WEBVTT 00:00:02.029 --> 00:00:04.549 I want to start today's episode on a personal 00:00:04.549 --> 00:00:07.969 note. As I've mentioned on this podcast before, 00:00:08.230 --> 00:00:10.570 my dad's a dentist and he owned his own practice 00:00:10.570 --> 00:00:13.929 in South Africa for over 30 years. He eventually 00:00:13.929 --> 00:00:16.429 had to sell that practice due to business constraints 00:00:16.429 --> 00:00:18.890 and also just feeling like he's working harder 00:00:18.890 --> 00:00:22.449 and earning less. A big reason for this was insurance 00:00:22.449 --> 00:00:26.390 companies. And I can't help but wonder that if 00:00:26.390 --> 00:00:29.829 my father had met my next guest all those years 00:00:29.829 --> 00:00:34.060 ago, where the things could be different welcome 00:00:34.060 --> 00:00:37.119 to bite -sized dental marketing my name is ian 00:00:37.119 --> 00:00:40.259 and today we are joined by the one and only sandy 00:00:40.259 --> 00:00:44.700 hudson from unlock the ppo sandy has helped hundreds 00:00:44.700 --> 00:00:47.880 of dentists navigate the world of dental insurance 00:00:47.880 --> 00:00:52.159 and how to actually get the deals that make sense 00:00:52.159 --> 00:00:55.340 for your practice or drop the insurances that 00:00:55.340 --> 00:00:58.799 are no longer benefiting your bottom line So 00:00:58.799 --> 00:01:01.000 if it feels like insurance companies are driving 00:01:01.000 --> 00:01:04.099 your practice, it seems like you're working harder 00:01:04.099 --> 00:01:06.099 and harder but the money's just not coming in 00:01:06.099 --> 00:01:08.420 and you don't know what the first step is to 00:01:08.420 --> 00:01:11.560 drop those bad insurances, well then this episode 00:01:11.560 --> 00:01:20.939 is for you. Enjoy. Today we're joined by what 00:01:20.939 --> 00:01:22.920 I would call one of the unsung heroes, Sandy 00:01:22.920 --> 00:01:26.840 Hudson from Unlock the PPO and... You're out 00:01:26.840 --> 00:01:29.420 here fighting the good fight, Sandy. I was talking 00:01:29.420 --> 00:01:33.159 to you just before we started of there's so many 00:01:33.159 --> 00:01:37.760 dentists that feel and can relate to the message 00:01:37.760 --> 00:01:41.659 that you have and what you're doing to help dentists 00:01:41.659 --> 00:01:44.939 kind of get back to feeling fulfilled in dentistry. 00:01:45.019 --> 00:01:47.019 And even though they work harder to make that 00:01:47.019 --> 00:01:50.560 money and to feel that patient care is coming 00:01:50.560 --> 00:01:53.989 first instead of this. this battle of insurance 00:01:53.989 --> 00:01:56.530 companies and feeling that they're not getting 00:01:56.530 --> 00:02:01.049 anywhere. I would love to know your story of 00:02:01.049 --> 00:02:04.430 how you got into this and what motivated you 00:02:04.430 --> 00:02:10.490 to get into this business. Yeah, it's a situation 00:02:10.490 --> 00:02:13.349 that is what most dentists are probably feeling 00:02:13.349 --> 00:02:16.330 like now. I'm married to a dentist, which is 00:02:16.330 --> 00:02:21.620 how I got into all this in the first place. My 00:02:21.620 --> 00:02:23.379 husband had been in practice for several years, 00:02:23.460 --> 00:02:26.639 had bought a practice. And the building that 00:02:26.639 --> 00:02:29.080 we were in went, all of the condos went on the 00:02:29.080 --> 00:02:32.280 market. So we were able to move to a larger office. 00:02:32.479 --> 00:02:36.800 And so we got moved. We got crazy busy, had all 00:02:36.800 --> 00:02:39.919 this growth. And then at the end of the year, 00:02:39.960 --> 00:02:42.460 kind of realized we didn't actually really make 00:02:42.460 --> 00:02:44.639 much more money. We were a lot busier, but we 00:02:44.639 --> 00:02:47.460 weren't necessarily a lot more profitable. And 00:02:47.460 --> 00:02:51.039 so the practice grew. But as anybody who's a 00:02:51.039 --> 00:02:54.639 dentist knows, dentistry is a hard business on 00:02:54.639 --> 00:02:58.740 your body physically. So that piece is not sustainable 00:02:58.740 --> 00:03:01.620 for most dentists, you know, as opposed to 20, 00:03:01.659 --> 00:03:05.120 30 years. So I started really looking at the 00:03:05.120 --> 00:03:07.620 numbers going, OK, we've got the patients, we've 00:03:07.620 --> 00:03:11.020 got all of the numbers. But what do we need to 00:03:11.020 --> 00:03:13.919 do differently to make this sustainable and more 00:03:13.919 --> 00:03:16.699 possible? And so we started really hammering 00:03:16.699 --> 00:03:19.240 away at the insurance side of things of just, 00:03:19.530 --> 00:03:21.770 evaluating things of okay what's working what 00:03:21.770 --> 00:03:25.289 isn't and you know realizing that by being busy 00:03:25.289 --> 00:03:29.090 and booking out far we were accommodating for 00:03:29.090 --> 00:03:31.009 fee schedules that just weren't even profitable 00:03:31.009 --> 00:03:33.569 and so they were plugging things up and so we 00:03:33.569 --> 00:03:36.490 just really had to start evaluating and figuring 00:03:36.490 --> 00:03:40.050 out what makes sense and what doesn't i originally 00:03:40.050 --> 00:03:42.270 got started because there weren't really companies 00:03:42.270 --> 00:03:45.699 doing that and so i just started posting helpful 00:03:45.699 --> 00:03:48.460 information just to say, OK, I feel like I made 00:03:48.460 --> 00:03:50.520 every mistake in the book while I was trying 00:03:50.520 --> 00:03:53.000 to figure this out on my own. How do I save some 00:03:53.000 --> 00:03:55.520 other offices? You know, some of the hassles 00:03:55.520 --> 00:03:57.580 and mistakes that I made so that they don't have 00:03:57.580 --> 00:03:59.860 to reinvent the wheel. I kept thinking, I wish 00:03:59.860 --> 00:04:01.580 there was somebody who could help me do this, 00:04:01.659 --> 00:04:04.400 you know? And so I just started kind of going, 00:04:04.580 --> 00:04:07.639 well, let's see. Maybe that is a thing that is 00:04:07.639 --> 00:04:09.460 a service that needs to be provided. And that's 00:04:09.460 --> 00:04:12.580 kind of how I originally got into this. And so 00:04:12.580 --> 00:04:15.879 it's just. learning how much the industry has 00:04:15.879 --> 00:04:20.139 changed as was 15 years ago. And now it's crazy 00:04:20.139 --> 00:04:22.300 complicated. Back then, it wasn't even nearly 00:04:22.300 --> 00:04:25.660 as complicated as it is now. So anyway, that's 00:04:25.660 --> 00:04:28.420 sort of my story of how I landed in this. Didn't 00:04:28.420 --> 00:04:32.339 really ever expect to be so in -depth with dental 00:04:32.339 --> 00:04:35.439 insurance, but that's what it translated into. 00:04:35.660 --> 00:04:39.480 So it's been a fun journey. I want to start us 00:04:39.480 --> 00:04:41.519 off with an interesting question or something 00:04:41.519 --> 00:04:44.959 that I personally am seeing or heard from other 00:04:44.959 --> 00:04:48.439 dentists, and I want to know if you agree. Are 00:04:48.439 --> 00:04:52.220 bad insurance contracts hurting the heart of 00:04:52.220 --> 00:04:54.579 what the dental industry is meant to be, and 00:04:54.579 --> 00:04:57.180 it's making dentists feel unfulfilled in the 00:04:57.180 --> 00:05:00.439 work? I know that dental insurance is needed. 00:05:00.519 --> 00:05:03.470 Insurance companies do play a role, but... Slowly 00:05:03.470 --> 00:05:05.790 but surely, I've been in this space for five 00:05:05.790 --> 00:05:08.389 years now, I've seen a trend of more and more 00:05:08.389 --> 00:05:11.189 frustration building up. What are you seeing? 00:05:11.850 --> 00:05:14.810 Yeah, well, it's no doubt becoming more challenging. 00:05:15.750 --> 00:05:18.290 When we look at dental contracting now compared 00:05:18.290 --> 00:05:23.529 to, you know, years ago or longer, so many more 00:05:23.529 --> 00:05:26.290 shared network agreements. So what used to be 00:05:26.290 --> 00:05:28.569 a little bit more simplified process of at least 00:05:28.569 --> 00:05:30.689 applying a contract, you knew what you were getting. 