The Dark Secret Dental Insurance Companies Don’t Want You To Know

Intro: This is The Thriving Dentist Show with Gary Takacs, where we help you develop your ideal dental practice, one that provides personal, professional, and financial satisfaction.

Intro: Welcome to another episode of The Thriving Dentist Show. I’m Gary Takacs, your podcast co-host. The title of today’s episode is The Dark Secret Dental Insurance Companies Don’t Want You to Know. Ah, this is gonna be a fun one. Uh, there’s actually a number of dark secrets they don’t want you to know, but I’m gonna focus on, uh, one that, uh, you probably aren’t aware of. I think you’re gonna like this episode.

Uh, before we get to this episode, two quick announcements to make. You know, here at Thriving Dentist Show, we routinely, uh, do virtual events. Um, you know, we started doing these after COVID, and we’re continuing to do those because, uh, we know that virtual events are, are convenient. It’s a convenient way to learn new things, and it’s a convenient way to, to add to your, uh, management skillset. And so we’re constantly doing, uh, doing virtual events.

Gary Takacs: Oftentimes, we do panels where we bring in experts to talk about their area of expertise, and, uh, we have some very lively panel discussions. Well, if you’d like to keep on top of, uh, when our virtual events are coming up, uh, just go to thrivingdentist.com/events , and you’ll see the next virtual event that’s on the calendar.

Uh, I would encourage you to sign up for that. Uh, we do these events at no tuition. Uh, they’re done as a courtesy to you, and thanks for your listenership. So there’s no tuition. You do have to register for them. So, uh, if you wanna periodically just check in, uh, at thrivingdentist.com/events,  you’ll see, uh, the next one that, that’s coming up on the calendar. Um, I do some of those. Um, and, uh, we have team members that also do some of those and experts that participate in those. Come join us.

Gary Takacs: Uh, we’d love to add to your, uh, your management, business, behavioral success. Come join us.

Hey, the next announcement I have is, uh, we have a returning guest, my, um, co-podcast host, uh, Naren Arulrajah. And Naren’s got a great, uh, marketing tip for you today. Um, he’s gonna talk about, um, what to do if your conversion percent — that’s the number of new patients that call — what percent of those, uh, end up making an appointment. If your conversion percentage is low, what can you do to improve it? Well, Naren’s got some great tips here. No further ado, uh, here’s Naren Arulrajah talking to you about how to improve your call conversion percentage.

Naren Arulrajah: Welcome to Thriving Dentist Marketing Tip. This is Naren, your co-host. I am here to talk about a very important topic, that is, conversion rates.

So, the question I got is, I’m currently converting 40% of my new patient calls. How do I improve it to 80%? Great question.

So let me define what a conversion rate is. Conversion rate is the percentage of new patients who end up booking new patient appointments. Now, majority of practice owners — 85% plus — do not know what their conversion rate is. And usually what they do is they ask the front desk person, "How are we doing with regards to phone calls?" And the person says, "We are doing an excellent job." Because in the, in the, uh, in the years — or the mind — of the person answering the phone, of course every patient we didn’t book is a bad patient anyways.

So we are getting a hundred out of a hundred. It’s kind of like, you know, every answer that I did not attempt is a bad question to begin with. So that’s not the way for you to figure out your conversion rate. You need a, you know, um, technology-driven way to figure it out. We offer this as part of our service at no extra cost.

And it’s really, really important why — the average practice, according to ADA, is only booking one out of three new patients. And there’s a huge opportunity to really up your business without spending more marketing dollars by fixing this.

So get an AI-enabled solution to figure out, um, you know, what your conversion rate is. And what a couple of things we’ll do is we look at your missed call percentage — in other words, how many new patients are not booking. That’s also an important data point. Why? In the old days, patients would leave voicemails. Today, they don’t. So if you miss that call, you lose that opportunity for good.

Obviously, you need to get this data every single month, and you need to know what your conversion rate is. If your conversion rate is, you know, 70%, you’re getting an A. 80%, which is the target for this particular gentleman who sent in the question — excellent target. And it’s very possible.

So how do you fix it?

Step one: Get the data. Figure out your conversion rate and missed call percentage. Step two: Create a friendly environment where you coach your team members and provide a little bit of incentive. So we are trying to improve. If you’re converting 40%, don’t say, "I want to convert 80%." Set reasonable goals.

So, step two is setting reasonable goals. Perhaps the goal might be to improve the conversion rate by 5%, 7%, 10%. You know, first month I would start low, because you don’t know what their capability is. So set a low goal. And then of course, revise the goal on a monthly basis as you achieve that goal. If you’re not achieving it, you’re going backwards, then you need to reset it. So step two is all around goals.

