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This podcast covers from START to FINISH How to Acquire a Dental Practice. Michael Dinsio, founder of Next Level Consultants has literally seen hundreds of deals as a banker in the industry & he has personally consulted hundreds of dentists as a Buyers Representative. Michael talks with GUEST SPEAKERS about Due Diligence, Legal, Demographics, and more... He invites experts to the show to help you avoid those headaches and heartbreaks. So start at the TOP w/ Episode 01 and work your way through the transition process. We break it down step by step in a true #UNSCRIPTED and genuine way.
00:00
Oh yeah, here we go practice acquisition. There are pitfalls throughout the entire process.
00:25
Acquisition Unscripted, the truth when buying and selling at dental practice.
00:36
And now your host, Michael Dinsio. All right, all right, guys. Welcome, welcome. Another episode of Dental Acquisition Unscripted. My name is Mike Dinsio, as you know, founder of Next Level Consultants. And today is a special, special interview because it's the second time that I've brought on a team member of Next Level.
01:01
And she is a huge part of what we do every single day and a huge, huge piece to our little puzzle over here at Next Level. She's all things front office, front desk, credentialing, billing. She's just the queen of the front. So I guess that's what we call her. But welcome to the show, Safani Sandoval with Next Level Consultants. What's up? What's up?
01:30
I mean, I talk to Stafani literally daily. And it's just different when you're interviewing someone on a podcast. But Stafani's my girl and we love her over here. We're lucky to have her. But today's topic is super important because as you all know, we've worked through the entire process of an acquisition and credentialing is such a beast. And it sucks. And so, we needed an expert on the show today.
02:00
to really just break it down. But Stafani, why don't you give us a little bit of the Stafani show. What's your story? Where are you from? Obviously we're from next level, but give us your goods here for a second. Oh yeah. Well, I'm located in Cleveland, Ohio. If you ever get the pleasure to talk to me on FaceTime, I'll just tell you Michael, I'm always in Cleveland, dear. Thought I'd dress up for the nice occasion we're having. But yeah, I started in dental with no knowledge.
02:29
started as specialist at an end of Donis office and I've had the pleasure just to keep diving in deeper and deeper. So went from endo that I went to general. Then I just started as an operations manager. I got to oversee dozens of dental offices. But then it's like, you know, hey, I get bored. So what's next on my agenda? But I mean, I'm an open book. But the biggest thing to me is I
02:57
had to do all the legwork myself, ask the questions, talk to the people. And I think that's what helped me get to where I'm at. Yeah, you dig in. mean, you know, the difference with consultants is like folks that have actually done it, you know, a small plug for next level. mean, if I was just the consultant for our clients and they're asking me questions, I have never done credentialing. I haven't actually picked up the phone and talked to the insurance companies.
03:27
I don't know what the F your freaking narrative should be. And I don't know why I said F people that follow us. hear plenty of F bombs. I know, know. she's like, oh no, I'm in trouble. can't swear. you know, experience matters, I think. And so that's our whole philosophy at Next Level is like, we get coaches that have been in the seat and have lived the world. And so
03:55
Like I said, lucky to have Ystofani. Let's get right into it. So credentialing. So a lot of you have to deal obviously with the insurance companies and the carriers. When you're buying a practice, you have to make sure that you're gonna get at least similar fees than what the seller has. And if you don't, it's naturally going to hurt you. You do the exact same procedures. You see the exact same people, but your credential,
04:23
you're collecting less. And there is a strategy here that Stafani helps our clients go through to really make sure that there aren't major pitfalls, major being keyword. There's always gonna be some in the transition process. let's get into the first question I have for you, Ms. Stafani, is what do providers need to have in place to get credentialing started? I always get the, well, where do we even start? I know it's a beast.
04:53
But it seems like before you can even start, you need a lot of stuff to give you to credential them. So, what is that stuff? Like, it's a lot. Well, the first I think is once you get your LOI in and you know you're gonna purchase, that's the time to start credentialing. Let's give us the biggest time opportunity to get it submitted, approved, come back. So, you start day one credentialed.
05:20
Right. That's ideally but that never seems to be never happened. Is that aggressive to me that never had to always take it how you want to take it. But no there's a lot of things that providers who are associates that don't necessarily think that they need to have in place. So we're already delayed because we've got to get an updated about.
