#905: All About Fees: Increases, Negotiations, and More

Dental A Team Podcast

Tiff and Britt discuss what the end of 2024 should ideally look like as far as fee schedule analyses and negotiations. They touch on comparisons within your area, the right percentile to aim for, when to send out negotiation letters and requests, and more.

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Transcript:

The Dental A Team (00:01.871)

Hello, Dental A Team We are back at you again. I have Britt back with me today. We have some fun stuff to talk about and I'm excited for it. Britt think you are fantastic. You're a fantastic brain and I love picking your brain. So thank you for allowing me to do that. And we talked a lot of clinical recently and now I'm like switching your brain because I want to talk business side.

Britt (00:02.536)

you

The Dental A Team (00:29.684)

great at everything, but those two are like your powerhouse specialties. Always hygiene because you're hygienist by trade and by heart. But the business piece comes still naturally to you too. So I'm excited for today's topic. But what is something I'm totally making this up you guys so it's nervous now.

Britt (00:48.887)

I'll say one while you think about it. I'm like, Tiff is very generous. Tiff has a brain too. That's why we're nerdy consultants guys. Like these are the things we talk about with each other all the time.

The Dental A Team (00:59.801)

That's so true. That's so true. Thank you. That was very true. We're like, guess what happened? Did you know? What is something that you're excited for, for yourself or Dental A Team, like in the professional world we'll say, for this quarter? What's something you're excited for?

Britt (01:03.189)

you

huh.

Britt (01:24.503)

excited. I'll tell you what, I love our group that we have going.

One, we've got quite a few people that are hitting their best months ever. So that's super fun. And I'm just excited for that group over there and all the things they're going to accomplish over this next quarter. Because it's just fun. It's a fun, like I get to interact with them every single week. And it's just such a good time for me that I'm excited for them to end their year super strong over there.

The Dental A Team (01:54.958)

I agree. I agree. I think the doctor community in general that we've been able to create this year and the momentum that they've got going on over there has been so incredible. We've got the two different communities. For those of you who are with our, I'm going to say practice with our company on the group coaching level with Britt that you guys are thinking that you're speaking of now, it's freaking exploding over there. And those doctors are seeing some massive improvements and it's just so cool to see them.

talking to because I think that's something just in nature that we need naturally as human beings is we need that like family space and they say it takes a village, right? They tell you it takes a village to raise a kid. It takes a village to do anything. We are meant to be in groups and not siloed. And in dentistry, it's so easy to silo ourselves. And I agree. I agree. I think that is a space of excitement this year.

I love it. I wanted to see what you would say. I'm excited for that as well. And I'm excited to see what's on the horizon for 2025 for the Dental A Team and excited to see who's going to come on that journey with us. And hopefully all of you guys are coming on that podcasting journey with us. You can anticipate that this podcast will forevermore be here as far as we can see. We love delivering this content to you guys. We love being able to reach you in this way.

And we hope that you have found benefits in it, that you share it, that you tell your friends, because we know, again, it takes a village. we love hearing stories of sharing. We love hearing stories of this podcast. Help me so much. I sent it to my friend. And just to remember you guys, like our mission is to get as much information out into the dental world as we possibly can and reach as many of you as we can. And it takes you to help us with that. So share these as they become.

your favorites and so helpful in your lives and then share with us too anything that you feel like we could do more of anything any topics or things that you want more of we do pre -schedule these and that is on my to -do list so if you've got ideas I'm here for them.

Britt (04:04.267)

you know who to tell you say, Tiff, we want more of this. And she will, with consultants, help us pick out some awesome topics.

The Dental A Team (04:07.649)

Yes.

The Dental A Team (04:11.694)

Yes, yes, it's one of my favorite things to do. So I'm super excited. Today, I really want to talk about rounding out the end of the year and what that could look like as far as fee analysis, fee schedule analysis, negotiations, all of those pieces, we're getting asked to kind of those questions right now. And I think it's a really great topic to just spread the information on. And if you're waiting longer than like October, November timeframe to get started on this, kudos to you hats off, it's going to be

going to be a busy road. But October, November timeframe is really when I start pushing clients to start looking at these pieces so that next year we can set you up for a win when it comes to your fees, when it comes to your goals, when it comes to what we're able to accomplish, making sure that we're super set up right away to get into a good group. So these schedule analysis and negotiation.

