Davy Clay & Josh Smith are both Dental Billing Experts with 10+ years experience working in the dental billing and dental insurance industry. Their passion is helping dentists and their staff to realize and change the inefficient, inexperienced, and sometimes illegal billing practices taking place within dental practices.
VIDEO - DUwHF #1261 - Davy Clay
AUDIO - DUwHF #1261 - Davy Clay
Both have a similar background with a degree from the University of Georgia, as well as both working for a DSO to start their careers. They started Dental ClaimSupport in 2012 knowing the need existed for insurance expertise in dental practices.
Dental ClaimSupport is one of the nation’s leading Dental Billing companies helping dental practices across the United States increase collections from insurance. Using the system they created, Dental ClaimSupport transforms the way dental practices manage insurance collections, as well as making the practices more efficient in getting claims paid.
Howard: it's just a huge honor for me today to be podcast interviewing Davy Clay wave your hand Davy and Josh Smith there's Josh are both dental billing experts with 10 plus years experience working in the dental billing and dental insurance industry your passion is helping dentists and their staff to realize and change the inefficient and experienced and sometimes illegal billing practices taking place within dental practices both have a similar background with a degree from the University of Georgia as well as both working for a DSO to start their careers they started dental claims support in 2012 knowing that need existed for insurance expertise and dental practices dental claims support is one of the nation's leading dental billing companies helping down practices across United States increased collections for insurance using the system they created dental claims support transforms the way dental practices manage insurance collection as well as making the practice more efficient and getting claims paid and I can tell you that being a dentist for 32 years what's the code for routine cleaning and they look at you like is there life on Mars I mean I mean how they go work at some associate for three years they have nothing good to say about it and I say well you actually worked for a DSO that owns like a hundred offices so what business did you learn oh I didn't learn any business I just kept a solid bad attitude for the whole time and then what you said would slap me upside the head and why I wanted to get you on this show is on your website you right lightly sometimes illegal billing practices dude you know when you go on cruises and you're in Cabo and you're in Al Capone when you see dentists that look like you and speak English there's a story there Wow what made you leave Iowa and go set up in Cabo well it's one this is one of the issues one of my best friends had the most adorable wife and but she was a little and a little crazy and she sent in the wrong Medicaid billing codes for about ten years and when they finally broke it down the lawyer said well it's not a matter of if you're going to jail it's you know do you want to plead so he had to go to Mexico and so he's living in Mexico because his lovely wife is not a criminal but she didn't doubt that and that's why I tell people don't get in bed with Medicaid because if you get in bed with anyone you're gonna get screwed but when you get screwed by the government they every government only has one thing in common they have the power they can project power onto an individual arrest you put you in a cage or kill you and those aren't good sleeping buddies I mean you know you don't get in bed with people that have a gun and reserve the right to kill you and and this is the classic reason why I won't do Medicare and I won't do Medicaid I won't get in bed with the government because I can be just misinformed and make a mistake but they're gonna punish me with a with a whip and a chain do you agree with that or disagree
Guest: no I agree I think one of the first lectures that we both attended was Charles Blair many years ago but was the civil lawsuits that that occurred and then the criminal lawsuits that occur on top of that so not only the pain they're also serving time criminally because somebody in their practice that was coding incorrectly or submitting things inadvertently sometimes on we see he's gonna say sometimes they don't know any better and sometimes they do know better we've seen both Ron Shelbourne you think he knew better or did know better taste that well specifically but essentially what I do know is the doctor is ultimately responsible for anything that goes on under under their wing and in their into practice but even without in there so unfortunately they are the ones responsible so he was he was on episode number 391 and just on
Howard: YouTube alone it's got a thousand views and by the way I'm just so humbled um we put up that a lawyer last week dr. Rogers and just on YouTube it's over 10,000 views so I love reading your views in the comments if you have questions but the bottom line is my buddy everyone knew I mean he was the greatest tennis in the world threw the best party he's just a great guy he to this day living in Mexico couldn't tell you what the what the code was for anything so him and his beautiful lovely wife just bumbling along and had to leave the United States of America because they had the wrong code that would that's that is the only reason if you need another reason not to do Medicare or Medicaid you're from Mars I can't help you you know would you would you date a woman who on every date had the reserved the right to shoot you in the head the way the way you're laughing I think you dated that woman I think so so anyway so so um um please stay for this whole show I know you're I I'm a Dentiss I get it you want to pull wisdom teeth and you want a bone graft you don't want to learn anything about dental billing experts but you have to wear all these hats so what would you
Guest: so talking points um what are the top insurance issues that you see in dental practices today so essentially if you break it down there's three different kind of aces of the claim you got the pre claim phase you got the claim submission and the post so in those phases you know in the pre claim phase its its credentialing whether they're gonna be with Medicaid or not or PPOs or not there are certain rules to follow what you do go in accordance with those getting the right fee schedules in their data entry is is probably the biggest issue we see we know practices all over the country data entry
Howard: okay okay I'm gonna try to get you guys to slow down because I know my homies my homies can do an apical activate they don't know anything about so you said the the insurance is three issues it's one is pre claim phase 2 as submission phase and three is post claim phase so let's just start with one pre claim phase you said it was credentialing data entry insurance verification correct which just still pisses me off that I have to have a full-time human being to verify insurance I'm like Delta where is the app where if they have Delta you just come in they open up their app I Bart scan it and they says oh my god this is Davi clay and his deductible what why why do I have to pay a human being to call every single person and go through the verification insurance firm and whenever we try to automate it it's like okay 32 years whenever I tried to automate it I've had to go back and stick my tongue in a light socket to be reminded but anyway so talk about pre claim phase credentialing data entry insurance verification and why the hell do these people not have an app to do all this for me
