Episode #356: What really Happens when practices drop PPO plans

Lester:

Hello everyone. Welcome to the Less Insurance Dependence podcast, your trusted source for insights, strategies, and expert advice to help you take back control of your dental practice and career. I’m Lester Alwis, your co-host, and I’m excited to bring you another value-packed episode with a very special guest, Art Wiederman. On this podcast, our mission is to help dental professionals reduce their reliance on insurance and create thriving, profitable and patient-centered practices. Whether that means building a fee for service model, optimizing systems, or improving leadership. We are here to guide you every way, every step of the way. 

Before we get into today’s discussion, I want to share a quick resource from our sponsor, and that’s Ekwa Marketing. Ekwa is offering a complimentary marketing strategy meeting valued at $900, where their team will basically provide expert recommendations on how to attract high quality new patients, ranked number one on Google locally, and increase the number of new patient calls every month. So you can book your complimentary marketing strategy meeting at lessinsurancedependence.com/marketing-strategy-meeting

And if you’re looking for a hands-on coaching for hands-on coaching to reduce insurance dependence and build a fee for service model, you can also book a complimentary coaching strategy meeting with Gary Takacs at thrivingdentist.com/csm 

Lester: Now onto today’s episode, we have a very special guest. I’m thrilled to welcome Art Wiederman, CPA nationally recognized dental CPA practice management consultant and host of the Art of Dental Finance and Management Podcast.

Art has spent decades of helping dentists make financial decisions improving. Profitability and plan for sustainable success. Today, art is joining us to share his perspective on what really happens when practices drop. PPO plans. He’ll discuss real client experiences, how most practices see higher revenues, strong patient retention, and even referrals when they go out of network. 

He’ll also share the math behind dropping PPO plans, the role of patient trust and how to know if your practice is ready for this transition. Art, we are excited to have you. Uh, thank you so much for being a part of the podcast. 

Art: Lester, thank you so much for having me on your podcast. I appreciate it. Looking forward to it. 

Lester: Of course. So let’s start with your perspective from your experience as a dental CPA. What financial results have you seen for practices that has reduced or eliminated that dependence on PPO plans?

Art: So Lester, that, that’s a great question. I, I, I have a tagline that I do, uh, that I use on my podcast, on my lectures that says that, uh, as a CPA, my life is a math problem. 

And this is all a math problem when you’re running a business. So there’s two ways to increase your profit of business. One is to raise your revenues and one is to cut your expenses. And my experience is that when you do choose to, as as we say, or as Gary Takacs, my good friend says. Uh, “change your relationship with insurance.”

Um, on the revenue side, uh, again, you’re looking at an average of, and these are, you know, these are Gary’s numbers. 38 to 42% increase in your revenues. By going out of network. So if you were, um, if your fee for service, uh, for a crown is $1,500 and you were getting paid $900, which is a 40% reduction, you’re now going to get paid $1,500. 

So that obviously is a, you know, a big increase. And that’s on every procedure the practice does. But another important thing, Lester, I think that people need to know is that there’s also significant administrative costs in your practice. Of being in network. I mean, if you look at the bigger practices, I, I can tell you that there are bigger practices that are doing, you know, million and a half, 2 million, 3 million or more, who have one or more dedicated people who do nothing more than hunt down insurance payments. Make sure that everything is coded correctly, fight with these insurance companies, and when you go out of network with insurance. Um, you don’t need those people because if your fee is $1,500, that’s what you charge. There’s not really a whole lot of, you know, negotiation and, and, and things like that. And, and, and it’s, it’s, it’s very difficult to, uh, you can’t argue with that. That’s your fee. And so, so. As an overview with this is you, you know, your revenues go up, they go up immediately, uh, and your expenses can go down. 

And the other thing it does on the, uh, on the, the practice management side, in my experience is that. The office administrative team who is now not spending hours and hours and hours filling out insurance forms, calling, following up, following up again, following up a third time. They can now do much more productive and important things for the practice, like making sure that patients are scheduled, making sure that. Uh, that, that, that every slot is filled, following up on, uh, treatment, uh, that’s been diagnosed by the practice, but, but hasn’t been scheduled. Um, you know, all these great things that we need to do to service our patients and to make sure that we. You know, generate the, the most possible revenue we can in our practice, because it’s a business, we can do that. We, we can’t do that when you’re dealing with insurance. 

