Episode Transcript
[00:00:00] Speaker A: Welcome to the relay presented by Lex Amica. My name is Gabriel Stewarts founder and CEO of lexameca, the leading attorney referral network. We are leaders who are passionate about leveraging technology and AI to enhance law firm practices. Our listeners, like yourself, are the owners NC suite at personal injury, consumer law and mass tort firms. My guest today is Dave Francolini, founder and CEO of InjuryRx. Dave, great to have you on the show.
[00:00:24] Speaker B: Yeah, thanks for having me Gabriel.
[00:00:26] Speaker A: Yeah, absolutely. So Dave, our topic today is telemedicine in the personal injury space. One of the things that we are doing with the show is deep dives into very specific ways that law firm owners can increase revenue, save costs, do things in their law firm to scale their business. And so would love to just kind of get an overview from you here of this space. It's something that's a little bit less familiar to me personally. Something that you have a lot of experience in. But give us the, give us a little bit of an overview and also your own background in the space.
[00:00:59] Speaker B: Yeah, perfect. So I appreciate the introduction. I'm founder of InjuryRx. Thanks for having me on Gabriel. You know, as far as the telemedicine space definitely has a place within personal injury, mostly it's utilized to bridge the gaps in treatment. You know, there's accident victims who their first course of action if not going to the hospital is usually to find an attorney and the time it takes to find that attorney and then when they do find the attorney, the time it takes to get them in with their medical providers. If it's not a serious accident, those gaps in treatment can cause financial loss for the, for the law firm and then for the client themselves. The insurance companies love to exploit those gaps in treatment and so what InjuryRx does and good telemedicine services do is they close that gap in treatment. So the insurance adjusters can't exploit that gap in treatment because the patient is seeing an MD immediately following their accident, be it through telemedicine. And that MD is in some cases depending on the medical necessity of the patient prescribing non narcotic medications for the patient. So what you're doing is you're bridging that gap from the time of accident to the time of seeing their medical providers. You're not replacing those providers in any way. You're bridging that gap and it really helps support the conservative care treatment and complements their existing treatment protocols as opposed to replacing.
[00:02:24] Speaker A: Those are fantastic. Thanks for the overview there. Help me understand in the personal Injury space right now. What percentage of law firms are doing this practice today?
[00:02:34] Speaker B: Yep. So I can tell you that to my. To the best of my knowledge, I hear that. That Morgan and Morgan is utilizing telemedicine services on the majority of their cases. From what I hear, they're not utilizing telemedicine and to prescribe medications, but they see the value in. In having that telemedicine visit in order to bridge that gap. A lot of times those initial MD visits, be it through telemedicine, they're also able to assess the patient and provide it an open referral, let's say, for physical therapy or for chiropractic treatment. And in some cases, if the need is there for medical necessity, then for neurology as well. So there's a lot of other benefits to the patient seeing an MD upfront prior to waiting to see their medical providers. As far as a percentage of clients that are currently utilizing this, I think it's very.
It's somewhat new to the. To the market. And I think. I think if I had to put a number on it, you're probably looking at maybe 20% of personal injury attorneys actually using that. And that's a complete guesstimate.
[00:03:42] Speaker A: Sure. I mean, there's no public data about most things in the space. That's why I like talking to the experts who've looked at this and have some understanding of what's going on here. 20% higher than I would have guessed, being very, very ignorant of the space. So it sounds like there's some traction here operationally with law firms that are doing this from a pure workflow perspective. How does it work? So you've got these clients, is this. People who have no medical coverage already, they don't have insurance of their own. How is this coming into play? How do you get a potential client involved with your telehealth? How does this work with their existing healthcare provider?
[00:04:25] Speaker B: Yeah, perfect. The. This is usually done on the intake level. So what we see is that the law firms that really embrace this and understand the value in our service, they build this into their intake process. And what I mean by that is they'll actually have a lead come in, which most law firms do, and they can actually use injurerx in the telemedicine service as a tool to hook that lead in. So what do I mean by that? They're on the phone. John just got into a car accident. John might even have an appointment with another law firm's medical provider, but they couldn't get him in for a Week. So it's a competitive market and John's still shopping around. They can say on the phone, John, you know, if you sign up with ABC Law Firm, our law firm, I can get you on the phone with an MD immediately and we can start treatment on your case. That MD will see you assess your, your, your medical needs. You'll have non narcotic medication to your door and in 48 hours. How does that sound? And to John it sounds better than, than the previous call he had with the, with the other law firm. Right.
[00:05:22] Speaker A: So do you have data points on like does this actually affect conversion rates? That's a great story. Have you done other case studies showing if that is changing the conversion rates for law firms that are so.
