California Bill, AB 952 was authored by Assembly member Jim Wood (D-Healdsburg) and signed into law by Governor Gavin Newsome on July 27, 2023.

Legislation was specifically targeted toward a lack of open disclosures with dental insurance.

Confusion often arises due to the distinction between insurance coverage referred to as “fully insured,” which is regulated at the state level, and “self-insured” plans that operate under the federal Employee Retirement Income Security Act of 1974 (ERISA) statutes. ERISA plans are exempt from compliance with California (and most state) laws, and they frequently lead to frustrations for both patients and dental providers.

Specifically, AB 952 requires that dental benefit plans at the time of determining patient coverage:

• Disclose through their online patient portal whether the patient’s plan is state regulated.
• Disclose upon the dental office’s request whether the patient’s plan is state regulated. This requirement is especially relevant for plans that do not have a patient portal.
• Include the phrase “state regulated” on the patient’s electronic or physical insurance identification card—or both if they exist.

Wood stated, “It is vital for patients and providers to be aware of which laws apply to a patient’s dental plan. What we have now instead is a profound lack of clarity about the standards the plans must meet and where patients and dentists can go to resolve a conflict with a plan. The ERISA notification will provide that clarity for the millions of Californians enrolled in these plans and will help alleviate confounding billing processes for dental offices too.”

In a statement provided to Dentistry Today, CDA president, Dr. John Blake offered, “With over 40% of Californians enrolled in dental plans that are regulated under federal ERISA law rather than state law, the resulting confusion can be all too common for patients and dental offices. AB 952 is a good step toward addressing that through improved transparency.”

Additional importance of such legislation was addressed by author of 2022 Massachusetts Question 2 on dental insurance medical loss ratios, Mouhab Z. Rizkallah, DDS.

“I think there is real value in this new California Law.” Rizkallah added, “I actually love this law—it is an easy way to strengthen sloppy ERISA management (though most of them are already quite good).”

Rizkallah delivered the following overview:

What are these plans?

ERISA plans (which are a type of self-funded plan that has FEDERAL control and no STATE control) are a fiduciary plan that is frequently used by unions, etc. (generally great coverage—if managed properly).

Most plans are not federal ERISA plans—they are just commercial plans licensed by the state (and under state control).

The failures of the plans are different in nature.

ERISA plans (federally regulated) are sometimes bad when they are “poorly managed” by their fiduciaries.

Commercial plans (state regulated) are usually bad when “insurers intentionally cheat” to make more money.

Taken together:

If you want to regulate a “poorly managed” ERISA plan—you threaten them with civil and/or criminal court (they are fiduciaries).

If you want to regulate an “intentionally unfair” standard commercial plan—you threaten them with a complaint to the state division (department) of insurance.

In Summary:

By knowing exactly which category the insurance plan is in, patients and dentists are empowered to hit them in the right place (rather than feel hopeless because they don’t even know where to begin).

This law (by its mere existence) puts sloppy ERISA managers on notice—they will be held to their fiduciary responsibilities.

ABOUT THE AUTHOR

Dr. Michael W. Davis practices general dentistry in Santa Fe, NM. He also provides attorney clients with legal expert witness work and consultation.

Davis also currently chairs the Santa Fe District Dental Society Peer Review Committee.

He can be reached at MWDavisDDS@Comcast.net.

FEATURED IMAGE CREDIT: Phloxii/Shutterstock.com.

Start with analysis.

We received many calls, texts, and emails at Levin Group asking about dropping out of one dental plan or all dental plans. These are often triggered by frustration on the part of the doctor over low reimbursements. The decision to drop a specific plan should depend on analysis and not emotion, and it certainly shouldn’t be a knee-jerk reaction.

The following points need to be considered:

• What percentage of the practice revenue is derived from dental insurance reimbursements?
• What percentage of the practice revenue does each individual plan represent?
• What percentage does each individual plan represent of the total dental insurance reimbursement revenue for the practice?
• Rank each of the plans in priority order by revenue.
• How many patients are in any of the insurance plans accepted by the practice?
• What percentage of patients are covered by dental insurance plans in which the practice participates?
• How many patients are in each individual dental insurance plan that is accepted by the practice?
• How many patients have dental insurance plans in which the practice does not participate?
• How many new patients joining the practice are in dental insurance plans that are accepted by the practice?
• How many new patients joining the practice have dental insurance coverage that is not accepted by the practice?

Analysis is important when making financial decisions. At first, this may seem complex, but in reality, it is relatively easy once the basic data is available. It is simply a series of mathematical calculations that look at both the numbers and the percentages from several different viewpoints.

Not to get too detailed, but if the practice only looks at patient numbers or practice revenue, it is probably not analyzing the insurance picture deeply enough. It is important to look at both because one could override the other in making the correct decision.

Every year, practices should perform an insurance analysis. Using the questions or points made above and other common-sense calculations and comparisons will allow a practice to quickly analyze whether it makes sense to keep certain insurance plans or even to add others. Once the data is available, it takes only a few hours to run the analysis and determine where the practice stands. And those are hours well spent.

