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Welcome to Dental Unscripted.
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Where Mike Dinsio and Paula Quinn break
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down the practice ownership journey,
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one episode at a time.
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Starting up, buying,
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and running a successful dental practice.
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What up?
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What up, guys?
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Welcome back to another episode of Dental
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Unscripted.
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This is Michael D'Incio and Paula Quinn
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potting it up again today, this afternoon.
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We're excited to be on the air again.
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It's been a minute since we've been doing
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this.
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And yeah, we've got a good episode today.
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It's all about due diligence and what to
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look at after you've made an offer and
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it's gotten accepted.
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And we've gotten a lot of clients that,
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not our clients,
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but a lot of people
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that have expressed issues, concerns,
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things that they've missed going through
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the due diligence and we're practice
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management client coaches.
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And we hear about all this stuff after
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they've closed.
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And so, you know,
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today it's just a really a breakdown of
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like what Paul and I think are the
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most important things to look at before
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you actually sign on the dotted line.
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And it's a scary thing to sign.
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And I, you know,
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i don't want to go on too much
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of a rampage here but like at the
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end of the day that anxiety that you
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get right before closing um a lot of
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people get it i'm hoping that our clients
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have less of it i think there's always
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going to be some of it
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But I can imagine folks that don't have
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a consultant buyer advocate, buyer rep,
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and they're really relying on the practice
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broker and maybe their CPA and accountant.
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There's some anxiety going into that close
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because maybe they didn't look at the
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practices performance deeper.
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They may have looked at the contract.
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The attorney walks you through all of the
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scary legal parts of this transaction.
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The CPA talks about all of the numbers
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and financials and the black and white of
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the practice.
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But did you spend enough time looking at
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how the business, the practice,
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the clinic operates on a daily and what's
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coming at you
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Post close.
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And I think that is why there is
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a world of buyer reps,
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because you need to look deeper.
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You need to see what's going on in
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the office, how you can improve it,
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things you need to fix,
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things you should be aware of before you
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get the keys and the team comes at
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you with all of the things.
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And look,
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you might not change all of it day
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one.
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But you need to be aware that some
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things might be broken in the house.
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And so, yeah,
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that's what today is all about.
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I'm super excited.
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Paula bought multiple practices more
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recently is right out of COVID.
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And, um, you know, she,
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she felt that real pain of owning in
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the first ninety days.
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That's a scary thing.
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It's a scary thing.
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So anything to add to that, Paula,
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why maybe a buyer rep makes sense for
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folks, uh, selfish plug for us.
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I know, but you know,
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even if we're not your buyer rep,
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why does someone need someone looking at
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stuff, uh, that like,
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did you feel like you were totally
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prepared when you bought your practice?
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I mean,
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No,
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I don't think you're ever totally
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prepared.
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I had your help.
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So that definitely opened my eyes to some
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of the things.
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I think it just boils down to you
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don't know what you don't know.
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And if you can have somebody there to
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help you not make an expensive mistake,
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maybe even help you save money,
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give you advice.
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I mean,
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you wouldn't probably buy a house without
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a realtor.
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You probably wouldn't.
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Would you buy a house without an
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inspection?
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Yeah.
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Yeah, that's even better.
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You know,
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you wouldn't usually typically sign a
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contract without having an attorney read
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it.
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I mean, it depends on what it is.
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Right.
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So I think that's the same thing.
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It's just like you said,
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the brokers are great.
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But at the end of the day,
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their client is the seller.
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And at the end of the day,
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they've never worked in a dental practice
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either.
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They only know what they know as well.
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So I think having...
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someone who's done it a lot,
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people on the team that have worked in
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dental practices, uh,
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people on the team who have bought and
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sold dental practices, um,
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really can just help point out, you know,
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even some of the mistakes that I made,
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um, you know,
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you and I learned from them,
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which is great.
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You know, you know, you know,
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what's interesting,
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Paul is like when I left bank of
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America, I thought I knew, uh, everything.
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Um, and the learning curve,
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for me on these transitions was like boom
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like straight up um and it felt at
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times like drinking from uh you know of
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uh what did i say fire hose um
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and like of course all of the knowledge
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i had about all those transactions i did
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with bfa obviously made me very capable
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but
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When I started doing stuff with you and
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Stefani,
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I was realizing there's a lot of stuff
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I was missing.
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So I'm sitting here thinking that I have
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conversations with CPAs all the time,
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attorneys all the time.
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And honestly,
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I don't even think they know why they're
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negotiating some things that they
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negotiate because they don't really know
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how it works in the office, truly.
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You know,
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they're just like they come up with these
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clauses or they say these things.
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I don't even think they really know how
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it works.
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And I didn't.
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You know,
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I said all those same things coming right
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out of B of A,
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because that's what you do.
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That's how you negotiate.
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This is how it is.
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Boilerplate contracts.
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This is just how we do it.
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But if you, if someone like actually said,
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well, why do you do it that way?
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And is this really a big deal?
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You'd say it's a big deal,
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but you wouldn't really know the
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consequence of it.
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If it's just a thousand dollar problem or
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a twenty thousand dollar problem.
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And they're just like dying on the hill
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over certain little five hundred thousand
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dollar problems.
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And they're not.
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big problems, actually.
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So I just think that like this episode
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is really, you know,
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just getting a little bit more operational
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and less risk and and
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and uh risk things transactional things
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that you might get from a cpa accounting
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banker this is going to be more
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operational so so all things due diligence
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of course we could never cover all the
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things we look at but i did write
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down some of my most favorite things and
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i think i think the first one's the
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hardest topic so let's hit it first it's
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active patients
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And it's,
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it's active patients because that's truly
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what you're buying.
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That's your goodwill.
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That's the goodwill you're buying.
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You know,
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otherwise it's just a bunch of equipment,
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you know, hard assets, computers,
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operatories, cone beams,
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whatever hard assets.
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And there,
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there is value on just hard assets,
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but typically when you buy a business,
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you're buying goodwill and that goodwill
00:08:14.072 --> 00:08:16.274
is, is what's most valuable.
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It's,
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it's the thing why it's the thing that
00:08:18.353 --> 00:08:20.214
you're paying for the most.
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and active patients and or hygiene
00:08:24.132 --> 00:08:27.454
patients is in my opinion kind of that
00:08:27.494 --> 00:08:30.175
goodwill it's a count it's the only number
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that i know of that actually represents
00:08:33.096 --> 00:08:36.817
good goodwill and so paula i like i
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know there's a bunch of ways that folks
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come up with kind of active patients when
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you're looking at active patients
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You know,
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how would you define active patients?
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What are some good ways?
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And you taught me this.
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What are some good ways to really get
00:08:55.779 --> 00:09:00.761
a decent estimate on actual active
00:09:00.802 --> 00:09:01.241
patients?
00:09:01.543 --> 00:09:02.942
How would you approach active patients
00:09:02.962 --> 00:09:04.124
when you're looking at a practice?
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Well, I mean,
00:09:06.625 --> 00:09:08.206
the rule of thumb out there is obviously
00:09:08.225 --> 00:09:09.186
the eighteen months.
00:09:09.265 --> 00:09:11.768
And the reason being is because not
00:09:11.807 --> 00:09:12.508
everybody's great.
00:09:13.090 --> 00:09:15.852
going to the dentist um so there is
00:09:15.913 --> 00:09:18.274
some room to recapture people who have
00:09:18.315 --> 00:09:19.876
gone over that twelve month mark
00:09:22.115 --> 00:09:24.157
Once it starts hitting over that eighteen
00:09:24.197 --> 00:09:24.517
month,
00:09:25.038 --> 00:09:27.379
it's more and more doubtful if they're
00:09:27.399 --> 00:09:29.500
really truly an active patient anymore.
00:09:29.541 --> 00:09:30.741
Do we have the right email,
00:09:30.761 --> 00:09:31.722
the right phone number?
00:09:32.144 --> 00:09:33.764
Did they already go somewhere else?
00:09:34.384 --> 00:09:34.846
You know,
00:09:35.066 --> 00:09:38.149
if we smiled and dialed and truly called
00:09:38.668 --> 00:09:40.551
the eighteen month to twenty four month,
00:09:40.591 --> 00:09:42.591
like how many people are we actually going
00:09:42.652 --> 00:09:44.494
to get to come back in?
00:09:44.693 --> 00:09:47.216
When we're talking the twelve to eighteen
00:09:47.275 --> 00:09:47.657
month,
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rule of thumb is, you know,
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there's still a chance, obviously,
00:09:52.981 --> 00:09:53.725
twelve months.
00:09:54.379 --> 00:09:54.539
you know,
00:09:54.559 --> 00:09:55.900
they've been in the last twelve months,
00:09:55.941 --> 00:09:57.221
you know, one hundred percent,
00:09:57.282 --> 00:09:58.842
I would consider them an active patient.
00:09:58.903 --> 00:10:01.365
But rule of thumb is last eighteen months.
00:10:01.544 --> 00:10:02.285
Eighteen months.
00:10:02.485 --> 00:10:02.546
OK,
00:10:02.826 --> 00:10:04.727
so so a lot of softwares kind of
00:10:04.748 --> 00:10:05.888
have twenty four months.
00:10:05.908 --> 00:10:07.149
Some have twelve months.
00:10:07.188 --> 00:10:07.509
It's like,
00:10:07.549 --> 00:10:09.451
why can't they just have an eighteen month
00:10:09.510 --> 00:10:09.730
button?
00:10:09.791 --> 00:10:11.932
And some of them do of all time.
00:10:12.712 --> 00:10:13.433
Yeah, all time.
00:10:13.453 --> 00:10:14.033
You know,
00:10:14.214 --> 00:10:16.296
in a good practice management software,
00:10:16.495 --> 00:10:18.778
if they're truly deactivated,
00:10:20.177 --> 00:10:22.961
or they're a patient who is a guarantor
00:10:23.000 --> 00:10:24.743
who's never had an appointment,
00:10:25.683 --> 00:10:27.385
or they haven't been in an AT month,
00:10:27.586 --> 00:10:30.389
we would be able to narrow all that
00:10:30.429 --> 00:10:33.192
down so that you don't get the guarantor,
00:10:33.212 --> 00:10:35.336
you don't get the patients who haven't
00:10:35.355 --> 00:10:37.278
been in, you know,
00:10:37.759 --> 00:10:39.441
we forgot to deactivate, whatever.