Art: And the other thing that I’ve seen and, and is that, you know, you’re not dealing with patient complaints about insurance. You know, the patients are gonna look at you and they’re gonna say, well, wait a minute. I, I, I thought everything is covered. Because in a patient’s mind. When they go into a physician’s office, they hand them the insurance card, maybe they pay a $20 copay and, and then everything is covered and, and maybe they have to pay a little bit, you know, they get a bill for $57. So in, in many patients’ mind, it’s like, well, wait a minute, wait a minute. 

I mean, everything, you know, you’re, you’re giving me a a $5,000 treatment plan. Well, this is all covered by my insurance. Well, no, it’s not. So it, it, it, it’s dealing and, and it reduces the stress in the office. Mm-hmm. Oh my gosh. It, it is so much less. I mean, the, the, the offices I’ve talked to who have gone out of network with insurance plans, um, it, it’s just a much happier place to work. It’s less stressful. Uh, you know, because there’s always that, that cloud hanging over your head of, oh my goodness, is that patient gonna understand that, you know, they’re only gonna be covered, you know, $900 of this treatment plan. 

They, they, and they don’t understand, and then you have to spend time. So those are, that’s kind of an overview of, of, of, I think. Of of, of how that would work as far as the, the financial benefits, I mean, 

profitability and dental practices. In my experience, I, I have never seen an office that has gone out of network with insurance and not had a significant. Increase in profitability. It takes time and, we’ll, I assuming we’ll talk about this in the podcast, it takes time because there are some bumps in the road. 

But in the long run, all my clients who have done this are absolutely so much happier by, by, by doing this. But it is scary. 

Lester: Mm. Yeah, it is. So in other words, they could basically emphasize on the patient care when they are doing this right, they can basically elevate the patient care, right? 

Art: Oh, absolutely. Because now you know, now you’re not dealing with the conversation of, oh, well you’re saying I need this work. Uh, is it covered by my insurance? That takes that conversation off the table. Now it’s all about, and, and this is what I teach in, in my lectures and we talk about on my podcast, I is that doctors, you, you need to emphasize that everything that you do in your practice. Is to help the total health of your patients. And patients don’t understand the connection between health in the mouth and all kinds of different diseases and afflictions that we have. So now if you take away the patient’s trepidation about accepting treatment because, oh, my insurance doesn’t cover it. Uh, then, then the, the conversation becomes a lot more geared towards Mrs. Smith, we wanna make sure that you live a healthy life. And Dr. Wiederman is suggesting this treatment for lots of reasons. And, and this is going to benefit your total health. 

Lester: Exactly. Exactly. So, um, now those are some powerful, um. benefits you mentioned. 

Lester: So now one of the biggest concerns dentists have always have when dropping insurance is, will my patients leave? Now, let’s dive into that. So may dentists fear losing patients if they go out of network. What has been your client’s experience with patient retention and how often do patients come back after leaving?

Art: Sure. So something that doctors need to understand is that there will be patients who will. Hopefully temporarily exit your practice. There is, I have never heard of a practice that has dropped an insurance plan where some patients are going to go to another office. Because, you know, if, if every one of your patients, um, were millionaires and money was not an issue. Then you wouldn’t lose patients. But for many patients, you know, they live, many people live paycheck to paycheck and they have to look at every dollar. And if there’s another office close to them that will take their, they will look at that. 

But, but here’s, here’s what happens. First of all, as far as losing patients. Yeah, you’re gonna lose some. But in my experience, here’s what happens. The patient, if you are providing world class service, they’re going to leave. They’re going to go to another office. They’re going to go to another office that they’re not familiar with. They don’t know the doctor, they don’t know the team. They’re coming to your office because they love you, they love your team, but they had in their mind, oh my God, financially, I can’t deal with this. My experience, I’ll, I’ll give you an experience with one office, uh, here in, in Orange County where I live with, they dropped a big plan and it was the last one that they had. We won’t mention any insurance company’s names, so they dropped XYZ insurance company. And they had patients who left. They had some, not, not a ton. And here’s what happened. Not only did most of those patients come back to the practice within 68 months, but those patients realized what a great practice they had left and what high class dentistry and high service dentistry they were getting. 