ABOUT THE AUTHOR

Roger P. Levin, DDS, is the CEO and founder of Levin Group, a leading practice management consulting firm that has worked with over 30,000 clients to increase production. A recognized expert on dental practice management and marketing, he has written more than 60 books and over 4,000 articles and regularly presents seminars in the U.S. and around the world.

To contact Dr. Levin or to join the 40,000 dental professionals who receive his Practice Production Tip of the Day, visit www.levingroup.com or email rlevin@levingroup.com.

FEATURED IMAGE CREDIT: nukeaf/shutterstock.com.

Insurance management has become significantly more time-consuming than ever before. Concerns shared by most offices center around task management and deciphering patient benefits. It is not just participating offices that struggle—even fee-for-service practices feel the pressure to be accurate with estimates and financial conversations. Experienced insurance coordinators are fine-tuning their systems on a regular basis, but what about the new administrative team members? How will they know if their systems are flawed? 

They learn by continually assessing the why of their current systems. Why do some offices send claims only at the end of the day? Why call for full benefits on every patient? Why reconcile checks once a week? Why send statements only once a month? All these examples were regarded as conventional wisdom at one time. Electronic capabilities changed the way we do these and many other tasks. Let’s dive into some concerns I regularly hear from attendees and clients. 

Is it True That Secondary Insurance Claims Should Be Printed and Mailed With the Primary Explanation of Benefits (EOB)? 

I haven’t mailed a secondary claim in years, maybe even a decade. You can submit the EOB as an attachment to the secondary claim. You will need to scan it so it can be sent digitally. Paper claims are not traceable, which is why I’m not a fan. Electronically submitted claims result in a transaction or tracking number, which is necessary for follow-up questions. Keep in mind that paper claims take longer to be processed. Claims with attachments can take even longer than that. Revenue cycles should be as short as possible; mailing claims increases your payment cycle. 

Carrier portals and some clearinghouses can display the EOB. Insurance systems can now include taking screenshots of an online EOB and sending the screenshot to reflect the primary payment. Most carriers will accept this screenshot as long as it provides the same information as a printed EOB.

Do I need to Check Benefits for Every Patient Appointment? 

We track down plan benefits so that we can provide our best estimate of the patient’s portion. Every time we get this right, our confidence level grows. It’s a time-intensive task, however. Frustrated team members tell me that they check this for every patient, every appointment. That’s overkill. For his or her first appointment, this makes sense, but not for other appointments in the same benefit year. Plan design doesn’t typically change midyear, so save yourself the time. 

Utilize your electronic capabilities as much as possible. It’s possible to check for this information via software, web portals, or faxback services. If benefit checks are overwhelming your office, then it may make sense to outsource this task. 

I’m Interviewing Someone who Claims to Know Insurance. How can I Tell if the Candidate is Actually Good With Coding and Claims?

An insurance coordinator from a single-provider location will have a different skill level than one from a multi-location office or DSO. Multiple providers and networks and a wide range of billed codes bring complexities that a solo office will not face. An applicant from a solo setting will quickly pick up on the changes as long as you give him or her time to adjust. Willingness to continue learning is key to this role. Just as clinical materials change and improve, so does insurance management.

You could also quiz him or her on a few basic concepts and experiences:

• How do you calculate payment when a deductible is involved? 
• What documentation is needed for scaling and root planing submissions?
• What is a missing tooth clause?
• Which procedure code is the most problematic for you, and why?
• How do you handle a patient who wants us to write off his or her portion?

An experienced coordinator will be able to answer these questions. The most important question is this one: How often do you take CE on dental insurance? If the reply is “I’ve been doing this for 5 (or 10 or 20) years; I know what I’m doing,” you should end the interview and be thankful for the warning sign. The best insurance coordinators I meet (and have trained) know that every year, carriers change policies, networks grow, and the current dental terminology is revised. Secondary insurance and non-covered services are handled very differently than 10 years ago. Standing still in this field is a guarantee for delayed and denied claims. 

I am a Dental Assistant. Could I Be an Insurance Coordinator? 

A million times, yes! The best coordinators I have trained have had extensive clinical experience. A huge learning curve for new employees is dentistry itself. Our terminology and procedures are not the easiest to learn. The requirements for documentation will make sense to an assistant—you had a front-row seat to those procedures! You will be able to quickly pick out any applicable radiographs and intraoral images. Discussing patient benefits will be easier because you already know what the patient is most likely to be concerned with. You have heard it all before. I would love for all insurance coordinators to spend time in the operatories to learn about procedures and the rationale behind treatment. This is valuable information. 

Why Is It More Difficult Now? 

An unfortunate combination of dental benefit complexities and workforce weakness has brought us to this point. Let’s tackle the carrier side first. No longer can we assume that dental plans follow traditional designs. Here are a few coverage examples that can take your office by surprise:

• Preventive and diagnostic services are very often subject to deductibles. In the past, these categories were usually exempt. 
• Radiographs are often subject to deductibles, but evaluations may not be. This requires your insurance coordinator to adjust the category tables, which can be time-consuming—even for experienced software users.
• Within the oral surgery category, simple extractions can be covered at a higher percentage than surgical extractions. Again, this requires software modifications.
• Timely filing deadlines of 180 days (vs the traditional 365 days) are becoming common. If you are dealing with a difficult claim (multiple appeals) with secondary coverage, you may come up against this barrier. A new employee tasked with cleaning up aging claims will be frustrated by this more restrictive limitation.

