 1 00:23:06 And you actually, uh, again, through the whole process that, uh, the, the just being available to take care of their needs, returns, things that don't work, broken equipment, working with the vendors, trying to be that, uh, time value of money situation where you can be doing that while the provider is actually yes. Taking care of patients and,
Speaker 2 00:23:34 And anticipating their needs and their future. A need that great point. Needs is very important also.
Speaker 1 00:23:40 Well, Shelby, thank you for bringing us a fresh thought, uh, today. And again, we hope that some of these items, uh, uh, can, can help those, uh, out there in the practices. Uh, again, the physicians who may need to be thinking through how the process is done, it's not just running off to some, uh, big box or whatever, or using the same vendor over and over again. Uh, can, can bring value to, to their businesses. The owner of the practice managers, everyone that's involved, as I said, the stakeholders. So again, we, uh, as we close today's revenue radio, uh, my name's Jeff Dance. I'm your host, uh, also the executive director at, uh, K H s Kassouf Healthcare Solutions, uh, where we, along with, uh, KAUSE Power this, uh, this podcast for you, that we can always bring you valuable information that will help to enhance your business of medicine. Thank you. And we'll see you next time.
