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308 Day to Day Wins and Challenges with Jake Skelton : Dentistry Uncensored with Howard Farran

308 Day to Day Wins and Challenges with Jake Skelton : Dentistry Uncensored with Howard Farran

2/3/2016 9:13:00 AM   |   Comments: 0   |   Views: 403

309 Day to Day Wins and Challenges with Jake Skelton : Dentistry Uncensored with Howard Farran




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309 Day to Day Wins and Challenges with Jake Skelton : Dentistry Uncensored with Howard Farran





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AUDIO - DUwHF #308 - Jake Skelton





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VIDEO - DUwHF #308 - Jake Skelton






This episode’s discussion: Operations, Career Paths, Growing & Managing an Emergency Dental Clinic, Time Management,  and the Consultants/Vendors that Dentists can save money using. 

 

I'm originally from Calumet City IL (South Side of Chicago). I attended Western Michigan University where I earned my degree in Aviation Business Administration. My Senior year at WMU I worked as a Flight Instructor for the university which helped springboard my career as a professional pilot. This is also where I met my wife Lauren (who is also a pilot).  She was actually a flight student (not my student) while I was an instructor.  Lauren and I went on to get married but found the life of a professional pilot wasn't conducive to starting a family so we decided to make some changes and chose starting a family over flying professionally.  I then went on to sell mortgages which led to a banking/finance/investing career.  While this was all going on, my best friend/college roommate/bestmen in each other's wedding/Godparents to each other's first born children/non-biological brother, Dr. Nick Bachman DDS was in the process of purchasing a dental practice in Greenwood Indiana with his wife Dr Beth Bachman DDS.  We had always talked about working with each other and decided that after the first year in business he'd see how the numbers looked and see if it made sense to bring me on to help manage the practice. Now one practice has grown to two and not a day goes by that I don't love going into work.  I now work as the Director of Operations or GM (for lack of better titles) for Bachman Family Dentistry in Greenwood Indiana and Affordable Columbus Dental Care in Columbus Indiana.  I also just started my own practice consulting business.  Bachman Family Dentistry is a large traditional practice but Affordable Columbus Dental Care is unique in that it is an emergency walk-in dental clinic.


Howard F.:

It is a huge, huge honor for me to day to be podcast interviewing another gorgeous, bald, Irish Catholic man named Jake Skelton, who is the director of operations at Bachman Family Dentistry. Where is it at?


Jake S.:

Greenwood. Greenwood, south of Indianapolis, Indiana.


Howard F.:

Is it a suburb of Indianapolis?


Jake S.:

Yeah. Yeah, south side.


Howard F.:

Are you still a Peyton Manning fan?


Jake S.:

I grew up in Calumet City, Illinois, so born and raised Bears and Notre Dame and all that good stuff that people love to hate.


Howard F.:

Love to hate. Let me read your bio. Originally from Calumet City, Illinois on the south side of Chicago. He attended Western Michigan University. I'm going to read this as from you because you wrote it from you. I am originally from Calumet City, Illinois, south side of Chicago. I attended Western Michigan University where he earned his degree in aviation and business administration. Senior year at WMU, worked as a flight instructor for the university, which helped springboard his career as a professional pilot.



This is where he met his wife Lauren, who is also a pilot. She was actually a flight student, not his student, while he was an instructor. Lauren and Jake went out to get married, but found the life of a professional pilot wasn't conducive to starting a family, so they decided to make some changes and chose starting a family over flying professionally.



He then went out to sell mortgages, which led to a banking and finance investing career. While this was all going on, his best friend from college, his roommate, his best man in each other's wedding, god parents to each other's first born children, Dr. Nick Bachman was in the process of purchasing a dental practice in Greenwood, Indiana and his wife, Dr. Beth Bachman, DDS. They had always talked about working with each other and decided after their first year in business he would see how the numbers look and see if it made sense to bring him on to help manage the practice.



Now one practice has grown to two, and not a day goes by that he doesn't love going to work. He now works as director of operations, or general manager for lack of a better title, for Bachman Family Dentistry in Greenwood, Indiana, and Affordable Columbus Dental Care in Columbus, Indiana. He also just started his own practice consulting business. Bachman Family Dentistry is a large, traditional practice, but Affordable Columbus Dental Care is unique in that it is an emergency walk in dental clinic.



