Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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1299 Lauren Kelly on the Value of Patient Membership Plans : Dentistry Uncensored with Howard Farran

1299 Lauren Kelly on the Value of Patient Membership Plans : Dentistry Uncensored with Howard Farran

11/25/2019 6:00:00 AM   |   Comments: 1   |   Views: 199
Lauren Kelly, Director of Strategic Markets, received her Bachelor of Arts in Marketing from the University of North Texas and has been in the dental plan industry for more than eight years. She began her career at Careington International Corporation in account management where she helped clients develop strategies to grow their business and served as their primary contact for their day-to-day needs. In 2015, Lauren transitioned into a sales and management role and currently oversees the Launch Loyalty sales and support teams. Lauren specializes in helping dental groups develop custom in-house discount plans for their offices. She has been integral in the development and strategy of the Launch Loyalty platform and has extensive experience in helping dental groups develop and refresh their in-house discount plans.

VIDEO - DUwHF #1299 - Lauren Kelly

AUDIO - DUwHF #1299 - Lauren Kelly

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Howard: It's just a huge honor for me today to be podcast interviewing Lauren Kelly, she's a director of strategic markets received for Careington International Corporation. She received her Bachelor of Arts in marketing from the University of North Texas and has been in the dental plan industry for more than eight years. She began her career at Careington International Corporation and account management where she helped clients develop strategies to grow their business and served as their primary contact for their day-to-day needs. In 2015 Lauren transitioned into sales and management role and currently oversees the launch loyalty sales and support teams. Lauren specializes in helping dental groups develop custom in-house dental discount plans for their office she has been integral in the development and strategy of the launch loyalty platform and has extensive experience and helping dental groups develop and refresh their in-house discount plans, your solution for dental discount plans and network access product aggregation TPA services and more. Careington international corporation is a leading provider of discount programs for health wellness and lifestyle services. The diversity and expertise that Carrington's people created extraordinary suite of products and services designed to provide unparalleled network provider access significant savings and unsurpassed value to any client or customer, give your patients a reason to keep coming back with a 100% compliant affordable customizable in-house dental plan offered through the launch loyalty whether you're an independent dental practice or a dental support organization if you're looking to take your in office discount plan to the next level or create a new plan entirely they're there to help launch loyalty is a full-service partner and this company was started by a dentist Dr. Martin Rinker he's now the dental director accountant but if you go to dentaltown and the reason I called them to be on the show not vice versa and the reason this isn't a commercial is because if you just drop in the word Careington in dentaltown. So dentaltown has a quarter-million dentist it's been out there since 9:00 1899 and it's got six million posts and the word Careington pulls up helmet it pulls up 96 different threads discussing the Careington PPO dropping connection Dental for Careington for specialists who are contract with Carrington, UHC Guardian Careington Careington is the business of discount plans your office. I mean there's so many questions on Careington so my idea was to try to reach out and get Martin Rinker to come on the show some day or just to get him to log on dentaltown ask answer questions but he's an old man like me so he probably would rather have young Lauren Kelly do it but Lauren if I really wish you could get on there and answer the 96 different threads discussing your company and I'm just as confused as they are so thanks for coming on the show today and telling us what you guys do. So why don't you whether we just start with pretend there it's a kid in dental school that's a quarter of her viewers she might be a senior graduating next year from a dental school in Texas what is your company what exactly do you do?

Lauren: Sure absolutely happy to answer that Howard so Careington actually is a national dental discount network dental network I'm sorry about that we actually have three national networks the majority of our networks are going to be discount dental base and then we also do have a PPO network. So we got started actually back in 1979 we were founded by two dentists who saw me for patients coming in that didn't have insurance eventually they developed a program and it planned and took that to local businesses and municipalities and sold that plan to those local businesses to drive patients into their practice and realize pretty quickly that it was really valuable and it was definitely addressing a need in the market. We eventually developed the largest dental HMO in the state of Texas we sold that and then focused solely on discount dental once we started to sell discount dental out in the market we realized quickly people that didn't have dental insurance most likely didn't have vision insurance or access to savings on prescriptions chiropractic care you name it so that we then partnered with over 90 vendor partners to offer this wide array of discount products to the market. So today Harrington has over 15 million members that have access to our products and services and then we also are nationally licensed third-party administrator so we do the backend billing administration customer service for some pretty large carriers like VSP, MetLife, where we are essentially answering the calls as if we are part of that organization we're doing the billing for them and what's really helped you know scale our organization is this driving need for direct consumer products and the prevalence of consumers out there looking for affordable alternatives to your traditional insurance has really increased our business over the years and then in the last 5 years or so we actually began marketing or helping dentists everyone from a solo practice to large dental groups create their own dental plans that could be offered at point of service so I'm sure everyone in the dentistry is pretty familiar with that a lot of offices actually laughs according to the summer before last we did a study and 39% of the offices we spoke with across the country we're offering some sort of in-house discount program or a membership program to their patients so...

Howard: What percent?

Lauren:  39% according to our study, so we had a bunch of interns working for us the summer before last we had them call 10 or more offices in every state across the US and 39% of the offices that they spoke with actually had said they offered a in-house discount or membership program. A couple years prior to that the consumer health alliance published a study about discount programs and they asked a similar question and they found one out of every 5 so 20% we're offering an in-house plan so just in a couple of years that number 20% went to 39 and we expect that to continue to grow as more offices are providing plans at point of service.

Howard: So you said 39 percent of dental offices offer discount dental plans or

Lauren: Membership plans

Howard: Membership plans okay so I get a lot of kids listening to this that are still in dental kindergarten school so this terminology what's the difference between a discount dental plan a membership plan and a PPO plan?

Lauren: So really the difference between a discount plan and a membership plan they're almost one in the same it's really according to you know people market at different ways and the state regulates these plans different ways but essentially anything that you're charging when you put a program together and it includes a set of services for free or at a discount then and you you charge your patient for that, that's considered a discount plan or a membership plan and you know a lot of companies will call the membership plans because the patient's subscribing to access those services or those discounts and then a PPO plan is usually tied to a risk bearing program or a self-funded program where an employee will have access to a network of dentists and have a set amount of coverage services under that program so a PPO network would really be something that's attached to an insurance plan.

