1 00:00:03,333 --> 00:00:08,513 Richard Track: : Okay, this is another Monday episode with Caitlin and myself, 2 00:00:08,713 --> 00:00:13,893 Richard Track: : and we are talking about metric blindness when it relates to accounts receivable. 3 00:00:15,413 --> 00:00:20,573 Richard Track: : Welcome to the Shared Practices Podcast. We are back for another episode of Coach's Corner, 4 00:00:20,753 --> 00:00:26,373 Richard Track: : and we are revisiting a topic that Caitlin and I hit last time on metric blindness 5 00:00:26,373 --> 00:00:32,353 Richard Track: : of areas of a practice that it's hard to know So if you're doing well enough, 6 00:00:32,413 --> 00:00:34,733 Richard Track: : because everyone thinks, oh, we're doing good enough. 7 00:00:34,953 --> 00:00:38,973 Richard Track: : And I'm joined here by my co-host, Caitlin. Caitlin, how are you doing today? 8 00:00:39,293 --> 00:00:40,593 Caitlin Track:: I'm doing well. How are you? 9 00:00:41,413 --> 00:00:46,353 Richard Track: : So good. This is fun because we're going to do an episode that you've been saying 10 00:00:46,353 --> 00:00:47,693 Richard Track: : that we need to do for a long time. 11 00:00:47,973 --> 00:00:51,473 Richard Track: : And I've been dragging my feet because I have metric blindness. 12 00:00:51,593 --> 00:00:55,593 Richard Track: : And so we're going to address my problems and our audience's problems all at the same time. 13 00:00:56,353 --> 00:00:59,793 Caitlin Track:: Yes, today we are going to talk a little bit about accounts receivable, 14 00:01:01,053 --> 00:01:05,493 Caitlin Track:: specifically the metrics that we tend to miss, and just how to look at it from 15 00:01:05,493 --> 00:01:06,893 Caitlin Track:: a more holistic standpoint. 16 00:01:07,433 --> 00:01:11,873 Caitlin Track:: And you know, this is one of those topics I know is not most people's favorite, 17 00:01:12,613 --> 00:01:17,233 Caitlin Track:: but it's such a necessary part of having a business eye on your business and 18 00:01:17,233 --> 00:01:19,473 Caitlin Track:: talking about, knowing your numbers. 19 00:01:20,213 --> 00:01:23,553 Caitlin Track:: It's not enough to just meet with the CPA. I mean, that's great if you're doing 20 00:01:23,553 --> 00:01:28,413 Caitlin Track:: that, but really understanding the health of that in your practice itself and 21 00:01:28,413 --> 00:01:31,893 Caitlin Track:: how quickly you collect a dollar after you produce it. 22 00:01:32,826 --> 00:01:35,886 Richard Track: : And this is something that a lot of dentists aren't strong at. 23 00:01:35,986 --> 00:01:38,386 Richard Track: : So I'm going to be the kindergartner here. 24 00:01:39,006 --> 00:01:44,446 Richard Track: : Explain to me what an accounts receivable is just in the dumbest version possible 25 00:01:44,446 --> 00:01:49,326 Richard Track: : so that I understand the different aspects of it if this isn't my strong suit. 26 00:01:49,526 --> 00:01:52,826 Caitlin Track:: Absolutely. And I don't think you'd be alone in asking this question. 27 00:01:53,166 --> 00:01:57,426 Caitlin Track:: Because I think a lot of people assume AR is inherently a bad thing. 28 00:01:57,606 --> 00:01:59,066 Caitlin Track:: It's not inherently bad. add. 29 00:01:59,366 --> 00:02:03,166 Caitlin Track:: It's simply the balance that's owed to your practice for services that you've 30 00:02:03,166 --> 00:02:05,526 Caitlin Track:: provided, but you have not yet collected on. 31 00:02:05,986 --> 00:02:09,266 Caitlin Track:: So, you know, it's measuring your uncollected production. 32 00:02:10,506 --> 00:02:14,466 Caitlin Track:: And specifically, it's divided into two components. You know what those two components are? 33 00:02:15,506 --> 00:02:18,366 Richard Track: : There's insurance and self-pay. See, I'm just like guessing. 34 00:02:18,886 --> 00:02:22,206 Caitlin Track:: Well, it's insurance AR and it's patient AR. 35 00:02:22,386 --> 00:02:27,206 Caitlin Track:: And so insurance AR is money owed to you through in an open insurance claim, 36 00:02:27,346 --> 00:02:30,766 Caitlin Track:: something that has not yet been successfully paid out or closed out, 37 00:02:30,886 --> 00:02:34,826 Caitlin Track:: and we've submitted an insurance claim on the behalf of our patient, right? 38 00:02:35,546 --> 00:02:39,306 Caitlin Track:: Once that claim is processed, if that patient has a remaining balance, 39 00:02:39,586 --> 00:02:41,306 Caitlin Track:: it's officially patient AR. 40 00:02:43,326 --> 00:02:47,326 Richard Track: : So I think the reason that people, at least for me, 41 00:02:47,526 --> 00:02:53,166 Richard Track: : the reason that you start to think of AR as as being bad is that like in my 42 00:02:53,166 --> 00:02:57,666 Richard Track: : dental school, which Midwestern University was a fairly progressive school that 43 00:02:57,666 --> 00:03:00,646 Richard Track: : I feel like has some pretty good systems and practices in it. 44 00:03:00,646 --> 00:03:02,186 Caitlin Track:: They do, they're a phenomenal school. 45 00:03:02,686 --> 00:03:07,346 Richard Track: : Yeah, so it was all collect before you do the procedure. 46 00:03:07,506 --> 00:03:11,026 Richard Track: : And I can't remember if we, I don't think they took insurances. 47 00:03:11,026 --> 00:03:18,086 Richard Track: : Maybe they did, maybe they didn't. But in a world where there was 100% collection of, 48 00:03:19,817 --> 00:03:26,057 Richard Track: : of the money due and there was no insurance involved, then someone could literally have no AR. 49 00:03:26,297 --> 00:03:30,877 Richard Track: : But then even then, I'm sure things would still happen where there would still 50 00:03:30,877 --> 00:03:35,857 Richard Track: : be circumstances, there would still be an outstanding balance owed. 51 00:03:36,117 --> 00:03:41,657 Richard Track: : So it feels like, okay, if I've got a problem with AR, I'm probably not collecting 52 00:03:41,657 --> 00:03:44,237 Richard Track: : the way I should, or I'm not handling insurance the way I should, 53 00:03:44,317 --> 00:03:46,917 Richard Track: : or we need to overhaul our whole practice. 54 00:03:47,397 --> 00:03:52,297 Richard Track: : And maybe that's where a sense of AR is bad comes from is like, 55 00:03:52,457 --> 00:03:55,557 Richard Track: : okay, well, I know in an ideal world, we would collect everything up front, 56 00:03:55,697 --> 00:03:58,417 Richard Track: : but that's not always possible. Does that make sense? 57 00:03:58,697 --> 00:04:02,637 Caitlin Track:: Yeah. It's very interesting for me to hear your perspective on that because 58 00:04:02,637 --> 00:04:06,337 Caitlin Track:: it's so different from mine with how I've been taught in dentistry. 59 00:04:06,557 --> 00:04:12,037 Caitlin Track:: And so, yeah, I think AR aging is bad, right? 60 00:04:12,197 --> 00:04:16,097 Caitlin Track:: But having an AR balance just in and of itself means you're producing. 