Welcome to Dental Unscripted,
where Mike Dinsio and
Paula Quinn break down the
practice ownership journey,
one episode at a time.
Starting up, buying,
and running a successful dental practice.
All right.
Here we go.
Dental Unscripted episode two.
We are streaming live.
I've got two amazing folks
on the horn today.
My co-host Paula Quinn.
Say hi, Paula.
Hi.
Stefani Sandoval,
our front office coach and
guru of all things front office,
credentialing, billing, you name it.
Today's episode is going to
be super exciting because
we are talking about a very
I don't know,
controversial and sometimes
challenging topic of
credentialing and dental acquisitions.
And it's something that we
just run across as a team all the time.
And we're gonna just talk
about it and break down issues,
common mistakes, pitfalls,
things that you guys may consider.
But before we get into the content,
I just want to make some
announcements that if
you're listening to this or
watching this on Startup
Unscripted or Dental
Acquisition Unscripted,
those are two separate channels.
Depending on which one you're on,
I want to remind you to go
to Dental Unscripted right now.
Go to your app,
Go to Dental Unscripted.
It's the new channel.
It's a navy blue and turquoise logo.
And all of our episodes are
going to be on this now.
So at some point,
we're going to shut down
those two other programs
and only be on this one.
So all things Dental Unscripted.
And Paula now is a full-timer now.
She is podcasting.
You're a podcaster, Paula.
Do you like it?
And it's not turquoise.
It's Tiffany blue.
Oh, Tiffany blue.
Is that why you're wearing that today?
It looks very,
this is more turquoise or green.
Oh, maybe that's where I was getting it.
I don't know.
I, uh, you know, girls and colors,
it's just your best,
your best not to even say a color,
but okay.
I hear you.
Tiffany blue, Tiffany blue, uh,
dental unscripted is the
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All right.
So let's get into it guys.
Uh, ladies.
Um,
I'm super excited because you guys are
both on, of course,
on the next level team and.
I'm excited because this new
program is all about
showing off all of the
coaches and we get the
chance to talk to Stefani.
So let's get into credentialing.
So we do a lot of
transitions and we're
fortunate enough to do the
credentialing for those clients.
And
it's just always something
and so I thought you know
uh paula from your from
your perspective why don't
I just pass it over to you
like what are the things
that you're thinking about
that these doctors go
through I mean you went
through it um with the
whole credentialing process
it's a very painful process
like what um why are we
having an episode on it
today because it's it's a hot topic
Well, I think it just starts with,
you know, well, there's lots of things.
I think it's, first of all, just starting,
like, when do you do it, right?
If you're acquiring a practice,
there's a very short amount
of time that you can actually flip that.
So, you know, I would say, you know,
a couple of things they're
not thinking about is they're thinking,
well, I'm already credentialed elsewhere.
Like, what's the big deal?
You know, it should be easy.
Just...
slap my name with a new
address on it and I'm
credentialed and there's a lot more.
I wish it was that easy.
We can dive in,
but I think some of the stuff is,
you know, having all your stuff prepared,
you know,
getting it all together so that
when that time crunch happens,
it can easily transition.
I think it's having updated
DEAs and malpractice and license.
We get handed a lot of
things and they're in the
middle of expiring or
expired or they have
malpractice through as an associate.
It all just looks completely
different as an owner.
Sometimes they're not even
aware that they're not credentialed.
They think that just because
they're working that they're credentialed
you know directly and a lot
of times it's the you know
the associate job they're
at the the owner is the one
credentialed everyone does
it a little bit different um
you know, and it's, it's having patients.
Once that happens, there's,
it gets pretty messy
because of the billing and
who's not like dental patients,
not dental patients, but patients,
patients, patients.
I'm from Indiana.
It probably comes out all
the same word patients
because it is a long process.
And there is a point where
they don't understand that
it's also not in our
credentialers hands anymore.
It's in the actual insurance
company's hands.
And it sounds like an excuse,
but they do what they want to do.
They go on vacation.
They've got more vacation
than the government days.
You know, it gets,
it gets thrown on someone's
desk and Mary points at
Susie and Jane and, you know,
all the above.
So it is, don't get me wrong.
