Documentation, charting, and insurance narratives are taking time away from patient care, and many teams are already stretched thin. In this episode, Kirk Behrendt sits down with Rushi Ganmukhi, founder of Bola AI and former MIT AI/NLP researcher, and Cassie Tallon, a dental operations leader and author, to explain how voice-enabled AI can reduce clinical documentation burden, improve note quality, and help practices get paid faster.

You’ll learn where voice tech fits best (perio, restorative charting, and clinical notes), what it changes operationally, and how to identify the friction points in your own workflow. Listen to Episode 1055 of The Best Practices Show!

Main Takeaways:

• Voice technology can reduce the time and disruption of perio charting by allowing hands-free entry during hygiene visits.
• Faster perio charting supports more comprehensive perio exams, which can improve identification and treatment of periodontal disease.
• Delayed or incomplete notes can delay insurance submission and cash flow, creating a backlog of unsent claims.
• Templated, generic notes and late documentation can weaken clinical records for both insurance review and legal defensibility.
• Insurers are increasingly requiring more documentation, including perio charting for restorative claims, to support medical necessity.
• Effective adoption of AI tools depends on fast implementation, flexibility in workflows, and customization to an office’s documentation preferences.
• Practices can start by tracking daily workflow “sticking points” for a week and mapping which issues could be reduced with voice-driven documentation.

Snippets:

00:00 Voice tech as the “hidden power” of AI for practice efficiency.

01:00 The documentation burden: perio charts, restorative docs, and insurance narratives.

02:10 Rushi’s background in AI/NLP and MIT research, and why he entered dentistry.

04:35 Why voice tech fits clinical environments better than consumer voice assistants.

06:00 Bola AI’s early focus on voice perio charting and expansion to notes and restorative charting.

07:05 Why integrations with practice management systems matter (Dentrix, Open Dental, Curve, Patterson, Henry Schein).

08:00 The time cost of manual charting and its impact on hygiene workflows.

10:00 How delays and backdating notes can hold up insurance submission and revenue.

11:20 The risks of cut-and-paste templates for insurance and legal documentation.

13:00 Insurance requiring more documentation, including perio charting for restorative claims.

14:00 Why “decay” alone is not a sufficient clinical reason in a narrative.

15:00 How dental-specific logic and terminology improve accuracy over general dictation tools.

16:35 What “plug-and-play” adoption should look like in the operatory.

18:10 Handling variation across practices (sleep/airway, medical billing, pediatrics, customization).

19:00 Current curiosity vs. adoption: workforce shortages and the cash-flow case for AI.

22:00 Overview of Bola’s three core products: Voice Perio, Voice Restorative, and AI Scribe.

26:00 A practical challenge: measure how long perio charting takes and identify workflow friction points.

29:00 Final guidance: start small, solve specific problems, and choose tools proven in clinics.

30:10 Where to learn more and request a demo (bola.ai).

Guest Bio/Guest Resources:

Rushi Ganmukhi is the founder of Bola AI and has a professional background in artificial intelligence and natural language processing, including research experience at MIT focused on helping computers understand human speech and language. He leads Bola AI’s work applying voice technology to dental workflows, including perio charting, restorative charting, and AI-assisted clinical documentation.

Cassie Tallon is a dental operations leader with 20 years of experience spanning multi-doctor practices and DSOs, including supporting growth and operational efficiency across multiple locations. She is an author focused on dental operations and has dedicated her current work to helping dentists improve efficiency, navigate growth decisions, and strengthen systems without adding unnecessary overhead.

Resources mentioned in the episode:

• Bola AI (demos and product information): www.bola.ai
• https://smilesource.com/exchange

More Helpful Links for a Better Practice & a Better Life:

• The Best Practices Show: https://www.actdental.com/podcast/
• Best Practices Association: https://www.actdental.com/bpa
• Upcoming Events & Workshops: https://www.actdental.com/events/
• Smile Source: https://www.smilesource.com/
• Subscribe on Apple Podcasts: https://podcasts.apple.com
• Subscribe on Spotify: https://open.spotify.com

Tracking every KPI can feel productive, but it often creates noise and diffuses accountability. In this episode, Kirk Behrendt sits down with Miranda Beeson, ACT’s co-host and practice coach, to explain why “tracking everything is the fastest way to improve nothing.”