Thanks for being on the show today. We're having the El Nino storm of our lifetime here in Phoenix, Arizona, so the internet has been all wacky all morning. In, fact that's why I'm wearing a jacket and I'm actually in my house freezing my butt off.



Those two dental offices are both in Indianapolis, Indiana basically or a suburb thereof?


Jake S.:

Yeah, yeah. Columbus is about forty minutes south of Greenwood, so it's a good, I would say, hour or so from Indianapolis.


Howard F.:

You're basically running two different types of dental offices?


Jake S.:

Yeah, absolutely.


Howard F.:

Describe those different business models.


Jake S.:

Okay. They're two totally different ones, and we always joke around because we had everything in place with the office in Greenwood that, when we were looking for another office, it would just be very cookie cutter. We knew who we would go for, who we would use for billing, who we would use for interoffice [inaudible 03:38], practice management software, all that good stuff, and then we went and found this other practice and it's completely different. None of that stuff really applies so to speak just from a budget standpoint. That one is all based on kind of like a hybrid emergency walk in clinic. Everything is paid. You pay the same day. It's very basic, very simple. Usually, we'll run two to three employees at a time out of there, doctor and assistant.


Howard F.:

You mean three doctors and three assistants?


Jake S.:

Nope, nope.


Howard F.:

One doctor and one assistant.


Jake S.:

One doctor and one assistant, yeah.


Howard F.:

You said three employees, so then one front office, one assistant, one doc.


Jake S.:

Yeah, and I'll float in and out of there too. I'm usually in there one or two days a week. On our busier days, like Saturdays are pretty busy, we'll bring sometimes another assistant in, but no front desk. I mean, there's no insurance claims. It's very simple. It's basic. It's awesome actually. It's refreshing.


Howard F.:

What is the percentage of net difference? Is one more net income profitable than the other? Is one business model better than the other?


Jake S.:

That's what's funny because after all write offs and adjustments take place at our Greenwood office, which is like the big, full service private practice, we can see a fraction of the patients and we're pretty much netting right about the same. Now, we have to do a little more like frequency of some procedures. We do a lot of extractions and dentures, but those are going to be higher paying procedures, so it's like if we see two, three, four denture patients in a day, we can end up netting the same or more of what we would do in the bigger office just handling smaller volume and that kind of thing. Less paperwork and administrative stuff.


Howard F.:

Describe the full service office.


Jake S.:

That one kind of reminds me a bit of your office. I was checking it out online, and one of the things when I first started listening to you, you caught my attention because you always said to kids out of college and graduate from dental school, it's like don't go after the Taj Mahal and build it in a pretty area. You want to go after somewhere that there's work to be done. The doctor has checked out. The MODBL enters the room before they do, and that's this practice. That's definitely what we do there, so when Dr. Bachman came in, he just digitized everything. He got digital X-rays in, pan-o. We added a E4D about April of last year. Just took everything digital. I mean, there was two computers in the whole building for about three thousand active patients, and they were running Easy Dental at the time and doing everything off of paper schedule, paper charts and everything, so we converted it all to paperless. Got Dentrix on board and just kind of modernized it all.



Yeah, I mean, we accept about nine or ten different insurance plans. Delta Dental is probably our favorite out of all of them. I just added PPO. That one is funny because it's like those fees are very comparable to our fee schedule down in Columbus while they're paying out of pocket, you know? By the time we adjust it and everything, we're making the same amount of money off the Delta PPO as we are down there. Some of them pay better than others. We've negotiated those too, so it's working out well though.


Howard F.:

It's funny because dentists traditionally always wanted to build the Ruth Krist steakhouse, and they just don't want to believe there's more money in McDonald's.


Jake S.:

I know.


Howard F.:

There's twenty five thousand McDonald's and there's not that many Ruth Krist.


Jake S.:

Mm-hmm (affirmative). Yeah, and this Columbus practice is very much like that. It's like what you always say. Provide for the masses and eat with the classes, and that's the place because anybody can afford it. I mean, not to say you pick off the menu, but we're not secretive about our fee schedule. It's like, if someone calls up, they know what they want by the time they get there. It's like going to the grocery store. You get up to the register. You've seen the prices for all the food as you load up the cart, so by the time you get to the register, it's not a surprise. It's like take my money. It's kind of like that there. We don't do the work unless they can pay, and we go from there.