Sometimes it goes like
smooth as butter and then
other times it just doesn't.
And, you know, our process stays the same.
So patience is what they need to have.
And I think that if anyone
has ever even tried to call
an insurance company and
they kind of get a little
bit of what it's actually
like to deal with them.
So that's kind of all of it,
but I think we should dive
into a little bit of each one of those.
So, I mean,
I would start with what can they prepare?
Yeah.
What kind of things they
should get together before
they're even thinking?
Because let's roll this back, Stefani.
We'll go to you on some of
the technicalities on the things,
the checklist that a
credentialer might need.
But let's put this in perspective.
So you're an acquisition.
You're going through the process.
You just did the...
all of the negotiations,
you're at the final leg of
the purchase and sale agreement.
You're stressed out.
You're thinking about all
the things of owning a
practice and the loan and
the conditions of the loan.
I mean, it's just a mess, right?
Your head's in the weeds.
And then and then someone like us says,
well,
if you don't get credentialing going,
all your patients are going
to be out of network and
then you just have a panic attack.
Right.
So so so it's like really
getting the process started early.
And what all should you be
like thinking about
gathering so that you're
totally organized?
I'm going to pass that to you.
want to say one thing though
too stefani if you can
bring this because I don't
know if this is a hundred
percent true but I would
think if they could even
understand who they're
actually already networked with
would that,
and could that help in the process?
Like I'm an associate,
I'm directed with Blue
Cross Blue Shield and Anthem,
or I'm with this leasing network,
because I know that
sometimes we come across like,
can we just do a tax ID
update and a location change, blah, blah,
blah, blah.
So what all would you say, you know,
their CAQH isn't up to date, they,
you know,
so kind of think about that with,
you know, as you're talking, sorry.
No, it's fine.
You're completely right.
So it's two parts is how am
I as the buyer currently credentialed?
And the second part is how
is that office currently credentialed?
Right.
Because you don't want to
just go in naive thinking, OK, well,
I like the way I am at this
zip code in this location
and now I'm on the other side.
side of the state and it you
know fee reimbursements
look different um and
you're just caught with the
shock that wow okay I
thought I was just going to
mirror but it may not one
be beneficial and two it's
not mirroring the office so
when we meet you know these
acquisitions we try to tell
you guys get organized find
out the seller's
participation right because
if we can fast track it so
we can get that turnaround
time we're just going to
mirror it right as long as
you do your duty
diligence and get us all
your forms you know we're
going to set it up to get
it done as quick as
possible but with these
acquisitions because you
know these are maybe a
first-time buyer right they
want to do everything the
right way they want to see
all of their options so
yeah I guess I got it I got
a question you know what
they want I got a question
for you we have people who
say we want a mirror and
get this done as soon as
possible but can you negotiate
Yeah.
Well, let's actually pause on that.
That's a great topic later on.
Like, can you negotiate?
And what's that look like?
And what's that process?
And how's that delay the process?
Let's pause on that.
You said something that's
really interesting that I
was thinking as a buyer's rep,
and that is like...
knowing what you're
credentialed with with your
associate positions that's
that's solid work with like
give some tips on that like
what kind of questions to
ask the front office gal
you work for someone you're
not really sure how it all
works they did all the
paperwork you don't
freaking know.
So like, what are some of those questions?
And think about that.
But like pivoting to knowing
what the seller,
how they're participating,
the challenge on that.
And this is you guys even
bust my butt on the buyer
rep side of like,
why don't you guys know this?
Well, first of all,
broker definitely doesn't know it.
They don't know anything.
The broker doesn't they
don't get into the weeds there.
Number one.
Number two,
the seller usually definitely
doesn't know it because she
lets Nancy Joe at the front
deal with all that.
And the seller doesn't want
to tell Nancy Joe that he's
getting ready to sell the practice.
And so like that's a strange situation.
So sometimes not knowing what the you know,
if you can,
you got a great relationship
with the seller and it's all perfect.
That is best case.
Right.
Knowing what the sellers,
how the sellers participating.
Well, why can't you just say, hey,
I'm working with a credentialing company.
I want to look at
renegotiation and the way
I'm credentialed in this practice.