00:05:31.230 --> 00:05:33.810 Now, most insurance companies have shared network 00:05:33.810 --> 00:05:36.689 agreements with multiple other companies, meaning 00:05:36.689 --> 00:05:39.610 you can be in network with one company through 00:05:39.610 --> 00:05:42.750 somebody else's contact. And so if you understand 00:05:42.750 --> 00:05:47.290 that, that might be fine. But it's gotten to 00:05:47.290 --> 00:05:49.649 a point where dentists are just, it's become 00:05:49.649 --> 00:05:51.990 very confusing. So dentists just don't always 00:05:51.990 --> 00:05:53.930 understand what they're getting when they sign 00:05:53.930 --> 00:05:56.550 a contract, which is... hold them in network 00:05:56.550 --> 00:05:58.589 maybe with companies they didn't intend to be 00:05:58.589 --> 00:06:00.750 in network with. And so that part has certainly 00:06:00.750 --> 00:06:03.170 gotten more complicated, something that you will 00:06:03.170 --> 00:06:06.370 have to, you know, pay attention to it. Also, 00:06:06.470 --> 00:06:09.069 there's just a crunch in the industry, you know, 00:06:09.089 --> 00:06:12.470 where it's, we're seeing so much more of certainly 00:06:12.470 --> 00:06:15.069 with new dentists, you know, their student loan 00:06:15.069 --> 00:06:19.050 debt is just so much higher now than it used 00:06:19.050 --> 00:06:22.709 to be, you know, 20, 30 years ago. So you can 00:06:22.709 --> 00:06:27.790 tile that with. So many, you know, dental support 00:06:27.790 --> 00:06:30.990 staff leaving the industry during COVID. So now 00:06:30.990 --> 00:06:34.269 you've got this new higher overhead that's come 00:06:34.269 --> 00:06:37.209 since then, combined with higher student loan 00:06:37.209 --> 00:06:40.629 debt. Now you've got this situation where kind 00:06:40.629 --> 00:06:43.790 of the only place to pull that from is the dentist's 00:06:43.790 --> 00:06:46.189 salary. You know, really, insurance companies 00:06:46.189 --> 00:06:49.410 are not keeping peace with that overhead. It's 00:06:49.410 --> 00:06:54.209 definitely squeezing. the solo practice dentists. 00:06:54.209 --> 00:06:56.649 And that's who we're advocates of. We don't work 00:06:56.649 --> 00:07:02.310 with large DSOs. We're very much people who just 00:07:02.310 --> 00:07:04.829 work with the solo practice business model. So 00:07:04.829 --> 00:07:08.250 that's certainly what we're seeing across the 00:07:08.250 --> 00:07:11.810 country right now is a challenge. Was COVID a 00:07:11.810 --> 00:07:15.329 big turning point for you? COVID was in that 00:07:15.329 --> 00:07:18.230 it's interesting when everything happened initially 00:07:18.230 --> 00:07:22.079 with COVID. We really reined everything in with 00:07:22.079 --> 00:07:24.519 our company thinking, you know, dentists are 00:07:24.519 --> 00:07:26.800 being shut down. They can't even practice right 00:07:26.800 --> 00:07:29.699 now. We expect it to have no business at all. 00:07:30.540 --> 00:07:35.180 And it was the opposite. It was almost like dentists 00:07:35.180 --> 00:07:38.939 were on this forced vacation time, shut down. 00:07:39.019 --> 00:07:40.959 Vacation is probably the wrong word for it. But 00:07:40.959 --> 00:07:43.060 they were forced to shut down in a way that has 00:07:43.060 --> 00:07:47.579 never happened before. And instead, it was almost 00:07:47.579 --> 00:07:50.899 like they had time to start reviewing their data. 00:07:51.079 --> 00:07:54.800 And they're like, OK, well, I'm going to dive 00:07:54.800 --> 00:07:56.800 into some of these projects that I never have 00:07:56.800 --> 00:08:00.220 a chance to do normally. And so we were completely 00:08:00.220 --> 00:08:02.899 overwhelmed. We were actually we stopped taking 00:08:02.899 --> 00:08:05.639 new clients for several months during and after 00:08:05.639 --> 00:08:08.000 COVID for a while because we just couldn't accommodate 00:08:08.000 --> 00:08:10.920 all of the phone calls. So it was an odd it was 00:08:10.920 --> 00:08:12.959 exactly the opposite of what we were expecting. 00:08:13.560 --> 00:08:16.100 But hats off to Dennis for really taking that 00:08:16.100 --> 00:08:19.019 time and saying, okay, we know changes are coming. 00:08:19.100 --> 00:08:22.160 How do we actually start looking at our business 00:08:22.160 --> 00:08:24.720 differently and start to make changes to respond 00:08:24.720 --> 00:08:27.959 to that? So I think overall, it was just not 00:08:27.959 --> 00:08:32.019 exactly what we were expecting. And that's so 00:08:32.019 --> 00:08:34.799 interesting that you said that because it's time 00:08:34.799 --> 00:08:40.700 for some introspective exercises to figure out. 00:08:41.159 --> 00:08:42.879 What are these things I've been trying to get 00:08:42.879 --> 00:08:45.340 at? And then you start seeing, holy moly, there's 00:08:45.340 --> 00:08:47.700 all of these things that I could be doing that 00:08:47.700 --> 00:08:49.580 will actually make my practice more money or 00:08:49.580 --> 00:08:52.440 make things better. And so it does make perfect 00:08:52.440 --> 00:08:55.399 sense. And that's actually a perfect segue into 00:08:55.399 --> 00:08:59.080 what I wanted to ask you next is dentists are 00:08:59.080 --> 00:09:02.340 typically in the hustle and bustle. I mean, they 00:09:02.340 --> 00:09:05.240 wear so many hats in a practice. We can't expect 00:09:05.240 --> 00:09:06.980 dentists to keep up with these things because 00:09:06.980 --> 00:09:09.629 it's... I'm the business owner. I'm the dentist. 00:09:09.710 --> 00:09:15.470 I'm the HR. It's a full -time jobs. I don't want 00:09:15.470 --> 00:09:20.950 to say job. But often there's things that dentists 00:09:20.950 --> 00:09:23.409 are just not aware of or there's just misconceptions. 00:09:23.490 --> 00:09:26.450 And I want to ask you, what are some of those 00:09:26.450 --> 00:09:30.409 misconceptions about insurance contracts or how 00:09:30.409 --> 00:09:33.169 we deal with insurance that you can share with 00:09:33.169 --> 00:09:35.090 dentists so that they can at least just start 00:09:35.090 --> 00:09:38.990 to ask? the right questions. In one of the previous 00:09:38.990 --> 00:09:41.429 episodes I listened of yours, you mentioned about 00:09:41.429 --> 00:09:44.250 how some contracts dentists just opt into things 00:09:44.250 --> 00:09:47.509 without even knowing about it, but then they 00:09:47.509 --> 00:09:51.090 have to formally opt out or otherwise it just 00:09:51.090 --> 00:09:53.330 continues. Are there some other examples of that 00:09:53.330 --> 00:09:55.610 that you can share with dentists they can keep 00:09:55.610 --> 00:09:58.070 an eye on? I think a couple of things would be 00:09:58.070 --> 00:10:01.269 they should be paying attention to the initial 00:10:01.269 --> 00:10:04.389 trials of a contract. So meaning how long do 00:10:04.389 --> 00:10:06.799 you have to stay in network? So all contracts 00:10:06.799 --> 00:10:10.279 will have, it's usually 30, 60 or 90 days that 00:10:10.279 --> 00:10:12.240 you can terminate a contract. So, you know, you 00:10:12.240 --> 00:10:14.720 give notice to the insurance company if you don't 00:10:14.720 --> 00:10:17.399 want to participate anymore. And they'll, you 00:10:17.399 --> 00:10:19.840 know, tell you in the contract the amount of, 00:10:19.840 --> 00:10:21.639 you know, leave time you have to give them to 00:10:21.639 --> 00:10:25.000 get back out. But there are cases where there's 00:10:25.000 --> 00:10:27.740 an initial term of a contract that might be a 00:10:27.740 --> 00:10:30.600 year, one way or two year, which means once you 00:10:30.600 --> 00:10:32.960 agree to a contract, you might not be able to 00:10:32.960 --> 00:10:35.830 terminate it. for a year or two, and then you 00:10:35.830 --> 00:10:39.350 have to notice after that. So just, you know, 00:10:39.350 --> 00:10:41.970 be reading through that garbage pretty carefully 00:10:41.970 --> 00:10:44.490 to make sure that if you're thinking, well, maybe 00:10:44.490 --> 00:10:48.029 I'll, or like with a renegotiation, maybe you 00:10:48.029 --> 00:10:49.549 think, well, I'm going to go ahead and take this 00:10:49.549 --> 00:10:51.830 increase for now. I might want to terminate this 00:10:51.830 --> 00:10:54.110 contract at the end of the year, but for now, 00:10:54.110 --> 00:10:56.730 I'll just go ahead and take it until I can reevaluate 00:10:56.730 --> 00:10:58.779 further. If there's language in that contract 00:10:58.779 --> 00:11:01.159 that says you have to remain contracted