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In this episode, Gary and Naren discuss the question most existing patients ask when you go out of network, and how you and your team should handle those patients and how to answer those questions. 

Are you and your team prepared on what to say?


  • Introduction to today’s topic > 01:00
  • About Gary’s Practice management support system > 02:20
  • How to communicate with patient > 04:28
  • How to make quality dentistry affordable > 05:32
  • Begin with the end in mind > 07:52
  • What your team members should say > 11:18
  • How to shift the way you think > 18:15


Naren: Hello everyone! Welcome to another amazing episode of the less insurance dependence podcast show. This is Naren, your co-host. We have now been doing this for a long time and we have quite a lot of episodes for those of you who haven’t listened to the past episodes jump in and binge-listen. Today’s topic is going to be an awesome topic. It’s a topic that will make everyone in your practice stronger. One of the questions people ask you if you start resigning from the insurance plan is, Why are you not taking my insurance anymore? And you as a person, as a doctor, as a team has to be able to answer this effectively. So, this is an episode that you may want to listen not just once, but multiple times with your team. This is something you need to bookmark and use it as a tool. We’ll also give you some scripts like a pdf so definitely take advantage of that and keep it, but before I jump in I want to share some feedback I’ve been getting from some clients of Gary’s who have signed up for the virtual practice management support system, sorry virtual coaching and practice management support system. The thing I hear a lot Gary from these clients is, I always wished I had someone like Gary in my practice just like Paul and Tim have Gary for the business side of LifeSmiles and that’s why they are in the top one-fourth of one percent I could do the same if I had someone like Gary and I think this practice management support system you created and you continue to tweak and improve Gary is really, really, the answer for that. So, this way the dentists can do dentistry which is what they love while your team and the practice management support system make sure all this all the systems are working and all the elements are working and they get better and better at it. So I just wanted to say that Gary and any comments on that what is your experience with that Gary?

Gary: Naren, I’m so excited about what we’re doing because so often I’ve heard from dentists that say  I wish I could just put my head down and just focus on nothing but the dentistry and man I get that, I  get that. That’s your superpower, right? That’s what you love but the truth is there’s an outlier dentist that enjoys the business side, there’s an outlier. Often times they have an MBA. They’re a DDS or DMD, MBA and the outlier dentist kind of enjoys it but I would say 95 percent of the dentists in the world, the business stuff is just a necessary, it’s a necessary thing they have to do. They don’t really love it and as a result they kind of stumble with it because it’s not their thing. Conversely, I love it and by the way, our team loves everything about the business side of dentistry. So we put together a really cool system to provide the support, the ongoing support, so that the dentist can pay attention to what they love which is the clinical side of their practice and then they can know if they can rest easy and know full well that everything’s being taken care of on the business side in a way that’s consistent with their value system that’s consistent with the way they would like to do it and it can be done with without a lot of time and effort on the doctor’s part and so I’m super excited, it’s really that practice management support system that I want to put an exclamation point on it. I have to say I have heard from many dentists over the years and it’s kind of embarrasses me but they say Gary I wish I had someone like you in my practice and I appreciate that I know it’s meant as a compliment. I appreciate the kind words and I think we’ve put together something that allows that to happen and I’m excited about it and super excited about the results we’re seeing with clients and we’re on a mission to preserve private practice dentistry, Naren, it’s nothing it’s a revolution, nothing short of a revolution. If there’s a little rebel side of you that listens to this and you want to join our revolution come join us, join us on the coaching side and you’ll get the benefits of it and maybe feel like, hey we’re preserving private practice dentistry for the future too.

Naren: And I know you’re very humble. You will never say this, but for this level of support other consultants charge 80 000 a year, 90 000 a year I mean they charge five times what you charge. So, I know one of your goals is to help as many dentists as possible.

Gary: yeah and that’s consistent with our practice. At LifeSmiles I don’t often talk about it but one of the things I will talk about here. One of our goals Paul, Tim and I is to make quality dentistry affordable and I grew up in a blue-collar working-class family. My dad was a lunch pail caring guy. I was the first to go to college on either side of the family and I treasure my blue-collar upbringing. I’m very grateful and I want to make what our avatar when a think about an avatar, a fictitious patient. I want to make quality dentistry affordable y to a single parent school teacher.