Plan designs will continue to change. Medicare Advantage dental plans are bringing new complexities, such as quarterly vs yearly benefit amounts. Every year will bring new plan designs and limitations.

The workforce issue has affected both practices and carriers. It is common to hear of 3-plus-hour phone hold times with carriers. Although carrier portals contain claim and coverage details, we need to speak with a live representative for many reasons. Understaffed carriers and their call centers mean less timely answers for our patients. Dental practices also suffer from understaffing, with the most significant issue being a substantial learning curve regarding the insurance coordinator position. I have lost count of doctors who lamented hiring for the position only to have the applicant quit with comments like “this is not what I expected” or “insurance is too complicated.” My hope is that we can attract more candidates to our industry. This will not happen overnight, unfortunately. The position is a specialized one that requires a fast-thinking and detailed candidate. A person with this personality mix will quickly pick up on the nuances of the job. If you are lucky, your candidate will love challenges! 

Effective insurance coordinators are very good at pivoting. We have learned to be flexible in the face of often-changing benefits and new plan designs. Perhaps your interview question should include “Do you like a good puzzle?” A great insurance coordinator will smile and say, “Absolutely!”

ABOUT THE AUTHOR

Ms. Duncan received her master’s degree in healthcare management from Marymount University in Arlington, Va. She has more than 20 years of healthcare experience, and frequently addresses topics such as insurance coding, office manager training, and patient conversations. Her memberships include the National Speakers Association and the National Association of Dental Plans. She is the author of Moving Your Patients to Yes: Easy Insurance Conversations as well as a contributing author to the ADA’s annual CDT Companion Guide. Her podcasts, Nobody Told Me That! and Chew on This!, provide regular coding and management updates. She can be reached at odysseymgmt.com or via email at teresa@odysseymgmt.com. 

Disclosure: Ms. Duncan reports no disclosures. 

Overjet (www.overjet.ai), the global leader in dental artificial intelligence (AI), today announced it has raised $27 million in Series A financing led by General Catalyst and New York-based global private equity and venture capital firm Insight Partners with participation from existing investors that include Crosslink Capital and the MIT-affiliated E14 Fund.

“Overjet is on a mission to improve oral healthcare for all,” said Dr. Wardah Inam, CEO and Co-founder of Overjet. “This ambitious vision pushed us to find world-class investors with a depth of experience supporting the scaling of high-growth technology companies.”

Overjet’s dental AI products are designed to help dentists deliver the best patient care and enable dental insurers to operate more accurately and efficiently. Today’s financing follows the FDA’s recent clearance of Overjet’s Dental AssistTM product designed for dental practices, the first dental AI company to receive such a clearance. 

“Overjet improves patient care by automating much of the clinical review process with AI and by helping clinicians increase diagnostic quality, consistency, and speed,” said Chris Bischoff, Managing Director of General Catalyst. “At General Catalyst, we are excited to partner with Wardah Inam and the entire Overjet team as they deliver on the vision of health assurance in dentistry – creating a win for patients, as well as insurers and clinicians.”

In the dental benefits space, Overjet has emerged as the leading AI company with dental insurers, inking 15 major carriers as customers for coverage of over 53 million Americans. The Guardian Life Insurance Company of America (Guardian Life), a leading dental provider, was the first national carrier to integrate Overjet’s dental AI into its claims processing. The two companies started their commercial partnership in late 2019 with a focus on supporting consistency in dental claims review and improving operating efficiency.

“Guardian Life continues to be committed to facilitating the best oral health care possible for our members,” said Dr Randi S. Tillman, Chief Dental Officer, at Guardian Life. “By partnering with Overjet, we are able to leverage AI technology to improve the consistency of our dental claim review process while ensuring that we are able to make decisions based on the most precise clinical data.”

“The rapid pace of customer adoption for Overjet’s software is a testament to its product differentiation and the market pull for powerful, rapidly improving AI technology in dentistry,” said Lonne Jaffe, Managing Director of Insight Partners. “As Overjet scales up, more and more dental payers and providers will get the chance to appreciate the predictive accuracy of its software and the caliber of its team. Overjet is on a mission to solve the most challenging problems in dentistry, which can positively impact millions of patients.”

With a rapidly growing customer roster, Overjet expects the new funding to only accelerate market adoption, new product launches, and impact on dentistry. “Tens of millions of Americans already have their dental claims processing streamlined and accelerated by Overjet today,” said Shaju Puthussery, Chief Operating Officer of Overjet. “With the recent FDA clearance and new funding, more Americans will see Overjet’s dental AI technology assisting their dentists at the next check-up. We’re committed to helping clinicians deliver the best patient care.”

