“I love dealing with insurance companies!” — No one ever. How do you transition into being a fee for service dental practice? Mark and Howie explain!


Podcast Highlights:

  • What is the average age of a practice that starts the transition?
  • How many new patients per month is “safe” before you start?
  • How long does the average transition take?
  • The dangers of going cold turkey on insurance
  • The team-oriented approach
  • How much of your revenue comes from insurance?
  • Promoting your practice during and after the transition
  • Which insurance companies to you get rid of first?
  • Celebrating the small wins
  • Targeting the right kind of patient
  • Setting the right foundation of internal marketing, internet marketing, and SEO
  • Where should you be promoting?
  • Online scheduling and being convenient

Podcast Transcription:

Hello, and Welcome once again to the Dental Marketing Mastery series. This podcast is brought to you by DentalWebContent.com and New Patients Incorporated. I’m Howie Horrocks, the Founder of New Patients Incorporated, along with me once again, as my friend and partner and the President of New Patients Incorporated, Mark Dilatush.

Howie: Hello, everybody. Welcome again to a podcast. An unusual podcast. This is Eclipse day. Mark, how you doing out there?

Mark: Good. How are you? It is a Eclipse day, I actually had a picture of a pair of glasses with two packages of Eclipse bubble gum taped to the front of them on Facebook as my as my public service announcement for the day.

Howie: Yeah, well, wouldn’t you know it yesterday, of course, sunny skies, hundred and three degrees, not a cloud in the sky. Today, of course, totally thunderstorm, Thunder showers. And so we don’t get to see the eclipse here in Vegas.

Mark: Well, I have a skylight in my office. So when it gets dim, I’ll know that the eclipse is happening. And when the sun comes back out. I will know that it’s not happening. And I will just continue on with my day,

Howie: And everything will be exactly the same

Mark: And everything will be exactly the same. That’s correct.

Howie: All right.

Mark: Well, anyway, um,

Howie: Today,

Mark: Today is what is this podcast? 66? Oh, my goodness.

Howie: Yes. So we’re going to talk about you know, we’ve talked about this before in transitioning out of insurance. It’s, it’s actually quite a hot topic. What we’d like to do is go back and say, do a little review of the procedure that we’ve, you know, been talking about over the years. And then some new things you can do in regarding, regarding this topic of getting out of the insurance contracts that you don’t want to be in anymore?

Mark: Yeah, I mean, the new things are kind of mandatory. So. So let’s just go back and review. Normally a dentist who’s been in practice for about 10 to 15 years minimum, are the folks that would come to us and say, Okay, how do we do this? Doesn’t have to be that way.

But that’s kind of normal. And normally, those practices are seeing, you know, 25 to 30 new patients a month through their referrals, through insurance plan websites, and through whatever marketing outside advertising they’re doing. And they’ve gotten to the point where they feel like a hamster on the hamster wheel, and they can’t really grow the practice, their four walls are constrictive. Maybe they have three or four operatories, they only going to work 32 to 38 hours a week, staff doesn’t work.

In other words, they need to make more money within the same capacities, the same doctor, same number of chairs, same number of office hours, same number of everything, and they’ve chosen to change up their marketing. And they come to us and they say, Well, you know, how do I how do I go about this, and normally, our counsel is really kind of to slow them down. And just let them understand that even in an average US market, a transition from being somewhat dependent on insurance to insurance free. I mean, hell, it can take 35 to 40 months, and actually does in most cases, and then most folks are okay with that. They’re there. Okay, you know, slow is good.

Howie: Is kind of a light at the end of the tunnel.

Mark: Yeah, yeah, it is. And, and I am, we’ve seen and heard of too many horror stories for people who, who go what’s called cold turkey. You know, that day in November, when they’re calling all the insurance plans and saying I’m not, you know, I’m, I’m not going to participate anymore. That’s the one day they’re really happy. That, you know, it becomes, you know, quite the quite the challenge to maintain the patient base. So there is certainly an option to cold turkey. And the option is very slow, very methodical, very team oriented path to, you know, not relying on insurance participation for either the majority of your new patients or even a minority of your new patients.

