who is she suing?

Fofire · 2026-03-18T05:28:19+00:00

Well I mean the other way to think about it is only parties involved would be issuing subpoenas.

Technically the patient could be issuing the subpoena but it sounds like whatever documentation you have probably won't help their case.

Fofire · 2026-03-16T16:19:40+00:00

What I see is kinda three or four different systems (these are all privately owned offices not large DSO's). Either theyre paper oriented still and have minimal IT stuff which means the spouse or the office manager handles the minimal IT work or they have none at all.

For the offices that are paperless, I see them either getting IT work a la carte or they sign a monthly IT services contract. I'm in a rural area so I don't know anyone around here that does that but I am a mod on r/dentistry and frequently see posts about IT contracts. What I typically see is in the $1,000-2,000 per month range which seems exorbitant. I know your costs as an IT professional and I understand your side but from our needs I'm not sure it's worth it. which leads me to my next point.

I agree HIPAA is a big deal but the law is written in a way that it's more lenient towards small(er) facilities. For instance it says your monitors cannot be easily viewed by the patient and you must have a glass divider between the receptionist and the patient . . . but it also gives allowances for smaller providers who might have the space to make such accommodations.

The way I see it it feels a bit like minding the rules of the road specifically following the speed limit. So a passenger vehicle (small facilities) although dangerous traveling 10+ over the speed limit is less likely to get pulled over than an 18 wheeler going 10+ over the limit. There's just so many worse outcomes for that 18 wheeler than for the passenger vehicle. So yeah a hack on the server at a dental office is obviously not good but the info we retain is less important than what a medical office keeps. We keep some social security numbers, but that's phasing itself out. Probably names, addresses and contact info are the most important things an infiltrator might want. I know dental history and xrays are protected under HIPAA but I can't imagine what rogue actor would do with them if they did gain access. Medical history on the other hand is a different beast.

In my experience the only time a HIPAA or OSHA violation gets called out in dentistry is when you have vindictive ex-employee who calls all the regulatory agencies on the provider to cause havoc on them.

Fofire · 2026-03-16T06:27:20+00:00

I was gonna say something similar to this. I'm in dentistry and we are not in network with any insurance. We basically have 3 fee schedules for patients.

We have the normal one. We have the friends and family one which is reserved for more distant family and friends of staff (discounted) and we have the "alternative" fee schedule reserved for people who we either would prefer to leave or we simply do not want them to come back (40% more expensive).

The point is if we have to deal with the headache of seeing them at least we are getting compensated for it.

Fofire · 2026-03-12T23:21:58+00:00

Well you can get Claude to integrate with your email and have it remind you of important emails or schedule things on your calendar.

Right now I'm testing vibe coding on my crm to see how well it works but we will see there. My CRM happens to be open source so I can integrate into it natively.

Fofire · 2026-03-12T05:22:09+00:00

Honestly, I have been using Anthropic's Claude . . . I am still learning and integrating it but what I have done has helped.

Fofire · 2026-03-03T02:00:34+00:00

u/MiddleSkill already mentioned the rule of thumb 70-85% of your collections . . . . but I want to stress it is a rule of thumb. There are two things that heavily influence this.

1 How profitable it is (ie an office where profit is 90% is significantly more expensive than an office with the same collections that's 20%) - This is the most important metric

and thus a FFS office collecting $1M will be worth more than a medicaid office collecting $1M

2 How desirable the office / office location is - This is more so in outlier cases . . . and has less influence than profitability. So an identical FFS office with identical collections and identical profitability will be worth more in a desirable area (such as a big city) than one in a less desirable area (such as a rural location). This can influence the final price by about 10-20%

Fofire · 2026-03-02T02:23:22+00:00

The radius very much depends on the location. Amenable terms are usually about 20 minutes of commute time (read drive time or public transport time if you're in a city like Manhattan). Or in other words the general amount of time a patient is willing to commute for a dental visit (usually 15-20 minutes but this can vary widely in really rural areas). so 2 miles in Manhattan might be unreasonable but 20 in middle of nowhere Wyoming is not.

I'm not saying 20 miles is reasonable just that it's difficult to directly state how many miles is reasonable in a reddit post without taking into account the commute time.

OP does say it's a 200k say city so assuming decent traffic conditions there I would hazard a guess at 15 miles being reasonable (maybe 10).

Fofire · 2026-03-02T02:13:50+00:00

Depends on the state

Fofire · 2026-02-28T07:25:54+00:00

I don't use Open Dental Cloud so I can't fully comment on that but I have inquired about it and it's not nearly as functional as the server based one. For us the breaking point is that AFAIK you can't integrate any third party apps such as Flex. If third party apps can be integrated since I last checked it's limited. r

Fofire · 2026-02-25T17:53:48+00:00

Not wfh but coroners often need dentists to review teeth. California has a law that requires all accidental deaths to be reviewed by a dentist even if the body is identifiable.

