The Dental Marketer

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My Key Takeaways:

• Great team culture is key. Patients can tell if there is tension between members!
• Sometimes growing slow and steady is the right path if it means good work life balance.
• Minimizing waiting time in the lobby and greeting patients with a smile goes a long way.
• Sometimes you're more of a therapist than a dentist. Help patients feel more comfortable by overcoming their dental fears.
• You will never feel 100% ready. Sometimes you just have to take the leap!

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Michael: Megan, how's it going?

Megan: It's going great. Thanks for having me today. Excited to be talking to you. No, thank

Michael: you for, did you just get off were you just finished right now with your last patient or it's been a

Megan: while or, I did.

I finished up about five and rushed home and did something with my hair and here we are. Was

Michael: it a busy day today, ?

Megan: It was a busy day, which is a good thing as a startup. So yes, thankfully it was busy.

Michael: how long have you been open for it with your startup?

Megan: Yep. We have been open for a year and a half, so we opened in May of 2021,

Michael: man.

Okay, so rewind a little bit. Yeah. Tell us a little bit about your past, your present, and how'd you get to where you are today?

Megan: Yep. So I did dental school in Dallas. So I graduated in 2017. I practiced once, I graduated in Dallas as an associate for, a couple years, two or three years. And then my parents had moved to San Antonio.

So that, that had always been the long-term goal was actually for my mom during my practice. So once they were in San Antonio, we knew that's where we had to be. So me and my husband moved. where I associated here for about a year and a half, and then Covid hit. So I decided when we were all off during that six weeks, what better time than now to start planning and, and getting the startup going.

So that's what I did. I, I spent that six weeks planning and thinking about what kind of practice I wanted to have, what I want him to do. And a year later

Michael: we were open. Okay. So you, yeah. We'll rewind a little bit more. Okay. You said you wanted to move into, San Antonio, cuz that's where your parents, Yeah,

Megan: so my parents, they had moved here four or five years before I did. So I'm from Amarillo, so they were in Amarillo. My dad has a cousin that lives here in San Antonio and they do all their hunting and fishing and all their guy stuff together. So, they moved down here so that they could do all that stuff together.

But my mom, she had started working in dental offices about the time that I started dental school, so that was always the plan for her to run my practice. Mm-hmm. . So I had to get where they.

Michael: she like a, a ma, like a consultant or something, or? No, she's just,

Megan: no, so she just, she's my front office.

So she runs, she's my front desk, everything. She does all my insurance. She answers the calls. She's my reception, my office manager, my bookkeeper, she does everything. CPA also. But, she, she runs my office. So she started working, doing the same thing in other offices about the same time I started dental.

Michael: Wow, that's really cool. Yeah. Okay. That's nice. It's, I thought you were from like, because you said you're in San Antonio, you've only been there for three years. I thought you weren't from Texas, so you should know where and everything is at cause. Okay,

Megan: so South Texas is a whole other country, man.

It's up in the Panhandle's, a whole other country by itself, so it's That's true. I'm

Michael: still learning, but yeah. Yeah, that's true. That's true. Okay, so then San Antonio, Dallas area. Yeah. You didn't wanna open your practice in Dallas?

Megan: No, I didn't. I enjoy living there. I think Dallas is a really fun place to be.

But it is super saturated. I mean, I wouldn't say here is too much better. But the most important thing to me was to be being your family. So that was definitely, that outweighed being in Dallas where I, I probably like Dallas a little bit better than I like San Antonio. But being near my family and having my mom to lean on and help me run the practice was a lot more important.

Michael: Okay. What did you learn in your associateship while you were only an associate for like one year, right? You said?

Megan: No, so I graduated in 2017, so Oh, okay. I've been outta school for five or six years now, so, I associated up until the last year and a half. But I assume your question was what did I learn in my associate positions?

Is that what your question was? How many

Michael: associate positions did you.

Megan: Let's see. I had two in Dallas, one that only lasted a year, and then one I stayed in up until I moved, and then one here in San Antonio. So three altogether, the one that only

Michael: lasted a year.

Megan: Why? Yeah. So that one it was, Private practice ish.

So he had three different practices. he run it more like a dsso. And I think any, any associate who's been in that position kind of knows how that goes. But I, I think for me, in that particular office, kind of what made me wanna leave it was it was a newer office and it was just really, really slow.

So I didn't feel like there was opportunity for growth there for me. I was sitting there seeing maybe one patient a day. It was really boring. And I just didn't have the opportunity to practice my skills and have that growth. And so I, I found something, something. .

Michael: Okay. And so in your associateships, what systems Yeah.

Or things did you learn that you're like, I'm gonna take this into my practice. And then what stuff did you, I guess, learn where you're like, I never, ever wanna do this with my team or my

Megan: practice? Yeah, yeah. So my second job, was in Lewisville. That practice was awesome. I really love the doctor that I worked for.

I think she had a really great team culture. And that was one of the things that I definitely took away and wanted to have in my office, was a really great culture within the staff. Patients know if there's tension or if it's, if it's a weird vibe when you come in, the staff don't like each other.

There's, all those. Negative things and negative energy. So that was really important and a really positive that I took away from her practice was really good team culture. I think my last associate job here in San Antonio, I learned the importance of what, how important leadership is and good leadership is, in that practice.

I, I. many chiefs, you know, I think there was too many bosses and, and too many different opinions. And, um, when that happens, it's hard to have a clear focus and direction. And everybody up underneath feels that, and I think. A really good one. Solid direction and focus the way we're pushing and the way we're moving.

I kind of learned how important that was, and just treating patients well. I will say I think my last two associate jobs, I didn't have the really bad horror stories that a lot of associate dentists do. I think my first one was probably my worst one. Uh, but my last two, I really don't have a ton of complaints.

I think I was really, really fortunate. . But I learned probably more good things than bad things. But I think you can always take things, situations, and, and improve upon them. So that's always my goal.

Michael: Gotcha. Okay. Gimme an example of that, leadership style, right? There's too many chiefs. Yeah. So. .

Megan: This is super specific and I dunno what I wanna call them out, but I guess I be as specific as I can be.

Mm-hmm. , um, and that, that particular practice, they had five different owners. So even for me as the associate there, I can think of a couple different times where one owner would call me, Hey, we need to do things this way. and then not an hour later a different owner would be like, Hey, no, that's not right.

We need to do it this way. So I never felt like I had clear direction of, okay, how do you wanna be doing things? Do we want to set up the schedule in this way or do we wanna do it this way? And so that was for me, I just wanted to be able to call the shots and, okay, this is how we're gonna. And not be felt like I was being pulled in opposite directions or trying to please two different or five different mm-hmm.

you know, Owners and who were kind of pulling in all different directions, because they really didn't get along and have, have a unified vision for things. So that made it tough.

Michael: Yeah. Yeah. Those owners aren't getting along. Then it's gonna be like, yeah, Megan, why didn't you do it my way? Or Why didn't you, I told you at this.

You know what I mean? Yeah. So, yeah, and you're the scapegoat. It's easy to blame. That doesn't go bad. Right. So then Yeah. In, in your. . What is good leadership?

Megan: For me, good le leadership, I think. Is having good integrity. I think it's having good clarity. And I think my particular style of leadership I think is a little bit different from people.

Like for instance, I am always in my room turning over rooms, cleaning rooms, going in the back, running instruments. I am working beside my team. I don't feel like I'm hierarchical working above my team. Mm-hmm. , That's just my style. I feel like there's no time. I always answer the phones if, if, you know, if I'm there and nobody else is, is around, or if they're all busy and I, I wouldn't have time, then I'm gonna be the one that picks up the office phone.

And patients are surprised by that. Like, oh, you're answering your phone. Like, yeah, I was the one that was available, so I'm answering the phone. But that's my particular style. I think I prefer to work beside my team and along with them rather than above them. But that's, that's me. That's my style.

Michael: Yeah.

Like, With them shoulder to shoulder kind of thing. Right, right. I like that. Yeah, exactly. Rewind a little bit, and you said you felt like one of them didn't have great team culture. So in your mind, what's what's really great team culture?

Megan: Yeah, so in my office we are always. Cracking jokes and we're laughing and we're happy to be there.

And we join and genuinely enjoy each other's company. Like there's not like, oh gosh, here comes Dave. We hate him, or whatever. It's, this silly team, gossip or the, I always call it like the hens and the hens nest. They're, you know, somebody who comes in, they're feather feathers, get ruffled.

Like, I hate that stuff. It's just so silly to me. . So just that, that great team culture of everybody's gonna help out, including myself, whatever the task is that needs to be, get, get done, we're all gonna pitch in. The job is gonna get done. And we're gonna have fun while we're doing it.

Michael: So it's kind of like nobody's above anybody.

We just, yeah. All gotta work together. Has that ever occurred so far to you where there's like a team member in your team where they're like, you just didn't feel it, instinct or that intuition where you're just like, it doesn't, it's not gonna continue to go good.

Megan: Yeah, it has, and that was probably one of my, third employee that I had.

And it just, it wasn't a good team fit. And it was kind of one of those things where I'm like, I don't enjoy being here. I don't, you know, it's just, personalities clash. And, so yeah, we ended up having to part ways, which was really tough. And I'm sure everybody who owns a practice is gonna have to do that eventually. I hated doing it, but it had to be done to protect the culture. So,

Michael: yeah. What was, uh, what was happening?

Megan: It, it was really, it was a lot of things with particularly, um, I. , their assisting skills weren't quite up to par and patients were complaining about kind of how rough that particular assistant was.

we had several complaints about him and then personality wise, I think he was just kind of driving a lot of my other employees, kind of Gracie, just, it was just personality clashes. Nothing that he was particularly doing wrong in that terms other than the assisting was quite not up to par. But yeah, that's kind of where that one was at.

Michael: Yeah. Do you w do you ever feel. I could have let go of that person sooner.

Megan: Yeah. I think we probably all feel like we probably could have let go of those people sooner, but I tend to be give people lots of chances,

Michael: yeah, yeah, definitely. I guess looking back now from that experience, what would you do differently?

Like telling yourself now, like Megan, the same thing's happening right now, nip it in the bud, or what, what would you.

Megan: Yeah, I think that's right. I mean, I think we all have that gut instinct of this is just not gonna work in the long term. And listening to that instinct and, and acting on it sooner rather than later because I think being miserable in your own practice or feeling like that you're not comfortable in your own practice or that you have to.

I don't know that you're just not liking being anymore. That's just miserable. So acting on those gut instincts and feelings sooner rather than later because it's gonna have to happen and might as well just get it over with and move on.

Michael: Mm-hmm. . Yeah. Okay. And then rewind a lot. Have you always wanted to own Sure.

Uh, dental practice or this was just something where you're like, I can't find something that I want. So, yeah,

Megan: so I think before I started dental school, that was my goal is to own a practice. . I had a lot of life events happen during dental school. I had big major surgery. I was married and divorced, and there's a lot of life that happened in dental school for me.

So by the time I was done just on top of the. Hectic schedule, how hard dental school is on top of that. I was just tired by the end of dental school. So I just wanted to get out and work and make some money and have a more work life balance for a while so I didn't hop right into ownership, which I don't think many do right outta dental school,

But I took that five or six years and worked and then kind of refocused and, and started back on on my. , did you

Michael: ever pause during dental school or no?

Megan: No, I didn't.

Michael: I didn't. That's a lot. That's a could. Could I ask Megan, like, what was the

Megan: surgery? Yeah, so I have Crohn's disease, so I had, I got really, really sick during my very first year of dental school, so I dropped to about 108 pounds.

I was just very, very thin. and I had a partial small battery section. I think it was actually the week of finals during my first semester. So the dental school was great. They were really accommodating and let me reschedule all those finals to do them like the week before I came back for the second semester.

But I think anybody who's gone through the first semester of dental school would probably agree. It's just, it was so hard and so tough that there was no way I was gonna repeat it. And I was like, we're gonna push forward. We're gonna keep going. Cause there was no chance I was gonna wanna do that again.

Michael: And in that time, is that when you were also going through like the divorce and everything or,

Megan: so I was, nope. So that was after, so I was married after that, so mm-hmm. , after my first year I got married and then I was divorced, I guess halfway through my third year. So I was married for about a year and a half.

So yeah, it was a lot of life.

Michael: So you got married and divorced in that?

Megan: During dental school, . Yeah. So I was married after my first year in, divorced during my third year. So yeah, that is a lot

Michael: of life. That is a, it

Megan: is a lot of life. .

Michael: how does that, I mean, how does that make you feel? But like, why do you think all this was happening?

Megan: Uh, gosh, I mean, Oh, why, why did I get divorced? Why

Michael: happen? Like, do you feel like, because I feel like with, with, you know, like stress flaring up and everything like that, maybe Yeah. Put a pause on dental school or put a po, you know what I mean? You're like, I need a, I need to focus on my health kind of thing.

Cuz that was a big surgery. Yeah.

Megan: yeah, I see where you're going. I think it was very life changing for me. All of that happened happening between the surgery and marriage and divorce. For me to kind of slow down a little bit and to not let all the pressure of everything get to me quite so much.

I think that's obviously a lot of stress in dental school for everybody. And then on top of all those other things, it was a lot, a lot of stress for me. . So I think for me it was a really big lesson of, hey, enjoy the small moments. Take back, take a step back. Don't let life get quite so heavy all the time.

And just kind of enjoy it as you go. I think life is, life is short and you better enjoy it while you're here. So I really took a lot of lessons away from that to not quite get so, so bogged down with everything.

Michael: Yeah. Yeah. That's good. Those are good lessons. Okay. And then now you're in your practice, right? Officially. . So yeah. Can we dive into the business part a little bit more? Yeah, let's do it. Okay. Awesome. So then your loan, did you go with a specific bank or how did that go? Yep, I went with Wells Fargo. Okay. Why'd you go with them?

Megan: So I. Looked at Wells Fargo and Bank of America, and at the time it was still pretty early Covid and Bank of America, I think was putting a pause on loans for a little while for general startups.

So really I only had really one option that I was looking into since Bank of America was pausing, uh, was Wells Fargo. But I was looking into those two specifically because they have, they do a lot of dental startup loans, and they have really good terms. For those loans. So they have a kind of a sliding scale of how you're paying that out.

So within the first year, your payments are smaller and they gradually get larger so that you're not really taking from your cash flow. Right on. So that's kind of why I was looking at those two options.

Michael: Okay. How much was the

Megan: loan for 500,000? Oh

Michael: man. And then the interest.

Megan: Interest on that, I wanna say it was in the high twos, like 2 7, 2 8, somewhere.

That's pretty

Michael: good. And then, so then in total, how much was your buildout?

Megan: I wanna say that was around the 200,000 mark. It may have been a little bit less, but I did have, I think, 90,000 in tenant improvement allowance, so that helped a lot too.

Michael: Yeah, that's really, really good. How did the build out process go? Was it smooth or was there major delays?

Megan: Yeah, I got super lucky. I think. I know in a lot of places there was a lot of delays and things were way behind, but in here in Texas, it ran exactly on time. I had zero delays. I think there was zero hiccups.

I was really fortunate.

Michael: Nice. Who was your Uh, yeah, I guess contractor construction.

Megan: I worked with MedTech, so I know they have offices and do a lot of medical buildouts. I don't know if they're just local to Texas, but I know they have multiple locations here in Texas, but that's who I went with.

Michael: Okay, and then how'd you find your location?

Megan: Yeah, so I did have real estate guys, so Practice real estate is who I worked with here in San Antonio, and they spotted, I wanna say it was maybe between six or eight locations that they kind of took me to. And we ran numbers and, and funny enough though, the location I ended up choosing my husband and I had kind of just driven around just.

Daydreaming and looking at spots. And that's one of the ones that we found. We like, oh, I really like this spot. And that's the first one that we went to and the real estate guys were taking me around. And that's where I fell in love with. And that's what stuck,

Michael: that's where you, is it in a location where, paint us a picture?

Like is it in the shopping strip or?

Megan: Sure. So there's a big shopping strip that's very close proximity, but there's like a big heb, so I don't know. That's a big grocery store that's here. I don't know where you, where are you at? . I'm in

Michael: LA but I know h e b. Okay.

Megan: Yeah. Yeah. So there's a big, yeah, there's a big h e b, uh, with a big shopping strip with a, and then I, right behind there is little individual professional buildings.

So I'm on the street that's like right behind there. I can see the h e b like curbside pickup right from my office, but kind of right behind there in little professional, individual, professional buildings.

Cool.

Michael: Do you ever get a lot of h e B employees going?

Megan: Yeah, we've had some, a lot of people that are like, I was picking up my groceries and saw you guys over there.

But we've had some h e b employees, not a ton yet. But some.

Michael: Okay. Nice, nice, nice. I like that. Yeah. So then type of practice that you have right now, is it like all p p o or are you planning to go feed for a service or general specializing in something or how does it look? .

Megan: Yeah, so it's a general bread and butter dentistry.

I do a little bit of Invisalign, a little bit of aesthetic cosmetic kinda type stuff, but, uh, overall it's, it's just bread and butter dentistry family, you see everybody. We are PPO o I'm only in network with about four plans. But we take all p p o plans and I, I pretty much run the PPOs as if we were in network.

Now I'm sure that's getting in a whole bunny trail about insurance, but. , we do it a little bit differently. So like for our hygiene visits, I pretty much write off the difference, even if we're out of network. Except if their plan pays like $20 for cleaning and then I charge a small bid, but I write off a ton.

So kinda trying to find that balance between being in network with insurances and not, and being fair to patients. So, we're kind of finding that that happy middle ground there.

Michael: Do you let the patients know that, like, oh, we're just writing this offer. How do you let them. That we're

Megan: writing off. Yeah.

my mom texts them . Yeah. Okay, cool. We got your eob. Where, you know, that says you have this much Dr. Morrison's writing off, you don't have a balance. So

Michael: they know Nice. And they're pretty happy with that. And they're like, yeah, okay, cool. Yeah, yeah, exactly. Okay, I like that. And then we know your mom's one.