And let’s go all the way back to the beginning, because the whole reason you would do this is because insurance participation, excuse me, insurance participation costs you. at the low end, 18% of your revenues at the high end, probably 30% of your revenues, and every every dentist that’s listening to this has heard the same stories coming out of Seattle, Minnesota, Massachusetts, it’s coming all over the place that the insurance, the dental insurance companies aren’t. They’re not increasing their reimbursements. They’re basically tightening the screws down on the providers. So if hoping that they’re going to reimburse you more, if you’ve already exhausted that as a possibility.

Now Now you’re faced with the choice of all right, so if I’m already spending 20 to 30% of my, my fee for marketing, basically, because that’s what insurance plans are you get on a list, you get on a website and you hope, potential new patients find you. That’s basically all it is, is a marketing medium. How do I do the marketing for less than 20 to 30%? And the answer is, almost every one of our client know how we we we have zero clients with a 30% marketing budget, right? We have zero clients with a 5% marketing budget.

Howie: Exactly.

Mark: I don’t know if we have any with a 10% marketing budget?

Howie: I don’t think so.

Mark: So the answer is, is you got to start to promote dentistry in your office in a smarter way. And the downside is, is that you’re going to have to take the insurance hit while you dig yourself out. And that’s always what stops dentists from doing it. They’re like, Oh, my God, I’m taking a 20 or 30% hit, and I have to spend 5% of my revenues on marketing. And we have to say, Yeah, you got to that’s, you know, that’s the first shovel in the dirt.

Howie: So it’s just a gradual thing here. Right? Right, you don’t want to overwhelm yourself,

Mark: Right? So the way you do it, you run an insurance company, a car insurance company list matched up to the number of patients you have, and you put them in order, then the insurance company with the most patients who are represented in your office all the way down to the insurance company with the least representation in your office. And you’re going to focus on the bottom of the list first, because those are going to be the easiest patients to replace, because there’s, not the numbers not that high.

Maybe there’s 17 patients who happened to have metlife insurance that you participate with in your office, well, getting 17 new patients through the door that don’t have metlife is a hell of a lot easier than let’s say if you had 300 Delta patients, right. And when you’re going through this process, like I said, it’s a real long term process and you want have these little successes that you and the whole team can point to.

So what you do is if you have a break room or a place that patients don’t go, maybe it’s your personal business office, you take your list, you invert it, you put the plan with the least number of patients in your office first, and you highlighted yellow and you let the whole staff know is that’s the first one, we’re going to promote this practice until we get 17.

Howie: I’m just using an example here,

Mark: We’ll get 17 people to replace the 17 that are on this plan. That way, when we call and say we are no longer participating in your nasty plan, you already have the 17 they’re already replaced. And if those all those 17 patients go elsewhere, you’re not impacted negatively, you’re actually impacted positively because you’re no longer writing off 20 to 30% of your fees.

Okay, so you want to have little successes first, and sometimes it’ll take three, four or five months to get that first one. But watch what happens to your team. When they understand what the goal was because trust me nobody on your team gets up in the morning and says, Oh, God, I feel so good. I went to the gym, I get to go to work and deal with insurance companies all day. No, nobody in the history of dentistry has ever said that ever

Howie: Said by no one ever

Mark: Said by nobody. Okay? So they feel just another driven by something different. But they’re driven just the same. Okay, they want to get rid of all these bad plans almost just as much as you do. Right. So you set it up in a way that you have success, and you have little steps of success. And let’s say it takes you three or four months to get those 17, then it takes you another six to eight months to get the other plan that has 27 people on it. And then maybe it’ll take you, it might take you the better part of a year to get the one that has 110, and then oh my goodness, there’s a big one at the end, there’s always the big one at the end.

Every time you check one of those off that list, you become more profitable every time. Because if you replace 17 new patients that are more or less fee for service dental practice patients, and you supplant 17 patients who have a plan that are is paying you 70% of your fee schedule, your your revenues will rise and your revenues will rise within the same footprint, same hours of operations, same number of dentists, same number of hygienists same number of everything. Okay, that’s how you do it. So that’s the review. Yeah.