61 00:04:16,697 --> 00:04:21,817 Caitlin Track:: So sometimes I'll have a client say, my AR is really high. I know you're probably concerned about that. 62 00:04:21,997 --> 00:04:26,777 Caitlin Track:: Not necessarily if it matches what you produce on an average monthly basis. 63 00:04:26,937 --> 00:04:30,937 Caitlin Track:: So we're going to get into that. And I think this is where learning to use your 64 00:04:30,937 --> 00:04:34,557 Caitlin Track:: metrics, to not be afraid of the metrics, turn off that blindness, 65 00:04:34,877 --> 00:04:38,677 Caitlin Track:: look at the ones that are going to tell you, okay, yeah, I have AR. 66 00:04:38,897 --> 00:04:42,897 Caitlin Track:: That's fine. That's a good thing. That means I'm producing, but how do I know 67 00:04:42,897 --> 00:04:44,557 Caitlin Track:: if it's getting into danger zone? 68 00:04:45,177 --> 00:04:48,817 Richard Track: : Okay. Okay, good. And this is good because it's like I said, 69 00:04:49,017 --> 00:04:53,497 Richard Track: : I've never been afraid to learn on air and I will continue to make a fool of 70 00:04:53,497 --> 00:04:55,937 Richard Track: : myself. So I'm glad we're continuing the tradition. 71 00:04:56,477 --> 00:05:01,637 Richard Track: : That's my misconception. And I want to now understand, okay, 72 00:05:01,697 --> 00:05:04,917 Richard Track: : what are the major metrics as it relates to AR? 73 00:05:05,437 --> 00:05:06,477 Caitlin Track:: Yeah. Yeah. So, 74 00:05:07,368 --> 00:05:11,228 Caitlin Track:: Well, I guess let's talk about the more basic ones that probably most are familiar 75 00:05:11,228 --> 00:05:15,008 Caitlin Track:: with that probably pull through the practice management software, 76 00:05:15,148 --> 00:05:21,468 Caitlin Track:: which is you're comparing your production, your adjusted production, and your collections. 77 00:05:21,768 --> 00:05:26,168 Caitlin Track:: And maybe some of us are taking those numbers and giving ourselves a collections ratio. 78 00:05:26,628 --> 00:05:29,908 Caitlin Track:: Does that sound familiar? Something you've probably done in management and ownership? 79 00:05:30,408 --> 00:05:30,948 Richard Track: : Oh, yeah. 80 00:05:31,068 --> 00:05:35,728 Caitlin Track:: Yeah, yeah. So that's a great metric. It's just it's not all encompassing. 81 00:05:35,728 --> 00:05:38,408 Caitlin Track:: It doesn't give us enough information to know the whole picture. 82 00:05:38,728 --> 00:05:41,768 Caitlin Track:: So first of all, I like looking at the collections ratio. 83 00:05:42,148 --> 00:05:47,308 Caitlin Track:: It's a valuable metric. I like looking at it in a 90-day perspective as opposed 84 00:05:47,308 --> 00:05:53,348 Caitlin Track:: to a monthly perspective because we may have a month that is a really high production 85 00:05:53,348 --> 00:05:55,388 Caitlin Track:: month compared to a lower production month. 86 00:05:55,508 --> 00:05:58,448 Caitlin Track:: And so collections kind of evens out over those two, right? 87 00:05:58,888 --> 00:06:02,308 Caitlin Track:: If we are processing insurance claims on behalf of our patients, 88 00:06:02,368 --> 00:06:07,928 Caitlin Track:: which I would say most offices Even those that say their fee for service pay 89 00:06:07,928 --> 00:06:13,828 Caitlin Track:: up front, we're still processing claims out of network as a courtesy to the patient. 90 00:06:14,008 --> 00:06:22,068 Caitlin Track:: And so all that to be said, it's typical for in a practice and AR days is a 91 00:06:22,068 --> 00:06:24,288 Caitlin Track:: metric where the goal is 30 days. 92 00:06:24,288 --> 00:06:28,648 Caitlin Track:: Days, that's basically saying, you know, when you produce a dollar, 93 00:06:28,748 --> 00:06:31,548 Caitlin Track:: how many days does it take on average for you to collect that dollar? 94 00:06:31,788 --> 00:06:36,328 Caitlin Track:: And ideally, that's going to be 30 days. And so when we look at the collections 95 00:06:36,328 --> 00:06:40,288 Caitlin Track:: ratio, I just like to look at it at a little bit of a longer span so that things 96 00:06:40,288 --> 00:06:45,168 Caitlin Track:: can kind of balance out a little bit and we can see a little bit more of a holistic approach to it. 97 00:06:45,768 --> 00:06:51,128 Caitlin Track:: The issue with just focusing on that, though, is that it's based on adjusted 98 00:06:51,128 --> 00:06:51,908 Caitlin Track:: unadjusted production. 99 00:06:52,148 --> 00:06:56,868 Caitlin Track:: And so it could look really, really good, but adjustments could be really, really high too. 100 00:06:57,828 --> 00:07:01,968 Caitlin Track:: So what questions do you have for me right off the bat? 101 00:07:04,168 --> 00:07:07,088 Richard Track: : You know, the first thing that popped in my head was like, man, 102 00:07:07,248 --> 00:07:11,568 Richard Track: : if you were doing financing in office, this would really screw with these metrics 103 00:07:11,568 --> 00:07:14,148 Richard Track: : was like my first ADHD thought. 104 00:07:14,368 --> 00:07:16,468 Richard Track: : So is that the that the case? 105 00:07:16,888 --> 00:07:23,088 Caitlin Track:: Yes. There's two things in a general practice that would maybe alter our goals 106 00:07:23,088 --> 00:07:24,828 Caitlin Track:: for some of these metrics that we're talking about. 107 00:07:25,208 --> 00:07:31,228 Caitlin Track:: One is extensive in-house financing beyond like maybe pay half now, half next month. 108 00:07:31,788 --> 00:07:36,048 Caitlin Track:: If you're doing anything more than like two to three payments over two to three 109 00:07:36,048 --> 00:07:38,688 Caitlin Track:: months, then yes, it's going to mess with that. 110 00:07:38,748 --> 00:07:41,288 Caitlin Track:: And you have to take these with a little bit more of a grain of salt knowing 111 00:07:41,288 --> 00:07:42,928 Caitlin Track:: you're offering some in-house financing. 112 00:07:44,379 --> 00:07:48,699 Caitlin Track:: And for that reason, I think a lot of my clients have kind of geared more towards 113 00:07:48,699 --> 00:07:52,139 Caitlin Track:: that's the cutoff and anything more than that, we're talking third-party financing. 114 00:07:52,799 --> 00:07:57,379 Caitlin Track:: The second factor is if you're doing orthodontic treatment, because that's the 115 00:07:57,379 --> 00:08:01,599 Caitlin Track:: one code that is not going to be paid in 30 days later. 116 00:08:01,699 --> 00:08:03,959 Caitlin Track:: You know, it takes longer to complete that treatment. 117 00:08:06,239 --> 00:08:12,199 Richard Track: : And this comes from the other side, from the denture implant half that I lived 118 00:08:12,199 --> 00:08:13,379 Richard Track: : in for a little while here. 119 00:08:14,379 --> 00:08:18,239 Richard Track: : In those situations, we'd be collecting upfront for a whole big case, 120 00:08:18,379 --> 00:08:20,319 Richard Track: : but the treatment wasn't done yet. 121 00:08:20,659 --> 00:08:26,319 Richard Track: : Does that shift things if you've collected for a procedure that has not been 122 00:08:26,319 --> 00:08:31,839 Richard Track: : set to complete and therefore you've got prepaid treatment? 