When insurance companies cut reimbursements, should you take it or leave it?
Transitioning away from insurance dependence.
Not feeling cornered or helpless—there is hope.
How to fight back and take action.
Finding patients who value you and your team more than an insurance plan.
Using Membership Plans to ease the transition.
How long does it take?
Unifying and motivating your team for success.
Preparing, executing, and budgeting for a marketing plan as a way to replace insurance-dependent patients.
Calculating how many new patients you need to replace insurance patients.
Consciously targeting higher-quality new patients.
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 once again to our podcast. We’re so happy to be here with you. And we’ve got Mark out there in the Joyce. How’s it How’s it going, Mark?
Mark: All right, man. I’m going to build an art. We haven’t seen the sun out here for like a week.
Mark: Yeah. Just ran and they’re supposed to be a hurricane coming.
Howie: Oh, that’s wonderful.
Mark: Isn’t that wonderful?
Howie: Yes. Exciting.
Mark: We have the remnants of the hurricane or tropical storm that hit? I think Louisiana. That’s what we’re getting now. And then right behind it will be Florence. So,
Howie: Oh, yeah.
Mark: Yeah, whatever.
Howie: Well, out here, our biggest problem is the temperature plunge from 106 to 102. And,
Mark: Yes, I know.
Howie: just really sad about
Mark: the rapid temperature change.
Howie: Okay. And, you know, what, what’s been floating around some of the dental Facebook groups and discussions and other places is just the outrage. And what I perceived to be outrage on dental insurance, you know, cutting back their reimbursements and doing it in the typical insurance company fashion of, we’re doing this, take it or leave it, you know, what do you think about that?
Mark: Yeah, it’s happening. It’s, um, I don’t know, we probably get, I don’t know, half a dozen phone calls. Week, maybe. Where that topic comes up. Um, and a lot of it comes with I don’t know what I’m going to do kind of a mentality.
Mark: Okay. So, I know we’ve done a podcast or maybe two, we’ve done 100. And I don’t know, 15 or 20 of these so far. And I think once or twice, we talked about insurance transitions. But especially now I think it’s it may not have been as hot of a topic as it is now. So that’s why we’re kind of a dip in the back subject matter and throwing it back out there. So, the first thing that I would encourage everyone, um, is to never feel like you’re cornered. You’re really not you’re really not corner. I mean, yes, there’s some areas of the country.
Southern California, Long Island, actually, almost any of the boroughs of southern New York, there are certain areas of the country where, yeah, it’s going to take a really long time to transition away from an insurance plan that is pretty much dictating to you. And like Howie says, they’re basically saying, you know, what, take it or leave it, man. You know, we have enough providers on our roles, we don’t need you. Um, but you don’t have to feel helpless. So. So that’s the first thing I would encourage everybody who’s listening to this podcast, this feeling of hopelessness or helplessness is that that’s, that’s not, it’s just simply not true. There is hope. And you can get help. Okay, so that’s,
Howie: You can do something about it.
Mark: You do some about it. Right? Exactly. You got actually you can get angry.
Howie: you can fight back,
Mark: Right, and then fight back and take action. Right. So. So we’re kind of here in the role of, um, I guess, mentor, and in trying to help, you know, get over that helpless feeling and say, Well, wait a second, of course, there’s something I can do. I can, I can attract patients who don’t have that insurance, I can find patients who care more about their mouth and an insurance deductible, there’s lots of things I can do. Your challenge might be that you don’t know how to do that. Now that make sense.
Mark: Because even after 29 years, we don’t have all the answers either. So,
Howie: Another daunting prospect, I think, in dentists minds, at least the ones that we’ve talked to, is that they somehow feel that it’s going to take a while. And the truth is, is it can it can take a year or more, you know, to transition out of away from insurance dependence, right?
Mark: Oh, yeah easily.
