Dentistry Support® : The Podcast

Dental Eligibility Verifications Going All Wrong: Ep 009

March 25, 2024 Sarah Beth Herman Season 1 Episode 9
Dental Eligibility Verifications Going All Wrong: Ep 009
Dentistry Support® : The Podcast
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Dentistry Support® : The Podcast
Dental Eligibility Verifications Going All Wrong: Ep 009
Mar 25, 2024 Season 1 Episode 9
Sarah Beth Herman

Send us a Text Message.

SHOW NOTES:
- Head to Sarah Beth Herman's website and learn more about her journey.

FROM TODAY’S EPISODE:

Welcome to episode nine of Dentistry Support: The Podcast! Listen to this week's episode with with Sarah Beth Herman as she braves the tough conversation of introducing AI into Dental Insurance Eligibility Verifications. This highly argued topic is one where if you miss it, you could turn your dental practice upside down for no reason at all. In this episode, she talks about one dental office who she has known for 7 years who tried out every platform you can think of and painstakingly waited four years before taking her advice. You'll be shocked at what you learn this week from how dental insurances are gatekeeping better than ever before and how you might just be able to improve your efficiencies with tips you've never thought of in the game of eligibility for dentistry..

Tune in as Sarah Beth shines a light on the power of knowledge, dental insurance, and AI in dentistry,  all topics that could truly make you the generational leader you know you were created to be. Dentistry Support®: The Podcast isn't just about inspiring leaders; it's about equipping them to make a lasting impact on their teams, businesses and shape the leaders of tomorrow. Join the conversation on leadership and transformation in this eye-opening episode, where every decision molds future generations of leaders.


SOCIALS:
Dentistry Support: Instagram | Facebook | Linkedin
The Dental Collaborative: Facebook
Sarah Beth Herman: LinkedIn
Free Training for Dental Offices

The Dental Collaborative:
The Dental Collaborative is a Facebook group dedicated to fostering a community of dental professionals and leaders. Within this supportive space, we engage in insightful discussions about dentistry, share valuable wisdom, and cultivate a strong referral network. It's a place where the dental community comes together to exchange knowledge, connect with peers, and build meaningful professional relationships. Best of all, membership is always free, making it an inclusive and accessible hub for those passionate about advancing their dental careers. Join us today!

DISCLAIMER:
Dentistry Support: The Podcast, Sarah Beth Herman, and affiliates provide all contents for informational purposes only and are not intended to serve as counseling or business consulting services. Listeners and viewers engage with the content voluntarily and assume full responsibility for any consequences or impacts resulting from the information presented. For proper credits or any inquiries, please contact us, and we will make the necessary adjustments to acknowledge individuals or sources mentioned in the podcast.

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Show Notes Transcript Chapter Markers

Send us a Text Message.

SHOW NOTES:
- Head to Sarah Beth Herman's website and learn more about her journey.

FROM TODAY’S EPISODE:

Welcome to episode nine of Dentistry Support: The Podcast! Listen to this week's episode with with Sarah Beth Herman as she braves the tough conversation of introducing AI into Dental Insurance Eligibility Verifications. This highly argued topic is one where if you miss it, you could turn your dental practice upside down for no reason at all. In this episode, she talks about one dental office who she has known for 7 years who tried out every platform you can think of and painstakingly waited four years before taking her advice. You'll be shocked at what you learn this week from how dental insurances are gatekeeping better than ever before and how you might just be able to improve your efficiencies with tips you've never thought of in the game of eligibility for dentistry..

Tune in as Sarah Beth shines a light on the power of knowledge, dental insurance, and AI in dentistry,  all topics that could truly make you the generational leader you know you were created to be. Dentistry Support®: The Podcast isn't just about inspiring leaders; it's about equipping them to make a lasting impact on their teams, businesses and shape the leaders of tomorrow. Join the conversation on leadership and transformation in this eye-opening episode, where every decision molds future generations of leaders.