Nancy Jo, how are we credentialed?
Yeah, yeah.
No, that is- They also have, by the way,
they also have fee schedules.
They should have only the
fee schedules they're using
in the computer.
Right.
Well, we all know that that's not,
we all know that that doesn't happen.
So-
I what guys, you know,
you know better than me and
we coach a lot of offices
with twenty percent
actually know what the hell
they're doing up front.
Like, come on, let's be honest.
But maybe that's a little aggressive.
I don't know.
But I wish they were that organized.
I don't know, Stefani,
you were front office
person for a hundred years.
Like,
what are these people thinking and
how to approach all this information?
Well, I mean,
there should always be a paper trail,
right?
These are contracts that
these providers are supposedly signing,
right?
Nobody should be signing
contracts for you to participate.
You should, right?
So the best thing I would
ask any dentist leaving a
practice to go start, you know, their own,
whether it's acquisition or
even a startup is,
gather your contracts before
leaving your current employer.
I'd like a copy of those
contracts because that's
also going to help us, you know,
the credentialing sign,
getting that information of how are you,
what are you currently contracting?
Because, you know,
you could be contracted at
location A and it may block
how you're going to
participate at location B, right?
Is there an easier way though to find it?
Yeah.
Is there an easier way?
Yeah, just asking.
I mean, calling.
Well, yeah, because what I'm saying is,
like Michael said,
like this doctor is leaving a practice.
He doesn't want to alert his
associate job besides, yeah,
D-IV students.
When you go out in the real world,
get your insurance
contracts and keep them.
But let's say that I've been
working two years as an associate.
Now I'm about to buy my own
practice without going up
to Nancy Jo and saying, am I contracted?
What is another way or is
there another way that
these docs can figure that out?
Yeah,
they can reach out to the insurance
networks independently, right?
Hey, here's my name.
Here's my locations.
Do I have an active contract?
It is.
I mean, it is what it is.
But insurance companies are
also getting to a point
where they are trying to
stop the multiple contracts
at different locations, right?
They're trying to really
condense it saying, okay, well,
if you're leaving here,
we're terming this location
and adding this location.
So you don't have, you know,
a whole bunch of different contracts out.
really like insurance
companies are trying to do
that when on average and
this is a statistic that
I've pulled through from
years and years ago that's
ridiculous of them because
so many of our clients
probably listening or not
clients just dentists they
work two jobs most dentists
actually moonlight for two
different practices that's
a very very common thing so
how ridiculous if the
insurance companies just try to do that
Well, I mean, they're going to block you,
but it's not that to say
that your contract,
you can't have two locations, right?
Under one contract.
The point is,
is that they are doing their
credentialing.
So many times they're asking
us to term the seller, right?
And we're not credentialing
anything to do with the seller.
We don't want to touch that,
but they will not allow
another contract to go in
there under a different tax ID.
Yeah.
Well, let's get into like that's perfect.
I think that's a really good
that's a really good thing.
So let's go through some of
like the big things.
So when you're when we're
processing Paul and Stefani,
you guys can you can take
this together because I know, Paula,
you touch this stuff, too.
What are some of the most
common things that are a
problem right before you
guys submit the applications?
It's like, oh shit,
the malpractice has expired.
I hear that one a lot.
Are there a bunch of things
or common things that you see that like,
oh gosh,
we could have did that a month
ago while we were... Can
you guys think about some
of those things now so that
these folks can look into this stuff?
I'll let you start, Stefania.
Definitely think one is...
OK, yeah,
so I definitely think one of them
is this malpractice.
These dentists who are an associate,
they don't necessarily
cover themselves with the coverage.
It's covered by an employer.
So when they're opening or
they're buying this new practice,
they have to carry their own coverage.
So during the credentialing process,
we get started and we're
using their malpractice
that is not theirs, right?
And so we're waiting now to submit time
for them to gain coverage, right?
Because they don't want to
pay for it unless that sale goes through.
And so one, that's a delay.
And two, that bill of sale, you know,
insurance companies don't
want to finalize these
contracts and these
acquisitions without that bill of sale.
Yep.
Paula, you want to add to that?
So I heard malpractice.
I heard bill of sale.