ABOUT OVERJET

Overjet is the global leader in dental artificial intelligence, helping both payers and providers improve patient care. The company was founded by experts from the Massachusetts Institute of Technology and Harvard School of Dental Medicine, and has assembled the largest and most seasoned team of technologists and domain experts with deep AI, dental, and insurance experience. Follow us at www.overjet.ai and on Twitter @overjetdental.

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One of the first places to start looking for a great pediatric dentist is with your dental insurance, which should be able to tell you which dental practices are covered and conveniently near you. But that only narrows down your options so much—and there are different factors to consider when choosing between pediatric dentists and adult dentists.

What’s the difference between pediatric and adult dentistry?

A pediatric dentist completes an additional 2-3 years of schooling beyond the undergraduate degree and four-year dental school that all dentists must complete. This training helps a pediatric dentist better understand how to work with children and how to specialize in preventative care that helps children’s teeth develop well throughout their lives.

Pediatric dentists also tend to run practices that are more welcoming for children. They might offer an abundance of toys in the waiting room, more kid-friendly posters and videos, and even different flavors of toothpaste.

HOW TO SEARCH FOR A GREAT PEDIATRIC DENTIST

Use your insurance provider’s directory

The best way to find a pediatric dentist covered by your insurance is to use their directory. You can often search by zip code, name, and specialization to find the right pediatric dentist for you and your children.

Ask for referrals

Sometimes it’s helpful to ask other parents about which pediatric dentists they take their children to. It’s always a great question to ask in a Facebook group for parents in your area, as other parents likely have the same question and everyone can easily share links to the practices they like. You could also likely find out from people who work at your child’s school or daycare, such as the school nurse, PTO leader, or anyone who has children that live in your area.

Check online reviews

Good online reviews are always a good sign of a well-respected pediatric dentist. When you search for the name of their practice, you should be able to see reviews on sites like Yelp and Google that give you an idea of what to expect. You’ll want to look for reviews that talk about how the children experience the dentist–any time you see a parent writing about how their kids look forward to coming back, that’s always the best sign you’re looking at a great pediatric dentist.

Community involvement

A great pediatric dentist cares about their patients and will often be involved in the community in some way, whether they sponsor a local baseball team, run charity events, and/or have an educational social media channel of sorts. It’s also perfectly reasonable to see a dental practice focusing more on dentistry than other things, but community involvement is always a good sign that the dentist and their team care deeply about their patients.

The Bottom Line

A great pediatric dentist understands how to work with children. They know how to make their practice kid-friendly, and they understand how to give children preventative care that will help their teeth develop properly. You can usually find out what insurance covers from your insurance company, and it never hurts to get the opinions of other parents in your area. At the end of the day, great parents tend to find great pediatric dentists.

Source: iQuanti, Inc, via Newswire

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“Circumstance does not make the man. It reveals him to himself.” – James Allen, As A Man Thinketh

The tallest peak in Utah where I currently practice is Kings Peak, which is about 13,000 feet above sea level. The lowest point in the state is Beaver Dam Wash, which is just 2,000 feet above sea level.

In the same way, our careers and businesses have lots of hills and valleys. Sometimes things going just the way we want them to, and sometimes they just plain don’t.

Finding and keeping long-term team members is one of the most interesting dichotomies in dentistry. For years, I’ve heard practice owners talk about finding the right people, turnover, managing compensation and benefits, etc. According to the American Dental Association as well as most business journals and reports, the majority of practices (and all businesses for that matter) are experiencing some type of labor shortage right now.

You may also experience this as well, with hygienists and assistants, being the most difficult to attract and keep in many parts of the country.

Right now, the problem that is that classic economic equation: demand is exceeding the supply of people who want (dental) services. But the same goes for many other businesses and industries as well. When I took a flight earlier this spring it was awesome. Tons of open seats, great service, and a more clean and comfortable plane that I’ve ever flown on before. Now the service stinks and planes are overcrowded as the demand has resumed for travel yet there is still an extreme shortage of labor to help equip and serve the planes and airports. So, how will we overcome this challenge in private dentistry? I will share with you six keys that have helped in our office stay productive during this interesting time.

1. GO VIRTUAL

Ensure that you have virtual help, where you can’t have in-office help. There are many excellent websites, such as Upwork, as well as local staffing agencies that can help you find virtual or temporary office or admin team members, as well as personal assistants. This will help to offset the shortage of team members in your practice. We have at least two or three virtual assistants going at any given time and they are a lifesaver when it comes to data entry, graphic design, typing articles etc.

There are a couple of reasons we do this. First, they are independent contractors, so we don’t have to worry about labor laws or benefits, etc. Second, they get paid for what they do. And third, we can pause or resume at any time.

2. INTERNAL VIEW

You may want to look within your existing team, or people who previously worked for you. See if you can move them to a different role, where they are more needed. Such as an assistant becoming a treatment coordinator or a hygienist becoming an office manager.

