I want to start today's episode on a personal
note. As I've mentioned on this podcast before,
my dad's a dentist and he owned his own practice
in South Africa for over 30 years. He eventually
had to sell that practice due to business constraints
and also just feeling like he's working harder
and earning less. A big reason for this was insurance
companies. And I can't help but wonder that if
my father had met my next guest all those years
ago, where the things could be different welcome
to bite -sized dental marketing my name is ian
and today we are joined by the one and only sandy
hudson from unlock the ppo sandy has helped hundreds
of dentists navigate the world of dental insurance
and how to actually get the deals that make sense
for your practice or drop the insurances that
are no longer benefiting your bottom line So
if it feels like insurance companies are driving
your practice, it seems like you're working harder
and harder but the money's just not coming in
and you don't know what the first step is to
drop those bad insurances, well then this episode
is for you. Enjoy. Today we're joined by what
I would call one of the unsung heroes, Sandy
Hudson from Unlock the PPO and... You're out
here fighting the good fight, Sandy. I was talking
to you just before we started of there's so many
dentists that feel and can relate to the message
that you have and what you're doing to help dentists
kind of get back to feeling fulfilled in dentistry.
And even though they work harder to make that
money and to feel that patient care is coming
first instead of this. this battle of insurance
companies and feeling that they're not getting
anywhere. I would love to know your story of
how you got into this and what motivated you
to get into this business. Yeah, it's a situation
that is what most dentists are probably feeling
like now. I'm married to a dentist, which is
how I got into all this in the first place. My
husband had been in practice for several years,
had bought a practice. And the building that
we were in went, all of the condos went on the
market. So we were able to move to a larger office.
And so we got moved. We got crazy busy, had all
this growth. And then at the end of the year,
kind of realized we didn't actually really make
much more money. We were a lot busier, but we
weren't necessarily a lot more profitable. And
so the practice grew. But as anybody who's a
dentist knows, dentistry is a hard business on
your body physically. So that piece is not sustainable
for most dentists, you know, as opposed to 20,
30 years. So I started really looking at the
numbers going, OK, we've got the patients, we've
got all of the numbers. But what do we need to
do differently to make this sustainable and more
possible? And so we started really hammering
away at the insurance side of things of just,
evaluating things of okay what's working what
isn't and you know realizing that by being busy
and booking out far we were accommodating for
fee schedules that just weren't even profitable
and so they were plugging things up and so we
just really had to start evaluating and figuring
out what makes sense and what doesn't i originally
got started because there weren't really companies
doing that and so i just started posting helpful
information just to say, OK, I feel like I made
every mistake in the book while I was trying
to figure this out on my own. How do I save some
other offices? You know, some of the hassles
and mistakes that I made so that they don't have
to reinvent the wheel. I kept thinking, I wish
there was somebody who could help me do this,
you know? And so I just started kind of going,
well, let's see. Maybe that is a thing that is
a service that needs to be provided. And that's
kind of how I originally got into this. And so
it's just. learning how much the industry has
changed as was 15 years ago. And now it's crazy
complicated. Back then, it wasn't even nearly
as complicated as it is now. So anyway, that's
sort of my story of how I landed in this. Didn't
really ever expect to be so in -depth with dental
insurance, but that's what it translated into.
So it's been a fun journey. I want to start us
off with an interesting question or something
that I personally am seeing or heard from other
dentists, and I want to know if you agree. Are
bad insurance contracts hurting the heart of
what the dental industry is meant to be, and
it's making dentists feel unfulfilled in the
work? I know that dental insurance is needed.
Insurance companies do play a role, but... Slowly
but surely, I've been in this space for five
years now, I've seen a trend of more and more
frustration building up. What are you seeing?
Yeah, well, it's no doubt becoming more challenging.
When we look at dental contracting now compared
to, you know, years ago or longer, so many more
shared network agreements. So what used to be
a little bit more simplified process of at least
applying a contract, you knew what you were getting.
