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Episode 103: Reasons to Stay In-Network with PPO Plans

October 01, 2020
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In this episode, Gary and Naren turn things around and talk about reasons to stay in-network! Yes, you heard that right! Listen now to find out the reasons why Gary might suggest it’s right for you to stay in-network with PPO Plans.

Highlights:

  • Introduction to today’s topic > 01:00
  • About the upcoming MBA > 01:21
  • Should a new practice sign up for PPO? > 03:50
  • The advantage of not going into network right away > 05:47
  • Reason #1 to Stay In-Network with PPO Plans – Not a relationship-driven practice > 08:59
  • Reason #2 to Stay In-Network with PPO Plans – High team member turnover > 12:58
  • Reason #3 to Stay In-Network with PPO Plans – Truthfully, no reason other than insurance for a patient to come to them > 16:43
  • Reason #4 to Stay In-Network with PPO Plans – No marketing at all or no willingness to find the right marketing resources to attract new patients

Resources

Naren: 

Hello everyone, welcome to another amazing episode of the less insurance podcast show. This is Naren your co-host. Today we have an exciting topic for you and the topic is, “reasons to stay in-network with PPO plans. I know this podcast is called less insurance dependence. So, we talk a lot about all the things you need to prepare as well as slowly resign from PPO plans but this topic is different. It’s reasons to stay in-network with PPO plans but before I jump in, I have a quick announcement. We had an amazing MBA the September 10th, September 11th MBA. It was sold out an awesome set of dentists from across the US and Canada. So, the next one coming up is on October 23rd and the 24th. So, it’s two half days. Half-day, Friday and half-day, Saturday plus we have other dates in November and December as well. So, check it out this is where Gary will go through the 10 elements and the 24 systems of a thriving practice. Of course, one of those elements is reducing insurance dependence, the podcast title. How to reduce insurance dependence, less insurance dependence. So, let’s jump in. Gary, how are you this evening?

Gary: 

Naren, I’m doing great. We decided to have some fun with this topic and we might have shocked some of our listeners because we titled it reasons to stay in-network with PPO plans and I thought it was an important topic because Naren, as I’ve had the opportunity to consult with as a coach with quite literally over 2 200 practices and in the last number of years, one of my areas of specialty has been helping dentists successfully reduce their insurance dependence and one of the realities the vast majority of new clients that I meet and they asked me, can I do this in my practice the vast majority the answer is yes with the proper training and preparation the answer is yes but on occasion, I do run into a practice where my answer is sadly doctor no you shouldn’t do this you shouldn’t reduce your insurance dependence and then I always say right now. It doesn’t mean you couldn’t do it in the future but your practice isn’t set up for you to be able to do this successfully. Naren, true confessions, I don’t like delivering that message

Naren: 

Right

Gary: 

I don’t like to deliver that but I’m not there as a coach to win a popularity contest. I’m there to serve the client

Naren: 

Right

Gary: 

So, I’m not going to give the client advice that is going to result in hardship for him or her

Naren: 

Gary, do you mind I know we didn’t we didn’t talk about this but I had a call today with one of our clients. He’s a new practice owner. He spent like half a million dollars building everything up and then COVID hits.

Gary: 

Yeah

Naren: 

So, he’s not able to pay his bills. Should he sign up for PPO plans?

Gary: 

well I mean it really depends on his practice. Now is this a start-up?

Naren: 

Yes Gary, total start-up but he went overboard on expenses. So, he just

Gary: 

Yeah, yeah, and then and then COVID hit and I need a little more information. How is doctor on personal savings practice savings reserves. I imagine they’re fin

Naren: 

Probably yes. Probably he didn’t think it through I mean unfortunately some people think magically everything is going to happen on day one I open the doors

Gary: 

Yeah

Naren: 

With the start-up it doesn’t work that way

Gary: 

Now he’s a client of yours so he’s made a great decision

Naren: 

Yes

Gary: 

He is a client of yours but we know that digital marketing is not an immediate

Naren: 

Exactly

Gary: 

solution

Naren: 

Exactly

Gary: 

It’s not it’s not like you turn the switch on or I like to use the faucet analogy like on the hose. The garden hose you turn the water you turn the faucet and the water comes out of the hose

Naren: 

