Podcasts about EOB

@JeffreyTheGreek continues the EoB summer series of interviews with another good one: @jessetemple of Badger Connect. Jesse has been cheese-deep with the Badgers since 2011 and provides GREAT insight to the current state of Luke Fickell's squad.  Take a listen! #AskForAmador

Episode 46 titled "What Are Extreme Overvalued Beliefs?", has Associate Professor of Psychiatry, Dr. Tahir Rahman, explain how beliefs and not delusions are responsible for attacks.Episode Summary:This episode of The Simple Questions Podcast features a discussion with Dr. Tahir Rahman, an award-winning author and physician-scientist at Washington University in St. Louis. Dr. Rahman is recognized for helping develop a threat assessment framework centered on obsessions, delusions, and extreme overvalued beliefs.Listen as Dr. Rahman shares his insights on the impacts of extreme overvalued beliefs (EOB).In this episode we discuss:00:29 - Introducing Dr. Tahir Rahman01:54 - Psychiatry Beginnings 08:08 - History of EOB16:00 - Escalation to Violence (Lee Harvey Oswald)30:13 - Warning Signs47:28 - Good vs. Bad 59:21 - Advice for Average Person1:06:08 - Learning More1:07:30 - ConclusionResources:⁠Dr. Rahman's WebsitePsychology Today ArticleExtreme Overvalued Beliefs BookThis episode includes the track 'RSPN' by Blank & Kytt. The song is used under the Creative Commons Attribution 3.0 Unported License. You can find more of Blank & Kytt's music ⁠here

‍What happens when patients don't pay their bill? In today's episode, I'm diving into a revealing conversation with Andy Grover Cleveland, the expert behind Collection Agency Ninja. Forget everything you've heard about the conventional timelines for involving collection agencies. Andy advocates for a proactive approach, suggesting engagement as early as 60 to 90 days post-EOB. This strategy not only streamlines financial operations but also nurtures patient relationships through clear communication.Andy reveals the secrets to choosing reputable collection agencies that enhance, rather than hinder, patient rapport. You'll learn why early intervention is a game-changer in maintaining your practice's financial health without compromising on patient satisfaction. From identifying common pitfalls in the collections process to crafting effective patient communication strategies, this episode equips practice owners with pivotal insights for balancing financial well-being and patient care.What You'll Learn in This Episode:Why early intervention with collection agencies can benefit your practice.The importance of notifying patients about balances promptly.How to choose the right collection agency for positive patient interactions.Best practices for encouraging patient payments gracefully.Common mistakes dental practices make in collections.Strategies to balance financial health with patient relationships.Listen now to master the art of patient payment collections in your practice!‍‍You can reach out to Andy Grover Cleveland here:Website: collectionagencyninja.com‍If you want your questions answered on Monday Morning Episodes, ask me on these platforms:My Newsletter: https://thedentalmarketer.lpages.co/newsletter/The Dental Marketer Society Facebook Group: https://www.facebook.com/groups/2031814726927041‍Episode Transcript (Auto-Generated - Please Excuse Errors)‍Michael: Hey Andy, so talk to us, what's one piece of advice you can give us this Monday morning? Andy: I'm going to give something that probably goes against everything that everyone has ever heard in the dental business. I Believe you should use a collection agency at 60 to 90 days. After the EOB, which is probably very unpopular, but it's really crucial in the business of dentistry.Michael: Interesting. there specific communication strategies that we should implement at 30 or 45 days mark or to avoid escalating to the 60 days? Andy: Yeah, great question. Of course you want to notify. You don't want this to be blind. you do want to notify them that they owe the balance.And even before that, you want to try to collect it at time of service so that you never create the problem. However, you know, you have a real world and you have the perfect world. And sometimes those planets are just not aligned. So if someone does not pay that full balance, After that service is provided, you definitely want to notify that patient at least a couple of times that they owe, letting them know to please pay, but about 60 or 90 days, that's when the tide turns, Michael.That's when people decide, Hey, I'm either going to take care of this obligation or I'm not. So that's the ideal time to use it. Now, if you had interviewed me five years ago, Or 10 years ago, I wouldn't be as staunch on this opinion. It's kind of like merchant services. I don't know if you've seen this trend where now merchant services fees are being passed on to the patient.Have you been keeping up with that? Michael: Yeah, I've seen that. Andy: Okay. So if you asked me five years ago, I would say that's the worst idea. It's cheesy. Don't do it. It totally devalues your practice, but guess what? Every time I order tacos, every time I go to the doctor's office, every time I go to the car dealership, and now every time I go to the dentist, it's passed on. So we're in that kind of spot where it was unpopular, but now everybody's doing it. So why shouldn't the dentist? Michael: Okay. Interesting. So then three steps points or takeaways that you have to streamline this or make it easier, smoother. What would be number one then? Andy: one of the first takeaways is by implementing some type of collection agency strategy that's going to reach out.Number one, it doesn't make you the bad guy anymore. When you think about it, do you want to be known for chasing people for money or do you want to be known for treating patients with clinical excellence? So it's nice to have a scapegoat that you can blame for reaching out for the balance because it's strictly a financial driven practice.So I guess the number one is, it's much more convenient to blame your billing company. Then is for people to complain about someone in your office reaching out too frequently. I think we can both agree the optics aren't that great. Michael: Yeah. I think that's where I guess the patient relationship can get iffy, right?how do you do that then Andy? How do you balance maintaining patient relationships with the need to use a collection agency? Andy: there's no one right answer, but at the end of the day, if you hire someone to help you with the financial part of the practice, you can basically, just stay out of it.So if you're clinically driven, to help patients. That's your focus. Let someone else basically deal with the headache. Now, another part of how that works is it will motivate a certain part of your patient base to come back to be a patient of record. So a lot of times when dentists are doing these procedures, patients will say anything to get out of pain.So once you make that pain go away, it's sometimes could be a little too convenient to not pay. So by having a company reach out, you can actually help motivate that person to communicate with the practice and pay. And ultimately, You want that patient to be a valuable member of your clientele. So you have a divide where you can motivate people who generally value the service you're providing and keep them as a good patient of record. Also, if people choose not to pay the bill, they probably don't value the services that you rendered anyway. And arguably they're going to go somewhere else. So that kind of helps push them in another direction to maybe go down to the practice down the road and not pay them rather than come back for more service and not pay you.Michael: Does that make sense? yeah. So then I guess break it down for me. How does it motivate the patient versus sometimes like, stress them out or irritate him or anything like that? Andy: So it's pretty simple, Michael. If you, you got two phone calls today, once from someone, you owed money to.And it's just their office calling you, Hey, Michael, please pay. And then you get another phone call, Michael, from a collection agency. Again, same thing, you know, you owe the bill, but the collection agency is calling. Who are you going to pay first? Michael: one's a friend and the other one's the collection agency. Andy: They're both the same. you owe two parties. You have no preference one or the other, but one is that business calling you for money, the other one is a collection agency calling the question is, who are you more inclined to pay first? Michael: Oh, I don't know. That's a good question.What are the, data show?Andy: Generally speaking, people are going to pay the collection agency first. Middle class America wants to protect their credit. Michael: So Andy: generally speaking, people are going to pay the agency first. They're going to give it more importance because there's nothing negative that happens if they choose not to pay that original vendor, they'll get another statement or call next month and they'll address it Michael: Interesting. Okay. I like that. So then can you walk us through the process of selecting a reputable collection agency? Like What key factors Should we consider? Andy: Yeah. I mean, You really want to, interview multiple agencies. I would say the number one most important thing that you can do, assuming that people are being ethical, providing good service and being cost effective, which most are is having an agency that works directly with. Your practice management software. So we're in, a digital age and the collections business as a whole has done a very poor job on getting involved with technology. So I would definitely steer any dentist to work with the company that works with the technology. Well, You might ask, why is that important?There's numerous reasons. That's important. Number one. You're going to ensure safe and secure and rapid exchange of information. So accounts will be sent by their team by pointing and clicking, not manually updating a web form. The second thing it's going to do is it's going to tell who's paid. So in the collections business, Michael, and it's obvious you haven't been in collections from some of your responses, which is great.We don't want that for anybody. But sometimes the patient will actually pay as a result of that collection company contacting them. So with companies that work within the software, they should be notified when that happens. So let's paint a picture. Let's just say you're working with a collection company manually. Okay. You've sent patient ABC over for collection and the collection company has been calling them and they will call them incessantly to motivate that person. And let's just say that person paid the bill. Well Guess what? If your front office doesn't contact that agency by logging into the website, calling them, emailing, however that feedback loop is. That agency is going to continue to call that person for money. And it's going to further damage that relationship when they did the right thing and paid. So you want to have like an automatic feedback loop so that if someone does pay, it's automatically reported to the agency. So the agency doesn't cause any further harm. Those are probably the two top biggest reasons. There's many more. Michael: Gotcha. Okay. So collection agency is just essential to have in this process, So number two, what would that look like? Bullet point number two. Andy: Yeah, so that was identify and motivate your ideal patients coming back into the practice as opposed to people that are just dentist shopping So we want to motivate people to pay and also be a patient of record. So when you turn people over to collection Granted, they're not happy about it, but it will motivate people that value that relationship with you to communicate and pay the bill. It will also motivate some people to leave the practice because they had no intention of paying to begin with. Michael: Okay. Got you. Got you. Now, how do you measure any of the success of a collection agency? What benchmarks or KPIs do you track? As a practice owner. Andy: So any agency that has technology to support you is going to give you metrics on how you can judge their efficacy. I will share with you as weird as this is, it's not all about the money. I specialize in working with independently owned dental offices. So it's a little more holistic and how they judge you. I would say that most independently owned practices, it's not about the money. That's more of a group practice thought process.Yes, money's important, but not the most important thing. Independent dentists, they don't compete. With corporate offices on cost, right? They can't, the economies of scale are not there. The flip side is also true. corporates can't compete with independent dentists on culture, right? They have turnover, you're getting new associates every six months. It's just a constant churn. So they don't really compete with one another, but at the end of the day, I think most dentists, will gauge the efficacy of their collection company, not only on the money recovered. And of course it has to be cost effective, but even more importantly than that, does it generate negative reviews?Does it motivate people to accept treatment? Does it allow their staff to focus on other things that are more important? So there's an opportunity cost To chasing your own accounts receivable. So it's much more multifaceted than just dollars in dollars out. Most dentists will hire a collection company basically to make their office run better.Michael: Have you seen that a lot, Andy, where some are hesitant to, bring on or call or ask about, money more for the review. Like, Oh man, I'm going to get negative. Andy: Yeah, of course. But in my experience, if you continue to chase your own money, you're much more likely to generate a negative review for yourself.If you hire somebody else to do it for you, they can give a negative review on that collection agency. Michael: Yeah. Andy: And certainly they could tie it back to you, but you can always, claim indifference, right? Hey that's what our billing department's for you know, you need to deal with them and it absolves you from some of that responsibility. Michael: Interesting. Okay. So then what are the financial risks and rewards of sending accounts to collections at 60 days versus waiting longer or not using collections at all? Andy: Great question. So you have this kind of traditional paradigm with collection agencies working with dental offices and that one is a very traditional approach where the office will work the account for months and months and months and years and years and years. And then they turn it over to collections, and then that company's working on a percentage basis. That's the way it's always been, but that is just not an effective way of running a modern or contemporary dental office. Sometimes you cause more harm than good there because if you wait that long, the accounts aren't collectible anyway. Right. If you wait a year or two, they're basically uncollectible. So I'd recommend just writing the accounts off if you're going to do that. The advantage to turning it over at 60 to 90 days is that's a very fresh account. It's still top of mind for that consumer and from a statistical perspective, it's much more collectible than something if you wait a year or two down the road to go after.So it's more about being proactive with that balance. The other thing you also have to measure in here, Michael. is a lot of times these practices are already getting hit with the PPO fee and basically reducing their billable amount. So they're already losing 30 or 40%. And then if you let that patient balance go unpaid. You're losing the rest. So in this environment, it's just too competitive to run a business like that anymore. You have to be responsible with not only the insurance portion, whether you're in network, out of network fee for service, but you also have to address that patient portion. It's crucial because again, you're taking such a big write off a hit in the beginning. It's really not cost effective for you to take another hit later down the road. You're essentially giving it away. Michael: Interesting. So then what common mistakes do practices make that you've seen when sending accounts to collections and how can they avoid these pitfalls? Andy: one of the things that clouds all of our judgment is emotion.So a lot of times, People get upset, and listen, if someone owes me money, I get upset about my own business, right? It hurts, but people still have that mammalian part of their brain that wants revenge, or maybe the patient was really rude last time they came in. So you have this, Emotional part of being owed money that clouds our judgment.that's a big mistake I see some practices, they just want revenge. That's usually where bad things start to happen when you think along those lines. So as a practice owner matures and goes through practice ownership, there's developmental stages where right in the beginning, it really hurts. Then you can start to kind of objectively step back and look at things more objectively. But at the end of the day, recommend the practice owners look at this from a very non emotional, like a CPA would, right? If you're producing a million dollars in revenue annually, and you have less than 1 percent of the people that owe you money, not pay you, write it off.You're collecting 99%. No one gets a hundred percent. I don't care how cool it is to say in the Facebook groups, nobody gets a hundred percent. There are times where it makes sense to write things off rather than pursue it. Especially if those services are disputed or you're dealing with a really difficult person, a lot of times it's just not worth it and you just have to let it go.Michael: Interesting. I love that. Thank you so much, Andy. I appreciate your time. And if anyone has further questions, you can definitely find them on the Dental Marketer Society Facebook group, or where can they reach out to you directly?Andy: Probably the best way to do it is going to my website. collection, agency, ninja. com spelled just like it sounds. Michael: Awesome. Collection, agency, ninja. com. that's going to be in the show notes below. So if anyone's interested, want to pick Andy's brain a little bit more and so forth, definitely reach out to him there and Andy.Thank you so much for being with us on this Monday morning episode. Appreciate you having me. Thank you very much and keep up the great work. I'm honored to be here.Andy: Thank you.

Tiff and Dana discuss the importance of coding accuracy in dental practices. That includes universal codes everyone can understand, how to stay up-to-date on resources, the best way to know team members are getting paid for all their work, different codes across specialties, and more. Episode resources: Reach out to Tiff and Dana Tune Into DAT's Monthly Webinar Practice Momentum Group Consulting Subscribe to The Dental A-Team podcast Become Dental A-Team Platinum! Review the podcast Transcript: The Dental A Team (00:01.11) Hello Dental A Team listeners, we are back at you today. I have the one and only Miss Dana here with me to podcast. I love pulling Dana in. I love pulling all the consultants in, but I truly love pulling in Dana. think I shouted you out this morning. do. Wednesday core value shout out in our.   I know that we've done some podcasts on that. So if you're not already doing a core value shout out every day or every week, please by all means go listen to those podcasts because it's freaking incredible and Dana you truly are the epitome of ease within our company and for your clients and I just think you need to publicly shout it from the rooftops be Just recognized for that aspect of your personality. You truly do make life easier I know a lot of your clients feel the same way you are   so good at finding the easiest path for the systems implementation for whatever it is that needs to be done for us as a company. So Dana, welcome today. I'm so excited to have you here with me. Thank you for joining me on this beautiful Wednesday. I don't know what day this is gonna air, but it's a Wednesday today. And it's absolutely gorgeous here in Arizona. How are you, Dana?   Dana (01:08.193) doing good, Tim, doing good. love days like today.   The Dental A Team (01:11.629) I do too, I do too. It's starting to get fallish in Arizona, which means 85 degrees instead of the 105 that we had last week, least up in Phoenix. I know you get a little bit more fall down where you're at, but I'll take the 85 over the 105 for sure. Today, Dina, I wanted to pick your brain.   I've got some information today I wanna share with the doctors. It's also for billing departments, for treatment coordinators, for whomever wants to listen to this. But I really wanted us to shout out our doctors for really, really just knowing everything about their businesses. I know that you guys are all here listening. I know you're watching, whatever it might be, to really learn more about the business side and about what the team is doing to help support your practice. So I wanna shout you out for that. And I just think it's a really incredible tool.   and resource to have to truly know what it is that's going on, the inner workings behind the scenes of your practice, aside from just the dentistry that you're performing. So shout out to you guys for being here, for listening. Team members, if your doctor's not listening yet, please share it with them. Dana, today I really wanted to pick your brain and go over some coding information. I know it sounds super boring, you guys, but stick with us. We've got some great tips and tricks and some tools, especially for you doctors who are out there to really   focus in and pay attention to the things that are being input into the system and sent off to insurance companies, or if you're fee for service, you still need to be insanely accurate within your system and making sure that we're using the right tools. So doctors, again, this one's for you as well. Billing representatives, treatment coordinators, front office representatives, office managers, whoever you might be, whoever might be touching a ledger or an account or a code in general dental assistance, hi, Genes, you guys.   This is all gonna be really great information for all of you. Coding with Accuracy happens to be a book, by the way, you can purchase that. But honestly, coding with accuracy is incredibly important and valuable to your system, not only for the billing portion to ensure that we're accurately sending things off to insurance companies, accurately getting paid, but realistically to show super accurately what you've actually done with your patients to your patients. That way, if anything were to ever come about and anyone needed to look into it or   The Dental A Team (03:28.327) your patients had questions and they asked for the account, it makes sense to the next person who's looking at it. And you can say, yes, I did that, that was me. I did that filling, I did that crown, I did that crown seat, I did those pieces. I know a lot of practices, and Dana, I think you've probably seen this too, a lot of practices will overuse, in my opinion, an office visit or a palliative treatment, to certain codes like that and unspecified, because they're just not sure.   what to use. And so they throw one of those, especially office visits, and I'm like, what is this office visit? How many, this patient's been in for 20 office visits. They're like, most of those are crown seats or like if a filling needed to be adjusted or like, and I'm like, wow, so we don't have any documentation right here that we ever sat any of these crowns.   That's an issue. looking at those pieces and making sure that we're super accurate with what we're calling things is something I really, really want to talk about today, Dana. Have you noticed that as well? I know you see a lot of clients, you do a lot of virtual clients, but you see a lot of ledgers, you get a lot of things sent to you, and you have been traveling a ton this year in office to practices as well. So what are you seeing when you're out there when it comes to coding and just kind of like randomness that you're seeing thrown around?   Dana (04:40.983) Yeah, I agree with you on just like the miscellaneous codes. I delivery. What did we deliver? Because we need to know exactly what we delivered today. And then a lot of just like 999 things and sometimes a 999 code you absolutely   The Dental A Team (04:47.133) Yeah.   Dana (04:55.967) can utilize it, should be utilizing it, but oftentimes too, it's like, no, there's actually a code for that. Like we don't have to send a 999 with documentation and notes, there's a code specific for that. So making sure that offices really are up to date, also to like when things change because they do change occasionally. And so just having somebody who knows those things in and out has resources to spot check and that we are billing what we're doing and coding exactly what we're doing.   The Dental A Team (05:25.511) Yeah, I totally agree. The 999 code, I love that one. It is thrown in there for everything and I am guilty of the 999 code because I'm like, don't know what he's even talking about. 999, that sucker. And I'll explain, I'll say exactly what he just said to me. I have no idea what he said, but I've got this. So I'm surely, surely guilty of that one. I do love the staying up to date and doctors, I really want you to know and understand within dentistry.   There's not, like we have a course for billing that will review billing for you and will go over the basics of billing, what it needs to look like, how to send a claim, how to input an EOB and a payment and all of those pieces. But there's really not a good school for billing where it's like, gosh, I'm gonna send them to a billing school and now they've got this accredited school has shown them this kind of like medical billing, right? You can go to medical billing school and now you're a medical biller.   to be a dental biller, you just needed someone ahead of you to show you how to do it. So within this world, it's just super important, like Dana said, that we stay on top of it as best we can. So making sure that we're getting ADA emails sent to us and that we're watching for any codes that change, because they will let us know. Whatever your state's dental association is, I know here it's the AZDA, the California Dental Association.   Whatever it is, make sure that you're signed up for those auto emails, because that's going to be the best resource. And then as those yearly conventions come around that we all love to go to, that we hate taking boring classes, look for any updates. I wouldn't say you've got to hit the billing courses yourself, or you have to send your billing rep to the billing courses. Sometimes they're a bust. Sometimes they're super insurance prone or driven. I don't love that. But if there's anything that's like coding updates or   New laws things like that. It's always a good idea. So I do want to preface it with that Just know always staying up to date just getting those resources sent to you is going to be super super important And now aside from that there are things like coding with confidence coding with accuracy All of those different books that you can get I believe coding with confidence you can order from Amazon or ADA I think both of them have it. I think it probably comes from the ADA when you do it from Amazon, whatever you choose   The Dental A Team (07:37.7) It's a fantastic book and having that resource, there's a companion book that goes with it as well. I always had that resource with me. It was literally in a drawer behind my desk and as soon as I had something pop up for an implant or gosh, when we were doing over dentures and there's just so many parts and pieces and little things that need to be accurately coded.   There's no way I'm gonna remember all of these things or intuitively know it. So I would pull those books out constantly and I would go through it with my doctor and I'd say, okay, does this describe, is this what you're saying? Is this describing it? Because even just for regular dentures, there's different codes that can be used. And if you use one that's a maxillary but you're doing a mandibular denture, you're not gonna get paid, right? And even if you put upper denture in the thing and you did a mandibular code, they're still not gonna pay it because it doesn't match.   So just making sure that those codes are super accurate. Now from a doctor's standpoint, why is this important? Super important because you need to be paid, right? So my owner doctors, you need to be sure that your practice is being paid, that you're being paid for what you're doing, your hygiene team's being paid for what they're doing, and that if, again, anything were ever to have been and come about, somebody looking at the ledger, looking at the account, looking at the chart, can accurately and confidently see exactly what you performed. So not only do you need to get paid,   you need to cover your tail. For my associate doctors and even my hygienist who might be listening, you really, really wanna watch your production and your collections, because typically, especially my associates, you guys are gonna be paid off of that in some form or fashion. So making sure that the coding is correct and that it accurately, actually reflects what you've done is key. Otherwise, you might get paid for a filling when you did an onlay.   Right, and the billing representative, has, or he has no idea, they were not chair side with you. So if it's not fixed chair side, or if you, gosh, Dina, how many times have you seen this one, where chair side, you know, we were scheduled for an MO, chair side, doctor's like, this went into the distal, we've gotta update that. So we update it, we tell the patient, we're like, got another service added, get the treatment plan going, lay them back, finish the filling, and then they go up front, and then they get paid on an MO.   The Dental A Team (09:51.99) because the MOD was never switched out and the appointment went before it was set complete. again, the billing representative, he's not chair side. They have no idea that that billing changed. The dental assistant needed to update and change it. So making sure that that's accurate in there. Now, Dina, I know you have a lot of practices and a lot of associates. You've got a lot of big practices that have a lot of associates. How do you make sure at the end of the day, at the end of the month, at the end of everything, that these guys are knowing exactly what their   being paid on? Like how do you make sure that they know with confidence that they're getting paid for everything that they did?   Dana (10:28.329) Yeah, I have them usually daily check their provider production and check their individual provider day sheet just to make sure that everything was accounted for. If there were changes, if something was walked out inaccurately, catching that from the very beginning is super important because honestly, like you pointed out, the difference in some of these codes is hundreds of dollars worth of production. And that can be even within implant parts, even with indentures, like a difference in that   that coding can majorly impact production. So making sure that everything is accounted for, everything that they did is on there and everything is walked out and ready to submit. So that whether it's insurance based or we've got to call a patient and say, hey, you know, we under collected that service did change, we had added. whether it is patient portion that we've got to update or insurance portion, just making sure that we're catching that. And I like to do it daily because   Claims are submitted daily. We're reaching out to patients and we don't want a patient to go till the end of the month before we're like, hey, by the way, you missed a thing, right? So I like my, especially my associates and hygiene to just look and make sure everything's accounted for each and every day.   The Dental A Team (11:34.98) Yeah. Yes.   The Dental A Team (11:47.01) Yeah, I agree. think that's perfect because pulling that sheet, especially like Dentrix and Eagle Soft and OpenDone, like all of these programs have a super easy sheet to print at the end of the day or even like print screen and then just look at it. So we're not using all the paper all the time. I've definitely had it where a doctor will come back like a week later and be like, we didn't actually do a buildup because we just, you you treat and plan a crown and we should plan a buildup just in case, or you have your doctors who treat and plan only a crown and then add a buildup.   if we needed a buildup and so vice versa. A week later, we're like, I didn't build up on that crown. I'm like, well, bro, she gone, she lost. There's no way, it's so uncomfortable to call a patient and be like, by the way, we forgot to charge you for that billing that's underneath the crown that's to build the tooth back up because of the K. And now I'm in this whole conversation of like, why didn't this just get done the first time? So I totally agree. I think that's brilliant. And doctors also, looking ahead at your schedule,   Dana (12:21.687) It was true.   The Dental A Team (12:43.172) Prepping your schedule in conjunction with that is gonna be huge. We get really comfortable. Our dental assistants are incredible. I was a dental assistant near and dear to my heart. It's my favorite position. If I were ever to like quit everything in life and go back to in-office dentistry, it would have to be as a dental assistant. I would not do anything else. It's my favorite space. But you guys, I messed up sometimes. Like it happens. I would get forgetful.   Like how many times did I forget to grab the bond? And I'm like, you can't do a filling without a bond. How did you forget that? And then expecting me to change it every single time in the chart or make sure that it was accurate ahead of time. Things flip through the cracks. So we've gotta have checks and balances. We can't just rely on one person to get it right every single time. So your dental assistants prepping the charts, prepping your schedule for the next day is huge, but I really wanna implore that you guys, you doctors,   You are looking at your schedules as well. You know what's coming up and you know that it's accurate. I had a dentist that worked in our practice. He's fantastic. He's gone to all of this oral surgery, like extracurricular. He's just, it's insane. I watch his videos on Instagram and I'm like, that's so gross. I always must do him. Like I remember the first time I did a bone flap with you and I was like, what? I can't do this, but he's so good. He did all of these like perio surgeries, oral surgeries. He did so many things in our practice and holy cow.   A GP girl over here, learning how to code for all of these extensive procedures that he was doing. He was doing, you know, he's doing the blood draws before it was even a thing. I am like, are we allowed to do that? Like I'm in my practice, like what the heck? This is crazy. And now I'm having to code things that to me are like outlandish.   and I'm sitting there Googling things. Like, this doesn't make sense. So I'm pulling out my little code book and like, gosh, it is in here. This is a dental thing. We can do this, but there's no way those added procedures would have been accurately coded if I didn't take those extra steps to ensure it. And if he didn't, bless his heart, come to me every day.   The Dental A Team (14:47.322) with a list of the things that needed to be added to tomorrow that wasn't accurate or things that we missed today. He would double check his treatment plans just because they were so extensive. And honestly, there were times, like he did GP work in our practice as well. So there were times too where he would catch a filling surface was missed or an onlay surface was missed. And I'm like, dang, not only are, you know, did we miss something on your giant surgery over here that I literally cannot assist with, cause I will pass out.   But we also miss like a surface on an online, like, goodness gracious, right? But he is my example because he was so diligent about making sure that the charting was accurate. Like, of course he wanted to get paid for the things he was doing, but he's like, I need to make sure that whatever it is that I'm doing, it's all here. It's all accounted for. And when he went to go do all of the accrediting with the oral surgery boards and implant boards and like, he's got all this crazy stuff behind him now. He needed all of those things. He called me from Texas years later.   And I was like, remember that patient that we did that thing? And I'm like, my gosh, yeah. So I'm like looking for this patient. He's like, I need all of their notes and I need all of their ledger and I need everything to submit to the implant board. And I was like, my gosh, thank goodness we went through and did all of those things. So you guys, it doesn't matter what you're doing. You don't have to be doing crazy dentistry or crazy oral surgery within your practice. Those minor things need to get caught as well. And Dana, earlier you mentioned like the 999 code.   And I know we have to go in or have the auto updates done and make sure that the codes are being updated. But I did notice there are more and more systems that even have as simple as broken appointment code already in there, Crown Seat Code, Denture Seat Code, all of these pieces. So when you're working with practices and you're seeing this, or they ask us, we'll get text messages from office managers that are like, this is what he said, what do I code that as?   I don't know, right? But what are you doing? How are you helping them to figure out, this is probably not a pallet over 999 or what an office visit, this is probably X, Y, or Z.   Dana (16:52.117) Yeah, I mean, I'll be honest, if a lot of times I am pulling like a coding with confidence, or I'm googling things and, I'm trying to piece it together or I'm asking, you know, okay, well, like, walk with what does that look like? Walk me through like, can you explain the process to me? So maybe I can find it in here or send me a picture of the part that maybe I can look it up. But it's really just doing due diligence and combing through the codes that are available. And then determining   The Dental A Team (16:58.797) Yeah.   The Dental A Team (17:10.987) Yes.   Dana (17:20.083) If there is a specific code for that procedure and if there's not, then yeah, you do a 999 code with lots of documentation, IOPs, all the things, so that once it gets to insurance, they can determine if it's something that they're covering.   The Dental A Team (17:35.266) I agree, yeah, I love that. I do love Google, I have Googled so many times. I've been in office trying to help them come up with cheat sheets, which is the next little topic here, but that I'm like, what is this? Or give me a picture of this so that I can put it on their cheat sheet. And doctors who are doing things like implants or dentures even, crowns, anything you're doing, having those cheat sheets is super helpful.   I have a lot of my practices throw those into their operations manual. So with the crown setup or whatever, it'll also have the steps and the codes that would be used. We have to update it when they update, but have all of those available there side by side with it. So it'll be like, crown seed, and it'll be the setup, and then it'll be all of the codes. The ones that get wild are our implants, right? Our All-On-X denture cases. Those ones get wildly insane.   dentures, right, start to finish because what happens is in the treatment planning mode, let's use denture, right, as a treatment planner, right, so I'm a dental assistant and the doctor says we need to do a full denture. Cool, maxillary denture. And then I'm like, treatment coordinator, here you go. And they're like, cool. And then they schedule a denture. There's like 16 steps sometimes to a denture.   Right, so having that and being able to break it down and break it apart shows that all the steps and processes were done and then having a cheat sheet that goes along with it helps not only your treatment coordinator and your scheduler, but it helps your biller and your dental assistant, even your hygienist. I've had so many hygienists come to me and say, what step are we on? And I'm like, well, I'm not sure, let's look. Like, let's look at our checklist and see where we're at. So even within that denture, having the denture treatment plan for pricing.   Dana (18:56.011) Yes.   The Dental A Team (19:24.294) Obviously, right, any extractions, any bone grafts that need to be done. If you're doing a temporary denture before the final is done, if you're doing, gosh, if you're doing a scan and a final delivery, like they're getting much faster. But before, remember, we had to have a wax rim, we had to have teeth and wax, we had to have the color shade, we had to have a try-in, then we had to have a realign. Like all of these pieces needed to be segregated out in there so that we treatment plan.   the one thing, but we have those steps readily available so that it can be scheduled correctly and in order. And then having those cheat sheets with those codes lined up is super helpful. I have a practice in Wisconsin that was just getting so confused on the implant process and an ortho process. And I was like, easy peasy, let's just like section this out. And now every single time they've got it laminated and they just pull it out. They're like, I've got my implant sheet. I've got my ortho sheet or whatever. So I always have them add that as well. So Dana.   Wrap it up for us. So we've got coding, checking, all the pieces. What could an office do, a doctor do to ensure maybe even adding it to their operations manual? What's the process they should make sure that is being followed and updated yearly within all of these pieces that we've talked about today?   Dana (20:42.627) Yeah, I think it's added to your yearly calendars that you make sure that you do know the updates you have the codes every year and just like we get Insurance fee schedules and we do all of our insurance updates just add that to that list one So add and make sure we've got do we have the resource for it? And do we know what they are? I think to any time that you are adding a new service just checking and double-checking that you know what the codes are So if you're bringing in a CBC team, make sure that those codes are in there and you've got fees attached to them   and all of those pieces. I love your cheat sheet idea as far as especially where there's a there's a lot of nitty-gritty things that need to get built out for specific things like ortho-like implants making sure that you've got cheat sheets and you make it really really easy and then make sure you've got a very clear communication system for when treatment changes so that it gets changed all the way okay and then I think daily having people look at them and just one   Final tip I guess in in with your cheat sheets oftentimes we call things things that like are not in the code, right? The description of the code is not that and then we're constantly like, what are they actually? What do they actually call right? A lot of your systems will allow you to add notes to like those procedure codes put in what you call it in the office so that it's easy to find it will still put the actual code definition on your piece going on your claims go out, but if you call something something specific   just update it in your system so it's easy for the team to buy.   The Dental A Team (22:12.623) That was brilliant. I know my dentist had like five different terms for a hater bar and I never, was like, I don't know what you're talking about. And the Ribon, he would call the, you know, the Perio procedure by the name of the material he needed. And I was like, so, and he only do this once every, I don't know, 10 years. Like this procedure is never done. He's like, we've got to do a Ribon. Where's the Ribon? I'm like, I don't even remember what this is.   I don't know what that says. So yes, I agree. I love that idea, the descriptions and making sure too then I would transfer. We do this in our Google Drive, you guys. Whatever you might call it, also probably put that on your cheat sheet, maybe in parentheses. Like this is what it is. These are the five different terms that any of our doctors may call it so that it is easy to find and easy to figure out. I think that's brilliant. Awesome, thank you for wrapping us, Dana. I think this was insanely beneficial for all of our doctors out there and our team members again.   Doctors, if you're here listening, congrats. I think that's so huge. It's really important for you to know and understand these things. Share it with your team, because they can use these pieces too, especially anyone who's doing your billing and your practice. And then team members who are out there whose doctors haven't heard this one yet, share it with them. Make sure that they understand what they're getting into as well, and that they're supporting you in your position as a team member to be super accurate, because you're depending on them.   to get things right so that you can do your job. So share it with them. Make sure you guys are all up to date and as always, reach out for any questions you might have. Hello@TheDentalATeam.com. We are not code masters, but you guys, we are solution masters and we will find the answers or find the way and we can help you with just about anything you can think of. Hello@TheDentalATeam.com. We can't wait to catch you next time.  

