WEBVTT
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Hey everybody, I am Courtney Steiger.
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I am with my colleague Amber Weber Gonzalez.
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And today it's just her and I, and we are talking about our prospective roles within the embezzlement and fraud community.
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Funny enough, they also happen to be a reflection of our positions when we worked in office clinical as well.
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Amber, I'm so excited about today.
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We are talking about reactive versus proactive today.
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it's just so funny how in, you know, our lines of work, throughout our careers, I worked clinical on the reactive side of it.
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I was an assistant, fixing everything that, people were told you know would become an issue.
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And ~ Amber was a hygienist and she was on the proactive side of it, telling people what you need to do to be preventive.
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and now prosperity we're in the Just different ways.
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Yeah, I love that approach on how you and I've talked about how we both worked on the proactive and reactive side and how I gave a lot of warning signs to patients.
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If you don't do your homework, if you don't do your home care, this is what will happen.
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And the same thing really translates to the financial side that we're now on.
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I still do investigations like you, but I I more so do the proactive approach and I tell clients, hey, if you don't have your financial health in line, this is what's going to happen.
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So we always have fun cases where you are doing the cleanup, right?
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Like you did when you were an assistant and you see the big mess that happened.
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And then I see cases where the mess is about to happen and proactively if clients listen, are they 100% safeguarded?
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No.
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But when you see the mess years later, it's much smaller because they did take that proactive approach.
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Could not agree more.
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I don't know about you, but when I was working clinical and I guess this kind of applies now, but you know, a lot of times a doctor would diagnose a filling and people would him and ha over it and would say, I don't want to do the filling, right?
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And the filling would be, you know, a hundred dollars and they would not come in, not come in, not come in.
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And just for the record, it does not bother me that they would not come in, believe it or not.
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because one way or another you will be back.
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it's just a matter of whether you would like to take Amber's advice in the beginning and spend $100 or come back to me later and spend six thousand dollars.
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So one way or another we will be meeting.
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The circumstances just might be different.
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Yeah, I used to have a p a patient that was a periodontal patient and ~ I knew him for over ten years.
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And so when I first met him, you know, he obviously needed periodontal therapy because he was at the beginning stages of periodontal disease.
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And so he didn't want to do that and he waited and then he finally did it and then, you know, the maintenance part what happened is he didn't stay up on maintenance because he thought I'm good to go.
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And so years go by.
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Yeah.
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And that's all he needed.
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Exactly.
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SRP, he's good.
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Okay.
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Yeah.
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All right.
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And so years go by, and when he finally came back in, it had turned into like a major rehaul now, right?
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Like what we see with cases.
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and so we always made the joke.
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He said, pay me now or pay me later.
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Like I'm either gonna pay you now or pay you later, because it ended up costing him more in the long run than if he would have just listened to that management oversight, the the maintenance.
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And the same thing goes within the financial aspect.
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where I think one of the best things we can tell any practice, whether it's a group practice, DSO, always have a third party do an audit and a review.
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It's just like doing those periodontal measure measurements and a diagnosis.
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Get a small diagnosis done to see realistically what the long term looks like.
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Don't wait until you have to see Courtney on that reactive side.
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It's so true.
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you need a comprehensive exam on your business, right?
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you need that comprehensive evaluation for somebody to come take a look.
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A snapshot in time.
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You know, obviously it is when, you know, patients come in, you you don't know where they've been the last 20 years, but you've got a pretty good idea in a snapshot in time.
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And you give a diagnosis and a treatment plan.
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And you give them a plan in which to move forward.
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and I think that's really important to notice on the side that we do as well, right?
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it's it's not an all or nothing.
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if they come to you, Amber, and they say, I can't afford to do, I don't know, pick something in ops, right?
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Like I can't afford to hire somebody fractionally right now.
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What can you do preventively in stages to help them?
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Well, the biggest thing for me is knowing where your data comes from.
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It shouldn't come 100% from someone handing you a report that they run.
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Not saying that you don't need to have accountability and delegation to the people who are part of your staff and your team.
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but also have the knowledge on how to double check that data and be able to use technology as your friend.
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and understand how your you're functioning.
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No different than clinical, right?
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I mean, you know the hand piece that you like, you know how to operate it very well.
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It's it's this and make sure that you maintain that hand piece.
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it's the same thing applies within the oversight of a practice.
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just know some operational details.
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Are these strategies part of your treatment planning for your clients that come through?
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do all of your clients get the exact same treatment plan every single time?
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Absolutely not.
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It's no different than a patient.
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Yeah, absolutely not.
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Because we all have different foundational health, right?
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So just like a regular patient, we all have different issues, you know, health-wise or things that could contribute to oral disease happening in our mouth.
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The same thing happens with any practice, right?
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Different software, different insurance company, how you're receiving revenue is different than than the guy that's you know five hours away.
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different patient dem demographic.
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So while we want to have a good foundational health, it's different with every practice that we interact with.
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You customize it to all of the different practices that come through to help them.
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Yeah.
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~ and you know, what what if a doctor just says, I don't have time to I mean, we've heard this from patients, right?
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Doctors, I know you have heard this.
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I can't schedule right now because I just don't have time.
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Amber, do you ever hear that?
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All the time.
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Yeah.
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All the time.
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Yep.
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The words I'm against that is it's no different than, you know, taking a walk or exercising.
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You have to carve out that time for oversight and management.
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And realistically, if it takes you longer than 10 minutes a day or even at the end of the week, 15 to 20 minutes, then structurally there's some systems and some things you need to be educated on.
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on how to make that a simple quick overview.
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You know, I think one of the important things here, Amber, is your talk about making it consistent.
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practice owners, dentists, even those of you who might be associates, when you came out of dent Amber, when you came out of hygiene school, how fast were you at doing those profis scaling and root plannings?
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were you at bust it out in 20 minutes and I'll meet you on the up front when you're done?
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Absolutely not.
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Over time.
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You you build it up, right?
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And you get into the repetition of it and you get you get better at it and more efficient at it.
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Yes.
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Yeah.
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No, it's the same thing, right?
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It's it it just becomes a habit.
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It's no different than looking at an x ray and being able to see what's going on on the mesial of a tooth when you first got out of dental school.
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And I know with your assistant background, it was probably the same way.
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Like when you guys did major procedures, it probably took a lot longer to set the room up or get the patient ready for a root canal or or a filling or something like that.
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And then how to retract my doctor and I used to crack jokes about you know retracting five hundred pound cheeks of steel, right?
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When when I first came out of school, I listen, I did not know how to do that comfortably.
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It was through lots of repetition and you know, d lots of patience and lots of, you know, over time seeing the pattern of Okay, if I if I place my retractor here, my doctor can get to the distal buckle of fifteen with ease.
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that certainly did not come day one.
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I promise you that.
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Well, and I think also as you grew, you found different tools, right, within the dental space that made it easier for that retraction, right?
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Yes, like instead of using a mirror, let's go get a larger retractor.
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that you can like pull whole cheek out of the way versus like this tiny number five mirror.
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Or one time I think I had a pedo mirror because that was all we had available.
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Not the best tool in the box, right?
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There's other tools in the box that you can use.
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So absolutely.
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Yeah, so same principle.
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And I think that's also why, you know, we all learn whatever area we're in.
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What I'm myself as a hygienist, you know, when I was practicing clinically, I'd always want to learn from a third party to know what's a better way I could be providing this service.
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And same for you as an assistant, your doctors that you worked with.
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And I think from a financial perspective, that's sometimes something that's overlooked from a proactive and even a reactive side, right?
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Yeah.
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I'm not going to mess with this until I have pain.
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So you saw that so much clinically, and I think you continue to see that now, right?
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So unless I'm in an emergency situation, you're not going to see me.
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You know, I highly discourage ~ practice owners from being that Friday at five PM emergency phone call to a fraud examiner.
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but you're you're correct.
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usually when when I get them on the reactive side of it, this has been happening three to six months.
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It's it's not something new.
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in our practices, you know, situation, they're they're losing money.
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They may or may not be able to make payroll tomorrow.
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And now they're coming to us in an emergency situation and we're trying to initially, find out the source of the problem.
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And sometimes it's relatively quick and I we can go right in there and I can hand it right over and I can say, Yep, you, you know, you just need a root canal and we can be away.
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And other times, you know, you find that the person's had a root canal, but we didn't do the C B C T and there's an ancillary, you know, canal and now there's a different methodology.
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And and not only were they taking this way, but they were taking another way.
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And that one takes a little bit longer, you know.
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So you're right.
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We do see very a lot of similarities in that.
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the reactive versus proactive approach to it.
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And one thing that I think happens is, you know, because we both worked in the clinical aspect, we feel like sometimes you're wearing seventeen hats, right?
