Ep. 170: Fixing the Revenue Cycle: AI’s Role in Urgent Care Billing & Automation - Interview with Ayo Omojola from Substrate AI
About this Episode
Nick sits down with Ayo Omojola, founder and CEO of Substrate AI, to discuss how AI is transforming revenue cycle management for urgent care clinics. Ayo shares insights from his experience at Carbon Health, where he helped scale operations using AI-driven automation, and explains how Substrate AI is eliminating tedious, repetitive billing tasks to help clinics get paid faster and more efficiently. They dive into the challenges of healthcare billing, the slow adoption of AI in the industry, and the future of automation in clinic operations. If you’re looking for ways to streamline your revenue cycle and cut unnecessary costs, this episode is a must-listen!
Book a demo with Ayo at Substrate.cc and see how AI can optimize your urgent care’s financial performance.
Topics Covered
- AI is transforming healthcare by automating repetitive tasks and streamlining operations.
- Substrate AI improves revenue cycle management, helping clinics get paid faster.
- AI enhances efficiency while allowing staff to focus on higher-value tasks.
- Payers often create friction to avoid payments, leading to unpaid claims.
- AI tools can automate claims processing and reduce administrative burdens.
- Scribes and AI-driven audits improve documentation and compliance.
- Human interaction remains crucial despite AI advancements in healthcare.
- The future of healthcare will increasingly rely on AI to improve patient outcomes.
- Substrate AI helps clinics save money, boost efficiency, and optimize workflows.
"If you have billers who work for you, we will save you money. Our goal is to eliminate the tedious, repetitive tasks so your team can focus on what really matters—delivering quality care."
Ayo Omojola, Substrate AI
About Ayo:
Ayo Omojola is founder & CEO at Substrate AI. Substrate helps providers and practices get paid what they've earned, utilizing AI to automate key, tedious processes in revenue cycle.
Previously, Mr. Omojola was the Chief Product Officer of Carbon Health, a technology enabled primary care and urgent care provider, where he helped grow the company 20x in 3 years. Before that, Mr Omojola was the founding product lead on the banking team for Cash App at Square. He co- created the Cash Card and scaled it as one of the fastest growing card programs in history, and a nine-figure revenue line for Cash App (and one of Square’s fastest growing products). Before Cash App, he founded Hipmob (YCombinator W12). Hipmob’s in-app messaging solution was used by leading companies like Rackspace and Samsung SmartThings. As founder/CEO, he built and scaled Hipmob across product, design, sales & marketing. Hipmob was acquired by Conversocial.com in 2017.
Connect with Ayo:
https://ayokunle.substack.com/
PCMP (00:00)
What's going on everybody? Nick is here with you on Walk-Ins Welcome. Excited to have another episode. I say Nick is with you because Michael is not. He had to take a personal day today, but I am excited to bring a guest with us to do today is Ayo Amajola. I'll get to that in a minute, but as always on the Walk-Ins Welcome podcast, we're here to help you get more patients, deliver better care, get repeat visits and scale your clinics. We have been on an AI journey together and I am so psyched to have Ayo with us. Let me do a quick introduction here. So,
Ayo Omojola (00:00)
you
you
PCMP (00:30)
IO is the founder and CEO of Substrate AI. It's a company that uses AI to automate revenue cycle management for healthcare providers, just like your urgent care. IO has a deep background in healthcare technology, AI and finance automation. And I'll get to that in a second because he's done some cool stuff like Square, Cash App, those kinds of things. But before he was with Substrate and founding that company, he was the chief product officer at Carbon Health. And I believe, IO, correct
Ayo Omojola (00:30)
you
PCMP (00:57)
me if I'm wrong,
You 20x that company in the seat that you held. That's just nuts. We're going to get into that for sure.
Ayo Omojola (01:04)
Yeah, you're
not wrong and you know, take some villages when I say.
PCMP (01:09)
I love it. So the expertise though, it spans from AI driven automation into FinTech into healthcare operations. I mean, this guy is the go-to in healthcare AI. So excited to welcome you to the podcast. Ayo, say hello to the Walk-Ins Welcome audience and tell us one thing about you that no one else knows.