Well,
I think it's their dental license in
general.
I think having their CAQH up to date,
log on there and pay
attention to that and
If you're moving states,
if you're just having that up to date,
I won't get into details,
but through Next Level,
we've partnered with a
phone system where...
we can get the phone number
in advance and they don't
have to pay in advance um
you know there's there are
certain things that they
can do um you know I I just
think as soon as they're
looking if they can even
meet with someone like us
just to get that checklist
of things they can start
getting in order and then
just be be diligent about
it you know we have docs that
are in such a hurry to credential,
we give them the list and it takes three,
four weeks to get that crap in.
And yes,
we might still be waiting on the
bill of sell,
but sometimes we can get
those applications even
filled out if they're not online.
And we can have them ready and waiting.
So there are just, you know,
there's only so much we can do,
but we can get prepared as
much as possible.
When we're sitting waiting
on a updated malpractice or
for them to hunt down, you know,
something, you know, it just doesn't need,
we just need that bill of
sale at the close and we're ready to go.
Yeah.
yeah I I find it's uh it's
funny because like I'm not
a clinical person right at
all you guys always make
fun of me I'm the business
guy of the group and
definitely don't well michael yeah
Uh, you guys could, I'm sure hear the, the,
um, uh, sarcasm there, but, uh, yeah, I,
I am definitely that,
that one in the group and, and, you know,
like these documents like CAQH and the,
the,
it's like a Chinese code sometimes I
I'm getting pretty good at it now, but.
I'm sure you guys feel the
same way as providers.
I mean,
some of this stuff might be a
little bit more familiar to you for sure,
but I get what's a CAQH or
how do I do the MPI too?
And all these things, right?
And so I think before we
pivot to the next topic,
which is timeline,
I'm going to timeline next lady.
So that's going to put you
on the hot seat a little bit.
But before we go to that, like just,
I think Paul is right on point with,
You got to work with a professional,
whether it's next level or someone else.
And you got to start the
process early and you got
to have that conversation
of what are the things this
company is going to need
from you so that when the
time comes and you're submitting apps,
you can go because that
does parlay into timeline now.
So that is the next question
is if you guys get really
dialed in on checklists and
all the things,
What's the timeline?
And there's a lot of crap out there.
A lot of people say, oh,
you can get it done in a
month or two months.
Two weeks.
Yeah, two weeks.
It only takes two weeks for Delta.
Yeah.
I love that.
And then you hear other people,
other credentialing
companies say it takes freaking a year.
And so...
I think we should talk about this.
What is the timeline?
What should be the expectation?
Yeah.
You don't have to raise your hand.
I just want to say there's a
difference between I'm
coming in an office as an associate.
Mary up front needs to add
me as an associate.
Yeah.
Then owning your own business is,
becoming the business owner
and now having to have your own tax ID,
your own MPI to your own credentialing.
Now,
if you own for five years and want to
bring in an associate,
we might be able to get
Delta in two weeks.
Yeah.
And it depends on the state,
but there's a difference
between buying a business and
and creating a completely
different entity than there is,
I'm now working for Dr. X
and he's gonna put me under,
he or she's gonna put me
under their tax ID.
I just wanna state that
because we hear it all the
time from front offices say, oh, well,
I got that associate in two weeks.
First of all,
I would be shocked if it was
exactly two weeks.
However, huge difference.
Okay, I'm going to let Stefani take it.
No, I think that's good.
Stefani, can you touch on that?
The difference between MPI-I
and MPI-II and why the
insurance companies are
doing it this way?
I think that's important for
the audience to understand.
Right.
Well, in any type of credentialing, right,
there's credentialing and contracting.
And so we have to get a
contract not only
established for the provider,
but for the entity itself.
So it's kind of like double whammy.
Right.
So Paul is one hundred percent right.
It's not that quick as much as we would,
you know, and to throw into that as well,
that then we have to talk
about terminating.
