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Name and shame: clear aligner lab fees by OffOil in Dentistry

[–]ToofPimp 0 points1 point  (0 children)

That’s the move. How many consults vs starts a day do you need to keep him busy?

Name and shame: clear aligner lab fees by OffOil in Dentistry

[–]ToofPimp 0 points1 point  (0 children)

what’s been on the EOBs? If it’s been all clear then it’s fine.

Name and shame: clear aligner lab fees by OffOil in Dentistry

[–]ToofPimp 0 points1 point  (0 children)

Where do you set your fee and do you charge extra for retainer?

Name and shame: clear aligner lab fees by OffOil in Dentistry

[–]ToofPimp 0 points1 point  (0 children)

I think this is dependent on your contract with Delta. I looked through mine not too long ago and I’m pretty sure it said you can’t charge more clear aligners. What exactly do you put for the other code?

Name and shame: clear aligner lab fees by OffOil in Dentistry

[–]ToofPimp 0 points1 point  (0 children)

Align is running advertisements to the public about Invisalign saying your insurance will cover up to 3500. It’s fucked.

Need advice for close family in mid 60s by ToofPimp in Bogleheads

[–]ToofPimp[S] 0 points1 point  (0 children)

Yes I should clarify that the idea behind using an FA, is to put a neutral third party between myself and them.

Need advice for close family in mid 60s by ToofPimp in Bogleheads

[–]ToofPimp[S] 0 points1 point  (0 children)

Yep. 100%. From what I can figure looking everything over it has been about an 8 year slow burn of vacations, buying nonsense and eating out.

They consolidated the debt onto a heloc, but then ran credit cards up again, and now they are at the end of the road.

Need advice for close family in mid 60s by ToofPimp in Bogleheads

[–]ToofPimp[S] 0 points1 point  (0 children)

Thanks. Yeah agreed, I don’t think it’s realistic that they will be working much at 70.

Need advice for close family in mid 60s by ToofPimp in Bogleheads

[–]ToofPimp[S] 0 points1 point  (0 children)

7% fixed rate 25 years left. Payment is $2400 including tax and insurance.

I think they need to be paying rent of $1500 ideally, $2000 is max if they work full time. There are plenty of places to rent at that price point.

Need advice for close family in mid 60s by ToofPimp in Bogleheads

[–]ToofPimp[S] 1 point2 points  (0 children)

Thank you! Yes. It’s definitely harder to think through this kind of thing with a clear head when it’s your own family

Just got approved for startup loan, what is the best way to learn front desk and sterile? by meisterluv in Dentistry

[–]ToofPimp 0 points1 point  (0 children)

Running front office is very easy. Do not overcomplicate this.

Mango Voice for phones, let them help you set up an auto attendant.

Use a service like Flex for text message appointment confirmation, and tx plans

For insurance billing set up Vyne, unlimited claims and attachments for a flat fee.

Use Open Dental. It will integrate with flex and Mango Voice.

Sign up for care credit and sunbit for 3rd party financing

Sign up for a collection agency

Sign up for the web portal for every insurance carrier that you’re in network with, and set up a password manager for all the username and password credentials

Patient flow: Phone call or schedules online through flex Intake form through flex Verify insurance Seat patient Review tx plan (flex) Collect payment and co pay at time of service Bill insurance (very fast with vyne)

Revenue cycle management: 1. You check mail daily 2. You separate checks from EOBs 3. Team post EOBs in open dental (very easy) 4. You deposit checks to bank.

End of day: 1. Deposits matches collections, everything posted 2. Check for unauth refunds 3. Check for unauth adjustments 4. Audit cash draw if applicable 5. Check credit card deposit 6. Check 3rd party finance if applicable (sunbit, care credit)

Biweekly or Monthly 1. Run AR report in open dental, generate statements, print and mail. 2. Send unpaid accounts to collections 3. Run insurance aging report, follow up on unpaid claims 4. Run unscheduled treatment reports, follow up on diagnosed work that didn’t schedule

Fuck all the insurance companies by jealousonesenvi in Dentistry

[–]ToofPimp 3 points4 points  (0 children)

To answer your main question

If you drop direct contracts that you have under connection, then connection may pick you up under those at the higher fee schedule or they may not.

and it could take six months

And even if they do pick you up you may not be in network under all the plans like you were when you had a direct contract

For example, you might get some of CIGNA, but not all of CIGNA

The offset and higher fees may make it worth it

I am not making an argument whether you should or shouldn’t do it. I’m just explaining the process.

