Dental Unscripted

Welcome to Dental Unscripted,

where Mike Dinsio and

Paula Quinn break down the

practice ownership journey,

one episode at a time.

Starting up, buying,

and running a successful dental practice.

All right.

All right.

Here we go.

Dental Unscripted episode two.

We are streaming live.

I've got two amazing folks

on the horn today.

My co-host Paula Quinn.

Say hi, Paula.

Hi.

Stefani Sandoval,

our front office coach and

guru of all things front office,

credentialing, billing, you name it.

Today's episode is going to

be super exciting because

we are talking about a very

I don't know,

controversial and sometimes

challenging topic of

credentialing and dental acquisitions.

And it's something that we

just run across as a team all the time.

And we're gonna just talk

about it and break down issues,

common mistakes, pitfalls,

things that you guys may consider.

But before we get into the content,

I just want to make some

announcements that if

you're listening to this or

watching this on Startup

Unscripted or Dental

Acquisition Unscripted,

those are two separate channels.

Depending on which one you're on,

I want to remind you to go

to Dental Unscripted right now.

Go to your app,

Go to Dental Unscripted.

It's the new channel.

It's a navy blue and turquoise logo.

And all of our episodes are

going to be on this now.

So at some point,

we're going to shut down

those two other programs

and only be on this one.

So all things Dental Unscripted.

And Paula now is a full-timer now.

She is podcasting.

You're a podcaster, Paula.

Do you like it?

And it's not turquoise.

It's Tiffany blue.

Oh, Tiffany blue.

Is that why you're wearing that today?

It looks very,

this is more turquoise or green.

Oh, maybe that's where I was getting it.

I don't know.

I, uh, you know, girls and colors,

it's just your best,

your best not to even say a color,

but okay.

I hear you.

Tiffany blue, Tiffany blue, uh,

dental unscripted is the

channel subscribe it so

that you guys don't miss any episodes.

All right.

So let's get into it guys.

Uh, ladies.

Um,

I'm super excited because you guys are

both on, of course,

on the next level team and.

I'm excited because this new

program is all about

showing off all of the

coaches and we get the

chance to talk to Stefani.

So let's get into credentialing.

So we do a lot of

transitions and we're

fortunate enough to do the

credentialing for those clients.

And

it's just always something

it's just always something

and so I thought you know

uh paula from your from

your perspective why don't

I just pass it over to you

like what are the things

that you're thinking about

that these doctors go

through I mean you went

through it um with the

whole credentialing process

it's a very painful process

like what um why are we

having an episode on it

today because it's it's a hot topic

Well, I think it just starts with,

you know, well, there's lots of things.

I think it's, first of all, just starting,

like, when do you do it, right?

If you're acquiring a practice,

there's a very short amount

of time that you can actually flip that.

So, you know, I would say, you know,

a couple of things they're

not thinking about is they're thinking,

well, I'm already credentialed elsewhere.

Like, what's the big deal?

You know, it should be easy.

Just...

slap my name with a new

address on it and I'm

credentialed and there's a lot more.

I wish it was that easy.

We can dive in,

but I think some of the stuff is,

you know, having all your stuff prepared,

you know,

getting it all together so that

when that time crunch happens,

it can easily transition.

I think it's having updated

DEAs and malpractice and license.

We get handed a lot of

things and they're in the

middle of expiring or

expired or they have

malpractice through as an associate.

It all just looks completely

different as an owner.

Sometimes they're not even

aware that they're not credentialed.

They think that just because

they're working that they're credentialed

you know directly and a lot

of times it's the you know

the associate job they're

at the the owner is the one

credentialed everyone does

it a little bit different um

you know, and it's, it's having patients.

Once that happens, there's,

it gets pretty messy

because of the billing and

who's not like dental patients,

not dental patients, but patients,

patients, patients.

I'm from Indiana.

It probably comes out all

the same word patients

because it is a long process.

And there is a point where

they don't understand that

it's also not in our

credentialers hands anymore.

It's in the actual insurance

company's hands.

And it sounds like an excuse,

but they do what they want to do.

They go on vacation.

They've got more vacation

than the government days.

You know, it gets,

it gets thrown on someone's

desk and Mary points at

Susie and Jane and, you know,

all the above.