00:10:40.020 --> 00:10:43.163
That's the best way to report.
00:10:43.303 --> 00:10:45.085
All practice management softwares are not
00:10:45.144 --> 00:10:46.005
created equal.
00:10:46.745 --> 00:10:47.927
And therefore, like you said,
00:10:48.427 --> 00:10:49.928
they may include guarantor.
00:10:49.969 --> 00:10:51.931
They may include people who haven't even
00:10:51.990 --> 00:10:53.591
had an ADA code attached.
00:10:55.712 --> 00:10:57.534
Somebody may forget to deactivate.
00:10:57.634 --> 00:10:59.115
They haven't been in an eighteen months.
00:10:59.235 --> 00:11:00.576
It still may count them.
00:11:01.857 --> 00:11:04.801
So there's kind of all kinds of things.
00:11:05.321 --> 00:11:06.101
If we were really,
00:11:06.142 --> 00:11:08.663
this would never happen in the world of
00:11:09.705 --> 00:11:10.546
active patients.
00:11:10.586 --> 00:11:11.167
But really,
00:11:11.207 --> 00:11:12.971
if we were really going to get to
00:11:12.990 --> 00:11:13.652
the nitty gritty,
00:11:14.173 --> 00:11:17.258
anyone that's only had a D zero one
00:11:17.278 --> 00:11:20.264
four zero wouldn't even really be counted.
00:11:21.505 --> 00:11:21.745
You know,
00:11:21.785 --> 00:11:23.366
it's just like a marketing company.
00:11:23.826 --> 00:11:25.268
We count it as opportunity.
00:11:25.469 --> 00:11:27.149
And that's why it's considered an active
00:11:27.190 --> 00:11:27.649
patient,
00:11:27.690 --> 00:11:29.471
because anyone who's been seen in the last
00:11:29.591 --> 00:11:31.653
eight months is an opportunity.
00:11:31.732 --> 00:11:33.455
Did somebody go try and get them?
00:11:33.995 --> 00:11:34.215
No.
00:11:34.254 --> 00:11:35.856
But if you you know,
00:11:35.897 --> 00:11:37.638
they only came in for like an emergency
00:11:37.677 --> 00:11:40.220
exam and they haven't been in in thirteen
00:11:40.259 --> 00:11:40.840
months.
00:11:40.980 --> 00:11:41.181
Yeah.
00:11:43.182 --> 00:11:44.625
But we can't get that nitty gritty.
00:11:44.664 --> 00:11:45.666
So we say, look,
00:11:45.846 --> 00:11:47.868
if they've had an ADA code,
00:11:47.888 --> 00:11:49.330
they've been in the last eight months,
00:11:49.669 --> 00:11:51.873
there is still an opportunity to go get
00:11:51.893 --> 00:11:53.934
these people.
00:11:54.054 --> 00:11:55.456
I, I get a lot of the, um,
00:11:57.073 --> 00:11:58.955
that I get that a lot as the
00:11:59.075 --> 00:11:59.934
as a buyer's rep.
00:11:59.975 --> 00:12:04.216
And that is, you know, emergencies versus,
00:12:04.616 --> 00:12:05.576
you know, true hygiene.
00:12:05.616 --> 00:12:08.597
So so like the purest of the pure
00:12:08.658 --> 00:12:10.538
active patients are folks that come into
00:12:10.578 --> 00:12:13.940
your hygiene department once a year or
00:12:14.019 --> 00:12:14.860
more, hopefully.
00:12:15.421 --> 00:12:17.701
And but it's interesting when you're
00:12:17.721 --> 00:12:19.601
looking at dental practice to purchase is
00:12:19.621 --> 00:12:21.322
like as you start digging into this,
00:12:21.363 --> 00:12:22.923
the number starts getting smaller and
00:12:22.964 --> 00:12:23.403
smaller.
00:12:24.024 --> 00:12:26.384
So the truth is, is like like
00:12:26.840 --> 00:12:27.000
You know,
00:12:27.139 --> 00:12:28.321
all the things that you might hear on
00:12:28.360 --> 00:12:30.062
this podcast, other podcasts is like,
00:12:30.082 --> 00:12:31.485
don't buy anything that's less than a
00:12:31.544 --> 00:12:32.404
thousand patients.
00:12:32.424 --> 00:12:33.647
But then you start whittling it down.
00:12:33.687 --> 00:12:35.508
It's like really only six hundred of them
00:12:35.788 --> 00:12:36.349
on the books.
00:12:36.589 --> 00:12:38.230
That doesn't mean it's a bad practice.
00:12:38.311 --> 00:12:38.772
It's just.
00:12:39.817 --> 00:12:41.538
it's just you're trying to figure out
00:12:41.619 --> 00:12:43.321
really what the like paula said is what
00:12:43.341 --> 00:12:45.481
that opportunity is to grab some of those
00:12:45.522 --> 00:12:46.842
patients and bring them in now if they've
00:12:46.863 --> 00:12:48.644
been too far out hey good luck you're
00:12:48.664 --> 00:12:50.485
not going to get them paula said that
00:12:51.366 --> 00:12:53.187
um you have to remember too though michael
00:12:53.227 --> 00:12:55.229
it's better than a new patient so a
00:12:55.309 --> 00:12:58.032
lot of our clients will go out and
00:12:58.072 --> 00:13:01.874
throw out mailers or throw out uh click
00:13:01.974 --> 00:13:06.418
uh what do you call it clicking uh
00:13:06.457 --> 00:13:07.918
yeah pay-per-click or mailers
00:13:07.938 --> 00:13:08.479
pay-per-click
00:13:09.759 --> 00:13:12.802
And they're doing that on, you know,
00:13:12.842 --> 00:13:14.004
patients that have never even been in
00:13:14.024 --> 00:13:15.424
their practice and they're just throwing
00:13:15.465 --> 00:13:16.785
money to the wind and hope it sticks.
00:13:17.166 --> 00:13:17.986
If you think about it,
00:13:18.027 --> 00:13:20.428
if you buy a practice where it says
00:13:20.448 --> 00:13:21.951
there's fifteen hundred active patients,
00:13:21.990 --> 00:13:23.631
but truly only nine hundred of them.
00:13:24.231 --> 00:13:24.491
I mean,
00:13:24.972 --> 00:13:27.434
just put something together for them
00:13:28.095 --> 00:13:32.678
that's marketable and appetizing because
00:13:32.698 --> 00:13:34.159
they have been in before.
00:13:34.860 --> 00:13:37.283
And if they've only been in an emergency,
00:13:37.322 --> 00:13:39.083
they probably still don't have a dentist.
00:13:39.605 --> 00:13:41.566
So, I mean, to me,
00:13:41.605 --> 00:13:44.008
you have better luck sometimes going after
00:13:44.048 --> 00:13:44.369
those.
00:13:44.389 --> 00:13:45.730
You just got to get creative.
00:13:45.929 --> 00:13:47.291
But I wouldn't bank on it.
00:13:47.311 --> 00:13:50.553
So the big rub, right,
00:13:50.754 --> 00:13:53.235
is that the brokers pull a report.
00:13:55.504 --> 00:13:56.966
I'm working on a deal right now in
00:13:57.046 --> 00:13:59.306
Sacramento and the broker pulled a report.
00:13:59.346 --> 00:14:02.027
The report says fifteen hundred after
00:14:02.086 --> 00:14:03.126
further investigation.
00:14:03.147 --> 00:14:04.307
It's closer to a thousand.
00:14:05.427 --> 00:14:08.369
And the reality is like the broker.
00:14:08.688 --> 00:14:09.028
Guys,
00:14:09.048 --> 00:14:11.749
you need to understand this broker's
00:14:12.190 --> 00:14:16.650
liability is is simply to pull reports and
00:14:16.730 --> 00:14:19.191
post what they what they what the report
00:14:19.211 --> 00:14:20.371
says out of the software.
00:14:20.432 --> 00:14:20.932
The software's
00:14:22.158 --> 00:14:23.942
Not accurate most of the time.
00:14:24.123 --> 00:14:26.448
So you're sitting here thinking, well,
00:14:26.469 --> 00:14:27.932
I'm going to sue the broker or screw
00:14:27.952 --> 00:14:28.313
that guy.
00:14:28.354 --> 00:14:29.375
He's trying to screw us over.
00:14:29.397 --> 00:14:30.539
He's misrepresenting.
00:14:31.397 --> 00:14:33.177
there's got to be some liability there.
00:14:33.219 --> 00:14:34.078
There isn't, guys.
00:14:34.460 --> 00:14:36.760
If the broker goes in, pulls a report,
00:14:36.981 --> 00:14:38.602
says active patients X,
00:14:38.743 --> 00:14:40.043
and posts it on the prospectus,
00:14:40.423 --> 00:14:42.206
that's literally all the liability they've
00:14:42.225 --> 00:14:42.505
got.
00:14:42.806 --> 00:14:43.886
And they can cover themselves.
00:14:43.927 --> 00:14:44.268
Hey,
00:14:44.768 --> 00:14:46.809
that's what the practice software said.
00:14:47.190 --> 00:14:48.571
The truth is you've got to look at,
00:14:48.591 --> 00:14:50.413
like Paula said, exams, hygiene,
00:14:50.552 --> 00:14:53.014
the cleanings, all the things,
00:14:54.755 --> 00:14:57.097
and really make a determination of what
00:14:57.138 --> 00:14:59.059
you think is the range of active patients.
00:14:59.559 --> 00:15:01.201
the other thing that i will say is
00:15:01.321 --> 00:15:04.023
some fun statistics is that like on
00:15:04.322 --> 00:15:07.904
average a patient's value to a practice on
00:15:08.245 --> 00:15:11.287
average if it's ppo i've seen a lot
00:15:11.307 --> 00:15:13.628
of fee for service practices lately the
00:15:13.648 --> 00:15:16.009
practice is ppo driven not so much
00:15:16.070 --> 00:15:18.750
medicaid just you know heavy ppo you're
00:15:18.770 --> 00:15:20.292
looking at like seven to eight hundred
00:15:20.312 --> 00:15:22.354
dollars per patient per year
00:15:23.354 --> 00:15:25.557
So if you take the total collections and
00:15:25.576 --> 00:15:27.519
divide it by what you think the active
00:15:27.559 --> 00:15:28.201
patient is,
00:15:28.240 --> 00:15:30.864
and it's a lot higher than seven,
00:15:30.884 --> 00:15:31.985
eight hundred dollars,
00:15:32.826 --> 00:15:35.990
then maybe you're off or vice versa,
00:15:36.111 --> 00:15:36.672
really low.