Howard F.:

If you had to open up a third office, which one would it be? Would it be the affordable Columbus Dental Care business model, or the Bachman Family Dentistry business model?


Jake S.:

I would go the affordable route. Yeah, definitely. The patients are so laid back. It's in an area of Columbus. There are no other offices. I mean, you look at the north side of Columbus. That's where some of the newer subs are, and that's where all the practices are, but this is an area that's a lot of retirees. It's mid to lower income. It's not the brand new, shiny part of town, so the patients are so thankful that they have a place to go because they're not going to go to the oral surgeon. They can't afford it. Now we're getting a lot of referrals from the hospital. People go in there over the weekend and they send them to us. The middle school, they're sending us kids that their parents can't afford stuff. They'll refer them over to us and we'll take care of them. We've even have patients pay for other kids. Classmates that they go to school with because they feel so bad for them.



Then we get a lot of retirees. They're great. Dentures, we've been spooling up a lot with dentures. That's been awesome. It's been fun because you talk about changing someone's life. I mean, there was a kid. He's like twenty eight years old. He's got six kids. He's a maintenance supervisor at his work, and he just has put off his mouth, his teeth. He put them off, took care of all his kids, and now it's his turn, so we extracted eight teeth basically. That was all he had left on top and bottom, and give him top and bottom denture. He said he hasn't seen that smile since he was a little kid. I mean, it was great.


Howard F.:

He's twenty eight and he had six children?


Jake S.:

Oh yeah. I know, right?


Howard F.:

Was he Catholic or Catholic?


Jake S.:

I was just going to say that.


Howard F.:

You're talking mostly to all dentists right now.


Jake S.:

Yeah.


Howard F.:

How do you see everything different from an operations and logistics point of view than you think that dentists who is in there trying to border mold the perfect impression for a denture?


Jake S.:

I think they've just got to remember it's the people skills. It's hard to teach that, but I think that's where they're missing that piece of the puzzle. There is just talking to the patients and relating to them like they're normal people. I mean, that's it, you know? Getting them to like you, and relate to them. Maybe not bombard them with all the treatment, but let them know that there's other stuff we've got to take care of, but not throwing out the whole kitchen sink at them and scaring them to death. Let them know you're going to be there for them and take it one step at a time. Break it up. I mean, that's where a lot of our success has come from honestly.



Also, the thing that I noticed right away coming into dental because I came from the outside. I came from the banks and aviation and it all kind of translates to this job really well honestly. With aviation, it's like instead of jet fuel, you're dealing with blood, you know? Instead of worrying about financial privacy, you're worried about HIPAA and PHI and all that stuff, so it's very transferable, but the thing that drove me nuts like right out of the gate is you see how much things are marked up. I'm not talking about things that have to be stamped and approved by the ADA or anything like that. It's just things that, like why? Why would you charge so much? Just because dentists are wealthy, or stereotypically doing well doesn't mean that you're going to quadruple the price for it, so we've hammered our reps pretty good and negotiated some pricing. The same thing with the insurances. That would be my biggest advice honestly. Don't take the first price and go along for the ride because you'll just lose. YOu'll just lose every time.


Howard F.:

Right. I think the prices aren't transparent in dental supplies. I think that American culture is we don't like to haggle. Some cultures like to haggle, and our culture doesn't haggle. If a dentist, every time the supply rep walks in and says, "How are you? How was your weekend? What's new with you, Jake?," then they just throw you the highest price.


Jake S.:

Yeah.


Howard F.:

It's kind of ugly and gross to sit there and say, "I'm not paying this." You know, back and forth. Everyone hates doing it on a car, but we have to do it with supplies. How do you recommend haggling on supplies?


Jake S.:

Just that you don't lose anything by asking. Worse case scenario, just ask. Can you do any better? That takes no effort. That should be the first question out of your mouth. Can you do anything for me on the pricing? Can you do any better? You need two plus one, and then go from there. If they shoot you down, then say, "All right, I'm going to have to think about it," and maybe just go and see what else is out there and who else you can go through.


