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Episode : #766: Successful  End-of-Year Benefits Tips!

Podcast Description

Kiera is joined by Billing Extraordinaire Sarah O’Brien to talk about hot ticket end-of-year benefits! They discuss ways to get patients to use their benefits, being strategic with scheduling so things don’t become overwhelming, how to address those who’ve used up their benefits, and a whole lot more.

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Episode resources:

Connect with Sarah: [email protected] or 602-318-9396

Learn more about Evolution Dental Billing

Listen to episode 648, Billing in 2023: New and Exciting Updates

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Kiera Dent (00:00.694)

Hello, Dental A Team listeners. This is Kira and oh, I’m so excited. This is a dear friend on the podcast. We have known each other for years. I actually, I think we got connected through a mutual friend, which I don’t even remember the mutual friend, but I’m super excited to bring back my one and only, my billing guru. She’s my girl. I have had her on the podcast many times. She works with lots of our offices. Sarah O’Brien with Evolution Billing. Sarah, how are you?


Sarah O’Brien (00:26.4)

Hey, Kira, I’m doing great. How are you?


Kiera Dent (00:29.138)

Good. Do you remember our mutual friend? Because I don’t and like I hope they’re not listening. I feel like it was Paige, but I maybe I’m lying.


Sarah O’Brien (00:32.43)



Sarah O’Brien (00:36.737)

No, it was Jennifer Jones, and she was a hygienist at a period office in, I think, like Gilbert, Arizona, that either Tiffany was consulting for, or somehow they knew each other, and then magic happened, and now we know each other.


Kiera Dent (00:48.833)



Kiera Dent (00:54.174)

This makes me feel a lot better because I’m like, I usually remember people real well. And I’m like, I don’t know who introduced me to you. I just know I met you. I’m like, this girl’s great. Can you help me write content? And so if you guys are a part of the virtual academy, fun fact, Sarah helped write a lot of those. So huge massive kudos to her. I like that’s where it started. And then she decided to start her own billing company. And she probably can always tell when I’m in office because I texted her and like, Hey, Sarah, I’ve got a question all the time.


Sarah O’Brien (01:23.774)

Such great questions though.


Kiera Dent (01:26.467)

It’s my phone a friend all the time and I am thankful because I believe billing is a sham and a scam and Sarah’s probably gonna disagree with me but if you can have a good biller on your side that knows what they’re doing can help you guide through it, it’s not that bad. But Sarah, like why do you even like billing? We have this conversation every time I podcast with you and I’m still trying to know.


Sarah O’Brien (01:46.337)

It’s the utter complete and anal control I can have over it. Because there are rules that must be followed and I know those rules and I know how to follow them and I also know when they’ll be broken. And I kind of know how the insurance companies manipulate them to their benefits. So that’s what I really like about it. To me, it’s a game. It’s getting those benefits for the patients.


Kiera Dent (01:53.453)



Kiera Dent (02:02.484)



Sarah O’Brien (02:12.621)

because they deserve them, they pay for them, why can’t they have them? So it’s all about getting the insurance to pay and making sure that we’re doing it right.


Kiera Dent (02:15.895)



Kiera Dent (02:21.606)

So it’s a game. I find it like pure torture, but I’m glad you think of it as a game. Everyone has their own flavor in life and that’s why Sarah and I are great friends. I’ll sit here, I’ll podcast, I’ll go console, I’ll go talk to people and Sarah will bill. And I’m so thankful for her being a biller. But we actually wanna get on the podcast. I pushed Sarah forward. She had a great idea with fall coming. I wanted this one released because…


Sarah O’Brien (02:22.691)



Sarah O’Brien (02:28.654)

I’m sorry.


Kiera Dent (02:47.054)

tis the season for end of year benefits. And I feel like I remember this right around November and scramble to tell you, so we’re being proactive and we’re gonna tell you sooner than later this year. So Sarah, kind of walk us through, it’s end of year, it’s benefits time, it’s open enrollment time, it’s verbiage for how to get patients who are quote unquote maxed out or their annual limit. Like tis the season for all of that because I think practices, if you can learn this skill, you will forever have a practice that’s.