Britt, I know you do a ton of this and you work with practices all across the nation that are doing this and in your group calls right now, a lot of this is coming up. So what do you feel like is the number one space to start with when it comes to fee schedule analysis and negotiation? Now, I think a lot of practices arbitrarily are like, I want to negotiate fees and like, how do I do that? And like, there's so many parts and pieces you could start anywhere, but where do you have your practices start?

from the get go to get on the path of getting this done.

Britt (05:36.395)

Yeah, this is a question that actually like it just came up this. Because we have a new client that just like finally closed on a practice and so they're getting into the practice. And so it's like, all right, well, we need to look at things and it's a little older practice. They're going to be transitioning a lot of stuff to upgrade and update it. And fees will be one of those things that they need to look at. And I think the first thing is knowing how your fees compare to like fees in the area.

So kind of where do we land? Are we low? Are we like in the higher? Are we right in the middle and starting to see where we're at right now compared to our area? Cause everywhere is going to be a little bit different. so that's the first thing that I would start with, cause that's going to help you to know how much do we need? Like, are we behind? Do we need to start increasing and maybe a little bit more, you know, a higher of a percentage than someone else who's already in like the 90, 90 plus percentile?

So that would be my first step for you.

The Dental A Team (06:36.475)

I totally agree. Now you mentioned percentile. On the majority, what do you recommend that they should be at? Because I know it kind of differs. It's kind of all over the place. But if you were to give like a flat rate percentage for majority of the procedures, what should that percentile look like?

Britt (06:52.663)

Yeah, and I want practices to be up at like, I want us to be practices that are providing right really high quality, which all our clients do right. And so I really do want them to be in that like, top 25 % is usually my marker somewhere in that top 25, if not 80 % or higher. And just so that we're staying on top of it. And we know entrance always lags. And so I'm like,

Let's not be crazy high, but let's be at the top and let's keep pushing things forward as far as insurance reimbursements go as well. Because that's another thing, if we don't ever look at our fees and our fees stay low, guess what? Insurance companies go off of that and they say, hey, out of all our doctors, we're paying pretty well if we never increase our fees. So we want to make sure that we stay competitive and that we keep driving things in the right direction while still being fair to our patients.

The Dental A Team (07:44.308)

Yeah, I love that. I agree. think something that we forget in dentistry is that we are not the only dental practice. Number one, not that we forget that because there's one on every corner, but the fact that what you're putting out there, what you're sending to the insurance company is impacting dentistry as a whole. So as people don't increase their fees and they don't change them and they stay okay with a $600 reimbursement or a $600 fee for a crown with a

$250 reimbursement as they stay okay with that over the years, it makes it more difficult for anyone to get the increases. And then all of a sudden this doctor that's been getting $600 for a crown is like, what the heck? Why am I upside down? And why do they pay so little? And I'm like, well, you said it's okay. You didn't change your fees. You've universally said this is what I'm worth for my crown. So I think that's a great reminder.

And on that just making sure too that in the back of the system, there's always a little button that says your UCR fees go to your insurance companies. I don't need to go on the ledger always because that's a write off and it's like extra work and that's human error availability. So while I'm not saying to put it always on the ledger that way, you can ensure that your UCR fees are going to insurances just so that it's in their system. They're constantly seeing it. They're constantly seeing that $400 write off.

for the crown or whatever that might be. So I do love that. So getting a fee analysis, well, looking at your fees, number one, then you said, be in that percentile, get those comparisons. Now that comparison needs to be done yearly. And I know a couple of practices that are like, I did it like two years ago, three years ago, I'm fine. If you're not doing it every year, you have that space to fall backwards. And I don't know about you, but I have never seen a space where

inflation falls backwards or doesn't happen. So if we're not looking at our fees, inflation is still happening. So two, three years, you've had two, three years of inflation stacking on you that you haven't looked at your fees and changed them, increase them or negotiated. getting that fee schedule comparison of your local area practices near you is going to be really, really important. You can hire companies that do it for you.