Howard: So to the kids out there insurance is basically in two words it's an actuarial risk analysis versus moral hazard of cheating or what have you you know a hundred people get fire insurance on their house and one house burns down so that that company has to accumulate capital in case there's a risk that they have to make a claim a house burned down or think of cars a hundred people have a car everybody pays car insurance and one car crash you need to have money. So a discount dental plan a membership plan doesn't have any insurance actuarial risk analysis or what you said risk bearing they don't have to store capital to make a claim it's more of a deal right it's of a deal a discount we're giving you more for less because you're a member so it's really not insurance then.

Howard: Correct it's not insurance and in some cases it could be a dentist and a patient relationship where they've arranged that or it could be a dentist in a network relationship so dentists are agreeing to participate in a network like they would for insurance but instead of having covered services the dentist has agreed to a fee schedule where patients that come in with an ID card that have a logo that correlates to that fee schedule well it basically is identifier for that office to charge them at that set rate. So it's really cutting out the insurance and letting the patient pay what they see on that schedule or letting the patient pay what you've agreed to charge them under that membership plan.

Howard: So you said you had you did your own survey of ten dental offices in each one of the 50 states and 39% offered discount dental plans or membership plans but you quoted another one that said 20% of what was the one you quoted?

Lauren: That was the consumer Health Alliance and they did a study on dental and vision discount programs I believe it back in 2015 and one of the questions they had asked where was if the office offered an in-house discount program to their patients in roughly 20% so they did. So what I thought was interesting about that was that was in 2015 and then our study was in 2017 just two years later and we found 39 percent of respondents actually we're offering a plan in their office.

Howard: So that that's crazy growth.

Lauren: It really is and I really think that the reason for that is offices are seeing that patients that have these programs are getting more of their treatment plans completed they're coming into the office more often and they're better affording the treatment it's almost like a perception thing so if you pay to get a discount you're going to use it just like you pay to have a Costco membership in exchange for that membership you're getting products at a wholesale rate or a cheaper rate that you would just going to a regular retailer, same thing here with these in-house discount programs the patient's paying to get a lower fee than the other patients or the patients that are just paying cash and then the data that we're seeing that our clients are sharing with us supports the fact that the patient that actually has the in-house program is spending more per year than the cash paying patient and in many cases spending more than the PPO patient so it's a huge win for the office it's a huge win for a group practice that's wanting to really scale the business and grow and that's what we're doing really helping offices get these plans off the ground and you know grow their programs.

Howard: Well yeah so I found that study increasing access to dental and medical care by allowing greater flexibility and scope and by Richard Manske is that the DDS MBA PhD is that the one you were talking about but anyway. So why is this such a big deal well I mean anytime something goes from 20% of the dental offices to 40% of dental offices and four years is crazy growth I mean like dental laser I mean CAD CAM it's a great example they bought my first CEREC machine in the I think 1987 or 1988 and here it is 2019 and 20% of the dental offices don't even have CAD CAM. Why do you think why do you think this doubled in four years from twenty to forty percent what is it about this in the secret sauce that makes it so appealing?

Lauren: Well I think a large part of that goes back to the treatment plan acceptance so if you are offering this patient a plan let's say their treatment plan that's going to cost them $2,000 to get everything done to bring their mouth to a healthy state if you then show them that $2,000 treatment plan then present an in house membership plan next to that even at a 20% discount that saves the patient $400 and it allows them to better afford the treatment and they're getting the treatment done more often because they're getting that discount and many times the cost of the plan actually is less expensive than or it's more valuable than actually the treatment so I said that a little bit backwards but the cost of the plan will pay for itself usually in that first visit so let's say the plan is $199 a year and it offers 20% off of all treatment in the office on that $2,000 treatment plan you say 400 you only spent 200 for that but when you think about it from the dentist's point of view and what is the value to them the long-term value of that patient is significantly greater when they're on these programs because again they're coming into the office more often throughout the year they're getting more of that treatment completed. So you know people don't really pay to get a discount when it comes to their medical and dental expenses it's just not the norm so if they're paying you can get them to buy into your program they're going to be twice as likely to actually use it and get the treatment done so we always advocate that offices sell the plan when the patient is in the office sell that plan to then present it to them as soon as they come in and you realize that they don't have insurance but another big reason why I think the market has you know shifted and it's we've seen such enormous growth and in this program is because insurance really over the years has not changed so for the last 20 years insurance dental insurance plans have had these $1500 annual maximums they have limitations and exclusions that tell the dentist that really you can't treat that patient or you keep whatever you're recommending and treatment is not what we're going to approve and the cost of dental care has only increased over those the last 20 years. So when you have the cost of care increasing and then the plan actually remaining flat and staying at that $1,500 annual max it's becoming less and less valuable so the perceived value of the plans is lowering among consumers more people are more conscious of their expenses as it relates to medical and benefits so there you know since employers are shifting from employer sponsored dental plans to saying okay employees now you have to pay for this a hundred percent on your own they're saying well I don't know if I want to spend thirty forty fifty dollars a month for this dental insurance that's only going to it's going to cap me out at fifteen hundred dollars so I think that consumers are realizing that more of them are walking in without a plan without an insurance plan and then at the same time too dentists are certainly realizing that and they're looking for ways to you know get around those insurance company and offer something better they are at point of service.