So it is, don't get me wrong.

Sometimes it goes like

smooth as butter and then

other times it just doesn't.

And, you know, our process stays the same.

So patience is what they need to have.

And I think that if anyone

has ever even tried to call

an insurance company and

they kind of get a little

bit of what it's actually

like to deal with them.

So that's kind of all of it,

but I think we should dive

into a little bit of each one of those.

So, I mean,

I would start with what can they prepare?

Yeah.

What kind of things they

should get together before

they're even thinking?

Because let's roll this back, Stefani.

We'll go to you on some of

the technicalities on the things,

the checklist that a

credentialer might need.

But let's put this in perspective.

So you're an acquisition.

You're going through the process.

You just did the...

all of the negotiations,

you're at the final leg of

the purchase and sale agreement.

You're stressed out.

You're thinking about all

the things of owning a

practice and the loan and

the conditions of the loan.

I mean, it's just a mess, right?

Your head's in the weeds.

And then and then someone like us says,

well,

if you don't get credentialing going,

all your patients are going

to be out of network and

then you just have a panic attack.

Right.

So so so it's like really

getting the process started early.

And what all should you be

like thinking about

gathering so that you're

totally organized?

I'm going to pass that to you.

want to say one thing though

too stefani if you can

bring this because I don't

know if this is a hundred

percent true but I would

think if they could even

understand who they're

actually already networked with

would that,

and could that help in the process?

Like I'm an associate,

I'm directed with Blue

Cross Blue Shield and Anthem,

or I'm with this leasing network,

because I know that

sometimes we come across like,

can we just do a tax ID

update and a location change, blah, blah,

blah, blah.

So what all would you say, you know,

their CAQH isn't up to date, they,

you know,

so kind of think about that with,

you know, as you're talking, sorry.

No, it's fine.

You're completely right.

So it's two parts is how am

I as the buyer currently credentialed?

And the second part is how

is that office currently credentialed?

Right.

Because you don't want to

just go in naive thinking, OK, well,

I like the way I am at this

zip code in this location

and now I'm on the other side.

side of the state and it you

know fee reimbursements

look different um and

you're just caught with the

shock that wow okay I

thought I was just going to

mirror but it may not one

be beneficial and two it's

not mirroring the office so

when we meet you know these

acquisitions we try to tell

you guys get organized find

out the seller's

participation right because

if we can fast track it so

we can get that turnaround

time we're just going to

mirror it right as long as

you do your duty

diligence and get us all

your forms you know we're

going to set it up to get

it done as quick as

possible but with these

acquisitions because you

know these are maybe a

first-time buyer right they

want to do everything the

right way they want to see

all of their options so

yeah I guess I got it I got

a question you know what

they want I got a question

for you we have people who

say we want a mirror and

get this done as soon as

possible but can you negotiate

Yeah.

Well, let's actually pause on that.

That's a great topic later on.

Like, can you negotiate?

And what's that look like?

And what's that process?

And how's that delay the process?

Let's pause on that.

You said something that's

really interesting that I

was thinking as a buyer's rep,

and that is like...

knowing what you're

credentialed with with your

associate positions that's

that's solid work with like

give some tips on that like

what kind of questions to

ask the front office gal

you work for someone you're

not really sure how it all

works they did all the

paperwork you don't

freaking know.

So like, what are some of those questions?

And think about that.

But like pivoting to knowing

what the seller,

how they're participating,

the challenge on that.

And this is you guys even

bust my butt on the buyer

rep side of like,

why don't you guys know this?

Well, first of all,

broker definitely doesn't know it.

They don't know anything.

The broker doesn't they

don't get into the weeds there.

Number one.

Number two,

the seller usually definitely

doesn't know it because she

lets Nancy Joe at the front

deal with all that.

And the seller doesn't want

to tell Nancy Joe that he's

getting ready to sell the practice.

And so like that's a strange situation.

So sometimes not knowing what the you know,

if you can,

you got a great relationship

with the seller and it's all perfect.

That is best case.

Right.

Knowing what the sellers,

how the sellers participating.

Well, why can't you just say, hey,

I'm working with a credentialing company.

