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Malcolm Lui:
Welcome to the High Value Sales Show of Eversprint.com. I'm Malcolm Lui, the Managing Member of Eversprint, and today we're speaking with Paresh Shah, the President of MindLeaf Technologies, a provider of compliance and revenue cycle solutions to healthcare organizations nationwide. Welcome to the show Paresh.

Paresh Shah:
Yeah. Thank you. Nice to meet nice media.

Malcolm Lui:
Paresh, you grew your company's revenue from $6.8 million in 2014 to $10.7 million in 2017, a 59% increase, and in 2018 you hit around $7.2 million. Before we talk about how you grew your company so rapidly over the 2014 to 2017 time period, can you briefly share what your company does beyond my quick intro, and how your company differs from the competition?

Paresh Shah:
Hi. Thanks a lot, Malcolm. Okay. Glad to be here at mainly. What we do is like me provide medical support, revenue cycle and compliance services to the providers. That is the physicians, the hospitals, the treatment facilities and the clinics basically work with the wider community. And we also work with large physician groups, how we default. We don't provide stopping people like much more than that. For example, if we had to do medical coding, we provide the process based on how the standards are required. The compliance is required. We let the processes to the particular facilities of our staff get totally thin and then we implement the solution. So we just don't go out. We can go it and get out. We just there we stayed there for one year to make sure that the processes are clean and definitely compliant and fully in support of the regulation and the revenue cycle and other compliance parameters which are there. And that's how we differ from the competition.

Malcolm Lui:
All right. And when you grow your company from six point eight million in 2014 to ten point seven million in 2017, what were the three biggest drivers of your sales growth during that time

Paresh Shah:
Well,

Malcolm Lui:
Period?

Paresh Shah:
A couple of things. Health care is kind of a different kind of animal. It is a very regulated, kind of regulated industry for the providers because they have so many regulations like you got to worry about hip hop onto worry about Corning's, got to worry about Mad Max. And then to complicate the effort to have electronic medical records, Cambridge creates a lot of documentation and everything. So understanding the physician bees. Understanding how the hospital works because every physician is different, every department within a hospital is different. Internal medicine much differently than a cardiology as well as their neurology. And then every hospital looks differently. And then you complicate the hospital how they're competing against other hospitals. So you could go and start at the ground roots level. And that's what we default. And that's what it was, because there was some critics. We understand how we how the workflow is at the roots level. And then we can expanded the department, at the hospital, at the clinic, at the hospital level, and then at that independent networks now. And that was the biggest. That was a public. We don't go top to bottom. We start from bottom and try to go up.

Malcolm Lui:
All right. So the driver is starting to bottom. Totally understanding the workflow and then expanding your influence, I suppose. Learning more about how they do their workflows and expanding from there.

Paresh Shah:
John?

Malcolm Lui:
All right. How about no drivers, number two and number three?

Paresh Shah:
That's the number one that's the biggest driver. The second thing is terrible. We always understand, like, you know, we have two sets of clients, the non government and the government clients. OK, we understand what the requirements are like from day one. What are the things to look for? What are the chief criteria? Like, you know, you've got to have everybody talks about. We have a great management skills. That is great. But what the management skills are supposed to do. What is their job? Is it the worry about the contract or is it to worry about the project management? So that's the second thing. What we look for is like, you know, do we cater to what the customer requires or we go once we had them, we tried to give them different solutions? No, we totally stripped totally state to what we know, OK. Like if the contract requirement is to do X, Y, Z, we will only work on X, Y, Z. Once we have finished X, Y, Z, then we start explaining, hey, we did X, Y, C, but these are the adage that, yes, you can take advantage. So we stick to project management, cost control, our staffing, our recruiting H.R. Then we can recruit in all 50 states all over the country because we have a very powerful agent engine, OK, a job platform. And the final thing was that that was number two is all the management skills, the process. H.R. cost control, project management. The final thing, the biggest and wonderful growth is having a good set of. Processes in place internally. OK. You can. You may have all those great things, but the most important things is how these internal growth of the company is. For example, what kind of stuff you have internally? We use automate a little bit of automation internally. We have a nice set up, a jar system, candidates election system. Okay. And then we also have a very good accounting system. And now we're trying to augment ourselves by getting a better accounting systems and doing all this business analytics. OK.

