Episode 114: Step #1 to Successfully Resign from PPO Plans

N: This is the Less Insurance Dependence podcast show with my good friend Garry Tacks and myself, Naren Arulrajah.  

G: We appreciate your listenership your time and most of all we appreciate your intention to reduce insurance dependency in your practice. Our goal is to provide information that will help you successfully reduce insurance dependence and convert your practice into a thriving and profitable dental practice that provides you with personal professional and financial satisfaction.

Welcome to another episode of the less insurance dependence podcast I am Garry Takacs your pod cast cohost. Hey we have something very cool for you something that we like to think is something extra. For those of you that are also our listeners for the thriving dentist shows podcast you know that we added the regular segment of thriving dentist clinical tips. Where we have partnered with some of the most amazing clinicians in dentistry here in the united states and we are sharing a quick tip from these experts, clinical tip. And we decided that we wanted to put one of those tips at the beginning of this episode. And the reason we decided to put it here is that this tip has literally gone viral and we want to make sure you benefitted from it as well. And the tip is from Doctor Baldwin Marchack – many of you will feel familiar with that Dr. Baldwin Marchack – he is a practicing dentist in Pasadena California, and he shares a wonderful tip about how to manage patient expectations, when you are treating teeth numbers 8 and 9. So obviously teeth in the aesthetic zone. I can create a challenge managing patient expectations sometimes. You have all experienced that. Baldwin shares a tip that you will forever remember and it will allow you to successfully manage patient’s expectation when you are treating teeth number 8 and 9. Here is that tip – following the tip we are going to get into this episode, which is step number one to successfully resign from PPO plans. Meanwhile here is that clinical tip from Dr. Baldwin Marchack.

Dr. Baldwin Marchack – “Hey Garry thanks for having me share a clinical tip with you and your listeners. Let me first say that I too am a listener of your thriving dentist podcast and I too have enjoyed the many tips you have shared from the experts and others, so it is my pleasure and honor to give back and share one now with you and your listeners. Hey everyone I am Baldwin Mashack and I practice in Pasadena California. There are many instances where we have to provide crowns or veneers for the two maxillary central incisors – teeth number 8 and 9. Or if you are in Europe or Asia teeth number one one and two one. Now if this has not already happened to you, mark my words the day will come when your patient will return the day after you have cemented the crowns or the veneers on 8 and 9 to complain that they are too long or two short or too fat or they feel Bucky or doc they just feel like horses teeth! Now you know that you show that to them before cementation and they even approved them – they give you the okay but they went home, and the husband or wife or neighbor said something and now they are back.  Your heart just sinks. So how do you avoid this from happening? well my solution – it is very simple and based on the principle that prevention is better than cure, whenever you are doing the two centrals, 8 and 9m and you need to preserve or duplicate the midline, the insides or edge the facial information, then what you do is you prepare one first say number 8 without touching the other. Or without touching number 9. Take that preparation of number 8 to completion and make an impression of that number 8 first. Once you have made this impression you cannot touch the prep gain. Now you go to the other central and prepare it. Once that prep is finalized you can make your final impression of the two preparations of the two teeth 8 and 9. Now when the lab is designing the definitive restorations, they can use the first model to guide them in determining the midline, in determining the spherical inspires length, the position of the incisor ledge and the facial contour. And thy can do that because all they have to do is to match it up to the untouched number 9. Now they can take that pattern of number 8, take it to the second model and start designing number 9. On the day of delivery the very first thing you do is bring out both models and explain to the patient what was done. You can say to the patients something like, Mrs. Jones you remember on our last appointment I told you that we are making two impressions and that the first one was to carefully preserve the midline and the original length of your teeth well look! See how this crown fits the first model – it is exactly the same length as this untouched tooth next to it, see see how it is exactly the same – we managed to preserve the midline the incisor lengths and the lengths are exactly the same, and the facial contours are exactly the same and be sure to show the patient all of these hinges – show the patients the midline, the incisors length, the facial contour, and then you show them both 8 and 9 on the second model and you affirm how beautiful they look. Now you do your pre-cementation prior and get their approval and go ahead and cement. There after they can never complain again about the length they have to forever hold their peace. Thank you very much Garry and it was my pleasure to share this tip with you.