Now, most insurance companies have shared network
agreements with multiple other companies, meaning
you can be in network with one company through
somebody else's contact. And so if you understand
that, that might be fine. But it's gotten to
a point where dentists are just, it's become
very confusing. So dentists just don't always
understand what they're getting when they sign
a contract, which is... hold them in network
maybe with companies they didn't intend to be
in network with. And so that part has certainly
gotten more complicated, something that you will
have to, you know, pay attention to it. Also,
there's just a crunch in the industry, you know,
where it's, we're seeing so much more of certainly
with new dentists, you know, their student loan
debt is just so much higher now than it used
to be, you know, 20, 30 years ago. So you can
tile that with. So many, you know, dental support
staff leaving the industry during COVID. So now
you've got this new higher overhead that's come
since then, combined with higher student loan
debt. Now you've got this situation where kind
of the only place to pull that from is the dentist's
salary. You know, really, insurance companies
are not keeping peace with that overhead. It's
definitely squeezing. the solo practice dentists.
And that's who we're advocates of. We don't work
with large DSOs. We're very much people who just
work with the solo practice business model. So
that's certainly what we're seeing across the
country right now is a challenge. Was COVID a
big turning point for you? COVID was in that
it's interesting when everything happened initially
with COVID. We really reined everything in with
our company thinking, you know, dentists are
being shut down. They can't even practice right
now. We expect it to have no business at all.
And it was the opposite. It was almost like dentists
were on this forced vacation time, shut down.
Vacation is probably the wrong word for it. But
they were forced to shut down in a way that has
never happened before. And instead, it was almost
like they had time to start reviewing their data.
And they're like, OK, well, I'm going to dive
into some of these projects that I never have
a chance to do normally. And so we were completely
overwhelmed. We were actually we stopped taking
new clients for several months during and after
COVID for a while because we just couldn't accommodate
all of the phone calls. So it was an odd it was
exactly the opposite of what we were expecting.
But hats off to Dennis for really taking that
time and saying, okay, we know changes are coming.
How do we actually start looking at our business
differently and start to make changes to respond
to that? So I think overall, it was just not
exactly what we were expecting. And that's so
interesting that you said that because it's time
for some introspective exercises to figure out.
What are these things I've been trying to get
at? And then you start seeing, holy moly, there's
all of these things that I could be doing that
will actually make my practice more money or
make things better. And so it does make perfect
sense. And that's actually a perfect segue into
what I wanted to ask you next is dentists are
typically in the hustle and bustle. I mean, they
wear so many hats in a practice. We can't expect
dentists to keep up with these things because
it's... I'm the business owner. I'm the dentist.
I'm the HR. It's a full -time jobs. I don't want
to say job. But often there's things that dentists
are just not aware of or there's just misconceptions.
And I want to ask you, what are some of those
misconceptions about insurance contracts or how
we deal with insurance that you can share with
dentists so that they can at least just start
to ask? the right questions. In one of the previous
episodes I listened of yours, you mentioned about
how some contracts dentists just opt into things
without even knowing about it, but then they
have to formally opt out or otherwise it just
continues. Are there some other examples of that
that you can share with dentists they can keep
an eye on? I think a couple of things would be
they should be paying attention to the initial
trials of a contract. So meaning how long do
you have to stay in network? So all contracts
will have, it's usually 30, 60 or 90 days that
you can terminate a contract. So, you know, you
give notice to the insurance company if you don't
want to participate anymore. And they'll, you
know, tell you in the contract the amount of,
you know, leave time you have to give them to
get back out. But there are cases where there's
an initial term of a contract that might be a
year, one way or two year, which means once you
agree to a contract, you might not be able to
terminate it. for a year or two, and then you
have to notice after that. So just, you know,
be reading through that garbage pretty carefully
to make sure that if you're thinking, well, maybe
I'll, or like with a renegotiation, maybe you
think, well, I'm going to go ahead and take this
increase for now. I might want to terminate this
contract at the end of the year, but for now,
I'll just go ahead and take it until I can reevaluate
further. If there's language in that contract