You’ll learn how to narrow your focus to a small set of metrics that match your top quarterly priority, how to separate leadership-level monitoring from team-level focus, and what to do when a metric is off-track so it actually improves. Listen to Episode 1054 of The Best Practices Show!

Main Takeaways

• Track data because feelings are not reliable indicators of what is happening in the practice.
• Too many KPIs create overwhelm, dilute accountability, and make it harder to prioritize action.
• Choose three to seven “main” KPIs each quarter that directly correlate to the practice’s current priority.
• Leadership can monitor a broader scorecard, but the team should stay focused on the quarter’s priority metrics.
• Practices that track everything often bounce between problems week to week without making measurable progress.
• When a focus metric is off-track, the team must issue-discuss-solve instead of only reporting the number.
• Assign clear ownership for collecting and reporting each KPI so the numbers stay visible and actionable.

Snippets:

00:00 Metric Mondays Kickoff

01:22 Meet Miranda Beeson

02:00 Why Tracking Everything Fails

03:20 Pick Few KPIs for Traction

05:51 Data Rich Direction Poor

07:52 What It Looks Like Done Right

08:42 Choose Focus Metrics This Quarter

10:47 Action Steps and Accountability

13:17 Solve Off Track Metrics

14:43 Wrap Up and Get Help

Guest Bio/Guest Resources:

Miranda Beeson has over 25 years of clinical dental hygiene, front office, practice administration, and speaking experience. She is enthusiastic about communication and loves helping others find the power that words can bring to their patient interactions and practice dynamics. As a Lead Practice Coach, she is driven to create opportunities to find value in experiences and cultivate new approaches.

Miranda graduated from Old Dominion University, and enjoys spending time with her husband, Chuck, and her children, Trent, Mallory, and Cassidy. Family time is the best time, and is often spent on a golf course, a volleyball court, or spending the day boating at the beach.

More Helpful Links for a Better Practice & a Better Life:

The Best Practices Show: https://www.actdental.com/podcast/

Best Practices Association: https://www.actdental.com/bpa

Upcoming Events & Workshops: https://www.actdental.com/events/

Smile Source: https://www.smilesource.com/

Subscribe on Apple Podcasts: https://podcasts.apple.com

Subscribe on Spotify: https://open.spotify.com

Cash flow confusion can make a busy, high-producing practice feel like it has no money left at the end of the month. In this episode, Kirk Behrendt explains why production and a “profitable” P&L don’t always translate into cash in the bank, and he brings in coach Robyn Theisen to break down the cash flow gap.

You’ll learn the difference between net profit and actual cash available, the three common places cash disappears, and which financial statements you need to see the full story and build a plan for taxes, debt, and owner compensation. Listen to Episode 1053 of The Best Practices Show!

Main Takeaways:

• Net profit on the P&L is not the same as cash in the bank.
• The cash flow gap is the difference between what your P&L shows and the cash actually available.
• Cash commonly disappears in three places that don’t show clearly on the P&L: taxes, debt payments, and owner draws/distributions.
• Interest expense may appear on the P&L even when the actual loan payments and balances aren’t being tracked.
• To understand where the money went, you need to review the P&L, cash flow statement, and balance sheet together.
• Predictable owner compensation, tax reserves, and a debt strategy reduce reactive decisions and stabilize cash flow.
• Ongoing monthly accountability and review are necessary to keep cash flow clean, especially in multi-owner practices.

Snippets:

00:00 Net profit versus cash in the bank.

06:00 What the cash flow gap is and where it usually shows up.

07:00 Why paying down debt doesn’t appear on the P&L.

10:00 The three strategies: tax reserves, debt strategy, and owner compensation.

