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#968: The Financial Piece So Many Offices Forget About
Tiff and Britt discuss how a practice that was upside down financially picked through their systems with a fine-toothed comb to find success — and how you and your team can avoid this scenario.
Episode resources:
Sign up for Dental A-Team’s Virtual Summit 2025!
Subscribe to The Dental A-Team podcast
Schedule a Practice Assessment
Leave us a review
Transcript:
The Dental A Team (00:02.146)
Hello, Dental A Team listeners. We are back again. I kept Britt today. If you've listened to the other one, that it was a beautiful Friday morning. It's still a beautiful Friday morning. I made her stick around so I could do even more with her today on this podcasting adventure. I know you guys love hearing from Britt and I love chatting with her. So Britt, welcome. Welcome. How was your day? We're rolling into the weekend.
How much fun are you excited to have? You're feeling better, you were sick, you caught what everybody else has had, and I think you get a true weekend, right?
Britt (00:29.812)
everyone.
This weekend should be better than last weekend. Let's just say that. And it is gorgeous out here. So I mean, I might have been slightly annoyed at the birds chirping and I'm like, really? Like waking me up? That's what you're going to be annoyed about. Get over it. It's a nice day outside.
The Dental A Team (00:47.151)
Oh my gosh, okay, Cinderella. I love that. I love that. It is like, it's a week. I keep thinking, gosh, it's like unseasonably warm and like it's not, it's supposed to be 85 degrees next week, FYI, but this time of year, last year was cold. That was the abnormality. This is actually normal for Phoenix. So I keep having to remind myself of that because it is warm, but the birds are chirping. The dogs are barking across the street.
Britt (00:49.486)
I know.
The Dental A Team (01:14.987)
There's people walking by and they they get angry. It's all here and we're here for it. And so if you hear the birds, you hear the cats, you hear the dogs, just know we are a company that fully encompasses the animals. We love them and they're here with us today. So I love it. Well, today's content I'm actually really excited about. wanted to I wanted to take like an excerpt from
Britt (01:28.136)
you
The Dental A Team (01:41.68)
practice that I've worked a ton with over the last few years. are near and dear to my heart. Some of my favorite human beings in the whole world. Trish was on a call with me with them, consultant Trish, and she just, she texts me on the side. She's like, he is the sweetest man. I'm like, he really, really is. They are just such a sweet, sweet human and individuals, but I've taken some journeys with them financially. And with a lot of their, their team members and doctors and stuff. And I wanted to kind of
highlight a piece that we found that I don't think I even like always thought about. And I think those are the spaces that I actually love about consulting is one, a challenge. I always love a challenge and decided like we're doing a steps challenge. I'm like, I'm to win. Like I was already doing it, but now I'm like, I'm for sure doing it. So you challenge me and it's going to work.
Britt (02:28.029)
We're going to
Britt (02:34.419)
Game on.
The Dental A Team (02:35.088)
It is, it is. It works every time. Ask Kira, she says it, she screams it from the mountaintops. It really does work, I don't know why. So I love a challenge, I love learning, and I really love when it's like, oh my gosh, that was so obscure from the normal, and it's so cool to see what we were able to create and figure out. And we all know at this point in the game that we need 98 % collections across the board.
And we all know it's not always that way. And doctors, I really wanted to bring you this information and this story, right? Storytelling time. This story from something that I've witnessed, experienced and worked through because I want you guys to be able to take some tools back to your own practices and implement some things that are actually really easy that not everyone is always doing. So, Britt, you're here with me for this journey and I'm excited because it brings in some of those business pieces.
that I know we love chatting about. So we're gonna chat through some of it and then I wanna bring in your brain on like, how can we implement these things in every single practice? So biggest space walking in to this practice was their overhead. Like their overhead was out of control and they were making massive production for a single doctor to hygiene. They're at like 140 to 160 consistently. And their hygiene department, let's do through some like,
digging, right? I find their hygiene department is like 11 to 15 percent of their production. So this doctor is exhausted. He is just like not able to sleep at night because he's stressed. He's working really hard and their overhead is really high, like almost 80 percent when we started working together, almost 80 percent overhead. You guys, that's before paying him. That's before paying loans. And so they actually had to take loans out.
Britt (04:07.923)
Yeah.
The Dental A Team (04:30.884)
to pay bills and pay loans, like this giant cycle, right? This just upside down, stressed mess. And he could not figure it out because production wise, right? He should be okay. But his overhead's almost 80 % and his doing calculations, right? And then like collections is like all over the place. One month, it's like 103%, one month it's 87%.
Then it's like 92 and it's just like jumping all over the place. Like what the heck is going on in this practice? Like the production is fairly consistent, right? But the collections is inconsistent and the overhead is consistently high. So from, I think from many people's standpoint, the number one thing you do, right? I had a doctor yesterday that I was talking to and he's like not as profitable as he wants to be and
I get it and we can make him more profitable working on it, but he's like, okay, so I need to produce more. And I'm like, whoa, whoa, whoa, you can't always outproduce the problem, right? And this practice is like that to a T because they are producing really well, but their overhead is still really high. And their collections, again, like they're collecting something, but it's just all over the place. So we had to like really do some...
weird tricks in my opinion. was just like, all right, we're gonna, we're gonna just dig in. We're gonna dive in. We're gonna figure some stuff out. So Brett, what we found one pre collections, right? love pre collects you guys. love pre collects, but what pre collects will do is inflate your collections. And so doctors implement pre collections, a hundred percent implement pre collections. But if you're going to implement when you implement pre collections,
Britt (06:19.931)
Laughter
The Dental A Team (06:21.144)
you have to pre-collect every time, right? So what they were doing is they were pre-collecting on large cases. They were doing full-mouth, like, large cases inconsistently. So they'd have two $50,000 cases in a month pre-collect that's, it's scheduled for next month, right? So they pre-collect for those two cases in January.