So how many employees do you have in your. .

Megan: Yeah, so we're still really small. So my mom is my front desk office manager, insurance person. She does all the front desk stuff. I have a hygienist, a full-time hygienist, and I have one assistant and me.

Michael: How is it like working with your

Megan: mom? It's awesome, but I also really get along with my mom.

I think you can't do it unless you really get along with that person. But we've, we've always been really close, like. . Yeah, we've always been super close. So, there was a small part of me that was worried about working with my mom and not knowing how that would be. I think you don't know how it's gonna be until you start doing it, but for us it's been amazing.

And I know there's somebody up front that's doing all of the, bookkeeping that I trust. And it's, it's been really great and I feel really fortunate that we get to spend these adult years together. I think that's really cool.

Michael: Yeah. Do you ever, has it ever happened, Megan, where it's one time where you're.

Now, mom, this is how I want it. Yeah, this is, and then she's like, no, Megan, trust me. I know how it's gonna work. And you're like, Ooh, you don't get it. Has that ever happened?

Megan: The first part, not the second part. So she is, , one of the humblest people you ever meet. Mm-hmm. . So I, there are plenty of times where I tell her, Hey, that's not right.

Or, Hey, let's do it this way. And her response is always, okay, great. Let's try it that way. She's, I, I can't say enough good things about her. She's amazing person, but she's so humble and she doesn't push back. And in that realm, she knows I'm, my say goes . Yeah. And, and of course she'll have opinions about things and I listen to those opinions.

But at the end of the day, she lets me do it the way I wanna do. .

Michael: Yeah. This level of respect her, that's nice. You know what I mean? Yeah,

Megan: for sure. There definitely is both, both ways. .

Michael: Yeah. Has there ever been a situation where you're like, no, mom, I wanna like this, and then, oops, the way you wanted it was wrong?

Megan: I think, yeah, she's definitely pushed back on certain things and I would actually say marketing was probably one of those themes. We worked with a marketing company at the beginning that. I don't know how to say this nicely. they definitely brought patients in. Mm-hmm. And that's really what we needed as a startup.

And so that was really awesome that we gave her, getting patients through the door. The way they were doing that was definitely not what I would call ideal or the way that I would want to do it. And she hated their marketing. She hated what they were doing and she let me know about it. And I think probably in long term she was right about that.

Michael: What was, uh, let me ask you this. What were they doing? No.

Megan: I feel like I'm gonna say this and you're gonna know exactly what I'm talking about, but I'll say it. So Facebook ads is their main, main way that they bring in patients.

That's their, their niche. Which I, I knew that from the beginning and they told me from the beginning, you know, we know it works. We are gonna write the ads the way we wanna write the ads, and we kind of just have to be okay with that. So, I had heard how successful they were about getting a patients in, and I know that's a really big stressor for a brand new startup.

How the heck are we gonna get patients through the door? We have bills to pay from day one and we gotta get those bills paid. So I, I kind of took the, took the leap there and, and signed up with them, knowing that it may not have been exactly how I wanted to do the ads or how I wanted to do the marketing.

So that being said their specific thing or their little niche is Facebook ads. So that's pretty much all that they do for marketing, advertising. But the way they word ads is somewhat. , Dr. Morrison is looking for 50 patients in the San Antonio area to help with their crown needs or for their denture needs.

And what it's really advertising is for patients that don't have, like insurance. It's advertising our membership plan, which does give them discounts. But it's worded in such a way that patients think we're giving away free dentistry. So that's what's peaking people's interest. it definitely felt a little bait and switchy. It felt that way to me, and I think it felt that way to send patients who were calling in, being like, Hey, did I win, did I win the free dentistry? And that's not what it was advertising, and it didn't say that anywhere, but I could, I could understand why patients thought that way.

So it was definitely attracting a certain group, but yeah. Which to me, I, I, I definitely moved away from as quickly as I could too, because a, I didn't. , it didn't feel true to who I wanted to be, who I wanted my practice to be. And I also felt like it was bringing up patients who genuinely had a really, really big need for dentistry.

And I'm just, as a startup, not in a position to provide free dentistry, unfortunately. I wish I could do that all day, and I, I have the heart to do that. I wish I could, but again, there's overhead to overhead to cover.

Michael: Yeah. Okay. And then your mom was the one who's like, Hey, let's, let's drop. But you were the one who was like, well, let's give it an extra week.

Or, or how, how did

Megan: that go? Yeah. I mean, so when you look at the number, I mean, we were really, really diligent about tracking who was coming in from what source. So if you pull up the numbers, they're bringing in people and they're, honestly, we're covering our bills. So it was kind of one of those things, it was kind of hard to pivot away from until we got a little bit more stable and got things up under our feet.

Hard to pivot away from that. But I, I did

Michael: when we could. Gotcha. If people reached out to you, probably would you let them know who it was or, yeah. Okay. So guys, if you guys wanna reach out to me,

Megan: then, and, and I'll say too though, to their defense, I think they're, I really actually did enjoy working with them, and I think they're really good people and they are good at bringing people in the door right away.

But I do think that you should know what you're getting into when you were getting into that. Mm-hmm. .

Michael: Mm-hmm. . So then how long did it take for you to get. .

Megan: Yeah. So, I mean, with their help, we were covering bills even two or three months into it. So we were covering bills pretty quickly. Now as we grew, overhead grew, so even now I'm still at the point of barely profitable.

Even a year and a half into it. . And I will say too, I think part of that falls on me in the sense of, I think could I spend more time getting out and doing ground level marketing? I probably could. But again, kind going, going back to that finding balance in life and not getting so stressed out and focused.

And that's, that's where I'm at in life. And I'm not gonna spend 24 hours a. on, on my business. I'm just not going to, so I'm, I'm okay with a little bit of a slower growth, which is kind of where we're at now, and it's a slow, steady, healthy growth. But am I, am I taking home the amount that I was making as an associate?

No, not even close. But I'm, I'm okay with that because I have a good balance in life and I get to spend time with my husband and our three dogs at the end of the day, and we get to be nerds in video game together. And, that's where

Michael: we. Oh. So if you don't mind me asking, what's the breakeven point, number wise, like you, in order to get here?

We're, we're good?

Megan: Yeah. Right now we're at about 40,000 a month. Okay.

Michael: And so that's where you're at right now? Like this is our break. You're a little bit above that. You, you said?

Megan: Our breakeven point is about 40,000 a month, so we're collecting maybe 41, 40 2000, like barely above it.

Michael: Okay, gotcha. Yeah. And.

That's, but you're doing the slow growth. Well, I think you're just growing great. I don't even think it's like slow growth, but you're growing great due to balance, right. At the same time. Yeah. Because what you've learned in the past. Yeah. How do you turn it off then Megan? cuz you're a business owner, right?

So it's not like, yeah. Going home and turning it off and then that's it. It's Friday, turning it off. That's it. Do you, yeah. Ever turn it off? . .

Megan: I, I think I'm fairly good at it. I think my phone is always by me, and if my patients text me or message me, I am responding to them. So that part I don't turn off.

I think, I think that's part of the, the beauty of my practice is that if, you know, if a patient is having an issue, I'm gonna respond to them. I'm not making them wait until the following workday or whatever. I'm, I'm gonna respond to them. Now if it's a scheduling issue, yeah, whatever, I'll, I'll respond to them on Monday.

But if they're having a, a. Tooth issue or something going on, I'm responding. So that part I don't turn off. But the rest of it, I think I'm fairly decent about turning off. I think it's always somewhere lurking in the back of your head there. I don't think it's always, I don't think it's probably ever possible for most people to completely turn it off.

. But yeah, like I said, me and my husband, we are, we're big old nerds. We'll come home and play our video games and kind of tune everything else out and, yeah. So I think it's important to enjoy your life and, or it is for me, so Yeah, that's, I do the best that I can.

Michael: Are you both playing games like in the same room, or does somebody go like in another room and you're like,

Megan: Hey, no, we have, yeah, I could, I could show you my setup right now, actually, we're at it, but we just built out my office.

I have my computer and he has his computer right next to me and we game.

Michael: Like you, have you built out a gaming office? Yeah, we did , , Mayhan. So you guys are like real what games?

Megan: we just started a new one. We, we played PC games, so we started ano, I dunno how to describe that one. It's a sort of a city building planning kind of sims esque, but you're not managing the people, you're managing the town.

It's like the 18 hundreds you're building this, the, the houses and the, I dunno, it's fun. But yeah, we play different computer. Okay. Oh,

Michael: I thought you had played the same one. Okay. No, nice. That's nice.

Megan: Okay, so yeah, yeah, no, we play the same one together, but I just mean different ones at different times. But this week, yes, we played together.

So we'll play like online co-op.

Michael: Ah, okay. Gotcha, gotcha. Okay. So then, right now, Ryan, a little bit back. You found your employees right? You have, how'd you find those employees? .

Megan: Yeah, so I think my two that I always go to is gonna be Dental Post, which I know is not everywhere. But in Texas it's pretty successful.

So Dental Post. And then Indeed, indeed is the other one that I've used. But I do think that I probably had more luck with dental posts than indeed, but I have found people through

Michael: both. And right now, the team you have, I mean obviously your mom, right? But like besides her, the team you have, would you say.

they're building blocks. Like they're, they're fantastic. I'm gonna build, they're my foundation. I'm gonna build on top of them kind of thing. Yeah,

Megan: absolutely. Yeah. I think I have a rockstar team right now. My assistant has been with me since opening, and he has been in dentistry for like 15 or 16 years now.

So he has been doing this for a really long time. He is really good at what he does. Yeah, he's, he's awesome. And then my hygienist is fabulous. Uh, she's an awesome team player. She's super fast, but really good at what she does. She's really good at communicating with patients. she'll jump in and, you know, if my other assistant's busy and she's gotten up and a new she'll hop in and assist me, like, we're all just really good team players, which is super important to me.

Michael: Nice. And how many days are you

Megan: open? So I just changed my schedule up this year, which I'm also super excited about to an alternated four week schedule. Hmm. So we'll work like Monday through Thursday one week, and then Tuesday through Friday the next week. So every other weekend we have a four day weekend, which is this weekend.

So, yeah.

Michael: So then well, what do you do on a four day weekend?

Megan: A whole lot of, nothing , it's the best. Or gaming. Gaming. I mean, that's nothing. So .

this weekend I actually do have a trip to Austin, planned for a wedding shower.

But yeah, usually nothing.

Michael: No, that's nice. Uh, whenever you come back from these like four day weekends, do you ever feel like you're, man, oh snap, I'm missing out. Or not missing out, but like, oops, uh, there's, I forgot to do that and this, and this slip my mind and all these things, right? Or do you come back and you're like, Refresh your mic, like almost like a creativeness kind of come back.

Megan: Yeah, so far the latter. Now we only started this in January, so it's still pretty new. But so far the latter. I feel like it has been really good, I think, for all of our mental health to have that little step away to kind of recharge batteries and not feel like we're just at the office constantly. So, so far it's been really positive.

Maybe you can check back with me again later this year and see if I still feel that way. . But so far I'm really enjoying

Michael: it's. Check back. You're like, we're on a five day,

Megan: we're off for five days, sleep better one day a

Michael: week, . One day a week. Oh my gosh. It's productive. So then right now, what system would you say is unique in your practice that you're really proud of?

Whether it's like the handoffs, new patient experiences, marketing, anything like that. What

Megan: systems would you say. . Yeah, I think I, I really do like our new patient experience. So, when patients come in, whoever is seating them, whether that's my hygienist or my assistant or myself, that patient gets a tour of the office.

When they're set down, not just new patients, but every patient we have. So I have TVs at the foot of the, the chair, and they're, I have like a little Canva that says, it's all blue and it says, welcome to Market Ridge Dental, and whatever their name is, welcome to our practice. Mm-hmm.

So it has their name up there at the foot. So they feel like, Hey, we, we care that you're here because we do. . And then the other thing that I think is super cool that we do with all of our new patients is that we scan them. So we do a digital scan of all of our patients. I have an IRO scanner, so, before I lean my patient back, I'm going through, you know, I'm pulling up the top teeth and I'm, I'm going through tooth by tooth and showing them their teeth and then go through the bottom teeth and I show them all their teeth and we look at the bite, so that they can see their teeth before I even lean them back.

cuz that's a super vulnerable position too. So I think that kind of, I'm, I'm sitting there chatting with them while I'm looking at their teeth. Hey, where are you from? What do you like to do? That kind of thing. Uh, just while I'm looking at the digital skin of their teeth. So I think it's kinda a, a good icebreaker and kind of a build trust moment before, before I even lean them back.

Michael: Hmm. How long are your new patient appointments?

Megan: Typically about an hour and a half. Okay.

Michael: And so, yeah, more. , that's when they're you're doing everything. The new patient experience. Yeah. Right. Yeah. And then normally, how many new patients are you getting a month?

Megan: So before I cut off my, my marketing company, we were doing about 40 to 50.

I'd have to look at my numbers to see, since we cut off the marketing what, what they were. But I do think they were a little bit lower, maybe 30, 35 right now. But before we cut off the, the marketing team, we were getting about 50.

Michael: Okay. So right now though, like 30. 30 to

Megan: I think 30, 35 or so. Yeah. Okay.

Michael: With the marketing company that you were getting, were there a lot of like, uh, what?

Yeah. Like, you know what I mean? They got the free thing or they got, they came there for something specific, they're like, bye. And you never saw them again. Yeah, for sure. Oh,

Megan: okay. Yeah, it was a lot of those, and I think. Yeah, exactly. So they were looking for the deal and they come, they get whatever deal they think and they're out the door, or they got in the door and realized it, it was not free and never saw ' 'em again.

That happened a lot too. So, yeah, I think now kind of turning away from that, we're getting fewer patients, but patients that are gonna stick with us for the long haul, which is more what I would like to do. You know, I'd like to build relationships with these people and get to know them. And, so that's, that's more what I'm looking forward.

Michael: So then right now, what are you currently doing for marketing and advertising?

Megan: So right now I'm kinda an in between. So, my cousin actually does SEO for a living, so I'm kind of letting him take over that side of things. I'll probably be doing Google ads with him pretty soon too. I have not figured out the second part of that.

So, I am actually meeting with a marketing company tomorrow, a local marketing company where I'm gonna kinda see. What, what plan they have laid out, what the, what the cost is gonna be on that, and kinda make some decisions from there. But I'm kind of in a little bit of an in between right

Michael: now. Okay. I mean, you're, you're still getting 30 to, you know what I mean?

Like how many ops do you have? Yeah,

Megan: I have four that are, uh, equipped. I have six total, but four that are equipped right now.

Michael: Okay. So you're, I mean, you're busy, you know what I mean? It's not like you're Yeah. In a lull. The whole week except for like two one day, you know,

Megan: so it, it's, Chris schedule's almost full.

So, I mean, we still have, I still have plenty of room to work patients in and see patients as they call. Like I can still work in a new patient within the same week. But no, we're, we're, we're still pretty busy. So it, it's good. .

Michael: Okay. What would you say, Megan, is the unique thing about your practice that has your community talking about you?

Like if, if I were to say like, Hey, I just came from my dental office, right? Or my, my dentist, it's Megan. And they're like, oh, cool. What I, what do you want me to be saying to my friend about you?

Megan: Yeah. So I think, I think the biggest thing is how we treat people, right? So we're a super small office. You know, when you walk in, my mom is right there, greeting.

one of the nicest people ever. She's super sweet to everybody or when they call on the phone, right? And then how easy we are to get ahold of, you know, when they, well back up a little bit too. My, my office, my waiting area in my office is super tiny. There's like four chairs in there, so people are not waiting, when they come in mm-hmm.

they're getting right back and there we see them. We know we respect people's time. We're running on time. People are not waiting for hours at a time. And how easy we are to get ahold of, like I mentioned before, you know, if my patient is gonna call me or text me with something going on on a Saturday, I'm getting back with them.

Which is is not very common anymore, I think. But yeah, I think, but the biggest thing to me is how we treat people. I mean, we're, we're kind to them. We're not judging them. We're giving them options, letting them decide. It's a no pressure environment. We're just kind to people.

Michael: Yeah. I like that. Being kind.

I like that too about that, the waiting room. I mean the, the room where it's like, I guess like the lounge area or whatever you wanna call it, cuz you're not really waiting. Yeah. I remember so many times, like we were always talking. What kind of coffee should we provide them and everything. And I'm like, the last thing I wanna do before getting my teeth checked is have coffee, breath

I don't, I'm not gonna get that. Right. Like that's when I floss the most and brush my teeth and most before I see my dentist. Yeah. So I wanna make sure that's perfect. So you wanna get in there quick kind of thing. Not like sit there and then drink your coffee and tea then, right. Donut or whatever. So I like that.

Where real quick. Yeah. Okay. Throughout this process, I guess from the moment you were in dental, . So today, what's been some of your biggest struggles or pitfalls?

My

Megan: biggest struggles. I think I probably didn't realize how much of a therapist you have to be on a daily basis to your patients. Cuz there's a lot of people who are really afraid of, of going to the dentist.

And helping them overcome those fears and making them feel comfortable and, helping them get through those procedures. I think I did not have a good grasp of, of that. So kind of learning how to be that person and helping people overcome those things. was, I mean, I think, I guess we all learned how to do it.

Hopefully we'll all learn how to do it. But figuring that out, I think within running a practice, I think just learning how to juggle everything because it is a lot, just a lot of balls in the air at one time. And just learning, like I said before, learning to find that balance.

Michael: that's true.

Yeah. How do you, how do you help your patients overcome peers? .

