Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
How to perform dentistry faster, easier, higher in quality and lower in cost.
Blog By:

1206 Dental membership plan with Dave Monahan, CEO of Kleer, LLC : Dentistry Uncensored with Howard Farran

1206 Dental membership plan with Dave Monahan, CEO of Kleer, LLC : Dentistry Uncensored with Howard Farran

6/10/2019 6:13:00 PM   |   Comments: 0   |   Views: 80

Dave Monahan is the CEO of Kleer and has a passion for creating technology-enabled businesses that improve people’s lives.

VIDEO - DUwHF #1206 - Dave Monahan

AUDIO - DUwHF #1206 - Dave Monahan

Prior to joining Kleer, Dave served as the President and CEO of FitLinxx, a leader in the wearables market, where he created simple, affordable and connected wearable devices for the medical and sports markets. FitLinxx devices enabled patients to monitor and manage chronic conditions and athletes to monitor and improve their performance. FitLinxx partnered with over 50 leading fitness and health companies to embed Fitlinxx devices and data platform into customized applications. 
While at Microsoft from 1999 to 2006, Dave developed new product, market and partnering strategies that helped Microsoft and thousands of Microsoft partners enter new markets and grow.

Howard: it's just a huge honor for me today to bring back for the third time Dave Monahan the CEO of Kleer who has a passion for creating technology enabled businesses that improve people's lives priority drain clear Dave served as president CEO of fit links a leader in the wearables market where he created simple affordable and connected wearable devices for medical and sports markets fit link devices enabled patients to monitor and manage chronic conditions and athletes to monitor improve their performance and then he turned his sights to dentistry and while Microsoft from 99 to 2006 they develop new product marketing partner strategies helping Microsoft and thousands of other partners inter new markets he's a graduate of the Pennsylvania State University and Loyola University and resides in the Greater Philadelphia area he's married he has three children when Dave was not coaching or supporting the kids activities he finds time to exercise his travel and play any sport of competitive II you know I actually started out running just recently running up my credit cards that's the only way are so  I'm bringing back to the third time just because um these  plans aren't just exploding and everybody's talking about it um what's really changed if they brought you on lance lamer or how was this business going are you glad you went into it or do you wish you would have into vets 

Dave Monahan : oh absolutely I'm very happy if we've gone into it and thanks for having me again it's a it's an honor to be on three times yeah so just  a quick update and we doing some other things but you know we launched the clear platform back in January of 2018 so it's been about 15 16 months and we have over 2,000 dentists on the platform I we are doubling our member base and our revenue every three months there's nothing but sort of huge growth in front of us I so and the reason is the sort of premise we had coming into the market is proven to be true and it's really a two sided proposition so uninsured patients want care and we've seen that over and over again they want coverage they've looked at things like insurance and they've turned it down because it's too complex too expensive but the net is they really value oral health so about eighty-five percent of uninsured patients I actually type oral health to overall health about 75 percent tied to quality of life and so they really want care the issue typically is they're afraid of the cost they'd understand the cost they don't have coverage so they stay away and then on the dentist side what we're seeing is it's just really driving people closer to the to the dentist so when they join a membership plan and become more loyal they visit more they accept more treatment so both sides of the sort of value proposition we sort of assumed was gonna happen has happened and to your point that growth has just been through the roof

Howard:  I'm the Dentist always ask me when I'm out there lecturing or in emails they say what do you think of these in-house insurance plans and  you and  there's a big word there you're saying membership plans and they're asking me what about these in-house insurance plans can you talk about that distinction what is the distinction of a membership plan and an insurance plan and then a lot of dentists I get all these emails forwarded me from their dental societies I start talking about the legalities of you know you're having an office insurance plan but you know you need that blah blah  so talk the difference for your membership plan and an in-house insurance plan 

Dave Monahan : yeah so that's just whatever misnomer in somebody calls it assurance it's not insurance you're basically just offering a care plan to your patients directly without a middleman in the way and so just to quickly just get anybody on the same page typically a dental practice will offer three dental you know membership plans ones for children ones for adults ones with a pareo patients and you can customize it and change it based on your patient base but that's sort of the standard and what you're doing is basically making an agreement with your patients that if they pay you a monthly annual subscription you'll give them their cleanings their exams or x-rays as part of the subscription and then typically you'll give a discount another treatment 20% 25% 10% whatever you want but you give some discounts and other treatment so it's not insurance it's a very simple plan and an offering between you and your patients and the reason that's really important is the number of reasons one is the patient's paying you they're not paying any sure who's holding on to the cash or you know creating all kinds of ministry and hassles between you and your patients so it's directly your patient they pay you and that's great on your side obviously but that's exactly what patients want so in this world patients are used to things like Netflix and uber and so on where you have a direct relationship with the person providing services they really value that and they trust people providing services direct and they obviously a lot less hassle so we rather than having a 10 page document they got to try to interpret typically you have three or four lines that explain the plan and so it's best it's exactly what your patients want it's exactly what you need in order to improve performance in your practice so yeah when somebody says insurance it makes me cringe a little bit because it's not insurance and then from a legality perspective just so you follow a set of rules you're fine you can offer a membership plan to your patients and we've looked at all states we've done a deep legal analysis of this and what we've done is Kleer is it structured around that illegal analysis and there's a number of things you need to do you can't just go into it blindly so things like it needs to be HIPAA compliant I it has to be the patient is paying you directly it can't go to a third party you can't be creating a network of dentists and offering one plan that covers lots of dentists like a sort of network of dentists that they sure  would have it's got to be direct between you and your patient so there's probably 10 15 even 20 rules like that that you have to follow but we've built that all into the platform so it's very easy you don't need to worry about it