Naren: Yeah

Gary: I have a soft spot in my heart for teachers. My wife taught kindergarten for many years and one of our daughters is the fifth-grade teacher and I think teachers are underappreciated heroes in our profession and if hopefully if she happens to be a single-parent school teacher, I want to make it affordable for quality care affordable for him or her. So that we’ve extended that to our coaching, we want to make it affordable and I think we’ve done that and if you’re interested come join us. It’s forward slash coaching, come join us.

Naren: Thank you, Gary! Let’s jump into today’s topic. So, someone has listened to your podcast. You have 80 plus episodes. I think close to 90 now and they have gotten ready. They have done all the prep. They are ready to drop insurance. They drop the first insurance. Does a patient say why are you not accepting my insurance anymore?

Gary: and I want to emphasize that this is the existing patients.

Naren: Right!

Gary: It’s an existing patient and in a past episode we’ve talked how do you handle the caller, do you take my insurance? Similar but different, similar but different, and by the way if you haven’t listened to that one that is our most downloaded episode on the less insurance dependence podcast. How do you handle the call, do you take my insurance? Just scroll and you can find that. Let’s put a link in the show notes for that one.

Naren: Yes

Gary: Okay so this is for your existing patients and let me back up and state a goal. Begin with the end in mind. Who’s one of my favorite authors Naren?

Naren: Stephen covey, “Seven habits of highly effective people”.

Gary: And what is habit number two?

Naren: Begin with the end in mind.

Gary: By the way, we did an episode on the leadership lessons from seven habits of highly effective people. Let’s put that in the notes as well.

Naren: Absolutely

Gary: number two is beginning with the end in mind. So, let’s begin with the end in mind. Now, this might shock you in a pleasant way. Here’s what the goal is. Remember when we went out of network in my practice, we kept 84 percent of our patients that were in-network when we went out of network. We kept 84 of them. Our goal with all of our clients is to do better than we did in 07 and 08 because frankly, we didn’t know what we were doing. I mean we had, we knew intellectually what we were doing, but we didn’t have the practical experience. That’s why I wanted to own a practice to have the experience. So, my goal always with this is to have you retain more than we did because we know more now and let me define it for you very specifically. I want you to retain between 85 and 90 plus of your existing patients when you go out of network. Now, you might be thinking oh no Gary that I think we’re going to lose like almost all of them. I mean that’s what that’s a fear, right? Naren, can you imagine that. If you had a practice that had 90 percent insurance you might think well, Gary that’s just a pipe dream. We’re not going to lose way more than that, right? Not if you are we have the track record now with clients all over the country, not if you do it right, and so the goal is to retain 85 to 90 and we have the track record to prove that and one of the things that’s in the readiness checklist is that every one of your team members needs to be able to answer the question at a surface level, why aren’t you taking my insurance anymore? Now if a team member hasn’t had training on that, it’s who knows what they might say. Especially if it was a clinical team member where that isn’t in their skill set. So just pre-empt that and provide the training for every one of your team members because it and what I don’t want to have happened on the first question, the first time it comes out of a patient’s mouth I don’t want the team member to just fold and say I don’t know, go talk to the office manager. How would that sound if you were the patient? Remember the filter I always like to use is, how would it feel if I was a patient. So how I mean just role play with me Naren, I don’t know, I’m just an assistant, I have no idea Naren go talk to the office manager. How’s that going to, what does that say to you, what message am I communicating to, not intentionally but what am I communicating to

Naren: Yeah I mean relationships are built on confidence, right? So that my like I mean already I’m kind of not happy about this because I don’t know what’s going on

Gary:  and what else, what else don’t you know

Naren: yeah exactly and now exactly and now instead of growing my confidence and reassuring me you are like, it’s like there’s a tiny wound you make it bigger. It’s just

Gary: Or it can’t even be worse and again  I’m always saying this because I’ve heard it. I’ve actually heard this with my own two ears. I heard a team member say I don’t know the doctor got some crazy idea and now we’re not on insurance.