They started telling their friends the story. Okay. So I left and, and now they’re, they’re not in network with insurance anymore. So I decided to go somewhere else and oh my God, what a mistake that was. And those patients started referring, and I’ve heard this several times, that these, these offices are not only getting their patients back, but they’re getting more referrals from those patients,’cause they realize, mm-hmm. What, what a, what a great office it is.

So the most important thing about going out of network is that you need to have a trust with your patients and you need to have a trust with your team. So your team has got to be on board ’cause. I’ve had situations where I’ve actually coached teams and they, they, oh gosh, my, my, everybody’s gonna leave. I go, no, they’re not. If your team is not on board with this decision, you’re gonna have a problem. And you have to explain to them why you’re doing this. And in addition to that, if your patients don’t trust you implicitly, like they would go to the moon for you, right? If they don’t, then it’s gonna be harder to do this because, you’ve gotta have people in the front office, and this is why working with you know, consultants, you know people like Gary, who’s a master at this, you know, it takes six months to a year to put the framework in place to go out of network. You don’t just listen to the by. By the way, folks don’t listen to this podcast and then tomorrow morning just go in and say, we’re going outta network with all our plans. That, that’s, that’s Russian roulette. That’s disaster. It’s not gonna work. So what you wanna do is, again, you wanna work with someone like Gary Takacs. You wanna work with Gary Takacs. I mean, Gary’s the best in the business and you know, they’re, he is gonna coach you through what are the steps, what do we say to the patients? 

The, the thing that you wanna really do is, is beat the insurance company to the punch so that by the time the insurance company finds out that you’re going on network. And they send that horrible letter to the patients telling me about all the people in their area that they can go to. It’s old news. So this is, this is, this is the important thing is doctors, you are gonna lose some patients, but here’s the deal. You’re gonna lose patience, but your revenues are gonna go up to compensate for that. We’re gonna talk about that in a little bit. But yeah, I mean that, that’s what you wanna do. It’s so, it’s a matter of making sure that your team is on board, that your team has the right verbal skills and facial expressions to back up the office’s decision to be able to educate in a very non threatening way. 

And, and a lot of offices need to understand too, uh, Lester is, is that, you know, it’s not like if you go out of network with an insurance plan that the insurance company’s gonna pay nothing. They’re just going to pay the out-of-network rate, which. If you look at the math in many cases is not, you know, life changing money. It is for some people, and again, there are gonna be some patients who are going to leave and those are probably the patients that don’t value the practice as much. Mm-hmm. As other patients who understand that you are here, you know, for, for total health. When I coach doctors, when they buy a practice, uh, I tell them this, I say, everything that you do in your practice, no matter what, must be in the best interest of your patient, whether you’re going to get paid for it or not, and the offices that keyed that advice do very, very well. But yeah, I mean, it, it’s all about trust. It’s all about understanding that, I mean, you know, if you lose some patience, you know. The other patients that stay are gonna be paying 40% more, It’s a math problem. 

Lester: so, yeah. Yes, yes. And it’s encouraging to hear this, uh, and still the numbers can feel daunting for practice owners who are weighing this decision. 

So, let’s talk about the math behind going out of network. So can you walk us through the financial math, for example, what happens when practice raise fees after dropping PPOs and balance that against the potential patient loss? 

Art: Okay, so let, let’s make up a math problem here. So let’s assume that a practice is got, I’ll make it easy, a million dollars of revenues that are coming in from insurance patients, okay? Mm-hmm. So let’s say that, um, 20% of the patients exit the practice. I, I don’t think that’s, if you do it right, it, it shouldn’t be that much, but let’s say it does. Mm-hmm. So now you lose 20% of those patients, alright? 

But that million dollar practice, that million dollars of insurance revenue from a PPO perspective is closer to about $1.4 million. In, in so, so basically, here’s what’s gonna happen, okay? You’re going to lose $200,000 of revenue, but for that $200,000 of revenue, you’re gonna gain significantly more than $200,000 because now you are doing production of, you know, 1.4, 1.5 million on a fee. Let’s just say it’s 1.5 million, because you know, if you lose one, let’s just say one third of 1.5 million is a million. I know I said 40%, but just make the numbers easy. 