Sarah O’Brien (03:12.351)



Kiera Dent (03:15.874)

freaking profitable because you’re never concerned about insurance. So Sarah, I’m going to let you kind of guide and lead on this. This is your world. This is not my world at all. But yeah, that end of year benefits. Let’s start with that one.


Sarah O’Brien (03:26.273)

Yeah, so we call it the use it or lose it time of year. It’s either you’re gonna get your benefits used because you’ve had your dentistry done or they’re just gonna expire and be gone in a few months. So it’s kind of like.


Kiera Dent (03:30.146)

Ha ha!


Kiera Dent (03:41.826)

Can I just go on a rant real quick? Like I already have such a distaste in my mouth for insurance companies that I’m like, I refuse and every practice should feel this way. Like I refuse like throw a temperature mic, I’m literally stomping my foot right now. Like we will not allow insurance companies on our watch to take home a penny more because our patients are not using it. Like that’s my, I don’t care if you’re a patient like Keira Dent who has like used me up.


I don’t care, fluoride, whitening, whatever I gotta do, I’ll come in and do like 100 more fluorides by the end of the year, but no more pennies to insurance. Okay, go on.


Sarah O’Brien (04:15.541)

100%. That is the whole point. Like let’s make them do their jobs and give us our money. So that’s a word, that’s a word kind of helping our patients recognize and see too. So we want to send them kind of some sort of a contact, like a friendly, lighthearted, super easy going, hey, Kira, your benefits are about to expire, you’ve still got a cleaning available or you’ve been holding off on these fillings for…


Kiera Dent (04:22.006)



Sarah O’Brien (04:41.593)

By the way, are your teeth sore? You know, since the last time we saw you. So we wanna reach out, have that contact, build that relationship and utilize the patients that are already in our practice to, two things, help them obviously get their dentistry completed and also fill our schedule and bump our production up for the end of the year. So we gonna reach out and we’re gonna give them a little tap and a nudge and see if we can get them scheduled.


Kiera Dent (04:44.519)



Sarah O’Brien (05:11.197)

A lot of offices will do that with a letter. Some offices still do postcards, which I think is like so cute and kitschy. Like send me a postcard all day long. Text them, email them, whatever your methods are, use those. But come up with some sort of a form, like a standardized, simple, reached out.


Kiera Dent (05:11.67)

I love it.


Kiera Dent (05:20.342)

I’m sorry.


Sarah O’Brien (05:34.305)

Hey patient, you still have hygiene available this year. Your benefits are expiring in a couple of months. Our schedule’s guaranteed to get jam-packed and hopefully you’ll be done before that happens. So let’s get you scheduled. Benefits don’t actually expire, but what happens is if they’re not used, they don’t roll over. So you can’t use this year’s money next year. So we wanna make sure that you’re getting as much bang for your buck as you can.


Kiera Dent (05:50.125)



Sarah O’Brien (06:03.158)

Another thing to consider is…


Kiera Dent (06:03.702)

Well, and that’s why I feel like that’s honestly where I was throwing my temper tantrum of like doctors, this money is going to go back to the insurance company. So if you wanna like take advantage of an insurance company, your best MO is to get your patients to use their benefits. And also for the patients, like, this is one reason I wanted to do this earlier because I feel like we wait to send end of year benefits until now when next year I hope to remind you guys around say like, you know, as soon as their benefits are up, like June, July, August.


in this realm because if we can get people there, what we do is we send these cute letters out, then our schedules get freaking slammed. And I’m like, but I had dead months and I had sucked timber. If I would have sent this benefits letter in August, I may have been able to prevent sucked timber. So next year I would note this in August to send it. And I like to do like seven touch points. And I know that sounds like exhilarating and a lot, but let me just ask a question of Sarah, how many times do you see an ad on social media before you buy it?


Like you don’t even know, you probably see like 500 times without even knowing. Like it’s insane. So that’s where I recommend like do whatever you can do. Agreed with the postcard, send the letter, send the emails, do the text messaging and you can make them witty. You can make them seasonal. You can say like tis the season to like fall into your best smile. You can do like, it’s like cookies and coaster time. Like there’s so many fun things you can do, but the reality is like, I’d be having these signs up in my practice everywhere.