11:00 The three financial statements needed to understand cash movement and what’s owed.

15:00 Why multi-owner practices add complexity and require consistent monthly review.

17:00 The cash flow statement tells the full story, not the P&L.

18:00 BPA tools mentioned: reading the three statements, Financial Gaps at a Glance, and the calculator.

Guest Bio/Guest Resources:

Robyn Theisen brings an entire life and legacy of dental experience to the team and every team with which she works as the daughter and sister of dentists. With almost 20 years of experience in dentistry, her roles ranged from practice management to operations at Patterson Dental to coaching teams. Robyn’s passion is empowering teams to realize that they can dramatically impact the lives of the people they serve by implementing skills and systems to remove barriers to life-changing dental treatment. She has done it for decades and does it every day with dental teams.

Outside of coaching, she enjoys time with her husband, Rob, and two daughters, Emerson and Ruby. She loves traveling, music, fitness, and cheering on the Michigan State Spartans.

Resources Mentioned:

Financial Gaps at a Glance: https://www.actdental.com/gaps-at-a-glance

Financial Gaps Calculator: https://www.actdental.com/gaps-calculator

More Helpful Links for a Better Practice & a Better Life:

The Best Practices Show: https://www.actdental.com/podcast/

Best Practices Association: https://www.actdental.com/bpa

Upcoming Events & Workshops: https://www.actdental.com/events/

Smile Source: https://www.smilesource.com/

Subscribe on Apple Podcasts: https://podcasts.apple.com

Subscribe on Spotify: https://open.spotify.com

Dentists often keep operating beliefs long after the market, technology, and patient expectations have changed. In this episode, Kirk Behrendt sits down with recurring guest Dr. Tom Hedge, practicing dentist and educator, to unpack myths dentists still believe — from selling to DSOs and misunderstanding recap/valuation, to overestimating the cost and complexity of modern technology, imaging, magnification, and hygiene staffing.

You’ll learn how to rethink “rules of thumb,” evaluate DSO offers more clearly, adopt practical tech that improves diagnosis and case acceptance, and use education and community to stay adaptable. Listen to Episode 1052 of The Best Practices Show!

Main Takeaways:

• Dentists often assume what worked ten years ago will keep working, even when costs, fees, and alternatives have changed.
• DSO deals can break down when recapitalization happens and cheap money is no longer cheap, shrinking what DSOs can “skim” between dentist pay and profitability.
• A “second bite of the apple” payout is not guaranteed, and dentists can lose value if the DSO is not financially strong when the holdback comes due.
• Technology prices and workflows have changed dramatically, and many tools (cameras, scanners, digital X-rays) now deliver faster diagnosis and better patient understanding.
• Patient imaging can be created quickly using AI tools, which can help patients visualize outcomes and move forward without high-pressure selling.
• Magnification and hands-free lighting can simplify clinical work, reduce operatory clutter, and improve the patient experience compared to traditional overhead lights.
• Investing in continuing education moves dentists from “not knowing what you don’t know” to confident clinical decision-making, but learning never stops.

Snippets:

00:00 Welcome And Setup

02:04 Why Myths Persist

02:38 Rethinking Fees

03:42 DSO Big Check Myth

05:31 Recap And EBITDA

08:19 Independent Dentistry Future

09:39 Tech Costs Myth

12:59 Hands Free Operatory Tech

13:50 AI Smile Imaging Fast

15:58 Magnification Lighting Simplified

17:33 Hygiene Crisis Reframed

19:27 Education And Community

20:35 SmileSource Exchange Invite

22:09 Final Takeaways Goodbye

Guest Bio/Guest Resources:

Dr. Tom Hedge is widely known as one of the top-notch cosmetic dentists in the United States. He received his Bachelor’s degree from Kenyon College in Gambier, Ohio, where he majored in biology and chemistry. While studying at the Ohio State University College of Dentistry, he conducted research resulting in the publication of seven abstracts and one paper, which received numerous awards at the state and national levels. After graduating from dental school, he completed a general practice residency at Richland Memorial Hospital in Columbia, South Carolina. This advanced education included training in anesthesia, pediatrics, emergency medicine, geriatrics, TMJ treatment, endodontics, periodontics, orthodontics, oral surgery, prosthetics, and implantology.

