Episode #389: Team culture, case acceptance, and the systems that set practices free with Kiera Dent

Naren Arulrajah: This is the Less Insurance Dependence podcast show with my good friend Gary Takacs and myself, Naren Arulrajah.

Gary Takacs: 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.

Lester De Alwis: Welcome to the Less Insurance Dependence podcast. I’m your host, Lester De Alwis. This podcast is dedicated to help helping dental professionals build stronger, more profitable practices with less reliance on insurance. Before we begin a quick message from our sponsors. A quick shout out to our sponsors, Ekwa Marketing, who’s offering a complimentary marketing strategy meeting to help practices attract high quality patients and grow through strong online visibility. There are pioneers at digital marketing, and if you ever want to get a health checkup on your online visibility, you can book your session at lessinsurancedependence.com/msm. And today I’m really excited about this conversation. Our guest is Kiera Dent, the founder and CEO of the Dental A team, a woman-owned dental practice consulting and management firm that has coached hundreds of practices across the country. Kiera has started her career as a dental assistant and worked her way to virtually every seat in a dental office, from treatment coordinator and scheduler, office manager, regional manager, and practice owner.

Lester De Alwis: She also scaled the practice from 500,000 to 2.4 million in just nine months. She was recently featured in USA today as one of the top 10 professional coaches in the country, and she hosts the Dental 18 podcast with over seven 20 episodes. So when Kira talks about what it takes to build a pro profitable independent practice, she’s not speaking from theory. She has lived it from every angle. So in today’s episode, team culture, case acceptance, and the systems that set practices free is what we have titled for this episode. We are going to dig into something that does not get talked about enough and transition about, and the transition away from insurance is not just a business decision. So it is a team decision as a systems decision and leadership decision. And Kira has, and Kira is gonna walk us through exactly how to get your team, your case acceptance and your operations ready so that when you start dropping plans, your practice does not just survive, it thrives. And Kira, we are so happy to have you, have you here. Welcome to the show. Yeah. yeah,

Kiera Dent: Thank you Lester. I’m so happy to be here. It’s always that moment where you sit and listen to your bio and yeah, I’m excited because like I like to say, I don’t just understand offices. I literally am offices. I’ve sat in the seats I understand and shoot to get on a podcast with you podcast Whiskey Lester, and talk about how to be less insurance dependent. I mean mm-hmm. That’s a highlight of my day today, so thanks. I’m super excited. Love what you guys are doing for the dental industry and honored to be a part of this today.

Lester De Alwis: Amazing. So, we’ll get to, we’ll get to the highlights that I just mentioned in the bio itself. since you have sat in nearly every seat in a dental practice from dental assistant and a treatment coordinated to office manager, regional manager and practice owner, you even scaled a practice from $500,000 to 2.4 million in nine months. With that kind of a frontline experience, what do you see as the biggest mistake practices make when they start thinking about reducing their insurance dependence?

Kiera Dent: Yeah, well again, thanks for the like juicy resume there. , I think the, I think the piece is sitting in all the different seats and having my own practices and growing a practice from 500,000 to 2.4 million people always are curious like, what’s the secret to success care? Like how do you do it? And then we coach hundreds of offices across the nation and I think one of the biggest mistakes I’ve seen personally and with clients, I think that they’re just annoyed with insurance. And so it feels like this haphazard decision. It’s like, I should get paid this much for a crown. And I’m like, I don’t disagree with you. However, with that said, before we go and chop off our knees of all the insurance in our practice, let’s make sure that we’re set up for success. And I think that’s the piece that people don’t realize is, I think they almost think about insurance as like a faucet.

Kiera Dent: We can turn it on, we can turn it off. I can use insurance, but I get so angry with insurance, but I don’t realize that insurance is a marketing piece of my company. And insurance is what’s driving patients to my practice. And believe it or not, I am your annoying patient who is not an insurance patient and I’m a free agent. So I float across the industry. I float across, doctor offices. I am not a set locked into this dental office because I don’t have to. And so I think when people are looking at like, I’m gonna reduce insurance dependence, I don’t wanna have it, number one, like let’s figure out how much really is the case. so many times I found if you just drop one or two insurances or we negotiate those fees, you can actually have just as much success as being fee for service.