Ayo Omojola (01:28)
Thanks, Nick, for having me. I'm super, super stoked to be here. One thing about myself that no one knows for the audience, I didn't really have time to prepare for this question. So I'm just going to use one that comes to top of mind. So when I was 25 in a previous life, I went traveling around the world with my best friend and we spent a month on a cargo ship going from Singapore to Brazil.
PCMP (01:31)
Absolutely.
You spent a month on a cargo ship from Singapore to Brazil. I'm trying to imagine.
Ayo Omojola (01:59)
We did. We were in stowaways. We
were not stowaways, but we were on the, we were on the cargo ship.
PCMP (02:04)
I immediately went to Stow-Away. have to be honest with you. all right. y'all were passengers, like meant to be there, passengers. So I bet you have all kinds of stories you could share there. What in the world were you doing on a boat out going to Brazil in the middle of the ocean on a cargo ship? What were you doing? Were you working?
Ayo Omojola (02:09)
Yeah
Yeah, yeah.
No, it was mostly I was reading and I watched seasons one and season two of The Office.
PCMP (02:30)
I mean, like, I really honestly, if I could just get away from here for a month and just watch the office, that's a win to me. Who's your favorite character?
Ayo Omojola (02:37)
It was great. Like what's not to like?
The Steve Carroll guy.
PCMP (02:42)
Okay, yeah, I don't blame you for that. Yep.
Ayo Omojola (02:44)
Also remember
this is almost 20 years ago.
PCMP (02:48)
No, no, no. I get that. Like I'm I'm a Dwight Schrute fan. He keeps the thing rolling for me. So I'm a big fan of that. I love it, man. Well, listen, bro, seriously, thank you for coming on the podcast. You and I met at the Merchant Medicine Symposium and the reason I wanted to have you on the podcast. and I know you'll recall this. You were a featured speaker and AI came into the conversation.
Ayo Omojola (02:53)
Yeah.
you
PCMP (03:11)
And it was almost like a completely foreign language to all these urgent cares. And these are like the top brass of urgent cares in the room. Right. And I can't remember if it was you. I think it was you. Somebody said, who's heard of chat GPT or, and like nobody raised their hand, hundreds of people in the room. I'm going, man, that's been out for like two years. It just set that up for a second. I got to know from your perspective, what it was like being an AI guru, talking to people who had no clue what AI was.
Ayo Omojola (03:15)
you
Yeah. Yeah.
Yeah, I wouldn't call myself an AI guru, well, I'll take it. So I would say that was a seminal moment for me actually, because prior to that, I kind of had this perspective that like, you know, just playing it back, carbon,
PCMP (03:43)
I do. It's good. We're giving you the title for this podcast. There you go.
Ayo Omojola (04:06)
I think today something like 90 % of carbon's visits utilize an AI scribe that we built. It's just been a game changer for the business. And so I'd like been living that life and watching that thing grow for a long time and kind of expected that everybody else had that thing. And so I think that the question I asked was how many people here have used AI, for example, an AI scribe in their practice.
or have somebody have a provider in their practice using AI. And I think it was 150 people and maybe two people raised their hands. And that just convinced me that it was so early. It took me like a week for it to sink in, but I went from thinking, man, like everybody's using AI already and we need to build these like really best things. after that interaction, I kind of changed my perspective to...
PCMP (04:46)
Yeah.
Ayo Omojola (05:05)
Wow, there's so much more leverage that providers can get if they adopt these tools and they just haven't yet. just, I think most people just don't know even what's possible.
PCMP (05:16)
Right. Right. I mean, it's unreal because it's not like that was years ago. That was just several months ago. I know. was just like, and I'm going, I'm in a room full of people. I use AI every day, not sometimes, like every day. And these guys don't even know what it is. So, well, look, you answered the call. You've come up with Substrate AI.
Ayo Omojola (05:23)
Yeah, that was like three or four months ago, yeah.
PCMP (05:40)
So something tells me you had already been boiling over this or already developing this and it was already a thing, but that had to have been just like a linchpin. I've got to do this. Clearly there's a market. So tell me about Substrate AI. What is it and what problem are you solving with it?
Ayo Omojola (05:51)
Hmm.