And when we come back, we’ll talk about three or four new tools that I’m not going to say their mandate, nothing’s mandatory in life, but I’m going to say, Wow, they really dovetail in really well, with the process of gaining and retaining um, you know, I’m not going to say uninsured patients, I’m going to say patients who care more about their mouth than a deductible.

Howie: There you go. So don’t go anywhere, anybody. We’ll be right back.

We hope you are enjoying our podcast. Let me ask you, do you have a roadmap for your marketing? Why not let new patients incorporated do it for you, our marketing plans have been proven effective for over 27 years for hundreds of practices across lots of different countries. We will give you the marketing data for your area, a marketing budget will show you how to allocate your budget. And then we will show you the proper deployment strategies for each medium. Click on the header where it says complimentary marketing plan when you go to www.newpatientsincorporated.

Howie: Okay, we are back. We’re talking about transitioning out of insurance plans that you no longer like,

Mark: No. Okay, well, so now we’re at the other end, where we need a little bit of review. Okay. A little more review, you gotta have your internal promotions, setup, right, all your referrals, I mean, you have to have a decent referral rate. In order for this to work, your online dental marketing media, your website, your SEO, these things have to be in place, they have to be rock solid. And you have to be promoting somehow locally through an offline media type to drive qualified local people to your website that’s already there. So if you have those in place, well, first of all, if you don’t, those, that’s what you need. Don’t spend any money on anything until you get those three, once you get those three.

The next things we’re going to talk about should be logically organized in your mind to take a fee for service or I think before the break, I define them as patients who care about their mouth more than a deductible because everybody listening to this, this knows that there’s insured patients that they’ve done $5,000 worth of work on in one year, their insurance only covered 1500 of it. So so what we’re talking about is extending or the additional things that you have at your disposal that you could use to build more of a fee for service type of practice. And from our perspective, they’re mandatory. So let’s go through them.

Number one is the internal communication. You have to have your texts, confirmations, recalls, newsletters, birthdays, your emails, all that stuff has to be done and done. Well, I think that’s a staple in the industry. If you don’t have it, you know, it’s extremely affordable. So allocate some of your marketing budget to it. Now we go outside the practice. And remember, we said we’re going to have a website, we’re going to have maybe SEO, maybe we’re going to have an offline campaign driving qualified local traffic to our website. So this next piece of this is really important, because when people go online, they don’t just go to your domain.

In other words, you’re here. Okay, let, let me give you an example. Let’s say you’re doing an offline promote, let’s say it’s a print ad. So open up the paper, and I see Dr. Phil Smith, DDS, and his email, or his URL for his website is, Phil Smith, is great.com. That print ad viewer has a couple of options they can type in, Phil Smith is great calm right into their browser, and they can go right to the doctor’s website, some do, some don’t, what many do is they type in Phil Smith, you know why they type in Phil Smith, because they want to see Phil Smith’s online reviews, and how those reviews stack up against his peers in order to make an even more qualified decision for the health care for.

And in this case, I’m going to say her family because that’s 99% of the people who are calling your office or women, a lot of women will just type in Phil Smith, because they know they’re going to get that little Google box with the Google reviews. They know when they click that they can click through and they can see the reviews stacked up for the rest of the market. And they can compare Phil Smith with the rest of the market.

So here’s what we’re saying. If you want to be a fee for service dental practice, if you want to rely less on insurance plans and insurance participation, for your patient, attraction, then be the review champ in your in your market. Now you can do that. There’s products that will do that. And those are one of the products that we want, we have one called NPI Crusader. But there are others. If you already have a product that you think is doing it, then I would ask you to go Google yourself and see how you stack up to others in your market. Because if you’re going to try to transition to a fee for service dental practice, you can’t be the third, fourth or fifth, you have to be one or two.

Right now that hopefully, it’s the same process you go through when you look for a restaurant, same process you look for when you look for maybe schools, or health, any healthcare. You look at reviews, you look at the first the second, and then you always look at the train wreck with the worst score. Just to justify your great decision of choosing the first one or the second one.