Howard F.:

Who do you buy your supplies from?


Jake S.:

Mostly Patterson. John Chapel, he's awesome. I would highly, highly, highly recommend him to anybody that lives in this area.


Howard F.:

Now, did you haggle with the insurance companies too on price?


Jake S.:

Yeah.


Howard F.:

Talk about that.


Jake S.:

We renegotiated pretty much everything. When I first came in, last April or April 2014, that was one of the first things we went towards. Everybody wants to go straight towards the crown price and that kind of thing, but what I started looking at was I created an Excel spreadsheet and basically broke down the procedures that we're doing the most of. IT's like if it can get an extra buck out of every prophie that we do, it's going to be much more impactful by the end of the year because of how many of them that we do than to negotiate an extra hundred bucks on an implant or a crown or something like that. That's what I would do. I would break down what you're doing the most of and then go from there.


Howard F.:

What procedures? Do you remember from the Excel what procedures were the highest volume that you were successfully able to negotiate up?


Jake S.:

Yeah. On the exams and the prophie, those are the ones that they don't really want to budge on too often. Crowns, we did negotiate crowns, so that was good because we were bringing the E4D on board, so we wanted to try and boost our margins on that. Then, I mean, pretty much everything. Every office, you're going to be running through the same procedures most of the time.


Howard F.:

You said you signed up for nine insurance plans?


Jake S.:

Nine. I think ten now that we added.


Howard F.:

Ten. Did you call all ten of them?


Jake S.:

No. I picked the ones that were the worst first because they're hard to get ahold of with the games that they play. You know, Guardian, and it's been a year now since this took place, so we're probably going to wait another year before we negotiate again just because it's so time consuming, and we're okay. It's like, when you look at your production, your production is going to jump up right away because we had to increase our fees in the office. Then when you look at your collections versus your production, it's going to be off a little bit. You're going to see more write offs and adjustments until the insurance catches up with you, but we wanted to bump our fees up just to keep the insurance honest.



Honestly, if I could pick one, I would go Delta Premier all day long. They're the best. They reimburse next day. We use Renaissance for all of our claim submission because they charge a flat $49 per month. Unlimited claims, unlimited attachments, and I think we were using E-Claims through Dentrix and we were averaging about $260 a month because every time they kick something back and you have to resubmit an attachment, you're going to get billed again. That's what we were coming into, so we went Renaissance.


Howard F.:

What's the website URL on that?


Jake S.:

If you just Google Renaissance. I think it's Renaissance or RSS.com. I think that might be it, but they'll pop up right away. They're pretty easy to find. They were sending things through our fax, like advertising $49.95 a month for unlimited claims, and I always thought it was a spammy thing because it sounded so cheap, but then we actually looked into it and it was awesome. If we submit a claim through Renaissance, usually if it's like 9:00 in the morning, sometimes by like 9:30-10:00 we can already see with Delta Premier and Delta PPO that it's been funded and paid for, so the next day it's going to show up in the operating account. I mean, they're that quick, and the EOBs you can click on there. There's little green check marks so you can look at the EOB and see what the max allowable is for the procedure. They're huge, and they're pretty much spot on.



If you join up with [maveris 17:15], or not Maverest. Renaissance, you can join one of their partners of ...


Howard F.:

Now, is that RenaissanceDental.com?


Jake S.:

No. Let me look. I can check on my phone real quick.


Howard F.:

I see they're in Indianapolis, Indiana where you're at.


Jake S.:

Yeah. Yeah, that would be them then. Yeah, and that was just pure coincidence that they happened to be kind of up the road from us, but they'll service the country as far as I know.


Howard F.:

Huh. Yeah, I didn't know. Wait, wait. That might be wrong. I don't know if there's a Renaissance dental insurance company, or you're talking about Renaissance claims processing, and if that's the same business.


Jake S.:

No, it's the claim process. Then they have some companies. They have like electronic lock box, which is like online payments and merchant services. Then they have Maverest, which is something I would definitely recommend too because, under Maverest, it's just a dental insurance group basically. They get two hundred thousand dentists or whatever behind them and then they go to the insurance companies that won't negotiate. Then they get them on board, so then you're submitting everything under the Maverest fee schedule. That was huge honestly. That was a really good one.