N: Hello everyone today’s topic is step number one to successfully resign from PPO plans is one of the topics that many of you have written in and asked about, so Garry lets jump in – this is Naren you r cohost of the les insurance dependence podcast show.

G: Yeah Naren we decided that we are going to get very granular in this episode and our inspiration for this, Naren you know we have common clients my coaching clients and your EKWA digital marketing clients that are common and we are seeing some amazing results with our coaching clients as they are successfully resigning from PPO plans, and Naren you know that one of the things we have in place to have a reediness check-list. A readiness checklist and what the readiness checklist does it allows our clients to literally check of everything they need to have done before they resign from their first plan and once they can check those things off, they know they are ready for it. And they are ready to be a successfully as possible because they have done their homework and it is kind of like Naren you know and your listeners will know, I am a long distance runner so I run marathons, half marathons, I do triathlons. Can you imagine someone Naren that decides to run a marathon but does not prepare for it? Can you imagine that?

N: Yes

G: It does not turn out very well ha- ha

N: I know it is like-

G: twenty six point two miles 

N: Yes

G: And there are people that literally just, they have good intentions about preparing for it and then life gets in the way and then here comes the marathon and they think I am going to do it anyway because I said I would do it and I signed up for it – and it usually does not end up very well, you know versus actually preparing for it. Well the same thing can actually happen when resigning from PPO plans what I have found Naren is that some dentists get impatient. And by the way I get your impatience – I feel it ha-ha. I get it and I understand it, and they just say –you know Gary I know we are not quite ready yet but you know Garry I am so done with delta dental and I am so done with these PPO plans I am just going to resign and see how it goes. And my caution to that is – you know we can do it doc and I am going to support you if that is your decision but a possible by product of that is that you are going to lose more patients that you would if you were fully prepared – are you willing to accept that consequence. Now when I share that with them, what do you think most dentists say? You know I support you doc, it is you practice – you get to decide, and if you are don with it I get it and you can pull the plug right now but you just have to understand that a possible consequence is that you lose more patients than you would if you were fully prepared. When I present that ultimatum to doctors what do you think most of them say? What do you think?

N: Ummm what do them, what do most of them say – I think they are not prepared – 

G: They say gosh thanks for the save Garry ha-ha thanks for helping me avoid pain and suffering

N: Man I just-

G: I will temper my impatience and yes let’s get ready

N: I was just thinking of- you know I m a movie buff and so I watch a lot of movies and a lot of movies there are two types of parents – the methodical thoughtful parents, they do everything properly and then there are parents, accidental parents – and sometimes it is like a horror r movie you know what the kids go through ha-ha

G: Exactly one disaster after another

N: Exactly! And you know it is pretty, I just see you saying avoid the horror movie and have the good movie with the good ending

G: Yeah hey so let’s get into step number one and so I am- we also wanted to time the publishing of this episode because I know many of you have been regular listeners of the Less insurance dependence podcast and we are hearing a lot of momentum among our listening audience about – getting ready . I think I am ready I am getting ready, getting ready getting ready I am getting ready, and so I wanted to time it now because I think a good time if you can get all the readiness done –  good time to start resigning from plan is going to be in qu. 1 and qu. 2 – first two quarter of 2021 and I will explain more about that in future episodes – to successfully resign from PPO plans, and number one is that you need to gather data in your practice, one three specific data points because the data will allow you to make good decisions when it comes to sequencing the order in which you resign form PPO plans, you do not resign casually and we do not just resign in a haphazard manner. Typically we will sign from one plan at a time, you know for our practice that had 34 PPo plans – it took us two years, but really two years is not that great a period of time when it came to resigning from 34 plans you know think about that Naren – that as about an average of a plan and a half a month you know it took us 24 months to resign form 34 plans that was about 3 plans every two months if you do the math on that – pretty quick, 