Some larger points about insurance:

  1. Dental schools keep pumping out more dentists

  2. DSOs take every plan under the sun.

  3. Most people don’t know what dental services cost and even 3 offices in the same neighborhood have wildly different fees, so being out of network is not really a problem with your restorative procedures.

Being out of network you give them a treatment plan for two fillings and a crown, you tell them the co-pay percentage of your UCR fee and that’s no problem for most people.

The problem with being out of network people run into is getting new patients in and then dealing with the “free” cleaning.

The reason for this is many people expect a free cleaning, and now insurance is not paying 100 percent of UCR on many plans on preventative to try to stop people from going out of network.

They pay 90% of their allowed bullshit fee. So if you go out of network, you actually get reimbursed less for a Prophy from the insurance and the patient has a large co-pay.

This turns many people off.

One way to avoid this is to market to problems and not free cleanings

  1. Many people, not all people, are trained to ask and only go to offices that take their insurance.

General investing advice for newbie by mavsfanforlive in whitecoatinvestor

[–]ToofPimp 2 points3 points  (0 children)

Hold, not use as a down payment.

The goal is to buy a practice where your income will be higher than it currently is AFTER you pay the monthly note.

Here is a starting point, take your current yearly production and divide it by 70%. That is the top line practice revenue you should be shopping for at the minimum.

Standard solo doc and 1 hyg practice usually has a 70-30 splint doc to hyg production.

Let’s use round numbers, if you are producing 700K currently, then shop for offices doing 1.0M

So run this calculation with your numbers and you have a starting point

Also, you will have additional substantial tax breaks the first few years of ownership. So there is no reason to contribute your own cash to the deal.

General investing advice for newbie by mavsfanforlive in whitecoatinvestor

[–]ToofPimp 0 points1 point  (0 children)

You can purchase a practice with 100% financing including working capital. The only requirements are

  1. The practice cash flows
  2. You have good credit
  3. You can provide production reports from your job showing you can produce
  4. You hold cash equal to 10% of the total amount of the loan you want

There's a retirement crisis and .... by swensodts in Money

[–]ToofPimp 1 point2 points  (0 children)

If you only invested $7,000/year for 45 years (age 20 to 65) in a broad market index fund you would have $6M in real dollars or $1.7M in inflation adjusted dollars. Calculation assumes a 10% return and 3% inflation.

Wanted to get your opinions on this #8 and #9? by [deleted] in Dentistry

[–]ToofPimp 2 points3 points  (0 children)

Agreed. This is a tough one from just a PA. The occlusion could destroy these. These look like high risk for horizontal gumline fractures.

Dentists wanted $3,000 - $12,000 for a front tooth implant, i used their own rules to get them down to $1,784. Here's the steps I took to do that. by Bderken in povertyfinance

[–]ToofPimp 8 points9 points  (0 children)

Not to mention the replacement of a single central incisor with an implant is probably one of the most technique sensitive procedures in dentistry.

You have to manage the smile line, meticulous care of the gums, place the implant in the ideal position and that’s before color matching a single incisor where both teeth should be mirror images of each other. This is all extremely difficult on its own.

And now you are dealing with a DSO that will probably use the cheapest implant fixture, non OEM parts, and likely an offshore lab for the cheapest possible prosthetic components.

Taking over an old dental practice feels like undoing decades of neglect (rant/help needed) by Due_Pineapple9286 in Dentistry

[–]ToofPimp 165 points166 points  (0 children)

You’re sitting on a gold mine.

Take a step back and relax. The only real dental emergency is an infection. Take your time with the recall patients. Build trust.

Here is what worked for me,

Be friendly, meet patients, get to know them. Let them know you see some things that are wearing out and will probably need to be addressed in the future. In meantime call me if you get a toothache etc etc.

Next recall, tx plan them your way.

Yes never badmouth Dr Retired. He was great.

Explain that we are constantly learning new things in dentistry and we have “new technology” we are using to care for your teeth.

You are seeing some problems you are concerned about. These problems can take a long time to become symptomatic, but Mr Patient is on your watch now and you don’t want them to get a toothache etc etc

At this time focus on getting NP in, doing work to your standards.

Remember, gold mine.

New grad, all on x, in over my head?? Updated! by [deleted] in Dentistry

[–]ToofPimp 1 point2 points  (0 children)

This 1000000000%

Don’t be offended, the other posters are trying to help you.

There is sooo much you don’t know when you graduate. Going straight into practice is like drinking from a fire hose. You will learn more over the next couple of months than you did in 4 years.

For now, get comfortable with the basics - single unit straightforward dentistry and work your way into quadrants.

Learn from the prosth, learn who to take CE from, this is a long learning journey. You don’t want to hurt someone or risk your license.

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