Howard: and a lot of dentists I'm there always asking is this you know is it a stock plan or is it a custom plan I mean now it's yeah go ahead it's a sorry 

Dave Monahan : yeah it's up to the dental practice so we have stock plans if you want to use them but typically every dentist wants to change it a little bit or you change the treatment protocol or whatever so from a treatment standpoint on the Kleer platform the dentists could decide you designed it how are they with like and it can be customized our ever they like so I sort of mentioned most practice will have a child playing a don't plan a pareo plan but we also service pediatric practices and we have one PDX practice that has three different children's plans and they're all customized based on the age of the children we have some dentists who you know they believe in fluoride for children other dentists that don't they can do that they can create the treatment protocol however they like you also can customize and set the subscription price yourself you can set things like are you allow your patients to pay on a monthly basis and they have to pay all upfront I you can even exclude procedure categories so let's say you want to include everything except orthodontics you can do that you can add specialists to the plan so let's say you have relationships with three different specialists you can add them to the plan and they're offering gets straight to your patients and there's a direct relationship there and you're sort of passing specialists on to them and that becomes a value proposition of your plan so it can be a night you go through a number of other things but the net is it can be customized for your practice but if you want to go straight forward just sort of do so what sort of you know common practice would do we have templates as well you can follow

Howard:  so on dental town if you do a search for clear there's several threads on there and dentists they love doing dentistry but I mean I cannot tell you how many dentists the day after they retired they still never sent one insurance claim they still couldn't tell you how many people called their office last they couldn't even tell you their return on asset for any year they practiced so you don't really like this stuff so they ask a lot of questions that they don't know like how do offices handle the bookkeeping our sign of payments in nard credit is how does it work technically

Dave Monahan: so basically think of clears the platform that connects your practice and your patients with the membership plan so we provide everything from the dentist's when you're setting up your playing we have a full registration application very simple very easy to design we give you a consultation with a clear success manager who will get you and help you design the plan how you want and then once you launch you have something we call the clear dentist portal and on Dentists portal that's where you can see everything you can see who's joy and you can see their payments we connect the back end of clear to your bank account so the all the funds flow straight through into your bank account I you can I invite patients from the portal you can do things like you know create Google Ads from the portal you can track your renewal so when renewals are coming up let's say you know their 12-month membership plans 90 days prior to the membership four expiring for a patient you'll get a notification the patient will get a notification it will automatically process that renewal and make and let you know that renewals to process so the net is I go through a number of other features just like that then that is the platform manages the membership plan for you once you launch it basically all you need to do is teach patients about it I promote it in your office you can promote it outside your office and then once they join you basically use the portal and the platform to match at all and then on the patient side they have a portal as well so once they join they can log in they can see their benefits they can manage their payments they can even add family members they can invite friends to join so think of it as a very sort of robust and comprehensive I you know sort of platform that you know really meets the needs of the dentist and of the patient and it's all automatic the practice doesn't need to do a whole lot to manage it 

Howard: well if you listen to the people talking about your products on dental town that they they love it seems like the open dental users say is so easy do you do you think clear works better with some practice management systems than others I mean I know you want to get all the ventric single stops I know you want to get them all but if some kid just walked out of dental school starting your own practice and said do you like your business person do you like what are these impression software's better than the other 

Dave Monahan : it's I can't say I like one better than the other and I get opinions what's interesting is our base of customers the dental practices if you look at the mix of practice management software that they're using it's very similar to just the overall market percentage so we have opened dental with den tricks and so on and so it's a very similar mix I haven't heard actually that one practice management system works better than the other so that's so I've actually the first time I've heard of that now we do typically get a lot of positive comments about open dental cuz it's very easy to access and you know things aren't hidden and it's just like a much more obviously open platform so I'm not surprised by it but that's the first time I heard one types of management software is better than the other relative to clear

Howard: so who do you think is your product champion in the dental office you think the dentist is recommending and closing Kleer is it the hygienist is it office manager the finance right when does this really come up and happen 

Dave Monahan: we provide all this guidance I it's really three people are critical it's whoever's at the front desk and greeting patients is sort of step number one and so the prostate here's the process we have in place and it's all documented we have a playbook for practices to properly promote their membership plan so when somebody walks in you eat it and they're uninsured you introduce the concept to them that we provide Brouchures to the practice you hand them for sure you explain it so on some practice some patients that point are ready to buy they get the value and all that stuff and they sort of buy right there others say let me think about it they'll go into the back we actually have a call I'm sorry a script for hygienists to talk to the patients when the patients in the chair just to introduce  the membership plan gives their perspective on it I the dentist when they walk in to do the checkup we also have a little script that they can use to talk to the patient obviously everybody can customize and talk to it in their own way but what we found is if there's if it's repeated and it's across the board it's the front desk it's the hygienist and the dentist and then when you doing the patients walking back out to check out if the person to front desk mentions it again that's the best way to sell is sort of reinforce it across the group now if I had to pick one or the other who's the base champion of the membership plan is the office manager is typically the  number-one person needs to be behind it organizing it make sure and everybody's on the same page find a coordinated sort of plan is the best 

Howard:  there's one clear thread that very very long and very common question is this more for indemnity dental insurance offices or PPOs or what does that have what is your fee schedule PPO is Medicaid what does that have to do with your product