Kiera Dent: But you get the benefits of the quote unquote marketing annoyance of insurance. But you’re paid. I have some offices, I’ve got one office in Illinois I’m thinking of right now. She literally is paid as much as the fee for service offices and she’s within network. Right. And so while I know this is a less dependent, mm-hmm . Insurance podcast mm-hmm . I think so many people feel like insurance is the enemy. And I’m not here to say I’m on the insurances team, trust me, I don’t like them as much as the next person. But with that said, I think we have to recognize that they are a marketing piece for us. They are a retention piece for us. And they do help in areas that I think if we don’t have those pieces checked into place before we drop insurance, you’ll be like another office that I have who is shockingly I, this wasn’t planned.

Kiera Dent: I didn’t think about my offices to put, I have to another practice. So I’ve got the one in Illinois who’s crushing it. They’re in network, they’ve negotiated fees, they’ve dropped the lower performing fee insurances and they actually have a neighbor to them, same city, not intentional, who just went out of network. They were sick of it there. And my practice, who’s less dependent on insurance but still uses it as a tool, they’re a $5 million practice. My other office who decided to just drop willy-nilly almost went bankrupt and is struggling and can never get their ducks in a row. So I think when I look at both of the pieces, I would say the number one thing is let’s make sure that we assess the costs. Mm-hmm . We assess, people think if I go outta network, they all love me. fun fact, they don’t.

Kiera Dent: And insurances are ruthless. And they write your patients and tell them, if you go to this other office, they’re in network. Like everybody’s against you. And so you really need to dial it in, make sure we understand what our cost is, how much marketing dollars we’re going to need to spend, what are our retention and reappointment processes, let’s make sure we got this great VIP killer experience. And then let’s start talking about a strategic way to start dropping. So doing it myself, having done it for lots of offices, I think that tends to be some of the biggest mistakes I see that offices do. But the ones who are really strategic, like, I have another office, we’re gonna move cities, he’s in Chicago. Yeah, he dropped and their practice flourished, but they knew the cost, they knew the consequence, they had the pieces in play and they were absolutely successful in exiting out.

Kiera Dent: So again, I’ve seen the, I’ve seen the highs and the lows. I’ve lived it with these offices. And I would say make sure you get those ducks in a row before we decide to drop insurance and make sure we know the, just like a patient, when we’re presenting a treatment plan, you want the patient to understand both sides of the coin. So like, what happens if they don’t do treatment? What happens if they do treatment? And I think the same thing with dropping insurance. What’s, what’s the both sides of the coin? And let’s make sure we’re prepared regardless of the decision we make.

Lester De Alwis: Yeah. That is really insightful and I think it makes sense that, you know, that we, the mistake starts before we make the business decision. So, yes. It sounds so like so much that you know, again, this comes back to the team as well now to the next question. now through the dental a team you coach hundreds of practices across the country. One thing you are known for is building team wide ownership mindset where the practice is not dependent on one person. How does that kind of team empowerment actually make it possible for a practice to move away from insurance reliance?

Kiera Dent: Yeah, great question. and it’s fun because Gary and I believe it or not, I know mm-hmm Gary Tack is we actually worked at Midwestern dentistry, like Midwestern, university of the Dental Yeah. In Arizona. Mm-hmm . And so I know Gary in my real life and then I know him professionally as well through the podcast we’ve chatted before. And I think about this and I think about coaching teams. One of the biggest things, and one of the reasons I built dental a team was because of all the students at Midwestern. Mm-hmm. And I think Gary probably can have a similar , a similar feeling. I worked with those students for three years. Mm-hmm. And like that’s what spurred me to start the consulting company, was because I thought, oh my gosh, poor little baby students, they’re gonna go out into this big world of dentistry and they’re gonna get their booties burned because they don’t know how to do business and they don’t know how to run a team.