N: Yeah

G: Most of our listeners will have less than 34 plans so you can figure out how long it might take you with that pace – it might even take you a year to fully resign from on how many plans you have, but here is step number one and again it is all about learning the data – there are 3 data points. Data point number one – I want you to find out the average insurance write off – which is the difference between your UCR fee and your contracted fees – I want you to find that out. Now – for those of you that have been listening to the podcast episode – to the less insurance depended podcast, you know that only 10 percent of the dentists in the united states can calculate that number easily – only 10 parent. The other nine percent have a challenge learning what their actual write off is because you have entire your contracted fees into your practice management software programme – so you have two ways to enter your fees and you can enter your UCR fee and then adjust off when you get the EOB – the explanation of benefit – you are just off your discount your insurance write off if you do it that way, then you can determine by pulling a report off your practice management software exactly what percent you are writing off, but only ten percent of the dentist in the world do it that way. The other 90 percent enter their contracted fees and that is kind of encouraged by the practice management software. And because you enter your contracted fees you never see the amount you are writing off – by the way the reason the software encourages you to do that, and the reason 90 percent of the dentists do it is because it is easier to track your collection percentage because then you have got your contracted fees against your collections it is one to one it makes it very easy to track it. I do not like doing it that way, because of the fact that you are in the dark about what the actual write off is, but I am not going to suggest you change that because there was a good reason for you to do it that way however what I am going to suggest is that you go to our – we created, Naren and I created and insurance write off calculator, that is very – it is very easy for you to figure out a ball park figure of what percent you are writing off, what percent you are writing off – it is accurate to plus or minus ten percent. Naren would you put in the show notes-

N: Yes plus or minus two percent – 

G: I am sorry plus or minus two percent- plus or minus two percent. Would you put in the show notes on less insurance dependence dot Com a link to that insurance write off calculator and I would encourage any of our listeners to go to that and just go through the exercise – very simple and it is a ball park that will be accurate to plus or minus two percent and you will know that you are writing off – I am going to suggest that what you are going to find out is somewhere between forty two and forty four percent but you are going to find out – so that is step number one the first thing on the list is what percent you are writing off – it is data that you need to know

N: And also I think this calculator will tell you how many dollars you are writing off – in other words is it two hundred thousand is it three hundred thousand dollars a year – you know what ever the dollar number is. 

G: While the calculator is doing its work you might want to sit down.

N: Ha-ha

G: You might want to find a seat because you are going to actually take a look at that number you are going to find out the percent and the dollars and depending on the size of your practice that number is going got be quite sobering, and here is what I want you to think about while you sit – let’s say hypothetically that number Naren is let me pick a number four hundred thousand dollar and I am just picking a number – right. Let’s say this cover you are writing off is four hundred thousand dollars a year. Form this moment forward doctor I want you to think of that number as a marketing expense. You are spending four hundred thousand dollars a year on marketing and you might be confused and you might be – thinking no no I am not. Yes you are! Because you are paying the insurance company to provide you patients – by the way that number – four hundred? Is thirty three thousand and three hundred and thirty three dollars a month. Thirty three thousand three hundred and thirty three dollars a month that you are spending on marketing. And you know you can get a much better resolve – let me just quantify for you how would you like to reduce that you know the thirty three thousand again, use my example thirty three thousand three hundred and thirty three dollars a month. Would you like to reduce that amount to a fraction of that – say twelve hundred dollars a month? Would you rather spend thirty three or twelve hundred? Mhmm I think I know the answer to that one

N: Thirty three thousand. thirty three thousand or twelve hundred?

G: Thirty three thousand or twelve hundred. Which one?

N: Twelve hundred!

G: I would spend twelve hundred, how do you do that? Well do what I do! Enlist the services of EKWA. Your company Naren that does digital marketing for dentists – you have a flat fee comprehensive all included marketing service that is twelve hundred dollars a month that by the way for us, provides us with over 80 new patients a month so doc what would you rather do? Spend thirty three thousand or twelve hundred?