SOCIALS:
Dentistry Support: Instagram | Facebook | Linkedin
The Dental Collaborative: Facebook
Sarah Beth Herman: LinkedIn
Free Training for Dental Offices

The Dental Collaborative:
The Dental Collaborative is a Facebook group dedicated to fostering a community of dental professionals and leaders. Within this supportive space, we engage in insightful discussions about dentistry, share valuable wisdom, and cultivate a strong referral network. It's a place where the dental community comes together to exchange knowledge, connect with peers, and build meaningful professional relationships. Best of all, membership is always free, making it an inclusive and accessible hub for those passionate about advancing their dental careers. Join us today!

DISCLAIMER:
Dentistry Support: The Podcast, Sarah Beth Herman, and affiliates provide all contents for informational purposes only and are not intended to serve as counseling or business consulting services. Listeners and viewers engage with the content voluntarily and assume full responsibility for any consequences or impacts resulting from the information presented. For proper credits or any inquiries, please contact us, and we will make the necessary adjustments to acknowledge individuals or sources mentioned in the podcast.

Moving + Packing Tips and Hacks, Real Estate & Life
Listen to 'Life Beyond Boxes Podcast' – the art of moving with ease and confidence!

Support the Show.

Welcome to episode nine of dentistry support the podcast. This episode is for you. My dear dental community. I am bringing you into an eyeopening discussion on HIPAA compliance and the digital age. Where the intersection of AI and healthcare or dental care. Demands every bit of our attention. We're talking on some real world stuff today. 

 And I'm sure when I said I'm going to be talking about HIPAA compliance in the digital age. You probably thought this is going to be the most boring podcast episode I've ever heard, but I'm going to challenge you a little bit. I'm going to talk about a real world situation where my company dentistry support onboarded, a dental practice that we kept in touch with for four years while they tried four different AI platforms for insurance, eligibility verification. And one seasoned eligibility verification company that is based out of Zimbabwe. They really thought that company could do everything that they needed. 

The dental office that I'm talking about. I reached out to me in the summer of 2017, they wanted to know what services dentistry support offered for eligibility support only. And we've kind of coined eligibility support as what we call that service, you might hear it referred to as eligibility verifications.  At the time they were shopping different companies that could do this service. Because their practice had four full-time hygienists. Three full-time dentists. 

The patient load was at 32 to 38 hygiene patients per day and 15 to 25 treatment patients per day.  . Let me pause the story right there. I want to make sure you understand the importance of HIPAA compliance before we get off on any tangents or stories. Because HIPAA compliance is often a buzzword in a dental office and you may not really know exactly what it means. 

And I want to educate you there. HIPAA compliance is actually spelled H I P a, which looks a little bit silly. But it is the cornerstone that ethical integrity of dental practices is actually built on. It reinforces the walls of trust that your patients rely on  for the safekeeping of their most sensitive health information. If you don't know what HIPAA really is, or it's just a word that you use because you know, someone has to sign something. Here you go.  HIPAA stands for health insurance, portability and accountability act. It's a set of rules that dental offices must follow to protect patients, private health information. It also ensures that patient data is kept confidential, secure and used only for appropriate purposes, like treatment presentations,  payments, healthcare operations. HEPA also gives patients certain rights regarding their health information. Such as the right to access and request corrections to their records. Overall. HIPAA helps to maintain trust between your patients. And your dental providers, it safeguards all sensitive information.  That can even include conversations with dental insurance companies. 



Now let's cover what AI means and dentistry. 