Malcolm Lui:
Uk.

Paresh Shah:
Is that your question, Michael?

Malcolm Lui:
Yeah, it does. So I guess the key to your really rapid growth this is being able to manage it, right? And

Paresh Shah:
The

Malcolm Lui:
Then

Paresh Shah:
Management,

Malcolm Lui:
You have about the.

Paresh Shah:
The management and the process associated. And then they did that process.

Malcolm Lui:
Right. All right. Got it. Now, your revenue took a bit of a dip from 2017, 2018 from ten point seven billion down to seven point two million. What happened there?

Paresh Shah:
Simple. I mean, a lot of what we had a lot of government contracts. We just got pushed back. So instead of starting on day one, it's got started then. Nineteen hundred and forty plus days, OK. And that was the main reason. And because of the lack of one of them did not even get started this year. So we saw last year was the transition year. This year is going to be a little bit condition, but beginning next year, we should be back to 22 to 15 million dollar range.

Malcolm Lui:
All right. Now, does that happen often with government contracts?

Paresh Shah:
It doesn't happen, but it does happen in a case.

Malcolm Lui:
Okay.

Paresh Shah:
I mean, it does happen often, but like, you know, it's like it happens eight out of 10 when we want to happen to be. I mean, it happens two out of ten. Nine. Eight out of ten. Two out of ten times. But this time we were one of those unlucky ones.

Malcolm Lui:
Right. Yeah. Sounds like the government's side, your business is quite substantial.

Paresh Shah:
Yes, it is substantial and we also are getting into New Age, which is outside the dormant.

Malcolm Lui:
Ok. What percentage of your revenue right now is on the government's side?

Paresh Shah:
We look up the goal is like, you know, until now it was like it started at nineteen ninety five hundred percent still years ago, reducing it by the end of this. And we plan to be like 80, 20, 80. GOLDMAN Twenty nine. Goldman next year could be 70, 30. The goal is to get 60, 40, 50, 55, 45.

Malcolm Lui:
Ok. When do you think you'll hit that target?

Paresh Shah:
The goal is to hit that target in 2021.

Malcolm Lui:
All right. Yeah. It's from my other conversations with other C suite folks. I mean, working for the government fantastic is a contract can be big and steady, but then it's also kind of a double edged sword, right? Because things can happen and you lose the contract and or you gets the firm and then you're kind of left hanging.

Paresh Shah:
Yep. I mean, that's part of the equation. I mean, you could. I mean, you could be able to weather the storm. OK. You going to have the processes, you've got to head the management, you've got to define names and you've got to have the internal processes to whether this done. This is kind of doesn't happen. I give an example. We had that Goldman set up in December and January. What can you do? You're not going to get paid. You can only offer and release Judas An. But those are part of the equation.

Malcolm Lui:
Yep. Yeah, for one of my my previous. Interviews that I had, they talked about the importance of winning the rebid. How does that work for you? A.

Paresh Shah:
I think we've been successful so far because don't forget the government health care exchanges. They were on a different electronic system and now they're moving to solo electronic medical records. Everything is changing along with that. And you've got to change along with.

Malcolm Lui:
Right.

Paresh Shah:
Ok.

Malcolm Lui:
What's.

Paresh Shah:
For example, if that implementing cylinder, they got to hit a hiccup, you kind of say don't all of the heat, the heat come through, it's going gonna affect a lot of side of the business. That is everything has to be part of the equation that he thinks like this aren't going to happen and we should be prepared for it.

Malcolm Lui:
Right. So what's your plan to grow the nongovernment side of your business?

Paresh Shah:
Ok. We had to do a medical scribing business. OK. We provide a total solution for the physician that is providing them all positions of physical Skype on the patient to text option as well as a virtual scribes. We will add and we provide a workflow, assistance and head and then Olympics. So that's the area we are going after. We hired a marketing guy to help us do a lot of inbound marketing. We are having a baby now about on the subject. We're having one baby not on 24 from Mass Health Data Consortium. OK, so we are doing a lot of things on marketing and trying to capture that business.