Howard: Well you know it's kind of funny dentistry is a cottage industry and in economics of MBA school at ASU they taught us a cottage industry is any industry where one player doesn't even have one percent of the market and when you look at them things like well you're in Texas I mean there might be is there as many cows and cattle in Texas as there are people I mean four to five my grandchildren and Beeville and there's just cows in every direction you can see but cattle is a cottage industry there's not cattle incorporated that owns twenty percent of the cows in America and dental offices take the biggest dental offices out there a Heartland dental they don't even have a thousand dental offices and there's a hundred and fifty thousand general dental offices the United States and another thirty thousand for specialist but when you look at the fortune 500 like chase credit card Southwest Airlines you mentioned Costco they replaced old-fashioned marketing and advertising for new patients a decade ago because who hasn't flown Southwest Airlines which was started by Herb Kelleher who passed away this year in your great state in your Dallas I love AirField. Everyone's flown Southwest once everyone's gone to Costco once everyone's gone to a chase bank once they don't want any new customers they want their existing customers to remain loyal so everybody has everybody in the sophisticated sp500 has gone well t program ten years ago and you still meet like like you go to a small town in Texas and not to mention any names because I love going there but you know it'll be some dentists my age. I met a dentist out near Beeville and he he still wants 20 30 new patients a month and he's been there 40 years in a town that doesn't have 5,000 people I'm like does that does anything about that not make sense to you wouldn't you rather just have 2,000 people in this town of 5,000 that were loyal to you and only went to you. So do you do you think that loyalty programs have superseded and replaced just marking and advertising for a new patient?

Lauren: I don't know if they completely replace them but it's interesting that you bring up that point because what we're seeing a lot of offices do especially you know the progressive offices they're replacing those new patients specials the one and done type thing with their membership plan marketing so instead of saying you know get exam x-ray and cleaning and a whitening kit for coming to see me for 75 bucks they're saying buy into my practice and let's help you save money and they're creating that patient for life because they're realizing the value of that patient over time is going to be greater than getting one brand new patient in and at the same time too in your example where let's say this office is the only dentist in town and you know he's got most of the market and maybe only 10% of the of his patient base is paying cash if you can get that 10% of your patient base to spend twice as much as they did before you're still winning without having to bring in new patients so there's all sorts of things that you can do with this but the real kind of key there is to get your patient on your program because once they are on the program they're that much more loyal they cannot take it from office to office you aren't competing with the Aetna's of the world you're actually bringing and tying that patient in to your practice in your family.

Howard: So I notice so when someone signs up for a recurring monthly revenue cycle you know they started discount dental plan lightly like Disney's the latest one I mean we've had Netflix we've had Spotify now Disney went out there and of course I have to get it because if you're a grandpa you need Disney and if you're me you need ESPN I mean it's all it's all rolled into one but it but when you sign up for that it's just monthly in perpetuity but a lot of these a lot of these discount plans you you do all the effort presenting it to the patient you sell it they sign up but then it expires at the end of the year and then you got to go through that reselling process I've been I've been wanting someone to come out with something like Netflix where if I put a lot of effort in getting Lauren Kelly to sign up for my plan man I got her on the hook till life until she has enough initiative to get on get on and I cancel her membership plan. It's the same thing when you go when you study the business models of these workout places like lifetime and all these LA Fitness and all that stuff they'll tell you that the the average personally only goes to the gym for like eight months but it takes some thirty eight months to cancel their gym membership so they give me 30 month free ride. How do dentists get that free right how do we get you to sign up for this membership plan the saw that what you guys are selling and when they decide to stop brushing flossing and visiting the dentist you're still dinging their credit card once a month for thirty eight months.

Lauren: So actually that's exactly what we do we actually work with dental practices to come up and create customized their plan to make sure it works for their office so they customize the discounts the branding everything is made to look and feel like it's their program because it truly is and then on the back end we're doing administration and we're sending up billing to automate everything so the office can choose if they want to offer the plan on a monthly basis or if they want to offer it on an annual basis so when the patient signs up and they pay with their debit card or their credit card or their bank account we're actually going to retain that in our system because we are a PCI compliant we hold that securely in our system and then we charge their card each month or each year on an ongoing basis until that patient calls and requests to cancel. So it is Auto renewing each year the plan will auto renew will send a renewal notice to that office again it's a notice that looks like it's coming from the dentist's to remind the patient that it's coming up for renewal and to let them know they can't cancel if they want but I think don't cancel or take action then the plan Auto renews. So we definitely are advocates for you know keeping patients on the program and Auto renewing anytime you can so that is the struggle if a dentist tries to offer a plan on their own and just set something up on their own then they would have to have their office staff ask those patients to re-enroll every year but if you're working with us and your plans on our rails then all of that automation is already built and set up to make the plan successful.

Howard: I mean that's huge or are you the only one that does that? So I mean the payment card industry data security standard is an information security standard for organizations that handle branded credit cards from the major card schemes the PSI standard is mandated by the cards brands but administered by the payment card industry security councils I was not aware of anybody who would automatically renew.

Lauren: So there are actually there's a few competitors out there that offer a platform to auto renew plans and to manage your plans but I would say the big difference is those are those platforms are more DIY programs so you have the software and then you kind of manage it yourself we're very hands-on and proactive and helping our clients implement new tools to go out and sell a program to improve the program and in addition to having that security on the payment card side we're also a nationally licensed discount plan organization it's called a dpo and there's actually 35 states that regulate discount plans so a lot of offices out there another thing that they don't realize is that these plans are regulated.

Howard: By who, who regulates them, say that name again.

Lauren: The discount plan organization is what we are but most in most states the 35 states that regulate discount plans those are usually regulated by the Department of Insurance even though it's a discount program and then there are around 15 states now that have enacted direct primary care laws that basically say that if you follow these set of rules then insurance regulation does not apply but you must follow those DPC laws and what's interesting is there's...

Howard: DPC laws?

Lauren: Yeah direct primary care laws and what's interesting is there's some overlap between the discount plan laws and the direct primary care laws and some states have both so we help our clients navigate that and basically provide that reassurance that if you're working with us your plan is going to be compliant so you see our Careington disclosure on the bottom of the materials that points any you know complaints or you know inquiries from the states to come to Careington first so that we can answer on the dentist's behalf we review and approve all material materials before they're released and before the office starts to sell the program because the last thing you want to do is implement this great thing for your practice and then you know at the same time add all this risks here to your organization so they're the competitors that are out there I would say they have the automation but they're not licensed DPOs in many cases. So I encourage all dentists out there that are looking to set up these programs to research the laws in your state and ensure that if you are working with a partner that's not Careington that they are licensed and that they are going to bear that compliance risk for your practice.