Step three: Why are people not booking? Many of these patient calls — there’s a few big culprits.

One is the mindset of the person answering the phone. They see their job as, you know, just answering questions and getting information for insurance purposes, as opposed to, you know, they are the first impression officer. They have to create that impression — welcome the patient, make the patient feel confident that they called the right office, answer any doubts they might have in a very, you know, constructive way, and most importantly — get the appointment.

So once you get them into the mindset, then the next thing that could trip people up is, um, you know, not knowing how to handle questions like, "How much does it cost?" or "Do you take my insurance?"

So, training people on how to answer those questions well. And also, mindset plays a role in, you know, how typical untrained phone team responds. Like, they think anybody asking about cost is a bad patient. Again, you have to fix that mindset. Why? We all do this. We go to a car dealership, we don’t know anything about cost — isn’t that the first question we always ask? "How much does it cost?"

So after you’ve set the goals, understand why things go wrong — which is, you know, starting with the right mindset for the person answering the phone. And then these common issues.

And then train them. Right? Like, give them some components. Like, you have to welcome people. You have to, you know, share your name, ask for the name, take control of the call, ask for the appointment, uh, you know, master verbal skills on how to handle questions like, "Do you take my insurance?" or "How much does this cost?"

And then keep at it. Keep at it, keep at it. It’s a friendly environment. If the numbers are really low, you might want to do your training more frequently. If the numbers are decent, you don’t need as much training.

So if this is an issue for you and you want to get more insight, definitely book what I call a Marketing Strategy Meeting. We can talk about best practices and other ways for you to solve it.

Now, you might be turning around and saying, "Hey, you know what? My problem is not conversion rate. My problem is I’m not getting enough new patient calls." If that’s your wheelhouse — again, that’s what we do. We help practices dominate Google, dominate SEO, and therefore have an unfair advantage when it comes to attracting ideal new patients.

So if you are interested in that, you want to see — are you ranking for a hundred or more keywords? Again, book a marketing strategy meeting. We would love to help. The way to do that is ekwa.com/msm  — for Marketing Strategy Meeting. Book that meeting. We would love to help. See you on the other side.

Naren Arulrajah:Welcome back to the Thriving Dentist Coaching and Action Segment. This is Naren, your co-host. Hope you enjoyed that tip about conversion rates. Hey, if you have any questions about conversion rates or marketing, like I said, book that marketing strategy meeting: ekwa.com/msm. 

Gary’s also an expert when it comes to improving practices. So, hey, if you feel like your problem is not just conversion rate, but it’s more than that, I would recommend talking to Gary. The link is thrivingdentist.com/csm.

Gary Takacs: Remember, Naren, one of my favorite things to do in our coaching is that call training — is working with team members. Uh, and we do it in a, in a really, um, safe manner, uh, where we work with your team members to, uh, improve, uh, their call conversion percentage.

Uh, you know, it’s been my experience, uh, throughout my career, um, that most dental team members have not had any call training. Not at all. You know, they’re literally just thrown to the wolves — answer the phones. Um, they’ve never had any training. And we find that, um, a little bit of training can go a long way to, uh, not only improve your conversion rate, um, but to really create an awesome, uh, impression with your patients so they know they called the right office.

They’ll be more likely to show up for that appointment. They’ll be more likely to accept your recommendations when they come in, and they’ll already, uh, have some rapport and connection with your practice before they ever come in. So, uh, you know, that’s part of our work and our coaching, uh, that we do, for sure.

Naren Arulrajah: Absolutely. And today’s topic is gonna be an awesome topic. It’s The Dark Secret Dental Insurance Companies Don’t Want You to Know. It’s gonna be an interesting topic because I think Gary’s gonna spill the beans and share a few things that perhaps many of us are gonna hear for the first time. So I’m really, you know, uh, really intrigued, Gary, by this topic that we’re gonna cover today. Take it away. I am looking forward to it.

Gary Takacs: Naren, if we had about a three-hour, uh, podcast, I would title this The Dark Secrets Dental Insurance Companies Don’t Want You to Know, you know, ’cause it’s not a single one. It’s many secrets they don’t want you to know. However, we’ve gotta keep these podcasts tight, so, uh, I’m gonna share with you, uh, some thoughts, uh, around this whole topic.

First of all, let me, let me share three secrets that they don’t want you to know. And I imagine that I’ll have some heads nodding along with me as I share these.

