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Episode 120: Step #4 to Successfully Resign from PPO Plans

January 28, 2021
The fourth step to successfully resign from PPO plans is to create an in-office membership plan. Listen to this episode to find out what an in-office membership plan is all about, how it works, and how you can create one for your patients!
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The fourth step is a lot more tactical, strategic step in terms of application. This step allows you to provide more benefits to your patients and become a dental practice that cares about the health of the patients. By providing benefits, you can retain your patients and also gain new fee-for-service patients as your patients will engage in referral marketing about your practice. Gary will explain how you can achieve this in today’s episode.   

  • Intro to today’s topic > 00:57
  • Masterclass to become insurance free! > 01:14
  • Benefits of the membership plan > 05:26
  • The design > 07:17
  • Keeping it simple > 12:12
  • Marketing to potential groups > 19:15

Resources

Naren: This is the less insurance dependence podcast show with my good friend Gary Takas and myself Naren Arulrajah.

Gary: We appreciate your listenership, your time and most of all we appreciate your intention to reduce insurance dependence 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.

Naren: Hello everyone, welcome to another episode of the less insurance dependence podcast show. This is Naren. your co-host today’s topic is step number four to successfully resign from PPO plans this is going to be an exciting topic because you know you need to do these six steps correctly and in the right order to get massive results, but before I do that, I have an awesome announcement for you you’re going to look forward to this. Gary is doing for the very first time ever a sixth you know six step master class which is called the six steps to successfully resign from PPO plans. This is happening on the 17th of February so it’s an evening three-hour course so you’re going to get tons of information you’re going to get a lot of material and also Gary’s going to help you think this through with regards to your practice so in that three hours you’re going to come out come out with a plan on what you need to do what are the six steps you need to take to successfully resign from PPO plan and it’s only going to be open for 20 people. So once we have 20 it’s sold out it’s closed off so nobody else will be able to get in and at the moment we are not planning to repeat this. So, for the entire 2021, this might be the only master class. So if you are interested in resigning from PPO plan I strongly suggest you sign up it’s 89 dollars, 3 hours of CE and you’re going to love it. It’s going to be led by Gary. Now let’s jump into the fourth step. The fourth step for just to tease it. It’s you know creating and successfully implementing an in-office membership plan. Gary let’s jump in

Gary: yeah, Naren you know I’m excited to continue this series. We’re doing a series within the podcast on the six steps to successfully resign from PPO plans and we are now on step number four.  If you’ve been following along step number one is know your data where we have to understand our data on the plans that we’re on before we can develop a strategy and an order in terms of our resignation strategy. Step number two is all about mastering digital marketing. We master digital marketing for two reasons, to replace any flow of new patients that are currently coming from the PPO plans because as soon as you resign it’s as if the PPO plan turned the spigot off and no more new patients but we also want to replace any patients you might lose. So step number two is to develop a successful digital marketing plan. Step number three is all about getting your team on board getting your team fully on board and behind the strategy to successfully resign PPO plans. You know i like to think that each one of these six steps is most important. In fact, I could actually argue the case like i was on the debate team I could argue that each step was most important but I could hardly think of a more important step than step number three and step number four is to create an in-office membership plan. Now step number four is a lot more tactical and it’s a lot more strategic in in terms of its application. However, it’s no less important. So, let’s dive into this one and membership plan we were one of the first offices in my life smiles practice, we were to our knowledge one of the first offices in the country to have an in-office membership plan. In fact, it was so new that we had to consult with an attorney to even discover if it was something that we could do. Now that was in 07 and our attorney did some research and he said yeah it looks like it is something that can be done however you cannot call it an in-office insurance plan he was able to uncover that in his research because if you call it an insurance plan then you’re subject to all the rules and regulations around the insurance industry. So just as a quick heads up, you can call it many things we call ours our TLC plan our tender loving care savings plan. So, it’s called our TLC savings plan it can be called your smile plan your smile savings plan, many different names you can use you just can’t call an insurance plan so let me walk through some steps in terms of how to do this successfully in your practice and I want to start by talking about the benefits of an in-office membership plan to your patients as well as to your practice. Massive benefits, and one of the benefits is the membership plan allows you to roll figuratively, roll out the red carpet and attract people in your community who don’t have insurance and we’re going to talk more about that but that group of people is growing. In fact, in some areas is growing geometrically and now the membership plan allows you to roll out the red carpet and let them know that hey we understand budgets we’re family people we get it. We wanted to do something for the wonderful people in our community that don’t have dental insurance.