00:15:37.614 --> 00:15:37.933
Okay,
00:15:37.974 --> 00:15:40.174
so that's kind of a nice little KPI
00:15:40.215 --> 00:15:41.796
or a little metric that you can use
00:15:41.855 --> 00:15:43.517
is eight hundred, seven hundred,
00:15:43.537 --> 00:15:43.917
eight hundred.
00:15:44.297 --> 00:15:45.417
The next person is going to ask, well,
00:15:45.437 --> 00:15:46.697
what is it for fee for service?
00:15:47.217 --> 00:15:48.519
Dude, it could be crazy high.
00:15:48.538 --> 00:15:50.099
We just saw one that was twenty five
00:15:50.159 --> 00:15:53.061
hundred dollars per patient,
00:15:53.221 --> 00:15:54.981
and I think it might be accurate.
00:15:55.841 --> 00:15:59.043
So so just the rules kind of go
00:15:59.102 --> 00:16:00.724
out the window with fee for service a
00:16:00.764 --> 00:16:01.224
little bit.
00:16:02.125 --> 00:16:03.424
But if it's PPO,
00:16:03.465 --> 00:16:04.645
it's a little bit easier to figure that
00:16:04.686 --> 00:16:04.806
out.
00:16:06.251 --> 00:16:08.773
OK, so we covered kind of active patients.
00:16:09.634 --> 00:16:10.734
You really want to dig in.
00:16:10.774 --> 00:16:12.095
The next thing I was going to say,
00:16:12.134 --> 00:16:12.534
though,
00:16:12.754 --> 00:16:14.816
is kind of retention pre-appointment.
00:16:15.355 --> 00:16:16.096
To me,
00:16:16.736 --> 00:16:18.538
it kind of goes hand in hand with
00:16:18.618 --> 00:16:19.658
active patients.
00:16:21.318 --> 00:16:26.881
But pre-appointment slash hygiene
00:16:26.922 --> 00:16:30.624
reappointment slash kind of all of the
00:16:30.703 --> 00:16:33.445
retention metrics matter to me when I'm
00:16:33.465 --> 00:16:34.926
buying a practice or thinking about buying
00:16:34.966 --> 00:16:35.365
a practice.
00:16:36.272 --> 00:16:38.854
And usually you can smoke this out by
00:16:39.033 --> 00:16:41.514
seeing how many active patients there are,
00:16:41.534 --> 00:16:42.576
like we just discussed,
00:16:42.916 --> 00:16:44.576
and then looking at the schedule and
00:16:44.616 --> 00:16:46.698
seeing how far out your schedule.
00:16:47.639 --> 00:16:47.839
So like,
00:16:47.879 --> 00:16:49.500
if you have a crap ton of patients,
00:16:49.539 --> 00:16:51.501
like twenty five hundred active patients
00:16:51.542 --> 00:16:53.123
and you get into that chart audit and
00:16:53.143 --> 00:16:55.803
you're seeing that hygiene's only out
00:16:55.844 --> 00:16:58.846
three weeks, we got a problem.
00:16:59.025 --> 00:17:00.287
Why is that a problem, Paula?
00:17:00.307 --> 00:17:01.107
Because again,
00:17:03.928 --> 00:17:05.950
It's every practice has kind of like this
00:17:06.049 --> 00:17:08.790
DNA with collections,
00:17:08.830 --> 00:17:11.112
with reappointing protocols,
00:17:11.412 --> 00:17:13.173
and the patients are trained a certain
00:17:13.212 --> 00:17:13.593
way.
00:17:14.093 --> 00:17:16.953
So as a buyer, well, first of all,
00:17:16.973 --> 00:17:17.953
what's pre appointment?
00:17:19.115 --> 00:17:22.215
What do you think about retention and all
00:17:22.276 --> 00:17:23.756
of that kind of why is that?
00:17:24.955 --> 00:17:26.297
If you're a buyer, is that a problem?
00:17:26.436 --> 00:17:27.196
Is that a concern?
00:17:27.457 --> 00:17:28.718
What should you be expecting?
00:17:28.758 --> 00:17:29.357
You know what I mean?
00:17:31.981 --> 00:17:32.442
Yeah.
00:17:32.501 --> 00:17:34.761
So people get real confused with the
00:17:34.801 --> 00:17:37.323
reappointment versus pre-appointment and
00:17:38.222 --> 00:17:40.443
pre-appointment is basically your entire
00:17:40.644 --> 00:17:41.804
active patient base.
00:17:41.824 --> 00:17:43.903
So whether it's your entire active patient
00:17:43.943 --> 00:17:46.424
base or your entire active hygiene patient
00:17:46.444 --> 00:17:46.704
base,
00:17:46.724 --> 00:17:48.305
depending on which reappointment you're
00:17:48.345 --> 00:17:48.945
talking about,
00:17:49.546 --> 00:17:52.546
it's how many of my active patient base
00:17:52.746 --> 00:17:55.446
actually has a next appointment.
00:17:55.487 --> 00:17:56.967
So when we're looking at hygiene,
00:17:57.106 --> 00:17:59.428
if we've got a thousand active patients,
00:18:00.088 --> 00:18:02.530
and fifty percent of those have a patient,
00:18:02.611 --> 00:18:04.952
we're at a fifty percent pre-appointment
00:18:04.992 --> 00:18:05.313
rate.
00:18:07.074 --> 00:18:09.576
That's not good.
00:18:10.096 --> 00:18:10.916
We see it a lot,
00:18:10.936 --> 00:18:11.717
but it's not good.
00:18:12.577 --> 00:18:13.459
And what does that mean?
00:18:13.499 --> 00:18:17.682
That means that our patients are either
00:18:18.082 --> 00:18:20.963
not rescheduling when they're leaving or
00:18:21.503 --> 00:18:22.944
they're calling and canceling.
00:18:24.326 --> 00:18:26.086
know they're falling off the schedule
00:18:26.988 --> 00:18:30.711
reappointment is when they left did i get
00:18:30.730 --> 00:18:33.873
them on the books so my reappointment rate
00:18:33.893 --> 00:18:35.693
could be ninety percent everybody's
00:18:35.733 --> 00:18:39.096
scheduling and then when we go take a
00:18:39.136 --> 00:18:40.917
look at the pre-appointment they could be
00:18:40.958 --> 00:18:43.098
falling off for whatever reason they could
00:18:43.118 --> 00:18:45.040
be appeasing me and scheduling
00:18:45.681 --> 00:18:47.561
They we could live in a place where
00:18:47.582 --> 00:18:49.462
everyone vacations and people just keep
00:18:49.502 --> 00:18:51.384
calling and canceling whatever it is.
00:18:51.743 --> 00:18:52.744
They're not on the books.
00:18:52.944 --> 00:18:55.566
So the problem with that for a buyer
00:18:55.786 --> 00:18:56.567
is, you know,
00:18:56.606 --> 00:18:58.147
you mentioned three weeks out.
00:18:58.688 --> 00:18:59.627
It means a couple of things.
00:18:59.667 --> 00:19:01.828
It means our patients either don't value
00:19:01.848 --> 00:19:03.130
their hygiene appointments.
00:19:03.309 --> 00:19:05.471
They don't think it's important to have a
00:19:05.530 --> 00:19:07.132
six month recare or whatever.
00:19:09.292 --> 00:19:11.794
frequency you have them on or our team
00:19:11.814 --> 00:19:13.835
just doesn't reschedule them.
00:19:14.055 --> 00:19:16.296
And what that means six months from now
00:19:16.655 --> 00:19:19.518
is our schedule's empty and somebody's got
00:19:19.538 --> 00:19:21.699
to smile and dial to fill our hygiene
00:19:21.739 --> 00:19:23.638
schedule or even our doctor's books.
00:19:23.699 --> 00:19:24.559
Now, doctor's books
00:19:25.279 --> 00:19:26.640
aren't scheduled six months out.
00:19:27.760 --> 00:19:28.040
You know,
00:19:28.101 --> 00:19:29.800
we like them a couple of weeks out.
00:19:29.921 --> 00:19:31.422
I've seen everything from a couple of
00:19:31.461 --> 00:19:32.682
weeks to a few months.
00:19:32.741 --> 00:19:34.162
Being a few months out can be a
00:19:34.221 --> 00:19:36.462
problem because then patients are waiting
00:19:36.663 --> 00:19:37.823
on the doctor's schedule,
00:19:38.202 --> 00:19:39.943
but being a few months out to six
00:19:39.983 --> 00:19:41.943
months out on hygiene is actually a good
00:19:41.983 --> 00:19:43.003
thing.
00:19:43.584 --> 00:19:46.484
So we won't talk about block scheduling
00:19:46.545 --> 00:19:47.704
and how they should leave.
00:19:47.744 --> 00:19:48.806
No, let's not get crazy.
00:19:48.826 --> 00:19:49.266
Yeah.
00:19:51.646 --> 00:19:54.667
it should be pretty full six months out
00:19:54.688 --> 00:19:57.568
um yeah so that's that's kind of i
00:19:57.588 --> 00:19:59.410
don't know if that's no that's perfect and
00:19:59.470 --> 00:20:01.290
i and i and sometimes it's kind of
00:20:01.330 --> 00:20:04.792
funny like guys get into the you have
00:20:04.813 --> 00:20:06.253
to understand what kind of practice you're
00:20:06.273 --> 00:20:09.875
buying like like i have clients that are
00:20:09.914 --> 00:20:12.497
buying like really small practices i don't
00:20:12.517 --> 00:20:13.936
want them to be buying these practices but
00:20:14.217 --> 00:20:15.198
they want to deal with
00:20:16.438 --> 00:20:18.480
It's almost like an asset purchase or they
00:20:18.500 --> 00:20:19.740
think it's like a fixer upper.
00:20:19.780 --> 00:20:21.082
There's a lot of those deals.
00:20:21.241 --> 00:20:23.463
And I don't love you did one.
00:20:23.604 --> 00:20:24.984
And I don't love those deals.
00:20:25.505 --> 00:20:26.026
I really don't.
