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Kiera and Dana chat about ways dentists can go "beyond the chair" with passive income streams, including real estate, investments, speaking gigs, and more. Episode resources: Sign up for Dental A-Team's Virtual Summit 2025! Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: Kiera Dent (00:00.802) Hello, Dental A Team listeners. This is Kiera and today, man, it's been way too long. I have the one and only Dana from our team. If you've known her, if you're here as like an OG, you know Dana from Donuts with Dana. Gosh, Dana, that's like way back in the archives. But if you're newer, you may have heard her as Dainey. I don't know if she loves that one. And then Dana, what was the one that I heard? I think it was like Dynamite Dana was the last one that I heard come through for you. So those are kind of when you're like morphing over time, but Which one do you prefer, Dana? And welcome to the show. Dana (00:32.799) I I think the OG of donuts with Dana is probably the one that like will continue to stick. Kiera Dent (00:39.342) It's true. A lot of people like even at events and they see you, they're like, oh my gosh, it's donuts with Dana, which is so fun and so cute, but super happy to have you. Welcome to the show today. So grateful. You actually brought up a really interesting topic that I thought it'd be fun for us to dive into from a lot of your clients that you've been talking to of like, what are maybe some passive income ideas for dentists beyond the chair? Now let's just clarify. This does not mean that you have to actually like give up dentistry that you're not working, but I think we have a lot of entrepreneurial minded dentists that are just starting to like get creative, want some ideas. So today, Dana and I are here to like pick your interests, just how you start thinking in different ideas. But Dana, give some more background. know this came from a lot of your clients. What are some of the things you've been seeing and hearing? Dana (01:26.34) Yeah, I do think that you're right. I think that if you are a business owner, right, if you're a practice owner, that just naturally comes to you. And I think that people that own businesses and people that have gone and graduated dental school and become leaders are just always looking for opportunity too. I think it's just a mindset thing in that group of people. So it's come up just on calls, like, what can I do? What are some things that I can do outside of the chair? And some interesting things that some of even my clients do that I thought would be really fun to share, to help brainstorm and give some ideas. Kiera Dent (02:02.542) I love it. I love a good brainstorm session like this, Dana. So this is gonna be a little different podcast style for all of you coming on. Today it's more of a rift. It's more of a like, oh gosh, I think these are like a good think tank. My husband and I, we go hot tubbing and we call it our like tub talk. So it's not Ted talk, it's tub talk because that's where a lot of our best ideas come. today is a, it's donuts with Dana and Kiera. It's like dabbling in dentistry. Like, but I want it to be better than like, dabbling outside of dentistry, maybe that's what it will have this brainstorm such as, because I agree with you, Dana, and I also think sharing some ideas that some of our clients do, obviously we mash and mix, so you can't really figure out who we're talking about, because I like to keep that private and confidential for them. But I think like, again, let's spur some ideas. So Dana, I've got some ideas, I know you have some, but let's take it on of what are some of the things that dentists can do for this passive income? But wait, before we go there, I also feel like it's important to say why. Dana, you mentioned about like a lot of these offices, these dentists want something beyond just dentistry. I also think for me, it becomes an insurance policy. Like dentist, if these little hands right here, if they break, well, that's your livelihood. So I do think for some dentists having passive revenue, passive income, coming through generating different ideas means you're not as dependent upon your hands, but more able to do that out of like desire rather than necessity. So I think it's a good morphing and it doesn't have as much stress and pressure from what I've seen from doctors that do it. But again, those are maybe just a few ideas within our dabbling in outside of dentistry talk today. Dana (03:42.022) Yeah, I think it's an exciting one and I will usually always preface the conversation with like make sure you have a good financial advisor too because some of the things is Make sure that the money you're currently making can also potentially make you money. So just really connecting with a strong financial advisor so that you can maximize the money that's coming into you from your practice, whether it's in investments, whether It's in bonds, anything like that. Connect with a strong financial advisor and they can help walk you through any of these ideas we roll out today in our talk that just helps them make better decisions. Kiera Dent (04:19.886) Couldn't agree with you more because also it's fun when you start to make these extra passive income ones Don't forget depending upon how it's set up what it's structured what it is Well, this could also incur a higher tax bill for you. I'm never opposed to you made more money no, I've got more tax But if you don't plan and prepare for it then instantly that can become a cash flow crunch for you end of year So agreed and with all things we are not financial advisors. We are not here to give you legal counsel We're not here to give you financial counsel. We're just here to riff with you And then you need to make sure that you take this on and get the appropriate advice for your specific needs because truth be told, it varies from client to client, state to state, location to location, and scenario to scenario. So what I do and what works for me, what Dana does, they're not the same, but again, today's a fun riff. So Dana, let's kick it off with what are some of these ideas that are brewing that you've heard? Dana (05:06.222) Yeah. Yeah, I mean, I think real estate is definitely something that a lot of dentists look at as like a more of a passive. I It depends on how passive you want it to be versus how active you want it to be as far as a supplementary income. So I think real estate is one. I think silent business partner in a business that is of interest. I mean, we have a mutual client who I think is in real estate and maybe even a farm. So there's those things. Kiera Dent (05:35.738) huh, true, it's true. Dana (05:39.352) and I've got another office where she is a spokesperson for a pretty big oral health company. So she does podcasts for them. She writes articles for them. She speaks at some of the conventions that they are at. I have heard of a dentist who created webinar series on a procedure that he felt like he was really strong in. And so I just feel like sometimes it just takes thinking outside the box, thinking about where your passions are, thinking about what you might enjoy spending your time if it's more of an active pursuit. So I think that there's endless ideas really. Kiera Dent (06:20.226) Mm-hmm agreed and I think like let's dig a little into real estate. Let's talk about this a little more I am no real estate professional on this there's different pieces, but we'll dabble a little bit venture out into that just so you can hear a few things because I am very passionate about real estate and I'm very intrigued by how to it started because I met some people at Tony Robbins like surprise surprise started chatting with them and I started meeting a doctor community surprise surprise because I wanted my husband to look for ways to not have to be always working at the hospital. I think hospitals are a little more grueling than dentistry, not as forgiving. And literally there was no way for my husband to get out of it. And I thought, well, shoot, we don't have kids. I wanna travel. But you're my travel buddy and you're always at work. So I started meeting these people and we started talking. And something I really was impressed by was they actually started talking about how... Like as doctors and dentists, we have it a little bit different. You don't have as captive an income as say a lot of medical professionals do. My husband, there was no way for him to make more money. Unlike in dentistry, you produce more, you're able to create more. And so what they do is there's actually a thing called rep status where you can actually, there's a couple different ways to do it. And again, I'm no guru on this. It's just giving you a couple of ideas to look at. But if you get rep status, so a lot of times people will have their spouse. become the rep status. So for example, in my situation, let's say I didn't work at dental team, let's say I had a lesser job right now, I would not be the right candidate for this relationship. But Jason, he's working at the hospital. I'm a spouse, I'm staying at home with the kids, or I'm working maybe only part time, I have more hours. What we can actually do is I can take on rep status, so real estate professional status. And what I can actually do is I can offset with deductions within our real estate portfolio, all of Jason's tax within his W-2. So it's a really good way for you to actually make more on a W-2 by offsetting. Now there's a secondary loophole on there for short-term real estate where you can be full-time working, but you can actually get short-term real estate in there and you can actually offset again through rep status. Now rep status are, there's like a lot of rules. So go read up on it, go talk to your financial advisor, go talk to your CPAs about how you get this rep status and see if it qualifies for you because like this is something my husband and I have looked into exponentially to figure out, hey, Kiera Dent (08:38.68) How could we offset this? Because if I can keep the taxes that I'm paying from our W-2, is there possibly a way that we could reinvest it? So now maybe you wanna do it, maybe you don't. There's also ways if you don't wanna be that involved and take that on, or you don't have a spouse or a partner that can help you with it, then other ways that you can do it are actually through syndications or being like Dana was mentioning of being a lesser buyer into it, where basically you just put money in. Those ones, they're a dime a dozen. There's a ton of them. And so usually the best deals are found through networking. So if you're interested, odds are your financial advisor probably knows someone. I know there's quite a few dental groups. I will put some asterisks around that bet. Some of the dental groups that I heard, I will not mention names. There are some dental groups that were doing investments that actually a lot of dentists lost a lot of money on. So just make sure with any investment, guess what? It's risk. We're like high five. And the best advice I was ever given on investments was same thing with like loaning money to people. Once that money is gone, I kiss it goodbye. Yes, I hope it comes back, but I have to be okay losing that money and it never coming back to me. So I think that there's other ways, but also let's not forget like investments, like putting money and maximize like for me, I utilize taxes and savings on the company. Those go into high yield savings accounts. I am still having true passive income off of those investments. They're not invested. They're just sitting there. I have to keep the money anyway. Why not have that? come back to me and some returns that way too. But I think those are some fun ways to look into real estate in some different zones, which again, I didn't even realize it realize and my brother didn't realize and several people I've talked to about this real estate professional status that you can achieve that will truly offset those W-2 taxes. So looking into that might be a fun way for you to see it. I am one who I know I'm not going to be getting the phone call in the middle of the night. I'm not going to be going doing the plumbing. Jason, he built custom homes. He still doesn't want to do it. We might do short-term rentals. And I was like, well, what are you going to do with the freaking snow, Jay? He was like, don't worry, Kiera, it will be an upfront cost, but we're putting heated driveways in. I'm never going to have to shovel them ever. No liability on us. just looking, and I know there's some really fun things, again, depending upon your area, but you can actually pick up some short-term rentals. Again, you've got to look at the areas. You've got to look at the zoning, but there's a lot of small houses that are like kit houses that are 20 grand, 30 grand, 40 grand. They literally come as a kit. You just need to... Kiera Dent (10:59.358) slab it and make sure that there's sewer and water to it. But those who can then rent out is like really cool Airbnbs too. Now Airbnb is hot topic right now. I don't know how much people are following it, but there are a lot of places that have been zoned for Airbnbs. Like we're even talking Dallas. I'm familiar with this because I live by Lake Tahoe. Lake Tahoe, a lot of those places were zoned for short-term rentals. And then after being purchased, so people have had these for years, they're actually being rezoned into residential, which I think is totally shady. There's opinions on both sides of this of like, yes, but we need housing. And I'm like, yes, but they bought it. But again, it is another investment. So it's not an always guarantee. But Dana, I just went on a real estate rant. Any thoughts that you've got on that? Because I agree. think real estate is usually where a lot of people do venture in. I mean, there's storage units, there's short term rentals. Well, excuse me. There's like farms. There's other things you can get into a lot of these pieces. But again, Be careful, do your homework and realize that money once it's gone, it's gone. Like hopefully it comes back to you, but maybe a few ideas in that realm too. Dana, thoughts, cause I really went on a rant on rep status. Dana (12:05.72) No, I love it. I think I learned something too during this podcast, which is awesome. And I agree with you. I think it just comes down to doing your research, knowing how much time you want to invest in something, knowing how much work you want to invest in something. And also too, how much money do you want wrapped up in things like that? And so I love that walkthrough of it. Kiera Dent (12:25.664) And Dana, as you said that, I also was thinking about Ryan Isaac with Dennis Advisors. He's my financial advisor and he reminds me that like really the biggest way to make wealth are independent businesses, real estate, and then like private equity and venture things where like you're going into venture capitalism. And so I also want to highlight while yes, we're talking about these getting outside of the chair, never forget that your business is your greatest asset in a lot of ways too. Now. For me as a business owner, I sometimes love all my eggs in my own basket. Other times I absolutely hate…
Full show notes at the publisherKiera shares exactly how Dental A-Team helped a practice with over $2 million in accounts receivable break even — and learn how to never fall behind again. Episode resources: Sign up for Dental A-Team's Virtual Summit 2025! Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript Kiera Dent (00:01.848) Hello, Dental A Team listeners. This is Kiera and welcome to the podcast. I hope today you are truly just so happy. I hope that you are honestly just living your best life and I hope you know that you're truly doing better than you think you are. So you guys, this is where we are. We're here to help you. Dental A Team is obsessed about helping you and your team thrive. To be able to give you guys the guidance that you need to navigate the challenges that we have in dentistry. so welcome. This is what I'm obsessed with. I hope that you just know that I I truly love and adore this podcast family. I'm so grateful for you. I'm grateful for you sharing this with your friends. I love, love, love seeing you tag us when you're driving to work or listening in the car or taking us on a road trip. And my goal is to be always something of value for you on this podcast that you can go and implement immediately to make your life and your practice even better. For those of you new, welcome. For those of you who are OGs, welcome. I'm so happy to have you here. As always, please. like and subscribe and leave reviews for our podcast. That way we can reach all the practices truly out there. Right now we have impacted several, but I know there's thousands of other practices that we could reach and guide. And the only way I can do that is through your help of sharing this. So as always, if you've shared, thank you. I just gave you a high five or a hug to say thank you. And I'm so glad that you're here. All right. Today I'm going to give you some quick tacticals on some billing help. how to handle old balances. think old balances are just annoying and I help practices with this all the time. Just to give you a little story, I kind of like stories on podcasts. I'm usually I'm here to rattle and roll and today I want to just take you down a little bit of memory lane. But there was a practice who reached out to us and wanted us to be a consultant for them and asked us to help them with their billing department. And I was like, all right, sure, like we do this. I'm more than happy to help you out. Let me know what you need. And this practice said, Well, Kiera, our over 90 and our total amount is about 2 million. And I was like, that's all right. It's not the worst I've ever seen. Tell me a little bit more. And they said, we literally have no handle on what we're doing with billing. And I was like, fantastic. So we got on. We started working with, they had a few different practices, 2 million. Could you imagine? Like, this is why I get paid what I get paid. Because we go and we find these little money holes in the practice and we patch them up. Kiera Dent (02:20.622) and we're able to add all this money back into your practice and to help you put systems into place so this doesn't happen again. I think that's the biggest thing is let's make sure this does not happen again. And so with this practice, what we ended up doing was we started checking in Trulie every single week with this billing team. We created spreadsheets. We had them download the AR. We prioritize which balances for them to go after first. And then we started like just chipping away at it. And we were heavy on our accountability. You better believe that I was hot to try on this practice. And it was every single week I was getting a report and update how many claims that they worked through. We looked to see, I think we had over 5,000 accounts to go through. So what we did is we said, all right, I'm gonna grab my calculator. I don't know off the top of my head. We said, all right, 5,000 accounts. We are working 20 days. That means we need to get through 250 accounts per day. We had three people working on it. That meant 83 accounts per person. Now that's not realistic, right? And so what we did is we took those 5,000 accounts and we did that over three months before we ran a new AR account. That way they could feel like they could get through that because then you have 5,000 charts. We have 60 days to work, right? 