123 00:08:32,139 --> 00:08:34,859 Richard Track: : Does that mess with these metrics at all? 124 00:08:35,099 --> 00:08:41,539 Caitlin Track:: It does because what that does is reduce your AR. are like if someone has ten 125 00:08:41,539 --> 00:08:47,879 Caitlin Track:: thousand dollars like credit quote right on their account then it appears that 126 00:08:47,879 --> 00:08:49,979 Caitlin Track:: you are ten thousand dollars less in the hole. 127 00:08:49,979 --> 00:08:55,339 Richard Track: : So so so if you did like a weird thing that dentist owners might do of like 128 00:08:55,339 --> 00:09:00,719 Richard Track: : hey just come do the flooring in my basement and i'll you know do 10k of dentistry 129 00:09:00,719 --> 00:09:05,839 Richard Track: : for you and they've got a credit on their account like that might be messing with your AR numbers. 130 00:09:06,339 --> 00:09:06,819 Caitlin Track:: Yes. 131 00:09:07,279 --> 00:09:12,779 Richard Track: : Yeah. Okay. Okay. So I just wanted to see kind of things that could swing it either way. 132 00:09:13,319 --> 00:09:18,259 Richard Track: : But you're going back to your point. You said you like to look at the collections 133 00:09:18,259 --> 00:09:20,179 Richard Track: : ratio over a 90 day period. 134 00:09:21,299 --> 00:09:26,839 Richard Track: : And you also want to make sure that we're not patting ourselves on the back 135 00:09:26,839 --> 00:09:33,579 Richard Track: : and being aggressive on our write-offs and losing kind of some of like the reality 136 00:09:33,579 --> 00:09:34,339 Richard Track: : of what's going on there. 137 00:09:34,399 --> 00:09:39,999 Richard Track: : Talk to me more about that of like areas where there might be concern if we're 138 00:09:39,999 --> 00:09:44,819 Richard Track: : either writing off stuff that we shouldn't be or stuff's getting lost between 139 00:09:44,819 --> 00:09:49,859 Richard Track: : those two metrics of the production versus adjusted production and this collections ratio. 140 00:09:49,859 --> 00:09:52,679 Caitlin Track:: Show yeah and it's it might not be that we're writing things off 141 00:09:52,679 --> 00:09:55,479 Caitlin Track:: that we shouldn't be but just the reason that this 142 00:09:55,479 --> 00:09:58,159 Caitlin Track:: is not this isn't the only metric you can use and i'm going 143 00:09:58,159 --> 00:10:01,079 Caitlin Track:: to get into my absolute favorite one soon the reason 144 00:10:01,079 --> 00:10:06,459 Caitlin Track:: this one's limited and another reason is that you may be in a situation where 145 00:10:06,459 --> 00:10:10,619 Caitlin Track:: you're in network with a lot of insurance companies and they get to dictate 146 00:10:10,619 --> 00:10:16,719 Caitlin Track:: what the patient owes which is why it doesn't truly become patient ar they may 147 00:10:16,719 --> 00:10:19,059 Caitlin Track:: pay their balance their estimated balance upfront, 148 00:10:19,319 --> 00:10:23,799 Caitlin Track:: which I recommend, of course, but it's not true patient AR until the insurance 149 00:10:23,799 --> 00:10:26,759 Caitlin Track:: company has said, this is the final patient responsibility. 150 00:10:27,159 --> 00:10:30,299 Caitlin Track:: If you're in network, they run the show, right? 151 00:10:30,879 --> 00:10:38,679 Caitlin Track:: So if we're in network with insurance and you produce and you do three crowns, 152 00:10:38,679 --> 00:10:43,059 Caitlin Track:: whatever the case may be, we submit all the paperwork, we fight with them back and forth. 153 00:10:43,059 --> 00:10:46,679 Caitlin Track:: And at the end of the day, an insurance company may come back and say, 154 00:10:46,819 --> 00:10:48,799 Caitlin Track:: we're not going to pay for this. 155 00:10:49,159 --> 00:10:53,099 Caitlin Track:: Not only are we not going to pay for this, the patient's not responsible for it. 156 00:10:53,919 --> 00:10:57,939 Caitlin Track:: So, we then have to make a huge adjustment and write that off. 157 00:10:58,499 --> 00:10:58,939 Richard Track: : Okay. 158 00:10:59,199 --> 00:11:02,399 Caitlin Track:: You know, and so, it's not necessarily that we're not supposed to, 159 00:11:02,499 --> 00:11:06,519 Caitlin Track:: but it's just, you know, there's factors involved with…. 160 00:11:06,519 --> 00:11:10,659 Richard Track: : The reality of being in network on certain downgrades that can occur. 161 00:11:10,659 --> 00:11:13,939 Caitlin Track:: Yeah, yeah. So collections ratio is huge. It's very important, 162 00:11:14,139 --> 00:11:16,819 Caitlin Track:: but it doesn't encapsulate everything. 163 00:11:17,019 --> 00:11:21,359 Caitlin Track:: And it also doesn't show you aging categories very well. 164 00:11:21,479 --> 00:11:25,239 Caitlin Track:: You know, if your collections ratio is 98% or higher, which is kind of my goal, 165 00:11:25,479 --> 00:11:29,679 Caitlin Track:: then you would think in theory that you probably don't have a huge aging problem 166 00:11:29,679 --> 00:11:34,939 Caitlin Track:: because clearly we've collected 98% of what we've produced over the last 90 days, right? 167 00:11:35,179 --> 00:11:40,399 Caitlin Track:: It could be true, but that doesn't give us any information about our aging categories. 168 00:11:40,959 --> 00:11:46,579 Caitlin Track:: So my absolute favorite metric, and you can calculate this manually, 169 00:11:46,799 --> 00:11:51,279 Caitlin Track:: but PBN gives it to us, it's the AR to production ratio. 170 00:11:51,679 --> 00:11:57,239 Caitlin Track:: And so what they do is they take the total amount that's in accounts receivable, 171 00:11:57,439 --> 00:12:02,399 Caitlin Track:: they divide it by the average monthly production over the last 12 months. 172 00:12:03,298 --> 00:12:06,858 Caitlin Track:: So net production over the last 12 months, divide that by 12. 173 00:12:07,298 --> 00:12:09,478 Caitlin Track:: What's your average monthly net production? 174 00:12:10,178 --> 00:12:15,098 Caitlin Track:: Take that into consideration with what's the total amount in your accounts receivable 175 00:12:15,098 --> 00:12:17,258 Caitlin Track:: that's sitting there right now that's owed to you. 176 00:12:18,218 --> 00:12:21,738 Richard Track: : So in theory, this could be higher or lower than that. 177 00:12:22,018 --> 00:12:25,638 Caitlin Track:: Exactly. And it often is. It's rare that it's just exactly 100%. 178 00:12:25,638 --> 00:12:31,478 Caitlin Track:: So if this metric is at 100% or less, that means that the practice does not 179 00:12:31,478 --> 00:12:37,058 Caitlin Track:: have an outstanding AR balance that's greater than what you produce on an average monthly basis. 180 00:12:37,258 --> 00:12:40,318 Caitlin Track:: You may still have some in your aging categories, but ultimately, 181 00:12:40,498 --> 00:12:44,218 Caitlin Track:: you're collecting your average production every single month, 182 00:12:44,258 --> 00:12:46,458 Caitlin Track:: and there's not this huge outstanding balance. 