Right

Gary: 

Well you don’t do SEO work on mastering SEO and tomorrow you get five new patients that found you on google

Naren: 

Right

Gary: 

That doesn’t happen

Naren: 

And it’s not just SEO but it’s the reviews it’s all the other things

Gary: 

Everybody else yeah and with that in mind he does need an immediate source of patience now I still want to explore it. Could that dentist find an immediate source of patience to get jump started like maybe he opened the practice up in his hometown and actually he’s fairly well known in his hometown, could he do some grassroots marketing and get his first 50 60 100 patients that are family and friends and if that was the case see here’s the advantage of not going in network right away. Because once he starts going down a network, he’s going down the slippery slope and he’s going to be dependent on those insurance companies. Why are the patients going to be choosing because he’s in network?

Naren: 

Right

Gary: 

But think if he went the other way any right from the beginning he didn’t he found other ways to find patients when you like a lot of dentists will say to me hey Gary I’m starting a practice from scratch I’m just going to stay in network for the first three or four years that’s it and just to get started once. I get started and then once I get a patient base then I’m going to go out of network. What’s the fly in the ointment there Naren, what’s the what’s the flaw in that? The flaw is why did those people choose him

Naren: 

Because he was on the plan

Gary: 

Yeah and many times in that case he’s become subconsciously very dependent on that source of new patients

Naren: 

Right

Gary: 

So, I would explore with this dentist first. Let’s just totally brainstorm could we find i mean we do very well with two doctors with 80 new patients a month. So, with this being a solo doctor could he find 30 or 40 patients in that first month and then another 30 and 40 the second month and could he give it a shot and see. Now you said he overspent. So that makes me think well that makes me think that he must have a nice office

Naren: 

Yeah, he has a beautiful office yeah

Gary: 

I mean then that could be but if that couldn’t be done to get a small base of practice to start with small base of patients to start with then sadly I would say yeah that it’s not the right timing for you doc because of your precarious financial situation

Naren: 

Right

Gary: 

Now I vacillate a little bit explaining my logic but does that make sense Naren?

Naren: 

Yeah it does make sense but I know I put you on the spot and I know there’s no straight

Gary: 

No, I’m glad we talked about it because that’s an example but back to our kind of our core example for this episode, a handful of times I’ve had to say doc you’re not set up for this. Now and I want you to hear this right now, doesn’t mean you couldn’t do it but I wouldn’t do it right now based on the based on your practice details. Every time I’ve had to deliver that message and let me explain again that that’s an outlier that’s not common it’s very uncommon but every time I’ve had to explain it every single time my client has said it’s what I felt in my gut and you’re confirming what I felt

Naren: 

Right is it like 5 percent of the time Gary like or in your experience that you have

Gary: 

Yeah, it’s about five percent

Naren: 

Okay

Gary: 

Yeah four or five percent. It’s an outlier. It’s one out of 20.

Naren: 

Right

Gary: 

Now let’s talk about why what is holding them back why and let me go through some reasons one, it’s not a relationship driven practice. Well Naren you might think well wait a minute are aren’t all dentists relationship driven practices. Well they are if they listen to the thriving dentist show

Naren: 

Yes

Gary: 

They are if they listen less insurance dependence podcast but the truth is some practices are very much just transaction driven. Our practice when we bought it was transaction driven was not relationship driven and when it’s not relationship driven, the patient doesn’t have a connection to the office or the team the dentist or the team that would cause them to stay there and when they don’t have that connection, they’ll jump off to the next one. The loyalty isn’t there. Relationship driven corresponds to some level of loyalty. I mean that’s right, that’s from Robert Chaldini, I mean that’s rooted in fundamental principles of the Robert Chaldini chair. When there’s a relationship there’s loyalty. Now the loyalty could be thick or thin, we hope it’s thick but when I’ve been in practices and I’ve said no don’t do this now one of the core issues is not it’s the truth is it’s not a relationship driven practice and it’s interesting when I talk to the dentist about that he or she will say yeah and I don’t want to make excuses Gary but one of the reasons is not relationship driven is I feel like the dang hamster on the treadmill and I feel like I just got a pedal, pedal, pedal, pedal I don’t have time to slow down to get to know them to do the things I’d like to do because of these darn PPO it’s like what came first the chicken or the egg what came first the lack of a relationship driven practice or the dependency on the insurance plans and dentists will say to me I know it’s an excuse and I need to overcome it but the reason I haven’t done it’s not that I don’t want to do this it’s that I feel like I just got to jump over to the next room and I’m kind of a robotic dentist just going through the paces but every single time they said you’re right it’s not relationship driven

Naren: 

Right can I give a resource Gary?