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I'm the owner, I'm the manager and and all of that.
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So you it's Probably also the therapist to the test.
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The therapist, yes, and putting out other emotional fires sometimes with a patient that's difficult and stuff.
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So I think knowing, you know, from that financial approach that to put that proactive hat on, once you train yourself and you have somebody who understands that and has been through that, like you have or I have, that it takes continual education, right?
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It's like having that license to practice dentistry.
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You have to do so much C E.
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Well, I feel like there should be a CE requirement for being an owner, so On the business, I cannot agree more.
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And you know, we talk about being proactive and preventive.
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with our own practice strategies, it's definitely to help prevent embezzlement and fraud from happening.
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But just as you see in dentistry, you can have a patient who comes in every six months and they're still prone to having issues.
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That does happen with practices as well.
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but what is the difference, Amber?
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What is the difference that you see with those people who have gone through the preventive side of our you know, fraud and examination portion of it when when they do have to become reactive versus those who do not, especially because you personally have seen both sides of it in in the dental, investigation portion of it.
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I it's it's funny that you say this because I've had people go through our proactive strategies and years later contact me and say, Hey, I've been tracking this alert that I that you told me to watch out for.
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And ~ I'm I'm nervous about this going on.
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But the biggest thing is they have a checklist and a method of knowing what to look for instead of just saying, I'm going to wait till financially I feel.
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The sting or I feel something, the pain like a toothache.
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so the biggest thing for the pre proactive approach is they know that there's more than one area to look at, right?
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And so they know how to approach it from a multifaceted way.
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And so they know the warning signs and they know that it takes time and a pattern and how to monitor that.
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I think that's the biggest thing.
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So it's like putting a watch on a tooth, right?
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When you see one tiny thing on an x-ray, and then you continue to do a regular x-ray.
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once a year and as you see something develop and grow, it's it's the same analogy.
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They're able to watch that easier because they know how to detect it earlier.
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So speaking from experience, I happened to get one of your proactive, people who would come through.
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And she had an employee come through and that employee worked for only six six weeks for the the business.
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And she came in and when I got her and she said, you know, I I don't believe anything has happened.
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I was watching all the things that had happened, but I I just want to be sure, So she it was still reactive in approach, you know, as far as she didn't know exactly forensically what to look for, but she knew enough that things just weren't right and to let her go ~ for that.
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And in that in the examination in six weeks, she was right, she was not being stolen from.
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but what she did catch in that, and she wasn't aware she caught it, was that.
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suspect was testing her systems out and testing to see where she could find that weak link.
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the suspect asked her questions like, Can I get your bank account login?
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Not not can I have read-only access, but can I have your bank account log in?
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Can I log into the carrier to see where your checks are going?
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you know, and the the practice owner didn't realize it at the time that that was the suspect's attempts to to gain access to things to attempt to defraud her.
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There were other things that I found in there where she was definitely attempting to defraud, but thanks to the proactive approach that Amber had given, she was able to quickly see those.
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So six weeks, you know.
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much faster versus most of our cases or at least a year or more.
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So, you know, the financial difference in that, you know, six weeks versus a year.
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I mean, most of our cases within six weeks, and I say most, we're talking less than five thousand dollars that they are able to take, maybe, versus a year.
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What is the average amber do you it's like at least a hundred thousand dollars or something like that, like within a year or something?
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So I mean we're talking thousand.
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you know, a a f a fraction by being doing that.
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But yeah.
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I don't want to shame our dentists that do come to us reactively and not just preventively.
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Listen, you guys are doing the best you can out there.
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and it is equally important that you do come to us reactively as well.
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Like if you see something, say something, right?
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doing this a lot longer than I have as well, you know, on even on the reactive side of it.
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What is something that you think prevents our doctors from coming to us on the reactive side of it?
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I would say time is one of them, right?
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Just saying, okay, I would love to do that, but when am I going to have the time to learn that skill?
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Okay.
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and then the second thing would be fear.
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For me, because you know, we're all educated professionals.
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We try to be as knowledgeable as we can.
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And so fear of why do I want to have to admit that I don't know what I'm doing here?
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But I don't think it's that anybody doesn't know what they're doing.
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I think there's so many different avenues now within a practice, different software, different insurance, it's become a lot more complex.
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So it takes a lot more education and knowledge to Be proactive so you don't wind up being reactive.
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And and even if you are proactive, you and I both seen cases like the one you just shared.
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Reactive things can happen.
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Yeah.
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Right.
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it's just knowing what to look for for that.
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But yeah, I would say time and fear are the two biggest things that are hard for people to carve out and say, I'm I'm going to take the time to do this.
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Do you know what the statistics are on how many practices will be your habit embezzled from?
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Do you have it to know off the top of your head?
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so our statistics show that close to seventy percent will have it happen occur at least once in in ownership in their in their lifetime.
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Yeah.
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And then we've got the repeat offenders.
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The repeat offenders.
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Yeah.
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Yeah.
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I know that we we actually had an examiner here who he was embezzled from twice.
00:17:34.252 --> 00:17:42.707
It's not funny that he was embezzled from twice, but he he self-admittedly the first the first time he self-admitted said he was not paying attention.
00:17:42.707 --> 00:17:50.006
The second time he was paying attention, do you think that some owners feel like they might be targets?
00:17:50.006 --> 00:17:50.556
Absolutely.
00:17:50.556 --> 00:17:59.419
I think some owners definitely feel like, you know, they're they're nice or they want to give their team of the benefit of the doubt.
00:17:59.419 --> 00:18:08.153
You know, I mean, I feel like healthcare and dentistry in general is we go into this space because we care about patients and we want to serve others.
00:18:08.494 --> 00:18:15.576
And so I think the unique thing about dentistry is we try to really build a team and a culture where we're all there for each other.
00:18:15.576 --> 00:18:27.854
And So I think as far as like the emotional support of your team members, I think a lot of dentists are very supportive of their team members and realistically in their heart want to see everyone do well.
00:18:27.854 --> 00:18:31.166
And so I think that's something that people notice.
00:18:31.166 --> 00:18:35.795
Let's talk about the team members for a second and let's talk about inherited team members.
00:18:35.795 --> 00:18:44.182
Many of the times you and I see practices, you know, are bought and sold and they inherit staff members.
00:18:44.182 --> 00:18:53.616
I have seen several cases, and I believe you have too, where those inherited team members are not as honest as you would think that they would be.
00:18:53.616 --> 00:18:59.394
And that's not to say that everybody who's worked, you know, for a practice for 15 to 20 years is stealing from you, right?
00:18:59.394 --> 00:19:00.644
Right.
00:19:01.631 --> 00:19:12.855
Do you feel as though, you know, the buying and and selling process of practice is a thorough as it should be, especially when dealing with some of those inherited team members.
00:19:12.855 --> 00:19:16.240
think it depends on the system that's that's in place.
00:19:16.602 --> 00:19:34.682
because from an operational standpoint what we see a lot of times is when a transition happens, yes there's habits that are have been in in place for a long time and knowing if those habits can be changed or if there are vulnerability sometimes is often overlooked.
00:19:35.196 --> 00:19:37.627
that's one thing that I see happen a lot.
00:19:37.951 --> 00:19:41.634
Is this something that you can help dentists who are looking to purchase practice?
00:19:41.634 --> 00:19:44.863
Is this something that you can help on the proactive side at like take a look at?
00:19:45.570 --> 00:19:46.931
Absolutely, we definitely can.
00:19:46.931 --> 00:19:53.240
I think what needs to happen before all pre-purchase is a forensic review needs to be completed.
00:19:53.240 --> 00:20:09.342
not so much to see if numbers match, but to see where vulnerabilities exist from how systems are being followed from staff members, how the software is set up, a lot of things that sometimes are not uncovered until after that transition has occurred.
00:20:09.342 --> 00:20:12.236
So I'm going to ask you, Amber, and I'm going to do this list too with you.
00:20:12.236 --> 00:20:23.032
I'm just curious if you were to give a top five toolbox or tools to a dentist to have outside of your hand pieces.
00:20:23.032 --> 00:20:24.710
Outside of the hand pieces.
00:20:24.710 --> 00:20:33.532
You know, outside of those, what would those top five tools or skills be for you for a practice owner to have?
00:20:33.532 --> 00:20:35.108
From a financial perspective.
00:20:35.108 --> 00:20:41.075
I think the number one thing is know where your revenue comes from, right?
00:20:41.075 --> 00:20:45.759
Understand how payments and and things are are being recorded in your software.
00:20:45.759 --> 00:20:46.950
Yes.
00:20:46.950 --> 00:20:52.921
And could you take a look at that and understand how that revenue is showing in your bank account?