Megan: Yeah. So the biggest thing for me is talking to patients about options and, and offering those options and letting them know what those options are. So, on my intake form it, it asks how afraid of you or the dentist, one to five, and I take a look at that and. We have that conversation accordingly. You know, Patients are like, one, I, I could be here all day, whatever. I like being here. I don't necessarily go over all those options. But patients who mark their three or four or five, here are the options we have laughing gas, you know, and I talk to 'em about what that option looks like.

We can do pul sedation and what that option looks like. I even have a doctor that I can bring in who does IV sedation. So I think just providing those options and, and what those options look like and letting patients. , they do have those out there. But from that, I think too, It's just our office like demeanor, right?

So I, I'm trying to make patients feel comfortable by chatting with them. I do have TVs on, on above the chairs on the ceiling so that patients can watch Netflix as they're getting their, their work done. You know, We have the noise canceling headphones that kind of block out some of the noise cuz that bothers some people.

Yeah. So we're kind of trying to make them as comfortable as we can while they're in the office and then letting them know about the options above and beyond all those. . Okay. I like

Michael: that. And then throughout this process of your startup, besides the marketing company, what's been some of the best companies you've worked with and some of the worst companies you've worked with?

Megan: Yeah, so I did work with ideal practices to help guide me along the way of my startup. And they were fantastic. I had a really good experience working with. . you know, I always tell people that are looking for, for companies, know what you're getting and know what you're not getting. They will definitely give you a really good blueprint of what to follow, kind of help you stay on track, make sure you're not forgetting anything.

They'll help you make introductions. Uh, to companies and good vendors, but they're not doing it for you. So , you need to know that, at the end of the day, it's you that is taking all the meetings. It's you that is making all the decisions. It is mm-hmm. you that is making, making all those things happen.

So as long as you know that, I think it's, it's, for me, it was great. I was working at eight to five Monday through Friday while I was doing my startup. So there was no feasible way that I probably could have done that without somebody that was helping me at least direct. Hey, this is what you need to get done.

Giving me the kind of, the, the blueprint to follow. No way I could have done both of those without them. So they were great. I I had a really good experience working with them. Did you ask me about bad vendors? Is that the second part of that question? ,

Michael: you, you, you're like, did you ask me about bad vendors?

Is it the same ? Yeah. Like, what, what's been some of the worst companies? But by the way, real, real quick. So, ideal practice. They do they just make introductions for you and that's it, or No? They, I'm cuz I, I understand like, you also have to pay, what is it, 50, 60,000? 50,000, something like that? Yeah, something like that, right?

Yeah.

Megan: Most of it comes out of your practice loan though. So you pay a portion of that upfront to get going with them, and then the rest of it comes out of your loan.

Michael: Okay. So, and then all that is they give you the blueprint. You're working with what, uh, coach or. .

Megan: they have a bunch of different ones, so, Every step of the way, there's a person that's helping you.

So like when you're doing the bank loan, there's a person that's helping you write your business plan to secure the bank loan. They're helping you make introductions to the, to the banks, and kind of helping you secure financing. There is somebody that is helping you find your location. So, oh, somebody that makes your introductions to like practice financing, who I worked with.

So they made that introduction and then they take that over from there. They do have a person that helps design your floor. and then they have somebody that helps you with equipment and somebody helps you with, the business side. So that's the person that you work with the most. So they call it like the startup mba.

Mm-hmm. . So they have, basically teach you anything and everything about running the business, and help you with like your operating procedure, like your manuals. and like your financial policies, they help get you, help you get everything in place to run your practice once it's going. so I would say that probably for me was the biggest value simply because I did not have any business courses prior to opening business.

They don't teach you that dental school, so, that was super valuable for me.

Michael: Okay. All right. So then what have been some of the worst companies you worked with? Or maybe not worse, but you're just like, didn't fit for me kind of thing. .

Megan: Yeah, I think the marketing company was a good fit in the in the beginning to get patients in the door.

I think long term it was not, not a good fit long term, just cause that was not the type of marketing that felt authentic to what it was that I wanted to be doing and how I wanted to be attracting patients. But so far I, I had really good experiences. Probably all the other vendors. I think working with Wells Fargo after the fact was kind of irritating and I actually ended up separating ways from them other than just paying my loans back from them.

But I don't really do my banking through them anymore.

Michael: Uhhuh, anything like your personal.

Megan: I wasn't doing my personal banking with them. Oh. Anyway. But I took all of my, I closed all of my checking and I had a credit card through them. I closed that. I closed everything except for the one account that pays the loan.

And I just transfer money into that right before it's pulled. And that's all I do with that. Well, I, I think I leave $500 in there cause that's the minimum. But I have to, for them to not charge me something.

they were, I feel like they were nickling and dimming me, like, and maybe it was my fault. I didn't know how to do their credit card. I don't know. Their credit card I felt like was charging me fees, even though I felt like I was paying it off every month. I feel like they were still charging me fees through that.

So I was just finding Yeah. In that, even though I would try to call and resolve it, they were just like, yeah, that is what it is. So,

Michael: Yeah. Yeah, that's the worst. Were they like major fees or were they.

Megan: I think it has like 50, $60 fees here and there, which,

Michael: oh, those are major. Yeah. That's that. No, to me that's like a lot.

I'd be like, what the heck? That could, I could go eat like a bunch. Right. You know what I mean? That's pretty big. Yeah. Yeah. It

Megan: wasn't like 50 cents, . you know, . Yeah,

Michael: no, yeah. I would've totally canceled. Even if it was like 10 bucks, I'd be like, uh, gimme a back. So yeah. I get you. Totally understand. Okay, so then one of the last questions. How has the startup process affected your personal.

Megan: Yeah, so I think in some ways, a lot in other ways, not at all. So through having a startup, I think that was probably the biggest thing that I was not prepared for, was how long it was gonna be until I took home a paycheck comparable to what I was making as an associate.

I think I had no clue how long that was gonna be, and I guess that that's different for everybody and that's super hard to. . But we had a lot of changes lifestyle-wise after we realized, oh, this is gonna be a while. Like we went from two cars down to one car so that we would only have that one car payment.

My husband actually found a whole other job that paid better so that we could pay our bills. Which he started traveling a lot with that job, which he's not right now, but he was traveling a lot. Like he was gone all throughout the week and then only home on the weekends. So that was your big personal lifestyle choice or changes.

But otherwise, I, I don't know that it's changed too much. Like I said, I strive really hard to find that balance. Like if I'm at work, I'm working, but if I'm at home, I'm at home. So, in, in some ways, a lot. In other ways, not a lot.

Michael: Okay. That's good to know. And then, yeah. Any final pieces of advice you want to give to people who are thinking about doing a startup or in the startup process, but not in your shoes yet?

Yeah. .

Megan: I feel like where I'm at in, in this whole process is, I don't wanna say the most positive cause I do feel positive about it. I guess it's more of a harsh, realistic kind of point of this whole process. I guess just know what you're getting yourself into, right? I think be prepared. be prepared to not take home a paycheck for a while, and kind of button down your personal finances so that you can live within whatever your spouse's means are, or whatever that looks like, so that you're not stressing about money, cuz that's, that's not a good place to be.

But I mean, I think there's never gonna be a right time to do it. I think if that's your, your dream and your goal. Make it happen, start doing it. I think there's, if you're in the right place financially, I think that is the big caveat. Make sure you're in the right place financially, and then make it happen.

Just do it. I think there's, there's never, you're never gonna feel ready. I think doing something for the first time, you're, nobody knows how to do anything for the first time, but you'll figure it out along the way, just like all the rest of us have.

Megan Morrison DRAFT: Awesome.

Michael: Megan, thank you so much for being with us. It was a pleasure.

But before we say goodbye, thank you. Can you tell our listeners where they can.

Megan: Yeah, you can find me on Instagram at Market Ridge Dental. You can find me on Facebook at Market Ridge Dental or market ridge dental.com.

Michael: That's all gonna be in the show notes below.

So guys, go check it out. And Megan, thank you so much for being with us. It was a pleasure. Yeah, thank

Megan: you so much. It was great talking to you.

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In this episode, Crystal May, from Devdent, details some of the essential tips and tricks around medical billing and how it can help your patients afford the care you recommend! At Devdent (Developing Dentistry,) their mission is to take the headaches out of medical billing, claims, and any appeals along the way. Crystal shows that with proper billing procedures using medical, a $10,000 treatment could be much more obtainable and affordable for your patients. She notes that it is less about "what" you are doing, but "why" you are doing it, to qualify for medical billing. If a patient's tooth is missing, and that is the reason why they are unable to chew, the procedure might qualify for medical billing!

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Follow Crystal and Michael's conversation here to learn more about how your practice could utilize medical billing!

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You can reach out to Crystal May here:

Email: [email protected]

Facebook

Devdent Website

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Other Mentions and Links:

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Imagn Medical Billing Software

Red, white, and blue card (Medicare)

Blue Cross Blue Shield

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If you want your questions answered on Monday Morning Marketing, ask me on these platforms:

My Newsletter: https://thedentalmarketer.lpages.co/newsletter/

The Dental Marketer Society Facebook Group: https://www.facebook.com/groups/2031814726927041

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Thank you for supporting the podcast by checking out our sponsors!

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Michael: Hey Crystal, so talk to us about medical and dental billing. How can we utilize this, or what advice or suggestions can you give us that will help us with doing medical and dental billing?

Crystal: Absolutely. So medical billing is quite a bit different than dental billing. a lot of people are scared of it.

They're intimidated. Maybe they've heard horror stories even that it takes forever to get paid or it's not worth the energy. And really my mission is just to explain to dentists how it is not as complicated as it sounds, and it's certainly worth the effort. So we get thousands and thousands of dollars of reimbursement from medical insurance for dental services. Many dentists don't even know that it's a possibility to bill medical for dental. Treatment, So when you think of an implant or a bone graft, you might be thinking, well, dental insurance might cover a little bit of that, or there might be that $1,500 per year max benefit available. But what if we could tap into their medical benefits?

So when you start talking about, especially larger procedures, if your patient portion is more than $5,000, we know that dental insurance doesn't make a very big impact in that patient portion, They're still gonna be spending at least $3,500 out of pocket after they use all their dental. So the combination of adding medical billing to your dental practice allows your patients to be able to afford the care that you recommend.

Taking a large treatment, 5, 10, 20, $50,000, and we can get medical insurance to pay sometimes a hundred percent of those procedures. So it's really about. Identifying the medical necessity. So you see a patient and you're trying to figure out which insurance should I build? Should I build their medical, should I build their dental?

What? What are my options? And so what we do is we teach Dennis how to find the medical correlation. So when I teach about medical billing, I use the statement a lot. It's not about the what you're doing, it's about the why you're doing it. So if you can prove that there's a medical correlation to your dental, So let's say again, an implant, for example, if you can't chew because of that missing tooth, then that's a medical condition and we can actually build medical for that.

Or what if you've lost that tooth for a medical reason? So maybe you took a medication that caused dry mouth. So now all of a sudden you had acid erosion and just all this enamel was gone because of this severe dry mouth. Well, we can prove the medical insurance that you are losing that tooth because of a medical condition.

So it's just about the why can we tie back something that's going on inside of the mouth to the rest of the body or something in the rest of the body that's affecting the oral cav.

Michael: So then once we identify the dental necessities and we decide, okay, we're gonna bill medical, right? Which sounds beautiful.

Like, we're like, we wanna bill medical. Where do we go from there?

Crystal: Wonderful question. So it all starts with the insurance card. So it doesn't matter how perfect the medical necessity is, you've got this patient that desperately needs this treatment and you can prove that it's directly related to an a medical condition.

If the insurance policy doesn't offer dental treatment for any reason. There's nothing we can do. So sometimes our best doesn't trump the payer. Okay? So the medical insurance determines coverage. Also, remember your patient chose that plan. A lot of times we get really like emotional about how we wanna help our patient more.

And darn it, this silly medical insurance won't do much, but remember, Your patient chose that plan, so they're paying a lower premium to have a higher deductible or less coverage. So, you know, we can't own that. We just have to say to them, unfortunately, the plan that you've chosen doesn't have medical benefits available.

Also, let's say Medicare, so everyone knows who, what Medicare is, right? It's, it's generally thought of as a, as a 65 or older plan. . Medicare's changed a lot over the last decade, and we are getting some coverage for dental treatment through medical, red, white, and blue insurance cards.

They're actually paying dental offices, but you have to sign the right paperwork. You have to be participating. So you look at the card. If it's a red, white, and blue card and you're not participating, you simply hand the card back to the patient and say, unfortunately. This plan won't pay anything here at our office, but let's say it's a good plan.

You get a card and you're like, Ooh, I know that one. I think they might cover benefits at this office. You then start with the verification of benefit. So we reach out to the insurance company and we ask them for details. What's the deductible? Are there any plan limitations? Does this plan cover dental treatment for these scenarios?

Maybe you're treating sleep in your practice. Well, medical billing for sleep appliances, by far the most common procedure that we bill. So you ask specifically, do they cover sleep appliances? What that end of that call? we give back to our clients a summary of coverage and we'll actually say, yay, ur nay, this plan makes sense, or this plan doesn't.

Assuming it makes sense to Bill Medical. Because we've called the payer, we verified there are benefits available for these services. Now the next thing is to talk to the patient. You give them their treatment plan with all their treatment options and with all their payment options. That's gonna include potentially dental, right? Because we're still gonna build dental for class two fillings. We're still gonna build dental sometimes for the crown or restoration. Some plans only cover the implant under medical. So we're still working very closely to maximize all of the. Insurance benefits, medical and dental. And then assuming the patient wants to proceed, most of these procedures I'm talking about do require pre-auth.

So we would actually then start the process of getting authorization to, to treat this patient. Um, and if that's approved, which we're averaging about 75 to 80% approvals on pre-auth. So it's a good high. As long as it's approved, then you complete treatment and you submit the claim the same day you finish the treatment.

So it's really not that much different than what we do in dental, with the exception of, most dental team members are not familiar with these insurance cards, so they have to learn how to look at them and read them.

Michael: Gotcha. Okay, because I was gonna ask you, why aren't people doing it more then? Well, it's

Crystal: not easy. Okay. So I don't wanna make it sound like, oh my gosh. Like all you do is take a copy of the insurance card and you've got a gold ticket, right? That's not it. . You have to code it correctly. You have to have the right documentation, you have to have the right submission tools. So most of our dental practice management softwares do not include enough information on medical to even use them. when customers come to me all the time, they're using any number of the large practice management companies and they're saying, well, they say they have medical. But if you read the fine print, it's very limited. They might allow you to print out a claim, but these claims to medical have to go electronically. So one of the things that causes a little bit of an obstacle is do you have a submission tool? Do you have a way to get these claims to these medical payers? Not dental, but these medical payers electronically? So I think that's one of the obstacle. But I'd say more often than not, the biggest thing is, is dentists and dental team members don't even know that they can bill medical.

It's not even so much they've tried it and struggled. It's just their, their minds are blown when I show the potential.

Michael: So then what submission tool should we have or would you recommend, or how did that work?

Crystal: Well, so there's a couple of different options. Some the, the manual way and the less expensive way is to go to some of the, uh, payer portals.

So you could go to Blue Cross Blue Shield, for example, and you can manually submit a claim directly to them. So that does get you your electronic submission. But it doesn't provide you tracking or any automation. It's very manual. Um, the option that we provide is actually a software solution. So Dev Den offers a system called Imagine Billing, and we are a cloud-based medical billing software built specifically for dentistry.

So all of our clients are dental, and everything in the software is directly related to something under the dental category. So with our solution, We have the clearinghouse connections and all the electronic communications to kind of take the technology piece out of the equation for the customer.

Michael: Okay.

So if I was front office right now and I'm, and let's just say there's a implant, right? That needs to be done and you're like, okay, we're gonna check that out, and stuff like that. And then you realize, okay, there is a necessity. It does, you know, the whole body is affected and things like that. I'm new, but I know dental billing, right?

But if I have dev. I can just use that and then it like kind of scans it out.

Crystal: Pretty much, so we built a cross code tool so you can go put a patient's entire dental treatment plan. So there's c d T codes into our software. It cross codes as it to medical forward for you. And then it also adds the diagnosis conditions that are required.

So it, it really takes the coding component entirely out of it, which is a lot of fear. The dentists aren't necessarily scared about the coding because generally speaking, that falls on an office administrator of some kind, right? Mm-hmm. . So when I talk to them, they're always like, oh my gosh, how will I know what codes to use and how do I do this Crystal?

I don't even know these acronyms. And so what we've done is just take away a lot of that. We've just allowed them to stick in their dental codes. So you use your C D T code, we cross it for you. We show you what documentation is required. And then part of our training program as a new customer is we teach them how to read those insurance cards.

We teach them exactly what to look for. We go over case presentation and how to present estimations to their patient because you know, you now have to explain to the patient their medical benefits and if it's scary and new to you. now you don't feel like the smartest person in the room anymore, and we don't like that feeling.

So we wanna make sure that our, our office admins are always the smartest person in the room when it comes to their medical insurance benefits. and then we offer, um, a lot of coaching on your clinical documentation. So, many dentists haven't looked at their clinical notes in a very long time, so they use auto notes.

There's just sentences that are just click, click, click and prefilled out. Unfortunately, medical, I. Spends a lot more time and attention when looking at clinical notes than dental, so we have to do a little better job. So we teach our clients exactly what documentation they need and how to incorporate it into their everyday dental process.

Michael: So then typically crystal, when someone signs on how much do they see an increase in like their collections or product?

Crystal: so across the board, we have 80% success rate on all of our claims submission. That's including the worst claims out there. The best claims out there. 80% is our average approval rate.