Yeah, so the way that I would describe it is substrate is building browser based AI agents for healthcare, starting with revenue cycle. Zooming out of the buzzwords, what it really means is in every practice, there's a bunch of people who there's a bunch of employees who a large proportion of their jobs is clicking buttons. And, you know, the examples I would give are
You know, if you do testing and you're updating your clear licenses, if you have somebody in your practice who works denials and they log into payer portals and they go into your practice management system and they download patient records and they look at them and they go back into the payer portal and they file appeals, payment posting is another big use case that we're going after where like a person is looking at ERAs and manually entering the amounts for each code on the claim.
Um, uh, checking eligibility. You can think of it as everything that happens in a keyboard. We believe that you can use large language models to automate. There's a lot of work in what I would describe as healthcare back office where you have to like, you just have to pick a phone and call somebody. have to pick a phone and call a payer. You have to create like an appeal letter. That's a giant document and it has to be very specific. Um, so we're not really going after those things.
But if it is, you know, repetitive click work in the browser, we do that. That is our thing. and so, just to make it really, really tactical, an example, we have one very large client, that has a few hundred, back office employees, and they had a team working on, on claim status and denial. just,
checking what has happened with this claim since we submitted the We 10 people on that workflow and it was just a lot of copy paste. It really, really repetitive, tedious work. And that team of 10 was able to do five to seven K claims a week.
PCMP (08:17)
Oh, wow. So 10 people are punching out 5,000 to 7,000 different claims.
Ayo Omojola (08:24)
Every week. Yeah. and so we came in, help build some automations for them. And again, it was all browser-based. was very easy. There's not a lot of integration. All we need is a login. And we, now they have zero people working on that and they're, they're doing about 60 K a week. So they've dramatically flattened, the amount of people that spend time on this thing.
and expanded how many they're able to do. And so that's just an example of the kind of thing that we are trying to do. It's very early, there's a lot of work to do still. I think there's so much opportunity, but at the end of the day, our North Star is we want to help providers get paid. there are many steps to doing that. But in our opinion, the first step is let's just get rid of some of this repetitive grunt work.
so that the people on your team can focus on things that really are complicated and require like a lot of attention.
PCMP (09:28)
I love it. So we spent so much time on this podcast talking about how AI is making healthcare more human, which is great. And we want that. But what this is doing is allowing the more technical side of the business to become more streamlined. I mean, you went from five people down to zero people and you went from seven to what now?
Ayo Omojola (09:33)
Okay.
10 to 0.
10 people to 0 people.
PCMP (09:52)
Sorry, I wrote down, I'm going off my notes. I wrote it wrong. 10 people down to zero people. That's 10 different payrolls or 10 people repurposed into doing higher level work.
Ayo Omojola (09:55)
Yeah.
Yeah, yeah. And I think ultimately what should happen is, and what happened in the specific cases, they just moved those people for like other things. Cause there's just so many, you know, if you look under the hood at most practices and this practice at larger, it's so complicated. You're in multiple states. There's so many sort of people you have to deal with and process and policies that you have to adhere to. And I think some of those things are just always going to be human.
PCMP (10:21)
Mm-hmm.
Ayo Omojola (10:31)
actually. And so our job, our objective isn't, hey, you're to fire all these people. But like most practices at scale, they struggle to hire, they struggle to fill these roles. And if we can take people who have a lot of context and knowledge about your practice, and allow them to do higher leverage things for you, and we can do these basic things, we think that's just, you know, everybody wins. And at the end of the day, you're saving money on a headcount, and you're getting paid more, and you're getting paid faster. Like, who doesn't want that?
PCMP (11:01)
No, I think everybody wants that. I wonder at what point it'll cross the line as far as like, instead of repurposing people, know, I owe the average entrepreneur, the average business owner, you know, they're looking to maximize their investment and cut their costs, right? So I think in addition to automating the problems that our urgent care clinics face every single day,
Ayo Omojola (11:09)
you
PCMP (11:29)
is finding ways to repurpose the people who were doing the task. I think there needs to be just as much focus. And again, I don't know how you feel about this, just as much focus on how can we help transition these people where they're still good team members, good employees, adding real value to our patients. That's going to be a challenge, I think, in the future.
Ayo Omojola (11:30)
you
those things. Yeah.
Yeah. So to be honest, I don't think that's going to be as much of a challenge as we think. So one of things that we found at Carbon is, and this may have just been a function of our approach and I could totally be wrong about this, but almost all the ways that we deployed AI helped increase quality. So we deployed an AI scribe, it's used in sort of 80 or 90 % of visits. What ends up happening is,
PCMP (11:54)
Okay.