Dave Monahan: nothing so now we're definitely not an indemnity plan we're not a PPO nothing like that so that is when you create a membership plan you control everything you control what the treatment protocol is you include you decide what's included in a plan you decide what the discounts are you set the office fee schedule so typically what our practices do is they'll provide their fee schedule they're just their standard fee schedule they have any office will upload that into the platform and then they'll just take a discount off of those standard fees and they decide that the practices sides typically it's 20% some are 10% some go to 30% but it's all off to the practices to decide it's not indemnity you want these patients coming to your office I what we see is when a patient's engage they're coming in a number of things happen they become more loyal to the practice obviously they're visiting more they'll accept more treatment and then just as important as all that if they're coming in and getting treatment and getting and doing their cleanings they'll renew the agreement and they and the membership at the end of the year which is critical to the long-term success of the membership plan and so it's  almost the opposite of some of those types of plans where you know it's fully in your control and you really really I want the patient to come in into the office you know you know 

Howard: just listening to Dentists talk you can really tell how far behind it is as a cottage industry then say the S&P; 500 like you go to dentistry and everybody's always talking about new patients new patients knee patients once you go to the fortune 500 where their life excitement when I was born the average life especially on the S&P; 500 was 60 years now it's down to 20 years and nobody at Southwest Airlines or Chase Bank is trying to get a new per customer to fly Southwest Airlines they're trying to do they're all about loyalty programs I mean Costco even went so far as said if you're not a member we wouldn't even let you in our store and they were showing soul Price was showing everybody all that you don't want to do marketing Sam Walton was the first one to cut market he goes when you tell mom that you have a going-out-of-business sell a fourth of July sell all this crap she it's an expensive marketing program that you got to raise your prices we're gonna do everyday same the same low price pricing and they put all their marketing money on wieldy programs so how does a membership plan increase patient loyalty and why do you think patient loyalty is more important than marketing marketing marketing

Dave Monahan: you nailed it I mean that is the value of a membership plan is the loyalty you get for your members and what happens from the loyalty so the reason a membership plan creates loyalty by the way you can do this in other ways treat people special right thank them for coming in your office shake their hand yeah look at me I just whatever you can do to make them feel special is gonna create loyalty but the reason to membership plan creates loyalty is remember these patients are uninsured patients there's their view of the world is I'm on the outside of the ropes looking in in to dental care and I'm the  odds are probably stacked against me to getting a deal and feeling good about it so what a membership plan does is it gets up closer to your practice gets them to commit to your practice it also makes them feel special it makes them we actually measured we would talk to consumers uninsured consumers who didn't have any coverage at all and then after they had to membership plan we asked him to explain the feelings to us this is amazing how these are the types of feelings that came out of it I feel good about myself we're like you feel good about yourself why is that and they would say I now have coverage and we get the care I need and that makes me feel good and we're like wow we never thought that right and then we say okay what else do you feel they said I feel financially savvy like really financially savvy oh yeah I bought into this plan and I'm getting a deal right and this feels good that I can commit to treatment to get the things I done I want it feels good to me that I'm getting sort of I'm making a financially savvy decision here's another one that came up I have peace of mind and we're like I explained that one they just say I have coverage so if I need it I can use it I don't have to wait forever right I can just go in and get the things I need done I so that's what happens from a sort of structural standpoint like this people feel good about you know getting access to a plan and taking care of their oral care needs and then we always tell practices to take it beyond that make it personal so I we have some practices you walk in the door if you remember you get a little gift when you walk in the door it doesn't have to be a lot it could just be something small you're saying is I'm thinking about you and I care about you and that will drive loyalty and I think I said before just greeting people and thanking them and shaking their hand does it have to be a gift the gift is I appreciate you so those just had a whole nother level of loyalty then what we see is when somebody feels the patient feels you know good about things and they trust you and they feel closer and now they're on the other side of the rope they accept treatment they come in more and they accept treatment and your case acceptance goes up quite a bit in to your point you don't have to be spending a lot of marketing money to go find you know new patients it's writing your charts it's just a matter of making people feel more comfortable and and get them to make the decision to accept the treatment 

Howard:  um it was just truly amazing I mean you you you go meet at us and he's worked in a small town of 5,000 people from age 25 to 65 he's gotten 20 new patients a month for his whole life and you ask him at 65 what do you need buddy he's like well I I need new patients it's like how the hell could you need new patients in a town of 5,000 you've been here 40 years they just don't understand you know they get rid of their there right there this amazing person upfront because she asked for a dollar raise and they're like no you're making sixteen an hour I could fire you and hire someone for twelve you could get a homeless person but I don't know if you're gonna make money off that so you know loyalty is just everything and you know it's just oil deal oily Southwest Airlines you punch a card ten punches you get a free chip and then the dentists say to me when I talk about merciful Enza my seminar they say well the reason I like the people that don't have insurance is because they're paying these higher fees and now your best idea to me is to give those guys a discount they say I don't like you know it started 30 years ago with high fee indemnity Delta and then they switch that to lower fee PPO and so now they're down to they only love their cash patients then here's some stupid Howard guys saying we'll do a membership plan and give those guys a discounts they're like that's crazy what would you say to that guy