Dr. Hedge is nationally recognized not only for excellence in clinical programs, but for sound business practices that make full use of the newest technologies in dentistry. He is an alumnus of the renowned Las Vegas Institute for Advanced Dental Studies, as well as the Pankey Institute for Advanced Dental Education. Dr. Hedge is a frequent contributor to dental publications, as well as professional development magazines.

Resources mentioned in the episode:

• Smile Source Exchange: https://smilesource.com/exchange

More Helpful Links for a Better Practice & a Better Life:

• The Best Practices Show: https://www.actdental.com/podcast/
• Best Practices Association: https://www.actdental.com/bpa
• Upcoming Events & Workshops: https://www.actdental.com/events/
• Smile Source: https://www.smilesource.com/
• Subscribe on Apple Podcasts: https://podcasts.apple.com
• Subscribe on Spotify: https://open.spotify.com

Why does hygiene feel “booked out” and still leave you scrambling to fill holes at the last minute? In this episode, Kirk Behrendt talks with ACT coach Ariel Siegel about why an underperforming hygiene schedule is almost always a systems problem—and how to fix it with two foundational levers: a strong reappointment/recare follow-up system and a calibrated periodontal protocol.

You’ll learn what breakdowns create reactive scheduling, what “getting it right” looks like in the numbers and in patient communication, and what your team can do today to start rebuilding predictability in hygiene. Listen to Episode 1051 of The Best Practices Show!

Main Takeaways:

• A consistently full hygiene schedule depends on two core systems: strong reappointment/recare follow-up and a strong periodontal protocol.
• When systems are missing, teams become reactive and spend significant time scrambling to fill last-minute openings.
• Automated reminders are necessary, but they cannot replace a defined recare follow-up process that tracks and re-engages unscheduled patients.
• “Booked out” hygiene can still indicate a breakdown if the practice is constantly scrambling to fill tomorrow’s holes.
• A strong hygiene reappointment process requires patients to leave with the next visit scheduled and a clear understanding of why they are returning.
• A calibrated perio protocol increases consistent diagnosis, patient understanding, and acceptance, which supports both hygiene stability and restorative scheduling.
• Building systems up front reduces future effort and prevents the ongoing “chasing patients” cycle that patients often resist.

Snippets:

01:55 The two systems that keep the hygiene schedule predictably full.

03:50 What it looks like when hygiene scheduling is broken and the team becomes reactive.

04:20 Why reminders can’t be the whole recare system.

05:40 “We’re booked out months” but still scrambling—what that signals.

07:10 What “getting it right” looks like: reappointment commitment and follow-up tracking.

09:00 How calibrating a perio protocol changes perio percentages and 4000 codes.

11:30 Stop chasing patients—capture commitment while they’re in the practice.

12:10 What your team can do today: find the gaps driving last-minute holes.

12:40 The easiest short-term win: improve hygiene reappointment expectations.

14:05 Why perio protocol calibration takes alignment, tools, and consistent messaging.

16:10 Systems save hours: invest now instead of living in reactive mode.

16:55 Where to find BPA resources for hygiene reappointment/recare follow-up and calibrated perio protocol.

Guest Bio/Guest Resources:

Ariel has a master’s in healthcare administration and several years of dental experience in all aspects of the administrative roles within the dental office. Her passion is to work with dental teams to empower team members to realize their full potential in order to better serve patients, improve office systems to ensure a well-functioning team/office, and to help everyone have fun in the process!