Naren: now one other thing I like about the membership plan is retention right because when you when they’re on a membership plan and they come twice a year for cleanings and they are paying for it so they’re going to take advantage of this and you are reviewing their entire oral health two times a year it’s very easy to keep them healthy it’s very easy to suggest things that’s going to you know get them on track again or even deal with some of the bigger issues like a beautiful smile and things like that right

Gary: You bet

Naren: so, I look at it as you know how do I put it. I look at it as you know playing off and so you have that that let’s say you have 500 people on a membership plan so all those 500 people are now hopefully going to spend a thousand dollars a year with you they are spending the membership plan fee plus they’re also going to do other dentistry that comes off of what happens in those hygiene visits.

Gary: yeah, it’s I, mean it’s a great way to have ongoing interaction with our patients reinforce treatment recommendations and just be preventive with them to help them become as healthy as possible and prevent future problems. Now here’s some really cool things. We’ll talk about how to design your plan in a minute but here’s some really cool things about it no claim forms. So, the office doesn’t file any claims no limitations. If it’s provided in your office if it’s a service you provide it’s covered under the membership plan. No tricks you know think about dental insurance if your patient heaven forbids comes in five months and 29 days after their first cleaning, what’s the insurance company going to do to that claim if they come for the second one five months and 29 days

Naren: denied

Gary: denied and then they’re going to have all kinds of fine print about services that aren’t covered ortho denied dental implants denied cosmetic dentistry denied and none of that stuff we avoid all that no annual limit, I’ve been in over 2200 practices Naren, today even today in 2021 a typical annual award is a thousand dollars maybe twelve hundred dollars in the best plans maybe fifteen hundred dollars and that’s it. Once they hit that no more benefits and what is the cap on your membership plan.

Naren: no cap

Gary: there’s no gap

Naren: yeah

Gary: I mean if the patient wants to have a fifteen-thousand-dollar smile

Naren: right

Gary: get the benefits of the membership plan for that. So, let’s talk about the design here’s what we recommend to our clients come up with an annual fee that covers two hygiene appointments two exams one comprehensive one periodic and then any necessary x-rays. Those could be bitewings they could be full mouse series they could be a digital pan or if you like us you have a CBCT it could include a CBCT because you want to have whatever records the doctor needs and you’re welcome to come up with your own fee for that when clients ask me Gary what do you think would be a good fee for that we recommend around three hundred dollars. It could be 299 297 and again you’re welcome to plug in whatever number you like on that. We also recommend that that be the fee for the first person in the family and then each additional person offer a 50 savings off of that. So, if you’re going with 299 annuals for the first person, make it 249 each additional person in the family. That’s a great value to them and we do it as an annual fee. The reason i like to do it as an annual fee is because then they’ve pre-paid for their hygiene visits for the year which what does that mean they’re going to show up

Naren: they’re going to show up exactly

Gary: because they pre-paid for it and then you want to provide a discount a savings on any service in your practice what a membership plan basically is it’s like having your own amazon prime card for your practice or your own costco membership card for your practice. Now we’ve done the heavy lifting for you. We’ve tested what percent of a savings makes the most sense. You don’t have to do this we already did it we did it across hundreds of practices. We tested 20 percent, 18 percent, 15 percent, 12 percent, 10 percent, and 8 percent and what we discovered because obviously you want the discount to be attractive enough to encourage a patient to sign up but as low a discount as possible to have minimal impact on your practice and what we discovered Naren in hundreds of practices that the sweet spot was ten percent, ten percent. Now I’m going to go on record right here saying Naren, I don’t like the 10 discount I don’t like it nope don’t like it but I like it a heck of a lot better than the 44 percent average PPO discount in 2021. Obviously, anything less than 44 would be beneficial to you but 10 certainly in the scheme of things is a much more palatable quote discount than 44. Would you agree with me on that?

Naren: 100 percent 100 percent I mean now and the other thing i like about this Gary is it’s fair right because the 44 percent discount now you are running a practice on very thin margins which means now you have to I hate to use the word couch the people who are paying regular fees a lot more to make up for this insurance companies CEO’s getting 20 million dollar checks you know it just is not fair

Gary: anyway, it’s not fair now we’re part of the fairness club because now we make it fair for everybody

Naren: yeah

Naren: Yeah, everybody gets a 10 percent exactly

Gary: in your I want to emphasize the importance of keeping your plan simple keep it simple and here’s why. Recently we have a new client in my coaching, coaching work that had created their own plan. They had three different plans there they had a healthy patient plan a perio patient plan and a restorative plan. Three different pricing, each of them had front and back printed on both sides for each plan all the fine print and all the details and by the way this practice they’ve had this in place for two years before working with me and my coaching they had a grand total of five patients on their membership plan

Naren: were you surprised Gary?

Gary: not the least I was surprised they had five but it’s because first of all you get confused well I could do this one I could do that and when people were confused what do they do?