One secret they don’t want you to know is their executive compensation — in other words, what the insurance company pays their CEO and their executive team. Uh, it is obscene the amount of money the dental insurance companies pay their executives. You know, just Google — uh, you can go to Google and you could, uh, Google: "What does the CEO of Delta Dental of California make?" And that information’s right there on Google.

So, number one — they don’t want you to know how much money they make. So they’re not taking that money and figuring out how to pay dentists more and help more patients get benefits. They’re using it to line their pockets.

Another secret that they don’t want you to know — second one — is, as I’m recording this, in 2025, fewer companies are purchasing dental insurance. Fewer companies. Why? Because of the inflationary climate that we’re in. It’s ever more expensive to run a business these days. And as a result of that, fewer companies are providing dental insurance benefits to their employees.

It hasn’t been — the way the benefits are provided — most patients don’t really appreciate those. And so they can spend their money on other forms of benefits. So less people are, uh, walking around with dental insurance.

Gary Takacs: These—I think that’s good news, by the way—but that’s another secret that they don’t want you to know.

A third one is, they don’t want you to know, doctor, that you are not their client. You are not their client. Now, you might be tempted to say, "Wait, wait, wait, I’m a provider. Aren’t I, aren’t I part of that?" Yeah, yeah, yeah. Part of that. But they don’t think of you as a client.

Who’s the client? The client is the employer that buys these plans. Who do they court? They court the employers that buy the plans.

Let me give you an example. You know, I’m in Scottsdale, Arizona. Delta Dental of Arizona has one of those executive booths at the Phoenix Suns—you know, the basketball team, the NBA basketball team—they have one of those executive suites, and they host guests in their suites.

I’m not aware of any dentists that have ever been invited to the suite that Delta Dental has at the Phoenix Suns game. Now, maybe there is, but I’m not aware of it.

Who do they invite? They invite executives of companies that they’re courting to buy Delta Dental insurance. So, you are not their client.

Mm-hmm. That’s a little bit of a wake-up call, isn’t it? I mean, it’s reality. But you’re not their client. I wish you were. They might treat you differently. If they looked at you as a client, they might treat you differently. Well, they don’t.

Well, all those are interesting. But it isn’t what I wanted to talk about today.

The dark secret dental insurance companies don’t want you to know is this: Well, if I was face-to-face with you, I’d ask you a question. And I would say, "Doctor, among patients that have dental insurance, what percent do you think used their annual benefit in the last year?"

Gary Takacs: What percent use their total annual benefit? And do you think that’s a high number or low number?

And, uh, I believe, uh, most dentists would say, “Oh, that’s gotta be a very low number. It’s gotta be in favor of the insurance company. Very few people actually use their annual benefit,” right?

Well, I recently discovered some research—some new research—that actually defined that with a specific percentage. And this research came from dental insurance company executives. Dental insurance company executives.

And here is the data: In the last year, only—wait for it, wait for it, wait for it—only 2.8% of people that have dental insurance used their annual max. 2.8%.

Now, let’s go ahead and round that up and call it 3%. Now, I knew it was going to be low, but I had absolutely no idea it would be 2.8%. I had no idea it would be that low. I was kind of thinking it’s probably in the low 20s, you know, maybe 22%, 23%, something like that. No—it’s 2.8%.

So think about that for just a minute. Think about how much money dental insurance companies make, you know, on benefits that go unused. They don’t carry over to the next year. Of course, we know that—they don’t carry over.

So that’s the dark secret dental insurance companies don’t want you to know.

By the way, that explains why they have no motivation to raise the annual limit when only 2.8% use the pathetic limits that they have. Now, you know, many insurance companies have an annual limit of, say, a thousand dollars—still. $1,200, $1,250, maybe $1,500 would be a very good dental insurance plan. Occasionally, there’s more than that.

But, uh, yeah, I’d say the average today is probably somewhere between $1,250 and $1,500 a year. But only 2.8% of people that have—3% of the people that have—dental insurance are using their annual benefits.

Alright, so how does this relate to you, and what do we do about it? Besides getting angry about it, what can we do?

Well, one of the things you can do is you can talk to people about their dental insurance, especially as we get past mid-year. You know, we can talk to people. If they have concerns—of course, we’re never gonna recommend anything just because it’s covered by their dental insurance. I believe that all of our listeners are ethical—we’re not gonna do something just because it’s covered by insurance.

But it’s kind of a shame when patients have needs and they leave those needs on the table, because the patient doesn’t really—you know, they don’t think about dental insurance 24/7/365.

Gary Takacs: They don’t think about it at all. Most patients know the benefits don’t carry over, but they conveniently forget that. So after we get to midyear, we can start talking to patients if they have a concern.