05:45
That's the one thing that I think that we always talk to dental offices and providers about is you may be covered, but we have to show proof that you're covered at your new location. Right. And that takes time because it's out of your hands. You have to reach out to your agent. We're waiting on paperwork. We can't really go any farther. So that's step one is we need to make sure that's in line. You know, all your license, everything's updated. Nothing's about to expire because we don't want to give them any reason.
06:15
to hold off your application. Like, oh, hey, 90 days, this is going to expire. We need something, you know, current. So then you're rushing to the last minute. Forms, your IRS forms, we have to show that this is a new business. You know, they need to make sure that your name is your legal name and that we are provided an authentic tax ID. And so if you don't have that form, you got to go dig in through your papers. You got to go reach out to your attorney. just
06:45
that little time adds up. So, we try to give them a laundry list of things we need. The biggest one is your CAQH. This is just a national hub that credentialing is done through. It helps timely, expedited, you know, how do I want to say it? The insurance companies look to this company and say, hey, is all this information good?
07:10
Oh, it's good. Great. We're going to move it on. It takes the leg work out of it. So, a CAQH is a company. It's a third party website that hosts this. Oh, okay. Yeah, I actually just learned about this. You taught me about this not too long ago, but if the CAQH is filled out, it streamlines things, makes it so much faster. By like three months. Oh, wow. It just makes it so much quicker.
07:39
But that application's a beast, Yeah. So that's another thing is we go once we get access to that profile, we look to make sure there's no discrepancies. You know, a big thing is providers who relocate from another state. If there's more than six months a gap in your employment history, we have to have a narrative of what was going on at that time. They look at every little detail on that. Plus, you know, when it comes to.
08:06
submitting applications to the other insurance carriers, we have one master application that we just take it to grab from. it quickly, we're not constantly looking back and forth, back and forth through all the documents. So there's probably seven more that you've got. So, but, the ones that are going to take the longest that always slow you down. Did I hear malpractice? CAQH is obviously when you just said.
08:33
ADA, everything updated with the ADA online, I'm assuming. That's an online thing. Yeah, CAQA just done through the ADA. So, that's okay. then there was another one I was missing there. Was there SS4 form? Maybe that's what you just said. So, yeah. And what's that? That's your tax identification. Oh. That's given to you by the IRS. Yes, that's what it was. as you were talking, I was thinking as much as Stafani takes shot at me every day and we have fun with it,
09:03
It's challenging for you guys to go through the process of looking at a practice, making an offer, going through due diligence, making sure the clinical works, because all of that needs to happen. Cashflow works. Banking is in check. mean, there's so many things. But it's kind of like this balance of like, do I spend money on Mike? Do I spend money on an attorney? Do I talk to the banks? Do I submit an LOI?
09:29
you've got all these things going on and you don't want to invest in things if you're not moving forward with the practice that you're looking at. So, one of those investments is setting up a business. Why set up a business if you're not going to go into business? And so, going through the due diligence process, all of this stuff takes time. And I always get the question, should I file for a new business? Well, I don't know. We're looking at this practice. How serious are you about it? We're negotiating it. Could work, might not.
09:58
But you could go ahead and set up that company. It's going to cost you 600 bucks or whatever with your attorney. And a lot of you don't want to pull the trigger on paying some of this stuff upfront. But as you can hear, it kind of slows down some of the other processes with the bank, with the credentialing. so, like, if you're serious about getting an ownership, you got to make some of these small investments, knowing that even if this practice isn't the one that you're going to find another practice that is. So anyways, just sorry, I'm rambling, but
10:28
No, it's 100 % true. They don't think about these things and maybe they get this tax ID and it's been good since 2015 and they are a little shy to pull the trigger. You don't know where that paper is. Then you have to request it again. It just takes time. So, that in mind, having your documents ready to go. Let's put a list, a quick list. Let's not give them the whole list.
10:55
But let's do like the main things, let's put it in the show notes below. Yeah. Of like the top 10 things you need to get prepared for, for the credentialer, whoever does the credentialing, hopefully it's Stafani, but if not someone else, but things that you need to get ahead of, let's put that small list below. Folks use that as a resource, our gift to you. And by the way, Stafani, you folks, when she says they, we're talking to you.