Naren: wow

Gary: I mean so let’s solve it. Here’s the type of and we’ll provide a script for this. Here’s the type of communication I’d like to have come from your team members and let’s say the patient asking the question is Linda. Linda, I’m so glad that you asked. Every one of our patients is important to us. You are important to us and Linda we’ve discovered if we were to continue to stay in-network with your plan we simply couldn’t deliver the quality of dentistry that we insist on and the doctor will never compromise the quality of dentistry and that’s why I work here by the way because I totally believe in everything our doctor does and our doctor would never compromise the care in any way. So we’ve made the difficult decision to no longer be contracted with your delta dental insurance. Now Linda here’s the good news. The good news is you can still use our benefits in your practice. We will still file claims for you like we always have and Meg our insurance coordinator. She will still be here being your advocate to help you get every nickel of benefit you have from that dental insurance. We think it’s great that you have it and we’re going to help you get every nickel of benefit and Linda we hope that you appreciate the quality of care we provide that you appreciate our attention to details as the doctor is a detail-oriented doc, that you appreciate the way we invest in technology for your benefit and you appreciate the individual time and attention we provide to you as a patient. It’s our fondest hope that you continue to come here for your dental care because we appreciate you. Now Naren, I didn’t ask you to listen as if you were the patient but how do you think that sounds to you if you’re a patient. What do you think most people say when they hear that? It’s like oh okay I’m in.

Naren: Yeah exactly! I think if that is no communication, I can make up any story I want. This kind of communication now I’m on your side I’m on your team like I want the best care I want to get every penny of my dental insurance because I know dental insurance doesn’t want to pay me anything. I mean everyone knows that insurance companies number one goal is to pay as little as possible, I mean like, I mean you talked about your experience with your

Gary: Everybody in the United States, yeah I mean I don’t know that I can use absolutes but I want to say everybody yeah had a negative experience doing battle with an insurance company to get them to pay what they what you paid for and everyone knows this and when you start framing it that way people get it and what we found is  with that level of communication with the example that I just gave and again imagine that coming from a dental system coming from a hygienist coming from someone they just bump into in the hallway in your office I mean patients don’t discriminate who they ask their questions to they’ll ask whoever’s next to them. When they get that level of support most patients like oh okay, I mean I get it now yeah, I mean I get it. Now if they get into really detailed questions there’s nothing wrong with saying Linda you’re that’s a really good detailed question and I’m going to go get Laura our office manager she’s our expert in that let me grab her there’s nothing wrong but I don’t want you to start there, because I want everyone to communicate confidence

Naren: I think

Gary: this will do it you’re just having that script and generally I’m not a fan of scripting

Naren: yeah

Gary: but if the scripting helps if it helps you get your voice, if it helps you like if you feel like well that just isn’t my thing just tell me what to say, well now you have the script and it works we have it it’s proven it works and obviously you’ve got there’s more than just the words there’s facial expression there’s a tone of voice there’s what I said at the beginning that Doctor will never compromise your care. If that’s true, by the way, that needs to be true right?

Naren: Yeah

Gary: Yeah and it’s the patient of course and that’s why I come here then everything else you say is going to be put in that context. So we got to back it up but I’m going to assume that you are backing it up in terms of the quality you care and so on but this works and this now this would be a really good episode to play in an office a team meeting, and I would encourage you to go around the room just repeating the script just go around because then you can practice on

Naren: yeah

Gary: facial expressions and tone of voice and the way you communicate passion in your voice and so on and then just get to the point where it’s like a habit and you just do it because you’re going to get the question, how come you’re not taking my insurance anymore? Right, and now you’re ready for it and I’m telling you when you can answer that question, you’re going to retain 85 to 90 percent of your patients. Let’s bring it back to that, bring it back full circle. You’re going to retain 85 to 90 of your patients. Now let me as we kind of come to the finish line here

Naren: Gary, can I say something, if it’s okay? I know you never talk about yourself but I feel like I have to say it like you’re experimenting with thriving dentist verbal skills with a limited number of your private virtual coaching and practice management support system clients and a couple of the feedback I have gotten is this alone is what my entire year’s fee just because I have not met a communicator in dentistry who is even one-fifth as you Gary, I mean I’m being

Gary: I’m very blessed to have inherited that from my grandmother. My grandmother was an amazing influence in my life and she and I have the same DISC personality type we’ve talked about that we’re both high eyes. Now she’s been gone for 38 years but she was the entrepreneur in my family and she taught me how to communicate and I’m very blessed that if I was asked a question she would say Gary stand up and answer that question and then she would critique me in a loving way but I’m very blessed to have had a tremendous, I think the best communicator in the history of mankind was my grandmother and if I can measure up to even a fraction of what she was I will consider myself very, very, successful

