Episode 90: Your Readiness Checklist

N: This is the less insurance dependent podcast with my good friend Gary Takacs and myself Naren Arulrajah.

G: We appreciate your listenership, we appreciate your time, we appreciate your intention to reduce insurance dependence in your practice. Our goal is to provide information to you that will allow you to successfully reduce dependency on insurance and make this your best year yet. Thank you.

N: Hello everyone. Welcome to another episode of the Less Insurance Dependence podcast show. Today’s episode is a very powerful episode – it’s called the ‘Your readiness checklist’ but before I talk about that I want to kind of share my thoughts on why this is a powerful episode.

See people are either choosing you because you are on their insurance, or people are either choosing you because you are ready to care of them at a level in which that accompany their pay out of their pocket – is ready to take care of them.

So your readiness checklist came out of Gary’s time spent over the last 40 years working with private practices to get them ready. So there are lots and lots of different reasons why people chose those practices and why people chose to stay with those practices. For example – 80% of Gary’s patients toady are not on insurance vs in 2007 80% of them were on insurance. So how did all these other people who don’t have insurance plus the people who do have insurance decide to go to Gary even though they are not in the network?

So it is a great episode and if you want to get a crash course on how this happens and you are not one of Gary’s coaching clients I would recommend you take the MBA. There’s one coming up in July – go to the ThrivingDentist.com/MBA. Its 2 evenings, 2 Friday evenings – check it out. There are also other dates and formats – pick the one you like. So Gary lets jump into today’s topic ‘Your readiness checklist’.

G: You know Naren I wish that I would have had this readiness checklist when we started to go out of network in 2007. I wish I would have had this because it’s almost like a- imagine you are building a house and you don’t have a blueprint. How would that go? *laughs* Not really well. Why do you need the blueprint? Because you need all the details – I wish I could have this when we were out of the network I 2007 – we didn’t have that – I discovered this after the fact but the great news is our listeners can jump in on our shoulders because we now know what this checklist is – we’ve done this many times and we’ve refined it – we’ve continually refined it and it’s all about being ready. I’ll use another analogy so that our listeners know that I’m a long-distance runner. Imagine Naren that someone decides they want to run a long-distance marathon – now a marathon is 26.2 miles

N: Right.

G: Imagine they don’t prepare for it – now they really want to run, they’ve always wanted to run a marathon – bucket list kind of thing and they decide I’m going to run for a marathon and they have good intentions for it but life gets in the way and they don’t prepare for it. How do you think that would go on race day? If they go without preparation – 26.2 miles – how do you think that would go?

N: it going to be a disaster *laughs*

G: They might make it to the first water stop *laughs* and that’s just a mile.

N: Exactly.

G: You know there are book out there – where you can sign up for 16-week preparation to successfully run a marathon – a 24-week program to successfully run a marathon or whatever it is – plug in whatever time frame and if you follow it guess what your success rate is going to be? It’s going to be much more likely, isn’t it?

N: Yeah

G: Imagine – I happen to have one I’m looking over at it in my bookshelf and it’s called the ‘Hansen Method’ – the coach’s last name is Hansen and its literally a 16 week programmed with prescribed training for every week to successfully run your first marathon and I did that, and I was prepared. So we are going to do the same thing for our listeners in the form of a readiness checklist.

One thing I want to help our listeners evade is the common reaction of impatience. Dentists can get impatient – we all are people and let’s just say people can be impatient – and I get it it’s like Naren I have this conversation with dentists weekly – I just had it and I’m going to resign I’m going to pull the plug from all these plans and just let the cards fall where they fall. Don’t do that – don’t do it because we can do it in a relatively short period of time but when you have successfully passed each benchmark you have enhanced your success and what I mean by that is that you are going to retain more of your existing patients when you go out of network by following this readiness checklist and Naren I have 6 specific steps – can I dive into those 6 parts of the checklist?

N: Absolutely Gary.