3. PROPER FEES

Right now, it is not a time to be working more for less. You have to make sure your fees are in line with the value of your services. You should not be stepping over dollars to pick up pennies. Instead, make sure that the procedures or services you are offering and can add more value to your patients, are fair and in line with what you see fit. In my opinion, dentistry is a huge bargain and a very high-value service compared to hospitals, and surgery centers. Where can you get a set of tires for $1500 that will last 5, 15 or even 40 years compared to a ceramic crown?

Of course, insurance doesn’t cover all major services that most dental patients need. But from a big picture view, dentistry, adds so much value to the lives of your patients. And there are many financing programs available today and you can look at an office internal financing program as well.

4. CHANGE UP

Reduce your hours as needed. This is not a time to overwork yourself. Following the 80/20 Pareto principle, you should spend 80% of your time on the 20% of your procedures and services that you’re good and most profitable at. If it’s of high value to your patience and you make a good profit at it while having fun, then continue doing it. Refer out or delegate to another provider in your practice services that do not meet the criteria.

You may find that fir example mornings or afternoons are the least desirable for your patients, or maybe Monday are usually slow. Turn those into training times, meeting times, or time off for your team. It’s important not to overwork those who you do have, or they will burn out.

5. LET GO

If you hire someone who’s not the right fit, don’t string it out or give them the perception that they’re going to magically get better. The truth is, all of us have our best behavior and best attitude when we’re applying for a position or trying to get something we want. It simply doesn’t get better from there – it’s human nature. Of course, you should be able to develop the skills and talents of your team over time to get better. But if the attitude isn’t there within the first few weeks, you need to free that person up back into the marketplace. Otherwise, they will sabotage the culture, and drive in your practice.

6. DON’T WASTE TIME

Get rid of your bad patients for people who don’t want to pay, aren’t responsive, don’t keep their end of the deal. For those who cancel and reschedule constantly, outsource them or refer them to another office, where they will be better served. If you run a production report, you will see that these people cost more than they bring in due to wasted chair time and unnecessary and preventable write-offs.

How to become an Insurance Independent Practice!

There are two reports, you should run in your software to determine if you have a membership office or an insurance drive office. The first one is running over-the-counter collections. This is a report that tells you how much you receive payments and non-insurance payments each month. For example, personal checks, credit cards, and third-party financing such as Care Credit or in-house financing payments.

The second report you should run is a production report, based on insured patients vs non-insured patients. This report will elaborate on an important comparison. For example, production and collection for your cash, self-pay, or membership plan patients each month as compared to how much you produce and collect each month with your insurance-based patients.

Why are these reports so critical? Because if you have a very high insurance dependence in your practice then you shouldn’t go cold turkey on dropping tons of insurance plans at once. If you have a high amount of cash pay and/or membership patients then you may want to be careful about adding insurance which could compromise the level of service in your office or your cash flow.

Insurance Plans

In my practice right now, we currently accept two dental insurance plans. Currently, we are planning to phase out one soon. We are confident that we can do this and still grow. How do we know? Because, as of right now, two-thirds of our collections come from our patients each month, rather than insurance. There is only one reason for us to accept insurance right now in my option, which is to get new patients.

Remember, that over the years, many of your patients will either go in and out of insurance or insurance networks, or eventually retire and lose their insurance altogether.

So, while on the front end, you may accept a loss, with an insurance discount, or write off. You can gain that on the back end through referrals and non-covered services. And also, when your patients lose their insurance or change jobs eventually. The key is to have data, and as the saying goes, “the data will set you free.” Right now, if 90% of your collections come from insurance each month, then a membership or no insurance model May not be a quick-fix option. Doing so may just choke and kill your practice. However, if 50% or less of your collections come from insurance, then a membership model or phased approach could be a fantastic option for you.

ABC: Always Be ‘Cruitin’

Prevent yourself from keeping all of your eggs in one basket. If you haven’t learned this already in dentistry someone in your office at any time could be going back to school, getting married, moving, getting divorced, having a baby, or going from full-time to part-time or part-time to full-time. This means you can’t rely on any one person including yourself two stay in the same position forever. People make us who we are and how we serve our patients. But people’s situations are more and more fluid these days and continual ly prone to change.

By doing these six things, you can ensure the rest of your year goes smooth and remains steady in a future of uncertainty. Dentistry is here to stay and demand for dental services remains high. Even where many of us are suffering from shortages of qualified team members in certain areas of the country. When I first graduated from dental school, I remember there were not enough dental related jobs. We would receive applications all the time from hygienists, doctors and office staff. Sometimes the pendulum swings the other way and it will eventually swing back once again in our favor. In the meantime, show appreciation and thanks for your patients, your current high-performing team members, and continue to prosper.

Some sources say the average hygienist burns out after seven years. There are several reasons why that may be true. But I’m providing a practice that continues to grow and continues to offer the most value for your patients. Especially for those who accept large treatment plans, in-office membership, or savings plans. You can build stronger relationships with them. Also, you can have a great year without working yourself to death, and as you continue to hire and add new team members. Remember the adage to fire quick and hire slow.

As a final thought, keep in mind the famous Prayer of Serenity used by the Alcoholics Anonymous group. “Lord give me the courage to change the things which can be changed, the serenity to accept the things which can’t be changed, and the wisdom to know the difference.” (Alcohol anonymous prayer of serenity).