Sarah O’Brien (07:05.474)



Kiera Dent (07:30.074)

Use your benefits, like let’s not pay your insurance company the money back that you ultimately deserve.


Sarah O’Brien (07:35.497)

Exactly, exactly. And take care of your mouth. Take care of your teeth. We want to see your healthy smile. Bring it on in.


Kiera Dent (07:43.774)

Exactly. Don’t worry, Sarah and I are here all day for all your subject lines of emails, postcards, you name it. But I think the more you can tie it to fun things and the sooner you can get these letters out, the better your schedule will be because I hate when patients call me in December and they’re like, my benefits are about to run out and I need to get this crown done. And I’m like, girl or guy, you waited this long, like I’ll do my best, but I’m not going to make my life psychotic because you chose to wait. So also let’s make sure we’re not.


making our lives psychotic because we haven’t sent out these letters as well.


Sarah O’Brien (08:17.825)

Yep, exactly. And you know, that brings up a good point, Keri, when your schedule does start to get towards the end of the year and you don’t have a single minute left, get yourself a VIP list. Let your patients know you’re gonna put the VIP on the list and if there’s any changes last minute, you’ll be happy to try and squeeze them in. It’s another really good method.


Kiera Dent (08:38.314)

Well, and also, this is something, here’s my, every year I feel like I get a little bit better. And this is my like 2.0 version of benefits that I was just thinking about this week, prepping for our podcast, is if you’re strategic, people are going to want to scramble. So you could block schedule in November, December, and hold big time, you know those crowns are coming through.


You know those bridges are coming through, you know, those implants are going to come through and those are the people that I’d rather be filling my schedule with. And I’ll have a few spots for fillings, but like if I’m going to have to have a psychotic November, December, anyway, let’s make it the best bang for our buck in our time, all these people waited. And so I feel like, well, going to the highest bidder is what I’m going to fill my schedule with because at the end of the day, they all need to get in. Why don’t we be more strategic with our schedules? I actually think you’ll see better profitability, better production.


and actually less stress if you are strategic of what appointments, like of course, if we can’t fill it, fill it with whatever, like Sarah said, build the VIP list, but then you get to dictate the schedule and it’s not pure mayhem. So I don’t know how you feel about it, Sarah. That’s my 2.0 version for this year of just like, I’m all in high demand. Why don’t I build the schedule I want it to be?


Sarah O’Brien (09:51.353)

Exactly. Yep. Consider opening more days, another column, bringing in a, you know, a temp hygiene if you need to, but get them in, let them get them done. Brilliant.


Kiera Dent (10:01.134)

Mm-hmm, exactly. But then there’s another side to this, Sarah, which is, okay, so we’re gonna get all these people to come and use their benefits. Those who haven’t used it, what do you do though, Sarah? Like you know billing way better than I do. Is there anything that a healthy patient like myself, other than 100 fluorides, could do to use my benefits? Like is it ortho, is it, like what else can a healthy patient do to max those benefits?


Sarah O’Brien (10:19.94)

I’m sorry.


Sarah O’Brien (10:25.317)

Great question. Let’s look at the benefits. What does your plan allow that we haven’t utilized for you year to date? Can you have another exam? Are you due for x-rays? Is there, you know, awesome cone beam available to you because you should have that done, even if you can’t have it. Check your benefits. See what your plan allows and go from there. There’s usually stuff that we aren’t utilizing, like bite wings. Some docs are like, oh, you just had them, you don’t need them.


If you have them, get them. You never know. You can’t predict what you’re gonna see. Same for your consults and your exams. Are you due for an eval? Do you need an ortho consult? What can we do for you to, that’s specifically for you also, not like every cookie cutter human that we see, we’re gonna do this, and this. What about Kira? What does Kira need? What does Kira’s benefits allow and how can we help her maximize those?