You know, “George, I’m concerned about those fillings on the upper left. Um, you know, it’s getting to the point where, um, uh, I’m afraid that if we wait too much longer, we might not be able to replace them with fillings. It might have to be replaced with something more complicated — you know, like root canals and crowns. Good for us, but not good for you.”

You know, “Our insurance coordinator says you may have some benefits this year. You might want to get that scheduled before the end of the year.”

So we can start talking to patients about this — talking to them about the fact that, hey, if you have any concerns, we might want to get it taken care of before the end of the year while you have these benefits.

Unused benefits do not carry over to the next year.

I like to say, “When the clock strikes midnight at Times Square and the ball drops, whatever benefits you have left go back to the fat cats at the insurance company.” That’s the language I like to use. I like the patient to think about the people running their dental insurance plans as the fat cats.

So that language — “When the crystal ball drops at Times Square at the stroke of midnight, whatever benefits you have — they do not carry over. They go back to the fat cats at the insurance company.”

So that’s one thing you could do.

This year, by the way, with our clients, we suggested a sequence of three different communications that you would send out. Three different communications — because not everyone is glued to their email, or glued to their mailbox, or glued to their text messages at all times.

Gary Takacs: I mean, how many times have you missed a message? Uh, often. I think all of us have experienced that.

So what we’re suggesting to our clients is we actually send, spaced apart, three different messages about the end-of-the-year insurance.

I recommend the first one goes out right after Labor Day. Right after—you know, Labor Day is the symbolic change of seasons. It’s not officially the change of seasons according to the Equinox—that doesn’t happen until September 21st—but, um, right after Labor Day, we send our first communication.

The first communication might be a letter. I call it the End-of-the-Year Insurance Letter. And we send that letter out to patients, reminding them if they have benefits, they may want to schedule before the end of the year. You can send that by email, and you could also send that by snail mail. There are some people that, you know, prefer communication by snail mail.

And then at the end of September, I recommend that you send a second message, and this one you send in text message form—quick text message.

And depending on the resources that you have in your practice for sending out text messages—like for example, we use Weave. And Weave has what they call campaigns. And campaigns are different messaging we can send our patients by text message. They have a number of different campaigns around the end-of-the-year insurance reminders.

So imagine an image that would go with your text message that says: Use it or lose it. And then there’s a quick text about, “Hey, just a reminder, you may want to schedule before the end of the year.”

And then we’ll send a third communication another two weeks later—maybe the middle of October—and it would be a different text message. And again, we’d send it by Weave, and we’d choose another one of their campaigns.

Whatever you’re using for your text messaging with patients likely has something like that that you can use. And of course, we send those to any patients that have insurance. Any patients that have insurance.

Now, you might be asking me, “Gary, I thought, you know, you’re all about going fee-for-service.”

You bet. And actually, that’s a little bit of a misstatement. I’m all about helping offices successfully reduce their insurance dependence. Reduce your insurance dependence. You don’t have to go all the way to fee-for-service to improve your practice. Every time you successfully resign from a PPO plan, you have improved your practice.

But if your goal is to go all the way to fee-for-service, I’m going to be your biggest cheerleader.

But you say, “Well Gary, I thought you were all about, you know, reducing this—how does that relate to this?”

Well, it relates very directly. Because whether you’re in-network or not, I want to help patients. You want to help your patients. Help your patients use whatever benefits they have.

So even if you’re completely fee-for-service, this is still a great message to send out before the end of the year. Because these people are sitting there with unused—go back to it—97% of the people with dental insurance are not going to use their benefits this year.

Now, we may not be able to change that societally, in the entire society, but you know what? We could change patients in your practice, right here.

Here’s something else that I’ve introduced to some clients. You know, many practices have a wide age range of patients.

Gary Takacs: And likely, if you’re a listener to The Thriving Dentist Show, you have some seniors in your practice. Um, you know, and think about those—I’m gonna call them "younger seniors." Now, I’m thinking like around 60 years old, you know, maybe silver-haired, no-haired—you know, they’re the younger senior, but they’re still working. They’re still working.

What about having a conversation with your seniors? And sometimes they tell you, you know, they might come in and, “What’s new, Doc?” You know, they’ll ask, “What’s new?” and you’ll ask, “What’s new with them?” and they’ll say, “Only three more years. Three more years, Doc.”

And what are they referring to here, Naren? When a senior says, “Only three…”

Naren Arulrajah: I mean, they’re referring to when they’re gonna retire. Of course.

Gary Takacs: Three more years. Especially for those that have jobs where they’re counting the time. Uh, you know, I hope they feel like they’re not doing hard time.