00:20:27.067 --> 00:20:28.528
And it's hard work.
00:20:28.988 --> 00:20:29.528
It's hard work.
00:20:29.548 --> 00:20:30.869
And there's a lot of reasons for it.
00:20:31.089 --> 00:20:32.770
That's a different episode, different day.
00:20:32.851 --> 00:20:35.873
But if there's like five hundred patients
00:20:35.932 --> 00:20:37.755
in the practice did, I don't know.
00:20:39.869 --> 00:20:42.510
six hundred thousand dollars last year and
00:20:42.550 --> 00:20:45.451
you go into a chart audit and the
00:20:45.491 --> 00:20:47.653
restorative schedule was like four days
00:20:47.772 --> 00:20:50.515
out three days out the hygiene appointment
00:20:50.835 --> 00:20:53.236
the hygiene book is is not six weeks
00:20:53.336 --> 00:20:56.076
out don't be shocked by that there's no
00:20:56.116 --> 00:20:58.837
patience it's a small practice if there's
00:20:58.877 --> 00:21:01.179
only five hundred patients active patients
00:21:01.318 --> 00:21:02.740
and the height and the restorative
00:21:02.779 --> 00:21:04.760
schedules two days out
00:21:05.601 --> 00:21:07.442
That front office person is constantly
00:21:07.502 --> 00:21:08.585
trying to schedule it.
00:21:08.605 --> 00:21:09.806
They're trying to do the same day
00:21:09.846 --> 00:21:11.048
dentistry immediately.
00:21:11.723 --> 00:21:13.845
It's kind of a high pressure situation
00:21:13.964 --> 00:21:15.786
until it's very painful.
00:21:15.826 --> 00:21:16.766
It's very stressful.
00:21:17.625 --> 00:21:22.008
So understand that's what you're buying.
00:21:22.028 --> 00:21:23.249
It's not the seller's fault.
00:21:23.269 --> 00:21:25.128
That's the business you put an offer in,
00:21:25.169 --> 00:21:26.410
and that's the business you're going
00:21:26.549 --> 00:21:26.829
after.
00:21:27.430 --> 00:21:30.050
Don't be expecting, I don't know,
00:21:30.912 --> 00:21:32.991
a blonde when you made an offer on
00:21:33.011 --> 00:21:33.472
a brunette.
00:21:33.593 --> 00:21:34.992
That's just two different things.
00:21:35.472 --> 00:21:37.794
Bigger practice has that kind of full
00:21:37.854 --> 00:21:39.275
schedule, or at least they should.
00:21:40.281 --> 00:21:42.044
And pre-appointment, hygiene appointment,
00:21:42.064 --> 00:21:43.224
reappointment, retention,
00:21:43.286 --> 00:21:45.748
all of that matters with big practices,
00:21:45.788 --> 00:21:46.689
small practices.
00:21:46.750 --> 00:21:48.692
But like if you've determined that the
00:21:48.711 --> 00:21:50.314
practice is five hundred patients.
00:21:51.380 --> 00:21:53.641
And four hundred of four hundred of them
00:21:53.701 --> 00:21:54.501
are on the schedule.
00:21:54.521 --> 00:21:55.741
They're they're damn good.
00:21:55.923 --> 00:21:56.502
That's good.
00:21:57.063 --> 00:21:57.522
But guess what?
00:21:57.542 --> 00:21:58.544
There's only four hundred.
00:21:58.624 --> 00:21:59.044
That's it.
00:21:59.064 --> 00:21:59.744
That's all you got.
00:21:59.765 --> 00:22:02.445
It's this schedule's not that full.
00:22:02.486 --> 00:22:03.826
So just think about that.
00:22:03.906 --> 00:22:04.287
Right.
00:22:04.386 --> 00:22:06.688
Like you are leaving big practices,
00:22:06.768 --> 00:22:07.729
making good money.
00:22:07.769 --> 00:22:09.509
You work probably for a DSO or some
00:22:09.569 --> 00:22:11.931
busy practice.
00:22:11.951 --> 00:22:13.251
That's probably not what you're buying if
00:22:13.291 --> 00:22:14.512
it's only five hundred patients.
00:22:15.432 --> 00:22:16.433
Hell, even a thousand.
00:22:16.693 --> 00:22:17.253
You know what I mean?
00:22:17.273 --> 00:22:19.095
If you're at a really busy practice today,
00:22:19.275 --> 00:22:20.556
a thousand patients is nothing.
00:22:21.380 --> 00:22:24.683
So just keep in mind that all of
00:22:24.703 --> 00:22:24.963
that.
00:22:25.424 --> 00:22:28.989
Um, the one big thing that like, um,
00:22:29.588 --> 00:22:31.371
I'm going to hit real quick is cashflow.
00:22:31.471 --> 00:22:31.652
Now,
00:22:31.771 --> 00:22:33.634
now the CPAs and the bankers do look
00:22:33.713 --> 00:22:36.557
at cashflow.
00:22:36.837 --> 00:22:37.057
Um,
00:22:38.246 --> 00:22:39.165
What's that mean, cash flow?
00:22:39.185 --> 00:22:40.646
So it's like a profit of the business.
00:22:40.987 --> 00:22:42.587
And, you know,
00:22:43.788 --> 00:22:46.349
if you this shouldn't be part of this
00:22:46.410 --> 00:22:47.951
episode, like due diligence,
00:22:47.990 --> 00:22:49.250
you should know the cash flow.
00:22:49.270 --> 00:22:50.412
You should know how much money the
00:22:50.451 --> 00:22:52.492
business makes before you even make an
00:22:52.673 --> 00:22:53.032
offer.
00:22:53.333 --> 00:22:55.394
So that's like before you even get into
00:22:55.433 --> 00:22:56.013
due diligence.
00:22:56.034 --> 00:22:57.694
This episode is all about chart audit due
00:22:57.714 --> 00:22:58.174
diligence.
00:22:58.836 --> 00:23:01.517
But what I will say is we get
00:23:01.537 --> 00:23:04.557
into a lot of conversations of scenarios
00:23:04.719 --> 00:23:05.638
where you
00:23:06.019 --> 00:23:08.163
the business throws off, I don't know,
00:23:08.202 --> 00:23:09.786
two hundred thousand dollars,
00:23:10.346 --> 00:23:13.612
but the seller wants to stay on or
00:23:13.811 --> 00:23:16.897
we're going to open up days or
00:23:18.007 --> 00:23:19.228
You're going to put a lot of money
00:23:19.248 --> 00:23:21.548
into marketing because the business needs
00:23:21.588 --> 00:23:24.530
to grow or you're losing a hygienist or
00:23:24.570 --> 00:23:26.711
there's a doctor doing hygiene and that's
00:23:26.771 --> 00:23:27.152
weird.
00:23:27.172 --> 00:23:28.413
So we're going to fire them and we're
00:23:28.432 --> 00:23:28.853
going to do that.
00:23:29.192 --> 00:23:30.794
Whatever the scenario is,
00:23:30.834 --> 00:23:33.096
a lot of scenarios of what that transition
00:23:33.135 --> 00:23:34.076
plan looks like.
00:23:34.615 --> 00:23:35.957
What I don't think a lot of people
00:23:36.017 --> 00:23:36.798
do is they don't.
00:23:37.838 --> 00:23:40.040
re-look at the numbers based on the
00:23:40.101 --> 00:23:42.321
transaction, the transition plan.
00:23:42.843 --> 00:23:44.763
So some CPA banker told you he was
00:23:44.784 --> 00:23:46.746
making two hundred, but your plan,
00:23:46.865 --> 00:23:48.186
the way you see it or the way
00:23:48.207 --> 00:23:49.468
you're thinking it's going to,
00:23:49.567 --> 00:23:50.788
the seller's going to stay on,
00:23:50.808 --> 00:23:52.210
they're going to get paid, all this,
00:23:52.410 --> 00:23:53.230
all these things happen.
00:23:53.509 --> 00:23:55.511
You're actually netting way less than what
00:23:55.531 --> 00:23:57.413
the CPA banker thought that you were going
00:23:57.432 --> 00:23:58.854
to make when you looked at the deal
00:23:58.894 --> 00:23:59.394
initially.
00:23:59.875 --> 00:24:01.256
So you have to run kind of like
00:24:01.276 --> 00:24:02.176
projections
00:24:03.536 --> 00:24:03.855
Again,
00:24:03.915 --> 00:24:06.037
things we do for our clients is like,
00:24:06.116 --> 00:24:08.217
okay, you've got a couple of scenarios.
00:24:08.297 --> 00:24:10.117
You could kick the seller out and make
00:24:10.157 --> 00:24:11.597
all this money, make two hundred grand.
00:24:11.817 --> 00:24:12.298
Good for you.
00:24:12.657 --> 00:24:14.538
Or you could keep the seller on one
00:24:14.558 --> 00:24:15.159
day a week.
00:24:15.479 --> 00:24:17.019
If you gave them one day a week,
00:24:17.038 --> 00:24:18.640
that's X amount of procedures.
00:24:19.019 --> 00:24:20.400
You're going to pay them thirty percent of
00:24:20.440 --> 00:24:22.560
those procedures minus the two hundred
00:24:22.601 --> 00:24:22.961
grand.
00:24:23.361 --> 00:24:25.642
Now you're only make one hundred and
00:24:25.662 --> 00:24:26.041
twenty.
00:24:26.061 --> 00:24:26.521
Is that cool?
00:24:27.201 --> 00:24:27.522
No.
00:24:27.923 --> 00:24:28.364
Oh, well,
00:24:28.384 --> 00:24:30.205
then maybe we shouldn't keep the seller on
00:24:30.445 --> 00:24:32.448
or whatever the scenario is.
00:24:32.548 --> 00:24:35.771
Make sure that you understand what the
00:24:35.811 --> 00:24:37.755
cash flow looks like before you even make
00:24:37.795 --> 00:24:40.357
an offer and then what the projection of
00:24:40.397 --> 00:24:42.480
the scenario is going to be and how
00:24:42.519 --> 00:24:43.801
that affects the cash flow.