20 days times three. And then we had three people working on it that broke it down to about 25 to 30 accounts per day. that felt a lot more doable. Now remember, a lot of these accounts just needed to have a resubmit from insurance. It was a denied insurance claim because we didn't attach an attachment. Others, we just need to call and collect from a patient. Others, there was more work that needed to be done that we had to dig into. And then there was the dun-dun-dun-dun, old accounts. Like, what do I do with these old balances? We can't collect on them. And so that's really where we started to work. And so with this practice, it took us Truly, I'm not exaggerating, it was about six months before we started to get a good handle on it. And then like at a year mark, they felt like very confident we were able to get through all the accounts. We had good processes in place. We started collecting when people were coming in the door and that way all those accounts of this billing team looked to see who on the schedule we could collect from. Because that then, instead of just these three people working on it, we also had all of our front office team working on it, all the back office team, we were prepping the route slips. Kiera Dent (04:33.774) which a lot of billers will tell me that just feels like a waste of time, Kara. I don't want to do that. I don't want to prep these charts. And I think, yeah, but think you probably see, I don't know, 25 to 70 patients per day. And if we could collect on all of those that come through and collect those balances, well, now I'm not having to go and like look for all this stuff everywhere else. I can just get this done like in real time. So again, I'm a person of let's work smarter, not harder. And so this practice started doing that. So that became a system of then we chart prep. consistently making sure that, my gosh, like let's get all these patients there. We put into a process for the front office to collect at time of service when they checked in. And then we also made sure that we were really good on our treatment estimates to make sure that we didn't get into this hot water. And the reason this office got into hot water is not because they were doing anything wrong, but because this practice did not consistently work there. their insurance. And so they got all these old accounts, they got all these old balances. And guess what? That's no fun for anybody. That's not fun for the patient. That's not fun for the practice. That's not fun for cashflow. That's not fun for the billers. I mean, gosh, like when I look at 5,000 accounts, I'm like, all right, we got to work. Like we've got our spreadsheet to get through. And so for these practices, I just want you to know that no matter where you are, there's still hope. If we can help you on that, by all means reach out. Even if you're not there yet, like that far. Let's great, like let's catch it because the ultimate goal is that you have no more than one month's worth of production in your total AR. So if you're producing a hundred thousand, then guess what? I want no more than a hundred thousand in your AR at any given moment. Also, I really watch your over 90 accounts because those can tip to where they're no longer collectible. So what I recommend we do is when I'm working with a billing team is we're going to start with those big balances and then like, let's make a big hit. Like let's do a good impact. So I have people put it on an Excel spreadsheet. We have it color coded. It's actually so simple. And once billers get into this rhythm and doctors, when you have it, it becomes truly like flawless. It's so beautiful. It's so easy to do. So we put it in there. We sort it. You can use it and sort the list and sort your AR list. So that way I can look usually within your over 90. It's usually held up in like five to 10 accounts. So what we do is we actually go hit those accounts that are going to give us the biggest bang for our buck and our time. Kiera Dent (06:48.238) and we're gonna go try and collect on those accounts, figure out what's going on with those accounts and try to collect. Now, when I have an office that has a lot of really, really, really old balances, there comes a question of, we just write this off as bad debt or do we try to collect? And my opinion is you did the work, let's try and collect whatever we possibly can. So on those offices, I usually send out statements. You'll be shocked at how much you actually can collect from those old balances, that old debt. And then we go, we try to collect, I usually send one, two or three statements, depending upon the practice and the doctor's choice. I do not think it's aggressive to send three statements. I also call, I'm making sure I call these patients. You can even let them know like, hey, we're updating our system and we noticed there was an outstanding balance. So we needed to get that collected for you. This is the total. And I can take Visa or MasterCard, which do you prefer? Collect right over the phone. It's very simple. I know it feels weird. It's like, my gosh, we were supposed to have collected this a while ago. Well, high five, we updated our system. Hashtag we updated to actually looking at it is what we're trying to tell people. We should have collected this. We didn't, but now we have a process in place where we do this every week. And then from there, what I like to do is have you guys truly start collecting on those calling. I am amazed at how many practices do not call. Also amazed at how many practices do not have an online payment portion. Well, that's a really easy way to get old balances. Cause if you're expecting them to call during working hours or send you a check, or write their credit card on a little piece of paper and send it back to you. Well, we've just made it to where it's like so much of a time delay. Why not just have them get on the phone, get on a call with you and start making the outbound calls. I just gave you the script, use that for your team. That's how we start to work with these old balances. So now we've tried to collect everything. We're working on it. I also am very sticky that our billers are working at least two days a week. Billers, I'm going to tell you, you can work more efficiently. And I say that with grace and love and a hug. Because I don't want you working on this all the time. What I want you doing is I want you clumping things together, clumping insurance plans together, looking for all the patients that I can call, working A to J and then my, what is it? JK, K to Z. So we work those every other week. We're sending out statements, we're sending out text messages, and we have a rhythm. I have a billing calendar that I share with offices so that way we don't get off track. Yeah, you're going to have some hard work to do at the beginning, but once we get this on track and we have a system, guess what? You'll have to work on it like two days a week. Kiera Dent (09:08.75) It really does cut down time and doctors, just so you know, again, that's pending upon the size of the practice. When we have multi-offices, it's a full-time job. When we're at one practice, one provider, it should be a two-day job for billing. Now billers might hear this and they might be angry with me. Billers, I'm saying that not because I think that you are doing things wrong. I'm just saying that most offices can do it that way. So let's give you the efficiency tips. Let's help you out. Let's make sure that you're able to do it too. That way you're able to... Do this in the most effective and efficient way as possible. My goal is to not waste time. Let's not waste time on hard things, but let's actually do things that are fun. You can also outsource this to third party companies as well. That can also help. They're working. They're hugely less expensive. So if you're struggling with billing, those are some solutions. So I promise you old balances. We've now gone through, we've done all this. We still have debt. We still have these balances that we can't collect. We've sent out our three statements. We've been contacting them. We've called them three times. This has also been documented in their ledger. So we know it's really been done. Doctors, can run reports when it's documented. I usually do made up codes for these, but that way doctors, can run reports to see how many of these procedures are actually being, or how many of these calls are being done consistently. okay. Now it's a choice. You have choices. So depending on how old it is, what I usually like to do is I run my AR report. And then doctors, it's your decision here. I'm not going to tell you what to write off. All this money is technically owed to you. You did the work, so you get to decide what you want to do. I'll tell you my preference and I'll tell you what I usually recommend. But at the same time, this is your money and I want you to know you are entitled to every single penny that has been billed in the practice. I usually recommend anything below $20. If we can't collect it, it's not there. There's no way for us to collect it. Just write it all off. I also like to do this at a strategic time point. where it's probably at end of year or end of quarter. So that way I know at this point in time, I wrote off all this bad debt because then we can move forward and we know that was like a bad time. We're never doing it again, but this was my one time. So anything $10 or less, $20 or less, just write that off, get that out of the accounts. It's gonna clear up quite a few accounts for you. Then, well, and before we do that, we've tried to collect also any person who has a balance on their account. Kiera Dent (11:27.79) I don't usually think sending someone to collections over $20, that's not my jam. I'm not usually a big proponent of collections, but again, every penny is entitled to you. So you decide what's best for you. So we write it off and then from there we get to start deciding what we're gonna do. Are we gonna call these patients and do a 50-50 split with them to where if they pay 50 % today, we're then gonna write off the additional 50%, but most likely they're probably not welcome back in the practice. Are we going to send them to collections? Are we just going to say these balances are never going to be collected? And we like pick through them and decide, but doctors, once we have this bad debt, it's your decision to decide what are you going to do with it? Look to see how much it's there. Look to see how much we've contacted them, called them. Can we do anything else? And then we really get to decide, we write this off? Now, if you do write it off for bad debt, it does need to be adjusted off. There needs to be a note on that practice, on that patient. And that patient does not get to come back to the practice until they've paid their debt. Let's not get ourselves back into hot water. but that's…
Full show notes at the publisherKiera gives listeners a "choose your own adventure" challenge for planning practice growth. She touches on comparing your growth to others', how and what to expand, taking advantage of opportunities (or not), and more. Episode resources: Sign up for Dental A-Team's Virtual Summit 2025! Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript Kiera Dent (00:00.856) Hello, Dental A Team listeners. This is Kiera, and I hope you are just having such an amazing day. I hope that you remember why you went into dentistry. I hope if yesterday was a bad day, today's a better day. And I hope that Dental A Team podcasts truly boost your spirits, lightens your mood, and gives you tactical tips that are gonna be able to make your life incredible because at Dental A Team, we're obsessed about making your life happy. So today, I wanted to get on of a choose your own adventure. This is kind of fun. I think it's fun to just kind of like... dabble in where can our practice go? What are some ideas? What are some things to think about? And we do this with our clients. And I just got jazzed about this one today. It was a really fun one that I chatted about with another office. And I thought, I think our Dental A Team family needs to have this. So if you are new to our Dental A Team podcast, welcome. I'm Kiera Dent. Dent really is my last name. I just make the joke. That's not really a joke. It's my real life. I had to just get three fiancees to get this last name. I didn't marry any of them. I just married the last one and I love dentistry, I love helping practices, our team loves helping offices. We truly are experts at what we do of helping doctors and teams come together to have the best practice, the best opportunities. We fly to your practice or we do it virtually. Both are super incredible. We also have an in-person doctor community that we go to as well, which is really magical. And really our goal is to make sure that you are living your best life, that you are profitable and that your team is thriving. And so really, and we're the experts. that do this. We have been team members ourselves. Every one of our consultants have been team members. They grow multiple practices, to hundreds and hundreds of thousands of millions of dollars. So we, are experts at doing this and we love to just share resources to help you and your team be absolutely the most incredible that you possibly can be. So with that today, I wanted to just dabble on a choose your own adventure, giving you a short tactical choose your own adventure. So there's a practice. So this is kind of an office autopsy, if you will. There's a practice and they started out kind of small. So they had a few ops and don't worry for all of you listening, I do smash a few practices together so you'll never know which practice I'm talking about. And I do that intentionally to keep practice confidentiality. So with that, this practice they started out kind of small. They had four operatories and they were in that practice for about five years. The doctor was taking on about 1800 patients solo. That's a lot of patients. And they were just booked out. Kiera Dent (02:25.72) They worked four days a week and they knew they wanted to expand. So they expanded to 10 operatories and within about two months of expanding, this is not an exaggeration, they had basically outgrown their space. So they had another associate that they hired. They brought in more hygienists. So they had four hygienists and they had an opportunity to add another associate and also another hygienist. And it kind of was coming to a crossroad of what do we do? And so I want to just place this for you in practices and I'm going to bring a bunch of choose your own adventure because I think a lot of times thinking outside the box really becomes something we don't do. We feel like we're living in a day in and day out. And so this practice made me think of like, let me bring to the table some options that I've seen with other practices for you to not compare, but to create a What do I want my practice to look like? What do I want my life to look like? So step one is that I'm really, really pro whenever we work with an office is A, we've got to know what you want to do. And I usually like to do it in 2-5 years stints. thinking about your kids, thinking about your age, thinking of who you are, where are you gonna be in the next 2-5 years? So when we look at that, But then I also wanna take it and expand you out to 10 years. Reason being is because decisions you make now actually might impact where you wanna be in 10 years. So for example, with that, if you were choosing your own adventure, let's say in the next 2-5 years, you're like, gosh, I really wanna scale back, I wanna be home with my kiddos, I wanna do some different things, that's really what I'm looking for in the next 2-5 years. Well then kiddos get older, they're in school or maybe your kids are graduating and you're like, gosh, in like 10 years, I actually want to be building a bigger practice. With that, if we scale down now in the next 2-5 years, your 10 year plan is actually gonna really be a problem because now you're gonna have to build it back up because you scaled it back down. So maybe there's a way that we could get you to scale down now without killing your patient base that's going to help you within the next decade of your life. So that's where I really love this choose your own adventure. And I get so giddy about this and I love helping doctors dream and I love building out dream boards with our doctors to help them see, all right, where do we wanna be in 2-5 years? But then where do we really wanna be in the next decade of our life and or the legacy of our practice? Because for some, some wanna grow these massive practices. For others, they wanna just have a solo practice. Something I'm really like, this is where I'm gonna get on a rant in a soap box. Kiera Dent (04:44.738) I get really frustrated with offices that are just growing for the sake of growing. They're looking on social media. feel like social media is such a blessing and a curse because we compare and we're like, gosh, like, what am I doing over here? I'm