Resources mentioned:

• Best Practices Association (BPA) resources: https://www.actdental.com/free-resources/

More Helpful Links for a Better Practice & a Better Life:

• The Best Practices Show: https://www.actdental.com/podcast/
• Best Practices Association: https://www.actdental.com/bpa
• Upcoming Events & Workshops: https://www.actdental.com/events/
• Smile Source: https://www.smilesource.com/
• Subscribe on Apple Podcasts: https://podcasts.apple.com
• Subscribe on Spotify: https://open.spotify.com

Many practices keep looking for more new patients when the bigger problem is the gap between what gets diagnosed and what actually gets scheduled, completed, and collected. In this episode, Kirk Behrendt talks with Sameer Bhasin of CareCredit about building reliable, measurable systems that make unscheduled dentistry visible, tighten the diagnose-to-schedule pathway, and improve follow-through so patients get the care they need without adding more chaos to the schedule.

You’ll learn how to create an actionable dashboard, protect procedure time, clean up revenue cycle habits, and use technology to amplify (not replace) your workflow. Listen to Episode 1050 of The Best Practices Show!

Main Takeaways:

• Most private practices aren’t short on diagnosing treatment; they’re short on conversion and follow-through.
• Unscheduled dentistry should be broken down into a dashboard by timeframe, procedure type, value tier, and patient readiness so it becomes actionable.
• A strong diagnose-to-schedule pathway requires consistent handoffs, clear “why now,” and protecting schedule time for the procedures you want to do.
• Production on paper isn’t the same as performance because value is often lost in handoffs, case acceptance, scheduling, and collections.
• Clean revenue cycle discipline includes early benefit verification, collecting patient portions appropriately, and consistent weekly AR and aging-claims follow-up.
• Technology should amplify an existing workflow (analytics, reminders, online scheduling guardrails) rather than replace human follow-up and accountability.
• As a benchmark, about 10% of patients should be applying for third-party financing to ensure financial options are part of the process, not an afterthought.

Snippets:

00:00 Unscheduled dentistry is the opportunity most practices aren’t working.

08:23 How to build an unscheduled treatment dashboard by time, procedure, and value tier.

11:52 Standardizing the diagnose-to-schedule pathway and creating urgency with the “next best appointment.”

15:40 What a “clean revenue cycle” looks like and why write-offs are a major hidden problem.

18:05 Technology amplifies a workflow; it doesn’t replace one.

20:10 The metrics Samir watches, including the 10% financing application benchmark.

23:10 The “Great Wall of China” myth and how misconceptions show up in practice systems.

26:55 Approval rate realities and why you can’t get approvals without applications.

33:00 What a CareCredit practice review reveals and how it’s used to find opportunities.

35:45 A simple action plan: pull the last 90 days of unscheduled dentistry and call the top 20 patients.

Guest Bio/Guest Resources:

Sameer Bhasin, Vice President of Strategic Alliances at CareCredit, is responsible for working with dentistry’s key opinion leaders and educators to gather the latest insights and trends. Previously, Mr. Bhasin held positions as a CareCredit Practice Development Manager and Regional Sales Manager where he acquired more than a decade of front line practice experience. He holds both a Bachelor’s Degree and Master’s Degree in Business and an MBA in Healthcare Administration.

• Email: [email protected]
• Social: https://www.facebook.com/sameer.bhasin/
• https://www.instagram.com/sam.i.am.329/

More Helpful Links for a Better Practice & a Better Life:

• The Best Practices Show: https://www.actdental.com/podcast/
• Best Practices Association: https://www.actdental.com/bpa
• Upcoming Events & Workshops: https://www.actdental.com/events/
• Smile Source: https://www.smilesource.com/
• Subscribe on Apple Podcasts: https://podcasts.apple.com
• Subscribe on Spotify: https://open.spotify.com

Core values sound simple until you try to use them to lead a team consistently, especially when things get busy or uncomfortable. In this episode, Kirk Behrendt explains how to turn core values into daily decision-making tools with Heather Crockett, coach at ACT Dental.

You’ll learn how to make values behavioral and observable, build them into your communication rhythms, and use them as a practical filter for hiring, accountability, and tough leadership calls. Listen to Episode 1049 of The Best Practices Show!