that says you have to remain contracted for two
years before you can donate it, if you accept
an increase, you want to really be aware of that
because you might be locked in a little bit longer
than you're definitely waiting through all of
that. Also, non -covered services is a thing
to pay attention to. So there's, I don't know,
probably over half the states now have passed
non -covered services laws, which really just
mean. If it's a completely non -covered service
under the patient's policy, you're not bound
by the PPO fee. In most cases, you could charge
the patient. There's solutions to that. You know,
federal plans don't fall under that. Every state
writes their laws a little bit differently. But
overall, the point is, if the insurance company
is not going to be paying for anything, they
can't tell you what you can charge. There is
paperwork sometimes, though. Where the insurance
company may ask you, let's say you're in a state
that's passed that law. The insurance company
may say, hey, even though you're not bound by
the PPO fee, would you like to just voluntarily
agree to abide by the PPO fee in cases where
you don't have to? You should always, always,
always check the no box if you're asked that
question. If somebody's saying, hey, we do veneers
and it's completely not covered under the patient's
policy and we can charge our cash fee. Do we
want to just agree to give the patient the PPO
fee anyway? No. I mean, you can certainly consider
if you might want to do that on your own, I guess
maybe, but you don't want to ever, you know,
agree to that with an insurance company. There's
a reason why those non -covered service laws
are passed, which is to say you have the right
as a business owner to be able to charge your
full fee if the insurance company is not contributing
to the cost of that service. And you want to
always retain that option. Keep an eye out for
that in paperwork as well. That's another one
that's kind of sneaking in there a little bit
more often these days. Is there a lack of transparency
in general with these companies? I mean, when
it's things like setting rates or how they deny
claims or the things that you've mentioned, how
can dentists navigate or challenge these things
if they thought they were getting a certain kind
of deal, but then actually the fine print? But
because we all know that insurance companies
are there to make money, like it's the fine print
exists. So is there a way that they can challenge
it effectively? Do you have a way where maybe
they'll have a higher chance of being successful?
It's just a lot of time invested, you know, to
say, I mean, obviously, if you don't get where
you're trying to get broadly with the insurance
company and it's like you've exhausted a lot
of moves. You know, certainly you can file a
formal complaint with the insurance commissioner
and for your state and just try to get it escalated
that way. And then just be very clear and careful
of reading the language to say, did you unfortunately
agree to something that may be unfair, but you
agreed to it, then there's not a lot of room
to move with it. So just I think back to your
original point, be very careful about what you
agree to. And also. Insurance contracts are typically
not going to be like normally the only thing
negotiable is going to be the faith themselves.
So when you're working with an insurance company,
if you think you wind through verbiage that you
don't like on a contract and that's going to
protect you, typically that's not the case. You
know, typically verbiage with an insurance company
is not going to be something that you can edit
out or change. It's really going to be. make
it or leave it. And then you need to be definitely
deciding, are there clauses in this that are
just not workable? Maybe I just better pass it.
On this, what you said of take it or leave it,
if I took it and at some point I now realize
this is not working. We know that there's so
many dental practices that have certain PPOs
that they realize it's not profitable for them
anymore. they're still hesitating to drop these
because they're scared they're actually going
to lose patients. As I mentioned to you earlier
on the ACT Dental podcast that I listened of
yours, you emphasize that this is something you
chip away at. It's not just I'm insurance and
now I swoosh over to fee -for -service. How can
dentists start to evaluate which of these is
no longer a good fit for me and I need to start
chipping away at it? So what we do with our clients,
and it's certainly something dentists can really
be looking at internally on their own as well,
is we typically get it down to about 30 top codes
for the practice. You don't need to be looking
at hundreds of 88. It's going to be 30 codes
or less for a general practice specialist, even
less than that. And then really look to see the
makeup of your practice and then evaluate all
of your current PPO contracts. So you want to
get... an estimated collections rate for everything
that you've got in place now, because that's
really your starting point. You need to know
truly on paper, not just what is your staff paying,
who do you think's paying you badly, but actually
get it down on paper so you're really crunching.