G: and I’m going to number these because in this case they aren’t numbered in order.

No.1 – develop a done for you marketing plan that consistently provides X number of new patients constantly each month – X number of new patients each month. Now I’m using the generic term X for the podcast interview because I don’t know enough about each one of your listeners’ practice to actually plug in a number but Coaching work – we actually define that number.

Let me tell you how we define it – we define it by the number of new patients that come into that practice historically because you are in that network so for example let me just use an example taken from our client base today.

This was a solo doctor’s office – one doc and 30 new patients a month came into his practice because he was in-network – collectively in all the different plans. Delta travelers – this was a dentist with 14 PPO plans and historically over time 30 new patients came in a month because it was on network – so the number we out in on his marketing plan was 30 and here’s why that’s so important – because he or she has already replaced the course of new patients with marketing – you’ve already replaced it.

So if he/she was seeing 30 new patients a month from the 14 different plans as soon as they have 30 new patients a month from digital marketing where they are choosing him for reasons because he is influencing them. He’s independent of the insurance because he has replaced them already. Now he still wants to maintain as many existing patients as possible but he’s already replaced the flow

N: Right.

G: That’s how you calculate it – go back and calculate historically how may a month and that becomes your number to replace the done for you digital marketing plan so that’s No.1

And you want to replace it ahead of time so that you are operating from a position of strength and not a position of weakness.

N: Makes total sense Gary

G: And Naren let me just ask for your comment on that because you are the marketing wizard on this. Am I thinking in the right way or is it the right priority to lead with this?

N: Absolutely it is. The only comment I will make is that I think you added a buffer. AN insured patient is only paying 40% less right so 30 insured patients are equal to If I were to do the math – 18 noninsured patients – assuming they are all paying full price and insurance guys are paying 40% less. Yeah, so I think if you are getting paid in new patients who are not choosing you because you are not of their insurance it’s like time and a half what you would if you were to get 30 non-insurance patients – again it’s a great place to start.

G: Naren I’m so happy that you did the math because you are absolutely right. You know if you are writing off 40% you can see 20 new patients and be better off but you out a buffer in there to sort of propel the practice to new levels of success and leave it to the math guy to figure that out, thank you Naren!

N: *Laughs*

G: No.2 component is to strengthen the relationship-driven component of your practice. Strengthen that – because that’s why they will stay with you.

N: Right.

G: and I will give you three specific things to do within those checklist items – 3 sub-points

number 1 – start doing the evening we care contact for any patient who got an injection that day – any of your new patients, and any patient that got an injection to make an evening we care contact – could be a call could be a text message depending on what effective communication your patient likes.

Number 2 – make sure you have a section in your computer for personal digital notes about your patients and that’s where you put spouse’s names, kid’s names, hobbies interest and events in their life, and so on. Don’t count on your memory is the system for that because ultimately that will break down somewhere plus the other reason why you are having this computer is that you invite your team members whenever they learn something about your patient have them supplement your notes so it becomes part of your records.

And number 3 – in the morning huddle, now make sure you do a morning huddle; prep doctors and team members on all the patients you are seeing today from those digital notes. Remember, ‘Oh yeah Gary has an anniversary coming up – be sure to mention that when you see him today’ So those three sub-points strengthen the relationship part of your practice.

Number 1 – start doing the evening we care contact for any patient who gets a shot

Number 2 – make sure you have a place in your computer where you can put digital notes

and Number 3 – consult those digital notes in the morning to prep the team for the patients you are seeing that day.

Number 3 – add and in-office membership plan as part of your practice so that you can figuratively roll the red carpet out for patients from your community who don’t have insurance. So add an in-office membership plan so that you can literally attract people in your community that doesn’t have insurance and I’m going to suggest a goal – a goal of 10 new patients a month. New patients coming from your membership plan so now add the number from step 1 on our digital marketing add 10 more that are coming from digital marketing and you have a robust flow of new patients coming in – none of which are tied to your insurance. Makes sense Naren?