11:23
the audience. She means you. They. Yeah. So, you all need to get your act together. Great stuff. Next question. Let's roll. How do you know what's an acceptable fee for the reimbursement? So, this is a good question because, well, let's have you describe it. Why, like the fee itself, I get questions all the time like,
11:51
Is this good? Is this bad? And I mean, to me as the evaluator, I want to make sure that the fee schedule is similar, if not exactly the same as the seller or better. And oftentimes you're getting better fees than the seller. Oftentimes. Most of again, how do we know that's good? So I guess that's the question is, how do you know it's good? Can we get better? Well, the first thing is, is that we get an updated fee schedule.
12:18
of the cash office cash fees. You know, I'm always reaching out to you, Michael, going, hey, what's the scope? What's going on around there? Who's charging? What? Where should they fall? And I think your recommendation most of the time is let's let's aim high. Let's be around that 90 percentile. You know, it's OK to put value on the work that these dentists are doing. There's no shame in not being the cheapest. Yeah, that's right. It speaks for itself. So when we're negotiating.
12:44
You know, we're gathering fee schedules. We're looking at what's the closest reimbursement to this office. You see our fees and the reason that they end up being higher than the the sellers is because one, they haven't updated their fees in years to I'm negotiating off of higher fees. You know, I never take no for an answer. It's always like, I'm pretty sure you could do better than that. You know, this is insulting. We're going to pass. So this is the negotiation process, right? Because I
13:14
I, to be honest, like I, I never thought you could negotiate with insurance company and you kind of can't, but, you kind of can, like, can you describe, do they really work with you? what, like, do they, you know, and usually it's, it's right at the end when you're like, I don't think we're going to move forward because there's always alternatives, right? We're either going to go out of network. We're going to go through another lease network. You know, there's options for this provider.
13:43
you need us more than we need you. And, you know, I had done a negotiation. They gave us like six and a half percent increase, which was good, but it wasn't competitive. Yeah. When I said, I think we're going to pass and what did they do? They came back going, is it the fees? Cause we can do better. And I'm like, exactly. Then we got a fee that topped out the whole board. Okay. How many insurance carriers do we know Delta doesn't play the game? How, how many
14:11
of all of the carriers actually will work with you on this. You just have to ask. So the majority? Yeah. Really? Yeah. You get Guardian, get Edna, you get DHA, Connection, Carrington. I mean, everybody is open and, you know, Connection lets you negotiate once a year. OK, so so you're talking. Sorry, folks. Let's get let's get into the weeds and I hope.
14:36
This is going to be one those episodes that you might want to rewind. Listen, rewind. Listen. Yeah, we move at a really fast pace around here. Yeah, we do talk fast. So, my brain's firing in all different directions. Like something that I'm thinking about, like is the umbrella versus the direct conversation. And folks, if you don't know what I mean, like there's two ways of going. And I don't really know what I'm talking about, but I do enough to be dangerous. But Stafani knows.
15:06
when I'm talking about. let's get into that direct versus umbrella. Now you're a big fan of umbrella, right? But I am a fan of leasing out the networks. Lisa, don't get too fancy with your umbrella leasing tomato, tomato to you, to you, to the, to the layman from, I can't say the layman from Ohio. You're from Ohio. I'm from Ohio. That's always my joke. I can't use this joke today.
15:36
The layman from Ohio, why direct? you could explain it, explain it. You could do better. Some insurance carriers offer their own network. That's what we call direct, right? They have their own assigned fee schedule and your credential directly with that. However, on the flip side, there are these larger networks, these umbrellas that. Hey, we have our own fee schedule.
16:04
You will follow hours, but in order for that to happen, you then get to see all of these PPO insurance carriers, their third party carriers. So example, Aetna has their own, but then you can also see Aetna through Zellis Network. You can see them through Connection Network. So if Aetna comes with you with a lower fee and you try to negotiate and they're still, you know, not budging, there's alternatives that we can still see these Aetna carriers. So do you do you talk
16:33
directly and then say, I can go to Carrington and get better. So why would I go direct? Yeah. that's usually like a tech, a tactic of mine is going, well, you know, I got another fee that's way higher. So what can you guys do? Because they want to keep it because they need to keep their, their members happy. if somebody really likes their dentist and they're not going to be a network with Aetna, I guarantee they're going to leave that network.