Guest: unfortunately although every website is different that's why you can't automate it we try we it's very difficult makes it very difficult but even back to data entry you know a third of the claims that are sent out and that's due to things like interest revocation dirt say yeah third of the claims what a third of dental plans actually get fruit paid on that first time base so one third of dental insurance claims don't get paid on the first submission correct on average so so what would what would the number have to be before they fix that would have to be half all of them office needs to correct all that up front and that's because of debt entry problems did the claim never gets through the Clearinghouse to the insurance company because of errors and ID number is incorrect social security number is incorrect subscriber or guarantor whoever and then there's replication part of it as well so if an office is not doing that your verification oh we're having some I do the interest replication for them then they're submitting claims based on patients telling them what insurance they have I may be getting insurance cards off the bat at the front desk so a combination of those things literally create 30 claims not getting to a church company correct
Howard: Wow now is this so basically what you're saying is your own receptionist is screwing up one-third of the claims not Delta Dental Blue Cross and Blue Shield you're putting in the hands of is the reason for these right and it's because that you know the dentist had four years of formal education in dental school the hygienist had four years of formal education hygiene school and the dental schools back when I was in there decided through their infinite lack of wisdom to shut down all the dental laboratory programs and then they were shocked when all the crowns started going to China so there I am lecture at Hong Kong and they only have one dental school and I'm in there and they had twice as many dental laboratory students as dental students and then when I would go to those dental labs in Shenzhen I'd say well what made you get into the dental lab business they said well the Department of Economic Security at China saw what all the other countries were closing down their dental lab schools so China blew them all open and if you want to hire someone that has a four-year degree in porcelain you got to come to China and it's the same thing with a receptionist they have no training they're hired off the street why did you hire Karen to be your dental office manager well she had five years experience with dr. with dr. Coney across the street really what happened to him oh he killed himself after he went bankrupt so I hired her with all that experience okay so there's no training so they hire people off the street there's no formal education and you're saying they submit one-third of the claims incorrectly correct you got a nice nice okay so what's the good news alright so that leads into the claim submission phase so once no no no I don't think my homies got pre claim phase is credentialing data entry insurance verification what is credentialing
Guest: credentialing is essentially getting any network with PP o--'s and or the Medicaid's and that's that's totally up to each dentist as well whether some of some of our fee for service they don't want to deal with insurance companies others see it as a marketing tool to get new clients to get new patients so they go in Cigna whatever it is these days umbrella networks are causing some issues with these schedules at being at the front desk the front desk staff doesn't know are we network with this company are we not this company due to the umbrella networks okay
Howard: slow downs think they don't even know what in-network and add in our ways what is it what does it mean when I mean I'm a quarter of my listenger in dental school and send me an email Howard at downtown comm tell me who you are but they're still no school so she doesn't know what sure network
Guest: so you had the opportunity to go in or into a PPO like I said these could be my wife Delta Dental evac in Korea depending on the employers in your area some large employers may have met whites and to get new patients these people from the employer going on the website and saying who's in network who can I go see there will take my insurance so okay so then what is out of network mean how do network is a fee-for-service so essentially a dentist may say I don't want to be a network of any any any dental insurance and when you're when you're in network you have to accept a fee schedule and the fee schedule is governed by the insurance companies individually so if you don't want to be if you want to have your own fee schedule and and not be in everybody you don't return yourself at all he just you a fee for services
Howard: and then the insurance company to abuse you um when they pay the claim they'll send the money to the patient instead of the dentist is that correct so is that is that a rare case or a majority case it's probably 5050 Arthur are there certain players that do it all the time and something yeah okay who who always sends it to the patient and who doesn't a typical Delta dentals in certain states will send money to the patient if you are not an hour yeah and then they want to know white white dentists hate them I mean they're they know I mean I mean in any industry you'd say well what's more responsible b2c real estate or b2b they say what you want to be in commercial you don't be dealing with crazy b2c people going through divorce and alcoholism and lose their job and domestic violence of course you'd send it to a business so when Delta says oh you know what I bet the smartest thing to do is to mail this to the patient they're intentionally sticking a knife right in your rib they know a dental office has someone who's paid to get the mail enter the claims and when you send it to someone an individual how it's a 15% chance sir they're batshit crazy so so so why why doesn't the a DA just take him to court and Sue them all day long until they stop this practice I mean do they have a reason
Guest: I think just need more lobbyists in Washington due to these reasons they don't want to be a member of the ATA because they thought of one thing they didn't like it's like you know oh you want me to give you a list of how many things I don't like about your parents my parents I have five sisters you know how many of them are perfect but but when you're but when you're talking to your mom guess what she's the only mom you got and when you're dealing with aA DA they're your only parents so to sit there and talk to your mom and say I wish you were a billionaire and I was gonna inherit all your money and that's not you know so the ADA is all you've got and when you tell me the reason why your mother not a member what all I'm hearing is that three out of four dentists have to pay the money because you're a cheapskate lying no-good rotten dentist and of course I don't like everything about the ADA but what's the alternative to have all the insurance lobbyist they're lobbying for crap like this and then no one's representing me right right so you pay your dues because you want them fighting if I and every time I've had ADA present on here like Milo in my Arizona I know the battles they're fighting every day on Capitol Hill but none of my drinkin dentist buddy do they don't advertise they don't mark it well enough no one I mean almost 90% of what the ADA does is behind the scenes and that so they don't advertise they don't market what they're doing but but you just said that that Delta Dental sends the claim the money to the patient and not the dentist if you're out of network which is just intentional punishment to try to get you to accept that fee schedule which is unamerican because if it is because you either economics is a joke to you or it's not so you decided so we got two guys sitting there and Davey and Josh both won a car and I'm the I'm your employer government I want to help you so I'll give you each a thousand dollars towards a car well Davey may want to play it - a ten thousand dollar car and Josh may want to play - thirty thousand dollar car but it's your money do what you want