Naren if you would, put a link in the show notes for your marketing strategy meeting and what I am going to do is invite our listeners to go to that link and schedule a strategy meeting with Lila Stone, Lila is the marketing director for EKWA – and she will prepare for that meeting and she will spend about 6 hours prep time, learning about your website, learning about your community, researching your Google analytic scores and she will share that information with you and she will share with you, how you can be very successful transitioning from an insurance dependent marketing plan to a comprehensive digital marketing plan and intern reduce your marketing expenses to twelve hundred dollars a month. So anyway that is step number one. Find out what you know data pint number one is find out what the amount is that you are writing off, and a percentage of that – what that is. Data point number 2, I want you to find out the number of active patients in your practice, on each plan. So make a spread sheet with each plan and it might be Edna, travelers, Blue cross, Blue shield and there might be multiple blue cross, blue shield plans in there. But find out the number of patients and active patients – I define an active patient as any patient who has had an appointment in your practice in the last 18 months. So you are able to do that in your practice management software – whether it be Dentrix, eagle soft, open dental, soft dent, go in and go into the report – your office manager might need to help you with that, but go into your practice management software and determine the number of patients. on, active patients, that you have on every plan, and that is the other data point I want you to have, because that is going to be an important information to decide the order and sequence in which we resign from your plans., and then the third data point that I want you to get is find out how much advanced notice you require to give the PPO plan under your preferred provider contract. Normally it is 30 days, meaning that you have to give notice – you cannot just quit today – you have to give a notice. The normal notice the most common notice I see is 30 days. It is kind of like if you are you know renting an apartment you have to give a notice before you move out – well same thing here. Find out what it is, most common is the 30 days – could be 60 days, could be 90 days – I have seen as long as a hundred and eighty days – why is that important? Because we are going to need that information when we sequence the order in which you go out of your plans that you start resigning from the plans – so that is the first step. The first step is homework, it is not particularly exciting, and it is kind of you know methodical to do your homework but I want you to do your homework because now that information is going to be very useful when we go on to the other steps and we start resigning from these PPO plans – so do that homework because now you are armed with the information and doctor you could make good decisions when you are armed with information – you might discover maybe you think  you have got a hundred people on a particular plan and once you do this homework you discover wait a minute it is actually two hundred and fifty and might be the other way around. Maybe you think that you have a massive number of patents on this plan, maybe you think you have two hundred and fifty and turns out you have fifty of them. Again good information – and now you are going to make information – make decisions based on information instead of a haphazard random way. So that is step number one. It is about gathering the data from three specific data points, so that you can now make good decisions based on the data, and in future episodes, we will march through the other readiness factors and round out all of these steps. But for now I want to provide this one. And I think it is going to be exciting for you in terms of getting this information so that now you can make informed decision rather than just random hap hazard – perhaps even bad decisions because you do not have the right data. 

N: Gary I know I am putting you on the spot so if you do not want this we can edit this out, I know you are on a mission to help as many people reduce insurance dependence, what do you think if we ask the people who complete the homework to send that in and maybe we can either share same tips or maybe we can make another episode from what we, what we would have – 

G: I would love to see it and of course it would be confidential and won’t be shared with others but I would invite that. Naren let’s put in the link in the show notes, so that when our listeners complete that data they can forward it to me – it will be an email type link that will forward to myself. I will review that data and it would be very useful. I would appreciate that Naren and again please note that this will be held confidential it will never be shared – there won’t be any names attached to it –but we will reach out to you once we get that information, and share some insights into that information. You know how I look at it is – is as a coach because we look at those for all our clients – how I look at it is as a coach and how this information will allow us to properly prepare to go out of network, so yes I like the thought Naren. Put that as a link in the show notes, it will be – there will be a link for you to email that data to me and doctors I will review it myself and I will provide a reply back to you in terms of what that information means to me and how I look at it from my seat having helped many many many dentists successfully resigned from PPO plans. Naren as we come to the finish line today hey was not that tip from Baldwin Marchack amazing? I know all of our listeners you know have dealt with frustration in patient expectations and the aesthetics of it – and in one fell swoop he solves it right there. I thought that was kind of fun I am glad we bought it to our listeners. Hey as we come to the finish line here – I just want to conclude by saying thank you – we appreciate each and every one of you. One of the things they have been happening recently is that we have been noticing a more reviews, more reviews on iTunes. If you have not done it yet, jump on iTunes and write us a review. It helps more dentist’s friend us. There is a building groundswell of dentists who are really preparing to successfully go out of network, there- it it is a movement, it is a grass root’s move net and all of our listeners are part of it – and that group is growing and man I just want to take a minute and applaud you for your intention to successfully reduce insurance dependence, and I want to thank you for being a part of our community. Thank you so much.