So if you aren't familiar with AI, You might be thinking, what does she mean as she just talking about chat GPT?  No, I'm not, but I love where you're going with that. AI stands for artificial intelligence. There are many ways. AI is incredible. And even if we don't want to accept it, Uh, AI is here to stay and continue to advance beyond way beyond where it is right now. In dentistry, we actually find it everywhere  I'm not planning on digging into every single area in a super in-depth way, but I want to give you some insight as to where AI already exists within your dental practice, because you may think, oh, my dentist is super old school or we don't have AI, but. I want to bring light to where AI has purpose and where it has meaning right now. So image analysis, that means.  Analyzing x-rays CT scans, inter oral photos for diagnosing things like cavities or gum disease or planning for treatments. , natural language processing or NLP,  NLP helps with voice recognition, dictation of clinical notes, and virtual dental assistants for appointment scheduling. Predictive analytics. AI analyzes patient data to predict oral health risks and create personalized treatment plans

Next is robotic dentistry., AI powered robots assist in dental procedures. It really is real. And this exists in tooth preps. Implants surgeries.  Really it's improving accuracy and outcomes of those services. . Virtual reality and augmented reality. 

 VR and AR. , VR and AR aid and dental education training simulations. It helps patients visualize treatment outcomes. , next is diagnostic tools.  AI driven tools, aid in early detection of oral diseases like cancer, periodontal issues, all by analyzing patient data and images for signs and patterns. And the one year probably most familiar with would be patient management systems. 

 There is a lot of AI that exists in streamlining administrative tasks, like appointment scheduling, billing, insurance, processing, patient communication, even insurance, eligibility verification. And that's the part. I'm going to talk about today. 

I know I own and operate a completely virtual team that specializes in the dental industry. I also have four other virtual companies that cater to businesses and organizations outside of dentistry.  My teams, they do much of what AI claims the ability to do so naturally you may have the thought that, of course, she's going to want to defend her space.   But what I am instead aiming to do. Is to open your eyes to what AI's capability is right now. And what it likely may not be able to accomplish in the future without some massive improvements.  My goal is to talk about these things, because there are a lot of really great salespeople that exist out there. I am a great one too. 

And  I know a lot of the tactics that people use. I know a lot of the ways people try to communicate. About services that they promise to offer. And I want to teach you to  pause and learn alongside me. What you should be watching out for before you just make a decision to put this into your practice. 

I know that AI has a incredible opportunity to streamline data processing in practice management systems. It also has an ability to auto-post payments  and verify active coverage for patients. 

However AI algorithms also have to adhere strictly to HIPAA regulations and safeguard patient information adequately. In my opinion. They just aren't there yet. They don't have the capacity to be sure of this with all of the different intricacies that go into what their software is designed to do. 

Integrating AI powered tools with existing practice management systems or EHR like electronic health records is a huge challenge. There are many different components that are active or structures that exist in existing practice management systems. And making sure that the interoperability and data exchange between the systems. Must exist in order for AI's potential. To be at its fullest. 

But how do you do that? 

That's my question. And I know there's a lot of really savvy tech companies out there that promise they've brought this. I'm going to show you why. I know they haven't. 

AI algorithms rely on data input for decision-making and inaccuracies or biases and data. Can lead to erroneous outcomes. There must be a continual validation and refinement of all AI models. And  if there isn't a constant reliability or checks and balances going on, There could be an influx of inaccurate information. 

And we don't know until four weeks later and four weeks later and eligibility verification gone wrong means a patient balance that likely isn't going to get paid. 

Now I know there is such a great space for AI to automate patient communication and tasks that have to do with getting a patient in the office. This is anything from appointment reminders to text messages, to schedule. I believe though that there is a need for a more sophisticated AI driven solution that actually improves patient engagement. And patient satisfaction. For example. I see a dentist that's located in a completely different state that I live in. They're an amazing dental office. 

I absolutely love them. However they're automated text messages, constantly texts me, trying to get me to schedule an appointment. But something, this AI lacks is the ability to know when there is a patient in the office that is only in town seasonally. So they constantly send me these messages that seem really bothersome and annoying because, Hey, I don't live there. 

And I know your office knows I don't live there. I'm only here during a certain time of year. So I can only come in during that certain time, or when I happen to travel to that state. 

There are things lacking in AI that fail to meet the patient where they are, and then level up the experience. 

AI algorithms need to operate ethically. Actually, I want to resay that. AI algorithms must operate ethically and transparently. Especially when it comes to sensitive dental care or healthcare contacts.  Making sure that these technology companies. Have decisions that align with medical and dental ethics and legal frameworks. Is really important in building the trust and acceptance among the providers. 