Ayo Omojola (12:18)
the provider gets to put the iPad next to them and talk to the patient. so NPS is higher, like the provider is like much more attentive. They're much more descriptive and what ends up, you know, the way these ascribes, the feed, they're, they really leverage the provider's thought process. So the provider has to like say more words actually to make sure the algorithm is doing its thing. But the side benefit of that is now they're explaining the rationale for the patient. Do you know what mean? So it's just like,
PCMP (12:22)
Yes.
Yeah.
Ayo Omojola (12:47)
The quality and density improves. One of the other sort of surprising examples, we spent a bunch of time, me and at the time he was our CEO, but he's currently CEO, Karam, spent a bunch of time listening to patient phone calls. So just like a patient calls in, they leave voicemails, sometimes gets answered, we recorded all those and we listened to those. And we kind of realized that in a lot of cases,
PCMP (13:06)
Mm.
Ayo Omojola (13:16)
a patient's calling and they're asking about, do you take my insurance? And we look at that as that person wants to come in and see you actually. And they just need some clarity about like, I going to the right place? They want to see if it's all just a drive. And it turned out that, I want to say something like 30 % of calls had real intent. Like that patient wanted to come see you that day.
PCMP (13:41)
Hmm.
Ayo Omojola (13:43)
everybody who listens to the podcast will know that urgent care is very, you know, last minute. It's a lot, a lot of your, I mean, this podcast is really called Walk-Ins Welcome. And so, so we created a process where all of that information, we would have an AI listen to call, summarize it, extract if that person intended to come in, extract like a couple of other, other, other things, try and match the patient with a patient in our system.
PCMP (13:51)
That's it, welcome on in.
Ayo Omojola (14:12)
And we we service that to the clinic managers who would then call the patient to try and get them to come in to basically try and answer their question.
The last I heard, we had something like a 95 % conversion rate on those patients calling in. Like it was crazy. And we're able to do that and drive top line without any reduction that had a real increase in quality. Cause that patient really like they got to talk to a human who was really knowledgeable was trying to be like, Hey, yes, come in today. And it also had other benefits. Like you realized in certain areas we weren't
PCMP (14:32)
Wow. Yeah.
Ayo Omojola (14:53)
doing a good job of communicating prescriptions to pharmacies, so we're getting a lot of pharmacy calls. So like there's all these things that become possible when you have like a human level of intelligence paying attention to your system and you're applying it in these strategic ways.
PCMP (15:12)
So I like this idea of using the AI more in a support role and letting the human aspect be the heavy lifting piece of it. So it's.
Ayo Omojola (15:14)
you
Yeah, yeah, yeah, I
think I do. do think and you made this comment that stuck with me around. You have good team members who are committed and.
you know, the healing process starts the moment a patient walks in the door. so having, having somebody at the front desk who is attentive and not harried and not bored, um, uh, who has like technology doing a bunch of what really are tedious things that should be handled by technology. Uh, that I'd like literally everybody was like, you're to keep your staff longer. You're to have less turnover. Patients are going to be happier. Um,
I can't think of a reason why you wouldn't do that, actually.
PCMP (16:04)
You know, it's funny that you mentioned that about the front desk, people that are engaged, people that care that you're there. Healing starts when you walk in the door. I love that. That is, you'd be a whole episode. As matter of fact, I may save that for later, just to be honest with you. But it reminds me of a story I've told before, but it's been a long time since I've told it. When I was in college, I went to an urgent care and there was this, to me was old. I was 20 at the time. So, you know, she probably wasn't that old, but you know.
But anyway, I remember when I was checking out, here I am 20 and she hands me a sucker and I'm like, what's this for? She goes, everybody needs to feel like an eight year old kid when they feel bad. And I'm like, man, that's, that's right. Like I do want to feel that way. You're right. Take care of me. know, no, no, you can't, but it did remind me of that. Like that, that healing starts at the door. Well, I mean,
Ayo Omojola (16:42)
Yeah. Yeah.
And AI can't do that. You can't technology that.
PCMP (16:59)
human to be human is to heal and to harm if you're not careful, but definitely to heal, right? Be careful with that as well. Something that you mentioned is that I want to talk a little bit about substrate for a second. I know we've talked about it a little bit, but I like the way you worded it. You said it's fixing the revenue cycle, right? Which automatically implies that it's broken. So let's talk about that. Why is it broken? And how is, how is a substrate AI
Ayo Omojola (17:02)
Yeah.