N: This is the Less Insurance Dependence podcast show with my good friend Garry Tacks and myself, Naren Arulrajah.  

G: We appreciate your listenership your time and most of all we appreciate your intention to reduce insurance dependency in your practice. Our goal is to provide information that will help you successfully reduce insurance dependence and convert your practice into a thriving and profitable dental practice that provides you with personal professional and financial satisfaction.

Welcome to another episode of the less insurance dependence podcast I am Garry Takacs your pod cast cohost. Hey we have something very cool for you something that we like to think is something extra. For those of you that are also our listeners for the thriving dentist shows podcast you know that we added the regular segment of thriving dentist clinical tips. Where we have partnered with some of the most amazing clinicians in dentistry here in the united states and we are sharing a quick tip from these experts, clinical tip. And we decided that we wanted to put one of those tips at the beginning of this episode. And the reason we decided to put it here is that this tip has literally gone viral and we want to make sure you benefitted from it as well. And the tip is from Doctor Baldwin Marchack – many of you will feel familiar with that Dr. Baldwin Marchack – he is a practicing dentist in Pasadena California, and he shares a wonderful tip about how to manage patient expectations, when you are treating teeth numbers 8 and 9. So obviously teeth in the aesthetic zone. I can create a challenge managing patient expectations sometimes. You have all experienced that. Baldwin shares a tip that you will forever remember and it will allow you to successfully manage patient’s expectation when you are treating teeth number 8 and 9. Here is that tip – following the tip we are going to get into this episode, which is step number one to successfully resign from PPO plans. Meanwhile here is that clinical tip from Dr. Baldwin Marchack.

Dr. Baldwin Marchack – “Hey Garry thanks for having me share a clinical tip with you and your listeners. Let me first say that I too am a listener of your thriving dentist podcast and I too have enjoyed the many tips you have shared from the experts and others, so it is my pleasure and honor to give back and share one now with you and your listeners. Hey everyone I am Baldwin Mashack and I practice in Pasadena California. There are many instances where we have to provide crowns or veneers for the two maxillary central incisors – teeth number 8 and 9. Or if you are in Europe or Asia teeth number one one and two one. Now if this has not already happened to you, mark my words the day will come when your patient will return the day after you have cemented the crowns or the veneers on 8 and 9 to complain that they are too long or two short or too fat or they feel Bucky or doc they just feel like horses teeth! Now you know that you show that to them before cementation and they even approved them – they give you the okay but they went home, and the husband or wife or neighbor said something and now they are back.  Your heart just sinks. So how do you avoid this from happening? well my solution – it is very simple and based on the principle that prevention is better than cure, whenever you are doing the two centrals, 8 and 9m and you need to preserve or duplicate the midline, the insides or edge the facial information, then what you do is you prepare one first say number 8 without touching the other. Or without touching number 9. Take that preparation of number 8 to completion and make an impression of that number 8 first. Once you have made this impression you cannot touch the prep gain. Now you go to the other central and prepare it. Once that prep is finalized you can make your final impression of the two preparations of the two teeth 8 and 9. Now when the lab is designing the definitive restorations, they can use the first model to guide them in determining the midline, in determining the spherical inspires length, the position of the incisor ledge and the facial contour. And thy can do that because all they have to do is to match it up to the untouched number 9. Now they can take that pattern of number 8, take it to the second model and start designing number 9. On the day of delivery the very first thing you do is bring out both models and explain to the patient what was done. You can say to the patients something like, Mrs. Jones you remember on our last appointment I told you that we are making two impressions and that the first one was to carefully preserve the midline and the original length of your teeth well look! See how this crown fits the first model – it is exactly the same length as this untouched tooth next to it, see see how it is exactly the same – we managed to preserve the midline the incisor lengths and the lengths are exactly the same, and the facial contours are exactly the same and be sure to show the patient all of these hinges – show the patients the midline, the incisors length, the facial contour, and then you show them both 8 and 9 on the second model and you affirm how beautiful they look. Now you do your pre-cementation prior and get their approval and go ahead and cement. There after they can never complain again about the length they have to forever hold their peace. Thank you very much Garry and it was my pleasure to share this tip with you.