Just like you. And then there's the implementation side of it. AI solutions and patient management systems. They involve a significant costs, including the infrastructure, the training, the maintenance.  The reason  I believe AI is not working well in dentistry is because many of our team members that exist in our practices. They've never dealt with this level of sophistication. 

And when you are trying to take a team member, who's dealing with hands-on experiences with patients. And you're transitioning that to them, needing to understand the technology, unless there is a robust training program that exists and a widespread understanding where. Anybody at any level can easily grasp the concept. 

It will not be successful in your practice. 

I know this sounds repetitive, but I do think there is a space for AI in our future. I just also think it can quickly get out of control by trying to replace the human touch  and aspect of that interaction. Yes, we all want to move faster, be more efficient and ultimately make more money. But there is a price to pay when you make changes in certain ways without making a conscious. An appropriate decision to do so.  Within the virtual walls of dentistry support. I'm not trying to replace the human hand in anything. I am actually improving the efficiencies of a dental practice. 

And right now you're thinking. Well, that's a similar argument for AI, right? When you take all of this information that I just dumped onto you into account. And then apply this to what aspects AI replaces in a dental business. It fits in certain places. But in my opinion, not quite in others. Our free training this week was titled AI doesn't work in dentistry. 

And man, you guys had some feedback. I know that that was a strong claim. I also think that it's important for you to understand why the human touch is still important, even in things like eligibility verifications. They are my prime example today. If you are a newbie around here and you don't quite know what I'm talking about. Or maybe you've been really bored in this podcast because I'm giving you a lot of information on the technology side of dentistry. 

I want to expand on a little mini training session here on what eligibility verifications is. Insurance eligibility refers to the process of determining whether a patient in your office qualifies for insurance coverage based on a specific criteria set by the dental insurance provider. This typically means that someone is in charge of verifying details, such as personal information. Policy details, coverage limits. And other relevant factors for that plan. This is typically done in advance of a patient's appointment. And in the average dental office, the rule of thumb is to do a breakdown of benefits one time every 12 months or calendar year, depending on the plan. 

And then a quick check to see if the patient is active at their next appointment. So as long as it hasn't been 12 months or a calendar year, At dentistry support,  we do a different, we have completed hundreds of thousands of dental insurance verifications per dental offices all over the United States. Honestly, it could very well be in the millions. 

In fact, as I'm recording this, I actually want to go see what our number is. And then I'm going to go update that on our Instagram this next week.  Anyways, we go beyond the basic insurance eligibility check we believe and providing a comprehensive breakdown of benefits. That's customized to each dental office that we support.  We have an office out of Texas, where we do a full breakdown of benefits that has over 125 dental codes on it. Yes, we check frequency, history and limitations on all of those codes. For every patient at every single appointment. I disagree wholeheartedly on the industry norms created by whomever created them in the 1970s or whenever they were created. 

This customized breakdown of benefits that we do here at dentistry support. Is very time-consuming and I know this is exactly why tech companies are trying so hard to break into the eligibility sector of dentistry. They are trying to solve a problem, but let me tell you what else we do. And I know I'm getting. A little bit passionate here, but I believe someone has to, because dollars are being left on the table at your dental practice. And I promise you. I have learned so many things and the landscape of insurance eligibility, and it is changing every single day.  When we do eligibility verifications, We're like doing it on steroids. Eligibility.  Means that every patient should have a mini breakdown of benefits. That's listed in the notes of the appointment related to the hygiene procedures recommended by the dentist. 