183 00:12:47,018 --> 00:12:52,198 Caitlin Track:: When it starts to get 100% or more, then sometimes that means what's sitting 184 00:12:52,198 --> 00:12:54,018 Caitlin Track:: in our total AR owed to us, let's 185 00:12:54,018 --> 00:12:59,418 Caitlin Track:: say it's $200,000 of total AR owed to us between insurance and patient, 186 00:12:59,638 --> 00:13:04,878 Caitlin Track:: but on average, you know you're only producing $100,000 a month. 187 00:13:05,672 --> 00:13:06,612 Richard Track: : Right then. 188 00:13:06,612 --> 00:13:12,532 Caitlin Track:: You know you're a 200 ratio that's an indicator that we've got some outstanding ar. 189 00:13:13,072 --> 00:13:16,092 Richard Track: : And that would be one way to make those numbers 190 00:13:16,092 --> 00:13:21,712 Richard Track: : work would be like if all of your ar took 60 days to collect you'd kind of have 191 00:13:21,712 --> 00:13:26,252 Richard Track: : two months sitting in there at any given time you'd have double your production 192 00:13:26,252 --> 00:13:31,212 Richard Track: : exactly so it's it's another way of so let me let me make sure i can like regurgitate 193 00:13:31,212 --> 00:13:34,332 Richard Track: : everything you just said because like there was a moment i went cross-eyed and 194 00:13:34,332 --> 00:13:35,412 Richard Track: : And then I'm like, no, no, I think I'm falling. 195 00:13:36,452 --> 00:13:41,612 Richard Track: : So you're saying on a month-to-month basis, stuff can get wonky. 196 00:13:41,752 --> 00:13:44,772 Richard Track: : You can have a high collections month or a high production month. 197 00:13:44,912 --> 00:13:51,552 Richard Track: : And so what we have outstanding this month versus what we produced this month 198 00:13:51,552 --> 00:13:55,492 Richard Track: : versus what we produced last month, it might not match up super well. 199 00:13:55,632 --> 00:14:00,992 Richard Track: : So instead of using just the current collections ratio, instead, 200 00:14:01,172 --> 00:14:03,392 Richard Track: : let's look at what does our practice normally do? 201 00:14:03,392 --> 00:14:08,472 Richard Track: : So let's take 12 months and find the average production, adjusted production 202 00:14:08,472 --> 00:14:15,592 Richard Track: : over 12 months and then look at our total AR balance and compare it to that 203 00:14:15,592 --> 00:14:18,192 Richard Track: : because that's not like a moving target. 204 00:14:18,192 --> 00:14:20,492 Richard Track: : That's a more average, stable target. 205 00:14:20,692 --> 00:14:25,232 Richard Track: : And we can just see, are we under 100%? 206 00:14:25,392 --> 00:14:32,192 Richard Track: : That means we're probably collecting in a reasonable amount of time what we 207 00:14:32,192 --> 00:14:37,092 Richard Track: : would expect to be collecting versus over 100% or growing or 200%. 208 00:14:37,092 --> 00:14:42,392 Richard Track: : Now we're looking at there's a lot of money owed to us more than a single month's 209 00:14:42,392 --> 00:14:45,992 Richard Track: : worth of production would normally be. Am I saying that all correctly? 210 00:14:45,992 --> 00:14:52,792 Caitlin Track:: You got that. Yep. And so when this particular metric is creeping up and it's 211 00:14:52,792 --> 00:14:59,692 Caitlin Track:: 103% and then it's 110% and on, that's your indicator. This is where the blinders are coming off. 212 00:14:59,852 --> 00:15:06,012 Caitlin Track:: And you know, there's a high likelihood that I either have too much outstanding 213 00:15:06,012 --> 00:15:09,112 Caitlin Track:: and what I mean by outstanding is 30 days plus. 214 00:15:10,234 --> 00:15:15,874 Caitlin Track:: I either have too much outstanding insurance AR, so I've got claims from patients 215 00:15:15,874 --> 00:15:19,354 Caitlin Track:: that I saw two months ago, three months ago, six months ago. 216 00:15:19,714 --> 00:15:23,834 Caitlin Track:: We're looking at 30 to 60 days. We're looking at 60 to 90, 90 plus. 217 00:15:24,334 --> 00:15:29,594 Caitlin Track:: I either have an insurance AR problem or I have a patient AR problem. 218 00:15:29,714 --> 00:15:34,614 Caitlin Track:: Those claims are getting closed out, no problem, but either we didn't collect 219 00:15:34,614 --> 00:15:36,934 Caitlin Track:: the data service, So we're chasing them down afterward. 220 00:15:37,574 --> 00:15:41,734 Caitlin Track:: Or, you know, we're just having a few patients that, you know, 221 00:15:41,734 --> 00:15:45,054 Caitlin Track:: still haven't paid their bill or, you know, whatever the case may be. 222 00:15:45,134 --> 00:15:48,314 Caitlin Track:: We're just, you know, between these two, maybe it's both. 223 00:15:48,434 --> 00:15:52,454 Caitlin Track:: But this is that AR to production ratio gives you that indicator of, 224 00:15:52,534 --> 00:15:55,654 Caitlin Track:: okay, time to dig a little bit deeper in my practice management reports. 225 00:15:56,134 --> 00:16:00,274 Caitlin Track:: Look at insurance AR, look at patient AR and see where my problem lies. eyes. 226 00:16:00,774 --> 00:16:04,434 Richard Track: : So which would you say is more common? 227 00:16:04,574 --> 00:16:08,734 Richard Track: : You know, like of all the, and this is just kind of a gut check of do offices 228 00:16:08,734 --> 00:16:14,854 Richard Track: : typically have more of a problem with the insurance AR or with the patient AR? 229 00:16:15,474 --> 00:16:22,854 Caitlin Track:: There's not really a slam dunk answer to that one. I think, but I will give you something. 230 00:16:23,234 --> 00:16:26,114 Caitlin Track:: Yeah, there's not really one that I see more than the other. 231 00:16:26,734 --> 00:16:30,034 Caitlin Track:: However, I'll tell you my favorite problem between the two. 232 00:16:30,274 --> 00:16:35,134 Caitlin Track:: And my preferred problem would be insurance, because that is easier to solve. 233 00:16:35,394 --> 00:16:40,254 Caitlin Track:: This is dealing with companies. This is a lot of times making sure we're attaching 234 00:16:40,254 --> 00:16:47,094 Caitlin Track:: x-rays and narratives, correct the first time, submitting claims on time with the right information, 235 00:16:47,454 --> 00:16:51,874 Caitlin Track:: with the right member ID number and payer ID, and all these things that insurance 236 00:16:51,874 --> 00:16:57,634 Caitlin Track:: companies need to process well, so that we're not having to follow up with claims. 237 00:16:57,834 --> 00:17:01,554 Caitlin Track:: And then And second of all, it's just pulling these reports and dedicating the 238 00:17:01,554 --> 00:17:04,734 Caitlin Track:: time to call these insurance companies, figure out why they're sitting there. 239 00:17:04,974 --> 00:17:08,994 Caitlin Track:: What do we need to do to get paid? And you can kind of badger those insurance companies. 