CG Moneta Q&A
General Information and Process
What is your close ratio?
It takes longer for hospitals, depending on levels of bureaucracy. It’s easier for organizations under $100M in revenue, with a 70-90% close rate.
What is the security surrounding the billing records needed to perform the review?
We do not access a client’s EMR or software. The ERA 835/837 is transferred in x12 5010 format from the clearinghouse to ADHC’s portal via SFTP.
What is the protocol for finding prospects and turning them over to the company?
Submit the opportunity into the ALPS Portal, and follow the Solution Registration instructions once it is ALPS Approved.
Objections and Client Concerns
What pushbacks or objections do you hear?
Some don’t understand the technology/process or think they already have it covered. It’s important to point out that this is a new, one-off audit. The CFO is the best introduction, as the CRO might look bad if there’s money on the table.
Do clients push this off with, “Sounds interesting, but we need to wait until next year”?
Sometimes. This usually happens if the hospital is undergoing an audit, or if it’s budget or tax time.
Are clients concerned about sharing the needed information to get started?
No.
Can you provide information or scripting to overcome frequent objections?
Yes. I have internal collateral with talking points and scripting to help overcome objections.
Objection: Our contracts are “per diem” and our payor mix skews toward Medicaid, so this wouldn’t be relevant.
Client and Prospective Client Details
Who are your biggest and smallest clients?
Our clients range from Children’s Hospitals to a $15M hospital in Flint, Michigan.
What organization types are your ideal clients?
Hospitals, large physician groups, surgical centers, and urgent care facilities.
What organization types have you had the most success converting?
Surgical centers.
What organization types are not a good fit?
Anesthesiologists, OBGYNs, and dentists. We qualify clients based on volume and variability, with an annual revenue of $50M+ being ideal (though we can audit facilities with $10M+). More CPT code variability improves results.
Service Performance and Results
“We find money 100% of the time.” How long does it take for the client to receive their portion of the refund?
Revenue is received in 2-3 months, with payments made in 6-7 months.
How long does it take for the company and representatives to receive their portion of the refund/revenue?
1 month after the client receives their portion.
What data or facts can we quote when meeting with a prospect?
Our average recovery rate is 10%-20%, with 10% being the lowest we’ve seen over the last 15 years. We’ve found revenue in nearly 100% of our
engagements, and the audit is contingency-based, so there’s no upfront fee or financial risk.
How long will underpayment refunds continue to be discovered?
Forever.
Client Continuation and Referrals
Do clients continue to use the services in subsequent years?
Yes, 95% of clients continue leveraging the services.
Are clients willing to refer you to other healthcare organizations?
Yes.
Logistics and Decision-Making
Who is the most effective person to approach in a healthcare organization?
The CFO.
Does the decision-maker vary by the size of the organization?
Yes, it can be the board, CFO, or general counsel, depending on the size.
Does the decision require board approval/executive team approval? Who has the final sign-off?
It depends on the facility. Hospitals typically require multiple levels of approval, while surgical centers and similar facilities may have partners or owners who can approve quickly.
Sales and Marketing
How many representatives or sales organizations are marketing and selling this?
Three companies act as distributors.
Other
Does the conversion timeline vary by the size of the healthcare organization?
Greatly, depending on how many departments the process must go through.
When would we face capacity issues if prospect flow increased significantly?
We currently have 30%-40% excess capacity. This is reviewed consistently, and ADHC is always actively hiring to ensure capacity is not a concern.
Does this work outside of the US?
No.
How many total clients do you have?
ADHC is close to 500.
Who would not be a good fit for this service?
OBGYNs, dentists, and orthodontists are too specialized. We look for variability in billing codes.
How long is my lead protected?
The deal is protected for 30 days upon ADHC submission to schedule due diligence meeting.
Once the due diligence meeting happens, the opportunity is protected indefinitely.