If you’d like more information on how to do this, simply shoot me an email, and I’d be happy to send you our one page template on setting up a profitable, (PPP) Pre-Paid Practice in your office.
Have a great month, and I’d love to hear your feedback or comments. You can reach me at twilliams@pinecrestdds.com or on the Pinecrest Practice Growth Youtube Channel.

ABOUT THE AUTHOR

Dr. Tyler Williams is the founder of both Pinecrest Dental and Pinecrest Practice Growth. He is a proud husband and father of three.

He has written numerous articles for the Utah Dental Association, Dentistry Today, and Dental Economics. He is the author of three books, The Owner’s Guide to a Productive Dental Practice: 7 Pillars Every Dentist Needs to Grow in the New Economy, Reason to Smile: 11 Keys to your best oral health ever, and The Consumer’s Guide to Dental Implants: 3 Keys Every Adult Needs to Know About a Smile Transformation which can be found at major bookstores and on Amazon.com. He is a real, “wet fingered dentist,” and has completed thousands of dental implant and restorative procedures.

Dr. Williams has been featured on ABC’s Good Things Utah, NBC News Radio, the ForbesBooks Radio podcast, The One Thing marketing podcast, Sirius XM Radio, UK Health Radio, KTALK Utah radio and in several national dental research publications, including reviewing articles for the Academy of General Dentistry’s General Dentistry journal. He has several published articles in online and print journals, including: Dental Economics, Dentistry IQ, ADA News, Dentistry Today, and The Profitable Dentist.

He has also been recognized as one of the most influential dentists in Utah by Kleer’s list of Most Influential Dentists in America. He also hosts a bi-monthly podcast called The Practice X-Factor.

He is currently the owner of Pinecrest Practice Growth, which helps practice owners create a prepaid dental practice, free of insurance dependency and poor financial health.

(To contact Dr. Williams, please email him at twilliams@yourpracticegrowth.com, text/call (801) 268-2323, or visit yourpracticegrowth.com.)

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Lightwave provides world-class business services so dental leaders and dental teams can realize their personal, professional, and financial goals

Light Wave Dental, a leading management services partner for top-tier dentists in the mid-Atlantic region, today announced its rebranding as ‘Lightwave,’ a Dental Leadership Organization (DLO) devoted to partnering with top-tier dental leaders, providing world-class tools, technology and training that drives practice growth with an unwavering commitment to quality, values and people.

The biggest transformation the organization is seeing as part of this rebrand is the overhaul of their business model from a traditional Dental Support Organization (DSO) to a DLO. This shift stems from Lightwave’s belief that dentists are the natural leaders of the dental practice and the best way to support doctor growth is by doing things the right way with a tight focus on high quality, core values, and taking care of our people. Lightwave’s approach preserves the unique identity and legacy of each private practice and then strengthens them with best practices, technology, and leadership training. This approach has taken Lightwave from 8 practices to 60 practices in five years.

“Leadership makes all the difference in dentistry,” said Justin Jory, CEO & Founder of Lightwave. “We are passionate about more than just patient care but about training and developing our dentists to become future leaders. We partner with high-quality, growth-minded dentists to help them grow even faster with less financial risk and better business support. We are building the group model for the future of the dental industry that solve dentistry’s big problems including retirement, management, reimbursements, and partnership by providing the benefits of a group, while preserving the essence of private practice.”

Lightwave sets itself apart from the rest by creating a business model that rewards individual achievement while still promoting collaboration. Experienced dentists can build on their success, while dentists just starting out are able to learn from the best and hone their craft. Lightwave provides a clear path to partnership and ownership for younger dentists and a roadmap to a rewarding retirement for experienced dentists. To make sure growth and patient care can be dentists’ primary focus, Lightwave removes the burden of tangential struggles like billing, insurance, payroll, HR, marketing, accounting along with other tedious administrative work. Unlike the known model for corporate dentistry Lightwave’s dentists call their own shots and make their own clinical decisions, while leveraging the relationships, research and buying power of the group network.

“Our business model has been shaped by dentists with patient care as our focus, knowing that loyal patients and trusted providers are the bedrock of our practices and our collective business,” said Dr. Clifton Cameron, DDS, Chief Dental Officer of Lightwave. “When small practice administrative burdens pile up, patient care can suffer, just as it does when large organizations push cost-cutting to boost short-term profits. Lightwave’s approach offers a win-win-win model of the highest patient care, business growth, and high returns on investment — fulfilling dentistry careers from launch to legacy.”

To learn more about Lightwave and their mission, please visit https://www.lightwavedental.com/ or reach out to info@lightwavedental.com.

About Lightwave

Lightwave, founded in 2016 by a team of experienced investors, operations experts, finance executives, and guided by dentists, is pioneering a fresh approach to DSO leadership. From the most promising recent dental school graduates to dentists whose successful practices reflect their skill and decades of commitment to their patients, we’re bringing together the country’s best dentists with a simple proposition: We promote flourishing careers by handling the distractions. When patient care is separated from administration, and each is expertly addressed by world-class professionals, the outcome reflects the future of dentistry. We are leading the way from launch to legacy. Lightwave currently manages 60 dental offices in 3 states with 170 full-time dentists and over 1,000 active employees.