Main Takeaways:

• Core values only work when they drive daily behavior, not when they’re just words on a wall.
• Values must be actionable and observable so the team can interpret and apply them consistently.
• “Core values without function” shows up as subjective interpretations, inconsistent culture, and leaders hesitating to hold people accountable.
• Make each value behavioral by defining what it means, documenting examples of how it shows up, and listing the results when it’s alive and well.
• Operationalize values by embedding them into hiring, onboarding, daily huddles, weekly team meetings, monthly check-ins, and quarterly planning.
• Use values as the decision-making filter for real-time issues like scheduling, finances, patient care, and team dynamics to reduce decision fatigue.
• Hire and evaluate people on two criteria: they get results and they fit your core values, using tools like a Right Person, Right Seat scorecard.

Snippets:

00:00 How to turn core values into daily decision-making tools.

02:10 Why core values matter only if they drive behavior.

03:10 Why vague values (like “excellence” or “integrity”) don’t work as daily tools.

04:30 What “core values without function” looks like inside a practice.

06:10 How to make values behavioral with definitions, examples, and outcomes.

08:00 Using “anti-values” and standout team behaviors to clarify what you want.

10:10 Putting core values into systems and communication rhythms.

12:10 Using huddles and team meetings for value shout-outs and accountability.

18:00 Using core values as a daily decision filter to reduce decision fatigue.

22:10 Heather’s final takeaways on visibility, systems, and reflection.

23:50 BPA tools mentioned: Identifying Core Values, bringing values alive, Right Person Right Seat scorecard.

Guest Bio/Guest Resources:

Heather Crockett is a Lead Practice Coach who finds joy in not only improving practices but improving the lives of those she coaches as well. With over 20 years of combined experience in assisting, office management, and clinical dental hygiene, her awareness supports many aspects of the practice setting.

Heather received her dental hygiene degree from the Utah College of Dental Hygiene in 2008. Networking in the dental community comes easy to her, and she loves to connect with like-minded colleagues on social media. Heather enjoys both attending and presenting continuing education to expand her knowledge and learn from her friends and colleagues.

She enjoys hanging out with her husband, three sons, and their dog, Moki, scrolling through social media, watching football, and traveling.

Resources mentioned in this episode:

• Identifying Your Core Values (exercise outline): https://www.actdental.com/hubfs/Identify%20Your%20Practices%20Core%20Values.pdf
• BPA tool on how to bring core values alive:
• https://www.actdental.com/free-resources/how-to-bring-your-core-values-alive
• Right Person, Right Seat scorecard:
• https://www.actdental.com/blog/2-key-tools-for-accountability-success

More Helpful Links for a Better Practice & a Better Life:

• The Best Practices Show: https://www.actdental.com/podcast/
• Best Practices Association: https://www.actdental.com/bpa
• Upcoming Events & Workshops: https://www.actdental.com/events/
• Smile Source: https://www.smilesource.com/
• Subscribe on Apple Podcasts: https://podcasts.apple.com
• Subscribe on Spotify: https://open.spotify.com

Burnout can feel like a personal failure, but it often shows up because the business isn’t operationally aligned. In this episode, Kirk Behrendt brings back coach Ariel Siegel to explain why burnout is a business signal, what numbers reveal the real problem, and which metrics to track so your schedule, profitability, and energy feel more sustainable.

You’ll learn how days worked, write-offs, and margin create (or relieve) pressure — and what to start measuring right now to regain control. Listen to Episode 1048 of The Best Practices Show!

Main Takeaways:

• Burnout often feels personal, but it is typically a signal that something in the business is not working.
• Adding more hours, skipping lunch, and squeezing in patients can increase effort without delivering proportional financial relief.
• Days worked and write-offs have risen significantly post-COVID, creating instability and stress when margin becomes inconsistent.
• Recovery is a requirement for success, and time away from the practice must be built in, not “earned” later.
• Dentists must track the true number of clinical days worked because most don’t know the real number from the prior year.
• Margin matters more than production because it shows what is left after overhead and debt, and it reveals profit leaks.
• Write-offs must be understood by source so you can see how many days you are effectively working “for free” and build a plan to improve.