Malcolm Lui:
All right. And of getting your name out there, you know, what's your plan on using any outbound sort of marketing to let people know about your product and service?

Paresh Shah:
Given that we did a lot of inbound marketing, for example, we had we subscribe to HubSpot, one of my employee is a physician and seen a lot of papers which gets published in the national magazines like Becca Hospital Review, Physician's Advisor and, you know, Healthcare Financial Management Association newsletters. So this is one piece we are doing. We are doing all those sending out time. So we made quarterly newsletters, webinars. We'd be having one. So those are the kind of things we are doing. Plus, we are doing a lot of local shows and having an exhibit I mean, exhibit hall, an exhibit table exhibit both at the local events. So that's what we are doing outbound as well as embalming.

Malcolm Lui:
Right. How about in terms of advertising?

Paresh Shah:
We don't have them gone into advertising. We just want to get this part done. And off duty and then move on. I won't advertise.

Malcolm Lui:
Right. How many people do you market to right now? Through your email marketing?

Paresh Shah:
Viet Taguba, all of the physicians of the large groups, greater than 10 physicians plus small hospitals, a large hospital of approximately accountable physician group practice outpatient centers. OK. And bless all the community clinic, small hospitals, big hospitals. We're talking about 700 plus in the New England media.

Malcolm Lui:
Ok, 700 individuals.

Paresh Shah:
Yeah.

Malcolm Lui:
Now, when you say, you know, marketing, are these out cold email marketing, you talk about or team of people who came to your site and signed up, and now it's more

Paresh Shah:
We

Malcolm Lui:
About the.

Paresh Shah:
It. That's a good question. Malcolm Reese, we're doing a lot of cool marketing. And then are having a lot of people who always ask for more. So it's a combination of both. But right now, 90 percent of it is called marketing, sending out tons of e-mails. We had a one campaign which was in May under that campaign, which was a joke. Now we're going to July. We took a time off because of the vacation time. July and August. And we got to start the campaign beginning September.

Malcolm Lui:
Okay, so you're saying out emails that people who have never heard of you. I heard from you before.

Paresh Shah:
Yep. Email

Malcolm Lui:
All right.

Paresh Shah:
Is great. We also send out the. Email is one. Yes.

Malcolm Lui:
Yeah, because the physician market is a very difficult market. From what I hear. Because doctors one doctors are extremely busy and it's a lucrative market as well. So

Paresh Shah:
Yes.

Malcolm Lui:
It's you know, I from from what I hear, people have difficulty getting traction. How is the traction working for you and what are you doing? It's allowing that to happen.

Paresh Shah:
I agree with you. Getting the traction with the physician is extremely, extremely difficult to understand what we are trying to do. It is something what they want, but getting the meetings, getting things started and everything. It's not that easy. We are working with a client, the three hospital network. We thought we got the project, but everything is on hold because of so many other factors. So it takes a lot, lot longer. How do you get around it? You do just keep on hitting and hitting and heading that sort.

Malcolm Lui:
He. All right. It's fantastic to hear you're getting good results from your coding and marketing to the physicians.

Paresh Shah:
Yup.

Malcolm Lui:
Now, do you do cold calling as well?

Paresh Shah:
We don't. We are going to stop the cold calling. Beginning in August. OK. We have. And that's what we can start doing. Until now, it has been e mail. So now we're going to start calling. My physician is going to start sending all the e mails to those physicians because docs been applied automatically to a physician. E-mail them to my e-mail. OK.

Malcolm Lui:
Right. Right. Makes

Paresh Shah:
And

Malcolm Lui:
Sense.

Paresh Shah:
We're going to have a call calling by one person. But that is something which we are debating internally. If a person cold cause is a physician going to take the card

Malcolm Lui:
Right.

Paresh Shah:
Because one line physicians hate the salespeople.