Howard: and by the way I just have to say that on this is one of the things that's always confused me like I remember when I've seen every pony I've seen every rodeo two or three times remember when dental insurance back in the day like you know 10 20 years ago decided that they were gonna start setting the fees for your patient bleaching and all these things and a lot of states said what do you tell me you don't provide any benefit for home bleaching why why you why are you setting the fee stay out of your lane but everyone always overreaches and I couldn't believe it in Arizona where you know this the plan does not assume any financial risk but you know the government they had to get involved and the insurance department you know how do you know start passing laws they passed HB 2113 Senate bill 11:05 signed by the governor this year April 2019 it's like why couldn't they just say we're insurance and they're not and leave it at that but it seems like nobody likes to leave anything alone it seems like I'm controlling is a very human drive I mean everybody like the old song everybody wants to rule the world I still I still can't figure out why the Insurance Commissioner had to get involved with this in Arizona do you have any insight or why 35 states have to regulate something in the insurance department when this is not insurance and the bearer has no financial risk?

Lauren: Well really I think the purpose is the main purpose of that is to make sure that these plans aren't misrepresented and to ensure that patients aren't thinking they're signing up for an insurance program when in reality they're not it is a discount program or it is a membership program so those rules and regulations are really in place to keep those materials compliant and keep dentists and even you know all of our marketers out there Carrington's got thousands of marketers to keep them in line to make sure that our plans aren't misrepresented and to make sure that the patient or the consumer understands that it's not insurance also you know there's some things even if your plan materials a compliant you said it everywhere that you had that this plan is not insurance you wouldn't want to at the same time charge let's say $1,000 a month for the plan because then what that looks like insurance or it looks like a prepaid program. So there's all kinds of little nuances and things like that and Careington likes to area on the side of caution to make sure that we're not putting our clients at risk and we're not taking any risks there either. So when we review materials we look at kind of the strictest standards and we follow those to ensure that there is no room for error there so but I do think that it has a lot to do with just making sure the plans aren't misrepresented into consumer.

Howard: I find it I want to teach a kid something at that you know as far as treatment acceptance plan I've said this a thousand times and you might think I've already said that before but you don't get it I mean there's two hundred and eleven thousand Americans who are alive today with an active dental license and these average Americans will buy thirteen new cars between the ages before they're 76 years old the average new car will be thirty three thousand five hundred and sixty and I can assure you that there's a dentist in your zip code who sells the case for about the price of an average new car about once every Friday from age you know I don't know they get out of school twenty five they learn complete dentistry by say 25 and they do that from age 35 to 65 the other 95% of all the dentists in America will never sell one case their entire career worth the average new price of a car which is only thirty three thousand five sixty so the Americans the biggest thing they'll buy is a house and that's the biggest thing to buy is a car and you can't sell them one car in your whole life but they have no problem going out and purchasing thirteen new cars before there's 76 years old you know Lauren not to put you on the spot wins last time you bought a new car?

Lauren: I actually bought a new car this year.

Howard: Yeah and did Medicare pay for it, did Medicaid?

Lauren: No it wasn't

Howard: Obviously your employer paid for it I mean you can't buy a car by yourself in the government or your employer buy all your new cars?

Lauren: That would be amazing

Howard: Yeah it's an insane concept but this is what people think about health care like like that 33 thousand dollar car I mean that would be it would just be insane for people to think oh well I can't spend that money on myself so what I used to do a dental insurance is you know people start talking about a predetermination this and that I don't say look look the the maximum your insurance can pay is a thousand bucks so I'll just you know your case is $18,000 I'll just take a thousand dollars offer right now regardless of if the insurance payers or not let's just take that out of the equation so now the patient has just eliminated that whole thought and say well the most insurance will pay is a thousand you just discount this out now they're back to the deal do you want a new car do you want to redo your teeth I mean you're 40 years old you're missing teeth you don't like your smile you're in pain do you want me to just fix this one tooth that's in pain or would you like to walk out of here with a brand new smile and the reason dentists don't do that is because they don't present it and the reason I don't presented is somewhere deep down in their back of their reptilian cortex they literally think that dentistry is so unimportant that if your boss didn't pay for it or the government didn't pay for it I mean you shouldn't even do it and then so now I've lectured around in 50 countries well half the countries on earth have no form of dental insurance and a lot of these countries don't even understand is they're like well isn't you know if you drink Coca Cola and eat chocolate and need ten cavities well shouldn't you pay for that to really feel the impact of your personal decisions and let's not get your boss and the government and between you and your dr. pepper and your Butterfinger I mean you need to own it and when humans have skin in the game they own it and my gosh so just financing is a is a mate treatment plan presentation financing insurance membership plans. I found it interesting the first words out of your mouth Lauren were this is going to help your treatment plan acceptance rate it's like yeah but I know my homies that's that just whooshed right over their head so I'm when you go back to that how is this going to increase treatment plan acceptance rate?

Lauren: Well if you think about it just like you mentioned most patients that come in that don't have insurance usually they're in pain they have an issue right and they're there because that pain finally drove them into practice and most the time if they don't have insurance they're just scraping pennies to try to pay for the one tooth that hurt you know that's in pain but if you have them take a couple steps back and present to them the full treatment the full treatment plan show them what you need to do to really get that mouth healthy and then you put that fee alongside so let's say back to the two thousand dollar example put that total in one column and in the next column write out the fees under your in-house discount program and compare those right there you don't have to be a good salesperson just to show the math there that the plan is for those treatment fees are going to be less expensive with the in-house membership program. So now the patient's like well you know what instead of just getting this one tooth done I'm gonna get these three things done or okay I've already paid to have to get access to this discount so I'm gonna take care of you know one or two things today and then I'll be back in and a month or two to get this other treatment done and there's kind of this it creates a sense of urgency for the patient if they know they've paid to get discounts for the year then they are going to use it. Another really neat tool that you can do is incorporate free cleanings into your programs as well so then you have patients coming in every six months that probably weren't coming in before because they weren't getting their teeth cleaned because they didn't think I was gonna be too costly without insurance so now they're coming in every six months and that presents another opportunity opportunity for the dentist to diagnose and treat that patient.