00:20:52.921 --> 00:20:54.442
That's that's the first one.
00:20:54.442 --> 00:20:58.905
The second one is understand your software and know how to run your own reports.
00:20:58.905 --> 00:21:00.742
That's A big one.
00:21:00.742 --> 00:21:02.734
don't rely on your own reports.
00:21:02.734 --> 00:21:04.605
So understanding your software.
00:21:04.605 --> 00:21:14.835
The third thing is understanding what how revenue can be changed or manipulated outside of simple just procedure entered payment.
00:21:14.835 --> 00:21:19.137
And what I mean is things like adjustments or different stuff like that.
00:21:19.137 --> 00:21:25.538
So what can be changing your revenue because of things that aren't necessarily about payments?
00:21:25.538 --> 00:21:27.516
the fourth one is.
00:21:27.516 --> 00:21:33.107
Really understanding what's your true how your receivables managed, right?
00:21:33.107 --> 00:21:34.518
Is that being managed properly?
00:21:34.518 --> 00:21:38.144
Is insurance being managed properly, which is something you're an expert in?
00:21:38.144 --> 00:21:43.671
are you having a loss occur just because billing isn't happening the way it is?
00:21:43.671 --> 00:21:53.132
And then the fifth thing is delegation, separation of duties, making sure that you're not relying on just one person to provide you the data that you're looking for in the software.
00:21:53.132 --> 00:21:55.849
software so having more than one person involved in that.
00:21:56.692 --> 00:21:58.012
I think that's pretty close to my list.
00:21:58.012 --> 00:21:59.317
So I'm with you.
00:21:59.317 --> 00:22:01.939
my number one is always separation of duties.
00:22:02.157 --> 00:22:05.852
I I think a lot of people think that that means having a lot of cooks in the kitchen.
00:22:05.852 --> 00:22:06.451
it does not.
00:22:06.451 --> 00:22:17.167
it means that the same person who posted the payments should not be the same person that is verifying, you know, like the verification at the end of the day, it's like for separation of duties.
00:22:17.167 --> 00:22:21.028
or I like to, you know, equate it to, you know, the Walmart manager.
00:22:21.401 --> 00:22:28.076
When there's an override being done, the same person that's making the adjustment is not the same person that can approve the adjustment, you know.
00:22:28.076 --> 00:22:29.346
So separation of duties there.
00:22:29.346 --> 00:22:33.278
the second, you know, also again, understanding your where your revenue comes from.
00:22:33.278 --> 00:22:36.172
Are do you do you subscribe to EFTs?
00:22:36.172 --> 00:22:37.586
Are you getting virtual credit cards?
00:22:37.586 --> 00:22:47.719
I how many dentists do we hear, Amber, that have no idea that they're accepting virtual credit cards from insurance companies or paying to get their payments from insurance?
00:22:47.719 --> 00:22:49.651
So understanding where your revenue comes from.
00:22:50.471 --> 00:22:51.604
fifty percent, yeah.
00:22:51.604 --> 00:22:52.876
Yeah, you're right.
00:22:52.876 --> 00:22:55.837
number three is understanding AR.
00:22:55.837 --> 00:23:03.692
And I'm I'm talking about like you said, insurance AR, patient AR, understanding what that truly means.
00:23:03.692 --> 00:23:23.346
Credits and balances, because having too many credits on on the books can be just as harmful and can actually hide some nefarious behaviors that are happening, or can even hide some unwanted behavior such as, you know, pay your your patients not being collected on.
00:23:23.445 --> 00:23:24.757
understanding yep reports.
00:23:24.757 --> 00:23:25.606
I'm with you there.
00:23:25.606 --> 00:23:26.767
That would be number four.
00:23:26.767 --> 00:23:28.118
Running your own reports.
00:23:28.118 --> 00:23:34.339
and I agree with you on the software as well To take a course from your software company seriously.
00:23:34.339 --> 00:23:43.630
Hire a trainer to to learn how your administrative privileges work, how to run an audit trail, how to post a payment properly.
00:23:43.630 --> 00:24:02.916
How many when we come across some of these things when I have to give recommendations and sometimes I don't find embezzlement that have happened, but some of the the really poor Choices that have been made and how to use their software really mimic embezzlement and fraud.
00:24:02.916 --> 00:24:06.910
And it's simply because they don't understand how to use their software.
00:24:07.230 --> 00:24:11.634
I think you and I are on the same, you know, page in terms of what it is.
00:24:11.634 --> 00:24:21.378
And for those of you that don't know as far as your software goes, Dentrix has trainers, EagleSoft has trainers, Open Dental does, Curve, Oryx, name a PM Exact.
00:24:21.378 --> 00:24:23.051
They all have trainers.
00:24:23.051 --> 00:24:26.126
Some of them come with your subscriptions and some of them do not.
00:24:26.126 --> 00:24:27.450
You might have to pay a little bit extra.
00:24:27.450 --> 00:24:31.196
It is worth investing in it in yourself and your staff.
00:24:31.196 --> 00:24:32.979
Just my two cents.
00:24:33.682 --> 00:24:34.143
Absolutely.
00:24:34.143 --> 00:24:35.442
I I totally agree with that.
00:24:35.442 --> 00:24:41.374
Always, you know, a third party is great and and having more knowledge.
00:24:41.374 --> 00:24:46.324
because you and I have been in this space forever, but we still learn things, you know, nonstop.
00:24:46.324 --> 00:24:51.534
now Courtney, I have a question for you because you see the reactive side like you did in the clinical world.
00:24:51.534 --> 00:25:02.450
How many times do you see, did you see this happen when you were in the dental space and even now where clients come in and they need a big restoration, right?
00:25:02.450 --> 00:25:09.190
It's like a full meal deal, but they don't follow up and get on that proactive side.
00:25:09.950 --> 00:25:10.449
goodness.
00:25:10.449 --> 00:25:18.455
All right, obviously, you know, HIPAA applies, so I'm not allowed to name names when it comes to patients, but we've all seen this.
00:25:18.455 --> 00:25:21.317
we had a patient who had an all on X.
00:25:21.617 --> 00:25:22.117
Mm-hmm.
00:25:22.117 --> 00:25:23.824
Thought, great, this is it.
00:25:23.824 --> 00:25:26.260
I don't need to do anything ever again.
00:25:26.422 --> 00:25:27.288
Mm-hmm.
00:25:27.362 --> 00:25:35.106
Three years later, one of the implants failed and they came back and were like, My implant failed, and this is your fault.
00:25:35.707 --> 00:25:38.173
Well, we hadn't seen that patient.
00:25:38.173 --> 00:25:42.083
In that three years after so I don't know if that was our fault or not, right?
00:25:42.083 --> 00:25:43.308
I honestly don't know.
00:25:43.308 --> 00:25:46.895
and this this applies to us on the financial side of it as well.
00:25:46.895 --> 00:26:03.421
if if you have spent the time and energy to be proactive or reactive with a fraud investigator, spend the time to follow up with it and you know, do your your due diligence and care.
00:26:03.421 --> 00:26:06.943
You s you put a lot of time and money and energy into that.
00:26:06.943 --> 00:26:09.553
And I don't know about you, but I don't like to throw away money.
00:26:09.553 --> 00:26:15.557
I don't I don't like I don't I don't have money in my mattress or in my walls hanging out.
00:26:15.584 --> 00:26:17.117
Yeah, yeah.
00:26:17.344 --> 00:26:19.500
Yeah so yeah, absolutely.
00:26:19.500 --> 00:26:20.343
yeah.
00:26:20.343 --> 00:26:22.133
And it goes hand hand in hand.
00:26:22.133 --> 00:26:27.071
I think just as we saw in the clinical world, you have to be proactive.
00:26:27.071 --> 00:26:31.703
You're still going to have some reactive things occur if you're proactive and vice versa, right?
00:26:31.703 --> 00:26:37.801
If you are a hundred percent just a reactive type client, then you're missing a lot of stuff with the proactive.
00:26:37.801 --> 00:26:47.451
If you just think you're a hundred percent foolproof because you're proactive and you learned how to do it one time, you learned how to brush and floss one time and you're never going to have a problem, that also doesn't work either.
00:26:47.451 --> 00:26:49.304
So No, no.
00:26:49.304 --> 00:26:50.555
It cons consistency.
00:26:50.555 --> 00:26:52.595
Showing up every single time, consistency.
00:26:52.595 --> 00:26:55.536
That's that's really where you're gonna get get that.
00:26:55.536 --> 00:27:05.018
And for those that don't know, by the way, Prosperity does happen to have a service where we can come in and do audits for you, you know, every so often to help you be a little more proactive.