They do the cases in February and they don't schedule any cases for March. So then, Britt, what happened to February? Then we've got 103 % collections over here in January and then February is 87 % because we did the production and we didn't pre-collect for new surgeries.
Britt (07:05.713)
your collections are ahead of your production because you're ahead of time, a month ahead of time even.
The Dental A Team (07:08.795)
Yes.
a month ahead of time. And they were so upside down financially that the pre-collects were being used to pay bills. And so they'd pay down, they'd even pay down their loan that they got to pay bills. And then they'd have a low collections month and they'd have to use the loan, which I think personally, all of us have probably been in that situation in our personal lives at one point or another.
Britt (07:22.851)
Mmm.
The Dental A Team (07:39.046)
And it's always interesting to me the parallels there, because we like to think of business and personal finances so differently, but they are parallel. guys, money is money, business is business, life is life. But anyways, so then we figured out, okay, let's start pulling this money. So you pre-collect, you pull it, and you put it in a different bank account. So we started building their buckets, right? Their profit first style buckets without doing real profit first, because we couldn't. So we're...
Britt (07:41.651)
you
Britt (08:05.099)
Yeah.
The Dental A Team (08:07.868)
pulling this money, planning for it, right? We're prepping for profit first. So we've got these buckets and I've got them starting to pull for lab because they were getting heat up, like, honestly, sometimes it was like 20 % lab bills. So we had to pull aside all this stuff and it was so fantastic to see the money moving in the right directions because it cleared things out of the way. And then we would like add it back in.
Britt (08:08.101)
of
The Dental A Team (08:35.6)
the month that we needed it, blah, blah, blah. So we were doing this like money moving, but the biggest piece of all that was like, okay, you guys level out your pre collects. You're going to be fine. Make sure you move the money. Make sure you've got the lab bills, lab expenses covered in a different account. The biggest piece of all Britt that blew my mind and the team found it. The team found it on their own as we're moving this money around. They're like separating it on my KPI sheet. have for them. So I'm like, okay, this is your collections.
This was your pre-collect. So this is your true collections. Your pre-collect were, that's gone. That's for next month. That's next month's money. This is your true collections. Their true collections tanked. And they're like, well, Tiff, we're actually, I'm seeing we're not actually collecting a lot over the counter. Like, well, that doesn't make any sense. What do mean you're not collecting? Like, so then collect, like get the money. And they said, well, everyone has credits on their accounts.
Britt (09:09.552)
Thank
The Dental A Team (09:34.066)
They found it. So the previous billing manager and treatment coordinator and front office total wasn't putting information into the system correctly or at all, right? They didn't have the insurance fee schedules in there. So we had already worked through a lot of that, right? The fee schedules, making sure all the insurance, making sure what goes out was correct because it was incorrect. That was already been, we've been solving that. But what
happened is she was guesstimating off of UCR, taking like 20 % ish off of UCR for treatment plans and collect over collecting for patients. then when insurance, which is great, I'd rather over collect than under collect. If you're going to pay attention to your credits and give credits back. We were not paying attention to the credits. And so Britt, all of these patients just like
Britt (10:17.875)
huh.
Britt (10:22.393)
Yes.
The Dental A Team (10:30.932)
thousands and thousands and thousands of dollars in credits of patients who were coming in. We had the treatment, we had the production, but we had already had the collection. So this is where it's like, truth be told, you cannot out-produce your overhead. Because if you produce and you've got $100,000 in collection or in credits, right? All of these patients are coming in for fillings and it's like a $56 copay, they've got $300 credit.
working away on on their account. So the money's already been there. The money's already paid the bills. They had to then on our KPI, I'm like, okay, well, we're going to do another column. Next column is like, how many patients, what was the amount of credits that you use today so that if we had collected it, I need to see from a financial standpoint, I need to be able to see if we had collected it, could, would our overhead be okay? Is the overhead issue because we can't collect that money or is it because we
Britt (11:10.318)
Yeah.
The Dental A Team (11:29.616)
need to produce and collect more. So it was so hard to like see all of the pieces because there was so much chaos in the accounts that was so like hard to find. did an incredible job keying into tip. think it's the credits and I was like, my gosh, you just blew my mind, right? Like I didn't even think of this. I thought for sure the pre collects, like let's level those out. Let's always pre collect on everything. We changed that model.
Britt (11:44.945)
Yeah. Yeah.
The Dental A Team (11:56.072)
but that was only adding now to the credits. So it was like, holy cow, but it was really cool, Brett, to be able to see that's one layer that I think a lot of practices and a lot of practice owners forget to look at, right? We look at our AR, we look at our production, our collections, our new patients. We never really truly look at our credits. And these credits had our overhead at like 80 % and our collections was literally like,
Britt (11:58.928)
Yeah.