Mark: We, we spoke to Sal and I were speaking to an office today, this morning. Um, you know, pretty famous consultant, who’s pretty famous for wanting all their practices to go insurance independent and be insurance free. And, um, low number of days work incredibly high, you know, production per day type of a consultant, which is great. As long as you know, as long as they can pull it off and this last step in this quest, was, you know, 25% of their practice is delta. And they’re getting out of delta. And they already made that decision, they actually already said in their letter, and then they called us three months later.
So, um, you know, naturally, when I’m on the phone with him, I can’t say, Oh, darn, you should have called us six months ago, instead of, you know, three, I’m not gonna do that. But um, that’s what they should have done. Right, they should have called us three, or, you know, three to six months before they even pulled the trigger on that sending that letter out.
Anyway, um, let me first say that in in, you know, in 31 years in dentistry, I’ve never seen every patient that had an insurance go to a different practice. So, your attrition rate will not be 100%. Okay, so you can start to erode that hopeless feeling? A little bit, okay. There are patients who have insurance x, that value you more and your team more, and the care you provide more than whatever their insurance plan is, there are going to be patients that if you sit down and talk to them about it ahead of time, there are patients who may opt out of their dental insurance at work and opt into your membership plan.
Howie: Yeah, good point.
Mark: It depends on whether or not you have a membership plan. Okay? Okay. So, there are definitely things that you can do to prepare for this type of a transition way, way, way in advance, like, three to six months before you send that. That letter, right. Um, while you’re preparing, one of the things, and this is where we get involved is you prepare a marketing plan. Because replacing 25% of your patient base at most is, you know, is not something that you’re just going to happen into, it’s not going to happen by luck. It’s not going to happen, just by throwing money at a problem.
Okay, it has to happen with the right plan, and the right execution of that plan. And the right application of the right budget amount. So, all that stuff really needs to be calculated up front. So, you know, how to prepare, you know how to prepare mentally, intellectually, you also know how to prepare emotionally, certainly financially.
Howie: Yeah, and your team has to be prepared to because they’re going to play a very big part in all of this.
Mark: Oh, your team, if you do this, right, your ala has helpless or as you may feel. After you get that letter from that insurance company that says we’re cutting your reimbursement, you know, another 20%, and we hope you like it, have a nice day. as helpless as that feeling is if you can reverse that. And imagine how incredibly motivating this could be for you and your team during day to day operations. climbing out of this. know, it’s like it’s like a rehab. Right? It’s like the 12 step process. Right?
It’s like, right, right. It’s part of the process as being jacked up every day, that when that phone rings, your team is going to be if you do this, right, if you prepare them, right, your team is going to be they’re going to be so psyched when they get a new patient into the schedule that is not beholden to this insurance company. Right?
They’re going to be paying extra attention to the way they answer the phones, how they have their conversations, where in the schedule, they go, the things that they do with the patient to follow up the extra little care and service that they provide each of these new patients, you watch you watch what happens, if they’re involved in this and you’ve involved them in a really good beneficial way. They’ll be on board with you, they’ll be 100% behind you. Because who in the office really seriously, who in the office thinks dental insurance is more of a pain in the butt
Mark: than your team.
Howie: Who likes dental insurance here? Raise your hand.
Mark: Yeah, raise your hand. you know,
Howie: It’s a pain.
Mark: Right, It’s a pain in the butt. Because you know, you’re the dentist, you have to look at you get some questions about dental insurance, I’m sure you’ve probably get accepted or rejected on a daily basis based on dental insurance. So there’s an emotional toll on you. But step back for a second look at your team. Because those patients are asking them the same question they ask you, but they got them first. Okay.
Mark: They’re not asking them any different questions. And they’re asking you, they’re just asking a different person. So there’s justice, they hate dental insurance just as much as you do. And if you have somebody in your office, your financial coordinator, whoever handles your insurance claims, and there, they I guarantee you they hate dental insurance. So,
Howie: Of course, I mean, the whole thing is, is faulty premise to begin with. It’s like, you know, dental insurance is a coupon, right? It’s a discount coupon. And, but the patients don’t know that they expect it to cover everything. Of course it doesn’t. And when they find that out who they’re going to get mad at, well, you and your team.