Dave Monahan: it's a leap I get this I get that yeah I sort of push back but we actually have data and what we see is if you compare a membership plan patient to it let's talk about uninsured for a second I'll talk about it short in a minute as well but when you compare a membership plan patient to just a typical uninsured a typical membership plan patient will call me in about 1.5 times a year where a typical uninsured patient comes in once every two years so 0.5 times a year so they'll come in what we see is two to three times more they'll visit more when they're in the chair they'll accept 50 to 75% more treatment as a membership plan patient versus uninsured and the I as part of that the net revenue obviously goes up in a similar way so that revenue goes up 50 to 75% for those patients the leap you need to make as a dentist is what is it this is the belief I just helped Dentist take a look at their data so I looked at a lot of different practices data and what you see is there's uninsured patients don't come in anywhere as near as much as the dentist thinks they do they think they're coming in all the time and there actually are not so that's number one is check your data and then number two is then check the case acceptance on those uninsured patients I so dilip you need to make is if I give let's say ten fifteen or twenty percent discount what I'm going to get in return is more this patients coming in more often in accepting a lot more treatment like I said we see it in the data but I know it's a hard leap to make you just need to be able to make that leap and it's based on when somebody has coverage they feel comfortable they trust you they're more loyal and they'll commit to more treatment in more visits Howard:  yeah I'm going to talk about what you just said for a minute because um it's obvious to us but it might not be if you're 23 and just graduated Friday it's called selling the invisible when I go buy an iPhone or a diet coke everybody knows what that is and the person doing the transaction I don't need to trust or have a relationship but we're dentists we sell the invisible and when I go to you and you say I have four cavities I mean how do I know that's true I mean how do I know anything so when someone is referred to you by a friend and we had the owner of Facebook is Mark Zuckerberg his dad's a dentist his dad's come on the show same down times you three adds up and unit Zuckerberg and  when I ask II D I said what's the best way to advertise your practice on Facebook he always says um the check-in when someone comes in your office you give them a free toothbrush after a cleaning why don't you give him a free dollar toothbrush when they check in on Facebook because this average verse has 140 followers and they say oh well my good buddy Dave he goes to Howard at today's I know so that's good for me so then when they come in they're referred and I say you got three cavities they're not thinking do I trust this guy Hailey's refers by name so now it's just about oh my god is it gonna hurt can you put me sleeve how much is it gonna cost what are you gonna do it blah blah blah so when you do all this marketing dollars for these new patients strangers and then they'll do something like cleaning examine x-ray for $19 and so they'll come in and that's the end of the exam for $19 say oh you have four cavities are 250 it'll be a thousand and the immediately think oh I get it a 2000 cleaning and I need a thousand dollars or the dentistry and they walk out the door then I turn to that dentist I say get on your practice manual system and show me your case acceptance rate they have no idea how to even figure that out they don't know how to track it they're just clueless so all you need to remember is that you just want one patient that thinks you're a good guy in your office is a good team and they trust you and build from there you don't want to do all this Groupon crap and get all these people that come in don't know you from anything and every time you're presenting treatment you're on the defense because they think you're selling so so loyalty I mean you want to make the people who trust you the most loyal and forget about the eight billion other people eleven six other comments focus on the people that have made a relationship and trust you know 

Dave Monahan : I couldn't agree more I mean we work with a lot of practices and I've yet to see somebody show me a new patient generations you know whatever special type of thing that actually worked over to the long haul they are almost all in the door out the door and they typically accept very very little treatment and what we do I actually when we work with the practices we get rid of those specials we just tell them don't offer the special offer the membership plan you're gonna get the very type of patient you don't want all patients you only want the right type of patient if somebody really wants to commit to you and be loyal to you they're gonna commit to a membership plan over the long haul and they're not gonna you know to your point the specialist is just going to keep the  door turning but yeah it's a it's funny when you talk about it for that you're sort of your eyes so the perspective I just sort of face from my previous background it's just known these things are just known it's just sort of a basic sort of fact that these are the things you do in order to create a long-term valuable business but in the in dentistry it's it's you know I seeing some good light I say 20 or 25 percent of dentists are getting it and moving forward I and the others hopefully are gonna come along as well 

Howard: so a lot of dentists and you know they like if they're into business they watch Shark Tank and you know that's they that's the big dental business show so the first question mr. Wonderful's gonna ask how do you make money on the deal 

Dave Monahan : so it's really simple I'm we don't make money unless the dentist makes money so we don't have any upfront fees no implementation fees nothing like that so we basically just take on average it's about four dollars per patient per month of patients that are on the platform paying a subscription to the dentist what we'd like about that model is Rho star aligned we're not just going to draw drop software on the practice and leave we actually have a success team and there's really three steps to success team the first is they meet with you they talk to you then changer practices you understand your patients they help you design the plan and they have experience working with thousands of practices so the you they can give a lot of good insight and sort of help you design a plan to meet the needs of your practicing your patients once that group is done they're handed to a launch team and the launch team's goal was to get that practice to add their first ten members within the first depending on the size of the practice that could be ten days that could be 20 days 30 days you know 40 days but the net is get the practice used to selling the plan make sure they're using their scripts make sure they have all the materials out in the in the office they're advertising it as needed outside of their office and things like that and just get them going and comfortable and moving forward once the practice gets to ten or so patients then they're handed over to what we call the gross team and the growth team basically says okay how are we gonna get this over hundreds or even thousands of patients and make this thing work for you at a you know a long-term and a high-value way so I the net is I know it's a long answer to your question but we think it's really important that we need to be aligned to the interests of the practice we don't want any money upfront we just want to get paid as you get paid

Howard:  um and then Dennis asked um what's the advantage this range of them just doing it themselves why do they need a company like clear to do this I mean isn't this something they could just do by themselves 