00:27:05.018 --> 00:27:08.574
Do we expect you to know every aspect of your business?
00:27:08.574 --> 00:27:09.683
Absolutely not.
00:27:09.683 --> 00:27:10.653
Listen.
00:27:11.020 --> 00:27:15.611
I am I am not an expert in every facet of the fraud world.
00:27:15.611 --> 00:27:16.051
Okay.
00:27:16.051 --> 00:27:17.354
my niche is dentistry.
00:27:17.354 --> 00:27:19.920
If you're gonna ask me, hey, can you do fraud on shipping?
00:27:19.920 --> 00:27:20.904
Probably not.
00:27:20.904 --> 00:27:21.403
Absolutely.
00:27:21.403 --> 00:27:22.088
Yeah.
00:27:22.088 --> 00:27:23.851
know, so same same kind of thing.
00:27:23.851 --> 00:27:25.218
we don't want you to know everything.
00:27:25.218 --> 00:27:30.501
We just want you to understand the world that, and the business that you're running.
00:27:31.112 --> 00:27:39.457
And one thing I want to end on is whether you're proactive or reactive, you just have to be active.
00:27:40.998 --> 00:27:43.298
That is the common denominator, right?
00:27:43.298 --> 00:27:50.222
So whichever whichever one you decide you wanna be, you have to be active just and that'll help you decide what approach you're gonna be in.
00:27:50.522 --> 00:27:54.193
I honestly I could not have come up with a better thing to say at all.
00:27:54.193 --> 00:27:59.992
you know, and and for our listeners and viewers out there who were kind enough to stick with us through the whole thing.
00:28:00.131 --> 00:28:06.126
if there is something that maybe you're doing, something you know, maybe you're not so sure on, reach out to us.
00:28:06.126 --> 00:28:07.968
We're happy to talk to you about it.
00:28:07.968 --> 00:28:11.410
We're happy to, help you understand Absolutely, I love that.
00:28:11.410 --> 00:28:14.363
Or if you want to know your vulnerabilities, go to our website.
00:28:14.363 --> 00:28:22.045
We have some great interactive questionnaires that you can take that'll help you understand what your vulnerabilities and your risks are.
00:28:22.045 --> 00:28:28.279
So definitely don't be afraid to actively participate and see where what your score is.
00:28:28.695 --> 00:28:39.714
And Amber, will you make sure to drop that link of how to take that quiz and so they can take a look at their health of their practice and see whether or not they had need to have a deeper conversation with you.
00:28:40.192 --> 00:28:41.323
Or with you.
00:28:41.343 --> 00:28:45.213
If there's a reactive thing going on, we've got a quiz for that as well.
00:28:45.213 --> 00:28:48.750
Like where do you score if some reactive things are happening?
00:28:48.750 --> 00:28:54.608
So, you know, do both of them and determine which which area, which avenue is is best for me.
00:28:54.608 --> 00:29:06.031
Now Courtney and I agree if you if you have a reactive type thing going on and you need a full investigation, we always think you should invest in the proactive part too, so that moving forward you're good there.
00:29:06.031 --> 00:29:11.104
But yeah, take both of the quizzes and And we'd love to answer any questions for you.
00:29:11.522 --> 00:29:15.748
As you s as your one patient said, pay me now, pay me later.
00:29:15.816 --> 00:29:18.769
Either way is gets going to happen, so Absolutely.
00:29:18.769 --> 00:29:20.644
So thank you all for joining us today.
00:29:20.644 --> 00:29:22.476
We really do appreciate your time.
00:29:22.476 --> 00:29:28.915
You can find us on prosperitant.com and check the show notes for the links for those of you who are interested in taking the quiz.
00:29:28.915 --> 00:29:30.557
Thank you so much for joining us.
00:29:30.632 --> 00:29:31.534
Thank you.
00:00:00.176 --> 00:00:01.997
Hey everybody, I am Courtney Steiger.
00:00:01.997 --> 00:00:04.722
I am with my colleague Amber Weber Gonzalez.
00:00:04.722 --> 00:00:12.663
And today it's just her and I, and we are talking about our prospective roles within the embezzlement and fraud community.
00:00:12.763 --> 00:00:21.126
Funny enough, they also happen to be a reflection of our positions when we worked in office clinical as well.
00:00:21.126 --> 00:00:22.702
Amber, I'm so excited about today.
00:00:22.702 --> 00:00:29.059
We are talking about reactive versus proactive today.
00:00:30.559 --> 00:00:37.972
it's just so funny how in, you know, our lines of work, throughout our careers, I worked clinical on the reactive side of it.
00:00:37.972 --> 00:00:43.944
I was an assistant, fixing everything that, people were told you know would become an issue.
00:00:43.944 --> 00:00:51.990
And ~ Amber was a hygienist and she was on the proactive side of it, telling people what you need to do to be preventive.
00:00:51.990 --> 00:00:58.326
and now prosperity we're in the Just different ways.
00:00:58.755 --> 00:01:08.771
Yeah, I love that approach on how you and I've talked about how we both worked on the proactive and reactive side and how I gave a lot of warning signs to patients.
00:01:08.771 --> 00:01:12.947
If you don't do your homework, if you don't do your home care, this is what will happen.
00:01:12.947 --> 00:01:17.206
And the same thing really translates to the financial side that we're now on.
00:01:17.206 --> 00:01:27.906
I still do investigations like you, but I I more so do the proactive approach and I tell clients, hey, if you don't have your financial health in line, this is what's going to happen.
00:01:27.906 --> 00:01:32.099
So we always have fun cases where you are doing the cleanup, right?
00:01:32.099 --> 00:01:36.061
Like you did when you were an assistant and you see the big mess that happened.
00:01:36.061 --> 00:01:44.134
And then I see cases where the mess is about to happen and proactively if clients listen, are they 100% safeguarded?
00:01:44.134 --> 00:01:44.495
No.
00:01:44.495 --> 00:01:50.096
But when you see the mess years later, it's much smaller because they did take that proactive approach.
00:01:50.096 --> 00:01:51.694
Could not agree more.
00:01:51.694 --> 00:02:06.474
I don't know about you, but when I was working clinical and I guess this kind of applies now, but you know, a lot of times a doctor would diagnose a filling and people would him and ha over it and would say, I don't want to do the filling, right?
00:02:06.474 --> 00:02:13.711
And the filling would be, you know, a hundred dollars and they would not come in, not come in, not come in.
00:02:13.752 --> 00:02:17.813
And just for the record, it does not bother me that they would not come in, believe it or not.
00:02:17.813 --> 00:02:20.360
because one way or another you will be back.
00:02:20.360 --> 00:02:30.502
it's just a matter of whether you would like to take Amber's advice in the beginning and spend $100 or come back to me later and spend six thousand dollars.
00:02:30.502 --> 00:02:33.650
So one way or another we will be meeting.
00:02:33.650 --> 00:02:36.430
The circumstances just might be different.
00:02:36.659 --> 00:02:44.955
Yeah, I used to have a p a patient that was a periodontal patient and ~ I knew him for over ten years.
00:02:44.955 --> 00:02:52.538
And so when I first met him, you know, he obviously needed periodontal therapy because he was at the beginning stages of periodontal disease.
00:02:52.538 --> 00:03:02.861
And so he didn't want to do that and he waited and then he finally did it and then, you know, the maintenance part what happened is he didn't stay up on maintenance because he thought I'm good to go.
00:03:02.861 --> 00:03:04.362
And so years go by.
00:03:04.362 --> 00:03:05.296
Yeah.
00:03:05.296 --> 00:03:06.733
And that's all he needed.
00:03:06.733 --> 00:03:07.185
Exactly.
00:03:07.185 --> 00:03:07.787
SRP, he's good.
00:03:07.787 --> 00:03:08.290
Okay.
00:03:08.290 --> 00:03:08.471
Yeah.
00:03:08.471 --> 00:03:09.012
All right.
00:03:09.012 --> 00:03:15.266
And so years go by, and when he finally came back in, it had turned into like a major rehaul now, right?
00:03:15.266 --> 00:03:16.778
Like what we see with cases.
00:03:16.778 --> 00:03:18.675
and so we always made the joke.
00:03:18.675 --> 00:03:20.728
He said, pay me now or pay me later.
00:03:20.728 --> 00:03:30.253
Like I'm either gonna pay you now or pay you later, because it ended up costing him more in the long run than if he would have just listened to that management oversight, the the maintenance.
00:03:30.253 --> 00:03:32.879
And the same thing goes within the financial aspect.
00:03:32.879 --> 00:03:41.729
where I think one of the best things we can tell any practice, whether it's a group practice, DSO, always have a third party do an audit and a review.