for two 00:11:01.159 --> 00:11:03.299 years before you can donate it, if you accept 00:11:03.299 --> 00:11:06.399 an increase, you want to really be aware of that 00:11:06.399 --> 00:11:09.019 because you might be locked in a little bit longer 00:11:09.019 --> 00:11:12.419 than you're definitely waiting through all of 00:11:12.419 --> 00:11:15.720 that. Also, non -covered services is a thing 00:11:15.720 --> 00:11:19.580 to pay attention to. So there's, I don't know, 00:11:19.600 --> 00:11:21.600 probably over half the states now have passed 00:11:21.600 --> 00:11:23.659 non -covered services laws, which really just 00:11:23.659 --> 00:11:26.629 mean. If it's a completely non -covered service 00:11:26.629 --> 00:11:28.970 under the patient's policy, you're not bound 00:11:28.970 --> 00:11:31.870 by the PPO fee. In most cases, you could charge 00:11:31.870 --> 00:11:36.049 the patient. There's solutions to that. You know, 00:11:36.049 --> 00:11:38.970 federal plans don't fall under that. Every state 00:11:38.970 --> 00:11:40.929 writes their laws a little bit differently. But 00:11:40.929 --> 00:11:43.490 overall, the point is, if the insurance company 00:11:43.490 --> 00:11:46.110 is not going to be paying for anything, they 00:11:46.110 --> 00:11:48.929 can't tell you what you can charge. There is 00:11:48.929 --> 00:11:52.070 paperwork sometimes, though. Where the insurance 00:11:52.070 --> 00:11:55.330 company may ask you, let's say you're in a state 00:11:55.330 --> 00:11:57.769 that's passed that law. The insurance company 00:11:57.769 --> 00:12:00.529 may say, hey, even though you're not bound by 00:12:00.529 --> 00:12:02.850 the PPO fee, would you like to just voluntarily 00:12:02.850 --> 00:12:07.110 agree to abide by the PPO fee in cases where 00:12:07.110 --> 00:12:10.029 you don't have to? You should always, always, 00:12:10.090 --> 00:12:12.590 always check the no box if you're asked that 00:12:12.590 --> 00:12:15.730 question. If somebody's saying, hey, we do veneers 00:12:15.730 --> 00:12:18.629 and it's completely not covered under the patient's 00:12:18.629 --> 00:12:21.129 policy and we can charge our cash fee. Do we 00:12:21.129 --> 00:12:23.789 want to just agree to give the patient the PPO 00:12:23.789 --> 00:12:28.250 fee anyway? No. I mean, you can certainly consider 00:12:28.250 --> 00:12:30.950 if you might want to do that on your own, I guess 00:12:30.950 --> 00:12:33.490 maybe, but you don't want to ever, you know, 00:12:33.490 --> 00:12:35.830 agree to that with an insurance company. There's 00:12:35.830 --> 00:12:37.950 a reason why those non -covered service laws 00:12:37.950 --> 00:12:40.549 are passed, which is to say you have the right 00:12:40.549 --> 00:12:43.009 as a business owner to be able to charge your 00:12:43.009 --> 00:12:45.409 full fee if the insurance company is not contributing 00:12:45.409 --> 00:12:48.070 to the cost of that service. And you want to 00:12:48.070 --> 00:12:51.139 always retain that option. Keep an eye out for 00:12:51.139 --> 00:12:53.419 that in paperwork as well. That's another one 00:12:53.419 --> 00:12:54.879 that's kind of sneaking in there a little bit 00:12:54.879 --> 00:12:57.919 more often these days. Is there a lack of transparency 00:12:57.919 --> 00:13:02.600 in general with these companies? I mean, when 00:13:02.600 --> 00:13:05.200 it's things like setting rates or how they deny 00:13:05.200 --> 00:13:08.559 claims or the things that you've mentioned, how 00:13:08.559 --> 00:13:11.960 can dentists navigate or challenge these things 00:13:11.960 --> 00:13:14.139 if they thought they were getting a certain kind 00:13:14.139 --> 00:13:19.370 of deal, but then actually the fine print? But 00:13:19.370 --> 00:13:21.230 because we all know that insurance companies 00:13:21.230 --> 00:13:23.769 are there to make money, like it's the fine print 00:13:23.769 --> 00:13:28.450 exists. So is there a way that they can challenge 00:13:28.450 --> 00:13:31.389 it effectively? Do you have a way where maybe 00:13:31.389 --> 00:13:34.450 they'll have a higher chance of being successful? 00:13:34.710 --> 00:13:37.549 It's just a lot of time invested, you know, to 00:13:37.549 --> 00:13:40.769 say, I mean, obviously, if you don't get where 00:13:40.769 --> 00:13:42.889 you're trying to get broadly with the insurance 00:13:42.889 --> 00:13:45.289 company and it's like you've exhausted a lot 00:13:45.289 --> 00:13:48.279 of moves. You know, certainly you can file a 00:13:48.279 --> 00:13:50.059 formal complaint with the insurance commissioner 00:13:50.059 --> 00:13:53.320 and for your state and just try to get it escalated 00:13:53.320 --> 00:13:56.799 that way. And then just be very clear and careful 00:13:56.799 --> 00:14:00.340 of reading the language to say, did you unfortunately 00:14:00.340 --> 00:14:03.940 agree to something that may be unfair, but you 00:14:03.940 --> 00:14:05.779 agreed to it, then there's not a lot of room 00:14:05.779 --> 00:14:07.779 to move with it. So just I think back to your 00:14:07.779 --> 00:14:10.840 original point, be very careful about what you 00:14:10.840 --> 00:14:14.480 agree to. And also. Insurance contracts are typically 00:14:14.480 --> 00:14:17.259 not going to be like normally the only thing 00:14:17.259 --> 00:14:19.179 negotiable is going to be the faith themselves. 00:14:19.659 --> 00:14:22.240 So when you're working with an insurance company, 00:14:22.379 --> 00:14:25.700 if you think you wind through verbiage that you 00:14:25.700 --> 00:14:27.740 don't like on a contract and that's going to 00:14:27.740 --> 00:14:31.279 protect you, typically that's not the case. You 00:14:31.279 --> 00:14:33.679 know, typically verbiage with an insurance company 00:14:33.679 --> 00:14:37.179 is not going to be something that you can edit 00:14:37.179 --> 00:14:40.730 out or change. It's really going to be. make 00:14:40.730 --> 00:14:43.730 it or leave it. And then you need to be definitely 00:14:43.730 --> 00:14:46.590 deciding, are there clauses in this that are 00:14:46.590 --> 00:14:48.690 just not workable? Maybe I just better pass it. 00:14:48.909 --> 00:14:51.049 On this, what you said of take it or leave it, 00:14:51.149 --> 00:14:55.490 if I took it and at some point I now realize 00:14:55.490 --> 00:15:00.070 this is not working. We know that there's so 00:15:00.070 --> 00:15:02.509 many dental practices that have certain PPOs 00:15:02.509 --> 00:15:04.789 that they realize it's not profitable for them 00:15:04.789 --> 00:15:08.200 anymore. they're still hesitating to drop these 00:15:08.200 --> 00:15:10.080 because they're scared they're actually going 00:15:10.080 --> 00:15:14.240 to lose patients. As I mentioned to you earlier 00:15:14.240 --> 00:15:17.000 on the ACT Dental podcast that I listened of 00:15:17.000 --> 00:15:20.279 yours, you emphasize that this is something you 00:15:20.279 --> 00:15:23.460 chip away at. It's not just I'm insurance and 00:15:23.460 --> 00:15:27.600 now I swoosh over to fee -for -service. How can 00:15:27.600 --> 00:15:32.139 dentists start to evaluate which of these is 00:15:32.139 --> 00:15:34.419 no longer a good fit for me and I need to start 00:15:34.419 --> 00:15:38.120 chipping away at it? So what we do with our clients, 00:15:38.259 --> 00:15:40.860 and it's certainly something dentists can really 00:15:40.860 --> 00:15:43.340 be looking at internally on their own as well, 00:15:43.419 --> 00:15:46.340 is we typically get it down to about 30 top codes 00:15:46.340 --> 00:15:49.419 for the practice. You don't need to be looking 00:15:49.419 --> 00:15:52.299 at hundreds of 88. It's going to be 30 codes 00:15:52.299 --> 00:15:55.139 or less for a general practice specialist, even 00:15:55.139 --> 00:15:58.259 less than that. And then really look to see the 00:15:58.259 --> 00:16:01.259 makeup of your practice and then evaluate all 00:16:01.259 --> 00:16:03.480 of your current PPO contracts. So you want to 00:16:03.480 --> 00:16:06.659 get... an estimated collections rate for everything 00:16:06.659 --> 00:16:08.139 that you've got in place now, because that's 00:16:08.139 --> 00:16:10.500 really your starting point. You need to know 00:16:10.500 --> 00:16:14.580 truly on paper, not just what is your staff paying, 00:16:14.740 --> 00:16:17.080 who do you think's paying you badly, but actually 00:16:17.080 --> 00:16:19.799 get it down on paper so you're really crunching. 