Naren: Nothing

Gary: Nothing, now how do you think a front desk team member is going to be able to explain this quickly at the front desk while they’ve got two other people waiting behind them to check out two people waiting to check in and all four phone lines ringing off the hook. No they’re not going to be able to do that

Naren: No, exactly, I mean imagine if there are seven different versions of prime, prime would be the mega flop of the century. You know not what it is today.

Gary: I mean so Naren, I’ll put you on the spot, explain prime to me right now

Naren: It’s discounts and lots of free stuff movies music you name it no not discounted free shipping

Gary: Free Shipping

Naren: Shipping sorry

Gary: free shipping on everything

Naren: Free shipping on everything, Yeah

Gary: I mean you can explain that in probably two sentences and it’s like can give me the pen, where do I sign like where do I start and that’s how you want your video

Naren: Even though amazon has millions of products you can explain it in two seconds

Gary: in two seconds, yeah Costco it’s a card that allows you to shop at a discount store where everything is priced low and the card allows you to be a customer at a store,

Naren: exactly

Gary: and it’s very inexpensive most people recover the cost of the card in less than one visit

Naren: right

Gary: boom you know so it’s very simple so don’t make the mistake of over complicating that so I’m always asked well Gary what if they have Perio, what do we do well Perio is covered under the 10 percent savings of any service in the practice

Naren: Right

Gary:  it’s covered so you want to keep it simple. Now I want to talk about something that is, I really want everybody listening to this podcast to get their arms around this. More and more people by the day do not have dental insurance benefits, more and more people. This was a pre-COVID trend because companies are not required to provide dental insurance benefits and more and more companies are realizing, it’s a horrible investment, you know it’s horrible, and they don’t get much of a return on it especially when less than 20 percent of all people that have dental insurance benefits even use them. So, they realize wait a minute we’re paying this massive amount of money to essentially enrich the dental insurance companies, how about we don’t do that anymore. Now in a post COVID 19 world I believe we’re going to see a stampede of companies abandoning dental insurance, because of the competitive cost structure and the loss of money that they made due to the shutdowns and everything else. So, more and more people are not going to have benefits and this is a great way for you to roll out the red carpet and attract them. Now there’s many groups of people Naren, that don’t have dental insurance benefits, but I want you to think about three big groups because in every community these three groups are large. One group would be retirees, retirees. Now Naren you’re in Mississauga outside of Toronto any retirees in Mississauga

Naren: oh tons

Gary: yeah now I’m in phoenix ask me that question

Naren: do you have retirees Gary?

Gary: are you kidding me, they outnumber everybody else

Naren: yeah, people from other parts of the country coming in

Gary: absolutely

Naren: and I’ll call the climate

Gary: so, retirees every community has them. Secondly the other end of the age spectrum millennials, people in their 20s and 30s where they haven’t reached the point in their career you know where they have receiving benefits and then the third group is a fun group because that group is growing geometrically, it’s called gig economy workers is the title for that group gig, gig economy workers. Those are freelancers’ independent contractors, they’re uber drivers, lyft drivers, they’re Airbnb owners, Vrbo owners, they’re Etsy shop owners, and that group is growing geometrically. So, when you know who you’re looking for we can now more successfully market it because you want to know who you’re marketing to and there’s ways through digital marketing otherwise so we can attract those kind of people and that leads me to the last recommendation. You want to develop a very specific component of your digital marketing plan to attract people, new patients in your community to come into your practice because of your membership plan and Naren an awful lot about this through your EKWA your digital marketing company but certainly there’s things we could do to attract retirees, would you agree?

Naren: absolutely Gary there are a lot of things we can do to attract all these groups of people for sure and for example the thing that I learned after I started working with several years ago is people don’t look at insurance as a benefit, they look at it as a coupon. I have this coupon I want to make sure I use it. So, their first question always is hey does my does the coupon cover this, right that’s why a lot of practices that are insurance dependent due to dentistry. Now the minute you get out of insurance and you do these six steps and of course one of them is giving them an alternative to the coupon which is the membership plan, now they can do everything they can do anything there’s no restriction there’s no cap, right, so it’s a total game changer. I think once you have it every call cut coming in you start talking not as a person who works for a shop where everything is coupon based, rather you start talking as a person who works in a wholesome practice where it’s all about the patient and what’s good for them.

Gary: everything is possible and by the way getting a wonderful savings on anything that leads to you becoming as healthy as possible. One of the coolest things about marketing and in office membership plan is referral marketing. Let’s just take that first group retirees, Naren, I’ll ask you an obvious question. If you have a patient let’s say her name is Linda and she’s a retiree, you think Linda knows other retirees just wild guessed you think she might know other retirees,

Naren: I’m pretty sure she does and she probably has a lot of time to share what a great experience she’s having at this particular practice and

Gary: I bet the apex the peak of her bell-shaped curve of her friends are also retirees

Naren: yes, yes.