just schmucking over here and I'm not really building a practice. And my gosh, I only have four ops and they have like 17 ops. And what am I doing over here? And gosh, that one just grew. And this one has like 12 practices and like, I'm just sitting over here in four ops. And I really get annoyed by that because There's no reason to grow unless that's ultimately going to serve your life. And I really want to hone that in today of is your practice serving your life or are you serving your practice? Because you can have whatever life you want to live. Some people who have 12 practices are like very miserable. Yeah, they look great on paper, but their life is miserable. And I think about that ballerina picture. If you haven't seen it, go do a quick search where a ballerina is on point. So that means they're standing on their tippy toes and they're in a beautiful ballet slipper. And the picture says like, everybody wants to be a ballerina on point until they see the work that has to happen. And the other foot is like this bloody ripped up, like the toes are gnarly. And you think about like, you can't see that behind the beautiful ballet slipper of this gnarly foot that's been like beaten thrashed and like, just chewed up and spit out on the other side. And I think about that often about these offices, like, we don't see what their life is like, we don't see. the problems that they're having. And I'm also not here to say that growing is bad either. I'm not here to say that if you're like 12 off, isn't it like, gosh, like my life's terrible and I wish I was a four off practice. I'm tired of the comparison. I'm tired of people just feeling like whatever they're doing is not good enough. And I think that that comes from comparison left and right. And so when we look at this, choose your own adventure, I also think it's choose our own adventure, but let's also choose the life we want to live. Choose the life that's going to make us freaking passionate. Choose the life that's just going to inspire us and do all the things that are. are going to be great for us and then be able to just flourish from there as well. So when we say that, with this practice, the choice is where do I wanna be in two years? Where do I wanna be in five years? And where do I wanna be in the next decade? And then there's options that we can do. So for example, with a practice, four ops, they have a choice. We can expand, we can maybe go next door, we can maybe find an op within our practice. Kiera Dent (07:06.574) Um, but what is the reason why for this office, what they were doing is they had so many patients, tons of patients, they couldn't see them all. And so they wanted to expand. So they knocked out the wall. They made it a 10 out practice. They were only going to do eight. And I said, Nope, always go for more ops. You will never be sad about adding more ops in. This doctor was so grateful that they added more ops in, uh, gives more choices, more opportunities, especially when you're growing that way. So now it's a matter of, all right, what do want to do from here? Do we want to keep growing? So that would mean we might expand out, bring on other people. Could we expand our hours so that we're not having to expand our days? Could we bring on more providers? What are some of the choices that we could do? And I think getting really creative in the space that you've got. So it's not always having to expand out, but could we add an operatory? Could we expand hours? Could we add another provider? Could we, if a doctor wants to pull back and only work two days for right now, but we don't want to drop our patient base, can they work two days and then maybe come in and do hygiene checks on another day to fill a doctor's schedule? I don't know what are the solutions? What are the things that we could do? are the things that I really love for you to look at. So when we look at that then, the next thing we're gonna ask ourself is, this is why it's important to look at your two year and your five year and your 10 year. Then from there it's, okay, we could keep doing that, we could scale back. Or if we have too many patients, maybe we consider dropping a few insurance plans. But be careful, because if I drop those insurance plans and in a decade I want to grow my practice back up, well, it kind of is like cutting my arm off and then I need to use my arm in the future. So what are some solutions that we could do now? Maybe with something where we say, is where we wanna be. This is what I want my life to look like for the next 20 years. Awesome. Then we know we can scale back. We can start to be more fee for service. I have a practice in there, six ops. And they're like, here, we're going out of network. And I was like, are you sure? And they're like, we don't freaking care. They have their new patients wait for three months. But guess what? They're busy and they know that they don't wanna expand any bigger. They want six ops. They wanna work four days a week. And they wanna be home with their kids for the next two decades of their life. They are so clear that now they're making decisions that impact their life rather than dictate their life. And so that's really where it's choose your own adventure. Do you wanna maybe scale back and only work a couple days a week? Do you wanna be working five days a week? Do you wanna have you and one provider? Do you wanna have you and then two other providers so you can scale back and maybe do some other things? Do you want to build a bigger building? I know I've got some practices that are like 17 ops. Gosh, I've got one that I think is pulling in a 50 ops. Kiera Dent (09:32.12) practice. That's insanity to me. I'm like, you're going to have to be like a hospital with a parking garage. Like that's not even a joke. It's like a 50 bed hospital, but it's a 50 op practice. Those things sound so dreamy, but again, that's fun. And if that's your vision, but this doctor has been practicing for about 20 years, who's building a 50 op location. but looking to see what do we want to do? Also, I like if you're in this practice and we're kind of bursting at the seams, there's a practice that I've got where we expanded them out, similar to the one I was alluding to at the beginning, they expanded out, they now have, think, 15 operatories, and they're like, we need more space. So they looked around, there's some real estate, and they're like, we're gonna build a surgery and a sleep center across the street, we're gonna keep this as our general. So are there other building locations, and do we wanna do more surgery or more sleep, or I have a practice that does a tongue and lip tie in their location, do we wanna add a dental assisting school, so that way, instead of it just being dentistry, we're also doing dental assisting. So our building is being double utilized and we're able to have another revenue stream in there. Do we want to bring in other specialties under one roof? These are the conversations that get me so lit up because I feel like there's so many choose your own adventures, but it's really choose your life. So if we choose our life first, then these adventures can really make something exciting for us and make something really fun for us that you can then determine what you want to do, how you want to do it. But I think it's really important of two years, five years, and then 10 years. That way these mash up. And so you might have opportunities right now and just because you have opportunities does not mean you need to take them. But I'm also very cautious of let's make sure we're not turning down opportunities too early or because we don't feel like we can get creative enough to think outside the box. And that's something I think as consultants, our job is really paramount to help offices do is to really 100 % help you think down the line, two years, five years, 10 years, what's gonna come your way? What do we need to do today to prepare you for? the future. And I think that's something just really fun and consulting of where is your practice? Where is your life? What do you want to do? And getting into this creative space. And so for you, I'm curious. And if you want to email me, you want to pop on a call with me, I love to choose your own adventure with offices. Like, let's talk about the possibilities. Let's talk about what you're capable of doing. Let's talk about what options are available to you. Let's let's dream. Let's think like, we're maxed space. I love when people give me their problems. So hey, if you've got a big problem, like I had an office and like, Kiera, Kiera Dent (11:55.734) We cannot see any more patients. I found space for them to add a whole other hygiene operatory in their practice. You might not like it. Like I had a doctor and I found a whole other operatory and she's like, Kirea, but I don't want to like be that cramped. And I said, all right, then that's your choice because there is space for you to add another operatory. So I don't want to hear you can't. I want to hear that you're choosing right now…
Full show notes at the publisherDentistry has a unique space in the medical world when it comes to building relationships with its patients. Tiff and Dana discuss effective ways to create trust with your patients, including the critical foundations your practice can't do without. Episode resources: Sign up for Dental A-Team's Virtual Summit 2025! Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript The Dental A Team (00:01.08) Hello, dental A Team listeners. We are so excited to be here with you today. I have my gal, Dana, on the cast with me today, and I am just so excited. Dana, how are you today? How are you enjoying this heat that we've got coming through? I know up here in Phoenix it's hot down there by you. It's gotta be warm too, but how are you? Dana (00:19.955) I am actually enjoying this weather. I was out a lot this weekend for sports. I have some wacky tan lines, but I am loving the sunshine and the extra warm weather we've got. The Dental A Team (00:30.958) I it. I keep getting the like bottom of my legging to my sneaker little I got a nice tan right there on my leg and I think it's the only spot on my legs at all that even knows how to tan anymore. So I feel you. Dana (00:45.779) Yeah. The Dental A Team (00:47.086) Today we have a really fun one, docs and teams that are listening and today's just all about relationship building. I really wanted to pick your brain today, Dana, and really see what you're doing with a lot of your practices, what you've done in practice, and very specifically maybe even like our pediatric practices that we have. What are we doing to keep the relationships? with our patients to keep the patient. So how are we investing in those relationships from a doctor's standpoint and really from a team member standpoint as well? I know a lot of my doctors out there, we definitely focus in really heavily on the team side. What can the team be doing? How can the team build the relationships? And that is super, super, super important. But I want to stress the fact that this is for you guys today too. It's very important also that you're building those relationships and that you're showing your team the kind of relationships that you want to have built so that they know what the heck you're looking for. So Dana, I'm excited for this one. I know we've got quite a few pediatric practices between the two of us and Christie's got some pediatric practices as well. So that's a space that I think is really fun in the relationship building area. And it does translate to GP, to oral surgery, all those pieces as well. So if you guys are not pediatric and you're listening, don't fret, this is for you too. But I thought it would be fun actually to pull in some of that pediatric side because it's just so cool, in my opinion, what they do, right? First of all, that they are just serving so many amazing little humans and creating an experience that these patients are forever going to love the dentist, which I think is amazing. but also they've got their hands kind of tied, especially when it comes to this relationship piece, because they're not, they are building a relationship with the patient, but their focus really is making sure that the parents are happy, that the parents understand what services are being rendered, why it's different, why their kids are getting such excellent treatment. The Dental A Team (02:45.666) Dana, how are you right now? You've got, I know one pediatric practice in general I'm thinking of, you've got quite a few, but one pediatric dentist in particular right now is really working on the new patient acquisition side. And a lot of that comes down to this patient relationship piece. So what do you suggest for your pediatric practices and really your general practices to really get that going and get that spearheaded for those? Dana (03:10.299) Yeah, I love this part of dentistry. think it's something that is like unique to dentistry as far as healthcare because we tend to see these patients multiple times for years and years. And so it's a unique space for dentistry and it's something that I think is so fun. And you're right with pediatric. I think that it's twofold right they've got the kiddo and they've got the parent and because pediatric relies on volume of patients they've got to build relationships really really quickly too right because they are churning and cranking through patients and parents all day long and the first thing that I always say to any pediatric practice is you have to The Dental A Team (03:39.192) Yeah. Yeah. They are. Dana (03:50.877) build the trust to be able to build the relationships. So as much as you can focus on the comfort pieces, the showtell do the walk them through everything. I love a pediatric practice that will pull the parent over and hey, let me show you right like, yes, we want to talk about flossing technique. Let me actually show you as I do it to your kiddo. Let me show you that spot that I'm talking about. Let me take a picture. Let me walk you through it. And as I'm taking the picture, letting the kiddo know exactly what they're going to do each step of the way starts at one visuals, we can't really deny the things that we can see with our own eyes, right? And trust and comfort when we know everything that is going to come next, and what it's going to feel like and what it's going to look like and how we're going to navigate that together. I think that pediatric practices like creating that space is something that's truly magical. and that a lot of general dentists can learn from because no matter what practice you're in, you're gonna have patients who are nervous, who are uncomfortable, who have anxiety. And I think kiddos like top the charts by 10, right? Because they're also little humans who are learning to manage those emotions too. And so if you can take any of those pieces that pediatric practices do really well and incorporate it into your general practice, but just that foundation of... Trust and comfort will go a long way in building any sort of relationship, whether it's with the patient themselves, the kiddo or a parent. The Dental A Team (05:20.298) Yeah, I think that's brilliant. And it translates so well to continuing that relationship as they age. So building those relationships for the kiddos. I love the the sea show tell do right all those pieces of like, this is what we're even just this is what we're doing today. Let me show you let me let me teach you how to do this at home. Let me show you all these pieces. It's the same thing when we become adults, right? We should be translating those similar practices in building those relationships, but really building a firm foundation of comfort for our patients. And part of that comfort level is really the amount of conversation we're willing to have with the patient. Sitting in silence, sitting there with a dental assistant or with a hygienist that's just like, I'm uncomfortable. I don't know what to say. It's awkward. So if they're not the ones initiating and creating the relationship or the doctors coming in and just going straight to work, not like... opening it up, not being introduced to the room, not having those spaces where communication is really abundant can really hold a patient back from being open. And that openness, that vulnerability is what builds the relationship. So I think just as you do with your pediatric practices and then... really taking a step back and reviewing the whole appointment, reviewing all of the information with the parent. We should be doing that in a GP, older adult practice as well for adolescents and adult patients and really sitting them down and covering what are we doing today? What questions do you have? Like let's really thoroughly go through this and make sure that you're comfortable before we start. So I think that's brilliant. I think it's awesome that we start at the pediatric ground level and really make the parents comfortable too. And then for the, you know, GP practices, for my adult practices, if they're getting this kind of care for their child at the pediatric dentist, they're going to change some expectations in my opinion for what they should be receiving as well at their own practice. So really ramping those spaces up is going to be critical. The Dental A Team (07:26.668) communication is the center focus of it all. So with oral surgery practices, endo practices, perio practices, GP practices, and even pediatric practices, you guys, where does that start? Like consider where does the communication start? And I know I had a call with a doctor the other day that was like, gosh, my front team just still will not put in the notes on my limited. emergency exams and it's driving them a little crazy. And it makes me think right there, right? That's an opportunity. It's a very easy opportunity to enhance and increase a relationship with the person just by letting them know. we paid attention just by caring enough to have that information already ready to go. So if you're taking an emergency call, really documenting what it is that we chatted about or call for a filling that's high or anything at all that's out of the ordinary on treatment that was recommended, a patient might say, I don't know, a patient might even call and say, hey, I had a crown that was