Malcolm Lui:
Yeah, so when you go about initiating the cold calling process house, how's that going to work? You hire someone who's had success, cold calling physicians. Is that the right you're gonna take or were you perhaps experimented more or tried different processes and offerings before you find one that sticks and then scale that up?

Paresh Shah:
V. F right now. I don't have an answer to your question, but this of the different options, we are looking at it. We already have. One person was going to go to college. OK. We are also looking hiring one of those core calling companies.

Malcolm Lui:
Yet.

Paresh Shah:
Ok, so that's the second option. The third option is I'm a physician. Maybe she can call the physician. But the question is, physicians are busy from 730 to 4:00 in the afternoon for only five. So I came to call that.

Malcolm Lui:
Yeah. Yeah.

Paresh Shah:
So, I mean, we don't have an answer to that. We are just evaluating it internally. I'm having a meeting with my marketing people next week, Monday. Do you still watch? What's an option? Those are the three options we have. And we go with maybe a combination of all three or maybe.

Malcolm Lui:
Yeah. Yeah. I actually had a conversation with a colleague. And he he he kind of made a suggestion about how I should just hire someone to do my cold calling. I go, Yeah, I could do that. But, you know, since it seems like you need to have a process for them to follow, right. Otherwise, what are they going to do? Just calling you

Paresh Shah:
In.

Malcolm Lui:
At random.

Paresh Shah:
We also thought we also had a meeting with one of the sage consulting companies and they told us. That's what we do is we are talking to the physicians. Don't try to have rookie or a smart person who has never worked with the physicians school, got a doc. He says you'll be shut out of that place for Anwar. Because with opposition, it has to click in the first 10 seconds of 20 seconds.

Malcolm Lui:
Right. Yeah. People are pretty busy.

Paresh Shah:
Yeah.

Malcolm Lui:
I can hear that. I can totally understand that. So for the four for next year when things are picking up again. How does that work, DSK? Are you the scale of your team as needed? Or do you have the systems and processes in place that they can handle the additional workflow that you see coming down the pipe?

Paresh Shah:
Now, on the Goldman side, we have the process and the people in place to handle. OK, but up to 500 people, employees on the federal side, OK, on the non-government side, the whole process and people in place. I got bond in 2012 or 2013 when the government implemented ICD 10 medical coding. And when the Goldman kept on delaying it, being a small company, I had to digest the cost and lay off the people, which is not a nice thing to do. So this time I spent a lot of money to do the process in place. Just created totally a man. What we need what we don't need, hiring a lot of people who are independent. So when we need them, we call them, otherwise we don't call them. So that's the approach I'm taking. But I know that approach only lasts once I have a clear view that I'd be making one billion on this side. Then I get staff accordingly. OK,

Malcolm Lui:
Yet.

Paresh Shah:
So we have to proceed with caution. At the same time, get aggressive to.

Malcolm Lui:
Right. To a degree, can you automate the services that you provide?

Paresh Shah:
We can be automating so many things. For example, when we and see the thing is you can not automate the services we provide because every physician within his government or non-government is different than the department. They work, let's say, internal medicine or E.R. or something. It's different with a bill and have a different vote. Now, the hospital, they won't fall. They all are different because the hospital looks from each and every department, not just one department or one doc. So you try to. It's like a Venn diagram and you tend to find a common denominator of common place. So that's how it is. Once you start figuring out those things, then so let's say a couple of government hospitals. We are pretty consistent on the processes that seem to be just document the process. Otherwise, we take a middle of the road process and then we say, okay, you need to deviate from this, you need to deviate from this. You need to deviate from.

Malcolm Lui:
Right. Got it. What sort of changes you see coming down the line that you need to adjust for or perhaps they offer a very attractive opportunity for you.