00:03:41.729 --> 00:03:45.973
It's just like doing those periodontal measure measurements and a diagnosis.
00:03:45.973 --> 00:03:50.337
Get a small diagnosis done to see realistically what the long term looks like.
00:03:50.337 --> 00:03:54.562
Don't wait until you have to see Courtney on that reactive side.
00:03:54.753 --> 00:03:55.473
It's so true.
00:03:55.473 --> 00:03:58.355
you need a comprehensive exam on your business, right?
00:03:58.355 --> 00:04:03.979
you need that comprehensive evaluation for somebody to come take a look.
00:04:04.500 --> 00:04:05.961
A snapshot in time.
00:04:05.961 --> 00:04:15.665
You know, obviously it is when, you know, patients come in, you you don't know where they've been the last 20 years, but you've got a pretty good idea in a snapshot in time.
00:04:15.725 --> 00:04:18.886
And you give a diagnosis and a treatment plan.
00:04:18.886 --> 00:04:22.067
And you give them a plan in which to move forward.
00:04:22.276 --> 00:04:26.028
and I think that's really important to notice on the side that we do as well, right?
00:04:26.028 --> 00:04:27.788
it's it's not an all or nothing.
00:04:27.788 --> 00:04:35.949
if they come to you, Amber, and they say, I can't afford to do, I don't know, pick something in ops, right?
00:04:35.949 --> 00:04:40.199
Like I can't afford to hire somebody fractionally right now.
00:04:40.199 --> 00:04:45.483
What can you do preventively in stages to help them?
00:04:46.391 --> 00:04:50.634
Well, the biggest thing for me is knowing where your data comes from.
00:04:50.634 --> 00:04:55.134
It shouldn't come 100% from someone handing you a report that they run.
00:04:55.134 --> 00:05:00.540
Not saying that you don't need to have accountability and delegation to the people who are part of your staff and your team.
00:05:00.540 --> 00:05:06.913
but also have the knowledge on how to double check that data and be able to use technology as your friend.
00:05:06.913 --> 00:05:09.946
and understand how your you're functioning.
00:05:09.946 --> 00:05:11.447
No different than clinical, right?
00:05:11.447 --> 00:05:15.492
I mean, you know the hand piece that you like, you know how to operate it very well.
00:05:15.492 --> 00:05:19.139
It's it's this and make sure that you maintain that hand piece.
00:05:19.139 --> 00:05:22.641
it's the same thing applies within the oversight of a practice.
00:05:22.641 --> 00:05:25.564
just know some operational details.
00:05:25.997 --> 00:05:32.233
Are these strategies part of your treatment planning for your clients that come through?
00:05:32.233 --> 00:05:37.802
do all of your clients get the exact same treatment plan every single time?
00:05:38.177 --> 00:05:39.139
Absolutely not.
00:05:39.139 --> 00:05:40.720
It's no different than a patient.
00:05:40.720 --> 00:05:41.891
Yeah, absolutely not.
00:05:41.891 --> 00:05:45.872
Because we all have different foundational health, right?
00:05:45.872 --> 00:05:54.206
So just like a regular patient, we all have different issues, you know, health-wise or things that could contribute to oral disease happening in our mouth.
00:05:54.206 --> 00:05:56.627
The same thing happens with any practice, right?
00:05:56.627 --> 00:06:05.521
Different software, different insurance company, how you're receiving revenue is different than than the guy that's you know five hours away.
00:06:05.521 --> 00:06:07.446
different patient dem demographic.
00:06:07.446 --> 00:06:14.021
So while we want to have a good foundational health, it's different with every practice that we interact with.
00:06:14.423 --> 00:06:18.233
You customize it to all of the different practices that come through to help them.
00:06:18.233 --> 00:06:18.817
Yeah.
00:06:18.817 --> 00:06:24.512
~ and you know, what what if a doctor just says, I don't have time to I mean, we've heard this from patients, right?
00:06:24.512 --> 00:06:26.245
Doctors, I know you have heard this.
00:06:26.245 --> 00:06:31.391
I can't schedule right now because I just don't have time.
00:06:31.391 --> 00:06:33.173
Amber, do you ever hear that?
00:06:33.416 --> 00:06:34.297
All the time.
00:06:34.297 --> 00:06:35.197
Yeah.
00:06:35.237 --> 00:06:36.418
All the time.
00:06:36.437 --> 00:06:37.278
Yep.
00:06:38.298 --> 00:06:43.750
The words I'm against that is it's no different than, you know, taking a walk or exercising.
00:06:43.750 --> 00:06:47.461
You have to carve out that time for oversight and management.
00:06:47.461 --> 00:07:01.177
And realistically, if it takes you longer than 10 minutes a day or even at the end of the week, 15 to 20 minutes, then structurally there's some systems and some things you need to be educated on.
00:07:01.177 --> 00:07:04.141
on how to make that a simple quick overview.
00:07:04.517 --> 00:07:10.095
You know, I think one of the important things here, Amber, is your talk about making it consistent.
00:07:10.095 --> 00:07:21.665
practice owners, dentists, even those of you who might be associates, when you came out of dent Amber, when you came out of hygiene school, how fast were you at doing those profis scaling and root plannings?
00:07:21.665 --> 00:07:25.632
were you at bust it out in 20 minutes and I'll meet you on the up front when you're done?
00:07:25.632 --> 00:07:26.762
Absolutely not.
00:07:26.762 --> 00:07:28.202
Over time.
00:07:28.238 --> 00:07:30.103
You you build it up, right?
00:07:30.103 --> 00:07:36.137
And you get into the repetition of it and you get you get better at it and more efficient at it.
00:07:36.137 --> 00:07:36.958
Yes.
00:07:37.867 --> 00:07:38.658
Yeah.
00:07:38.658 --> 00:07:40.017
No, it's the same thing, right?
00:07:40.017 --> 00:07:42.040
It's it it just becomes a habit.
00:07:42.040 --> 00:07:48.663
It's no different than looking at an x ray and being able to see what's going on on the mesial of a tooth when you first got out of dental school.
00:07:48.663 --> 00:07:51.636
And I know with your assistant background, it was probably the same way.
00:07:51.636 --> 00:08:01.452
Like when you guys did major procedures, it probably took a lot longer to set the room up or get the patient ready for a root canal or or a filling or something like that.
00:08:01.452 --> 00:08:09.475
And then how to retract my doctor and I used to crack jokes about you know retracting five hundred pound cheeks of steel, right?
00:08:09.637 --> 00:08:15.949
When when I first came out of school, I listen, I did not know how to do that comfortably.
00:08:15.949 --> 00:08:36.890
It was through lots of repetition and you know, d lots of patience and lots of, you know, over time seeing the pattern of Okay, if I if I place my retractor here, my doctor can get to the distal buckle of fifteen with ease.
00:08:36.961 --> 00:08:39.696
that certainly did not come day one.
00:08:39.696 --> 00:08:41.325
I promise you that.
00:08:42.173 --> 00:08:50.979
Well, and I think also as you grew, you found different tools, right, within the dental space that made it easier for that retraction, right?
00:08:50.979 --> 00:08:54.903
Yes, like instead of using a mirror, let's go get a larger retractor.
00:08:54.903 --> 00:08:58.878
that you can like pull whole cheek out of the way versus like this tiny number five mirror.
00:08:58.878 --> 00:09:02.452
Or one time I think I had a pedo mirror because that was all we had available.
00:09:02.452 --> 00:09:05.346
Not the best tool in the box, right?
00:09:05.346 --> 00:09:07.418
There's other tools in the box that you can use.
00:09:07.418 --> 00:09:09.120
So absolutely.
00:09:09.529 --> 00:09:10.730
Yeah, so same principle.
00:09:10.730 --> 00:09:16.179
And I think that's also why, you know, we all learn whatever area we're in.
00:09:16.179 --> 00:09:25.134
What I'm myself as a hygienist, you know, when I was practicing clinically, I'd always want to learn from a third party to know what's a better way I could be providing this service.
00:09:25.134 --> 00:09:28.099
And same for you as an assistant, your doctors that you worked with.
00:09:28.099 --> 00:09:34.932
And I think from a financial perspective, that's sometimes something that's overlooked from a proactive and even a reactive side, right?
00:09:34.932 --> 00:09:35.461
Yeah.
00:09:35.461 --> 00:09:39.152
I'm not going to mess with this until I have pain.
00:09:39.471 --> 00:09:44.163
So you saw that so much clinically, and I think you continue to see that now, right?
00:09:44.163 --> 00:09:49.546
So unless I'm in an emergency situation, you're not going to see me.
00:09:49.875 --> 00:10:00.812
You know, I highly discourage ~ practice owners from being that Friday at five PM emergency phone call to a fraud examiner.