240 00:17:09,154 --> 00:17:13,454 Caitlin Track:: You can be firm with them. You can really spend a lot of time on this and get 241 00:17:13,454 --> 00:17:16,634 Caitlin Track:: an ROI quickly if you just follow what they tell you to do. 242 00:17:17,301 --> 00:17:20,061 Richard Track: : It's it's funny and you say all this because like in my 243 00:17:20,061 --> 00:17:25,481 Richard Track: : mind it was the opposite like i have so much anxiety around like complicated 244 00:17:25,481 --> 00:17:30,141 Richard Track: : paperwork yeah and like following up with like big complicated systems so i'm 245 00:17:30,141 --> 00:17:33,201 Richard Track: : just like oh it'd be so much easier to fix the patient side of things because 246 00:17:33,201 --> 00:17:35,981 Richard Track: : you can just you just got to be the collections agency you just got to be a 247 00:17:35,981 --> 00:17:38,521 Richard Track: : jerk and go get your money well but see but with. 248 00:17:38,521 --> 00:17:39,881 Caitlin Track:: Your patience you're trying to. 249 00:17:39,881 --> 00:17:45,881 Richard Track: : Preserve goodwill and yes and it's delicate balance of the mismatch expectations. 250 00:17:46,061 --> 00:17:51,561 Richard Track: : I think it's this like delivering the bad news and all of a sudden, 251 00:17:51,681 --> 00:17:56,481 Richard Track: : and this is actually why I don't like patient financing on larger, 252 00:17:56,541 --> 00:17:58,881 Richard Track: : longer, complicated treatment in office. 253 00:17:59,321 --> 00:18:04,521 Richard Track: : Because when something goes wrong and they're still balances owed, 254 00:18:04,781 --> 00:18:07,541 Richard Track: : all of a sudden the complication rate goes up. 255 00:18:08,301 --> 00:18:11,601 Richard Track: : They're just like, well, I still don't like Yes. 256 00:18:11,601 --> 00:18:12,241 Caitlin Track:: Totally. 257 00:18:12,921 --> 00:18:16,761 Richard Track: : And so it creates this tension to the relationship immediately. 258 00:18:18,121 --> 00:18:22,281 Richard Track: : And they don't want to show up or they're mad or they're threatening bad reviews. There's just... 259 00:18:23,981 --> 00:18:28,221 Richard Track: : It's just hard. And so I can completely understand why you would say what you 260 00:18:28,221 --> 00:18:29,481 Richard Track: : said, which is the insurance... 261 00:18:29,481 --> 00:18:33,981 Richard Track: : We can be mean to insurance companies and just actually follow their book and 262 00:18:33,981 --> 00:18:36,821 Richard Track: : they have to eventually give in and do what they said they would do. 263 00:18:36,821 --> 00:18:41,761 Richard Track: : Whereas patients can misbehave and we can burn bridges and lose people and get 264 00:18:41,761 --> 00:18:44,281 Richard Track: : bad reviews if we don't handle this delicately. 265 00:18:44,281 --> 00:18:48,081 Caitlin Track:: And with if we have a patient ar problem it's 266 00:18:48,081 --> 00:18:51,041 Caitlin Track:: it's also we've got to dig deeper with the team and 267 00:18:51,041 --> 00:18:54,201 Caitlin Track:: talk about same thing we talk about with retention this 268 00:18:54,201 --> 00:18:56,941 Caitlin Track:: is another aspect that there's a proactive approach and a 269 00:18:56,941 --> 00:18:59,741 Caitlin Track:: reactive approach and both have a spot in 270 00:18:59,741 --> 00:19:02,761 Caitlin Track:: the dental practice but we need to be as proactive as 271 00:19:02,761 --> 00:19:05,561 Caitlin Track:: possible which means signed treatment 272 00:19:05,561 --> 00:19:08,261 Caitlin Track:: plans plans accurate cost estimates to the 273 00:19:08,261 --> 00:19:11,141 Caitlin Track:: best of our ability and collecting at the date of service 274 00:19:11,141 --> 00:19:14,401 Caitlin Track:: go back to our coach's corner maximizing treatment 275 00:19:14,401 --> 00:19:17,321 Caitlin Track:: presentation from back in the day we talk a lot about why 276 00:19:17,321 --> 00:19:21,821 Caitlin Track:: this matters you know doing that stuff well so that when insurance does their 277 00:19:21,821 --> 00:19:26,361 Caitlin Track:: part the balance is at zero because patient already paid the the perfect estimate 278 00:19:26,361 --> 00:19:31,241 Caitlin Track:: or within five dollars of it or something you know but there needs to be a reactive 279 00:19:31,241 --> 00:19:35,461 Caitlin Track:: approach to you know that what's the cadence of how often we send statements? 280 00:19:35,881 --> 00:19:39,321 Caitlin Track:: What's the cadence of how often we send letters? At what point do we send a 281 00:19:39,321 --> 00:19:42,761 Caitlin Track:: pre-collections letter? Do we send patients to collections or not? 282 00:19:43,321 --> 00:19:47,341 Caitlin Track:: All of these things are not one size fits all. And if you have these questions, 283 00:19:47,521 --> 00:19:51,821 Caitlin Track:: it's where a coach really comes in because every practice is different and every 284 00:19:51,821 --> 00:19:52,881 Caitlin Track:: philosophy is different. 285 00:19:53,850 --> 00:19:57,490 Caitlin Track:: But what it comes down to, and I'm going to get a little preachy here, 286 00:19:57,590 --> 00:20:01,950 Caitlin Track:: but as dentists, like you deserve to be paid for the work that you do. 287 00:20:02,210 --> 00:20:07,010 Caitlin Track:: And when some of these systems aren't in place, I think you're often tempted 288 00:20:07,010 --> 00:20:12,730 Caitlin Track:: to bend a little bit and discount and cut yourself short when there's a better solution. 289 00:20:12,890 --> 00:20:17,650 Caitlin Track:: And I think taking off the AR blinders will allow you to really, 290 00:20:17,770 --> 00:20:19,170 Caitlin Track:: you know, be more fulfilled. 291 00:20:19,170 --> 00:20:26,430 Richard Track: : Well, and so that does lead me to the question of when you realize you have a patient AR problem, 292 00:20:26,830 --> 00:20:34,470 Richard Track: : how much emphasis is there chasing down that aging patient AR versus changing 293 00:20:34,470 --> 00:20:39,550 Richard Track: : our systems up front so that we have less of this moving forward? 294 00:20:39,730 --> 00:20:44,190 Richard Track: : Or is it both? And where does the emphasis lie for you? 295 00:20:44,190 --> 00:20:48,210 Caitlin Track:: Well, it has to be both because if we're in this problem in the first place, 296 00:20:48,310 --> 00:20:49,550 Caitlin Track:: there's a reason we got there. 297 00:20:50,130 --> 00:20:55,390 Caitlin Track:: So you certainly are not going to waste any time and resources by getting to 298 00:20:55,390 --> 00:20:59,230 Caitlin Track:: the bottom of it and say, okay, starting tomorrow, this is what we're doing. 