no that's not Delta they're saying no we're only selling thousand dollar cars there's not gonna be ten thousand dollar cars there's not gonna be F 150 pickup trucks we're gonna control the auto industry and we're gonna make you one car well that we've already tried that in the Soviet Union in Russia does Russia export a car no cuz that was their business model for 50 years so so so not just like they'll pay this much towards a composite well the gold on li lasts a lot longer maybe I wanted the benefit and apply it to a four hundred dollar gold only but don't say no no we're gonna make the decision you have to have a shitty plastic posterior composite that will only last six and a half years and you can't apply this to gold because we're communists we believe in a centrally planned economy and we're making Bank under the false pretenses of non profit and and and the dentists just roll over and a quarter I'm aren't a member of the ADA and and the that that specific issue you go out-of-network they send it to the patient and and that they will not allow for Chrysler to have a Chevy a Pontiac a Buick and olds there can only be a shitty Chevy brought to you by Delta and you agree to our fee or we're gonna send the money to drunk Karen who is unemployed and getting the money from the patient is never never easy for sure yeah so I mean this is a battleground this is where dentists should pick up arms and go to battle and and you know all you have to do is tell just tell your ad I mean that that's the clear line you know it's not woulda shoulda coulda it's do you believe and market segmentation where price has a very elastic effect on demand that you'll sell more more Chevy's than you will Cadillacs true but does that mean we're gonna ban all Cadillacs and Mercedes and BMWs no you do do they do they send the check to the patient because they have emails that could be found in discovery that are telling them this is a really bad idea and this will really screw over the dentist yes that they'll find that in discovery so on you know anyway so okay I got off on a little tangent sorry about that so the prize is credentialing so so if you're in dental school credentialing is when you sign up for Delta Dental in my life and as and as hard as I am on Delta Dental MetLife they're they're perfect compared to the government and from here to Milan Asia Japan I mean I've been I've lectured all over the world and when you get in bed with the government you're gonna get screwed and it can be very violent you might wake up one morning living in Mexico because you made a mistake okay so that was
Guest: the pre claim phase was credentialing data entry would you say the data is entered incorrectly one third of the time and then anything else you want to say about that or go to the final on pre claim phase in church verification all that leads into claim submission phase right so the way you talk about entry verification yeah I'm about to get a little bit more on the data entry because of how important it is so you know when patient calls in and they give you their insurance card that needs to be entered incorrectly and the patient demographics need to be correct in order to actually do the insurance verification which you are right as most of the time done by an individual in your office one third of those claims don't get through to the insurance because of a data entry and another thing is all the exclusions new to your point with the the good analogy about your your insurance is is they don't want to pay claims that's another reasons they will send a payment to a patient because there's a chance to that patient gets mail from Delta Dental they don't want to read that nobody wants to read anything from an insurance company that's when it goes back on the trash but could have been a check in there right that happens all the time and we'll probably will get into word that's more of staff education at the inner you know collecting upfront when you know that a patient is going to be paid by their own insurance collect upfront you know that's patient education as well as staff education but data entry and then along with the insurance verification you need to understand what is going to be paid and what benefits can be paid by the insurance for a patient you don't want to be doing cert you want them you don't want insurance to dictate your dentistry and I'll say that again do you not let insurance dictate your dentistry but if you get in network with an insurance company yes you're getting in bed and you are shaking hands with them saying I am only allowed to charge my patient this much if you have a missing tooth clause or if you have a frequency limitation I have to accept that and I've got to tell my patient left that's why understanding insurance verification is is paramount to making sure that these claims get through to the insurance company correctly and then get paid and then you you get away from the 33% of claims that don't get to the insurance company the right way the first time if you can handle the data entry the right way they interact verification the right way and you do that work that will limit the 33% but there will still be claims as you have to call back there'll still be claims he after research okay
Howard: so I want to give you a little history lesson so there's just some I went to create University in Omaha Nebraska where they had the Oracle of Omaha Warren Buffett of Berkshire Hathaway and and the lecture to our freshmen business class because he was good buddies with they had a business there and Warren said there's two businesses you don't want to invest in one if it's capital intensive I mean you say you want to get into nuclear power I mean you got 10 billion dollars to build a nuclear power a deal and perhaps not make a penny of revenue for 10 20 30 years he doesn't like capital intensive and he doesn't like you have the freedom to price so if you don't have the freedom to raise your price well you know inflation is gonna raise your price you know every time the earth goes around the Sun all your staff wants a dollar based on the zodiac symbol and and so so when they're holding when they're setting the price and inflation is raising yours they know where your profit margin is and they keep you kissed enough had over water and I can prove it because since I've been a dentist longer than probably you two have been alive please please tell me that you're both older than 32 how old are you guys are you really yeah you're both 33 all right you're alive when I was born that just made my day you were alive um the bottom line is that and my gosh when you I'm when you don't have the power to raise your price they the insurance company I'll tell you how I know this because thirty years ago the dental insurance companies like Cigna were saying well I know what these dentists making all this man we're gonna have our own data offices and they hired some of my birdies like her but Kauffman and others around here to open up their own dental office and then they running them and they're like we're losing money and it took him like ten years I remember going up to kaiser permanente they had nine offices in Oregon and they brought me up there I met with Danny see up there and they were like trying to figure out what's wrong what are they doing wrong because they're not making any money it took them all a decade to realize oh my god the fees were paying them they don't make money thank god half their patients are paying cash and they're not smart enough to know that they're losing money on us and subsidizing their loss with cash and then I'll give you another example there is no fortune 500 company in cattle you know why you guys know you're in Georgia most of the cattle are raised grandpa is an accountant his wife's a schoolteacher but they got 50 head of cattle and they're not smart enough on quicken to know that they making any money on their cattle you factor in all the land the feed all the time the vet bills you're losing money so when you're in cattle and 99 percent of your competition is willing to not only lose money but never even know it that's not a good business to get into but Warren Buffett and say pick a business that's not capital intensive that's why you don't buy the land and building underneath your dental office and you'll buy $100,000 CB CT when you can just like every other doctor send them a script to go get their MRI taken somewhere else you don't need it and you and all your periodontist and oral surgeons will do it for free that's why you don't buy capital intensive stuff yet you stay mean and lean as Rickerson would say and then you have the power to price so that when your overhead goes up you can sit there and say well you know I want my overhead to be here we're gonna raise our fees but the insurance companies take that away but my point is this are you mostly dealing with dentists in Georgia or these all around the United States so what percent of dentists do you think are out of network today with everybody I mean I'd say