Happy Halloween! In this episode, Kiera lists four “tricks” in dental practices that might scare a practice owner off, and gives advice on how to turn them into treats. Leaking revenue A team that doesn't care about company goals Untapped potential holding you back Low case acceptance and high overhead Episode resources: Reach out to Kiera Tune Into DAT's Monthly Webinar Practice Momentum Group Consulting Subscribe to The Dental A-Team podcast Become Dental A-Team Platinum! Review the podcast Transcript: Kiera Dent (00:01.09) Hello, Dental A Team listeners. This is Kiera and happy Halloween -y. man, I love Halloween. This year, I'm so excited. We have some really, really, really special neighbors and they have two kids and they have definitely allowed us to be a part of their family. And so they're now six -year -old son. They have a six -year -old and a two -year -old. Their six -year -old plans our Halloween costumes for us. If you know anything about Kiera Dent or if you don't, my mom was very much not.   pro having her kids trick or treat. My mom is very, very, very conventional and she did not want to teach her children. She felt like trick or treating was slightly like begging and she did not want her children to be that way. And so I do not, I do not endorse that nor agree with that. And my mom has since changed, but that was her beliefs as a young mom. so trick or treating, she had us go what's called pick a treat where we would actually take treats to our friends instead of trick or treating. And so   Actually last year, 2023 was the first time that Kiera Dent actually went trick or treating. And it was with this family that takes us with us. Last year we were Incredibles. And this year he has given, this little boy has given all of us the assignment of something from Toy Story. He plans every one of us who we're going to be. So this year I get to be Little Bo Peep. My husband's Woody. Don't worry. We'll definitely post up some pictures for you guys, but happy Halloween. I hope you have the best time. I hope it's fun, but.   What I wanted to do today is one, thank you guys for being a part of our podcast family. But two, remind you, please share this podcast with someone fun. Today's gonna be a fun one. These are things that should scare you as a dental practice owner. Our goal is to help you learn to overcome them and running practice does not need to be scary. So come and join our consulting with us. There's no tricks, just treats for you guys. And I'm gonna give you guys four little things that probably do scare you as practice owners and ways to overcome them.   We're going to do a little trick or treating here where I might trick, I might treat. Of course I'm going to treat guys. Here we go. but please share this podcast with those around you. And thank you for being a part of our Dental A Team podcast family. If I could give you a giant hug right now and just tell you how much I love and appreciate you for who you are and the special things that you bring to dentistry and to this world. And, just you being here, no matter what you do or don't do is a huge blessing to those around you and in my life as well, even though I might not know you personally.   Kiera Dent (02:26.07) I feel you, I feel your energy and I'm so grateful for you. just share this with someone that you feel could use that huge giant hug of love and appreciation and probably just like some fun and some support. with that, right. Number one possible scary thing in a practice is revenue leaks in your practice. So what are some of those things that are leaking out revenue that if we just were able to patch up that hole might actually be able to help you. So things such as inefficient scheduling, billing errors, uncollected payments.   So I want you guys to look at your practices and see where are our revenue leaks. I think this could be a really fun almost scavenger hunt for you and your team to think about like, where are all the ways that we might be losing money on imperfect handoffs, on not billing out all the procedures that we do, on not having the correct dollar amounts attached to those. Keir Dents practice definitely sent out a $0 crown. We billed it straight to insurance. You better believe they were so happy to send me the EOB on that. That is a revenue leak in our practice. so,   on our inefficient scheduling? Have you built in the block schedules? Have you created a perfect day schedule? Are we working and role playing on how we can get people perfectly in there? Are we looking for same day treatment opportunities? That's a huge revenue leak within your practice. Looking for those same days, you get raving fans out of it and you're also able to help a ton of people with it. So can we actually help you guys close up that revenue leak and make it even better? What about the billing errors? Like I mentioned, attaching the correct things to our procedures so we get our money in within those.   20 to 30 days the first time and we're not having to rebuild or reattaching like setting up a process and a policy that we all follow every single time. Make that quick checklist, have it in the notes. We just grab it and go and everybody's there with it. It makes it so much easier. Uncollected payments, I can't tell you how many offices just let patients leave without stopping at the front desk or getting credit cards on file so that way we can bill these patients very quickly and collect. It's so easy. You guys, I have all of my stuff on autopay. I go to the therapist, I credit card on file, click, paid, done.   At my chiropractor same thing at my therapist my my physical therapist same thing at my gym person All these quick ways like you guys we live in a world of credit cards on file. We have Apple pay We have all these different pieces. Can we do that there? And what are the revenue leaks within your practice? Those are just some to get your your mind spurring But really look at that because that could be very scary in a practice. You're doing the work Let's make sure you're getting paid for it. Like I said, no tricks just treats. It does not need to be scary   Kiera Dent (04:50.132) Number two, your team not caring about your company goals. Well, that can feel scary because doctors can feel like, I'm rowing this boat all by myself and it can feel awful. And so let's get your team to care about the goals. How can this help give them a better life? How can this help them help more patients? How can we get them on board and excited? I have an office right now and we're rolling out sleep in their practice and I cannot wait. We're making it all fun. They're going to get like part of the bonus and the rewards of helping more patients not die from sleep.   That's incredible. That's such a fun way to do it. And so looking for ways, people don't care about things that they're not passionate about. No surprise, right? Like that's a very easy thing. Kiera, give us some wisdom here. But I think sometimes simplicity and remembering what we already know is half the point of learning. And a lot of times learning is just remembering what we already know. And so getting our team, like what inspires them? Why do we want to hit these goals? How many patients do we want to serve together as a team? And oftentimes if your team doesn't care about the goals,   guess what, they might not be your right team. You want people that are obsessed about hitting these goals. You want people that are excited about building this practice. It's gonna serve so many patients. And so you also, as the owner and the leader, need to feel that way about it. Oftentimes when teens don't care about goals, it's because the owner doesn't actually care. And I say that with love and a huge giant hug and no judgment, because sometimes it's hard to stay motivated as owners. Sometimes we need someone to pick us up.   You guys, am so appreciative over these last couple of months. I've had some personal things in my life and so grateful for the coaches in my life that literally have like lifted me up with love and support and helped me figure out what is my vision? What is my path? I have probably five really strong people in my life and I'm so grateful. I happily pay them. so, I could not do this without all five of them. And just so thankful that I have that support system around me because   A lot of times it is hard to keep trying to figure it out on your own day in and day out. And so really being able to have that from your team and have that support is something absolutely magical. All right, number three is untapped potential losing you money. So things like, could we do some CE within our practice? Could we do helping a lot of our team start like learning to scan or taking impressions, or could we add Invisalign or could we add sleep to our practice?   Kiera Dent (07:09.886) Or what other things are untapped potential within every team member? Could we do better with our treatment plan acceptance? Can we do better with how we schedule our practice? But what is this untapped potential? If I was looking at your practice today, what I think that your practice is a brand new baby, like in the life cycle of a business. Is it maybe a toddler? Is it maybe like a teenager? Is it a young adult? Is it like in its prime? Is it a dying practice, like getting a little bit older to retirement? Or is it on its way to death?   There's untapped potential within all of those lifespans. And so what's our way that we're able to find that untapped potential because there's so much opportunity. I have offices right now that are, we've just added very simple things to the practice and we've been able to take them from a $2 million practice to a $4 million practice just by adding in some untapped potential with them. Are there untapped potential within like the operatories in the space within your practice?   Is there untapped potential around your hygienist being able to offer fluoride to every patient or fluoride therapy where it's toothpaste and fluoride treatments? Is there untapped potential with us scanning for night guards? Is there untapped potential with us looking for same day treatment opportunities? These are fun little things that could be spooky and scary, but if we look at them, make them fun. Now, I'm gonna put a huge like asterisk caveat with this.   We do not wanna add all these things at the exact same time because that is very scary and daunting for our team, but we can brainstorm and like throw everything on a board and then pick the thing that's the easiest, least amount of effort with the greatest impact. And that's what we wanna go implement and execute on our practice. right, number four of things that are scary, no tricks, just treats today, of low case acceptance and high overhead. So kind of technically two in one.   So low case acceptance, that can feel really scary. It can make doctors feel like patients don't like me. It can make treatment coordinators feel like, we're just not closing cases. Case acceptance to me just tells a story. One, are we doing incredible with how we're presenting treatment? Doctors, are you using that NDTR next visit date, time, the re -care, there we go. Are you doing that and putting the bow on every single treatment plan that you're giving?   Kiera Dent (09:20.032) Are you diagnosing with confidence? Are we doing quadrant dentistry rather than solo tooth dentistry? Are you confident on how you're presenting it to the patient? Are you possibly planting weeds in your flower garden by giving them obstacles as opposed to opportunities without realizing it? After doctors give this the most amazing confident treatment plan, they put the bow of NDTR on it. Team members, are we all taking that perfect hand off, scheduling them first and then having our team present the treatment plans and the finance?   Are we leading with insurance? Because if you better believe if I'm any part of your life, you will never lead with insurance. You will always lead with what we need to do. And then we will help the patient say yes to the treatment. Low case acceptance to me tells what are the doctors confident in, what's the treatment coordinator confident in, and where are awesome opportunities to grow. I love case acceptance. I'm obsessed with it. I'm obsessed with helping offices. I have literally taken a practice from 9 million.   to over 40 million just by working with them on case acceptance. I kid you not, there's multiple practices in it. They are incredible. And we just work on case acceptance over and over and over over over and over and over and over over again, because we know that that's what's gonna help more patients have a happier life. So when I look at this, I love it. It tells me what is that treatment coordinator afraid of? What does that treatment coordinator need to break through? What does that doctor need to break through? I can look to see the type of treatment plans just by looking at your case acceptance.   And so looking at this and how can we boost it? Now, if it's too high, I know we are actually not diagnosing enough. If it's too low, I know we're not closing and it's a happy medium. If you're presenting implants and high cases, it should be a little bit lower. If we're doing a single tooth dentistry and general dentistry more so, you should have a much higher case acceptance. So looking at that, because that can feel very eerie in a practice of like, what are we doing wrong? Oftentimes it's not what are we doing wrong? It's what are we saying? That's actually not helping us get to our case acceptance that we want.   So play the game, have fun with it because that case acceptance fills the schedule. Now if our schedule is too full and we're not hitting our goals, let's look to see what are we diagnosing doctors? Let's see, are we truly diagnosing full comprehensive care or are we diagnosing what we think they want? No, those are questions for you to answer that can feel spooky and eerie, but they do not need to be. Just be confident, the patient's there. It's not your fault they're there. It's not your fault that they have this treatment. It didn't get there overnight and now you have the amazing opportunity to educate them.   Kiera Dent (11:40.93) help them get healthy again and become like so fulfilled by having that confident smile again. And then that in turn can also reduce your overhead. Looking at our P &L consistently, making sure that we're not overpaying for things that we don't need, but also making sure that our revenue we're producing what we need to be producing for our practice. These are things that I am obsessed with. I love them. It doesn't need to be spooky for you. It really just needs to be fun for you. And so that's why at this Halloweeny time,   No tricks, just treat. And within our consulting, we have our online version and we also have our in -person version and both of them give you a way for these spooky things to actually be done with ease. So I'd love for you guys to come try it out. Like, what's it gonna hurt you to come and be a part of a community of people of like -minded dentists, to have consultants at your fingertips that literally will give you the answers to all these spooky things and also get your team on board with you.   to come and either be in person and meet us. We're literally getting ready to have our doctors in person together and work on your business from the minds of brilliant people to be able to lift you and your practice to the highest heights that are out of this world, to be able to have consistent accountability in your practice of people that hold you to a higher standard and grow you. Come join us and be a part of it. I'd love for you to come try it out. Running a practice truly does not need to be scary. So come try us. I'd love to have you.   No tricks, just treats for all of you. You guys, I am obsessed with dentistry. I'm obsessed with helping you guys have the life that you deserve to live and that you're worthy to live and that you have every capacity to have. I'm obsessed with getting your team on board with you. So come try us out. Hello @ TheDentalATeam .com or just go to TheDentalATeam.com. Book a call with us. You guys, it's not scary. We literally like meet you with open arms and a huge hug. And we're there, whether you are on the top of your game or you are at the bottom of your game, anywhere in between.   We're there for you and I can't wait for you guys. end of year. It's a great time for you to be looking at these things, to make decisions, to make sure that next year that you are successful without knowing that it's maybe going to happen or not, but being confident that it will happen for you. Now is the time for you to take action, to not have it be scary and to have the best, best life that you could ever imagine. Reach out. Hello@TheDentalATeam.com. And as always, thanks for listening and I'll catch you next time on the Dental A Team Podcast.  

Ever received an EOB (Explanation of Benefits) from your insurance company and thought, "What even is this?" Spoiler alert: it's not a bill! But it is your crystal ball, giving you a heads-up about any upcoming bills. Join us in this quick, fun, and enlightening episode as we break down the mystery of the EOB. We'll walk you through the key info it contains, how to read it, and what it means for your wallet. Episode Highlights: - What exactly is an EOB and why should you care? - The must-know parts of an EOB to look out for. - How to use your EOB to anticipate bills and avoid surprises. For more hands-on learning, check out these sample EOBs: -- Sample EOB 1 - https://www.cms.gov/files/document/11819-sample-explanation-benefits-508.pdf -- Sample EOB 2 - https://www.patientadvocate.org/explore-our-resources/interacting-with-your-insurer/what-does-an-eob-look-like/ Join us for a bite-sized dive into the world of insurance paperwork that's both informative and surprisingly fun. By the end, you'll be an EOB-reading pro, ready to tackle your insurance mail with confidence. Hit play and demystify your EOB today!