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When you’re ready to start your own dental practice, there’s a lot to think about, not least of which is the financial side of opening an office. From leasing office space to getting the equipment you need, a lot of costs are involved. Navigating the finances of running your own business takes some planning.

Like everything in life, you may never feel fully ready to take the plunge into your own practice. But with preparation and careful planning, you can take that step with confidence. You’ll first need to decide between starting your own practice or buying an existing one. From there, it’s a matter of knowing how much funding you need and making sure you’re not overextended.

Stepping out of the comfort of working as an associate in a practice where someone else is responsible for the details is scary, but owning your own practice comes with rewards that are well worth it. Start with these tips to make sure your dreams come true with the least amount of risk and struggle along the way.

Start From Scratch or Buy an Existing Practice?

Before you work on the finance side of things, decide whether you want to build a practice from the ground up or buy an established practice. There are pros and cons to each option.

First, the obvious benefit of buying an existing practice is that everything is already in place. You won’t have to hunt down the perfect location or buy everything right down to the chairs in the waiting room.

Of course, that comes at a cost. Buying everything all at once is expensive. You’ll also need to carefully review how the practice is performing and take into account updates that might be needed to equipment.

Starting from scratch is costly as well, but it does give you the opportunity to start smaller and expand later, which may be the more affordable option. The ADA estimates the cost of starting a dental practice at about $500,000, with a higher cost if you’re buying a large, thriving practice.

Loans to Finance a Dental Practice

As long as you’re on good financial footing, you shouldn’t have much difficulty with approval for a loan. Most large financial institutions will offer financing to dentists looking to start their own practice.

Compare several loans before you sign anything, and don’t be afraid to fill out more than one application. Rates and terms will differ from bank to bank, so make sure you sit down with a few options and compare the fine print. You should also take advantage of any special offers for members of the ADA. Some banks will reduce fees and offer other benefits as part of the deal.

A traditional bank is just one of the options, though. Today’s online lenders can offer speedy and convenient loan applications and processing. Just remember that fast isn’t always best. Make sure you aren’t jumping into something just because it’s convenient.

An option that offers the potential for lower interest rates is a loan from the US Small Business Administration (SBA). SBA loans generally have more generous terms, but they can also take a long time to process and have strict requirements for eligibility.

Staying on Top of Your Finances

There’s a lot going on when you’re starting a new business, and keeping track of the ins and outs of your finances requires careful attention to the details.

You’ll first need to open a business bank account for handling all of your expenses. With direct deposits and direct payment of bills, you can avoid the mistake of missing a loan payment or forgetting to pay the water bill for your office.

Running a business involves a lot of legal and financial details, so find a good lawyer as well as an accountant to help you stay on top of things. Business taxes and employment laws can be complex, and you’ve got enough going on with building a practice.

Let a professional make sure everything is done by the book. A good accountant can also help you with the right tax strategies for dentists to save you money in the long run.

Cost-Cutting Tips When Starting Your Practice

Looking at the costs involved in starting your practice can be daunting, but there are some ways to keep the bills in check.

Start small. If you’re starting out alone, start with a smaller office space. While a large, airy waiting room and multiple treatment rooms may be part of your vision, that might have to wait.

Once things are established and going well, you can expand your space. But in the beginning, a smaller office comes with a smaller price tag and lower maintenance costs. It also requires a smaller staff to run it, reducing your payroll costs.

Consider a partner. Starting a practice with another dentist allows you to share the costs and may help the practice grow more quickly. Make sure you carefully consider who you want to partner with, however, as dissolving the partnership later can be complex and costly.

Start with an interest-only period. If it’s available, consider taking on an interest-only period at the start of your loan payments. It’s usually offered for the first six months to a year and allows you to make smaller monthly payments while you get established and deal with other costs.

During this time you won’t be paying down the principal of the loan, which does mean slightly higher payments later. But it may be the cushion you need in that first year.

Avoid high-interest credit cards and loans when possible. When buying equipment for your practice, buy as much as you can with cash. (It’s vital to have a decent amount of cash on hand when you start out.) Or, use funds from your business loan to avoid the high cost of credit card interest rates.

Use the cash you have to buy things that would result in drawn-out monthly payments on a high-interest card. Look for options to finance equipment at lower rates where possible.

Save money in other areas of your life. Reducing what you’re paying on other bills opens up more cashflow to your fledgling practice. If you’ve got a high car payment, consider switching to a cheaper set of wheels for a while, or look to refinance the loan.

At the same time, look at the options for reducing the cost of car insurance for dentists. This is also not the time to increase other costs of living, so put that new home purchase on hold.

There are a lot of ways to make owning your own practice affordable. But bear in mind that if it’s not in the cards right now, odds are good you will get there.