Kiera Dent (11:23.006)

And I think actually, Sarah, this is something I’ve never thought of, because I usually just send the blanket email. I want the treatment, I’m telling them how much they’ve got left. Usually I like strategically will go for letters of people with big treatment, people that have remaining benefits, but I haven’t ever thought until right now when you just said that, why don’t we start right now looking at our hygiene schedules closer? What things do they need to be able to utilize these patients benefits? Because guess what? I’m going in next month for my cleaning. I promise you they’ve not looked at benefits.


They have not looked to see what I’ve used, what I haven’t used. I’m a clean patient. There’s really nothing left to do. But like Sarah said, there are things that you could do. And if each person just looked to see like, what is in Kira’s benefits, she’d be able to then maximize me. So what I love about this is like, there’s ways to make our practice and our patients healthier and our practice more productive. And that is we either increase the patients, we increase the production, or we increase the transaction per patient. So me coming in, I’m already coming in the door, I’m already scheduled.


Why don’t we look to see is there anything additional that Kira could use that would be a benefit for her? A cone beam, fluoride, they never offer me fluoride anyway. Like Hocus Pocus, whatever. Like have you taken my PAs? Honestly, I haven’t had PAs since I started with them like five years ago. So clearly that’s something that they haven’t used. That is a way to increase my transaction for the practice and help me be a healthier patient without having to do any more work. You’re not seeing anything more. You’re not having to do more treatment on me.


you’re just better utilizing my time. So I think end of year benefits, yes, let’s use the treatment, but also let’s maximize the benefits for those that are healthy patients and see if we can help them have more treatment or more care by being better with using their benefits.


Sarah O’Brien (13:04.421)

Absolutely. And that really brings it back to the foundation of everything that’s dental billing. And those are the benefits. Are you pulling your benefits? Do you know what you are entitled to for that patient? We, as billers, harp on this constantly, right? Like, we have to have this. We have to have this. Here’s why. We want to make sure that we’re maximizing every visit for every patient every single time.


And it’s super important to audit your schedules and make sure that you’re not leaving anything off. You know, build those frequencies and those recalls and those re-cares and all of those tools within your software that alert you when some things do, use them, get them connected and moving and working for you and get that stuff done.


Kiera Dent (13:47.922)

I love it. So Sarah, there’s the flip side of the coin. We’ve got the people who have benefits remaining. And then we have the people who have used up all their benefits. And little backstory, Sarah used to work in an office. She used to be a treatment coordinator and office manager. So she’s got the clinical side to her while in addition being a biller. I really, like it would just like nails on a chalkboard when patients like, well, Kira, I’m just gonna wait until next year. And I’m like, well, you wouldn’t do that if you had cancer.


Sarah O’Brien (13:56.486)



Kiera Dent (14:16.874)

Like, why are you doing this with your mouth? Like, this is the mouth that feeds you every single day. Why are you doing this? So that’s care unfiltered today. But they say this like, well, you know, I’m just gonna wait till next year when my benefits renew and I’m like, stop. So Sarah, you probably have some magic verbiage of what can people say, what can people do when to like flow past that annual limit and to see the dentistry needs to happen with or without that budget, the insurance being there or not.


Sarah O’Brien (14:30.477)



Sarah O’Brien (14:42.805)

Yeah. You know, there’s a few different ways to look at this. One of them is have you just had a whole bunch of dentistry completed? You just invested this much time, energy and money into your mouth already. And you’re going to let this particular last chunk, this little tiny one little thing hang out, possibly destroying everything we’ve just accomplished, because your insurance isn’t pitching in their tiny little percentage towards it.


To me, that’s absurd. That’s crazy talk. That’s like, I just bought new clothes and I’m gonna throw them in the back of my closet until they’re old clothes to wear them. Like, that is counterproductive. Get it done. Why are you waiting? There’s nothing like now to get things over with and out of the way. You don’t have to think about it. We won’t have to continually call and ask you to schedule it. You’ll just be complete. You’ll know your mouth is healthy.


Kiera Dent (15:22.448)

I agree.