The Dental A Team (12:24.18)
87 to 95 on a really like good month of no surgeries pre-scheduled. So it was wild to see, but then once we started accounting for that, it took about a year to really truly get through all of those credits or most of those credits that were coming in. So it took about a year, but being able to visually see on the overhead spreadsheets, on the KPIs, all of the money and where it was going, what it was allocated to helped them to be able to see
where they needed to move money to, pull money to, what needed to be done. He could project like, how long do I have to work this hard? Because he's got to produce as much as he can to get through the credits, plus get some collections in. So he truly had to just work his tail off for this year to really dial back some of those issues. But it was really fun to see, okay, these are all of the spaces that you've got to make sure you're paying attention to.
especially because, I think we've all experienced this. I mean, I did in practice too. I'm like, the billing rep has got it, right? So many owner doctors, that's, you want to be able to, and I'm not saying you can't trust, right? But human error is a thing and we don't always know what we don't know. And I think that this gal just didn't know how to do it any other way. So she was doing it the best she could and honestly, like more money, the better. So if you're going to, I want you to collect more.
if that's an opportunity, but we have to be able to give it back. Like we have to be able to watch those. So I'd rather over collect than have to track somebody down for a bill. Right. I totally agree with that theory, but if we're not watching it though, like it's wild. So Britt from business standpoint, right. We've got all of these moving pieces, like from a business standpoint, if this doctor or a doctor who might be in a similar situation, right. They're like nearing
Britt (14:03.431)
Agreed.
The Dental A Team (14:20.792)
what they thought was going to be retirement, right? They thought they were getting there. Now their business is like spiraling. I mean, I did, you know, I did my digging. We did it. We got through it. It took a while. The next year, like we decreased their overhead by 10 % in that year. The next year, we decreased it again, almost another 10%. Like they're down to like 55 to 60 % overhead. At this point, they're freaking
Swim and they're doing fantastic. Their team is doing great. They're able to do great things with their team and with their family. So we did it. But from a business standpoint, we had to get a lot of help in there, a lot of CPA and financial advisors and things. But from your perspective, just on the outside hearing that, what would you tackle or what would you tell a doctor? Implement this right now so that you know if these things are happening. Like how would a doctor
from your standpoint, and if you were, I'm the doctor and you're the consultant, what would you tell me to be watching and be prepped for so that I don't fall into a situation like that?
Britt (15:20.657)
laughter
Britt (15:28.113)
Yeah, and number one, think this is like one of great scenario tips. Like these are the things that consultants love puzzles. So like this is one of those that it's like, there's something, I know it is, we're gonna find it, but we gotta figure out what exactly is happening in a scenario. And this is, think, one example of sometimes situations that doctors can find themselves in where it's like, okay, shoot, we figured something out and yeah, that's
The Dental A Team (15:37.048)
Mm-hmm.
Britt (15:58.128)
sucks. It's crappy, right? And we lived the high life for a while, but we spent money that really wasn't our stuff for a little while. So now we've got to work through this in between period and get it filled a squeeze because it's like, all right, we are now collecting the more accurate amount and we're using up these credits. So that is why our cash flow is struggling big time right now. And so I think what I would tell doctors from that end is
The Dental A Team (15:59.362)
Yeah. Yeah.
The Dental A Team (16:06.604)
Yeah.
The Dental A Team (16:19.801)
Listen.
Britt (16:25.683)
I think you've got to watch all the pieces and the real numbers. think a lot of times, right, especially with credits, like, it's like the, the like thing we don't talk about. It's like the terrible awful that it's like, man, we're just going to be like, we know it's over there, but we're just going to kind of ignore that it exists unless someone asks about it. then we'll look at it. And the better way to do it to avoid
The Dental A Team (16:45.069)
Yup.
Britt (16:50.887)
pitfalls like this is of course watch it like there's always going to be some over there yes and have a process for handling your credits to where One credit should always be audited before we're refunding make sure it's actually due to that patient before we refund it because that's also a scenario I've seen where it hits us on the cash flow side if we just refund and Sometimes there's an arrow error and it's not actually theirs. So I think watching your credits
Having a process for how we handle credits for a couple of reasons, cashflow reasons, and also know the laws of your state, like fun surprise if you don't know already. Each state treasury has laws on credits and how those should be handled. So make yourself aware of those and then create your system to meet your clients with it. And with that, it's usually great by x.
date, like if it's a credit higher than X amount, you have to like do your part to try to notify that patient. And then sometimes once it gets old enough, you've got to pay that to treasury like fun fact, also go look up your name to see if you've got any credits sitting out there that I do back to you. And like that's the proper way to go through it. So have a system for it. And I think don't be afraid of refunds. Yes, we always want to try to schedule appointments, get treatment time.
The Dental A Team (17:57.498)
So.
Britt (18:11.367)
Get them to use it. Like that is my ultimate goal is get them to use it in the office. But if not, make sure you've got a process because then it's more digestible amounts to refund instead of like big amounts that hit you when they're surprises. Surprises aren't fun. So as much as we can avoid surprises, let's do it and have a process for it. Now, if you're in a scenario like this doctor was where there's a lot of sitting out there, strategize how we can handle that. Cause we can't just go refund a hundred thousand dollars all at once.