I want to look at

renegotiation and the way

I'm credentialed in this practice.

Nancy Jo, how are we credentialed?

Yeah, yeah.

No, that is- They also have, by the way,

they also have fee schedules.

They should have only the

fee schedules they're using

in the computer.

Right.

Well, we all know that that's not,

we all know that that doesn't happen.

So-

I what guys, you know,

you know better than me and

we coach a lot of offices

with twenty percent

actually know what the hell

they're doing up front.

Like, come on, let's be honest.

But maybe that's a little aggressive.

I don't know.

But I wish they were that organized.

I don't know, Stefani,

you were front office

person for a hundred years.

Like,

what are these people thinking and

how to approach all this information?

Well, I mean,

there should always be a paper trail,

right?

These are contracts that

these providers are supposedly signing,

right?

Nobody should be signing

contracts for you to participate.

You should, right?

So the best thing I would

ask any dentist leaving a

practice to go start, you know, their own,

whether it's acquisition or

even a startup is,

gather your contracts before

leaving your current employer.

I'd like a copy of those

contracts because that's

also going to help us, you know,

the credentialing sign,

getting that information of how are you,

what are you currently contracting?

Because, you know,

you could be contracted at

location A and it may block

how you're going to

participate at location B, right?

Is there an easier way though to find it?

Yeah.

Is there an easier way?

Yeah, just asking.

I mean, calling.

Well, yeah, because what I'm saying is,

like Michael said,

like this doctor is leaving a practice.

He doesn't want to alert his

associate job besides, yeah,

D-IV students.

When you go out in the real world,

get your insurance

contracts and keep them.

But let's say that I've been

working two years as an associate.

Now I'm about to buy my own

practice without going up

to Nancy Jo and saying, am I contracted?

What is another way or is

there another way that

these docs can figure that out?

Yeah,

they can reach out to the insurance

networks independently, right?

Hey, here's my name.

Here's my locations.

Do I have an active contract?

It is.

I mean, it is what it is.

But insurance companies are

also getting to a point

where they are trying to

stop the multiple contracts

at different locations, right?

They're trying to really

condense it saying, okay, well,

if you're leaving here,

we're terming this location

and adding this location.

So you don't have, you know,

a whole bunch of different contracts out.

really like insurance

companies are trying to do

that when on average and

this is a statistic that

I've pulled through from

years and years ago that's

ridiculous of them because

so many of our clients

probably listening or not

clients just dentists they

work two jobs most dentists

actually moonlight for two

different practices that's

a very very common thing so

how ridiculous if the

insurance companies just try to do that

Well, I mean, they're going to block you,

but it's not that to say

that your contract,

you can't have two locations, right?

Under one contract.

The point is,

is that they are doing their

credentialing.

So many times they're asking

us to term the seller, right?

And we're not credentialing

anything to do with the seller.

We don't want to touch that,

but they will not allow

another contract to go in

there under a different tax ID.

Yeah.

Well, let's get into like that's perfect.

I think that's a really good

that's a really good thing.

So let's go through some of

like the big things.

So when you're when we're

processing Paul and Stefani,

you guys can you can take

this together because I know, Paula,

you touch this stuff, too.

What are some of the most

common things that are a

problem right before you

guys submit the applications?

It's like, oh shit,

the malpractice has expired.

I hear that one a lot.

Are there a bunch of things

or common things that you see that like,

oh gosh,

we could have did that a month

ago while we were... Can

you guys think about some

of those things now so that

these folks can look into this stuff?

I'll let you start, Stefania.

Definitely think one is...

OK, yeah,

so I definitely think one of them

is this malpractice.

These dentists who are an associate,

they don't necessarily

cover themselves with the coverage.

It's covered by an employer.

So when they're opening or

they're buying this new practice,

they have to carry their own coverage.

So during the credentialing process,

we get started and we're

using their malpractice

that is not theirs, right?

And so we're waiting now to submit time

for them to gain coverage, right?

Because they don't want to

pay for it unless that sale goes through.

And so one, that's a delay.

And two, that bill of sale, you know,

insurance companies don't

want to finalize these

contracts and these

acquisitions without that bill of sale.

Yep.

Paula, you want to add to that?

So I heard malpractice.