Sarah O’Brien (15:38.225)

and we’ll be able to start fresh next year with those new benefits. That’s one tactic. Another one is for the patients who are literally so financially driven that they can’t see past the dollar signs, what if your benefits aren’t as good next year? What if your out-of-pocket costs increase next year? And then you would have saved this much money by completing your treatment now than you would have next year when your fees all go up, which they probably will, because it’s real life and nothing goes down.


Kiera Dent (15:44.903)

Mm-hmm. Love it.


Sarah O’Brien (16:07.005)

So consider that as an option. Another thing.


Kiera Dent (16:07.288)



I don’t think they realize that people think that their benefits, like just to chime in on that one, people think that their benefits are going to be the same year over year, exact same thing. And the answer is they’re not. Insurance plans can change, employers can change, they can dump those plans. And so while yes, in theory, most of them will stay similar, I don’t like to gamble on my mouth. Like I said, the thing that literally feeds me every day is my mouth and my teeth. Like that is a literal…


thing and so helping patients realize, I think like Sarah said, I also love to show how like, okay, this is how much you would actually be saving. And my husband gave me a good analogy when we were dating because my car window broke and I’m a downright poor college student in college. And I was like, I don’t want to pay the 250 bucks to fix this. And he said,


all the repairs happening because it’ll be 250 for the window. And then when something happens with the seats or something happens with the radiator, then that’s an additional cost and it’s just going to keep stacking up on you. Let’s take care of it now. Let’s utilize the benefits we’ve got. We know the fee of what it’s going to be this year. We have no clue what it will be next year. And we also don’t know what your mouth is going to do or your body that’s aging is going to do next year as well. So, Sarah, I want to hear all your words, though, but those are my thoughts of like, don’t let it stack up either and help them realize like


it truly might change. That’s not a sales tactic. That’s a true reality of fact. You might lose your job. You might not have these benefits next year. Like tomorrow’s not certain, next year’s not certain. Why don’t we take care of what is certain? Because that’s a guarantee that we can count on.


Sarah O’Brien (17:43.385)

Absolutely, 100%. And we live in Nevada, we are surrounded by casinos. I can tell you for sure your benefits are gonna change if you were employed by one of the casinos. They don’t say the same, you’re here. So plan for that, plan for the change and be proactive for it. Another good thing to do is to treatment plan a whole mouth, not just a particular tooth or a quadrant. Treatment plan the full mouth of dentistry, present the entire…


Kiera Dent (17:55.999)



Sarah O’Brien (18:10.765)

you know, from start to finish, this is what we need to do. This is what your out-of-pocket expectation will be. That way they aren’t surprised. What I coach my offices to do is to break their patient’s treatment plan total into four parts. Four appointments, four equal parts. We know we’re gonna get it all done. Insurance is probably gonna be maxed out if you need a lot of dentistry anyway. So be prepared for your four payments and your full out-of-pocket cost, and it won’t matter when it happens, as long as it happens.


Kiera Dent (18:18.19)



Kiera Dent (18:40.754)

Mm-hmm clever, especially those bigger treatment plans like let’s not play the insurance game. You know, you’re gonna max it out I like the four equal parts the four the four appointments. It’s a clever way to do it. It’s real clever Sarah. I like it


Sarah O’Brien (18:52.996)

Thanks. I’ve got some good ideas sometimes.


Kiera Dent (18:55.126)

Yeah. Because at the end of the day, patients need to realize and team members, I also think like team members, we’re here to educate you, this is not just your patients. How many times do patients come up to you and say, well, it’s past my annual limit and you’re like, okay, like team members realize your job is to educate. And for me, if I went to the doctor and I had cancer, which heaven forbid, I hope never happens to me, I would hope and pray they didn’t look and be like, well, Kara said she’s out of benefits for this year, so we’re just going to skip along and not fill her in on her options.


like you have a moral obligation to help your patients get healthy. And getting healthy means finding a way to do dentistry. And let’s remember insurance is literally a coupon. It’s not like medical insurance. My husband told me, he’s like, yeah, go get all the things this year. We’re max on our deductible. Insurance is the exact opposite way in dental. And so making sure you help educate your patients 1500 bucks a year. It’s not going to go far in dentistry. Like let them know the dental insurance has not upped their fees since like the 1800s. Like these fees are ridiculous.