Yeah, yeah, yeah, well said.
PCMP (17:29)
Fill it in that gap and fixing it.
Ayo Omojola (17:32)
Do you have three hours?
PCMP (17:34)
I
do, but our listeners don't.
Ayo Omojola (17:37)
Yeah, yeah.
I think revenue cycles broke up for so many reasons. And this isn't an original thought, but I think it really rings true, which is you can explain 99 % of the things that happen in revenue cycle with one insight, which is the payers don't want to pay providers. And I think that's like a cynical perspective, but it is really hard to look at the facts on the ground and not think it's true.
PCMP (17:58)
There it is.
Mm-hmm.
Ayo Omojola (18:10)
I'll give a couple of examples. So for our clients, we do a lot of appeals. Medical record requests are a common one.
A frequent denial reason is a, you know, claim was denied for medical necessity. Please submit, you know, medical records and prior authorization. but the practice author, they did a prior author for the, so you, like the payer has it already. So the payer knows like the mayor, know, sometimes it was like the prior author has done like that day to like that, that service.
PCMP (18:47)
Right.
Ayo Omojola (18:55)
and so I think of that as like, you know, pessimistically, it kind of looks like the payers just throwing up friction and roadblocks, to force the provider to staff, to force the practice, to staff humans, and just eventually miss them. and, and in that world, you know, another, another thing that supports the idea of the payers don't want to pay you is.
that if I as a patient walk in the door, I get care, the practice admits the claim, the practice doesn't get paid, the payer actually has the best of all worlds. Their member is better. They got the care they need. The payer got the data because it all came in the claim and the payer didn't pay anyway. So they got free care, they got all the data they need, they know what was done during the visit. So I sell that to say,
PCMP (19:44)
I
Ayo Omojola (19:54)
You know, it sure does seem like payers don't want to pay. I can share like five or six more examples. There are crazy things that happen when you like go down this rabbit hole where like, you know, one of my favorite examples from a couple days ago is if you go into a payer portal and you look up, you know, like, just use the blues, for example, and you look up a claim.
The information available to you about what happened with that claim is different. If you do the lookup by patient demographics, so like name, of birth, patient ID, versus if you look up the claim by claim number. Like crazy, really, really crazy, crazy things. And I just don't know what rational, I cannot come up with a reason why you would design it that way. Because now what's happened is,
PCMP (20:37)
That's crazy.
Ayo Omojola (20:48)
Like, you know, for a lot, like this is a recent insight for me. So I didn't know this, but I'm just thinking of all the billers throughout history who've like showed up at a claim and thought the claim was denied for one reason when it was denied for another reason. You know what I mean? And that's like, like every single, everybody listening on this call, everybody they know has had a doctor's visit.
PCMP (21:09)
No, I know exactly what you mean.
Ayo Omojola (21:18)
over the course of their life where this happened, where like the claim was denied and somebody went and looked and like couldn't figure it out. And the, you know, practice ultimately ended up not getting paid. And I think it's just the same. So I think there are many reasons why it's broken and there's lots of evidence. It is, it does kind of feel.
PCMP (21:20)
Mm-hmm.
It's sinister, man, it is sinister. There's no nice way to say it.
It is. remember one of my favorite movies is the Incredibles. Have you seen it? So Mr. Incredible live in his boring insurance life and the little old lady sitting across the desk, you're denying my claim. And then he's like, yes, but I'm covered. Okay. I can't tell you to go to this person at this place and fill out this form and turn it in on this color sheet. And I can't help, but think that your software does this
Ayo Omojola (21:50)
Yeah.
You
PCMP (22:07)
for you. Like that's what it does.
It's like, it's like right when it fires back denied claim, goes and instead of looking it up by the patient, it looks up by the claim number and then fixes it and grabs it. does all these things. That's a thousand clicks and here it does it in seconds. And that in my opinion is where substrate just shines, right?