But what we're finding is patients are accepting treatment. At a faster rate because they can now afford the treatment. Imagine you had a $10,000 treatment plan and you got presented $1,500 from dental, and you were gonna owe the $8,500 difference. Now imagine I present that same $10,000 treatment plan, but I explained to you that you have to meet your $3,000 deductible and then you have a hundred percent coverage.

So now that treatment plan costs the patient $3,000 instead of 85. We all know that there are far more patients who would be willing to pay 3000 than nearly 9,000. So that's the story we tell. That's the, the, the purpose of medical billing is to help patients access the care that they need. So historically, we're seeing about a 20% case acceptance increase with cases over 5,000.

So if you're a $5,000 case and we can decrease patient portion, at least 20% more of those patients are proceeding with treat. .

Michael: And then what headaches can we encounter with.

Crystal: You're dealing with insurance, ? it's just the insurance companies. It's nothing else. The, the conversations with patients is quite easy.

They're just excited. They're just really feel great that their dentist is willing to go above and beyond to help them get more, more access to PA care. Right. They're, that's what they care about. Even when deductibles are in play, even if the patient gets no actual payment from the insurance company.

There's gratitude for helping them access their deductible in these medical benefits. But so that's not the obstacle. Never the patient, uh, it's never the coding. We can teach the coding. It's, it's just one plus one equals two, right? Mm-hmm. , it's not challenging. but it's the insurance payers. One minute one payer says this.

And literally the next claim, we call back and we'll get a different response. So the quality of representatives that are answering the phone are, are quite low. They haven't been well trained, they're not very familiar. So you get really inaccurate information will literally be told, yes, we'll pay for this.

And so we submit the claim with an approval number and they'll deny saying We changed our mind. So then we have to appeal it. Now again, a huge benefit of working with a company like DevNet is we do all of that follow up. So when you submit a claim through our system, we're responsible for it all the way through the process.

So we are the ones on the phone with the insurance companies arguing these approved prs or these denials and things like that. So I would say the first initial obstacle is just understanding the I. Knowing which plans pay what and why. And then I think the forever frustration is that we're just dealing with insurance companies and they are not in the industry of wanting to pay claims.

Their goal is to slow down and reject claims as quickly as possible.

Michael: Yeah, retain that money too.

Crystal: Yeah, that's their job, right? So we're kinda going against, against a big force in that sense. The good thing is, is there's a lot of rules and regulations. Insurance companies cannot just choose not to pay. And so when we know all the proper paths to take and all the right words to say, and all of the right, you know, if you will, threats to make.

They finally process our claims. So we do have some tools in our, our toolbox to help us make those go faster. But I would say to anyone who's getting into medical billing or is considering it just, just pre-prepared for the first few months to be exceptionally frustrating, these medical payers will not recognize you.

They won't recognize your M P I and tax ID numbers. There's gonna be a slight delay. Usually if you can get past the first 90 days, if you can just stay with it. Be diligent. Follow our program. By the end of 90 days, you've pretty much got a system in place that's working. .

Michael: so Dent is a program or is it like a software that I can utilize forever?

Crystal: dent is an education and distribution company. So Dent stands for developing dentistry. We just are here to pri find solutions that help dentists improve their practices and improve patient care. So that's our mission, is to just provide tools and solutions for dentistry. One of the tools we provide is Imagine Software.

So Imagine is a cloud-based software that handles these cross codings and handles all of this documentation. And behind that is a third party billing company. So we actually facilitate the entire billing process for our clients.

Michael: Okay. Awesome. Awesome, crystal, I appreciate your time and if anyone has further questions, you can find her on the Dental Marketer Society Facebook group, or where can they reach out to you? So

Crystal: you can always find [email protected]. We've got some awesome resources, re recorded webinars, tutorials, demos, everything you could possibly want to see. We have some awesome programs going. You can check out our Facebook page and you'll see success stories and just a whole program we've got specifically to different types of dentistry.

And then if you want to reach out directly, you can reach [email protected].

Michael: Awesome. So guys, that's all gonna be in the show notes below. And Crystal, thank you for being with me on this Monday morning marketing episode. Thanks for having me.

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My Key Takeaways:

• If you're taking on an associate, be sure to set clear expectations at the very beginning!
• Having systems in place to show what happens when, and how to do it, can take a lot of stress off of an associate.
• When treatment planning with a patient, always address their chief complaint and how the treatment will solve this.
• If you let your profession guide you entirely, you may not find as much fulfillment!
• Try investing in your education, automation, and systems, so that you can perform your job without all the headache.
• There are clinical-minded dentists and business-minded dentists. You may find that owning your own practice isn't for you if you favor only clinical work!

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Michael: Avi, how's it going man?  

Avi: It's going pretty good. How are you doing? Pretty good. If you don't mind me asking, where you located? I am in Austin, Texas.  

Michael: Oh, nice. Home of Salt Lake  

Avi: and, yeah.  

Michael: Yep. I forgot the other donut plate. Round Rock donuts.

But that's in  

Avi: Round Rock, right? Yeah, Those are both great. Where where are you based out of?  

Michael: Los Angeles. Okay. So, yeah. But my family's in, we, I grew up in Texas. We all live in Texas, but more like in the Houston area. Okay. Uh, but Nice. I know, like lately, how much has it blown up lately?

Austin.  

Avi: So I'm part of the, uh, the blow up, I guess, . Cause I, my wife and I came here about two years ago. Oh. Uh, and we came from New York, so Yeah. It's like California, New York, everyone, just met in Austin. But no, it's, uh, a lot of the, like a lot of my patients who have been here for a while, they all say like, it has changed completely.

Like, we live downtown, in downtown. I call it like the millennials playground. You've just got, The ECUs restaurants, bars, like, whole Foods Trader Joe's. It's awesome. Yeah, . Nice dude.  

Michael: Nice. Awesome. So then Avi, tell us a little bit about your past, present. How did you get to where you are today?

Avi: Yeah, so I grew up in Florida. And went to dental school up at nyu and after I graduated, I didn't do a residency, I just went straight to practice. I wanted to get a sense of what real life dentistry looked like, and so I jumped in and at that point I was practicing in Connecticut as an associate. and I got like a real heavy dose of reality

Um, Basically I was in and out of Associateships every couple year or every couple months. And you know, at the time it was, it wasn't that great, but, you know, looking back, it, it kind of gave me an opportunity to see how multiple. Different office, like how multiple offices practice. And I learned very quickly that not everybody is not doing dentistry.

From a practice, from a clinical side and a business side, the same. Everybody's doing it a little bit differently. Some people are better at certain things than others in terms of practice owners and how they're running it. I just had kind of like my learning cap on, so every opportunity I was just trying to absorb as much information as I could.

Always trying to learn whether it's from the owner themselves, from other associates, right from. Office managers to kind of see how like, the front works and stuff like that. And, it was good, but it was nothing like I had imagined. I thought that I was gonna come outta school.

you know, I thought I was gonna find a mentor, they take me under their wing, they teach me, show me all the ropes. And then, after a year or two, I would be this like all-star dentist. But I, it was a lot more of like balls in my. and I had to make the most of every situation that I was in.

Mm-hmm. . And so that's what I did. And so I was doing that. And then you fast forward a couple years was in two private offices and then the pandemic hit. And so at that point I was already starting to burn out on dentistry because of the procedures that I was doing were your basic kind of crown filling, just very bread and butter dentistry and.

I mean, I was two years outta school and during the pandemic I was just kind of like, this is not good . Cause I had just got, just got going and I had $500,000 of student debt. And, uh, I wasn't, wasn't too thrilled about what I was doing. So then I kind of just started to look around and, and see what I could do.

And that's where I. Started to just invest in education, invested in education, invested in myself, learned how to do, uh, implants, and then I dove into Invisalign cuz I was already certified, because I went to nyu. And for me it was more just like I wanted to find something that would just kind of get me excited again, uh, to do, to do dentistry.

So, Pandemic's happening. And then uh, go back to work. and then the office owner actually I told them, Hey, I took these courses, would love to implement them. And uh, the owner actually told me that they didn't want me to implement aligners cuz they didn't think it was profitable.

we had like a proper meeting and stuff about it, but that was the gist of it and that kind of surprised me because everyone that I had talked to about had said good things about aligners and at that point I had worked at like 10 offices. in the Connecticut area. And so my wife and I decided to move and relocate.

We heard great things about dentistry in Texas. Uh, we loved Austin. So we came here and I actually joined A D S O, so they were a smaller D S O and um, they were fully supportive of me doing whatever I wanted, procedure-wise. Mm-hmm. , so. They had an iTero, they had an implant system and they were basically just like, you know, go crazy with this thing.

So that's what I did and I tove in, uh, I started placing implants. When you first place implants, it's all about like case selection and, it's definitely, I mean obviously a surgery, so you're not doing crazy stuff to start and you just kind of are building your confidence and stuff that I did and that was nice.

It's like an adrenaline rush when you're doing implants, and I loved it. and then I also started doing aligners and I started like 50 cases in my first six months. And so, that's like 250 grand in revenue given that each case is, $5,000. So that was like eye-opening for me because it's almost like a, a switch flipped in terms of Feeling more passionate about what I was doing, like I was actually making a difference. Providing a procedure to patients that is changing their lives, it's improving their oral health. you know, It's night and day from when they finish treatment to when they start. And then I also got more time and freedom, in my life because I got, align.

It's not like a very like labor intensive procedure. It's a lot more of educating the patient, selling the case, and then setting up the case on a computer. , then assistant places the attachments on and you kind of essentially just like cheer the patient on throughout treatment and make sure they're motivated and, and wear the aligners.

And then when you're done, you just polish the composite off and get 'em into retainers. And so that was awesome because now I was making more money. I had more time, and I just felt very aligned with what I was doing. So I took that feeling. And I wanted to share that. So I was working with another dentist.

He had about 20 years of experience. Practiced as an owner before, and then him and his wife moved from California and then I started just showing him how to do aligners. And he also started to feel the same thing. And he was, he started doing like 10, 10 or 12 cases a month. And he, he basically said that, uh, he wished he'd started doing it earlier because it completely changed the way that he practiced.

I also helped out some of the other doctors in the, in the organization, but then I went to leader. and I told them, Hey, I would love to just have like a, a legitimate role in the company where I could just be like this in-house, call it director of, you know, of aligners and just like coach up all the doctors cuz they had about 35 doctors in their D S O. And they liked the idea of it, but it just wasn't. Aligning with kind of what they wanted to do, and they just wanted me to focus on doing the dentistry in the practice. So at that point I was pretty bummed. And then my wife told me, she was just like, you pretty much know what you're doing in terms of coaching and teaching.

She's like, why don't you just start a consulting company and consult with that test? So, I started doing that, I created a consulting company last year at the beginning of the year, and I started working with some docs and um, one of the docs I worked with, they had zero experience doing aligners. They're a practice owner. And they understood the value of having aligners in their practice and they wanted to do it. And so I worked with him and then he basically went from zero cases to 25 cases in his first two months. And then he's been able to kind of carry out At least like 10 cases a month ever since.

Because with aligners, once you know how to do it, once you, once you start doing it, you don't stop. It's like a dentist that places implants. They don't stop placing implants. Like once they learn it, it just becomes part of what they do and they continue to do that. So that was awesome.

And then, Then the consulting thing got a little crazy because man, like working full-time and trying to schedule time with other doctors full-time as well was tough. And then I stumbled upon this concept of like creating an online course mm-hmm. To, you know, make it real scalable to, to be able to reach and help more doctors, but then also not have to spend so much like time with the scheduling and all that.

So, Fast forward, to middle of last, uh, middle of last year. Yeah. And I created a uh, online training program for dentists. So it's brand agnostic. It is for meant for general dentists looking to start implementing aligners. They can have either zero experience or just a little bit of experience and.

They can basically watch these modules. I've created about four hours of content and it helps coach them through everything, from what cases to select, how to talk about it, how to set it up pretty much like A to Z, what you need to know to get started. And then I also include monthly, coaching in the program where, , they have an opportunity once a month to meet with me.

We can discuss, cases, any questions they have, all that kind of stuff. And it's been awesome because it's really started to take off and grow and it's allowed me to cut back on my clinical days, and I've been able to now focus on this, this online business essentially, that I've created. But it's, uh, it's pretty cool. you know, I may not be seeing as many patients as I used to, but by teaching other dentists how to do this procedure, I kind of get like a little piece of being able to help, a bunch of patients all over the world. And it's, uh, it's a feeling that I didn't know existed.

Cuz if you would've told me two years ago, like, Hey, you're gonna create a training program and you're gonna love the way that it feels to help and teach, I would've been like, you're crazy. Like, why would I do that? Like, I'm just. I, I, I just, I think growing up I never actually understood, what it meant to like be an educator and then now being on the other side of it, it feels awesome.

So, yeah. And then, the other thing I think is kind of how we connected was through social media. I started just putting out clear aligner content. On to my Instagram page. Uh, I even have a YouTube channel now. And just trying to get as much information out there to other doctors as possible and then help 'em wherever I can.

Nice  

Michael: man. Okay, so real quick, let's rewind a little bit, right? you mentioned that you were already burning out in dentistry because of the procedure that you were doing. What were those procedure.  

Avi: Fillings, crowns, extractions, some root canals. I didn't really go crazy with root canals, but yeah, that's pretty much it.

Michael: Those were the ones where you're like, I don't wanna do this ever again. Yeah,  

Avi: yeah. It's like you do it and then it's like, it looks good on the x-ray and then comes back, and then it's, it's just, I don't know. I, I, I have slowly come around to them, so I will do them here and there, but, . Yeah. Like a lot of dentists out there, I was just like, I would rather let the specialists do this procedure.

Michael: Yeah. Gotcha. Okay, so then you dove into Invisalign or Clearliners, right? Invisalign and then implants. And then you joined A D S O. who's D S O? Did you join  

Avi: Yeah. So they were smaller. They were called what was it called? I remember the office name.

The office name was Rose. and then they ended up selling to a bigger one.  

gotcha. Yeah. Are you still with them? No. No. So I am now at um, a smaller group practice yeah, they're called Enamel Dentistry. That's where I'm at now. Oh, enamel  

Michael: Dentistry. I may know. I don't know. So then when it comes to right now, you worked at how many as an associate?

what are some things you can take away? Like what are some things that you wanna tell, like practice owners, like, Hey man, y'all need to chill out with this. And then like, Hey, do more of that. Less of th Yeah. What are some things you learned?  

Avi: Yes. It's funny you say that. I literally have an entire playlist on YouTube with like my reflection from every job.

So definitely they can check that out. But no, it's, uh, I think the biggest thing is like above all, like, remember that your associate is also a doctor and they're also a person. And I say that because, when you treat a colleague like a person, you're gonna treat 'em a little bit differently than you would if they're just someone that you don't really care about.

And I'm not saying like, you know, you need to get all emotional and affectionate and whatnot, but like little things like be a professional. if you're gonna let somebody go, don't text. them. They did that to you. Yep. Uh, if you're gonna let someone go, don't, don't give 'em a phone call.

T talk to 'em, tell 'em face to face and let them know why you're doing it with, you know, with the notice and honor it. Like, just be a professional. and, and the other thing too is like if you actually. understand your business, which I believe a lot of practice owners don't. If you actually understand your business, you should be able to set goals from the beginning when you bring on an associate and have expectations so that way the associate understands what's expected of them. Because if you don't tell me what you, what you really need out of an associate or what you're hoping to achieve, I can't help you.

And so then you fast forward three, six months a year later, and now the owner. Internally has an expectation of their associate. And the associate may not be living up to it, but if that was never communicated, then know, nobody's gonna win there. If you are hiring an associate to just do all of your fillings, be straight up about it.

just say, Hey, I am doing a lot of surgery. I'm looking for a dentist who is willing to do all the basic restorative in the practice. I think dentists are afraid of losing candidates because if they say that, that may scare some people off. But guess what? There are so many associates out there that would love to go to a practice and only do restorative.

So I think they need to know what they want first and then communicate that. And then I think you're gonna have less turnover because when everybody knows what's going on, then the partnership is, much more likely to last longer. those are a couple things. What else? I really, I, I really love it when practices have systems and like really good systems and like, literally like order of functions, just kind of like, Hey, This is how, you know this is how the staff operates.

Like these, this is how we set up. This is like the handoffs. It's not whenever, it's like too much freedom. I take, what I've learned is like if there's too much freedom in a practice, then there is no system, right? Because now you're relying on the associate to kind of piece everything together. And that's frustrating because when you're an associate, I do think you need to, like, they should be allowed to have autonomy, but they should be able to have autonomy in the system that's already created. Otherwise your business is not efficient. Ah,  

Michael: that's smart dude. That's smart. Yeah. Cuz I feel like um, that happens quite often. You just feel so overwhelmed and you're like, look, I got extra cash coming in.

I know I need an associate. Or maybe now or eventually, Hey, do this man just, just help me. Right? You just kind of say that, like, just help me with the load. But in reality, , I guess you never really, like you said, dove into like your business and being like, what do I really wanna do? Not wanna do you think it's cuz they don't have time.

Avi: So I think what it is, it's this whole thing where, and this is my theory, is I think a lot of dentists who are practice owners, rewind. You have to go all the way back to like when they graduated dental school. And then I think what happens is they go through associateships. a lot of dentists come out.

Some definitely want to be owners from the get-go. those are the ones who have the best practices and systems because they are entrepreneurs and business owners, and they just went to dental school to have a dental degree and then like, there's two different types.

And so you've got your, your business minded dentist and you've your clinical dentist. And what happens is the business minded dentist dominated in terms of being a practice. and those are the ones who have like, a bunch of practices as well, or maybe just a couple well oiled machines.

Then you've got your clinical guys who go out and what happens is they go and they go to a couple of these associateships and then they get burned by some owners, Things like the owner will take procedures off of the associate's schedule and like really fill. Their own schedule before they fill the associates.