So if I’m getting a million dollars in fees. In an office that is based on PPO, discounted insurance fees, and now I leave that, okay, if I’m doing all those same procedures, on a fee for service basis and all the patients stayed, I would have $1.5 million. So now I have 80% of these patients. Okay? Yeah. So what’s 80% of $1.5 million? 1.2 million. So I’m getting an extra 200,000 in revenues. And, and guess what, Lester, I am seeing 20% fewer patients, which means that, you know, here’s a, here’s another thing, you know, and, and I’m sure that, that you and, and Naren and Ekwa, and those you guys are amazing, right? So, you know, they, they come in and they, they put in a marketing plan, right? And we pick up some new patients to fill in the holes of those 20% that left. Who are probably gonna come back. Right. And, and, and now. I get myself back up and I replace those 20% either by patients returning to the practice or by new patients, and now I have four or 500,000 more of revenues, and it doesn’t change my overhead. 

And again, as we talked about earlier. It could be a situation where, um, you know, if I have a bigger practice, maybe I don’t need that full-time insurance, um, administrative team member to do that. I can let that person go. Don’t like to do that, but that is business. And that could add another 50,000 on the bottom line. So the math. The math absolutely works if you do this in a coordinated, targeted method so that all of the patients are informed of the decision long before you choose to go out of network with the insurance company. 

Because we know what the insurance company, the insurance company’s gonna let the patient know, oh, well, Dr. Wiederman has gone outta network. Uh. Here’s a list of five incredible tr uh, dentists that are within two miles of your home that are in network. And then the patient’s gonna get that and they’re gonna say, oh, well that’s cool, but it’s a non-issue. I’m staying with the office that I love, and that letter goes in the trash. So the math works. I mean, it absolutely works. 

Lester: Like, yeah, that, that makes a lot clear, right? It’s, I think it’s not just about losing patients, but about working smarter and doing less for more revenue. But of course not every practice may be ready for this change. So, uh, it’s going to take some preparation, like you said.

Lester: So let’s wrap up with some guidance. What advice would you give your dentists who are considering dropping PPOs but feel hesitant because of patient trust, team readiness or financial risk?

Art: Okay, so first of all, um, I think using a coach to do this is who has done this over and over and again, I I, I don’t have to make a commercial for people like Gary Takacs. ’cause Gary’s nationally known for 40 years. I mean, Gary, Gary’s real good at this. Um, and, and, and there are pe lots of people do this, but, but you, you know. 

Number one is to talk to somebody who has helped. Hundreds, thousands of offices to do this and, and, and to get over the fear of losing patients. And it’s a mindset. Okay? So that, that’s the first thing. 

The second thing is, as I was saying earlier, you need to have a very serious heart to heart discussion with your team. And if you are not a good leader in your practice, it’s gonna be a little harder if you’re a good leader and leadership. Lester is so important in dentistry in any business. I mean, I ran my own CPA firm for 33 years, and I read leadership books, but I never took leadership classes in, in, in college or anywhere else. I, I, I just, you know, a leader has a plan and if you are a leader. In your practice and you set the vision of what you’re doing. Okay, we’re gonna add another operatory, another treatment room in our practice because we’re getting busier and I wanna do extra procedures and what have you. Um, we’re gonna buy this new technology because of this and this. Okay? So as a leader, you’re now making this other decision and, and saying, I’ve sat down. I’ve looked at the numbers and you know, team, this is just, the math doesn’t work. I sat down with an Art wiederman or with a, another dental, CPA. Uh, you know, I’m a member of the, uh, academy of Dental CPAs. There’s 25 firms across the country that represent like 12,000 dentists, and we, we all have these conversations with our clients, and, and, and, and we look at this and, and the doctor says, okay, team. I, I am not just being, I wanna have a conversation with you because while the doctor is the leader and the doctor can do whatever he or she wants to do, that’s clear. ’cause they own the practice. I never made a major decision in my CPA practice, and again, I’m in a service business. 

Dentists are in a, a service business. I never made, a, a major decision in my practice without talking this through with my team and you and you say to the people at the front desk say, how do you guys think our patients would react to this? 

And if the entire team just absolutely freaks out and says, oh my God, we’re gonna be sitting here talking to ourselves. There’s no way I can’t do this. And it’s really important to have. People in the front who are positive and not negative people. If you have negative people working in your front office, this is probably not gonna go as well. Uh, it’s probably not gonna go well because if you have a negative person who’s trying to explain all of this, and then the patients are complaining, they’re just going to, they’re gonna fold. Whereas if someone in the front desk says. Mrs. Smith, you know, we value you as a patient and everything that we do in this office is for your best interest. We use the best labs and the best supplies, and the best this, and the best that. And we have the best team. And unfortunately, um, the way insurance works is they continue to provide us with reimbursements that do not allow us. As a business to provide this world class care, that and, and doctor Will, will accept nothing less.