This process of adding these procedures and a mini breakdown. It is catered to each of the dental offices that we serve. Not every dental office offers everything that the next dental office does. And we have many specialty practices. So there are different services that are recommended by a dentist, and we want to make sure we meet that. We upload all of the details of the benefit breakdown. To the dental offices, practice management software. And for many of our practices, we're checking treatment procedures, same day or the day before to see if there is history reported from the insurance.  What a lot of dental offices don't know. His insurance companies talk to each other. And you may not realize it, and maybe it doesn't happen all the time in your practice. But dentistry support sees such a large pool of patients and interactions between insurance companies at our level, because of how many dental offices we support. That oftentimes you could do a full verification of benefits for a patient. And see that there is no history on file. 

And then all of a sudden magically the patient is being seen in your office tomorrow. And maybe they have Delta dental insurance, but somehow met life reported to Delta dental because their employer changed insurance companies. And now all the data that was with MetLife. Is now over to Delta dental and all of a sudden there's history on file. Or there's a policy change. Or the employer elected to change what their plan looks like. There are so many scenarios like that.  When a patient is scheduled for treatment. We are committed to always making sure that the breakdown is updated and whatever procedures are attached to that appointment, we have re verified and made sure that the coverage, the office quoted to the patient is actually correct. The last thing dentistry support offers is same-day verifications. 

So patients are often referred from one dental practice to another based on specialty, or maybe they're an emergency that walked in or a new patient that scheduled. Those patients need to be seen. And there is no time for the front office to sit on hold for an hour or two hours and try to get a full breakdown of benefits. So we have a 24 hour help desk that our clients use and preliminary information on those plans is delivered to the office within 10 minutes. Then within the hour, everything is updated in their system. So that a treatment plan can be delivered. Accurately. Now, I know every dental office is not like this. 

And. As an owner of a practice or the office manager or the front office, this all sounds like a really great idea. 

But implementing this within an office team member. Is nearly impossible for the sheer fact of HIPAA compliance. You are not supposed to be talking on the phone in a dental office to verify benefits. With an insurance company. When there are patients around or team members in your office that don't have a medical need to know about that patient's coverage. Or that patient's insurance or that patient's treatment. So if you're thinking, wow, everything that dentistry support does. I want to go ahead and do that in my office. I'm proud of you for making that decision, but you need to have a plan. 

That's HIPAA compliant. Because that process that we do is extremely time-consuming. So where you might have one team member in your office. We will have three team members for your, every one. We have team members that literally just wait on hold with insurance companies waiting to get information. We have such a robust and incredible process to support your practice so that hold times don't have to be so bad. 

So that HIPAA is not something that we're violating. We're doing the right thing for our offices by being robust in our approach, but we're also taking  into consideration. HIPAA and what that needs to mean for your practice. My company is not out to replace your front office, though. That does happen many times. We are here to support dental practices and keep them compliant. Our goal is that we will be effective and utilizing the software. In the systems of the dental insurance companies. And the people that we have employed here,  are planning to accurately get your benefits verified for you. 

 There are many technology companies that exist that have integrated AI within them. They've created software's that are intelligent. They can get a breakdown of benefits and how these typically work is that there is some sort of API that has been released to these companies, or they've created a software that can automatically log in to a dental insurance portal. Or somehow they have created a technology that has an interface that connects with these insurances. 

There are many problems with that. That there has not been a remedy for, and that's what I'm teaching you right now. So when you work with the technology side of things, sure. You can create a software that can see if a patient has active. Many practice management softwares out there offer something just like that.  But there are some things you need to know about how those softwares work. One. No dental insurance ever is going to release the ability for an external company to have 100% access of their software. 

Ever not for any dollar amount. The reason they will not do this. Is because dental insurance companies are banking on your claims being sent. The wrong way. 

These dental insurance companies are banking on being able to delay or extend out how frequently they pay you or how they pay a claim based on errors based on you not checking insurance properly. 

They're not going to make it easy for us to get the information we need. They don't have to, that's not the side of their business. Their business model. Just isn't built that way. No matter what software exists out there, there is no one particular software that's going to get permission from every dental insurance company in existence to have access to the full scope of their business. To pull benefits, pull history, pull frequency, pull limitations. For every patient. Every code in every scenario, it's just not going to happen. 

