The Navigating Dental Insurance Podcast

As CEO of Dental Intelligence, Weston oversees the strategic direction of the company and its products. He manages Dental Intelligence’s revenue growth and future expansion plans. He also dedicates a large part of his time to be intimately involved with our clients, the dentists, to fully understand their needs, wants and experience with Dental Intelligence’s products and solutions. Weston has spent the previous 10 years as the principal partner in Lunsford Peck Certified Public Accountants providing services for medical and dental professionals with nearly 2,000 clients. Weston’s vision and desire to create value has emanated passion throughout the company. During this episode Weston explains data analytics in dental but also talks about important numbers to follow when you drop insurance plans. While our podcast is not intended to promote insurance boycotting we recognize that many doctors are better off being out of network. This episode will provide some feedback about how a certain client of Weston was successfully able to drop insurance plans and achieve the goal of working less for more. To contact Dental Intel visit www.dentalintel.com or call them at 855-776-2673 or email Clay Shubin at Cshubin@dentalintel.com.

Lorraine Guth started out as a dental assistant at the age of 17. Although her job consisted of the “dirty work” like cleaning out suction, plaster traps and dip tanks, she quickly fell in love with dentistry. After shifting into administrative roles, she spent time helping people make potentially life-altering decisions about their care and realized something was missing. She observed a disconnect between practitioners and patients that was causing patients with serious issues to forego treatments they desperately needed due to financial concerns. Lorraine knew there had to be a better way to handle those conversations. In {year}, Lorraine had the opportunity to work with Dr. Carl Jenkins. After just two days of working with Lorraine, Dr. Jenkins was so overwhelmed by the results she was able to produce in his practice that he referred her to 100 dentists in one day! And with that show of confidence and validation of her methods, Guth Dental Consulting was born. Though she had already considered shifting into speaking and consulting “someday”, his enthusiastic endorsement gave her the “push” she needed to share her expertise at a whole new level. Her company is known for: · Achieve results-driven new client calls · Improve the office experience for your clients · Improve communication among you and your team using straightforward feedback · Achieve treatment compliance · Monitor your progress in an ongoing way · Turn potential clients into YOUR clients for life During this Episode we discuss how first impressions impact patients decisions to accept treatment plans. Lorraine also gives her take on the insurance driven mentality and how you can avoid or eliminate unnecessary insurance discussions. To contact Lorraine directly you can reach her at lorraine@guthdentalconsulting.com or her office at 636-273-9500.

The Revolution is here folks! Imagine a future that reduces the need for you to submit claims. Imagine a future where you don't have to be on hold for hours each day to fight claims. For years many though that such a future doesn't exist. Many even argue that the DSO model is the way of the future as solo practitioners simply cannot keep up with the risking cost to deliver dentistry combined with the stagnant reimbursement rates set by insurance carriers. Then there are those who warn that quality care will be redefined to a lower standard as the quality of dental services will mirror what insurers and other 3rd party payors are willing to compensate dentist. While such a future may still be possible for some, we believe that those who take action today will find a way to protect the financial integrity of care in a great way. We believe the solo practitioner model will continue to thrive! We believe dentistry has a bright future! We believe that the future of dentistry does not need to be as dependent on dental insurance as it has become over the last 10 years. We believe there is a better way than the flawed claims processing system we are currently dealing with. Simply stated, we believe we found the solution to fully protect the financial integrity of quality care and it does not involve insurance. We invite you to listen to this webinar and we also invite you to get involved. Send your questions to q@procaredent.com or submit a contact request at www.PcEnrollment.com. Thank you for listening! Ben Tuinei and Jordon Comstock