Kiera Dent: What they do know how to do is get their box drop correct and get their crowns and they know how to prep teeth. But running the business and running a team. So then I started thinking, oh my gosh, there’s no podcast out there that talks to dentists and team members. We don’t have this like yin and yang and being a team member myself, I’m like, everything out there is geared to the dentist but nothing’s geared to a team. So hence why I built dental A team, it’s dentist and team consulting. It’s where I bring both of them together. And I’ve literally lived on both sides. I’ve practice owner, I’m a business owner, multimillion dollar owner, to being a team member of working in offices, multi offices, single offices, all the positions. So when we come to this, that’s where it’s a big piece of, doctors might have this great idea and doctors, we need you for that.

Kiera Dent: We need your visionary aspect. Yeah. But the team makes the freaking dream. So we’ve gotta make sure that this team and this buy-in and team members, if they’re truly empowered, and this is where I love to help doctors know, like what should you be able to count on your team members for and team members knowing this is what my job should be, being an om myself. Yeah. It’s like grandma’s recipe, like passed down through the generations. You have no idea what an OM should or shouldn’t do. Like that’s real life for us. Mm-hmm . And so helping teams realize, like I just got back from a practice in New York. There’s eight locations where 29 million in revenue. And one of the biggest things we do, I do eight team meetings over the course of four days. It’s absolutely exhilarating, utterly exhausting and so fulfilling. is one of our core values is ownership mindset.

Kiera Dent: And what I’ve seen, ’cause I’ve coached this practice for about eight years, very incredible, very successful, is we have a core value for these offices called ownership mindset. Mm-hmm and the teams, I’ve watched them over the years when they start to think about ownership in a way of they’re responsible for this, it’s not just the dentist. They’re responsible for our collections, our overhead. And you don’t need to teach them every ounce of business. But the more they understand business, like I was drawing graphs of like, what is profitability and how do we get there? We either increase our production, increase our collections, or decrease our spending. Like those are our three levers to go after. When teams start to see it and it’s like a, it’s like a math equation. When they start to see the business and they start to take ownership of it and they start to elevate into this realm, doctors become so much happier because you’re not trying to drag this boat behind you and do it all on your own.

Kiera Dent: Teams start to rally of hey, well why don’t we look at our insurance plans and see which ones are our lowest paying And if we dropped those or hey, what if we negotiated and we’re able to increase our fee, could we maybe maintain this? Or hey, we have too many patients. Which is usually when people start to, they usually wanna drop because they got too many patients and not enough space or they’re sick of being paid nothing. Like that’s usually the two indicators for people to wanna drop. Yeah. but when the team has this ownership mindset and they see the team and the practices their own, they’re responsible for it. They help making decisions, it is so much easier to get them bought in understanding the pros and the cons, the consequences of making these decisions. And like I said, with these offices, there’s eight of them now.

Kiera Dent: When I started there were three and we’ve grown over the course and it’s multiple millions. I watched these teams take full ownership, but they take ownership of the decision to make the decision and then also the ripple effect afterwards. ’cause when you decide to drop insurance, oh get ready, I feel like it’s Red Rover. Red Rover. Like let this dental insurance come over. like you gotta grip, you gotta hold on and you gotta hold on for dear life because you can’t let go and everyone needs to be united. But when you elevate your teams, you trust them with making business decisions. Yes. You as a dentist are still leading and guiding these teams freaking rally with you. And it becomes so much easier to get that buy-in that engagement. And that’s why I built the company. It was ’cause those poor little Midwestern students, they didn’t know this, but you elevate a team, you elevate the dentist, you bring those two together, that is a magic in the making. And you can really, truly drop insurances, make better decisions all the way around. And your team is more bought in ak they last longer, less turnover because this is their practice, not just your practice.

