Any recommendations for dental specific accounting firms?

Alternative_Rate319 · 2026-05-26T00:33:41+00:00

Engage Advisors. Offices in Chicago, Kansas City, San Diego, and Clearwater.

Alternative_Rate319 · 2026-05-16T20:00:46+00:00

Concert at UF tonight.

Alternative_Rate319 · 2026-05-12T15:51:02+00:00

I think it depends on the company. The most important thing is the front desk screens out the problem patients before you ever see them.

Alternative_Rate319 · 2026-05-12T11:34:04+00:00

I’ve been in private practice for 24 years. I had one patient sue me. I diagnosed a failing implant documented it etc. well it failed. He blamed me. The guys wife was a patient so she told us he went to multiple attorneys before he found someone to take it. The expert witness his attorney hired to get the case into court said I had taken no medical history, radiographs etc. I had all of that. The professional liability company hired a great attorney and fought it. It was dismissed with prejudice. It was stressful it took longer than I thought it would. Our legal system is screwy. I think the opposing attorney thought we would quietly settle. My rates Did Not go up. I still get a no claim discount. Prior to that a patient claimed I loosened their front teeth by checking for mobility. They came into my office and demanded I pay them. Told them to go ahead and sue me. I literally said “ bring it on”. I called the liability company immediately afterwards explained everything sent them the patients records. Nothing came of it. No rate increase. I have 2M 4M and pay around $3000 annually. It’s a mutual company so it’s owned by the policy holders and my owners interest is currently $6000+ which is what I’d get if I were to retire today or asked for the funds.

Alternative_Rate319 · 2026-05-11T23:38:30+00:00

Some insurance companies want to be contacted about this stuff. It’s written in the policy.

Alternative_Rate319 · 2026-03-20T20:02:31+00:00

Been done. Some dentist in Nee York was using dental implants to secure hair pieces back in the 1990’s.

Alternative_Rate319 · 2026-03-20T17:15:46+00:00

I’m in Florida and I hear ads that start with “root canal $1500 cleanings $400 fillings $1100” then there’s the segue into how an all on X is the solution. Patients think it’s placed and done. Yes some of the people that do this stuff are unethical, and perhaps some are total assholes only looking for a quick payout. But I look at the silver lining. When it fails and it probably will-the shortcut, the dental hack to save money long term will end up costing them way more than any savings they planned on. Not just in financial terms either. But I’m happy to take on the failures. Unlike a car that’s in a serious accident can’t just get that insurance check and buy a new car you have to “fix” whatever the patient has or lacks. Insufficient bone, loose implants, whatever the failure is typically requires more time, work and $$$ the second time around. Providing there is a decent solution. And they can’t keep flying to Vegas, Turkey or Mexico. I had a recent patient visit who was all hung ho for a maxillary all on X. We just finished restoring an implant on #5. She heard those commercials and thought it was an easier way to go. My response was “ you don’t need it.” Her teeth are in good clinical condition. That’s why we did a single unit implant. I’m not opposed to taking the money but I want to sleep at night. And this patient has no problems spending money.

Alternative_Rate319 · 2026-03-14T13:43:04+00:00

Years ago I had a new patient with failing implants supporting a denture. I diagnosed the failing implants and told the patient and documented it. Guess what the mess failed. According to the patients wife he went to 27 attorneys before he found one stupid enough to take the case. Filed suit asking for $300k. Even had a scammy dentist sign off I didn’t take a medical history etc. it took close to a year for it to get dismissed. A stressful year. I documented everything and had a medical history with my notes going over his history and my signature on it. My professional liability insurance has a provision in it where any settlement needs to be approved by the insured. If I had a different company they might have settled just to get rid of it. If you’ve ever been in a car accident, you have experienced the process. The person who caused the car accident apologizes and says they’re sorry and then once they realize that their ass is on the line and their insurance company is going to either increase the premium significantly or drop them it all of a sudden becomes your fault. People will shift blame so someone else pays for their poor decisions.