Howard F.:

Are you on your computer now, or on your cell phone?


Jake S.:

Yeah, yeah.


Howard F.:

Okay, so that's Renaissance Dental then?


Jake S.:

Yeah, let me check it.


Howard F.:

See if that's Renaissance Dental. I want to make sure I've got the right company.


Jake S.:

Yeah, they're awesome.


Howard F.:

That's right? It's Renaissance Dental?


Jake S.:

I'm pulling it up right now. Yeah, so the website is RSS-LLC.com.


Howard F.:

Okay, so let me get this right.


Jake S.:

Renaissance System and Services.


Howard F.:

It's RSS ...


Jake S.:

Dash LLC.


Howard F.:

Then what?


Jake S.:

Dash LLC.


Howard F.:

LLC.


Jake S.:

Dot com.


Howard F.:

Dot com.


Jake S.:

All right, I told them I sent you.


Howard F.:

Yeah, that is the same company.


Jake S.:

Is it? Okay, yeah.


Howard F.:

Yeah, that's the same logo. Okay, so then the electronic dental claims, and you're saying that's a flat how much a month?


Jake S.:

Like $49.95 a month.


Howard F.:

Forty nine?


Jake S.:

Yeah, forty nine and some change.


Howard F.:

You're saying they help you negotiate your fees with insurance companies?


Jake S.:

No, no. That's who you submit all your claims through electronically.


Howard F.:

Okay.


Jake S.:

Instead of doing it through Dentrix or Eagle Soft, or wherever you're sending it, you do it through them. They go in and install some software on your computer. I don't know. It works. It's integrated into your server basically. Yeah. I mean, you basically just switch the printer on it. If you're going to print a paper statement or a paper claim, they install their own printer on there and you just select them as a printer and hit submit. It goes through their portal and then you can basically hold the claim's hand the whole way through the process. It's awesome.


Howard F.:

Who were you saying with your fees? That if people don't negotiate your fees, they lump a bunch of dentists together.


Jake S.:

Yeah, so that's one of their like spin off companies, or sister companies that they have.


Howard F.:

One of Renaissance's spin off companies?


Jake S.:

Yeah. It's called Maverest.


Howard F.:

It's called Maverest?


Jake S.:

Yeah. M-A-V-E-R-E-S-T.


Howard F.:

WWW dot M-A-V-E-R ...


Jake S.:

E-S-T.


Howard F.:

M-A-V-E-R-E-S-T dot com?


Jake S.:

Let me see here. There's links, like if you go to their website, it's all at the bottom. That Maverest Dental Network. Let's see. I'll get you there. Yeah, so it's M-A-V-E-R-E-S-T dot com.


Howard F.:

M-A-V-E-R-E-S-T dot com.


Jake S.:

You got it.


Howard F.:

Tell us what Maverest is going to do.


Jake S.:

It's just basically like if you were going to credential and sign up with an insurance network and agree to their fee schedules, you're doing that with them, but they have several different insurance companies underneath and already agreeing to their fee schedules. When we submit something to ... I'm drawing a blank on the insurance, but like Met Life was a big one. Basically, Met Life is agreeing to their fee schedule, so any claims that go through is going to be paid in accordance with Maverest. Because a lot of them won't negotiate. It's against their policy, so if you ...


Howard F.:

Who negotiated? Who will say we won't do this?


Jake S.:

The company does. There's no negotiating from the dental office standpoint. It's Maverest has already done that with the insurance companies themselves, so you're ...


Howard F.:

But which dental insurance companies should the dentists listening here ... I realize they're going to hit a brick wall that says they just don't do that. I mean, does Delta? Does Delta negotiate?


Jake S.:

Delta Premier, their fee schedule, it's a rolling fee schedule, so it's going to go off of your zip code and what doctors in that area are submitting. This is what I was told by Delta, and it does make sense because you'll see it change every once in a while if you check how much they're paying. It's just a rolling fee schedule, so over a certain period of time, everybody is submitting $2,000 for a crown. You're going to see that crown max allowable price tipped upwards.


Howard F.:

Delta Premier does not negotiate.


Jake S.:

As far as I know, no.


Howard F.:

What about Delta PPO?


Jake S.:

I don't believe they do either honestly.