Howard: That is interesting I am when you started to say when the patient comes in they don't have dental insurance I want to tell you what the dental office team starts thinking, they start telling the person they feel sorry for them they're a victim and they man makes them smaller they say well I'm sorry because I'm you don't have any dental insurance and it's like where does that come from when you walk on a car lot no one says I'm sorry you don't have a new car when you drive by a house no one's out there saying I'm sorry this isn't your house I mean why when you make a human feel like a victim they feel helpless and and humans don't like to feel helpless they like to be in control and I some team members go in there say oh my gosh if you're gonna do this tooth look at this tooth and they start talking about complete dentistry like the late Peter Dawson talked about his entire life and and when they don't have dental insurance I mean I don't care I didn't have dental insurance to buy my iPhone I didn't have dental insurance to buy it I can't think of anything I bought this year that that took insurance and and it's just in so the people who make dental insurance have the power that they do today is all coming from the dental office team. They're the ones that just bring up this this false god every conversation well I don't know if the insurance will pay for that I don't I mean could you imagine the look in the car and say well you know I want a moonroof and then the first thing he said well I don't know if the government will pay for a moonroof if you have a moonroof I I don't know I mean just just stop worshiping insurance and start worshipping optimum oral health and you'll have a couple cases that will change your life and I always refer to this one I'll never forget where when our full mouth rehab was done and she looked at the handheld mirror she was standing up she had to take a knee I mean she had to take a knee I mean and you deprived all of these people from taking a knee that have enough money to buy 13 new cars in their lifetime because you're all caught up that Delta is not going to cover it and yeah I mean in an interview say dental insurance well this who's gonna be the dentist for this patient if all the dentists work for the dental insurance company where my grandchildren gonna go when they need a dentist I don't want him to go into some dental insurance agent they got a dental degree from Baylor but really works for Blue Cross and Blue Shield and is only gonna tell you whatever the talking points are from Blue Cross and Blue Shield I want my grandchildren walk in there and say hey you don't brush and floss your teeth you got five cavities or 250 each and you're gonna give me your chase debit card and we're gonna do those today so they don't turn into five root canals and your grandpa starts rolling over in his grave but so the problem with dental insurance is the dentist and the the the Mafia said the head the what is it the fish rots from the head down so when the dentist is always talking about dental insurance and I also think it's funny here's the here's the the two thing that drives me crazy the dentist is always the one that brings up insurance but then he never wants to talk about the price or how much goes well how much does this cost oh well you know I don't know I'm Megan we'll figure out your dental insurance and what your max it's like what she just asked you how much this cost why didn't you look it right in the eye and say you know the whole thing's $5,000 and you know most of us guys work Monday through Thursday 8-5 but in a case like yours I'd like to just do it all at one time what we like to do on a case like yours just come in Friday I don't have any patients and we'll meet you here at eight o'clock and it'll probably take about three or four hours in fact we have an anesthesiologist have you ever had a baby did you have a.. what is it called?

Lauren: Epidural

Howard: If you want that here's the number two the anesthesiologist he can meet you, you could talk to him over the phone he could meet you down here 30 minutes for the appointment in fact when I walk in the room you could be sleeping but why don't we just why don't we just do all of this at once are you thinking you'd rather just stay awake maybe laughing gas are you thinking you'd want to epidural and just and and see now we're working towards you're gonna make a great decision I'd rather you max out your credit card on your teeth than in a Gucci purse at that what's that mall in Dallas that everybody what is it?

Lauren: Is it North Park or Galleria?

Howard: The Galleria oh my god you walk in the Galleria they have purses for $5,000 I'm like who made these was it like Tibetan monks you know softening the leather with your teeth how do you get to a $5,000 purse and then you go into the dental office and they can't even comprehend presenting a $5,000 treatment but the Galleria sells $5,000 purses all day long. How many pairs of shoes does the average girl that walks in the Galleria own in her closet today?

Lauren: Yeah 

Howard: and how much would the average pair of shoes cost would you say?

Lauren: Probably I'd say yeah they're probably walking out with 1 to 2 pairs a day 4 per person and the shoes are probably anywhere from you know 80 to 200 dollars

Howard: Okay there's my point 200 dollars that's a filling. So you didn't brush you didn't floss eight research peanut butter or not you got it you got a cavity and it's 200 bucks they can go they don't blink at spending 200 on a pair of shoes or a thousand on an iPhone but the reason they blink in a dental office is because of the dentist and the culture the dysfunctional culture they've created and then at the end of their career 95% of never restored one full mouth to complete dentistry and this is where we got to where we got to make an impact and you're obviously making impact with 15 million members I mean my gosh.

Lauren: Yes we have 15 million members are in our dental discount networks and other networks out there and other products out there as well as services so that's across all Careington clients but back to your point about you know dentists and this mindset they've got any other mindset that only the insurance patient is valuable because the math is proving itself now and the data is showing that the patient that's on these membership plans are spending more money in many cases than even your PPO patient not to mention we have all of these baby boomers you know out of retirement hitting 65 and needing care so there's actually two generations that are entering that market that are needing care and there they have the funds to get this treatment actually I can't give you the exact numbers but on our DSO sides if you look at our large group setter marketing these membership plans more than 50% of those patients enrolling in the programs are over 65 years old so you have this huge market of patients that an appetite for a plan with the dentist and it's up to the dentist to make sure they have these programs in place to be able to get those patients because pretty sure pretty soon they're going to shop around if you present someone a five ten fifteen twenty thousand dollar treatment plan they're going to make sure that they're not overpaying for that and you don't want them to go to the dentist down the street because he had an in-house membership program there's so much value in getting those patients on these programs and I completely agree that we've gotta get out of that mindset that only the insurance patient is valuable.

