Good morning, and welcome to the MTBC Third Quarter 2018 Earnings Conference Call. All participants will be in listen-only mode. [Operator Instructions] Please note this event is being recorded. I would now like to turn the conference over to Kim Grant, Associate General Counsel. Please go ahead.

Good morning, everyone. Welcome to the MTBC 2018 Third Quarter Conference Call. On today’s call are Mahmud Haq, our Founder and Executive Chairman; Stephen Snyder, our Chief Executive Officer and a Director; A. Hadi Chaudhry, our President; and Bill Korn, our Chief Financial Officer. Before we begin, I would like to remind you that certain statements made during this conference call are forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 as amended, and Section 21E of the Securities Exchange Act of 1934 as amended. All statements, other than statements of historical fact, made during this conference call are forward-looking statements, including without limitation statements regarding our expectations and guidance for future financial and operational performance, expected growth, business outlook and potential organic growth and acquisitions including any discussion regarding the details in closing of Orion and other acquisition opportunities. Forward-looking statements may sometimes be identified with words such as will, may, expect, plan, anticipate, upcoming, believe, estimate, or similar terminology and the negative of these terms. Forward-looking statements are not promises or guarantees of future performance and are subject to a variety of risks and uncertainties, many of which are beyond our control, which could cause actual results to differ materially from those contemplated in these forward-looking statements. These statements reflect our opinions only as of the date of this presentation and we undertake no obligation to revise these forward-looking statements in light of new information or future events. Please refer to our press release and our reports filed with the Securities and Exchange Commission, where you will find a more comprehensive discussion of our performance and factors that could cause actual results to differ materially from these forward-looking statements. Finally, on today’s call we may refer to certain non-GAAP financial measures. Please refer to today’s press release announcing our third quarter 2018 results for a reconciliation of these non-GAAP performance measures to our GAAP financial results. With that said, I will now turn the call over to the Chief Executive Officer of MTBC. Steve?

Thank you, Kim. And thank you everyone for joining us on our third quarter 2018 earnings call. We are pleased to report a strong quarter of record revenue and cash from operations. Our revenue for the third quarter were $17 million, which represents nearly a doubling of our revenue as compared to the prior quarter. Likewise, during the third quarter, we generated $2.8 million in cash from operations, a record for us while positioning us to approximately double our adjusted EBITDA for full year 2018. In addition to reporting the strongest quarter in our history, we are pleased to now have more than $20 million in cash and available credit to support our growth initiatives. With regard to our focus on growing through acquisitions, let’s discuss our most recent transaction in order to explore the broader strategy. In July, we acquired substantially all of the assets of multiple affiliated companies, which we collectively refer to as Orion. Orion was an aggregator in our space and we purchased it’s assets through a bankruptcy proceeding. Orion was attract was an attractive opportunity for a value buyer like MTBC. We paid $12.6 million in cash to acquire a Orion’s customer contracts, which we expect to generate approximately $30 million on an annualized basis. We also acquired that are accounts receivable, furniture, equipment, and certain other assets. In addition to helping us scale this acquisition, further rounded our service offering and allowed us to onboard additional talented team members who will help us grow during 2019 and beyond. Since companies with the Orion’s revenue mix and size often sell for one to two times annual revenues. We were pleased that paid less than one half times revenues. The seller indicates that 28 other potential acquirers signed nondisclosure agreements and perform due diligence on a…

Thank you, Steve, and thank you everyone for joining us on our third quarter 2018 call. With our most recent acquisition, we had also broadened our service offering. We believe that as the healthcare market continues to become more complex, positions increasingly need a comprehensive turnkey solution and ours is among the most comprehensive in the industry. For an ambulatory practice that leverages our entire scope of services. We provide the following technology enabled services. Cloud based practice management with real time insurance eligibility, online scheduling, secure patient communications and business analytics. Technology based and life patient support, cloud based electronic health records that digitized and enhance physicians charting, while connecting of practice to be broader healthcare community. Mobile health apps, insurance credentialing designed to ensure that each provider is properly contracted with insurance payers, coding, which enables providers to receive optimize the reimbursement and avoid compliance risk. Insurance claims scrubbing, utilizing our proprietary loan, claim submission and follow-up oriented towards effectuating proper payments, all of which is commonly called revenue cycle management. And group purchasing discounts on leading vaccine and other supplies from top pharmaceutical manufacturers. Most of the industry is comprised of vendors that either to like acknowledge the solution such as electronic health records application, also wide standalone revenue cycle management. We provide both in a fully integrated solution. We also interface with third party applications. We believe that this is an important differentiator and will support our continued growth. Separately as a result of our Orion acquisition, we now provide additional niche hospital solutions such as Medicaid and Charity Care eligibility services. Additionally, we now manage multiple physician offices and long-term physician practice management agreements. In summary, we now have an even stronger and broader service offering. We intend to leverage this trend and we focus on continuing our high revenue and adjusted EBITDA growth into 2019 and beyond. In addition to further enhancing voice recognition and AI functionality in our talkEHR. We had started to develop an incorporate telehealth capabilities in our talkEHR and mobile app. My using our mobile app or a PC patient will be able to book and have a telehealth session with the doctor using our talkHER. We have also completed development of our first blockchain based interoperability solution this first EHR vendor. It is currently being tested and we anticipate this to be in production this quarter. We also actively working on exploring other opportunities in the industry where we can connect with other blockchain based solution providers in the healthcare industry, including clearing houses. I will now turn the floor over to our Chief Financial Officer. Bill?