Mark: Right, exactly. Right.
Howie: They’ll ruin your day.
Mark: They’ll give you a bad Google review. And then you’ll become stressed, right? So,
Mark: We get it, we understand it. Um, and it’s not helpless. It’s not hopeless, you can definitely prepare things to get out of this. I’m not even going to call it a mess, because I’ll take the whole other side of this discussion. And I’ll say sometimes we recommend patients, not patients, we recommend clients, at least temporarily sign on with two or three plans, especially when they’re opening up a startup or something like that. Right?
Mark: Just to get bodies in the chairs
Mark: at high volumes, you would use insurance participation for something like that. But then you would plan the migration out what a lot of dental practices never did. And, and, and honestly, the recession has something to do with this too. So let’s go back to let’s go back to the heyday up to about 2007 2008. When dentists were busy doing all kinds of dentistry and all kinds of cosmetics, everybody had money and life is great. It’s the heydays.
And then all of a sudden the recession hit. And insurance became, at least to the consumer, more important because they couldn’t tap their credit card, tap their home equity to buy things. So the insurance was kind of a fallback. That became more important. So the demand became more important for dental insurance. Now that you’re in a recovery. The dental insurance companies are saying, okay, we’re going to drop your reimbursement rates because we’re out actually more popular now than we ever were. So that’s where you are, basically today.
Howie: Let’s take a little break here, and then we’ll come back and talk about the transition process. Okay. All right. Don’t go away.
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Howie: Alright, we are back, talking about insurance transitioning.
Mark: Well, we’ve been talking about actually mostly about how it how it feels to be in the stuck in that situation.
Mark: And how to how to change that into a positive and it’s definitely going to come from you and your team. Because there’s nothing more rewarding. Well, one of the most rewarding things that can happen in a dental practice is the day you call the company and you say, I’m done. While you’re preparing for this, the key is to prepare and the way you prepare is you count the number of patients that have this insurance, have this insurance plan. And you promote your practice. And you accumulate a number of patients. That equals the number of patients on this insurance plan. And then you call the insurance plan. And you say I’m done. Here’s my letter. Take me off your roles. I don’t need you. Now, doesn’t that feel good? Doesn’t that feel the opposite of helpless? Right?
Mark: Okay, doesn’t that make it feel like you’re in control rather than they’re in control? The only thing in between is a plan and executing the plan. That’s the only thing in between those two things. Okay. So then you go over your next insurance plan your next insurance plan in your next insurance plan. And you may never get to have a fee for service practice. That’s okay. You may but you may only end up with one or two insurance plans that actually have decent reimbursement rates. And that’s fine, too. We’re not we’re not judging you, we’re not telling you what to do or what not to do. We’re just saying, you know, don’t feel helpless about this.
There’s people going through this transition all over the place. Once you’re once you’ve crossed off the first insurance plan on your list, you have a little team meeting, your whole team gets together. You have some cake, maybe a candle or two somebody blows it out, probably insurance coordinator. Maybe go bowling, whatever activity you want to do as a team, there’s an enormous celebration. And then you simply say, Okay, the last insurance plan had 225 people on it. We have replaced those people, we are off of that plan. Yay. The next plan has 370 people on it tomorrow we go to work replacing those 370 people. Now. Howie said at the beginning of this podcast, this could take a year, um, it could take three years.
Mark: Four years, five years. Okay. It dental insurance participation is just going to sound terrible, but it sounds it’s like crack, right? One hit. And it becomes something that dentists get addicted to, is the phone rings patients come in, okay, they’re not, you know, it’s not the best reimbursement, but at least it’s not an empty chair. Right. And they get hooked on it. Pretty soon they become real reliant on because the more patients that come in cash flow rises a little bit, they go buy more equipment, their debt rises a little bit, they buy these things by that thing, and pretty soon, their debts, almost up to where revenues are. And now we got the hamster wheel.