I heard bill of sale.

Well,

I think it's their dental license in

general.

I think having their CAQH up to date,

log on there and pay

attention to that and

If you're moving states,

if you're just having that up to date,

I won't get into details,

but through Next Level,

we've partnered with a

phone system where...

we can get the phone number

in advance and they don't

have to pay in advance um

you know there's there are

certain things that they

can do um you know I I just

think as soon as they're

looking if they can even

meet with someone like us

just to get that checklist

of things they can start

getting in order and then

just be be diligent about

it you know we have docs that

are in such a hurry to credential,

we give them the list and it takes three,

four weeks to get that crap in.

And yes,

we might still be waiting on the

bill of sell,

but sometimes we can get

those applications even

filled out if they're not online.

And we can have them ready and waiting.

So there are just, you know,

there's only so much we can do,

but we can get prepared as

much as possible.

When we're sitting waiting

on a updated malpractice or

for them to hunt down, you know,

something, you know, it just doesn't need,

we just need that bill of

sale at the close and we're ready to go.

Yeah.

yeah I I find it's uh it's

funny because like I'm not

a clinical person right at

all you guys always make

fun of me I'm the business

guy of the group and

definitely don't well michael yeah

Uh, you guys could, I'm sure hear the, the,

um, uh, sarcasm there, but, uh, yeah, I,

I am definitely that,

that one in the group and, and, you know,

like these documents like CAQH and the,

the,

it's like a Chinese code sometimes I

I'm getting pretty good at it now, but.

I'm sure you guys feel the

same way as providers.

I mean,

some of this stuff might be a

little bit more familiar to you for sure,

but I get what's a CAQH or

how do I do the MPI too?

And all these things, right?

And so I think before we

pivot to the next topic,

which is timeline,

I'm going to timeline next lady.

So that's going to put you

on the hot seat a little bit.

But before we go to that, like just,

I think Paul is right on point with,

You got to work with a professional,

whether it's next level or someone else.

And you got to start the

process early and you got

to have that conversation

of what are the things this

company is going to need

from you so that when the

time comes and you're submitting apps,

you can go because that

does parlay into timeline now.

So that is the next question

is if you guys get really

dialed in on checklists and

all the things,

What's the timeline?

And there's a lot of crap out there.

A lot of people say, oh,

you can get it done in a

month or two months.

Two weeks.

Yeah, two weeks.

It only takes two weeks for Delta.

Yeah.

I love that.

And then you hear other people,

other credentialing

companies say it takes freaking a year.

And so...

I think we should talk about this.

What is the timeline?

What should be the expectation?

Yeah.

You don't have to raise your hand.

I just want to say there's a

difference between I'm

coming in an office as an associate.

Mary up front needs to add

me as an associate.

Yeah.

Then owning your own business is,

becoming the business owner

and now having to have your own tax ID,

your own MPI to your own credentialing.

Now,

if you own for five years and want to

bring in an associate,

we might be able to get

Delta in two weeks.

Yeah.

Yeah.

And it depends on the state,

but there's a difference

between buying a business and

and creating a completely

different entity than there is,

I'm now working for Dr. X

and he's gonna put me under,

he or she's gonna put me

under their tax ID.

I just wanna state that

because we hear it all the

time from front offices say, oh, well,

I got that associate in two weeks.

First of all,

I would be shocked if it was

exactly two weeks.

However, huge difference.

Okay, I'm going to let Stefani take it.

No, I think that's good.

Stefani, can you touch on that?

The difference between MPI-I

and MPI-II and why the

insurance companies are

doing it this way?

I think that's important for

the audience to understand.

Right.

Well, in any type of credentialing, right,

there's credentialing and contracting.

And so we have to get a

contract not only

established for the provider,

but for the entity itself.

So it's kind of like double whammy.

Right.

So Paul is one hundred percent right.

It's not that quick as much as we would,

you know, and to throw into that as well,

that then we have to talk

about terminating.

