Is your practice going out of network to make more money? Fantastic, but make sure you listen to this episode first. Kiera talks about all the numbers you absolutely need to know before you make the decision, and other, smaller considerations
you could make instead.
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Transcript:
Kiera Dent- Dental A Team (00:00)
Hello, Dental A Team listeners this is Kiera and today I am excited to chat with you about a pretty popular topic that people are always wanting to ask questions about they want to get to know like Kiera, I just want to go out of network. And I say, great, let's talk about it. Let's have a really good conversation about what going out of network actually means what it looks like for you and your practice and how we're able to support you on that.
So if you're new to the Dental A Team, welcome, I'm Kiera Dent. I love all things dentistry. My last name really is Dent and I believe that our job is to positively impact the world of dentistry in the greatest way possible. I think that we are so lucky and so blessed to be able to work in dentistry, to be able to serve and help so many patients. And so I hope that you just know that you're doing a great work out there, that you are changing lives, that you are benefiting so many people. And I am so glad that you've chosen to spend your time with Dental A Team.
If you love our podcast, please, like, please go leave us a review. Like, subscribe, share. It helps us out so much. You have no idea. Just like you want patients to leave you great reviews after you see them. Leaving us a great review for the podcast actually helps us reach more practices and that's our ultimate goal. And I do read them and I'm so grateful for your amazing reviews. So let's talk about going out of network. Going out of network, everybody wants to do it because they want to make money, right? Like I am getting these terrible reimbursement rates and so that's why I'm going to do it.
But what I want you to realize is when you go out of network, you actually become a marketing company. Okay, I hope you heard that. When you go out of network, you become a marketing company. And what that looks like is you now have to work to retain these patients. So when I help practices go out of network, like that's totally fine. You're allowed to do it, but let's make sure we look at the numbers. Let's make sure we do the math. How much is it going to cost for us to market to these new patients? How is it going to be for us to retain these new patients? How are we going to be able to actually get these patients to stay with us long-term?
Now we don't have the insurance clause that's keeping patients here. Also, if you don't know, insurance companies do often send letters to your patients telling them, hey, if you just go down to this other dentist, they're actually an in-network provider. I kid you not, you think that it's dirty, they're allowed to play dirty. So just so you know, when you do this, you start facing this huge uphill battle and I've had practices almost go belly up after going out of network. That's not to say that going out of network's wrong.
but I even have practices that are fee for service right now and they're like we just cannot drive new patients because trying to compete with people in network is so hard and I think about it like Let's just run the fees and I know you sit here and you dream about this grand day of like but Kiera if I was out of network I could get paid so much for a crown and I'm like, yes But then you're only doing like two crowns instead of 20 crowns So there is a volume game, which is not a wrong game to play But I just want you to like realize that you really have to drive your marketing. You have to be
top notch, you have to look to see how you're gonna drive patients to your practice. You have to beg, you will have an uptick in your spend on marketing when you go out of network as well. So it's not all flour, sunshine and gravy. And so sometimes I just look at like, what's the biggest pain point and could we maybe drop one or two insurance companies instead of dropping all of them. If you have more patients than you know what to do with and I'm talking you are booked out seven, eight, nine months to get your patients back in. It might be worth considering, could we drop one or two plans?
Or could we expand and add in more providers before we drop insurances? So look at our lowest paying reimbursables and see what if we just drop those and offer them our membership plan so they become these fee for service patients. But with the membership plan, they are more tethered to the practice, right? Because they're paying for this, they're going to be coming in two times a year. You have two opportunities to see them. I will tell you as a fee for service patient myself, I do not usually go in two times a year. And it's because I'm like, I gotta pay like 300 bucks. But when they have a membership plan,
They don't think like that. They're like, put my cleaning is free. Just like they think of with insurance. So when you're going out of network, really starting to think about all these possibilities of like, all right, what are we going to need to change to be able to drop? So when I have people looking at this, I think about number one, what is the cost to benefit ratio? And if we lost all these patients, let's pretend none of them come, let's go for our worst case scenario, would we be able to sustain? Do I have enough patients to be able to sustain that? And am I willing to do that? Some practices,
Totally, they're good to go. They're like, yes, Kiera, I'm just fine. I can absolutely 1000 % handle this. Other people are like, no, I can't. If I lost all those patients, we would not be able to sustain. So that's the first step before we go out of network. The second step is let's make sure we're prepared to go out of network and handle all those phone calls. And how are we going to save and maintain and retain these patients? Can we get them on membership plans? Third, what are you gonna do about the insurance companies that are calling your patients constantly?