Dave Monahan : yeah we get that question a number of times so jump in to the to the chase and I'll go through some details well our best practices are once you try to do it on their own so I  can't tell you how many practice we've had and come and say I got 250 patients on the you know on my membership plant or 75 and it started collapsing on me there's a number of reason it starts to collapse it's just hard to track everybody and when they bought and when the renewals are what benefits they have you know what they paid what they've not paid and just and then also create experience for the patient that feels good and they feel confident in I we've seen a lot where its paper-based you print something out and you fill out a form and then somebody takes it behind a desk or somebody takes information and the patient doesn't see where it goes and they leave with pretty much nothing but a brochure and they feel like okay what did I actually buy there I'm not sure exactly what actually would happen so the net is a number of reasons to use the platform versus doing it on your own one is just the administrative side of it costs a lot of money to administer plan itself also it's difficult renewal rates what we typically see in manual plans is renewal rates in the 25 to 50 percent area because it's hard to track and then when somebody comes up for renewal you got to call him you got to get the credit-card information typically they say I'm not gonna renew until I come back into the office which might be three months or six months from that time so on our platform we have auto renewals so when you sign up and buy a plan you're into an auto renewal program you can opt out if you want but pretty much nobody does and so when you're twelve months renewal comes up it renews automatically it'll notify that we have legal reasons or Lo and our legal regulatory things we need to follow as far as renewing that membership but we take care of all those things we send notifications that's needed but renewals happen and the renewal rate on our platforms over 80% and we have practices that are in the 90s and you can do that just by following a few simple sort of best practices we provide eye things like compliance II and regulatory issues I'm trying to create something manually the tip of compliant is very very difficult and so just be able to protect the data be able to meet the state regulations there's data privacy regulations outside of HIPPA there's consumer laws you got to follow so there's a lot you got to follow from a compliance II standpoint I the other is just having all the materials prepared for you so if you're going to create your own membership plan then you need to start creating marketing materials and brochures you need to create a place in your website landing page I you got to create a process for people to patients to purchase we take care of all that it's all out of the box if you can get going in minutes I so you don't have to spend a lot of time doing all that work and spending a lot of money at getting ready and there's a bunch of other things like just the play books we provide so we have a playbook on how to implement a successful membership plan it's really simple step-by-step it'll tear you exactly how to do it we have a renewal guide how do you maximize your renewals and this is again a step-by-step guide and things like that so I think then that is could you do it you could will be correct it probably won't appropriate issues with it and then you'll also probably will have some regulatory issues and then we see very consistently renewable issues with manual plants

Howard:  so this one guy writes to this plan clear has really been helping I've had quite a few longtime patients finally decide to do proposed work they have been putting off for years I was skeptical and somewhat stressed about the discount and why was i discounting when those people were perfectly happy paying my full fee it dawned on me though that yes they came in for the hygiene visit paid but there was no guarantee they were going to come back in six months duty in any way you're your biggest fans are posting about this on dental town I know that's why we we had you back yeah

Dave Monahan: we see that all the time and that it's it's funny to me that it's a surprise that that happens because we know what happens it happens every day on these membership plants it's just a matter of people seeing it right and seeing it live in their practice but you know with like I said we're seeing acceptance rates 50 to 75 percent higher for membership planned patients and then uninsured and when what it's it's I know how do what to call it it's almost you have active opportunities and latent opportunities and the active opportunities I might have like a major pain I got to get take care of so I get it taken care of and if somebody's I'm sure they're gonna do those things but the latent opportunities where I can put something off if they're not part of it members should plan a lot of times they put those off if they are part of membership plan they often move forward with the with the treatment

Howard:  yeah this one guy is writing on the truth about in-house membership plans is that you can use them to get off PPOs and HMOs and Medicaid and Medicare I'm do you what is that part of the I mean what would you if something said I want to do this because I'm trying to get off PPOs and do you think that's a good strategy or do you say no no that's that's not that's not even right II think it's I

Dave Monahan: I would not suggest that if you had a high percentage of insured patients if you have a small percentage yeah you could you can manage it and I would not do it overnight so what we see successful practices do is they'll drop the worst of their PPOs and replace it with a membership plan and they'll do that over the course of time so they might you know six months in advance or 12 months in advance that you're not gonna accept that you know particular insurance and if you like we have this membership plan for you to move over and like I said it's typically the worst of the worst on the insurance side I'm if somebody said I'm going to just sort of wipe the the slate clean and not accept insurance anymore I'm gonna put my measure plan into place I'd say they're gonna face a bit of a daunting challenge in the short term because that assurance is being subsidized by an employer and the employee that your patient isn't seeing the full cost of that plan so the idea that they need to now pay full price for a membership plan versus some subsidized value for a insurance plan it's gonna be difficult to make that happen now I'll foreshadow and say the day is coming when that will be a perfectly legitimate strategy is to drop insurance for a membership plan we're gonna have some features and functionality coming that'll enable that to happen but as of today it's it'd be difficult and I'd be I'd be cautious and and I'd work it over time not just sort of snap my fingers and move forward with 

Howard: the another issue that we're having is you know this is on the internet so it's international there's two million dentists around the world there's a quarter million on dental town from every country or it's on earth and whenever you go to Asia Africa that the insurance said that blows their mind I mean I think a lot of dentists in America don't even realize that they don't do this in China and Chinese got five people hurt one of you but when I'm lecturing in China it hurts their brain to want to know why well if you drink Coca Cola and eat Hershey's chocolate bars all day why is that your government or employer pay for your dental work they call it perverse incentives and when and then the other day somebody from New Zealand put together a law that proposed a law that all dentistry breathe through New Zealand and every dentist I know from New Zealand that was emailing me the link to this article is like oh so  now they have zero incentive to quit drinking Mountain Dew and just even brushing their teeth with lollipops and tootsie rolls I mean but why I don't understand how this insurance thing it's really gotten bad like  when people say they want free health care well white  would you switch from a breakfast of cigarettes and coffee to a grapefruit if all your cancer was free I mean incentives matter and I really think incentives it's one of the reason the 20 richest countries are broke from all these free health insurance and then when you go to these people and say well at least make him do a 10% co-payment they look at you like you're some kind of criminal like how could you how could you want this person to pay well maybe because he had a cigarette and a cup of coffee every morning for breakfast a Taco Bell for lunch I mean incentives matter but it's just uh but back to the United States where 80% of our listeners are there's something about the culture in the United States that when it comes to health care if they don't have insurance the they can't spend it's like why I don't have insurance but then they go buy an f-150 pickup truck for 90 grand and fly to Disney World so this kind of satiates that psychological Western civilization mind that you have dental insurance even though it's not dental insurance and it's a membership plan do they need this in their decision-making because it's just so illogical 