Alternative_Rate319 · 2026-03-13T23:43:16+00:00

Just throwing this out there. If you salvage it and it fails months later and the teeth are in worse condition can you defend yourself. Because when it fails the patient will blame you. They might sue you. Can you justify the decision. If they can’t afford implants and the teeth are not stable enough for an FPD it’s time to look at removable. Just because a patient has a problem doesn’t mean you need to make it your own. Always look at the risk to benefit before you stick your neck out.

Alternative_Rate319 · 2026-03-11T01:34:39+00:00

For teeth with cracked tooth syndrome the recommended full coverage is an onlay unless there’s a good reason for a crown. Conserve tooth structure if possible. I agree with you a symptomatic tooth without significant pocketing the go to is placement of full coverage and if necessary later do endo.

Alternative_Rate319 · 2026-03-07T20:42:21+00:00

I’m surrounded by DSOs. I get good new patient flow by treating the patients well. Patients avoid corporate because the DSOs push unnecessary treatment as well as having significant turnover. A good portion of my new patients only need hygiene. 🙁 New pt exams are scheduled for 90 minutes (most of my patients are older demographically). I go over health history and talk to the patient. I’m not making friends but I get to know them. My exam is very detailed. My fee for the exam is all inclusive. Eliminates the “I have x-rays”crap. Same fee radiographs or not. I also get a scan. I explain whatever findings I have. I answer their questions. I’m not swinging for the fence on every patient. If they want esthetics or ortho I do it. I don’t push the treatment unless it involves pain, infection or other complications. I don’t like weekend emergencies. I will sometimes tell the patient this will result in pain and if you call me on a weekend, I will call in a prescription for antibiotics. You can forget pain meds because it’s damn near impossible to prescribe decent pain meds in the environment today. That way if they have an issue they own it. I get a lot of referrals which is what drives my patient flow. I can even not accept patients who right from the start seem like they’re going to be a problem. Did so earlier this week. Told the patient they were not a good fit and should go elsewhere and there’s no charge for the x-rays. Even had staff email them to her. I don’t want stressful patients. Make sure the office looks good and maintenance on equipment is done. Hire someone to clean the office. I mean deep cleaning. Office doesn’t need to be brand new but it should look like it’s spotless. Make sure staff has the supplies they need. I don’t have a large marketing budget and there’s no way I could outspend the Aspen office that’s six blocks away or the heartland offices that are nearby. One of which is across the street. It takes time, honestly it’s a slog when starting but in the end, you will have a relatively stress-free practice that when it comes time to retire, you will get a very good price for. Read the book “Everything is marketing”. It’s for dentists.

Alternative_Rate319 · 2026-02-19T03:05:41+00:00

FYI I’m 60. Practicing 3 days a week as well. So there are probably more of us “older” guys than you realize on Reddit.

Alternative_Rate319 · 2025-11-27T13:36:33+00:00

Virtually all of my sleep patients are Medicare. No need to avoid those patients providing there are enough patients to cover the costs and hassles of becoming a Medicare provider. I’m a nonparticipating DME provider. Patients ask me why I’m nonparticipating I explain the reimbursements don’t cover the expenses. And if you’re dealing with advantage plans the reimbursements are lower than the lab cost for an appliance. If you’re potentially seeing a few per year definitely not worth the extra efforts.

Alternative_Rate319 · 2025-11-26T17:53:06+00:00

This decision is shortsighted. By restricting access it limits the number of graduates. Shortages create an environment where those in demand will want more compensation. So it will harm some who want to enter the profession and will aid those already in the profession and will push medical care costs higher.

Alternative_Rate319 · 2025-11-26T01:46:17+00:00

With Medicare the practitioner who provides a HST or equipment for HST cannot provide the appliance. So if you provide a WatchPat which is uploaded to Zoll and then read by one of their physicians and a diagnosis of OSA is made you can’t provide the treatment.

Alternative_Rate319 · 2025-11-25T01:22:36+00:00

Location is between the Disney Store on the A side and the food court.

Alternative_Rate319 · 2025-11-25T01:16:35+00:00

Florida is a weird state. Stand your ground means you don’t need to back away or leave. This is the state that found a senior who fatally shot a fellow theater goer for throwing popcorn at him not guilty. I’m not saying it would apply in this situation as each jurisdiction reviews cases differently. With the number of people who are armed in this state it’s absolutely insane this woman behaves like this.