299 00:20:59,990 --> 00:21:03,930 Caitlin Track:: But at the same time, clearly there's a cleanup project that needs to be done. 300 00:21:03,930 --> 00:21:10,030 Caitlin Track:: And so oftentimes we'll kind of call this crisis mode, which makes it sound worse than it is. 301 00:21:10,090 --> 00:21:13,790 Caitlin Track:: But we say to the front office team and to the doctor, you know, 302 00:21:13,830 --> 00:21:15,750 Caitlin Track:: we have this mess to clean up. 303 00:21:15,810 --> 00:21:18,930 Caitlin Track:: And so for the next one month, two months, whatever. 304 00:21:19,792 --> 00:21:23,692 Caitlin Track:: This particular financial coordinator or office manager in your practice is 305 00:21:23,692 --> 00:21:25,412 Caitlin Track:: going to need more power over time. 306 00:21:25,632 --> 00:21:28,592 Caitlin Track:: The amount of time she's sitting here pouring over statements, 307 00:21:28,872 --> 00:21:33,832 Caitlin Track:: calling patients, calling insurance companies is going to be double than what 308 00:21:33,832 --> 00:21:34,992 Caitlin Track:: it normally really should be. 309 00:21:35,152 --> 00:21:39,032 Caitlin Track:: But we've got to climb out of this hole and here is our recommended approach 310 00:21:39,032 --> 00:21:41,972 Caitlin Track:: to that. And we have resources for that in our coaching toolbox. 311 00:21:42,672 --> 00:21:48,312 Caitlin Track:: And then just know this shouldn't be the norm. Once we get back to ground zero 312 00:21:48,312 --> 00:21:54,692 Caitlin Track:: and our AR to production ratio is 100%, we're cleaned up and then now we're 313 00:21:54,692 --> 00:21:55,932 Caitlin Track:: relying on our new system. 314 00:21:56,012 --> 00:21:58,592 Caitlin Track:: We all learned from these mistakes of how we got here. 315 00:21:58,892 --> 00:22:02,512 Caitlin Track:: Sometimes it's a totally previous front office team and it's not even the same 316 00:22:02,512 --> 00:22:08,292 Caitlin Track:: people, you know? And then now moving forward, in theory, this should be clean 317 00:22:08,292 --> 00:22:13,832 Caitlin Track:: enough to where this takes five hours of the week and not 25 hours of the week. 318 00:22:13,912 --> 00:22:17,812 Caitlin Track:: The same way we could say, listen, if you reappoint hygiene at 90%, 319 00:22:17,812 --> 00:22:22,452 Caitlin Track:: your patient care coordinator will only need to spend an hour a week reactivating 320 00:22:22,452 --> 00:22:24,492 Caitlin Track:: patients instead of three hours a week. 321 00:22:25,152 --> 00:22:28,652 Richard Track: : That makes sense. Well, and the other hard part about this too is that until 322 00:22:28,652 --> 00:22:32,072 Richard Track: : this gets cleaned up, it is sullying your data. 323 00:22:32,792 --> 00:22:38,092 Richard Track: : So if you don't address the existing stuff it's it's throwing everything off 324 00:22:38,092 --> 00:22:40,912 Richard Track: : and it's hard to kind of see what's accurately going on in your practice so 325 00:22:40,912 --> 00:22:44,812 Richard Track: : like you have to do both you have to fix the input you have to fix the the backlog 326 00:22:44,812 --> 00:22:51,052 Richard Track: : and and then you've got a clean slate to to work from moving forward or as clean as you can get yeah. 327 00:22:51,052 --> 00:22:55,472 Caitlin Track:: And like you know we're talking about kind of the best metrics and if you have 328 00:22:55,472 --> 00:22:58,972 Caitlin Track:: practice by numbers or a similar software there's a lot of them out there and 329 00:22:58,972 --> 00:23:00,292 Caitlin Track:: they're kind of called different things. 330 00:23:00,452 --> 00:23:04,632 Caitlin Track:: But I think the other one I just kind of want to speak to, which I'm not totally 331 00:23:04,632 --> 00:23:09,332 Caitlin Track:: reinventing the wheel, is really AR over 90 days. 332 00:23:09,572 --> 00:23:13,412 Caitlin Track:: If you're going to focus on something, focus on 90 days plus. 333 00:23:13,752 --> 00:23:18,132 Caitlin Track:: And look at the patient side, how many claims are in 90 days plus? 334 00:23:18,592 --> 00:23:21,472 Caitlin Track:: Or excuse me, look at the insurance side for that. Look at the patient side, 335 00:23:21,732 --> 00:23:24,272 Caitlin Track:: what's the total patient balance in 90 days plus? 336 00:23:25,372 --> 00:23:29,472 Caitlin Track:: Because that's going to be the hardest to collect and that's the most indicative 337 00:23:29,472 --> 00:23:31,252 Caitlin Track:: of how big of a problem you have. 338 00:23:31,812 --> 00:23:37,032 Caitlin Track:: At this point, if, you know, insurance claims are in really 60 days plus, 339 00:23:37,112 --> 00:23:40,292 Caitlin Track:: but definitely 90 days, they're not going to move unless we call. 340 00:23:40,432 --> 00:23:44,532 Caitlin Track:: There's something they're waiting on and so we have to call for that to move. 341 00:23:44,852 --> 00:23:48,992 Caitlin Track:: And then 90 days plus with patients, we've got to look and see, 342 00:23:49,032 --> 00:23:50,552 Caitlin Track:: well, how many statements have they received? 343 00:23:50,852 --> 00:23:53,352 Caitlin Track:: You know, what do we want to do about this balance? Is it collectible? 344 00:23:53,932 --> 00:24:00,712 Caitlin Track:: And so for this metric and like setting a goal for it, ours here at SP is less than 10%. So, 345 00:24:01,610 --> 00:24:05,570 Caitlin Track:: the amount of accounts receivable that's 90 days or older should be less than 346 00:24:05,570 --> 00:24:08,290 Caitlin Track:: 10% of your total accounts receivable balance. 347 00:24:08,770 --> 00:24:15,050 Richard Track: : Right. It's funny that you say that over 90 is what to focus on and what to 348 00:24:15,050 --> 00:24:19,710 Richard Track: : focus on first, because in my mind, that's like the, okay, we just got to bury our old. 349 00:24:19,910 --> 00:24:24,390 Richard Track: : We just got to take it out back and get rid of all this, write it all off, 350 00:24:24,430 --> 00:24:25,270 Richard Track: : pretend like it didn't happen. 351 00:24:25,270 --> 00:24:29,050 Caitlin Track:: See, this is the martyr in you as a dentist. 