00:16:20.820 --> 00:16:23.159 And then we just put everything in order and 00:16:23.159 --> 00:16:25.139 best to worst. So we want to say, you know, who's 00:16:25.139 --> 00:16:26.679 paying you well, who's not paying you so well. 00:16:26.840 --> 00:16:29.600 We start down there at the bottom. Now, let's 00:16:29.600 --> 00:16:31.480 say your very worst paying piece schedule, you've 00:16:31.480 --> 00:16:35.759 got... you know, $300 ,000 a year of production 00:16:35.759 --> 00:16:38.620 tied to it. And your second lowest one, you've 00:16:38.620 --> 00:16:41.659 got $30 ,000 in production. Well, maybe you want 00:16:41.659 --> 00:16:44.120 to start with that little bit smaller one and 00:16:44.120 --> 00:16:46.580 you want to go ahead and eliminate that one first 00:16:46.580 --> 00:16:48.940 and then give your staff a chance to go through 00:16:48.940 --> 00:16:51.580 that transition, get used to talking to patients, 00:16:51.720 --> 00:16:53.519 and then you kind of work your way up to some 00:16:53.519 --> 00:16:56.559 bigger ones. So just make it a good game plan. 00:16:56.720 --> 00:16:59.639 I mean, looking at who's really paying you at 00:16:59.639 --> 00:17:03.000 a rate that is not sustainable. And also, I think 00:17:03.000 --> 00:17:05.920 it's hard. You know, you kind of mentioned we 00:17:05.920 --> 00:17:09.240 don't want to lose all of our patients. But I 00:17:09.240 --> 00:17:12.059 think when you're especially a solo practice 00:17:12.059 --> 00:17:16.660 dentist, you've spent years building relationships 00:17:16.660 --> 00:17:20.240 with patients. And it matters to you if patients 00:17:20.240 --> 00:17:24.059 stay or go. So there is this sense like we worked 00:17:24.059 --> 00:17:25.920 so hard to build our patient base. We don't want 00:17:25.920 --> 00:17:29.880 to lose anyone. But the reality is. that, you 00:17:29.880 --> 00:17:31.900 know, if you drop a plane and you lose a few 00:17:31.900 --> 00:17:35.500 patients, number one, there's a good chance they're 00:17:35.500 --> 00:17:37.519 probably going to come back later if they are 00:17:37.519 --> 00:17:39.539 jumping ship just for insurance and don't have 00:17:39.539 --> 00:17:41.559 a good experience somewhere else. Are they going 00:17:41.559 --> 00:17:44.500 to, you know, circle back around in a year anyway? 00:17:45.059 --> 00:17:48.200 But also, is it just a case where, you know, 00:17:48.240 --> 00:17:51.200 if you lose, like, let's say you lose 10 % of 00:17:51.200 --> 00:17:53.019 your patients with that insurance company, but 00:17:53.019 --> 00:17:55.599 you collect your full fee from the other 90 % 00:17:55.599 --> 00:17:59.640 of the pay, it actually is... a better business 00:17:59.640 --> 00:18:02.240 model for you to start making some of those changes. 00:18:02.380 --> 00:18:05.599 So yes, we ideally want to lose patients, but 00:18:05.599 --> 00:18:07.440 there is a point where you need to recognize 00:18:07.440 --> 00:18:10.799 shrinking things just a little bit can definitely 00:18:10.799 --> 00:18:14.599 make sense from a business perspective of being 00:18:14.599 --> 00:18:17.480 able to then take care of those 94 % who stay 00:18:17.480 --> 00:18:20.660 at a higher level because you have the time, 00:18:20.740 --> 00:18:22.640 you have the ability, you're getting reimbursed 00:18:22.640 --> 00:18:25.640 at a rate that's workable by the kind of dental 00:18:25.640 --> 00:18:27.809 care you want to provide. So there's definitely 00:18:27.809 --> 00:18:29.690 a tipping point in there. And when you think 00:18:29.690 --> 00:18:32.309 about it, if you're writing off 50 % of your 00:18:32.309 --> 00:18:35.349 fee, you can lose half of your patience and still 00:18:35.349 --> 00:18:37.329 collect what you're collecting now. And not to 00:18:37.329 --> 00:18:40.930 say that that's the goal by any means, but when 00:18:40.930 --> 00:18:43.849 you really start to crunch the numbers, sometimes 00:18:43.849 --> 00:18:46.630 dentists, I think, are very surprised at how 00:18:46.630 --> 00:18:48.750 much it does make sense to start chipping away. 00:18:48.869 --> 00:18:50.849 So yes, we want to be looking at this to say, 00:18:50.970 --> 00:18:53.089 we're not just going to randomly pick a company. 00:18:53.519 --> 00:18:55.640 We're going to really get all of our ducks in 00:18:55.640 --> 00:18:58.380 a row first and evaluate where all of the current 00:18:58.380 --> 00:19:01.119 contracts are at and then start getting a game 00:19:01.119 --> 00:19:04.279 plan into play. And for some offices, maybe they're 00:19:04.279 --> 00:19:07.380 on a two to three year fight. You know, let's 00:19:07.380 --> 00:19:09.559 drop one plane every six months for the next 00:19:09.559 --> 00:19:12.380 three years and go very gradually. And then others 00:19:12.380 --> 00:19:15.539 are going more aggressively. But you can start 00:19:15.539 --> 00:19:18.710 to move in this direction without it being. huge 00:19:18.710 --> 00:19:21.170 major changes that are going to upset your whole 00:19:21.170 --> 00:19:23.549 practice you know just starting to go little 00:19:23.549 --> 00:19:27.170 by little and is definitely the direction a lot 00:19:27.170 --> 00:19:30.289 of practice one as you explain that almost sort 00:19:30.289 --> 00:19:33.029 of like it's like a toxic relationship it's like 00:19:33.029 --> 00:19:36.170 you you're like if i leave then i will be alone 00:19:36.170 --> 00:19:38.210 and i won't have any but you actually know that 00:19:38.210 --> 00:19:42.069 you're going to be better off and i mean as you 00:19:42.069 --> 00:19:45.730 said why would you stay if You know that you're 00:19:45.730 --> 00:19:48.049 writing all of that money off anyway. Rather 00:19:48.049 --> 00:19:51.230 work less initially and then build that up again, 00:19:51.349 --> 00:19:54.009 but still make the same amount of money instead 00:19:54.009 --> 00:19:58.609 of trying to do what you're doing now. You mentioned, 00:19:58.730 --> 00:20:02.069 Sandy, that negotiating all those contracts, 00:20:02.130 --> 00:20:04.970 it is a difficult thing. Is there some room? 00:20:05.069 --> 00:20:07.309 If I'm a dentist now and I'm saying to you, Sandy, 00:20:07.549 --> 00:20:11.490 I can't drop these insurance companies now. Like, 00:20:11.490 --> 00:20:13.369 I'm bleeding on this side. I can't find another 00:20:13.369 --> 00:20:15.069 staff here. I'm doing this. The money's looking 00:20:15.069 --> 00:20:19.609 thin. Like, I can't just drop this now. How can 00:20:19.609 --> 00:20:22.089 I renegotiate? What is that path to renegotiate 00:20:22.089 --> 00:20:24.769 now if I just absolutely can't start chipping 00:20:24.769 --> 00:20:28.769 away at these PPOs? Well, it definitely never 00:20:28.769 --> 00:20:31.430 hurts to try that. And that's part of what we 00:20:31.430 --> 00:20:33.630 do in our process as well. Because we always 00:20:33.630 --> 00:20:36.029 want to see, let's get everybody's best offers 00:20:36.029 --> 00:20:38.349 on the table. before you start dropping plans 00:20:38.349 --> 00:20:40.369 anyway. Because if you're thinking, well, I'm 00:20:40.369 --> 00:20:42.029 going to drop this one because it's low, well, 00:20:42.210 --> 00:20:44.170 let's make sure they're not willing to negotiate 00:20:44.170 --> 00:20:46.349 first before you make any changes. Maybe they 00:20:46.349 --> 00:20:48.450 go from being your worst payer to being more 00:20:48.450 --> 00:20:52.410 tolerable if they are willing to do a negotiation. 00:20:52.750 --> 00:20:55.829 So yes, it's definitely always worth going to 00:20:55.829 --> 00:20:58.910 the insurance company and seeing what their offer 00:20:58.910 --> 00:21:02.869 is before you make a final decision. So it's 00:21:02.869 --> 00:21:05.940 just, it's... It is just a time -intensive process. 