Okay, now you end up feeling like you’re running in circles. And you’re just barely making ends meet, even though you’re working, you know, patient care four days a week, maybe five days a week. And now it’s time to get off the hamster wheel. What do you do? Okay, that’s, I understand why it feels helpless. I understand what feels hopeless. But the transitions have been done hundreds of times.
Um, and really, really, really can be alarming, alarmingly rewarding, team unifying. And things that to be honest with you things that attract the best team members from surrounding practices to yours. I’ve actually seen that happen. I’ve had multiple times I’ve seen that happen. Where practice in transition went from that helpless and hopeless to actually the dental practice in the area that was cool to work at. Because that’s how that’s how unifying This process can be.
So we understand that the some of the insurance companies are lowering reimbursement, to us, especially me who’s much more, I guess, numbers oriented. To me insurance participation is a marketing vehicle. Usually, you trade 20th 30% of your fees should be on a website. And, and maybe in a printed flyer that goes to the employees surrounding you who happened to have that plan. I mean, that’s what that’s what you’re spending your 20-30%.
Howie: It’s marketing expense.
Mark: It’s a marketing expense. That’s the way we don’t look at it with emotion, but people aren’t rejecting us every day. Okay, so, okay, so we don’t have that, that emotional side. So if you know, you’re talking to people are listening to us speak. And you may sound like Mark and Howie are, you know, feeling types of people. Well, people aren’t rejecting us 10 times a day. They’re rejecting you 10 times today. Okay,
Mark: And that’s where that that’s where that helpless and hopeless feeling comes in. So don’t insurance, actually, we should title this insurance transit. Turn hopeless into hopeful, right? That’s the way this should be titled.
Mark: Um, well,
Mark: Go ahead.
Howie: I was just gonna say, when we, the sort of the flip side of this is, is you can solve a lot of this transition, these transition difficulties way, you know, obviously, you’re gonna have to change your marketing approach, right? and attract figure out how to attract patients who care more about their smiles than an insurance deductible. Now, those people are out there, they’re in the top half of the dental market, Mark and I have talked about top half bottom half for years. And that and, and it takes a different approach than, than the old, you know, you can get X amount off the first visit or this that you know, this offer that offer, it requires a conscious targeting a higher quality patient.
Mark: Right. And, and that’s true for anybody, whether it’s our client listening to this or you’re a do it yourselfer, or even if you’re using a different marketing company. This is true in any market. And for the dentists out there who don’t believe it. I can almost guarantee you that if you tell me your address, I’ll find a fee for service dental practice near you.
Mark: Okay. So it is bother Not only is it possible, but it’s probably sitting right in front of you. Okay, so that’s that, that uneasy feeling, you know, we would be hopeful with this podcast, get rid of that uneasy feeling. Look at this for what it is. Lineup your insurance plans by from least to most least number of patients to most number of patients. Put that first one on your bulletin board how your team meeting, promote your practice a different way.
Bring in higher quality new patients to replace the patients who are on your insurance plan. And when you hit that number, whatever that first number is, call the insurance company or send them a letter as a team. You can even print it and frame it and stick it up in your staff lounge. Right? Have your party. Next up. What’s the next insurance plan? How many we have on that on those roles? 193? Fine, let’s go let’s market promote, let’s replace those patients and then get off of that plan.
Mark: And in two or three years, you’ve arrived and slow steady, like the turtle in the hair. Right? Slow. Be turtle. Okay? Don’t be the hair. Right? Um, well, you’re going to be a dentist in two or three years anyway.
Mark: So there really isn’t any hopeless or helplessness involved at all. It’s just a plan.
Howie: It was climbing out.
Mark: That’s right. That was basically the point of this podcast to let everybody who was in that situation know, no, if there’s definitely a better way out there.
Howie: Yeah, you can get out of the whole. Alright, well, thank you for listening. We’re gonna let you guys get back to your days now and tune in again next week. We’ll look forward to it. Bye now.