N: Hello everyone today’s topic is step number one to successfully resign from PPO plans is one of the topics that many of you have written in and asked about, so Garry lets jump in – this is Naren you r cohost of the les insurance dependence podcast show.

G: Yeah Naren we decided that we are going to get very granular in this episode and our inspiration for this, Naren you know we have common clients my coaching clients and your EKWA digital marketing clients that are common and we are seeing some amazing results with our coaching clients as they are successfully resigning from PPO plans, and Naren you know that one of the things we have in place to have a reediness check-list. A readiness checklist and what the readiness checklist does it allows our clients to literally check of everything they need to have done before they resign from their first plan and once they can check those things off, they know they are ready for it. And they are ready to be a successfully as possible because they have done their homework and it is kind of like Naren you know and your listeners will know, I am a long distance runner so I run marathons, half marathons, I do triathlons. Can you imagine someone Naren that decides to run a marathon but does not prepare for it? Can you imagine that?

N: Yes

G: It does not turn out very well ha- ha

N: I know it is like-

G: twenty six point two miles 

N: Yes

G: And there are people that literally just, they have good intentions about preparing for it and then life gets in the way and then here comes the marathon and they think I am going to do it anyway because I said I would do it and I signed up for it – and it usually does not end up very well, you know versus actually preparing for it. Well the same thing can actually happen when resigning from PPO plans what I have found Naren is that some dentists get impatient. And by the way I get your impatience – I feel it ha-ha. I get it and I understand it, and they just say –you know Gary I know we are not quite ready yet but you know Garry I am so done with delta dental and I am so done with these PPO plans I am just going to resign and see how it goes. And my caution to that is – you know we can do it doc and I am going to support you if that is your decision but a possible by product of that is that you are going to lose more patients that you would if you were fully prepared – are you willing to accept that consequence. Now when I share that with them, what do you think most dentists say? You know I support you doc, it is you practice – you get to decide, and if you are don with it I get it and you can pull the plug right now but you just have to understand that a possible consequence is that you lose more patients than you would if you were fully prepared. When I present that ultimatum to doctors what do you think most of them say? What do you think?

N: Ummm what do them, what do most of them say – I think they are not prepared – 

G: They say gosh thanks for the save Garry ha-ha thanks for helping me avoid pain and suffering

N: Man I just-

G: I will temper my impatience and yes let’s get ready

N: I was just thinking of- you know I m a movie buff and so I watch a lot of movies and a lot of movies there are two types of parents – the methodical thoughtful parents, they do everything properly and then there are parents, accidental parents – and sometimes it is like a horror r movie you know what the kids go through ha-ha

G: Exactly one disaster after another

N: Exactly! And you know it is pretty, I just see you saying avoid the horror movie and have the good movie with the good ending

G: Yeah hey so let’s get into step number one and so I am- we also wanted to time the publishing of this episode because I know many of you have been regular listeners of the Less insurance dependence podcast and we are hearing a lot of momentum among our listening audience about – getting ready . I think I am ready I am getting ready, getting ready getting ready I am getting ready, and so I wanted to time it now because I think a good time if you can get all the readiness done –  good time to start resigning from plan is going to be in qu. 1 and qu. 2 – first two quarter of 2021 and I will explain more about that in future episodes – to successfully resign from PPO plans, and number one is that you need to gather data in your practice, one three specific data points because the data will allow you to make good decisions when it comes to sequencing the order in which you resign form PPO plans, you do not resign casually and we do not just resign in a haphazard manner. Typically we will sign from one plan at a time, you know for our practice that had 34 PPo plans – it took us two years, but really two years is not that great a period of time when it came to resigning from 34 plans you know think about that Naren – that as about an average of a plan and a half a month you know it took us 24 months to resign form 34 plans that was about 3 plans every two months if you do the math on that – pretty quick, 