And then we just put everything in order and
best to worst. So we want to say, you know, who's
paying you well, who's not paying you so well.
We start down there at the bottom. Now, let's
say your very worst paying piece schedule, you've
got... you know, $300 ,000 a year of production
tied to it. And your second lowest one, you've
got $30 ,000 in production. Well, maybe you want
to start with that little bit smaller one and
you want to go ahead and eliminate that one first
and then give your staff a chance to go through
that transition, get used to talking to patients,
and then you kind of work your way up to some
bigger ones. So just make it a good game plan.
I mean, looking at who's really paying you at
a rate that is not sustainable. And also, I think
it's hard. You know, you kind of mentioned we
don't want to lose all of our patients. But I
think when you're especially a solo practice
dentist, you've spent years building relationships
with patients. And it matters to you if patients
stay or go. So there is this sense like we worked
so hard to build our patient base. We don't want
to lose anyone. But the reality is. that, you
know, if you drop a plane and you lose a few
patients, number one, there's a good chance they're
probably going to come back later if they are
jumping ship just for insurance and don't have
a good experience somewhere else. Are they going
to, you know, circle back around in a year anyway?
But also, is it just a case where, you know,
if you lose, like, let's say you lose 10 % of
your patients with that insurance company, but
you collect your full fee from the other 90 %
of the pay, it actually is... a better business
model for you to start making some of those changes.
So yes, we ideally want to lose patients, but
there is a point where you need to recognize
shrinking things just a little bit can definitely
make sense from a business perspective of being
able to then take care of those 94 % who stay
at a higher level because you have the time,
you have the ability, you're getting reimbursed
at a rate that's workable by the kind of dental
care you want to provide. So there's definitely
a tipping point in there. And when you think
about it, if you're writing off 50 % of your
fee, you can lose half of your patience and still
collect what you're collecting now. And not to
say that that's the goal by any means, but when
you really start to crunch the numbers, sometimes
dentists, I think, are very surprised at how
much it does make sense to start chipping away.
So yes, we want to be looking at this to say,
we're not just going to randomly pick a company.
We're going to really get all of our ducks in
a row first and evaluate where all of the current
contracts are at and then start getting a game
plan into play. And for some offices, maybe they're
on a two to three year fight. You know, let's
drop one plane every six months for the next
three years and go very gradually. And then others
are going more aggressively. But you can start
to move in this direction without it being. huge
major changes that are going to upset your whole
practice you know just starting to go little
by little and is definitely the direction a lot
of practice one as you explain that almost sort
of like it's like a toxic relationship it's like
you you're like if i leave then i will be alone
and i won't have any but you actually know that
you're going to be better off and i mean as you
said why would you stay if You know that you're
writing all of that money off anyway. Rather
work less initially and then build that up again,
but still make the same amount of money instead
of trying to do what you're doing now. You mentioned,
Sandy, that negotiating all those contracts,
it is a difficult thing. Is there some room?
If I'm a dentist now and I'm saying to you, Sandy,
I can't drop these insurance companies now. Like,
I'm bleeding on this side. I can't find another
staff here. I'm doing this. The money's looking
thin. Like, I can't just drop this now. How can
I renegotiate? What is that path to renegotiate
now if I just absolutely can't start chipping
away at these PPOs? Well, it definitely never
hurts to try that. And that's part of what we
do in our process as well. Because we always
want to see, let's get everybody's best offers
on the table. before you start dropping plans
anyway. Because if you're thinking, well, I'm
going to drop this one because it's low, well,
let's make sure they're not willing to negotiate
first before you make any changes. Maybe they
go from being your worst payer to being more
tolerable if they are willing to do a negotiation.
So yes, it's definitely always worth going to
the insurance company and seeing what their offer
is before you make a final decision. So it's
just, it's... It is just a time -intensive process.