Guest: I'll probably say less than 5% yeah absolutely and what do those 5% have in common the 5% that have in common they're probably gonna be in an area where they don't need to be a network with anybody and the other 5% it might be like they they might have enough fare fees and they do get enough dentistry they run a well-run practice and they there's no deep for them to be a network in order to you know increase their their patient base I think it I think it's the older demographic as well that's true and yeah and older dentists tend to be out of network because again this is fairly new when you really think about it all you and the whole grand scheme of things it's it's fairly new
Howard: so when you go around the world you get to see different levels of where people are experimenting with governments and insurance all that so when I got out 32 years ago every dentist in the United Kingdom was in bed with the government deal and it took them 10 20 years to realize what was going on they were getting the you know the law and a stick I've seen in Singapore I've seen all around on the world very stages but what what Americans are still doing is they're trying to set up these high overhead factories of you know one or two hygienist two or three operative chairs this big volume practice where they're not making hardly any money and then when you go to a real mature market like Singapore or the new breed in London there say you know I'm gonna have one operatory I'm gonna charge a thousand dollars for a crown and four hundred dollars for a filling and if I just do one filling for 301 crown for a thousand I'll go home today with 300 dollars and that income and then there's that UK dentist across the street signed up with the with a with the government and he saw 40 patients today and went home exhausted and and actually didn't even make any money so I don't know how long it's gonna take me to tell you that healthcare is not a game of volume if you're gonna have prostate surgery let's keep it personal you know we're one one screw up it's gone would you want a guy playing low fee high volume or would you want a guy who does one surgery in the morning one surgery in the afternoon and is out of network
Guest: we have a conversation with you're working hard for less instead of working and and here's why you know and that's exactly it you see dentists that are that are overworking themselves literally literally day in and day out and some we see something that's working six days a week I mean you're gonna you're gonna end up eight after a while and you know you're seeing twice the amount of patients because their reimbursement is twice as low as somebody that might be next door to them but not in network and not in bed with every single insurance problem you know so to keep up with the person that to door you're having to see that many more patients we see it all the time
Howard: you know it's fun when you're young because when I got out of school I used to just be amazed and I did all my dental school requirements every two weeks I mean I was like a kid in a candy store all the candy was free all the lids are off the jars and I work seven two seven seven days a week the first year just because I couldn't quit shoving candy in my mouth I mean how broken to that root you know it's just so fun but my god you can't keep that up I mean I'm 57 now if I had to do that now I've just I've just dropped dead in the chair so it's fun when you're young and you're just filled with energy and you're green and you just want to have all these cases but health care is not a game of volume and run and when government says oh people can't afford it well they afforded their house they afforded their car the average person that gets lung cancer was able to buy a 10 dollar pack of cigarettes seven days a week for three decades but now that they need lung cancer treatment which is less money than their Ford 350 pickup truck now the government decides that you're too stupid to make that decision we got to decide for you and they and people believe that so that's crazy so I'm so the first was the the pre claim phase which was credentialing sign up a network I'm dating and by the way if you if you're starting a scratch practice you're doing all this marking to grow and grow and grow and grow so why don't you just pick the half of America what percent of America head does not have dental insurance oh good question it's just more more commonalities and of course obviously that percentage five years ago of people that had to have insurance and books that don't have insurance well what but I'm saying is if you want to target market like some I'm gonna say you know what I just want to target elderly people for implants hey I got an idea wants to target people who don't have dental insurance so yeah you have the power to price okay so you're talking about insurance data entry insurance verification so the next phase is claim submission Clearing House orders what's going on there correc
Guest: t so the Clearing House is the vessel in which a claim gets from your dental software and the office to the insurance that's every single office in the United States should have a clearing house now do not be mailing claims to all your primary claims we still come across offices that are not utilizing electronic claim submission you are wasting money you're wasting time I mean not to mention all the hours of all the man-hours in your office stuffing envelopes and whatnot so first and foremost make sure that you're submitting claims electronically but the Clearinghouse and what percent what percent your field experience you've been doing this for a decade coast-to-coast what percent are still doing a snail mail I'd say ten percent animal
Howard: oh okay okay so five percent or out-of-network and ten percent are still in paper and I just got to tell you on on behalf of my friends the ones that are still on paper that are my age a millennial might look in and say is a dumb old man no they they don't like the hacking they don't like the ransomware they didn't want to go digital has nothing to do with anything other that they didn't want somebody to hack yet and have everything on a damn computer and there's some truth to that you know there there there they do have a point but so 5% or out-of-network and less than 10% are still doing so 10% are doing it by mail okay what else