00:10:00.912 --> 00:10:02.317
but you're you're correct.
00:10:02.317 --> 00:10:09.486
usually when when I get them on the reactive side of it, this has been happening three to six months.
00:10:10.366 --> 00:10:12.427
It's it's not something new.
00:10:12.547 --> 00:10:16.783
in our practices, you know, situation, they're they're losing money.
00:10:16.783 --> 00:10:19.215
They may or may not be able to make payroll tomorrow.
00:10:19.215 --> 00:10:30.932
And now they're coming to us in an emergency situation and we're trying to initially, find out the source of the problem.
00:10:31.225 --> 00:10:39.628
And sometimes it's relatively quick and I we can go right in there and I can hand it right over and I can say, Yep, you, you know, you just need a root canal and we can be away.
00:10:39.628 --> 00:10:48.611
And other times, you know, you find that the person's had a root canal, but we didn't do the C B C T and there's an ancillary, you know, canal and now there's a different methodology.
00:10:48.611 --> 00:10:51.724
And and not only were they taking this way, but they were taking another way.
00:10:51.724 --> 00:10:53.394
And that one takes a little bit longer, you know.
00:10:53.394 --> 00:10:54.014
So you're right.
00:10:54.014 --> 00:10:57.296
We do see very a lot of similarities in that.
00:10:57.421 --> 00:11:00.142
the reactive versus proactive approach to it.
00:11:00.905 --> 00:11:09.586
And one thing that I think happens is, you know, because we both worked in the clinical aspect, we feel like sometimes you're wearing seventeen hats, right?
00:11:09.586 --> 00:11:12.984
I'm the owner, I'm the manager and and all of that.
00:11:12.984 --> 00:11:15.957
So you it's Probably also the therapist to the test.
00:11:15.957 --> 00:11:22.513
The therapist, yes, and putting out other emotional fires sometimes with a patient that's difficult and stuff.
00:11:22.513 --> 00:11:38.996
So I think knowing, you know, from that financial approach that to put that proactive hat on, once you train yourself and you have somebody who understands that and has been through that, like you have or I have, that it takes continual education, right?
00:11:38.996 --> 00:11:41.609
It's like having that license to practice dentistry.
00:11:41.609 --> 00:11:43.581
You have to do so much C E.
00:11:43.581 --> 00:11:50.299
Well, I feel like there should be a CE requirement for being an owner, so On the business, I cannot agree more.
00:11:50.299 --> 00:11:54.763
And you know, we talk about being proactive and preventive.
00:11:54.763 --> 00:12:03.278
with our own practice strategies, it's definitely to help prevent embezzlement and fraud from happening.
00:12:03.298 --> 00:12:09.807
But just as you see in dentistry, you can have a patient who comes in every six months and they're still prone to having issues.
00:12:09.807 --> 00:12:12.307
That does happen with practices as well.
00:12:12.816 --> 00:12:14.086
but what is the difference, Amber?
00:12:14.086 --> 00:12:33.490
What is the difference that you see with those people who have gone through the preventive side of our you know, fraud and examination portion of it when when they do have to become reactive versus those who do not, especially because you personally have seen both sides of it in in the dental, investigation portion of it.
00:12:34.298 --> 00:12:47.745
I it's it's funny that you say this because I've had people go through our proactive strategies and years later contact me and say, Hey, I've been tracking this alert that I that you told me to watch out for.
00:12:47.859 --> 00:12:51.740
And ~ I'm I'm nervous about this going on.
00:12:51.740 --> 00:13:01.644
But the biggest thing is they have a checklist and a method of knowing what to look for instead of just saying, I'm going to wait till financially I feel.
00:13:01.972 --> 00:13:04.903
The sting or I feel something, the pain like a toothache.
00:13:04.903 --> 00:13:11.701
so the biggest thing for the pre proactive approach is they know that there's more than one area to look at, right?
00:13:11.701 --> 00:13:15.844
And so they know how to approach it from a multifaceted way.
00:13:15.844 --> 00:13:20.986
And so they know the warning signs and they know that it takes time and a pattern and how to monitor that.
00:13:20.986 --> 00:13:22.355
I think that's the biggest thing.
00:13:22.355 --> 00:13:24.668
So it's like putting a watch on a tooth, right?
00:13:24.668 --> 00:13:30.388
When you see one tiny thing on an x-ray, and then you continue to do a regular x-ray.
00:13:30.388 --> 00:13:34.975
once a year and as you see something develop and grow, it's it's the same analogy.
00:13:34.975 --> 00:13:40.384
They're able to watch that easier because they know how to detect it earlier.
00:13:41.244 --> 00:13:45.916
So speaking from experience, I happened to get one of your proactive, people who would come through.
00:13:45.916 --> 00:13:54.373
And she had an employee come through and that employee worked for only six six weeks for the the business.
00:13:54.373 --> 00:14:00.554
And she came in and when I got her and she said, you know, I I don't believe anything has happened.
00:14:00.668 --> 00:14:17.587
I was watching all the things that had happened, but I I just want to be sure, So she it was still reactive in approach, you know, as far as she didn't know exactly forensically what to look for, but she knew enough that things just weren't right and to let her go ~ for that.
00:14:17.587 --> 00:14:22.270
And in that in the examination in six weeks, she was right, she was not being stolen from.
00:14:22.297 --> 00:14:28.240
but what she did catch in that, and she wasn't aware she caught it, was that.
00:14:28.267 --> 00:14:34.469
suspect was testing her systems out and testing to see where she could find that weak link.
00:14:34.469 --> 00:14:39.043
the suspect asked her questions like, Can I get your bank account login?
00:14:39.043 --> 00:14:43.876
Not not can I have read-only access, but can I have your bank account log in?
00:14:43.876 --> 00:14:50.481
Can I log into the carrier to see where your checks are going?
00:14:50.875 --> 00:15:00.695
you know, and the the practice owner didn't realize it at the time that that was the suspect's attempts to to gain access to things to attempt to defraud her.
00:15:00.695 --> 00:15:09.874
There were other things that I found in there where she was definitely attempting to defraud, but thanks to the proactive approach that Amber had given, she was able to quickly see those.
00:15:09.874 --> 00:15:11.817
So six weeks, you know.
00:15:11.876 --> 00:15:16.678
much faster versus most of our cases or at least a year or more.
00:15:16.720 --> 00:15:22.437
So, you know, the financial difference in that, you know, six weeks versus a year.
00:15:22.437 --> 00:15:32.399
I mean, most of our cases within six weeks, and I say most, we're talking less than five thousand dollars that they are able to take, maybe, versus a year.
00:15:32.399 --> 00:15:37.061
What is the average amber do you it's like at least a hundred thousand dollars or something like that, like within a year or something?
00:15:37.061 --> 00:15:39.282
So I mean we're talking thousand.
00:15:39.682 --> 00:15:43.357
you know, a a f a fraction by being doing that.
00:15:43.418 --> 00:15:44.539
But yeah.
00:15:45.421 --> 00:15:50.605
I don't want to shame our dentists that do come to us reactively and not just preventively.
00:15:50.664 --> 00:15:53.363
Listen, you guys are doing the best you can out there.
00:15:53.363 --> 00:15:56.995
and it is equally important that you do come to us reactively as well.
00:15:56.995 --> 00:15:59.207
Like if you see something, say something, right?
00:15:59.207 --> 00:16:02.763
doing this a lot longer than I have as well, you know, on even on the reactive side of it.
00:16:02.763 --> 00:16:10.403
What is something that you think prevents our doctors from coming to us on the reactive side of it?
00:16:11.389 --> 00:16:14.965
I would say time is one of them, right?
00:16:14.965 --> 00:16:20.179
Just saying, okay, I would love to do that, but when am I going to have the time to learn that skill?
00:16:20.179 --> 00:16:21.379
Okay.
00:16:21.379 --> 00:16:23.475
and then the second thing would be fear.
00:16:23.475 --> 00:16:26.467
For me, because you know, we're all educated professionals.
00:16:26.467 --> 00:16:28.168
We try to be as knowledgeable as we can.
00:16:28.168 --> 00:16:33.991
And so fear of why do I want to have to admit that I don't know what I'm doing here?
00:16:33.991 --> 00:16:36.634
But I don't think it's that anybody doesn't know what they're doing.
00:16:36.634 --> 00:16:45.135
I think there's so many different avenues now within a practice, different software, different insurance, it's become a lot more complex.
00:16:45.135 --> 00:16:51.717
So it takes a lot more education and knowledge to Be proactive so you don't wind up being reactive.
00:16:51.717 --> 00:16:56.019
And and even if you are proactive, you and I both seen cases like the one you just shared.