Although the numbers have declined a little, by age 55 a solid 92.3% of dentists do have their own practice, and opening a practice as a younger dentist can be a reality, too. Do your research and plan ahead, and it will soon be your name above the door.

Ms. Kasperowicz is an insurance and finance expert who is the managing editor of CarInsuranceCpmparison.com. She is a former Farmers Insurance and Financial Services CSR and has been helping people understand insurance and finances through education for more than 10 years.

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Depending on which economists you listen to, inflation is about to rear its ugly head like it did in the late 1970s, or it will resolve on its own once supply chains come back to normal.

Regardless of who’s right, as we reach the middle of 2021, now is the time to sit with your financial advisors and plot out your strategy for the remainder of the year, while paying attention to what you can do with your office policies to finish out the first full year since the COVID-19 outbreak.

Increasing Costs

Chances are your practice is feeling the immediate effects of inflation in terms of the costs of personal protective equipment (PPE) that you have purchased since March of 2020, when the closings of dental offices began.

Some of the supply chains for PPE have improved, but the cost of these items will likely never revert to their pre-pandemic prices. Most dentists have responded by raising fees to offset the increased cost of providing dental care.

Also, salaries of dental assistants and dental hygienists have increased throughout the country. Despite salary gains in both those job descriptions, shortages of both can be found in many areas nationwide.

The rising cost of all insurances related to running a dental office will start rising as well. Health and malpractice coverage have seen significant change, along with all business-related insurances.

Fees and Loans

If you haven’t taken a good look at your dental procedure fee schedule, now is the time to consult with your financial advisors about what type of fee increases are appropriate for your zip code, since most insurance companies base their payment schedules on the area that you practice in.

If you belong to any PPO or insurance networks, there is usually a time period that limits the frequency of dental fee increases (two years is common), so that calculation should be based on what you predict will be the overall inflation trend two years forward.

A rise in inflation could affect the commercial loan default rate, forcing many banks to raise rates. A review of your current business loans would then be in order, including “locking in” with a fixed rate loan, if you don’t have one already.

Lending rates are controlled by the Federal Reserve, which at this time has shown constraint in its policy, but it could raise rates in the very near future.

Finally, most young dentists have student loan debt upon graduation. An uptick in inflation with a corresponding rise in rates would have a significant impact on their current loans, if they have chosen to refinance the loans at a variable rate.

What’s Next?

The US economy is showing signs of recovery, as more people get vaccinated and are free to travel and enter into a different work environment than the one they left in March of 2020.

How that will impact the overall inflation rate is yet to be known. But having a plan for your dental office is a smart way to be ready for what effects it will have on your financial well-being.

Dr. Huot is the founder of Beachside Dental Consultants. He has lectured on topics such as leadership issues, transitioning to an insurance-free practice, common sense office design, proper insurance coding, financial planning, and buying and selling dental practices. His articles have been featured in Dentistry Today, ADA News, and other dental journals. He retired from the US Air Force Reserve Dental Corps after 30 years of military duty. He also served on active duty from 1982 to 1985. He was a private practice owner from 1985 to 2008 and still practices clinical dentistry. Also, he has been a member of multiple dental organizations, serving in many leadership positions, including vice president of the ADA. Dr. Huot is a Fellow in the American College of Dentists, the International College of Dentists, the Academy of General Dentistry, and the Pierre Fauchard Academy as well. He can be reached at drhuot@militarydentist.com.

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Henry Schein has acquired a 70% ownership position in virtual dental billing outsourcing service developer eAssist Dental Solutions.

Headquartered in American Fork, Utah, eAssist was founded in 2011 by James Anderson, DMD, and Sandy Odle to assist with billing challenges in Anderson’s dental practices. Anderson will continue to manage eAssist as CEO along with the current company management team.

“Henry Schein has a long-standing commitment to supporting dental practice growth, efficiency, and profitability through our comprehensive offering of solutions,” said Stanley M. Bergman, chairman of the board and CEO of Henry Schein.

“We are delighted to add eAssist to our leading portfolio of value-added services, which will help our customers improve their critical insurance and billing functions so dental teams can focus on delivering quality patient care,” Bergman said.

The eAssist platform uses a combination of technology and human expertise to provide outsourced insurance billing services to dental practices, freeing up resources so they can focus on patient care and clinical outcomes while simplifying operations and reducing stress related to cashflow, the company said.

“By addressing the important topic of collections, we not only expand our value-added services, but also strengthen our relationship as a trusted advisor to our customers,” said Jonathan Koch, senior vice president and CEO of Henry Schein Global Dental Group.

“eAssist will help practices enhance cashflow from timely collections and more accurate claims submissions and processing,” Koch said.

Currently, eAssist is designed to support dental practices of all sizes through technology supported by a network of dental billing professionals, the company said. It also secures detailed patient eligibility information, bills certain dental procedures through medical insurance, and provides practice bookkeeping, the eAssist said.

“Henry Schein represents an exceptional and complementary cultural fit as a partner for eAssist. Through new and powerful sales, marketing, and technology resources, we expect to bring the myriad of benefits from eAssist’s technology-powered service offerings to many more dental practices,” said Anderson.

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