Guest: yeah so the ones that are submitting the claims you know electronically they have to use a clearing house the clearing house is paramount to making sure that your your your taking care of your you're basically making sure that these claims are getting there the right way whenever submit a claim and it goes to the Clearinghouse you can actually go to parent house website and see if you had any validation errors or rejections and take care of those right then and there that will limit again that 33 percent that we talked about if you go ahead and you work those claims that had a validation here a validation there is anything from a date of birth not being entered provider ID number being wrong NPI number tax ID things like that if you can go and fix it right then and there and submit the claim that means when the patient comes in for their recall six months later you're not going to have that issue because you've fixed it in your dental software as well you can also fix other rejections you know if if you found out that the patient told you they had met life and you didn't do your internship verification like you should have but they end up coming back and they don't have MetLife you're able to actually call that patient figure out what insurance they may or may not have and get the claim resubmitted again all of these claims are going to show up on your outstanding insurance agent report and that over 30-day report is a perfect snapshot and tells you a perfect snapshot of how your office is operating on the insurance low your across the United States we like to see insurance agent reports that are over 30 days old only 10% of the agent report actually be 30 days old and outstanding claims so to put it in perspective say you have a hundred thousand dollars in insurance claims outstanding you really should only have ten thousand of that money being over 30 days old in claims because of the way that that if you're doing your data entry correctly if you're doing your insurance verification if you're sending claims electronically and checking your Clearinghouse and you got the right team in place that is educated enough and they know what their roles and responsibilities are and you're taking care of it you will limit the amount of denials and that was just that's going to increase your collections and your in your overall collection percentage which is paramount to running a you know well we're on office well
Howard: denial I thought that was a river in Egypt so just to go back to who has dental benefits I'm if you go to the the NADP dot org the National Association at all it's basically seventy seventy seven percent of so a quarter doesn't so there's three there's a 324 million Americans 249 million have insurance so a quarter doesn't and so I would rather do one filling for 200 bucks and make 50 bucks than to do seven fillings for breakeven or 20 bucks I mean again dentistry can be a game of volume when you're young and this is so damn fun and you'd never thought you'd get to do this many root canals in a week as in dental school I mean you know it took you years to do that number but gosh when you get older you're gonna get tired and slow down so when you said about going to that site to check your your claims what what site are you talking about
Guest: yeah so the there's multiple different clearinghouses you've got Renaissance dental exchange and etc yeah they all have their own website in order to go and take a look at your claims that you submitted that day that's where you would go and then somebody needs to be checking that daily in order to keep up with it but what percent of the dental practices does someone check it daily to keep up with it I'd say under 5% for checking that daily they just a lot multiple offices across the United States when they hit that submit button they think it automatically gets to the insurance company and a lot of these same officers are the ones that when the check shows up or the electronic funds transfer shows up from the insurance company they go okay well that claim paid they're not doing any claim research and that's that's how the 33% of claims don't get paid on which is decreasing the amount of money that doctors put in his or her pocket okay so um let's go logistics
Howard: I'm you you like snail mail I mean you don't like snail mail you like digital electronics of course the the the trade-off to that is ransomware and all things digital and we just had the Wisconsin Dental Association did you hear about that one anyway they you know they had a you know they got hacked into and a lot of dentists with a ransomware that was tough but um back to the is there any insurance practice major software that's year to do everything you're doing like denture single-side is there is there anyone where you say because young kids are listening to you right now they're in school they're gonna go wherever REM started where did REM start in Georgia you know that is the the greatest that should be like the music capital of at least the solar system perhaps maybe the universe is the best so if REM decided to open up a dental office what practicing your software do you have any favorites are they all equally the same and I know I know I get I know my homies are saying how Italy invites people on the show if they like go up and down oh no no no I had no idea but yeah basically if their IQ is high they're on open dental and if they have no idea what their return on assets return equity in turn if they know almost nothing there on bentrik sore eagle soft but anyway continue it's okay but when open it came out was I would say thing you know I have a special needs sister and one of my best friends Mike the man MuRF dog works in a special-needs daycare home and they're the happiest people in the world cuz they're not aware of any problems a lot of people feel sorry for someone with special needs why they're not worried about the Trump and the trade deal and overhead there I mean I mean they're just the happiest people in the world that's what dendrix users remind me of you know they just have no idea that you know ya know anyway let's let's continue I wonder why they never advertise with dental town I've always I've always wondered why they don't yeah this is why cuz I tell you the truth and it costs me money but the bottom line is opened it also explain to these kids why you like open dental and
Guest: the ledgers I mean I love going through the ledger honestly I love the the patient info site just everything about it when it comes to and posting payments and group checks and everything about it is just to me line up my line and I'm posting getting especially offices that are paid on collections paying their associates on collections and hygienic collections it's just so easy for all that reporting is by far better than any other I don't mind in tricks and I could post an objection a problem eagle solves that to me that's a totally different ballgame there but compared to the other two
Howard: let me tell you how bad Eagle soft is Eagle soft is from Effingham Illinois that's where Heartland metals from they were right normally I would when I would go visit Eagle salt I would you know go down the street I mean the town's only ten thousand and they couldn't get Hart one to use them like that they're homies they went to high school together they grew up together and they're like no no we're friends so yeah so again and then the one I got I got to give due diligence to my friend Stan Bergman who is a CEO of Heartland in resign he heard my views about dendrix and he was such a genius he said okay I'm listening to Howard he's been on the show so he sent out an MBA from Melville New York she flew down she spent the day with me and my team we explained her how not having this dendrix or Eagle softer and him hooked up to accounting how it's just a disaster so she had an MBA Sheila in fact she went she got her MBA from a issue like I did she's like oh yeah yeah so stan is a businessman so they wrote up a letter they mailed it to 1,000 dentists they said would you like these features and it would have been every basic thing you needed if you owned a McDonald's a subway or chick-fil-a and guess what my homie said no and in this report I almost I oh I no if I should cry or laugh she asked them she asked them what changes would you like to see on dentures and guess what the number one change was to change the color of the font I've always told my boys no when they tell me some sad story I say look you know if you were born on earth and there were no other humans it would be a meaningless horrible existence so humans other humans are the only reason you want to be alive and they're the only reason you want to just jump off a cliff I mean they're they're so challenging to love and like