Dave Monahan :  yeah so yeah I think the I'm back to comment on the health insurance I because I have some experience from a prior life there but I agree we got to present we need incentives to keep people healthy it's never gonna happen unless there's a sentence and by the way I think the I know people hate them but the move towards high deductible plans I think is actually the right plan I'm not talking about that I'll talk about medical because it's such a it's such a big part of US healthcare and it's the least understood even by the providers yeah so I think what happened to the perverse part of it is that healthy shirts started covering everything right why should healthy shirts be covering my you know whatever you know by the penicillin pills all right they shouldn't it should be if I have a catastrophic accident yeah it's gonna cover me but if I'm not taking care of myself and I need some medications I don't think insurance should cover that I think that should be on your own yeah I so the high deductible plans I think is trying to shift it towards you know what if I don't take care of myself I'm gonna eat into that $5,000 deductible and I'm paying it out of my own pocket therefore I'm gonna try to be more healthy right and it's an economic solution to it I think the other way to do it and I have some history here as well is you incent people based on if they're willing to start taking steps in the right direction so I have some sort of chronic condition and I'm willing to take steps in that direction which might include I'm gonna monitor my activity and with a you know step on a weight scale you know once a day and I'm actually gonna take actions to move myself in the right direction I'll get incentives based on that I'm with you a hundred percent if people want full coverage every you know everybody gets everything covered and there's no penalty for being unhealthy we're just gonna go bankrupt I think the country's gonna basically swallow every whatever choke on it's a health care bill and

 Howard: you go to these countries like let's go to Kandak is there the closest neighbor with socialized medicine well everybody loves the health care is granted well let's break that down first of all only 1% of Americans are Canadians spend the night in a hospital on any given year so 99% of course I think it's great they didn't use it that year and but what you said you know they'll go drop 50 bucks at a Mexican restaurant and have margaritas but they expect to go in because I have a sniffle and they want antibiotics and they think all that should be free and in insurance is about an actuarial risk analysis versus moral hazard I don't buy insurance to change the oil in my car and gas it up and  clean the window I only have it in case I have an accident and health care took that actuarial risk analysis of an unforeseen accident and said no let's just pay for every little piece of the car if you want to have to change your air filter your oil filter whatever you want to do your boss or Obama should pay for it you're like why and then and then when I ask my patients well why did you get that knee replacement because it's 50 grand knees are 50 hips are 100 and she'll say well I don't know that doctor said I should do it I said well how much was it oh I don't know man a caretaker well if he was said look grandma it's 50 grand and your portions 10 percent so give me five grand half thumb would have said hell no I'll take buffered and then they want to know why the utilization so high the costs and then if she had a patient percent she might say there and say well my portions five thousand whoa we're in big expensive Phoenix I'm gonna call my sister who lives in Sliney Kansas then she finds out that the fifty thousand dollar knee in Salina Kansas only forty thousand so she drives so she flies south as airlines to go spend a week with her sister to save on her coping but you whenever you talk about these reforms in socialized medicine from Canada to England they look at you like are you just a bad guy are you like a main evil person what would other what other things do you think are confusing to you from your background in in insurance 

Dave Monahan : well the thing that amazes me is how the insurers don't move and change I mean they have a guess I mean it's just the way they are but the net is just trying to get them to do anything differently or incent people in a different way or the sort of change the system they're just not gonna do it because you know obviously they've been making money for a long time and they continue to make money and there's no reason to change if Obamacare didn't scare them I don't know what's gonna scare them and they just continue to move down the same path so I feel like it's just got to come from the outside and you're starting to see that there are people out there like the large employers are now taking things under their own control and doing self insurance I so I don't think it's gonna change for the shorter thing is gonna change from the outside as to people paying the bill that are gonna end up changing and when you think about its the employers who pay the bill for the most part plus the the US government but the US government obviously isn't gonna do too much either so that is to me the changes come from the employers and it's become a I almost a backbreaker for a lot of businesses to try to form forward healthcare so I'm actually encouraged that the starting with people like Walmart and Amazon and Microsoft are now taking action to improve it how much you have seen some of these alliances but there's now thousands of employers aligning with each other to try to take this on 

Howard: so I can't believe read my mind that was my fallout question what do you think about Bezos and Chase and Microsoft getting together and starting to think tank on this work what do you think they're thinking and what do you think's it may come of that 

Dave Monahan : so I think it's awesome I think it's exactly what needs to happen and the reason is they're paying the bill right and they should have a say on how things happen you know what they're trying to do they're trying to get rid of the middleman they're trying to hold the healthcare providers accountable so trying to measure the results I mean think about that Howard for a second if you didn't have a business where you help people accountable and measured results how you gonna get results right and they know that they run successful companies so and then here so that is I'm 100% behind it I think it's absolutely the right move and I think it they are going to solve the problem on their own doing it directly and there's plenty of now data is getting it's easier to get a hold of data it's easier to measure it's easy to create relationships with healthcare providers and it used to be all right so I think they are gonna figure it out here's the power of the lobby but by the way to dental the the dentist need to do something similar right the dentist has at some point stopped you know it's accepting insurance or stopped accepting what the insurers are giving them and this is part of the membership plan thing and go direct and there's no reason not to do it this is a matter of getting the critical mass to move in the right direction and we're seeing on the employer side in healthcare I think we're gonna see and hopefully we'd be part of it with dentist on the in against it that ensures 