Gary: 

Please

Naren: 

So what I we could do is we could include in the show notes your google page and I would like our listeners to of course not when you’re driving but when you go back home click on the show notes and read some of those reviews and if life smiles Gary’s practice is a 10 or let’s say 10 where do you stand on a score of 1 to 10, and that way like I mean again when you read the reviews just go through a few reviews and look at the number of reviews and the number of stars you can then compare, are you relationship driven or you’re not

Gary: 

I mean the truth is that your google reviews are evidence

Naren: 

yes

Gary: 

if yes or no of I mean when I’ve been in those practices and I’ve said not now what do you think their google reviews look like

Naren: 

Probably low rating

Gary: 

There might be a handful, there might I mean we can probably count on two hands and they’re often a number rating with no like it might say three or four sometimes even five

Naren: 

Yeah

Gary: 

but no expansion on that

Naren: 

no love letter reviews no long paragraph reviews

Gary: 

Yeah

Naren: 

It’s just so usually I mean you have but I don’t know the exact numbers but I think 570 ish reviews and all five stars and these are love letter reviews so

Gary: 

And it might say four stars and they say very near my office

Naren: 

Yes

Gary: 

Very near my work. So, why’d they choose you. Very near the work.

Naren: 

Right

Gary: 

I’ve even seen I’ve even seen a five-star review they take my insurance

Naren: 

Right

Gary: 

Okay that I mean that’s a legit review

Naren: 

Right

Gary: 

It’s not the kind I’d like to see but it’s a straight up legit review

Naren: 

it’s not a relationship-based review

Gary: 

No

Naren: 

It’s not that appreciates the relationship

Gary: 

So, a second reason that I see that’s holding them back and why I would say not now is they have high team member turnover. So, patients are not connected to the team and again these are all think of this all as an ecosystem where one relates to the other. I mean I was in a practice as a coach doc Gary do you think I can do this here now the doc was mid-career. So, this isn’t a newbie he’s mid-career mid-40s. The newest the longest team member the longest team member was there four months. Now granted some element of turnovers outside of our control but that’s not a good situation with which to go out of network because if the new the longest team member was there four months the newer ones were there weeks

Naren: 

Right

Gary: 

Where’s the relationship with the team with the patients it’s not there

Naren: 

Right

Gary: 

It’s not there so that would be another indicator that maybe now’s not the right time. You’ve got high turnover versus I did a wonderful zoom meeting with one of our mutual clients today Naren, and he now he did have a she did have a new team member that was there just six months but it was because they grew. They added a position but among the other team members I have to think for just a minute I believe the next newest one was 17 years

Naren: 

Wow

Gary: 

That was the next one so the new one that was only there six months was because they added someone. Now that’s strong wouldn’t you agree?

Naren: 

A hundred percent

Gary: 

yeah

Naren: 

You’re bringing up a good point like you can’t love your patients when your people don’t feel loved, meaning

Gary: 

Yup

Naren: 

I mean if they’re leaving that means for whatever reason they don’t feel appreciated or they don’t feel valued or something

Gary: 

Well legitimately Naren, there are elements of turnover outside of our control. Their spouse gets a job transfer and they move out of state or a mom having her first baby decides to be a stay-at-home mom or maybe it’s an older team member who is taking care of an elderly parent

Naren: 

Right

Gary: 

And they need to focus their time and attention on that. Those are all legitimate reasons but if that was the case now, we had all kind all everyone else was new in the practice then we got to give the team a chance to connect and settle with patients in order to develop that rapport relationship with them that is so vital in this in success of going out of network. Now let me add another one and this one I’ll ask you to comment up. The office has either no marketing at all other than they sign up for the plans or no willingness to find the might right marketing resources to attract new patients. Would you agree that’s a deal killer on going on a network? They either have no marketing

Naren: 