Lester De Alwis: Yeah. Basically teamwork makes the dream work. . So , I

Kiera Dent: Used to think that was such a funny phrase, Lester. And then I started because I was like, teamwork makes the dream work. And then I broke it down. I was like, okay, you’re like teamwork them all working together is what makes this dream actually become a reality. It’s like that’s, and you’re exactly right. Like you get that team thriving and jiving and really rally. It’s so easy. So I would say if your practice feels hard or these decisions feel hard, I might just throw out, we might not have our team gelling and jiving. And having that ownership mindset, you get them locked into that. You get them bought into it. That’s how your teamwork really does make that dream work.

Lester De Alwis: Yeah, exactly. And yeah, so now let’s talk about case acceptance. Now case acceptance is one of the most critical factors for any practice trying to go fee for service. And you focus heavily on this through your consulting. What does a high performing case acceptance system look like and how does it change financial reality for a practice that is still heavily insurance dependent?

Kiera Dent: Lezzer, I was so excited for this question when I was reading and prepping for this podcast. This is the one that I was like, this is the like silver bullet. This is the magic nugget because I get so excited to talk about case acceptance. Case acceptance when I was in practice. So my practice we grew from 500,000 to 2.4 million. We had five locations in it. we were closing like $50,000 cases same day. I did not know credit cards could be swiped for that. I was like, okay, we’re buying a boat today. Like did not even know that was real. And I love that. And this is where I get so excited about case acceptance because whether we’re selling and closing a $500 case up to a $50,000 case same day, having different pieces insurance, oh gosh, it’s such a crutch. And I get so annoyed by it because I’m like ladies and gents, it does not actually make or break your case.

Kiera Dent: Acceptance insurance is just a coupon. Mm-hmm And so I think first step to dropping insurance and being less insurance dependent is getting your team to stop leading with insurance. I say in case acceptance sequence matters. So whatever we put at the forefront of our treatment planning, which most people are scared of rejection. So they lead with, well it looks like your insurance is going to cover this. Or if you’re not as trained of a practice, you say your insurance is going to cover this. And then they’re super mad at you when their insurance doesn’t cover. So one words are free, let’s use them to our advantage. Like let’s make the reality we want them to be. And so when I look at case acceptance first, at first, I don’t care if you’re less insurance dependent, more insurance dependent, no matter what, let’s just break the model and see that dental insurance is truly a coupon And I break it down for offices and help them see because most people don’t understand.

Kiera Dent: Most people get medical insurance. Medical insurance. We pay our deductible insurance covers the rest. Why? Oh, if you haven’t been in a hospital, you don’t know how much those things cost. Like we lived in Arizona for a while. Mm-hmm . Scorpion bites. One little teeny tiny vial is like 10 to 50 grand. Like it’s ridiculous. That’s expensive healthcare. Yeah. On the flip side, dentistry might feel expensive, but like let’s talk about it. A filling is like 500 bucks. Crowns about a thousand, 1500. Yeah. We’re not talking hundreds of thousands of dollars for treatment. Mm-hmm . Unless we’re in the all OnX cases. And then those are a completely different model. But you better believe I’m not using insurance for any of those all on X cases. Like truly. So when I look at insurance for dental is the exact opposite. They give you about a thousand dollars coupon and once that thing’s mapped out and tapped out, there’s nothing left.

Kiera Dent: So either you can say it’s like a coupon or a bucket of money and insurance is just take money outta that bucket. And when it’s done, it’s done. So when I look at the cost of dentistry, when I look at everything we’re presenting in cases, stop for the love of everything wholly using insurance as your like crutch. No matter if you’re going less insurance dependent or current, we lead with this is our total treatment. If we’re using insurance, this is our insurance estimate and this will be the total out of pocket when I see you on Wednesday. We schedule them, we tee it up, we don’t, we don’t lead with insurance. And when you can get to that space, people are like so nervous to drop insurance ’cause like, oh my gosh ki no one’s going to accept. And I’m like, that is so not true.