Howard: Yeah and again this is the dentist this is their whole kit and caboodle this this is something they're gonna have to figure out I mean there's only so much you can do I mean I don't understand how and they love dentistry they would never walk around with ten cavities and a missing tooth and all this stuff like that but it's just one of the biggest mental blocks in dentistry is that someone else has to be responsible for you want you want the government responsible for your housing would you would you like to just close down the housing market and we'll all live in government housing would you like this close down all the car dealerships and we just use government transportation. I mean humans are most motivated when they have skin in the game they're making it like look at housing they may want an apartment a two-story house a one-story house a trailer the odds are all over the board and when you start having dental insurance try to corral them all in one area like look what they've done they basically killed inlays and onlays you had a file down the whole tooth for a crown if you want the insurance to pay for half whereas if you have a membership plan and you're sitting there and you remove the mod amalgam you remove the decayed you're like you know what I just want to shoo this functional cusps and take it from there well I don't have to worry about some non dentists and some dental insurance bureaucracy who's never went to a day a dental school or hygiene school telling me oh we'll we don't cover inlays and onlays it's like well are you a dentist, no, okay so then you're practicing dentistry without a license that's illegal right but they got too much money too many lawyers and all this like that and it just doesn't get about.  I want you to focus on two things specifically when we look at the dental industry you know it's like a hundred and seventeen billion dollars last year in the United States as far as people paying a dentist 117 billion and so that now would pay for all the equipment supply everything in dentistry so about two hundred and eleven thousand license dentist they employ well over a million people globally that's a half trillion dollars with over ten million employees that's how many that's how much eight billion humans value their mouth that you know that that basically I mean it's a huge huge industry but that industry is pretty much just growing you know one and a half to three and a half percent a year you know going out into perpetuity for fillings cleanings amps the only double-digit growth we see is in clear aligners and implants and those are double-digit growth insurance as a pay for clear aligners and they don't pay for implants hello, in fact you should change the name from the Careington dental the Careington what do you call it that Carrington...?

Lauren: Actually we market our administrative services under launch loyalty that's our brand for the administrative services

Howard: So it's called the Launch Loyalty program or just Launch?

Lauren: It's Launch Loyalty and it's powered by Careington but you can find us at

Howard: I would change the name to clear aligner dental implant lunch loyalty. So talk about those two things so what does this have to do with clear aligners there's nobody there's not one girl and the Galleria that walked in there didn't look at her smile that morning and didn't wonder if she needs clear aligners so talk about clear aligners and implants and how you think this plan will be a game-changer for them.

Lauren: Well I mean that's a great point you make the fact that those are the two largest growing markets and they're only two with a double-digit growth I think proved something right there patience that you know those services are not covered and they're still paying for that treatment and affording that treatment and if you think about it's really two totally different segments you know you've got people as young as 18 using the clear liners and then you've got implants or traditionally for your you know 50-plus market. So both sides of the spectrum are paying for treatment that wasn't covered by insurance so if you can get more of your patients on your in-house program they're going to be more loyal to your practice and they're more likely to get those those procedures done as well and we've got offices that will actually carve out special discounts for clear liners or have a special arrangement on implants we have GD's who are actually partnering up with specialists in their areas to funnel patients back and forth because they're not competing but it creates this really attractive program for the patient there's all kinds of things that you can do with it and I like doing that targeted marketing where if you want to focus on selling implants this month use that in your marketing for your in-house discount program and a way you could do that is for instance if you want to run in social media campaign you could say 20% off clear aligners with you know doctor Farran's membership program there's all sorts of things that you can do to cater to each demographic and you should specifically target people with specific procedures and you can do that with your membership program.

Howard: Okay so I think yet this isn't a commercial there's no money changing hands but Lauren did promise me she'd buy me a Gucci purse from from the mall with matching shoes. So when you go to your website the first thing you see is launch loyalty solutions we specialize in helping dental offices create and successfully manage in-house discount plans and increase treatment plan acceptance boost patient loyalty and attract new patients but you have two solutions I want you to expand one is a semi custom in-house plan best suited for independent practices and small groups the other one is a fully custom in-house plans best suited for mid to large group practices and I know the DSO kingpins are a big fan of this show because they always text me and stuff after some of these shows and and is it safe to say Lauren that I always tell companies when they're launching something if this makes smart sense business spend all your time you know explaining this to DSOs because they obviously got the business of Dentistry down my buddies you know if you're a solo practitioner you'd rather go to a bone grafting conference than anything to do with dental business so so explain the difference between semi-custom in-house plan and a fully custom in-house plan.

Lauren: Sure so really we're doing that to cater to both markets an office that's an independent practice with just you know one location is usually looking for a quick solution that they can implement low-cost they aren't too particular about really having branding and having fully custom marketing language so they just want to know what have what are our tried and proven methods what materials work and we can quickly put together a program for them within 30 days so our semi custom solution allows you to customize a plan so that it has your logo you still customize the discounts and things like that however it's more of a speed to market solution and you use some of our web templates in our brochure and marketing templates that are already effective and we pop in colors and logos to kind of go with that dentist color scheme without having to spend you know months and months creating it which gets that plan out there quicker for the dentist and it's a low cost option. So that's really where our semi-custom solution is and then on the other side we have fully custom plans and by the way we could create a fully custom plan for an independent dentists if you would like or if you just have one practice or maybe let's say we have a small group book like three locations and they're looking to scale and they know they're very particular about branding their branding and the customization is really what sets that fully custom option of apart from semi custom so we will do everything from your custom writing the language will take the offices set of branding guidelines and make sure we're following that when we're creating the materials and then we can get really into the weeds on the fee schedules we can have different these schedules by location and things like that so really the difference is more in the setup and the customization the level of customization and the materials but that allows us to cater again to both that independent practice and then your large you know 200 plus location groups as well.