The Dental A Team (18:12.942)
Go.
The Dental A Team (18:21.336)
Mm-hmm.
Britt (18:40.933)
So come up with a plan that's manageable that you can handle with your cashflow that you have to be able to work on getting that into a good place. And that's a lot of times with these things. takes, usually things take at least six months in a dental office, right? Big things like this, it's usually at least six months to put an FX into play, if not a year. So know that sometimes when you find these things are right, we start to put the fixes into play and then we start to clean up what's been there and it can take a little bit of time.
The Dental A Team (18:41.046)
Okay.
The Dental A Team (18:55.864)
Mm-hmm.
The Dental A Team (19:10.16)
Yeah, I agree. love all that. think I love the tertiary comments. I totally go figure it out guys. And most practices I think on that note will give like, well, I know for me when I was office manager of my practice, I had like a certain amount that was allocated every month for refunds. So I'd have 3000 or 5000 or whatever it was that was like, okay, this is what I have allocated that I can give back as refunds this month and the next.
Britt (19:16.411)
No.
The Dental A Team (19:36.078)
If another one came in, was like, cool, I'm gonna hit it next week, because it's next month or whatever that was, like that'll go into next month. So make sure you do have that solid plan. And I love all of that and make sure you're looking at it. I think that's the biggest piece here that Britt's highlighted. Just make sure you're pulling those. I think production collections, new patients, like those are making sure we're thriving. Your active patient count, we talk about those all the time. Those are the ones that like, yes, let's make sure we're thriving. Our AR, our insurance AR and our patient AR, so it's outstanding money.
But that AR can get super skewed, you guys, if you've got money sitting over in credits, because your AR total, usually, unless you click the little button that says not including credits, will deduct the credits from the total. So your AR might say, like, our total AR is $68,000, and you're like, I'm freaking killing it, right? And you could be, and that's totally fair. But make sure it's not deducting $50,000 of credits sitting over there.
Britt (20:27.059)
You
The Dental A Team (20:32.847)
that need to be addressed as well. I want you to...
Britt (20:35.155)
which is a good point if I think on knowing how your system does things. And that's why sometimes it's not as easy to see. I've even seen some where it's allocation issues, right? And skew things a little bit as well. So yeah, good point on knowing how your system accounts for things.
The Dental A Team (20:38.629)
Yeah.
The Dental A Team (20:45.125)
Mm-hmm.
The Dental A Team (20:51.453)
Yeah, yeah, I've done it myself, like not clicked that little button and been like, oh, we're good this month. And then I'm like, wait, where are all these credits coming in from? As an as a manager, these are all things that I had to learn. Because again, you guys, unless you have a professional by your side, there's not a really great like go to school to be a dental, you know, professional like dentistry dentist, hygienist, dental assisting schools. I'll add those in there.
Britt (21:18.122)
Yeah.
The Dental A Team (21:19.405)
haphazardly adding those in there, right? There's not a place for the front office, really, unless you have a coach or a consultant or someone who is able to train them on the things that we've learned across the board, across learning all of the things. There's business classes that a lot of us have taken. Britt's got freaking so much, so many beautiful degrees behind her name. Like, there's so much that can come from that, but there's so much that can be missed because we're literally just learning from the person who was in front of us and we're teaching ourselves. So just make sure.
Britt (21:37.572)
Yeah.
The Dental A Team (21:49.37)
You know your stuff, you know how your system works, you know what your numbers mean. And if you have any doubts or suspicions or you're just like, gosh, I just want to make sure we're doing the best that we can reach out. You guys were here for it, whether you're a future client or you're like, I just need free information. Like you guys, we built this company on serving the dental community in the best ways we possibly can. And we will stay true to that. So reach out any questions you have. [email protected]
I'm gonna put this caveat in there. We're not super pros at your dental software, but we can help you find the information and we can tell you what you should be looking for and what the stats should be. So reach out, you guys. Number one piece of information today, your number one to do, go figure out what your actual numbers are and figure out how your system is reporting them. Add them into your conversations with your office manager, your KPI reports, making sure that you're looking at those monthly, okay? Britt.
Thank you so much for taking this journey with me today. I love this. I told you like every time I'm like, okay, I'm gearing up. We're gonna figure this out. And it's just so much fun. I have so much fun with all with all of Dental A Teams clients in general. We have some of the most amazing people who partner up with us and team up with us. But I am partial to my clients. You know, I do. I have some incredible people that I get to talk to every single day. So.
Britt (22:47.027)
There's a fun one.
The Dental A Team (23:10.995)
Thank you for taking the journey with me. [email protected] you guys for any information. TheDentalATeam.com there's all kinds of stuff on there. There's all kinds of free resources and you guys we do these fun practice assessments where we really help dial in on areas that you should be focused in on. These are free free information. It's a free what I think hour with our team. So I don't know why you wouldn't sign up for that. If you're a client you guys just text your consultant. I promise you they'll hop on a call so.
That's that. Leave us a five star review. can't wait to hear how much value you took from today's conversation. Britt, thank you so much for giving me your time today. It means a lot to me. And everyone will catch you next time.