Kiera Dent: Yeah. 80% of case acceptance is psychology and your mindset 20% is your skill. And so if you’ve got this mindset of insurance is gonna make or break your insur, your cases, that’s going to continue and you are going to, it’s like literally your brain is wired to whatever you believe. It’s gonna find more and more of that to make it true. So if we believe that insurance makes or breaks our cases, you’re gonna have more and more people saying yes or no to you. But I’ve also seen working with hundreds of offices that they’re also the flip side. We’ve got some practices in Indiana, there’s five of them. Shout out to them, I’m sure they’re listening to this podcast ’cause they live for anything where I’m speaking . we have trained all of their treatment coordinators to be able to work through the insurance to where we’re adding multiple millions every single year.

Kiera Dent: Whether they’re max on insurance or whether they have unlimited insurance or whether they’ve got a thousand dollars or they don’t have anything. And I think when I look at case acceptance, please, like it is not insurance. Insurance is not make or break case acceptance. The way you think about it, the way you present it, the way you talk about it, I say stop planting weeds in your flower gardens. Like let’s stop talking about insurance is the first thing. Let’s stop talking about insurance. Is medical catchall. It’s not. It’s a coupon. Let’s start saying what it is. Educating our patients on it that’s going to help you with your case acceptance. So to me, this is the easiest one when you’re dropping it because today you should already be training your team. Insurance does not diagnose dentistry. You diagnose what that patient needs. That is your moral obligation.

Kiera Dent: And on the flip side of that, us as team members, it’s our moral obligation to be able to help those patients. If my dentist is amazing and my dentist diagnosed it, my job as a team member is to find a way to help that patient say yes today and to present the other side of the problem for them. So they make the best decisions for themselves. Again, sequence matters. Words matter the way you say it’s 80% what you’re thinking before you even walk into that. They’re buying your confidence. They’re not buying a crown, they’re not buying a filling, they’re not buying an all on X. They’re buying your confidence in what that’s going to give them in the future. Are they focused more on cosmetic function, cost or longevity? Ask them these questions, tie it back to that. But you better believe that insurance does not make or break your cases.

Kiera Dent: It’s your belief system that’s making or breaking that. So to me lesser, this was the easiest question of all was to help offices that. Mm-hmm. When you knock it outta the park and you believe and you have it where like then it’s just a conversation. We’re doing the dentistry, how do you wanna pay for it? It’s really the piece that we’re trying to figure out. Like that’s all it is. Mm-hmm. We’re moving forward. You came to the dentist, we’re doing this, how are we paying for it? You get your team to have that mindset. You get your whole practice on that mindset. You tee it up with great handoffs, we talk about next visit, date to return time needed. And if they’ve got their recare scheduled, you are so crystal clear to where patients know they walk up to the front office, they can literally say, Dr. Lester wants to see me back for a crown on the upper right in two weeks for an hour and a half and I need to get my cleaning scheduled.

Kiera Dent: Mm-hmm . You have those kind of handoffs, you’ve got that kind of buy-in from your patients. Complexity is the enemy of compute of execution. It’s not insurance. So please stop making it hard. Please stop presenting insurance and please just realize that your patients need great dentistry and that’s your obligation. Insurance is just a nice bonus if you choose to use it. But it’s such a pathetic coupon. It’s such a like, it’s not even a worthwhile coupon. Mm-hmm . But hey, if they’ve got it, let’s maximize it. And if not, let’s just start learning to not use it as a crutch before we go. insurance less dependent.

Lester De Alwis: Exactly. I think that frames the whole, that reframes the whole conversation and now every practice is different. So let’s talk about how you actually customize this. You have said you don’t only believe in one size fits all, in consulting and that every practice needs own operations, culture, hiring, strategy and systems. So when it comes to reducing PPO participation, how do you customize that roadmap for your practice and what KPIs tell you that they’re ready to start dropping PPO plans? I think that’s a big question many of this, many of the dentists have.