Ayo Omojola (22:28)
Yep. Yep. Yep. Yep. Yep. So, so just closing the loop. So, a big part of our hypothesis and, know, we're still early in this. We've only done a couple of things that we ultimately think we can do is, we just don't think that your staff should have to deal with this. They just shouldn't. and so, so ultimately in all these flows, eligibility, charge entry, denials, payment posting,
Um, overpayments, like the fact that the fact that you get a letter, a physical letter that someone has to like, go read and say, they're going to take money from this visit that happened nine months ago. Uh, I just, we just, I just don't think people should have to deal with that actually.
PCMP (23:00)
Mm-hmm.
Well, I mean, look, I'm not trying to be insensitive here and I'm not trying to blame a person, but when a CEO of a major insurance company gets murdered in the street and just like plain sight and people don't immediately go, my God, that's terrible. They sit back and go, Hmm. Like that. mean, sucks for you dude. Like, and I don't feel that way, but what I'm saying though is like, it's so broken.
that people are justifying murder because that's how broken it is. Right? So I'm not, I'm not justifying that. What I'm just simply saying is, like, people have been abused by their insurance companies. Clinics have been abused by the insurance companies for so long that they're justifying this stuff. And it's really nice to see a solution that's going to connect all those dots and really just kind of fight for your clinic. I feel like it's going to battle for you, you know?
Ayo Omojola (23:46)
Yeah.
at the Coscos.
Yeah.
that like we really do think of ourselves as if we win in order for us to be successful, providers will get paid and that's like the job actually. And I think there's a version of this, this is like many years away, but I outlined the pessimistic case that payers just don't want pay you. think optimistically, think like payers are also large, very disorganized entities.
where like one hand doesn't talk to the other. And so this is going down a tangent a little bit, but I think this is important. It's an important question people ask all the time, which is if we're successful, ultimately, know, payers do view this as a zero sum game and they will fight back. And so I think at scale, the thing that we are going to try to do is give very similar tools to payers actually to help them
PCMP (25:01)
Right.
Ayo Omojola (25:12)
actually create more money that can go to paying for care. So like, if you don't have to pay for all this headcount to do these things, actually, all of a sudden, there's like more of a pool of money that can go to pay for patient care. And I think that's how we make the pie bigger. The way we make the pie bigger is, hey, as a payer, you should instantly tell a provider whether or not they're going to get paid. So they should have that confidence. And you should give them instant responses about claims that you submit. And
And you shouldn't have hundreds of thousands of in India, Guatemala, the Philippines, physically looking at these things. You should have a system that does it automatically, and you should spend that money on the care of them.
PCMP (25:55)
So what you're saying, I'm hearing this the right way is the insurance companies are going to make the profit that they're going to make to satisfy their shareholders. And in order for them to do that, because they're not going to change in that mindset, then we have to find a way to feed the beast in such a way that it doesn't mind sharing its food with the urgent care clinics. So like we need to free up some of their money in other areas in their own businesses so that when they are paying the claims that they're responsible for paying,
they can still make the profits and targets that they're trying to hit. And then that could, at the end of the day, it's still greedy, but at the same time, it's also like it's serving a purpose for everybody, not just for them.
Ayo Omojola (26:40)
I think that's a good way to put it. think, you know, barring like neither you nor I are going to like run for office. So, and I think barring like a change in the structure of how healthcare is paid for, like if you believe that the way healthcare is paid for is going to remain the same for like the next couple of decades, then we kind of have to, I don't see another way. And, and the thing that I would hate is I hate the idea that
PCMP (27:02)
Yeah.
Ayo Omojola (27:09)
Like, we, you know, no, no startup can fix if payers don't want to pay you if it's like an actual malice thing. But I hate the idea that like some of the reason that your care or my care might own my mom's care might not get paid for is just because a pair was inefficient. That feels crazy to me. Like, why would you want that?
PCMP (27:31)
Yeah, no, you're right. I mean, if you clean up the inefficiencies, I think there'll be a season in all honesty, this is the cynic in me and I don't mean to be this way, but I know what will happen in this scenario is there'll be a season where something like that would clean up those profits so that they can pay and then they'll find creative ways to not pay again. And I don't mean to be cynical like that. It's just been what's happened. Right?
Ayo Omojola (27:39)
Yep.
Yeah. Yeah.
Yeah, yeah, yeah, I
don't think I don't think it's that cynical. think it's a real thing. The one the one caveat and I'll let this go. Payers are regulatory constrained and how much profit they can make through sort of medical loss ratios and so on. And so I do think actually there is some there is just like a lower bound where like a payer can't just have like 50 % margin on premium. They're like literally not allowed. And so a lot of what I'm thinking of is, is if you can
PCMP (28:22)
Right. Right.