View all episodes
By Kiera DentTiff and Britt discuss how a practice that was upside down financially picked through their systems with a fine-toothed comb to find success — and how you and your team can avoid this scenario.
Episode resources:
Sign up for Dental A-Team’s Virtual Summit 2025!
Subscribe to The Dental A-Team podcast
Schedule a Practice Assessment
Leave us a review
Transcript:
The Dental A Team (00:02.146)
Hello, Dental A Team listeners. We are back again. I kept Britt today. If you've listened to the other one, that it was a beautiful Friday morning. It's still a beautiful Friday morning. I made her stick around so I could do even more with her today on this podcasting adventure. I know you guys love hearing from Britt and I love chatting with her. So Britt, welcome. Welcome. How was your day? We're rolling into the weekend.
How much fun are you excited to have? You're feeling better, you were sick, you caught what everybody else has had, and I think you get a true weekend, right?
Britt (00:29.812)
everyone.
This weekend should be better than last weekend. Let's just say that. And it is gorgeous out here. So I mean, I might have been slightly annoyed at the birds chirping and I'm like, really? Like waking me up? That's what you're going to be annoyed about. Get over it. It's a nice day outside.
The Dental A Team (00:47.151)
Oh my gosh, okay, Cinderella. I love that. I love that. It is like, it's a week. I keep thinking, gosh, it's like unseasonably warm and like it's not, it's supposed to be 85 degrees next week, FYI, but this time of year, last year was cold. That was the abnormality. This is actually normal for Phoenix. So I keep having to remind myself of that because it is warm, but the birds are chirping. The dogs are barking across the street.
Britt (00:49.486)
I know.
The Dental A Team (01:14.987)
There's people walking by and they they get angry. It's all here and we're here for it. And so if you hear the birds, you hear the cats, you hear the dogs, just know we are a company that fully encompasses the animals. We love them and they're here with us today. So I love it. Well, today's content I'm actually really excited about. wanted to I wanted to take like an excerpt from
Britt (01:28.136)
you
The Dental A Team (01:41.68)
practice that I've worked a ton with over the last few years. are near and dear to my heart. Some of my favorite human beings in the whole world. Trish was on a call with me with them, consultant Trish, and she just, she texts me on the side. She's like, he is the sweetest man. I'm like, he really, really is. They are just such a sweet, sweet human and individuals, but I've taken some journeys with them financially. And with a lot of their, their team members and doctors and stuff. And I wanted to kind of
highlight a piece that we found that I don't think I even like always thought about. And I think those are the spaces that I actually love about consulting is one, a challenge. I always love a challenge and decided like we're doing a steps challenge. I'm like, I'm to win. Like I was already doing it, but now I'm like, I'm for sure doing it. So you challenge me and it's going to work.
Britt (02:28.029)
We're going to
Britt (02:34.419)
Game on.
The Dental A Team (02:35.088)
It is, it is. It works every time. Ask Kira, she says it, she screams it from the mountaintops. It really does work, I don't know why. So I love a challenge, I love learning, and I really love when it's like, oh my gosh, that was so obscure from the normal, and it's so cool to see what we were able to create and figure out. And we all know at this point in the game that we need 98 % collections across the board.
And we all know it's not always that way. And doctors, I really wanted to bring you this information and this story, right? Storytelling time. This story from something that I've witnessed, experienced and worked through because I want you guys to be able to take some tools back to your own practices and implement some things that are actually really easy that not everyone is always doing. So, Britt, you're here with me for this journey and I'm excited because it brings in some of those business pieces.
that I know we love chatting about. So we're gonna chat through some of it and then I wanna bring in your brain on like, how can we implement these things in every single practice? So biggest space walking in to this practice was their overhead. Like their overhead was out of control and they were making massive production for a single doctor to hygiene. They're at like 140 to 160 consistently. And their hygiene department, let's do through some like,
digging, right? I find their hygiene department is like 11 to 15 percent of their production. So this doctor is exhausted. He is just like not able to sleep at night because he's stressed. He's working really hard and their overhead is really high, like almost 80 percent when we started working together, almost 80 percent overhead. You guys, that's before paying him. That's before paying loans. And so they actually had to take loans out.
Britt (04:07.923)
Yeah.
The Dental A Team (04:30.884)
to pay bills and pay loans, like this giant cycle, right? This just upside down, stressed mess. And he could not figure it out because production wise, right? He should be okay. But his overhead's almost 80 % and his doing calculations, right? And then like collections is like all over the place. One month, it's like 103%, one month it's 87%.
Then it's like 92 and it's just like jumping all over the place. Like what the heck is going on in this practice? Like the production is fairly consistent, right? But the collections is inconsistent and the overhead is consistently high. So from, I think from many people's standpoint, the number one thing you do, right? I had a doctor yesterday that I was talking to and he's like not as profitable as he wants to be and
I get it and we can make him more profitable working on it, but he's like, okay, so I need to produce more. And I'm like, whoa, whoa, whoa, you can't always outproduce the problem, right? And this practice is like that to a T because they are producing really well, but their overhead is still really high. And their collections, again, like they're collecting something, but it's just all over the place. So we had to like really do some...
weird tricks in my opinion. was just like, all right, we're gonna, we're gonna just dig in. We're gonna dive in. We're gonna figure some stuff out. So Brett, what we found one pre collections, right? love pre collects you guys. love pre collects, but what pre collects will do is inflate your collections. And so doctors implement pre collections, a hundred percent implement pre collections. But if you're going to implement when you implement pre collections,
Britt (06:19.931)
Laughter
The Dental A Team (06:21.144)
you have to pre-collect every time, right? So what they were doing is they were pre-collecting on large cases. They were doing full-mouth, like, large cases inconsistently. So they'd have two $50,000 cases in a month pre-collect that's, it's scheduled for next month, right? So they pre-collect for those two cases in January.