diagnosed, I never. I never scheduled and now I'm in pain. Well, that needs to be documented. Schedule the crown, document the pain because when that patient comes in, we can really pour the love and the care and the attention into the situation rather than finding out firsthand. And the patients love that because they feel seen, they feel heard, and they feel valued. And Dana, from your experience even in office and working with practices, where else are you seeing some spaces that practices can really increase or even just like capitalize on what they might already be doing to really build those relationships so that patients keep coming back and they refer other amazing people to our practices. Dana (09:07.347) Yeah, I've been coaching a lot of practices one thing is new patient paperwork, right? We've asked a lot of questions on that new patient paperwork and we ask them because it's a valuable information and so getting practices to build in part of their exam protocol and their prep for patient protocols We actually look at the answers and we notate them somewhere so that we remember to discuss them I've got a lot of practices that are incorporating smile Raiders to try to you know open ortho discussions and those are great absolutely, but we have to The Dental A Team (09:11.277) Yeah. Dana (09:36.089) engage in it. It's not enough just to ask it on a piece of paper. We have to actively look at it, plan, prep, and then actually bring it up and discuss it with the patient. So I think new patient paperwork is a space where a lot of practices have best intentions of getting that information and making it super personal. We just have to make sure that we're looking at it and we're translating it and we're talking about it in the exam for the patient to understand. The Dental A Team (09:45.027) Go. Dana (09:59.895) how that information corresponds to their care in your office. Same thing with new patient phone call, just like you gave an example of that limited saying that, you know, hey, I was scheduled for that crown and now I'm in pain, right? And notating the pain. Same thing on the phone call, the questions that you ask to make sure we get that information to the team and the team is prepped and ready so that they can dive in a little bit deeper with the patient and have the patient feel like, hey, man, they asked me those questions on the phone. They heard my answers. The team was prepped and ready. for it and we jumped right in with my main concerns with the things that I'm here for. Even if it is just establishing care, right? Making sure that we are reinforcing that we know that that's why you're here because we took the time to get the information. So a lot of times we take the time to get all the information. We just don't actually utilize it with the patient. The Dental A Team (10:50.414) And I think that's a great action item you guys is really take that back to your teams of anywhere where we are gathering information making sure that it's put in the appropriate space and you guys that there's Consistency and where that space is so that everybody knows where to find it everybody knows where to put it But having that conversation with them of making sure that that information is put in that space and it's relayed to the next person Huge huge huge caveat here if we're putting the notes in the biggest easiest way to deter a front office team from putting phone call notes in the appointment is for you to not use them. So if you're gonna ask for it, make sure you're using it. I don't know how many times when I was up front, somebody would come and they'd say he tipped it. Is this patient on any medications? Are they taking Tylenol or anything? Like I'm about to go get them. Like what's the stitch here? What's the scoop? And I would look at them and be like, did you read the notes? I'm happy to have a conversation with you if we have to like that. I'm fine if you need clarifications, but I'm not I'm not going to double dip. So I'm either going to put the notes in or I'm going to talk to you every single time. I'm not I'm not going to double dip because I am not a person that will work harder than she has to. So I'm not going to duplicate my efforts. I'm just going to do the path of least resistance and whatever is going to be the most efficient. And if they're not, the notes aren't being used for me, that's an inefficiency. I'm working for nothing. And so I'm going to reduce and remove the inefficiency and go with whatever the rest of the team is going to accept. So I would stop making the notes and then they'd get frustrated. So you just have to stick with it for an office teams. Remind them, refer them back to the notes. They've got to get used to it. And back office teams and docs, just make sure you're utilizing those notes in the best ways you possibly can. On the notes of really building the relationship, I want to remind everyone that our words truly matter. The Dental A Team (12:43.8) The words that we use, the way in which we use them make a difference because the person you're talking to is interpreting those words and they're gonna interpret them however they see fit in that moment. So if we're not very careful with our words, we could turn a situation into something totally different. And it doesn't mean it It could be catastrophic, but it doesn't mean it's gonna be catastrophic every time. It just literally changes the tone. in slight variances, dependent on what you're doing. And I have to tell you this story, Dana, and everyone listening, I have to tell you this story. Aaron and I were out on Saturday. We went to our favorite little golf club, you know, restaurant, and he had just passed this really, really hard, crucial, studied for a year test, and we were celebrating him, and I was just so excited. And we're at the, we decided to sit at the bar because we did not make a reservation, and it was wild in there. But regardless, we're sitting there so I can hear other conversations going on. And the…
Full show notes at the publisherKiera is joined by Dr. Robert DiPilla to talk about his world of dentistry, including the transition from cosmetic to holistic services, how he educated his patients, lessons learned during his multi-practice ownership, and more. About Dr. DiPilla: Dr. Robert DiPilla studied dentistry at the University of Detroit-Mercy, and then went on to attain a Fellowship for Dental Implants at the Harvard Club. He was quickly recruited to Manhattan, where he honed his dentistry techniques, and had the opportunity to work on many high-profile clients. Dr. DiPilla became a partner at the renowned Rosenthal Dental Group on Madison Avenue, and earned the title "the dentist's dentist" by his peers in the industry. Dr. DiPilla has had the privilege of perfecting the smiles of celebrity clientele such as Kathie Lee Gifford, Wayne Gretzky, Steve Duchesne, and Sarah Ferguson among others. While Dr. DiPilla maintains a Manhattan office, he now focuses on the location where his career began in the Detroit Metropolitan area. He contributes regularly to nationally circulated trade publications, and continues to be recognized as a leader and expert resource in aesthetic dentistry. Episode resources: Sign up for Dental A-Team's Virtual Summit 2025! Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript Kiera Dent (00:00.768) Hello, Dental A Team listeners. This is Kiera And today I am so jazzed to have an incredible guest. We have been following this man. We've been wanting him on our podcast. He is incredible. And I feel like what he's doing is changing the way dentists are doing dentistry. I think he's kind of in this new age, new era, adapting with the times. And so was so excited to bring him on and have his knowledge. So welcome to the show, Dr. Robert DiPilla. How are you today? Dr Robert DiPilla (00:25.484) I'm doing well. Thank you very much. I'm excited to be on your show. There are so many great things about you and your show. I I once again, I went back to some of your podcasts and you some great, great guests on. Kiera Dent (00:37.376) Well, thank you. am quite shocked. Dental A Team is about to release their thousandth episode. And I was thinking, I cannot believe I've been on this microphone a thousand times. So I'm super honored that you are a part of that journey. And really everyone who listens to the podcast knows our ultimate goal at Dental A Team is to positively impact the world of dentistry in the greatest way possible. so bringing guests on like yourself, people who are passionate about dentistry, making sure that we keep the passion alive in dentistry, making sure that people realize I believe we're in the best industry we possibly could ever be in. And so I'm super excited because I feel like you're taking a new edge spin to some things in dentistry. So before we get into some of these fun topics, Dr. DiPilla, why don't you take us through kind of your journey? I know you have a pretty interesting route of how you were able to go from where you were and where you started in dentistry to where you are today. So if you kind of want to take us on your journey, that way the audience gets to know you as well. Dr Robert DiPilla (01:31.854) That journey starts 36 years ago. I graduated at the University of Detroit, Mercy in 1989, and I did a residency at Harvard at the Harvard Club for doing implants. And from that, I really was interested in the cosmetic realm. So you got to think about in the early 90s. And it was kind of like touched upon. And I was very fortunate. to take a course with Bill Dickerson and Larry Rosenthal. And this is the first time they were together in doing these particular courses. And my first patient for my aesthetic course was my sister, believe it or not. when I mentioned this, it was an amazing journey. She was very appreciative. It was a great case. And from that, one interesting point. Kiera Dent (02:16.68) Wow, that's brave, an aesthetic course. Dr Robert DiPilla (02:30.828) when I was in the lecture and they were talking about different materials, different processes, the way to do things. I know once again, I just graduated, I did like a little surgical residency and I thought to myself, mean, the auditorium was packed, there's probably like a hundred students. And I'm like looking around and I'm thinking myself, am I the only dumb one here that doesn't know this? I said, this is insane. And they're going over these seven different steps to do bonding and veneers. I'm like, my gosh, did I learn this in school? you Kiera Dent (03:05.28) Did I skip that day? I promise I didn't miss too many, right? That's what you're probably thinking, like I was there. Dr Robert DiPilla (03:10.237) I would promise I was there. But I promised myself since then, it was like a real, not say a low point in my life, but it was a low point in the sense of how come I didn't know this? And I kind of pride myself in understanding things and certain process and procedures. And I said, from that day, this will never happen again. So that journey led into teaching with Bill Dickerson before it was LVI and also aesthetic advantage with Larry Rosenthal. And as you know, there were two separate groups and I had to make a decision on what camp was I going to go into. Was I going to do the LVI camp in Vegas? And mind you, I'm in Michigan. Or do I go to New York route? And my decision was New York was closer. So I went with Larry Rosenthal. So I was an instructor with him for about three or four years. And then I was invited to be a doctor in his office. And I was there for a good 10 years. that journey right there was probably the highest point of my life in that particular aesthetic office. There was a lot of great contacts, a lot of great people that we met. And I always say everything is a blessing for me. I don't hold anything back as far as this was a disappointment. This didn't happen for me because I think everything is a growing experience. So for me, being in Larry's office was really, truly, truly, like I said, a blessing. It was a great thing for my career. And then I knew that when I started having a family and kids, New York for me personally wasn't the place for me. Coming from the Midwest, Midwest values, I wanted to have the family where I grew up because my mom is still here and my extended family is here as well. So once again, from that, I left New York. Kiera Dent (04:51.21) You Dr Robert DiPilla (05:01.806) And then, but I kept a practice in New York as well, because I had a lot of patients to see. And I started my own practice in Birmingham, Michigan. And that was in 2000, probably 2003, 2004. And then from that, you know, we grew to five different practices. So it's been a really challenging once again, but it's been a great journey for us. Kiera Dent (05:15.338) Wow. Kiera Dent (05:25.706) That's incredible. And so I'm curious because when I first started as a dental assistant, one of the doctors that I worked for had a practice in California and Utah. And so every Thursday or Wednesday, I think it was, we would close out in California and he'd catch a flight and he'd go to his practice in Utah. He'd be there Thursday, Friday, fly home, and we do Monday, Tuesday, Wednesday. So did you fly back and forth between your two practices? Dr Robert DiPilla (05:45.93) I did the same thing. When I moved back to Michigan, I would work in Michigan Monday, Tuesday, Wednesday, would fly out to New York and work Thursday and Friday. And then plus New York's a great city and I stayed for the weekend and I flew back the first flight out 6 a.m. on Monday morning to make it to my practice at 9 a.m. So I did that for seven years. So back and forth. then once again, Kiera Dent (05:56.106) Yeah. Kiera Dent (06:02.806) sure. you Dr Robert DiPilla (06:12.462) It was great. To me, people, how did you do that? Why did you do that? It was just my routine and it worked out really, really well. And then there was some point where I kind of have to slow down and kind of give that up a little bit because I wanted to build more practices in Michigan. Kiera Dent (06:27.414) Sure. No, that makes sense. And I was just curious because when that Dennis would do it, I thought like it was so wild, but it made sense of how he was able to have the two practices. So it's either you fly back and forth for a while or you get associates. Did you end up keeping that practice in New York or did you have an associate running it or did you end up selling it and then focus in Michigan? Dr Robert DiPilla (06:45.186) Yeah, no, I actually, believe it or not, a lot of my New York patients actually will fly to Michigan to have their work done. And then the rest is I gave it to a really good friend of mine, Dr. Michael Krause, that's in the city on 49th and Madison. So, you know, basically a lot of my patients just kind of ended up with him. Kiera Dent (06:52.564) Incredible. Kiera Dent (07:06.728) Amazing. And that's great to know. And I hope dentists heard that of when you are really great at your craft, they will fly, they will come to see you. And I think that that's something that's different in today's world. I think that it's very common for patients to fly other places rather than just going to their dentist down the street. I think people fly for different surgeries to different places. Now I think for your day in day out routine dental care, you'll probably stay closer to home. But also we only go six, like two times a year. So it's really not that much to travel if you want to. Dr Robert DiPilla (07:25.919) percent. Yeah. Yeah. Dr Robert DiPilla (07:34.798) Yeah, there's a lot, know, as you know, there's a lot of patients that will seek out plastic surgeons and they will go to a certain destination if it's New York, LA or Miami. And that's the same thing with dentistry. I mean, I've been very fortunate. I've had a of patients from Miami that will fly up and for me to do their work, their veneers, New York, of course, all the way even from LA. So it's been it's been a wonderful thing. I'm very humbled, you know, to do that. I don't take that take that lightly. Kiera Dent (07:40.214) Mm-hmm. Kiera Dent (08:02.812) No, and I think that there's when you love what you do and you're really great at what you do, people fly. I mean, I am a dental snob. think being in dentistry, it makes me one of the worst patients. And so I'm always nervous. And so I do travel to dentists out of the state. And I think it's something of the world has changed. And so I love your journey. I love the passion you have. I love that you've built multiple practices. I think you bring an interesting perspective. And so I'm super curious because you've kind of gone into a holistic route as well. So I'm curious, how do you go from dental implants, veneers, which feels very cosmetic, into holistic? Like what's kind of the bridge? How have you done that? Because I think people feel like I'm either traditional dentistry or I'm holistic dentistry. And I feel like you're bridging this gap. And I think the world is bridging this gap as well. I don't think it's as polarized as it used to be, but what's kind of your take on that and how did you transition? What got you excited about that? Give some insights. Dr Robert DiPilla (08:53.684) I mean, you You know, for you as you know, being a hygienist, know, to me, for our patients, we want to make sure that they have a healthy foundation. a healthy foundation is the bone and also the gingival tissue. And, you know, it doesn't matter how great of a cosmetic dentist you are, how great of an implantologist you are, the tissue has to be stable. It has to be making sure that, you know, the oral microbiome is sufficient. Kiera Dent (09:05.299) Mm-hmm. Dr Robert DiPilla (09:25.774) You got to make sure that the biofilm is eliminated. And one of the biggest things that, I mentor 22 doctors here in Michigan, from guys who've just, guys or gals who've just been out a year and guys like myself that been out for 36 years. One of the things that I try to impress upon them is that don't be a mechanic of the mouth. And my feelings, is that dental schools right now, and once again, different than my era, is just really, they're really teaching you how to pass the board exams. And then the real age of dentistry is what you get after as far as continued education. And I think