Guest: I think once people get set they don't like that change their software for years what does that mean software manipulation just just kind of putting in your own information this is what you know you know why do you do this and that's just you know you're like well ok there is a proper way to do this well we see a lot of software manipulation when it comes to older software's when you could go to an open mineral and everything is essentially there for you explained they do a lot of trainings and lunch ranks to help there's out there offices not do any manipulation it's the most efficient software it's the quickest software you know your your staff it helps your staff out in the long run because they can be more patient focused - you shouldn't all day every day be having the manipulative software and posts all day you should be able to utilize your software what it needs to be utilized for and then take care of your patients and open that kind of gives you the ability to do that at the same time it's open sourced you're basically allowed to put in a request for a certain report that needs to be run and if enough people vote on it they'll write that in its software and then put that into the next update so they listen to to all their clients they listen all the doctors and the staff members that they use it and they make it better every single month I mean there might be an update and then it's the quickest software to update I mean it can update on each computer in 10-15 minutes saying you know you've got the best version of opened and out there and a lot of times it can have the new report that you want that you want to run which is huge for every office to understand the reporting
Howard: yeah and the reason it was started by a dentist did you know that yeah Jordin Sparks and basically he had dendrix and he bleaching came out and we were both young Docs and he um he tried to export all of his patients names and addresses to labels so he could do a postcard mailing and he got in their infinite not only could he not but they actually went in there and program firewalls around it so that he couldn't so he called the owner and said the hell's going on I can't even export my patients names and data and they said well that's our data and he blew a gasket like what do you mean it's your data I bought dendrix you're in American Fork Utah I'm in Oregon these are my patients and the guy in American Fork Utah I said no no that's my data so that was the Bertha open dental and when you travel around the world hmm every country uses open dental because say you're in Malaysia and you're in Thailand well you can't go in and convert everything to tie in enclosed systems so when I go to any other country with the foreign languages oh yeah I bought one copy of open dental ten years ago for one month's fee converted it to Thai or Cantonese or Vietnamese and now I'm the big software developer and and and I asked Jordan and Nathan I said does that upset you it didn't matter because sure enough five years ten years later they want all their updates they're like well you have a hundred users who have used it every month so you have a hundred twenty months pay times a hundred user so send me a fat check and yeah you get ahead eight foot and it's it's the only thing moving forward everyone else is trying to control you and get you walked in to a system and what I see about open dental is it's where all those are going because they can hire their own programmer in fact ai ai is the biggest thing and it's artificial intelligence and they only have one programming language for that it's called Python and every Python programmer I know in dentistry is already programming AI to the data and open dental to mix it with the data from their accounting their practice by numbers and everybody's gonna do that so so so how many so this website to go in the claims I wish you would make an online seee course to teach my homies to do that because then they could just show it to their their staff because I I know my homies that they're gonna die not knowing what the code is for a pro fee do you uh do you have any videos to teach them how to do this
Guest: we do we train all of our staff that way to be quite honest now we're actually working on a way to actually get this out as well for everybody in the United States to be able to utilize it and somebody brought it up because it's important again I don't like the fact that dentists are networked with everybody in the world and they're overworking but if we can help them to get as much reimbursement from insurance that's why we're here we're here to put money in Dennis pockets and keep money in patient's pockets and that's really what we're about so to your point which you said earlier you said you know five percent aren't a network those are probably the ones that are still submitting claims by mail and I get that it's perfectly fine but the 95 percent that aren't we're still here to help them out so yeah the clearinghouses absolutely we've got videos on how do you go house of clearing houses and exactly
Howard: when i'm on your website I see dental claim support comm dental yeah dental claim support com do you also own dental claims support yeah I own dental porn.com I do it's an inside joke and you click it a good dental town but I just love having an email Howard porn.com and they say what is this and I say you think I made all this money legit obviously obviously it's so obvious I'm a porn star I mean I don't know how but I but where's the videos I see why outsource billing services about careers contact where's the videos to teach them how it's coming soon well you you might you might look at it as a marketing deal it might be one of those deals where if you put that course on dental town a lot of people might discover you there I mean we put 400 courses on they've been viewed a million times and then what I would love about it is my homie wants to learn about bone grafting but he could have a lunch and learn where you know you go buy a couple of pizzas you keep the staff on the clock and you say hey tomorrow at lunch you're gonna get paid through lunch I'm we're gonna send Karen to choke up you can get some fries and burgers and whatever else and we're gonna watch this one-hour video by yours truly Davey clay and Josh Smith who are certified dental coders so do you so you guys became certified was that here in Arizona where we actually have the american dental coders association did you guys go through the program to be certified dental coders good yes and is that something you recommend absolutely so does that so they the CEO that is Mindy Roth ins B SHAC b c d BS c d CC d CS right here on carefree highway didn't there write a song carefree highway so you reckon so tell them what american dental coders association is and why you think they should get certified well