00:24:45.239 --> 00:24:47.339
know this whole thing is like there's no
00:24:47.380 --> 00:24:49.681
reason why you should be like oh after
00:24:49.721 --> 00:24:52.362
you buy you should know exactly what this
00:24:52.382 --> 00:24:54.542
looks like post close because you should
00:24:54.563 --> 00:24:56.243
be doing all of this before you buy
00:24:56.663 --> 00:24:58.944
including adjusting the cash flow so
00:24:59.505 --> 00:25:02.326
that's my little rant on cash flow but
00:25:02.365 --> 00:25:04.846
you know cpas bankers they they kind of
00:25:04.886 --> 00:25:06.448
look at it in the beginning and then
00:25:06.508 --> 00:25:09.229
nobody really discusses well what if the
00:25:09.269 --> 00:25:11.950
seller stays on well the bank didn't
00:25:12.029 --> 00:25:13.790
underwrite it that way you're deciding to
00:25:13.830 --> 00:25:14.510
keep the seller up
00:25:15.696 --> 00:25:17.498
They're thinking you're firing the seller
00:25:17.718 --> 00:25:19.778
and they're saying yes to the loan.
00:25:21.079 --> 00:25:22.921
But maybe if you told the lender that
00:25:22.941 --> 00:25:24.142
you were going to keep the seller on,
00:25:24.182 --> 00:25:26.042
maybe the bankers wouldn't be doing this
00:25:26.083 --> 00:25:26.363
loan.
00:25:28.003 --> 00:25:28.523
But still,
00:25:28.804 --> 00:25:30.164
that's something that you should know.
00:25:32.806 --> 00:25:33.807
So that's my little thing.
00:25:33.926 --> 00:25:36.708
And that kind of lays us up into
00:25:36.748 --> 00:25:37.348
the next one.
00:25:37.388 --> 00:25:40.970
And that's procedures by count by dollars.
00:25:43.196 --> 00:25:47.559
There's been a few times where we've
00:25:47.599 --> 00:25:50.340
looked at practices and thought that it
00:25:50.361 --> 00:25:52.321
was a bread and butter practice.
00:25:53.123 --> 00:25:55.403
And it turns out we got into it
00:25:56.463 --> 00:25:58.365
and they didn't really tell us they were
00:25:58.404 --> 00:26:01.047
doing all these implants or all on Xs.
00:26:01.086 --> 00:26:02.968
Because when you look at procedure codes,
00:26:04.488 --> 00:26:04.788
And Paula,
00:26:04.807 --> 00:26:05.689
you're going to be better at this
00:26:05.729 --> 00:26:06.750
conversation than me.
00:26:06.789 --> 00:26:08.451
But like, if you're just seeing implants,
00:26:08.471 --> 00:26:09.571
you're thinking they're just dropping
00:26:09.652 --> 00:26:10.173
implants,
00:26:10.212 --> 00:26:11.614
but it could be all on X and
00:26:11.634 --> 00:26:12.795
that's four implants, right?
00:26:12.815 --> 00:26:13.835
So like, or whatever.
00:26:15.596 --> 00:26:18.838
So how would you smoke something like that
00:26:18.960 --> 00:26:19.099
out?
00:26:19.140 --> 00:26:20.681
Because I got to be honest, guys,
00:26:21.561 --> 00:26:24.084
next level CPAs, bankers,
00:26:25.064 --> 00:26:27.326
even brokers that don't know dentistry,
00:26:28.307 --> 00:26:30.368
they're looking at the procedure counts
00:26:30.588 --> 00:26:31.849
and representing the
00:26:33.003 --> 00:26:34.726
And they might not really know what's
00:26:34.746 --> 00:26:36.126
going on in the office,
00:26:36.186 --> 00:26:38.249
and it's your job to determine if you
00:26:38.269 --> 00:26:40.671
can do the dentistry of that office.
00:26:40.711 --> 00:26:42.271
That's the whole point of a chart audit,
00:26:42.291 --> 00:26:44.054
by the way, is to look at charts.
00:26:44.513 --> 00:26:44.954
So, Paula,
00:26:44.974 --> 00:26:47.757
what would be some things that you could
00:26:47.817 --> 00:26:48.417
do?
00:26:48.698 --> 00:26:49.659
And I'm putting you on the spot.
00:26:49.679 --> 00:26:50.599
I don't know if you have an answer
00:26:50.640 --> 00:26:50.880
here.
00:26:50.980 --> 00:26:52.161
Let's maybe just have a discussion.
00:26:52.201 --> 00:26:54.063
But what are some things that you can
00:26:54.143 --> 00:26:57.365
do just to determine if you can handle
00:26:57.405 --> 00:26:59.507
this clinic procedurally?
00:27:00.509 --> 00:27:02.289
Procedurally, again,
00:27:02.330 --> 00:27:03.250
putting you on the spot a little bit.
00:27:03.270 --> 00:27:04.672
Yeah, I mean,
00:27:04.893 --> 00:27:07.894
there's going to be additional codes that
00:27:07.954 --> 00:27:15.441
go with all-on-fours that are in addition
00:27:15.480 --> 00:27:18.123
to just a one-off implant.
00:27:18.804 --> 00:27:19.044
I mean,
00:27:19.064 --> 00:27:20.986
you're probably going to have more massive
00:27:21.086 --> 00:27:22.267
numbers of implants.
00:27:22.727 --> 00:27:22.886
I mean,
00:27:24.729 --> 00:27:26.269
it's just going to be the other codes
00:27:26.309 --> 00:27:26.930
that go with it.
00:27:27.069 --> 00:27:28.852
You're just going to look at all those.
00:27:28.872 --> 00:27:30.053
The cluster of codes?
00:27:30.410 --> 00:27:30.710
Yeah,
00:27:30.769 --> 00:27:32.990
like the different codes that are going to
00:27:33.010 --> 00:27:33.671
go with it.
00:27:33.770 --> 00:27:36.772
Well, do dentists know that?
00:27:37.813 --> 00:27:40.074
Like the clusters and the combos?
00:27:40.374 --> 00:27:41.954
Or we're just telling them that that's
00:27:41.974 --> 00:27:42.375
what they need?
00:27:42.474 --> 00:27:44.875
Yeah, I mean, no, I think they know.
00:27:45.256 --> 00:27:46.156
I think they know.
00:27:46.277 --> 00:27:46.557
I mean...
00:27:47.292 --> 00:27:48.634
They're going to know if they drop
00:27:48.733 --> 00:27:49.233
implants,
00:27:49.273 --> 00:27:51.214
they're going to know the three codes they
00:27:51.335 --> 00:27:52.615
use to drop an implant.
00:27:53.135 --> 00:27:54.876
When other stuff stops going,
00:27:54.916 --> 00:27:55.877
starts going with it,
00:27:55.938 --> 00:27:57.479
like hybrids and things like that,
00:27:57.598 --> 00:27:59.579
there's going to be other additional
00:27:59.640 --> 00:28:00.000
codes.
00:28:00.039 --> 00:28:00.720
They're going to be like,
00:28:01.000 --> 00:28:01.840
what is this code?
00:28:01.861 --> 00:28:04.382
Cause it's also typically a six thousand
00:28:04.762 --> 00:28:05.323
code.
00:28:05.762 --> 00:28:07.483
So there's going to be like other codes.
00:28:07.963 --> 00:28:09.785
I think you could probably also look at
00:28:09.825 --> 00:28:10.905
some lab bills.
00:28:11.026 --> 00:28:12.906
Like if the lab is out of control,
00:28:14.914 --> 00:28:16.576
you know, when you when you do,
00:28:16.976 --> 00:28:19.076
you can look at referred out, I mean,
00:28:19.438 --> 00:28:21.638
most dentists when when an all on X
00:28:21.679 --> 00:28:27.021
is being treatment plan and performed,
00:28:27.622 --> 00:28:29.022
they're either going to have the lab come
00:28:29.042 --> 00:28:30.064
in and help them out,
00:28:30.304 --> 00:28:33.105
or they're going to send some things out.
00:28:33.125 --> 00:28:33.605
So I think
00:28:34.185 --> 00:28:35.906
looking at referred out,
00:28:36.067 --> 00:28:39.930
I think looking at lab expenses and I
00:28:39.950 --> 00:28:42.392
think looking at codes.
00:28:42.751 --> 00:28:42.932
Okay.
00:28:43.311 --> 00:28:43.492
You know,
00:28:43.512 --> 00:28:45.233
if you get in there and there's five
00:28:45.314 --> 00:28:46.994
implants all year long.
00:28:47.015 --> 00:28:47.095
Yeah.
00:28:47.134 --> 00:28:49.355
And even if they did a high,
00:28:49.497 --> 00:28:52.278
you know, an all on four, who cares?
00:28:52.317 --> 00:28:54.180
It was one, you know, or two.
00:28:54.799 --> 00:28:56.060
If you get in and there's a ton
00:28:56.101 --> 00:28:57.701
of implants and,
00:28:57.942 --> 00:29:00.144
you know, yay, if you drop implants,
00:29:00.523 --> 00:29:02.226
but then you're going to want to go
00:29:02.326 --> 00:29:04.487
three steps further and start asking
00:29:04.527 --> 00:29:08.490
questions to make sure that these are
00:29:08.691 --> 00:29:11.373
single and not something crazy.
00:29:11.593 --> 00:29:13.795
Yeah, no, I think that's on point.
00:29:14.556 --> 00:29:14.756
I mean,
00:29:14.836 --> 00:29:16.537
I know it's on point because like,
00:29:17.157 --> 00:29:18.558
I just don't think guys,
00:29:18.578 --> 00:29:19.859
if there's one thing to take away from
00:29:19.900 --> 00:29:21.340
this episode, it's this part,
00:29:21.901 --> 00:29:26.144
because most of the due diligence is,
00:29:26.621 --> 00:29:30.983
that any of us could do that could
00:29:31.044 --> 00:29:32.785
mitigate some big risk.
00:29:33.806 --> 00:29:34.686
But this one,
00:29:34.727 --> 00:29:37.607
this segment of procedure counts and how
00:29:37.648 --> 00:29:39.349
to snuff out if you can handle this
00:29:39.390 --> 00:29:39.869
practice,
00:29:39.890 --> 00:29:42.571
this is the single most important due
00:29:42.592 --> 00:29:44.492
diligence factor.
00:29:44.532 --> 00:29:46.334
And I feel like going into the chart
00:29:46.374 --> 00:29:47.414
audit, people think,
00:29:48.476 --> 00:29:50.477
at least our clients or folks that I
00:29:50.517 --> 00:29:50.978
talk to,
00:29:51.357 --> 00:29:54.500
they think it's about validating what the
00:29:54.539 --> 00:29:55.820
broker represented.