it's really important, as you know, even being a hygienist, is that you have a patient that comes back, yet you did scaling and root planning. Kiera Dent (10:01.694) Right. Dr Robert DiPilla (10:17.15) and you see him back in three months and they're saying, yeah, I brush every day, I floss every day, I have the water pick that you recommended, I'm doing the oral care, I'm doing this. And they come back and it's like, my God, are you really flossing? Are you really brushing your teeth? No, no, I am. But why is that? Why are we doing maybe supervised neglect or super profis? The question comes in is that we have to understand why, my biggest thing is the why, why is that happening? You know, we incorporated now we're doing genetic testing, we're doing saliva testing for our patients because as we know, a lot of, you know, reintroduction of refractory periodontitis that happens. So even the same thing with my hygienist, you know, we're very strong in continuing education. We're very strong in not just scaling and root planing teeth, just for the matter of fact of doing it. And one of the things that, you know, my hygienist, they all know, is that if you're doing Scanlan Root Planning, what type of attachment do you want back? So I think you have to have a strong foundation in histology. You have to know the periodontium very, very well. And a lot of times in school, yeah, yeah, that was that class. I had it, but this is what I want to do. So I think for us in dentistry, you have to move away from being that mechanic of the mouth, because I can teach my assistant to prep a tooth, easy. But you have to understand the diagnosis and the Kiera Dent (11:26.774) you Kiera Dent (11:38.368) you Dr Robert DiPilla (11:42.094) And it also goes back to different materials. The whole rage now is zirconia, crowns, and it's a lot stronger. But is it really? Is it lithium disilicate, or is it philospathic porcelain? So I think there has to be an understanding of where to place those materials in the proper patients and proper occlusion. So because a salesperson comes in, oh, this is the latest and greatest, doesn't mean that you should buy it. So I think. Kiera Dent (12:09.824) for sure. Dr Robert DiPilla (12:10.894) For me, it's kind of taking a step back and understanding dental materials, understanding the periodontium, understanding all that. I the classes that we hated in school, believe it not, I've been doing this for 36, are probably the most important now than anything else. Kiera Dent (12:25.67) No, for sure. And I'm so grateful you talked about that because agreed like the healthy foundations, I think it's so easily overlooked. So I'm curious, how did you start to incorporate this with your patients? Because you didn't come out of school having this, you didn't learn all these things right away, you started incorporating it. I think people are oftentimes afraid to add this into their practices due to patient pushback. So how did you, how did you educate your patient base? Dr Robert DiPilla (12:48.702) Well, yeah, I think it's just having a good com…
Full show notes at the publisherTiff and Kristy share not only how to cut down your accounts receivable, but also how to develop systems that will keep your AR low. They discuss time management, clear job descriptions, protocols, and more. Episode resources: Sign up for Dental A-Team's Virtual Summit 2025! Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: The Dental A Team (00:01.752) Hello, Dental A Team. I am so excited to be here with you. I have Kristy back here with me today, and we are excited to talk to you about a really fun subject today. It's not always the top of the fun list. think billing gets pushed down in the fun category, and a lot of people put a lot of stress on it, which I totally understand. But Kristy and I are here today. to bring some fun to the billing department and to bring some fun around how to make billing work within your practice. Kristy, thank you so much for being here with me today. How are you? Kristy (00:34.658) Good! It's a good Monday! The Dental A Team (00:37.955) Good, I know. Our Mondays get busy here at the Dental A Team. They are our meeting days and our project days and they just, they get chock full of so much stuff every single week and we absolutely love them. We get to spend a lot of time prepping for our client calls and our client visits. A lot of us have client visits coming up soon and just getting all the things together. So Mondays are always a little chaotic. Kristy, in your... In your experience, you've got a wealth of knowledge, a wealth of experience behind you. What was your favorite position or your favorite space to work when you were in practice? Kristy (01:16.704) interesting. Favorite Space was probably really helping getting patients the care they deserve, filling that patient advocate role. here's the thing, I know we're talking about AR today. If we If we aren't cognizant of a patient's budget, we're really not doing good by them. So being cognizant and finding a way to fit it, you know, the care they need within their timeline and their budget is, it's rewarding. The Dental A Team (01:50.047) I love it. I totally agree with you. think making sure that we're giving them the best experience all the way around, no matter what is the best space to live in within a dental practice. can get homes fulfilled us. It gives us a purpose and a reason to be there. And on those notes, I think you're absolutely correct. If we don't know what the patient wants, what their desires are, what they can do, and we end up down a path. that might not be the right fit for them and ends up not being the right fit for us because we end up in situations where we have high AR, outstanding claims, outstanding bills, all of those pieces. I also know one of the biggest reasons that people leave a dental practice or write a bad review, I have so many practices that are like, don't put me on swell, I want to have control over who gets reviews and who don't. And I just think everybody should get a link for review. So I love advocating for that company and for within our marketing. But I know that the biggest reason that we're afraid of something like that and that people that patients leave their practice is for billing inconsistencies or billing issues. So really having standards and protocols and just everything wrapped around the billing department is so imperative and so important because even down to that patient advocate space. When you're that patient advocate, which is also sometimes, you know, patient coordinator, front office check-in, like all of those are kind of wrapped around similar spaces within the practice. But when you're sitting in that space, Kristy, so many times you are walked into a really hard conversation because there was confusion over previous billing or you're the one that's responsible for collecting today's balance that's due or outstanding balances. And so you kind of walk into really uncomfortable situations because you're not sure what it is sometimes, the patient doesn't know what it is, and sometimes that patient comes in upset. So knowing how to diffuse those situations too, think Kristy is a really great space and just builds that relationship as well. I think I love your answer. Kristy (03:50.149) Thank The Dental A Team (03:51.193) That's my wrap up there. So today I've brought Kristy here to talk with me and chat with me for you guys today about really cutting your AR down and hopefully building systems that keep it so that your AR doesn't get high. And just so you guys know, doctors, your AR is your accounts receivable. So this is money that's supposed to be coming to you, but hasn't made its way through the door yet. And so we're trying to get that money through that door into your bank account to help your overhead ultimately. and by increasing your collection. So we really don't want a lot of money sitting out in that AR, in the accounts receivable, that outstanding collections. We really don't want a lot of money out there, but it is also flip side of that unrealistic. Many of you are like, I shouldn't have any AR. I should 100 % collect. While that is, you know, the dream, it is very unrealistic. So there will always be something outstanding, even if you're a free for service practice, in my opinion, there's always going to be something outstanding. So Just building those systems and those protocols is going to be absolutely fantastic. And for you doctors that are listening today, which I hope you guys are here because I hope you're ready to cut your AR down or keep it from ever increasing, I want you guys to know the back end side as well, because I don't want you to be afraid of your billing department anymore or afraid of money. A lot of doctors, I think, steer away from even looking at bank accounts or overhead or... Any of that I think we do in our personal lives too, just because there's so many misunderstandings. So if you can get involved in conversations like this today, really know the expectations of different spaces like that. I really think that it helps to build your confidence in moving forward and keeping those ARs from getting any higher. that's my caveat for today, doctors. I want you listening, I want you taking notes, and then want you taking it back to your team, because this is gonna take a whole team to get a lot of these things done. Kristy. Where do you see the biggest hang up in practices you have worked with? You've worked in many practices, you've consulted many practices in your current clients too. Like, where do you see the biggest hang up when it comes to accounts receivable and that outstanding money? Where do you feel like, gosh, it's really just stuck here if we had to say one space. Kristy (06:04.576) one space. Honestly, probably in the insurance realm, verifying and getting the correct breakdown so that we're giving the proper estimates and therefore collecting the proper copays, right? The Dental A Team (06:20.264) I totally agree. Yeah. And I think that's a space that gets really confused. And I think doctors get very confused about it. Like, what is that supposed to look like? What should I be doing? What should I be expecting from my team? How can they get it all of those questions? So I totally agree. We have so many different podcasts on so many different aspects of that. We have so many clients that are working on all of those pieces as well within their consulting with us. But I agree that You have to remember whatever you put into the system is as good as the information you're going to get out of the system. So while it's a computer, while it's software, like it's supposed to, you know, at one point be smarter than us, like it can only be as smart as we can make it. And so the information that you're putting in is going to spit out the information that you're going to get out of it. And if we're rushed, if we don't have clear clarity on what's expected or clarity on what's the most important. Like things get muffled, things get confused. So I think when practices have high AR or to keep them from getting high AR, I always recommend like three basic things. The first thing is time management. We'll dive into time management. The second is ensuring you know what's the most important. So how do we figure out what's important and what's not important? And then the third is having really clear systems and protocols. to be able to use. Those three things, you guys, if you have time management on your side, you can decipher what's important, what's not important, and you have really simple protocols and standards that you consistently use all the time, that's going to propel you to really have cut AR or no AR, or little, I should say minimal AR in the future. So. Kristy, what are some areas that you've worked with your clients or you've worked with in the past that you can say, gosh, these really work in the time management realm? Where do you see things working over there for you? Kristy (08:21.58) Yeah, for time management, honestly, I think it's about dedicating the time and getting it into your schedule. We like to call it, you know, putting that power hour and really diving in and creating that time to focus on the AR. The Dental A Team (08:36.616) Yeah, yeah, I love a power hour because you can let it. Kristy (08:43.694) Okay, sorry. The Dental A Team (08:46.026) way because I think a power hour, I love power hour, I've used it in multiple facets. I used it in my personal life as well. Power hour, you guys, is so simple. It blows my mind every single time at how well it works, and I utilize it for all kinds of positions in the practice, but I think it's amazing for the billing rep position. So, Kristy, I love that you mentioned that the power hour, literally you just split an hour into like four chunks or two chunks, but you always make sure that you've got it scheduled. So your time management piece, right, is making sure that you've got it scheduled somewhere. And then you've got your list of things that you're going to be doing within those 15 minutes. And you've got some sort of timer handy, even if it's your watch, if it's your phone, like whatever, you're gonna set for 15 minute timer. So you guys, it's that simple. And you're gonna say in the first 15 minutes, I'm gonna do X, and Z. In the second 15 minutes, I'm gonna do ABC. In the third, and so on and so forth, and you're gonna set that timer for those 15 minutes where your billing rep is going to, you guys do this as well, you're gonna set that timer, and at that 15 minute mark, you're gonna take inventory and you're be like, okay, what did I get through? Did I get through the top most important items? Do I need to shift one down to the next 15 minutes or am I ready to move on to the next set of most important items? So. I love that Kristy. So we have the power hour. What other things have you utilized? Kristy (10:12.718) yeah, Putting the block schedules into the appointment book so everybody knows that you are dedicating that time and working specifically on AR. The Dental A Team (10:12.81) sketchbook. Kristy (10:29.022) And I would also say be sure that we detail this because AR can be broken down into two different categories. We have the patient AR and the insurance AR. you know, dedicating time. And I would say, you know, weekly dedicating time to work on these and specific timeframes. The Dental A Team (10:46.174) Yeah. The Dental A Team (10:49.802) I totally agree. I love that. And I think we think block scheduling and we think patient schedule only. And it's so interesting to me to consider any kind of system or protocol. Like there's so many spaces where it can be dropped, like copied and pasted into another aspect of life. And when we think about block scheduling, which we have talked about so much for patient schedules. we can now copy and paste that into like even our personal lives, you guys, if I wanted to get crazy with it. But really, if we look at the positional duties, like what is it that I need to do as a billing representative and how do I block my schedule to fit that? I'm going to think, okay, just like thought, doctors, I made you go think, where should I do a root canal? Like where should my high priority pieces be? My high income procedures, where am I going to put those? Where should I do root canal? flip-flop that over to your billing representative, right? And we're not gonna like call on patient balances at 7 a.m. So where is it likely that I'm gonna be able to call on patient balances? So I'm gonna build my schedule using time management skills that I know how to do because I know how to build a patient schedule. So if I start thinking of my duties, the things that I'm responsible for in whatever position I hold, even treatment coordinator, whatever position it is, If you take that same thought process, look at the duties that you're responsible for, and then figure out how do I manage this in my day, what makes the most sense? So do I want to start my day at 7 a.m. or 8 a.m. with patient calls? Gosh, probably not. Or is it smarter to maybe check on unpaid claims at that time? If you start unpaid claims from 8 to 9 a.m., that's your power hour. Right there, 8 to 9 a.m. I'm working on unpaid claims and I'm divvying it out by the 15 minutes or whatever, right? Or maybe by week, first week I'm doing zero to 30, second week I'm doing 31 to 60, et cetera. But if I'm divvying those hours out, I know the insurance companies are gonna be open at 8 a.m. no matter where I'm at in the country, right? If it's 8 a.m. Pacific, it's now 11 a.m. East. So I know no matter where I'm at in the country, if I start at 8 a.m. The Dental A Team (13:05.931) I can get a hold of the insurance companies. Then I move on to a patient, then I move on to statements or whatever, but I'm power blocking and utilizing locked scheduling rules to get the same results in my position as what I'm looking for in a patient's schedule. So you can literally copy and paste that over and manage those times. But something, Kristy, that I think gets lost in translation sometimes, you can think, power block, I'll time manage, sure. But the second piece, right, first piece is time management, learning how to manage your time, learning how to see that. But the second piece, I can't time manage if I don't know what my duties are. So if we don't have job descriptions, if we haven't been taught how, you what are the results that are driving my position? Because those results that are driving my position that are within the job description, that's going to allow me to be able to see what's the most important thing. Because, Kristy, you said earlier too, getting the information in is gonna affect the information out. But then we sit in this space, I think, of like trying to figure out, do I get the verification? Do I call on unpaid insurance claims? Do I call patients? Do I send statements? And we're just like, my gosh. And so how do you help doctors to be able to help their team really figure out what that driver is and to be able to say, this is the most important thing or this is where I can time manage these pieces because I can see What I'm responsible for, how do you help doctors to really be able to help their billing departments figure that out? Kristy (14:39.692) Yeah. Absolutely. So even with AR, there's the lag measure and the lead measure, righ…