N: Absolutely.

G: Number 4 – do verbal skills training to any of the members who would answer the phone on how to answer new callers on ‘do you take my insurance’ – we’ve done entire episodes on this Naren – but I want to emphasize this – if you skip that step and they start getting calls from people ‘do you take my insurance’ and the team hasn’t been trained what will 99% of team members, how will they respond when they haven’t had training, ‘do you take my insurance’

N: ‘Nope’

G: ‘Nope’ – now your marketing worked but your conversion didn’t work. So we’ve done episodes on those go back and revisit those on less dependency insurance, but let me go ahead and wordplay that – here’s how that should go:

‘I’m so glad you called, we love seeing new patients, my name is Carly – who am I speaking with?’ ‘Naren it’s great to meet you – I look forward to meeting you face to face. Naren let me answer your question; although we are not contracted with Delta you can absolutely use your insurance at LifeSmiles Dental Care. Not only can you use it but you are going to meet Meg when you come in. Meg is our insurance coordinator and she is going to do everything possible to help you get every dollar of benefit that you have from your dental insurance. Think of her as your advocate towards the insurance company to get every dollar of benefit that you have.

Naren we actually have many patients who have the same Delta insurance that you have. Do you like mornings or afternoons?’ There’s the script here’s the guideline for that verbal skill training.

N: This is really really important Gary see because there are the emergency patients who give them reasons not to come in. hey are going to come in regardless they have already decided. Then there are other patients who are non-emergency who have done a lot of research and who have decided.

But then there is a majority of patients who have decided that maybe 70% -they are not 100% yet. They are picking up the phone and calling to get over that hump and they are saying, ‘yeah let’s book an appointment’. If your team is not trained unfortunately I would say 80% of the teams are not trained – not at the level at which LifeSmiles is trained, I would say even 90% of the teams even –

G: I think you might be understating it at 80 –

N: Yeah at least 90%, so think of it like this – I remember you used an analogy when you first purchased this practice that was insurance dependent, you said certain types of providers you are better off telling the patient to go away and also giving them a 50 dollar or a 100 dollar bill because you end up saving money by not treating them.

G: The worst one for us Naren was MetLife. Now that may or may not be the worst one for you because it depends on the fees and states and so on, but every time we did a crown on a MetLife patient it cost Paul and I a 138 dollars. Now I’m not saying an opportunity cost Naren – it cost us 138 dollars out of pocket to do a crown for that patient.

N: Right

G: We would have been better of handing them a 100 dollar bill and say, ‘Hey Naren please go somewhere else’ *laughs*

N: Exactly

G: Here’s a 100 bucks! Not that’s silly but it would have cost us less money we would have lost less money if we did that.

N: Yeah so the point that I’m trying to make is if this part of your business is not fine-tuned it’s like you’re taking a 100 dollar note and burning it because the phone is ringing, marketing is ringing but the majority of people who are not totally convinced yet – they are not booking and I have done the analysis – we listen to calls and provide feedback. Analysis on many many clients and many of them a literally leaving like 500 extra clients on the table every year. Some are 100 some are 200, but it is unreal the number of clients that have been left on the table.

G: Yeah that so true. Why don’t we go to the next verbal skill training? That was number 4 on the checklist, let’s go to number 5. Now I want you to do verbal skill training for all team members. 4 was about training your team members on the phone, handling inbound calls – the next one 5 has to do with verbal skill training for every team member to answer the question, ‘How come you are not taking my insurance anymore?’ Now I asked in a very blunt way but I want every team member to be able to have some level of conversation with a patient with that question.

Now they don’t have to be the expert at it but I want them to have some level of communication because patients do not discriminate who they asked the question to. They will ask that question from whoever happens to be next to them. Now I don’t want any team member just folding their tent, ‘I don’t know I’m an assistant’ because hat message does that communicate to the patient? It wasn’t a confident message!

