Jeremy Shiner

Founder and President

Myriad Systems

Interview conducted by:

Lynn Fosse, Senior Editor

CEOCFO Magazine

Published – February 14, 2022

CEOCFO: Mr. Shiner, what is Myriad Systems?

Mr. Shiner: Myriad Systems is a technology company that deals with healthcare technology, anywhere from revenue cycle management and payment processing to EHR, billing software and small business loans; all with the mission of preserving the private healthcare practice and making sure that it is a viable method of doing business with doctors’ offices moving forward.

We believe that not only is it best for the doctors when they have solidarity and ownership of the practice, but it is best for the patient and best for healthcare as a whole.

CEOCFO: Why did you decide to be a full-service company in this arena?

Mr. Shiner: We started out on, and our primary revenue is generated by, the payment processing side of things. That is still our main business today – revenue cycle management and consulting, all that is under the MediPay Compliance Consultants branding. We have a really dynamic understanding of the nuances and how patient payment works within doctors’ offices. We have thousands of doctors’ offices that are utilizing that. Under that branding we have been building custom integrations with existing EMR, EHR and practice management softwares. Meaning that when offices take a payment, we can post it into the ledger of their current software. This ability enables us to work with thousands of different EHRs and tens of thousands of private doctors’ offices, and we really have our finger on the pulse of their needs, patient needs and what makes up this process – from patient check-in and patient payment to insurance balances, and all the way through to revenue cycle. It makes it smooth and efficient. It keeps patients coming back for more treatment. In doing so, we saw a need and that is where Myriad Health was born. In speaking with doctors’ offices, we consistently heard they’re paying for their EHR and that it’s just okay, that it does the job. We saw a need to disrupt the market a little bit and deliver something more streamlined, efficient and has a revenue cycle angle and expertise behind it but at a severely discounted price point. Because our book of business is all healthcare, we’re able to provide all of these added services and only monetize them through the payment processing. We deliver a clearinghouse, scheduling, unlimited text reminders, patient communications and a what I think is one of the most truly dynamic patient check-in processes – all for no extra cost. They just pay their credit card processing fees, which is our wheelhouse since that’s where we started out.

CEOCFO: Why is it so difficult for companies to get it right and what is it that you understand about how to simplify?

Mr. Shiner: I think it comes down to customization. There are so many different practice types and patient demographics, that a lot of these out-of-the-box solutions do not quite fit their needs, where some practices are fee for service, some are heavily insurance based, some are Medicaid and Medicare, or some need a payment plan. What ends up happening is the market gets extremely segmented into very niche practice management softwares, which cuts down their potential client base so much that it drives up prices to the point that many practice management softwares are priced at 2,000% profitability on each account, because they might be only going after one sliver of the market, so when we built Myriad Health customization was a key word. Everything is fully customized on the back end, and we are going to provide a white-glove service to build that out for practices tailored exactly to their workflow. We are going to ask the critical questions around their workflows in terms of patient and insurance payments and revenue cycle management, and build it out so there is no work for them and on day-one they are functioning exactly the way they need to, and we can calibrate it from there.

CEOCFO: Myriad Health is fairly new; how are you rolling it out?

Mr. Shiner: This is all brand-new, so we are doing a phased roll-out. We have so many incoming inquiries about it so we have a queue setup and we are scheduled out to March or April with installations. We are going to roll it out a little at a time to make sure everything goes smoothly and make sure practices have an easy and seamless experience getting set up.

CEOCFO: How easy would it be to make a change?

Mr. Shiner: The usability is really user-friendly. We studied other softwares, even in other industries such as CRM, and we studied the marketplace and emulated some of that from UI and UX standpoints and had consultants come in. Learning the software will be easy. The biggest sticking point to getting anybody to change software is data import and export because they have hundreds or thousands of patients and thus a lot of files, so we are aiding with getting data imported to our software and exported from the previous software. Because we have a free solution, which is extremely unique in the marketplace, we envision a lot of new practices signing on to keep their overhead low, as well as a lot of smaller practices, such as psychiatry practices, physical therapy offices, chiropractors and others that may not be paying for an EHR solution, ePrescribing or any of the things that we are offering. As you know ePrescribing is the standard and required in certain states, so we will be able to get this solution into their hands without any upfront investment and without any commitment or monthly investment. They just pay their credit card processing fees.

CEOCFO: What did you learn as you started to develop Myriad? What did you recognize that you did not expect to find when putting the whole system together?

Mr. Shiner: I learned a lot over the three years of research and development, especially how complex charting can be. As I mentioned, my expertise is the revenue cycle side. From the outside looking in, I had a good understanding of patient charting and what it was. There is a lot of nuance, different details and changes that go on. When you get to the clearinghouse, that is also a big undertaking as far as verifying insurances and communicating directly with insurance companies and making sure denied claims are responded to quickly. It kind of goes back to the question about why it is difficult to get it right. That’s because there are so many aspects. When you build a software like this you are touching on the amount of content that spans four or five industries. When you talk about these different aspects and we are able to try to deliver that under one platform that is easy to use and customize at one price point. I think the value of Myriad is that we’re able to deliver all of this in one, easy to use and customizable platform at one price point, but that is also the difficulty of it on the flip side.