N: Yeah

G: Most of our listeners will have less than 34 plans so you can figure out how long it might take you with that pace – it might even take you a year to fully resign from on how many plans you have, but here is step number one and again it is all about learning the data – there are 3 data points. Data point number one – I want you to find out the average insurance write off – which is the difference between your UCR fee and your contracted fees – I want you to find that out. Now – for those of you that have been listening to the podcast episode – to the less insurance depended podcast, you know that only 10 percent of the dentists in the united states can calculate that number easily – only 10 parent. The other nine percent have a challenge learning what their actual write off is because you have entire your contracted fees into your practice management software programme – so you have two ways to enter your fees and you can enter your UCR fee and then adjust off when you get the EOB – the explanation of benefit – you are just off your discount your insurance write off if you do it that way, then you can determine by pulling a report off your practice management software exactly what percent you are writing off, but only ten percent of the dentist in the world do it that way. The other 90 percent enter their contracted fees and that is kind of encouraged by the practice management software. And because you enter your contracted fees you never see the amount you are writing off – by the way the reason the software encourages you to do that, and the reason 90 percent of the dentists do it is because it is easier to track your collection percentage because then you have got your contracted fees against your collections it is one to one it makes it very easy to track it. I do not like doing it that way, because of the fact that you are in the dark about what the actual write off is, but I am not going to suggest you change that because there was a good reason for you to do it that way however what I am going to suggest is that you go to our – we created, Naren and I created and insurance write off calculator, that is very – it is very easy for you to figure out a ball park figure of what percent you are writing off, what percent you are writing off – it is accurate to plus or minus ten percent. Naren would you put in the show notes-

N: Yes plus or minus two percent – 

G: I am sorry plus or minus two percent- plus or minus two percent. Would you put in the show notes on less insurance dependence dot Com a link to that insurance write off calculator and I would encourage any of our listeners to go to that and just go through the exercise – very simple and it is a ball park that will be accurate to plus or minus two percent and you will know that you are writing off – I am going to suggest that what you are going to find out is somewhere between forty two and forty four percent but you are going to find out – so that is step number one the first thing on the list is what percent you are writing off – it is data that you need to know

N: And also I think this calculator will tell you how many dollars you are writing off – in other words is it two hundred thousand is it three hundred thousand dollars a year – you know what ever the dollar number is. 

G: While the calculator is doing its work you might want to sit down.

N: Ha-ha

G: You might want to find a seat because you are going to actually take a look at that number you are going to find out the percent and the dollars and depending on the size of your practice that number is going got be quite sobering, and here is what I want you to think about while you sit – let’s say hypothetically that number Naren is let me pick a number four hundred thousand dollar and I am just picking a number – right. Let’s say this cover you are writing off is four hundred thousand dollars a year. Form this moment forward doctor I want you to think of that number as a marketing expense. You are spending four hundred thousand dollars a year on marketing and you might be confused and you might be – thinking no no I am not. Yes you are! Because you are paying the insurance company to provide you patients – by the way that number – four hundred? Is thirty three thousand and three hundred and thirty three dollars a month. Thirty three thousand three hundred and thirty three dollars a month that you are spending on marketing. And you know you can get a much better resolve – let me just quantify for you how would you like to reduce that you know the thirty three thousand again, use my example thirty three thousand three hundred and thirty three dollars a month. Would you like to reduce that amount to a fraction of that – say twelve hundred dollars a month? Would you rather spend thirty three or twelve hundred? Mhmm I think I know the answer to that one

N: Thirty three thousand. thirty three thousand or twelve hundred?

G: Thirty three thousand or twelve hundred. Which one?

N: Twelve hundred!

G: I would spend twelve hundred, how do you do that? Well do what I do! Enlist the services of EKWA. Your company Naren that does digital marketing for dentists – you have a flat fee comprehensive all included marketing service that is twelve hundred dollars a month that by the way for us, provides us with over 80 new patients a month so doc what would you rather do? Spend thirty three thousand or twelve hundred?