Right.
the current seller so it's
like three contracts that
have to be done in order
for it to be successful and
it does take time um you
know insurance companies
what are you doing wait on
that termination part
sometimes don't you have to
terminate like let's say dr
quinn is now owning and
she's with signy here don't
you sometimes even have to
terminate my own contract because
I'm at other locations on
the participation yeah
sorry yeah no they'll say
okay great are you no
longer going to practice at
this associate job right so
there's so many different
little contractings that
are contracts that either
have to be terminated or
established so yeah ideally
we would love for it to be
so quick but again we're
playing a game with this
insurance company you know
we knock at their door every week,
just being annoying, trying to get,
you know, it moving along.
That's why we're so
successful because we're so annoying.
I'm not sure what the key is,
but patience is obviously
something that has to be
established and expectations.
If you think you're going to
get in there day one and in
thirty days out of sight, out of mind,
you don't have
Any other credentialing issues,
you're sadly mistaken.
So what are we talking about, ladies?
Are we talking about worst case?
Sorry, best case, you know, four months,
worst case, twelve months.
Like, what do we like?
Can we put some brackets on it?
Like I if a credentialing
company like us is touching
it and owning it and
following through and all the things.
And and look,
I always say on the podcast like this is.
This is like in theory,
this is like theory class textbook,
right?
We're giving you textbook answers,
but like Stefani said,
if you're an associate
somewhere else and this and
that and the MPI too, like it's,
it all changes.
There's variables to this, right?
But in theory,
if the perfect world was
happening and everything
worked out really great and
it was super clean and not
complicated bracket from what to what,
what are you expecting here?
What should you expect
post-close after you buy the practice?
I would say we're probably
around a twelve week turnaround.
You know, that's what insurance companies,
you know, twelve weeks and business days,
you know what I mean?
But to Paula, you know,
at the very beginning of the show,
she said they are never in office.
Right.
They're always out.
A part of what can delay
things is if you're not
truthful on these applications,
if they're not complete,
if they're missing something,
because then you're
starting all over again.
Right.
You got to go back into the line.
So I do think insurance
companies give us a timeframe,
whether they stick to it or
not is a whole nother
conversation we can have.
But you know,
these are the guidelines that
they give us, but always we're expecting,
you know,
we have more volume than we can handle,
or we are behind this many weeks.
So I think it is,
I would say a minimum to
give yourself is twelve weeks.
I mean,
we've definitely seen Delta a
little bit quicker, but again,
it has to go perfect,
like really perfect.
But we have definitely seen
that one good thing is we
can not even think and put
that application in pretty
quickly right when the sell happens.
They don't typically negotiate.
So even when a doc wants to
look at all the fees and
all their options, Delta Swan,
we just kind of say you're
kind of you get what you get.
So let's just fill that out
and get going on it.
So that's number one.
And then we have, you know,
we have the whole.
Right now, it's Anthem, used to be Cigna.
It's taken nine.
We've had a year on some of these.
The other thing about leasing networks is,
and Stefani might have to correct me,
once you...
If you're using a leasing network,
once you're credentialed
with a leasing network or in contract,
I don't know the proper words for it.
They get up to ninety days
to actually notify the
actual individual insurance
carriers under there.
So, you know,
I might I might be in with connection,
but connection might not
notify Humana for an
additional ninety days.
So guess what?
I'm out of I'm having out of
network conversations now.
with my patients.
So I think that's probably
the next place is how to be prepared
when you open and you are
not in network with insurance companies.
Yeah.
You're, you're reading,
you're reading my mind.
I had it queued up here.
What's the impact.
Nice work, Paula.
It's weird.
Brain waves here.
We have worked together for a while.
We have.
And so, so just to put like a,
an explanation point on, on those,
those two first topics of
getting organized and pitfalls folks,
if you didn't, if you didn't hear it,
I'll just say it.
Dummy Denzio style.
Get extremely organized and
cross every T and dot every
I. And get lots of patience.
And have lots of patience.
That's right.
Because...
Like as a buyer rep,
before we brought this in house,
because we brought it in
house a while ago and we process,
I don't know, a lot every year,
probably close to forty of these a year.
And before I'd refer like other companies,
said name companies and
I mean, what the hell is taking so long?
What's their problem?
Now I feel those companies pain.
I know exactly what.
And my clients,
like even now hearing you
guys that manage this department,
like it's like you guys
never can get their their
documents and the details
are terrible and their
malpractice is expired.