CEOCFO: What else is in the platform and what might surprise a potential client that they are able to do with Myriad?

Mr. Shiner: I think some of the things that may surprise them is the patient check-in process. We have copyrighted approach to patients that we are using now, but this is going to mechanize all of that so that not only is it foolproof where nobody is falling through the cracks, but it is customizable. The patient is going to be able to check-in, register, leave all their demographic information and verify their insurance all from their cell phone, and then based on those numbers the practice can come back and provide the estimated patient portion and all these things. It is going to prompt the patient to sign a pre-authorization with a PCI-compliant, encrypted card on-file so that offices are not billing for insurance balances, and even if it does get into the billing portion, we have all electronic invoicing built right in. It is going to eliminate the cost of billing – which is $3.00 to $5.00 per bill in administrative costs – not to mention the time spent waiting on the patient, then sending another bill, following up with threat and collection or even writing it off as a loss at the end of the year. This is the top way practices lose patients – by allowing them to owe money. It has nothing to do with the quality of treatment that was applied. However, patients are out there saying it did have to do with treatment and leaving negative reviews simply to save face. Therefore, not only does the office lose the initial amount the patient stuck them with and the cost of collecting but future treatments and future referrals – an average of over eight referrals per practice.

Myriad will seamlessly address all of these issues and is guaranteed to cut down billing and account receivable balances. It is something we ask the offices to try, to keep those numbers – and the software itself will keep those numbers for them if they enter it in ahead of time and it will record how much they reduced the account and how much they reduced the billing cost right in the software to show them the value of this.

CEOCFO: Are you focusing on the Myriad and leaving Myriad Systems alone or will you be offering them together, what is the strategy?

Mr. Shiner: Our plan is to corner our niche to our market. We are going to be able to walk into any practice or meet with any contact and say that we can either build a custom integration and do their payment processing with their current software if you are happy with it, but if you are not we can provide this one – Myriad – at no cost and no monthly fee for the software itself and you process credit card payments with us. Either way they benefit from our services. Those are Myriad Systems main services, the integrations with MediPay Compliance Consultants and Myriad Health software that takes care of every aspect of their practice.

CEOCFO: Are you concerned that people will be leery because you are offering a free version?

Mr. Shiner: It has been done but not particularly successfully. Practice Fusion had a free version – just the EHR not billing – that was monetized through advertising, and I think users found it a little spammy, and the advertisers found that there were not very good returns on those ads, so they ended up monetizing it. Therefore, yes, everybody is leery, but they are interested. When we explain the business model to them, they understand and are less leery. We are not giving Myriad away without any benefit to ourselves and we are not trying to convey that. We are getting the payment processing out of it, so our profitably will be about 2% rather than up to 2,000% or even higher in some cases. Our business model is to make a very small amount of money over a very long period of time through the payment processing. We have very low overhead in the payment processing so we can fit these added services, all within that umbrella.

CEOCFO: Why is this the right time to come out with Myriad Health?

Mr. Shiner: I think there are two perspectives. You can look at it from a healthcare perspective, there is no better time than now because doctors’ offices are being squeezed on all sides. Rents are climbing. Malpractice lawsuits are higher than ever. Malpractice insurance is higher than ever. Insurance companies are paying out less than ever, and patients are more likely than ever to not pay healthcare bills, so they are writing off more than they have ever written off. Medical school puts doctors in hundreds of thousands of dollars of debt, and doctors are earning less than they ever earned.

If the trend continues, large corporations are going to continue to buy-out private medical practices until they cease to exist. It is not good for doctors nor patients. The more doctors become employees, the less our brightest and best are going to gravitate towards medicine. We need great doctors and great healthcare.

We are trying to do our small part in cutting down the crushing overhead that is taking over these practices and pushing doctors to sell their practices. When I speak to doctors who have done so, regret is a constant. Many time corporations decide what medicines the doctors can prescribe, what tools they can use and how they can treat their patients. They lose that special connection and that solidarity, and a lot of the doctors regret it. They are basically cornered into making that decision in many cases.

CEOCFO: What if anything might a practice considering using your company miss when they first look at Myriad Systems?

Mr. Shiner: Because Myriad Health is a free software, they could be leery of it and think it is cut-rate. Again, our model is to monetize Myriad through the payment processing, and they pay that anyway, so it is free to them and we are getting business out of it through our sister company MediPay Compliance Consultants so they work in conjunction with each other. We want them to understand that this is an elite-level software, and it will be one of the most dynamic, user-friendly, customizable and comprehensive software on the market if not the most comprehensive on the market. This is something that is a true disrupter, a better product for less. That is our mission.