Ayo Omojola (28:28)
use software to eat the operating expenses, that extra surplus, some of it the payer is going to eat, like they just are, because like we live in a capitalist society, but some of the payers and payout providers and, and I would rather live in that world than live in a world where there's like, there's, there's somebody out of practice, like clicking buttons to get claims paid. And then somebody at a payer clicking buttons to deny those claims.
PCMP (28:34)
Yep. Yeah.
Right.
mean, you kind of feel like they're sitting back to back though, right? Or like they're across the screen from each other and go, Hey, I'm about to send one to you. Can you go ahead and deny that? It's approved, but I need you to deny it. No, I don't want to live in that world either, man. I hope that doesn't happen, but that does bring up the future of AI and healthcare. So let's go down that rate. We're running out of time because I'm having such a good time talking to you, but we see a slow adoption rate.
Ayo Omojola (28:59)
Yeah, yeah, yeah.
Yeah.
Yeah.
PCMP (29:22)
in the healthcare industry, but it's coming. We're going to see it. So what do you see? I mean, what do you see with the revenue cycle? How it's managing clinics? What's changing in the industry? Where is AI having an impact in healthcare?
Ayo Omojola (29:32)
Yeah.
Yeah. We're so going to run out of time because I have so many examples. But so the very obvious one is the scribes. There are just like a lot of scribes out there. They're partnering with everyone. And I think as a practice,
PCMP (29:42)
Do it.
Ayo Omojola (29:55)
You know, I think I said this at the conference, you just have to try it. They're not all perfect. They're not all exactly the same, but the reality is they're like, most of them are mostly good enough that some of the time you will, it will save you the carpal tunnel of typing out, you know, hundreds of characters, as a prac, as a provider and as a practice. think they also, you know, as a provider, you have to, you do have to change how you.
conduct visit, like you have to be a lot more vocal about what you're saying or what you're doing and what you're thinking about. But one of the effects we found was our documentation at Carmel was just way more complete as a Like there's just a lot more context in there than what was available when a doctor was just typing out notes. So I think the scribes are a very obvious category that I think that is here to stay. And I wouldn't be surprised if a decade from now it would
You would almost look skeptically at someone who, at at a clinician who didn't use Scrum because they're just like, it's like a memory tool. Like why wouldn't you do this thing? So that's one. Um, there's a company I spent some time with and invested in called Charter Health. Uh, that I think is pretty interesting. Uh, Charter C H A R T A health. and they, they take pretty interesting tack.
PCMP (31:12)
spell that because I didn't hear you quite clear.
Okay.
Ayo Omojola (31:23)
where they go after audit. And so they say, hey, you have an audit program where somebody looks at visit notes and figures out the documentation, split CPT code, CPT codes, it coded at the right level and so on, and scores them. And then that feeds into a process of talking to providers. But you do that once a quarter for every provider. You only look at four or five visits per provider. You have a team doing it. And what they do is,
They, they take your process, they configure a large language model around it. And then they help you audit a hundred percent of your visits and they do it in real time. So you every day are like, Hey, you know, we did a thousand visits yesterday. D seven, we're out of compliance. And by the way, six of them were like this one provider. So I'm gonna talk to her.
PCMP (32:02)
That's cool.
Okay.
Ayo Omojola (32:17)
Uh, so I think that's an interesting one. And it dovetails into a bigger theme in my head. Where you, if you think of the concept of compliance and audits, it's historically been a sampling base. It's historically been, you sample some things on some kind of horizon. And I think what AI makes possible is you can audit everything and you can do it real time. And I, I do think like for, for, you know,
standard of care from our practice, actually think that's going to be a really transformational sort of movement. I spent some time in the last couple of days with a company doing model explainability. So, basically, if you have a clinical process that passes through a model, it basically, and it comes out with some result, it basically explains how it got there. And so, I think, again,
when I just think of the impact of my practice and reasoning and being able to surface that to a clinician group that, to a clinician that like, hey, there may be something that you missed about this visit, about this patient problem that the model was able to catch and that kind of improves center of care. And then the last example I will use is again, so this one is another company I invested in called
Recon Health. And what they do is use AI to read your contracts and extract all the structure out of your contract for you. So, for example, what's timely filing for Blue Cross versus United or Zetna? What payer policies do you have to adhere to? What are your contract rates for your, you know, MDs versus mid levels? They pull all those things out for you. And then they use
PCMP (33:50)
That's cool.