So “only three more years”—that we celebrate. “Oh, well, great.”

Well, one thing we could identify with our seniors—say, late 50s or 60—is, “You know, George, one thing we might want to do is, while you have dental insurance, we might want to get some records and see what we can do to get you as healthy as possible before you retire, while you have these benefits.”

You know, my clients have reported back to me, when they’ve had that conversation with patients, patients have universally said, “Oh my gosh, I never thought about that.”

You know, the truth is, most people, when they retire, don’t have dental insurance benefits. Most don’t. Which I think is great, by the way. We can offer our membership plan—our in-office membership plan—to those, which is a much better plan than any dental insurance plan.

Maybe that’s a topic for another podcast episode, Naren—the in-office membership plan, right?

But meanwhile, if they have benefits, you know—think—if they’ve got that $1,500 annual award, and they’ve got three more years while they’re employed, there’s $4,500 worth of benefits that we could use to help stay ahead of things with them and prevent future problems.

So another thing you can do is be proactive with your patients. I love helping patients utilize their benefits. And we’ve gotta do something about that 3% usage rate.

That is the dark secret the dental insurance companies don’t want you to know—that 2.8% of people that have dental insurance use it.

Do you think Delta is going to send an end-of-the-year insurance letter out, Naren? You think Delta’s gonna send that to your patients?

Naren Arulrajah: No, they’re not. That would be… no.

Gary Takacs: If anybody suggests that at an executive meeting at Delta, they’ll be fired. Because they don’t want them to use it.

Naren Arulrajah: Yeah.

Gary Takacs: Yeah. Well, this has been a fun conversation. Hope I’ve spurred some thinking about this, and hopefully you put some things into action.

By the way, you could also send a beginning-of-the-year insurance letter out: “Hey, new year, new benefits. You might want to plan ahead before it gets too much of a rush.”

You know, one of the reasons why we send those messages out starting right after Labor Day—we’re trying to spread the end-of-the-year rush out over four months: September, October, November, and December, instead of having all of it come crunching down the last two weeks of December.

You will still get patients that call you on December 30th and are trying to get in before the end of the year, but by then it’s gonna be too late. We’re trying to spread that out over four months.

So I want you to have a trimester of great months—September, October, and November, and December—and lend an assist to your patients at the same time.

Well, Naren, we’ve got some great questions. Let’s hit pause here, and we’ll switch over to the Thriving Dentist Q&A Segment.

Naren Arulrajah: Welcome back to the Thriving Dentist Q&A Segment. Gary, it was an interesting episode, nevertheless, and you gave us some awesome tips, so appreciate that.

Let’s jump into the Q&A segment. We have four questions for you.

Let me start with question number one: How can I determine if my practice is ready to resign from PPO plans?

Gary Takacs: Uh, what a great question. This is a question I get, uh, multiple times a day. Um, uh, both in email format, uh, and, uh, other communication format that I’m hearing from our listeners. So I’ve got three. There’s, there’s a number of factors. There’s actually many factors to consider, um, when you’re considering resigning from PPO plans, but there’s three that are primary, uh, factors to consider. And I’m gonna number ’em one through three. Um, but they’re not numbered in importance. They’re equally important.

Uh, number one is how relationship driven is your practice. Now, I know that that is a very subjective question. It’s, it’s not objective. I wish I could be objective, but if we draw a horizontal line, you know, on the horizon and the left side of the line, we have, you’re completely relationship driven. You’re like relationship driven to the max. And on the right-hand side of that spectrum, you’re very transactional.

You’re transactional. Where do you fall in that spectrum there? Let’s say there’s a midline in between. Where do you fall? Are you more towards relationship driven or are you more toward transactional? And it’s just an assessment, just assess it. The more relationship driven you are, the more ready you are to consider resigning from plans. Because it means you’re connected to your patients and they don’t want, you know, dentistry’s personal. Hopefully they know, like, and trust you.

If it’s transactional, do they know, like, and trust you? Probably not. But if it’s relational, they know, like, and trust you. They don’t wanna go somewhere else. So if you find yourself on the right-hand side of the spectrum where you’re more transactional, it doesn’t mean you can’t, can’t go out of network. It means we need to do some prep before we start resigning. We need to get over on the other side of the fence.

Okay? The second factor that I use. So let’s say you’re listening and you’re saying, well Gary, we’re not perfect. Um, but we’re definitely more relational. Then I’m gonna give you a green light on readiness. Okay? Let’s go to the second factor. Demand. What’s demand like in your schedule? And I’m gonna ask you a very specific question.