Full show notes at the publisherKiera gives listeners 3 tactical tips on exactly how to find and put a stop to cash flow leaks and grow your practice exponentially. Episode resources: Sign up for Dental A-Team's Virtual Summit 2025! Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: Kiera Dent (00:00.824) Hello, Dental A Team listeners. This is Kiera and welcome to today's show. You guys, I'm so excited to have you here. I absolutely love podcasting. I can honestly not believe that we have created as many podcasts as we have and thank you for being a part of this journey. So today, you guys, I wanted to just ask you that like, are you struggling with cashflow leaks in your practice? I think this is such a big hot topic for you that I cannot wait to go into it because honestly, Every dollar leaking out of your practice is a dollar not reinvested into your growth. So really there's a few couple quick cashflow leaks that I see in tons of practices that I wanted to share with you. These small little changes, tweaks are going to add up to exponential amounts of cash in your practice just by stopping these small few cashflow leaks. We did a webinar on this the other day and it was super, super popular. So I thought I'd bring a few of those highlights over here to the podcast. As always, you guys know we are the Dental A Team and our job is to help practices optimize profitability, increase their happiness and fulfillment and truly make teams and doctors get on the same page to be able to live the best life that they possibly can. That's what we're about, you guys. Honest to goodness, I do know that cash flow is the lifeblood of a practice and the way that we prevent these leaks and the way that we're able to grow our practices is by being great stewards over the businesses that we have. This is gonna be a short actionable podcast for you. guys know I like tactical practical and I'm super happy you're here. If you're new to the show, welcome. I'm so glad you're here. If you've been an OG, which stands for original gangster, I used to think it was an oldie but goodie. I found out that that's not the case. If you're an OG, I'm so glad that you're here and that you've been on this journey with me. Please, please as always, leave a review if it's helpful for you and make sure that you're sharing this with friends because the reality is our goal is to positively impact the world. in the greatest way possible. And the way we do that is through expert consulting for dentists and teams. So we are the Dr. Seuss of systems. We are the gurus of making practices, like truly be simple, living at profitable practice and making it simple. All right, are you ready for these three simple tips? I hope you are. Number one, I want you to, like I said, we just did this of how to stop these cashflow leaks. And what you wanna do is you wanna look at some numbers. So you wanna look at the last six months production. Kiera Dent (02:18.902) You want to look at the last six months collections. And then you also want to do your collection percentage per month and also your collection percentage over the last six months. The reason it's important for this is some months will actually have a lower collection percentage. That's okay. So for example, a lot of practices in December only worked 2 weeks. And so then you have to think that money rolls 30 days. And when it rolls 30 days, then what's going to happen is we're going to collect that money. So if in December we only did 50,000, then in January we did a hundred thousand. Well, I only have 50,000 over here to collect to then be able to go into my 100,000. Well, that's going to be low collections. But over the course of the year, we should be averaging a 98 % collection amount. We also want look at our patient AR, our insurance AR, our adjustments, claims not sent to insurance, procedures not attached to insurance, P &L revenue matching collections, because a lot of times maybe we're not collecting even though it looks like we're collecting. So making sure money in the bank actually matches the money that's coming into the practice. And then doing an overhead deep dive, are there things that we could cut, subscriptions we no longer need, things that we've been paying for forever, just like in personal finance, right? Like when you go look and you're like, my gosh, we're paying for all these subscriptions, we're not even using half of them, that's a cashflow leak. So a lot of common causes of cashflow leaks are going to be unnecessary adjustments in your practice, claims and procedures not sent to insurance. Literally this one report, have literally... brought 50,000 into a practice in one simple report. So it's a huge, huge zone to take a look at. Over-the-counter collections, maybe those aren't up, they're not high enough. And then not having a good claim follow-up, insufficient AR follow-up. So claims are one thing, we're sending out those statements. And the other side is that we're actually looking at our AR, following up on those claims, making sure that they're not having denials, resubmits, those types of things, high expenses, and then not producing enough to cover our expenses. So. A lot of these things come in tandem. And so I just wanted to walk you through a quick three things to do. So #1 I want you to really focus on tightening up that insurance and collections process. Like truly, truly, truly, how are we doing this? Because I brought in $1000s to a practice. There was an office I consulted in Oregon. We were able to take them from producing about a $100,000 to $150,000 by being in their practice one time. And in 30 days, they were up to that amount. People were like, Kiera, how did you do it? And I'm like, well, 1 Kiera Dent (04:37.1) We've made the scheduling better and we presented full treatment. And 2 we were able to increase their collections simply by just collecting at the end of the appointment. And I know that sounds so like primary and so juvenile, but the reality is all of this is simple. It's very simple. And so I hope that you take this on and you realize that these are just simple things. So when we don't have a good insurance process and collection process, then what happens is we delay the money even further. Already with insurance as we're on a 30 day delay. most of the time. You can actually be faster than that in practices. I have some offices that get paid in 2 weeks, but the reality is usually we're on a 30 day delay. So going back to our December example where we made 50,000, then we were produced 100,000, well, our collections are going to be down, but just think what if we actually are even further delayed? Well, that's going to send it down further and further and further. I've seen offices where in their over 90, they have tons and I'm talking millions sitting in their over 90. Well, that's very stressful because A, that's money that should be collected. You did the work and B, if it gets too far out there, we actually can't collect from insurance. So what we wanna do is we wanna make sure that we're verifying the patient's insurance benefits before they come into the practice, make sure we have correct fee schedules attached so we're able to present correctly. Then we wanna make sure we're submitting claims within 24 hours at the most. I either like them submitted at the end of the day or the next day. Make sure all of our attachments, all of our narratives, all of our inter-orals, all of our x-rays are truly like attached correctly. Clean claims out, clean claims in. Like we wanna make sure that we're paid and then make sure that we have an automated way to have like our balances collected once we get the insurance there. So we wanna be watching our insurance payments and we also wanna be watching our patient payments. So we wanna collect a time of service. So whatever their patient portion is, I strongly, strongly, strongly recommend that we collect at time of service. We're also watching for balances when patients are checking in that we're actually collecting at that time as well. So. When they check in, if there's a balance, we collect right then and there. Also when we present treatment plans or when they're doing their treatment, we're collecting payment at that time as well. I understand they're not going to be perfect. I understand there's a lot of fear around this of, Kiera, what happens though if we misestimate? And I'm gonna say you become an amazing word ninja. I would much rather you collect rather than chase money. I think all of us would rather get paid rather than chasing our paychecks down the street. Same thing with patients. Once they're gone, there's no longer a need for them to be doing Kiera Dent (07:00.35) to paying for it. So I really, really, really, really, really encourage you to do this and then make sure that what we're doing is we're actually checking our insurance every single week. So we're checking and working those 30, 60, 90 day claims. We're making sure that we're working on the biggest balances first and then we're able to then chip away at it and collect. Patient portions, go call them. Please, please, please stop sending statements. Call those patients right now. Get them on the books. Make sure we're getting them taken care of. That is one of the easiest ways to stop these cashflow leaks in your practice. So the goal is make sure great insurance verification is there, make sure we're submitting claims, and then make sure that we're actually speeding up our collection process by staying on top of it every single week, hitting those biggest balances. There's more in depth for it, but that's a quick highlight of what you can do. Step 2 is control our overhead and unnecessary expenses. So now we've talked about, we fixed the problem with hopefully collecting. We fixed the process of making sure that we're getting our payments faster. And now we need to make sure we're looking at our overhead and the expenses to see what on there is unnecessary. Like I said, like all those subscriptions, I don't know how many times I see like in real life, we're paying for Netflix, we're paying for Hulu, we're paying for Amazon Prime, we're paying for all these different ones, but we're actually only using one or 2 of them. Could we cut some of those out? It doesn't change our quality of life, but it does change our bank account and small little things add up. I did a podcast on this, a little areas where you can find this in your overhead expenses. But the reality is like, can you start to actually order your supplies through something like Synergy or Ordo, which are 2 great companies that are actually supply companies that do it in bulk to reduce, like you're getting the exact same product, but you're able to actually reduce the cost. Why not do that? Just asking questions like we're buying the same bread, let's get it for half off or pay full price. I'm gonna get it for half off. It's the same bread, same price, like same quality. just different pricing because we're able to buy it through group pricing. So can we negotiate? Can we talk to our reps? Can we make sure? Also, can we set a supply budget for the person who's ordering? I like four to 5 % for supplies. You take your pick for ordering dental supplies. So last month we collected 100,000, 4,000 or 5,000 would be our supply budget. Give that budget on Excel tracker to your ordering team member and have them deduct down making sure they stay within budget. Kiera Dent (09:16.856) This way they're able to then assess and make sure we really are spending the appropriate amount. This gets them scrappy. They start looking for better deals, but it cuts those overhead expenses that are unnecessary for you. Can we also look for better lab deals? I know we love our lab person, but maybe there's a new lab that's come onto the scene that's just as good, if not better, but maybe not as high of pricing as our current labs. I'm not here to say cut dentistry for one second. I'm just saying kind of like car insurance, let's go look around and see. And I'm not saying that labs are equal. I understand that all labs are different. and we wanna make sure we give our patients the highest quality. I'm just saying if you haven't looked for a while, let's see if we could get a different way to have a different lab fee for us. Can we negotiate other areas within like our subscriptions, looking to see what can we cut, going line by line by line to see are there extra expenses in there? I know like I pay for audible, but I switched over to Libby. Libby is great, I use a ton of it, I'm constantly on there. Do I still need my audible expense on the overhead? Do we still need to be paying for the subscription? Like I know for us, we have a lot of subscriptions, a lot of softwares. Is there a software that we could get a discounted rate? What about our credit card processing fees? Could we maybe switch over to a company like Mula and maybe save on that? Honest to goodness, plug for Mula. If you're looking at credit card processors or you're questioning Mula, tell Mark from Mula that we sent you over there. Clients who I've recommended to Mula have loved it because they're cheaper. They're more affordable, their rates are incredible, there's no contract, they're able to get their membership plans on it, they're saving money. Even that one or 2 % change on your credit card statement can radically increase the cashflow leaks in your practice. And then just like make sure that our payroll, like let's look at our human capital. I am not here to cut costs for payroll. I'm here to pay our team members insanely well, but let's make sure that can we re-utilize our human capital? Could we maybe outsource certain things that we don't need in-house? What do we have? And let's just make sure that what we're doing and producing, we're adequately staffed, that we're adequately doing our jobs. And that if there's easier ways, like we've outsourced certain jobs for virtual assistants. And I know a lot of offices have done that and it's been great. It's been amazing. We've been able to benefit from it. You have opinions about that. I'm not here to tell you one way or another. I am here to say, maybe be open to the ideas around it, just to see what can we do. And so my call to action on tip number 2 for controlling overhead. Kiera Dent (11:38.038) and unnecessary expenses is go and do an expense audit and look to see what can we do to cut costs. Maybe there's nothing, but I promise you there's probably one, 2 or three things that you could actually change or adjust. I do this every single quarter. So when the quarter ends, the CPA sends me over a detailed P &L line by line by line. I'm looking at that to make sure that I'm actually staying in track. All right, step number three. is I really want you to look at making sure that we're producing enough. So are we optimizing our schedule and are we producing enough? Because a lot of times cashflow leaks come from the insurance and the collections and the overhead, but maybe we need to also look at our scheduling to make sure we're productive on there. And we're also making sure that we're producing enough for our expenses. So what I like and what I prefer is…
Full show notes at the publisherBlock scheduling can transform your productivity into profitability. Kiera makes the implementation as easy as 1, 2, 3:
Identify your practice's production goals.
Design your ideal block schedule.
Implement, train, and track.
Episode resources:
Sign up for Dental A-Team's Virtual Summit 2025!
Subscribe to The Dental A-Team podcast
Schedule a Practice Assessment
Transcript
kiera Dent (00:02.36)
Hello, Dental A Team listeners, this is Kiera. And today, I just really wanted to dive into, are you truly tired of missing production goals? Because if you are, block scheduling is honestly the secret to hitting them consistently with ease. And I know this is something that's talked about so often. So what I wanted to do is I wanted to break this down into three easy steps to make sure that you're able to do this with your team in a fun, effective, and just like overall amazing way for you.
Block scheduling can truly transform your productivity into profitability. And it's something as simple as doing a quick puzzle in your practice where we're able to add the pieces, have an incredible patient experience, incredible team experience, incredible doctor experience. And to me, that's a win-win-win. So for that, these three steps are going to really make it easy for you and your team to...
chunk this down into a tactical practical way. You guys, I'm Kiera Dent, owner and CEO of the Dental A Team, a consulting company where we are committed to not just understanding you, but actually being you. All of our consultants have worked in every position in the practice where we're able to understand what it's like to not be able to hit productivity goals, to schedule with no frustration, to have cancellations that are dropping off on us, to where we know what it's like to lose team members. All of those things are something that our Dental A Team
consultants are experts at and something that I'm really really proud of as a company because I know that when we understand you we're not just coming to you with theories and ideas but actual tips that have been proven, tried, consistent across hundreds of offices in all the states in multiple different countries to make sure that we're giving you guys efficiency that helps your team stay focused. So this is gonna be able to help you guys out and today it's gonna be short and actionable because I want you guys to able to take what we talk about and implement it today.
So step one is going to be identify your practices production goals. Now that what we got to do is we've got to look to see what did our practice produce last year and a healthy standard benchmark is that we want to actually be increasing a minimum of 10 % year over year. We also want to make sure that we've increased our fee schedules every single year and most practices go up about 5%. Now, if you're concerned about that with your fee for service patients or your out of pocket patients, I want to just remind you that this is standard across the board with most businesses to increase 5%.