Consultants Tiff and Dana talk all about accounts receivable and why knowing your numbers is so critical to practice success. Hint: Once you know where your numbers sit at, you can develop systems to improve the areas in need of help. Episode resources: Reach out to Tiff and Dana Tune Into DAT's Monthly Webinar Practice Momentum Group Consulting Subscribe to The Dental A-Team podcast Become Dental A-Team Platinum! Review the podcast Transcript: Tiffanie (00:08.706) Hello everyone! Welcome to today's podcast. I am here with my fave Dana. Dana thanks for being here with me today. I know we have busted out so many podcasts recently. You have been my like go -to gal for months now. So thank you for taking the brunt and the load of all of the podcast needs that I keep sending your way. I truly appreciate you Dana. How are you today?   Dana (00:30.92) Doing good. Absolutely. You're so welcome. And I feel like podcasting with you is so easy Tiff So it's never a burden on my end.   Tiffanie (00:37.666) Thank you, thank you. And it's our time together. We got to spend some time together at Retreat and I was like, my gosh, I really do love just like the moments that we get together. So it's perfect. And I have...   You're down more southern in Arizona than I am, so you're closer to this beautiful hike, Seven Falls, and it has been so hot on my mind. I mean, it's way too hot outside right now, so we have to wait. But we're projecting that one for the fall, and I just cannot wait to do it. As soon as we have a date, I'm going to make sure that you know so we can go together. We'll have to take some photos for our podcast listeners so they can see these beautiful falls. Love it.   How is everything in your world from a client standpoint and just from a consultant standpoint, how is the mid -year going for you as a consultant and what kind of trends are you seeing aside from, I know we chatted about hiring on another one, on another podcast, but what other kind of trends are you seeing? We've been talking a lot of finances the last couple of months. Are you seeing anything within that with your clients right now, Dana?   Dana (01:47.112) I think, yeah, the finances right now are a hot topic and I think we're looking at numbers more than ever and a lot of those numbers are including expenses and so I think that conversations have shifted absolutely to be more heavily related to numbers and halfway through the year, right, this is a big time where I look at, okay, let's check on goals, like where are we halfway through the year and let's build out the rest of the year. So really looking at numbers right now at time with clients.   Tiffanie (02:12.45) Yeah.   Yeah, totally. And we've done a couple of numbers podcasts recently as far as like budgets and overhead and really figuring out how to get those numbers down. So I know, I know when those things come up podcast wise, it's usually because it's relevant to some of the consulting that we've been doing. So I think we both have seen that a ton this year in general for a lot of our practices. I think people are just starting to get a little bit more business savvy. It could be, you know, the DSO market is on the rise and, and, and   and my GP owner doctors and my specialty owner doctors even are really starting to try to get a handle on what their overhead looks like, what their profitability of their business is and what that might look like, not just to sell, but I always say, and I learned this from Ms. Kiera Dent, that any business should always be set up to be sold if in the event they do ever want to. It doesn't mean that they're going to sell, but you should always have yourself set in that way so that you're the best and the most profitable that you possibly are.   possibly can be. So I think it's really brilliant that a lot of the doctors and the trends that I'm seeing are more business savvy in that way and really trying to get a handle on the knowledge so that they can move forward and be their most profitable. So on the topic of profitability, I really wanted to discuss, we've chatted a lot about like overhead, how to manage it, how to control it as best we can, manipulate the pieces that we can within overhead, but I really wanted to talk about   talk today about looking at our AR as a way to also increase profitability. I think that I've seen a lot of people miss this. And if I'm blunt and honest here, I've had a lot of consultant interviews that have missed this as well. And so I know it's not a super common thing to look at because it is something that's so drastically overlooked a lot.   Tiffanie (04:12.578) I know, Dana, when I have doctors that are trying to increase profitability, most of the time, and I've had interviewees, you've seen this too, where we're like mock interviewing, we're trying to guide them to the right answer. We've seen it a lot where people, we want to increase the profitability. We want to decrease overhead, increase profitability, and people tackle production. They're like, well, you have to produce more. But you can't.   out -produce the problem. We've been saying this for years. You cannot out -produce the problem because the problem is not typically in your production. Dana, where is the problem typically found? My all -star lovely consultant of the Dental A Team that would know this and did know this, where is the problem typically found when profitability is low and overhead is high?   Dana (04:57.896) Yeah, absolutely. You're going to look at your collections for that. And great news is AR can add to collections month over month.   Tiffanie (05:06.146) Yeah.   Yeah, exactly. Spot on. Nailed it. She's hired. She's staying for a lifetime. She's here forever. Yes, your AR, you guys, your collection. So a lot of the times, practices don't know what your collections should be set at, like what your projected collection should be, what your percentage should be. So for a standard GP practice, meaning we're general producing, we're doing a lot of bread and butter, maybe implants, maybe surgeries, things like that, but not a ton of ortho.   were PPO or fee for service, you should be 98 % or higher in your collections percentage every other month. So that means that your team is collecting 98 % of the production for that month. 100 ,000, you got $98 ,000 in collections. Now caveat, doctors, because this comes up a lot.   your collections from your software is not always going to match your collections in your bank account. Sometimes there's a week or so that it takes for something to post on the bank account that's come through, so it's in a different month. That's always a caveat. And then also, you have your merchant services fees that are deducted from your deposits when you have credit cards ran, or if you're doing credit, or any other kind of merchant services. Those fees are deducted from your deposit. So you're always going to be a little bit skewed there. So   minimum of 98 % or higher is going to keep your profitability and your deposits pretty standardized high, if I could say that. Now, AR, this is your accounts receivable. Most doctors don't know a ton about AR, and that's OK. You didn't learn it. But the sad part here that I'm going to announce,   Tiffanie (06:50.754) Most dental professionals, most of the front office team, the dental assistants, the things that we know about these systems and these processes like AR, accounts receivable, was taught to us from the person who did it before us at the practice where we learned how to do it.   And hopefully, that person knew how to do it. And hopefully, the person who was trained how to do it next did some more research and learned how to do it even better, took some courses, went to some CE. There are courses and things out there. There are ways to learn it. But it's not always happening. So doctors, it's really important to us as a company, the dental A Team, we spend a ton of time with our doctors ensuring that you guys know and understand what these numbers mean because they can affect your profitability so much.   So you should have 98 % or higher collections rate. And then your AR, your total outstanding money, meaning the total amount of money that you're waiting, it's out there in the universe, and you're just waiting for it to fall into your lap, should be less than one month's total production.   So I've had a doctor, I've had a couple times, I've had a couple practices come to us, but I had a doctor, he is one of my favorite human beings in the entire world. He is the most genuine person I have literally ever met. And he came to me a few years ago and he said, I think something's going on, I have no money, but I have a ton of production and I feel like my AR might be high. And I said, okay, cool, I'll get in, I'll dive into it. And I get there for his first in office visit, this was like,   years ago, I think 2018. And I opened it up and I was like, my gosh, I think I'm going to cry. This is a one and a half doctor, like his associates, I'm going to count them as like a half doctor, and two hygiene. And their outstanding AR was like $270 ,000, I think.   Tiffanie (08:41.89) And I was like, my gosh. And so much of it was untimely filing from insurance. So much of it was patients hadn't had statements in years. So there are balances here that are five years old that they just haven't gotten taken care of. So much of it was just a disaster. And it was so scary. And I was like, we're going to get a handle of this. And it's OK. We're going to figure this out. We're going to get your profitability up. So looking at it.   at that 98 % or higher on collections rate and your outstanding AR less than one month's production is going to help that. So knowing those stats though doesn't change the game. So if you know those stats, you look at it and you're like, OK, Tiff, Dana, we're at 92 % collections. It's really close, for sure. If you're doing ortho or if you're a Medicaid accepting practice, I want 95%. So you've still got 3 %   higher to get to. And you've got quite a bit of ways to go for that 98%. So Dana, when you're working with practices, because I know we both see this a lot, where practices come on for systems. And they're like, these are the things we think we don't know. And we dive in, and we're like, gosh, we need to start here, because we've got to get your profitability up before we start working on new patient phone calls. We've got to make sure that the money is being collected on the back end. So what are some systems that you put into place? What are some things that you've   things that you do to help doctors find that profitability in their AR and to really get their billing department working for them and not against them.   Dana (10:16.936) Yeah, yeah, I think first it is like pulling those reports regularly and looking at those numbers and then knowing of that what is collectible so having a system to if you have agreed upon payment plans like if you have ortho or you do some in -house payment plans knowing how much of your ar is sitting on those that really like We can't count on collecting now because we agree to take that over time   Then once you know what you have that's collectible, just kind of knowing where it sits and knowing how quickly we're getting insurance claims paid and kind of looking at trends is most of that patient is most of it AR because when you know those things, then it helps you create systems to improve on things so that you know basically like where you want to put your effort as far as reinventing the wheel or coming up with systems. So it is, I think, pulling those reports and knowing where that money sits, then you can start creating   basically a cadence right for your billing person to really follow to ensure that the bulk of your AR is sitting in current and you have clear processes for the aging especially when we get to that 90 point I see so often in offices they don't have a cleanup process really for AR so AR continues to grow and money continues to sit there and we have   hopes that we can collect it, right? Or we say, well, I've got a lot sitting in AR and that will come in. Well, that's really not collectible and we've done everything that we can at this point, then having a cleanup process too, so that you have accurate numbers when you're looking at your AR.   Tiffanie (11:51.874) Yeah, totally agree. Totally agree. I think something that a lot of practices miss is creating a cadence for statements for patients. And number one, you shouldn't have a lot of statements, you guys. Doctors, if your billing department is sending out a massive amount of statements, you're like, gosh, why am I always buying stamps? Why do we need more envelopes? What is happening right now? It's 2024, right? We shouldn't have this many statements. Or why am I sending out so many texts to pay? What is going on here? You shouldn't have a lot of statements.   and dive into the root cause of what's going on every single time. And Dana's pulling the reports and look, that's what she's talking about. She's talking about, let's see what's happening here. So if we're not profitable and we're like, gosh, employee cost is high and supplies are high and labs are high, all of these things are high, how do we change this? First, look at your collections and say, am I at 98 % or higher on my collections? If you are, that's a separate conversation.   will happen a minute. Most of the time you're not, or you've got a ton of money sitting in AR that wasn't collected before and you're trailing that, and so your collections is still not in a healthy standpoint and it could be better. So first look at that piece and then dive into those pieces that Dana's talking about. What is collectible? So maybe even have a spreadsheet. A lot of billing representatives love to work off of spreadsheets. That's just kind of how their brains work. So have a spreadsheet maybe that says this is how many ortho accountants   We have this is how many in -house savings plans we have We've got this many patients that are making three months worth of payments, which I am NOT an advocate for I would much rather pay I would much rather you pay the percentage to care credit to be the banker than for you to be the banker and chasing money forever So make and make a good decision for your practice, but that's always what I advocate I know all of us here at the Dental A Team do we don't advocate being the bank or the lender It's just not who you are. You're a dentist not a bank and you don't have a bank   a banking facility. So go through and see what is collectible and then go through and see what's insurance and what's patient due, right? So what's outstanding from patients? If you have a high patient outstanding situation going on there, you really want to look into that and figure out what's creating that. Something before the patient statement is creating this situation. So oftentimes it's bad information in our computer. Oftentimes it's not the right   Tiffanie (14:21.3) Insurance verifications not the right information and we're not able to give a good treatment plan So we're giving bad information to our patients And so they're not actually truly paying what they should be or close enough to what they should be I'd rather you have credits that have to be returned than statements and we're chasing money We can always say hey, you've got more treatment to do. Let's use it for that or hey good news We've got a credit on your account. I'm so excited to return this back to you rather than hey, by the way, you're   Your insurance paid less than we anticipated they would, and it left you with a balance. Much different conversation. So if you do have a high number of statements going out, or you feel like your patient outstanding is high, I want you to dive into those reasons and really just ask your team. Like, hey, guys, I don't want you to have to chase all this money. I don't want you to have these hard conversations with these patients. It seems like it'd be incredibly uncomfortable.   It is. And ask them, what are we doing prior to the statement point to make sure that you guys don't have to do this? Now, I want you guys to pay attention to how I worded that, because it's much different than saying, what are the systems that aren't working that's creating these patient balances where patients have to pay us? I know it sounds the same. It sounds very similar. And to you, you're black and white, and you're saying the same thing. I'm saying, let me help you not have to make these hard conversation calls and tell patients they owe us money. Let's make it work.   make sure our systems are in line and that they're actually working for us because the result that I'm seeing means that something along the way isn't working and it needs to be changed. I don't want you guys to have to do these hard conversation phone calls. So look into that and look to make sure your systems are working. Now,   Flip side, maybe your patient base is super clean, and I'm super impressed, and I'm like, Fran, freaking fantastic. You're getting the right information in the system to produce the right information to collect from the patients. That's fantastic. Now it's held up in insurance. Now.   Tiffanie (16:16.354) Y 'all know 2024, we had a whole insurance mishap early this year. Okay, so there's still a lot of stuff caught up in there. And there are a lot of practices that I have that I work with that were like, it's the change health thing to like, I'm just waiting for that to clear up. And I'm like, wow, okay, cool. But if you're still not calling on it change health situation or not, if you're not calling and following up on these, they're likely not.   to get paid. So making sure no matter what the situation, what the climate is, we're always following up on these insurance claims is what Dana's talking about there. Like making sure we have a cadence and a system. And Dana, I think you and I probably work very similarly this way. And you guys, this is where you're going to see we're two consultants at the same consulting company that could do this slightly different. So there are a million ways to do this and to do it right. You just have to find the way that is going to work the best for you. So Dana?   Typically, what I'll do is I'll have an office manager or a billing representative pull those reports at the beginning of the month. And each week, they're going to work a different section of those reports. So the first week, they'll probably work 0 to 30. Then they're going to do 31 to 60, then 61 to 90, and then 90 plus, and then restart again. Now, I have them working those chunks and then also sending a chunk of the alphabet because.   Oftentimes I see practices, and this is how we did it in my practice years ago. It was like, okay, the first Thursday of the month is statements day. They've got to be out by the 15th, so I'm going to give myself a week to work through all the statements. And then that second week of the month is insurance follow -up, period. And it was like bombarded with so many questions about statements for a week, a full week of bombarded with billing questions. And then,   a ton of insurance claims still fell through the cracks because we weren't giving ourselves enough time and we were trying to bite off more than we could chew at one time. So Dana, how do you split it up with your practices? I say this all the time, you guys, Dana is my systems queen. We all have systems. We have systems for dental lighting we know are tried and true and that they work. But Dana, she teaches, preaches, and just coaches systems.   Tiffanie (18:39.81) Constantly with the type of clients that she is working with virtually that's mostly what she's doing So I lean on you Dana a lot to just make sure like what is it that you're seeing? And what are you seeing is working the best for your clients as you're creating these systems for AR with them?   Dana (18:56.52) Yeah, it's very similar to yours, Tiff, in that the first thing is first is the second that you get an EOB and you know that the patient has a balance, right? You're going to send something right then and there so that they get that initial contact. I also usually to kind of preemptively try to avoid some of those phone calls, template notes or add notes to your statements to let patients know why there is a balance, especially if it is an unexpected balance. Okay, so that should help reduce the bombardment of those   Tiffanie (19:25.89) Good.   Dana (19:26.474) calls. And then it is it's working insurance AR every single week. And then I do split it up so that we aren't what can happen is, okay, I'm working 30 this this day, or this week, week one, and I get so far into it. And then when I work current again, I call on those same ones and the ones that are lower down the totem pole, I'm not hitting for a month or two. So I do tend to break them up and alphabet is an easy way.   Tiffanie (19:45.826) Yeah.   Tiffanie (19:51.906) Yeah.   Dana (19:56.394) to break them up so that we ensure every claim or every patient gets that consistent follow -up.   Tiffanie (20:03.394) Yeah.   I love it. I love it. And it works, you guys. So then what happens, like that's wonderful systems for your AR. And we'll do, we'll always do AR system, like podcasts, we'll always do those for your teams as well. And we train the teams how to do it. But this, you guys, is to increase your profitability. So when you have these solid systems, I hope you see that kind of snowball effect. How if it's not a good system and it's not working, it snowballs and snowballs and snowballs into more debt, basically, right? Your practice has this outstanding money.   that's not been collected it's like debt from all of your patients and your insurance companies to you which decreases your profitability because profitability is about money in the bank not production on the schedule.   So I hope that you're seeing that and I hope that you're seeing the snowball effect of good information in means good information out, which ultimately means the correct collections is happening, satisfied patients, everyone's happier, team doesn't have to like chase money, doesn't have to have these hard conversations and your profitability goes up. Happy people, happy money, happy all of the things and really see that.   It's not always about the production. Now I did promise you, if you do have your high collections and you're like, you know what Tiff, like my AR is not horrible, but my profitability just isn't there. Now it's the time to look at your production and look at your schedule because you could be missing some huge opportunities on your schedule. Now we talk a ton about blocked scheduling. Dana's a freaking whiz at.   Tiffanie (21:32.482) implementing block scheduling. So many of our consultants do it with almost all of our practices, I would say, are on some form of block scheduling within their practice because it guarantees the profitability, right? Or it guarantees the production, I should say. And if your practice is on top of the collections, like you're saying they are, it guarantees the profitability. I've had practices, and Dana, I know you have too.   implement this block scheduling and find not only thousands of dollars on their schedule, but also hours of time. With the right efficiency, with the right mold and the right model, you can save time, create space for more patient treatment.   And with the right collections, it increases your profitability. I did have a dentist text me yesterday, and he said, should I start pushing my PPO, like low paying fee schedules out, because today's production was junk. And I said, well.   No matter what the fee schedule is, no matter what the insurance is or non -insurance, if we're scheduling to a productive schedule based on our blocks and not just scheduling to get a crown on the schedule, no matter what fee schedule it is, it should work.   So if we're not to production yet today, or tomorrow, and we're $3 ,000 off, but your crown you're trying to schedule is $1 ,200 only, then probably don't take that whole block.   Tiffanie (23:03.01) or a week from now. You're going to look for the spaces that it makes sense for the financial aspect of it to go in. We're treating all of our patients. Our patients are all getting the treatment that they need. And no one's being forced to wait longer than they should. They're getting put into the schedule where they should be put into the schedule. And he said, yeah, we usually do that. Today was an anomaly. I'm just in a sour mood. I'm like, OK, fantastic. Then I don't need to call the practice and figure out what happened to my blocks. They're working. But that's the same thing.   space you guys that if the collections is there the AR is fantastic in this practice the the one I'm talking about that texted me we worked I don't know 18 months hardcore   on overhead AR collections and profitability and figuring out his money. So for him to be texting me complaining that he had a rough production day, that was a blessing. I was like, fantastic, if that's the least of our worries right now, we can get back on track. But if that's where you're at, and Dana, I think you've probably seen this too, where doctors are like, we're clean. My AR is clean, we're collecting the money we're supposed to. Our systems are fantastic, but we're just not producing enough. And have you seen, I know,   scheduling is a really huge, huge aspect of it. But have you seen even in like diagnosis and watching those numbers, have you seen that you've been able to increase that for doctors to really help that profitability?   Dana (24:26.375) Yeah, and it's just it's really just a series of questions. Okay, what are the obstacles to getting to where you want? One, do you have enough patients, right? Because it can be new patients. What is our case acceptance of the patients that we have? And what's our diagnosis rate? Oftentimes, that's the one that's overlooked. It's the hardest probably to talk about or for doctors to maybe admit or take a look at and that's okay. But knowing that like, hey, if my goal is $5 ,000 a day, and I know our case acceptance rate is, you know, 55 to 65%,   Tiffanie (24:35.682) Yeah.   Tiffanie (24:44.61) Yeah. Yeah.   Dana (24:56.282) what does that look like for diagnosis and then what does that look like per patient and no that doesn't mean we're forcing diagnosis on patients but it gives us an idea and we know what we're striving for it helps us get there so absolutely all of those pieces lead into production so there's lots to take a look at when we say hey we aren't profitable that doesn't have to do with AR for sure.   Tiffanie (25:02.466) Yeah.   Tiffanie (25:16.834) Yeah.   Yeah, I love it. I love it. Thank you, Dana. So we've got a ton of tips in here for you guys. Today, I want you to go look at your collections. I want you to get used to looking at it and know what that percentage is. Have those conversations with your billing department so that they know that you're watching it too and that you want to know and be a part of it. So look at the systems and processes, you guys, by pulling your reports first. Dana said pull those reports. Look at what is collectible. What's your outstanding look like? What's your percentage? And then work backwards from there. What are the systems that got you here?   or trouble point, like troubleshoot, what is it that's pointing to the root cause of whatever it is that you're seeing, and then dive in from there. Okay, so pull your reports, do your due diligence, and break it apart, like Dana said earlier. I want you to be in communication with your billing department or your office manager, whomever is the one that's reviewing these accounts and taking care of it, and ensure that you guys have a good system and a cadence that spreads these things out so that whomever is responsible for it has the time to   actually get it done. Go do those things. Make sure that your team knows you do not want them to have those hard conversations with the patient. So let's do everything in our power to make sure that we don't have to have those. When they do come up, it makes it much easier because they're few and far between.   As always, Dana, first and foremost, thank you for being here with me today. Thank you for sharing your tips and your systems. You are honestly a fantastic consultant, and your clients are just so lucky to have you. So thank you for being here with me today, Dana. Anything that you want to add into their action items before I wrap up today.   Dana (26:55.592) Not anything I want to add. I just want to stress the point that you made and that is asking the questions and figuring out and coming from curiosity. Oftentimes doctors steer away from this because they know nothing about billing, right? Or they don't know anything about AR. So it's, they avoid conversations because I don't really know what they do. So I don't know what questions to ask and just don't let that hold you back. Just come from curiosity. Like you said, tell me what you do. Walk me through this, right? And how can we make those pieces better to get better results?   Tiffanie (27:05.89) Yeah.   Tiffanie (27:24.962) Yeah, I love it. That was a fantastic statement. Thank you, Dana. All right, guys, go do the things. Go figure it out. As always, we want to hear from you. If you've got a system that's working and you're like, guys, I think people need to know about this, let us know. Drop us a five -star review and let us know what you're doing. Or email us at Hello @ TheDentalATeam .com. We are here to serve the dental community in the best ways that we know how. And one of those ways is just pumping out massive amounts of information that you guys can implement if you need help training your teams on these kinds of things. things.   systems or if you need help learning them, this podcast was a good start, but you need a deeper dive and you need more knowledge, please reach out. The team that gets the emails, Hello @ TheDentalATeam .com. You can schedule a call on our website. We do know what we're doing. And those beautiful ladies and gents that will take those calls will point you in the right direction. We are here to help you. We just want you to have the best, most solid information and the best business possible. So go get your profitability up. And until next time, we'll see you later.

We get asked this question all the time. Well, it's time to remove the obstacles. Say goodbye to providing free dental services, due in part to the confusing and often misleading EOB guidelines and contractual language from dental insurance companies. It's also time to say goodbye to the dental consultants and other individuals who truly lack the expertise you need to navigate the business of dentistry.Support the Show.

In this enlightening episode, we sit down with Jennifer S. Then, my very own sister who is a Registered Nurse and Certified Professional Coder, to unravel the complexities of insurance language and billing. The purpose of this episode is to  listeners to navigate the system with confidence and clarity.Jennifer brings her wealth of knowledge and expertise to the table, providing invaluable insights into understanding insurance which promises to be an indispensable resource for anyone seeking to gain a deeper understanding of insurance billing.Key Points to Expect:

The US National Debt is at nearly $35T dollars. In the 10 seconds it's taken me to read this line... it's gone up $400K dollars. EOB yesterday... to now... $20B. Dave wanted to know... how to do you pay off the national debt? Is it like your credit card? You have a minimum you have to pay... and anything above and beyond goes to principal? Nope... it's not that easy... but it's also not that hard. Dave walks through what he learned from a conversation with BYU Professor of Economics,  Mark Showalter.

The End of the Bench with Geoff Haxton and David Collier tells you what you need to know in the world of sports both locally and nationally, and they read your comments from the chatline. John Calipari is leaving Kentucky to take the Arkansas job, does Scott Drew now leave Baylor to replace him? The college basketball season ends today with the national championship. Voting for the EOB derby has begun on X, and the guys take questions from the chatline to end the show with Ask The Benchwarmers.

Dive into the world of vocal artistry with Monique B. Thomas in episode 19 of Monique on the Mic. This session, we're getting into a deep and revealing chat with Sandrine Crescini, an incredibly gifted artist. Discover why starting vocal coaching early can make all the difference, how to handle the pressures artists put on themselves, and the significance of having a team that's got your back. Sandrine opens up about understanding vocal registration and shares her personal experiences with the studio's unique challenges, offering priceless advice for emerging talent. This episode is a treasure trove of insights on the ups and downs of a music career, finding and owning your vocal identity, and the life-changing impact of music. Don't miss out—tune in to uncover the strategies that can unleash your artistic potential.Resources : Sandrine CresciniInstagram page : EOB : https://www.instagram.com/eob.music/Step up your vocal game with 'Elevate Your Singing: The Ultimate Guide to Unlocking Effective Practice.' This 26-page guide is distilled from over 25 years of vocal coaching wisdom, offering a laser-focused approach to revolutionizing your practice sessions. Discover how to customize your routines for peak efficiency, grasp the critical elements of effective practice, and learn the optimal timing and duration for your sessions. Plus, get insider tips on creating the ideal environment for your vocal workouts. Don't let your practice become a rut. Click the link to grab your guide now and start practicing with purpose!Get the Practice Guide