Thank you, Hadi. Revenues for third quarter 2018 were $17 million, an increase of 127% or $9.5 million compared to $7.5 million in the same period last year and an increase of 96% compared to the second quarter. Not only was this a new record, but it was the largest percent increase in any quarter in MTBC’s history fueled by the Orion acquisition. In addition to doubling the company’s size, the Orion acquisition added several additional service offerings to MTBC’s portfolio. During the third quarter, we generated $3.3 million of revenue from practice management services. We now manage pediatric practices in Ohio and Illinois, through multi-decade management service agreements. We employ nurses, medical assistants, receptionists, practice managers and other practice personnel in five locations. We share patient revenue with physicians in these practices, and exclude the physicians’ portion from the revenue we report. We also now manage a group purchasing organization, enabling 4000 physicians across the country to purchase vaccines through leading pharmaceutical companies at discounted rates. During the quarter we generated $477,000 of revenue from this GPO. Physicians purchase vaccines directly from Merck and Sanofi Pasteur, and we receive rebate checks from the pharmaceutical manufacturers. Physicians can learn more about our GPO and enroll for free to start saving up to 20% on vaccine purchases at www.mtbc.com/gpo. Third quarter 2018 GAAP net loss was $1.8 million, compared to a net loss of $980,000 in the same period last year. Similar to our previous acquisitions, from an accounting perspective, a large portion of the purchase price will be attributed to intangible assets, most of which we will amortize over the next few years. This means that our non-cash amortization expense has increased, which always happens within acquisition. Amortization is excluded from non-GAAP financial measures, but because of it we expect…

Thank you, Bill. We had a remarkable year so far and we are ready for a year of record breaking growth and continued profitability. We thank our investors, customers, and employees for their support. We will now open the call to question. Operator?

[Operator Instructions] The first question will come from Kevin Dede with HC Wainwright. Please go ahead.

Good morning guys. Thanks for taking the call. You guys issued press late October regarding an addition to the GPO. And I’m wondering two things on that. One, if you can offer more detail; and two, can you talk about how well your entrenched physicians, the ones already on MTBC’s revenue cycle management program have adopted the GPO platform?

Thanks for the question Kevin. With regard to the GPO, as a quick recap, we have about 4,000 providers practicing in primary care who are part of that GPO. And through the GPO, we have negotiated discounts with three of the top pharmaceutical companies that provide then in turn discounts to our members. We added another pharmaceutical manufacturer as you referenced Kevin, in October to that list. And we have some of the details if you go to mtbc.com/gpo, you’ll see the member that was most recently added. When we look at it from a revenue perspective, the GPO generates about $1.2 million roughly in annualized revenue. But where we really see the opportunity is exactly where you alluded to, which is being able to cross sell between the GPO and the RCM base. We’ve started the first phase of that and what we’ve done is, we’ve now created a web based online automated process for signing up members of our RCM Group, which we just launched and it’s been well received within our client base over the last week. So moving from a kind of a human based, more labor intensive process of enrolling new members to one that’s automated such a huge step that we just launched that over the last week and it’s been very well received. The second phase of this will be going to our GPO customer base, those 4,000 physicians and cross selling our RCM and other solutions into that base. And just to kind of illustrate the reason why we’re so excited about that is, for every one provider who moves from being simply a GPO customer to a GPO plus RCM customer, we believe, we’ll be able to increase the revenue for that provider by roughly 40 times. So there’s a significant upside, associated with that.

Well. Okay, Steve, so what you’re saying is that by – we’re talking about your revenue, right? The revenue that you’re able to recognize from that, from one of the 4,000 preexisting GPO customers in that group that’s what you’re alluding to?

That’s right. Absolutely.