So that's another little takeaway is owners, if you hire an associate, leave treatment on their schedule because you make 70% of what they do. So fill their schedule before you fill your own and everybody wins because you'll have a happy associate that's busy and you're literally gonna make 70% off of what that associate does, and you don't have to do anything.

that's another like mindset thing. But going back to. What happens is they go out, they'll have maybe a couple associateships, they'll get burned, and then they'll get frustrated and they'll be like, okay, screw this. I'm just gonna go open my own practice. And they have zero business, business education.

And then they go and they become a small business owner overnight because the bank just hands out money and then they open up a practice and then they don't know what the heck they're doing. And all they really wanted to do was, they just wanted a place where they. Practice dentistry in like a, and just focus on that, right?

Like if you talk to, I'm sure you talked to a lot of dentists and a lot of 'em just want, I just wanna do the dentistry, right? Mm-hmm. , and, and so they, their only solution in their mind is to go open their own thing. But then now you've just like opened the door to an entirely new career, and you're not even, you don't even have your feet grounded in the one career that you have as a dentist.

And so now it's just like you, you're terrible at being a business owner. And then what happens is that cycle just. , it just keeps perpetuating. Cuz now they're the business owner and the doctor that's an owner. And then they hire an associate and then they traumatize that associate because they don't really know what they wanna do, being the owner.

And it's just, it's bad. Again, this is not everybody, and this is not every practice I've worked in. It's just what I've seen and what I've heard from, you know, from colleagues and it's, uh, yeah, it's, it's like a vicious, it's very vicious. No, a  

Michael: thousand percent, man, I, I hear that all the time. When. , you know, like I just wanted to do it on my own terms, my own dentistry, you know, I didn't want people to tell me what to do, buy my own technology or whatever kind of thing.

And then, you know, now they're, they're stuck with that only option. Mm-hmm. , well, I guess in the community that they're in, what would that be? On the only option if they're like shopping around associate, associate, associate and then you're like, there's no, there's no other place I have to do this. That kinda the only option.

Avi: it could be. But my thing is also is I think you could kind of get creative with it, again, there's no such thing as like a magical associateship, but I do think with even just the rise of DSOs and just opportunities out there, I think if you know, as a clinician what you want out of a practice, and you can put your ego.

Because a lot of these, a lot of dentists want to be like the person in control, But like, with great power comes great responsibility and a lot of 'em can't handle it, right? Mm-hmm. . So it's just like, maybe check your ego at the door. If you just want to be like a, a clinician, then you can find a place where you can have a role, like a specified role to do that.

Like they exist. I know they do. I've seen it. and that's why you have some associates who love their job. . they're hyper focused on what they do, and they're really good at it, and they've just found a home. And they're not the owner, right. Or they're not the, the, the number one top dog.

But they're okay with it. Yeah.  

Michael: Do do you think you'll ever start your own practice or No. ,  

Avi: uh, I don't know. I think I'm gonna start like a movement or something. , before I started practice . I'm looking to make, yeah, I'm, I'm looking to make an impact, I think right now. Yeah. My focus is definitely the, the aligner training program.

and then, uh, yeah, I, I just, I don't know. I'm not, I'm not crazy about practice ownership. I've. , think I could do it. I just don't have an interest in it right now. Gotcha.  

Michael: Okay. Gotcha. One little bit, you said you were let go through text, right? You were let go through a phone. Why do you think you were let go?

Avi: So the reason why I was let go through text is because that owner, so that practice, the agreement was that I would be part-time and I was originally, he wanted me to work every Saturday. and I was like, dude, you're crazy. I was like, I one, why are you open every Saturday? And then two, I was, this was the first time I ever heard about it. I was like, dude, I can't work every Saturday. So I was just like, I just need like a couple days. And then, so I was working like two days during the week and then we agreed to like every other Saturday. and it was actually kind of messed up because I was doing it and then this is like right around when I, uh, took that implant course and I gave him a heads up.

I was like, Hey, I'm gonna take an implant course. Is it cool if I. You know this, it's gonna be a couple Saturdays, so I'm not gonna be able to make some of those. But then when I come back, I would love to implement the procedure. And so he was fully set up for implants and he was like, yeah, absolutely.

He, he's like, you should always invest in yourself. He's like, the more you can do the better. And I'm like, sick, this is gonna be awesome. And I did it. I got the, I was doing the implant course and I'm on my, like last day, like the second to last day of this course. and then I got the text from him and he was just like, Hey, we're gonna let you go.

you haven't been working as many days as you originally did, and so we just really need Saturday coverage. Mind you, I've been there for almost a year, so I was just like, I told you that I was gonna do this, and then, and then no response Can that even happen?

it Ha, it happened .  

Michael: I'm like, it happened, man. Dude, that's crazy.  

Avi: I got the text, I looked at my wife and then I was like, I guess I'm fired. And she's just like, what? And then I was just like, yeah, like, and I showed it and then never heard from him again. Man.  

Michael: How long did it take you to find another associate after that?

Avi: So after that one I was like dropped on a. . And then I started looking in Austin. So then that's when I just started cold calling offices in Austin. I called like 30 practices. and get this, like, nobody works on Fridays in Austin. , like every practice I called, they were like four days a week, like Monday through Thursday.

And I'm like, damn, that sounds good. And like, everybody's like enjoying themselves. But no, I, uh, I tapped into my network and then I connected with this Dsso within like, it took me a couple weeks. It took me like two to three weeks to really kind of, to find it. But um, yeah. Okay.

Michael: Yeah. That's good, man. That's good. All right, so then let's talk about that aligners. I know you have like, you know, you do the consulting chorus as well, right? let's open up like Pandora's Box a little bit. Teachers right now, if you can, from someone going from zero cases where they're like, I would love to do more align.

How can we reach to 25? Like what are the instructions and steps that we need to get to?  

Avi: Okay. So in a nutshell, you have to simplify it, right? So the biggest thing is like, you cannot a lot of these dentists, these general dentists that you see doing a lot of cases , they're doing it not because they're taking on every ortho case that walks through the door, but they have over time taken on these simple, straightforward cases, gotten good results, and they've gotten confidence to then continue to do them first thing is you gotta talk about it, start talking about it with your patients. So once you know the cases that you can treat, which are basically cases that I refer, I'll just say it, I refer class three cases, bilateral posterior cross bytes. Deep by cases greater than four millimeters.

and teenagers, Those are all the cases that I refer to the orthodontist. Off the bat. I have a conversation with the patient about their issues and then I refer it. So then that way they're more likely to see the specialist and get the treatment that they need. Everybody else is pretty much fair game, so I then have a conversation in, the hygiene exam.

and they show the patients, we have a scanner. You definitely need a scanner. If you wanna do aligners, have to have to have to. And I show them their scan. I educate the patient. I talk about oral health. I do not talk about cosmetics. Mm-hmm. . And then I I believe in the treatment. And so when I believe in something, and as any dentist, if a dentist believes in it and they talk to their patient from a place of belief that it's going to improve that patient's oral health and life in some way, the patients are way more likely to accept it. it's that simple. it can be scary because it's something new. But it's that simple and that's how you start. And then um, and then I would say get a mentor, right? And, and cuz that's what I did. I, I pretty much did it. And I got a mentor, Dr. Christina Blocker. She helped me out early on, like setting up cases. sure not every case was perfect off when I first started.

Uh, I definitely made some mistakes. Everybody does when they start something new. but you have to just have the confidence to continue to push forward because, you know, with ortho it, there's gonna be patterns. And so when you take on a certain number or certain types of cases, you're gonna see certain patterns it, it's honestly easier than doing a composite class two filling.

and it's a lot of fun. I like it because you get to, you get to see a patient's. Entire mouth transformed. most of my patients that come out that were bought in for the oral health aspect and they complied, they come back and they're just like, doc, I actually floss my teeth now. And I was like, oh, wow.

And then they're like, I love it. They're like, I can't not floss my teeth. Because they're like, I can feel it. They're like, I feel the difference. And so that's why I love, that's another reason why I love aligners is because it's like this daily, it's this daily kind of like accountability. , You take them out when you eat, when you're done eating, if you don't brush and floss and you pop them back in, all the food between your teeth, you're gonna feel it, right?

Yeah. So patients will, they'll take out their liner, their brush, they'll floss, they'll put it in. So you got patients that are flossing and brushing like four or five times a day for eight months, and then when they're done, you're just like, Hey, you only have to brush twice and floss once. And they're just like, , it's, that's so easy.

And so it's like this habit that gets built and it's just like a beautiful, like comprehensive way to just treat your patients.  

Michael: What are some, I guess, mistakes you've seen along the road where that maybe like some of your clients or people have been making where you're like, no wonder, no wonder you haven't reached or passed this threshold or breaking point or,  

Avi: Uh, I think it's lack of education.

I just think a lot of dentists are doing it, not really knowing what's going on. Honestly, because it's like what happens is, and I blame the aligner companies for this, is they make it seem as though it's as easy as scan the patient, upload the records. , they'll give you like a, a simulation and then you just hit accept and you get it.

Like, that's what I thought when I first started. And there's, I bet there's a bunch of guts listening right now that are shaking their heads, and agreeing, or they're, some of 'em probably just like, wait, that's not what you're supposed to do. No, that's not what you're supposed to do. You're not supposed to accept that first treatment plan.

You have to make modifications, but you're not gonna know what modifications to do. , you know, you've been taught. So that is something that really helped my confidence and accelerated, my ability to do cases is because I kind of knew the guardrails, right? I knew, I was just like, look, I just don't wanna cause any harm to this patient and I wanna improve the current situation.

How do I do that? And so it was by knowing what to do and what not to do, and. . after you do them. Like I said, you find the patterns, you get more comfortable with it. But the biggest thing is, yeah, as people accept the first treatment plan and they, they don't know that you're not supposed to do that.

Michael: So then I guess, how do you, how do you go from there? You don't accept the first treatment plan. You're like, okay, I'm gonna continue to make, where's the guardrails? Yeah, where's the guard?  

Avi: Yeah. So for those, you always focus on the chief complaint. Basically what are you trying to solve, right?

Like, are you trying to just fix the crowding on the bottom? Are you trying to close spaces? Are you trying to, you know, the patient doesn't like the way their teeth stick, like flare out and they wanna bring that in. So it's all case dependent. But then once you know that, then you need to just, make sure you're making the movements.

that are going to achieve that result. And you're eliminating the movements that are not going to help that, cuz that's what happens is essentially what happens is you submit a case and an algorithm kicks back to you. The result and the algorithms programmed in a very general sense. You as a dentist have to make the modifications to personalize it and customize it for your case.

basically to answer your questions like, okay, so we're, that's literally why I created my program because there really, unless you have like another doctor helping you out, like there's not really that many, things out there resource wise that are accessible for dentists. There are some like in-person courses like Dr.

Galler, uh, hi, his course is, , you know, but it's an in-person course and there's a wait list. So I, I think it's, money well spent to take his course. But you also need to know the basics before you go diving into that because, um, you can go there and, and, and learn all that, but if you, you don't know how to like, have the conversation and implement it, right.

You're gonna struggle. So yeah, it, it's crazy like this, the world of aligners, it's, it's starting to take over. , I think it's already made its way into obviously the dental industry. Mm-hmm. . Mm-hmm. . Um, But at this point dentists have to have to skill up and invest in learning how to do this and bring it into their practice.

And there's so many different resources out there. And there's gonna be even more in the future, I believe.  

Michael: Okay, man. Nice. So then production wise, how much can someone expect collections and productions to, for example, let's go with that case study from zero to 20.  

Avi: so each case is, I believe they were charging like 48, 75.

just for the treatment. And then I think they charge like 700 bucks for the retainers. So that's like 55, 75, I mean, it's around $250,000, right? No, 25 times five. No, that was like a hundred and something. . No.  

Michael: still? No, I mean, like, that's a, huge amount, you know? and how much is like your, your course or your consulting?

Avi: So yeah, so right now I'm not doing the consulting, I'm just doing the course right now. My course is a thousand bucks. Oh, okay. Yeah, it's in intro pricing. Definitely gonna be raising the cost. But it's a thousand bucks. You. Like I said, all the modules to learn how to do this, you get the cheat sheets scripts for the team, teaches everybody what to say.

I go over some like insurance stuff, like people are always kind of confused on how to bill for it. I, I cover that. And then I also do a year of training, right, the year of monthly coaching. So let's say you take the course and then six months later you're like, oh, like I have a bunch of cases. I dunno what to do.

You can hop on the monthly call and then I can help you out. So that's my way of. being able to do like a group coaching type situation. But yeah, I tell doctors, I was just like, if you're serious about doing aligners, take my course. You will definitely start at least one case after, uh, and that you've already made your money back plus some.

Michael: Yeah. Okay. Nice man. I like that. So then, right now, what do you think a dentist can do today to improve their.  

Avi: A dentist they can do to improve their business. I think they can invest in systems to help automate as much of their business as possible. Cuz what that's gonna do is that's gonna lead to less stress for them.

Cuz when things are systemized and automated and there's protocols, it just has a trickle down effect and it just will oh, bring them a lot more peace. , And then they should also invest in education. Because the more procedures that you can offer, You know, The more services right, your, your, your patients are able to kind of take, take up and do.

So whether it's aligners, whether it's implants, whether it's Botox go learn this stuff. And I think the more the experience, dentists kind of know this, but the, the ones who may be younger or just may not have been thinking about it as much. You, uh, you went to dental school to learn how to not hurt people.

And after that is where you actually learn different skills and procedures and techniques and you can learn it from people who have done it and you know who, who it's worked for them, it's worked for others. So, yeah, those are the two biggest things that I would say they could do to improve their business.

Michael: Nice man. Okay. Okay. Awesome man. So then if we wanted to reach out to you, where can we.  

Avi: Uh, easiest place would be Instagram. Uh, my handle is Dr. Avie and Doctor is spelled out. I also have the YouTube channel, but yeah, if you wanna reach out to me, just shoot me a DM on Instagram. easiest way. Okay. And what's next for you?

Michael: Do you plan to do lectures, like workshops or how does that, like, or do you, I mean, you already said you didn't wanna own your own practice,  

Avi: but like yeah. So yeah. So right now, right, I, I've got this online training program. I think what's next is growing that as big as I can, trying to make as big of an impact. And then after that, I really want to try to find a way to help dentists out, uh, on the mental health side.

The, the depression, the stress, the suicides, all that stuff, because I've seen it, like I've been in that dark hole of dentistry that a lot of dentists have either been in and gotten outta or are still stuck in. I don't have like a real stat, but I would, I would say about 70 to 80% of dentists have felt some form of depression just because of the realities that, that we face as being dentists, especially when you're early on and, I wanna be able to, to create something and, and, and help people help other dentists rather, either work through it or.

Or, or completely avoid it if possible. So that'll take me time. But yeah, that's, that's next. That's where like a deep passion of mine is.  

Michael: where were you when that happened to you? Like what, why was that happening to you?  

Avi: So this was like, uh, like right before the pandemic, and it was just because I was in and outta so many jobs.

I was in and outta so many jobs and I couldn't, I couldn't hold an associateship for like three to four months. Right. I had like, I was burning out on, on the procedures and I was just kind of like, did I make a mistake becoming a dentist? Like this sucks. Like, I thought this was because for me, like my uncle's a dentist and I actually wanted to be a dentist because of him, because I saw the life that he was living, like he was able to like help his patients.

You know, His patients loved him. He was able to just good do good work. He worked great hours, great family. He was able to golf. He was, he was living a very, like, good and comfortable life. And then I became a dentist and I was like, oh, can't wait for that to happen.

And then it's just like, , I started looking at the realities. I'm like, okay, so $500,000 in debt. making like 125 grand a year. Uh, like I'm in and out. Like I, I'm doing shit that I don't even like, like I was just like, where is this fun? Like when, like when does this get fun? ? Yeah. So, yeah.

And that's when I, I just like invested in myself, right? And I was like, okay, I need to learn something. I need to do something. Cause if I just let the profession guide me, the profession was, was not going to help me. The only person who's gonna help you is yourself.

And then ever since then, I had like a mindset switch. And now I've just been following my passions and, you know, it's been like a progressive thing, right? . The first passion was the procedure, Was aligners, and then the next passion was teaching, which is now, which was then the consulting, which is, you know, has now morphed into the online course.

And so that's kind of what I'm doing. Like I'm just, at this point, I'm like, if I just follow the passion. I will be happier and I will be in a better place than where I was previously. And I think a lot of dentists have to wall off their passions or they feel like they have to wall off their passions.

Because the only other examples really that they have out there in terms of like what other dentists are doing is this whole model of like, okay, I. Graduate dental school being associate, okay, now I need to get my own practice. Okay, now I need to get five practices. Okay, now I need, you know what I mean?

And it's like mm-hmm. , there's other ways to do this. You just have to pause, out what lights you up and what makes you want. , to get up every day excited. Some people it's, it is running multiple opposites. Some people love that. Mm-hmm. , some people love, just wanna do insane, crazy, cool surgery.

Some people just want to kind of like coast and chill. Some people want to be entrepreneurs and, have a side hustle and create something outside of dentistry completely. I think it's all possible. I think we have to stop lying to ourselves and, and stop telling ourselves that, there's only one way to be successful as a dentist.

Because it's just not true. Yeah.  

Michael: I think that's where sometimes the depression can come in, right? Where you kind of mm-hmm. because you hear a bunch of things of it. You hear like follow your passion. Then you hear people like, nah, follow the work. Right? Like what? Make it work. And then another thing, no, follow your talents, right?

Then everything else will fall into play. So you're like kind of picking and choosing the, the road you. You think you're good at something, but then you find out 80 billion other people are better at it. And you're like, well, that's not my talent. Oops. So should I have gone the other way? And it gets confusing, man.

It gets confusing.  