The Dental A Team (10:04.31)

But I also know a lot of Patterson and Henry Schein reps, those people that are, you know, you're ordering your supplies from, they can usually grab one of those pretty quickly and pretty easily for you. So check with those reps as well. And I would surely get your this year's analysis in preparation for 2025. So once you have that analysis, you see where you're at, you're like, gosh, okay, my UCR, my usual and customary rates can increase here, here and here, we kind of

I don't know, I go through them. And when I was an office manager, I'd sit down with my doctor and we'd go through them almost procedure by procedure to look for it. You're looking for like reds, right? I'm looking for like, this is really out of line. Sometimes I'm changing my wings by $2 or an exam by $3. Sometimes it's only a dollar to get in line, but doing it procedure by procedure really is helpful. So you've got that fee schedule analysis, you're updating it, you're going through it. And then what? What's

what's next? You're like, cool, I know what I need to do. Now how do I get other people to believe me that this is what I'm worth and get these insurance companies paying more?

Britt (11:10.261)

Yeah, and I want to make one quick plug. You mentioned on making sure we're clicking the little button that our fees are going out to insurance companies. Guys, that's like a strong recommendation. It's almost like I have to because what happens if we're not is fees can change and insurance might be paying more. But if you're not submitting your office fee and you're submitting what you thought their fee was, they're going to keep paying the lower fee.

The Dental A Team (11:23.029)

Cheers.

Britt (11:37.471)

And also a plug for just like evaluating. I know I've seen some practices where I know that that insurance actually pays a higher fee for the service than you're charging as your office fee. And it's a like generally insurance covered procedure. So you're missing out on so much because you're keeping that fee so low. So just a couple of plugs for like the reason why you do it. Those are some of the reasons as it's completely fair. And I know some doctors, right, get afraid of, you know,

Well, I don't want to increase it. Or some that have a lot of cash paying patients, which is totally understandable. And that can be a factor in deciding how quickly you start to increase things. But when you start to get it on a track of consistently evaluating where your fees are and every year making some sort of increase, and even if it's on your financial policies that you have a line in there that's like, know, fees are like,

may change over time and if you're doing a big increase, I don't like to cause alarm where alarm is not due. So it can be, hey, you know, on all our treatment plans, make sure we've got a disclaimer if it's good for 30 days, whatever it may be for fees. So when we update them, we honor whatever it is we plan to honor. And then we have a line in there that also says that fees can change, you know, or fees may change. So it's only guaranteed for a certain amount of time.

The Dental A Team (12:43.104)

Thank you.

Britt (13:03.147)

And that guarantee is not what insurance is gonna pay. That guarantee is just what our fees are that we're charging out. So as long as we have some of those things in place ahead of time, then when we go and increase them, guess what? You go and increase them. And when patients have questions, then you can let them know just like everybody else out there in every other business, right? Our fees will increase over time. We all know, we've all lived in the past.

couple of years and seeing what's happened with inflation so it shouldn't be a surprise that just like every other industry out there that the dental practice is going to increase their fees over time as well.

The Dental A Team (13:41.662)

I completely agree. I completely agree. think you said something really important there of like, making sure that you're honoring what you said and making sure that you're saying everything you need to. And I know, even when I was treatment coordinating and treatment planning patients at the end of the year, that was part of my spiel. Like that was part of what I would say is, I don't know what your insurance is going to decide to do next year. And they may decide not to cover this at all. They may increase the rate so it increases your out of pocket.