Gary: and Linda can be the person that will go out and tell all of her friends about this you know first of all you need to come to my office they are absolutely amazing and let me tell you about this really cool thing they do and that can be another part of your marketing through referral marketing

Naren: i’ll share an example like I used to belong to this gym and I used to be part of this course and I mean like a gym class around nine o’clock so everyone showing up is retiree except me and I continued this for six months so they’re sharing notes and they’re sharing tips on things to do and of course they have their own life and stuff but it’s fun so you’re absolutely right they talk amongst other retirees

Gary: yeah, and this is easy for again when you design it simply it’s very easy for them to talk about and you know everybody understands it it’s super easy. Well, that’s step number four to successfully resign from PPO plans and that’s to create an in-office membership plan and market it to your community to bring people into your practice who don’t have insurance. What I love when that happens two things when a patient doesn’t have insurance, they don’t ask you two questions. They don’t ask are you in my network because that would be a simply ridiculous question to ask foolish and then when you present treatment to them, they don’t ask you is that covered by my insurance and I think those are two questions that every dentist on the planet would just as soon never hear again and that’s what an in-office membership plan allows you to do. Well we’re going to continue this series. We’ve got two more steps i do want to bring it back full circle and invite you all as Naren did at the beginning to attend our first ever master class. It’s all about the six steps to successfully resign from PPO plans. We’re going to in we’ve got three hours in in that workshop, in that class. We’re gone go into a copious amount of detail much more detail than we’re able to cover in podcast episodes I want to encourage you to attend, it’s Wednesday evening February 17th 7 to 10 p.m. Eastern. We will strictly limit attendance to 20. It’s priced very favourably it’s 89 dollars. You get three hours of CE credits. I think that breaks down to about the least expensive CE any dentist could participate in but we’d love to have you join us simply go to lessinsurancedependence.com forward slash master class there’ll be a counter on that page that will tell you how many seats are available. We do anticipate this course selling out if there’s spots available jump in the water’s warm. Hey thanks so much for joining us and I hope your 2021 is off to an amazing start.


Gary Takacs

Gary Takacs Gary Takacs is a well-known presence in dental practice consulting. He brings deep knowledge of the individual elements of business success together with genuine compassion for the dilemma of the dentist in today’s insurance-driven culture. As host of the Less Insurance Dependence podcast series, Gary guides dental professionals to a healthier practice style that lets them deliver a hallmark-level quality of care.

You may recognize Gary’s dynamic style from his speaking engagements at a variety of symposiums and continuing education classes, or as host of the popular Thriving Dentist podcast show. As a dental practice coach, Gary’s insight is available on a one-on-one basis or through seminars, audio, and video programs.

As co-owner of a dental practice, Gary has the first-hand experience in making the transformation from high-volume/low fee insurance dependency to a fee for service model. His lively discussions run the gamut from eye-opening lessons in cost accounting to communication that shows consumers what they have to gain from a patient-centric practice.

A published author, progressive rock fan, biker, businessman, and family man – Gary Takacs always has a unique perspective to share.

Learn more about Gary’s coaching: www.thrivingdentist.com/coaching/
Connect with Gary Takacs on Linkedin

Naren Arulrajah

Naren Arulrajah Naren Arulrajah is a self-described "serial entrepreneur," enthusiastic about serving others. For more than ten years he has helped dentists, doctors, lawyers, coaches, consultants, and other professionals find practice success with personal fulfillment.

As founder and CEO of Ekwa Marketing, Naren has brought together a talented team of global experts in all areas of digital marketing. Ekwa’s International client base currently numbers about 200, at all stages of practice from start-ups to growth, transitioning to new leadership, and merger and acquisition.

Naren is always focused on giving back much value to the dental and medical community that has been instrumental in his success.

With a philosophy, in personal and professional life, of surrounding himself with others as passionate about success as he is, Naren fosters a philanthropic environment of sharing.

Naren is a consultant, speaker, author, and above all an inspirational innovator. AceTech Ontario honored Naren’s accomplishments with their 2014 Leadership Initiative Award.

Learn more about Ekwa: www.ekwa.com

Recent Episodes

Episode 130: Talking Points Versus Scripts
Episode 129: What Percentage of Patients will I lose when I drop PPO Plans?
Episode 128: The Important Role of Practice Champions in Reducing Insurance Dependance
Episode 127: The Role of Confidence in Successfully Dropping PPO Plans