Thank you. Next, next question is, real quickly – you took pains to make it clear how MTBC’s scale was able to accept all the additional Orion business without incurring huge costs? And given some of the comments also made on a call with targets on trying to continue to grow the business. I’m wondering if you can talk to how stretched, how stretched your internal – I guess your internal foundation is, your internal workings. Can you speak to the amount of pressure that you’re feeling internally in order to make these huge operational changes that you’ve made on the incoming business versus straining the relationships that you have that either already had? And talk – yes, and then talk a little bit to how you see that integration driving margin improvement more specifically. I mean, sort of rapid open ended and I appreciate that, but if you look at – if you look at past quarters your gross margin was running in the high 40% to 50% – over 50% even in June. And I’m just curious and how far or how long it might take you to navigate back to that area?

Absolutely. So I’ll address the first part of that question, and then Bill can jump in, in terms of the margin expansion. With regard to the first question, in terms of the internal stress, we really have the benefit of having done this many times over the last five years. In fact, I think it’s accurate to say that we’ve closed more of these types of transactions in this space than any other player in the market during the last five years. So that has given us the ability candidly to build a team that has really been able on a very disciplined methodical way to be able to integrate companies like this, even companies of this size. So we feel great about where we’re at in terms of that integration candidly, it’s exceeding our internal expectations. And our excitement now is really about the next acquisition that’s where our energies are really largely focused on identifying the best mix fit to acquire. So from the perspective of the internal – the internal kind of components of this, we feel great about where we’re at on track, both with regard to cost cutting and retention. And I’ll let Bill jump in with regard to the margin expansion.

Thanks, Steve, and Kevin, good question on margin expansion. I think if you look at our acquisition of MediGain, we went through six months of integrating the business before we turned into positive EBITDA and then it really took us another three to six months before we were able to get to a good solid positive EBITDA margins. In this case, obviously we stayed positive immediately and in some respects, the practice management business and the new purchasing organization really helped us, because those pieces were already positive. Having said that, those pieces won’t show as big improvement. So, well I do think, we’ll get ourselves back to a 50% EBITDA margin that’ll probably take us a year to do. I do expect you to see significant margin improvement over the next one or two quarters. However, again, as we continue to pursue this very quickly and aggressively again with the experience, every time you do this, it gets a little bit easier.

Okay. Fair enough gentlemen. Thank you. I think, I asked two groups of three questions, so I had to feed the floor.

Thank you, Kevin.

Thanks, Kevin.

The next question will come from Brian Marckx of Zacks Investment Research. Please go ahead.

Good morning guys and congrats on the quarter. Very nice. Can you disclose how much of the RCM revenue in Q3 was directly related to the Orion addition?

Thanks, Brian. We typically don’t disclose how much has come from each piece. But again, you could think about the fact that in the first half of the year we had $17 million of revenue. So, if you think about $17 million in the first half, round numbers $8.5 million a quarter, and then you say, I got $17 million of revenue this quarter, roughly half of the total revenue came from Orion. And again, I think we mentioned the $3.3 million of practice management and $170,000 of GPO, the rest of the Orion business – the rest of the revenue during the quarter was all RCM.

Okay. And then in terms of integration and acquisition costs, that would be somewhat one-time characterized and would be potentially just captured in Q3. Is there a number that you can give us that of the acquisition and integration costs that would not repeat after Q3?

When you look at the table that shows the adjusted EBITDA, you’ll see a number for integration and transaction costs in that table. And most of that is one time cost, some of that relates to the actual acquisition transaction, some of it relates to the integration of the business. They’ll probably be a small amount in there during Q3 and even into the beginning of next year. For example, if we need to pay, do I have to get out of a lease early or if we need to do some other one time severance or other costs. But some of what did there or even as we worked on migrating off of a subcontractors when you’re using the subcontractor and you’re also paying your employees, that’s regular cost that that doesn’t get excluded. So you’ll see some of that, you’ll see a few hundred thousand dollars of that, that will go away because we no longer use those subcontractors. But in addition, we structured an arrangement with a large subcontractor. We put some money in escrow so that at the end of a successful integration, they would get a pot of gold at the end of the rainbow. That kind of money goes into the integration to transaction cost and would not repeat.

Okay. And then in terms of potential additional acquisitions, is there anything specifically on your radar – I don’t fix back that you’ll be able to necessarily talk about specifics, but is there anything that’s on your radar that you think is at least a reasonable probability that you would pull the trigger on here in the next, say six to nine months?

A great question. And then I think you probably alluded to our answer in the question itself. So certainly we’re focused on identifying the right next acquisition and you’re right, we will disclose that when we’ve identified that and there’s reasonable certainty around that. But I think if we step back for a minute, we think about where we are at right now. We’ve never been better positioned to move forward on the right acquisition opportunity. And we’re committed to continuing to employ, a very disciplined approach, which has served us very well in terms of identifying the right target and negotiating optimal terms. Over the last couple months, we’ve been in ongoing conversations with a key investment bankers and intermediaries, industry players, executives, and it’s from this group that will most likely be able to source the very best opportunities. So we’re excited about where we’re at again I have more capital today than we’ve ever had in the past to be able to invest that in our growth initiatives. And clearly as soon as we’re at that stage where we have a target at that point we’ll announce that.