When you out of network, you move into a marketing company. You are constantly striving to keep these patients with you, retain these patients, make sure that they're always there. They're no longer just coming to quote unquote automatically. And so I think about it like, let's run the opportunity cost for when we're going out of network to see, is this something I really want to do? do you want to do this? And I think so many people are like, okay, I'm going to just do this.
we're going to run, we're going to do, and then like, let's maybe do a little bit of prep work. And so there is out of network, like collection verbiage, there is an out of network plan. ? There is all of this. And I just think like, when we go through it, you want to make sure that you are fully prepared financially, mentally, emotionally, as a team, we are locked and loaded and we are good to go. And so if you've looked at those numbers and you're set,
I really want you to think about how you're going to be a marketing company. And so when we look at this, thinking about how can I retain all these people? How can I make sure before I go and drop, like truly before you go and drop insurance, how can I make sure all these patients are going to continue to come back to us? Is it something that we can do of like, can I put into place and start reaching out membership plans? Can we work on our patient experience? Can we make sure like, what's gonna set us apart from the insurance company down the street?
I have a doctor and they are amazing and they are fee for service and they've been fee for service for years. I'm talking like they are so lucky. They've got the Taj Mahal of a practice. It's gorgeous. They've got state of the art technology. Their fees are really not that much higher, but they have like, could you not multiple practices? There's probably 10 around them that are all insurance driven and they're like, but our dentistry should speak for itself. And I'm like, I don't disagree with you, but when times get tighter, things get harder.
People are gonna look at this. guys, I have even, Kiera Dent, who knows dentistry, I have switched. I have a doctor who's fee for service. This is embarrassing. Me as a patient, I'm going to tell you. I have a dentist fee for service. I know they do great dentistry, but they're fee for service. My husband, he's got a great dentist who's got a great hygienist. They're in network with my husband's insurance. I was like, well, I'll just go to them for my cleanings. And if I ever have work that needs to get done, I'll go to the fee for service practice.
Even myself, because I'm just like, well, is it really worth the cost? Like, it's just a cleaning. Like I could just go to the other dentist and you might be like, no cure. But you got to think about the patient. I know you think your dentistry is amazing, but to that patient, a cleaning is a cleaning is a cleaning. Unless they love your hygienist or they love you, they love your front office. They love something about your practice so much that they're willing to pay almost like I pay $300 out of pocket versus insurance. pay $30 a month.
and I get to go have a great cleaning by this amazing hygienist. I also can look at my x-rays, but I think about it, this is where I say you've got to be a marketing company. What's going to make this person continually come to you and choose you every single year when the insurance companies are hitting them, the economy's hitting them, the price is hitting them, and they don't know if your filling is better than the dentist down the street that is closer to them, is in network with them, and they don't need to drive to you. How do you set yourself apart?
So ways that fee for service practice, like I'm telling you, I got the Taj Mahal. They're amazing. They're great. But even then they struggle. And so I think before we decide we wanna drop out of network, I really want you to just make sure, am I committed to being a marketing company? I'm doing the reels. I'm doing the social media. I'm putting like a freaking banner outside. I am asking for reviews and referrals. I'm making sure that we concier all of our patients. We're doing follows with them. Our doctors are giving them a call afterwards. Like I'm talking next level.
So I go to a fee for service chiropractor. She's amazing. She does a nerve and I have actually some like weird nerve things going on. And so I really love her. She's fee for service. But when I have like something that comes up in my life and I message her, it is an above and beyond over the top on her of like, absolutely care. I take care of yourself. I'm going to reappoint you. I'll reschedule you. It is a white glove service when I work with her. And so I'm willing to pay a premium. I also am able to get in on the weekends. If I need something from her, I message her and she's like, yep.
I, she can do house visits for me, but I think you have to realize like when people are paying out of pocket full price, just doing great dentistry is not enough for them. They are expecting great customer service, great experiences. Why should I be paying my money? And sometimes that's not even enough. And you can say, we've got say to the art this, we've got say to the art that. So what this practice we had to do for fever service, they get a tour every single time we walk them through, we have towels for them. We walk them to the front. They have a dedicated treatment coordinator.
There's somebody who's dedicated for phones. We have a dedicated concierge who sits in the front office who brings things for you. That's the welcoming and greeting who sits there and chit chats, who knows every single patient by name. That is the level of concierge service and marketing for these fee for service practices. If you've got competition around you. If you don't, podcast doesn't apply to you. But I think when most people are thinking about going out of network, they're just like, I'm going to go like screw it. Delta Dental, Aetna, I'm so sick of your freaking fees. I'm going to now be paid what I'm worth.