Right.

the current seller so it's

like three contracts that

have to be done in order

for it to be successful and

it does take time um you

know insurance companies

what are you doing wait on

that termination part

sometimes don't you have to

terminate like let's say dr

quinn is now owning and

she's with signy here don't

you sometimes even have to

terminate my own contract because

I'm at other locations on

the participation yeah

sorry yeah no they'll say

okay great are you no

longer going to practice at

this associate job right so

there's so many different

little contractings that

are contracts that either

have to be terminated or

established so yeah ideally

we would love for it to be

so quick but again we're

playing a game with this

insurance company you know

we knock at their door every week,

just being annoying, trying to get,

you know, it moving along.

That's why we're so

successful because we're so annoying.

I'm not sure what the key is,

but patience is obviously

something that has to be

established and expectations.

If you think you're going to

get in there day one and in

thirty days out of sight, out of mind,

you don't have

Any other credentialing issues,

you're sadly mistaken.

So what are we talking about, ladies?

Are we talking about worst case?

Sorry, best case, you know, four months,

worst case, twelve months.

Like, what do we like?

Can we put some brackets on it?

Like I if a credentialing

company like us is touching

it and owning it and

following through and all the things.

And and look,

I always say on the podcast like this is.

This is like in theory,

this is like theory class textbook,

right?

We're giving you textbook answers,

but like Stefani said,

if you're an associate

somewhere else and this and

that and the MPI too, like it's,

it all changes.

There's variables to this, right?

But in theory,

if the perfect world was

happening and everything

worked out really great and

it was super clean and not

complicated bracket from what to what,

what are you expecting here?

What should you expect

post-close after you buy the practice?

I would say we're probably

around a twelve week turnaround.

You know, that's what insurance companies,

you know, twelve weeks and business days,

you know what I mean?

But to Paula, you know,

at the very beginning of the show,

she said they are never in office.

Right.

They're always out.

A part of what can delay

things is if you're not

truthful on these applications,

if they're not complete,

if they're missing something,

because then you're

starting all over again.

Right.

You got to go back into the line.

So I do think insurance

companies give us a timeframe,

whether they stick to it or

not is a whole nother

conversation we can have.

But you know,

these are the guidelines that

they give us, but always we're expecting,

you know,

we have more volume than we can handle,

or we are behind this many weeks.

So I think it is,

I would say a minimum to

give yourself is twelve weeks.

I mean,

we've definitely seen Delta a

little bit quicker, but again,

it has to go perfect,

like really perfect.

But we have definitely seen

that one good thing is we

can not even think and put

that application in pretty

quickly right when the sell happens.

They don't typically negotiate.

So even when a doc wants to

look at all the fees and

all their options, Delta Swan,

we just kind of say you're

kind of you get what you get.

So let's just fill that out

and get going on it.

So that's number one.

And then we have, you know,

we have the whole.

Right now, it's Anthem, used to be Cigna.

It's taken nine.

We've had a year on some of these.

The other thing about leasing networks is,

and Stefani might have to correct me,

once you...

If you're using a leasing network,

once you're credentialed

with a leasing network or in contract,

I don't know the proper words for it.

They get up to ninety days

to actually notify the

actual individual insurance

carriers under there.

So, you know,

I might I might be in with connection,

but connection might not

notify Humana for an

additional ninety days.

So guess what?

I'm out of I'm having out of

network conversations now.

with my patients.

So I think that's probably

the next place is how to be prepared

when you open and you are

not in network with insurance companies.

Yeah.

You're, you're reading,

you're reading my mind.

I had it queued up here.

What's the impact.

Nice work, Paula.

It's weird.

Brain waves here.

We have worked together for a while.

We have.

And so, so just to put like a,

an explanation point on, on those,

those two first topics of

getting organized and pitfalls folks,

if you didn't, if you didn't hear it,

I'll just say it.

Dummy Denzio style.

Get extremely organized and

cross every T and dot every

I. And get lots of patience.

And have lots of patience.

That's right.

Because...

Like as a buyer rep,

before we brought this in house,

because we brought it in

house a while ago and we process,

I don't know, a lot every year,

probably close to forty of these a year.

And before I'd refer like other companies,

said name companies and

I mean, what the hell is taking so long?

What's their problem?

Now I feel those companies pain.

I know exactly what.

And my clients,

like even now hearing you

guys that manage this department,

like it's like you guys

never can get their their

documents and the details

are terrible and their

malpractice is expired.