All right. Thanks guys.

Thank you.

The next question will come from Pranab Kumar of [indiscernible]. Please go ahead.

Congratulations, management for the incredible quarter. I would like for the management to elaborate a little bit on the Salus partnership and explain to us how it will be beneficial in the long run?

Thanks for your questions. So Salus is an example of many of the similar types of relationships we have with other industry players, other companies work with our target market. Salus provides a specific type of telemedicine that’s primarily focused on larger groups and hospital settings, and it’s a cross referral relationship. So the way in which will benefit from our relationship with Salus or from many of the other partners we work with is by being able to share leads with each other, and then being able to support each other and closing those leads. And when those leads are then closed, there’s oftentimes in these relationships there’s a referral fee that’s paid. So there’s an incentive that baked into these relationships to be able to help each other grow. And that’s the gist of the Salus relationship.

Thank you very much.

Thank you.

[Operator Instructions] The next question is a follow-up from Kevin Dede of HC Wainwright Please go ahead.

Thanks. Hadi, you went back to talk about the blockchain development and I’m wondering if you can offer a little more color on that one group of physicians that you have working with you, and some of the – I guess maybe just some anecdotes to give us some flavor for how that’s developing and whether or not you think you’ve shown up on other players radar?

Thank you, Kevin. We have completed the development for the integration of that one, the first vendor with our blockchain network. In the – given in the – in the press release the details of that first relationship and it is currently being thoroughly tested and tweaks have been made at as we’re working through communicating between the two EHR system. And we anticipate this to be in production within this quarter. And at the same time, we are in discussion with at least one other vendor and exploring other possible opportunities with vendors providing blockchain solutions even including the clearing houses.

Do you have – I mean, do you have enough visibility? How do you give us an indication of when you think you might be able to talk about how – I mean how it’s growing. I know it’s very, very early days. I’m just wondering, I mean your crystal ball is much clearer than ours and I was just hoping you could give us a little insight on – how you see growing and maybe what the perception is from – from outside and even that lot of people have tried to do this unsuccessfully. I’m just kind of curious as to see if you think your – your initial steps are more successful.

Kevin, as you’ve mentioned even in your question a bit. It’s an initiative and we believe this could become one of the solution for the industry for interoperability and transmitting the healthcare information between the different systems in more secure way. We just actually even recently attended the one of our member, they did not change in healthcare conference in Tennessee over the last two days as well. And there have been many vendors talking about it and trying to find the different opportunities of the possible things that can be done in the industry, which can drive towards a one thing – one final solution or some possible solution in this industry. So it will be I think premature at the stage, what’s the final shape would look like. But for sure as the every – many vendors have started to talk about it, the industry as started to look at it as one of the possible solution in this space. It will get, it will be concluded towards one more meaningful solution for the interoperability.

Okay, Hadi. Thank you. Fair enough. Bill, could you give us the figure for the preferred share count, I guess at the end of the quarter and post deal?

Sure. So we – at this point we’ve got it back $53 million worth of a preferred outstanding. And that’s as of today. And I think we mentioned that in October we had sold a $50 million worth a $50 million growth for 600,000 shares. So, therefore we had $38 million worth of a preferred outstanding at the end of September. And the question that you didn’t ask, it’s $53 million in preferred, our dividends are $490,000 a month. When you think about our Q3 cash flow, our cash flow in the quarter was $2.8 million which was a $1 million more than our Q4 level of dividends. So we’re already generating enough cash flow to easily pay those dividends and have money left for reinvestment.

Okay. So you served 600 shares, so what was the – what’s the total now, the total count?

Yes. The total count is $2,136,000.

Okay. And also down that $2,136,000, the monthly dividend is almost $500,000?

That’s correct. $490,000 in a month.

Yes. Okay.

We paid our monthly dividends now every month for over three years and, we are really excited about the tremendous advantage that we get being able to do the financing that way without needing to dilute our shareholders.

All right. Okay. So you’ve doubled the SUB line and that’s a $10 million that stands now. How long would it take them to get that cash to you? Just give us a scenario where you identify, you see from your team, identify a target. How long can you, or how long would it take you to -- to pull the trigger on it?

It’s a revolver, so a few seconds, maybe half a minute if the internet is running really slow between New Jersey and California.

Okay, fair enough. Thanks a lot gentlemen for taking my questions. Really appreciate it.

Thanks, Kevin.

And this concludes our question-and-answer session. I’d now turn the conference back over to Kim Grant for any closing remarks.

We just like to thank everybody who’s joined us for this call. We thank you all for your questions and we wish you all a great day.

The conference is now concluded. Thank you for attending today’s presentation. You may now disconnect your lines. Have a great day.