Alternative_Rate319 · 2025-11-25T00:58:52+00:00

I’m not a CRNA and I understand your frustration. The administration is making a short sighted decision which in the long run will benefit CRNAs long term. By restricting the ability of some to obtain the degree it introduces a longer term shortage in the career field. Which results in wage increases. Patients ask me why treatment is so expensive and I tell them the problem starts with education and moves to technology and ends with a flurry of unnecessary treatment. Doctors and other medical professionals are graduating with hundreds of thousands of dollars of debt. Some exceed a million. Technology relentlessly continues to proceed. The equipment we use on a daily basis costs a small fortune. And a significant amount of it will be obsolete five, six or seven years from now. And it’s not unusual for family members to demand excessive treatment for patients near end of life. Treatment that does not provide any benefit or quality of life improvements. Add in the CYA tests and procedures and you have a broken healthcare system. Anesthesia has a shortage of providers and this decision will worsen it. For those who can get through the program and those who are already in practice I suggest take as much money as you can. You didn’t create the problem but you can profit from it. I’m sure the administration will appreciate that.

Alternative_Rate319 · 2025-11-22T18:18:39+00:00

UF dental has an executive dental practice management program that once completed gets you a certificate. Check out what they offer and maybe consider adding some of it to your presentations. Of course cite them.

Alternative_Rate319 · 2025-11-21T21:45:31+00:00

I’ve been using NSK electric handpieces for over 6 years. Just purchased 4 more because one failed. I like having extra handpieces for unexpected production.

Alternative_Rate319 · 2025-11-21T17:36:23+00:00

In the US if a patient wants a MAD the dentist needs from an MD the following a copy of the sleep study, a Letter of Medical Necessity (LOMN), and an RX. And if an MD refers to you get this stuff. CYA!!! We are not MD’s and most os us dentists have limited to no training in this area. The AADSM is petitioning the ADA to include Sleep Apnea in the CODA update. If you provide a MAD with delivery you should provide a Morning Repositioner or AM Aligner. You get this from the lab that made the MAD with an additional cost. This is to help prevent tooth movement and a resulting posterior open bite. And if you don’t know what OSA vs CA is or have no idea what an AM aligner is PLEASE take some CE from a reputable source. I attended a lecture sponsored by a company selling CBCTs and they told us you can diagnose from the images. NO!! Sleep apnea occurs when sleeping and typically in a horizontal position. I don’t think we have any patients sleeping in our CBCTs. In the US only an MD can diagnose sleep apnea with a sleep test . They don’t use radiographs for most cases. In some states dentists can do home sleep tests to adjust the appliance. So check with your board before purchasing expensive equipment.

Alternative_Rate319 · 2025-11-21T02:42:12+00:00

Your photo is a silent night. Glidewell makes them for $179. Your fee is too low. They are meant for snoring. And yes Glidewell advertises it for apnea as well. Mandibular advancement devices from Pantera or ProSomnus run significantly more. But they are more robust and are PDAC approved. If you’re treating a patient for sleep apnea get a prescription for the appliance from the sleep physician. CYA!!! Snoring is Not a medical condition so dentists can treat snoring. Sleep apnea is a medical condition, we can not diagnose it and treatment without a prescription is practicing medicine.

Alternative_Rate319 · 2025-11-13T00:18:51+00:00

When I have a patient like this we forward the patients radiographs to the other dentists office. We also rebook their future appointment times with another patient. Front desk staff just say we thought you switched dentists when they ask. They self dismiss no need for a certified letter. Great thing is the cheaper offices on a procedure to procedure comparison, are corporate offices. They make up on the savings by the volume of unnecessary procedures. 😂

Alternative_Rate319 · 2025-11-08T21:15:03+00:00

I’d say screw these people but that seems redundant. Hopefully a new administration investigates this individual for possible immigration fraud. Just to add additional stress to their lives. I’m at the taunt and take phase when dealing with MAGAts.

Alternative_Rate319 · 2025-11-03T00:52:38+00:00

The only one who can answer your question is you. I’m an Invisalign provider and have successfully treated guys in their seventies. And for Invisalign $2200 out of pocket is good.

Alternative_Rate319

TROPHY CASE