It really is just reaching out. It may take a
few days to get assigned to a rep. It could take
a month or longer, just depending on how backed
up they are. So your staff just has to be very
persistent in continuing to follow up and making
sure that you actually get, you know, a final
offer with some back and forth. And definitely
don't take the first offer. You know, keep going
back on your top codes. And your top 10 codes
are going to be by far the most relevant one.
So really focus in on that. So don't just go
in asking necessarily for butter fees on the
entire fee schedule. Have the data for your practice
really at your fingertips so that you know which
codes are going to be the most relevant. I want
to play devil's advocate here too. We know the
games that the insurance companies are playing
on their side. What are the mistakes that dental
offices are making, though, where they're actually
missing out, where they're like these insurance
companies, but then Sandy and her team comes
in and goes, well, Doc, you're actually making
these mistakes and you could be making a lot
more money. Yeah, I would say, you know, the
biggest one, and I don't even know if I would
say it's a mistake. It's just a reflection of
how much the industry is changing. A lot of it
is the downgrade. If you have multiple shared
network agreements and a particular insurance
company maybe three years ago was paying on one
of your better fee schedules, but since then
they've entered into shared network agreements
with a couple of other companies that you have
contracts with. And then they're all of a sudden
just gradually downgrading over time. And it's
really tough to catch those because nobody's
sending you a notice that says, by the way, I
know we were paying you $1 ,100 for a crown.
But now, you know, there's another contract you
have that's paying $750 for crowns. We're just
going to start using that piece. You know, there's
no notice that's being given. You might get a
shared network agreement notice, meaning you
might get some kind of notice that says, hey,
great news, we're entering into a new shared
network agreement with XYZ. But you have to think
beyond that and say, well, what does that actually
mean for me? Does that help me or does that hurt
me? And the insurance companies, when they do
a notification, They all used to explain how
you could opt out of that agreement. And sometimes
they still do. But sometimes the announcement
just says, here's what's happening. They don't
specifically tell you how to opt out of it. And
almost all of those are going to have an opt
out option, meaning they can choose not to participate
with it. You're going to automatically get opted
in. You have to be the one to opt out. So if
you get that notice and you're not. Sure, if
you want to participate and you want to opt out
of that, you're probably going to have to reach
out and specifically ask. We do post on our website,
but mostly on our Facebook page. Anytime we get
one of these shared network agreements, just
to say, what does this mean and what do you need
to do with this for your situation? Just because
it's very confusing. So it's not, like I said,
it's not that necessarily dentists are making
mistakes, but what is happening. is if you're
not spot checking EOBs to say, wait a minute,
we used to be getting paid way better than this.
What's happening? You really have to catch it
on an EOB and remember how you were getting paid
before versus how you're getting paid now in
order to figure out how to rearrange some of
that contract. So it's very tough. I always tell
Dennis, you know, this is all that we do and
we have a hard time. feedback of all the people.
If you're working in a dental practice and you're
actually seeing patients, trying to check benefits,
collect payments, all the things that busy front
office people are doing, it's very hard to catch
them. So it's not meant to be a criticism of
offices who are feeling like things have gotten
very messy. We hear that all the time where offices
tell us, I don't even know what I have anymore.
I signed contracts 10 years ago. I don't even
know what's coming and where. It's gotten so
messy that I just need to do an overhaul and
revisit everything from the ground up. And every
couple of years, you really do need to be doing
that. It's just changed so much that it's easy
to just get caught up in these downgrades and
not realize it. You were talking about change
now. Are there more trends that you've been seeing
as time is going on? As you said, this industry
is changing so fast. AI came to mind for me.
I do want to ask you about that in a second,
if that has a role in the work you're doing.
But what trends are you seeing with this change
that you're talking about that's impacting PPO
negotiations and these contracts and that dentists
should understand? So one big one that has really
changed more recently is Insurance, as we all
know, everything's supposed to be confidential,
right? So dentists are not supposed to share
fee schedules with any other offices. We're very
cautious about that. We don't ever read the schedules
from another office other than where it was intended.