So we’ve made the very difficult decision to change our relationship with your insurance company. But here’s the good news, okay? Here’s the good news. The good news is you can still come to this office. Hmm. You can still see our team. We love you. We want you to stay, and here’s how this works. So I want you to have a full understanding of this so that when you come for your next appointment, you’ll understand and when you start explaining to them that it’s not that big of a deal finding because all they care about is financially, they’re coming to your office and they like your office, they love your office. Their only trepidation is, Oh my gosh, I’m gonna have to pay so much more money. And it just really depends, you know, because it just depends on, I mean, there’s thousands of plans and thousands of, of iterations of all this. 

So if your team, uh. Is prepared either on their own or probably with a coach. And I, I really, really would encourage anybody who’s thinking about going out of network with any, any plan or plans to use a coach. And you always wanna start, I think, uh, with the smallest insurance plan. I mean, you have a plan that maybe you’re, you have a hundred patients on as opposed to the big insurance company where you got a thousand patients on that plan or whatever, start with a hundred because if you lose a bunch of those, you will get to see your, you know, how it works. You get a live, you know, a, a live demonstration of what the objections are so you can overcome them, so that when you go to drop the bigger plans, you are ready. So, so, yeah. The, the, the trepidation, the scaring that the, the, the, the fear that the doctors have absolutely. It, it is legitimate because this is their business. This is how they support their family. This is how they fund their retirement and pay their house payment. 

Art: So it’s important Lester, that the team be on board and that the team used the right verbal skills, eye contact language and that everybody is backing this up, so the front office explains it. The patient goes in for their cleaning, and then they’re talking to the hygienist.

And the hygienist doesn’t have anything to do with the administrative part of this, but the hygienist is sitting there for 50, 60 minutes with the patient and the patient says. Hey, Jane. I, I, they told me at the front that you’re not in network with, with my insurance. I mean, is, is that a big deal? And that hygienist and that dental assistant and that treatment coordinator all need to have the same language and, and, and saying. 

You know, we all, as a team talked about this and we value you and we refuse to provide anything but the best possible care for you. 

And we just all came to the conclusion which many dentists in America are coming to by the way. I think the statistics cluster, I don’t remember what it was. It’s either one in three or one in four, dentists in the United States are looking at changing their, and this is from the ADA, looking at their Yeah. Changing their relationship with one or more plans and, and everybody in the office has the messaging. But if your team, ’cause they’re the ones that are gonna have to be, they’re the ones that are the gatekeepers. And that are gonna help keep the patients, if the team is armed with the proper verbal skills and messaging and, you know, eye contact and everything like that. And, and the message to the patient is, yes, we’re doing this, but you can still, and a lot of ’em think that if you go outta network, they can’t come to you.

That’s the first thing. So I, I, I think that’s important. I think that, you know, you have to look at some worst case scenarios. Sit down with your dental CPA and say, what if 20% of the practice walks outta the office? Now, here, here’s another thing that we have to consider. While you know, you and I, and Gary and Naren are all very like-minded, about the effects of dental insurance, uh, on dentists in America who we have served for a long, long time. You do have to be careful. 

For example, one time I lectured, uh, at a, and again, won’t mention names, uh, I lectured to, uh, for a dental supply company in a state capital. Uh, and in that state capital, it was on the East coast. Um, 90% of the pay of the, of the people that lived in that town worked for that state government. Mm-hmm. And they all had a particular insurance. So if you go out of network in that state capital. You are gonna have a heck of a hard time maintaining a practice. 

Art: So there are situations where you have to deal with that. And that is where when you start a practice or buy a practice, you, you need to understand, we had a doctor Lester. Mm-hmm. Uh, who is a, a, a specialist and 80% of the practice that she had was with one particular insurance company and she called me up one day and she said, alright, my reimbursements are under 40% of UCR. Under 40% and she’s telling me that she’s writing checks for 10, 15,000 a month into the practice. 