And I'm just thinking to myself,
these are dentists who are very.
very educated guys.
If you're listening, you're very educated.
You took the test you and
sometimes took the boards.
You dude, you're doctors.
This is the time to dial in
and get detailed and cross
every T dot every I and get
organized because the work
that you put in on the
front end bears the fruit
on the back end.
And,
and so that tees us really nice for
what's the impact of
If you don't get it going
and you're not prepared and
you close on the business
and now all of a sudden
these patients you're
meeting for the first time
and you got to say, oh,
we're out of network with you.
We're working on it.
They hate you right now, right?
So not really, but that is the impact,
right, ladies?
Like the patients and let's
have that discussion.
Paula, when you owned,
I think you were out of
network for a hot minute
with some of these.
I don't know.
What are our clients facing
by not taking this extremely seriously?
Does that make sense, what I'm asking?
Well, before we go there,
there was just one more
thing we wanted to mention
that we forgot on the pitfalls.
The other thing is that we
run into is offices or
dentists need re-credentialed.
So they're right.
They've been credentialed
with their associate job.
And we go submit an
application for because
there are different
applications for different things, too.
Just so everyone knows it's
not some some insurance companies.
It's all one.
But others, it's like, are you doing this?
Are you doing this?
And sometimes it's.
You know, it's different for each one.
So we'll submit a particular
application based on them
now being an owner.
And it'll be like, oh,
you need to be recredentialed.
So there's a whole nother
process for being
recredentialed if you've
been credentialed before.
So I wanted to throw that
out there because it is
another thing that we we
come across as a pitfall.
But as for the out of network,
it literally is.
okay,
I'm going to say this because I'm
experienced.
When someone says, I'm going to say this,
you got to like,
people are turning up the volume.
Yes.
It's not that hard.
Dental offices make it very
difficult when they're out of network.
Um,
there's two different things when
you're completely going out
of network for real, for real.
There's one conversation
that can be a little bit more, uh,
you know,
of a process and really need to
dial in everything.
But when you're only doing
it in the interim,
and you can still honor the
insurance network fees,
the allowable amount,
that's not a hard conversation.
They make it very hard.
What do you mean?
Why?
Why are they making it hard, Paula?
Walk us through that.
What you mean is Mary and Nancy Jo,
they're making it hard?
Sorry for all the Mary's and
Nancy Jo's out there.
Well, and even the dentist,
because they don't know and
they hear it and they start
flipping out because Mary
Jo said something and it's like,
calm down.
We give them this.
It's just that I don't know what happens.
Anyway, I would say, first of all,
nothing should change.
If you have fee schedules in
your software and we'll
just use Delta as an example.
Well, let's not use Delta.
Let's use Guardian as an example.
You're nothing's going to change.
Your conversation with the
patient is not going to change.
The way you submit a claim
is not going to change.
The only thing that's going
to change the amount you
get back from the insurance company.
That's it.
And no one really knows that.
So it's not a big deal.
Don't delete your fee schedules.
Don't stop attaching them.
Just treat it like you normally do.
I would say most doctors go
with the exact they mirror.
So your dentist is going to
mirror what the seller is going to do.
Your process doesn't change.
So stop making it complicated.
You're going to honor the
patient's allowable amount,
their copay that you would have before.
You're going to submit the
insurance claim in your UCR.
And yes,
the insurance company is going to
pay you a little bit more
because you're out of
network in the interim.
It's that simple.
Now you've taught me for the
folks that know their stuff,
other consultants,
other credentialing companies,
whatever you've taught me
that that does impact, uh, well, I'm,
I'm the dumb one here in the room.
So, uh,
but so we should probably mention
that though, you know,
where I'm at right now.
So let's mention it.
Well, it does impact their maximum.
So a patient gets a thousand
dollar maximum.
It's going to impact it
because the insurance
company is actually going
to reimburse more,
which is going to quickly eat that up.
But honestly,
anybody over a crown and a
root canal is going to have
to pay out of pocket anyway.
They've just they're a
maximum benefit anyway.
I can't stress it enough.
front office people,
you do not work for the
insurance company.
You work for your dentist
and the patients.
And that's it.