[00:05:33] Speaker B: Yeah. Two years ago when we started Injury Rx, we started with a high volume MVA firm out of Georgia and we have all the case studies to, to back that up. The specific percentages on that I'd have to get back to you on. But it does definitely increase the, not only the conversion rate on there, but also the retention rate. So what I mean by that is a competitive market. These statistics I do have. So the law firm that I'm referring to in Georgia, their loss rate was 6% with their clients. Meaning because it was a competitive market, they would get the client signed up and then that client would take another, assign another retainer with another attorney and they would lose that client 6% of the time. After utilizing injury Rx, they got that down to 2%.
And the reason why is because once they see a doctor and they receive a medication, they're invested in the case. Much more so than just retainer. They feel that because you told them that they've received treatment, they now have their medical provider, they have their lawyer, but they also have their medical provider and they know that they're starting to add bills or treatment on their case. So why go elsewhere?
[00:06:41] Speaker A: Sure, yeah. It's going to create stickiness and it's going to, if nothing else, there's a sense of psychological investment by the client who's already taking action on behalf of the case. With the law firm that they signed with, there's a lot of psychological studies that show that the best way to get someone to commit to your selling process is to make them do something that, to give something to you, whether that's time, energy. There's a lot of studies that show that. So absolutely would, would believe that, that that passes the smell test. How does the billing side of this work? And is that like baked into the process or do law firms have to set that up with the telehealth provider?
[00:07:20] Speaker B: Yeah, and I think, Gabriel, if I can go back to finish answering the previous question on there, because I think that was important where you asked about how do they implement it? Right. So outside of the. Yeah. Outside of the hook and the retention. Right. How they're actually implementing it is a part of their. Is a part of their intake process. So what their first priority is obviously getting the client to sign up with the law firm. And then once that's done, they're simply live transferring into our physician network. And then the physicians are available in all 50 states in real time. So there's no dropped calls or we'll call them back. When we originally started the model, that was the case and we had about a 40% rate where we couldn't get them back on the phone. So we make it very easy for them as a part of their intake process.
[00:08:04] Speaker A: Live handoff. I'm the intake rep. I've made the. I've signed the client. Okay, thanks for signing your retainer. Now let me transfer you over to a doctor in our network. I'm going to do a warm transfer. I'm going to get the doctor on the phone, hand everybody off. And then now the doctor and the client are talking to each other.
[00:08:23] Speaker B: It's that real time. Yeah. So there we have, we have a representative in between. So the law firm is transferring into entry RX platform. Our representative is answering the phone and connecting to the doctor. So it's, it's seamless. But you're correct, it is a live transfer. The other way that our system is used in the process is, let's say it's a more serious accident and the patient goes to the hospital. But many times throughout the life of a case, there's, there's a time where that patient doesn't have a ride to the hospital because they can't drive and their ride doesn't pick them up. Or they live in a rural area. So they were able to go to the hospital. But going in for treatment, you know, is difficult at times. You can utilize a telemedicine console to bridge the gap not only in the front of the case, but also throughout the case so that you don't have a gap in treatment throughout the case. And RMDs can, can speak with them and help them out in the middle of a case as well.
[00:09:14] Speaker A: Got it. So. So talk about the pricing structure. Is this something. Is there, is there, is it on a lien basis? Is there financing involved? Like how are law firms implementing this and how does it affect the client on their side? Are they, are they paying anything out of pocket on this? How does that work?
[00:09:29] Speaker B: Y. So no, the way that we have the model set up is that there's no out of pocket cost for the patient or for the law firm. What I mean by that is Indriox is running the cost covering the cost of the doctor consult as well as the prescription medications that the patient might receive. We hold a lien on the case with the patient and lop and we're paid when the case settles. No different than the rest of their medical providers being in personal injury for many years. We do accept reductions just like all of their other providers and so on. So yeah, there's no out of pocket for their, for the client whatsoever there. There's no co pays that apply to this as well. And from the law firm standpoint, we also provide them with a risk free guarantee so that on the cases that they don't settle, which there's going to be a percentage of those, then we eat those bills with them. So there's never a time where the law firm is out of pocket and they. Even if they don't settle the case.
[00:10:21] Speaker A: Yeah, I mean fantastic. Sounds like you understand the space and what lawyers care about here in terms of their business and also the way that clients are serviced. Are there any ethical issues surrounding this? I'm not necessari necessarily seeing that, but obviously that's a massive question that you want to make sure that you've got that covered. And is there anything on like on a state to state level where some states are more favorable? Is any. Is anyone opposed to this at a state on a state by state basis?