17:02
Yeah, right. Okay. So, you can go direct, you can go under an umbrella or lease as you called it. Fancy, fancy. So, there's a couple strategies there. So, when you're looking at a seller's fee schedule, ultimately, you've got a couple paths to go. And you've been doing this long enough to know that you've created a spreadsheet, which I've personally seen, and you can call people on their BS and say, dude, you're not
17:30
giving me a good deal and you can have that conversation. So there is a strategy there and it's not just filling out paperwork. I mean, that's obvious. That's obvious. I think a lot of people think that, oh, well, Stafani's just filling out paperwork. The paperwork's really long and I'm paying her to fill out the paper. No, dude, it's people, folks, audience, friends, followers.
18:00
We're kitchen ass around here. So, can get you the best B schedule. Let's be honest. Follow what it is. Yes. So, Stafani is just, you know, asking as nice as she can what she can do, the best deal that she can get. which leads me to my kind of next question with the whole, well, we kind of touched on this with the ch, aq form. Caqh. Caqh. Caqh form. It makes it much faster.
18:30
But before we had used to Fonny at Next Level, we used to deals out or my clients out to some of the bigger credentialers out there. And it would always take eight months, sometimes 12 months. And it was a process and communication was challenging. And so I would get an answer, how long does it take to get in network? And it was always like kind of this random
18:59
I mean, not random, like it was just this huge spread. So I mean, realistically, conservatively don't go on record now you're being, how long does it take to get completely in network with all of the carriers that it takes you usually. And then let's just say Delta by itself, cause they're such a beast in itself. So I would say.
19:26
where I'm not stressing myself out and fighting, you know, regretting my decision to come on this podcast. Would probably be six months. Six months allowing ample time for, you know, if you're going through these umbrellas, they're letting their third party know it's like, hey, we've got a new provider, update your records. You're going to be on their directories. It's allowing that ample time for everybody to get their ducks in a row.
19:55
Realistically, mean, with the success that we've been able to have, I mean, we're at probably a three month, four month mark. Yeah. I was going to call you out. I'm glad you doubled down and said three to four, but I wouldn't say three because three is probably that's like probably four. But by the way, the clients probably had their file super dialed and tight and sent you everything. That's probably a three month there. But if we're starting from scratch and
20:24
you're waiting and waiting, waiting on our client, it could take four or five months, right? Exactly. And so, you you slip up on one of those applications and you forget, you think, oh, I don't need to fill this out. I'm just gonna, you know, fill out the basics, what I think they need to know. It's like a dental claim. You're giving them a reason to not pay you or to hold off on, you know, approving you. So we probably give them more than they asked for and everything is absolutely touched
20:54
eyes dotted, teeth crossed, we leave nothing, stone left unturned, whatever that's saying. We need to we always check everything. It's the right paperwork. We're giving them the right documentation. So, that also really helps. I think Anthem is always like good file, never a problem. I'm like, yeah, because I don't want to wait for you to tell me that something's wrong. I don't have time for it. But Delta Dental, with these acquisitions, those happen a lot quicker.
21:25
because they understand someone's leaving and, know, we don't want to break the law and use somebody's credentials when they're not there. They kind of expedite the transition for those practices that are, you know, selling because they want to make sure day one, their credentials. As much as we all hate Delta, we also kind of like Delta too. You know, they got a lot of great things about them. I have to admit, this is one of those.
21:53
Don't kill me, don't send me hate mail or whatever. But- No, go ahead. Go ahead. I'd love to read them. Love to read them. But they are dialed in on their systems. They're quick. Their customer service is pretty nice, but their fees suck usually. anyway, that's the- Okay. So up to this point, this has been to me an average podcast. Let's take it to the next level because-
22:19
you're going to hear a lot of the same stuff in articles and other podcasts and other credentialers. Let's talk about what all this really means. Really means. Because you're also a front office coach for our clients. so credentialing is one of those things we can help with and a lot of other stuff. But to me, Stafani's true value is helping our front office clients be better.
22:48
just be better. Systems, verbal skills, processes, whatever. So, from an acquisition perspective, folks, dial in here, okay? Because this is the part where the episode really gets good. You're going down the path of due diligence, you're in a contract, you get your banking, we know we're buying the practice. It's happening. It's just a matter of time now. And so, the bank's getting an order and we know we're going to close. Now, the question is...