So I want any team member to be able to say Naren I’m so glad you asked that question. You know let me show you – first of all every patient in our practice is important Naren to our Doctor and the team – you are important to us. Now remember if you have been working on the relationship side of your practice – that’s a true statement. You will feel that – would you agree Naren?

We’ve done the things that make a relationship practice when I say you are important to us, in your mind you are thinking, ‘yeah I get that I get it’ and if you haven’t done that then that’s an issue.

N: Absolutely.

G: Naren you are important to us and we have determined – now I’m going to put those in Covid19 context. ‘You see all the things we are doing to make this a safe environment for you Naren. You see all the additional PP, all the additional steps that we take to make this a safe environment and you have to understand that the Doctor – his number 1 priority is your safety. We would ever compromise that in any way. This is a safe environment for you, for the doctor, and for the team members. The doctor determines that if he was to continue to be in-network with Delta we couldn’t do that and that was not acceptable to him. So he made the difficult decision to gout of the network to deliver on the promise to always make this a safe environment. Now Naren here’s the great news, even though we are out of network you can still use your benefits in our practice not only can you use them, Meg’s going to continue to file your insurance like she always has – she’s going to be your advocate to help you get every dollar of benefit that you have, and it is our fondest hope that you appreciate our priority of your safety. We hope you appreciate the way we invest in technology, for your benefit. We hope you appreciate the individual benefit you get from the doctor and the team. Appreciate the way we treat you as if you were a family member and our fondest hope is that you continue to come here for your care.

Now I want every team member to be able to have that level of discussion. Now if it does get deeper and they want to know exactly what goes on and so on then we can say, ‘You know what you are asking the right questions – here let’s go over and talk to Linda. Linda is our insurance coordinator, Meg is our insurance coordinator – I want to make sure that you get all the right answers, let’s go talk to Meg.’ I want that first level of discussion to come from every team member. In training, in practice, in role-play – that’s step number 5.

And finally step number 6 – are you ready for step number 6? Are you ready for this Naren?

N: Yes.

G: Doctor I want you to rattle off improvisationally- its right off the tip of your head, 10 reasons why a patient should choose your practice. Give me 10 reasons right now and I want every team member to be able to rattle off 10 reasons why. If you can’t give them 10 reasons why – you aren’t ready. It’s just like – I’m going to skip week 12 to 16 for the training of my marathon, I’m ready to just run it I’m done with training. I’m going to go run it. What’s going to happen? *laughs* you are not going to be prepared!

Naren what are the reasons, let’s try a role play – why don’t you come up with 5 and I’ll give you 5. Give me 10 off the tops of your head reasons why you would choose a fictitious office we are just thinking in our head.

N: I’ll think of LifeSmiles *laughs*

G: Think about Life

N: I mean I don’t live in Phoenix but I’ve read the reviews so I think the number one reason people chose you guys is both Paul and Tim treat every patient like it’s one of their family members. Number 2 reasons I believe they chose your practice is it’s not Paul and Tim but it’s the person answering the phone – it’s the patient care coordinator, it’s the insurance coordinator who’s going to get everything- so these are multiple reasons right

G: So you just named a third.

N: Yes – the insurance coordinator who’s trying to get every penny from the insurance company for you. When I walk in here I see those beautiful smiles of after pictures though out where I can start visualizing myself or my husband looking like that 65-year-old instead of who he actually looks like *laughs*

G: Give me one more you’ve got all 4, give me one more and then ill roll more from there.

N: Yes I think the other reason why people choose you is because I think the care calls you guys make – I think even today I think you are like 6 7 ties bigger than what you used to be still every single day Paul and Tim call those patients they want to call that evening so that’s fine.