Kiera Dent (02:14.402)
And if you wanna keep those preventative ones out, by all means go for it. I just wanna be able to remind you that by doing so, when we actually send our statements out to insurance and we bill out to insurance, it actually helps the insurance companies determine what the fee should be within our area. So I wanna make sure that we're not missing opportunities and possibly a membership plan could actually help our patients when we're concerned about those preventative services. So make sure that we know what we need to do for that 10 % growth.
make sure we understand how many days we're off in the practice. So I like to go through every single month. What are the vacations? What are the holidays? What are the times off? What are our high and low months across the board? I know for some pediatric practices, our certain months in the year are actually not great, but our summer months are incredible. I know for other areas based on where they are, they get a lot of snowfall in February. So February actually becomes a terrible month for them. There's also other offices where there's a notorious, suck timber or slam dunk September.
where we actually have a dip right after school gets back in session. So knowing those trends are actually gonna be able to know your practice's production goals to be able to hit them successfully. And while yes, this might take a little time for us to go through, map these things out, what it What it it does is it actually helps us go through and see what does our production need to be? How can we realistically hit it based on the days that we're working? What does each day need to be? What does each provider goal need to be for our doctors and our hygienists? And then we're able to actually bring all that information together.
and make a perfect puzzle for us. And then we start to place it into place. So when an office does this, usually I'm seeing a minimum of a 10 % increase, but oftentimes I'm seeing a 10, 20, 30, 40 % increase year over year. I've added multiple millions to practices and our consultants have done as well just by effective block scheduling where we're not increasing the new patients. We're not changing the hours that they're working. We're not adding more days for them to work. We're just being very consistent with how they actually schedule. And it's like I said, it's a puzzle.
I can put in five puzzle pieces of one type, or I can do five different puzzle pieces. Again, I put five puzzle pieces in same amount of time in a day, but I'm actually able to make a thousand dollars versus a $5,000 a day. It was crazy. had an office that I went into and I remember they had never been scheduled to 10, $10,000 in a day. And so when I went in and I showed them, here's how we can actually do 10,000, I scheduled them to 10,000 the next day. What was wild was the day I was there, they were producing 4,000.
Kiera Dent (04:35.778)
The next day I scheduled them to 10,000 showing them how to do this. And at the end of the $10,000 day, they looked at me high-fiving. We were out the door on time and they said, Kiera, that was actually easier than our day was yesterday when we only produced 4,000. And I said, it was just with blocks. It was just with us being strategic of where we put people as being intentional. And from there, we were actually able to be productive. So just helping you guys see, we've got to figure out what our specific production goals are before we restructure the schedule. That's step number one.
Step number two is design your ideal block schedule. Some doctors like to start early in the day with a crown. Some like to start later in the day with their crowns. Whatever it is, we need to design it of where do we actually want these to be? And I like high value, follow ups, zero dollar appointments. And instead of just saying a crown, I actually like to build a block schedule based on dollar amounts. Like I said, it's puzzle pieces. So that way if a crown or a quad of fills comes through, I know there are 1500 or a thousand, whatever it is, they're going into this block.
Blocks are held for us for 24 to 48 hours, pending upon your practice to make sure we're able to put the puzzle piece in that we want. We're able to actually map it out and we're able to then tell patients when they're coming up, hey, Dr. Smith likes to do crowns in the morning. I have an eight o'clock or a nine o'clock on Monday or Wednesday, which do you prefer? Now I'm not asking the patient, where do you wanna go? I'm literally asking the patient, this is what we do. This is where I can put you. This is how we do it. What works best for you?
We actually eliminate a lot of the excuses. We eliminate a lot of the frustration and we're directing and guiding the patient rather than trying to come back after they've told us they want a four o'clock when our doctor really doesn't do crowns at four o'clock. This is going to help you exponentially build the blocks. Also, I'm not putting implants and fillings next door to each other because that can get tricky. I'm not doing two crowns back to back where I can't see it. We're literally building a puzzle that our doctors can actually do. All of us get our lunches. All of us get out on time.
Doctors can get over to their hygiene exams. So I'm also then playing Sudoku across the board where I've got my doctor procedures, my new patients and my SRPs. Square up your SRPs and your implants. So that way the doctor can literally get the implant done and not have to go do the hygiene checks. It's a way for us to truly make a puzzle that's 80 to 90 % effective and efficient. So when we do that, that's step two of design our ideal block schedule and build that out. Now, the way I do this is I draft block schedules in Google Sheets.
Kiera Dent (06:58.242)
So in Excel, map it out of what the perfect amount is, put the dollar amounts there of what this is actually going to equate to for the day, and then figure out where my hygiene blocks need to be. I need to also figure out the number of new patients that we're seeing, the number of SRP and the number of perio maintenance blocks that I also need to add into my schedule to make sure I have enough hygiene hours to accommodate the patients that we have in there. So that's in how we're gonna draft this up. So that's gonna be what you'll need to do next is draft a block schedule template for your practice that will actually be effective.
And then step three is to implement it, train our team and track our progress. So what we do is we then go put it into place. I understand that hygiene is usually blocked out six months. And so that does take a little bit longer to get into place, but our doctors can get their blocks put in right away. And we need to train our team, put those blocks in, educate them of what do we do when a patient wants a four o'clock, but we only do crowns at two o'clock. And I want to just remind you that an ideal schedule for our doctor is an amazing schedule for our patients.
us being on time, us being happy as a team, us having our doctor fresh and prepped and ready to go is so much better for these patients than us like trying to shove them in because the reality is patients can adapt the schedule as long as we're using our words, which are free to be able to put our patients where we want them to go. So how do we do this? So we host a team meeting, we explain the block schedules, we assign a point person who's going to oversee and implement, and then we actually help them make sure of...
What happens when we put this in a block when we're not supposed to? What's the follow-up? And I really get offices to work on this for six weeks to two months where we are rock solid on this. And then we come back and we adjust it after that. So when I've done this, there was an office and they were producing about 2 million a year. We put in block schedule, like I said, no extra days, no extra time. So we went from 2 million up to 3.5 million simply by being effective with our time with block schedules. To me, that's a wild growth. We have gone
Exponentially, we've gone from 2 million to 3.5 just by putting these blocks in. were like, Kiera, patients are happier. Our team is happier. We're having our lunches on time. Our doctors are getting out on time. And to me, I just feel if those are the wins, then amazing, this is worth it. So for you getting your team excited about it, helping them see like, understand teams don't like change. Why do you think I love being the Dental A Team where we do this in a fun and effective way? I love to do this because I help teams see what's possible when it feels impossible.
Kiera Dent (09:18.488)
helping them see where we can create ease when there's chaos, helping them see how we can be more efficient rather than cumbersome. So the reality is block scheduling is going to change your life. It's going to help you be effectively productive. It's going to help you hit your goals with ease. One of my favorite quotes is by Walt Disney where he says that he was able to create predictable magic because of the systems behind the scenes. And so for you to be able to create predictable production with the systems behind the scenes of block scheduling to me is a gift that you can give yourself and your team this year.
So what I want you guys to know is this is going to honestly simplify your productivity and give you guys goals to be able to hit them with ease. You don't have to be perfect. We have those snow days. We have the slow summer days. We have the December that's only two weeks. We have all these different things put in so we know exactly what we need our blocks to be. And then we're able to hit our goals with ease and more consistency. I really don't love having success be happenstance where I'm like, will I get it or will I not? I like your success to be inevitable. And I believe that block scheduling is one of the greatest ways to do that.
So if you're interested, DMS or email us for a free block scheduling template, Hello@TheDentalATeam.com And as always, you guys, this is how we're able to help you run a successful dental practice with ease. I don't believe that running a practice should be hard. I believe that this could be easy. And I want you just to ask yourself, what if it could be easy? How would you feel? How would your team feel? How would your patients feel? Because that can be a reality. This is what the Dental A Team does. And if that's helpful for you, reach out. Hello@TheDentalATeam.com And as always, thanks for listening. I'll catch you next time on the Dental A Team podcast.
Kiera touches base with doctors on how the first quarter of 2025 has gone. Ask yourself:
Are we tracking key performance indicators?
How's the team efficiency and morale looking?
Do we need to adjust and refocus our annual goals?
Episode resources:
Sign up for Dental A-Team's Virtual Summit 2025!
Subscribe to The Dental A-Team podcast
Schedule a Practice Assessment
Transcript
Kiera Dent (00:00.908)
Hello, Dental A Team listeners, this is Kiera, and I hope you're having just an incredible day. I hope life is incredible for you. And today, I just wanna highlight that Q1 is almost over. Can you believe it? We're almost a fourth of the way through 2025. And today, I wanted to ask you, are you on track for your best year yet? Because I wanna make sure that we break this down to ensure that you are thriving in 2025 and that success is predictable for you rather than just happenstance. So today, you guys, if we go through...
that reviewing our Q1 of what we did well, what we missed, how we can improve, are we on track, are we off track? This is gonna really be able to help you find the opportunities for growth to make sure that you are thriving in 2025. Today, I'm gonna break it down into three simple steps for you, tactical, practical, as always. You guys know I'm Kiera Dent, owner and CEO of Dental A Team, where we are a consulting company founded upon making your life easy, more fun, and more fulfilled.
We do that through you as a person. We also do that through making sure you're profitable. Let's cut the stress. Let's make sure you're profitable. Aiming for at least 20 to 30 % true profit, post everything else. And then we also do it with system and team engagement and top to bottom systems for your team to thrive. Truly, it's what we're about. We love working with teams. We love working with dentists. Our consultants are experts in the field. They have been in every single position in the practice, making sure that your life is easy.
fun and that you feel like you have someone in your court with you that has the answers for you, has the solutions for you, and ensure that you are successful and profitable. So today, you guys, we are going to go through this. is going to be a concise action packed episode. cannot wait. So let's dive in. Step number one to make sure you are on track through Q1 is I want you to actually go back through and assess how do we do based on our metrics this year. If you are not tracking KPIs, key performance indicators, today is a great day to start that.
Your team should be tracking. We should be able to look at Q1 and see where were we on track, where were we off track, why were we off track and what's going forward. I love to be doing this every single week and then really assessing every single month. If you haven't gone to do that, rock on. It's the time to do it. You still have three quarters left. Let's make sure that you're super successful for that. So things that I like to look at are production, collections, new patients, case acceptance. We wanna make sure we've got our hygiene reappointment. What's our hygiene percentage?
Kiera Dent (02:16.354)
We wanna make sure we're looking, those are like the main key things. And then I really always dig into profitability. I, like I said, we aim for our offices to be at a 20 to 30 % profit margin, post paying their doctors. I like you to have free cashflow in there. And so really looking at that, but also if we can dig into the nitty gritties of how's our AR, how are our cases coming across? What are we presenting? What are we closing? How is our hygiene team producing? How are we doing with our new patient count? Are we getting those raving fan referrals?
And if not, what's the one area that we're gonna highlight or two or three in Q2 to make sure that we actually get on track. Also, we look at our annual goal, which I hope that you have said, because it gives us kind of the benchmarks. To me, these are like the mile markers. Q1 is a mile marker, Q2 is a mile marker, Q3 is a mile marker. To make sure in Q4, we actually hit where we were trying to go, we are at mile marker one of the year. Where are we at? What needs to be adjusted to make sure by Q4, we actually crush our goals and we do it with ease.
Did we maybe get hit with some snow? Did we maybe get hit with some sick days? What was it? Let's not make excuses. Let's learn from it and project and move forward. So right now I want you all to block out 30 minutes this week to go look through Q1 metrics and compare them to where we wanna be by the end of the year. I recommend doctors and office managers do this. Go and look at it separately and then come together collectively. You can also do this with your leadership team. It's a really great time for you to block that time out right now and make sure you're on track. All right, step number two.
evaluate our team's efficiency and morale. Why? Why? because if we don't have a team that's synergistic, we actually are not able to have long-term success. Think about when we watch sports. mean, hello, March Madness. Hello, football season. Hello, all of them. You can tell teams that are synergistic and working well together, and you can tell teams that aren't. And something that's really paramount in team synergy is can we tell each other when we're off track and not have it be eggshells? I really love the book, Five Dysfunctions by Patrick Lenziani.
It's really a great way for you to see your team health. There's also difficult conversations don't have to be hard. There's ways that we can, crucial conversations if we're struggling with this, but really how do we actually do this? And are we checking in one-on-one monthly with each of our team members and getting honest feedback? Are we celebrating the wins and acknowledging the shortcomings? Are we looking for support and training that we need to have? Where are we at? But this is something that's so important to have really truly team efficiency and morale, because if we're not operating as a strong team,
Kiera Dent (04:40.942)
we're not gonna make it to the finish line. And so having that like true focus right now on it is going to honestly be able to help you all truly flourish and thrive in 2025. All right, step three, I want you to adjust and refocus our annual goals. Looking at where we are, where we need to go, what do we need to be changing or adjusting to make sure that we're there? We might need to adjust right now. We might need to say like, we gotta be a little more flexible here.
This is something we didn't plan for. Maybe we lost an associate. Maybe we lost a hygienist. Maybe we lost an office manager. Some of those things, if they're out of our control and they truly will impact us, we do need to adjust. If we lost a provider, we've got to adjust those goals. Otherwise, we're chasing a dream that we can't quite get. And so I don't like to create excuses, but I also want to make sure that we have flexibility within the rigidity. So we've got the strong goals that we've set. We also have the flexibility of if life happens, we're not making excuses.
but we're actually coming to the table. So what do we actually need to do? Where are we at? What are the top priorities that we did really well in Q1? And what do we need to be setting up for Q2? I love the model of traction by Gina Wickman. This is something we work with a lot of our offices on. It's what we were building within our in-person community where we really are helping you assess your business every single quarter, just these simple three points. We have a deeper dive that we do within our teams to make sure that we're...
quickly adjusting, but not adjusting too quickly that we're able to give them the momentum and the traction that our teams need. So for this, like I said, we need to assess where we are, take 30 minutes and look to see where we are, what did we do well in Q1, where are we off track that we need to get back on track? Two, look at our team efficiency. How are we working together as a team and what do we need to change? And then three, adjust and refocus our goals to make sure moving into Q2 that we are actually set up for success.