00:29:56.806 --> 00:29:56.925
Well,
00:29:56.965 --> 00:29:59.048
they put in the prospectus that the
00:29:59.087 --> 00:30:01.309
collections were three hundred and twenty
00:30:01.329 --> 00:30:01.789
thousand.
00:30:01.829 --> 00:30:03.510
And so we need to pull our report
00:30:03.550 --> 00:30:04.711
and make sure it's three hundred twenty
00:30:04.751 --> 00:30:05.813
thousand guys.
00:30:06.634 --> 00:30:10.196
The brokers have no time to manipulate
00:30:10.237 --> 00:30:10.737
reports.
00:30:10.817 --> 00:30:12.338
It's not what the chart audits for.
00:30:12.638 --> 00:30:13.940
We will pull those reports.
00:30:13.960 --> 00:30:14.299
Sure.
00:30:14.339 --> 00:30:16.342
And we're going to do our analysis.
00:30:16.402 --> 00:30:16.801
Sure.
00:30:16.862 --> 00:30:19.703
But like you're missing the whole point of
00:30:19.724 --> 00:30:20.045
a chart.
00:30:20.065 --> 00:30:22.267
But we're pulling those reports to just
00:30:22.406 --> 00:30:22.686
dig
00:30:23.067 --> 00:30:25.469
two layers deeper we're not pulling those
00:30:25.509 --> 00:30:27.951
reports to see if the broker
00:30:28.550 --> 00:30:31.354
misrepresented exactly because there's
00:30:31.413 --> 00:30:33.996
other information that we're looking for
00:30:34.276 --> 00:30:37.137
like like these you know with this implant
00:30:37.618 --> 00:30:39.480
you're gonna you're gonna look to see if
00:30:39.519 --> 00:30:45.345
there's yes exactly a prosthetic i well i
00:30:45.365 --> 00:30:47.125
can't even like a denture not a denture
00:30:47.165 --> 00:30:48.086
code but a um
00:30:50.469 --> 00:30:51.069
Like, yeah, basically.
00:30:51.089 --> 00:30:52.692
Yeah, we're digging in deeper.
00:30:52.813 --> 00:30:54.875
And it's not about trying to catch the
00:30:54.895 --> 00:30:56.679
broker in an aha situation.
00:30:56.719 --> 00:30:56.959
You know,
00:30:57.680 --> 00:30:59.202
active patient account is one of those
00:30:59.242 --> 00:31:00.904
things that your broker is probably wrong.
00:31:01.425 --> 00:31:02.468
It's just they just are.
00:31:02.488 --> 00:31:04.029
They're pulling a report and posting it.
00:31:06.064 --> 00:31:07.865
um we get the number we've got to
00:31:07.904 --> 00:31:10.866
kind of like i know i gotta be
00:31:10.886 --> 00:31:12.688
honest i'll never know exactly what your
00:31:12.748 --> 00:31:14.749
active patient count is but i'm gonna look
00:31:14.808 --> 00:31:16.810
at it three different angles and kind of
00:31:16.951 --> 00:31:19.432
narrow in on a bracket that's my that's
00:31:19.471 --> 00:31:21.193
the way i i coach but like
00:31:22.224 --> 00:31:22.785
Again,
00:31:23.585 --> 00:31:26.026
just make sure you can handle the
00:31:26.066 --> 00:31:26.506
practice.
00:31:26.526 --> 00:31:27.846
That's what the chart audit's for.
00:31:27.885 --> 00:31:28.566
You're going there,
00:31:28.586 --> 00:31:29.605
you're looking at procedures,
00:31:29.625 --> 00:31:30.626
you're looking at x-rays,
00:31:30.646 --> 00:31:33.646
you're looking at the befores and afters
00:31:33.686 --> 00:31:34.846
and trying to figure out what the
00:31:34.886 --> 00:31:35.867
diagnosis is.
00:31:35.887 --> 00:31:37.548
And then you're also looking for big stuff
00:31:37.567 --> 00:31:38.627
that you can't do.
00:31:39.188 --> 00:31:40.127
That is like,
00:31:40.147 --> 00:31:42.028
we've coached some clients post-close that
00:31:42.088 --> 00:31:44.469
could not handle the practice.
00:31:45.470 --> 00:31:46.349
And they said we could.
00:31:47.069 --> 00:31:47.750
Is that our fault?
00:31:48.382 --> 00:31:49.342
No, that they,
00:31:49.461 --> 00:31:51.063
they should have really dug into that and
00:31:51.083 --> 00:31:54.744
made sure only you can tell us that
00:31:54.785 --> 00:31:55.884
you can handle or not, which,
00:31:55.984 --> 00:31:57.306
which kind of leads me to the big
00:31:57.346 --> 00:31:59.105
cases, ortho work in progress.
00:31:59.926 --> 00:32:02.667
So like guys, gals,
00:32:02.847 --> 00:32:04.709
if you can't like big cases,
00:32:04.909 --> 00:32:06.189
ortho work in progress,
00:32:06.209 --> 00:32:07.509
this is always something that gets
00:32:07.529 --> 00:32:08.109
discussed.
00:32:08.269 --> 00:32:09.590
And, um,
00:32:10.798 --> 00:32:11.479
You know,
00:32:11.499 --> 00:32:13.019
I'm throwing this up just because
00:32:13.181 --> 00:32:14.961
specifically because of ortho lately,
00:32:15.082 --> 00:32:17.123
I had a conversation with a broker once
00:32:17.202 --> 00:32:19.505
and the broker's like, well,
00:32:19.545 --> 00:32:20.904
doctors come out of school.
00:32:20.944 --> 00:32:22.465
They know how to do ortho.
00:32:22.787 --> 00:32:24.186
They do cases in school.
00:32:24.268 --> 00:32:24.907
I'm like, dude,
00:32:25.428 --> 00:32:26.929
what school are you talking about?
00:32:26.969 --> 00:32:28.390
First of all, and second of all, no,
00:32:28.869 --> 00:32:30.912
they are not comfortable doing ortho
00:32:30.991 --> 00:32:34.394
unless they are ortho kings and queens at
00:32:34.413 --> 00:32:35.575
their associate job.
00:32:36.295 --> 00:32:38.615
so like this is the the brokers think
00:32:38.655 --> 00:32:40.557
that you guys can do well and this
00:32:40.576 --> 00:32:44.298
line is in almost every but to think
00:32:44.637 --> 00:32:46.898
but to think that someone could come in
00:32:46.959 --> 00:32:48.839
and do exactly i i just looked at
00:32:48.880 --> 00:32:50.340
a practice that was doing two hundred
00:32:50.381 --> 00:32:52.902
thousand dollars worth of ortho and i
00:32:53.021 --> 00:32:54.201
asked my buyer do you do ortho they're
00:32:54.221 --> 00:32:55.663
like no but i can learn it i'm
00:32:55.702 --> 00:32:58.104
like okay we're talking about fifteen
00:32:58.144 --> 00:33:00.625
percent of this practice is clear liners
00:33:01.095 --> 00:33:03.478
This is like a full blown indoctrination
00:33:03.577 --> 00:33:04.419
of the practice.
00:33:04.819 --> 00:33:07.022
They're diamond whatever with Invisalign.
00:33:07.063 --> 00:33:08.364
Most people can't do that.
00:33:08.744 --> 00:33:09.405
Right.
00:33:09.425 --> 00:33:10.767
Otherwise, everybody would do it.
00:33:10.987 --> 00:33:12.249
We try to get our clients to do
00:33:12.269 --> 00:33:13.931
it and they don't want to do it.
00:33:14.171 --> 00:33:16.294
That's the point is like, no,
00:33:16.334 --> 00:33:17.816
you don't just pick up ortho.
00:33:18.016 --> 00:33:19.698
You don't just pick up implants.
00:33:20.740 --> 00:33:22.842
So implants, big cases, ortho,
00:33:22.902 --> 00:33:23.801
you got to look at that.
00:33:23.961 --> 00:33:24.541
You got to look at it.
00:33:24.561 --> 00:33:26.042
Even sometimes endo.
00:33:26.343 --> 00:33:26.623
I mean,
00:33:26.722 --> 00:33:28.083
a lot of people aren't comfortable doing
00:33:28.844 --> 00:33:31.763
endo, third molar extractions.
00:33:31.824 --> 00:33:32.684
If they do do endo,
00:33:32.704 --> 00:33:35.125
they don't love upper molars.
00:33:35.945 --> 00:33:37.145
There's all kinds of things.
00:33:38.846 --> 00:33:41.467
And that's why on the prospectuses and the
00:33:41.527 --> 00:33:42.887
bank's application,
00:33:42.928 --> 00:33:45.028
you're going to see break down the
00:33:45.067 --> 00:33:46.548
procedures by percentage.
00:33:48.188 --> 00:33:52.108
That is literally the box they're filling
00:33:52.210 --> 00:33:54.009
out for you.
00:33:54.150 --> 00:33:56.691
And you should pay attention to that and
00:33:56.750 --> 00:33:57.431
look at it.
00:33:57.611 --> 00:33:59.711
And if you see three percent,
00:33:59.791 --> 00:34:02.853
four percent, five percent ortho,
00:34:02.932 --> 00:34:04.472
now we got to look at the eighty
00:34:04.513 --> 00:34:06.193
ninety code and we got to dig into
00:34:06.213 --> 00:34:06.413
that.
00:34:06.433 --> 00:34:07.374
We got to look at the chart.
00:34:07.453 --> 00:34:08.755
We got to look at the cases in
00:34:08.775 --> 00:34:11.556
the in the pantry on chart audit day.
00:34:12.673 --> 00:34:14.014
And we've got to see how much money
00:34:14.054 --> 00:34:14.976
they've collected.
00:34:15.516 --> 00:34:17.077
Because most of these big cases,
00:34:17.117 --> 00:34:21.360
there's a collection amount up front that
00:34:21.400 --> 00:34:23.460
the practice holds before the procedure.
00:34:24.001 --> 00:34:25.601
So if you close in the middle of
00:34:25.663 --> 00:34:26.682
one of those procedures,
00:34:26.702 --> 00:34:27.903
we've got to figure out the money.