I know that because I work very closely with a specific software company in the dental industry. That is partially owned by a very large dental insurance company. And that dental insurance company's CEO and I have had multiple conversations. And even though they own a portion of this dental software company, They still will not release their full API to that software for them to be able to verify benefits. So, what am I telling you? 

So, what I'm telling you is that even though these salespeople that own these technology companies make really big promises and their advertising states, this grand claim of how they can verify benefits for you in an automated way. Everything they're telling you as a sales pitch,  it's words that are designed to appeal to the pain points you have in your practice. 

. I need you to learn, to pause and think. About all the ways that software will be operating in your practice. And if through that operation, The answer is yes to the question. Is it going to meet the needs of my demographic? Insurance is accepted. And procedures we diagnose. Properly and accurately. 

If that answers. 

Yes, you're good to go. 

But you have to consider all of these small mom and pop dental insurance companies that exist out there. The onesy twosy ones that come in and happen to have a PPO, but they're such a small insurance plan that they don't even have an online portal. The thing is, is AI can't replace what people are doing. 100% and dentistry, especially when it comes to insurance. 

I do understand that AI is very helpful and confirming appointments and many of the scientific and technological aspects of dentistry. It's fantastic. Really? But it's not going to work. And the eligibility side, and I need dental offices like yours to not fall for that gimmick. Because there is no way in our current state. That it is going to work. 

And I don't see an opportunity for it to 100% work in the future. Not just for the fact that dental insurance companies will not release their full API. But dental insurance companies that don't even have a specific software that has an API. How will they verify benefits on an automated basis? That still leaves something left for humans. What about the different levels of credentialing that you may have with a dental company?  There are some insurance companies where you can be a platinum credentialed provider or a low level credentialed provider. 

What about those scenarios? So when that software has verified benefits, how does it know that it needs to verify benefits based on you being a platinum gold entry level provider? 

What about the other providers in your location that aren't credentialed at all? 

 We have a dental office located in North Carolina that has seven dentists. Three of them are credentialed the same way. Two of them are credentialed the same way. And the remaining dentists are not credentialed at all. And they're out of network or fee for service. 

When we verify benefits for this office, we actually have a dropdown created for each of these providers. 

 If the patient were to see any one of them, they would actually know which provider they would want that patient to see, according to how we verify the benefits. 

We don't want to put a patient with a non-credentialed provider, unless the patient is aware of what that looks like. And we want to make sure we can maximize their benefits. 

There are many different reasons that verification of benefits have to be very specific. 

 If you don't believe me yet. That's totally okay. But think about the aspect of when you  log in to an insurance portal. This is proof that I actually know what I'm talking about. Let's talk about MetLife, for example. The details that you get when you log into MetLife. It is extremely robust. 

You can search by code. It's fantastic. But if you were to go log into a completely different insurance company, pick any one of them, you will never find that exact scenario that you see in MetLife because it's MetLife software. They have something completely different. 

That's exactly why I'm saying. The technology companies. That are creating these platforms with AI attached to them. They need to figure out so many aspects of so many softwares. And how to get all of that. And it just doesn't exist. Every patient is different. Every demographic is different. If you're out of network with dental insurance, they're not even willing to release you a fee schedule because you're not in the in-crowd, you can't even know what they're going to pay until you see the EOB, because since you're out of network, they don't give you a fee schedule. 

So how will you verify accurate benefits when you can't get certain information as an out of network player? Do you think every technology out there with AI attached to it, somehow magically has accomplished getting in and out of network benefits for every code. Along with history, frequency, limitations, and everything that goes into a breakdown for every plan for every patient. 

The answer is no  it sounds crazy. It sounds like I'm rambling, but. The answer is no it's way too complicated.  I want to encourage you today to take a minute and think about things before you go signing up for something.  I'm not on this podcast today telling you that you need to work with my company, dentistry support. But I am telling you that if you did. You would be a much more successful practice. 