00:21:06.079 --> 00:21:09.059 It really is just reaching out. It may take a 00:21:09.059 --> 00:21:11.539 few days to get assigned to a rep. It could take 00:21:11.539 --> 00:21:14.339 a month or longer, just depending on how backed 00:21:14.339 --> 00:21:16.700 up they are. So your staff just has to be very 00:21:16.700 --> 00:21:19.819 persistent in continuing to follow up and making 00:21:19.819 --> 00:21:22.900 sure that you actually get, you know, a final 00:21:22.900 --> 00:21:26.160 offer with some back and forth. And definitely 00:21:26.160 --> 00:21:29.579 don't take the first offer. You know, keep going 00:21:29.579 --> 00:21:32.509 back on your top codes. And your top 10 codes 00:21:32.509 --> 00:21:34.609 are going to be by far the most relevant one. 00:21:34.690 --> 00:21:38.269 So really focus in on that. So don't just go 00:21:38.269 --> 00:21:41.009 in asking necessarily for butter fees on the 00:21:41.009 --> 00:21:44.089 entire fee schedule. Have the data for your practice 00:21:44.089 --> 00:21:47.269 really at your fingertips so that you know which 00:21:47.269 --> 00:21:50.509 codes are going to be the most relevant. I want 00:21:50.509 --> 00:21:56.990 to play devil's advocate here too. We know the 00:21:56.990 --> 00:21:58.990 games that the insurance companies are playing 00:21:58.990 --> 00:22:02.390 on their side. What are the mistakes that dental 00:22:02.390 --> 00:22:05.630 offices are making, though, where they're actually 00:22:05.630 --> 00:22:08.250 missing out, where they're like these insurance 00:22:08.250 --> 00:22:10.890 companies, but then Sandy and her team comes 00:22:10.890 --> 00:22:14.230 in and goes, well, Doc, you're actually making 00:22:14.230 --> 00:22:16.609 these mistakes and you could be making a lot 00:22:16.609 --> 00:22:19.650 more money. Yeah, I would say, you know, the 00:22:19.650 --> 00:22:21.309 biggest one, and I don't even know if I would 00:22:21.309 --> 00:22:24.710 say it's a mistake. It's just a reflection of 00:22:24.710 --> 00:22:27.130 how much the industry is changing. A lot of it 00:22:27.130 --> 00:22:32.099 is the downgrade. If you have multiple shared 00:22:32.099 --> 00:22:35.099 network agreements and a particular insurance 00:22:35.099 --> 00:22:38.259 company maybe three years ago was paying on one 00:22:38.259 --> 00:22:40.700 of your better fee schedules, but since then 00:22:40.700 --> 00:22:43.059 they've entered into shared network agreements 00:22:43.059 --> 00:22:44.940 with a couple of other companies that you have 00:22:44.940 --> 00:22:47.319 contracts with. And then they're all of a sudden 00:22:47.319 --> 00:22:50.480 just gradually downgrading over time. And it's 00:22:50.480 --> 00:22:53.480 really tough to catch those because nobody's 00:22:53.480 --> 00:22:55.960 sending you a notice that says, by the way, I 00:22:55.960 --> 00:22:58.559 know we were paying you $1 ,100 for a crown. 00:22:59.039 --> 00:23:01.619 But now, you know, there's another contract you 00:23:01.619 --> 00:23:04.000 have that's paying $750 for crowns. We're just 00:23:04.000 --> 00:23:05.940 going to start using that piece. You know, there's 00:23:05.940 --> 00:23:09.160 no notice that's being given. You might get a 00:23:09.160 --> 00:23:11.839 shared network agreement notice, meaning you 00:23:11.839 --> 00:23:14.099 might get some kind of notice that says, hey, 00:23:14.160 --> 00:23:15.980 great news, we're entering into a new shared 00:23:15.980 --> 00:23:19.619 network agreement with XYZ. But you have to think 00:23:19.619 --> 00:23:21.039 beyond that and say, well, what does that actually 00:23:21.039 --> 00:23:24.500 mean for me? Does that help me or does that hurt 00:23:24.500 --> 00:23:27.259 me? And the insurance companies, when they do 00:23:27.259 --> 00:23:31.049 a notification, They all used to explain how 00:23:31.049 --> 00:23:33.750 you could opt out of that agreement. And sometimes 00:23:33.750 --> 00:23:35.609 they still do. But sometimes the announcement 00:23:35.609 --> 00:23:38.150 just says, here's what's happening. They don't 00:23:38.150 --> 00:23:40.809 specifically tell you how to opt out of it. And 00:23:40.809 --> 00:23:43.789 almost all of those are going to have an opt 00:23:43.789 --> 00:23:46.170 out option, meaning they can choose not to participate 00:23:46.170 --> 00:23:48.789 with it. You're going to automatically get opted 00:23:48.789 --> 00:23:51.710 in. You have to be the one to opt out. So if 00:23:51.710 --> 00:23:55.740 you get that notice and you're not. Sure, if 00:23:55.740 --> 00:23:57.559 you want to participate and you want to opt out 00:23:57.559 --> 00:23:58.900 of that, you're probably going to have to reach 00:23:58.900 --> 00:24:03.019 out and specifically ask. We do post on our website, 00:24:03.019 --> 00:24:06.900 but mostly on our Facebook page. Anytime we get 00:24:06.900 --> 00:24:08.559 one of these shared network agreements, just 00:24:08.559 --> 00:24:10.160 to say, what does this mean and what do you need 00:24:10.160 --> 00:24:13.099 to do with this for your situation? Just because 00:24:13.099 --> 00:24:17.160 it's very confusing. So it's not, like I said, 00:24:17.240 --> 00:24:19.460 it's not that necessarily dentists are making 00:24:19.460 --> 00:24:22.630 mistakes, but what is happening. is if you're 00:24:22.630 --> 00:24:25.309 not spot checking EOBs to say, wait a minute, 00:24:25.549 --> 00:24:27.930 we used to be getting paid way better than this. 00:24:28.029 --> 00:24:31.349 What's happening? You really have to catch it 00:24:31.349 --> 00:24:34.950 on an EOB and remember how you were getting paid 00:24:34.950 --> 00:24:37.490 before versus how you're getting paid now in 00:24:37.490 --> 00:24:40.009 order to figure out how to rearrange some of 00:24:40.009 --> 00:24:43.029 that contract. So it's very tough. I always tell 00:24:43.029 --> 00:24:46.109 Dennis, you know, this is all that we do and 00:24:46.109 --> 00:24:48.940 we have a hard time. feedback of all the people. 00:24:49.200 --> 00:24:51.420 If you're working in a dental practice and you're 00:24:51.420 --> 00:24:54.359 actually seeing patients, trying to check benefits, 00:24:54.720 --> 00:24:56.720 collect payments, all the things that busy front 00:24:56.720 --> 00:25:00.140 office people are doing, it's very hard to catch 00:25:00.140 --> 00:25:03.119 them. So it's not meant to be a criticism of 00:25:03.119 --> 00:25:05.480 offices who are feeling like things have gotten 00:25:05.480 --> 00:25:08.319 very messy. We hear that all the time where offices 00:25:08.319 --> 00:25:11.400 tell us, I don't even know what I have anymore. 00:25:11.619 --> 00:25:14.109 I signed contracts 10 years ago. I don't even 00:25:14.109 --> 00:25:15.730 know what's coming and where. It's gotten so 00:25:15.730 --> 00:25:18.150 messy that I just need to do an overhaul and 00:25:18.150 --> 00:25:20.970 revisit everything from the ground up. And every 00:25:20.970 --> 00:25:23.890 couple of years, you really do need to be doing 00:25:23.890 --> 00:25:27.450 that. It's just changed so much that it's easy 00:25:27.450 --> 00:25:29.289 to just get caught up in these downgrades and 00:25:29.289 --> 00:25:31.509 not realize it. You were talking about change 00:25:31.509 --> 00:25:34.450 now. Are there more trends that you've been seeing 00:25:34.450 --> 00:25:37.670 as time is going on? As you said, this industry 00:25:37.670 --> 00:25:42.369 is changing so fast. AI came to mind for me. 00:25:42.410 --> 00:25:44.190 I do want to ask you about that in a second, 00:25:44.230 --> 00:25:45.869 if that has a role in the work you're doing. 00:25:45.970 --> 00:25:49.849 But what trends are you seeing with this change 00:25:49.849 --> 00:25:52.029 that you're talking about that's impacting PPO 00:25:52.029 --> 00:25:54.789 negotiations and these contracts and that dentists 00:25:54.789 --> 00:25:59.150 should understand? So one big one that has really 00:25:59.150 --> 00:26:03.809 changed more recently is Insurance, as we all 00:26:03.809 --> 00:26:05.410 know, everything's supposed to be confidential, 00:26:05.630 --> 00:26:07.609 right? So dentists are not supposed to share 00:26:07.609 --> 00:26:10.630 fee schedules with any other offices. We're very 00:26:10.630 --> 00:26:13.269 cautious about that. We don't ever read the schedules 00:26:13.269 --> 00:26:15.609 from another office other than where it was intended. 