G: Let me keep rolling – we offer hours aside from normal work hours. We are open from 7 am to 4 pm, and many of our patients love the 7 and 8 am appointments because they can come in and not take time from work. It’s an absolute state of the art office; we have every piece of technology known to mankind in dentistry because that’s what we would want if we were a patient. We use the highest quality of material. We wouldn’t put anything in the patient’s mouth that we would not put in our own mouths.

Number 4 – we stand behind our work. If something isn’t right, we redo it and we redo it at no charge and number 5 – my hygienists are not only thorough but gentle at the same time.

There are 10 reasons. Now Naren – true confessions.

N: Yes

G: I didn’t prep you ahead of time now did I?

N: No and I didn’t think of LifeSmiles until I thought ‘who do I think of’ *laughs* so anyways

G: So doctor I want you to be able to rattle off ‘Give me 10 reasons why I should want to come to your practice’ and I want your team members to repeat yours and they can come up with roughly as you go around the room you should actually end up with 30 or 40 or 50 reasons why they should come to you.

N: Now one point I want to add is- I know Gary’s modest so he will never say this but this is not stuff he makes up. Go and read the reviews, just type in LifeSmiles Dental Care – Phoenix Arizona. This is what the patients say about the practice. 530 5 star love letter reviews.

G: There could be some other ones – Doctor and team members listen to me. They take the time to listen to me. You know that could be another one. We offer services that pretty much for the most part that they can have all their dental care taken care of within our dental practice.

N: Now there are a few things-

G: Say that again Naren…

N: You didn’t mention sedation

G: So we offer all kinds of sedation and other benefits. We are totally synced into the oral systematic link – so we are helping our patients improve their health. So let’s go back over those 6 items on the checklist and again ill number them and just repeat them summarized here. Number 1 – Develop a done for you marketing system that provides X number of new patients each month. You can peel your own net – X based on the current number that you are seeing from being n network.

Number 2 – you strengthen the relationship component of your practice and you do that by your evening we care contact, by your personal notes in the computer that are updated by both you and the team members that you consult before you prepare for your patients every day.

Number 3 – have an in-office membership plan to figuratively roll the red carpet out, to attract new patients that do have insurance, and as part of that have a goal of attracting 10 new patients every month from your in-office membership plan. Now

Number 4 – you have verbal skills training for your team members on the phone when a new patient calls and says, ‘Do you take my insurance’ do you know how to answer that.

Number 5 – you have full verbal skills training for the entire team to answer a question from the patient, ‘Hey how come you are not taking my insurance anymore?’ and

Number 6 – you and your team members can quickly rattle off 10 reasons why a patient should choose your office.

It’s almost like you’ve now completed the 16-week training program to successfully run your marathon. You are ready for that starting gun. You’ve done those, you are ready. So how long does it take? Well, you are going to answer that yourself. How long – answer that yourself, this readiness checklist can be done fairly quickly if you stay on task.

N: Right.

G: But pass the litmus test, make sure you are not skipping steps because it’ll result in more attrition than what we’d like. You want to keep as many of the existing patients as possible. Naren why don’t we do him – could we put this checklist in the form of a PDF for our listeners so that their team members could be in a team meeting and that they could really make this episode come alive in the practice, could we do that?

N: Absolutely Gary Absolutely.

G: As we kind of come to the finish line here on the day that we are publishing this – July 2nd some of you may have some trips coming up and if you do you may not have had the chance to listen to the entire library of our less insurance dependency podcast. You can download all of the episodes going back to the episode Number 1 and they are all free and they can be downloaded on iTunes, they can be downloaded on Google play, or they can be downloaded on the Less Insurance Dependency podcast. SO if you have some travel coming up this might be a good way to spend your travel time getting caught up on some episodes to further strengthen your strategies as you further go out of network.

Ok, thank you, thanks in advance for those of you who have written good reviews. If you haven’t the jump on iTunes and write us a review on the Thriving Dentist and we appreciate each and every one of you as a listener. Thanks for listening and giving us a chance. Thank you bye.