There's very strict rules about that. The same
thing on the insurance company side. They're
not to exchange fee schedules with other insurance
companies. Okay, well, what's happening, though,
is that's getting a little bit fuzzier, meaning
insurance companies are definitely, buying data
in an anonymous format that says, you know, they
can look at your office and see what's the average
PPO fee that you're expecting. So how that's
playing into negotiations is if an insurance
company has a request from your office for a
higher fee schedule and they look at your office
data and they can see your average fee that you're
collecting is less than what this insurance company
is paying you. We're seeing a lot more denials
at times where an insurance company just says,
we're already above what you're willing to accept
from other insurance. Now, I do not like that
at all. I don't think that that should be a possibility
for any insurance company to see any fee that
any office is agreeing to regardless. Just like
any of us, like, you know, to have our, you know,
Have somebody say, well, here's what you're making.
And, you know, we're just not going to give you
a raise this year because, you know, we think
you're already getting paid enough. And that
does not set well with me at all. However, what
dentists need to then be thinking about is if
you're willing to take lower fees than are workable
for you, that's going to potentially have an
impact the farther down the road we go with this.
The more data that insurance companies can see
about what you're agreeing to with other insurance
companies. Now, it's not going to be labeled.
It's not going to say the specific name of the
insurance company and their fees. They are able
to see what you are willing to accept from selectively
from other insurance companies. So you want to
be thinking about that impact that that can have
on you. Because if you're saying your fees aren't
workable for me, I need a higher node. You really
do need to be away at some of those bottom ones
so that you are raising up as far as what you're
agreeing to accept from collectively all of the
insurance company contracts that you've got.
Because that really can now start to hurt you.
The other thing is be paying attention to where
your cash fees are at. Some insurance companies
don't care about your cash fees. They don't look
at them or they're not. using them as much. Some
insurance companies will want to see your cash
fees before they negotiate. So you might be thinking
that you're doing your patients a favor by keeping
your cash fees on the lower side. And in some
ways, we are. But the way that that can work
against you is insurance companies want to see
what the write -offs are. And bigger write -offs
mean they're delivering a, you know, kind of
fair value to the patient. So if your cash fee
is, you know, $1 ,000 for a crown, but the average
crown fee is really in your area is more like,
let's say, $1 ,400. Well, then their $900 crown
offer is actually very good. So they're going
to use that to justify, you know, the write -offs
are very minimal for you. So this is a good deal.
It doesn't mean that it's necessarily a good
deal. It means your cash fees may be no. So you
never want to artificially inflate your cash.
I'm not saying play games with creating cash
fees that aren't actually what you're charging.
You want them to be real fee. But you do want
to be paying attention to your cash fee as far
as where they fall for your area. And the other
always reminder that I give, always fill out
your cash fees on the claim forms. Don't fill
out the PPO fee. Because if an insurance company
is seeing your PPO fees on what you're billing
out, In their world, they're paying 100 % of
your fee because the only fee that they know
for your office is what you're putting on the
claim. So do not bill out PPO fees. Bill out
your cash fee so that you can monitor the write
-offs. That's the other thing. How can you monitor
write -offs if you're not billing out your cash
fees and comparing your cash fees to your PPO
fee in terms of write -off? So you really want
to be billing out cash that can make a difference
on the fees that you're able to make. And that's
actually what the insurance companies want you
to do. Insurance companies will all tell you,
fill out your cash so that they're authentic.
As you're saying these things again, I go back
to, this is so much admin for someone that's
already trying to run a dental practice or things
to even know. I mentioned AI a second ago. I
know for the work that I'm doing, it's been a
fantastic companion in just helping speed up
some of the tasks. Have you played around a bit
with AI or seen anything in the industry? We're
just starting to, just in our own company. It's
kind of very exciting all wrapped up into one
little bundle, you know, but it is being very
powerful in a lot of ways. You know, I think...