Howard: and then another I want to comment on that question about that dentists say well you know I you know cuz here's the problem in their mind the indemnity has gone from you know when I get at school you just build Delta and they just paid you whether it's a hundred percent clean examines x-rays eighty percent for virchow's fillings 50 percents for crowns and dentures partials and then after about ten years they said now let's not do that let's say we're just gonna tell you this is the fee for a building crown and and that's been drifting down nicely for 30 years so so they love this this fee for service people and and then when they want to go drop that PPO they say well you think I should drop that PPO now I'll just say well how many patients are on that ppl they don't know what does on that plan they don't know you know you want to you want to know your numbers first and then you would want to drop the smallest PPO I mean you start with let's drop a plan that not even 1% of my patients have let's start there but let's get how many were on that plan how many of them had their records transferred never came back what if what if you drop that 1% and then you mailed them or called them about in office membership plan you know I mean you know but it didn't you need to have a scientific approach forward on this 

Dave Monahan : absolutely yeah boy I dropped the ones that have no patience on a very few patients I'd also drop the ones where I lose money right why I accept that I'm and would I to your point about not knowing data we asked practices every day one of our first questions to them is how many patients do you have how many are uninsured and you know they'll swear the darkness your patients are coming in often but they don't even know how many uninsured patients they have all right so just even the most basic of questions is typically hard to get answered and that just amazes me given that that's sort of the lifeblood of their practice so yeah I'm not surprised to hear that they don't know their data but hopefully I think over time there's some solutions out there now that can extract data better out of practice management software and you can view better and use it I so I think over time that'll be that'll become better 

Howard: um what I like about talking to you is that you know these dentists they only know their own office and then this issue comes up membership plans and again they know their own office how many offices have you worked with alright couple thousand yeah so so they just not gonna have that framework I mean they're they're not gonna be able to see this issue at 30,000 feet like you do what do you think the the solo guy doesn't understand that if he could see a couple thousand offices at 30,000 feet on just specific merger plans you'd think about this very differently 

Dave Monahan : it's really just understanding what your patients are doing day in and day out and how many what how many you have how often do they come back how many what type of treatment they're accepting like it's the basics it's like it's not even that applicated it's just understanding the patterns of your patients and what they're doing day in the day out and it's  actually a pretty easy view to see so what we do when we work with practices who don't see that and would like to see it is I'll just take it Excel dump and we'll just do a quick analysis of it and show them exactly what's going on with their uninsured in the insured patients so the net is I wish I could just show that to every practice with a you know snap of my fingers and then show when you put them into membership plan this is what happens this is the do so there's a step forward you'll take and what happens is you're not going to spend a lot of money on new patient market you're gonna so just engage your existing patients cuz you can see the benefit you know right away

Howard:  I just got this I post on dental Thomas and I'm podcasting this guy right now what are your questions first first guy what what is the mission the mission of clear is simple what is your mission he's asking

Dave Monahan: it's to improve access to real care that's the net and as part of that an outcome of that is patients get better oral care and dentist practice performance improves so let me just improve access to care if I'm an uninsured patient walking into a practice that access you might think they have access to care but to them they don't they feel like they're on the outside looking in so we want to improve their access their ability to get care i we're gonna be moving that to other patient bases I mentioned earlier the employer space so about 50% of small businesses don't offer dental insurance to their to their employees and the reason they don't offer it is it's too complex it's too expensive they just don't have time to deal with it so what if we could simplify that and make that a lot easier for a small business they actually provide in fund care for their employees in a small business we're gonna improve access to care if we want to do things I can't mention it yet but we're gonna be coming out fairly soon with new services on top not just the you know typical service you would come into an office and get care but other services people can use at home I and we're gonna provide a level of care there that the dentists can offer to their patient as part of the membership plan that makes easy again for their patients access to care so in short it's improve access to care that's sort of the net of our mission

Howard:  AHA that is uh that is distinct and then some guy says where does the name Kleer come from 

Dave Monahan : so when we took a look at they did all the market research so I don't think I mentioned the beginning of the podcast where Claire came from the Nick I thought maybe the second but the company came from market research we had done where we talked to patients and dentists and tried to understand the issues and then we said ok at the net of all that research was uninsured patients wanted more access to care one of the affordable simple transparent access not a crazy complicated insurance and what Dennis wanted was easier ways of making connections with their patients getting them in more often having them accept treatment and not showing you know not taking 40 or 50 percent cuts from the shore like all that stuff was sort of you know came out of the market research and we just said okay where they connect the two and what we realized that you know it was a connection to the two and the  issues both sides are dealing with the the natural thing that came from that is let's make this clear this just make it clear for the patient and their ability to get access to care and let's make it clear for the dentists and their ability to improve performance of the practice by by offering some more simple care to their patients so that's where Claire came from 

Howard: I noticed Netflix Netflix and what's the other one Amazon Prime you know Amazon when they set this up they charge you for a year so we know that's obviously a working business model it's flippin Amazon and then Netflix bills you every month and this Dennis asking um would you want a monthly plan that just rolls over every month like Netflix oh I never have to sign him up again or verses a yearly plan where at the end of the year I've got to go back and try to get this guy signed up talk about that