Avi: And then it gets lonely too. Like dentistry's lonely. Like a lot of dentists are practicing by themselves, you know, sometimes they do get to practice with another dentist or such. So it's that's the other thing is like for me, Yeah, it got lonely too. Like I didn't, all my friends, like I went to NYU and all my friends, like, pretty much, we all graduated and scattered.

A lot of them went back to California. Some were in Canada, some were, they, they went up to like Massachusetts and stuff like that, and, and it's just like it's very easy to get disconnected, from your peers. And so that's why it's super cool when I see these other communities out there for, for dentists.

Um, It's awesome and I'm actually pumped cause I'm going to a conference tomorrow, voices of Dentistry and I'm excited to just meet other dentists, just meet 'em and see what's going on and, and so that's the other aspect of my program. is, uh, I have like a Slack community as well, and it's just a, another space for like-minded dentists to just kind of like be together and, and connect with each other.

And so I'm hoping that also continues to grow and, kind of how these other communities have, like their meetups and conferences and stuff. So, we'll, we'll see how that takes shape, but I think more than anything, like if you're a dentist out there, , if you're feeling lonely, you just need someone to talk to.

Like, you can hit me up. We don't, we don't have to talk about aligners or growing your business like we could. We could just, we could just, you know, we could just talk. Uh, it's always cool meeting people because I feel like a lot of us are, are going through or have gone through like similar things. sometimes just Feels good to know that you're not the only person that's experienced it. And then kinda just hearing ways to kinda combat your situation. Yeah.  

Michael: Kind of sounds like you fell in love with. or you really enjoy doing a procedure right now, but you're more in love with the mental health aspect. You know what I mean?

Of like, we really gotta get this thing to blossom somehow, but right now what I need, you know what I mean, to, for my mental health is the, uh, director of liners or that thing, you know what I mean?  

Avi: Correct, correct. Yeah. No, and that's the thing is I think it's a stepping stone, right? It, I think it's, uh, something of value that will generate. You know, You, you're gonna have happier patients. The doctors make more money after they take the course, obviously. Like I get to make some money off of it too. But it's a step, it's like a a means to, yeah. To this greater, this greater thing. I could get on stage and start motivating people, but like, who the heck is this guy?

, you have to kinda establish yourself first. And that's what I'm doing. I'm just in the process of, doing that. But by the way, I'm the director of aligners that that didn't work out. That's what I was hoping would, would be a thing at that dsl. But yeah, right now I'm, I'm just kind of building my own.

I'm just calling you  

Michael: that right now is the Hey, he line . You know what I mean? Like of his own thing, you know what I mean? That's cool. Awesome. Avi, man, I appreciate your time and real quick again, let people know where they can find you.  

Avi: Yeah, on Instagram my handle is Dr. Avi.  

Michael: Awesome guys. So that's gonna be in the show notes below along with everything else that was mentioned.

And Avi, thank you so much for being with us. It was a pleasure. And we'll hear from you soon. Awesome.  

Avi: Thanks for having me.

In this episode, Susan Laine, from 180 Dental, gives us her three best tips for a smooth and easy billing process!

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1. Determine Your Business Type - You can register as a sole proprietor, s corp, or pc business. If you are planning on having associates, it may be beneficial to incorporate, rather than use your social security number for tax ID!

1. Input Incoming Associate Data - If you have an incoming associate, getting their tax and credentialing information in your practice management software as soon as possible will offer the smoothest transition!

1. Inactivate Old Providers - This can be a handy way to transition practice ownership in software such as Dentrix, Eaglesoft, or Open Dental. Inactivating the old provider when bringing in the new provider, allows them to pick up where you left off in a seamless schedule transfer!

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Listen in on Michael and Susan's conversation to get more in depth on these three topics and more!

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You can reach out to Susan Laine here:

Instagram: @180dental

Facebook

180 Dental Website

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Other Mentions and Links:

Dentrix

Eaglesoft

Open Dental

Sole Proprietor

S Corp

PC - Professional Corporation

Lori I Owens

NPI - National Provider Identifier

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If you want your questions answered on Monday Morning Marketing, ask me on these platforms:

My Newsletter: https://thedentalmarketer.lpages.co/newsletter/

The Dental Marketer Society Facebook Group: https://www.facebook.com/groups/2031814726927041

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Thank you for supporting the podcast by checking out our sponsors!

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Michael: Hey Suzanne. So talk to us about medical and dental billing. How can we utilize this, or what advice or suggestions can you give us that will help us with doing medical and dental billing?  

Susan: I have some ideas, some suggestions. That is for any office. Mm-hmm. , you know, my company, we specialize in Dentrix, Dentrix.

and my company goes in and we do a lot of transitions. So what I'd like to pinpoint today are three key things that will help a startup or somebody who is thinking about bringing in an associate to make sure that, one, they're getting paid. Two, the associate is getting paid and they can track their numbers. So, . The three things that I really wanna highlight, one is how you're setting up your company as a pc, an S corp, or just a sole proprietor. You know, as a new dentist comes in, they have a choice. Mm-hmm. , it is recommended and you know, I think Lori Owens and some of the other people out there would definitely agree.

setting up your company, which is your dental practice as an S corp, has specific tax advantages, and it also gives you some long-term down the road advantages because if you set yourself up as a PC or an S corp, you're not using your social. as your tax identification number. You're also, able to set it up as a type two N P I, and that is very beneficial, right from the startup.

But again, even if you're already in your practice, you've had your practice for a while, you're looking for an associate, if you set up your tax ID as having a type two m. , you can bill under that entity and then your provider can change. For instance, like if a female dentist needs to go on maternity leave and she has a locum tenants come in for six, eight weeks, they can bill under the tax ID for the corporation, the type two n p.

With the new locum tenants provider, and there could be a contract in place for that specific timeframe. Hmm. And it doesn't need additional credentialing. It doesn't need W nine sent for each and every claim during that six to eight week period. Or you know, I had a, I had one of my clients who was an avid golfer, he ended up needing back surgery and was out for five and a half weeks and in a back brace.

Mm-hmm. and came back very slow. So he had a contract for a locum tenants and it was still bill out under his type two. And it worked out very well. As long as you have your contracts in place to do it that way, there's a lot of legal. loopholes that you can use. But I do suggest that you always, and this is a startup or a, you know, an individual practice that's already going seek good legal advice.

I'm not a lawyer, but there are really good people out there that can advise you in that is just a suggestion. you know, with that in mind, when you have somebody come in and you're paying them on either, collections or product, You wanna be sure that you are paying them what they should be paid.

And in Dentrix well and Eaglesoft and Open Dental, you wanna set that person up before they ever enter your practice and see a patient. , for instance. Um, a transition. This is what my company does quite a bit in transitions, is when we know that there's negotiations, we will get the credentials of the incoming dentist, his N p I license, d e a.

We set it up in Dentrix and we can build his schedule and build it up. months before he ever sets foot to see patients so that there is a smooth transition. Your schedule is full. You have, you know, no lag in production. Well, you're gonna have that here and there. The sooner you set up a new provider in your system, the better it is with scheduling, the easier it is to get them paid in a timely manner and know exactly.

how they should be paid. Figuring out, you know, if they want, if they want 35% of collections, what is that per day? You wanna look at that backwards and do the calculations mathematically to make sure that you have the production on the schedule. The third point, I'm just gonna close with today. is, I wanna talk about, the process within inactivating old providers in Dentrix, which is where my love for software came from, is with Inactivating, that old provider, you can reactivate a provider after you move the patients over. I just did this again for another office. They purchased on 1231, brand new dentist came in. We set up the transitioning senior dentist as an associate, and we closed everything out and moved all the patients to the new purchasing doctor. We reactivated the seller as an associate, and now all of. Finances cuz he purchased the ar.

Mm-hmm. are under the corporate, the schedule is under the new doctor. And this can be done in Eaglesoft, in Open Dental. It's just understanding the software, understanding how you wanna structure your business. So those three things are really gonna help out any dentist, whether you're a startup transitioning with a senior doctor that is moving out as retirement encroaches, or if you're bringing on a brand new a.

you wanna look at those three key things to really help set yourself up for success. Gotcha. So  

Michael: these three things, how do, I guess, how does that ease the process? Also with the billing part?  

Susan: With billing, especially with the N P I. Mm-hmm. , you can credential your type two. , and again, when you have a locum tenants come in, it continues under that tax id, and you don't have that lag in claim processing as long as you have it set up so that you have it in writing and you have that temporary doctor coming in and everything is already on the claim for that provider.

So, , it helps get you paid timely without having to delay and say, who's this? We don't understand who this person is. Mm-hmm. ,  

Michael: what are some of the most common mistakes when it comes to utilizing Dentrix or, or, or doing this right here? When, when it comes to like the, the yang of the, uh, I guess like the three processes that you mentioned.

Susan: I have had to go in and run audits on some offices that have utilized a sole proprietor's social security number when they have somebody come in temporarily and one, you're paying the taxes for all of that income. , that's a negative. You don't wanna have to pay self-employment taxes on all of that income.

Two, the provider that does the service legally has to be on that claim. Mm-hmm. , you cannot legally do it any other way other than listing that provider. So I've had to go back through and audit for the insurance companies in the past, and it is, an infraction, and there are fines involved and it can be construed as fraud.

Mm-hmm. , but I hate to say that word because it really scares people, .  

Michael: No, it's true. Yeah, yeah, yeah. So it can be construed. It's true. It can be construed as that. What else?  

Susan: Yes. . So with setting things up in your system for the way Dentrix does it, you can also utilize block scheduling for multiple providers. and you can really help your office flow. And meet or exceed your goals consistently on a daily basis. So if you have your providers set up correctly, you can actually implement that into Dentrix on a daily basis, and you can go home at the end of the night and feel like you have really accomplished a good day and that you met your goal.

Michael: Yeah. Yeah. The block scheduling I think works pretty, pretty real, really well. You know what I mean? When we know how to utilize that. This is really good. We want to understand how are you setting up your company right from the very GetGo, uh, L L C you said, right? S corp. What  

Susan: was that one for? A pc?  

Michael: Yes. Pc, yeah. What would you recommend when it comes to those three, the best? Depending on their goals.  

Susan: Depending on their goals. if they never wanted to bring an associate, you can set it up as a sole proprietor. , I would advise talking to a C P A to see if there's probably a tax advantage for being an S-corp over all of that self-employment tax.

So me, I suggest always going with an S-corp and then credentialing that S-corp. Now, credentialing and contracting are two different things. What's the differe? Credentialing is that background check that the insurance company does to say that you are a licensed dentist in the state that you are wanting to practice. That you have an active license that has no infractions against it, and that you are operating in the scope of that license. So that's the credentialing process. That's why you have to give them your malpractice insurance, a copy of your license, your photocopy of your id, your dea, e. All of that is credentialing and you can be fee for service.

But you still have to credential so that you can get paid. They need that W nine with your tax id. They need to know that your tax ID matches your I R s confirmation that you're gonna pay taxes on the income, cuz they're gonna issue you a 10 99 from the insurance company based on that tax id. with.

all of that information, I really think that you're gonna see the best results by being an S-corp.  

Michael: Gotcha. Okay. So S-corp, if, if anything, right, like right now we're like, okay, we wanna have an associate, you know, we wanna do all these other things that you mentioned. We wanna have an S-corp have the associate in Dentrix as well, right?

Yes. Whenever you start bringing them. And  

Susan: then And market. Yay. Marketing. Yeah. Yeah.  

Michael: And marketing. Inden.  

Susan: yes, open dental, Eaglesoft. They all have the ability now to text, email, do campaigns. They can put it out on their website and do a blast. There are so many opportunities to get information out there now, of all the transitions that I've seen over the course of the last, you know, almost two decades that I've had my company.

what has been detrimental is not informing people, not letting them know that there is a doctor that is retiring or that the office is selling. they get a feeling of betrayal a little bit. , they get their feelings hurt when there's not transparency there. So I, I'm a huge advocate for marketing the new incoming provider at any stage, you know, even, even if a doctor's, you know, going out for surgery or a doctor is going out from maternity leave.

They wanna be included. Not just your staff, but your patients. They wanna feel a little bit of a connection.  

Michael: Gotcha. Yeah, I a hundred percent agree with that. Like you wanna, you know what I mean, like let them know you're part of the family kind of thing, you know, so. Exactly. Gotcha. Okay. So in a nutshell, these three steps and processes or methods help out specifically how with our, our medical and dental.

Susan: getting you paid, you want paid, how are you gonna get paid? You wanna get paid fast, have things in place so that that happens. Mm-hmm. , these three things will help you get there.  

Michael: Get paid. Gotcha. Get paid. Awesome. Awesome, Suzanne. Thank you. I appreciate your time and if anyone has further questions, you can find her on the Dental Marketer Society Facebook group, or where can they reach out to you  

Susan: directly? My website is, 180 dental.net. I'm also on Instagram at 180 Dental and Facebook at 180 Dental. Awesome. So they can reach out to me on any social media platform and I primarily work with other dental referrals. I don't have a marketing campaign where I solicit.  

Michael: that's good.

Referrals is like the best way. You know what? It  

Susan: really is. It is. I love, I love what I do and I love my clients. Nice. Wonderful. My team is very good at cleaning up Dentrix databases after a transition or before to get your numbers. So they're real. Yeah, they're trustworthy.  

Michael: Gotcha. Awesome. So guys, that's all gonna be in the show notes below.

If you wanna reach out to Suzanne and Suzanne, thank you for being with me on this Monday morning marketing episode. Thank  

Susan: you. I appreciate it.

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My Key Takeaways:

• If your savings and checking accounts are an iPhone swipe away, they are too close! Try opening accounts at different financial institutions.
• Always look for testimonials and high quality recommendations when considering a financial advisor.
• Instead of an end of the year CPA, search for a financial planner for quarterly tax planning.
• Do not sell your practice to a DSO too early! Owning a cash flowing practice over time can be much better that multiple years of up front revenue in an offer.
• Have a plan for retirement. If you are aimless in post-retirement plans, it will be an abrupt transition.
• The difference between a true business owner and a self employed individual, is that the business owner can walk away and it continues to run.

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Hey, what's up guys? Welcome back to the Dental Marketer Podcast. I'm your host, Michael aas, and in this episode I'm speaking with Ross Brannan, who's a financial advisor and a strategic wealth specialist, and we dive into some really interesting topics and questions. He does holistic planning and he goes deeper into what that specifically is, and we discuss how there's so many financial planners, advisors out there.

So how do we know who to trust and who we're. Take our money. So we dive into that. We also discuss how we can reduce taxes legally and what strategies dentists would appreciate most when it comes to budgeting or accruing wealth and savings. And then we discuss what he hates and loves about dentistry, how he thinks.

Every dentist needs a system to ask for referrals, and we dive deeper into that topic and how people weren't really designed to retire, and we also dive deeper into that and what he means by that. So guys, without further delay, here is Ross.

Ross, how's it going?

Ross: Brighton, Mike, how are  

Michael: you? I'm doing pretty good. Thanks for asking. If you don't mind me asking, where are you located right now?  

Ross: I'm in Tallahassee, Florida. Oh, nice. So, uh, it, you know, it's, you know, it's January right now and it's 75 degrees in humid.

So, uh, we don't really have a winter here.  

Michael: Yeah, that sounds nice right now though. You know what I mean? Like in. Like the weather, the degrees, and the heat. But that's all good. That's good. So Ross, tell me a little bit about your past, your present. How'd you get to where you are today? So  

Ross: I grew up in Atlanta.

Uh, and I went to play football and scholarship at Florida State University back in the mid nineties, mid to late nineties. Uh, came to Florida State, had a lot of success. Um, started. On a national championship winning team in 1999, unfortunately had six knee surgeries while I was playing at F S U, so I didn't finish my career, but, uh, ended up staying in Tallahassee.

Ended up marrying a local girl, now have five kids and two dogs. And I was a client of the firm that I'm a part of now, and I'd always been kind of financially minded and they kind of saw that so. Asked me to come work with them. And that was many years ago. Uh, and, and then, you know, I, as I'm working as a financial advisor, I work with a friend who's an orthodontist, and next thing you know, he introduces me to his college roommate who's a, who's a general dentist.

And the snowball effect happens. And next thing you know, I've got dentists all over the country as clients and, uh, it's just kind of where I started focusing. Gotcha.  

Michael: So your area of expertise is,  

Ross: So I do personal financial planning for dentists now, and, and that's, that's a little bit different. Um, you know, cause I do holistic planning, so it's a little bit different than the traditional financial advisor.

So to kind of educate people, there's a couple different silos in the financial advisor world. You have probably the majority of people are what's called assets that are management, you know, Might be a Merrill Lynch, it might be a, uh, Morgan Stanley, it might be an independent r i a, which stands for Registered Investment Advisor.

And all they do is gather assets. So you really don't, they won't talk to you typically unless you have half a million dollars or more. And they will ma help you manage your money. And that's investment accounts, IRAs, things like that. And there's nothing wrong with that. That's, that's definitely a, they, they do, they help a lot of people then you.

Maybe like the Northwestern Mutuals who do a little, a little more insurance work, what might be disability or life insurance. And then there's, there's very few, but I, I think it's probably the best. It's kind of what's you see as some, practices and advisors that integrate both insurance and investments, but then you find even less who really do planning.

So a lot of times planning is basically planning around the facilitation of a financial product. Now we all need financial products. That's not bad. Is it really planning? So when we talk about holistic planning, the question is, what does that mean? Well, that means looking at everything that your money touches.

So it could be something as boring as auto insurance, something as complex as legal in the state documents. or something as as practical as how much money you save and where you save it. And oh, by the way, if you're saving money in a checking account, that's great. Nobody gets paid on that, and that's why nobody talks about that.

But that's something you have to talk about because having liquidity and saving money is a big deal.  