And I'm just thinking to myself,

these are dentists who are very.

very educated guys.

If you're listening, you're very educated.

You took the test you and

sometimes took the boards.

You dude, you're doctors.

This is the time to dial in

and get detailed and cross

every T dot every I and get

organized because the work

that you put in on the

front end bears the fruit

on the back end.

And,

and so that tees us really nice for

what's the impact of

If you don't get it going

and you're not prepared and

you close on the business

and now all of a sudden

these patients you're

meeting for the first time

and you got to say, oh,

we're out of network with you.

We're working on it.

They hate you right now, right?

So not really, but that is the impact,

right, ladies?

Like the patients and let's

have that discussion.

Paula, when you owned,

I think you were out of

network for a hot minute

with some of these.

I don't know.

What are our clients facing

by not taking this extremely seriously?

Does that make sense, what I'm asking?

Well, before we go there,

there was just one more

thing we wanted to mention

that we forgot on the pitfalls.

The other thing is that we

run into is offices or

dentists need re-credentialed.

So they're right.

They've been credentialed

with their associate job.

And we go submit an

application for because

there are different

applications for different things, too.

Just so everyone knows it's

not some some insurance companies.

It's all one.

But others, it's like, are you doing this?

Are you doing this?

Are you doing this?

And sometimes it's.

You know, it's different for each one.

So we'll submit a particular

application based on them

now being an owner.

And it'll be like, oh,

you need to be recredentialed.

So there's a whole nother

process for being

recredentialed if you've

been credentialed before.

So I wanted to throw that

out there because it is

another thing that we we

come across as a pitfall.

But as for the out of network,

it literally is.

okay,

I'm going to say this because I'm

experienced.

When someone says, I'm going to say this,

you got to like,

people are turning up the volume.

Yes.

It's not that hard.

Dental offices make it very

difficult when they're out of network.

Um,

there's two different things when

you're completely going out

of network for real, for real.

There's one conversation

that can be a little bit more, uh,

you know,

of a process and really need to

dial in everything.

But when you're only doing

it in the interim,

and you can still honor the

insurance network fees,

the allowable amount,

that's not a hard conversation.

They make it very hard.

What do you mean?

Why?

Why are they making it hard, Paula?

Walk us through that.

What you mean is Mary and Nancy Jo,

they're making it hard?

Sorry for all the Mary's and

Nancy Jo's out there.

Well, and even the dentist,

because they don't know and

they hear it and they start

flipping out because Mary

Jo said something and it's like,

calm down.

We give them this.

It's just that I don't know what happens.

Anyway, I would say, first of all,

nothing should change.

If you have fee schedules in

your software and we'll

just use Delta as an example.

Well, let's not use Delta.

Let's use Guardian as an example.

You're nothing's going to change.

Your conversation with the

patient is not going to change.

The way you submit a claim

is not going to change.

The only thing that's going

to change the amount you

get back from the insurance company.

That's it.

And no one really knows that.

So it's not a big deal.

Don't delete your fee schedules.

Don't stop attaching them.

Just treat it like you normally do.

I would say most doctors go

with the exact they mirror.

So your dentist is going to

mirror what the seller is going to do.

Your process doesn't change.

So stop making it complicated.

You're going to honor the

patient's allowable amount,

their copay that you would have before.

You're going to submit the

insurance claim in your UCR.

And yes,

the insurance company is going to

pay you a little bit more

because you're out of

network in the interim.

It's that simple.

Now you've taught me for the

folks that know their stuff,

other consultants,

other credentialing companies,

whatever you've taught me

that that does impact, uh, well, I'm,

I'm the dumb one here in the room.

So, uh,

but so we should probably mention

that though, you know,

where I'm at right now.

So let's mention it.

Well, it does impact their maximum.

So a patient gets a thousand

dollar maximum.

It's going to impact it

because the insurance

company is actually going

to reimburse more,

which is going to quickly eat that up.

But honestly,

anybody over a crown and a

root canal is going to have

to pay out of pocket anyway.

They've just they're a

maximum benefit anyway.

I can't stress it enough.

front office people,

you do not work for the

insurance company.

You work for your dentist

and the patients.

And that's it.

They've got to learn that.