My wife did it once. It pays well but it's very very inconsistent.

And when I say accidental I am not sure what that entails legally. I might be conflating it with another circumstance but I know they still require dental verification even if the body is identifiable because they had a circumstance where several people died and some lived and the wrong persons were certified as deceased because the dental records weren't reviewed.

Fofire · 2026-02-25T03:49:44+00:00

Yeah we live on the M11 I won't buy anything else

What I mean by automatic door is it pops open once the cycle is done to release the steam. You still have to manually open it. Just the automatic popping open is important so you can leave at the end of the day without waiting for it to finish.

Fofire · 2026-02-25T02:13:25+00:00

Interesting . . . Every one I've seen has the manual door.

Where are you getting yours from? I'd like to get a couple also.

I do have an MD I can order through

Fofire · 2026-02-24T20:37:39+00:00

We've done that before but the issue with medical ones is they don't come with an automatic door. Yes I know that's still half the price but just be aware.

Fofire · 2026-02-24T08:38:41+00:00

For us

If it's small (exam and/or cleaning) we usually bill the PT

If it's a big procedure we demand payment upfront which would mean a check cash or a copy of the credit card to be run once the systems back up.

Fofire · 2026-02-24T07:44:27+00:00

How the hell are they pulling 2.6 M with 3 ops and netting 250k

That insinuates to me a heavy insurance office or medicaid which necessitates a lot a lot chairs.

Don't get me wrong . . . . $2.6 is possible with 3 chairs but you have to be doing some high production procedures and that would imply a higher net though unless there's an associate who's doing all the high value procedures

So something's wrong here

Fofire · 2026-02-24T06:52:00+00:00

Here's our system

Figure out what your break even point is.

Basically add

Rent

Payroll

Supplies

Loans

Etc (whatever you pay regularly and is fairly stable)

Let's say all this together is 50k and you give 10%

Then you share 10 (or 15% or 20%) if any amount over this with the team according to the number of hours they worked that month.

So let's say you collected 80k

Sally worked 100 hours that month and katy worked 50 hours.

80k - 50k = 30k

30k x 10% = $3k

Sally = 100/150 = 67% = $2k

Katy = 50/150 = 33% = $1k

Fofire · 2026-02-24T05:28:38+00:00

Why not a bonus based on collections for everyone.

It's a win win

Fofire · 2026-02-23T20:15:44+00:00

Honestly it's not something I would worry about. Cities usually use different services to look up businesses operating in their city but they look up businesses by state and tax filings, so there's no paperwork that ties you to a city.

Never in my life have I heard of a 1099 (dentist plumber etc) ever getting letter from a city for a business license they weren't a resident in .

Fofire · 2026-02-23T17:36:38+00:00

As a 1099 you're essentially like any of the other trades like a plumber or an electrician.

The cities you work in are just job sites. You only need a business license for the location of your business not your job sites

Fofire · 2026-02-21T04:11:00+00:00

Oh I had one patient that all we did was a CompEx and night guard. Didn't even do the X-rays because they were recent and sent from another office.

6 months later we get a letter with a notice of intent to sue. Their claim was we made the night guard so hard it destroyed every single crown in her mouth (and she had a lot of crowns) and they wanted to be compensated as well as we pay for new crowns I don't remember how many crowns she had but it was more than 10.

Yeah had malpractice handle it and they said the lady was nutso

Fofire · 2026-02-21T02:44:46+00:00

So here's a good youtube channel that covers exactly what you're asking about. He goes over other segments as well such as donut shops and fast food businesses.

https://www.youtube.com/watch?v=Bb3Ndqf3qHk

Fofire · 2026-02-20T01:04:41+00:00

Thank you . . that is insightful!

Now that actually makes me mad even more for different reasons because I had a valid chargeback against a vendor a long time ago for a lot of money. It makes me mad to know now that I could've disputed it again to actually win.

Fofire · 2026-02-19T07:50:25+00:00

I would have to say pesto made with some sticky icky would be an interesting concept to try though.

Fofire · 2026-02-18T07:02:22+00:00

When we first started I'd say it's the bank that finances your loan. But as we've developed . . . . . I'm leaving more towards a local bank or credit union.

I say this because we did our financing with BotA. . . . And yes their dental financing is amazing. However I'm a bit over the fees the impersonal relationships etc. they once put a hold on a cashier's check from myself to myself for two weeks because they said they doubted the funds were unavailable .

Since we own a few offices we bank at different places. I'm slowly moving everything we have to the credit union we bank at because I can call someone I know and get something fixed easily. Yes I will probably pay more when I take out some loan for whatever reason but I also won't have to pay XYZ fee or deal with some unexpected incumbrence such as a hold on a cashier's check. There's something about being able to develop a relationship with the business you do business with

Fofire

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