Probably a little bit more of the scary side
for dentistry is are these claims being reviewed
by actual dentists? Are they things that are
being automated in a way that may be good and
may not be good? So I am interested to see where
this goes. Yeah, I think we're just on the very
initial frontier of where that's all going. Because
I do worry, Sandy, we came at a point of... We
take insurance companies, take the human side
out of these claims in these things. And it's
just some AI bot going like this number was wrong
on this thing here or like this isn't covered.
And it's like, no. And then someone that actually
did qualify for the care is now just being denied
because it's this robotic kind of conveyor belt
system that's just pushing people out. And that's
a concern. There are, you know, and I won't mention
specific names, but, you know. There are some
companies where you cannot get a live person
anymore when you call in. And, you know, it's
so frustrating because just what you said, there's
cases where, like, there's a real person that
just needs to jump in and help resolve something.
And so, you know, moving even more away from
that is not helpful for this industry. You've
already provided so many helpful things today
for dentists and tips. I'm looking to reduce
my reliance on insurance companies and transition
towards more of a fee -for -service type of practice.
What are some of the initial things? And keep
in mind, again, I'm this dentist that I'm scared
because I think many dentists feel this way.
I'm scared that I'm going to lose my patient
base. I've heard that it doesn't impact me that
much, but what if it does? I don't know, and
I need to pay my staff. What are some of those
initial steps that you can encourage dentists
like, you've got this, this is where you can
start? I think what you all do is a really key
piece to it. It is, you know, and I know that
your client base has a lot of overlap with us
in terms of business models, meaning looking
at how do we position the solo dental practice
business model or small group business model.
to be competitive. And so a big part of that
is the marketing side of what, you know, you
all are the experts at that piece of it. So all,
a lot of times, fellow officers too, you're going
to go dropping plans. Remember, the only thing
the insurance company is really giving you in
exchange for your PPO participation is a listing
on their website. You know, that's what you're
getting. That's the marketing value that they're
giving you in exchange for your participation.
So if you know your plan is to start going out
of network with more proactively, then build
the marketing side of your practice differently
so that, you know, you're not waiting necessarily
to drop something big. You are already proactively
building your new patient flow coming from some
other place. I particularly talk about this if
it's a fee -for -service office who is slowed
down maybe and they're thinking about adding
some PPOs. And sometimes that is the right thing.
But also make sure, have you also piggybacked
that with marketing in other ways? I mean, PPO
write -offs are just marketing dollars. It's
just figuring out what's in our place in your
practice. So I think the marketing side, you
know, what you all do is how do we not just look
at our marketing as far as people who find us
on the insurance company website? How do we build
our name and brand differently and let people
know about it? The other part I think is important
is, and there's a lot of conversation happening
about this in the dental world, is, you know,
the traditional dental business model has been
hygiene oriented. And people come in through
a routine cleaning and checkup. They get their
cleanings twice a year. And then as they come
through, you know, dentistry is being diagnosed
on them for the doctor side of things. The thing
that is so difficult right now is the hygiene
shortage. So what happened, as everyone knows,
during COVID, so many hygienists left the industry
permanently. We are overflooded with new dental
schools opening. We don't need more dental schools,
but we need more hygienists. So there's a true
lack of hygienists. I talk to dentists every
day across the country, and there's just not
enough hygienists. You know, we don't have that
same growth coming in by replacing hygienists
last year with COVID. So now we're in a situation
where, you know, hygiene salaries have gone up
substantially. And that's if you can find a hygienist.
It is very common now for a practice to go without
a hygienist for six months, just trying to find
a replacement or relying on temps until they
can be permanent. So that traditional hygiene
business model has become really challenging.
So thinking outside that box more and saying,
am I going to continue to follow that or do I
need to be doing marketing to get patients in
the door who are looking for something beyond
just a cleaning and checkup? You know, how do
we kind of enhance the way patients find us beyond
just that? And, you know, again, not all your
expertise, not mine, as far as how to do that.