And even if you're out of out of benefits now, like it's never going to be less than it is today. The rates are never going to go down. So at the end of the year, it's definitely something that we can utilize in conversation, but always having those, those caveats of this is good for 30 days or 60 days or 45, whatever it is that your practice has decided. And then honoring those as you move forward, as those changes happen. I know that's a scarcity mindset for a lot of people.

not just doctors, but even the billing coordinators or the office managers who have to make those changes of like, what are my patients gonna say? What are my patients gonna think? And when we really add it up on a re -care appointment, it typically is less than $10 increase when you go through everything line item by line item. And to me, that's a Starbucks drink. And so it's like, can you allocate a Starbucks drink for me every six months?

to make sure that you're getting the services that you deserve in the amount of time you deserve. Because what happens if we don't increase our fees, we don't change how we're doing things and how we're being reimbursed, we have to do more in less time. So if we don't ever increase our fees, now we're like, shoot, it's not paying for itself. My hygienist now has to do 40 minute appointments or 50 minute appointments instead of 60 so that we can add another patient every day.

to get the reimbursement that we need. Or we stay up with the times we figure out what our fees should be. We ask for the increases from insurance companies and we get paid what we should, you guys. That is, I am so strong on that. That is like not even a soft suggestion. That is a strong must. Get paid what you deserve to be paid. And your fees will reflect that. It'll reflect where you're at. If you feel like a $600 crown is what you deserve,

The Dental A Team (16:07.226)

then do a $600 crown. I don't I have no qualms about what you decide. Your crown is valued out or whatever procedure it is. I'm just begging you to ensure that you're always staying up to date because the things you want to do with your practice, the things you want to do for your team depend on the money that's coming in that depends on your revenue. And your happiness and your life depends on the revenue of the

practice and these are easy ways to ensure that you're constantly growing and creating a space that you actually want to live in. So I will always advocate for that and I will always be the push potentially that you guys need and I think Brit is in alignment with that. So once you have those fees, once you've come to terms with it and you guys, if you need help with verbiage by the way, and this one little podcast didn't do it for you, reach out to us. Hello @ The Dental A Team .com.

Instagram, we're on Instagram all the time. We have our Facebook, we have our Facebook groups, we've got our doctor communities, like reach out to us wherever level you need to and we will help you with all of that. We love that stuff. Burbage is my jam. Communication is my jam. Once you've got those fees in alignment, you need to send out negotiation letters. You need to send out the request to the insurance companies. It's gonna be a very rare occasion. I've personally never seen it. An insurance company is like, hey, guess what? Merry Christmas.

I'm upping your fees next year, congratulations. Sometimes you might get, I would get EOBs that I'm like, we got paid a dollar extra on this exam. Apparently our fee changed. Sometimes they will just gift it to you, but it's never going to be anything extravagant and it's never going to be anything that's going to get you to the percentile that you're actually looking for if you're not asking for it. So those negotiation letters and those requests, Britt, when do you suggest they start sending those and what's that process look like that?

that you've worked with clients and kind of worked through that with them.

Britt (18:03.509)

Yeah, so with that...

like starting to evaluate your fees now, right? And start sending those things. like end of year, third, fourth quarter is a good time to go ahead and do it. So then you can start implementing those things in January, right? So that would be the nice thing. It's nice when you have a set time that you usually do it. Because also when you increase those fees, right? Treatment plans, if we have a 30, 60 day guarantee, whatever it may be, then, you know, those patients come back, even if it's already signed, we, it's

It's very easy for us to know when we need to update treatment plans just systematically for the team. And then it comes down to sending a letter. So usually it's a letter, but you can always contact your insurance company and say, hey, right?

What do I need to do in order to go ahead and submit for an increase in fees and they can inform you of what that process is. There's also companies out there that help to do it for you if you want to go that route as well. So it depends on, you know, either on your own, find out what the process is with the insurance company, the correct apartment to contact.

what form it needs to go in and then also reach out to a company if you kind of want to see what their process is and what that would look like. I'll have some tips and tricks. I'll just caution. Sometimes they'll talk about going in an umbrella plan to get some better fees. There's pros and cons to it. That might be a thing for another time, but just know there's pros and cons and understand what that would mean for the office because it's a little bit more administrative effort being under an umbrella plan and making sure

Britt (19:34.463)

plans and network with us than just being directly contracted with an insurance company.