Snippets:

00:00 Metric Monday Intro

01:35 Burnout Is A Signal

03:36 When It Goes Wrong

04:56 Post COVID Metrics Shift

06:16 Margin Stress Spiral

08:26 Getting It Right

09:51 Track Days And Margin

13:15 Busy But Not Profitable

14:55 Action Step Write Offs

16:47 Resources And Wrap Up

Guest Bio/Guest Resources:

Ariel has a master’s in healthcare administration and several years of dental experience in all aspects of the administrative roles within the dental office. Her passion is to work with dental teams to empower team members to realize their full potential in order to better serve patients, improve office systems to ensure a well-functioning team/office, and to help everyone have fun in the process!

Guest resources mentioned in this episode:

• PPO Freedom Course: https://www.actdental.com/free-resources/ppo-roadmap/

More Helpful Links for a Better Practice & a Better Life:

• The Best Practices Show: https://www.actdental.com/podcast/
• Best Practices Association: https://www.actdental.com/bpa
• Upcoming Events & Workshops: https://www.actdental.com/events/
• Smile Source: https://www.smilesource.com/
• Subscribe on Apple Podcasts: https://podcasts.apple.com
• Subscribe on Spotify: https://open.spotify.com

When PPO write-offs climb, adding more patients can increase stress while decreasing profitability. In this episode, Kirk Behrendt sits down with Miranda Beeson, ACT’s Director of Education, to unpack “the PPO trap” and explain why more patients can mean less money.

You’ll learn how to spot the effort gap, gather the right data before making insurance decisions, and shift the insurance mindset and language so your team can confidently support a more profitable model—whether that means going fully fee-for-service or reducing PPO exposure strategically. Listen to Episode 1047of The Best Practices Show!

Main Takeaways:

• More patients can increase production but still reduce profit when write-offs and effort gap widen.
• Practices should make PPO decisions with data—not emotion—by analyzing write-offs, plan mix, production, and procedure impact.
• Going fee-for-service must match your business model and requires leadership, team alignment, and consistent communication.
• If you’re not ready to go fully out-of-network, you can improve profitability by tracking write-offs per plan and participating selectively.
• Capacity matters: if you have holes in the schedule, it may not be the right time to drop plans aggressively.
• Teams must shift language from “coverage” to “benefits” and keep clinical recommendations separate from insurance limitations.
• Front office and team buy-in are critical, because inconsistent messaging and fear-based language will sabotage the transition.

Snippets:

00:00 More patients doesn’t automatically mean more profit—and why the effort gap matters.

04:59 How write-offs have grown after COVID, including practices seeing 30–55%+.

10:18 Why going fee-for-service isn’t just an insurance decision—it’s a business model and leadership decision.

14:22 The key data to review before dropping a plan (patients, production, write-offs, procedures, attrition tolerance).

18:40 How to participate strategically: track write-offs per plan, evaluate plan impact, and consider fee negotiation.

22:29 How to identify “poor fit” plans and include admin team friction (appeals, phone time, denials) in the decision.

28:05 The mindset shift: insurance as a benefit, not coverage—and why insurance shouldn’t drive diagnosis.

31:53 Language that protects the health recommendation and reduces insurance-driven conversations.

36:48 How to answer “Do you take my insurance?” without undermining value or confidence.

38:10 First steps: confirm you bill full fees, know true write-offs, and clarify your practice model direction.

Guest Bio/Guest Resources:

Miranda Beeson has over 25 years of clinical dental hygiene, front office, practice administration, and speaking experience. She is enthusiastic about communication and loves helping others find the power that words can bring to their patient interactions and practice dynamics. As a Lead Practice Coach, she is driven to create opportunities to find value in experiences and cultivate new approaches.