They do the cases in February and they don't schedule any cases for March. So then, Britt, what happened to February? Then we've got 103 % collections over here in January and then February is 87 % because we did the production and we didn't pre-collect for new surgeries.
Britt (07:05.713)
your collections are ahead of your production because you're ahead of time, a month ahead of time even.
The Dental A Team (07:08.795)
Yes.
a month ahead of time. And they were so upside down financially that the pre-collects were being used to pay bills. And so they'd pay down, they'd even pay down their loan that they got to pay bills. And then they'd have a low collections month and they'd have to use the loan, which I think personally, all of us have probably been in that situation in our personal lives at one point or another.
Britt (07:22.851)
Mmm.
The Dental A Team (07:39.046)
And it's always interesting to me the parallels there, because we like to think of business and personal finances so differently, but they are parallel. guys, money is money, business is business, life is life. But anyways, so then we figured out, okay, let's start pulling this money. So you pre-collect, you pull it, and you put it in a different bank account. So we started building their buckets, right? Their profit first style buckets without doing real profit first, because we couldn't. So we're...
Britt (07:41.651)
you
Britt (08:05.099)
Yeah.
The Dental A Team (08:07.868)
pulling this money, planning for it, right? We're prepping for profit first. So we've got these buckets and I've got them starting to pull for lab because they were getting heat up, like, honestly, sometimes it was like 20 % lab bills. So we had to pull aside all this stuff and it was so fantastic to see the money moving in the right directions because it cleared things out of the way. And then we would like add it back in.
Britt (08:08.101)
of
The Dental A Team (08:35.6)
the month that we needed it, blah, blah, blah. So we were doing this like money moving, but the biggest piece of all that was like, okay, you guys level out your pre collects. You're going to be fine. Make sure you move the money. Make sure you've got the lab bills, lab expenses covered in a different account. The biggest piece of all Britt that blew my mind and the team found it. The team found it on their own as we're moving this money around. They're like separating it on my KPI sheet. have for them. So I'm like, okay, this is your collections.
This was your pre-collect. So this is your true collections. Your pre-collect were, that's gone. That's for next month. That's next month's money. This is your true collections. Their true collections tanked. And they're like, well, Tiff, we're actually, I'm seeing we're not actually collecting a lot over the counter. Like, well, that doesn't make any sense. What do mean you're not collecting? Like, so then collect, like get the money. And they said, well, everyone has credits on their accounts.
Britt (09:09.552)
Thank
The Dental A Team (09:34.066)
They found it. So the previous billing manager and treatment coordinator and front office total wasn't putting information into the system correctly or at all, right? They didn't have the insurance fee schedules in there. So we had already worked through a lot of that, right? The fee schedules, making sure all the insurance, making sure what goes out was correct because it was incorrect. That was already been, we've been solving that. But what
happened is she was guesstimating off of UCR, taking like 20 % ish off of UCR for treatment plans and collect over collecting for patients. then when insurance, which is great, I'd rather over collect than under collect. If you're going to pay attention to your credits and give credits back. We were not paying attention to the credits. And so Britt, all of these patients just like
Britt (10:17.875)
huh.
Britt (10:22.393)
Yes.
The Dental A Team (10:30.932)
thousands and thousands and thousands of dollars in credits of patients who were coming in. We had the treatment, we had the production, but we had already had the collection. So this is where it's like, truth be told, you cannot out-produce your overhead. Because if you produce and you've got $100,000 in collection or in credits, right? All of these patients are coming in for fillings and it's like a $56 copay, they've got $300 credit.
working away on on their account. So the money's already been there. The money's already paid the bills. They had to then on our KPI, I'm like, okay, well, we're going to do another column. Next column is like, how many patients, what was the amount of credits that you use today so that if we had collected it, I need to see from a financial standpoint, I need to be able to see if we had collected it, could, would our overhead be okay? Is the overhead issue because we can't collect that money or is it because we
Britt (11:10.318)
Yeah.
The Dental A Team (11:29.616)
need to produce and collect more. So it was so hard to like see all of the pieces because there was so much chaos in the accounts that was so like hard to find. did an incredible job keying into tip. think it's the credits and I was like, my gosh, you just blew my mind, right? Like I didn't even think of this. I thought for sure the pre collects, like let's level those out. Let's always pre collect on everything. We changed that model.
Britt (11:44.945)
Yeah. Yeah.
The Dental A Team (11:56.072)
but that was only adding now to the credits. So it was like, holy cow, but it was really cool, Brett, to be able to see that's one layer that I think a lot of practices and a lot of practice owners forget to look at, right? We look at our AR, we look at our production, our collections, our new patients. We never really truly look at our credits. And these credits had our overhead at like 80 % and our collections was literally like,
Britt (11:58.928)
Yeah.