Kiera Dent: Yeah. great question and you’re right. I built a consulting company based on what I wanted. I never worked with a consultant. So everything you got came from what my little Midwestern babies needed all the way to what I wish as a team member, I would’ve gotten whether for better or for worse, but I was like mm-hmm I have not found a dentist or a practice that is on rinse and repeat. They’re not the same. With that said though, systems behind the scenes can be the same. Mm-hmm . And systems operate the same and the way we run a practice can be the same. But your culture, your nuances, that is solely dependent for you. So this is how we reframe it for how a practice is going to be dropping. PPO is looking to see what does your practice, what’s your culture and you better believe, I’m like, you’re become fee for service.

Kiera Dent: You better make this incredible. Think about like I think, I have a chiropractor, she’s completely fee for service and I look at how she operates when I come in. If I’m late, there is no berating me. If I come 15, 20 minutes late to my hour appointment, she sees me. There is nothing about rescheduling me. She loves me and she does the work in that time. So I’m not getting extra time. But she is not sitting there like nickel and dimming me. Yeah. If the weather’s bad and I text her, she’s like, Kira, no problem. You take care of yourself. She spends a full hour on me. You go to another chiropractor, I’m getting like 10 minutes of the actual clinician’s time and the rest of the time is spent with it. I am willing to pay 250 to $300 per hour session with a chiropractor because I know she’s gonna have dedicated time with me.

Kiera Dent: Yeah. But I think so many dental practices believe that you can continue to operate as if you’re an insurance company, but charge premium fees. So I’m here to say fun fact that does not work just because you’re an amazing clinician. They’ve got to feel like you’re an amazing clinician. They’ve got to experience it as an amazing practice and you’ve gotta get those things into place. So when people are like, are we ready for this? And you ask about specific KPIs, what I look for is, like I mentioned before, the bulk of times people are like, when am I ready to drop insurance? I ask the question of how far out are we booked on hygiene? Because usually we are coming into a hygiene crunch. And so whether we are not able to see our patients on time, we’re maxing it out. That’s oftentimes one of my first indicators that like, hey, we should be looking to drop insurance because we’ve got too many patients there.

Kiera Dent: I know people want me to tell you that the KPI to look for is I wanna make more money and if I just drop this insurance, I’d make more and I’d have to work less. With that said, though you are not wrong with less patients. You do make more money, but you are also working your tail off to get those patients in the door. Retain them, keep them as these new fee for service patients. A fee for service patient costs you a lot more to bring into your practice than a PPO one does. It’s harder, it’s harder work, it’s harder marketing. So I’m looking at what’s your insur, what’s your hygiene, how far booked out are you? Mm-hmm . If you’re not booked out very far, don’t think about dropping because you need to use this insurance as your marketing engine. Mm-hmm . To get your patients in the door.

Kiera Dent: Also, I’m looking at doctor’s schedules. , if we are not full as an office, please do not drop insurance. Because if you drop insurance now, again, most of the time when offices drop we’re losing. I tell them to bank on losing 50% of those patients when you, when you drop. And can you sustain that drop as a practice if you drop Now you might get lucky and you might only lose 30% of them, but if we’re like, I would rather plan for worst case scenario and get best case scenario. So 50% of the patients on Delta, you lost every single one of them. Could you maintain your hygiene schedule? Could you maintain your doctor schedule? The other thing that when I tell people they’re ready to drop insurance is when they are like, if they wanna drop days. So they’re like, Hey here, I don’t care.

Kiera Dent: I don’t care. I only need to work two days. I’m gonna cut it because I need to cut back. And that’s something, by all means, that’s probably a really good way to do it. Other times I also look, like I said, looking at plans because not all plans of insurance are created equal. So you can do a thinning to me instead of it being a full drop or not drop. What if we just look at a thinning, like can we thin out maybe the 2, 3, 4 insurances that are just clunky? They’re not taking up a lot of our space to open up space for more fee for service patients. Open up more space for higher paying PA patients. Other piece I look at is, could I get my insurance patients to pay more? So could I use my insurance if I’m an all on X? You better believe those practices.