They've got to learn that.
Stop worrying about, yes,
we have to be honest.
We have to tell patients,
but you tell them positively.
Actually,
Stefani's got a great way she
talks about assisting.
Stefani, go for it.
Do your verbal skills on that.
No, it's just, you know,
Any news is good news when
it comes to insurance coverage, right?
We have to get out of the
mindset of entitlement, right?
And think of it that it's great news.
They're going to assist you
with twenty five percent
rather than no percent.
And we behind the scenes are like, God,
that coverage is terrible.
Right.
But any news is good news.
Right.
And so it's always
assistance when people start.
Start thinking as an entitlement.
Oh, well, this, you know,
cleaning is free or, you know,
I don't have to pay.
It's not you in all of that coverage,
you know, and that's an estimate.
Let's just make that very clear.
But I think to go to what
Paula was saying about these front office,
I think what's really,
really hard is at the
moment you try to change something.
And now we've got a new dentist.
So they're already, you know, on guard.
But then we are and, you know,
our estimates are really, really off.
We're just losing, you know,
the chance to maintain them
and really sell this new doctor.
So I would really, really recommend,
you know, to Paula, keep it the same.
Business is normal.
What it looks like on the billing side,
we'll handle that.
Right.
Claims come in.
We are electing not to
charge anything in addition,
which we can.
Right.
But that's that's.
the offices part.
Don't let the patients feel that.
What I heard was,
is don't overcomplicate this.
And I think this is a very,
very complicated subject.
It's really hard to do a podcast on it.
So ladies,
you're doing a great job trying
to explain literally a Chinese menu.
And after three years or
however long we've been
doing credentialing,
I finally feel like I got
ten percent of what the
hell you guys are talking about.
But
um the point the point is
this is a very complicated
situation you've got you
got nancy joe telling you
one thing post close you
got your credentialing
company telling you another
then you got the law
telling you one thing and
the insurance company and
contracts telling you
another thing so you're
getting all of this
information it's really tough for you all
I think at the end of the day,
I think Paula said it perfectly.
So rewind and listen to that
part is just just chill and
keep doing what what you're
doing and have the same
conversations and and
everything's going to be fine.
But it is a it is a creepy
topic and there's a lot of
opinions out there.
So with that being said,
you'll and then you'll also
notice that this
conversation is about credentialing.
But here we are talking
about verbal skills.
I think everything comes
down to verbal skills, Paula.
I mean,
don't you agree on how you deliver
how you deliver what a
complicated situation or a
hard conversation or a treatment plan,
a treatment that's gone
wrong or a billing thing?
It's all about how we communicate.
Yeah, and I think that for me,
I'm going to state this very simple.
Why trust someone who's done
it one time in an office
for an associate versus a
company who's done it hundreds of times?
And not just hundreds of times,
hundreds of times for acquisitions,
hundreds of times for startups.
Like why we're on a forum
listening to other dentists
who have never credentialed themselves.
Right.
They've gone through a process.
They have no idea what
process they've gone through.
Oh, I became an associate.
I was credentialed in two weeks.
Number one, you don't know.
You truly don't know.
Number two, phone offices work in one,
hopefully max five places
their whole life.
How many times are they credentialed?
listen to a professional
company we have nothing to
gain by extending your
credentialing time why
would why would our team
want to track your
credentialing for nine
months or a year why would
we want to do that we want
to like there's nothing we
want more than for you to
be off our plate in three
months and not because we
don't love you but because
we're just getting more and
more credentialing the
quicker we can track this
get it because it's a lot of tracking
It's a lot of front leg work.
It's a lot of during work
and it's a lot of tracking.
Nobody wants to do this.
I promise.
So trust us when we say we
do everything in our power
to get you credentialed as
fast and as painless as we can.
Now it's up to you to
understand the process and
the timelines and give
grace because it is there
is a point that it's out of
our hands and there's
nothing we can do but check on it.
We can yell, we can scream, believe me,
we have.
We can hang up on people.
We can threaten, we can threaten.
At the end of the day, you call,
and that's the other thing.
Let me just state this.
When you call majority of
insurance companies,
so I'm Nancy Jo at the
front desk and I call and say,
how's our credentialing going?