00:26:15.829 --> 00:26:18.509 There's very strict rules about that. The same 00:26:18.509 --> 00:26:20.549 thing on the insurance company side. They're 00:26:20.549 --> 00:26:23.490 not to exchange fee schedules with other insurance 00:26:23.490 --> 00:26:26.029 companies. Okay, well, what's happening, though, 00:26:26.089 --> 00:26:29.269 is that's getting a little bit fuzzier, meaning 00:26:29.269 --> 00:26:33.049 insurance companies are definitely, buying data 00:26:33.049 --> 00:26:36.630 in an anonymous format that says, you know, they 00:26:36.630 --> 00:26:39.410 can look at your office and see what's the average 00:26:39.410 --> 00:26:42.769 PPO fee that you're expecting. So how that's 00:26:42.769 --> 00:26:45.809 playing into negotiations is if an insurance 00:26:45.809 --> 00:26:49.150 company has a request from your office for a 00:26:49.150 --> 00:26:51.670 higher fee schedule and they look at your office 00:26:51.670 --> 00:26:55.549 data and they can see your average fee that you're 00:26:55.549 --> 00:26:59.269 collecting is less than what this insurance company 00:26:59.269 --> 00:27:02.089 is paying you. We're seeing a lot more denials 00:27:02.089 --> 00:27:04.390 at times where an insurance company just says, 00:27:04.430 --> 00:27:07.470 we're already above what you're willing to accept 00:27:07.470 --> 00:27:12.230 from other insurance. Now, I do not like that 00:27:12.230 --> 00:27:16.990 at all. I don't think that that should be a possibility 00:27:16.990 --> 00:27:20.470 for any insurance company to see any fee that 00:27:20.470 --> 00:27:24.470 any office is agreeing to regardless. Just like 00:27:24.470 --> 00:27:28.789 any of us, like, you know, to have our, you know, 00:27:29.099 --> 00:27:30.759 Have somebody say, well, here's what you're making. 00:27:31.400 --> 00:27:33.420 And, you know, we're just not going to give you 00:27:33.420 --> 00:27:36.440 a raise this year because, you know, we think 00:27:36.440 --> 00:27:38.920 you're already getting paid enough. And that 00:27:38.920 --> 00:27:43.119 does not set well with me at all. However, what 00:27:43.119 --> 00:27:46.539 dentists need to then be thinking about is if 00:27:46.539 --> 00:27:49.920 you're willing to take lower fees than are workable 00:27:49.920 --> 00:27:52.819 for you, that's going to potentially have an 00:27:52.819 --> 00:27:55.759 impact the farther down the road we go with this. 00:27:55.980 --> 00:27:58.200 The more data that insurance companies can see 00:27:58.200 --> 00:28:01.180 about what you're agreeing to with other insurance 00:28:01.180 --> 00:28:02.819 companies. Now, it's not going to be labeled. 00:28:02.980 --> 00:28:05.660 It's not going to say the specific name of the 00:28:05.660 --> 00:28:08.579 insurance company and their fees. They are able 00:28:08.579 --> 00:28:13.519 to see what you are willing to accept from selectively 00:28:13.519 --> 00:28:16.559 from other insurance companies. So you want to 00:28:16.559 --> 00:28:19.200 be thinking about that impact that that can have 00:28:19.200 --> 00:28:22.619 on you. Because if you're saying your fees aren't 00:28:22.619 --> 00:28:25.049 workable for me, I need a higher node. You really 00:28:25.049 --> 00:28:28.069 do need to be away at some of those bottom ones 00:28:28.069 --> 00:28:31.309 so that you are raising up as far as what you're 00:28:31.309 --> 00:28:34.990 agreeing to accept from collectively all of the 00:28:34.990 --> 00:28:37.509 insurance company contracts that you've got. 00:28:37.710 --> 00:28:40.910 Because that really can now start to hurt you. 00:28:40.950 --> 00:28:43.869 The other thing is be paying attention to where 00:28:43.869 --> 00:28:47.170 your cash fees are at. Some insurance companies 00:28:47.170 --> 00:28:49.269 don't care about your cash fees. They don't look 00:28:49.269 --> 00:28:53.509 at them or they're not. using them as much. Some 00:28:53.509 --> 00:28:56.569 insurance companies will want to see your cash 00:28:56.569 --> 00:28:59.390 fees before they negotiate. So you might be thinking 00:28:59.390 --> 00:29:02.490 that you're doing your patients a favor by keeping 00:29:02.490 --> 00:29:04.970 your cash fees on the lower side. And in some 00:29:04.970 --> 00:29:08.609 ways, we are. But the way that that can work 00:29:08.609 --> 00:29:11.549 against you is insurance companies want to see 00:29:11.549 --> 00:29:14.289 what the write -offs are. And bigger write -offs 00:29:14.289 --> 00:29:16.490 mean they're delivering a, you know, kind of 00:29:16.490 --> 00:29:21.220 fair value to the patient. So if your cash fee 00:29:21.220 --> 00:29:26.259 is, you know, $1 ,000 for a crown, but the average 00:29:26.259 --> 00:29:28.660 crown fee is really in your area is more like, 00:29:28.660 --> 00:29:33.460 let's say, $1 ,400. Well, then their $900 crown 00:29:33.460 --> 00:29:37.440 offer is actually very good. So they're going 00:29:37.440 --> 00:29:40.339 to use that to justify, you know, the write -offs 00:29:40.339 --> 00:29:43.000 are very minimal for you. So this is a good deal. 00:29:43.119 --> 00:29:45.680 It doesn't mean that it's necessarily a good 00:29:45.680 --> 00:29:49.509 deal. It means your cash fees may be no. So you 00:29:49.509 --> 00:29:51.630 never want to artificially inflate your cash. 00:29:51.730 --> 00:29:55.609 I'm not saying play games with creating cash 00:29:55.609 --> 00:29:57.490 fees that aren't actually what you're charging. 00:29:57.569 --> 00:29:59.769 You want them to be real fee. But you do want 00:29:59.769 --> 00:30:03.089 to be paying attention to your cash fee as far 00:30:03.089 --> 00:30:06.690 as where they fall for your area. And the other 00:30:06.690 --> 00:30:10.349 always reminder that I give, always fill out 00:30:10.349 --> 00:30:12.170 your cash fees on the claim forms. Don't fill 00:30:12.170 --> 00:30:14.549 out the PPO fee. Because if an insurance company 00:30:14.549 --> 00:30:17.470 is seeing your PPO fees on what you're billing 00:30:17.470 --> 00:30:21.279 out, In their world, they're paying 100 % of 00:30:21.279 --> 00:30:23.680 your fee because the only fee that they know 00:30:23.680 --> 00:30:26.000 for your office is what you're putting on the 00:30:26.000 --> 00:30:29.859 claim. So do not bill out PPO fees. Bill out 00:30:29.859 --> 00:30:32.240 your cash fee so that you can monitor the write 00:30:32.240 --> 00:30:34.099 -offs. That's the other thing. How can you monitor 00:30:34.099 --> 00:30:36.420 write -offs if you're not billing out your cash 00:30:36.420 --> 00:30:39.299 fees and comparing your cash fees to your PPO 00:30:39.299 --> 00:30:42.200 fee in terms of write -off? So you really want 00:30:42.200 --> 00:30:45.480 to be billing out cash that can make a difference 00:30:45.480 --> 00:30:49.210 on the fees that you're able to make. And that's 00:30:49.210 --> 00:30:50.650 actually what the insurance companies want you 00:30:50.650 --> 00:30:53.210 to do. Insurance companies will all tell you, 00:30:53.269 --> 00:30:55.609 fill out your cash so that they're authentic. 00:30:56.470 --> 00:30:58.809 As you're saying these things again, I go back 00:30:58.809 --> 00:31:02.650 to, this is so much admin for someone that's 00:31:02.650 --> 00:31:06.490 already trying to run a dental practice or things 00:31:06.490 --> 00:31:10.390 to even know. I mentioned AI a second ago. I 00:31:10.390 --> 00:31:12.329 know for the work that I'm doing, it's been a 00:31:12.329 --> 00:31:14.650 fantastic companion in just helping speed up 00:31:14.650 --> 00:31:17.410 some of the tasks. Have you played around a bit 00:31:17.410 --> 00:31:20.769 with AI or seen anything in the industry? We're 00:31:20.769 --> 00:31:24.289 just starting to, just in our own company. It's 00:31:24.289 --> 00:31:28.109 kind of very exciting all wrapped up into one 00:31:28.109 --> 00:31:31.869 little bundle, you know, but it is being very 00:31:31.869 --> 00:31:34.809 powerful in a lot of ways. You know, I think... 00:31:35.390 --> 00:31:37.549 Probably a little bit more of the scary side 00:31:37.549 --> 00:31:40.210 for dentistry is are these claims being reviewed 00:31:40.210 --> 00:31:42.950 by actual dentists? Are they things that are 00:31:42.950 --> 00:31:48.309 being automated in a way that may be good and 00:31:48.309 --> 00:31:51.650 may not be good? So I am interested to see where 00:31:51.650 --> 00:31:53.809 this goes. Yeah, I think we're just on the very 00:31:53.809 --> 00:31:58.210 initial frontier of where that's all going. Because 00:31:58.210 --> 00:32:01.880 I do worry, Sandy, we came at a point of... We 00:32:01.880 --> 00:32:04.299 take insurance companies, take the human side 00:32:04.299 --> 00:32:06.380 out of these claims in these things. And it's 00:32:06.380 --> 00:32:09.380 just some AI bot going like this number was wrong 00:32:09.380 --> 00:32:11.420 on this thing here or like this isn't covered. 