How far out are you booked to schedule a new patient today? And the new patient that I’m talking about scheduling is not an emergency. Nothing’s going on. Maybe it’s someone who just moved to your community. They met their neighbor, they asked their neighbor for a dentist recommendation. The neighbor highly recommended your office. Now they’re calling you to set up an appointment to get established in your office. How far out are you booked?

In the perfect world, by the way, I like a balance here. I like to be able to offer a new patient appointment within a week. Within a week. Uh, if the patient pushes back and says, well, I was thinking, you know, maybe three or four weeks from now, then go ahead and push ’em off. Fine. But I’d like to offer a new patient within a week because we’re rolling the red carpet out for them. We’re make—we’re available.

But in this case, the more demand—let’s say the way you answer that question is, uh, Gary, I’m, I’m sorry, we’re no, we’re not even close to that. We’re booked six weeks out to work in a new patient. If that’s the case, then that’s good news for going out of network. It’s bad news for operations in your practice, but it’s good news because now you have the demand in your schedule.

If you answer that question, how far out are you booked, and you say, Gary, we can work people in today, then I wanna build your demand before we go out of network. ‘Cause you’re gonna lose patients when you go out of network. But if you’ve got a jammed up schedule, you can afford to lose the ones—I’m not, you know, I don’t wanna lose patients, but you’re gonna lose some. You can afford to lose ’em. So look at your demand.

Uh, the third criteria that I use, and this is as important as the other two: do you have marketing in place to replace any patients you’re going to lose? And also to replace the historic flow of new patients that’s come from PPO plans. Like hypothetically, if you get 20 new patients a month from Delta—I’m just making it up—you know, if you got 20 new patients a month from Delta, um, let’s annualize that. The day you resign from Delta, that gets cut off because you’re no longer listed on their website. So that goes to zero.

So if there are 20 new patients a month, 20 times 12, 240 new patients, we’ve gotta replace through some other form of marketing. You know, one of the things I notice is most dental offices don’t spend much money on marketing ’cause they’re spending so much money on those adjustments. The insurance adjustment. I’d like you to think of those insurance adjustments as a marketing expense.

I did this in a, in a call yesterday with a new client, and we determined together that his office is spending just a hair under a million dollars in insurance adjustments every year. Naren, just a little bit over a million dollars. And I said, I want you to think of that as a marketing expense. And his eyes lit up in this Zoom call. He says, oh my gosh, I could spend a tiny fraction of that and get a much better result.

Well, those are the three factors. There are others, of course, but those are the three factors that I think are most important. You know, as we review those: how relationship driven is your practice—number one. Number two, what’s demand look like in your schedule? Is it favorable or not? And then number three, do you have marketing in place proactively? Are you leading—not lagging? Are you leading with marketing so we don’t get behind the eight ball? We already have the marketing in place. Great question.

Naren Arulrajah: Thank you, Gary. Appreciate it. Question number two, what are some things I can do in my practice to better connect with our patients?

Gary Takacs: Ah, that’s, that’s a response to that being relationship driven. Well, I think it, it starts at the top, doctor. It starts with you. Um, but we have to create a mindset in your practice with your team members that one of their primary goals is to connect with each and every patient every day—each and every patient every day.

Um, otherwise, you know, we’re just, uh, uh, patients are numbers. You know, in, in the worst DSOs—I could name them, but I’ll let you fill in whatever blank you like—in the worst DSOs, they’re entirely transactional. Uh, and they don’t know their patients. It’s just sit down, shut up, and hang on. Um, you’ve gotta be the opposite of that. But I think it starts at the top. And, and doctor, I think you can model this.

Let me give you the best thing you could do to begin to become more relational in your practice. Find your own method of coming up with an easy way for you and your team members to log personal information about each one of your patients. What am I talking about? Spouses’ names, kids’ names, dogs’ names, hobbies, interests. Um, maybe where they went to college. Maybe we know that one of your patients is taking care of an elderly mother.

Right there. Back in the day before digitization, we used to have note cards. We’d have, you know, uh, five by eight note cards, and they’d be in a Rolodex file. Um, today you have that information. It’s in your digital records, but it’s so buried that you don’t have quick access to it. You need to find a quick way to access that.

And every morning, I want you, doctor, to come in 10 minutes early before your morning huddle. Now I know I lost a few listeners right there. And Naren, I want you to come in 10 minutes early. And I want you to pull up that digital note card, and I want you to scan it really quick in your head. And if I was one of your patients, you’re gonna scan that note card, and you come in to do my hygiene check:

Gary, it’s so good to see you. How’s your wife, Therese? Hey, how’s her yoga studio going? You know, I’ve been to some of her classes. I need to get back there. Her yoga helps me, uh, keep my back and neck health. Um, and I have to ask you about your grandson, Canan.