You're speaking to a
representative that doesn't
even have access to the backend.
They don't even because I get it.
And I say, there's no way I have proof.
Well, then I'll get pushed through,
pushed through, pushed through.
Finally,
I can get a hold of somebody that
actually knows and can give me an answer.
But when you call up and say, oh,
am I a network?
And they say, no, oh,
we don't even have an
application on file.
Like, don't have a heart attack.
That is not true.
We submit applications.
They're submitted to usually
an entirely different team
than the front end when you
call to check on a patient.
The outsourced call service
company that they've
outsourced in India or something.
When the roosters are
crowing in the background.
Right.
You just it's such a process.
And again, I'm going to state it.
We don't want you any longer
than you want to be with us.
And it's not you.
It's it is one more thing on
our credentialers plates.
It's it's almost like a joy
for us to check the boxes.
So if we get to check a box
and you graduated from college.
you know, here to here to here to, Oh,
we're done.
I mean,
it is the happiest day of our life.
So yeah, that's awesome.
And I'm sure that, you know,
a lot of companies out that
feel that way.
But I think that, you know,
the other thing I just want
everyone to know is as
compared to other companies,
I want them to know why we're different.
And I think why we're
different is we are a fairly small team.
We're not,
We're not a big, big company.
And a lot of times we're
dealing with our own clients.
So these are clients that
we're going to have in
membership or practice
management or billing.
And we want that
relationship to be amazing.
So we do everything in our
power to be boutique and
make sure that they're
getting white glove.
And I know it doesn't feel like it,
but I think the reason it
doesn't feel like it is
because they just don't
understand the process.
If they could live a day in our shoes,
they'd be like, holy crap.
These guys care.
They're doing everything they can.
I love that.
Stefani.
no I mean how so it it's
easy to get passionate
about this topic stefani
any last comments from you
that that's in the weeds
and grinding with these
insurance companies every
day getting the the emails
from the clients of worry
and and distress any final comments
oh we got a delay on
stefani's end um I yeah I
think that it's really in
oh sorry now you're you're
you're you're fine stefani
uh if you if you want take
it away and any any final
comments okay yeah yeah I think you know
The same thing,
comparing credentialing to a claim,
right?
Trying to give the insurance
company's networks
everything and then some, you know,
so they don't have to come
back and ask us for anything.
But even though credentialing, you know,
could be complete,
in your case,
you are still going to run
into issues with the carriers, right?
And it's really important to
know what's the difference
between a credentialing
issue and what's the difference between,
you know, insurance processing issue,
whether it's they are
showing you out of network
or they're having you with the, you know,
incorrect fees.
It's really important to be
resourceful during your credentialing.
journey,
just knowing who you should be going to,
what questions you should be asking.
And if somebody's never been in here,
they can feel like they're
just drowning and they
don't know where to go.
So I think it's important to
really educate the team saying,
if this is an issue, here's where we go.
If this is happening, this is where we go.
That's perfect.
I think that's on point, Stefani.
Yeah, this is an interesting topic.
We didn't get into kind of
like the strategy and how
to maximize and how...
to get that bigger fees
because you can there's too
many people saying you
can't you absolutely can
get better fees and um to
paula's point of being a
boutique uh organization
that's what we pride
ourselves on getting
getting our buyers uh
higher fees than the seller
and that's a bump that
um that's a free bump
congratulations you get
more money for doing the
exact same procedures and
you can do it no not from
delta not from some of the
ones that have us um uh
have the biggest stick in
the in the on the
playground no you can't beat them up
but there's a lot of other ones you can,
and it can give you a serious bump.
So maybe we can touch that
on a future podcast.
We've also done this
credentialing episode in the past.
And so check that out if
anybody's doing that one.
But ladies, thanks so much for joining us.
And Paul, of course,
helping me co-host this new
brand of Dental Unscripted.
Mike D'Incio, Paula Quinn,
Stefani Sandoval here signing off.
Guys,
we've got a lot of other episodes
coming down the pipe,
and I'm really excited
about the lineup we have in
the next few months.
So stay tuned and subscribe
and follow us along the way.
Cheers.
Take care.
Thanks for listening.
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