The Dental A Team (12:24.18)
87 to 95 on a really like good month of no surgeries pre-scheduled. So it was wild to see, but then once we started accounting for that, it took about a year to really truly get through all of those credits or most of those credits that were coming in. So it took about a year, but being able to visually see on the overhead spreadsheets, on the KPIs, all of the money and where it was going, what it was allocated to helped them to be able to see
where they needed to move money to, pull money to, what needed to be done. He could project like, how long do I have to work this hard? Because he's got to produce as much as he can to get through the credits, plus get some collections in. So he truly had to just work his tail off for this year to really dial back some of those issues. But it was really fun to see, okay, these are all of the spaces that you've got to make sure you're paying attention to.
especially because, I think we've all experienced this. I mean, I did in practice too. I'm like, the billing rep has got it, right? So many owner doctors, that's, you want to be able to, and I'm not saying you can't trust, right? But human error is a thing and we don't always know what we don't know. And I think that this gal just didn't know how to do it any other way. So she was doing it the best she could and honestly, like more money, the better. So if you're going to, I want you to collect more.
if that's an opportunity, but we have to be able to give it back. Like we have to be able to watch those. So I'd rather over collect than have to track somebody down for a bill. Right. I totally agree with that theory, but if we're not watching it though, like it's wild. So Britt from business standpoint, right. We've got all of these moving pieces, like from a business standpoint, if this doctor or a doctor who might be in a similar situation, right. They're like nearing
Britt (14:03.431)
Agreed.
The Dental A Team (14:20.792)
what they thought was going to be retirement, right? They thought they were getting there. Now their business is like spiraling. I mean, I did, you know, I did my digging. We did it. We got through it. It took a while. The next year, like we decreased their overhead by 10 % in that year. The next year, we decreased it again, almost another 10%. Like they're down to like 55 to 60 % overhead. At this point, they're freaking
Swim and they're doing fantastic. Their team is doing great. They're able to do great things with their team and with their family. So we did it. But from a business standpoint, we had to get a lot of help in there, a lot of CPA and financial advisors and things. But from your perspective, just on the outside hearing that, what would you tackle or what would you tell a doctor? Implement this right now so that you know if these things are happening. Like how would a doctor
from your standpoint, and if you were, I'm the doctor and you're the consultant, what would you tell me to be watching and be prepped for so that I don't fall into a situation like that?
Britt (15:20.657)
laughter
Britt (15:28.113)
Yeah, and number one, think this is like one of great scenario tips. Like these are the things that consultants love puzzles. So like this is one of those that it's like, there's something, I know it is, we're gonna find it, but we gotta figure out what exactly is happening in a scenario. And this is, think, one example of sometimes situations that doctors can find themselves in where it's like, okay, shoot, we figured something out and yeah, that's
The Dental A Team (15:37.048)
Mm-hmm.
Britt (15:58.128)
sucks. It's crappy, right? And we lived the high life for a while, but we spent money that really wasn't our stuff for a little while. So now we've got to work through this in between period and get it filled a squeeze because it's like, all right, we are now collecting the more accurate amount and we're using up these credits. So that is why our cash flow is struggling big time right now. And so I think what I would tell doctors from that end is
The Dental A Team (15:59.362)
Yeah. Yeah.
The Dental A Team (16:06.604)
Yeah.
The Dental A Team (16:19.801)
Listen.
Britt (16:25.683)
I think you've got to watch all the pieces and the real numbers. think a lot of times, right, especially with credits, like, it's like the, the like thing we don't talk about. It's like the terrible awful that it's like, man, we're just going to be like, we know it's over there, but we're just going to kind of ignore that it exists unless someone asks about it. then we'll look at it. And the better way to do it to avoid
The Dental A Team (16:45.069)
Yup.
Britt (16:50.887)
pitfalls like this is of course watch it like there's always going to be some over there yes and have a process for handling your credits to where One credit should always be audited before we're refunding make sure it's actually due to that patient before we refund it because that's also a scenario I've seen where it hits us on the cash flow side if we just refund and Sometimes there's an arrow error and it's not actually theirs. So I think watching your credits
Having a process for how we handle credits for a couple of reasons, cashflow reasons, and also know the laws of your state, like fun surprise if you don't know already. Each state treasury has laws on credits and how those should be handled. So make yourself aware of those and then create your system to meet your clients with it. And with that, it's usually great by x.
date, like if it's a credit higher than X amount, you have to like do your part to try to notify that patient. And then sometimes once it gets old enough, you've got to pay that to treasury like fun fact, also go look up your name to see if you've got any credits sitting out there that I do back to you. And like that's the proper way to go through it. So have a system for it. And I think don't be afraid of refunds. Yes, we always want to try to schedule appointments, get treatment time.
The Dental A Team (17:57.498)
So.
Britt (18:11.367)
Get them to use it. Like that is my ultimate goal is get them to use it in the office. But if not, make sure you've got a process because then it's more digestible amounts to refund instead of like big amounts that hit you when they're surprises. Surprises aren't fun. So as much as we can avoid surprises, let's do it and have a process for it. Now, if you're in a scenario like this doctor was where there's a lot of sitting out there, strategize how we can handle that. Cause we can't just go refund a hundred thousand dollars all at once.