For Allegheny Health Network (AHN) and Highmark, the goal isn't just to reinvent health care, but to also provide a seamless and supportive patient experience right down to the details of patient billing. After all, patients can get overwhelmed by the disconnected bills and explanations of benefits piling up in their mailboxes. Not only can it compound stress patients already have about their health, but it can also lead to missed payments and costly customer service inquiries. In this episode of Health Care Reinvented, we explore how ANH and Highmark leveraged technology and a leading-edge health care IT company, Cedar, to deploy a solution that not only increases payments but reduces patient stress around the billing process. Listen in to Neil Kulkarni, Vice President of Customer and Clinician Experience Solutions at Highmark Health; Kimberly Wilkinson, Director, Central Business Office, AHN; and Shanti Krishnan, Vice President of Sales at Cedar, detail their journey to radically simplify their customer financial experience by implementing Cedar Pay. With the Payer Intelligence Layer, Highmark members who receive care at AHN have access to uniquely integrated billing information and insurance data. In less than one year with Cedar Pay, AHN added $17 million in patient payments, thanks in part to the integration with Highmark. But the clearest signal that payer-provider partnership was working came from patients themselves, who gave the integrated experience a 90% satisfaction rating. Listen and learn how embracing technology can create so much positive impact and how more projects are in store for the future. Transcription: You're listening to the healthcare reinvented podcast series. And I'm your host, Jonathan Kersting. With the Pittsburgh Technology Council. This podcast is all about the intersection of technology and healthcare. And we talk about it at every single level, whether it's in the operating room, whether it's about virtual visits, and everything in between. It's where technology is making a positive impact. And today, it's all about how technology is simplifying the payer provider system. Simplifying just makes it sound, dare I say too simple, because it is super complex. But you want a streamlined system, you want a sensible system, you want an easy system and understandable system, so the customers don't have to be stressed out when it comes to paying and understanding their bills. And joining us on the podcast today is Neil Kulkarni, who's the vice president of customer and coalition experience solutions at Highmark Health. We have Kimberly Wilkinson, who is Director of Central Business Office at Allegheny Health Network. And we have Shanti Krishnan, who is vice president of sales at Cedar. Thank you so much for hanging out with me today. I'm excited to explore this conversation. And I always love starting with introduction. So our listener knows who is who. So why don't we just start down the list and I went through Neil, let's start with you your background real fast, and what you do, how you do it off the ball, Jonathan, thank you so much for having us and really excited to be able to kind of talk about this with the group today. I've been at Highmark, for a little under five years. And really what my role is all about is how do we transform our delivery system? And how do we make things easier for our customers? How do we make it easier for our clinicians? How do we think about simplification experiences being more practice personalized, and then working with our provider partners to really deliver a seamless and blended experience for people and so we say customer because it doesn't really matter if it's a insurance member or a provider system patient than today, it's a person. And healthcare is really complicated. And so I'm excited and unfortunate that I get to spend kind of my day thinking about how we think make things easier from a system perspective. And you make it sound easy. And that's very complicated, because it's like, like I said, In the beginning, it's one of those deals where it's like, you're dealing with people here, we need simplicity from a very complex system. And that's when you get to work on every day. And that's just improving the quality of people's lives. I love that is so cool, Neil. So Kim, how about yourself and what you do at Allegheny Health Network? Hello, everybody. I'm Kim.  I'm the director of the Central Business Office for Allegheny Health Network. And my team is compromised of our Customer Care Center, which is our call center where patients are calling in inquiring about their bills, our Single Billing Office cash management, enrollment and credit balance. So as you can imagine, my areas are very involved with the patients and answering their questions as healthcare is very complicated. And we're, as Neil said, trying to make it uncomplicated for our patients and it easier for them to navigate and understand their bill. And not make it so stressful, because they're stressed enough. That's what I was gonna say. I mean, you're often talking to customers that are at an inflection point in their life where they're dealing with maybe a medical crisis or something and you're just stressed out like crazy. And all of a sudden, they you're getting some, some bills, or some get some questions, and you can't figure it out. So it's just increasing that stress. And you don't want your folks to be stressed out. So that's why I love what you're doing, because let's bring the stress down and help people heal. Right. Right, and make it easier for them make it easy. That's what I'm talking about. And of course, we couldn't have this conversation without our friends from cedars. So Sean cheap. Tell us about yourself and really like what cedar is all about, because I love the fact that like Highmark comes in and uses these tech partners like this to make these things happen to make that simplicity happen based on a technology platform. I'm Shanti Krishna and vice president of sales at Cedar I've been with the company for almost four years now. So we've evolved quite a bit over that time. But really thrilled to be here today. And of course, just so excited to have such wonderful partners in Miele Kim and the rest of the Highmark and AHN teams. What cedar does is that we have a platform that really aims to make it easier and more intuitive for patients to navigate and ultimately fulfill their financial and administrative obligations in health care. We know this is a real pain point for patients and as Kim just alluded to, it's often coming at a moment that is already stressful because of some sort of healthcare incident. And so our view is if we can take the stress out of what is already a pretty stressful situation, you know, we're doing our job. And so, we aim to do this in two kind of key related ways. One is just bringing the best of other consumer industries to this known pain point in the patient healthcare experience, making it more personalized, more intuitive, really leaning on data and design science to help inform the experience And the second is really bringing disparate parties such as payer and provider together on one platform because we know that patients don't see these things as being entirely separate. They're actually very related, yet our system treats them as totally separate. So, again, an area where agent and Highmark have just been such fantastic partners and really helps us to realize this vision. Yeah, I was looking at your website. And you have, I mean, you have the biggest clients out there. And of course, Allegheny Health Network. Highmark, they're right there with you guys. So you're, you're helping lots of lots of big organizations solve these very tough problems. So that's, that's cool stuff. Certainly a privilege. Most definitely. So let's get the conversation rolling. I guess maybe starting off with talking with with Neil Kim about maybe some of the problems that were that Highmark was looking at knowing that you needed to find a solution around this. Can you guys set the stage for us? Yeah. So happy to kind of chat through that. So I think the last couple of years, as we've been looking at how do we drive a better experience for our customers, I really started to break that down into a bunch of buckets of things that we want to focus on. But one of the major ones is around kind of the end and healthcare financial experience to say, hey, people struggled to understand financial costs, they struggled, they don't get treatment at times, because they really don't understand that as well. So that relates is often delayed care, when they actually get then care, then there's really complicated payment processes, we don't do a good job of connecting people to financial services and advocacy programs that they might have access to. So that entire ecosystem is really, really complicated. Everything from kind of understanding what costs are known, giving, comparing cost options, making it easy for people to kind of pay their bills, helping them understand the benefits that they have, as well. And so once we started kind of looking at the space, we said, hey, this is an area that we really need to kind of dig in and and tackle, and we're not doing a good enough job today. And so about three years ago, we really started kind of looking into, Hey, what are the set of partners because this is it's complicated, like it's talked about, it isn't something that we're going to solve completely on our own. And we know that there are other organizations and kind of other companies that are really partnering to drive this experience. And so we started looking at who are the center partners that are doing that. And so through that process, we identified initially, a company called boot up as a place that we wanted to start and that transition into cedar. And so I think one of the interesting parts, which I think we'll talk a little bit further about, and kind of our discussion is, one the place to start might not be completely the place that yet. And so if this was a one where hey, everyone solve it in healthcare, it's easy, go do it, just go implement a solution, and we're good that it would be easy to go saw. And so we started experimenting and working with the senior team on Hey, initial concept, here's what we think, how would you scale it? How would you deploy that? And so we iterated on that with them. And with hm, team over time on how do you start making these things really easy? How do you bring the best of kind of other experiences that as a person, you've gotten used to whether it's financial services, whether it is retail, other things in your life that you're doing, and we really worked collaboratively to go through that with them. But that was been a three year journey to say where we started and the product that the solution that we started with right now is very different than what we actually have live. But I think that's a good part of this partnership to say, hey, continue to iterate, change, really meet the customers understand what they need, and deliver a set of capabilities or experience to a customer that really makes it easy for them to understand on the provider side, what they need to pay on a payer side, does that match what their payer has paid their EOB and really bring all that together in a really seamless way. So that's, that's really kind of what brought us to Cedar in the partnership between cedar age and a hybrid on ours. That's super interesting. And you bring up the point of fact that like, it's not like this is one of these places where you go, you buy the software, you plug it in, and though your problem solved, but know that this has been an iterative process, you don't end up where you think you're gonna end up. Because as you're discovering things along the way, it changes and of course, time changes, the industry changes, and that you got to, I guess, continually be addressing this as an issue as it goes along. Because you never fully get to like, let that's the one solution. We're done. So, Kim, I'm curious. From your side, obviously, you're much on the front lines, when you're hearing from the customers and so forth. What were some of the key things that they were kind of bringing up realizing like we got to keep improving? Like, how can we make sure that our customers are number one, and that we can we can do right by them all times. The one thing that we were lacking was the ability to provide an electronic communication, ie the text messages, the emails, or QR codes, things like that. So that partnering with theater has given us the ability to do that and evolve. And as you said, healthcare is ever changing. So as soon as we're getting one thing implemented, there's another section that you need to work on. And adding that payer intelligence for our Highmark members, has been a game changer for us, letting them know What their HSA and FSA balances are, and having that EOB comparison so that they can see. And again, helping them understand, as Neil was saying, with the payer and the provider, and linking that to that they can see that they are matching, you know, and helping eliminate that confusion. And just giving them access to some self serve options that they did not have before that we're now able to do has been a game changer for us as well. It's very empowering for the customer as well. I mean, I love that. But to get it makes, it seems like it's so easy, but you need a partner like cedar here. So I'm curious to hear from Shanti. And he obviously you come together with a client like this, and you know, this is a big project, right? And then it's going to evolve it. And it's what was it like kind of kicking this project off and kind of walking through this journey, as you're able to, you know, go through each step and then see ours as needs change, and then use those cedar products to help solve this problem. Yeah, I mean, I think to Neil's point, when we started out this started on this journey over four years ago, I think it really came from a place of collaboration. And, you know, at the time, Gouda really wanted to solve this problem of payer and provider collaboration, payer and provider coordination for the benefit of patients, but obviously not wanting to do that in a vacuum wanting to do it with a partner that could really inform us of the key pain points, and really what was most feasible out of the gates. And so that's kind of how this journey started. And so where we are today is that the cedar platform is live on the post visit billing side at Allegheny Health Network. And we've incorporated additional functionality known as the payer intelligence layer, which is both Neil and Kim alluded to, enables patients to see elements of their benefits information alongside their bills, so they can see it, their EOB and Bill have been reconciled, they can see their deductible status, and they actually have the ability to pay their bills out of their HSA. So this is available for Highmark members presenting at h n, we're continuing on this journey. This is really just the start. I was gonna say found, yeah, we found that even just this this what seems like a very small kind of tweak and an otherwise typical billing experience has led to really, really, really positive impacts for both a financial perspective for both payer and provider as well as the patient and member experience perspective. So I would say throughout the entire journey, the entire the, the approach has been extremely collaborative. And we've really leaned on both these teams to kind of help direct us and where we can have the most impact. Without a doubt, as I mentioned before, I was sneaking around on the cedar website, and I did come across that case study based on what we're talking about today. And the results have been pretty, pretty, pretty substantial. So far from these initial, you know, first steps of the rollout. Can you talk a little bit about some of the the results for lack of a better term so far? Sure. So we've definitely increased our pace patient satisfaction, we put several initiatives in place to contribute to that we have flexible payment plans, allowing for Apple Pay as a source of payment or the QR code. Again, as we mentioned, the payer intelligence for Highmark members, the ability to do your cell service options, we've updated our statement format, enhanced our payment plans to allow patients to consolidate their many visits into one payment plan so that they're not making multiple payments. And cedar has also assisted us with our customer service area. And this has helped us tremendously with reducing our abandonment rates. So when patients are calling in, you know, we are under the industry, industry standards for our abandonment rate now, which is that the standard is 3%. And we are well under that at an average of 1.3%. Our POST call surveys. And the results were first call resolution are up a percentage of 82%. And again, our satisfaction scores tend to increase as well. So I feel like we're servicing the patients in a better fashion, answering their questions. And again, giving them that ability to self serve as they feel need. Yeah, I think some of the other things, at least kind of but also more broadly, I think we've seen a big impact on collections. So I think it's over 17 million in income, incremental patient payments. That's not even accounting for it. We have a huge influx of people that are out on payment plans that didn't have payment plan options before. And so I think even from a customer experience perspective, hey, cost of healthcare is high and it has an impact on affordability that has an impact on the rest of your life to say Hey, can you pay your mortgage, can you pay your phone bill, you need to make a trade off decision on on some of that type of stuff. So really that payment plan functionality and things that we've done have been really impactful. I think the two other really big ones for us that we've seen is really a 33% lift in HSA FSA. So health spending accounts, utilization. And so to me, that's a big thing to say people in identical plans, they have these things, but I know what happens for me, I forget my car, I forget that you have that available. And then actually, right by reading my mind, Neal, you're reading my mind. If I remember, I was like, where's my HSA card and said, I don't keep it in my wallet with me at all times. And so one nudging and reminding people that they have these funds available to use for a payment has been really, really big. And so we've seen a big effect of that. Also on the Highmark side, we look at it in terms of what is our net promoter score or customer experience holistically in a segment and industry in a market right now. And so we've seen really good improvements overall in western Pennsylvania, with our net promoter score with the types of solutions that we're implementing in the space. So I think it's been a win win all round to say, a big impact for HN, but also a really big benefit for Highmark, in terms of making it easy for our customers to access care and pay for Kevin, you get to have so much fun doing what you're doing, because you're actually seeing a positive impact. It's only got us invigorate you more and more on both sides on the theater side on the high marks actually, like basically, we came together we're going through this journey, we're actually seeing the results we wanted. And we realized there's still more opportunity to do more. So you must be pretty stoked. We are really excited, we have a big roadmap and backlog of things that we want to tackle. So I think some of the things that we're we're really starting to lean into. So Shanti alluded to something that we call the payer intelligence layer. And so that is the component that is a Highmark insurance oriented to say, how do you provide a differentiated and unique experience for a high mark customer that might be going to a system like Allegheny Health. And so if we want to make it so much better, so much more streamlined and easy that you don't need to think about certain things, if you have a that type of a partnership? So a couple of things that we're working on, one is continuing to expand and scale that payer intelligence layer to other providers systems in other parts of the market to say, how do we work with not just ah, and in western Pennsylvania? How do I work with other systems and other geographies that Highmark operates in to really offer the same types of capabilities that we're really offering in this place. But that is one of the things that we're kind of working with the Cedar Key more holistically to expand that, I think we also have, I'll say, new capabilities and new use cases and new experiences that we want to launch as part of that payer intelligence layer that can go directly to a patient specifically with age as well. So a good example of that would be, hey, there's a treasure trove of information and things that we know, on an insurance side about a person, and we actually want to allow them to engage in those types of things. And so cedar and HN, they have eyeballs they have, they have engagement. And that's a moment that matters for a person when they're paying a bill. And so can we remind them to say, hey, you might have a need for colorectal screening, you might have a need for getting your flu shot. And there are certain things that we think are really valuable to help people manage their healthcare holistically, that we really want to use this platform to kind of start offering to our customers as well. So that's a second thing that we're kind of looking at in terms of a payer intelligent expansion of those capabilities. And I think the third one is, when you go to a system like Allegheny Health, there's still a lot of I'll say, secondary or tertiary providers that yet to say, hey, might be called a Gen, you might still get a separate bill right now. And in your mind, as a customer, you don't necessarily see that as up that was a 10 as a system, why am I getting a separate bill from this doc for a thing? You don't always know that? Are they employed? Are they not employed? And as a customer, I would not expect you to know that or figure that type of stuff out. And so how do we start working on things like consolidation of those types of bills to say, hey, it's all together, whether it is a different different entity that operates our end, if it's a different entity operates our neighbor and hospitals, but all of that if that sits under that age, and banner and brand, how do we start really making that experience really seamless as well. So just a couple of examples of that the types of things that we're looking at our our roadmap for the next year to be able to continue expanding on this capability. That's amazing. When I hear that you're able to take this and keep building on it and scaling it out for more impact me so exciting. Oh, my goodness. So yeah, like I'm confirming that you could have a lot of fun at work doing this. As far as that goes. How do you like prioritize and because I get it seems like the world just keeps opening up. How do you prioritize make sure that you can actually follow through on these things to make sure they happen because I'm sure it's got to be tough. And so it kind of goes with, hey, at the top kind of whether it's President leaders of the organizations, is there a strategic alignment in the direction that we're moving? And so we spent a good amount of time to make sure our leaders are kind of aligned at that level and are really working through that. I think then the next step goes into exactly what what Kim talked about, hey, we spent a lot of time right before the holidays on Hey, joint brainstorming and collaborative brainstorming on hey, let's throw 80 ideas over them. And let's see, what are all the things? Do they make sense for a provider system like Allegheny Health? Do they make sense for Highmark, but they make sense for Cedar? What's the Venn diagram of those types of opportunities? Let's start kind of figuring out what's the value? What's the impact on experience? What's the impact on financials? What's the impact on operations? And let's kind of collectively prioritize what makes the most sense across that organization? And then let's also short than that on a, what does the next 12 to 18 months look like? Well, we try to keep a forward looking roadmap across our organizations of the things that we want to go do. And then part of that turns into what am I learning from something I might be doing in a different space, my bringing that board to this discussion, other things that Allegheny Health Network is seeing in a completely different era that they think kind of makes sense on our roadmap as well. Then for Cedar? What are they seeing with other maybe payers or providers that they're working with as well? And how does that impact the things that we think that we're really what the I'll say, click into market and really deliver from a better experience for our customers. I like it, I tell you what, we've been doing this podcast series for almost five years now. And we've covered so many different topics like technologies in the operating room to you know, virtual health and everything, and I'm always my mind is mesmerized. Now, I think this has been one of our most important conversations, because we're talking about technology at a level. That's that's all around just how like a customer is able to interface and understand what's going on, you know, as as the as they go through the pay experience. And to me, that's just so important, and the amount of horsepower it takes to do that, and the complications behind it. Once again, it just goes to show you how technology and healthcare just they go hand in hand and they intersect in such a cool way. at every single level. I have been blown away, but with today's conversation, because these are things I just didn't know. And now I know I'm kind of excited. So if you have any parting words, anything we haven't covered, the people just need to know about this collaboration. And really, I think the excitement that as this moves forward into 2024 and beyond. This has been a great conversation. And again, I'll just kind of plus one to what Neil and Kim said, I think, for partnerships like this to work, there has to be some shared accountability, but there also really has to be alignment of mission and values. And, you know, I think at least from our side, we've definitely felt that and it's really enabled us to do what we've done so far. And we're excited about what's coming next. I love it. I'm so glad you guys are working together. I had so much fun having this conversation and learning what it takes to make something that seems as simple as a bill and it being understandable to have that happen in a seamless way. I think it's just awesome. I can't thank you guys enough for hanging out with me here on healthcare, reinvented, fantastic stuff, everybody. Transcribed by https://otter.ai

Happy January 31st to those who celebrate! I am not an accountant, I am not a lawyer, I am not an IRS agent, merely an EA in a small company who is responsible for tax form distribution. Should this task fall to you, make it a priority to print and postmark W2s and 1099s before EOB on Wednesday, January 31st.  I promise I'll post next year's episode a bit earlier than the actual deadline.  ;)

Join Practice Booster's Dr. Greg Grobmyer as he talks with Dr. Dominique Fufidio about the use of Artificial Intelligence in dental insurance claims adjudication, document scanning, image interpretation, and more! Dr. Dominique Fufidio, DDS, FAGD, is the founder and main coach at Fufidio Consulting Group (FCG). Dr. Fufidio has pioneered a unique coaching experience focused on teaching an understanding of the dental insurance claims review process and the rationale behind the decisions on the EOB. Dr. Fufidio has established herself as a successful, fee-for-service, former private practice owner, dental artificial intelligence co-creator, and top-performing dental claim reviewer and Utilization Review Director for the largest Utilization Review Agent in the United States. Now, she is on a mission to bring clinical alignment to dental providers and the dental insurance payor market, helping dental offices get paid for what they do! Each insurance carrier is different and each reviews claims differently. Each payor selects claims to review differently and has clinical criteria that are different from one another, albeit largely similar. The concern across the industry is that the clinical documentation submitted needs to substantiate a “proof of loss” and true “medical necessity” for the treatment rendered. It is crucial to understand that the decision from the insurance payor is a benefit determination, not a treatment recommendation. The treatment recommendation is clinically yours, and yours alone. You must make the best recommendations for your patients and submit your diagnostic evidence in support. Practice Booster is the leading resource for information on how to best utilize the CDT code set; featuring the Code Advisor database, the Insurance Solutions Newsletter, administration resources, coding support call center, and more. Visit us online at http://www.practicebooster.com. The CDT codes are the property of the American Dental Association. Interpretations of the CDT codes in this podcast represent the opinions of our experts. Always refer to the latest CDT codes for use in your practice and contact the ADA directly for the ADA's interpretation of the CDT codes. You are responsible for your own use of the CDT codes. For more information, refer to ADA.org.

In this episode of The MHP Broker's Tips and Tricks podcast, Maxwell Baker, president of The Mobile Home Park Broker, interviewed Ed Bridgman, president of EOB Consulting. They discussed the services his team delivers to mobile home and RV community owners.   This and every Tips and Tricks podcast episode is brought to you by The MHP Broker's'  proprietary Community Price Maximizer. Use this four-step system to get the highest price possible for your mobile home park or RV community when you sell it through The MHP Broker. Guaranteed. Ask Max for details.    Here Are the Show Highlights:  This is a return visit to the podcast for Ed, who addressed several additional topics of interest for mobile home park and RV community owners and investors. Max and Ed started the conversation with the challenges related to monitoring (and getting paid for the electricity used by RV community guests. (Max, 00:59)  RV destination owners are starting to understand the importance of metering guests' electricity consumption. But most don't have the infrastructure in place to do it effectively. (Ed, 1:21)  Those owners are starting to understand the importance of individually charging guests for their electricity use. Ed used as an example a guest to his own state-of-the-art Homestead RV Community. The guest arrived in a 32-foot RV decked out with an extensive solar panel array and about 800 pounds of batteries, so Ed didn't expect this guest to use much, if any, community power. (Ed, 2:03)  What Ed didn't expect was for the guest to boondock under tree cover. As a result, he wasn't able to recharge his solar batteries, and the guest ended up using $45 worth of community electricity in just a few days. (Ed, 3:35)  As another example, Ed had several RVs arriving together over the Christmas holiday. Several had heated floors, and each consumed 125 to 150 kw of community electricity. In other cases, guests might have electric cars or golf carts being recharged through the park electrical, or have freezers, space heaters, air conditioners or other big appliances tapping in. The point is, park owners must charge individually for consumption or go broke. (Ed, 3:47)  Besides encouraging RV park owners to monitor electrical use, Ed also consults on helping new owners of parks turn a profit on a previously unprofitable property. (Max, 5:09)  Ed gets called by both sellers and buyers. He helps sellers appraise their property for sale value, and will walk a property with the prospective buyer to suggest actions to increase park value and satisfy lender concerns. When investors are building parks, he'll consult during the layout design stage to find potential problems and opportunities. (Ed, 5:46)  Ed's review can be so comprehensive as to include interviewing city officials and local businesses to see about the regulatory and employment environment. For instance, he might call Walmart to see if rumors are true about the company building a new distribution center just miles from the park. He also researches local affordable housing demand and the market competition, and looks for other advantages or obstacles to profitability. (Ed, 7:01)  With all that he learns, he creates a CAD site layout for new builds or existing structures, emphasizing strategies that might be used to maximize park value. With that, they arrive at a preliminary ten-year budget that goes into a spreadsheet to give a good idea of expected capital expenditures and when the company can expect to earn a return on initial investment. (Ed, 8:02)  For  this consulting service, Ed charges a flat rate of $20,000 plus lodging and travel expenses. (Ed, 9:35)  Through this service, Ed and his team design and maximize the profitability of an average of about three client properties a month. And through his own Homestead RV Community, they have over 240 guest reviews, for a Google review rating of 4.9.. (Ed, 10:44)  The company website, at EOB_Consulting.com, includes a section called Step by Step. This is a free and informative tutorial that lists actions you should take in developing your own RV park, whether from new construction or purchase. It includes a thorough explanation of the five different destination RV communities. (Ed, 12:19)  Ed can be reached either through his website, EOB.Consulting.com, or by calling him at (512) 785-1379. You can also learn more about Ed's own property, Homestead RV Community, billed as “the most technologically advanced RV destination in the world.” Just visit HomeRVC.com and take a virtual tour. (Ed, 13:30)  When thinking about buying or selling an RV community, it pays to start with a consultation with Ed Bridgman of EOB Consulting. When the for-sale sign goes up on your mobile home park or RV community, trust The Mobile Home Park Broker and our innovative Community Price Maximizer platform to optimize your park value and sale price. Drop Max Baker a line at info@themhpbroker.com or give him a call at (678) 932-0200.    Power Quotes in This Episode:  “...we come out, we walk the property with the owner, and we develop an understanding of what their vision is for this property. That's one of the ways that we are unique from our peers, we don't try to do it from the basement of our house back in Texas. We actually travel to the property, we find every property is unique. Every property has some nuances that need to be brought out during the layout design.” (Ed, 5:46)  “...we know what the market wants, we know what the vision of the owner (is), we know the correct RV destination type, we know what the revenue generation is going to be. Now we put together a CAD design site, a complete site layout of how to maximize that value of that property.” (Ed, 8:02) 

Jsme digitální generace. Jenže Česko s digitalizací zaspalo a nutí nás provádět mnoho analogových úkonů. Úřady někdy ignorují datové schránky, které jsou navíc uživatelsky nepřívětivé. Na všechno máme papírové, nesrozumitelné a obří formuláře. Daňové přiznání nevyplníme za 10 minut z gauče a na mobilu. Nemáme ani e-občanku, natož e‑volby.01:59 – Volby10:03 – Výměna informací s úřady18:45 – Občanky a doklady23:02 – Placení28:46 – Reklamace33:20 – Měřáky39:12 – Podcasty s hosty 

This episode is sponsored by New Leaf Hyperbaric Oxygen Therapy - oxygen therapy that's non-invasive treatment that strengthens your body from the inside out. Our next guest, Sandy Kibling discusses the importance of understanding medical bills and the prevalence of errors in billing. Sandy shares her experiences working in a large health insurance company and witnessing the lack of accountability and attention to claims issues. They also explain the difference between a bill and an explanation of benefits (EOB) and provide tips on what to look for when reviewing medical bills. About Sandy:  Sandy is a health care professional having served in numerous roles including physician consulting and working for a large healthcare insurance company. She has worked on the frontline addressing physician and subscriber issues and has heard first-hand the frustration and concern about affordability and navigating a complicated healthcare system. Sandy's passion is to create a trusted source with Get Savvy…Demystifying Healthcare – a podcast that breaks down the complexity of healthcare and empowers consumers to navigate the healthcare system. This is where to find her online: Website: www.savvyhealthcareconsumer.com FB: https://www.facebook.com/Savvyhealthcareconsumer Instagram: https://www.instagram.com/savvyhealthcareconsumer/ TW: https://twitter.com/SavvyHconsumer TilTok: https://www.tiktok.com/@thesavvyhealthcarelady?_t=8ZIQ8ILjL7T&_r=1 Looking for something specific? Here you go! 00:01:30 Understanding medical bills is essential 00:09:05 Verify insurance coverage and understand 00:11:13 Understanding insurance can be confusing 00:17:29 Advocate for itemized medical bills 00:20:25 Healthcare costs vary widely 00:25:42 Take advantage of preventative care 00:30:36 Check drug websites for discounts 00:37:06 Insurance companies determine physician reimbursements 00:42:51 Knowledge is power in healthcare 00:50:30 Complexity of healthcare billing 00:56:53 Knowledge is essential for advocacy 00:57:24 Complexity of healthcare insurance decisions 01:02:32 Negotiate medical bills for savings 01:06:39 Amazon may launch Amazon Rx. Our Advice! Everything in this podcast is for educational purposes only. It does not constitute the practice of medicine and we are not providing medical advice. No Physician-patient relationship is formed and anything discussed in this podcast does not represent the views of our employers.  The Fine Print! All opinions expressed by the hosts or  guests in this episode are solely their opinion and are not to be used as specific medical advice.  The hosts,  May and Tim Hindmarsh MD, BS Free MD LLC, or any affiliates thereof are not under any obligation to update or correct any information provided in this episode. The guest's statements and opinions are subject to change without notice. Thanks for joining us! You are the reason we are here.  If you have questions, reach out to us at doc@bsfreemd.com or find Tim and I on Facebook and IG. Please check out our every growing website as well at  bsfreemd.com (no www)  GET SOCIAL WITH US! https://www.withkoji.com/@bsfreemd

"God & Wrong Thinking" Watch Here: https://youtube.com/@GodSexandLove?sub_confirmation=1 Listen Here: https://anchor.fm/godsexandlove Supporting Verses: Lamentations 3:25, Job 34: 14-15, Colossians 1:16 Go Deeper: gotquestions.org "What are the attributes of God?","Is God a cosmic killjoy?" "Is God a person?", "What was Elihu's message to Eob?" Bible Verse of the Day: Proverbs 13:20 GodSexandLove.com Support Us! https://anchor.fm/godsexandlove/support --- Send in a voice message: https://podcasters.spotify.com/pod/show/godsexandlove/message Support this podcast: https://podcasters.spotify.com/pod/show/godsexandlove/support