Sarah O’Brien (19:34.584)

It is.


Sarah O’Brien (19:53.305)



Kiera Dent (19:55.09)

It’s not going to cover dentistry. It’s literally a coupon and let’s get you guys healthy.


Sarah O’Brien (19:59.409)

Yep, you hit the nail on the head, Kara, that’s correct. Literally, the benefits have not changed since 1950, whatever, when they started. So imagine the inflation difference between, what, 75 years ago now, coming up, $1,500.


Kiera Dent (20:14.754)

Sarah, how can we do this? I wanna do a business model like this, Sarah. What can we do? We’re gonna set the fees of this. We’re gonna just like rack in the dough. We’re gonna make it towards a junk benefit for patients. I’m probably gonna get like audited by insurance companies because of how much I rag on them. But like bottom line is I’m not here to rag. I’m just here to say like, up your fees, make it towards an actual benefit and don’t like shortchange the doctors or the patients. But guess what? I’m not here to advocate for the insurance companies. I’m here to advocate for patients and teams and doctors.


So basically it is use your benefits, use it or lose it time. Let’s get our patients in. And then when we can look past that annual limit, helping patients realize like, this is a coupon, let’s maximize it, let’s use it now. So Sarah, any last thoughts you’ve got around billing? This is your world, things people should know. I know I’m always thinking about like, well, when should I start looking at next year’s new changes of billing? Like when is the timeline? Any last thoughts you’ve got before we wrap up today?


Sarah O’Brien (20:48.638)

Use it or lose it.


Sarah O’Brien (21:12.653)

Get your numbers ready. It’s about to be end of year time start looking for your statistics doing all your KPI Looking for your counts and your you know You’re big exciting numbers that these are when this is this time of year where you want to look at what? Kind of production are you getting from these insurance companies reconsider your contracts with them Is this something that you want to continue working with is it beneficial for you? Is it harming you more than it’s helping you? get


get all your ducks in a row and get ready for next year because it’ll be here literally tomorrow it feels like.


Kiera Dent (21:45.798)

Um, well, fun fact, this will not be accurate when this podcast is released, but the day we you can go back in time and figure out when I actually recorded this. Um, as of tomorrow, there are only 15 Fridays left in the year, which feels shocking to me. I was just, you know, doing a little fun facts over here, but I think it’s really important to get that done. So I know there’s a hot, hot conversation going on right now of do we go out of network? And I would say go look to see if you can negotiate before you go out of network. Like


I usually recommend going out of network once you’ve done everything and maximized all that you can do. So with that, Sarah, let’s wrap this up. If people are interested, Sarah’s an incredible biller. So if you guys are looking to outsource things like that, I know a lot of you are doing projections. Sarah, how can they get in touch with you? I know you do aging, you do all the different things. You do all the billing, A to Z. How can they get in touch with you?


Sarah O’Brien (22:35.369)

Email me, sarahatevolutiondentalbilling.com. We’ll get you figured out and how we can help and get you on a nice solid system and protocol to make sure your billing is helping you collect everything you produce.


Kiera Dent (22:48.75)

Oh, I love it. Sarah is so helpful. I call her often to help with our patients and our clients. And like I said, I call her all the time. So Sarah, thank you guys. Check out, check her out. Let her know you came from Dental A team. Sarah’s incredible. She’s a great resource. Even if you don’t need her now, I would tuck her information in your back pocket because you never know when you’ll lose a biller. It’s a pretty common thing. We get asked a lot. So use the benefits, go past the annual limit. We gave you a lot of verbiage. This would be a great podcast to take to your team.


And if you need help, reach out to Sarah, Evolution Billing. And Sarah, thanks for being here. I super appreciate you.


Sarah O’Brien (23:22.681)

Thank you, Kara. I appreciate you so much.


Kiera Dent (23:25.514)

All right, everyone, thanks for listening. I’ll catch you next time on the Dental Team Podcast.

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