23:18
when the seller leaves and we're not in network, and by the way, why we're not in network? Because we're credentialing. And you're like, well, let's just start the process sooner. Well, we can't because the insurance companies usually alert the office in some way that, yo, someone else is credentialing under your stuff. And then they get a letter and then the front office person knows and the team knows, and that's devastating for the seller. So, you can't fuck around there. I'm just going to say that right now. You can't.
23:48
screw around. That will really mess up your deal and the seller's deal. There's nothing worse than tipping off a team in a transition because they'll just scatter to the wind and then you'll have no team and then you just screwed up the seller's transition. mean, that's about as bad as it gets. So, unfortunately, we have to wait. so, okay. So, we now have permission to start credentialing. We only have maybe a month to go. That's what Stafani was having.
24:15
calling me out earlier in the episode. She never has enough time. here we are, month out. Stafani still needs probably three more months to get you credentialing. So, you're in business, you've got the keys, you're the owner, the seller's gone. And we're three months into ownership and you're not in network. What is the solution? Go on record. It's okay. Say whatever you want to say. Don't worry about what the attorneys would
24:44
would tell you to No, seriously, like because the reality is that the insurance companies know what you're about to say. So and they're OK with it as long as you tell. So go ahead. Go ahead. What do we do? We try to bill you out as a local tenant. I'm a temporary dentist with this tax, the seller's tax ID. I'm working here while he's not whatever business. Why is why I'm here? It's none of your business, but I'm I'm a temporary dentist. I'm going to use the seller's credentials or.
25:13
90 days before I'm kicked out and I can't do this anymore. And then by that time, it should allow you ample time to have your credentialing completed. Like I said, these insurance companies can expedite the credentialing for transitions a lot quicker than they do startups. So, know, having, you know. Now that's a sign that the seller will let you do that, right? Correct. And I mean, if they don't, you're going to bill out a network, which is sometimes.
25:41
because you're getting a higher reimbursement rather than maybe the seller's negotiated fees. Yeah. Let's not go down that. We'll be on another hour conversation about Oh, God, yeah. But what Stafani just said is, my experience, spot on that it's not the end of the world if you're not in network. You either build out a network and take the hit for a small period of time, make the patients feel great and...
26:08
Let them know that, listen, we're trying to get a network with your carrier. It's just going to take a minute. But until then, we're going to make this right. You're building goodwill. The patient's going to love that because you're like, dude, I'm taking it on the chin right now, but we'll be in network next time you're in. They're going to love that. Again, communication. But the best case, and I'd say the majority of the time you just said it, we're using the seller's credentials, right? Yeah. Yeah. So.
26:37
that have you ever had an issue processing claims doing this? No, and I mean, we're forthcoming with these dental insurance companies saying, hey, this is a local tenant claim. We have a provider that's not credentialed under this tax ID. And when they hear that, they get their gears going and they finish that application because they don't want you to continue to do that. Yeah. And you're telling them.
27:04
You're telling me. Yeah, we're forthcoming. We don't ever try to hide anything. Yeah, because what is it? The patient, the only person, the only person that gets that suffers from all that is the patient. And the carriers don't want the patient to have to suffer in that, right? We're not trying to commit fraud. Like we're not trying to hide it. Yeah, the buyer, our client, now the owner is not trying to commit fraud.
27:30
The seller is not trying to like pull one over. We're just trying to make this work for the patient's sake. And I think that the insurance companies recognize that. They know that. Yeah. Minimal disruption is what we say. We're trying to do this with minimal disruption, this transition. And you know, I think the sellers are very apprehensive because they're leaving and their tax IDs just like lingering in the office.
27:54
So, you we say like in 90 days, if you want to see your system, it's out of here, your tax ID and your practice management. We're not using it. Yeah. Yeah. I think the sellers need to to understand that. There's a lot of alarmists like and that's why I said the attorneys that they they kind of they kind of set the insurance fraud and and and they're not wrong, but they're kind of alarmist because as long as you're forthcoming with.