First of all, Quality Care matters! We believe dental insurance was an inspired effort to encourage the public to seek dental care and receive routine preventative care. Unfortunately, dental insurance has become increasingly difficult to manage within the dental practice. Too often do we submit clean claims that get denied over and over again with no legitimate cause or reason. Many dentist feel like insurance carriers are inserting themselves in the diagnostic process and redefine treatment for patients for reasons that may only benefit an insurance carrier. A good example is when insurance carriers deny scaling and root planing because they there is not enough evidence of gum disease or other indications for perio. Even when you submit images, x-rays, perio charting, narratives, and any other items to support your diagnosis claims continue to get denied. Sometimes insurance carriers will report that they do not see what you are seeing and yet they haven't examined the patient themselves in person. Of course they are not going to see what you see! But if you turn around and perform a prophy on that same patient you get sued for malpractice as that, in essence, is what insurance carriers are insinuating you should be providing the patient anyway. A prophy instead of SRP or perio maintenance. What a joke! It's time for a change as this type of business practice needs to exit healthcare in general. For years we've explored every opportunity to replace dental insurance for the sake of protecting the financial integrity of quality care. This year, we've found it! The purpose of this episode is to spread the awareness about an insurance replacement program that is designed to reward Quality Dentistry in a way Quality Dentistry needs to be rewarded. We are all fed up with the abuse from dental insurance and quite frankly, we do not believe dental insurance cares about quality care measures. They certainly do not care about what it cost to deliver quality care. It is our mission to engage and promote services that will help dentist protect the financial integrity of quality care and we found a program that will allow dentist across the country to do so. Please indulge in this podcast to learn the following: *How we can reduce and replace dental insurance in your practice *How we can influence an increase in revenue by 300 to 600 percent *How overhead can be significantly reduced by eliminating or reducing the need to handle insurance *How our insurance replacement program will allow you to better protect quality dentistry Thank you for listening and cheers to brighter days ahead of us! To contact ProCare please email Q@procaredent.com.

3rd party payor negotiating, more specifically Dental Insurance Fee Negotiations, is still a foreign concept to dentists nationwide, and worldwide. Mr. Tuinei has spent the last 10 years improving and perfecting this relatively new effort in the Dental Business world and will be sharing a few secrets about how to effectively negotiate better fees with dental insurance companies in his lecture “3rd Party Payor Fee Negotiations”. Mr. Tuinei began his dental career in 2007 while working for a small dental corporation in Phoenix Arizona managing all insurance related functions. He was hired as the Executive Director of 3rd Party Payor Operations. During his first few months, he created systems and operating protocols and restructured a 12 person billing department that improved collections from a low 65% to 98%. At the same time, Mr. Tuinei learned how to effectively negotiate with 3rd party payors that gave a boost in annual insurance related revenue of nearly 1 million dollars for a team of only 10 general dentists. Mr. Tuinei’s early experience in negotiating with 3rd party payors caught the attention of other large group practices and hundreds of solo dental practitioners in Arizona, Utah, Nevada, Idaho and Colorado. Consequently, he unintentionally discovered an under-served section of the dental industry: 3rd party payor negotiating (aka insurance fee negotiating). Mr. Tuinei opened Optimum Dental Solutions in September 2009 to serve the needs of dentists who were actively seeking assistance in improving their insurance reimbursements. In 2015 Optimum Dental Solutions was rebranded to Veritas Dental Resources. Veritas stands for truth and is a core value you will not find while dealing with dental insurance directly. During its first 2 years in operation Optimum Dental Solutions contracted with over 400 dental practices influencing a combined $10 million in additional annual revenue increases by implementing Mr. Tuinei’s proprietary PPO optimization strategies and effective 3rd party payor negotiating. To-date, Mr. Tuinei has worked with over 5500 dentists influencing over a billion dollars of newly negotiated revenue for his clients. Mr. Tuinei currently serves as the President of Veritas Dental Solutions. Mr. Tuinei is going on his 19th year as a professional public speaker. He currently serves as the Director of Insurance for ePractice Manager, President of Veritas Dental Resources and sits on the Board of Directors for The Dental Business School, Business Ownership Mentoring of America, and The Dental Leadership Academy. He is also the co-host and co-founder of the Navigating Dental Insurance Podcast and the Say No To PPOs listening series. Mr. Tuinei has been recognized by several state Dental Associations and various dental study clubs as “The Authority” on PPO strategies and PPO fee Negotiating. He has been featured on the DentalPrenuer (www.trudentalsuccess.com), Thriving Dentist Podcast (www.takacslearningcenter.com, The Passionate Dentist Podcast (thepassionatedentist.com), the Dentist Money Show (www.dentistadvisors.com), The Summit Group Practice Summit (www.masterycompany.com) and several study club articles throughout the nation. Please see his most recent article in Dental Economics, January 2016 magazine and stay tuned for his next annual article in February of 2017.