In the beginning of this episode, I spoke about the dental practice that I work with for four years. I spoke with the owner of this dental practice at random times throughout the year.  We never had a future meeting scheduled. We would always talk for 60 to 90 minutes. It was these long drawn out calls and conversations about how we would do eligibility.  He kept saying  he was going to try this software or he was going to try out this new team member. Or he was going to outsource this to another organization overseas. Or he would find his own overseas team member to do it. 

Software after software after software. 

 He kept calling me telling me just how it didn't work. In the beginning of our conversations, I didn't really understand why they didn't work because I just assumed that technology was advancing faster than I was understanding it. And in many capacities. Yes, that is true. Technology is advancing faster than I can grasp it. But with the sheer pool of dental offices I work with, and those that have reported back to me, working with every technology company that exists out there. I can tell you right now, it is not designed, right? 

It's just not there yet. Maybe it will be there in five years. Maybe it will take 10 years. Maybe dental insurance will have to completely be changed and it won't happen for 20 years. I just don't see it right now, though. And we need to protect the dental industry because every time you decide to trust one of these technology companies,  you're losing money in your practice. One of the things that sets us apart that I kept telling this doctor over and over and over. As that we know certain procedures that have eligibility to be billed in conjunction with others. To increase the revenue on certain procedures. 

So if you're a client of ours, you already know what I'm talking about. You already know the services that we should be verifying in conjunction with others, because if a patient is diagnosed with that treatment, then we know these two things are eligible to be billed together. They fall in the same category. 

There's something that can be done. So as long as the patient is diagnosed with it, Perfect. Let's set our office up for success and plan our breakdown of benefits around that.  The other thing that we talked about over and over with this dentist was the fact that when you're verifying benefits, no matter what company you're working with, Everyone has the ability to create a customized breakdown of benefits for your practice. If you're talking with an organization to do this for your office, and someone tells you they can't. They don't have a robust enough training program for their team to make sure that whoever is assigned to your practice is skilled enough to make sure they verify all the things listed.

If you're working with a third party company and they can't make a custom breakdown of benefits for you. You need to find one that will, and these technology companies, they're not providing a custom breakdown of benefits. They're not understanding all the intricacies that are happening in dentistry and how those are changing. 

These technology companies might tell you, we get every code. Well, we already know that's not possible.  Even if a technology company were to actually be able to get you every single code and verify it. Do you really want to have to train your treatment coordinator to read a 10,000 coded breakdown of benefits? I mean that will take hours for them to figure out where to look, how to memorize. 

That is a situation. And I do not think that's a good decision to make. Here at dentistry support, we have a color coded breakdown of benefits that very easily. You learn to read? It tells you yes or no. It's color coded in different ways by procedure. It's customized to your dental practice. These are the arguments I'm making with this doctor. 

And he was never taking me up on it. But he was always calling to get advice from me.   It's like he knew I knew what I was talking about, but he wasn't willing to accept the reality that technology was not able to automate his office in this capacity. He went through four different technology companies. Then he hired one of the top eligibility companies that existed for dental practices at the time. And I don't say top because they provided some incredible level of service. They've just been around for more than 20 years. 

I believe when he chose to go with that company, he went with them because he knew a lot of dental practices use them. 

And even though they had issues, there was just such a large pool of dental offices that use them, that it felt like. Oh, this could work. This company is very well known for charging per eligibility verification and different fee schedules based on different kinds of eligibility. So if you got a full breakdown of benefits, it's $8. 

If it was a partial, it might be a dollar 20. It just depends on how they charge. But this company also used emails to do verification of benefits, which is not compliant. And not the manner in how it should be done and compliance. That is a massive standard here at dentistry support 

here at dentistry support. Our path is that we are always going to be honorable to whatever process is ethical. Respectful.  In compliance with Phi and HIPAA. 

And works for our office. We are never going to be perfect. And I know that, 

but we are always going to do our very best to make sure we do things the right way. We do not use email and we do not use the phone to talk to you about your patients' insurance eligibility. Simply put it's not compliant, and we're not touching that with a 10 foot pole. 