Kiera Dent: I say keep your insurance patients because they come in and usually those insurance patients become great all on X patients, pretty much fee for service. So I just need to look at it differently. So really I’m looking at my hygiene amount. I’m looking at how far out I’m scheduled on treatment and I’m looking to see if I dropped and lost 50% of my patient base. Again, I know that’s extreme, but people usually live in the positive and then like they think in the positive and live in the worst. Let’s plan for the worst and live in the best. So if I lost 50% of those, could I still pay all my payroll? Could I have that? And then you also need to be looking at your marketing dollars and your overhead because you need to be pushing out probably 10, 20, 30% in marketing costs because you’re switching that you took a 30% hit on insurance, you’re going to be offsetting that with now paying for marketing that you haven’t been paying for. So I look at that. I also look at the Google reviews, like if we dropped insurance, would these patients still continue to come? Mm-hmm. How is your, like how is your cult following of your patients? Will they continue to come? Are we insurance dependent on our case acceptance? If you are still living on any of these areas where insurance is pushing hard, those are KPIs. I’d be checking to make sure I don’t drop yet. Let’s button those up, let’s tidy those up and then let’s consider dropping.

Lester De Alwis: Wow. Look, that’s, I think I love how you basically framed that. thank you answer for that question. And I think, that’s how I think, how you say you don’t believe on one size fits all, fits all consulting. And that’s, that’s basically what everyone should be looking for when they’re looking to, get some mentorship for their practice. So now if a dentist,

Kiera Dent: Sorry, I missed one thing. One other big piece that I would look for is making sure you’ve got a membership plan in place. Because if you can get them on a membership plan, you can retain them for you’re offsetting and you’re getting paid higher. But I would definitely check to see how many patients you have on that are active to see do you have them to where they’re going to stay with you or can we start to convert more to protect that patient base? Sorry, Lester, that was one thing. Like that’s very big on dropping. Yeah, it is very to make sure you look for,

Lester De Alwis: Yeah. So if a dentist is listening right now and thinking I want to build a more profitable, less insurance dependent practice, but I do not know where to start, what is the first move you would recommend that they make today?

Kiera Dent: Wester, I hope that you’re ready for some honesty. ’cause I thought about this question a lot and I thought, which way could I take this? I could take it a few different ways and I would rather be honest. mm-hmm rather than optimistic for dentists because I think there’s a lot out there that tell you, go do it. It’s gonna be amazing and I’d rather speak honest and truth and I think that’s what I’m very well known for. Mm-hmm . Yeah. The first thing I would say is your practice today fee for service ready? Like are you having a fee for service experience with your patients? Are we on time for all of our patients? Like, just think of your most high-end restaurant that you go to. We’re not talking Chick-fil-A, we’re talking like Ru Chris. So like, let me just give you a comparison there.

Kiera Dent: If your experience is not quite ru Chris yet, or your equivalent of a rus Chris, I might suggest that’s where we start. So let’s refine our patient experience. Let’s make sure we’re answering the phones. Let’s make sure we’re super pleasant to these people because there will be no reason for them to continue to come to you other than if they absolutely love you and they love your team. Yeah, that’s it. That’s the only reason they’re gonna keep coming to you. So I would start there. I would look to see what’s my experience, what little areas can we button up? Next thing I’d be looking at is what are my lowest reimbursement rates? What if I just trimmed those out and we dropped those? How would that impact my bottom line? Don’t go for best case scenario, let’s go for worst case scenario and hope for best case scenario.

Kiera Dent: So like, what would that actually be? And I’d run the numbers and I’d look at that to see can you financially sustain this hit like my office in Illinois mm-hmm . They did not run these numbers. We told them do not do this. They did it. They were like, I’m gonna get paid more. And they almost went bankrupt. So to me, you cannot negate looking at the numbers to see how is this financially going to impact me. Then the third step is, hey, if you’ve checked the box, you’ve got a great fee for service experience already. We know what it’s gonna cost us financially. We have a great membership plan in place so we can retain these people. The fourth step that I would then look into is perfect. Let’s build a plan and let’s start like teeing this up. Let’s start training our team. Let’s make the plan of when we’re gonna drop.