But what's happening is because. You know, insurance
rates are not going up at the same pace as overhead
is going up. We've got to crunch that way. And
then we've got this hygiene piece where even
if you can find a hygienist, you might be paying
$10 or $20 an hour more for a hygienist than
you were a few years ago. So the only place to
support that is coming in front of the dentist's
salary. There just isn't another way to offset
that. So definitely looking at, do we want to
continue with the same you know, business model?
Or do we need to be a little bit more creative
about how we look at? So definitely some pieces
that I think are going to be changing because
that hygiene piece is not a quick fix. You know,
you've got to have a lot of time to rebuild a
hygiene pool after what was lost during COVID.
And that is, you know, probably many years down
the road before we would see a change with that.
So, you know, look at things a little differently
than we have in the past. sandy i want to ask
you if dentists want to get a hold of you or
take these next steps because that is ultimately
the first thing they need to do is they need
to get in contact with the right people the right
person to to help them do these things because
as we said it is difficult it is overwhelming
to do these things do are you doing workshops
do you do consults is there How can people contact
you to make sure that they take these first steps?
Well, our website is unlocktheppo .com. And then
if you go into that, we have an established site.
That's going to be probably where the majority
of people listening today would qualify, meaning
you already own a practice. And then we also
have a startup site if you're getting ready to
do a scratch, you know, open your doors from
the ground up. We have kind of two different
pieces. If you click on the Contact Us page,
on our website it'll ask some questions about
who do you have contracts with now we just give
complimentary feedback to first to say do we
think we would be a good fit for your situation
and then we offer a complimentary consult as
well just to chat through you know do we're pretty
conservative about we don't want people to move
forward with us unless we really think that there's
big changes that we can make for them So we'll
get some feedback on that. But yeah, our website
is unlocktheppo .com. And then just for somebody
who's maybe keeping this in -house or maybe just
doesn't have a lot of changes to make but wants
to stay up on these shared network agreement
changes, then I recommend find us on Facebook.
We're Unlock the PPO on Facebook. But we really
do try to post a lot of educational things. There's
also some educational videos on our website.
that just are open to anybody. So there are just
three things that we provide just to try to keep
people a bit more educated in the industry. So
that's an easy place to start. A last question
came to mind, as you said, now on the startup
side and on the established side. If you had
a megaphone to dentists that are just coming
out of a dental school, are you saying, fight
the good fight and go fee -for -service and try
and get the patient that you want to get? Or
are you saying there is a place for you to start
out with these insurance companies, but then
you need a strategy to wean it off over time?
Yeah, and I think the second one is pretty common
as far as what's the rightful place of insurance,
meaning what are fee schedules that are workable,
and then setting the foundation well from the
beginning. So if you're doing a startup and you're
evaluating, okay, do we need some participation?
But if so, what's the right participation? Certainly,
you know, we do the demographics to say, well,
here's the insurance companies that are going
to be relevant by employer group in your area.
That's a big part of it. And then figuring out
what's the best fit. If you're looking at opening
up fee -for -service from the get -go, A couple
of pieces to that. One is going to be certainly
demographics. If you're in Southern California,
that's a pretty rough place to start there and
kind of not have to work your way up to over
time. If you're in an underserved area, that's
certainly going to make that much easier. And
the other piece is to a little bit of like if
a dentist is thinking they're going to open beaker
surveys, a lot of times what they might want
to do then is, They might continue to work as
an associate for a couple days a week, somewhere
else. And they go into it knowing, I really want
a fee -for -service business model, but I'm just
going to have slower growth with that. So how
do I kind of blend my work to do that? You know,
maybe opening and expecting a little bit slower
pace with that. Or do we go as a little bit more
insurance to be able to wake up a little bit
faster and then, like you said, give that a few
years for growth and then maybe get back once
you get where you're trying to get. Sandy, thank
you so much. I appreciate you. And I admire the
work that you do. I told you a bit about my story
with my father and how I wish that you had met
him seven years ago and that you had shared with
him everything that you do now. Keep up the good
fight. And it's amazing that you're able to help
dentists get more out of what they do in dentistry.
So thank you for the work that you do. And I
appreciate your time today. Thanks for having
me.