The Dental A Team (18:12.942)
Go.
The Dental A Team (18:21.336)
Mm-hmm.
Britt (18:40.933)
So come up with a plan that's manageable that you can handle with your cashflow that you have to be able to work on getting that into a good place. And that's a lot of times with these things. takes, usually things take at least six months in a dental office, right? Big things like this, it's usually at least six months to put an FX into play, if not a year. So know that sometimes when you find these things are right, we start to put the fixes into play and then we start to clean up what's been there and it can take a little bit of time.
The Dental A Team (18:41.046)
Okay.
The Dental A Team (18:55.864)
Mm-hmm.
The Dental A Team (19:10.16)
Yeah, I agree. love all that. think I love the tertiary comments. I totally go figure it out guys. And most practices I think on that note will give like, well, I know for me when I was office manager of my practice, I had like a certain amount that was allocated every month for refunds. So I'd have 3000 or 5000 or whatever it was that was like, okay, this is what I have allocated that I can give back as refunds this month and the next.
Britt (19:16.411)
No.
The Dental A Team (19:36.078)
If another one came in, was like, cool, I'm gonna hit it next week, because it's next month or whatever that was, like that'll go into next month. So make sure you do have that solid plan. And I love all of that and make sure you're looking at it. I think that's the biggest piece here that Britt's highlighted. Just make sure you're pulling those. I think production collections, new patients, like those are making sure we're thriving. Your active patient count, we talk about those all the time. Those are the ones that like, yes, let's make sure we're thriving. Our AR, our insurance AR and our patient AR, so it's outstanding money.
But that AR can get super skewed, you guys, if you've got money sitting over in credits, because your AR total, usually, unless you click the little button that says not including credits, will deduct the credits from the total. So your AR might say, like, our total AR is $68,000, and you're like, I'm freaking killing it, right? And you could be, and that's totally fair. But make sure it's not deducting $50,000 of credits sitting over there.
Britt (20:27.059)
You
The Dental A Team (20:32.847)
that need to be addressed as well. I want you to...
Britt (20:35.155)
which is a good point if I think on knowing how your system does things. And that's why sometimes it's not as easy to see. I've even seen some where it's allocation issues, right? And skew things a little bit as well. So yeah, good point on knowing how your system accounts for things.
The Dental A Team (20:38.629)
Yeah.
The Dental A Team (20:45.125)
Mm-hmm.
The Dental A Team (20:51.453)
Yeah, yeah, I've done it myself, like not clicked that little button and been like, oh, we're good this month. And then I'm like, wait, where are all these credits coming in from? As an as a manager, these are all things that I had to learn. Because again, you guys, unless you have a professional by your side, there's not a really great like go to school to be a dental, you know, professional like dentistry dentist, hygienist, dental assisting schools. I'll add those in there.
Britt (21:18.122)
Yeah.
The Dental A Team (21:19.405)
haphazardly adding those in there, right? There's not a place for the front office, really, unless you have a coach or a consultant or someone who is able to train them on the things that we've learned across the board, across learning all of the things. There's business classes that a lot of us have taken. Britt's got freaking so much, so many beautiful degrees behind her name. Like, there's so much that can come from that, but there's so much that can be missed because we're literally just learning from the person who was in front of us and we're teaching ourselves. So just make sure.
Britt (21:37.572)
Yeah.
The Dental A Team (21:49.37)
You know your stuff, you know how your system works, you know what your numbers mean. And if you have any doubts or suspicions or you're just like, gosh, I just want to make sure we're doing the best that we can reach out. You guys were here for it, whether you're a future client or you're like, I just need free information. Like you guys, we built this company on serving the dental community in the best ways we possibly can. And we will stay true to that. So reach out any questions you have. [email protected]
I'm gonna put this caveat in there. We're not super pros at your dental software, but we can help you find the information and we can tell you what you should be looking for and what the stats should be. So reach out, you guys. Number one piece of information today, your number one to do, go figure out what your actual numbers are and figure out how your system is reporting them. Add them into your conversations with your office manager, your KPI reports, making sure that you're looking at those monthly, okay? Britt.
Thank you so much for taking this journey with me today. I love this. I told you like every time I'm like, okay, I'm gearing up. We're gonna figure this out. And it's just so much fun. I have so much fun with all with all of Dental A Teams clients in general. We have some of the most amazing people who partner up with us and team up with us. But I am partial to my clients. You know, I do. I have some incredible people that I get to talk to every single day. So.
Britt (22:47.027)
There's a fun one.
The Dental A Team (23:10.995)
Thank you for taking the journey with me. [email protected] you guys for any information. TheDentalATeam.com there's all kinds of stuff on there. There's all kinds of free resources and you guys we do these fun practice assessments where we really help dial in on areas that you should be focused in on. These are free free information. It's a free what I think hour with our team. So I don't know why you wouldn't sign up for that. If you're a client you guys just text your consultant. I promise you they'll hop on a call so.
That's that. Leave us a five star review. can't wait to hear how much value you took from today's conversation. Britt, thank you so much for giving me your time today. It means a lot to me. And everyone will catch you next time.