Healthcare transparency is essential for patients to make informed decisions, yet price disparities in the industry remain a major issue. In this podcast episode, we explore how financial incentives and contracts between hospitals and insurance companies can misalign the incentives of brokers, employers, doctors, and patients. We discuss the importance of understanding the influence of these incentives and the need for accountability in developing an equitable healthcare system. Through transparent communication and a focus on an equitable system, we can help ensure that patients receive the care they need and deserve.Episode Outline:(00:00:02) Healthcare Transparency(00:04:42) Price Disparity in Healthcare(00:09:37) Health Insurance Incentives(00:14:21) Doctor Compensation Metrics(00:19:05) Incentive MisalignmentQuotes:(00:03:21) The thing that boggles my mind about healthcare is that in most of healthcare, neither the consumer, which in healthcare is the patient, nor the provider of the goods or services, which in most cases is the doctor, neither one of those parties know what the price is going to be until long after the services are already rendered.(00:09:10) You might only be paying a copay or you might only be paying your $200 and $5500 out of pocket that's falling off of your coinsurance. And they have no idea until they get the EOB what the build charges were and what the allowed charge was. So I think they're so disconnected from how much health care actually costs.(00:12:23) But I'm going to put it really bluntly and I think I got this from Dave Chase, this little metaphor here. But imagine for a minute if fire departments only got paid when there was a fire, they would want as many fires to occur as possible. And the bigger the fire, the more money they get.(00:17:22) And not only that, I think to deny that you're influenced by the financial incentives is to deny you're human. I mean, we've operated on financial incentives long before currency even existed.(00:21:08) I challenge you, if you are not already, if you're a consultant, even if you're a patient, if you're an employer, figure out what you can do. What one thing can you do differently to turn that incentive around?Social Post:Are you tired of feeling like you have a healthcare hangover? We've all been there. That's why we created the Healthcare Hangover podcast. We dive into the headaches we've been encountering in the healthcare system that are leaving us feeling a little hungover. In our latest episode, we talk about the importance of healthcare transparency. We heard a story about a patient who was charged $475 for an X-ray at a hospital, when they could have gotten the same X-ray at a chiropractor's office for less than $75. We also spoke with a hernia surgeon who was able to do the same procedure for $7,200 instead of the $20,000 quoted by a local general hospital. Tune in to the Healthcare Hangover podcast to learn more about the importance of healthcare transparency and how it can save you money.Are you curious about how doctors are paid? Tune in to the latest episode of The Healthcare Hangover podcast to find out! From patient volume to RVUs, David Contorno and Emma Fox break down the complex system of doctor pay and how it influences health care decisions. Plus, they discuss how traditional brokers are put in an unfair position and how financial incentives can be used to deliver better outcomes. Don't miss out on this eye-opening episode! #TheHealthcareHangover #DoctorPay #HealthcareAre you tired of the broken healthcare system? Tune in to the latest episode of The Healthcare Hangover to learn how the system was designed to benefit certain people and how you can help turn the incentives around! From the perverse incentives of commission-based compensation to the Cigna CEO's 20 million dollar salary, David Contorno and Emma Fox will take you through the details of the current system and how you can help build an alternative. Don't miss out! #TheHealthcareHangover #BrokenHealthcareSystem #IncentivesBlog Post:The healthcare system is broken, and it's time to start fixing it. In this episode of Healthcare Hangover, hosts David Contorno and Emma Fox explore the lack of price transparency in healthcare, and how providers are taking advantage of patients by charging them more than necessary. Insurance companies make money by renewing plans every year, regardless of how much they pay out, and people often think that more expensive care results in better outcomes, which is not true. Unfortunately, people often cannot afford their out-of-pocket costs, leading to debt or even lawsuits. Insurance companies do not provide any positive benefits to doctors, employers, or patients, and people have been led to believe that they need health insurance to get quality health care, which is false. The hosts also discuss how fire departments operate on a fixed budget, while health care systems make more money the sicker people are. Health insurance companies have a massive workforce that they pay very little to, and they have bonus programs for brokers that are available on their websites. Hospitals are not changing their practices due to lack of consumer demand, and MRF (Machine Readable File) is not human readable, requiring a middleman to translate the data. Additionally, hospitals often put programming on their website to prevent spiders from finding the data. David Contorno and Emma Fox also discuss how cash prices are almost always the lowest prices on hospital spreadsheets, and the disparity between prices for the same procedure from different carriers is outrageous. Commercial carriers pay the highest reimbursement rate to hospitals, and patients are disconnected from the cost of healthcare due to copays and coinsurance. To illustrate this, David Contorno visited a chiropractor for an X-ray of his shoulder and was asked if he was okay with the price before the X-ray was taken. The X-ray cost $75 at the chiropractor's office, but the same X-ray would have cost $475 at Atrium, the hospital system next door. Michael Reinhorn, a hernia surgeon in the Boston area, charges $7,200 for hernia surgery, while a local general hospital charges $20,000. The hosts also compare the healthcare system to the veterinary system, noting that veterinarians often give customers options and prices up front before giving any treatment. Doctors, on the other hand, are typically paid based on two metrics: patient volume and RVU (Revenue Value Unit). Patient volume is the number of patients seen in a day, with some doctors having minimum patient volume requirements of up to 30 patients per day. RVU is a measurement of how much revenue a doctor is helping generate for the health system, often in areas outside of their office. Doctors are incentivized to prescribe opioids to deal with pain, and to send patients to the most expensive care, regardless of whether it is the appropriate treatment. The most likely outcome of back surgery in the US is a second back surgery. Additionally, traditional brokers are paid more when they retain their book of business and cross-sell additional products that benefit the carrier they represent. Healthcare and health insurance employees often think they are doing good, even though the results they keep delivering are bad. The company bills their clients and has a performance bonus for achieving the client's goals of paying less for healthcare. Ultimately, the hosts conclude that people should focus on changing one thing at a time to build an alternative system that is more affordable. The Cigna CEO made 20 million dollars last year, and the sicker people are, the more money they make. It's time to start demanding more transparency and accountability from health insurance companies, and for patients to take control of their own healthcare. We have the power to create a system of trust between providers and patients, and to make healthcare more affordable and accessible.Episode Links:Connect with Emma FoxWebsiteEmma's WebsiteConnect with David ContornoLinkedInWebsiteOther MaterialsThese materials help you promote your podcast. Quotes can be used for audio & video grams or quote cards. Blog and social posts will help your website and social media presence.

The Big Mates discuss Interstellar, U2, hats, and Earth by EOB.Adam, Steve, and Lucas continue their deep dive into the career and discography of Radiohead by discussing the debut solo album from guitarist Ed O'Brien. They look at how it was conceived, written, and recorded and select a few highlights from the album to talk about.They make predictions on what Ed will do next, explore the features of his Fender Signature guitar line, and have a look at a remix he did for Paul McCartney.What does and Ed solo album sound like? Is it cosmic? How do you do that on bass? Find out on this episode of What Is Music?Our next episode is out on Monday June 12th and we welcome Dr. Brad Osborn, author of Everything In Its Right Place: Analyzing Radiohead.Join the conversation on:Twitter: https://twitter.com/whatismusicpodInstagram: https://www.instagram.com/whatismusicpodE-mail: whatismusicpod@gmail.comGet access to more shows, exclusive bonus content, ad-free episodes of this show, and more music discussion by subscribing to our Patreon!Head to patreon.com/whatismusicpod and receive up to two new episodes of our various shows every week (including shows about Manic Street Preachers and monthly themed playlists!), ad-free archives of What Is Music?, and access to our Patron-only Discord server for even more music (and non-music) discussion!Support our show when starting your own podcast!By signing up to Buzzsprout with this link: https://www.buzzsprout.com/?referrer_id=780379Check out our merch!https://whatismusicpod.redbubble.comDonate to our podcast!https://ko-fi.com/whatismusichttp://whatismusic.buzzsprout.com/Support the show

Welcome to "Powering Your Retirement Radio"! Today, I want to address one of the most frequently asked questions about the documents you should keep hard copies of and for how long. It doesn't matter if it's your tax return or investment statements; fortunately, digital copies are acceptable for many of these documents now. But you may have a concern about what happens if the drive fails. Many people still have banker's boxes or a filing cabinet hiding somewhere. And if you are like many people, it is overdue to be cleaned out. I will go over Tax, Healthcare, Legal, Asset and Debt, and Other Documents to keep track of. Let's start with Tax Documents, as outside of CA, tax season is over, and in CA, it is at least starting to slow down. A. Tax returns and supporting documents - 7 years. B. W-2 and 1099 forms - 7 years. C. Deduction receipts and statements - 7 years. D. Business expense receipts and statements - 7 years. E. Investment statements - until you sell the investments + 7 years. F. Property records - until you sell the property + 7 years. G. Retirement plan statements - until you close the account + 7 years. You should keep these documents for at least seven years in case of an audit. The same goes for your W-2 and 1099 forms. Deduction receipts and statements should also be kept for seven years, as should business expense receipts and statements. You might ask why? The IRS can audit your return up to three years after it is filed unless they are claiming fraud, and then it is seven years. Investment statements and property records should be kept until you sell the investments or property, plus seven years. Finally, retirement plan statements should be kept until you close the account, plus seven years. Now for Healthcare documents, things like: A. Medical records - indefinitely B. Insurance policies - indefinitely C. Explanation of benefits (EOB) - 1 year D. Prescription receipts - 1 year E. Health savings account (HSA) statements - 7 years Medical records should be kept indefinitely, as should insurance policies. Explanation of benefits (EOB) should be kept for at least one year, and prescription receipts for at least one year. Health savings account (HSA) statements should be kept for seven years. I got an EOB this week from May of last year. Since I switched carriers this year, it was good to be able to pull out the old policy and call and find out what the charge was for. Also, on HSA, since you can carry forward expenses into the future, it really is seven years after you have claimed the expense since that is when you would claim the deduction. How about those Legal-related documents: A. Estate planning documents - indefinitely B. Marriage and divorce documents - indefinitely C. Adoption and custody papers - indefinitely D. Wills and trusts - indefinitely E. Power of attorney - indefinitely F. Real estate deeds - indefinitely G. Vehicle titles - until you sell the vehicle. H. Lawsuits and settlement agreements - indefinitely This section is simple, keep everything. You need the current copies but also the old copies to document the changes and when they happen. It doesn't happen all that often, but when a distant relative shows up claiming they were promised or are entitled to something, having clear documentation of when a change occurred can save a lot of hassle and potentially money. Now for Asset and debt-related documents, basically for financial information: A. Loan agreements and promissory notes - until the debt is paid off + 7 years. B. Home purchase and improvement documents - until you sell the home + 7 years. C. Vehicle purchase and maintenance documents - until you sell the vehicle + 7 years. D. Investment and brokerage account statements - until you sell the investments + 7 years. E. Real estate purchase and sale documents - until you sell the property + 7 years. Loan agreements and promissory notes should be kept until the debt is paid off, plus seven years. Home purchase and improvement documents should be kept until you sell the home, plus seven years. This is important when you make improvements that will increase your cost basis. Vehicle purchase and maintenance documents should be kept until you sell the vehicle, plus seven years. Investment and brokerage account statements should be kept until you sell the investments, plus seven years. On this one, I tell people to keep their monthly statements for the current year and then keep the comprehensive year-end on file, and they can get rid of the monthly statements. Finally, real estate purchase and sale documents should be kept until you sell the property, plus seven years. Finally, all your other important documents: A. Birth certificates, marriage licenses, and other vital records - indefinitely B. Social Security cards - indefinitely C. Passports - until you renew. D. Education transcripts and diplomas - indefinitely E. Employment contracts and personnel files - indefinitely You should keep hard copies of these documents. Birth certificates, marriage licenses, and other vital records should be kept indefinitely, as should Social Security cards. On Social Security Cards, you can get a new one issued, but you can't get more than three in a calendar year and ten in your lifetime. Passports should be kept until you renew them. Education transcripts and diplomas should be kept indefinitely. Employment contracts and personnel files should also be kept indefinitely. That is a bunch of documents. It's important to note that the above recommendations are general guidelines and may vary depending on individual circumstances or jurisdictional requirements. Always consult with a professional advisor if you have any questions or concerns about document retention. I have attached a link here so you can download a checklist or fill out an online version. Until next time stay safe! You can visit the podcast website here: https://poweringyourretirement.com/2023/05/09/documents

In this episode of The Phia Group's Empowering Plans podcast, attorneys Katie Malkin and Jon Jablon take a dive into three aspects of TPA operations designed to try to make the TPA's job more manageable: simplifying EOB denial codes, sending family EOBs, and recouping overpayments by offsetting. These are three common strategies used by TPAs, but applicable law places certain limits on all of them that are not always so intuitive. Tune in as Jon and Katie discuss some best (and worst) practices, and examine critical issues facing TPAs and health plans in today's self-funded industry.