Stop worrying about, yes,

we have to be honest.

We have to tell patients,

but you tell them positively.

Actually,

Stefani's got a great way she

talks about assisting.

Stefani, go for it.

Do your verbal skills on that.

No, it's just, you know,

Any news is good news when

it comes to insurance coverage, right?

We have to get out of the

mindset of entitlement, right?

And think of it that it's great news.

They're going to assist you

with twenty five percent

rather than no percent.

And we behind the scenes are like, God,

that coverage is terrible.

Right.

But any news is good news.

Right.

And so it's always

assistance when people start.

Start thinking as an entitlement.

Oh, well, this, you know,

cleaning is free or, you know,

I don't have to pay.

It's not you in all of that coverage,

you know, and that's an estimate.

Let's just make that very clear.

But I think to go to what

Paula was saying about these front office,

I think what's really,

really hard is at the

moment you try to change something.

And now we've got a new dentist.

So they're already, you know, on guard.

But then we are and, you know,

our estimates are really, really off.

We're just losing, you know,

the chance to maintain them

and really sell this new doctor.

So I would really, really recommend,

you know, to Paula, keep it the same.

Business is normal.

What it looks like on the billing side,

we'll handle that.

Right.

Claims come in.

We are electing not to

charge anything in addition,

which we can.

Right.

But that's that's.

the offices part.

Don't let the patients feel that.

What I heard was,

is don't overcomplicate this.

And I think this is a very,

very complicated subject.

It's really hard to do a podcast on it.

So ladies,

you're doing a great job trying

to explain literally a Chinese menu.

And after three years or

however long we've been

doing credentialing,

I finally feel like I got

ten percent of what the

hell you guys are talking about.

But

um the point the point is

this is a very complicated

situation you've got you

got nancy joe telling you

one thing post close you

got your credentialing

company telling you another

then you got the law

telling you one thing and

the insurance company and

contracts telling you

another thing so you're

getting all of this

information it's really tough for you all

I think at the end of the day,

I think Paula said it perfectly.

So rewind and listen to that

part is just just chill and

keep doing what what you're

doing and have the same

conversations and and

everything's going to be fine.

But it is a it is a creepy

topic and there's a lot of

opinions out there.

So with that being said,

you'll and then you'll also

notice that this

conversation is about credentialing.

But here we are talking

about verbal skills.

I think everything comes

down to verbal skills, Paula.

I mean,

don't you agree on how you deliver

how you deliver what a

complicated situation or a

hard conversation or a treatment plan,

a treatment that's gone

wrong or a billing thing?

It's all about how we communicate.

Yeah, and I think that for me,

I'm going to state this very simple.

Why trust someone who's done

it one time in an office

for an associate versus a

company who's done it hundreds of times?

And not just hundreds of times,

hundreds of times for acquisitions,

hundreds of times for startups.

Like why we're on a forum

listening to other dentists

who have never credentialed themselves.

Right.

They've gone through a process.

They have no idea what

process they've gone through.

Oh, I became an associate.

I was credentialed in two weeks.

Number one, you don't know.

You truly don't know.

Number two, phone offices work in one,

hopefully max five places

their whole life.

How many times are they credentialed?

listen to a professional

company we have nothing to

gain by extending your

credentialing time why

would why would our team

want to track your

credentialing for nine

months or a year why would

we want to do that we want

to like there's nothing we

want more than for you to

be off our plate in three

months and not because we

don't love you but because

we're just getting more and

more credentialing the

quicker we can track this

get it because it's a lot of tracking

It's a lot of front leg work.

It's a lot of during work

and it's a lot of tracking.

Nobody wants to do this.

I promise.

So trust us when we say we

do everything in our power

to get you credentialed as

fast and as painless as we can.

Now it's up to you to

understand the process and

the timelines and give

grace because it is there

is a point that it's out of

our hands and there's

nothing we can do but check on it.

We can yell, we can scream, believe me,

we have.

We can hang up on people.

We can threaten, we can threaten.

At the end of the day, you call,

and that's the other thing.

Let me just state this.

When you call majority of

insurance companies,

so I'm Nancy Jo at the

front desk and I call and say,

how's our credentialing going?

You're speaking to a

representative that doesn't

even have access to the backend.