Naren: so, there are two things that I wanted to say. one is so you not only teach your clients and their teams on how to communicate but you also help shift the thinking because many practices when they start with you they come with the idea that oh this is what I know this is what works this is the way the world is going to be tomorrow. so, you shift that thinking, the dentist thinking the office manager is thinking about the team’s thinking. so, then they all realize now that we can keep that 40 or 38 that insurance takes for ourselves, we can do so much with it for the patients for the team. So, I want to thank you for that Gary and I want to commend you for what you do for the industry what you do for the profession and I’m going to ask our listeners one thing if that’s okay with them. if you like the lesson insurance dependence podcast show, binge it, if you have a weekend catch up on five episodes you will learn a ton and of course like this other dentist we met recently who shared her experience binging all of Gary’s knowledge on the I love dentistry community, do that and of course, if you are serious, I would say check out the website. maybe sign up for an MBA it’s pretty much, there are different formats, easy to do, easy to digest and of course, we love reviews so it’s just like a review on google for your dental practice we love reviews on iTunes as well as google play. so please share your feedback. Thank you so much and I want to take a moment to thank you Gary for everything you do for the industry.

Gary: Thanks for your kind words Naren and I want to bring it back for a closing comment. so if we’re going to keep 85 to 90 percent of your existing patients, we can look at the reverse of that for a minute and say well we’re going to lose some and boy I’d be thrilled if it’s only 10 or 15 but maybe you’re thinking that but you’re going to want to replace those 10 or 15 percent that you’re going to lose, you’re going to want to replace them you’re going to want to place them ahead of time just as we did. So that way you are doing this from a position of strength and the best way to do that and Naren I’ll turn it right back on you, the best way to do this is to become an EKWA client like we are EKWA your digital marketing company. We are LifeSmiles, is a paying client of EKWA and you are my support system to attract quality new patients and Naren I know you’ve been kind enough to offer a free marketing strategy meeting with Lila stone your director of marketing for any of our listeners here on the less insurance dependence podcast. if you haven’t taken advantage of that take advantage. We’ll put a link in the notes. Lila will spend time with you in a scheduled call to let you know exactly how you’re doing with your digital marketing relative to google analytics. So she’ll be able to tell you exactly how you look in the eyes of Google, and whether you choose to work with EWKA or not I think you’d be nuts not to, but whether you choose to work with them you will get information that you didn’t know about marketing and about how your practice looks in the eyes of google. So, click that link. It’s free normally you charge 900 for that marketing strategy meeting but you waived that for our less insurance dependence listeners. On that note let me simply say thank you for all of our listeners. Thank you for the privilege of your time and we can’t wait to connect with you on the next less insurance dependence podcast.

Gary Takacs

Gary Takacs One of Gary's most significant achievements as a dental practice management coach is transforming his own practice, LifeSmiles, from one that was infected with PPO plans, no effective marketing strategy, and an overhead of 80% to a very successful dental practice that is currently one of the top-performing practices in the US.

With over 2,200 coaching clients, Gary has first-hand experience transforming insurance-dependent practices into thriving and profitable practices.

Through his Personalized Coaching Program, Gary shares access to the systems, strategies, processes, and experience gained over 41 years of coaching dentists and transforming over 2200 practices worldwide.

Learn More:
Connect with Gary Takacs on Linkedin

Naren Arulrajah

Naren ArulrajahAs CEO of Ekwa Marketing, Naren has over a decade of experience working with dental practices and helping them attract the ideal type of patients to their practices. It is his goal to help dentists do more of the type of dentistry they love with the help and support of effective digital marketing.

Ekwa’s "Done-For-You" Digital Marketing model blends fundamental persuasion principles with an all-in-one Digital Marketing solution to help your ideal patients find you and choose you for reasons other than being on their insurance plan.

If you’re interested in finding out if Ekwa is the right fit for you and your practice, book a Free Marketing Strategy Meeting with Ekwa’s Marketing Director, Lila Stone.

Book Free Marketing Strategy Meeting:

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