Miranda graduated from Old Dominion University, and enjoys spending time with her husband, Chuck, and her children, Trent, Mallory, and Cassidy. Family time is the best time, and is often spent on a golf course, a volleyball court, or spending the day boating at the beach.

Resources mentioned in this episode:

• PPO Roadmap: https://www.actdental.com/free-resources/ppo-roadmap/\
• Say This Not That: https://www.actdental.com/hubfs/Say%20This%2C%20Not%20That%20-%20Fillable.pdf
• To The Top Study Club: https://www.actdental.com/ttt/

More Helpful Links for a Better Practice & a Better Life:

• The Best Practices Show: https://www.actdental.com/podcast/
• Best Practices Association: https://www.actdental.com/bpa
• Upcoming Events & Workshops: https://www.actdental.com/events/
• Smile Source: https://www.smilesource.com/
• Subscribe on Apple Podcasts: https://podcasts.apple.com
• Subscribe on Spotify: https://open.spotify.com

When patients don’t accept treatment, most dentists assume it’s about money — but the real breakdown often happens earlier in the process. In this episode, Kirk Behrendt brings back Dr. Jim McKee to share the five questions that determine whether a patient will say yes and whether you should take the case.

You’ll learn how to diagnose the real problem, frame expectations, evaluate timing and affordability, and build the kind of trust that prevents conflict in complex dentistry. Listen to Episode 1046 of The Best Practices Show!

Main Takeaways:

• Case acceptance starts when the dentist clearly understands the problem and has a predictable solution.
• Patients say no when they understand the complaint but don’t understand the real diagnosis or why the proposed solution makes sense.
• Many declined treatment plans are a timing issue in the patient’s life, not a fee issue.
• Affordability often comes down to phasing treatment while clearly explaining the risks, changes, and potential added cost over time.
• Unrealistic expectations — clinical, financial, or both — are a leading cause of difficult cases and post-treatment conflict.
• Trust is built by accurate diagnosis, transparent expectation-setting, and having the clinical skills to manage complex problems.
• You should trust your “spider senses” and be willing to lose the case early rather than getting stuck in treatment you can’t deliver predictably.

Snippets:

00:00 Where the “five keys to case acceptance” came from.

00:05 “Checkers vs. chess” patients and why Julie’s case changed the conversation.

00:07 Why tooth-based solutions fail when the problem is skeletal or joint-based.

00:11 Unrealistic expectations and the hidden mismatch between insurance and “perfect” dentistry.

00:17 Why “too expensive” is often a timing issue, not the real reason patients delay.

00:19 The money question: phasing complex cases without surprising patients later.

00:25 The trust question and why sustaining practices are built on relationships, not volume.

00:30 How to think through failure points before you start treatment.

00:33 Why it’s better to lose up front than disappoint a patient mid-treatment.

00:38 Where to learn more: online training, hands-on workshops, and a Chicago study club.

Guest Bio/Guest Resources:

Dr. Jim McKee is a restorative dentist and educator focused on occlusion, TMD, and restorative diagnosis. He is a member of the Spear Resident Faculty. He has maintained a private practice since 1984 in Downers Grove, Illinois, where he treats a wide variety of cases with a focus on predictable restorative dentistry. He is a member of the American Academy of Restorative Dentistry and former president of the American Equilibration Society. He has lectured both nationally and internationally for over 25 years and directs several study clubs. Dr. McKee graduated from the University of Notre Dame in 1980 and earned his dental degree from the University of Illinois College of Dentistry in 1984.

Guest Resources Mentioned:

• Online program through Phelan Dental Seminars: https://courses.phelandentalseminars.com/tmd-pds
• Advanced Occlusion Workshop at Spear Education : https://app.speareducation.com/events/workshops/advanced-occlusion

More Helpful Links for a Better Practice & a Better Life:

• The Best Practices Show: https://www.actdental.com/podcast/
• Best Practices Association: https://www.actdental.com/bpa
• Upcoming Events & Workshops: https://www.actdental.com/events/
• Smile Source: https://www.smilesource.com/
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