Paresh Shah:
I mean, for us, we plan to continue in the same arena. We are on the provider side. The kind of changes which is going to come is not a small hospitals are going to be absorbed by larger ones. OK. But because if we look at the ground roots level, it so. If a doc is working for ABC Hospital, which got acquired by X, Y, Z. We gotta know how the ABC is going to flow into the X, Y, Z Hospital. So those are the things which is going to be very difficult because, for example, in Austin you might have an independent delivery network, which is like on a very policy mode. So they might be in a monopoly mode on doing a monopoly or whatever you call it. So those are the changes which is going to come out of smaller ones are going to be taken away. The physicians, they are going to be much more like a value base or they they're going to be able to be measured on outcomes. So on those things that are changing and you start seeing that effects and we have to change along with that.

Malcolm Lui:
Right. Are there any huge changes coming that would require a radical change? Because I know health care is evolving all the time, right?

Paresh Shah:
Yes. I mean, right now they're talking about so many changes coming. I give an example of passive income saying I think is but he's about this I don't know about a lot of hospitals has to state how much it costs a patient for a particular treatment. So now the idea resources are ongoing to me. They want data about putting those information on the web. OK, let's say you go for a simple procedure or it's gonna cost me a hundred dollars. X, Y, Z Hospital is gonna cost me eighty dollars. You know, things like that.

Malcolm Lui:
Yeah.

Paresh Shah:
Now they do have electronic medical record which they have to support. They have all these other regulations which they had to support like makes maker and not there to support others. Regulations. Just going to come up. So they're already stage. What is going to happen? Many of the small ones that just I mean, many employees will quit because they don't want to work 70, 80 hours for every day. So those are the changes. We're just going to come in the next one to two years and still. For example, if you're in a hospital in the deep, you fought a particular disease with a particular medication. They got to state how much it is going to be painful.

Malcolm Lui:
Right.

Paresh Shah:
Ok, so on this changes and video, a limited amount of IBP people and all those people. What are they going to concentrate on that is supporting the electronic medical record, supporting the regulations and the requirements as well as at the same time to support the new requirements?

Malcolm Lui:
Yet.

Paresh Shah:
Ok, and then you go on, the physicians were complaining that they're getting burned down because they look working like, you know, 15, 16, 17 hours a day.

Malcolm Lui:
Yet.

Paresh Shah:
So those are the changes which is going to come and. We have to be ready and how to work with them. So that is less bottom line. Less money for the physician, less, but not for the people in the idea and other support services to support.

Malcolm Lui:
All right. You think it's going to happen? The price transparency may be able to compare services more easily.

Paresh Shah:
It could happen, we don't know.

Malcolm Lui:
Because a lot of people don't want it to happen, right?

Paresh Shah:
But there are two sides to the coin, one side will say, hey, for a simple appendicitis, it cost me 4000 over. That is why is it costing me seven thousand people to start questioning? So, I mean, think about it. You get on company. Health insurance is growing at the rate of 5 percent to 10 percent a year. Is the income increasing by 5 to 10 percent? You ask yourself a question.

Malcolm Lui:
Right.

Paresh Shah:
So let's see what happens at Washington. I can not predict and I don't know what will happen.

Malcolm Lui:
Yeah. I mean, for sure people would appreciate the price transparency, the boy is not a vested interest. You would not

Paresh Shah:
I'm.

Malcolm Lui:
Want to have that happen as well. All right. Now, in terms of the structure of your business, you see a lot of consolidation going to happen in terms of your industry and the services you provide.

Paresh Shah:
Yes. Yes. Because I made it. Let's say we I do x y zi. We had about so many people. Of course, efficiency, effectiveness and all of those things have got to play much more because the customer side are the provider. Marketing out of the health care market is changing. So maybe because the better and maybe smaller ones are better. I don't know. But things really change. I don't know which direction.

Malcolm Lui:
Did you see the consolidation occurring simply as a bigger is better sort of concept? Or do you think you might be acquired or you might acquire someone else and might be in a different part of the supply chain and complementing it from that perspective?

Paresh Shah:
I mean, I have a very simple example based on our previous conversation, you said you lived in Providence. Let's say we work at Providence Hospital. OK. We are doing a couple of things. We are doing medical coding, medical oddity. But what we are not doing is other health insurance. OK. And there is a company out over there which does other health insurance for a patient. Combining the two will help Providence Hospital much more than dealing with two different vendors. OK.