Guest: first of all if you're gonna you know practice it and preach it you need to know what you're talking about so if we were running a dental billing company and we were started by decoders people shouldn't take us seriously and that's why i got my MBA yes I always lecture in business and I didn't have the credential so I wouldn't do this so you so you credentialed yourself for the obvious reasons yes and we put our staff members through and we find it very important to do that and keep up with coding after the fact you also learn a lot of medical coding as well but I mean it's a series of courses in order to become certified dental coders you know your terminology your coding when to win to build something out depending on though on the procedure and you need to know that if you're gonna be in an office because if you build the wrong things as we've talked about you're building the wrong procedures and insurance companies they're either not gonna pay it or they're gonna start flagging you so you need to know exactly what you're doing to me to me there's no there's no real training like we talked about like you talked about earlier the dentist's go through school and I just go through school but fry her of the front desk there is no school for that there's not very many if any tech schools maybe but other than that people come into dentistry at the front desk was typically no prior knowledge when they got in so anything you can do in learning dental we interview people all over the country all the time office managers the one question I say do you have any problem training and the answer is usually 95 percent time it's not so to me anything you can do formally training front desk staff sure
Howard: George never said and by the way I want to say something because I know my homies and if they're my age baby boomer they're all right wing conservatives who hate government and don't like any regulation and they say and well you know when you go to Germany and you and your toilet breaks down you call a guy the guy that shows up he's a plumber he's got training he's got an apprentice he'll fix your toilet one time it worked for 10 years you live out here in Arizona oh you got 24-hour tight repair some guy will be here in an hour I'll charge you three times more than it should have been and the things broke a week later so America you have all these sales and half of it is crap I would read know that the guy building my house has some type of continued education training has to take 15 hours of seee every year has to get coated and I think the German and Japanese model of manufacturing I mean think of Germany mercedes-benz BMW then think of America Chrysler why are we still having this discussion and so I like the fact that you got training and you know I'm embarrassed at dental town just released a another course today and let's see what the let's see what the course is you know it's um it's basically dental implants from planning to restoration grafting with socket preservation and implant placement by dr. Charles Lester I mean I get it that's the coolest thing and nobody wants to watch dental coding I get it but follow the money I wish you guys would do a case on this and because when you're a business owner you have to wear a lot of hats and doesn't mean you like all the hats you know cuz I got my favorite hats in dentistry I mean I'd rather pull wisdom teeth in fact I should have been an oral surgeon I could just extract teeth oh I just love that and I'd rather go to hell with Lucifer than then make an upper denture
Guest: I mean I just don't like and dealing with insurance companies that deal with those clients so you recommend the dental coders Association sure
Howard: do you think yeah you think you might put an insurance could CE Course on dental town someday we will we will I I think it'd be great marketing so then we were going along the the line and we were at a was pre claim phase credentialing day and transportation to was claim submission phase a clearinghouse errors is there any Clearinghouse you like more than others that doesn't jerks and eagles up don't they pretty much all use the same clearinghouse cuz they make money off that deal in the back end like a nickel and
Guest: for that I believe and they have their own or their a middleman it goes to you like flame acts through a den tricks and you know Patterson has their own through Eagle soft now you can still use a dental exchange or a Renaissance which is so dental exchange users claim connect and Renasant to use this remotely those are our two favorites because of so dental exchange will exchange and their Clearing House is called clean connect okay wait I'm not so dental exchange week on dental exchange calm so de MT al x CH a and G that's right dental exchange.com uses what claim connect and that's one word claim connect claim connect calm
Guest: no it's just that's their Clearing House through dental exchange okay and then the next one is Renaissance okay yep they're out of Indiana aren't they I believe so yeah and their Clearinghouse is called remote light and those two sync up with I've not come across on we've been in 15 different softwares if not 20 different software's at this point I've not seen a software that there's two couldn't connect with and hook up with and so if you would direct through
Howard: let's say you're on dendrix if you could you go direct to claim connect to dental exchange and then not use dentures and would that be lower cost because because that doesn't denture it's an eagle sock they're just a middleman they're just trying to make some money off the claim then they send it back to these other guys
Guest: yes I believe I'm pretty sure that's okay don't quote me on it either but paper were all along the same hell no I'm totally quoting you because I don't want to add soon so
Howard: so what would be the advantage of if you use a eagle software dendrix or whatever and you said I'm just gonna go to
Guest: I'm going to use claim connects through dental exchange I like it because essentially claims you're getting kicked back before they actually get to the insurance company and so you can go on their site and you can go ahead like I just imagined the validation errors the rejections and the also the meaning attached so if you ever send a claim it needs attachments let's say you implant these attachments you know you can you can use these clearinghouses and that software itself in order to go ahead and do these electronic attachments and send them on you know another electronic attachments offers any a and that's good too national electronic attachment that's something good something very similar to it at the reasoning it to Didrik so
Howard: so you're never gonna guess what the website is for dental Renaissance out of out of Indianapolis Indiana I was right it's a it's actually called dental here oh yes that's right yeah and I I've tried to get those guys to come on the show in time you ever work with them direct
Guest: we don't really have different context at both of those companies but as far as like the upper ups no we don't think we have any direct contact with them so I wonder I wonder why that is I wonder I wonder
Howard: it's probably channel conflict whenever you don't know when something seems weird it's channel conflicts so you know if if you're making you know so if you're making a lot of money off all these other companies you don't want to go out there on record and say oh yeah I screw those guys come to me direct you know it's just it's just channel conflict and it's one of the worst things about my media company because I run my mouth off and I in fact what's funny is you know my history with dental exchange know that we were in the same space they got when when the inter came out 494 when when Amazon went out I was slowed took me till 98 before I wanted to start dental town dental exchange actually went got venture capital money and the five seasons of the internet were what the five seas were content commercials content community which is the which is what I did I was the only one eating community o commerce which is why you know there was hurting connectivity and they burned through all their venture capital money trying to sell commerce and I didn't sell commerce for the same reason I started a community I mean to me that little Henry that little Ben kool-aid ëthat comes in once a week house is my only connection to the outside world she's the only one that could tell me what everyone was doing and then they were saying oh well you want to get rid of her and just buy online site no she's my only connection outside world in fact I'm on ESPN watching people talk about football and I want to go somewhere