Michael: Yeah, that was a big deal, especially like two years ago, right in the middle of everything where everything was like covid and stuff like that. So holistic planning is everything your. Touches. So is that kind of like when we sit down and we are doing a budget, we're like, okay, where's our money coming out of?

Like where? We're in debt. Well, yeah.  

Ross: so I've got some strong opinions on lots of topics. Budgeting is one of them. I, I don't think what I call spreadsheet budgeting works very well unless you're an engineer. And I'm not an engineer, and most people aren't engineers. Some people are.

And so I'll ask people, Hey, what does it cost you live? What's your burn rate every month? And they'll be like, they'll look at me like I'm an alien. They have no idea. . So let's suppose their burn rate to $20,000 a month. Mm-hmm. . And let's suppose they bring home after tax $30,000 a month. And I'll say, okay, you're saving 10 grand a month.

Right. They, they in look at me like I'm an alien, so I'm not here to put you on beans and rice. And if you're a dentist, you probably don't need to be. Some, some might, but you probably don't need to be. And so it's like, let's create a cash flow structure. that makes sense and works for you. the typical cash flow structure is all your check goes in your check account, you spend what's there, whatever's left over you save.

And that's typically not very much.  

Michael: Mm-hmm. . Mm-hmm. .

I feel like that's what we, we kind of tend to do a lot. So then let's do that. Let's build a cash flow structure. What does that look  

Ross: like? So because expenses rise to mean income, it's Parkinson's law. So that would mean something as simple as, okay, I have a dedicated account somewhere else, and that account, my check goes into that account.

Let's just use my numbers of 20 and 30 as an example. $20,000 goes down to that, or $30,000 goes to that account. I need 20 a live. So that account then transfers 20 year checking account to live. And so now I'm automatically, by default, saving 10,000. . Mm. And so then every month it adds up. It adds up. So you build enough of a rainy day fund for whatever you need, that four.

Then once it starts getting to a certain level, then you start saving. Then you start deploying that money to other investments. Too many people they're only savings as a 401K or something like that and, and then there's plenty of people listening saying, oh, I saved more than that, but I can promise you you're not saving as much as you could be or should.

So  

Michael: how can we do that? What, what, because you're kind of talking about , you're also talking about me here. Like, I'm like, oh my everybody. Exactly. Yeah. It's a, it's a human being thing. It, it's exactly what I do. Like, I, I, and there's something in me where I'm like, I don't wanna see my checking account ever hit a specific number kind of thing, right.

And I can allocate whatever left I have to savings and other things like that. But, . So you're saying have a specific account, make all the money go there, then by default, take out what you need to live.  

Ross: Yes. And they do not, they cannot be at the same financial institution. So for example, if you Bank of a Bank of America, you can't have two checking accounts or saving the account of checking account, run next to each other because it's only an iPhone.

Swipe away. Yeah. I closed my savings account at my bank because it was just an iPhone swipe away. So you had, they have to be at separate financial institu. And what you do is you have the money. So if you bank of a Bank of America, you set up, you know, let's suppose you put, oh, your check goes into some online account.

Let's call it Ally. Let's suppose your check goes to Ally. You don't have Ally. Push the money, you have Bank of America pull the money that way it avoids a fee.  

Michael: Mm. Okay. Okay. I like this. So then if we're not pro like spreadsheet budget, Where do we start? For example? Let's just say, so,  

Ross: uh, continue.

Here's what I do. Okay? I'll go, what's, okay? What's your car payment? Uh, it's $560 for the month. Well, then I round up and call it 600 bucks. Okay. What do you spend on your cell phone? It's $213. That's two 50. And just round up, create a built-in fudge factor. Just go through every expense. What is gas? Well, gas is obviously a variable expense. Let's go on the high side. What is grocer? , let's go on the high side. Therefore, we have a 500 to a thousand dollars fudge factor built in because there's always things that come up. all right, so maybe your real cost will be is 9,000, but we're saying it's 10,000. And so we build that fudge factor in.

Now you still have to be aware, cognizant of how much you're swiping, cuz nobody pays for cash anymore. you gotta be careful how much you click the Amazon button. so that's like legalized crack, that Amazon button. Um, yeah, it's so, so we have to do that now if you're a higher income person, because for dentists you mean, you've got dentists making, lower income, and then you've got dentists who are making much higher income.

But if you're a higher income dentist, uh, the best way to save is to reduce your tax liability, to reduce the amount of taxes you owe. And then to the, the typical response is, I'm doing the best I can. My CPA says I am. and I would argue, no, you're not. More than likely you're not, because most CPAs don't do tax planning.

Most CPAs prepare tax returns. That's what you're paying them to do. There are the rare tax planning CPAs, many of whom I know. Um, , but if you're not meeting with your C B A on a quarterly basis, you're not doing tax planning. that doesn't mean they're bad or they're a bad person. It's just the average C P A probably has 500 clients and, uh, you know, maybe five or 10% or less.

are the super high income business owners. The rest are W2 employees, and so they aren't motivated to go learn advanced tax reduction techniques for the minority. It's just human nature. And so you have to begin to think outside of the box because we've been conditioned to think, oh, I have to pay what I have to pay.

And uh, I was looking at a client case today. This guy makes $5 million a year. and through proper tax planning, it looks very likely that he'll be able to save a million dollars in tax if he implements the strategies that are available. Mm-hmm. , so there's a couple things there. Everyone's situation is different, so that doesn't mean that's you.

and it requires work and you have to do certain things. So, When this is presented to this individual, he may not like the strategy for X, Y, and Z reason, and that's fine, but he just won't get the tax benefit from it.  

Michael: Gotcha. When it comes to that, what strategies have you noticed that are more popular?

More what more dentists would appreciate, and ones that are  

Ross: like, eh, Well, it all depends. So the, so obviously the, the low hanging for the easy one is a 401k, so you can put, you know, up to 60 some odd thousand dollars into a 401k with, um, the profit sharing, uh, portion of it. And, and that's, that's a deduction.

That's, that's right away. It's easy. you could then go on top of that with a cash balance plan. The way a cash balance plan works though, it's dependent on the census, meaning the age and demographics of your, your employees. So the older you are, the better. So if you're older and your employees are younger, it's better.

But if you're 28 years old and all your employees are 45, it will not work. The numbers just don't make sense. So those are some low hanging fruit ones. Uh, there are some more advanced strategies that Some of them are, they're all a little more outside the box, but they are, uh, they work and you people just have to have an open mind and learn about 'em and see how they feel about 'em once they, once, once they hear  

Michael: about ' em.

Like what are some of those? The out of  

Ross: the box ones? Well, there's certain charitable strategies that you could do. So you could do, uh, and obviously this is not a recommendation cuz everyone's situation's different. So you could do a charitable remainder trust and there's all different variations of. . so that that could be something.

there are, uh, certain types of, um, investments that have, deductions tied to them. and so, yeah, and I'm, I'm speaking generally for the purposes of, you know, just cuz I don't want people to think I'm making recommendation mm-hmm. , but it really comes down to everyone's fact pattern is differently.

So, . I'm 45. I have five children. I live in Florida. My situation is uniquely different than yours. You're younger than me. You live in California. every dentist situation is different, but if you are a high income earner, there are situations where advanced planning strategies can make sense and could potentially reduce your tax.  

Michael: Yeah. Cause I think that's something that we all wanna, , all wanna do as much as possible, reduce taxes. Well, well,  

Ross: I would argue the highest rate of return you're ever gonna receive is a dollar taken back from the irs. The second highest rate of return, in my opinion, is investing in your business. So there's no financial product or widget that I can offer you that is going to give you a higher return than those two.

Yeah.  

Michael: I feel like, um, when it comes to your type of planning, right? Um, cuz you do personal financial planning, right? Not holistic planning,  

Ross: right? Well, holistic, it's, it's p holistic is personal. So we're looking at everything  

Michael: here. So when you're looking at everything, and maybe a practice owner also does separate things, right?

Maybe they have investments in real estate, things like that. are those things like you recommend that or not? Maybe not recommend, but you're like, oh, that, that looks good. When it comes to reducing  

Ross: taxe. ? Well, there are definitely benefits to real estate. You know, obviously if you own your building, there are some tax reduction strategies with that, depending on the specifics of your building.

real estate tends to be a very good financial asset. but you, you don't wanna just go buy it just because it's real estate. You get the numbers gonna make sense. You need to make sure, it makes sense as a part of your overall plan. Just buying blindly. Buying real estate isn't always the best thing, but buying real estate.

Can be very, very good.  

Michael: Gotcha. Okay. And you mentioned something called fudge factor. Break it down at me. What is that?  

Ross: Well, I, you know, if I say it costs me $10,000 a month to live, there's always going to be, an unplanned expense. does it matter what it's, and so if I'm saying it costs me, $250 for gas for the month.

I'm rounding up to $300 just to build a, a cushion of another $50 in the overall, budget. So if I put a fudge factor in over 15 items of like 60 or 70 bucks, that adds up. All of a sudden. Now it's like, okay, I got, I built in roughly a thousand dollars of. Cushion in case the numbers are office month, cuz the numbers are never gonna be exact.

Mm.  

Michael: I like that, that, that helps me a little bit, my, I guess my mind to be put at ease because I feel like every time our numbers aren't exact, I'm like, where are we going wrong? What am I doing? You know what I mean? Kind of thing. And  

Ross: well, and the prices are going up. Yeah. We've had inflation the last year, so it's like, you know, the same thing.

Doesn't cost the same thing. That's true.  

Michael: Yeah, you're right. I remember going to Costco and I was like, I'm getting the same stuff I've always gotten. Why is it, you know what I mean? More, but,  

Ross: well, just, Costco has, they put fairy dust in their stores and it makes you buy stuff that you wouldn't normally buy.

Next thing you know, it's like $700 and you're like, what? What just happened? ?

Michael: That's uh, that's so true, man. I don't know why that happens. I have, I have a question. . I don't know if you saw this about Ussein Bolt, right? But we were talking about it, us in a couple, a lot of us price owners and dentists not that long ago, where he depended on a financial company, right.

Personal finance, something like that. And they kind of ran with it and took his money and so,  

Ross: oh, that happens all the time to professional athletes.  

Michael: how do we know who we can trust when it comes to personal financial?  

Ross: Well, I mean, you can do a FINRA broker check and, and I'm, I'm looking up you saying Bolt right now, just so now mm-hmm.

Um, you can do a FINRA broker check. oh. Yeah, there you go. I see it right there. so you can do a FINRA broker check. That's not always going to, um, tell you the whole story, but I'll tell you if there's any complaints or anything on that. Um, obviously a high quality recommendation from somebody.

anytime you are working with somebody, you know, you know, if you're making a kind of a non, non-traditional investment, you wanna make sure there's a lot of due diligence done. So I like, I don't know what kind of investment account he has. or he had, but uh, you know, those people are probably gonna go to jail if they get caught.

What is he gonna get? His 12.7 million back is a different conversation. But, FINRA broker check, any outside the norm Investments I would require, I would, I would, make sure there's lots of due diligence on it. Many times you'll hear about these great ideas that there's no due diligence on it.

And then, you know, , ask for, uh, recommendations, ask for testimonials from, you know, you're dealing, you're talking to John Doe, financial advisor. He's, he's trying to make you his client, ask for, um, testimonials from some of his clients.  

Michael: Okay. That's good. And then when would you recommend as a good time to start?

Let's just say I'm a startup practice. I'm a, have $700,000 in debt. Right. Um, when would it be a good time? Break even, or a little bit before that, once I reach a certain amount, when would be a good time to start doing this holistic planning. Well,  

Ross: most people don't really get serious about their money until they have a kid. that that's how typically most people work. But if you buy a practice, you know, obviously the first year or two you're just kind of swimming upstream. Once you feel like you've at least kind of got your head above water, it's probably time to at least start having a conversation with somebody just to get a, a few of the basics taken care.

Michael: Okay. Okay. And that's like where we can reach out to you or somebody like that, right?  

Yeah. You  

Ross: reach out to me or somebody else. But I mean, there's just certain things you should make sure you do, from a personal planning standpoint. But I realize most people in that situation, they're so focused on just trying to get things going.

They don't have the mental bandwidth for something like that at that point, typically. Yeah,  

Michael: because I feel like sometimes you just. Okay. Yeah, I'm gonna do a 401K or ira, and then I have a savings, then I have a checking, and then I'll just keep racking it up. Right? Why is that not a good idea?  

Ross: Well, okay, so should you put money, let's just uses pick on the ira.

So you're 27 years old, you have a, you're a brand new practice. Should you put money on ira? Well, everyone says start saving for retirement and, and what's funny? . I had someone in my office, they were talk and they had just finished school, finished, uh, dental school, and they were talking about saving for retirement.

And I said to them, you're already start talking about quitting your job before you even started it. so I, I'm not a big retirement guy. If you read the history of retirement, it's, it's kind of a made up thing in the 20th century. Mm-hmm. , um, no one's ever retire. and most people when they retire, it doesn't go well.

But that's another topic for another day. But so you're 27 years old, you put money in a retirement account, which means you cannot touch it until you're 59 and a half. What's more important at 27 years old than new practice money that you can't touch for 32 years or money in a savings account for a rainy day?

And they're like, absolutely, well, I'm not gonna save for retirement. Which by the way, you don't just use retirement accounts for retirement, use all, all of your assets, all of your investments. And so not putting whatever amount you were gonna put in for the first couple years is not gonna change your retirement, whatever that looks like.

But, Not taking on credit card debt cuz you don't have enough cash flow or, cash or, not being able to buy a house cuz you don't have enough cash.

That's tough. I mean, I, I mean there's doctor loans out there, but still you, you need liquidity and, and enough savings.  

Michael: Gotcha. So then what do you recommend then for that 27 year old Right. Who just opened another practice? Like what moves can we make  

Ross: stash? oh, I'm not making any interest on my cash.

That's correct. Not all your dollars are supposed to make in, are supposed to earn interest. You need to have a rainy day fund. What happens if I have no liquidity and all of a sudden my breaks go out? And by no liquidity, I mean no savings. I have no my, my breaks squad. I gotta get no breaks. What does that cost?

if, what if I need new tires? . life will throw all sorts of things at you that cost money and we need liquidity to do that. So, more often than not, there are some people who have too much savings, but usually it's people who have too little savings, not too much.

Hmm,  

Michael: gotcha. So when it comes to the too much savings part, let's just say we stash cash, we're like, okay, we, we can cover enough for like the breaks to go out a million times, right. Or whatever. What do we do now do? Is that when we start with like our,  

Ross: well, I think you need to determine what I call your peace of mind number.

So what does it take you to sleep well at night? Okay. Is it 50,000? Is it 10,000? Is it a hundred thousand? It's a different number for every people. For every person, so you know, whatever that number is. Anything over and above that, I would start deploying to an investment. and there's obviously millions of types of investments.

The most, the easiest one is just to set up a brokerage account, whether it's through an advisor or through yourself and, and start putting money in there. But there's a million different ways to deploy capital.  

Michael: Gotcha. And so that's where we can kind of come in and be like, Hey, Ross, like, what should I do?

Right. Like, look at my stuff. Yeah.  

Ross: Yeah. I mean, that, that's one of the many things that I do. So, um, but there, there's a lot of things that quite frankly, have to be done before.  

Michael: Does anybody ever go to you when they're like, I'm drowning in depth. I have no idea where these holes are coming from, or I kind of can tell, I'm like, I'm not even living with a life that I want, or whatever.

What, what am I doing wrong? Does anybody ever go for you?  

Ross: Um, they have on occasion, to be honest with you. I, I can help those people with something. Really, what I focus on though, and if you're drowning in debt, just listening to someone like Dave Ramsey probably makes sense. Now, I don't agree with everything Dave Ramsey says, but he helps a lot of people.

I think the challenge with him is some people listen to him when he's not the demographic he's, he's reaching to, but he helps a lot of people who are in debt. Um, so, but you know, really if you're a high income I dentist, you know, that's typically where I tend to really help people the most  

Michael: and that's where you help them with allocating to.

Ross: Places, well, it's making, making sure their cash is going the right places, making sure that they're talking with the right tax professionals to mitigate their taxes. I'm not a C P A, I'm not an enrolled agent. I do know an a fair amount about taxes, but there are tax attorneys and there are tax professionals that, um, I connect my people with my clients with to make sure they are, paying the least amount of taxes.

Michael: Gotcha. That's interesting. Okay, so then Ross, what can a dentist do today to improve their business?  

Ross: So, that's a really good question. So there is this continuum that I say for dentists. So, uh, on one side you have dentists who basically own a job. These are all people who their own, their own practice. Dentists who own, own, own their job. It's a good job, but they own. Their job. Then you have dentists on the opposite extreme who are business owners who happen to be dentists. So for example, like I have a friend, he wa, he practices two days a week. It's a fee for service practice. He makes 2 million a year. He is a business owner that is a dentist. I've got numerous clients and friends who make more than that and they're business owners. And then there are some who. , own a job. It's a good job. And there's, and owning a job and being a business owner, one is not better than the other, but it's what do you want? Now, obviously most people are in the, between, in the middle. But what do you want? you wanna be a business owner, maybe you don't have the skills to do that will go educate yourself, find a mentor, and learn how to be a business owner and, and grow your practice because this is the greatest.

Way to create wealth in America is owning a business and a dental practice is a business.  

Michael: Gotcha. And I feel like a lot of people might mainly want to do that. They want to own their, they wanna be the business owner, you know what I mean? Um, yeah. But  

Ross: a lot of people are very shortsighted and they make a critical mistake, which you're gonna ask me about here in a minute.

What is that? They'd sell out. The DSO is way too young. They, they're giving away the golden goose. So I have a cash register. In my basement that throws off whatever amount of money a year, and now I sell it for five to seven years of cash production, and it's gone forever. So if I'm a dentist, I make a million bucks a year, I sell my practice and I get 7 million.