352 00:24:29,210 --> 00:24:30,330 Richard Track: : Like, oh, I don't. 353 00:24:30,330 --> 00:24:31,990 Caitlin Track:: Deserve to be paid for that it's so. 354 00:24:31,990 --> 00:24:38,090 Richard Track: : Old you know yeah well i i think it's less of that and i really do think that 355 00:24:38,090 --> 00:24:42,230 Richard Track: : like i don't know why i was talking to this about i think it was too i can't 356 00:24:42,230 --> 00:24:46,630 Richard Track: : remember if it was to my wife or one of my daughters but it was it had to have 357 00:24:46,630 --> 00:24:47,990 Richard Track: : been christine because there's no way my 358 00:24:48,270 --> 00:24:52,510 Richard Track: : 11 my 10 year old would follow this but it was like doctors in 359 00:24:52,510 --> 00:24:56,190 Richard Track: : a physician's you know a hospital setting there's 360 00:24:56,190 --> 00:25:00,910 Richard Track: : like no sense of like feeling bad about not only are you billing for the first 361 00:25:00,910 --> 00:25:05,850 Richard Track: : procedure but you're billing for like the procedure to fix that procedure and 362 00:25:05,850 --> 00:25:09,850 Richard Track: : like it is what it is if you have a procedure and then there's a second one 363 00:25:09,850 --> 00:25:12,550 Richard Track: : and we're gonna have to bill for both of those and we expect you to pay for 364 00:25:12,550 --> 00:25:14,190 Richard Track: : both of those or we're gonna send you to collections, 365 00:25:14,650 --> 00:25:17,670 Richard Track: : whereas in dentistry if like something doesn't go right with the 366 00:25:17,670 --> 00:25:20,790 Richard Track: : first procedure we're having to like go and fix something or 367 00:25:20,790 --> 00:25:24,130 Richard Track: : do something because we're the business owner who 368 00:25:24,130 --> 00:25:27,050 Richard Track: : is also the clinician and the patient 369 00:25:27,050 --> 00:25:30,010 Richard Track: : can kind of hold our reputation over our 370 00:25:30,010 --> 00:25:33,010 Richard Track: : head there is a through bad reviews 371 00:25:33,010 --> 00:25:35,870 Richard Track: : and all of that versus like a hospital system 372 00:25:35,870 --> 00:25:38,750 Richard Track: : if you tell a doctor like hey i'm not going to pay my balance i'm going to leave 373 00:25:38,750 --> 00:25:42,790 Richard Track: : you guys a bad review like the physician does not care like if you leave the 374 00:25:42,790 --> 00:25:49,250 Richard Track: : hospital system a bad review um so i i think a lot of it comes from that dynamic 375 00:25:49,250 --> 00:25:55,150 Richard Track: : of just feeling there's a vulnerability and a guilt in like. 376 00:25:55,908 --> 00:25:59,148 Richard Track: : If something's not perfect or there was stuff that was our fault, 377 00:25:59,188 --> 00:26:02,368 Richard Track: : like we should have built this better sooner. We should have gone to the insurance. 378 00:26:02,428 --> 00:26:05,148 Richard Track: : We should have followed up with the insurance better. We should have been more 379 00:26:05,148 --> 00:26:06,968 Richard Track: : clear upfront with their estimate. 380 00:26:07,148 --> 00:26:10,888 Richard Track: : So there is this kind of guilt of like, no, this is kind of our fault. 381 00:26:11,868 --> 00:26:16,888 Richard Track: : And if I call them up asking for a hundred dollars and it's kind of our fault, 382 00:26:17,848 --> 00:26:20,248 Richard Track: : like how's that going to go down and how is that going to look? 383 00:26:20,548 --> 00:26:23,888 Caitlin Track:: Well, exactly. And this is why I say it's not every situation. 384 00:26:23,888 --> 00:26:28,428 Caitlin Track:: It's not a blanket, you know, answer where there are going to be scenarios. 385 00:26:28,548 --> 00:26:31,668 Caitlin Track:: And especially with those 90 days and older insurance claims, 386 00:26:31,868 --> 00:26:38,008 Caitlin Track:: we're already at a place where if we finally get this processed six months later, 387 00:26:38,148 --> 00:26:41,088 Caitlin Track:: whenever the case may be, patient finally has an official balance, 388 00:26:41,388 --> 00:26:45,048 Caitlin Track:: we look pretty silly sending a bill six months later. 389 00:26:45,188 --> 00:26:49,668 Caitlin Track:: And they're like, I would have been fine to pay $250 for this treatment had 390 00:26:49,668 --> 00:26:52,908 Caitlin Track:: I gotten this bill 30 days after the appointment. 391 00:26:52,988 --> 00:26:54,888 Caitlin Track:: Now I'm like, this is just poor planning. 392 00:26:55,368 --> 00:27:00,688 Caitlin Track:: So the doctor kind of has to be the one to, along with the office manager, 393 00:27:00,788 --> 00:27:02,728 Caitlin Track:: make those decisions in those cases. 394 00:27:03,688 --> 00:27:09,788 Caitlin Track:: But it reminds me, I've met so many amazing and funny office managers through the career. 395 00:27:09,928 --> 00:27:15,868 Caitlin Track:: And we hired someone that came in and the AR was certainly an issue. 396 00:27:15,968 --> 00:27:19,028 Caitlin Track:: The previous OM was doing a lot of discounts, a lot of payment plans. 397 00:27:19,528 --> 00:27:23,928 Caitlin Track:: And the doctor also had that vibe of like wanting to make people happy, 398 00:27:23,988 --> 00:27:28,788 Caitlin Track:: wanting to give discounts, wanting to be the friend in the community and everything too, right? 399 00:27:28,908 --> 00:27:32,048 Caitlin Track:: So we get to a place where AR is out of control. 400 00:27:32,188 --> 00:27:37,308 Caitlin Track:: As a result of this, you're trying to be the good guy, but then you're panicked on the financial side. 401 00:27:37,588 --> 00:27:41,788 Caitlin Track:: And we brought somebody in and she was kind of telling me the story afterward 402 00:27:41,788 --> 00:27:45,188 Caitlin Track:: where a couple of patients had written bad reviews about her. 403 00:27:45,308 --> 00:27:50,488 Caitlin Track:: And he had kind of heard through friends at church that his new manager is not so good. 404 00:27:50,728 --> 00:27:54,728 Caitlin Track:: And, you know, and why? Well, he freaked out, called her in and go, 405 00:27:54,848 --> 00:27:56,628 Caitlin Track:: you know, you're making people upset. 406 00:27:56,808 --> 00:28:00,188 Caitlin Track:: And she very calmly said, okay, I understand. 407 00:28:00,688 --> 00:28:04,748 Caitlin Track:: What I'm hearing you say is that you'd like me to write, write all of this off. 408 00:28:05,776 --> 00:28:08,296 Caitlin Track:: He's like, well, no, I don't want you to do that. 409 00:28:09,676 --> 00:28:14,036 Richard Track: : We want our cake and eat it too. We want to be the good guy and we want our money. 410 00:28:14,416 --> 00:28:18,516 Caitlin Track:: Yep, absolutely. And that same office manager, and I think he just had that 411 00:28:18,516 --> 00:28:22,496 Caitlin Track:: epiphany, you know, and you certainly need to be cautious and make sure the 412 00:28:22,496 --> 00:28:26,736 Caitlin Track:: people that you've hired to chase this money down for you are handling your 413 00:28:26,736 --> 00:28:27,636 Caitlin Track:: patients with compassion. 414 00:28:27,876 --> 00:28:31,736 Caitlin Track:: There's a right way to do this. There's a way to treat people with respect and 415 00:28:31,736 --> 00:28:36,396 Caitlin Track:: offer them a discount and a payment plan, maybe because it was on our end for 416 00:28:36,396 --> 00:28:38,056 Caitlin Track:: incorrect processing or whatever. 417 00:28:38,676 --> 00:28:42,356 Caitlin Track:: But you still, at the end of the day, need to be able to stay firm and hold 418 00:28:42,356 --> 00:28:45,616 Caitlin Track:: them responsible for the balance that they owe you. You provided the service 419 00:28:45,616 --> 00:28:46,836 Caitlin Track:: and you deserve to be paid. 420 00:28:47,036 --> 00:28:50,156 Caitlin Track:: So it's this art and it's this balance. 