00:32:11.519 --> 00:32:13.319 And it's like, no. And then someone that actually 00:32:13.319 --> 00:32:16.500 did qualify for the care is now just being denied 00:32:16.500 --> 00:32:19.660 because it's this robotic kind of conveyor belt 00:32:19.660 --> 00:32:22.359 system that's just pushing people out. And that's 00:32:22.359 --> 00:32:24.599 a concern. There are, you know, and I won't mention 00:32:24.599 --> 00:32:28.059 specific names, but, you know. There are some 00:32:28.059 --> 00:32:30.619 companies where you cannot get a live person 00:32:30.619 --> 00:32:33.539 anymore when you call in. And, you know, it's 00:32:33.539 --> 00:32:36.339 so frustrating because just what you said, there's 00:32:36.339 --> 00:32:39.579 cases where, like, there's a real person that 00:32:39.579 --> 00:32:42.119 just needs to jump in and help resolve something. 00:32:42.319 --> 00:32:45.900 And so, you know, moving even more away from 00:32:45.900 --> 00:32:50.359 that is not helpful for this industry. You've 00:32:50.359 --> 00:32:52.619 already provided so many helpful things today 00:32:52.619 --> 00:33:00.220 for dentists and tips. I'm looking to reduce 00:33:00.220 --> 00:33:04.180 my reliance on insurance companies and transition 00:33:04.180 --> 00:33:07.220 towards more of a fee -for -service type of practice. 00:33:07.700 --> 00:33:11.200 What are some of the initial things? And keep 00:33:11.200 --> 00:33:14.660 in mind, again, I'm this dentist that I'm scared 00:33:14.660 --> 00:33:16.460 because I think many dentists feel this way. 00:33:16.539 --> 00:33:18.700 I'm scared that I'm going to lose my patient 00:33:18.700 --> 00:33:20.880 base. I've heard that it doesn't impact me that 00:33:20.880 --> 00:33:24.339 much, but what if it does? I don't know, and 00:33:24.339 --> 00:33:27.339 I need to pay my staff. What are some of those 00:33:27.339 --> 00:33:29.200 initial steps that you can encourage dentists 00:33:29.200 --> 00:33:31.220 like, you've got this, this is where you can 00:33:31.220 --> 00:33:34.700 start? I think what you all do is a really key 00:33:34.700 --> 00:33:37.279 piece to it. It is, you know, and I know that 00:33:37.279 --> 00:33:40.059 your client base has a lot of overlap with us 00:33:40.059 --> 00:33:42.559 in terms of business models, meaning looking 00:33:42.559 --> 00:33:46.460 at how do we position the solo dental practice 00:33:46.460 --> 00:33:49.180 business model or small group business model. 00:33:49.799 --> 00:33:52.819 to be competitive. And so a big part of that 00:33:52.819 --> 00:33:55.200 is the marketing side of what, you know, you 00:33:55.200 --> 00:33:58.440 all are the experts at that piece of it. So all, 00:33:58.460 --> 00:34:01.660 a lot of times, fellow officers too, you're going 00:34:01.660 --> 00:34:04.759 to go dropping plans. Remember, the only thing 00:34:04.759 --> 00:34:06.660 the insurance company is really giving you in 00:34:06.660 --> 00:34:09.420 exchange for your PPO participation is a listing 00:34:09.420 --> 00:34:11.800 on their website. You know, that's what you're 00:34:11.800 --> 00:34:14.079 getting. That's the marketing value that they're 00:34:14.079 --> 00:34:16.300 giving you in exchange for your participation. 00:34:16.860 --> 00:34:19.579 So if you know your plan is to start going out 00:34:19.579 --> 00:34:23.340 of network with more proactively, then build 00:34:23.340 --> 00:34:25.219 the marketing side of your practice differently 00:34:25.219 --> 00:34:27.820 so that, you know, you're not waiting necessarily 00:34:27.820 --> 00:34:32.099 to drop something big. You are already proactively 00:34:32.099 --> 00:34:34.699 building your new patient flow coming from some 00:34:34.699 --> 00:34:37.539 other place. I particularly talk about this if 00:34:37.539 --> 00:34:39.900 it's a fee -for -service office who is slowed 00:34:39.900 --> 00:34:41.699 down maybe and they're thinking about adding 00:34:41.699 --> 00:34:44.219 some PPOs. And sometimes that is the right thing. 00:34:44.619 --> 00:34:47.760 But also make sure, have you also piggybacked 00:34:47.760 --> 00:34:50.900 that with marketing in other ways? I mean, PPO 00:34:50.900 --> 00:34:52.659 write -offs are just marketing dollars. It's 00:34:52.659 --> 00:34:55.980 just figuring out what's in our place in your 00:34:55.980 --> 00:34:59.380 practice. So I think the marketing side, you 00:34:59.380 --> 00:35:03.460 know, what you all do is how do we not just look 00:35:03.460 --> 00:35:05.980 at our marketing as far as people who find us 00:35:05.980 --> 00:35:08.260 on the insurance company website? How do we build 00:35:08.260 --> 00:35:11.539 our name and brand differently and let people 00:35:11.539 --> 00:35:14.440 know about it? The other part I think is important 00:35:14.440 --> 00:35:16.460 is, and there's a lot of conversation happening 00:35:16.460 --> 00:35:19.539 about this in the dental world, is, you know, 00:35:19.559 --> 00:35:21.739 the traditional dental business model has been 00:35:21.739 --> 00:35:24.800 hygiene oriented. And people come in through 00:35:24.800 --> 00:35:28.000 a routine cleaning and checkup. They get their 00:35:28.000 --> 00:35:30.480 cleanings twice a year. And then as they come 00:35:30.480 --> 00:35:33.679 through, you know, dentistry is being diagnosed 00:35:33.679 --> 00:35:37.579 on them for the doctor side of things. The thing 00:35:37.579 --> 00:35:39.900 that is so difficult right now is the hygiene 00:35:39.900 --> 00:35:42.940 shortage. So what happened, as everyone knows, 00:35:42.960 --> 00:35:46.179 during COVID, so many hygienists left the industry 00:35:46.179 --> 00:35:53.159 permanently. We are overflooded with new dental 00:35:53.159 --> 00:35:56.300 schools opening. We don't need more dental schools, 00:35:56.420 --> 00:35:59.400 but we need more hygienists. So there's a true 00:35:59.400 --> 00:36:01.599 lack of hygienists. I talk to dentists every 00:36:01.599 --> 00:36:04.199 day across the country, and there's just not 00:36:04.199 --> 00:36:07.579 enough hygienists. You know, we don't have that 00:36:07.579 --> 00:36:10.800 same growth coming in by replacing hygienists 00:36:10.800 --> 00:36:13.480 last year with COVID. So now we're in a situation 00:36:13.480 --> 00:36:16.320 where, you know, hygiene salaries have gone up 00:36:16.320 --> 00:36:19.639 substantially. And that's if you can find a hygienist. 00:36:19.739 --> 00:36:22.820 It is very common now for a practice to go without 00:36:22.820 --> 00:36:25.480 a hygienist for six months, just trying to find 00:36:25.480 --> 00:36:28.300 a replacement or relying on temps until they 00:36:28.300 --> 00:36:31.719 can be permanent. So that traditional hygiene 00:36:31.719 --> 00:36:34.820 business model has become really challenging. 00:36:35.320 --> 00:36:38.039 So thinking outside that box more and saying, 00:36:38.139 --> 00:36:41.000 am I going to continue to follow that or do I 00:36:41.000 --> 00:36:44.519 need to be doing marketing to get patients in 00:36:44.519 --> 00:36:46.800 the door who are looking for something beyond 00:36:46.800 --> 00:36:48.880 just a cleaning and checkup? You know, how do 00:36:48.880 --> 00:36:53.639 we kind of enhance the way patients find us beyond 00:36:53.639 --> 00:36:56.760 just that? And, you know, again, not all your 00:36:56.760 --> 00:36:59.619 expertise, not mine, as far as how to do that. 00:36:59.920 --> 00:37:05.449 But what's happening is because. You know, insurance 00:37:05.449 --> 00:37:09.429 rates are not going up at the same pace as overhead 00:37:09.429 --> 00:37:12.429 is going up. We've got to crunch that way. And 00:37:12.429 --> 00:37:15.070 then we've got this hygiene piece where even 00:37:15.070 --> 00:37:17.289 if you can find a hygienist, you might be paying 00:37:17.289 --> 00:37:20.610 $10 or $20 an hour more for a hygienist than 00:37:20.610 --> 00:37:23.949 you were a few years ago. So the only place to 00:37:23.949 --> 00:37:26.309 support that is coming in front of the dentist's 00:37:26.309 --> 00:37:28.570 salary. There just isn't another way to offset 00:37:28.570 --> 00:37:32.530 that. So definitely looking at, do we want to 00:37:32.530 --> 00:37:35.610 continue with the same you know, business model? 