Howie: Exactly.

Mark: You almost never choose the seventh one.

Howie: Right.

Mark: And I think if you’re honest with yourself, you’ll go Yeah, you know, what? Kind of makes sense? Why the hell would I choose the seven it’s kind of like a review limbo. It’s like the old have no reviews. Seventh, right. So now I’m not going to get into Crusader and all the way it does and all that stuff, we can do that a different day, but the dental office reviews and paying attention to them. And even if you’re verbally asking your patients for reviews before they leave, and to leave them on Google, that’s a head start, you can do that tomorrow, you don’t need a piece of software to do that for you, you could literally make a change tomorrow from listening to this podcast. Okay.

Now, the other one is, and this is going to be maybe hitting on some of you, but it shouldn’t be yet another one is online scheduling. And, um, so let’s go through the scenario, we just went through a scenario where we generated through offline media interest in your practice, and that person either went to your website directly or your Google page, and they judge you based on your reviews and your online reputation, and they still chose you. That’s awesome.

They went to your website, and on your website they saw they’re going to see the availability of scheduling online or they’re not not a form an actual appointment. You can’t do a form, because forms are not convenient for mom. They will soon shortly become things of the past. If you have a fee for service dental patient on your website, what’s the one thing you want to do with them right now you want to close the deal? You want to convert them right now. And the only way to do that is to allow them to schedule in real time from your website. It’s a it’s your closed? It’s eight o’clock in the evening on Friday. Yeah, it’s Saturday. I’ve got a toothache. It’s Sunday. I’ve got a toothache. We had two appointments made on Super Bowl Sunday.

Howie: Oh, that’s right. We did.

Mark: Yeah, I know. No, I just insane when I saw, like, what are you doing? Why are you one of the 65 billion people watching the Superbowl. You’re making dental appointments, right. So if you’re going to take the time, if you’re going to spend the money, if you’re going to go through the growing pains, if you’re going to go through this with your staff, and if you’re going to do all this stuff, right? And you’re going to have to do all of it right?

You can’t do any of it wrong. You can’t make a mistake on your way there. If you do, you’re going to have to recover real quick, right? So if you do everything right, and get them to your website, after they’ve reviewed your reviews and your online reputation, you’re still going to lose them. That’s what the online scheduling does. That greatly helps with that. It converts that traffic that you’re paying so dearly for. So this is an attendant to a podcast, we did what I don’t know how it was probably like in the 20s or something, or maybe even the teens.

Um, and you know, we manage a lot of fee for service dental practices. So we see it, we see the we see the review the impact, we see the you know, online appointments coming through, we see him coming through on weekends, we see him in the evenings.

So this isn’t like a you know, an idea. This isn’t a This isn’t a thought or hope. Okay, we’re actually visually watching it happen on and so it’s no longer like a luxury. It’s, it’s just straight up. It’s it’s a necessity. And the cool thing is, is that they’re all very affordable. There’s not none, none of this stuff is going to break your bank. And when you’re starting to make an insurance transition, man. We get it. I mean, you’re taking the 28% hit through the insurance plans, and you got to promote with 5% of your revenues. We know it hurts. So we have to make your money spread out all over the place.

Howie: We get help. It helps that these are very low cost. Yeah, of things that you can implement. That helps tremendously. Well, great. I think we’ve covered that for today, right Mark? We think,

Mark: I think so, there’s so much more. I wish I had I wish we could do a 48 hour podcast. I just sit here and talk but

Howie: yeah. Well, we can’t we can do 48 one hours, but

Mark: yeah, yeah. Nobody would listen to a one hour podcast either. We go with the 48 hours times. 20 minutes. It’s like 150 podcasts. Wow.

Howie: Yeah. Okay.

Mark: We’ll get there. We’ll get there.

Howie: Well, thank you everybody for listening once again, and we will we will be back with you before you know it. Goodbye.

We hope you’ve enjoyed our podcast today. You can find more podcasts on our YouTube channel, on Stitcher and iTunes. Also on our websites, dentalwebcontent.com and newpatientsinc.com