00:34:27.983 --> 00:34:30.365
So anyways, big procedures,
00:34:30.646 --> 00:34:33.967
specifically ortho, implants, big stuff,
00:34:34.088 --> 00:34:34.909
we've got to work through.
00:34:35.048 --> 00:34:36.750
That's obvious, guys, but like...
00:34:37.889 --> 00:34:40.251
Be very humble in this process and just
00:34:40.291 --> 00:34:42.710
say, well, you know, I could be better.
00:34:42.851 --> 00:34:46.152
This guy or gal seller is probably better.
00:34:46.211 --> 00:34:47.552
How am I going to bridge that gap?
00:34:48.092 --> 00:34:48.972
Be humble about it.
00:34:49.351 --> 00:34:50.773
Too many buyers are like, oh,
00:34:50.793 --> 00:34:51.313
I can do it all.
00:34:51.572 --> 00:34:52.052
No problem.
00:34:52.233 --> 00:34:53.432
And then that's how they get themselves
00:34:53.472 --> 00:34:55.213
into trouble post-close.
00:34:55.494 --> 00:34:57.414
So talk to the seller.
00:34:57.934 --> 00:34:58.173
You know,
00:34:58.193 --> 00:34:59.594
you'll have the opportunity to talk to the
00:34:59.635 --> 00:34:59.914
seller.
00:34:59.954 --> 00:35:00.574
Talk to the seller.
00:35:00.594 --> 00:35:00.815
What do you?
00:35:02.144 --> 00:35:03.365
What kind of cases do you do?
00:35:03.385 --> 00:35:04.628
What kind of cases do you love?
00:35:04.648 --> 00:35:05.969
Which ones do you pass on?
00:35:06.690 --> 00:35:08.451
Tell me about your ortho protocols.
00:35:09.072 --> 00:35:10.472
That's the kind of stuff that you need
00:35:10.492 --> 00:35:11.753
to figure out as a clinician.
00:35:11.833 --> 00:35:16.278
So procedure counts by count, by dollars,
00:35:16.338 --> 00:35:17.679
big cases, work in progress.
00:35:17.699 --> 00:35:18.501
We kind of covered it.
00:35:19.061 --> 00:35:21.083
The last thing before we shut this episode
00:35:21.123 --> 00:35:22.445
down, it's kind of a longer one,
00:35:22.465 --> 00:35:23.246
but this is a good one.
00:35:23.326 --> 00:35:24.045
This is a good one.
00:35:24.927 --> 00:35:26.489
It's collection protocols.
00:35:27.588 --> 00:35:27.967
Paula,
00:35:28.228 --> 00:35:29.829
and this is something that I've been
00:35:29.869 --> 00:35:31.731
really digging into more lately.
00:35:31.791 --> 00:35:32.570
It's interesting.
00:35:33.090 --> 00:35:36.032
Your career develops just like doctors.
00:35:36.072 --> 00:35:38.594
Your career develops stuff I wasn't even
00:35:38.635 --> 00:35:40.275
looking at the first five years of my
00:35:40.315 --> 00:35:40.536
career.
00:35:40.596 --> 00:35:41.275
Now I'm like,
00:35:41.476 --> 00:35:44.137
what's going on with the billing and the
00:35:44.358 --> 00:35:47.420
codes they're using and their adjustments?
00:35:47.500 --> 00:35:50.081
And does that really matter about the
00:35:50.161 --> 00:35:51.422
value of the business?
00:35:51.541 --> 00:35:51.742
No.
00:35:52.842 --> 00:35:54.563
We're never going to like ask for a
00:35:54.603 --> 00:35:56.545
concession because they use too many
00:35:56.565 --> 00:35:59.606
adjustments or write offs or their
00:35:59.646 --> 00:36:01.827
software sloppy or their whatever they're
00:36:01.867 --> 00:36:03.389
building their collections over the
00:36:03.449 --> 00:36:04.269
counter sloppy.
00:36:05.210 --> 00:36:07.532
It doesn't affect the value,
00:36:07.612 --> 00:36:11.034
but it does set the tone for how
00:36:11.134 --> 00:36:14.755
your what you're going to inherit back to
00:36:16.036 --> 00:36:17.898
the conditioning of the patients.
00:36:18.177 --> 00:36:19.278
We coach a lot of clients.
00:36:20.199 --> 00:36:21.340
I'll I'll say it again, like
00:36:22.150 --> 00:36:24.891
there's oftentimes a reconditioning of the
00:36:24.972 --> 00:36:25.632
patients.
00:36:25.652 --> 00:36:26.733
And the team.
00:36:27.333 --> 00:36:29.315
And the team, thank you.
00:36:29.476 --> 00:36:30.456
It's really the team,
00:36:31.157 --> 00:36:32.838
which then conditions the patient.
00:36:32.878 --> 00:36:35.320
So it started with the team being that
00:36:35.360 --> 00:36:35.601
way,
00:36:35.641 --> 00:36:38.182
and then they conditioned the patient.
00:36:38.222 --> 00:36:42.427
So do the patients expect to pay the
00:36:42.467 --> 00:36:43.367
day of service?
00:36:44.188 --> 00:36:46.230
Are the patients expecting to be
00:36:46.349 --> 00:36:47.130
reappointed?
00:36:48.226 --> 00:36:51.108
like are they expecting a very crystal
00:36:51.148 --> 00:36:53.588
clear treatment plan that's exact dollars
00:36:53.688 --> 00:36:57.190
like just all of that right and um
00:36:57.389 --> 00:37:00.411
the collection protocols is something that
00:37:00.451 --> 00:37:02.710
i've really dug into or started digging
00:37:02.751 --> 00:37:07.873
into more um so i just find in
00:37:07.932 --> 00:37:13.894
general um that front offices need a lot
00:37:13.974 --> 00:37:15.275
of help so paula like
00:37:16.880 --> 00:37:19.621
like when when we're coaching a buyer post
00:37:19.661 --> 00:37:24.385
close what are what are very common things
00:37:24.405 --> 00:37:26.646
that need to be fixed let's just say
00:37:26.666 --> 00:37:28.407
the top two most common things that need
00:37:28.427 --> 00:37:30.307
to be fixed day you want i know
00:37:30.327 --> 00:37:32.389
that's it's like opening up literally a
00:37:32.429 --> 00:37:35.231
can of worms but like the ones that
00:37:35.472 --> 00:37:37.233
matter the most i suppose i don't know
00:37:37.612 --> 00:37:42.076
um i would say the first is um
00:37:43.193 --> 00:37:45.454
like rescheduling patients before they
00:37:45.494 --> 00:37:45.835
leave.
00:37:46.576 --> 00:37:48.237
Usually hygiene's a little bit better,
00:37:49.438 --> 00:37:50.117
not always,
00:37:50.157 --> 00:37:52.699
but usually we're conditioned when a
00:37:52.739 --> 00:37:55.320
patient's back in our operatory to go
00:37:55.340 --> 00:37:56.501
ahead and get them scheduled for their
00:37:56.541 --> 00:37:57.463
next appointment.
00:38:00.384 --> 00:38:02.306
What everybody's bad at is saying,
00:38:02.385 --> 00:38:03.686
do you wanna reschedule?
00:38:03.786 --> 00:38:06.027
Thank goodness we have some patients that
00:38:06.268 --> 00:38:07.228
just say yes,
00:38:07.329 --> 00:38:09.030
because the way we ask and the way
00:38:09.070 --> 00:38:10.990
we do it is typically,
00:38:12.152 --> 00:38:14.313
not going to get the best results.
00:38:15.072 --> 00:38:16.092
Front office,
00:38:17.114 --> 00:38:18.373
it's a little bit different story.
00:38:19.255 --> 00:38:22.016
I would say we're not as conditioned to
00:38:22.036 --> 00:38:23.235
get people on the treatment,
00:38:23.356 --> 00:38:24.496
on the schedule for treatment.
00:38:24.637 --> 00:38:26.237
We leave it a little bit up to
00:38:26.277 --> 00:38:26.556
them.
00:38:27.277 --> 00:38:29.737
There's money, bigger monies involved,
00:38:29.938 --> 00:38:31.358
there's decisions involved.
00:38:31.958 --> 00:38:34.659
And I wouldn't say more often than not,
00:38:34.679 --> 00:38:37.101
but a lot of, but enough.
00:38:37.541 --> 00:38:39.442
patients want to look at a schedule.
00:38:39.501 --> 00:38:40.601
They want to think about it.
00:38:40.641 --> 00:38:42.483
They want to talk to somebody if there's
00:38:42.523 --> 00:38:43.802
any type of investment,
00:38:44.182 --> 00:38:46.003
which means they're going to walk out the
00:38:46.043 --> 00:38:47.664
door without an appointment.
00:38:48.465 --> 00:38:50.644
And not only do we allow them to
00:38:50.704 --> 00:38:51.244
do that,
00:38:51.585 --> 00:38:54.547
we have a horrible follow-up system and we
00:38:54.567 --> 00:38:56.286
leave it in the patient's hands to call
00:38:56.447 --> 00:38:59.427
back and reschedule that fifteen hundred
00:38:59.467 --> 00:39:01.568
dollar crown or a thousand dollar crown or
00:39:01.608 --> 00:39:02.208
what have you.
00:39:02.856 --> 00:39:04.376
i would say that's probably one of the
00:39:04.416 --> 00:39:07.358
biggest things is training or help
00:39:07.838 --> 00:39:10.960
recondition the front office to you know
00:39:11.141 --> 00:39:13.402
number one let's get them scheduled we can
00:39:13.442 --> 00:39:15.302
find creative ways to go ahead and get
00:39:15.322 --> 00:39:16.844
them on the schedule and they can still
00:39:16.943 --> 00:39:20.445
think about situations number two is if
00:39:20.485 --> 00:39:22.907
they don't get on the schedule making sure
00:39:22.927 --> 00:39:24.568
that we don't leave it in their hands
00:39:24.608 --> 00:39:26.128
to give us a call back that we
00:39:26.188 --> 00:39:27.909
control that situation so i would say
00:39:28.449 --> 00:39:29.851
that's number one um
00:39:30.994 --> 00:39:32.914
if we want to throw collecting money it
00:39:32.994 --> 00:39:35.916
is probably number two it's we either
00:39:35.976 --> 00:39:39.519
don't know the exact amount um you know
00:39:39.559 --> 00:39:42.461
we there's things we're doing to not get
00:39:42.481 --> 00:39:45.023
an accurate treatment plan so we're either
00:39:45.123 --> 00:39:48.746
sending a pre-d or which i don't like
00:39:48.806 --> 00:39:50.746
and i can that's a whole another episode
00:39:51.422 --> 00:39:53.266
or we're guesstimating.