  Canada is at the forefront of the global energy transition, leading with the goal to be net zero by 2050. To get there, the electricity sector must be decarbonized by 2035, from coast-to-coast, province-to-territory. So what does that transition look like close to home? How will customers be impacted in the near future? The Ontario Energy Board's Harneet Panesar, Chief Operating Officer, and Carolyn Calwell, Chief Corporate Services Officer & General Counsel, share their insight on thinkenergy episode 108.   Related links   Carolyn Calwell, LinkedIn: https://www.linkedin.com/in/carolyn-calwell-648318b0/ Harneet Panesar, LinkedIn: https://www.linkedin.com/in/harneetp/ Ontario Energy Board: https://www.oeb.ca/ Engage with Us, OEB digital engagement platform: https://engagewithus.oeb.ca/ Energy Exchange: https://www.energy-exchange.net/ Adjudicative Modernization Committee: https://www.oeb.ca/stakeholder-engagement/stakeholder-engagement/adjudicative-modernization-committee   To subscribe using Apple Podcasts To subscribe using Spotify To subscribe on Libsyn --- Subscribe so you don't miss a video: YouTube Check out our cool pics on Instagram More to Learn on Facebook Keep up with the Tweets on Twitter --------- Transcript: Dan Seguin  00:06 This is ThinkEnerfy, the podcast that helps you better understand the fast changing world of energy through conversations with game changers, industry leaders, and influencers. So join me, Dan Seguin, as I explore both traditional and unconventional facets of the energy industry. Hey, everyone, welcome back. The world is going through a major energy transition driven by a multitude of reasons. political policy, economic prosperity, environmental urgency, social change, Greta Thornburg, technological advancements and innovation to name just a few. Canada is at the forefront of the energy transition movement and certainly seen as a leader on the world stage thanks to its aggressive target, to achieve net zero emissions by 2050. Of course, the country's other closer Net Zero target is the decarbonisation of the electricity sector by 2035. emissions free electricity grids in every province, and territories across Canada in just under 12 years. For many provinces and utilities, the race to transition their energy sectors began years ago, in Ontario, where the electricity grid is already more than 90% emissions free. This was in part due to the provincial shutdown of all coal plants between 2005 and 2014. It's no longer business as usual for energy providers, how we've operated for more than 100 years is neither viable nor sustainable. It's becoming clearer and clearer that for the Net Zero future to be reality, we must go further, still eliminating and remaining emissions from our provincial grid to make wait for the electrification of our grid, our vehicles and yes, our houses and buildings. But with all of the unknowns in our evolving energy future, there needs to be a steady hand to help guide the way forward. Enter the provincial regulator, the Ontario Energy Board, energy utilities are more closely regulated than many other industries because of their unique characteristic surrounding energy supply, and delivery. So here is today's big question. Given that the electrical grid needs to be emission free by 2035, what does the energy transition look like here at home in Ontario? What can customers expect in the near future? Today, my special guests are Carolyn Calwell, Chief Corporate Service Officer and General Counsel, and Harneet Panesar, Chief Operating Officer of the Ontario Energy Board. Welcome to the show, Carolyn. And perhaps you can start by telling us a bit about yourselves, your background, and why you chose to join the Ontario Energy Board.   Carolyn Calwell  03:39 Thanks, Dan. I'm a lawyer by training. I started off in private practice at a big firm and then I moved into the public sector, first at the municipal level and later at the provincial level. Shortly after I began working for the Ontario Provincial Government, I got into energy when that ministry merged with the one I was hired to. And that gave me the opportunity to work on the energy file in progressively senior legal positions, while also serving some other ministries. I eventually became an assistant deputy minister at the Ministry of Energy with a broad portfolio that touched on things like distribution, transmission, agency oversight, indigenous energy policy issues, all kinds of things, lots of fun with a lot of challenging files, and always with great people to work with. So then, when the restructuring of the EOEB came along, I got excited about where the OEB  was gonna go. On a personal level, I saw an opportunity to work on things from both policy and legal perspectives as the chief Corporate Services Officer and General Counsel. And I saw the chance to learn some new skills in the corporate services side of things. And I also saw an opportunity to learn the role of the regulator and get a new perspective on files I'd worked on. So most enticing though, was the opportunity to make some changes a lot like her nude, so I was thrilled by the opportunity to come over.   Harneet Panesar  04:54 Alright, thanks, Dan. So in terms of my background, maybe I'll open it up by saying you know, Today as we talk, I'm hoping to bring three different perspectives, and three different hats that I can wear. And the first one is that a utility, you know, I've spent about 14 years working for Hydro oOne, which is Ontario's largest transmission and distribution company. And I did nine different roles across the organization. And most recently, just before I left, I was Director of Strategy and Integrated Planning. My team looked after the investment plan, the overall capital that the utility was looking to spend, I had the strategy Research and Development Innovation team. And I also had a team that focused on reliability, which is a very important outcome for utility. So we focused on metrics benchmarking studies, and I had a really cool team. I'm an engineer by background. So I find this fascinating, I had a team that did post event investigations. So when equipment fields, we bring in massive cranes, pull them out, and dissect them to see what went wrong, and try and see if there's any systematic issues that we could look to solve across the system. I also had a team that looked after the modernization of the joint use portfolio, which is the use of the poles that are looking to attach other things aside from electricity, infrastructure, it could be things like fiber and telecommunication things or other things that, you know, cities and municipalities might want to attach to poles. And lastly, we also looked after secondary land use for hydro and corridors and pathways for things like parking, lots, parks, pathways, things like that. In June of 2021, I got a phone call about the opportunity at the Ontario Energy Board to join as Chief Operating Officer. And really, it was about modernizing the regulators. And the value proposition of that was huge. And it was just something I can see, it was exciting to know that that was taking place with someone who's in industry. And I saw some of the work that Susanna was doing. And so it was a no brainer. It was something that I wanted to do. And so I joined the Ontario Energy Board June of 2021. And so I'll bring the regulator perspective, obviously, in the conversation. And the third perspective is that of academia, I've been teaching energy, energy innovation, energy storage courses to Master's students, at the university level. And I think it's important when we talk about energy, we look across borders, we don't just get confined with current practices or policies or rules and regulations. Sometimes when we're trying to explore innovative ideas, we need to broaden that scope. And so I'll look to sometimes also bring in some of the academic view of what's happening in this space, too. So those are sort of three perspectives and from our background.   Dan Seguin  07:22 So, Carolyn, for those that don't know, what is the Ontario Energy Board, and what does your organization do?   Carolyn Calwell  07:33 the Ontario Energy Board, or the OE B is the independent regulator of Ontario's electricity and natural gas sectors. An important part of our mandate is to inform consumers and protect their interests with respect to prices, reliability, and quality of electricity and natural gas services. We have oversight over roughly 60% of the electricity bill, and we influence a large part of natural gas bills. We work closely with companies that work in the sector, distributors, transmitters, generators, and with associations like the Ontario Energy Association, the Electricity Distributors Association, CHEC. And of course, with the Independent Electricity System Operator and the Ministry of Energy, we're really just one piece of a much bigger puzzle.   Dan Seguin  08:13 Harneet, there's been a lot of discussion lately about the energy transition in our industry. What does that mean? Exactly? And how will the Ontario Energy Board support the transition?   Harneet Panesar  08:31 Sure, and maybe I can begin this one by even just focusing on the word energy transition, you know, it sounds nice and clear, cotton sounds like there's a linear glide path to this transition, that's going to happen. But you know, it's multifaceted. It's very complex, huge capital dollars are going to be required, it's gonna be a need for a lot of collaboration and how we move forward on it. So it's a very complex transition that's underway right now. And let me also talk to you about it. From what are some of the drivers, you know, a lot of times we talk about transition, we talk about the innovation behind it. And we also focus on what are the catalysts behind some of this change? And we often frame our conversation using four D's and I know in the industry, there's a debate whether there's three days or five, I think we've taken middle ground here, so let's go with our four D's. So the first one is Decarbonisation. You know, as you look globally, or you look federally you look even down to the consumer level, there are commitments being made and choices that are deliberately being made with regards to emissions and and a goal and targets that are being said with regards to decarbonisation. One of the sectors that I know that's going to be really impacted by this is transportation. They have the ability to make some significant changes in terms of the release of greenhouse gasses, and we're seeing a massive shift from combustion engines to EVs (electric vehicles). And so what does that mean? That means a huge need for electricity to also feed these. And maybe I'll also just take a pause and say that, you know, when I talk to other jurisdictions in Ontario, we're quite fortunate, a lot of our generation here is non-emitting, about over 90% of our generation is not emitting. And sometimes we take that for granted, you know, I talked to some of our colleagues down south, or even across the country, they can only dream to get to where we're at in the near future. We're pretty lucky to be where we are from that perspective. And so when we look at what we need to fuel these vehicles, we're going to need a grid that has the ability to supply this type of demand. So what is the EOB doing about it? There's a couple of things. The first one is we've got a couple of industry working groups that are really helping to lead the charge on making clear decisions on what is the process, you do some of this stuff. One of them is the DER connection review workgroup. And I'm excited to say that, you know, we've, we've broken up this work into tranches, and we've made some substantive releases already on changes that we've proposed to our distribution system code. These are really there to help reduce burdens, and, and really help bring on adoption of things like EVs. And I should also back up and just say, you know, when I talk about DER connections, DER stands for Distributed Energy Resources and EVs fall within that category, too. We also know that the grid will need to be able to supply this power, we have a working group called the Regional Planning Working Group that is focused on making sure that regions have what they need to be able to supply this type of energy. And that includes providing them guidance with what they need to look at when it comes to planning for that future. And how do we fill that all in? Well, we also updated our filing requirements. And so our filing requirements are really there to articulate to applicants that come forward to the Ontario Energy Board with their applications to say, look, this is what we need from you. And we've been pretty clear that we've updated our requirements to include things like electric vehicle integration, adoption, into their load forecasting and planning, we need to make sure that utilities are putting the building for the load that's required, based on the Evie adoption in the province. The next D is Digitalization. No, back in the day, our distribution system was just poles and wires, and maybe some fuses. But it's become a lot more complicated. We've deployed a lot more grid modernization in the system, a lot more innovation, and a lot more non-wires, alternatives, and different ways of investing in solving problems that the grid was having. And so what role does the Ontario Energy Board have in that? Well, number one, prudency is something that we expect utilities to take into account when they're building out their investment plans. So we're to check for prudency and make sure that the liability service quality and cost is all kept in mind. The other aspect is, you know, as we digitize the system, there are other risks that come with it, and we need to make sure we're managing them. There are new risk factors that get created from a cybersecurity perspective. And obviously, the Ontario Energy Board plays an important role. You know, we established the Cybersecurity Advisory Committee a number of years back that helped build Ontario's cybersecurity framework, which is something we expect utilities to look at, and also report annually on how they are ready and mature to respond to detect and deal with cybersecurity threats. The last two days, and maybe I'll just kind of shorten this by bringing them together. It's around decentralization and democratization. But the role of consumers is changing. And the investments and the choices that they're making are also changing. You know, the fact that you can go to a shopping mall and go pick up an Eevee, and maybe even a battery pack. These are, by definition, consumer products. Now, they're no longer utility grade investments, like Pull Top investments, switch gears, things like that, the role that they're playing is important. And so going back to our DER. Working Group, it's important that we make sure that we look at the integration of these types of consumer choices into our grid. So that's, that's maybe a roundabout way of looking at all of our structures and the innovation that's taking place and the catalysts that are fueling the energy transition there.   Dan Seguin  13:53 Carolyn, I'd like to hear your thoughts on what you believe is driving the energy transition.   Carolyn Calwell  14:00 Thanks, Dan. I see this largely the same way Harneet sees it, but I would say it maybe a little bit differently. I agree that the four Ds are the catalyst for the energy transition decarbonisation and the move to net zero emissions, the need to deal with and respond to climate change. Digitalization in my mind reflects the growing internet of things and the need for new tools and technologies that allow us to use energy differently. We've talked about decentralization and Harneet mentioned the move away from grid scale, utility planning to decentralized resources, whatever technology or weather wherever they may sit on this system. And her need also mentioned democratization about the changing expectations of customers and their relationship with energy. And in my mind, that just leads to increasing customer choice. So, you know, I think there's tremendous opportunity in all of this, and of course, tremendous challenge. But I think what's exciting is that there's broad consensus that this is a time of extreme change, and there's an imperative to actually make that change. So at the end of the day, it's pretty exciting.   Dan Seguin  15:05 Okay, our need, what does the electric future look like from an industry perspective, and from a customer perspective?   Harneet Panesar  15:15 So let me first look at the customer perspective. And maybe even the term customer, I think, is looking to evolve. As we look at energy markets around the world, we know that consumer choices and how consumers interact with their energy is changing. And even the role of consumers is changing. You know, the term prosumer is also one that is often used in which consumers aren't just consuming power, but they're producing them. And so therefore, the Pro and the prosumer. You know, that's an important aspect of how the grid may evolve. And we're certainly seeing changes in perspective, talked about decarbonisation, just a few minutes ago, that will also create a higher dependency of reliable power while managing costs. So you know, going back to our discussion around EVs, you know, nowadays, if there are reliability issues, utilities will get phone calls. And you know, that hear about power, power off situations where the lights aren't working, or ice cream is melting, or the air conditioner just isn't going. But just imagine the dependency that gets created when you know, I've got to go to work the next morning, and I couldn't go because I couldn't charge my vehicle, you know, the dependency on the grid is gonna grow. But I think there are a lot of opportunities in this type of environment. Also, you know, if Carolyn, for example, is working from home and doesn't need her vehicle, well, maybe I can take 20% of her battery, and then perhaps you're on vacation, and maybe you don't need part of your vehicle, I could maybe take 30% of your battery, you know, I've got 50% of the charge. And now I've got an opportunity to actually use my vehicle. The shifting of how sort of load and suppliers is going to be looked at on the distribution side, I think is exciting. We're seeing a lot of these micro grids around the world interact on these sort of transactive markets. But at the end of the day, you know, the value proposition for consumers is shifting look, I've now got a vehicle that has charge and lets me get to where I need to go. And both you and Carolyn have now gotten some dollars in your pockets for helping me out by supplying some of the energy that you didn't need. This is a real shift. I think that's happening from the consumer perspective and multiple different facets. From the industry perspective, I think we're going to need a lot of help and dependencies on industry to help guide us through this energy transition, you know, there's a lot of capital that is going to need to be spent, there's going to be a lot of steel that's going to be required for Transformers or pole tops, and, and even steel towers and conductors, there's a lot that's going to be required from a supply chain perspective. But there's also growth, I mean, this is an opportunity, there's a lot of growth that's going to take place in the economy for jobs. And we also know that there's gonna be industry in terms of labor markets, to be able to help supply and build the infrastructure that we're going to need for the future. And that includes maybe in adapting some of the skill sets. And I've been speaking to colleges and universities over the last year, and they've been asking, you know: what does the energy industry need in terms of the skills or the shortages? Is there an evolution of the skills that are required, and with all the transition and change that are taking place? I think the labor markets are also important to us to make sure that they're up to speed with helping us get to where we need to be. I think the last aspect maybe I'll cover off in terms of the industry is, I think there's a lot of new players that are entering the energy market, which we haven't seen traditionally, in the past. I've talked about automotive manufacturers moving away from combustion engines to electric vehicles. I think they're going even further by opening up subsidiaries focusing on energy. It's a pretty bold move for the automotive industry to be forming these massive subsidiaries. But even on the technology side, you know, we're seeing companies like Microsoft take stronger and larger positions within energy. So I think we're seeing a shift. And even in industry, I think we're seeing a lot of new players that are joining in.   Dan Seguin  18:52 Okay, so what's the greatest risk to the electricity grid, Harneet?   Harneet Panesar  18:57 So when I think about risk, and you know, I often reflect on that word, because I think when you look at risk, it usually is a reason for why adoption of things like innovation just gets repeated. And even in the energy industry, we've got a wide variety of entities that have different risk appetites. And some of them, you know, stakeholders, shareholders, customers may not be looking to them to take the greatest risk. But what we do know is that there are entities that thrive on the risk reward model. And I think it's important that we look at risk blending, we talk about risk. And why do I bring this all up? The need for collaboration is so important when we talk about moving forward in this transition. You know, in Ontario, I'd say we've got the most complex energy market in North America. I've got 800 Almost licensed entities, and I've got 60 local distribution companies fairly complex that's on the electricity. And we've also got gas distributors. It's fairly complex. So in terms of what is the one of the greatest risks I think alignment and how we move forward. The risk in this would be misalignment. You know, there's no room to backpedal, we need to collaborate and work together and make sure that there's no room to backpedal, and that we move forward collaboratively. So misalignment, I think, could be a risk, but we're making sure we're doing whatever we can. And I know there's various entities within the energy sector that are trying to make sure we're working together, you know, we're holding hands and might be taking penguin steps to make sure we don't slip here. But I think when you hold hands, we'll get a bit more firmness. And we can take bigger, bigger steps forward.   Dan Seguin  20:33 Harneet, what kinds of major investments and other considerations need to be made to deliver the energy transition to the province?   Harneet Panesar  20:43 So when I look at some of the studies that have just recently passed, the IESO released their Pathway studies. And we know that when they looked at generation and transmission, it's gonna require hundreds of billions of dollars, some fairly substantial investments on that front, the other side to this whole thing, and going back to the sort of consumer side is, you know, the tail end of the delivery of power is also going to require a huge influx of dollars. So the distribution system is going to require a lot, I will say that, you know, within our province, you know, we've got a lot of aging infrastructure that we also need to deal with. So it's not just about the forward move around the energy transition, but we also need to look at the assets that we have, the age of them, the condition of them, and really make sure that as we're spending the money, we're still holding things up. While we're also moving forward. You know, there's a lot of advancements in the system, in terms of the dollars that we've spent on the distribution system, primarily, I'd say, on deployment of capital open fields. But we're also seeing a lot of shifts on how some of that technology is now being utilized out into distribution systems. I know that, you know, we talked about dependency on the system. The minister has also asked us as part of his letter of direction to us to help provide recommendations going forward on resiliency and responsiveness and cost efficiency. And I think that's an important consideration that we need to look at when we build out capital plans and look at how we're going to build out the future. Extreme weather events are impacting our grid and energy system, the infrastructure, so the energy systems are vulnerable to that. And we need to make sure that we're resilient and we're able to respond to things like that. And lastly, you know, the other aspect around a lot of the investments that we just talked about, again, is around cybersecurity and the importance of making sure that we're ready for any of those types of issues too.   Dan Seguin  22:28 Carolyn, I read that the Ontario Energy Board's new legislated mandate is to facilitate innovation in the energy sector. How will you do that?   Carolyn Calwell  22:41 A mandate to facilitate innovation with regard to electricity was added to our legislative objectives in 2020. And this put innovation squarely in the mix for us. I thought it signaled to the energy sector a need to take new approaches to doing business, and to think about the services they provide to customers. And it signaled to the OEB that we also need to think about new approaches and new ways to do business. And so we've tried to do that through programs like our innovation sandbox, where we've encouraged local distribution companies to come to us with ideas about how they want to make change, and to test those ideas out in a safe regulatory environment where we can talk through the barriers and hurdles that they face or that they perceive to see what what really stands in their way. We've tried to do this through work like ours in our framework for energy innovation, where we asked the sector to come together to talk about distributed energy resources and how we go about dealing with the questions that they pose. What does it mean for utilities to use them? What barriers are there? So we've tried to take new approaches to having conversations about different types of innovation, and to encourage others to come to us to talk about these things. The change to our objective occurred at the same time as a restructuring of the governance of the OEB. And I think that really underscored for us our change mandate. But when we talk about innovation, our Chief Commissioner would remind me, very wisely Anderson, that our objective has always existed in balance. So innovation is never our only driver. It's one of several others, which include informing consumers and protecting their interests, promoting economic efficiency and cost effectiveness across the sector, and promoting electricity conservation and demand management. So there's a lot going on for us and for everyone in the sector in addition to innovation.   Dan Seguin  24:36 Okay, now, let's talk about the Innovation Task Force. With the report now released, where does it all go from here? Can regulation and innovation coexist and even flourish?   Carolyn Calwell  24:53 I think regulation and innovation have to coexist. We've been talking about change a lot this afternoon. I I don't think we have any choice. But to innovate. Our innovation task force was about strategy and governance, and this was an initiative by our board of directors to ask about disruptive change in the sector and its implications. And to make sure that the OEB was positioned to prepare for that change. The work involved jurisdictional scanning, looking at broad disruptive technologies and trends across the globe, and to look at what other regulators were doing about it. And that certainly provided inspiration for us. And at the same time, we curated experts working at global national and provincial levels to help us understand disruption in the sector, what they were seeing and what they were working on. So all of that informed the strategy that our Innovation Task Force adopted. And what we're trying to do with that is now map out what the OEB is doing about the energy transition. We've got a lot of projects and go and a lot of things that touch the energy transition, but don't necessarily do that directly. People need to understand how those fit together, and how they actually get at the big policy question of the day. What are we doing about climate change and about the energy transition? So what we've tried to do through our engagement with our website is map out the different projects, how they come together, and what people can expect about where they're going. If listeners haven't checked it out, I really encourage you to look at the OED "Engage with us" web page and see all that we have going on and what the next steps are across these projects. There's no shortage of work here. And we're asking a lot of people to come together to meet with us and try to make it work.   Dan Seguin  26:33 Harneet, on the topic of electric vehicles (EVs), what about supporting mass EV adoption? What can you tell us about the proposed ultra low overnight price plan for electricity? And how will it help get more EVs on the road?   Harneet Panesar  26:52 Sure. Thanks, Dan. And when we look at things like ultra low overnight price plans, I think it's also important for us to reflect on the fact that I think I'm sure he's made some good choices in terms of deploying the right capital. Over the years, you know, we sometimes take for granted that we have what is known as AMI, which is Advanced Meter Infrastructure. The fact that we have smart meters deployed across the province, is huge, because it enables us to do things like these price plans. You know, I talked about other jurisdictions, not everyone has smart meters like we do, and therefore don't have the ability to actually even implement price plans. But let me tell you why it's important and why having some of these plans is helpful. Utilities often build to meet peak demand, whenever the demand is there, they're trying to make sure that they have the infrastructure required to meet it. And by introducing pricing plans, which create the right incentives and choices that can help leave to sort of behavioral changes from a consumer perspective, that will ultimately also help utilities manage how they build their system. And what that means is they'll be able to not just build the peak but better manage peaks. You know, if we're able to utilize the system when it's not at peak or it's not fully utilized, there's available capacity generation available. There's no bottlenecks in the system. That's when we want people to use power. And so generally, you know, overnight is when the system is a little bit quieter, and we're able to actually, you know, supply a lot more power. And so for folks like myself, who have an electric vehicle, you know, I have no problems charging overnight. In fact, it's fantastic. And having the right incentives to keep people charging overnight means that we take any additional peaks on the system during the day that might occur away. And ultimately, that also means that it helps keep rates lower, because utilities don't need to invest additional capacity, because they're better able to manage when people are consuming their power. So price plans like the ultra low overnight plan is one way of curbing the behavior and incentivizing sort of the right approach on when we want people to be using the grid to feed things like their electric vehicles.   Dan Seguin  29:03 Okay, now, how does natural gas fit into the energy transition to a carbon free future in the province? What strides are being made in the natural gas sector or Harneet?   Harneet Panesar  29:18 So I think it's an important question. And it's something that we think about quite often at the Ontario Energy Board. You know, natural gas has a lot of potential to replace some of the higher emitting fossil fuel energy sources that are still being used for mostly industrial processes here in Ontario. And to maybe give you an example, you know, one of our natural gas distributors is working with steel mills, to try and replace some of their coal usage with natural gas, which would also bring down some of their greenhouse gas emissions. But you know, when you talk about Net Zero and sort of the net zero future, it's obviously going to involve things like large reductions and even eventually eliminating the GHG emissions from the US to greenhouse gasses, and that's gonna require a couple of things. It's gonna require a combination of energy conservation, some electrification, carbon capture and storage, and even a shift to use things like orangey, which is renewable natural gas, and even other new fuels like hydrogen. There's already work that's underway. Enbridge has been investing about $120 million a year. And this is really around some of the conservation programs. And we also just had a recent decision that the will be rendered. And in that we're going to increase the amounts that are going to be spent. And this is also going to include a new home energy efficiency program that's going to be offered by Enbridge gas, and it's going to be in partnership with Enercon, which is Natural Resources Canada, you know, thinking about what are the next steps, the OEB has also convened a group of experts to help identify and evaluate future opportunities for natural gas conservation. And really, finally, I just want to make sure, I know, acknowledge that, you know, millions of residential, commercial industrial consumers, we've got three and a half million gas consumers who depend on natural gas to heat their homes and run their businesses. And the OEB is going to continue to support these consumers by ensuring natural gas is delivered to them safely, reliably and responsibly.   Dan Seguin  31:14 Okay, again, this one's for you Harneet. Ontario is Canada's most populated province, can you tell us a bit about how you ensure Ontarian voices are heard, and included in your decision making?   Harneet Panesar  31:30 Yeah, so we've got 5 million electricity consumers I just mentioned, we've got three and a half natural gas consumers. So we've got a fairly large consumer base. And it's really important that we hear what Ontarians have to say. And so we've done a couple of things. And let me run you through them. The first one Carolyn, alluded to earlier, which was around making sure people could engage with us, we actually opened up a new platform and launched it, and it's called engage with us. And if you ever wanted to join it, just Google, we'd be engaged with us. And it really lays out all the various initiatives and work streams and programs that the Ontario Energy Board is undertaking. It gives timelines, it has documents, it even has a friendly smile of some of our staff that are helping lead the work along with their emails, so you can contact and reach out to us, it's one way of us making sure that we're transparent about all the work we're doing. And we're engaging with tumors, and taking in any input that they may have. So that's one way the other, the other piece that I think is really important is listening to the customers themselves. About a year ago, just shortly after I joined the Ontario Energy Board, I started a program called voice of the customer. And it was an important program for me, because one of the one of the teams that I have within my shop is responsible for the call center, they take in the calls, the emails, and the chats. And it's one thing to see all that data on a dashboard, or you know, in a PowerPoint slide deck, it's another thing to actually get on the horn and actually hear the voices of consumers, understand their sentiment, hear the emotion, hear their voices. And it was really important for me to be able to do that. And so we set up this program, and it's a monthly occurrence in which myself and my peers, the executive team, we get on the call, and we hear the voice of the customers, we hear what they're saying to us. And so that's one other way that we connect with our consumers. The other thing I'll note is that, you know, our adjudication process is a public process. And, you know, we look forward to having Ontarians participate in that we do also have consumer interest groups, part of that. But we also look to utilities to make sure that as they're building out their plans, that they're engaging with consumers, they also have a role to engage with them and make sure that they're delivering what consumers want. I'll also just put in a bit of a plug that, you know, I talked a little bit about our call center that handles the calls and emails and chats, we get almost 10,000 interactions. And these are really important data points for us. And you know, I created a part of the organization about a year ago called Operation Decision Support, to really help us make data driven decisions. And so collecting information from our calls is very vital. But the point I want to make is that we also have a chat function, which also won an award about a year, year and a half ago. And it's not fed by robots. It's actually the same agents that would also pick up your calls and also respond to emails. So the message you get is very aligned and consistent. We're very proud of, you know, our ways of being able to communicate with our consumers.   Harneet Panesar  34:19 Okay, now it's your turn, Carolyn, let's talk about the OEB's two stakeholder committees. What are the energy exchange and adjudication of the modernization committee all about?   Carolyn Calwell  34:34 Our stakeholders are critical to us. And so we've made some deliberate efforts to create structures to engage them. Energy Exchange is a form of CEOs and senior leaders. And it's really a tremendous platform where we receive advice about our priorities and direction. We've tried to use that forum, not just to talk to people but to hear from and to engage them on questions. Is that we're struggling with? What should we focus on? How should we go about our work? What matters to them, because it's important that the regulator, not just tell everybody what to do, but also listen to the sector that we work in. So this advice has been really critical for us. And it's really helped us on work, for instance, around the letter of direction that we received from the minister, as we've tried to figure out how to unpack that letter, to figure out what the priorities are within it, and how to actually deliver against it. The adjudication modernization committee is made up of regulatory experts, and they give us advice and provide feedback on all things that you indicate from rules of practice and procedure and filing requirements, to advice about intervenors. This has a specific focus to consider best practices and approaches to adjudication. And what's particularly helpful I think about this group is that they have a direct line with the Chief Commissioner. So it's a way for her to talk to stakeholders, and hear about what matters to them on what happens in the hearing room, and everything that goes around. So these are just two examples of how we engage with our stakeholders. But we value tremendously the various working groups, forums, meetings that we call that people participate in, because we know we ask a lot of people we know we demand a lot of their time and a lot of their thinking. But this is all part of the communication that we need on the two way street, so to speak. And, and we really do value everything that people give us in these various forms.   Dan Seguin  36:31 SoI'll ask you both. What is Ontario doing right, right now, that gives you hope, either provincially, or from the energy sector itself?   Carolyn Calwell  36:47 I'll jump in on though, you know, we've spent the afternoon talking about some of the challenges that the energy sector faces and that, you know, that really society faces. And these are big, big challenges, daunting tasks ahead of us. But what gives me hope is that there are some tremendously smart people in our sector and a real commitment to work together. So we're all in this together, we all have a role to play. And I truly believe that we'll make progress.   Harneet Panesar  37:19 Well, I totally agree with Carolyn. I mean, you know, this notion of collaboration coming together and working together, I think we're doing a lot of things right. From that perspective, even this podcast, you know, being here and talking to you and connecting with your listeners, hopefully, that brings a bit of a circle back to us and people reaching back out to us, we need to, you know, no one can be operating in a black box, you need to collaborate and work together. The only other thing, maybe I'll say, in terms of what we're doing what we're doing, right, and I'm going to put on my proud Canadian engineering hat on here and say, look, we've been pioneers in the energy space for decades, you know, when it came to hydroelectric generation in southern Ontario, to even the CANDU nuclear reactors, I think Canadians have been doing a lot to pioneer push the energy sector forward. And you know, advancements and technologies even like SMRs, I think is, is a proud moment for Canadians and leading the charge and how energy is now sort of delivered, you know, bringing energy sources closer to where they're being consumed. And these are game changing types of investments and technologies that, you know, Ontario is making. So definitely a lot of things, things of pride. And I think a lot of things that we're doing right, Dan,   Dan Seguin  38:23 Carolyn, and Harneet, we always end our interviews with some rapid fire questions.Are you ready?   Carolyn Calwell  38:33 Ready to go.   Dan Seguin  38:36 Harneet, maybe you could start us off by telling us what you're reading right now?   Harneet Panesar  38:42 Okay, well, I'd be lying if I didn't tell you that every night I read Paw Patrol and Peppa Pig for bedtime. That's not my bedtime at someone else's bedtime. But in terms of myself when I put my feet up. Now I just picked up a book. It's not new on the shelf. It's just new to me. I haven't had a chance to really go through it, but it's a book by Rupi Kaur or R-u-p-i, last names core K-A-u-R. And it's a political novel and the book is called The Sun and Her Flowers.   Dan Seguin  39:09 Okay,what about you, Carolyn?   Carolyn Calwell  39:11 I'm reading some essays from MFK. Fisher in the Art of Eating. It's fantastic. Very funny.   Dan Seguin  39:19 Okay, Carolyn, who is someone that you truly admire?   Carolyn Calwell  39:24 Retired Chief Justice Beverley McLaughlin has to top my list.   Dan Seguin  39:27 And what about you, Harneet? Who do you truly admire?   Harneet Panesar  39:32 I would say it would be my 99 year old grandfather, who was a retired Air Force engineer from the Royal Indian Air Force who lived a very colorful life full of incredible stories and journeys. And as always a source of inspiration for me.   Dan Seguin  39:51 Okay, we've all been watching a lot more Netflix and TV lately. What are some of your favorite movies or shows?   40:01 For me, Madness is coming up. So my TV is dedicated to women's NCAA basketball.   40:08 I'm a bit of a foodie. And I have a bit of a travel bug. So I like traveling and eating. And so there's a series called Somebody Feed Phil, which brings sort of traveling and food together and a little bit of comedy. So it's a nice casual watch. So we've been watching a lot of that.   Dan Seguin  40:23 Lastly, Harneet, what is exciting you about your industry right now?   Harneet Panesar  40:30 For me, it's changed. And, you know, maybe I'm a creature of change. It's sort of where I thrive. But it's exciting to see us move forward and in the directions we are in. So for me, change is really what's exciting. I'm proud to be part of it. I'm looking forward to what the future brings with it.   Dan Seguin  40:50 Okay, what about you, Carolyn, what's exciting you?   Carolyn Calwell  40:54 I couldn't agree with Harneet more, change is exciting. I think there's a tremendous opportunity ahead of us. I think we're gonna see the world shift, and I'm eager to be part of it.   Dan Seguin  41:04 Well, Carolyn, and Harneet. This is it. We've reached the end of another episode of The Think Energy podcast. If our listeners want to learn more about you, or your organization, how can they connect?   Carolyn Calwell  41:20 They can find us on LinkedIn or at OEB.ca. And we're eager to hear from everybody.   Dan Seguin  41:28 Again, thank you both so much for joining me today. I hope you had a lot of fun.   Carolyn Calwell  41:34 Thank you so much for having us.   Dan Seguin  41:38 Thanks for tuning in for another episode of the Think Energy podcast. Don't forget to subscribe and leave us a review wherever you're listening. And to find out more about today's guests or previous episodes, visit thinkenergypodcast.com I hope you will join us again next time as we spark even more conversations about the energy of tomorrow.      

In this throwback episode of The Power Producers Podcast, David Carothers interviews Clayton Wood, Managing Partner at C.B. Wood Financial. Clayton discusses how claims are paid in the industry and how C.B. Wood Financial is helping brokers deliver savings.   Episode Highlights: Clayton explains that some clients and employees who go to the doctor to get a prescription or have surgery or imaging don't know how much their claim will cost until they get the EOB. (2:31) Clayton discusses the several factors of how claims are priced. (3:09) Clayton highly recommends Marshall Allen's book: Never Pay the First Bill because it provides a clear idea of how claims are paid in the industry. (8:27) Clayton explains C.B. Wood Financial's big win-win solution for its clients, which has been a huge success. (9:40) David mentions that finding individuals who are specialists in things you don't know about, in areas of coverage that you don't represent every day, will lead to significant changes in your book of business. (13:50) David explains that he was never interested in bringing benefits into the agency because it moves too quickly (14:43) Tweetable Quotes: “Glad we could help out some of these P&C brokers, learn how to help their plans, their client's plans. And ultimately, if we can show them that there's another strategy out there, they're the hero, you know, that's what we're trying to do make your the P&C broker the hero and deliver a ton of savings” - Clayton Wood “Find the people that are the expert in the little things that you don't know about in the areas of coverage that you don't represent every single day. And that ultimately is what's going to drive significant change in your book of business.” - David Carothers Resources Mentioned: Clayton Wood LinkedIn C.B. Wood Financial Book: Never Pay the First Bill David Carothers Kyle Houck Florida Risk Partners The Extra 2 Minutes

In this throwback episode of The Power Producers Podcast, David Carothers interviews Clayton Wood, Managing Partner at C.B. Wood Financial. Clayton discusses how claims are paid in the industry and how C.B. Wood Financial is helping brokers deliver savings.   Episode Highlights: Clayton explains that some clients and employees who go to the doctor to get a prescription or have surgery or imaging don't know how much their claim will cost until they get the EOB. (2:31) Clayton discusses the several factors of how claims are priced. (3:09) Clayton highly recommends Marshall Allen's book: Never Pay the First Bill because it provides a clear idea of how claims are paid in the industry. (8:27) Clayton explains C.B. Wood Financial's big win-win solution for its clients, which has been a huge success. (9:40) David mentions that finding individuals who are specialists in things you don't know about, in areas of coverage that you don't represent every day, will lead to significant changes in your book of business. (13:50) David explains that he was never interested in bringing benefits into the agency because it moves too quickly (14:43) Tweetable Quotes: “Glad we could help out some of these P&C brokers, learn how to help their plans, their client's plans. And ultimately, if we can show them that there's another strategy out there, they're the hero, you know, that's what we're trying to do make your the P&C broker the hero and deliver a ton of savings” - Clayton Wood “Find the people that are the expert in the little things that you don't know about in the areas of coverage that you don't represent every single day. And that ultimately is what's going to drive significant change in your book of business.” - David Carothers Resources Mentioned: Clayton Wood LinkedIn C.B. Wood Financial Book: Never Pay the First Bill David Carothers Kyle Houck Florida Risk Partners The Extra 2 Minutes

Insurance-Free: Is It for Me?Episode #546 with Shelley DeGroffInsurance is a game, and insurance companies have the upper hand. So, what can you do to win? To help answer that question, Kirk Behrendt brings in Shelley DeGroff, founder and CEO of PPO Advisors, a company that turns PPOs into profit. She shares insight into how PPO contracts work and advice for strategically dropping your PPOs. Insurance-free is the way to be! To keep more of the money you deserve, listen to Episode 546 of The Best Practices Show!Episode Resources:PPO Advisors: https://ppoadvisors.comPPO Advisors Facebook: https://www.facebook.com/PPOAdvisorsLLCSubscribe to the Best Practices Show PodcastJoin ACT's To The Top Study ClubJoin ACT's Master ClassSee our Live Events Schedule hereGet the Best Practices Magazine for Free!Write a Review on iTunesMain Takeaways:Add and drop PPOs strategically.Do an EOB audit on a regular basis.Start credentialing as early as possible.Negotiating isn't easy, but everyone should do it.Understand how to stack and navigate your contracts.Quotes:“Credentialing and insurance contracts are not what they used to be. It used to be that you could sign up with an insurance company, and you were going to get a great rate, and you were going to get patients from that contract. It doesn't work that way anymore. You're signing up for a contract, or with a contract, and you're getting 50 other shared networks with that. And if you don't set yourself up into the right contracts, you're really backing yourself into a corner for successful PPO negotiations and contracting down the road. So, we really need to understand what we're doing so the success of our practice can continue to grow.” (3:02—3:42) “[Credentialing is] not fast. Nothing about credentialing is fast, so prepare yourself. If you're a new doctor doing an acquisition or doing a startup, you need about 120 days to get yourself a network. So, don't wait until you take ownership. Start that process as soon as you have the letter of intent signed and you know this practice will become yours, or your startup six months in advance, if you can.” (4:08—4:35)“As you're still building out, get your PPOs set up. You need a tax ID number, a physical address, a phone number — which, you can get a Google number and then we can transfer that somewhere else if we need to. Those are really the key things we need to get you set up with an insurance contract. So, get that process going as soon as possible. Don't wait around and think, ‘Oh, I've got 30 days till closing. I know this is in the bag. Now, I'm going to start the process.' You're going to overwhelm your staff and you're going to overwhelm yourself. It's hard. It's a long process. They don't make it easy.” (4:35—5:11)“Delta Premier is everybody's worst nightmare. We're to the point where now we're seeing most states do not honor Premier status through an

Are You Billing Your Full Fee?Episode #510 with Kirk Behrendt & Ariel JudayYou think you're billing your full fee — but you're not! So, to help you get the pay you deserve, Kirk Behrendt brings back Ariel Juday, an amazing ACT coach, to explain why billing your full fee is crucial, how to train your team members to do it, and ways to not be the limiting factor to collecting your full fee. Stop working one out of every three days for free! To start collecting your full fees today, listen to Episode 510 of The Best Practices Show!Episode Resources:Ariel's email: ariel@actdental.com Ariel's social media: @actdental Subscribe to the Best Practices Show PodcastJoin the To The Top Study ClubSee our Live Events Schedule hereGet the Best Practices Magazine for Free!Write a Review on iTunesLinks Mentioned in This Episode:AADOM: https://aadomconference.comMain Takeaways:Understand the consequences of not billing your full fee.Train your team members to always bill your full fee.Involve your admin team and ask for their input.Show patients the true cost of your dentistry.Check your fees annually to be up to date.Don't assume patients can or can't pay.Quotes:“The most important part is you want to show the patients the value of dentistry. If we're not showing them what it costs, they're not going to know. So, we're giving discounts, or we're showing our PPO fee. They're going to think, ‘Oh, this is normal. This is what it is.' So, we're not showing them the true value, and they're going to make up their own numbers in their head based off of what they're seeing.” (3:21—3:46) -Ariel“You can't make decisions off of your practice if you're not seeing the real numbers. So, if we're billing our PPO fees because we think that it simplifies our processes, we can't make true decisions because we don't really know what the fee is, what is our overhead for that procedure. We really can't make decisions, and we don't know if we're keeping up with our PPO fees. So, the easiest is to bill our fee and let the PPOs keep up with us.” (3:50—4:23) -Ariel“Your practice management software is going to try and tell you to put in the PPO fee and bill it. Because that way, when insurance pays, you don't have to do the individual write-offs, and your team doesn't have to focus on anything. So, they make it sound like it's super easy. A lot of practice managers and team members who don't really know the unintended consequences of not billing your full fee, they also think it's easier. They think it's saving them time. But really, the unintended consequences are they could be making mistakes.” (4:50—5:25) -Ariel“I've seen lots of dentists give back refunds to patients that were never deserved because we're doing multiple write-offs, because we don't know how to read the EOB and the ledger. So, that's why to keep it simple is actually to bill the full fee. When the insurance check comes in, then we can make the appropriate write-off. We know...