28:22
insurance company. They're cool with it too. They know what we're doing here. So, we're just trying to make it so that the patients experience better. okay. What other little practice hacks as far as credentialing goes? Like, it's such a beast. And it's very expensive, by the way. It's very expensive. It's a lot of time. It's lot of time. Very time consuming. I think one thing that these acquisitions need to know is that
28:52
You know, you're yes, you're acquiring a new practice, but that's not where your dream stops. Right. As I got my own practice now, it's like, OK, well, I want to grow. I want to get bigger. You know, I want to take on an associate down the road. There's a lot of things that you have to start preparing for. And, know, that's where we talk about that type to end. Yeah, I'm like, well, that everyone's like, what I heard I needed. I heard I don't. Yeah. You know, you're going to be investing so much money into your marketing, getting your name out there.
29:21
that we want the insurance companies to mimic what your name is, what your entity, what your DBA is doing. So type two NPI, right? We're going to be billing as an entity. And so that is an application in itself that these providers have to think about is like this name. I don't want it to be just, you know, Dr. Tooth DDS, right? We want it to be, you know, Tooth Fairy Dentistry, whatever you want your name to be. We had a client, Tooth, something, Tooth Fairy. Anyways, yeah.
29:50
But exactly you're spending your money in your marketing and you're going to be an insurance. If you're in network with insurance company, you want them to do that marketing under your entity. So a type two NPI, I think is something important that we talked to you, Dennis, about is that your DBA, you guys got to figure that out. You have to apply for it. know, yes, you have your LLC, but you got it. You got to start getting that into motion. You got to get your domain to match all of the stuff that goes
30:20
is involved in it. You don't think about it until like, you know, two weeks it left. It's hard. The key to all this, in my opinion, is just knowing you're not going to be credentialed by close, just having that expectation because it's, it's Stafani can't do something magical. I always get into these conversations with clients. It's like, what's Stafani doing? Dude, you have no idea the amount of time that she sits on the phone.
30:50
to get people just to respond. It's just, it's the most ridiculous process in a lot of ways. yeah, you can't control it. just, you're just trying to be a nag. Your job is to be a professional nagger. What do I say? I'm going to stock that application like an ex boyfriend. I'm on it. I'm calling it every week, finding out who's it's been, you know, who's touching it, what it's been doing. I'm on it. And they hate me, but I don't really care. Ex boyfriend. That's exactly right. And so I,
31:19
So so just have the expectation that you're to be out of network the day you close and to have a strategy before you knowing that going in next level helps you with that. Stafani can help you with that. And I and I would even negotiate in the L.O.I. probably. You know what? I'm starting that idea now. I add that out loud. Right. Add that to the L.O.I. because it should be right there that we're going to you're going to allow.
31:48
us to use your credentials because it's not that big of a deal, but they act like it is and it's not. so just have that idea. And like you said, to be out of network for three months, it's not, it's, I mean, you build, you're a professional builder, you came from billing. Like what's the impact in your mind for out of network?
32:16
Right. You have a lot more adjustments, right? But what's that look like? I mean, but it's not necessarily adjustments. I mean, it's patient responsibility. Like it's billable. The difference. You just have to have somebody, you know, smart enough to go and, OK, I know that no, no patient's going to have to pay additional money after something's covered at 100 percent. Right. We know what the treatment plans are saying. We just honor that. But let's not.
32:43
get it wrong. There's sometimes where we're going to be out of network with certain insurance carriers because we can't come to an agreement and you're going to have to be prepared on how you want to handle that. So whether you're going to make the patient, you know, pay the difference, or if you're going to say, I'm going to just, you know, accept it. I don't have to follow their guidelines. I don't have to, you know, I can build a patient. I don't have to build a patient. I don't have any rules to follow if I'm not in network. Actually, let's, let's have that conversation. Um,
33:14
does it make sense? When does it make sense to potentially drop a carrier? Because I get the conversation, especially in California, our California, our California clients have to deal with this more than pretty much most because of the whole premier PPO issue. Yeah. It's an issue all over the country, but it's extra, extra, uh, extra a problem in California. So we're faced with the idea of going fee for service or dropping some carriers. So
33:44
When does it make sense? I get that question all the time. we also have some bigger clients that they're almost too busy. They don't want to bring on an associate. So to me, my natural brain goes to, let's drop some carriers, maybe get less busy, but more profitable, whatever. That's my question. When is it a good idea? To drop a network. Maybe not go, like, I don't, I never believe in just.