And I said, you have two choices. You must either go out of network with this plan or you must shut your doors unless you, uh, hit the Powerball and you’ve got all this money and you’re doing this as a hobby and you don’t care, which I doubt is what’s going on. So this doctor dropped, uh, went out of network. Uh, the profitability went up, I believe in two years, about a million dollars. It was a big practice. I mean, and, and, and, and 80 plus percent of the patients stayed. But you’ve gotta have a coordinated plan to do this if you just say, oh, oh, I just wanna let you know next time you’re not gonna be in network. And, um, here’s what’s going on, and we’ll see you next time. That, that does not work. It absolutely does not work. And, and the whole impetus of your. Uh, you know, reduced dependency on insurance, podcasting, What have you got? You’ve done three, 400 episodes of this? How many? I don’t know. A lot. Yes. I mean, you talk about every single possible iteration of this and, and it, it’s not an easy thing to do, but it will make the doctors happier. It has to be over time, and it has to be with the team’s understanding. 

But the most important thing is building trust with your patients. If you’ve got a practice where you build trust with your patients, uh, this is gonna be a lot easier. Uh, if, if your patients just come in. Um, because it, it’s a low cost office, or it’s a low this, or it’s a low that, um, uh, it’s, and, and you change it and you go to fee for service, it’s can be very difficult. 

Um, you know, we have a practice in, uh, uh, in a, uh, in a town, uh mm-hmm. It’s about a 75,000 person town. And you know, they’re 90 plus percent insurance. But the problem is, is this is not a town where fee for service would work. Yeah. And you know, they have, um, and, and, and, and they have to live with that model. So, but that’s not the case everywhere. Uh, most dentists have the ability to do this. They will make more money, they will be happier. Here’s another thing we haven’t talked about. 

Art: They can spend more time with their patients. That’s what they’re telling me. They get to spend more time with their patients, talking about getting to know their patients, getting to know their fears, getting to know their families, and explaining to them the benefits of the treatment that’s being recommended. And, and again, doctors. You know, technology is huge. You, you, you, you, you wanna be on top of technology. I mean, have the best technology you possibly can because that’s gonna bring people back. But I, I, I think that those are some good tips for people who are nervous or afraid of making this, um, decision.

Lester: So. Great advice. I think. I think, um, the, the verbal cues, the examples you just present, and plus the real world, uh, the scenarios that you just presented, I think that really ties together the financial patient and the leadership sides of this decision. So Art, thank you so much for sharing that advice and for all the insights you’ve given us today, I think our listeners will find a lot of encouragement and clarity from your perspective. 

So again, I want to thank you so much for joining us today and sharing your invaluable perspective on what really happens when practices drop PPO plans. Your experience as a dental CPA, backed by real client stories and the financial math gives our listeners both clarity and confidence about reducing insurance dependence. Thank you so much. 

Art: Thank you for having me, Lester. It’s a great service that you’re doing to the dentist that listened to this podcast. 

Lester: Of course. So the key takeaway from today’s episode is that going out of network isn’t just possible. It can actually lead to higher profits, stronger patient loyalty, and less stress for you and your team. So, and remember, this podcast is about taking action. There are two simple steps you can take right now to move your practice forward. So, first up, first, if you want to attract better quality patients and reduce your dependence on insurance. Schedule a complimentary marketing strategy meeting with Ekwa Marketing. Their experts, will show you, show you how to replace PPO dependence with strong, organic SEO strategies. You can, you can visit and book a time with them at lessinsurancedependence.com/marketing-strategy-meeting  to book your session. 

So secondly, if you’re looking or if you’d like coaching. Like art meant art dimension during the episode. Uh, like coaching on building a thriving, profitable fee for service model schedule, a complimentary coaching strategy meeting with Gary Takacs, Gary has helped thousands of dentists successfully drop PPOs and gain true practice freedom. So you can reserve your spot at thrivingdentist.com/csm

Again, these are all complimentary. You can book a time at your convenience. So, um, again, complimentary resources are designed to help you take meaningful steps towards the practice and the life you truly deserve. So, if you found value in today’s episode, please share it with a friend or colleagues, who could benefit from reducing their insurance dependence. The more we spread these conversations, the more we can help dentists regain control of their future. 

Thanks for joining us today. I look forward to connecting with you on the next episode of the Less Insurance Dependent podcast. Until then, keep moving towards a thriving independent practice.