The power of ICD-10 codes used with CDT codes is what Ericka covers in this week's episode. She talks about how she recently saw an EOB that rejected a claim for fillings because the insurance payor wanted appropriate ICD-10 codes on the claim form. Listen in as Ericka breaks down why every office should be incorporating diagnosis codes into their billing departments. With gratitude,The Dental Billing College TeamFollow us on Instagram: @dental_billing_coachEmail questions: admin@dentalbillingcollege.com

In this episode of The Power Producers Podcast, David Carothers interviews Clayton Wood, Managing Partner at C.B. Wood Financial. Clayton discusses how claims are paid in the industry and how C.B. Wood Financial is helping brokers deliver savings.  Episode Highlights: Clayton explains that some clients and employees who go to the doctor to get a prescription or have surgery or imaging don't know how much their claim will cost until they get the EOB. (2:31) Clayton discusses the several factors of how claims are priced. (3:09) Clayton highly recommends Marshall Allen's book: Never Pay the First Bill because it provides a clear idea of how claims are paid in the industry. (8:27) Clayton explains C.B. Wood Financial's big win-win solution for its clients, which has been a huge success. (9:40) David mentions that finding individuals who are specialists in things you don't know about, in areas of coverage that you don't represent every day, will lead to significant changes in your book of business. (13:50) David explains that he was never interested in bringing benefits into the agency because it moves too quickly (14:43) Tweetable Quotes: “Glad we could help out some of these P&C brokers, learn how to help their plans, their client's plans. And ultimately, if we can show them that there's another strategy out there, they're the hero, you know, that's what we're trying to do make your the P&C broker the hero and deliver a ton of savings” - Clayton Wood “Find the people that are the expert in the little things that you don't know about in the areas of coverage that you don't represent every single day. And that ultimately is what's going to drive significant change in your book of business.” - David Carothers Resources Mentioned: Clayton Wood LinkedIn C.B. Wood Financial Book: Never Pay the First Bill David Carothers Kyle Houck Florida Risk Partners The Extra 2 Minutes

In this episode of The Power Producers Podcast, David Carothers interviews Clayton Wood, Managing Partner at C.B. Wood Financial. Clayton discusses how claims are paid in the industry and how C.B. Wood Financial is helping brokers deliver savings.   Episode Highlights: Clayton explains that some clients and employees who go to the doctor to get a prescription or have surgery or imaging don't know how much their claim will cost until they get the EOB. (2:31) Clayton discusses the several factors of how claims are priced. (3:09) Clayton highly recommends Marshall Allen's book: Never Pay the First Bill because it provides a clear idea of how claims are paid in the industry. (8:27) Clayton explains C.B. Wood Financial's big win-win solution for its clients, which has been a huge success. (9:40) David mentions that finding individuals who are specialists in things you don't know about, in areas of coverage that you don't represent every day, will lead to significant changes in your book of business. (13:50) David explains that he was never interested in bringing benefits into the agency because it moves too quickly (14:43) Tweetable Quotes: “Glad we could help out some of these P&C brokers, learn how to help their plans, their client's plans. And ultimately, if we can show them that there's another strategy out there, they're the hero, you know, that's what we're trying to do make your the P&C broker the hero and deliver a ton of savings” - Clayton Wood “Find the people that are the expert in the little things that you don't know about in the areas of coverage that you don't represent every single day. And that ultimately is what's going to drive significant change in your book of business.” - David Carothers Resources Mentioned: Clayton Wood LinkedIn C.B. Wood Financial Book: Never Pay the First Bill David Carothers Kyle Houck Florida Risk Partners The Extra 2 Minutes

In this Tuna on Toast Podcast episode, Ted Stryker welcomes the very funny and talented Brian Aubert from Silversun Pickups. SSPU release their 6th full length album titled Physical Thrills on August 19th. Brian talks to Stryker about working once again with the legend himself Butch Vig! This episode is filled with so many random and funny weird conversations..From Brady Bunch Trivia to discussing the movie Jaws, Godzilla, Universal Studios and the Fast and Furious franchise. Brian tells Stryker that The Rock IS the reason why those Fast movies are so good! Brian and Stryker discuss Silversun Pickups history, from the early shows in Los Angeles, to getting signed by Q Prime Artist Management and all the fun stories that go with it. The guys also talk about Kate Bush and Stranger Things, SSPU has been playing "Running up that Hill" pre-show for a while. Brian also tells Stryker about the email he sent to Ed O'Brien from Radiohead to tell him how much he appreciates Radiohead and the EOB guitar that he's been using. Ed wrote Brian back!  Brian Aubert is a talented, fun, self aware and cool warm gentlemen.  Thank you for listening to another episode of Tuna on Toast with Stryker.

Today we are talking about how to read an Explanation of Benefits. Especially if you are posting payments. As Ericka mentions in today's episode-not all EOB's are created equally. The language used by each insurance plan varies. Can we all agree that it would be so much easier if there was a universal explanation of benefits? Listen in as we discuss the breakdown of an EOB, the revenue cycle, and obtaining dental benefits. Want to learn more about dental billing? Take our 10-day dental billing challenge! Click the link below and we will see you in the challenge!https://linktr.ee/dental_billing_coachJoin our Facebook group to stay up-to-date on our next workshops and participate in our weekly LIVES! The name of the group is Hidden Dental Profit. See you in the group, my friends!Hugs!The Dental Billing College Team

When your doctor prescribes a new medicine, there's a pretty good chance that some snafu will crop up before you get it filled. Either your pharmacy doesn't carry it, or your insurance provider won't cover it, or they'll say you need "prior authorization," or your out-of-pocket cost will be sky-high. The basic problem is that the electronic health record systems and e-prescribing systems at your doctor's office don't include price and benefit information for prescription drugs. All of that information lives on separate systems at your insurance company and your health plan's pharmacy benefit manager, or PBM. And that's the gap that a company called RxRevu is trying to fix. Harry's guest on today's show RxRevu CEO Kyle Kiser, who explains the work the company has done to bring EHR makers, insurers, and PBMs together to make drug cost and coverage information available at the point of care, so doctors and patients can shop together for the best drug at the best price.Please rate and review The Harry Glorikian Show on Apple Podcasts! Here's how to do that from an iPhone, iPad, or iPod touch:1. Open the Podcasts app on your iPhone, iPad, or Mac. 2. Navigate to The Harry Glorikian Show podcast. You can find it by searching for it or selecting it from your library. Just note that you'll have to go to the series page which shows all the episodes, not just the page for a single episode.3. Scroll down to find the subhead titled "Ratings & Reviews."4. Under one of the highlighted reviews, select "Write a Review."5. Next, select a star rating at the top — you have the option of choosing between one and five stars. 6. Using the text box at the top, write a title for your review. Then, in the lower text box, write your review. Your review can be up to 300 words long.7. Once you've finished, select "Send" or "Save" in the top-right corner. 8. If you've never left a podcast review before, enter a nickname. Your nickname will be displayed next to any reviews you leave from here on out. 9. After selecting a nickname, tap OK. Your review may not be immediately visible.That's it! Thanks so much.TranscriptHarry Glorikian: Hello. I'm Harry Glorikian, and this is The Harry Glorikian Show, where we explore how technology is changing everything we know about healthcare.If you live in the United States and you've ever had your doctor prescribe a new medication, you've probably had the following experience.You drive from the doctor's office to the pharmacy.And when you get there, you find out that the pharmacy doesn't carry that particular drug. Or that they do carry it, but your insurance provider doesn't cover it. Or your insurance does cover it, but they require prior authorization. Which means you have to get back in touch with your doctor and ask them to tell the insurance company that you really do need the medicine.Or you already have prior authorization, but you haven't met your annual deductible yet, so your out-of-pocket cost is much more than you expected.If any one of these problems crops up, the chances that you'll actually get your prescription filled on the day you need it go way down.And it's not uncommon for several of these snafus to happen all at once.Fundamentallythat's because the electronic health record systems and the electronic prescribing systems at your doctor's office don't include price and benefit information for prescription drugs.All of that information lives on separate systems at your insurance company and your health plan's pharmacy benefit manager, or PBM.And that's the gap that a company called RxRevu is trying to fix.My guest on today's show is the CEO of RxRevu, Kyle Kiser.We talked about the software they've built to make drug cost and coverage information available within the major EHR systemsWhen doctors can see in real time which drugs are covered, at what price, for a specific patient, it    obviously solves a huge pain point for patients, because it means they're more likely to get the drugs they need at an affordable price.But it also solves a big problem for doctors. Because, fairly or not, they're the ones who usually shoulder the blame when it turns out the medication they just prescribed is too expensive or isn't available.The kind of information RxRevu provides is going to be more and more important as the U.S. enters into an era of far greater price transparency, as mandated by the federal No Surprises Act, which went into effect on January 1 of this year.RxRevu is based in Denver, Colorado, and I reached Kyle Kiser at his home in Seattle, Washington. Here's our full conversation.Harry Glorikian: Kyle, welcome to the show.Kyle Kiser: Thanks, Harry. Happy to be here.Harry Glorikian: So, you know, we were just talking. You're in Seattle and I'm in Boston. I don't think we could be much farther apart when it comes to this particular country. So but let's start with a little bit of background, right. So. You're the CEO of RxRevu. And can you tell us a little bit about sort of the origin story about how you got started here? I mean, I understand your co-founder, Dr. Kevin O'Brien, had an interesting experience trying to get prescriptions filled for his mother, Lucy, but. What's the rest of that story? What did that story reveal to you about what's broken or missing in the way that doctors prescribes medicines or, you know, where the way that maybe payers approve prescription?Kyle Kiser: Yeah, absolutely. So a little background on Kevin's story. Kevin was initially inspired to do this because he wanted to solve a problem for his mom. She had an outsized out-of-pocket spend for meds. Like any good son, he wanted to help solve a problem for his mom. He used his expertise to find sort of ways to save on those medications, and that inspired him to start doing that in his clinic for his patients more comprehensively. So he was, you know, way ahead of his time and putting in all of this extra effort to really help find prescription options for patients that they could afford more easily. And that was the initial inspiration for what we've done today, which is connecting the point of care and clinical decision making with costs and coverage information that's real time and patient specific and location specific and moment in time specific, because all those things matter as inputs into a price.Kyle Kiser: So, you know, really the challenge we've been focused on is, is largely that, you know, the clinical decision making process has been pretty, pretty much disconnected, right, from marketplace information. So, you know, anything that impacts the purchasing of that care. And that was okay in a world where deductibles were low, formularies were relatively inexpensive and simple. But that world has changed dramatically over the last 10 to 20 years, right, as consumer driven healthcare has become the way of the world. And first dollar risk is now at the feet of the patient. It's that patients are now demanding that providers can consider not just what's best from a clinical perspective, but also set expectations around costs, set expectations around any restrictions that exist, and be an advocate for access to care. And the problem we're solving. We're building an access network. And within that access network, we help drive affordability and speed to care for patients. And we're doing that with a number of stakeholders. But at a high level, that's what we're trying to accomplish.Harry Glorikian: Well, you know, it's interesting, right? You know, entrepreneurship 101, solve a real need, right? So that there's a market there because everybody wants it. But so, I mean, look, I think everyone in the United States has probably had experiences similar to Dr. O'Brien's mom. I mean, you get to the pharmacy, you find out that the medication your doctor prescribed isn't covered by your plan, or you find out that the co-pay is outrageously high. But behind their personal experiences, I bet most people don't have a concept of how big and widespread this problem is. You know, you have any maybe some statistics that might illustrate the scale of the problem or how much money is wasted in the medical system because of these disconnects. I mean, I'm wondering how many prescriptions get abandoned or how many patients don't get the meds they need.Kyle Kiser: Yeah, I mean, at a. A macro level, you know, the prescription drug market makes just over makes up, you know, just over a half a trillion. Right. And, you know, estimates are that a third, even as much as half of that is waste and waste in the form of, you know, medications that aren't taken as prescribed or aren't delivering the right outcomes. I don't it's hard to find actually a a stakeholder in the supply chain that's delivered more value than meds themselves. I mean, if you think about, you know, the innovation in that world over the last 30 years, it's second to none. But the, you know, the supply chain within which they exist is complicated and it's hard to navigate. And the consequences of that is waste. And, you know, a ton of administrivia and friction. And frankly, patients bear the brunt of that. Ultimately, it's health plans and PBMs and risk bearing entities making rules on one end. It's providers and care teams making clinical decisions on the other end. And both of those processes are largely disconnected. And the only way that that gets harmonized in any way is a patient advocating for themselves. And we just fundamentally don't believe it should happen that way. What we're building is the connectivity between those stakeholders so that whether it's a provider at the point of care making the decision, whether it's a care team member trying to help you overcome a prior, or whether it's a patient trying to advocate for themselves using their own technology, we want to put real time, patient-specific, moment in time specific information in their hands to drive affordability and speed to care for that patient, no matter where they are in the care continuum.Harry Glorikian: Yeah. I mean, so this lack of prescription cost data, I mean at the point of care feels like a real canonical example of deep systemic problems with the with origins that are buried like deep in at least three of these complex organizations. Providers, payers and EHR makers. I mean, once you guys decided what the problem you wanted to fix was, how the hell did you figure out where to like -- okay, let's start here and let's move forward, right? Because.Kyle Kiser: Yeah.Harry Glorikian: Not trivial.Kyle Kiser: No, it's exactly the right observation because ultimately what we're building is a multi-sided network. And what's difficult about building a multi-sided network is, you know, users on one end, in this case, providers, aren't going to engage if it doesn't have the appropriate information in it. And the data sources, the ability to capture that appropriate information, they don't want to provide that data to you unless you have the appropriate users. So you get stuck in this chicken or the egg problem. And that's job one in growing this business, is to overcome that chicken or the egg problem. And the way we went about that was we worked really closely with health systems, with provider organizations, primarily because that's where the trust exists, is that ultimately patients seek out their provider and their care team to answer these questions. And so we worked closely with them as strategic partners and brought some of them in as investors in the company and aggregated a group of meaningful collaborators on the health system side, which then helped us bring PBMs and payers to the table to say, how do we solve these problems together? And that's that's sort of how we got out of the gate.Harry Glorikian: So I mean, tell me if we could dig a little into I think the product is called SwiftRx, if I remember correctly, but at a high level. You know, if you could describe for listeners, what is it? How does it work? And. Where does it fit in relation to the overall system?Kyle Kiser: Sure. Yes. So SwiftRx Direct is the product you're describing. What it provides is, is that real time, patient specific, location specific, moment in time specific information in the provider's native ordering workflow. So we are a data network that's powering a native feature inside the EMR that provides that insight while providers are selecting medications. So a typical flow would look like, a provider selects a medication. They then place that into a pending status in the software that they use. When that happens, we're able to gain visibility to that choice. We send that transaction out to our network of data sources, payers, PBMs, etc.. And what we get back is the price that is patient specific. We have formulary insights, so prior auth, quantity, limit, step therapy, those sorts of things. Those are also patient specific. And then most importantly, we get back alternatives. And those alternatives come in two forms. They're either a lower cost medication or a lower cost pharmacy where the patient can fulfill that medication. And that's sort of the core information that we then render back into the e-prescribing workflow. And we only interrupt those providers' workflows, or we and our partners only interrupt those providers workflows, when there's relevant information to consider. Because as I'm sure, you know, being deep in this world, provider engagement stuff -- you really have to be thoughtful about when, when is the appropriate time to intervene and when, when do we want to sort of get out of the way and make sure that when we are intervening, it's meaningful and understood to be meaningful?Harry Glorikian: Yeah. So I'm going to I mean, I heard a lot of what you said. I'm I want to maybe summarize all the. A few of these areas that people run into problems. But to try to understand sort of what are the big problems you had to solve to get it to really work? Because I'm just trying to get my head around the magnitude of the data headache here. Right. So if if you'll allow me, I'll just try to break it down into parts and then you can tell me how you're bridging all of these. So for one thing, there's the patient specific data about what kind of insurance each patient has and what level of benefits they have. And none of that is stored in the EHR at the clinic. As far as I know, typically the EHR would only list the patient's group number, subscription number or maybe the RxBin number. And then separate from all that, every insurance has a formula of drugs that will cover and sometimes a, you know, a schedule of different copay amounts for those drugs. And those formularies change every year and even more often. Right. And then there's a patient's actual prescription data which may live in their EMR or may live in a different system at the pharmacy. And then on top of that, there's this obscure black box system of prior authorization criteria that insurers may use to deny a prescription if they don't feel like paying for it. So the fact that the system is so fragmented is a familiar story to anybody who listens to this show. But tell me, you know, how on earth you were able to sort of get all this data under one roof, so to speak? You know, is there a specific architecture of the Swift system that makes you good at collecting all of this changing data and presenting it to the providers in real time?Kyle Kiser: Yeah. The only other element I'd add to your complexity salad is also benefit design, right. Is that yeah, the, the out-of-pocket cost can be and is dramatically different based on where you are in your coverage. If you're a commercial member with a high deductible, you're bearing the, you know, the in-network negotiated rate inside that deductible. And that changes pretty dramatically once you reach a deductible. Or if you're a Medicare member, there's the donut hole. And all of those things are also inputs and complexity to add to this. So to answer your question, it's really working closely with the stakeholders that control those, that are the source of that data. Right. You really can't get to an accurate price without working with those with those data sources specifically. So we work closely with the PBM, with the payer, and we do more or less a mock adjudication. So the same type of adjudication activity that happens on their end when a patient arrives at the point of sale is happening when a provider is making a prescribing decision in this case.Harry Glorikian: I mean, I can tell you, like the last time I had to sit and choose an insurer, and you would think that I'd be better at this than most, I remember having to take two Tylenol, because when I got done, because I thought my head was going to explode. And I could honestly not say to you I made the best choice. It was at the end, it was almost like a Hail Mary, I guess with all the complexity. And the other thing that I keep thinking about is when I used to watch, I think if you have kids, you've watched The Incredibles and there's a point in the show where the manager says they're penetrating inside of our systems to understand how to get how to get the system to pay them or whatever. It feels like it's that level of complexity. And you really need a sophisticated system to sort of bring all that information together to make sense of it all.Kyle Kiser: Yeah, that's true. And it is it is dynamic, it is highly variable and it's very different from administrator to administrator. Right. And a specific example of that, right, is that responses we get back are not across the board consistent, that here's an error and here's what that error means. And that error message is consistent from health plan to health plan. That's just not the way the world works, right. The error messages are specific to those claim systems because ultimately on the other side of the fence, these are mainframe systems in some cases that were designed decades ago that they've then created a layer to expose to the outside world, in this case us. And, you know, it's not simple work for us or for them. So I think the thing also to point out here is that there's a lot of effort from the payer- rrPBM community to make this accessible and to sort of change the way they're doing business and to change the way their technology works to enable some of these things, which is which is progress and should be commended for sure.[musical interlude]Harry Glorikian: Let's pause the conversation for a minute to talk about one small but important thing you can do, to help keep the podcast going. And that's leave a rating and a review for the show on Apple Podcasts.All you have to do is open the Apple Podcasts app on your smartphone, search for The Harry Glorikian Show, and scroll down to the Ratings & Reviews section. Tap the stars to rate the show, and then tap the link that says Write a Review to leave your comments. It'll only take a minute, but you'll be doing a lot to help other listeners discover the show.And one more thing. If you like the interviews we do here on the show I know you'll like my new book, The Future You: How Artificial Intelligence Can Help You Get Healthier, Stress Less, and Live Longer.It's a friendly and accessible tour of all the ways today's information technologies are helping us diagnose diseases faster, treat them more precisely, and create personalized diet and exercise programs to prevent them in the first place.The book is now available in print and ebook formats. Just go to Amazon or Barnes & Noble and search for The Future You by Harry Glorikian.And now, back to the show.[musical interlude]Harry Glorikian: Interesting. So if I'm not mistaken, both Epic and Cerner have made it possible for providers to embed SwiftRx into their EHR. So if I understand it correctly, it even comes as a standard part of Cerner now. So those are two of the biggest EHR providers in the US.Kyle Kiser: And Athena.Harry Glorikian: And Athena, so question: how did you make that happen?Kyle Kiser: Well, you know, we've got a great team and the team executed ultimately. We worked really hard on those relationships. And I think it's both working with the right customers in small ways in the early days that leads to working with these types of partners and bigger ways. And frankly, some of the open programs at some of these places led to this. So early days, we were working in kind of the more open developer type programs with these EMR partners. We were working closely with some of their customers. Banner was one of our first customers. UC Health was one of our first customers, both a Cerner and an Epic user respectively, and, you know, is working in small ways to solve these problems together with those health systems that led us both to interacting with PBMs and ultimately building these enterprise level relationships with the EMR. It's, you know, it's, it's earning the trust, it's delivering for these customers and then earning the right to do this at scale. And we're to a point now where we'll do almost 100 million of these transactions this year. And it's you know, it's grown fast.Harry Glorikian: Yeah, that's a lot of that's a lot of data flowing back and forth. But so let's ask the money question, like, what's the business model? Who ends up paying you? Is it the provider buying SwiftRx as an add on to the existing EHR or how does that work?Kyle Kiser: It's the risk bearing entity ultimately. So think about that as payer and PBM. In most cases, there are cases where we work with health systems and there are some things we do that that are either channel related or related to specific needs that they have when they're that risk bearing entity. But at a high level, we follow the risk and we want to work with the customer that is bearing that risk because ultimately they're the ones that stand to benefit from an optimized prescription choice.Harry Glorikian: Okay. So that everybody gets a clear idea of like, can you give me a before and after picture at a clinic that brings SwiftRx into their EHR?Kyle Kiser: Sure. Yeah. So. You know, this is probably an experience many of many of the listeners have had. Right. Is that. Before such acts you interact with your physician, they diagnose you with whatever condition they've perceived. They select a medication. They route it to the pharmacy. You go to the pharmacy and cross your fingers that all of the requirements have been met. And that is at a price that you can afford if there is a prior or if that's too expensive. When you arrive at that site of fulfillment, you discover that, right, if there's a prior that's not been completed, then you've got to go through that prior authorization process and you're not picking up that prescription today. If it's a price you can't afford, you got to figure out how to pay for it. And there's a variety of ways that that happens. But ultimately, it's up to the patient to figure those things out. In a world where SwiftRx is installed, the difference is, as that prescription decision is happening, we notify the prescriber of the patient's out-of-pocket cost. In some cases, even the plan cost associated with that choice. Any restrictions that exist like prior or quantity limit or step therapy. And we also notify them of any lower cost alternatives. So in many cases, simple changes make big differences in in the out-of-pocket cost. And it might even be something as simple as, time release metformin can be hundreds if not $1,000, and regular old metformin is four bucks and has been four bucks for decades.Kyle Kiser: So it's some of those almost unintentional, I hesitate to call them errors on the provider side. It's just they're making choices based on their own sort of clinical expertise. But they don't they don't know these things, right? They don't know how a time release metformin might be reimbursed for one of the ten or 12 payers that they may see in a given clinic day. So it's just providing that insight upfront so that they can make those decisions and understand the trade offs. Is time release really important or is this patient going to be fine? And is that out-of-pocket costs for a med going to prevent them from being able to actually take that medication? And as a result, they're not going to receive any of the clinical benefit. So ultimately, the $4 option is probably better. So it's really connecting that clinical decision making process with all of the complexity that exists on the payer and PBM end so that we can get the decision right the first time. And when the patient shows up at the pharmacy, they know how much is going to cost, they feel comfortable that they can pay for it and they're either aware of the prior auth and have already completed the requirements or have some, some level of expectations set to how to complete those requirements.Harry Glorikian: So for all the reasons we've been discussing, doctors traditionally have been able to stay somewhat separated or maybe called it shielded from discussions about drug prices. I mean, they just prescribe a drug, leave it to their office staff or the patient or their pharmacy to figure out whether it's covered. But now, for organizations that are using your system that are built into their EHR, a clinical encounter, it can involve essentially going shopping in real time for the best drug at the best price. I mean, in your experience, how do doctors like being pulled into these decisions? I mean, I can see how it be great for patients, but I wonder if doctors are equally excited.Kyle Kiser: You know, one of the things that's been the most surprising to us around this subject, specifically patient out-of-pocket cost, is one of the most requested pieces of information in a primary care clinic, because it's so complex and it creates so many callbacks and it creates so much patient dissatisfaction. Because ultimately the patient's going to, at some level, hold that prescriber accountable for that decision. And if it's really expensive med there's an assumption that the provider knew that already or should have known that, whether that's true or not. And so what that's resulted in is primary care providers want this information, they want it. They want to have this at their fingertips when they're making decisions. It's the world certainly changed in that way. So I think, you know, it's becoming a part of the standard of care being able to consider cost. Because to the point earlier, the only medication that works is the one the patient can afford. And so you really have to consider those things because of the way our sort of health care payment infrastructure exists. Right. There's just, patients are bearing a dramatic portion of that cost these days and got to consider that as a part of the way you deliver care.Harry Glorikian: I mean, I almost feel like your company is is pushing. These providers and payers and to fix the prescription benefit system or making them more efficient or compatible.Kyle Kiser: Yeah. I think there is a, I maybe describe it as rationalizing. R I don't think that a clinical team and a PBM and PNT committee at a health system have dramatically different opinions on what medications should be prescribed, for what conditions. The friction exists in that they're making those decisions in isolation of one another. So I think I see our role as a connector to help, you know, in a value based world, the incentives start to align between risk bearing entity and health system. And many times the health system becomes the risk bearing entity fully. And so our goal is to empower providers to understand those things in real time, to manage the complexity for them, only engage them with the information that makes a difference in the decision they're trying to make and ultimately create a better experience for the patient, a better outcome for the patient, and a less burdensome process for the provider organization.Harry Glorikian: So as we all know, I mean, the American medical system is famous for sending patients surprise bills after clinical encounter or an emergency room visit, right. Where a bandage or an aspirin can carry some crazy prices that I've seen. And I'm trying to project onto where you are as a company and where you want to go. I mean, now that you've tackled the rrtransparency in drug pricing, which I would honestly like to see everywhere, because I think I've heard my wife complain all the time when she encounters some astronomical price. Right. Can you imagine trying to tackle or bring greater transparency to other medical costs, such as maybe a surgical procedure or hospital supplies. I mean, is there anything that you've learned about prescription benefits that's transferable to all these other types of care?Kyle Kiser: Absolutely. Yeah. We're already moving beyond prescriptions today and focused on labs, radiology services, generally. And see the dynamics of the payer-PBM end of the market five or six years ago as it relates to pharmacy real time benefit shaping up much in the same way around medical benefits. That payers are thinking about these problems in the same ways and are showing initiative and prioritizing putting this information at the point of care for for all of the reasons that we just described on the drug side are true in many ways on the medical side. So, yes, absolutely. That's where we're headed. And the regulatory tailwinds are there in a new way. Right. If you think about in the last 12 months, there's been more price transparency legislation than in the last 30 years. And that, combined with the no surprise billing legislation, really creates this this kind of pre EOB requirement for each of the stakeholders and they got to solve that problem. And we see ourselves as really well positioned to be a part of that solution.Harry Glorikian: Yeah. I mean, you know, it there was no way. I mean, the Affordable Care Act got put into place and there were certain things in there that just there was no way that you were going to be able to do that without some level of transparency and understanding what's going on.Kyle Kiser: Yeah. Yeah, that's right. But even further, right, before the end of last year there were price transparency regulations for health systems, for providers, for payers. And then the no surprise billing legislation has in it a component that says, you know, before you deliver care, you got to be able to give an estimation of cost. And so all of those things sort of work together from a regulatory perspective to start to drive the market in that direction. So absolutely, it's coming everywhere. It's going to be, it's going to be a part of the way that every health care decision is made in the future. And it's just a matter of time before that's the case.Harry Glorikian: Yeah. It's interesting because I have lots of conversations with, you know, lots of different people. And they I don't think they understand that. If you don't have that level of transparency, you truly don't have a competitive environment, right? You can't make choices because you don't have the information to be able to make that choice.Kyle Kiser: That's exactly right. Without it, there is no marketplace. Right. That's probably overstated. It's without it, it's a dysfunctional marketplace. And with transparency, we will start to see real competitive dynamics emerge. And I'm hopeful for that. Sunlight's the greatest antiseptic.Harry Glorikian: Oh, I totally agree. I mean, for me, it's always been like a walled garden. Like, you know, either you're here or, you know, you're out of luck, right? Because you don't have any information so you can go across the street. So. So. I guess I should be asking. I've probably reached the limit of my knowledge on the subject matter, but like, is. Is there anything I haven't asked you or anything, you know, that you would want to add to the conversation that would be enlightening to the people that are listening?Kyle Kiser: Yeah, well, the only thing I would sort of make sure we reframe a little bit is that this isn't necessarily about price transparency. Price transparency is a component of providing access to care for patients, and that's ultimately what we continually focus on inside of our company, that price is an input. Affordability is an input. Convenience is an input. The ability to actually receive the prescription is an input. We're ultimately trying to make sure that affordability and speed to care lead to better outcomes. And that's an access story, not just a price transparency story. And so that's the only sort of reframe that I'd offer is that ultimately this has to lead to better health, people getting healthier, getting the care they need, being able to afford the medications that they need. And that's the work. And we're going to stop at nothing to make sure that that happens.Harry Glorikian: Excellent. Well, it was great talking to you, Kyle. I wish you great success because, I mean, whenever I talk to anybody, I'm like, I know I could be benefiting from all of this, so I want everybody to be successful.Kyle Kiser: We appreciate the well-wishes and we'll be working hard to ensure that that's the case.Harry Glorikian: Excellent. Thank you so much.Kyle Kiser: All right. Thanks, Harry.Harry Glorikian: Bye bye.Harry Glorikian: That's it for this week's episode. You can find a full transcript of this episode as well as the full archive of episodes of The Harry Glorikian Show and MoneyBall Medicine at our website. Just go to glorikian.com and click on the tab Podcasts.I'd like to thank our listeners for boosting The Harry Glorikian Show into the top three percent of global podcasts.If you want to be sure to get every new episode of the show automatically, be sure to open Apple Podcasts or your favorite podcast player and hit follow or subscribe. Don't forget to leave us a rating and review on Apple Podcasts. And we always love to hear from listeners on Twitter, where you can find me at hglorikian.Thanks for listening, stay healthy, and be sure to tune in two weeks from now for our next interview.