Yeah

Gary: 

And or no desire to find the resources I mean the doc might legitimately say I marketing is so out of my element I feel like a fish out of water. Hey that’s fair but just go find the resources then

Naren: 

Yeah absolutely I mean because one of the reasons people stay on network is, they get quote in quote new patients. Even though they end up riding off a lot so you need to replace that. How do you replace it? With powerful I recommend I’m biased of course. Digital done for you organic google centric marketing so

Gary: 

sure

Naren: 

That way you just have a stream of new patients who are coming to you because they want to come to you because of your reviews because you keep showing up for various keywords in all kinds of subconscious reasons

Gary: 

Right well that leads me to the fourth reason that might be a deal killer for going out of network is truthfully. Now you have to be blunt, docs have to have thick skin to receive this information but truthfully in a blunt analysis these practices provide patients with no reason to come to them other than they’re in network. In other words, there’s no reasons for patients to stay in these practices when they go out of network. They’re not technology oriented, they don’t have relationship driven practice, they don’t offer patients the reasons why they should stay and every time I’ve delivered that message which I don’t enjoy delivering um the doc says yeah I you’re right you’re absolutely right and thank you for sharing this with me because I know all you care about is my success and thank you for saving me the pain of aggravate and aggravation of making mistakes now and now show me what I need to do to get ready and here’s the great news here’s maybe we’ll finish on this error because here’s the great news. Let’s say a listener was in those situations yep no relationship driven practice. Sadly, have had high turnover and they don’t have long-term team members. Up until now they haven’t been interested in marketing or finding the right resources and truthfully there are no reasons for the patient to stay once, they go on a network. Let’s say that’s the case. A practice can turn that around in in less than a year and trend in the right direction in all four of those categories in less than a year. So, starting from the worst possible situation no you can’t do it now they could put themselves in a position to successfully do this in a year or less. It’s going to take some hard work and it’s going to take a lot of effort over that year but they could do that in less than a year. So, I hope that’s encouraging to our listeners that regardless of where they’re where they feel like they’re starting from now they could turn this around and a good place to go would be the past episodes of the Less Insurance dependence podcast. Go through those, make an action plan there’ll be actionable items on every single episode. We’re approaching episode 100 Naren, so they could listeners could go through those make a list of things to do and put themselves in a great position to be able to do this soon but again remember that 19 out of 20 dentists that I meet can do this and can do it successfully now with again with a little bit more prep and a little bit more readiness they could do this. Hey Naren as we wrap this up, I want to make a suggestion to our listeners. As we have listeners discover the less insurance dependence podcast every day and this might be the first episode you’ve heard. In my practice my life smiles practice one of the most powerful resources we have is your marketing agency Naren is EKWA, our marketing agency. We are a paying client of EKWA and we get 80 new patients a month. They allow us to grow allow us to achieve all of our goals in the practice, so one of the coolest things you could do to get ready is to enlist the services of EKWA and Naren, I know you’ve been kind enough to offer a complimentary marketing strategy session with Lila stone your director of marketing where any of our listeners could set that up and spend time with her. She’ll do a significant amount of preparation time. Doctors will learn all kinds of metrics on in the way they look in the eyes of google and she’ll make very specific recommendations on things they could do to strengthen their marketing and just do what we’ve done and that would be one of the most powerful preparation tactics they could use to get ready to successfully go out of network. Let’s put a link in the show notes for that free marketing strategy session and let me invite you as a listener to take advantage of that. Normally they charge a 900-dollar fee for that session and it’s worth every nickel of that however you’re been kind enough to offer this at no cost to the listeners of the less insurance dependence podcast. You’ll learn things about your practice you’ll learn things about marketing you’ll learn things about what you can do to successfully go out of network. On that note let me take a minute and say thanks to our listeners we appreciate each and every one of you. Thank you for those have that have jumped on iTunes and write reviews. We’ve had a wonderful surge of iTunes reviews that helps more dentists find us. Thanks so much for your listenership we appreciate each and every one of you and we look forward to connecting with you on the next less insurance dependence podcast.

Episode Resources:

Recent Episodes

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Episode 104: Serve Patients Who Value Your Worth
Episode 102: What are the Consequences of Staying In-Network with PPO Plans?