Christine Taxin is the founder and president of Links2Success, a practice management consulting company to the dental and medical fields. Prior to starting her own consulting company Ms. Taxin served as an administrator of a critical care department at Mt. Sinai Hospital in New York City and managed an extensive multi-specialty dental practice in New York. With over 25 years’ experience as a practice management professional she now provides private practice consulting services, delivers continuing education seminars for dental and medical professionals and serves as an adjunct professor at the New York University (NYU) Dental School and Resident Programs for Maimonides Hospital. During this episode Christine explains how day to day dental procedures and services can be covered under medical insurance. In her experience if practices learn how to cross code they would capture hundreds of thousands of dollars on procedures that are normally written off. To contact Christine please visit her website www.links2success.biz.

Tessina Barney is a high powered dental office manager in Salem Utah. She co-operates the Utah Chapter of the Academy of Dental Office Managers. Tessina explains her experience in policing unethical and illegal insurance practices by a particularly large national insurance carrier. In this day and age when insurance carriers tend to make up their own rules many dental practices feel hopeless and helpless. When insurance tells you to write-off hard earned money many feel lost in getting insurance carriers to comply with the same rules as you do. If you can't up-code why do insurance carriers get away with down-coding? This interview will open your eyes to new opportunities in policing unethical and illegal practices by insurance carriers. It's time more offices take action in intelligently fighting insurance carriers in battles you can win! If you wish to speak with Tessina or chat with her about potential opportunities to help police unethical practices please send an email to help@veritasdentalresources.com.

Mike Pedersen is the founder of The Dental Boost a leading-edge dental SEO and web design agency helping dentists attract more visitors and converting them into new patients. We met Mike through mutual clients he's helped. One of our clients raved about Mike helping to improve this doctor's online ranking from page 44 to page 1 in a matter of weeks. We've never seen that before and that's why we've invited Mike to participate in this interview. Good marketing is a key formula in reducing insurance dependency and Mike has some tricks you may enjoy. You can find out more at https://www.thedentalboost.com

Alan Hollander began consulting healthcare professionals as an individual in 1985. Nine years later, with a team of over 50 and a roster of thousands of clients, the company had become one of the largest healthcare consulting entities in the US. Alan sold the company in 1995. Alan then developed Practice Optimizer™ an online suite of services with over 2000 pages of practice management content and material. These were licensed to Enserve of Houston, TX and became a valuable part of their online array of resources for over 20,000 doctors in the US. The international medical waste company, Stericycle, then acquired Enserve in 2010. Alan has taught and lectured on every facet of practice management, from executive skills and personnel management to the effective selling of treatment and development of new patient flow. He has done presentations in all of the 50 states and every major city in Canada. Alan is a graduate of Hofstra University and New York University. During this episode Alan discusses eliminating the insurance driven mentality during case presentation. It is no secret that insurance has crept in and taken over treatment conversations and that can often not serve the best interest of patients. A good example is an onlay. When patients need treatment that is something between a filling and a crown and onlay may be the best form of treatment. But because dental insurance does not cover onlays patients end up receiving alternative treatment dictated by their insurance that may be more aggressive than conservative options. Each doctor has their own opinion on how to handle the clinical aspect of these cases but what rings true among most is that insurance can interfering with the appropriate care the patients may need. This episode is to provide some insight on how to overcome the insurance driven mentality.

In this podcast interview we discuss the issues with dental insurance and how to improve your practice by creating an in-house membership program.