[00:10:49] Speaker B: No, because it's, it's actually telemedicine has been much more widely embraced especially because of the, because of COVID and I believe it was the CARES act, which actually makes it that insurance providers need to look at telemedicine visits no different than than in office visits. So while it is a telemedicine visit, it's treated no differently than an in office visit. You'll also see that with our visit, even though it's a short visit with the physician, we provide extremely detailed doctor's notes. No different than as if they were seen in person. I think there are three to five pages of detailed notes on there which is important for the case managers when discussing with the adjusters. So from a compliance standpoint, I think it's my personal opinion is that it's much better Medicine, I mean as opposed to somebody waiting a week to get treatment. You know, they're able to see an MD immediately and that MD is able to exercise, you know, the tools that they have in their toolbox to benefit that patient and then from there make referrals because they're not seeing them in person. Right. So they're again bridging that gap. They're not the end all be all by any means. It's, you know, it's bridging that gap and doing their best to get that patient some type of relief until they see their, their in person providers.
[00:12:03] Speaker A: Sure, sure. You mentioned getting those notes. Obviously one of the things that, that we're big on is data integration. Does this integrate with systems like filevine, Lettify, Smart Advocate? Can you push the data in programmatically? What, what does the interface look like in terms of getting information into the system of record and especially in terms of like the cost and the billing?
[00:12:26] Speaker B: Yeah, so right now it's a great question. Right now we have a system that we provide to all of our clients. It's cloud based so their intake department this up at all times. For example intrirx.com forward/abc law firm. So they would have a log in there where they're able to pull down the doctor's notes, the pt, Cairo Neuro referrals where medically necessary. The invoices in real time. They have a login that they can, and they can track the status of all their clients submitted. We're in the process of integrating with Litify, filevine, Clio, all the Smart Advocate, the major law firm CRMs. Right now we're actively, I think we're in two out of the two out of the major five right now and the other three were in the setup.
[00:13:09] Speaker A: Process within which ones are Live now?
[00:13:12] Speaker B: Live now is Clio, Smart Advocate and filevine.
[00:13:17] Speaker A: Okay, okay, yeah, yeah, that's, that's great. So just taking this back out. High level, don't, don't want to dwell too much on like on a specific product here. Sounds like a really clear use case. Beginning of the case part of the intake process and then an immediate handoff. You can do this telemedicine and you can also use it when you're, you've got clients in rural areas or physical access to healthcare is difficult. High level, it sounds like value add, both from the perspective of you're getting that treatment done, but also from a client retention perspective. Is there any data on how this affects clients from a satisfaction perspective? A lot of law firms really care about their client satisfaction, getting those Google reviews, clients referring their friends and family to the law firm. I mean, gut says, yeah, it's a better experience. I mean, my take is that law firms generally all need to be moving in this direction. And what I mean by that is that most of us interact with our goods and our services through apps, through our phone, through Zoom. You and I are on a video call right now. All of us do this all the time. We use delivery services, we get our food delivered. So I think that there's really not even a question about should law firms be using telemedicine. Clients want to interface with their lawyers, with their medical providers, the same way they interface with everyone else. It doesn't mean that they never want to interface with people in person. But generally, most of us, I'm sure that your life is similar to mine. Most of my interactions with service providers are digital at this point. And if you give me an option, most of the time I'm going to say, what's the one? That means that I can do this from where I am already on my time and not have to drive somewhere. And yeah, it seems to me like this is one of those places where five years from now it's going to be a done deal. Everyone's going to have done this and said, okay, well, we made it through the transition period from when there wasn't telemedicine as part of the basic workflow of law firms to now there is telemedicine. And I really am having a hard time seeing why someone would say, absolutely not, no way. And I get it, like, there's law firms out there. You may be listening to this and saying, oh, well, we still send people to the door to sign up our clients. And our clients love that in person interaction when they come to the office and get a physical check. And that's fine. I'm not saying that you shouldn't do those things, but if you look at the best companies in the world and the way that they're running, they are 100% out there bringing your experience with that company to the phone where I do everything else. So telemedicine is, I think, the logical next step in the way that treatment is done, whether you have an existing relationship with doctors that can do that or you need to set it up. I think that that is something that you need to decide as a law firm. But a lot of the firms that I'm talking to, and Dave, this may be your experience as well, people are broadening their geographic reach Very quickly. And my sample size may be skewed because a lot of the folks that I'm talking to are in expansion mode or they're inherently national. But I think the other massive plus to telemedicine is that it's scalable and it's not geographically connected to one city, one state, one county. Once you plug into it, you have access across the country, which means that even, let's say, if you're going to refer that case out, you can still have done a level of workup and medical treatment on that case that you would not have been able to without a telemedicine provider. So when you get that call, if you're the kind of law firm that signs a case and then refers it out, you can sign it and do some medical and then refer it out. And there's more value to that. You're going to get a higher referral fee percentage. You're going to provide a better experience to your referral partners because you're sending them a case that already has medical done on it. So I just, I see a lot of value here in integrating this into your workflow as a law firm. I don't really see any downside. There's, you know, maybe a little bit of friction in terms of getting your team trained on this, and I would say, look like, pilot it with some of the people on your team that you would most trust to do this, see how it works, and then roll it out more from there.