00:39:53.766 --> 00:39:55.190
We think we're doing as accurate as we
00:39:55.210 --> 00:39:55.349
can.
00:39:55.369 --> 00:39:56.692
We're chicken scratching,
00:39:56.771 --> 00:39:58.715
trying to figure out how much because
00:39:58.735 --> 00:40:00.277
we're not using our software
00:40:00.338 --> 00:40:00.978
appropriately.
00:40:01.059 --> 00:40:02.922
So that's kind of number two is,
00:40:03.597 --> 00:40:04.539
They don't even know how to use their
00:40:04.559 --> 00:40:05.521
software appropriately.
00:40:06.601 --> 00:40:07.762
So then their treatment plan isn't
00:40:07.884 --> 00:40:08.364
accurate.
00:40:08.423 --> 00:40:10.726
So they're either afraid to collect
00:40:11.288 --> 00:40:12.530
because they're not a hundred percent
00:40:12.590 --> 00:40:12.789
sure.
00:40:12.809 --> 00:40:14.271
And they're going to wait on that EOB
00:40:14.291 --> 00:40:16.675
to come back so they can then collect
00:40:17.036 --> 00:40:21.121
or they're just weren't ever
00:40:22.362 --> 00:40:24.864
made to collect so they invoice the
00:40:24.884 --> 00:40:25.324
patient.
00:40:25.384 --> 00:40:30.726
So whatever that collection system is,
00:40:30.806 --> 00:40:33.148
it's broke in some way, shape or form.
00:40:33.307 --> 00:40:38.210
And that's what I've been seeing a lot
00:40:38.251 --> 00:40:40.152
of lately is like looking at accounts
00:40:40.192 --> 00:40:42.972
receivables and seeing claims versus
00:40:43.032 --> 00:40:46.574
patient portion and then seeing credits
00:40:46.855 --> 00:40:49.297
and then trying to draw and then looking
00:40:49.356 --> 00:40:49.516
at
00:40:50.362 --> 00:40:53.824
adjustment percentages so it's a hot mess
00:40:53.864 --> 00:40:55.224
so like when i'm looking at all of
00:40:55.244 --> 00:40:56.744
that you're trying because you can't
00:40:56.844 --> 00:40:58.985
interview the front office person that's
00:40:59.025 --> 00:41:02.106
the hardest part of being a buyer's agent
00:41:02.126 --> 00:41:05.387
or rep or whatever is like figuring out
00:41:05.628 --> 00:41:08.429
how nancy joe at the front does this
00:41:08.489 --> 00:41:12.210
without talking to her and and it's just
00:41:12.331 --> 00:41:13.371
all based on like
00:41:15.099 --> 00:41:18.862
random reports but you can see what's
00:41:18.902 --> 00:41:21.565
going on at a high level but you
00:41:21.606 --> 00:41:24.427
don't necessarily know what the problem
00:41:24.467 --> 00:41:27.630
specifically is and so like i think that's
00:41:27.670 --> 00:41:32.114
important for buyers to see uh going into
00:41:32.235 --> 00:41:35.538
a purchase is okay they're good at
00:41:35.577 --> 00:41:38.641
collecting insurance payments or they're
00:41:38.900 --> 00:41:40.161
or they're not or they're good at
00:41:40.262 --> 00:41:41.963
collecting over the counter or they're not
00:41:42.043 --> 00:41:42.083
or
00:41:43.079 --> 00:41:45.780
Um, they are not good at either or,
00:41:45.900 --> 00:41:47.862
or their adjustments are so big because
00:41:47.882 --> 00:41:49.384
they're not using the software, right.
00:41:49.403 --> 00:41:50.603
Or maybe they're not doing insurance.
00:41:50.623 --> 00:41:53.106
Sometimes it's so clean because what
00:41:53.146 --> 00:41:54.967
they'll do is instead of cover up their
00:41:54.987 --> 00:41:56.748
trucks, that's right.
00:41:56.768 --> 00:41:57.188
It off.
00:41:57.608 --> 00:41:59.289
Um, yeah, when it's too clean,
00:41:59.309 --> 00:42:01.032
that's exactly what I think is someone's
00:42:01.072 --> 00:42:02.652
club covering up their tracks and it's
00:42:02.672 --> 00:42:03.213
like, okay,
00:42:03.233 --> 00:42:04.673
they're trying to show that the reports
00:42:04.693 --> 00:42:05.353
are like, perfect.
00:42:05.373 --> 00:42:05.855
There's no way.
00:42:06.355 --> 00:42:06.695
Yeah,
00:42:06.715 --> 00:42:08.938
I've always equated it to I've probably
00:42:08.958 --> 00:42:10.139
heard me say this, Michael,
00:42:10.219 --> 00:42:11.880
and maybe even the audience is like,
00:42:12.340 --> 00:42:14.362
it's like when you get your car with
00:42:14.382 --> 00:42:15.503
a lot of technology,
00:42:15.583 --> 00:42:16.885
or even your cell phone,
00:42:17.585 --> 00:42:17.826
it's
00:42:18.496 --> 00:42:20.315
You know how to in my cell phone.
00:42:20.436 --> 00:42:21.436
I know how to text.
00:42:22.277 --> 00:42:23.936
I know how to get on social media
00:42:24.496 --> 00:42:25.958
and I know how to schedule an appointment.
00:42:26.338 --> 00:42:27.018
That's about it.
00:42:27.438 --> 00:42:28.697
Sometimes people will show me something.
00:42:28.717 --> 00:42:30.079
I'm like, oh, wow, it does that.
00:42:30.298 --> 00:42:30.818
I didn't know.
00:42:31.239 --> 00:42:32.378
My car is the same way.
00:42:33.079 --> 00:42:34.539
So you have to think about these front
00:42:34.639 --> 00:42:38.099
office gals and guys do the best with
00:42:38.139 --> 00:42:38.780
what they have,
00:42:39.001 --> 00:42:40.701
whether they taught themselves or they
00:42:40.721 --> 00:42:41.780
learn from somebody else.
00:42:41.900 --> 00:42:44.202
And they're at the helm of this ginormous
00:42:44.242 --> 00:42:44.621
ship
00:42:46.646 --> 00:42:47.668
just doing it.
00:42:48.050 --> 00:42:51.018
And sometimes it's a super hot mess.
00:42:51.659 --> 00:42:53.244
And sometimes they figure some of it out.
00:42:54.106 --> 00:42:55.266
But at the end of the day,
00:42:55.887 --> 00:42:58.969
there's no school or there's very few,
00:43:00.108 --> 00:43:02.771
which is something we help with on front
00:43:02.851 --> 00:43:05.172
office and how to use your software
00:43:05.211 --> 00:43:06.911
correctly and how to really,
00:43:07.413 --> 00:43:08.432
when to do adjustments.
00:43:08.532 --> 00:43:10.213
And by the way, when you do adjustments,
00:43:10.333 --> 00:43:11.373
how do you allocate them?
00:43:11.393 --> 00:43:12.815
You don't just stick an adjustment in
00:43:13.175 --> 00:43:14.695
because you want those adjustments to tell
00:43:14.795 --> 00:43:15.155
a story.
00:43:15.976 --> 00:43:17.396
That's the biggest thing is, yeah,
00:43:17.976 --> 00:43:20.619
you got to be careful on those ARs
00:43:20.679 --> 00:43:23.480
and what is really the problem for sure.
00:43:23.500 --> 00:43:24.041
That's right.
00:43:24.101 --> 00:43:24.820
That's perfect.
00:43:24.920 --> 00:43:25.661
Well,
00:43:26.161 --> 00:43:28.963
this was a forty-minute jam-packed due
00:43:29.003 --> 00:43:32.005
diligence tutorial.
00:43:32.985 --> 00:43:37.327
If you didn't look at true active
00:43:37.367 --> 00:43:39.989
patients, the retention, pre-appointment,
00:43:40.030 --> 00:43:42.210
kind of that, procedures by count,
00:43:42.251 --> 00:43:43.112
dollar-wise,
00:43:43.831 --> 00:43:47.554
by count, making sure you can handle that.
00:43:47.574 --> 00:43:47.773
ARs.
00:43:47.793 --> 00:43:48.514
ARs, collection protocols.
00:43:48.534 --> 00:43:53.117
Patients versus interns.
00:43:53.137 --> 00:43:54.699
Work in progress, big cases,
00:43:54.938 --> 00:43:55.958
things like ortho.
00:43:56.018 --> 00:43:57.780
If you haven't looked at any of that,
00:43:58.340 --> 00:43:59.561
if some of those things you haven't,
00:43:59.621 --> 00:44:01.902
go back to the office and look.
00:44:01.943 --> 00:44:03.804
The brokers are going to really love you
00:44:03.844 --> 00:44:05.105
doing a second chart audit.
00:44:05.144 --> 00:44:07.766
But these are all things that are very
00:44:07.786 --> 00:44:10.708
important and things that we help our
00:44:10.748 --> 00:44:11.309
clients with.
00:44:11.369 --> 00:44:12.429
So
00:44:13.594 --> 00:44:17.275
Thank you all for always listening in.
00:44:17.996 --> 00:44:19.237
We appreciate it.
00:44:19.777 --> 00:44:22.137
Please like, subscribe, all the things,
00:44:22.577 --> 00:44:26.018
giving us a little star, a five star,
00:44:26.079 --> 00:44:29.019
not one star on Spotify.
00:44:29.500 --> 00:44:30.780
Whatever you're listening to,
00:44:31.021 --> 00:44:33.121
it really does help the program.
00:44:33.141 --> 00:44:34.942
So without further ado,
00:44:34.961 --> 00:44:37.922
let's close this thing down and make it
00:44:37.943 --> 00:44:38.304
a great day.
00:44:38.324 --> 00:44:38.684
All right.
00:44:38.724 --> 00:44:39.664
Peace out.
00:44:49.958 --> 00:44:51.840
thanks for listening let us know how you
00:44:51.880 --> 00:44:55.407
like the show rate us on apple and
00:44:55.467 --> 00:45:00.936
spotify subscribe and follow for more