The Dental A Team (19:39.515)

Totally. That was a really good caveat to mention. I think of fee negotiations the same as I think of signing up with insurances, Like credentialing with insurances, decredentialing, negotiating fees. It's all a very similar process. And in that process, it takes a lot of follow -up. So making sure

Whenever you start, usually say just like Britt said, fourth quarter, like October, November timeframe, I really want to be through the thick of that by the time next year comes so that I get that renewal right away. And it's not lingering into February, March or April, but now I'm making changes on things. I really like it to be clean at the beginning of the year. So October, November timeframe and those follow ups are, are crucial. That's where I think these companies come in really handy.

Especially at the end of the year, we're really busy. So we don't have a dedicated someone that can add that to their schedule. That's where I would lean on that or I don't know, virtual assistants, things like that too, that can do that kind of follow up for you to ensure that these letters are being received. They're being put into action just the same as a claim you guys. It's all the same insurance is the same no matter what you're sending them, whatever the piece of paper is that you're sending them electronically or on paper, it's all processing about the same. So it's gonna get

received and they're like, that's cool. And then they're to be like, let's see if they really care. Do they really want this thing to happen? Do they really want this provider credential? Do they really want to get paid more? And they're going to like let it sit there. So a lot of follow up that goes into that, but make sure you get it done. Timeline is now. If you need help with that, if you need ideas, if you're looking for a company that might help.

Reach out. We've got a couple of different people that we recommend and that we work very closely with that we've loved over the years. Hello @ The Dental A Team .com. Or if you need a quick like checklist, we've also got all of those always available. So just let us know. Now, action items because we never leave without action items, whether it's a coaching call, an event, or a podcast, you will always have some sort of action items coming to you. So Britt, help me round this out. We need fee schedule comparison.

Britt (21:38.828)

you

Britt (21:50.091)

Yep, so make sure you do analysis with your area, right? So evaluate your fees. Yep.

The Dental A Team (21:50.167)

I'm from a company in Europe.

The Dental A Team (21:55.166)

Yep. Then we're gonna percentile it, we're gonna get in that higher percentile. So I think for me, I would say get the fee schedule analysis, evaluate, do your UCR, and do your negotiations kind of simultaneously. I give a deadline, Britt, do you do you agree with my deadline of having your fees, your UCR, usual and customary rates updated by January 15, no matter what next year, have somebody dedicated to it. So somebody is pulling and asking for fee schedule analysis now.

You're comparing that fee schedule analysis to your current fees. You're sending out negotiation letters to your insurances you're contracted with and you're getting your rates increased by January 15th, no matter what, do or die. Yeah.

Britt (22:38.389)

Yep, and I want to add to this just in case you've got some people where you haven't done this before, increasing your fees is not dependent on your insurance fee negotiations. like implement though, that can move forward. Like that piece, whatever you decide on your increases, that can go into play for your office fees. While even if it's not by January 15th, we're still working on getting those negotiations done.

The Dental A Team (23:02.467)

Good call. Good call. Thanks for seeing through that. All right, you guys, you've got your actions, you've got your tips, your tricks, if you need more, if you need clarifications, whatever it may be, I'm telling you, I say this every time we are honestly here for you. So reach out. Hello @ The Dental A Team .com drop us a review down low five stars are always appreciated. And we like to know that this was very helpful for you. Give us a share.

Britt (23:05.601)

You

The Dental A Team (23:24.049)

and give us a download, whatever that looks like so that you can make sure that your other friends in the dental community know to get this done as well. So we're here for you. We love you all. Thank you, Britt, for being here with me today and for helping me through that analysis situation. You're fantastic. All right, everyone. Of course, I will always have you. All right, everyone. Have a great rest of your day. I hope you go listen to other podcasts on here. We do have other ones that...

Britt (23:39.339)

Thanks for having

The Dental A Team (23:49.468)

relate back to this and back to some of the stories I talked about today. So enjoy your day. We will catch you next time.