[00:17:22] Speaker B: Yeah, I think I'd like to address one of the things that you said, Gabriel, because I think it's important, is that what we hear when you said about the satisfaction from the law firm standpoint as well as the client standpoint, a lot of the law firms that are probably listening to this or that we've heard, you know, have some type of relationships where they're. Where they're purchasing leads in some way or doing advertising, whether it's billboards or Google Ads or anything like that. Right. And so you don't necessarily always know where your, where your client base is going to come in from. You know, your hope is that they'll come in metropolitan areas where there's good PI doctors and you have a network and, you know, but picture yourself as a, as a PI firm in Texas or, you know, and you're advertising and you're getting clients in, and majority of those clients are able to be seen within the metropolitan area. They have good physicians that are, that are treating the patients. But the other cases, and this is what we Hear all the time. The other cases that are, that are outliers, they're spending marketing and they're getting patients in, in these areas, areas that they don't have a solid network. In some cases, those minimal or no treatment patients are amazing for telemedicine. And what we do, because what we hear is that, you know, without our platform, they would have, you know, $0 on a case, for example, because there's nobody there for the patient to treat with or minimal treatment on the case. So when you utilize a telemedicine service, at least the patient's getting some type of relief and the case has some type of bills on there as well from a settlement standpoint. So those cases that would have normally been goose eggs, so to speak, for the law firm and for their client. Now the patient, from a health standpoint, gets the treatment that they need and deserve. And also the law firm is able to capture a settlement on behalf of their client that they probably wouldn't have normally been able to capture in those areas.
[00:19:09] Speaker A: Well, and the other thing that you should be doing if you're using this telemedicine for that group of clients is looking at the signals you're getting. Because if you have no data around what's going on with their treatment at all, let's say they don't have any, you don't know how serious their injuries are. But if you have a telemedicine provider who's able to give you reliable information about what's going on with that client, you can flag those cases as potentially needing additional oversight in terms of, you know, just checking in with the client and seeing what's going on with their treatment, even if it's harder for those clients to get there. Something that you mentioned that's really interesting to me and I've never had this conversation with a law firm.
I think as a way of looking at the upside here, like you said, you're basically increasing the floor value on all of your cases because you have more consistent medical processes on those cases and those clients. If you're a high volume law firm, go run a heat map of where your clients live and then use the location, the geodata and then the treatment information and see if there's a correlation between your clients that live in those metro areas closer to treatment facilities versus the ones that are further away and see if there is correlative data. Because if there is, for your law firm, I think that's a really strong case for bringing in telemedicine. If all of your clients are coming the same urban areas, metro areas that have the treatment. It's not going to be the same level of upside. But if you're a law firm that has more rural population or and then it may not be even your client base, but go cross compare that with a friend who does run a law firm in a more metropolitan area and see if that data points to lack of treatment based on distance from treatment centers. Fascinating idea that you raised there, Dave, that I've never talked to anyone about. I certainly don't think that any of the law firms that I'm in regular contact with are running that kind of an analysis on their clients. And I think that could be really, really important. Just to leave some really practical takeaways here. From what I'm seeing and hearing, we've got law firms that are doing this at scale, like Morgan and Morgan. We've got a level of market adoption somewhere in the 20% range. And we're not quoting anyone on that, Dave, don't worry. But there are firms that are doing this at scale. It makes a lot of sense because you can really seamlessly integrate it into your existing workflows. There's some really specific use cases around rural clients, clients that are further away from treatment centers who can get value and then just more consistent medical treatment. Not a lot of downside because there's incentive alignment. At least with InjuryRx. I'm not sure about other providers in the telemedicine space. And if you're a law firm that's scaling geographically or you already have a broad reach, this is a national proposition. It's a plug and play option, which I'm always a big fan of folks who've gone out and built out geographically agnostic systems that law firms can plug into. Dave, really appreciate you being on the podcast today. I've learned a lot about the space from you. Really appreciate it. I'm sure we could talk about a lot of other things, but try to keep it around 20 minutes for our listeners. So thank you so much for being on today. Really appreciate it.
[00:22:14] Speaker B: Yeah, thanks so much, Gabriel. Thanks for having me. Take care.