Naren if you would, put a link in the show notes for your marketing strategy meeting and what I am going to do is invite our listeners to go to that link and schedule a strategy meeting with Lila Stone, Lila is the marketing director for EKWA – and she will prepare for that meeting and she will spend about 6 hours prep time, learning about your website, learning about your community, researching your Google analytic scores and she will share that information with you and she will share with you, how you can be very successful transitioning from an insurance dependent marketing plan to a comprehensive digital marketing plan and intern reduce your marketing expenses to twelve hundred dollars a month. So anyway that is step number one. Find out what you know data pint number one is find out what the amount is that you are writing off, and a percentage of that – what that is. Data point number 2, I want you to find out the number of active patients in your practice, on each plan. So make a spread sheet with each plan and it might be Edna, travelers, Blue cross, Blue shield and there might be multiple blue cross, blue shield plans in there. But find out the number of patients and active patients – I define an active patient as any patient who has had an appointment in your practice in the last 18 months. So you are able to do that in your practice management software – whether it be Dentrix, eagle soft, open dental, soft dent, go in and go into the report – your office manager might need to help you with that, but go into your practice management software and determine the number of patients. on, active patients, that you have on every plan, and that is the other data point I want you to have, because that is going to be an important information to decide the order and sequence in which we resign from your plans., and then the third data point that I want you to get is find out how much advanced notice you require to give the PPO plan under your preferred provider contract. Normally it is 30 days, meaning that you have to give notice – you cannot just quit today – you have to give a notice. The normal notice the most common notice I see is 30 days. It is kind of like if you are you know renting an apartment you have to give a notice before you move out – well same thing here. Find out what it is, most common is the 30 days – could be 60 days, could be 90 days – I have seen as long as a hundred and eighty days – why is that important? Because we are going to need that information when we sequence the order in which you go out of your plans that you start resigning from the plans – so that is the first step. The first step is homework, it is not particularly exciting, and it is kind of you know methodical to do your homework but I want you to do your homework because now that information is going to be very useful when we go on to the other steps and we start resigning from these PPO plans – so do that homework because now you are armed with the information and doctor you could make good decisions when you are armed with information – you might discover maybe you think  you have got a hundred people on a particular plan and once you do this homework you discover wait a minute it is actually two hundred and fifty and might be the other way around. Maybe you think that you have a massive number of patents on this plan, maybe you think you have two hundred and fifty and turns out you have fifty of them. Again good information – and now you are going to make information – make decisions based on information instead of a haphazard random way. So that is step number one. It is about gathering the data from three specific data points, so that you can now make good decisions based on the data, and in future episodes, we will march through the other readiness factors and round out all of these steps. But for now I want to provide this one. And I think it is going to be exciting for you in terms of getting this information so that now you can make informed decision rather than just random hap hazard – perhaps even bad decisions because you do not have the right data. 

N: Gary I know I am putting you on the spot so if you do not want this we can edit this out, I know you are on a mission to help as many people reduce insurance dependence, what do you think if we ask the people who complete the homework to send that in and maybe we can either share same tips or maybe we can make another episode from what we, what we would have – 

G: I would love to see it and of course it would be confidential and won’t be shared with others but I would invite that. Naren let’s put in the link in the show notes, so that when our listeners complete that data they can forward it to me – it will be an email type link that will forward to myself. I will review that data and it would be very useful. I would appreciate that Naren and again please note that this will be held confidential it will never be shared – there won’t be any names attached to it –but we will reach out to you once we get that information, and share some insights into that information. You know how I look at it is – is as a coach because we look at those for all our clients – how I look at it is as a coach and how this information will allow us to properly prepare to go out of network, so yes I like the thought Naren. Put that as a link in the show notes, it will be – there will be a link for you to email that data to me and doctors I will review it myself and I will provide a reply back to you in terms of what that information means to me and how I look at it from my seat having helped many many many dentists successfully resigned from PPO plans. Naren as we come to the finish line today hey was not that tip from Baldwin Marchack amazing? I know all of our listeners you know have dealt with frustration in patient expectations and the aesthetics of it – and in one fell swoop he solves it right there. I thought that was kind of fun I am glad we bought it to our listeners. Hey as we come to the finish line here – I just want to conclude by saying thank you – we appreciate each and every one of you. One of the things they have been happening recently is that we have been noticing a more reviews, more reviews on iTunes. If you have not done it yet, jump on iTunes and write us a review. It helps more dentist’s friend us. There is a building groundswell of dentists who are really preparing to successfully go out of network, there- it it is a movement, it is a grass root’s move net and all of our listeners are part of it – and that group is growing and man I just want to take a minute and applaud you for your intention to successfully reduce insurance dependence, and I want to thank you for being a part of our community. Thank you so much.