Dave Monahan: yeah so they both come with pluses and minuses so on a clear platform you can you can do both you can do one or the other but let me tell you we typically advise practices to do both offer both and what you see is and this might change depending on your demographics of your patient base but about 80% of pages 55-plus will pay up front annually even if you offer a monthly option and the psychology of it is I don't anything out hanging over my head I grew up in a world where I pay for what I get and I just want to pay the bill and I don't want this thing you know hanging out there now you shift all the way to the other end in spectrum you go down towards the Millennials and Gen Y and they love monthly plans they don't have a lot of disposable income they grew up in a subscription world and so then it's very natural to pay on a monthly basis now if I offer both of those you obviously cover the full spectrum if you've got a heavy patient basis 55 plus that's you know that has a lot of suppose William company but you might not want to offer monthly not want to deal with it because there are some hassles associated with that but no matter which plane type you offer which payment plan type you offer when you're on the clear platform the platform handles at all it automatically does the monthly payments charges it automatically reduced the patient at the end of the year if they paid on an annual basis and handles all the notifications so you don't need to deal with all that in what we see by the way on from a failure sort of painted failure perspective when somebody's on a monthly plan the failure rates about 1.5 percent over the course of those 12 months so it's very low it's not a big deal and what we do is we'll flag those and make you aware of those and you can follow up with the patient to get the it's typically a stolen or lost card I on the renewal front when somebody pays annually and then we wait 12 months to charge their card in 12 months what we see is about a nine percent issue rate with payment and the reason is over those 12 months people lose credit cards right they change credit cards they have credit cards stolen so there's this natural sort of about 90 percent issue area at the annual level but once again we flag those we notify you we notify the patient to get that card switch so it's just a matter of seeing it record and sort of reacting with another mask 

Howard: well my practice is all fee-for-service patients and they've they've already got insurance so why would I do this if I already if all my patients already fee-for-service on insurance is there any advantage with that

Dave Monahan: right now I say there isn't a big advantage unless you want to try to drop some of those you know the worst of the insurance it would just depend on how many patients you have on the worst of the insurance I'd say right now probably make doesn't make a lot of sense like I said until we come up with a solution for how you handle employers and get employers onto the plant but for now I would say yeah if you got a hundred percent insurance there's probably not a lot of reason to move to a membership Lynne 

Howard: what was I not smart enough to ask I mean what do you wish I would ask that I didn't ask good question

Dave Monahan: I thought about it one feature I think it's really cool with our platform that I wouldn't expect you to have to ask but we actually have a data scientist on our on our staff that they actually will compare your practice to peer practices of same size and same sort of makeup and it will show you how you're performing relative to those practices on your membership plan and it's a pretty cool little tool that I sort of basically says are you on average you're above average below average it also measures whether you're plateauing or rising so you may have gotten off to let's say a good start and then you start plateauing and your peers are ahead of you and it will flag it so there's some cool data stuff we're doing on the backend and that's just the start of it I tell practices you know really make their membership plans perform well

Howard:  well you know I have to tell you when I started dental town I got the idea in 98 got it up on st. Patrick's Day 99 and everyone else that started out there was about 20 in that race and some of them had venture capital private equity money I mean dental exchange got funded like 20 million dollars and everybody was trying to disintermediate the supply wrap and sell everything during this 20 years ago but I knew my homies that that that Henry shine girl that comes in once a week was his only connection to the outside world and my gosh I'm they didn't get rid of him and here it is 20 years later they you know Amazon still don't even sell supplies and these  people that are connected to the outside world the dentists all the dentists I know that are doing two three four million dollars a year it's because they're always they won't place an implant and they'll pick the implant system based on the most amazing rap in their area and then they'll figure out like oh my god there's like seven periodontist in three or surgeons that are placed in a hundred implants here and they all buy from this person and that that point do you know what type of implant it is it's all about what you know and who you know and the networking and so when you have a date a guy like this that there's no dentists out there that can look at data from thousands of practices and the smart ones are are the ones that want to see transparency in the marketplace and says tell me what i'm doing right tell me what I'm doing wrong and day one when my cells rep came in I told my friend off don't ever come stand at the counter for how or why I'm doing a roof you know make her an appointment just like you would anyone else and I want to respect them and then over thirty two years when I needed like a new amazing assistant who would i go to i go to my supply lady and say well you call on twenty offices who do you think the best dental assistant in town is and she tell you and then when it was about endo i I don't care what she thinks of an endo file I I'd say the best endodontists in my backyards Brad gentleman is there any do you know what file he's using and she'll say oh yeah now or I'll find out you know so it's all networking and if you can take advantage of data and get more from your little own bubble and if you can learn to come outside your bubble and  that was the biggest gift I got just from Dental extra I had no idea when I started in a lecture in August 4th and 1990 that 30 years later I would have lectured in 50 countries and I learned the most about my own country by seeing all the other countries and the first earliest questions I've have is why is there no dental insurance in Africa Asia Central or South America and why is everybody in America think it's just it's just it's just the God you have to worship and it's like it's not a God you have to worship man I mean I mean there's I mean it's just so interesting that that's what I love about the internet it's really flattening it's making the cost of knowledge almost go to zero like look at this podcast I'm talking to you you're talking to me they're listening to it for free the cost of knowledge is draw upping to zero and you young Millennials got to get out there and look at the data don't spend 30 years to reinvent the wheel go out there and just say you know if my mom who's been practicing could start her own dental office tomorrow what would she do differently and but uh thanks so much for coming on and really I hope you go in dental town you or your team and answer some of these questions because a lot of them are sold on the idea and on you but there's the Devils in the details they're just trying to figure out what to do yeah I'll get on there and also answered the questions but yeah I appreciate it Howard thanks for having me on I always enjoy talking to you and being part of dental town all right buddy thank you so much for coming on the show today

More Like This

Total Blog Activity

Total Bloggers
Total Blog Posts
Total Podcasts
Total Videos


Townie Perks

Townie® Poll

Do you allow parents into the operatory?

Site Help

Sally Gross, Member Services
Phone: +1-480-445-9710

Follow Dentaltown

Mobile App



9633 S. 48th Street Suite 200 • Phoenix, AZ 85044 · Phone: +1-480-598-0001 · Fax: +1-480-598-3450
©1999-2019 Dentaltown, L.L.C., a division of Farran Media, L.L.C. · All Rights Reserved