Howard: So Chad Hendricks on your page who's the owner a clear choice Consulting says our prayer in-house discount plan had only 2,500 members in three years after partnering with Careington our Planning see of 5000 members in only six months Careington may be easy and is a great partner Chad Hendricks where why do you think that is, well I mean that that's huge I mean have twenty five hundred members and three years and instead of doing their own in-house plan they do with you you get to fight that you double it in six months how does something like that happen what do you think makes something like that happen?

Lauren: well I think a big part of that

Howard: or did you just send them some shoes to say that...

Lauren: You know we were very hands-on with the training of all their offices and and we are no matter what size client you are when we can we like to train in person and with that particular group we saw almost all of the offices or at least the office managers in person to do trainings to go through not only how to use our tools but how and when to present the plan to the patient what phrases to use to share you know success stories from our other clients and what they're doing to really get these patients to sign up so we are very much we develop a partnership relationship with our clients because the success of our business is you know depend upon the success of the plan so everything from that training to giving them all the right tools and marketing materials to get the word out about their plan all of that goes in hand-in-hand to make it successful but I think in particular we have a really great training team we not only have our own trainer here and the launch loyalty division but we also have nine client relations representatives that work for Careington that are working on our massive accounts that also help in providing this hands-on training so you have that dedicated support and you have the expertise of a team that has been selling plans for many years and knows what it takes to make the plan successful.

Howard: So it says your success so far and who's biting more yous biting more on this bait is it DSOs because they understand business or is it private?

Lauren: You know I think that the DSOs were probably the first to adopt the concept but shortly after we saw private practices having the same interest and now I think really it's a good mix of everyone but if you look at you know the makeup of all the DSOs and you know the number of practices they make up and then you look at private practice obviously a larger chunk of the market from the DSO side actually has these programs but the independent dentists or right behind them. I think it's a little bit tougher to get the fee for service dentists to understand that you know not getting a hundred percent of your UCR that you use your typically used to getting from your cash paying patient is you know something that you're going to have to take a risk on but when they have these programs in place after a year's time they will see that that patient that was paying 100% of UCR maybe only came in you know one time a year and now they're coming in two three times a year and getting more treatment done so knocking that down to let's say 70% of UCR on each procedure still at the end of the day made that dentist more money because more treatments being performed and not to mention we wrap in vision discounts prescription discounts into these programs to increase the value of the plan and now becomes a really good marketing tool word of mouth marketing tool because patients love it and they're telling their friends and family about it and you're creating this you know whole new network of patients that you can bring into your office.

Howard: So if you do if they do with you you also add vision and what else?

Lauren: Yes we vision discounts LASIK discounts and prescription and that's really up to the dental office whether we add that or not but for us we meet strongly and highly recommend it we actually don't charge the dentist's anything extra for that we don't charge the patient anything extra but we do that because it we know it increases the value of that dentist's program and also every time the patient's out using that ID card that was for doctor Farran's membership program and using it to get their diabetic care medication at the pharmacy or to get their new pair of glasses of every year they're reminded that they got that program from you. So that creates more loyalty to your practice to the plan and increases the value and these are large national networks that we'd used to provide that access of discounts on the vision and prescription so it's not like we went out and cut contracts with different optometrists and pharmacies we use actually Eyemed for the vision side and then we use United networks of America and envision for the pharmacy side and those networks are contracted with you know your CVS pharmacies, Walgreens, Rite Aid, Target, so those are all participating and then on the vision side you've got your LensCrafters pearl vision you name it all the big-box retailers are in that network as well so the dentists can rest assured that patients will have access to participating providers. So again it just adds value to the plan and that's been a really point of difference for us from our competitors and you know if it's working for the Careington plans we're going to try it and it's going to work for the membership plans as well we like to you know maintain those say those same principles.

Howard: So what speaking of so who does your pharmacy benefits you said vision was Eyemed?

Lauren: So Eyemed is the vision Network and that's Eyemed

Howard: Oh cute it's Eyemed

Lauren: Yes

Howard: Wow that's a great name I never heard of that so there okay so Eyemeds for your vision and they're out of Ohio and then...

Lauren: and they've got thousands of ophthalmology clinics across the country.

Howard: Okay he did your than the prescriptions from who?

Lauren: United Networks of America and they will provide discounts on your generic and your brand name drugs at thousands of pharmacies across the country like I said you know your CVS, Walgreens, you're Rite Rids those are all in network and we give all of our members and the dentists members access to a link where they can search for providers that are in their area and they can see you know where they can use their card.

Howard: Yeah so Eyemed provides optometrists affiliated with LensCrafters, pearl vision, JCPenney, optical Sears. Have you have any of those companies Sears, Target, JC Penney's or Walgreens of any of those guys contacted you for this to work with you guys?

Lauren: No they that Eyemed really holds a relationship with them Eyemed are vendor partner and they hold their relationships with each of those retailers so no we haven't been directly contacted by them we just you know we go through an extensive vetting product with all our process with all of our vendors and I met someone we've been working with for years and it's a valuable product so that's why we've incorporated it into our programs.

Howard: and then on this a united networks of America so what do you think so them so was that that's not related to the United dental insurance?

Lauren: No it's a large national pharmacy discount network and patients get access to discounts on their generic and brand name prescriptions they also have a tool where the patient can type in their zip code and then type in the name of the drug that they're needing to get or they're needing to get access to and see what exactly it would pay at each pharmacy so they can see their savings right there which is really nice.

Howard: Well can I be a spoiled brat and make this show all about me can you, can you summarize all this and email me so I can show this to my team and see what they think about it?