Trends in Insurance Reimbursement Episode #432 with Dr. Roy Shelburne Everything you know about dental insurance today — well, it may be different tomorrow! So, to help you stay ahead of the trends and changes and protect your practice, Kirk Behrendt brings back Dr. Roy Shelburne to share his expert advice. There are ways you can maximize your reimbursement, and it starts with one thing: read and understand your contracts! If you want to collect every cent you're entitled to, listen to Episode 432 of The Best Practices Show! Main Takeaways: Dental insurance rules are constantly changing. Always read and understand your contracts. Double and triple-check your documentation. Audits are done for a reason, not at random.   Be prepared when communicating with insurance. Quotes: “What you know about dental insurance today, the rules are going to change tomorrow. The codes are going to change tomorrow. So, we have to continually keep our focus on understanding and doing it correctly.” (4:36—4:52) “[Insurance companies] like claims that are clean. They don't like to have to send it back and ask for other information. It's harder for them and it's more expensive for them. So, that's the reason why they're concerned about having it done the right way.” (8:29—8:42) “So many dentists look at the contract and only review the fee schedule and think, ‘Okay, I can live with this fee schedule.' But, in fact, there are all kinds of other limitations or restrictions on that plan that have a broader effect on the reimbursement scheme. So, they aren't aware. It's like, ‘Well, this says it's going to pay at this amount.' However, there's also a different section in that contract that says, ‘Oh, and by the way, under this situation, we can't pay. Under this situation, we can't pay.' So, it's understanding, first off, the restrictions and limitations not only in the fee schedule, but also the way the contract is set up.” (9:18—9:59) “The contract, primarily, is seldom read. Or if it's read, it's misunderstood. And secondarily, the contract that you've signed with the insurance company gives them the right to change that contract with 30 days' notice. So, not only have dentists not read the contract when they signed on originally, those letters that the insurance companies send to their network dentists periodically could have some very significant modifications to that contract where they're letting you know it's changing, and the person who gets that letter, or the doctor who gets that letter, looks at it and goes, ‘This is junk mail,' dumps it in the trash can, when the contract has been changed and it's been disclosed in that letter that you haven't read.” (10:14—10:56) “The concern is, we're talking about inflation and how it is now increasing at a not foreseen rate. Maybe, what was it, in the ‘80s, it was similar to this? But now, do the costs for dentists go down? Absolutely not, as far as you have to pay teams more money. We have to be competitive in the employment market today. And as far as the supplies, they've gone out the roof. And what has been the trend with reimbursement? Has it increased? No. Absolutely, it's going down. How do you make that work? How do you work harder and make less? And how many additional patients do you have to see, and what's your capacity?” (13:39—14:33) “As far as the EOB, I think it's meant to be obtuse, to be able to not follow. The more confused you are, the less likely you are to go ahead and counter, to appeal that denial.” (18:34—18:46) “Ignorance is no excuse. And honestly, the bottom line, you're going to bleed a whole lot of money on the table if you don't pay attention.” (20:30—20:36) “In my experience, although they say it's a random audit, I don't think that's a thing. It's an audit that is caused, triggered, by being unusual in your submissions. And the insurance companies view that very, very specifically, very succinctly. So, any kind of deviation. And as far as the...

You might be wondering: how can a doctor charge several hundred dollars for a ten-minute office visit? Why can the hospital bill $100k for a three-day stay? Who makes up these numbers besides me? Today's episode is going to answer those questions so patients can get closer to what price transparency in healthcare should become.One hilarious irony of medicine is that you won't always know how much you need to pay for a visit and providers themselves don't know how much they'll get paid for the same visit until long after the fact. The dollars on your medical bill are going to be all over the place because of what your insurance covers, doesn't cover, and writes off. However, let's focus on the largest and usually shocking number on the EOB or invoice—the actual dollar amount billed to you or your insurance before any discounts. To be consistent, that top-line figure is called the charge or chargemaster price. The charge is nearly 100% at the discretion of the provider or whoever owns the facility. A general primary care doctor running their clinic might wake up one day and decide that a new patient office visit is $500. Or maybe $50. In either case, that charge is going straight to the insurance company. Charges vary a lot based on arbitrary choices about what providers believe their expertise is worth. However, there are some other factors based on a little common sense that influence healthcare prices.The first major drivers for charges are staff and equipment. Healthcare facilities are more than just doctors and front desk people. Nurses, administrators, and other professionals are necessary inputs for making sure the medical system breathes. Shortages of any given personnel will make the entire system more expensive. The extreme demand for nursing during these last couple years is one such clear example. Equipment quality and depreciation affects charges as well, especially for hospitals and larger medical groups. Getting an X-ray is going to cost you more than guessing if you have a compound fracture or not with a naked-eye glance. Two patients arrive with the same broken left forearm but patient A might have a blood clot or pressure problem that complicates treatment. If patient B has an otherwise unremarkable history, then charges for patient A would likely be higher due to the degree of care needed to deal with the same broken forearm.Let's return to our earlier example of a general doctor charging $500 or $50 for a standard new patient appointment (such a visit might be coded as 99203 for reference). Regardless of the charge, no two insurance companies will reimburse the same amount for the same visit code. Even if you control for the insurance company, the payout still changes based on the individual plan due to how deductibles and coinsurance are spread. Health insurers don't automatically pay the doctor a negotiated fee if the asking charge is less. For example, if the doctor bills $500 for the appointment, the health plan may reimburse $200 and write off $300 (assuming the patient doesn't have a copay or coinsurance). However, if the doctor chooses to bill $50, the insurance will pay $50 even if the negotiated compensation should be higher. Doctors have to overbill as part of this dance with the insurance companies. This incentive, more than any other factor, is why patients see astronomical medical charges. Dr. David Belk, who runs the True Cost of Healthcare website, shows this reality among other medical charge trends directly affecting patients. Dr. Belk's site and the other sources in this post will be on my page at rushinagalla.substack.com. There should be little surprise that providers are charging amounts several times more than what the final payment is. The requirements to get paid vary between health plans. Some insurers pay by the service, by the time, or by the diagnosis. Since these policies vary, providers have to submit all information possible on their claims as well as overbill to claim the max possible reimbursement. And if the insurance company chooses not to pay the doctor, the pumped-up tab is 100% on you.To follow up on this phenomenon, researchers at the Health Affairs policy journal reviewed costs for two portable and common procedures done at most facilities: colonoscopies and MRIs for lower limbs (which are coded 45380 and 73721, respectively). The study's data taken from Mass General Hospital, the University of Michigan Health System, and Vidant Medical Center (Greenville, NC), track the variation in cash fees, private insurance payments, and public insurance payments. The chargemaster prices for each of the procedures were 27% to 24x greater than the lowest respective final reimbursements. These health systems, all of which have a similar bed count, have such gaps between charges due to both patient demographics and overbilling incentives.These eye-popping numbers affect patients' wallets. Even though you may not be on the hook for a full chargemaster price, any increase of that charge will make either your cash payment higher or your long-term health insurance premiums higher. Per conventional wisdom, hospital and office payments across types of plans suggest that privately-insured patients with higher charges are subsidizing the low-margin public and self-pay patients such that everyone is getting the same level of care. The Journal of the American Medical Association debunked this “cost-shifting” with their own review of evidence from the Medicare Payment Advisory Commission. The newest evidence implies that cost shifting does not 100% apply to making up reduced earnings from publicly-insured patients; rather, a rise in private health plan payments go toward dealing with the rising costs of production to take care of that corresponding population. One economic fact about healthcare applying to this situation is that medical offices have mostly fixed expenses. That is, staffing, equipment, and real estate costs have to be paid no matter how strong the business is. Hospitals and large groups notice they get paid more from private health plans and in turn direct that extra money to raise profits while adding higher costs linked to attracting more of those patients. Medicine is an otherwise low-growth business so major providers have to exploit these gaps when possible. Equalizing medical quality for patients isn't part of the equation here. Reality shows that private vs public patients get different levels of care regardless of how payment trends change. Hence, cost shifting doesn't happen unless a multi-millionaire is consistently getting the same quality of care as someone on a low-income plan like Medicaid.Given all this commentary on how medical charges affect you, the last takeaway is that critical events are unfolding right now for helping you deal with the mysteries of billing. The Transparency in Coverage and No Surprises Act are recent laws among many requiring hospitals and insurance companies to disclose certain prices. Changes to come in 2023 make it so various health plans must offer price comparison platforms for 500+ common services and then for all major services in 2024. Although only 6% of US hospitals have been complying with publishing their cash prices as of July 2021, you can still be cognizant of the difference for what providers bill for service XYZ vs what insurance covers for service XYZ, and also be persistent in asking what the charges are.More patients inquiring about pricing are better for our system's accountability. By now it should be no surprise that Americans get sensitive to healthcare prices whether it be for drugs, services, or procedures. There is another certainty. No charges occur if there are no providers. Unfortunately, US doctors can't keep up with the American people's medical needs as things stand now. For the next pod, I'm going to break down the physician supply and demand time bomb that has a countdown much closer than we'd like it to be. Subscribe and stay tuned to Friendly Neighborhood Patient for modern healthcare consumer tips and tricks. I'll catch you at the next episode. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit rushinagalla.substack.com

Radiohead guitarist Ed discusses his diplomatic ‘mum' role in the iconic Oxfordshire band, wrestling with imposter syndrome while also expanding his creative horizons in his solo work, EOB. There's some geeking out about specific sounds on OK Computer as Ed's musical tales cross Brazil, Buckland and the Brecon Beacons. Plus an encounter with a rambling rock star, a jazz legend and oh, so much dancing! Learn more about your ad choices. Visit megaphone.fm/adchoices

A recent survey showed that more than one in three adults carry medical debt to some degree. Today on MoneyWise, we'll let you in on something that could help. STAGGERING MEDICAL DEBT That survey was published onHealthcare.com. It also revealed that more than half of those with overdue bills carried balances over $1,000. The total outstanding medical debt for the nation may be as high as$140 billion. But it might surprise you to know that you don't always have to pay your full medical bill. You cannegotiateto have the bill lowered. As Christians, we mustalwayspay our debts. Proverbs 16:8 readsBetter is a little with righteousness than great revenues with injustice. But it's certainly not a sin to ask for a discount. The truth is, many medical providers want to be paidnowjust as much as they want to be paidin full.More on that in a minute. You're probably wondering how exactly you go about asking to have your outstanding medical bills lowered. I'll give you the steps, and you can do these even after your insurance company has paid its part of the bill. STEPS TO SEEKING A REDUCTION OF MEDICAL DEBT Before you pay anything, first get an Explanation of Benefits, or EOB. You may have to ask for one from your medical provider. You need to go over every bill and the EOB to make sure there aren't any mistakes. Insurance companies and medical billing departmentsoftenmake mistakes, sometimes even double-charging you for a visit or procedure. If you find something that seems out-of-place, talk to the office manager to have the item explained. As we mentioned, medical providers are keenly interested in receiving their money as soon as possible, and that means you have negotiating power. They're often willing to give you a discount if you offer to pay a lump sum right away. A reduction of up to 20% isn't uncommon. But you have to do your homework before you ask for the discount. Let's say you owe $1500. You'd be plenty happy with a 20% reduction, but you should probably aim a bit higher to start, say 30%. Multiply your $1500 bill by 0.3. That comes to $450. You subtract that from the original 1500 and you get $1,050. Round it down to a thousand and offer to pay that now if it closes the matter. Expect some pushback. This is a negotiation, after all. And let's say they offer to reduce your bill by $300 instead of $500. The reduced bill is now $1200 or 20% off. You've met your goal. Your results may vary, of course, but asurveyby Lending Tree of more than 1500 Americans with medical debt showed that a whopping93%of those who negotiated their bills had them reduced or eliminated. And here's another tip: The higher the bill,the deeper the discount you should ask for. For instance, if you owe $5,000 or $10,000, start by asking for a 50% reduction if you pay the reduced amount in full today. When you agree on a new figure, get a confirmation number and make the payment immediately. Of course, you must have the money on hand to do that, and you should never put medical debt on a credit card. Your doctor usually won't charge interest, but credit card issuers always do. But what if you don't have a big chunk of money to pay even the reduced amount now? You can still negotiate a lower bill by offering to set up a payment plan. Once you have the new amount, you'll have to negotiate how many months you'll have to pay it off. When you reach an agreement, make sure you stick to it. Keep in mind that you may not be negotiating directly with your doctor's office. Many providers outsource their billing to third party operations. If they're not willing to negotiate, you can try calling the doctor's office directly and make your pitch with the office manager there. Here's another approach you can take: Many hospitals have financial assistance for low income families and individuals. If you meet the requirements, you could have your bill reduced significantly. Call the hospital to get more information about available financial aid. Now, a final note: As you go about negotiating a lower bill, always be polite and cheerful. As the saying goes, you catch more bees with honey than vinegar. On today's program, Rob also answers listener questions: ●How do you determine whether it's wise to use savings or investment money to pay off auto debt? ●How do you approach your tax requirements as an independent contractor? ●When does investing in an annuity make sense? RESOURCES MENTIONED ●Find a Certified Kingdom Advisor Remember, you can call in to ask your questions most days at (800) 525-7000 or email them toQuestions@MoneyWise.org. Also, visit our website atMoneyWise.orgwhere you can connect with a MoneyWise Coach, join the MoneyWise Community, and even download the free MoneyWise app. Like and Follow us on Facebook atMoneyWise Mediafor videos and the very latest discussion!Remember that it's your prayerful and financial support that keeps MoneyWise on the air. Help us continue this outreach by clicking theDonate tab on our websiteor in our app. To support this ministry financially, visit: https://www.oneplace.com/donate/1085/29

In this installment of Evolution Revisited, I'm sharing some takeaways from my conversation with Swire Ho on Episode 046 of Evolution of Brand.  I'll also go drop some more thoughts and perspective on customer experience and building a consistent customer onboarding process. And finally, I have a sneak preview of Episode 048 of EoB featuring none other than Vince Reginella. 10 Tips For Becoming a Valuable, Fully Optimized Podcast Guest: Click here to learn more and get your free copy MUSIC CREDIT: "Victory" courtesy of purple-planet.com

In this installment of Evolution Revisited, I'm sharing some takeaways from my conversation with Swire Ho on Episode 046 of Evolution of Brand. I'll also go drop some more thoughts and perspective on customer experience and building a consistent customer onboarding process.And finally, I have a sneak preview of Episode 048 of EoB featuring none other than Vince Reginella.10 Tips For Becoming a Valuable, Fully Optimized Podcast Guest: Click here to learn more and get your free copyMUSIC CREDIT: "Victory" courtesy of purple-planet.com

Some stats say that up to 80% of medical bills have errors! With healthcare more expensive now than ever, it's important to understand exactly what you're getting charged and to understand how to argue it if you disagree.In this episode, Valerie talks about how she successfully argued her healthcare bill. She provides tips on what to do if you believe you had a billing issue on your claim. Also, is there anyway to prevent confusion?Like I've said before on the show, I do work in healthcare, and this is in no way affiliated with the work I do there. Checkout Family Money's YouTube Channel

L'Rain, Keyon Harrold, Hinako Omori and Sinkane discuss not getting stuck on the details, the visceral versus the cerebral, why there's nothing like those vibrations in the room where you play, and why writing music is like walking to the shops. L'Rain is an experimental multi-instrumentalist, songwriter and vocalist from New York, who makes music that is an intoxicating blend of R&B, free jazz, noise music, and orchestral pop. She was also once in an Iron Maiden covers band. Jazz trumpeter, vocalist, songwriter, and producer Keyon Harrold was born into a musical family of 17 children. He's provided instrumentation for Beyonce, 50 Cent, Jay Z, former Music Life guest Gregory Porter and Mary J Blige, as well as being a trumpet stunt double in the film Miles Ahead. Hinako Omori is a musician and producer with a love for synthesisers who was born in Yokohoma, Japan, and is now based in London. She's worked with artists including Kae Tempest, EOB, and Georgia. You may recognise our host Sinkane's voice, as the Sudanese-American multi-instrumentalist and singer has previously hosted the Music Life show, chatting to the likes of David Byrne, St Vincent, Cautious Clay, Emel Mathlouthi and Vagabon.

In this installment of Evolution Revisited, I'm sharing some of my big takeaways from Episode 038 of Evolution of Brand featuring Rocky Buckley. I've also got some additional insight and commentary on beginning with the end in mind, mastering the inner and outer game of success, and vetting your ideas before investing time into bringing them to life. And finally, I have a sneak preview of Episode 040 of EoB featuring Charles Alexander. 10 Tips For Becoming a Valuable, Fully Optimized Podcast Guest: Click here to learn more and get your free copy MUSIC CREDIT: "Victory" courtesy of purple-planet.com

In this installment of Evolution Revisited, I'm sharing some of my big takeaways from Episode 038 of Evolution of Brand featuring Rocky Buckley.I've also got some additional insight and commentary on beginning with the end in mind, mastering the inner and outer game of success, and vetting your ideas before investing time into bringing them to life.And finally, I have a sneak preview of Episode 040 of EoB featuring Charles Alexander.10 Tips For Becoming a Valuable, Fully Optimized Podcast Guest: Click here to learn more and get your free copyMUSIC CREDIT: "Victory" courtesy of purple-planet.com

Marisa has worked in the healthcare industry for more than 22 years and she feels really strongly about her Explanation Of Benefits (EOBs) and getting in good with her sister-in-law. Marisa shares why an EOB should be read, even if it's electronic. #gogreen You can follow our podcast on Twitter @UndrTheCoverage

In today's installment of Evolution Revisited, I'm sharing my takeaways from Episode 013 of Evolution of Brand featuring Angelica Ross.I've also got some hot takes on Black Friday for you to enjoy.And finally, I've got a sneak peek of my two-part interview with the one and only Rachel Sheerin that will unfold on Episodes 015 and 016 of EoB.Connect to the show here MUSIC CREDIT: "Victory" courtesy of purple-planet.com 

In today's installment of Evolution Revisited, I'm sharing my takeaways from Episode 013 of Evolution of Brand featuring Angelica Ross. I've also got some hot takes on Black Friday for you to enjoy. And finally, I've got a sneak peek of my two-part interview with the one and only Rachel Sheerin that will unfold on Episodes 015 and 016 of EoB. Connect to the show here  MUSIC CREDIT: "Victory" courtesy of purple-planet.com 

Benjamin Prinzing is the Founder & CEO of Rover Analytics, a company on a mission to help small group employers get access to claims data by scraping member EOB's (Explanation of Benefits). Ben is a serial entrepreneur and started his journey in the healthcare and wellness world over a decade ago, motivated by the passing of a young friend due to a potentially preventable heart condition. There is no question that Rover Analytics is making waves in the self-funded world! https://roveranalytics.com/ --- Support this podcast: https://anchor.fm/spencer-harlan-smith/support

In this very informational episode, you'll hear from our Lead Billing Specialist Coleen Hausfeld, and Corporate Office Manager Rebecca Engelhardt on everything there is to know about understanding your PT Bill. Get the answers to all your questions. As a patient, you have the right to know where the charges come from, what EOB's and co-insurances are, and why getting treatment from Oxford PT is such a great deal in terms of cost! If you or a family member has a question about your PT bill, please do not hesitate to ask. Contact us at 513.701.6100 or email us at marketing@oxfordpt.comDid you know that you don't need a doctor's prescription to receive physical therapy? The laws of Direct Access allow you to receive physical therapy without a referral and still use your insurance benefits! Learn more on how Direct Access can help YOU!Our website: https://www.oxfordphysicaltherapy.com/

Adam talks with guitarist Ed O'Brien about embarrassing Radiohead videos, stolen mini discs, getting cosmic, the romance of space, whether Ed really is the 59th greatest guitarist of all time and his new solo project EOB.This conversation was recorded in London in early March 2020.Thanks to Séamus Murphy-Mitchell for production support and to Matt Lamont for additional editing and Dan Hawkins for bass playing on the Star Trek jingle (Star Trek theme composed by Alexander Courage)RELATED LINKSADAM BUXTON'S RAMBLE BOOK (AUDIO BOOK AT AUDIBLE) (2020)PRE-ORDER SIGNED HARDBACK COPIES OF RAMBLE BOOK AT WATERSTONES (2020)EOB (ED'S SOLO PROJECT) - BRASIL (2020 MUSIC VIDEO ON YOUTUBE)EOB - SHANGRI-LA (2020 MUSIC VIDEO ON YOUTUBE)RADIOHEAD - HACKED OK COMPUTER MINIDISCS (2019 YOUTUBE PLAYLIST)ED TEACHES BEGINNER GUITARISTS HOW TO PLAY CREEP (2020, YOUTUBE)MEETING PEOPLE IS EASY (1998 RADIOHEAD DOC ON YOUTUBE)RADIOHEAD - STOP WHISPERING (1993 MUSIC VIDEO ON DAILY MOTION)REVIEW OF THE GUITAR ED DESIGNED - THE EOB FENDER SUSTAINER STRATOCASTER (MUSICRADAR, 2017)100 GREATEST GUITARISTS by DAVID FRICKE (ROLLING STONE, 2010)DAN HAWKINS (ON LINE BASS PLAYER)HORNE SECTION FEATURING ROBBIE WILLIAMS - ANGELS 2020 (FACEBOOK) See acast.com/privacy for privacy and opt-out information.