All that’s on the note card. You don’t have to know all your patients at all times. You just need to know the ones you’re seeing today. Come up with a way to do that. Have your team involved. As team members learn things, they put that information in the note card. That won’t cost you anything and yet will produce a massive result in becoming more relational in your practice.

Naren Arulrajah: Thank you, Gary. Let me go to the next question. I have heard you talk about doing marketing before I resign from PPO plans. With a limited marketing budget, what marketing would be most effective?

Gary Takacs: Naren, I’m gonna flip that to you as our marketing expert, but I wanna amplify something first. Most offices, most dental offices that are, um, heavily involved with PPOs don’t have much of a marketing budget because they’re—they’re—they’re paying the fat cat at Delta. That’s why they don’t have it. So I think this question’s very good: what can they do with limited funds?

Naren Arulrajah: That’s a great question, Gary. And I think, um, I wanna start by talking about something you always say: every single practice is paying for marketing, especially the ones who are on a PPO plan. They’re spending 30, $40,000 on marketing because a—

Gary Takacs: A month. A month.

Naren Arulrajah: A month, exactly. And can you explain that, Gary? Why do you say that every practice is spending $30,000–$40,000 a month on marketing?

Gary Takacs: Look at your adjustments. The insurance adjustments. Insurance adjustments are the difference between your UCR fee and your contracted fee. That’s an adjustment. So for example, let’s say your UCR fee for a service is a thousand dollars. A patient doesn’t have insurance—patient pays a thousand dollars. I’m picking a round number there so it makes sense. It’s easy to do, right?

And let’s say that particular PPO plan has a 45% discount. You don’t get a thousand dollars for that service. You now get $550 if it’s a PPO patient. And so you paid $450—I’m using air quotes for “paid”—you didn’t actually write the check to Delta. It was worse. They took the money out before you got it. So it’s those adjustments.

If you enter your UCR fees into your practice management system, you can run an insurance adjustment report. But you better be sitting down before you run that because you’ll learn how much you’re writing off. However, 90% of dentists enter their contracted fees. It’s easier to track your collections that way. Dentrix, Eaglesoft, Open Dental, Curve all recommend that you enter your contracted fees.

And I don’t necessarily disagree with that. The only problem with it is you never know what you’re writing off, ’cause it’s invisible now. And now you’re driving an exotic sports car—the exotic sports car is your practice—with a set of blindfolds. That’s what I want you to get your arms around, because you may not realize it, but you’re likely spending—depends on the size of your practice.

This practice that I said had insurance adjustments of a million in real dollars of real fees, they produced $2.2 million, but they only collected $1.2 million because of the insurance adjustments. It wasn’t a collections problem. It’s an adjustment problem.

So what would you recommend they do if they have a limited budget? Naren, how are you gonna direct ’em?

Naren Arulrajah: Thank you, Gary. Yes. So we have established every practice is doing marketing, and the worst ones are spending $30,000 a month on marketing. They’re called the PPO practices. And the lowest way to get patients—the highest quality patients at the lowest cost—is search engine optimization.

For example, our clients spend $1,250 a month, which is a fraction of the $30,000 the ones who are on PPO plans are spending in the form of invisible marketing, right? The difference between their regular fees and their UCR fees. So the lowest cost way to attract new patients is SEO.

Gary Takacs: And you’re talking about organic? Explain the difference between organic and paid.

Naren Arulrajah: Absolutely. So organic is—you know, I type in a search or I type in anything I want into Google. People use Google now 12 billion times a day. And when I type what I want into Google, I get an answer. And I get two types of answers: some are ads, and some are the results that Google shows without the word “sponsored link” or “ad” next to it, right? So I know that’s the organic or the natural or the correct answer if I’m a consumer.

So SEO is about getting listed for hundreds of different phrases or keywords without you having to pay money. Paid ads is the same keywords and phrases, but you’re paying Google to show your ads, and every time somebody clicks on it, you pay Google $5, $10, and so forth.

Gary Takacs: It’s literally pay-to-play.

Naren Arulrajah: Exactly. And the reason pay-to-play is at least five—many times ten—times more expensive is people don’t trust paid ads, right? They know only people who are inferior—who are low quality—subconsciously speaking, have to spend money on ads. Because if they’re good, why do they need to advertise?