Lauren: Sure absolutely

Howard: My emails yeah this is so interesting and the other thing about Americans is sometimes I feel sorry for Americans because when you go to countries like China and Brazil where there's no dental insurance people's thoughts aren't cluttered with all this stuff like well I wonder well you know I will have to change a job because my job doesn't have dental insurance so they like their job and they're not gonna change your job and it does that dental insurance so we're done thinking about teeth because I'm intellectually challenged because if my job doesn't have dental insurance well I obviously can't go to the dentist and I'm texting you this right now my thousand dollar iPhone I mean it's just such a bizarre bizarre concept. So what do you what do you think about KKR trying to buy Walgreens right now in a leveraged buyout I mean they you know that for fifty seven billion dollars I wonder I wonder why KKR which owns Heartland I mean that's the largest dental office chain in America in the world as far as I know with a thousand locations and the people that own Heartland are now trying to buy Walgreens this is this is a rapidly changing industry a healthcare seventeen cents of every dollar it's the biggest chunk of change you saw Warren Buffett and Jeff Bezos and Jamie Dimon of Chase Bank now they've got together and they're trying to brainstorm and they asked them why are you guys so interested in this I like dude it's the largest expense in America seventeen cents of every dollar goes to health care and we're competing with all these other company countries who don't even spend 9% on health care. So your your job is just going to get it's gonna move faster and faster and faster and faster. I can't believe we went over an hour and I feel like we spent my fault we spent way too much time on launch payments and all that stuff so just in overtime can you explain your other website Careington com what learn more about our PPO and discount networks and how to increase patient volume and loyalty with Careington can you tell us more about that?

Lauren: Sure so our Careington dental networks are really what's going to drive new patients into your practice so we have these schedules for all of our networks and we've got three discount related fee schedules and then we have our PPO schedules and essentially on the discount side patients that have access that plan will pay those set fees so the dentist gets access to that patient and gets cash at the time of service there's no insurance component there and it's really a huge growing segment for us obviously dental is the core of what we do however what we've seen as this market shifted from an employer-sponsored dental benefit to 100% voluntary we're starting to see a lot of large employers offer dental discount plans alongside insurance as an alternative or even as a supplement to their traditional PPO plans. So we have more dentists now adopting discount programs and joining our networks I encourage all of you to do so we have large employers such as American Airlines offering our dental plans to their employees cracker-barrel we have a large oil and energy company called southern I'm sorry Southern Company we have White Castle so that list continues to grow and we're not there to replace insurance when we approach these employers as Careington we're there to be an additional option a low-cost affordable alternative to insurance that also can actually supplement a PPO plan. So we've got our large national dental networks we've got our 90 plus vendor partners that allow us to aggregate discount programs and present a package that fits each client as well as our TPA arm which is under Careington benefit solutions where we provide the backend administration customer service billing claims processing for large carrier clients so that's in a nutshell you know Careington really has their hands in so many different things and we are definitely a well rounded organization but the reason why we break off into these verticals such as launch loyalties so that we can be focused and experts in those areas and in 2018 we actually also launched our own proprietary telemedicine Network called Dial Care and that is a medical product so it's a telemedical program where employees members that have access to that product can call and speak with a doctor a physician and be sent a prescription to their can be prescribed medication to their nearest pharmacy and telemedicine is no secret I mean that's been out for a number of years but we decided to launch that a couple of years ago because we were distributing a lot of telemedicine and we knew we could really do a better job of reporting and customizing things for clients than what we were seeing in the industry and that's been tremendously successful as well and actually in 2020 we're launching a Dial Care mental health as well we're people all over the world will be able to call and be able to speak to licensed counselors so that's in a nutshell Careington and what we do.

Howard: and I just want to I just want to end I know I'm the hours over we're at hour five I just want to end on one thing and that is I'm you said that people are getting caught up on not reaching not getting the 100% of their UCR that when whenever a dentist tells me that I always say okay look I took my 30-day dental MBA which and it's for free I put it up on YouTube I put up on iTunes of your listeners on iTunes Dentistry Uncensored I also have dr. Farran's 30-day MBA be a let me just tell you something you have fixed costs and variable costs your your fixed cost is your you know rent mortgage equipment build-out computer insurance malpractice professional dues on and on and on you pay your rent every month if you're closed see one patient ten patients or 100 the only variable cost the cost that are increase or decrease if versus seeing one patient versus ten versus 100 it's just going to be staff labor and I mean labor lab and supplies and none of your fees are linked to time you're all your costs are time base you have your fixed cost you pay your rent whether you're open or closed and then all your other costs is a time of a labor lab supplies all this stuff like that so you say you want a thousand dollars for a crown and the ppo will only give you 650 so you won't do the crown and then there's other people say okay Lauren you need a crown three fillings and we're gonna do the whole thing in one appointment well if you do the crown the three fillings and you do the whole thing in one appointment and what is your break-even point per day and take the average dental office only open 16 days a month, so go back last year take what your average all your bills paid for staff labor let all your bills and then divide it by the number of days that you're open in the office and then if you want the an A+ in overhead 50% you would sit there and say that's your break-even point for the day. So when most dental offices do they say okay we have to do $2,500 to pay the bills okay we'll just come in we're gonna do $2,500 we're not gonna schedule a lunch we don't know when we're gonna get a cancellation a no-show we might have emergencies we might have people come in we have an extra operatory the people who collect the most money and net the most money all have one or two extra operatories so that when someone calls and say my tooth just broke they don't start flipping through saying well I'm trying to find a chair I'm trying to find a chair no you found a dental office of course we have a chair and and you got to start getting your mind to we need to collect $2,500 to pay all the bills today and then everything after that were in the profit zone and if you think you're UCR fee is somehow magically related to your overhead of people lab labor supplies you're actually out of your mind so listen to that 30-day dental MBA but Lauren it was an honor to have you come on the show today I would like to do a follow-up podcast with Martin Rinker you said he was one of the two dentists who started Careington International who was the other one?

Lauren: You know actually Dr. Rinker is our owner and chairman today so he's active in the organization and is the primary owner so I think Dr. Rinker would be the perfect person for you to speak with.

Howard: Well tell Martin I would love to meet him and the only thing I'm sure we'll ever disagree about is Dallas Cowboys which is not an accredited credentialed football team like the Arizona Cardinals but since my four out of my five grandchildren live up the street from Houston I did watch the Houston Texans game and but anyway Lauren thank you so much for coming on the show today.

Lauren: Thank you for having me.

Howard: It was an honor and best of luck to you guys and tell Martin I can't wait to meet him.

Lauren: Alright I will thank you so much.

Howard: Alright have a great day.

Lauren: You too 

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