421 00:28:50,656 --> 00:28:55,296 Caitlin Track:: That same OM, another funny story that I think she just kind of got him to think 422 00:28:55,296 --> 00:28:57,796 Caitlin Track:: of things a little bit differently. And he told me this himself. 423 00:28:58,236 --> 00:29:01,456 Caitlin Track:: They were in the huddle and a certain patient was coming up, 424 00:29:01,516 --> 00:29:03,616 Caitlin Track:: assistant said, well, what do you want me to do about this? 425 00:29:03,776 --> 00:29:06,876 Caitlin Track:: And last time he was kind of complaining about the price of this. 426 00:29:06,876 --> 00:29:09,256 Caitlin Track:: And that doctor goes, okay, yeah, yeah. 427 00:29:09,316 --> 00:29:13,336 Caitlin Track:: If he says something, you know, we'll go ahead and give him 10%, you know. 428 00:29:13,536 --> 00:29:20,316 Caitlin Track:: And that OM goes, wow, I wish I could take my family out to dinner at Olive Garden and get 10% off. 429 00:29:22,076 --> 00:29:30,156 Caitlin Track:: And he's like, gosh, you're right. Why am I just so quick to discount my services? Yeah. 430 00:29:30,896 --> 00:29:36,956 Richard Track: : No, it's something deep inside of us that we feel guilty charging for what we 431 00:29:36,956 --> 00:29:40,896 Richard Track: : do because we're helping patients directly and we need to get over it. 432 00:29:41,036 --> 00:29:46,516 Richard Track: : So I love when people can have these mindset shifts and people can call us on 433 00:29:46,516 --> 00:29:48,176 Richard Track: : it and provide Provide examples of like, 434 00:29:48,236 --> 00:29:54,976 Richard Track: : it's okay to bill for the work that you're doing to provide necessary hard tissue 435 00:29:54,976 --> 00:29:56,956 Richard Track: : surgery on a moving target. 436 00:29:57,196 --> 00:30:01,736 Richard Track: : You know, it's like, this is not just like, oh, okay, we're brushing their teeth 437 00:30:01,736 --> 00:30:03,116 Richard Track: : and packing them along the way. 438 00:30:03,516 --> 00:30:08,696 Richard Track: : So these are the types of like mental things behind these metrics. 439 00:30:08,696 --> 00:30:13,276 Richard Track: : I think AR has more more mental 440 00:30:13,276 --> 00:30:19,336 Richard Track: : like guilt and like shame than almost any other dental metrics because it's 441 00:30:19,336 --> 00:30:24,136 Richard Track: : like our past sins come to light in these these AR numbers and so that there's 442 00:30:24,136 --> 00:30:27,096 Richard Track: : like a purposeful blindness we don't want to look at them because they're going 443 00:30:27,096 --> 00:30:28,896 Richard Track: : to tell us a story that we don't want to hear. 444 00:30:29,898 --> 00:30:32,138 Richard Track: : And so then we just like pretend like, oh, we don't understand it. 445 00:30:32,198 --> 00:30:33,318 Richard Track: : And so I'm not even going to worry about it. 446 00:30:33,478 --> 00:30:38,658 Caitlin Track:: Yeah, I'll give Derek Green a shout out. He said, Caitlin, I just like to outproduce my problems. 447 00:30:39,318 --> 00:30:43,558 Richard Track: : I just like to outproduce my problems. That's great. 448 00:30:43,738 --> 00:30:50,038 Richard Track: : I love it. Not ideal, but it can work for a little while. Eventually, they all will catch up. 449 00:30:50,838 --> 00:30:56,958 Richard Track: : Well, this has been an awesome discussion of really understanding the different 450 00:30:56,958 --> 00:31:00,658 Richard Track: : numbers at play here and understanding where we can improve, 451 00:31:01,058 --> 00:31:06,498 Richard Track: : where we need to focus, and getting on the same page and not pretending like 452 00:31:06,498 --> 00:31:10,718 Richard Track: : these problems don't exist or there aren't areas of improvement and having benchmarks 453 00:31:10,718 --> 00:31:12,658 Richard Track: : that we can hold ourselves and our team to. 454 00:31:12,878 --> 00:31:18,398 Richard Track: : So thank you for outlining this whole other area of metric blindness that I 455 00:31:18,398 --> 00:31:21,898 Richard Track: : didn't want to look at because I knew that I'd have skeletons in this closet 456 00:31:21,898 --> 00:31:23,658 Richard Track: : as well, along with all of our listeners. 457 00:31:23,658 --> 00:31:28,338 Caitlin Track:: Yeah thanks for for promoting the episode and allowing it to happen i think 458 00:31:28,338 --> 00:31:31,998 Caitlin Track:: it's a good conversation to have and and there's so much more we could get into 459 00:31:31,998 --> 00:31:35,718 Caitlin Track:: and and like i said every office is a little bit different with the situation 460 00:31:35,718 --> 00:31:39,858 Caitlin Track:: and also how they got to this point so um you know. 461 00:31:40,978 --> 00:31:42,118 Richard Track: : It's not one size. 462 00:31:42,118 --> 00:31:43,118 Caitlin Track:: Fits all this is. 463 00:31:43,118 --> 00:31:47,138 Richard Track: : This is definitely one of those like we're gonna have to look at the mess to 464 00:31:47,138 --> 00:31:51,758 Richard Track: : figure out the solution rather than here's the one blanket recommendation I 465 00:31:51,758 --> 00:31:54,018 Richard Track: : heard on the podcast of what to do with your AR past. 466 00:31:54,018 --> 00:31:56,118 Caitlin Track:: 60 days or 90 days. 467 00:31:56,258 --> 00:31:59,218 Richard Track: : It's like, it depends. It all depends on what's going on. 468 00:31:59,758 --> 00:32:03,558 Richard Track: : So once again, it's one of those invites. If you're not working with a coach, 469 00:32:03,658 --> 00:32:06,718 Richard Track: : go to sharedpractices.com, book a discovery call. 470 00:32:06,958 --> 00:32:11,718 Richard Track: : If this is a problem in your office, there is immediate money to be made. This is great. 471 00:32:11,878 --> 00:32:16,278 Richard Track: : If this is the best problem to have to then need coaching, because you're like, 472 00:32:16,318 --> 00:32:19,318 Richard Track: : listen, I can pay for the coaching out of our AR problem. 473 00:32:19,478 --> 00:32:22,898 Richard Track: : Just by fixing the problem, coaching has paid for itself. And then all of the 474 00:32:22,898 --> 00:32:27,658 Richard Track: : other growth of the practice is just gravy in comparison to the issue that we started off with. 475 00:32:27,798 --> 00:32:31,618 Richard Track: : So this is actually a really good problem to have. Come to us with this problem. 476 00:32:31,858 --> 00:32:33,098 Richard Track: : We'd love to help you with it. 477 00:32:33,218 --> 00:32:37,478 Caitlin Track:: Yeah, we could even help on air too. Send me an email and we'll get you on here. 478 00:32:37,558 --> 00:32:41,218 Richard Track: : Yeah. Yeah, let's do it. We will do a practice underwater. 479 00:32:41,538 --> 00:32:44,738 Richard Track: : We'll talk about it. So let's work through it together. Caitlin, 480 00:32:44,818 --> 00:32:46,258 Richard Track: : thank you so much. Thanks, Richard. 481 00:32:47,218 --> 00:32:49,818 Richard Track: : We'll talk to you guys next time on the Shared Practices Podcast.