We have a HIPAA compliant chat system where you have immediate access to us, just like you're hearing this podcast right now. 

If you were a client of ours, 

we would be texting you back and forth. You get instant access to us in a HIPAA compliant way. It's very simple to realize things that are in place to protect your practice and things that exist to make a dollar. I tried so hard to explain this to this doctor. And finally, after four years of this back and forth of him trying this other company and these four other technology companies, he finally took me up on it and enrolled in our support. 

And he's been a client of ours for the last three and a half years. He's referred us 16 different clients since then. And. Maybe you're just thinking I'm a really bad sales person. But did you know that the average dentist takes 18 months to make a decision for their practice? Did you know that. 

Maybe it does make me a really bad salesperson, but I'm never going to be down the door of everybody. Sometimes dentists and business owners. Have to make their own decisions. I'm here to help you along the way. I'm not here to steal business from everyone else. And I do think there's room for us all. But I'm not here to be negative about our industry. 

I'm here to grow the industry. Tyler Reddick is a NASCAR driver and he said, I'm obsessed with winning. Even if I have to lose hundreds of times. That makes sense to me. I'm not going to win with every dental practice. You're not going to win with every patient. I'm not going to get every single dental practice in the United States to be part of dentistry support. 

But what I am on a mission to do is to provide free knowledge to the dental community because I really care about it. And that means I'm going to fail hundreds of times because people aren't always going to listen. They don't want to be part of my network. They don't want to hire someone remotely. I get it. 

I really do get it. But this is why I provide free training on my website. I have this free podcast for you to listen to. I will have conversations with you for four years until you finally take my advice and enroll in support. Your dental office is absolutely capable of getting to the next level. Because heck that's why you're listening to this podcast. 

You're asking yourself, how do I get to the next level? 

And do I need to buy into the AI talk right now to get there? I hear you. But to get to your next level. You need to be able to pause and think for two seconds. If you know the answer on what you want to do, still pause for two or three seconds before answering the question or signing up. You have a lot of information right now. You can listen to your intuition on what's going around you and not every shiny new product or technology needs to be in your practice. 

Dentists have been doing dentistry for a very long time, without the most perfect of everything. What you need to focus on. Is what is practical for your practice? What's going to give you more certainty. I'm not saying my team is the most perfect team and that they've never made a mistake. Things happen. But you have to be prepared and ready for the challenges that come with trying new, shiny things. When I am evaluating what I need to do to level up my people and my organization. I try to let myself avoid the always stressed out mentality. 'cause I know for me, if I'm always stressed out about everything, every technology, every shiny new aspect that could be brought into my organization. Every competitor. 

I have every social media presence. That's seemingly a light year ahead of mine. Then I'm never going to be good at a single thing. 

Your that's good moment from this episode is the importance of understanding insurance eligibility in the dental industry. Technology does offer solutions. But I need you to recognize its limitations. Especially regarding insurance complexities and compliance requirements like HIPAA Phi. Dentistry support goes beyond basic eligibility checks. 

We provide custom breakdown of benefits, real-time verifications and HIPAA compliant, communication channels. Look for those things in the companies that you want to bring on board. Our goal is not just efficiency. But also ethical and compliant practices that empower dental offices to thrive. For your thriving dental practice, it's about finding what's practical and reliable for your individual success. 

You need to navigate the landscape. With informed decisions rather than chasing every shiny new trend. I want to keep the conversation going. And bring you more details on this topic and many others. The dental collaborative is our exclusive page for the dental industry. And we're going to have several days of questions posted there to continue the discussion online. Head over there and let's chat. 

I love to hear your perspective on this. Until then I'll catch you on the next episode.   

Intro
Oh, that's what HIPAA is?
AI (Artificial Intelligence)
The Problems.... yikes!
You mean? Eligibility Verifications?
(Cont.) You mean? Eligibility Verifications?
Putting what? With What?
What You Never Considered...
The Dental Office
The Perfect Breakdown of Benefits
I am a Bad Sales Person