00:16:56.019 --> 00:16:57.630
Reactive things can happen.
00:16:57.630 --> 00:16:58.034
Yeah.
00:16:58.034 --> 00:16:58.428
Right.
00:16:58.428 --> 00:17:01.751
it's just knowing what to look for for that.
00:17:01.751 --> 00:17:10.199
But yeah, I would say time and fear are the two biggest things that are hard for people to carve out and say, I'm I'm going to take the time to do this.
00:17:10.626 --> 00:17:14.310
Do you know what the statistics are on how many practices will be your habit embezzled from?
00:17:14.310 --> 00:17:16.128
Do you have it to know off the top of your head?
00:17:16.432 --> 00:17:25.080
so our statistics show that close to seventy percent will have it happen occur at least once in in ownership in their in their lifetime.
00:17:25.080 --> 00:17:25.509
Yeah.
00:17:25.509 --> 00:17:27.705
And then we've got the repeat offenders.
00:17:27.845 --> 00:17:28.847
The repeat offenders.
00:17:28.847 --> 00:17:29.769
Yeah.
00:17:29.791 --> 00:17:30.241
Yeah.
00:17:30.241 --> 00:17:34.252
I know that we we actually had an examiner here who he was embezzled from twice.
00:17:34.252 --> 00:17:42.707
It's not funny that he was embezzled from twice, but he he self-admittedly the first the first time he self-admitted said he was not paying attention.
00:17:42.707 --> 00:17:50.006
The second time he was paying attention, do you think that some owners feel like they might be targets?
00:17:50.006 --> 00:17:50.556
Absolutely.
00:17:50.556 --> 00:17:59.419
I think some owners definitely feel like, you know, they're they're nice or they want to give their team of the benefit of the doubt.
00:17:59.419 --> 00:18:08.153
You know, I mean, I feel like healthcare and dentistry in general is we go into this space because we care about patients and we want to serve others.
00:18:08.494 --> 00:18:15.576
And so I think the unique thing about dentistry is we try to really build a team and a culture where we're all there for each other.
00:18:15.576 --> 00:18:27.854
And So I think as far as like the emotional support of your team members, I think a lot of dentists are very supportive of their team members and realistically in their heart want to see everyone do well.
00:18:27.854 --> 00:18:31.166
And so I think that's something that people notice.
00:18:31.166 --> 00:18:35.795
Let's talk about the team members for a second and let's talk about inherited team members.
00:18:35.795 --> 00:18:44.182
Many of the times you and I see practices, you know, are bought and sold and they inherit staff members.
00:18:44.182 --> 00:18:53.616
I have seen several cases, and I believe you have too, where those inherited team members are not as honest as you would think that they would be.
00:18:53.616 --> 00:18:59.394
And that's not to say that everybody who's worked, you know, for a practice for 15 to 20 years is stealing from you, right?
00:18:59.394 --> 00:19:00.644
Right.
00:19:01.631 --> 00:19:12.855
Do you feel as though, you know, the buying and and selling process of practice is a thorough as it should be, especially when dealing with some of those inherited team members.
00:19:12.855 --> 00:19:16.240
think it depends on the system that's that's in place.
00:19:16.602 --> 00:19:34.682
because from an operational standpoint what we see a lot of times is when a transition happens, yes there's habits that are have been in in place for a long time and knowing if those habits can be changed or if there are vulnerability sometimes is often overlooked.
00:19:35.196 --> 00:19:37.627
that's one thing that I see happen a lot.
00:19:37.951 --> 00:19:41.634
Is this something that you can help dentists who are looking to purchase practice?
00:19:41.634 --> 00:19:44.863
Is this something that you can help on the proactive side at like take a look at?
00:19:45.570 --> 00:19:46.931
Absolutely, we definitely can.
00:19:46.931 --> 00:19:53.240
I think what needs to happen before all pre-purchase is a forensic review needs to be completed.
00:19:53.240 --> 00:20:09.342
not so much to see if numbers match, but to see where vulnerabilities exist from how systems are being followed from staff members, how the software is set up, a lot of things that sometimes are not uncovered until after that transition has occurred.
00:20:09.342 --> 00:20:12.236
So I'm going to ask you, Amber, and I'm going to do this list too with you.
00:20:12.236 --> 00:20:23.032
I'm just curious if you were to give a top five toolbox or tools to a dentist to have outside of your hand pieces.
00:20:23.032 --> 00:20:24.710
Outside of the hand pieces.
00:20:24.710 --> 00:20:33.532
You know, outside of those, what would those top five tools or skills be for you for a practice owner to have?
00:20:33.532 --> 00:20:35.108
From a financial perspective.
00:20:35.108 --> 00:20:41.075
I think the number one thing is know where your revenue comes from, right?
00:20:41.075 --> 00:20:45.759
Understand how payments and and things are are being recorded in your software.
00:20:45.759 --> 00:20:46.950
Yes.
00:20:46.950 --> 00:20:52.921
And could you take a look at that and understand how that revenue is showing in your bank account?
00:20:52.921 --> 00:20:54.442
That's that's the first one.
00:20:54.442 --> 00:20:58.905
The second one is understand your software and know how to run your own reports.
00:20:58.905 --> 00:21:00.742
That's A big one.
00:21:00.742 --> 00:21:02.734
don't rely on your own reports.
00:21:02.734 --> 00:21:04.605
So understanding your software.
00:21:04.605 --> 00:21:14.835
The third thing is understanding what how revenue can be changed or manipulated outside of simple just procedure entered payment.
00:21:14.835 --> 00:21:19.137
And what I mean is things like adjustments or different stuff like that.
00:21:19.137 --> 00:21:25.538
So what can be changing your revenue because of things that aren't necessarily about payments?
00:21:25.538 --> 00:21:27.516
the fourth one is.
00:21:27.516 --> 00:21:33.107
Really understanding what's your true how your receivables managed, right?
00:21:33.107 --> 00:21:34.518
Is that being managed properly?
00:21:34.518 --> 00:21:38.144
Is insurance being managed properly, which is something you're an expert in?
00:21:38.144 --> 00:21:43.671
are you having a loss occur just because billing isn't happening the way it is?
00:21:43.671 --> 00:21:53.132
And then the fifth thing is delegation, separation of duties, making sure that you're not relying on just one person to provide you the data that you're looking for in the software.
00:21:53.132 --> 00:21:55.849
software so having more than one person involved in that.
00:21:56.692 --> 00:21:58.012
I think that's pretty close to my list.
00:21:58.012 --> 00:21:59.317
So I'm with you.
00:21:59.317 --> 00:22:01.939
my number one is always separation of duties.
00:22:02.157 --> 00:22:05.852
I I think a lot of people think that that means having a lot of cooks in the kitchen.
00:22:05.852 --> 00:22:06.451
it does not.
00:22:06.451 --> 00:22:17.167
it means that the same person who posted the payments should not be the same person that is verifying, you know, like the verification at the end of the day, it's like for separation of duties.
00:22:17.167 --> 00:22:21.028
or I like to, you know, equate it to, you know, the Walmart manager.
00:22:21.401 --> 00:22:28.076
When there's an override being done, the same person that's making the adjustment is not the same person that can approve the adjustment, you know.
00:22:28.076 --> 00:22:29.346
So separation of duties there.
00:22:29.346 --> 00:22:33.278
the second, you know, also again, understanding your where your revenue comes from.
00:22:33.278 --> 00:22:36.172
Are do you do you subscribe to EFTs?
00:22:36.172 --> 00:22:37.586
Are you getting virtual credit cards?
00:22:37.586 --> 00:22:47.719
I how many dentists do we hear, Amber, that have no idea that they're accepting virtual credit cards from insurance companies or paying to get their payments from insurance?
00:22:47.719 --> 00:22:49.651
So understanding where your revenue comes from.
00:22:50.471 --> 00:22:51.604
fifty percent, yeah.
00:22:51.604 --> 00:22:52.876
Yeah, you're right.
00:22:52.876 --> 00:22:55.837
number three is understanding AR.
00:22:55.837 --> 00:23:03.692
And I'm I'm talking about like you said, insurance AR, patient AR, understanding what that truly means.
00:23:03.692 --> 00:23:23.346
Credits and balances, because having too many credits on on the books can be just as harmful and can actually hide some nefarious behaviors that are happening, or can even hide some unwanted behavior such as, you know, pay your your patients not being collected on.
00:23:23.445 --> 00:23:24.757
understanding yep reports.
00:23:24.757 --> 00:23:25.606
I'm with you there.
00:23:25.606 --> 00:23:26.767
That would be number four.
00:23:26.767 --> 00:23:28.118
Running your own reports.