They don't even because I get it.

And I say, there's no way I have proof.

Well, then I'll get pushed through,

pushed through, pushed through.

Finally,

I can get a hold of somebody that

actually knows and can give me an answer.

But when you call up and say, oh,

am I a network?

And they say, no, oh,

we don't even have an

application on file.

Like, don't have a heart attack.

That is not true.

We submit applications.

They're submitted to usually

an entirely different team

than the front end when you

call to check on a patient.

The outsourced call service

company that they've

outsourced in India or something.

When the roosters are

crowing in the background.

Right.

You just it's such a process.

And again, I'm going to state it.

We don't want you any longer

than you want to be with us.

And it's not you.

It's it is one more thing on

our credentialers plates.

It's it's almost like a joy

for us to check the boxes.

So if we get to check a box

and you graduated from college.

you know, here to here to here to, Oh,

we're done.

I mean,

it is the happiest day of our life.

So yeah, that's awesome.

And I'm sure that, you know,

a lot of companies out that

feel that way.

But I think that, you know,

the other thing I just want

everyone to know is as

compared to other companies,

I want them to know why we're different.

And I think why we're

different is we are a fairly small team.

We're not,

We're not a big, big company.

And a lot of times we're

dealing with our own clients.

So these are clients that

we're going to have in

membership or practice

management or billing.

And we want that

relationship to be amazing.

So we do everything in our

power to be boutique and

make sure that they're

getting white glove.

And I know it doesn't feel like it,

but I think the reason it

doesn't feel like it is

because they just don't

understand the process.

If they could live a day in our shoes,

they'd be like, holy crap.

These guys care.

They're doing everything they can.

I love that.

Stefani.

no I mean how so it it's

easy to get passionate

about this topic stefani

any last comments from you

that that's in the weeds

and grinding with these

insurance companies every

day getting the the emails

from the clients of worry

and and distress any final comments

oh we got a delay on

stefani's end um I yeah I

think that it's really in

oh sorry now you're you're

you're you're fine stefani

uh if you if you want take

it away and any any final

comments okay yeah yeah I think you know

The same thing,

comparing credentialing to a claim,

right?

Trying to give the insurance

company's networks

everything and then some, you know,

so they don't have to come

back and ask us for anything.

But even though credentialing, you know,

could be complete,

in your case,

you are still going to run

into issues with the carriers, right?

And it's really important to

know what's the difference

between a credentialing

issue and what's the difference between,

you know, insurance processing issue,

whether it's they are

showing you out of network

or they're having you with the, you know,

incorrect fees.

It's really important to be

resourceful during your credentialing.

journey,

just knowing who you should be going to,

what questions you should be asking.

And if somebody's never been in here,

they can feel like they're

just drowning and they

don't know where to go.

So I think it's important to

really educate the team saying,

if this is an issue, here's where we go.

If this is happening, this is where we go.

That's perfect.

I think that's on point, Stefani.

Yeah, this is an interesting topic.

We didn't get into kind of

like the strategy and how

to maximize and how...

to get that bigger fees

because you can there's too

many people saying you

can't you absolutely can

get better fees and um to

paula's point of being a

boutique uh organization

that's what we pride

ourselves on getting

getting our buyers uh

higher fees than the seller

and that's a bump that

um that's a free bump

congratulations you get

more money for doing the

exact same procedures and

you can do it no not from

delta not from some of the

ones that have us um uh

have the biggest stick in

the in the on the

playground no you can't beat them up

but there's a lot of other ones you can,

and it can give you a serious bump.

So maybe we can touch that

on a future podcast.

We've also done this

credentialing episode in the past.

And so check that out if

anybody's doing that one.

But ladies, thanks so much for joining us.

And Paul, of course,

helping me co-host this new

brand of Dental Unscripted.

Mike D'Incio, Paula Quinn,

Stefani Sandoval here signing off.

Guys,

we've got a lot of other episodes

coming down the pipe,

and I'm really excited

about the lineup we have in

the next few months.

So stay tuned and subscribe

and follow us along the way.

Cheers.

Take care.

Thanks for listening.

Let us know how you like the show.

Rate us on Apple and Spotify.

Subscribe and follow for more.