I don't do tax planning, I get murdered on taxes. and now I am no longer a business owner. I'm a W2 employee. I've lost all my deductions. I'm making half of what I was, and I'm basically somebody's employee and I can't do what I want. I had a guy, he, so he was 47 years old. He sold his practice for like 10 million bucks and he says, I said to him, Hey, now you sold your practice.

What are you gonna do? He goes, I'm gonna manage my investments. And I looked at him dead in the eye and I said, brother, you ain't that. Unless you're day trading. And, uh, you know, he's heard me say this story before on podcasts. He's like, were you talking about me? I was like, yeah, I was talking about you.

And he is like, man, I wish I hadn't sold. It's the biggest mistake I ever made.  

Michael: So then when, where is it? Where is it? Where it's like, now it's okay to sell?  

Ross: Well, first of all, Do you wanna sell for the highest dollar? If you do, you're selling to a D S L. You're not selling to an associate or somebody else. Second of all, I don't believe in retirement. I believe in transition. What are you gonna do next? If you don't have a plan after you sell, you're gonna go freaking insane. I've seen people who have gone into deep depression after they retired because they're, they didn't have have anything planned. If you're gonna sit home and watch TV or watch Netflix or whatever brother you have, you might as well just go ahead and start buying your, uh, your coffin. I mean, people were not designed to retire. If retire means do nothing, you have to have a plan. Second of all, a lot of people don't realize how long they're gonna live.

Most people, higher educated and higher income people live. Those are the facts. Whether they're fair or not is besides the point. There is a high probability that most people are gonna live to a hundred years old. Well, 10 million at 47 acts pretty hard to get to a hundred years old. But the longer you work, the less money you need.

Not suggesting you should go spend all your money, but what are you gonna do? So you gotta have a plan. Maybe you decide that you want to go. change careers, that's fine. just don't sell because you got some crazy number. What if you decide to build your business bigger and then sell for twice as much in 10 years?

Yeah,  

Michael: I feel like sometimes. So then what? What is the driving factor that in your experience, that you've seen people sell to  

Ross: soon? Well, a lot of people hate their job. there's a lot of dentists who hate being dentists. There's also a lot of dentists who hate managing people. and that, you know, cuz in dental school you don't learn, you don't learn business, you just learn clinical.

Mm-hmm. And I've seen people try to sell a practice cuz they hate managing people. so that's a challenge. And but I mean, as a dentist you are starting late. You went to, you went to four years, four, at least four extra years of school, you likely incurred a large amount of debt. So you're late to the party when it comes to saving.

So these are things that we, we've gotta make sure that we think through. Just cuz you heard someone get some great, some great multiple, doesn't mean you're gonna get that same multiple. It's not the same situation and you may hate your three to five year earnout, and then you may walk away and lose all that money, which I've heard numerous stories of it.

Michael: Yeah. Interesting. Okay. Okay, so then. We really, really need to brainstorm on this, right? Like, think about it. What are we gonna be doing after? If you're ready to retire? Are you even sure you should be retiring right now.  

Ross: So anyone who wants to think of the word retirement, they should Google the name Dan Sullivan and Retirement.

Dan Sullivan is the founder of Strategic Coach and he does a lot of, he's talked a lot about retirement and what it really means and what it is. Mm-hmm. . , I think we've been conditioned about this whole concept of retirement and I don't buy it. I don't ever wanna retire. Mm-hmm. , my dad had a force retirement.

He was a good saver, so he was okay financially, but he retired in his early fifties and I saw him over the next 20 years physically and cognitively declined to be a shell of himself. I saw that. I was like, I ain't doing that no interest whatsoever. I'm never stopping working. I mean, I may do something else, but I'm not stopping working.  

Michael: Yeah. No, no, no. But I mean, like, what do you mean by like your dad? He became Michelle like, he's like,  

Ross: well, he is physically, he's so frail. It's not because he's so is 75 years old. Even he is still alive cognitively, he's not using his brain.

Your brain's a muscle. He watches TV all day and he is, you know, he's just a parrot of what's ever on tv. He can't have an intellectual conversation. it is just, it's no way to live. Yeah. So I I'm not doing that.  

Michael: Yeah, no, I get you. I get you. I, I don't, I don't ever think. I don't ever think I can just stand still and, um, you know what I mean?

Like, just be there. It's like your brain's constantly like, oh, this idea has to, has to happen right now, you know, kind of thing. And you build it, do something, uh, conversation. So I agree. You said Dan Sullivan Retirement.  

Ross: Yeah. Google those three things. Okay. Dan Sullivan's the founder of Strategic Coach and it's a phenomenal program I would probably recommend any dentist, any business owner, consider it. Okay. So, all right. So the, if you type, if you type Dan Sullivan retirement into Google, it's not Sullivan Retirement Resource. The first one. It is the second link. It's why I don't Believe In Retirement by Dan Sullivan. Okay.  

Michael: Okay.

It's gonna put a link to that in the show notes below so you guys can, can also read about it. Check it out. I'm gonna read about it. Check it out. You know what I mean? Oh, oh yeah, for sure. Yeah. Awesome. Okay. Okay. So. These next questions, Ross, are just to get into the head of, of someone who isn't totally involved on the clinical side of dentistry.

Right. Okay. So for you, what would you like to see more from a dentist?  

Ross: Well, it's hard for me not to go back to the start thinking like a business owner. . So you start thinking like a business owner. And I think that enhances the overall practice in so many ways. It enhances the lives of the staff because if you start thinking like the business owner, you start creating more revenue.

And now you can also, as you create more revenue, you can start paying your people more. You can start rewarding them more. and so I think that I is a really important idea. And the, and the bigger you go, the more people you. . Do you feel  

Michael: like sometimes dentists think they're thinking like a business owner, but there's signs that  

Ross: they're not? I think everyone who owns a business many times thinks they, they're thinking it and, and they may be missing them both, even you and I. So, um, the question is to really be a business, can you walk away and still continue? versus being self-employed. so the example I gave someone practicing two days a week, he's got two or three associates.

If he walked away completely, he may not make money he's making, but he is still doing really well.  

Michael: compared to someone who can walk away. Okay. And then right. What do you hate about dentistry? What do you not really like at all about dentistry?  

Ross: Okay. At the risk of offending people, uh, I don't like that they're sheep and that kind of comes up harsh, but they all do the same thing.

They all join the same club. They all get the same Facebook group. If one person says it, they all. . It's like if one person says by Bitcoin, then all of Bitcoin was bought by Dennis . I'm, I'm exaggerating, but only slightly, I'm making a broad brush, uh, generalization, but they tend to they just tend to all do the same thing.

and they trust anybody who is a dentist or a former dentist, and there are some people out there who are, you know, dentists and they give recommendations to people and they're just not good or they just immediately trust them because they are a dentist.

or a former dentist or whatever. And I mean, not that these people are bad people, but you just have to be a little wiser and smarter about what you do. Um, you can't just join something or be a part of something or trust somebody just because they do what you do. And you know that, that might be a little unfair on my part because, you know, there is a, a, probably a fraternal feel.

To someone in your industry, but, you just wanna, I mean, and I'm not saying that they're bad groups or bad people, but don't just do it because everyone else will do it. Start to think a little bit contrarian, if that makes sense. So I'm not trying to disparage anyone individually, I'm just saying people need to think for themselves and not just follow the crowd.

Gotcha. You see that pretty. I mean, I've seen a fair amount of times and, uh, I view jokes to, uh, some of the, some, some, uh, dentists. I said, you know, there I met like a few guys from, one certain Facebook group and I said, oh, that, that group's a cult. And they just started laughing. And so, uh, so it's kind of funny.

Michael: Okay. Okay. And then right now, what do you love about dentistry?  

Ross: I love that. I love that it's an opportunity to build a business. I was talking to a. a senior in, in, in college, and he wanted to go be, he wanted to go be a doctor, a physician. I said, dude, go be a dentist. You'll make twice as much money. And most physicians are W two earners.

and they gotta go to med school, then they gotta do a residency versus dentist. You know, you're, you're a business owner and so you have the ability to make so much more. You're not getting. , your pay cut by insurance reimbursements. Obviously dental insurance has its challenges, but nothing like medical insurance.

and so it's just an incredible opportunity to create wealth. Owning a business is a great way to create wealth.  

Michael: Gotcha. Okay. And then right now, what, when it comes to, I guess, building wealth, pieces of advice, can you give us like instructions when it comes to, uh, building that  

Ross: well, I would assume everyone who's listening has heard of Warren Buffet, and he says, the number one habit to acquire is the habit of thrift.

What does he mean by that? He means savings. Save your money so I can prove your savings rate is more important than your rate of return. So saving 20 or 25% or 30% of income is more important than getting 10, 11, 12%.

Now, you do wanna get a rate of return on your money, don't get me wrong, but you wanna save at a high savings rate, first. So save money. Now, obviously you need to invest it, but save your money.  

Michael: Gotcha. Okay. So. Save it as much  

Ross: as you, let's, let's, okay, let's, let's deal with the problem of too much savings versus having too little savings.

So if I told everyone listening, don't do a thing with your money until you get a hundred thousand dollars in the bank. There'd be a lot of people who have have to stop doing what they're doing until they get a hundred thousand dollars in the bank. So let's save our money. There's lots of places to deploy capital, but we need to have a lot of cash on.

Michael: Yeah, I, I, I think it's, uh, I think it's Ramit Safety from that book. I will teach you to be rich where he is like, saving isn't sexy, but it's like the best thing we can kind of do. Right. Just like, just put it in there and that's it. just don't move it. But we get that shiny object syndrome sometimes where we're like, what?

Oh, they're doing this. We gotta do that, and then we gotta do that. And we got, you know what I mean, kind of thing.  

Ross: It's like what Elon tweeted about Dogecoin, let me go buy $10,000 worth Doge Dogecoin, which is the same thing as lighting my money on fire.  

Michael: I fell into that and then I was like, uh, it's there now.

It's, you know what I mean? But you're right. It's the, it would've been better just to save it way, way better. So I get you a hundred percent. Awesome. Any final pieces of advice that you wanna give to our listen?  

Ross: No, I mean, nothing at all. Just, I mean, there's a lot of advice that's kind of in silos out there and, and really you want to get advice that's kind of, like I said earlier, more holistic.

So that's the ideal scenario. obviously everyone has some things are trying true no matter what. Some things are opinion, but you want to mathematically verify whatever you're talking about. So let's weigh and measure decisions so we know. What the right decision is.  

Michael: Gotcha. Awesome. Awesome.

Ross, I appreciate your time. Thank you so much for being with us, and if anyone has any questions, where can they find you?  

Ross: Two places. One ross brennan.com. The site's getting rebuilt. It's, it's sufficient for now. It's getting rebuilt though, so if it's not as sexy as you like, please forgive me. Um, but ross brennan.com or you can call me or text me.

Uh, I, I, I answer every phone call. I'm not afraid of the phone. Uh, eight five oh five six six seven nine nine nine eight five oh five six six seven nine nine  

Michael: nine. Awesome. So that's gonna be the show notes below. And Ross, thank you for being with us. It was a pleasure. And we'll hear from you soon. Thank you  

Ross: so.

Michael: Thank you guys so much for tuning into that episode. And Ross, thank you so much for being a part of the podcast. We truly appreciate it. Guys, if you wanna reach out to him or you wanna talk about this episode or any other episode in the past, you can definitely do so two ways, actually. You can do it on our Instagram.

Just search us under the Dental marketer. That's our handle. You can find us there. Or second, you can join the Dental Marketer Society Facebook group. It's a free Facebook group. It's gonna be in the show notes below the link to that. You can definitely talk to the guests who've been on this podcast, or you can talk to other guests who've been on other episodes in this podcast as well on there and ask any questions or concerns.

But thank you guys so much for tuning in and don't forget to check out Care Stack. More and more people are signing on because it's an in. Cloud-based practice management software. So click the first link in the show notes below to see more and schedule a free personalized demo. And you can see all the exclusive deals that, uh, you're gonna get as well in that link in the show notes below.

So if you're just nosing, you wanna check that out, go ahead and check that out. All right guys, so the book is called Essentialism by Greg Macallan, and the quote is, pause Before You Speak. It can greatly reduce the possibility of making a commit. You'll regret. All right, that's gonna do it for this episode.

Thank you so much for tuning in, and I'll talk to you in the next episode.

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In this episode, Dr. Roy Shelburne, breaks down medical and dental insurance billing, and the shifts he has seen in the dental world. He expects to see more movement towards medical billing in the future and recommends training on it! Dr. Shelburne goes over different billing code manuals, how to implement them, and how to make sure you are following the right information. While internet searches and groups are a helpful resource, he endorses finding a qualified consultant in billing as an important step. With rules and codes constantly changing, this might be one of the overlooked areas worth updating in your practice!

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Drop in on Michael and Roy's conversation here to get the latest recommendations and predictions for medical and dental billing!

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You can reach out to Roy Shelburne here:

Email: [email protected]

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Mentions and Links:

Medical Dental Cross Coding with Confidence 2023

Dr. Roy Shelburne Bootcamp and CE Events

ICD - International Classification of Diseases

ADMC - The Academy of Dental Management Consultants

ADA - American Dental Association

ADA Coding Manual

ADA Coding Manual Companion

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If you want your questions answered on Monday Morning Marketing, ask me on these platforms:

My Newsletter: https://thedentalmarketer.lpages.co/newsletter/

The Dental Marketer Society Facebook Group: https://www.facebook.com/groups/2031814726927041

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Thank you for supporting the podcast by checking out our sponsors!

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Linkedin

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Heartland Dental

EBITDA - Earnings Before Interest, Taxes, Depreciation, and Amortization

Eaglesoft

Excel

E*Trade

Bear Stearns

Affordable Dentures

Dr. Rick Workman

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Join my newsletter: https://thedentalmarketer.lpages.co/newsletter/‍

Join this podcast's Facebook Group: The Dental Marketer Society

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My Key Takeaways:

• You do not have to own multiple practices to be successful!
• Revenue is a secondary thought for buyers. Ultimately they want to see positive EBITDA and cashflow in your practice.
• Sometimes selling a negative EBITDA practice can help your portfolio in the long run!
• Using the newest tech to inform patients what is going on in their mouth can make treatment much more palatable.
• With worry about the upcoming economy state, if planning to sell in the next 12-18 months, selling sooner could be the right choice for your practice.
• It is possible to have millions in revenue and no profitability. Watch out for this when evaluating your practice!
  

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In this episode, Dr. Ben Burkitt, from We Care Dental Care, shares his experience in dropping PPOs and when to do it! Like many of us, Dr. Burkitt started off with what he calls "too many" PPOs. While being in network with insurances can be a great place to start, gradually switching to other forms of marketing can offer a large boost in profitability for your practice! Ben shows us that high volume does not mean high profitability, and even though you may lose some patients dropping PPOs, it may be worth it. He states when dropping PPOs, being transparent with patients is especially important, communicating that you are dropping their insurance in able to maintain high quality care. It is also important to keep track of your highest production procedures and whether or not the insurance is direct, leased, or under an umbrella plan. These all contribute to making the right choice for your practice.

Learn more about when and how to best drop PPOs to maximize your profitability in this week's episode!

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You can reach out to Ben Burkitt here:

Raising Dental Income Website

Email: [email protected]

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Mentions and Links:

Humana

Delta Dental

Cigna

GEHA

United Concordia

Yellow Pages

Eaglesoft

Dentrix

Open Dental
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If you want your questions answered on Monday Morning Marketing, ask me on these platforms:

My Newsletter: https://thedentalmarketer.lpages.co/newsletter/

The Dental Marketer Society Facebook Group: https://www.facebook.com/groups/2031814726927041

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Thank you for supporting the podcast by checking out our sponsors!

This Episode is Sponsored By:

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Jaws: The Story of a Hidden Epidemic

Breath: The New Science of a Lost Art

Profit First

Dentrix

Eaglesoft

Bigcom Healthcare

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Bank of America

Wells Fargo

@thedentalmarketer

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Join my newsletter: https://thedentalmarketer.lpages.co/newsletter/‍

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My Key Takeaways:

• Infancy is the stage to start screening for future sleep apnea issues!
• For an older demographic, running an ad in the local newspaper might be a better strategy than all social media.
• Sometimes just offering different services isn't enough to differentiate from your competition!
• Try having separate meetings for admin and clinical planning and processes.
• Be understanding with parents concerned about upcoming surgery on their children! This can be a scary concept for them.
• Collaborating with local chiropractors, physical therapists, and lactation professionals can be a great way to broaden your offerings!

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Download any of these forms and templates mentioned in this episode here: DOWNLOAD INSURANCE TEMPLATES & FORMS

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In this episode, Khoa Nguyen, from Verifixed, shows us some of his favorite tips for efficiency, mindset, and effectiveness when handling insurance claims! Khoa notes that we need to start thinking of lower reimbursement rates on insurance claims as a marketing expense. When we are out of network with insurances, we do not have access to their patient-base! When claims are denied, Khoa recommends getting a live person on the phone from the insurance company. If you use this method for all of your appeals and focus of what you know, rather than accusing, the insurance company agents will likely help you out. It is also wise to keep track of specific information on your patient's benefit breakdown to ensure a smooth appeal.

Drop in on Michael and Khoa's conversation here to learn more about insurance tips and best practices!

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You can reach out to Khoa Nguyen here:

Email: [email protected]

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Other Mentions and Links:

Verifixed

Khoa's Previous MMM Episode

Metlife Insurance

Delta Dental Insurance

Cigna Insurance

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If you want your questions answered on Monday Morning Marketing, ask me on these platforms:

My Newsletter: https://thedentalmarketer.lpages.co/newsletter/

The Dental Marketer Society Facebook Group: https://www.facebook.com/groups/2031814726927041

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