You are a doctor. If you’re a good doctor, people will come to you, right? That’s our subconscious feeling as a consumer. So the minute you start running ads, your conversion rate drops. The way your phone—phone conversion rate, the number of people who call you—all those numbers start dropping.

So SEO is the lowest cost way to get new patients. Of course, you can also do social media ads, which is as expensive if not more expensive than Google ads. So I would recommend SEO.

Now, SEO is not easy. I’ll tell you what the catch is. The good news is, unlike organic social media where you become a celebrity, with SEO, somebody else can do it for you. Organic social media—nobody can do it for you. You have to spend the time becoming a celebrity—what they call influencer—on social media platforms.

SEO can be delegated. That’s the good news. But just like organic social media, organic Google or SEO takes time. So it takes a year before you rank for a hundred or more keywords and get, uh, you know, approximately 20 new patient calls a month.

The good news is those new patients are gonna cost you $50–$60 a new patient, versus a PPO patient might cost you $1,000 a new patient. Why? As long as the patient is coming to you—even for $4,000–$5,000 every year—you are kind of paying a ransom or a tax to the PPO company in the form of an adjustment.

So would you rather spend thousands of dollars per patient or would you rather spend $60? Now, like anything else, you are the owner. You have to be responsible. So you need to know if things are working for you or not. So you need to set up tracking numbers. You need to track all these results and then compare apples to apples—how much are you spending for each method, how many new patients are you getting?

So that’s my 2 cents, Gary. But if anyone is interested, they could book a marketing strategy meeting. We can do a comprehensive review on how they’re doing marketing, what are they doing right, what are they not doing right, give them a report card and, more importantly, like a plan on how they can start dominating Google—how they can get the lowest cost, highest quality patients. The link is ekwa.com/msm. 

Gary Takacs: Great, great, great answer, You know, the, um, uh, organic SEO is the solution. Imagine spending $15,000 a year, you know, instead of the million that I gave you as an example. That’s where I’d like all of you to be.

All right,Naren, we’ve got one more.

Naren Arulrajah: Thank you, Gary. Question number four: what is the best way to inform my patients that I’m going out of network?

Gary Takacs: Well, I’ll start by telling you the worst way—wait for it. The worst way is just send ’em a letter.

Naren Arulrajah: Right?

Gary Takacs: Don’t do that. Yes, we’re gonna send ’em a letter. We’re not gonna lead with the letter. The problem with the letter is, regardless of how you send it—you can send it by email letter, you can send it by snail mail—not everyone’s gonna get it. Some people are gonna read it and not understand a single word. They can’t. They can’t. It’s a one-way street. They can’t communicate with you.

They’ll—if you send a letter—your phones will blow up. If you want your phones to blow up, send ’em a letter. The best thing to do is to talk to as many patients as possible face-to-face over a period of time. Talk to your patients. It could be you, doctor. It could be your hygienist. It could be your assistant. It could be your insurance coordinator.

But we wanna talk to people about this. We wanna give ’em a heads up. Let ’em know what’s coming. And more importantly, we wanna tell ’em: how does this affect you? And we wanna let them know that even once we’re no longer contracted with your insurance company, you can still choose our office for your care. You can use those benefits. You can still use those benefits right here in our practice.

Number three, we’re gonna file your claims for you like we always have—just wanna make it easy for you. And number four, we’re on your side. And now I’m gonna tell ’em what I want ’em to do:

Naren, nothing’s changing today, but you know, sometime—and maybe we have a date, you know, effective this date—we’ll no longer be contracted with your plan. But after that date, it would be our fondest hope that you appreciate the quality of care we provide, and you appreciate how we all work hard to make every visit a positive experience for you, that you continue to come right here for your dental care.

So there you go. Talk to as many people as possible. We call that the heads-up conversation. The actual conversation is a little longer than that, but I’m giving you the highlights here for the benefit of time in this podcast.

Well, now this has been a fun episode. The dark secret the dental insurance companies don’t want you to know is that only 2.8% of all people that have dental insurance will use their annual benefits this year. Let’s go on a campaign to change that.

And for those of you that are curious about maybe wanting to start the process of reducing insurance dependence, please know I’d l ove the opportunity for myself and my team to work with you on that. If you’d like to learn more about that, schedule a coaching strategy meeting with me. Go to thrivingdentist.com/csm.

It’s one of my passions. It’s part of developing your ideal practice. Of course, love the opportunity. That meeting would be with me. I’d talk to you, I’d learn about your practice, share a little bit of our coaching, and see if it’s a good fit.

On that note, thank you all for the privilege of your time. Naren and I look forward to connecting with you on the next Thriving Dentist Show.