00:37:35.690 --> 00:37:37.650 Or do we need to be a little bit more creative 00:37:37.650 --> 00:37:41.409 about how we look at? So definitely some pieces 00:37:41.409 --> 00:37:43.730 that I think are going to be changing because 00:37:43.730 --> 00:37:46.030 that hygiene piece is not a quick fix. You know, 00:37:46.070 --> 00:37:49.630 you've got to have a lot of time to rebuild a 00:37:49.630 --> 00:37:52.789 hygiene pool after what was lost during COVID. 00:37:52.989 --> 00:37:56.789 And that is, you know, probably many years down 00:37:56.789 --> 00:37:59.690 the road before we would see a change with that. 00:37:59.809 --> 00:38:02.949 So, you know, look at things a little differently 00:38:02.949 --> 00:38:07.389 than we have in the past. sandy i want to ask 00:38:07.389 --> 00:38:10.389 you if dentists want to get a hold of you or 00:38:10.389 --> 00:38:14.230 take these next steps because that is ultimately 00:38:14.230 --> 00:38:16.869 the first thing they need to do is they need 00:38:16.869 --> 00:38:19.170 to get in contact with the right people the right 00:38:19.170 --> 00:38:23.469 person to to help them do these things because 00:38:23.469 --> 00:38:26.250 as we said it is difficult it is overwhelming 00:38:26.250 --> 00:38:31.210 to do these things do are you doing workshops 00:38:31.210 --> 00:38:34.500 do you do consults is there How can people contact 00:38:34.500 --> 00:38:36.699 you to make sure that they take these first steps? 00:38:37.260 --> 00:38:41.119 Well, our website is unlocktheppo .com. And then 00:38:41.119 --> 00:38:44.159 if you go into that, we have an established site. 00:38:44.320 --> 00:38:46.219 That's going to be probably where the majority 00:38:46.219 --> 00:38:48.519 of people listening today would qualify, meaning 00:38:48.519 --> 00:38:50.460 you already own a practice. And then we also 00:38:50.460 --> 00:38:52.300 have a startup site if you're getting ready to 00:38:52.300 --> 00:38:55.500 do a scratch, you know, open your doors from 00:38:55.500 --> 00:38:57.840 the ground up. We have kind of two different 00:38:57.840 --> 00:39:00.559 pieces. If you click on the Contact Us page, 00:39:01.369 --> 00:39:03.969 on our website it'll ask some questions about 00:39:03.969 --> 00:39:06.909 who do you have contracts with now we just give 00:39:06.909 --> 00:39:09.590 complimentary feedback to first to say do we 00:39:09.590 --> 00:39:11.610 think we would be a good fit for your situation 00:39:11.610 --> 00:39:14.730 and then we offer a complimentary consult as 00:39:14.730 --> 00:39:17.650 well just to chat through you know do we're pretty 00:39:17.650 --> 00:39:20.590 conservative about we don't want people to move 00:39:20.590 --> 00:39:23.130 forward with us unless we really think that there's 00:39:23.130 --> 00:39:26.820 big changes that we can make for them So we'll 00:39:26.820 --> 00:39:29.219 get some feedback on that. But yeah, our website 00:39:29.219 --> 00:39:33.099 is unlocktheppo .com. And then just for somebody 00:39:33.099 --> 00:39:36.920 who's maybe keeping this in -house or maybe just 00:39:36.920 --> 00:39:39.119 doesn't have a lot of changes to make but wants 00:39:39.119 --> 00:39:42.539 to stay up on these shared network agreement 00:39:42.539 --> 00:39:46.239 changes, then I recommend find us on Facebook. 00:39:46.260 --> 00:39:48.780 We're Unlock the PPO on Facebook. But we really 00:39:48.780 --> 00:39:52.059 do try to post a lot of educational things. There's 00:39:52.059 --> 00:39:53.960 also some educational videos on our website. 00:39:54.489 --> 00:39:57.389 that just are open to anybody. So there are just 00:39:57.389 --> 00:39:59.550 three things that we provide just to try to keep 00:39:59.550 --> 00:40:02.150 people a bit more educated in the industry. So 00:40:02.150 --> 00:40:06.550 that's an easy place to start. A last question 00:40:06.550 --> 00:40:08.690 came to mind, as you said, now on the startup 00:40:08.690 --> 00:40:13.670 side and on the established side. If you had 00:40:13.670 --> 00:40:17.909 a megaphone to dentists that are just coming 00:40:17.909 --> 00:40:24.630 out of a dental school, are you saying, fight 00:40:24.630 --> 00:40:26.889 the good fight and go fee -for -service and try 00:40:26.889 --> 00:40:29.150 and get the patient that you want to get? Or 00:40:29.150 --> 00:40:31.289 are you saying there is a place for you to start 00:40:31.289 --> 00:40:33.269 out with these insurance companies, but then 00:40:33.269 --> 00:40:36.429 you need a strategy to wean it off over time? 00:40:37.429 --> 00:40:40.789 Yeah, and I think the second one is pretty common 00:40:40.789 --> 00:40:45.010 as far as what's the rightful place of insurance, 00:40:45.269 --> 00:40:47.590 meaning what are fee schedules that are workable, 00:40:47.909 --> 00:40:50.289 and then setting the foundation well from the 00:40:50.289 --> 00:40:53.869 beginning. So if you're doing a startup and you're 00:40:53.869 --> 00:40:56.690 evaluating, okay, do we need some participation? 00:40:57.010 --> 00:41:00.389 But if so, what's the right participation? Certainly, 00:41:00.530 --> 00:41:02.889 you know, we do the demographics to say, well, 00:41:02.949 --> 00:41:04.449 here's the insurance companies that are going 00:41:04.449 --> 00:41:06.849 to be relevant by employer group in your area. 00:41:06.909 --> 00:41:10.030 That's a big part of it. And then figuring out 00:41:10.030 --> 00:41:14.309 what's the best fit. If you're looking at opening 00:41:14.309 --> 00:41:17.789 up fee -for -service from the get -go, A couple 00:41:17.789 --> 00:41:19.409 of pieces to that. One is going to be certainly 00:41:19.409 --> 00:41:22.110 demographics. If you're in Southern California, 00:41:22.389 --> 00:41:27.929 that's a pretty rough place to start there and 00:41:27.929 --> 00:41:30.429 kind of not have to work your way up to over 00:41:30.429 --> 00:41:34.230 time. If you're in an underserved area, that's 00:41:34.230 --> 00:41:37.610 certainly going to make that much easier. And 00:41:37.610 --> 00:41:42.070 the other piece is to a little bit of like if 00:41:42.070 --> 00:41:44.110 a dentist is thinking they're going to open beaker 00:41:44.110 --> 00:41:46.110 surveys, a lot of times what they might want 00:41:46.110 --> 00:41:48.719 to do then is, They might continue to work as 00:41:48.719 --> 00:41:50.840 an associate for a couple days a week, somewhere 00:41:50.840 --> 00:41:54.480 else. And they go into it knowing, I really want 00:41:54.480 --> 00:41:56.599 a fee -for -service business model, but I'm just 00:41:56.599 --> 00:41:59.239 going to have slower growth with that. So how 00:41:59.239 --> 00:42:03.760 do I kind of blend my work to do that? You know, 00:42:03.780 --> 00:42:05.880 maybe opening and expecting a little bit slower 00:42:05.880 --> 00:42:09.090 pace with that. Or do we go as a little bit more 00:42:09.090 --> 00:42:11.210 insurance to be able to wake up a little bit 00:42:11.210 --> 00:42:13.730 faster and then, like you said, give that a few 00:42:13.730 --> 00:42:16.670 years for growth and then maybe get back once 00:42:16.670 --> 00:42:21.409 you get where you're trying to get. Sandy, thank 00:42:21.409 --> 00:42:24.989 you so much. I appreciate you. And I admire the 00:42:24.989 --> 00:42:27.070 work that you do. I told you a bit about my story 00:42:27.070 --> 00:42:29.530 with my father and how I wish that you had met 00:42:29.530 --> 00:42:33.989 him seven years ago and that you had shared with 00:42:33.989 --> 00:42:37.039 him everything that you do now. Keep up the good 00:42:37.039 --> 00:42:40.360 fight. And it's amazing that you're able to help 00:42:40.360 --> 00:42:42.440 dentists get more out of what they do in dentistry. 00:42:42.619 --> 00:42:44.639 So thank you for the work that you do. And I 00:42:44.639 --> 00:42:46.780 appreciate your time today. Thanks for having 00:42:46.780 --> 00:42:47.079 me.