00:23:28.118 --> 00:23:34.339
and I agree with you on the software as well To take a course from your software company seriously.
00:23:34.339 --> 00:23:43.630
Hire a trainer to to learn how your administrative privileges work, how to run an audit trail, how to post a payment properly.
00:23:43.630 --> 00:24:02.916
How many when we come across some of these things when I have to give recommendations and sometimes I don't find embezzlement that have happened, but some of the the really poor Choices that have been made and how to use their software really mimic embezzlement and fraud.
00:24:02.916 --> 00:24:06.910
And it's simply because they don't understand how to use their software.
00:24:07.230 --> 00:24:11.634
I think you and I are on the same, you know, page in terms of what it is.
00:24:11.634 --> 00:24:21.378
And for those of you that don't know as far as your software goes, Dentrix has trainers, EagleSoft has trainers, Open Dental does, Curve, Oryx, name a PM Exact.
00:24:21.378 --> 00:24:23.051
They all have trainers.
00:24:23.051 --> 00:24:26.126
Some of them come with your subscriptions and some of them do not.
00:24:26.126 --> 00:24:27.450
You might have to pay a little bit extra.
00:24:27.450 --> 00:24:31.196
It is worth investing in it in yourself and your staff.
00:24:31.196 --> 00:24:32.979
Just my two cents.
00:24:33.682 --> 00:24:34.143
Absolutely.
00:24:34.143 --> 00:24:35.442
I I totally agree with that.
00:24:35.442 --> 00:24:41.374
Always, you know, a third party is great and and having more knowledge.
00:24:41.374 --> 00:24:46.324
because you and I have been in this space forever, but we still learn things, you know, nonstop.
00:24:46.324 --> 00:24:51.534
now Courtney, I have a question for you because you see the reactive side like you did in the clinical world.
00:24:51.534 --> 00:25:02.450
How many times do you see, did you see this happen when you were in the dental space and even now where clients come in and they need a big restoration, right?
00:25:02.450 --> 00:25:09.190
It's like a full meal deal, but they don't follow up and get on that proactive side.
00:25:09.950 --> 00:25:10.449
goodness.
00:25:10.449 --> 00:25:18.455
All right, obviously, you know, HIPAA applies, so I'm not allowed to name names when it comes to patients, but we've all seen this.
00:25:18.455 --> 00:25:21.317
we had a patient who had an all on X.
00:25:21.617 --> 00:25:22.117
Mm-hmm.
00:25:22.117 --> 00:25:23.824
Thought, great, this is it.
00:25:23.824 --> 00:25:26.260
I don't need to do anything ever again.
00:25:26.422 --> 00:25:27.288
Mm-hmm.
00:25:27.362 --> 00:25:35.106
Three years later, one of the implants failed and they came back and were like, My implant failed, and this is your fault.
00:25:35.707 --> 00:25:38.173
Well, we hadn't seen that patient.
00:25:38.173 --> 00:25:42.083
In that three years after so I don't know if that was our fault or not, right?
00:25:42.083 --> 00:25:43.308
I honestly don't know.
00:25:43.308 --> 00:25:46.895
and this this applies to us on the financial side of it as well.
00:25:46.895 --> 00:26:03.421
if if you have spent the time and energy to be proactive or reactive with a fraud investigator, spend the time to follow up with it and you know, do your your due diligence and care.
00:26:03.421 --> 00:26:06.943
You s you put a lot of time and money and energy into that.
00:26:06.943 --> 00:26:09.553
And I don't know about you, but I don't like to throw away money.
00:26:09.553 --> 00:26:15.557
I don't I don't like I don't I don't have money in my mattress or in my walls hanging out.
00:26:15.584 --> 00:26:17.117
Yeah, yeah.
00:26:17.344 --> 00:26:19.500
Yeah so yeah, absolutely.
00:26:19.500 --> 00:26:20.343
yeah.
00:26:20.343 --> 00:26:22.133
And it goes hand hand in hand.
00:26:22.133 --> 00:26:27.071
I think just as we saw in the clinical world, you have to be proactive.
00:26:27.071 --> 00:26:31.703
You're still going to have some reactive things occur if you're proactive and vice versa, right?
00:26:31.703 --> 00:26:37.801
If you are a hundred percent just a reactive type client, then you're missing a lot of stuff with the proactive.
00:26:37.801 --> 00:26:47.451
If you just think you're a hundred percent foolproof because you're proactive and you learned how to do it one time, you learned how to brush and floss one time and you're never going to have a problem, that also doesn't work either.
00:26:47.451 --> 00:26:49.304
So No, no.
00:26:49.304 --> 00:26:50.555
It cons consistency.
00:26:50.555 --> 00:26:52.595
Showing up every single time, consistency.
00:26:52.595 --> 00:26:55.536
That's that's really where you're gonna get get that.
00:26:55.536 --> 00:27:05.018
And for those that don't know, by the way, Prosperity does happen to have a service where we can come in and do audits for you, you know, every so often to help you be a little more proactive.
00:27:05.018 --> 00:27:08.574
Do we expect you to know every aspect of your business?
00:27:08.574 --> 00:27:09.683
Absolutely not.
00:27:09.683 --> 00:27:10.653
Listen.
00:27:11.020 --> 00:27:15.611
I am I am not an expert in every facet of the fraud world.
00:27:15.611 --> 00:27:16.051
Okay.
00:27:16.051 --> 00:27:17.354
my niche is dentistry.
00:27:17.354 --> 00:27:19.920
If you're gonna ask me, hey, can you do fraud on shipping?
00:27:19.920 --> 00:27:20.904
Probably not.
00:27:20.904 --> 00:27:21.403
Absolutely.
00:27:21.403 --> 00:27:22.088
Yeah.
00:27:22.088 --> 00:27:23.851
know, so same same kind of thing.
00:27:23.851 --> 00:27:25.218
we don't want you to know everything.
00:27:25.218 --> 00:27:30.501
We just want you to understand the world that, and the business that you're running.
00:27:31.112 --> 00:27:39.457
And one thing I want to end on is whether you're proactive or reactive, you just have to be active.
00:27:40.998 --> 00:27:43.298
That is the common denominator, right?
00:27:43.298 --> 00:27:50.222
So whichever whichever one you decide you wanna be, you have to be active just and that'll help you decide what approach you're gonna be in.
00:27:50.522 --> 00:27:54.193
I honestly I could not have come up with a better thing to say at all.
00:27:54.193 --> 00:27:59.992
you know, and and for our listeners and viewers out there who were kind enough to stick with us through the whole thing.
00:28:00.131 --> 00:28:06.126
if there is something that maybe you're doing, something you know, maybe you're not so sure on, reach out to us.
00:28:06.126 --> 00:28:07.968
We're happy to talk to you about it.
00:28:07.968 --> 00:28:11.410
We're happy to, help you understand Absolutely, I love that.
00:28:11.410 --> 00:28:14.363
Or if you want to know your vulnerabilities, go to our website.
00:28:14.363 --> 00:28:22.045
We have some great interactive questionnaires that you can take that'll help you understand what your vulnerabilities and your risks are.
00:28:22.045 --> 00:28:28.279
So definitely don't be afraid to actively participate and see where what your score is.
00:28:28.695 --> 00:28:39.714
And Amber, will you make sure to drop that link of how to take that quiz and so they can take a look at their health of their practice and see whether or not they had need to have a deeper conversation with you.
00:28:40.192 --> 00:28:41.323
Or with you.
00:28:41.343 --> 00:28:45.213
If there's a reactive thing going on, we've got a quiz for that as well.
00:28:45.213 --> 00:28:48.750
Like where do you score if some reactive things are happening?
00:28:48.750 --> 00:28:54.608
So, you know, do both of them and determine which which area, which avenue is is best for me.
00:28:54.608 --> 00:29:06.031
Now Courtney and I agree if you if you have a reactive type thing going on and you need a full investigation, we always think you should invest in the proactive part too, so that moving forward you're good there.
00:29:06.031 --> 00:29:11.104
But yeah, take both of the quizzes and And we'd love to answer any questions for you.
00:29:11.522 --> 00:29:15.748
As you s as your one patient said, pay me now, pay me later.
00:29:15.816 --> 00:29:18.769
Either way is gets going to happen, so Absolutely.
00:29:18.769 --> 00:29:20.644
So thank you all for joining us today.
00:29:20.644 --> 00:29:22.476
We really do appreciate your time.
00:29:22.476 --> 00:29:28.915
You can find us on prosperitant.com and check the show notes for the links for those of you who are interested in taking the quiz.
00:29:28.915 --> 00:29:30.557
Thank you so much for joining us.
00:29:30.632 --> 00:29:31.534
Thank you.