Malcolm Lui:
Right.

Paresh Shah:
So those are the advantages as far as us are concerned. I'm going to keep myself open to all the different directions. I don't know. OK, but if it makes sense for the my side sense for my employees and sense for everybody else, who knows?

Malcolm Lui:
Right. Yeah, I guess is the government being a big, important player in the health care industry and yet not really knowing how things will unfold, it does make it hard to foresee the future.

Paresh Shah:
Yeah. So women say.

Malcolm Lui:
Hit the relaxed questions for you, Paresh. What message would you show in a billboard along the freeway? It's only going to be seen for six seconds or less.

Paresh Shah:
Let me explain to you. Long time ago, I was talking to a physician. I mean, this is like, what, Glenn, 14 years then 20 years ago. And now it's talking. And what he had asked me, what do you do? I was at a physician meeting. OK. And I explained to him, we do compliance and all that. I it was a kind of a long five foot five or six sentences. So the physician kind of told me you basically screwed docs like me.

Malcolm Lui:
Why would he say that at.

Paresh Shah:
Not because he says, I don't have time and you guys are coming up with all those things, and so you basically screwed me, so it got me thinking, OK, the mindset physician telling me that.

Malcolm Lui:
Yes. That you help them, not screw

Paresh Shah:
Yeah.

Malcolm Lui:
Them over.

Paresh Shah:
So what I do. So what if I have a six second billboard message? This is my physician member. My message is very simple. We work with physicians or providers, so they do not get screwed by all these regulations and requirements.

Malcolm Lui:
Right.

Paresh Shah:
So I changed it on what the physician had told me and used that as a billboard message.

Malcolm Lui:
Right. Now, why did the physician think that you in particular, your business particularly, would screw the minority? And I see

Paresh Shah:
With

Malcolm Lui:
The

Paresh Shah:
Us.

Malcolm Lui:
Connection.

Paresh Shah:
Yes. I sat down with him and I talked to him. He totally loses out at six six thirty in the morning. Each time I see the patient at seven thirty two for 430. When he sees a patient, he has to do so much documentation on the electronic medical record. He has to follow so many rules and regulations about hip HEPA and other stuff. Then he has to follow the rules and regulations for MIPS and make about how they are going to be measured. And then at the end of the day, he has to make sure that his notes are clear so that people from billing coding can easily do coding and start billing the insurance companies. He says by the time he is done, it's about eight. He goes home at five like a distant one physician and took him a lot of internal physician, internal medicine physicians. I did a survey on the go home seven, seven thirty. I'll get this guy doing documentation for two hours. That's a lot of look, my friend.

Malcolm Lui:
Yeah.

Paresh Shah:
Within 15 hours, every day.

Malcolm Lui:
Right.

Paresh Shah:
What is happened? Because of that, the physicians are getting burned out. Just think you are sad that you are sick and you go to a physician. Do you want to be treated by a physician who is one of.

Malcolm Lui:
No, of course not.

Paresh Shah:
That's what it is.

Malcolm Lui:
Yes. All right. Cut it. Lots of questions for you. Who are your ideal clients and what's the best way for them to contact your company?

Paresh Shah:
My deadlines are basically larger department of groups like Emergency ROOM Emergency Medicine Physicians and X, Y, Z Hospital, Internal Medicine. And what they are a treatment facilities. Those are the smaller ones. Less the less they have in 50 bags or something are usually the outpatient. Those are my ideal contacts appliance. And the best way for them to contact me usually docs with on this call by phone. I send out an email at the end of the day, but I should be in touch with the CFO in those places.

Malcolm Lui:
All right. Got it. Paresh, it's been awesome having you on my show today. I really enjoyed hearing about how you grew your business and how you navigated last year and your plans for the future.

Paresh Shah:
Ok. Thank you Malcolm, I want to wish you all the best.

Malcolm Lui:
We've been speaking with Paresh Shah, the President of MindLeaf Technologies, about his company's rapid growth. For interviews with other fast growing, high value sales companies, or to learn how we can accelerate your firm's high value sales through automation, visit Eversprint.com.

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