Kiera Dent: Let’s get all of our ducks in a row. And I love to do this for offices because as you can tell, I’ve been called the Dr. Seuss of systems. I think when you have a plan and it’s executed smoothly, we prevent 80% of the problems and we’re able to deal with the 20% as they come through. But if you do the reverse and you just cut and trim and hope and pray, most of the time those offices turn out like that office in Illinois. And all of that can be avoided if you do those four steps to begin with. and really just make sure you’re, and I think this is where you as a, as an owner, as a CEO of your practice, this is your job. Your job is to make sure you land the plane successfully. You don’t go like you’re gonna go through turbulence, yes. But your job is to make sure you get your team, your patients, your practice to the final landing successfully. That means you prepare, that means you put into place things and then you execute. But if you do it out of order, that to me is sloppiness on being a CEO and the job that you were hired to do and the job that only you could do. So protect your team, protect your patients, protect your practice, that’s your job, and then move forward.

Lester De Alwis: Amazing. Some great nuggets, some great advice. so Kiera, I think a lot of listeners listening to this episode will have a lot of questions or might even want to discuss with you with regards to what you do with your team at the dental, a team with the, with the dental a team. So, how can they reach out to you or what is the best way that they can reach out to you, or get in contact with you?

Kiera Dent: Yeah, thank you for that Lester, and please, this does not need to be hard. I’d say that, running a successful practice does not need to be hard. You do not need to do this alone. So if that resonates with you, I’d love to chat with you. so like lesser said, we do have a podcast, the Dental a team podcast, so you can always check us out there. but if you want to email me, I love a good pen pal, so hello at the dental a team.com or click on our website, go to the dental a team.com, that’s the dental a team.com and book a call. We do a complimentary call. We’ll give you free advice, we’ll walk through your practice with you, give you any tips and tricks we can. but yes, any way that we can help you because again, dentistry should be fun. It shouldn’t be stressful. And I love to give people their lives back, their money back, their happiness back, and to do it with doctors and teams. So Lester, it has been an absolute pleasure, so grateful to be here and, really just hope everybody gets lit up and excited because it does not need to be hard. but it does need to have some preparation to get less insurance dependent.

Lester De Alwis: Exactly. And, if any, if any of you’re listening in, you can also find, the details of this, of Kira, her podcast and her consulting firm on the show notes of this episode. And you can get them right away from there. So Kiera, thank you so much for being, here today. This has been one of the, one of those conversations where I know our listeners are going to hit rewind a few times because there’s so much gold in what you just shared.

Kiera Dent: Thank you. I appreciate it. It was truly so fun to be here today with you. So

Lester De Alwis: Here is what I’m taking away from this is if you want to reduce your dependence on insurance, do not start by looking at your fee schedules at your PP or your PPO contracts. Start by looking at your team. Are they empowered? Do they have an ownership mindset? Is your case, is your case acceptance where it needs to be? Because when your team believes in the value you deliver and your patients can see it too, that is when the math starts working in your favor. And that is when dropping insurance plans goes from scary to strategic. So if you’re ready to take the first step, I want to make sure you have the right support, just like I mentioned in the intro. I would like to give this time to basically, to schedule a complimentary marketing strategy meeting with Ekwa marketing at lessinsurancedependence.com/msm, they are the marketing sponsors for this episode. They’ll help you attract the kind of patients who value call to care and are willing to pay for it. And you can also book a complimentary coaching strategy meeting if you’re looking for mentorship with Gary at Gary , at thrivingdentist.com/csm to map out your specific path to independence. Remember all these nuggets, all these advice we shared, even care as consulting firm or all complimentary, you can take them right away. And if you want to take action, that is the first step that you should be taking. Remember, the goal is not just to drop insurance. The goal is to build a practice where your team is empowered, your patients trust you, and your profitability reflects the real value of the care you provide. That is what freedom looks like. And if this episode helped you chat with a colleague who might need to hear this. and thank you for and thank you all for listening to the less insurance dependence podcast. I’m Lester De Alwis and I will see you on the next episode. Thank you so much.