An LFJ Conversation with Reid Zeising, CEO and Founder, Gain

Reid is the CEO of Gain, the fastest-growing SaaS-based, AI enhanced, medical lien servicing and legal funding company in the United States. He is an industry expert on optimizing the utilization of technology in personal injury cases and in maximizing reimbursements in a challenging environment.

Reid has been featured on national and local media outlets throughout his career, including Inc. and Becker’s Hospital Review. He was named the 2022 Ernst and Young Entrepreneur of the year in the Southeast Region, an award given for his entrepreneurial spirit, purpose, growth and impact. Reid is passionate about making a difference by connecting, mentoring, opening doors and leading people.

1. Why the recent rebrand to Gain? What was the motivation for this change?

The recent rebrand from Cherokee Legal Holdings to Gain was driven by the need for clarity and unification of our various brands under a single, cohesive go-to-market identity. This change aims to unite our entire organization under a shared mission: to facilitate access to quality medical care for individuals who have suffered injuries through no fault of their own, regardless of their financial or insurance situation.

In 2011, I founded Cherokee with the aim of offering financial options to personal injury victims awaiting settlement. Over time, that mission has expanded to include innovating and transforming the personal injury space to truly level the playing field for personal injury plaintiffs as they battle big insurance companies. Gain Servicing, a subsidiary of Cherokee Legal Holdings, was established as an AI-enabled platform to do exactly that and to provide Letter of Protection (LOP) servicing and collections to doctors. Our technology simplifies the process for doctors to accept LOPs as payment, allowing them to focus on delivering quality medical care to individuals in need, particularly those who lack health insurance or sufficient savings. In 2022, Gain Servicing accounted for a significant portion of Gain’s total revenue, and this is expected to grow even further in the future, highlighting the need for the innovations we are prioritizing.

By consolidating all of our capabilities under one unified brand, we now provide comprehensive solutions for every facet of personal injury, with a steadfast focus on the plaintiff at the heart of all of our endeavors.

In essence, the rebrand to Gain represents the company’s dedication to supporting personal injury victims – by providing resources to access quality medical care, and by making it more accessible to those who would otherwise be limited by financial or insurance challenges. It reflects Gain’s mission to create a fairer insurance system and a more equitable healthcare model for all Americans.

2. Gain is seeking to streamline the medical lien process for healthcare providers. What are the challenges at play here, and how does Gain address those issues?

Treating personal injury patients who may not have the financial means to pay upfront can make it a challenging process for healthcare providers.

The main challenges in this context are:

1. Delayed payment: Healthcare providers often have to wait for an extended period of time to receive payment for their services, which can strain their cash flow.
2. Administrative complexity: Managing a portfolio of liens and receivables associated with legal cases can be administratively burdensome, diverting resources from patient care.
3. Collection efforts: Collecting on these liens and receivables can be time-consuming and challenging, leading to potential write-offs.
4. Risk management: Healthcare providers may also face the risk of not being compensated if the legal case does not result in a settlement or judgment in their favor.

Gain has developed solutions to address these specific lien challenges:

Lien Management Services: Our team of experts takes on the responsibility for full revenue cycle management services, including negotiation and collection of medical liens associated with Letters of Protection (LOP). Leveraging data from our AI-enhanced LOP servicing platform and industry experience, we help practices reduce write-offs and enhance collections. On average, our approach yields approximately 900 basis points more than practices that self-manage lien receivables.

Medical Billing Partial Advance: We offer healthcare providers the option to receive partial payment at or near the time of treatment for personal injury patients with pending legal cases. By blending a partial advance of future cash flows, combined with additional payments at the time of collection, we increase healthcare providers cash flows while improving reimbursements over selling these liens outright.

Bulk Lien Purchase: For healthcare providers with outstanding liens, we offer a bulk purchase program. This allows them to receive cash immediately, eliminating the time and stress associated with managing and collecting lien receivables.

Gain is dedicated to simplifying and expediting the medical lien process, empowering healthcare providers to focus on providing quality patient care while ensuring they receive timely and fair compensation for their services. We understand the unique challenges faced by providers in this space, and our solutions are designed to alleviate those challenges and improve their financial stability.

3. How does Gain’s AI technology help attorneys and healthcare providers? Can you give us an example of how Gain’s AI can be used for enhanced efficiency or business intelligence?

Gain’s AI technology plays a pivotal role in assisting both attorneys and healthcare providers by revolutionizing the management of complex medical claims. Here’s how our AI technology enhances efficiency and provides valuable business intelligence:

Efficiency Enhancement

• Imagine a personal injury case where various parties, including attorneys and healthcare providers, need to collaborate seamlessly to ensure the best outcome for the injured patient. Our AI-powered platform streamlines this process. For instance, it offers a patient record center, simplifying the updating and retrieval of information and documents. This feature alone saves valuable administrative time, ensuring that nothing gets missed in the case.
• Our AI-enhanced dashboard and reporting capabilities provide real-time insights into case status and financials. This means better monitoring, quicker decision-making and enhanced efficiency in managing personal injury cases. The messaging and notifications feature further streamlines communication among all stakeholders involved.