like that and talk about dentistry so I started dental town with community but dental exchange burned through almost all of its money trying to do Commerce and then their most genius move at the end they said you know what we ought to do we had to take the remaining venture capital money and go buy some dental businesses so as they actually owned a real business and since they were digital they bought electronic claims brilliant genius move and and you look at that comma bubble from 94 to 2004 no idea what they were do they all went under but dental exchange you're smart players if you ever talking to someone there tell them I'd love them to come on the show and talk about that so I'm so you recommend those two and then the last but not least on number three post claim face claim follow up posting dual insurance staff I know when I talked to my team the thing they hate the most is when people come in with to parents you know to parents each have different claims uh so talk about number three cuz we already went over an hour we can talk for another just to bore everybody yeah and just just to reiterate just kind of what we see in it these are kind of the top issues that we see in dough Rises number one being that Clinton follower and we see that not being done a majority of the time and they could check this themselves if they use dental exchange they just go to claim connect calm and check it themselves they can make a go online and check every what every insurance companies website and check claims essentially will adjust what Jeff hit on earlier was in charge major import and this is
Guest: where we're talking about so we're talking after we've sent the claim what's the next step one follow-up and what we see what we tend to see in dinner prices is there is no claim so if it didn't supposed to get paid if dentist or listening and you're saying why I'm not getting paid we're not collections down the number one thing to do is go to your interrogator and we wanted to be ten percent of your of your over zero okay so you're under over zero day and it's call it let's say it's a hundred thousand dollars about standing money then you're on the 30 day plus that should only typically be around ten to ten thousand dollars so ten percent of your overall but it's mostly having someone in your office your insurance coordinator your office manager whoever it is is responsible for that thing follow-up and that's typically one of the major major things that we see not being done internal practices claim follow so when almost when it also call us they may have a 60 percentage we've seen 90 percentage reports we've seen two million hours outstanding from a dental practice on the Rangers injury report so claim fella is by far one of the most important things an office can be doing on a daily basis
Howard: okay but what can you do for him and give you you guys are being humble and shy you give me your pitch if there listen to all this they're saying
Guest: I'm never that's the reason we start this business is because of what we saw was errors in posting a nofollow so those are the two major factors that brought us into our business and we added sending claims as well or for the form of the practice because see if he's sitting in collecting clintons incorrectly it creates more work on the claim follow right so we essentially decided to go ahead and send the claims form as well do the follow up and do the posting in the office because those are the major areas of expertise that we felt we had to help dental practices and that's where they needed the most as well dual insurance dual insurance is a different can of worms it's of knowledge to know it takes a lot of effort Josh loves it as well but what we have found is that dual insurance is a major hiccup with a lot of dental insurance coordinators yeah and in every office it seems to be one of the most challenging things how to post it how do I know who's primary and secondary really really and also educating your patient on the fact that just because you have two insurances that doesn't mean your claims gonna be paid in full I actually actually want to say that I love dual insurance because it gets the doctor more money and that's one thing doctors don't realize they say some of the I'll find the primary you're gonna I'm gonna have you seen the signor yourself to the patient or we don't accept dual insurance and always ask people always say well why not mmm because you're most likely going to get more money and I'm gonna so why don't you do this we've never been well that's when we take over an office that's one thing that we implement as well to really understand to insure once you really understand dual insurance it can really be a benefit to practice so given the strong clothes how what what service do you provide how much is it how do you get paid well the services we're providing it really is claim submission claim follow-up and I just want to hit on that a little bit claim follow-up and clean research are one in the same we're making sure that claims if a claim is not only follows and not on file we resubmit that claim if it needs more attention we resubmit that if there's other additional information needed and that's by making phone calls insurance companies and also utilizing the insurance web portals in order to figure out what is wrong with the claim why is it on my Adrienne port how can I get it paid in process that's what claim follow-up is if people out there didn't know exactly what but that's the bread and butter a dental claim support we make sure you get paid by the insurance companies you know that's our primary focus you know we we still want you to be able to collect from your patients yourself but we're gonna make sure the insurance pays you so that's the three main things we do claim submission primary and secondary insurance is with attachments posting payments and doing claim research and claim follow-up making sure interest is pay of the claims or is it a monthly fee our monthly fee it starts at $1,300 a month and if you do the math at thirteen times times twelve months is what sixteen eighteen yeah yeah it's like $13,000 so if you take to factor that if you hire somebody your office to do it you're gonna pay them thirty five plus benefits we're gonna do it for half that price but we're gonna do it more efficiently we have experts under our staff under our training our system it'll get you paid in faster every single month
Howard: well I don't know what else I need to tell you gentlemen I do hope you make a online C course I think I'd be great they also would love that girl in my own backyard with a decoding Dental Association Mindy Roth ins to come on the show because again our receptionists have no formal training at the universities I mean they can make you a hygienist they can we have Dental Assisting programs all over the valley from anywhere from six weeks to a year there they're outstanding and my gosh the receptionists are just hired off the street I prefer mine from the Waffle House you might like your ashram but anyway thank you so much for coming on the show Devi clay MBA certified dental coder Josh Smith certified dental coder where's Ryan where's that right into letter he's your third musketeer well tell Ryan that I have four sons and I named my son Ryan after him and who didn't come on the show anyway thanks for all you do for dentistry and thanks so much for coming on the show and I hope you make an online C course that thank you for all the work that you're doing we will certainly do that we appreciate you us on and please please no I don't mind throwing out my email just assist Josh at dental claim support comm if anybody has any questions sit in my way and we'll make sure we get him answered for you I mean again we're out here for you guys so just please keep that in mind and my email is a Howard at REM Athens Georgia comm send it loud cause I'll be playing the guitar with my buddy have a great day