Ayo Omojola (34:12)
that to calculate underpayments. and so they help sort of with this revenue optimization problem where like you're, you've, you've negotiated this shiny new contract repair and they're just paying like two or three bucks less than your contractor rate consistently. and they're doing it over. Yeah, exactly. and, and they helped detect that for you. So, so like, I do think there's, there's.
PCMP (34:15)
cool.
Death by a thousand cuts.
Ayo Omojola (34:40)
there are things that are around sort of just improving the profile of a business by improving revenue or improving a head count. And then I think there are things that are around improving the just compliance footprint, just making sure that all care delivered is within the standard of care. And then I think there's, there's many, many tools that are around just improving the clinical like experience. like,
I think that just like literally makes a doctor's life better. Cause like a happier doctor who's less burned out, like who doesn't want that?
PCMP (35:17)
can tell you every patient wants that for sure, right?
Ayo Omojola (35:20)
Every
bitch wants that. Every time you walk through a doctor's office, the only thing you care about is that the number one thing that that doctor's thinking about is you.
PCMP (35:27)
right. And for the most part, they do a really good job. I don't want to sell our doctors short. I think for the most part, they do a really good job. It's when they're thinking about the 30 other things that aren't working well, mainly like I'm not getting paid for the work I'm Yeah. Yeah. Yeah. Cause at the urgent care level, they're business owners for the most part too. Right. mean, until you get into like a carbon health situation where, you know, at that point you're probably more of a corporate side of things, but
Ayo Omojola (35:37)
Yeah, they run a practice, somebody just quit. Like there's so many things.
Mm-hmm.
PCMP (35:53)
All right.
So we're at 35 minutes and I've had a blast and I feel like there's a hundred more questions down rabbit holes. We could go. I think we're going to have to do a follow-up episode in the near future for sure. And I'll reach out to you about that, but I can't thank you enough for coming on the podcast, but we, can't go without telling people to go to substrate.cc, not.com.CC. And we'll drop that in the show notes, but your main call to action is to book a demo. Right? So I want to take just a minute before we, before we go off.
Ayo Omojola (35:59)
Okay.
PCMP (36:23)
And I want you to tell us like, what can they expect in a demo?
Who are they going to talk to? What can they expect on there? Is this going to be like, you got to sign up or is this like, it, talk me through the process.
Ayo Omojola (36:35)
Yep. The demo is pretty simple. You're going to get on a Zoom call with me. And we're going to talk about your problems. How many people you have, how many claims you have, what are you doing with them, what are your major buckets of problems. And then I'm going to show you one of our agents working through a problem.
PCMP (36:39)
Okay.
Okay.
Ayo Omojola (36:56)
And then you'll be able to see it with your own eyes and decide for yourself if you want to try it. I think, you know, just my closing comment is...
If you have billers who work for you, we will save you money.
A lot depends on, know, some people have like really, really tightly run ships and, they're very efficient already. So maybe we'll save them less. and some people are, are, you know, less efficient, but we are going to save you money. Like I, that is like my, you know, promise.
PCMP (37:36)
All right. So that's it. Y'all, you're to get a demo. You're going to get to see how the software is going to work specifically for your clinic. And his guarantee is that he's going to save you money. And I love that. Awesome. Well, listen, you've been having a conversation with me and AO and IO, IO, going to say that right. And you just increase your average. you're the average of the people you hang out, you just increase your average. I want to encourage everybody to go find IO. We'll drop his LinkedIn.
and a link to the website and the show notes. And I want you to go connect with him because he's such a cool guy. I really enjoyed getting to specifically hear from you at the Merchant Medicine Symposium, but we sat down and we had lunch together too. And it was so cool, man. So I just appreciate you. Thank you for coming on the podcast. Thank you for adding value to all these urgent cares that are listening to man. And we hope to see you in the near future.
Ayo Omojola (38:26)
Thanks Nick, that is super kind, appreciate it. All right, bye, thank
PCMP (38:28)
We'll talk to you soon. Thanks.