I love this, so I want you to revisit your annual goals, break them into Q2 action steps. Like I said, I love to do it in traction. I love to do this with our offices. It's something very fun and fulfilling for me. We do it as a team. We have a coach that comes and meets our leadership team. We break it down to our departments and make it really easy. So three steps, you've got them. You know where we need to set the time aside now. Wherever you are on the journey, high five. This is where we are. We got here. And this is also, if there was a hard quarter, Tony Robbins is one of my favorites.
Kiera Dent (06:59.574)
And he says, if it's a hard quarter, something that's just really beaten us down, we just look at that and say, well, hello, we finally have a worthy opponent. If we're riding high, we're doing everything, we're on such a good roll. Amazing, ride that high, ride that wave because a worthy opponent will show up at some point. We do not fall apart, we do not break down. We look at it, we face it, we figure it out, and we rise again with a true plan.
You guys, it's truly so important for you to assess where we at. We have three more quarters. Let's make them the best quarters. Let's make sure you're thriving in 2025. I am happy to share with you a Q1 checklist, whatever we can do for you. DM us, email us, Hello@TheDentalATeam.com You guys, please subscribe. We have newsletters every single week that come out to you. So if you want, head on over to our website, TheDentalATeam.com for more dental leadership insights.
Dental A Team is truly committed to you thriving in 2025. And if you're like, Hey, I could really benefit from one-on-one of having someone there with me benefiting from a community that started to support you having a structure that, that air quotes forces, but we really do. hold you accountable to it to make sure you're deep diving on your business. Reach out. This is what we do. Hello@TheDentalATeam.com as always. Thanks for listening. I'll catch you next time on the Dental A Team podcast.
Tiff and Britt discuss how a practice that was upside down financially picked through their systems with a fine-toothed comb to find success — and how you and your team can avoid this scenario. Episode resources: Sign up for Dental A-Team's Virtual Summit 2025! Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: The Dental A Team (00:02.146) Hello, Dental A Team listeners. We are back again. I kept Britt today. If you've listened to the other one, that it was a beautiful Friday morning. It's still a beautiful Friday morning. I made her stick around so I could do even more with her today on this podcasting adventure. I know you guys love hearing from Britt and I love chatting with her. So Britt, welcome. Welcome. How was your day? We're rolling into the weekend. How much fun are you excited to have? You're feeling better, you were sick, you caught what everybody else has had, and I think you get a true weekend, right? Britt (00:29.812) everyone. This weekend should be better than last weekend. Let's just say that. And it is gorgeous out here. So I mean, I might have been slightly annoyed at the birds chirping and I'm like, really? Like waking me up? That's what you're going to be annoyed about. Get over it. It's a nice day outside. The Dental A Team (00:47.151) Oh my gosh, okay, Cinderella. I love that. I love that. It is like, it's a week. I keep thinking, gosh, it's like unseasonably warm and like it's not, it's supposed to be 85 degrees next week, FYI, but this time of year, last year was cold. That was the abnormality. This is actually normal for Phoenix. So I keep having to remind myself of that because it is warm, but the birds are chirping. The dogs are barking across the street. Britt (00:49.486) I know. The Dental A Team (01:14.987) There's people walking by and they they get angry. It's all here and we're here for it. And so if you hear the birds, you hear the cats, you hear the dogs, just know we are a company that fully encompasses the animals. We love them and they're here with us today. So I love it. Well, today's content I'm actually really excited about. wanted to I wanted to take like an excerpt from Britt (01:28.136) you The Dental A Team (01:41.68) practice that I've worked a ton with over the last few years. are near and dear to my heart. Some of my favorite human beings in the whole world. Trish was on a call with me with them, consultant Trish, and she just, she texts me on the side. She's like, he is the sweetest man. I'm like, he really, really is. They are just such a sweet, sweet human and individuals, but I've taken some journeys with them financially. And with a lot of their, their team members and doctors and stuff. And I wanted to kind of highlight a piece that we found that I don't think I even like always thought about. And I think those are the spaces that I actually love about consulting is one, a challenge. I always love a challenge and decided like we're doing a steps challenge. I'm like, I'm to win. Like I was already doing it, but now I'm like, I'm for sure doing it. So you challenge me and it's going to work. Britt (02:28.029) We're going to Britt (02:34.419) Game on. The Dental A Team (02:35.088) It is, it is. It works every time. Ask Kira, she says it, she screams it from the mountaintops. It really does work, I don't know why. So I love a challenge, I love learning, and I really love when it's like, oh my gosh, that was so obscure from the normal, and it's so cool to see what we were able to create and figure out. And we all know at this point in the game that we need 98 % collections across the board. And we all know it's not always that way. And doctors, I really wanted to bring you this information and this story, right? Storytelling time. This story from something that I've witnessed, experienced and worked through because I want you guys to be able to take some tools back to your own practices and implement some things that are actually really easy that not everyone is always doing. So, Britt, you're here with me for this journey and I'm excited because it brings in some of those business pieces. that I know we love chatting about. So we're gonna chat through some of it and then I wanna bring in your brain on like, how can we implement these things in every single practice? So biggest space walking in to this practice was their overhead. Like their overhead was out of control and they were making massive production for a single doctor to hygiene. They're at like 140 to 160 consistently. And their hygiene department, let's do through some like, digging, right? I find their hygiene department is like 11 to 15 percent of their production. So this doctor is exhausted. He is just like not able to sleep at night because he's stressed. He's working really hard and their overhead is really high, like almost 80 percent when we started working together, almost 80 percent overhead. You guys, that's before paying him. That's before paying loans. And so they actually had to take loans out. Britt (04:07.923) Yeah. The Dental A Team (04:30.884) to pay bills and pay loans, like this giant cycle, right? This just upside down, stressed mess. And he could not figure it out because production wise, right? He should be okay. But his overhead's almost 80 % and his doing calculations, right? And then like collections is like all over the place. One month, it's like 103%, one month it's 87%. Then it's like 92 and it's just like jumping all over the place. Like what the heck is going on in this practice? Like the production is fairly consistent, right? But the collections is inconsistent and the overhead is consistently high. So from, I think from many people's standpoint, the number one thing you do, right? I had a doctor yesterday that I was talking to and he's like not as profitable as he wants to be and I get it and we can make him more profitable working on it, but he's like, okay, so I need to produce more. And I'm like, whoa, whoa, whoa, you can't always outproduce the problem, right? And this practice is like that to a T because they are producing really well, but their overhead is still really high. And their collections, again, like they're collecting something, but it's just all over the place. So we had to like really do some... weird tricks in my opinion. was just like, all right, we're gonna, we're gonna just dig in. We're gonna dive in. We're gonna figure some stuff out. So Brett, what we found one pre collections, right? love pre collects you guys. love pre collects, but what pre collects will do is inflate your collections. And so doctors implement pre collections, a hundred percent implement pre collections. But if you're going to implement when you implement pre collections, Britt (06:19.931) Laughter The Dental A Team (06:21.144) you have to pre-collect every time, right? So what they were doing is they were pre-collecting on large cases. They were doing full-mouth, like, large cases inconsistently. So they'd have two $50,000 cases in a month pre-collect that's, it's scheduled for next month, right? So they pre-collect for those two cases in January. They do the cases in February and they don't schedule any cases for March. So then, Britt, what happened to February? Then we've got 103 % collections over here in January and then February is 87 % because we did the production and we didn't pre-collect for new surgeries. Britt (07:05.713) your collections are ahead of your production because you're ahead of time, a month ahead of time even. The Dental A Team (07:08.795) Yes. a month ahead of time. And they were so upside down financially that the pre-collects were being used to pay bills. And so they'd pay down, they'd even pay down their loan that they got to pay bills. And then they'd have a low collections month and they'd have to use the loan, which I think personally, all of us have probably been in that situation in our personal lives at one point or another. Britt (07:22.851) Mmm. The Dental A Team (07:39.046) And it's always interesting to me the parallels there, because we like to think of business and personal finances so differently, but they are parallel. guys, money is money, business is business, life is life. But anyways, so then we figured out, okay, let's start pulling this money. So you pre-collect, you pull it, and you put it in a different bank account. So we started building their buckets, right? Their profit first style buckets without doing real profit first, because we couldn't. So we're... Britt (07:41.651) you Britt (08:05.099) Yeah. The Dental A Team (08:07.868) pulling this money, planning for it, right? We're prepping for profit first. So we've got these buckets and I've got them starting to pull for lab because they were getting heat up, like, honestly, sometimes it was like 20 % lab bills. So we had to pull aside all this stuff and it was so fantastic to see the money moving in the right directions because it cleared things out of the way. And then we would like add it back in. Britt (08:08.101) of The Dental A Team (08:35.6) the month that we needed it, blah, blah, blah. So we were doing this like money moving, but the biggest piece of all that was like, okay, you guys level out your pre collects. You're going to be fine. Make sure you move the money. Make sure you've got the lab bills, lab expenses covered in a different account. The biggest piece of all Britt that blew my mind and the team found it. The team found it on their own as we're moving this money around. They're like separating it on my KPI sheet. have for them. So I'm like, okay, this is your collections. This was your pre-collect. So this is your true collections. Your pre-collect were, that's gone. That's for next month. That's next month's money. This is your true collections. Their true collections tanked. And they're like, well, Tiff, we're actually, I'm seeing we're not actually collecting a lot over the counter. Like, well, that doesn't make any sense. What do mean you're not collecting? Like, so then collect, like get the money. And they said, well, everyone has credits on their accounts. Britt (09:09.552) Thank The Dental A Team (09:34.066) They found it. So the previous billing manager and treatment coordinator and front office total wasn't putting information into the system correctly or at all, right? They didn't have the insurance fee schedules in there. So we had already worked through a lot of that, right? The fee schedules, making sure all the insurance, making sure what goes out was correct because it was incorrect. That was already been, we've been solving that. But what happened is she was guesstimating off of UCR, taking like 20 % ish off of UCR for treatment plans and collect over collecting for patients. then when insurance, which is great, I'd rather over collect than under collect. If you're going to pay attention to your credits and give credits back. We were not paying attention to the credits. And so Britt, all of these patients just like Britt (10:17.875) huh. Britt (10:22.393) Yes. The Dental A Team (10:30.932) thousands and thousands and thousands of dollars in credits of patients who were coming in. We had the treatment, we had the production, but we had already had the collection. So this is where it's like, truth be told, you cannot out-produce your overhead. Because if you produce and you've got $100,000 in collection or in credits, right? All of these patients are coming in for fillings and it's like a $56 copay, they've got $300 credit. working away on on their account. So the money's already been there. The money's already paid the bills. They had to then on our KPI, I'm like, okay, well, we're going to do another column. Next column is like, how many patients, what was the amount of credits that you use today so that if we had collected it, I need to see from a financial standpoint, I need to be able to see if we had collected it, could, would our overhead be okay? Is the overhead issue because we can't collect that money or is it because we Britt (11:10.318) Yeah. The Dental A Team (11:29.616) need to produce and collect more. So it was so hard to like see all of the pieces because there was so much chaos in the accounts that was so like hard to find. did an incredible job keying into tip. think it's the credits and I was like, my gosh, you just blew my mind, right? Like I didn't even think of this. I thought for sure the pre collects, like let's level those out. Let's always pre collect on everything. We changed that model. Britt (11:44.945) Yeah. Yeah. The Dental A Team (11:56.072) but that was only adding now to the credits. So it was like, holy cow, but it was really cool, Brett, to be able to see that's one layer that I think a lot of practices and a lot of practice owners forget to look at, right? We look at our AR, we look at our production, our collections, our new patients. We never really truly look at our credits. And these credits had our overhead at like 80 % and our collections was literally like, Britt (11:58.928) Yeah. The Dental A Team (12:24.18) 87 to 95 on a really like good month of no surgeries pre-scheduled. So it was wild to see, but then once we started accounting for that, it took about a year to really truly get through all of those credits or most of those credits that were coming in. So it took about a year, but being able to visually see on the overhead spreadsheets, on the KPIs, all of the money and where it was going, what it was allocated to helped them to be able to see where they needed to move money to, pull money to, what needed to be done. He could project like, how long do I have to work this hard? Because he's got to produce as much as he can to get through the credits, plus get some collections in. So he truly had to just work his tail off for this year to really dial back some of those issues. But it was really fun to see, okay, these are all of the spaces that you've got to make sure you're paying attention to. especially because, I think we've all experienced this. I mean, I did in practice too. I'm like, the billing rep has got it, right? So many owner doctors, that's, you want to be able to, and I'm not saying you can't trust, right? But human error is a thing and we don't always know what we don't know. And I think that this gal just didn't know how to do it any other way. So she was doing it the best she could and honestly, like more money, the better. So if you're going to, I want you to collect more. if that's an opportunity, but we have to be able to give it back. Like we have to be able to watch those. So I'd rather over collect than have to track somebody down for a bill. Right. I totally agree with that theory, but if we're not watching it though, like it's wild. So Britt from business standpoint, right. We've got all of these moving pieces, like from a business standpoint, if this doctor or a doctor who might be in a similar situation, right. They're like nearing Britt (14:03.431) Agreed. The Dental A Team (14:20.792) what they thought was going to be retirement, right? They thought they were getting there. Now their business is like spiraling. I mean, I did, you know, I did my digging. We did it. We got through it. It took a while. The next year, like we decreased thei…
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