Business Intelligence

• Our AI technology equips attorneys and healthcare providers with predictive analytics capabilities, which provide invaluable business intelligence. AI-enhanced reports shed light on payor sources, case characteristics, jurisdictions, third-party liability carriers, financial outcomes and other vital decision-making factors.
• For instance, attorneys and healthcare providers can gain insights into case volumes, treatment costs, reimbursement rates, duration and more. They can drill down to obtain detailed information on cases, attorneys, healthcare providers or individual patients. Moreover, Gain’s database of similar cases helps in understanding standard treatment costs, reductions and reimbursement rates. All of this information empowers those providing services to personal injury plaintiffs to make better decisions and optimize their approach to specific cases.

Collaboration and Communication

• Effective collaboration and communication are vital in personal injury cases. Gain’s secure document storage and messaging system make it incredibly easy to share important documents and updates related to cases securely. This not only saves administrative time but also ensures that critical information is readily accessible.
• Real-time notifications and status updates keep medical and legal teams in sync as cases progress, enabling them to take timely actions and prioritize tasks efficiently.

Gain’s AI technology is a powerful platform that brings attorneys and healthcare providers together, simplifying the management of personal injury cases. It enhances efficiency by providing tools for streamlined collaboration, offers valuable business intelligence for informed decision-making, and ensures that all stakeholders are well-informed throughout the process. We’re proud to be recognized for our commitment to innovation and our mission to provide access to care and financial solutions to those in need.

4. How is Gain pursuing fairness and equity in the Consumer Legal Finance and Medical Lien spaces?

Gain is committed to pursuing fairness and equity in the Consumer Legal Finance and Medical Lien spaces by addressing the challenges faced by both personal injury plaintiffs and healthcare providers. Our goal is to create a more balanced and efficient system for all stakeholders involved.

• Supporting personal injury plaintiffs – and those who support them: For personal injury plaintiffs who lack the financial means to pay for essential bills and necessary medical treatment, navigating the insurance system can be incredibly challenging. This is where Gain steps in to offer assistance. We specialize in managing Letters of Protection (LOP), collections and funding, providing the support needed to ensure plaintiffs receive the care they deserve. Our AI-enhanced platform simplifies the handling of LOP agreements, personal injury receivables and medical liens. It facilitates better communication between personal injury attorneys and healthcare providers, streamlining document sharing, case updates and financial transactions. Through the platform, we also compare reimbursement amounts to thousands of similar lawsuits, ensuring fair payment for services provided.
• Enhancing efficiency with AI: Our AI technology plays a crucial role in achieving fairness and healthcare equity. It empowers healthcare providers and attorneys with predictive analytics capabilities, providing valuable business intelligence. Attorneys and healthcare providers can access AI-enhanced reports that offer insights into payor sources, case characteristics, jurisdictions, third-party liability carriers, financial outcomes, duration and more. This data equips professionals with the information they need to make informed decisions, ultimately leading to better patient care and fairer financial outcomes.
• Fighting back with a wholistic team approach – Managed Services: Gain’s Managed Services team is dedicated to managing personal injury receivables and medical liens. They work closely with healthcare providers to monitor progress, follow up on key items and ensure that cases are advancing toward settlement. This partnership helps push back on reductions, reduce write-offs and increase collection amounts. Leveraging our third-party status also helps minimize the risk of being targeted in legal proceedings.

Gain is fiercely committed to creating a fairer and more equitable system in the Consumer Legal Finance and Medical Lien spaces. Our suite of services, including our AI technology, managed services and funding solutions, coupled with our commitment to transparency and efficiency all contribute to this mission. We believe that everyone deserves access to quality care and fair financial outcomes, and we are actively working to make this a reality in the personal injury space.

5. Gain is leaning into AI and Legal Technology heavily. What has the response been from claimants, attorneys and healthcare providers? Do you plan to continue making investments in Legal Tech initiatives going forward?

The response to Gain’s heavy investment in AI and legal technology has been incredibly positive from claimants, attorneys and healthcare providers. Our innovative approach to managing complex medical claims through advanced AI solutions has garnered recognition and appreciation within the legal and healthcare industries. Just within the last few months, our AI platform has been recognized by the Technology Association of Georgia as a most innovative company of 2023 and by the Software & Information Industry Association as a Best Healthcare Technology Solution. This recognition further validates our dedication to helping injured patients by revolutionizing the management of medical claims.

Attorneys have found tremendous value in our AI platform, which accurately assesses case values and informs them of available funds for reimbursements. This empowers attorneys to collaborate more effectively with healthcare providers, resulting in higher reimbursements and improved outcomes for their clients.

Our technology has also been welcomed by healthcare providers. Gain’s platform streamlines the process of accepting LOPs as a form of payment, allowing providers to focus on delivering superior clinical outcomes and ensuring access to high-quality medical care for everyone, regardless of their payor source. This has made a significant difference in the efficiency of their practices and their ability to provide care to those in need.

As for our future plans, we are fully committed to continuing our investments in legal tech initiatives. We believe that technology is the key to driving meaningful change in the legal and healthcare sectors. Our goal is to further enhance and evolve our technology, making it even more efficient and effective in serving the needs of claimants, attorneys and healthcare providers. We are dedicated to advancing our mission and ensuring that everyone receives the care and support they deserve.