I don't disagree with you. You are worth that. But I also want to make sure that you're fully prepared to be that high level concierge doctor that has to do so much more to retain these patients. I have another doctor who went out of network, literally almost went bankrupt. ? The practice is struggling. They don't have enough patients. They are constantly trying to recruit new patients. They're looking at it and they're looking to rejoin in network because everything is falling apart. Family's falling apart. Life has fallen apart. Profitability has fallen apart.
because they just did not realize how much effort it is to try to bring in new patients on your own. So one way you could look before you even go into it is look at your new patients and see how many new patients are we attracting just by reviews and referrals alone before I go out of network. And if I'm not bringing in a lot of people by reviews and referrals right now as the best dentist, they love me. I've got like this healthy cult following with them. If I don't have that, I might wanna work on that to see what are the patients who are fee for service
Why are they coming here? Ask them, ask people like, you can survey your patient base. Like what would you guys love? Like if you had to pay a little bit more for dentistry, what would it be? Are you more, because they don't know the difference of a great dentist and a not so great dentist. And I think that that's what people don't realize is our dentistry, as much as I wish that it was a differentiator for patients, it's not. They don't know if that filling in that crown is better than the dentist down the street who's in network. They have no idea.
What they're looking at is cost and even a great experience, they still might come down to cost. And I'm not here to say that it's all cost because I believe that people are willing to pay for great experiences. You look at why does Chick-fil-A do better than McDonald's? We look at why is Target oftentimes better than Walmart, but is it really? And who are you? And I don't think all patients come for cost. I think there is a lot of space in today's world to stand out of knowing their name, driving it, but we also have to be careful because
We are facing real people are like, how's the economy and is it impacting dentists? And I'm like, those who are doing regular dentistry, no, it's not. They're great. But those who are outside of that, so we're talking all on X cases, cosmetic cases, fee for service patients. If they don't have a loyal patient base right now, people are considering costs. They are considering what are we going to do? And I know that that's why you are also probably considering fee for service. What about fee for service? What about this? What about that?
those pieces I think are very much needing to be highlighted and addressed of, all right, if the economy is pushing dollars, what can we do to offset that? If I'm needing to increase our fees to offset dollars within our practice for profit margins, what else can we do for this? And I really think for you to look at when you're going out of network to say, is this something I'm willing to do? Is this something our practice is fully equipped with?
Are we getting enough reviews and referrals just by being a great practice today to go out of it? And am I willing to like up my ante, not just being a great dentist, because you dropped that network guys, they're going to like fly away to a practice that does accept them. And like I said, your insurance company is going to try to convince them because they get a lot more money when it goes through an in-network provider than an out-of-network provider. And they're going to, they hustle them. And so for you to just accept that you will be a marketer, you will be constantly looking for patients.
you'll be constantly trying to fill your books and is it something you want to do? And is that an additional piece you want to add to your already big to-do list or is it not? And you might be hearing like, Kiera's pro insurance. I'm not, we have a lot of offices that are out of network, but I will say my out of network ones, every single call, it is always a, do I get more new patients? How do we get patients? Unless you're in a really busy area, I have a few where like them cutting insurance was the best thing they could have done because they just were inundated with patients.
and it was like kind of pruning a tree and they needed to prune. So them dropping insurances strategically, they were okay if they lost every single patient, they would still be able to take care of their entire team. All the people, they even had like a dental office across the street moving. They're like, that's fine, take our patients. Like we are good with that. But I will say, if you are not prepared to do that, I might just add a pause for you before you go out of network. So thinking about going out of network, run your numbers to see, can we survive when we lost all the patients?
Number two, I want you to think about are we prepared to be a marketing company and what do we need to do to make sure people stay? Number three, look at our reviews and see how many of them and our referrals and our new patients, how many are coming from reviews and referrals of people referring us and would they continue to do so? Please like check your ego, pretend you are not this person. Will they continue to do so if you go out of network? Four, what can we proactively do to make patients want to stay here? Can we start adding some of these concierge pieces or is it like, hey, when we go out of network, we add these concierge pieces.
Can we get people more on membership plans? So when we go out of network, it doesn't hurt us as much because they're tethered to our practice already. I would be prepping and preparing you and this is what we do with our offices before they do it. Some offices still choose to go out of network and I say that's fine. But again, every choice has a consequence, whether positive or negative that you need to be aware of to make the best decisions. And I believe better insights, better knowledge result in better decisions. So if you need help going out of network, you're like, my gosh, these are things that I need help with.
please reach out before you do it. Hello@TheDentalATeam.com. This is how we're able to help you. This is how we're able to just make sure that you've thought through all the pieces and then whatever path is best for you, we're able to guide you through it. And if you've already decided to go out and now we're kind like, shoot, I don't have all these things in place. Great. This is what we do. So reach out. Hello@TheDentalATeam.com. This is what we specialize in. This is what we're experts in and you can choose. It's like, it's a choose your own adventure.
Just make sure you know what the ending looks like for either opportunity so you choose the best decision for you, your practice, and your patients. And as always, thanks for listening, and I'll catch you next time on the Dental A Team