34:11
going crazy and just dropping all of them. I feel like there should be a strategy around. Nuggets here and there. Yeah. So you don't, you know, piss off too many people. But one, you know, let's look at the reimbursement. If you're getting seven hundred dollars for your porcelain ceramic crown, buh-bye. No way. Your lab fees and with inflation and everything, you're losing money. What that patients in the chair, you know, if you're not doing same day crowns, you're not going to get your money back. You know, it's it's the reimbursement.
34:41
But also if you're finding that they're trying to find every reason to deny your claim based on medical necessity, like they're questioning your work. You shouldn't have done a buildup. They didn't need it being out of network. You don't, they don't get to have that authority over how you treat your patients. They either pay for it or they don't have any money to pay for it. What I was sitting here thinking and, and, and you're right. It's not just, um, fees, fees, but
35:09
maybe it makes sense to look at how many patients you have and each insurance and really pick the ones that you don't have, you know, the least impact and just start slowly slicing them off the, the, you know, the, list. Yeah. And if you've got a great front office team and someone who's doing treatment presentation, like, listen, they're going to cover your crowns at 35%. You're still having to come out of pocket.
35:36
with what you're paying out of pocket and your premium that you're paying monthly, let's get you on our in-house membership. You're gonna save money by electing out of PPO plans. Amen. Yeah, no, that, I love that. I think that's a great place to kind of shut this episode down because all of it is great communication. Like, if you suck at communication, I'm serious. If you guys suck at communication, it's okay.
36:04
A lot of offices do in the practice that you buy. If you hear your front office is not good at communicating this stuff, do not try to go fee for service because they are going to screw that conversation up and the patients are going to leave. But if you feel like they're good talkers, they're connecting with their patients, they're really digging into it, they need some scripting, Stafani and Paula can help with that. Don't call me. But you know,
36:33
there's a strategy around all that and it really does come down to effective communication. When you were at that specialist, I bet you that's where a lot of your- all my sales, right? Because I got to get somebody to pay this money, the thousand dollar procedure, and then they know they have to get an additional crown. It's a hard sell. So really trying to dive into what makes sense for them, to be a real person, to talk to them going,
37:03
doesn't suit you. They're not covering this anyways. Why are you paying for it? You know, I found MetLife sold insurance to some lady who had dentures who had a missing tooth cause. man. Oh, disgusting. Right. I'm like, get out of this. What are you doing? Oh my God. Okay. So, so if you missed, uh, if you're like membership plan, what does she mean? People are trying to take this stuff in house. The membership plans in my opinion should not be facilitated in house. You can absolutely get by with it.
37:30
We're big fans of Dental Menu. There's an episode on Startup Uncensored with Dental Menu. Learn more about membership plan because you can use it in the pitches like Stafani just said. Use it. It's a way for you to come down from the insurance companies if you decide to come off. So check out the Dental Menu episode at Startup Unscripted. Stafani.
37:57
You're the best. Thank you so much for being here. I'm glad we're doing this. We should do round two sometime. We should. need to pick a new topic. But this one's a hot one. And any last comments? Any any any last things that you can think of? Last nuggets that you could give these? Stay organized. Keep it going. Make sure you got all your ducks in a row. That's all the advice I can give you. And just be patient. You know, it's.
38:24
It's a waiting game. You know, we, the next level try to go as fast as we can. It's probably in our hands for two weeks and then it's done. Um, then it's, you know, we're waiting on other people. So patience is key, but again, having the verbiage and staying organized. Yeah. Organized. Okay. So folks, uh, again, to back her up, we're going to give you that list in the show description below. Stafani, make sure I got it. going to email you after this a quick top, maybe top 10 things, the things you need to get in order.
38:52
so that when your credential or picks up your file, you can say, here you go. And then boom, you're off to the races. That would really speed things up, but 90 % of it is sitting around waiting for these insurance carriers to really come through and the negotiation and the strategy. I mean, that's all Stafani's brain, but yeah, thank you so much for being a part of this and being an amazing team member for Next Level. We appreciate you. Thanks.
39:20
Alright, peace out guys. Thanks again. Tune in next week or gosh, I think we're doing this every other week. Tune in and we'll keep the process going with Dental Acquisition Uncensored. See you guys later. Bye. Tune in next time for another truth-filled episode of Acquisition Unscripted.
39:42
We want to hear from you. Interact with your host, Michael Dinsio. Follow us on Facebook, Instagram, and YouTube. Comment and subscribe.