Howard F.:

What other companies do not negotiate?


Jake S.:

Let's see. Do not. Anthem, Met Life. What else is there? There's Cigna. I didn't have any luck with Cigna.


Howard F.:

Who did you have luck with?


Jake S.:

Guardian we had luck with. Let's see here. I've got to look at this real quick. Honestly, it's like that can change too. I mean, if there's other insurances that you're in network with or going up with, just call them up and get to provider relations. Just say you want to negotiate the fee schedules. I mean, I learned a lot of it listening to some of the people you interviewed on your podcasts. I know there's companies out there that do just that. That just negotiate all of that, but I mean, you can easily call up and do it. It's like one of those things. You've just got to ask, and if you drop them, and then go to join back up later on, we've had luck with that before too.


Howard F.:

What other things do you want to talk about? Career paths, growing and managing emergency dental clinic, time management, consultants and vendors. Where do you want to go next?


Jake S.:

My biggest thorn in my side is hiring associates honestly. I was going to ask you and see if you had any feedback on that because you have a couple of associates that work out of your office, but just in general. To find an associate for the Greenwood office is a piece of cake. It wouldn't be a problem, but the Columbus office where you're dealing with mid to lower income demographics. It's not a bright and shiny office. The area isn't the pretty area with walking districts and all that stuff. We're advertising to pay our associates 50% of collections, which our production and collections go hand in hand because they pay same day, but it's like that's it, man. That's the only thing holding us back right now is doctor coverage honestly.


Howard F.:

What do you pay the doctor in the affordable Columbus Dental Care?


Jake S.:

50% of collections.


Howard F.:

You pay half?


Jake S.:

Half, yeah.


Howard F.:

Your overhead would have to be 50% just to break even.


Jake S.:

Yeah.


Howard F.:

Then what is your overhead over there?


Jake S.:

It's about, so 50% with that and then it's about 20% everything else. Just payroll. Your payroll for the doctor is 50%. Everything else is coming out to 20%, so we're looking at 70% total.


Howard F.:

The doctor gets half and, for 20%, you can pay the rent, mortgage, equipment, build out, insurance, everything?


Jake S.:

Everything, yeah.


Howard F.:

Everything. Yeah, a low cost emergency clinic is low overhead dollars.


Jake S.:

Yeah, it's awesome. I mean, honestly, it's like the way dental was supposed to be. I mean, back in the day, and because these patients don't have to have insurance. They don't have anything. They have cash. That's what they have. Cash, check, credit cards, care credit. That's it. We looked into payment plans. If we can come up with a payment plan option for them, I mean, there would be people lined up around the block, but it's just too risky. You know, to be tracking people down and collections and stuff. You can send them to collections. They're not going to care.


Howard F.:

Are you glad you bought an E4D for the Bachman Family Dentistry?


Jake S.:

Yeah. Honestly, yeah. I've heard you talk about this quite a bit, and I completely agree with you. We still send out a lot of our anteriors. We'll send through a lab just because they get a little bit trickier. They're more time consuming to design. When we brought that on board, I went to Texas with Dr. Bachman.


Howard F.:

Dallas?


Jake S.:

Yeah.


Howard F.:

To the E4D headquarters?


Jake S.:

Yeah.


Howard F.:

Which is now owned by Plan Meca, right?


Jake S.:

Yeah, I believe so.


Howard F.:

Out of Helsinki, Finland?


Jake S.:

Yeah, sure. Yeah. No, it's been great. I mean, we didn't use it for a brief period of time when Dr. Bachman, he had to have some neck surgery. Old football stuff with a ruptured disk and everything. He was out of the office, so we parked it for a couple of months, and that was a complete headache for me personally. Just keeping track of all the lab cases. When they're coming back, when they're going out. That was a headache, so I love that it takes that off the table. I got trained on designing and milling and doing the maintenance and stuff, so I can handle a lot of that and take it off of his plate, but usually he'll go in. He'll scan and then hand it off to me. I'll get started on the margin. He comes in and checks it, and then I'll get started on the design. Usually, before we send it to the mill, he'll take one last peek at it. In the mean time, he's doing hygiene checks and working on other patients. It works well.



Now we have a new assistant that we hired a couple of months ago, three months ago, and she's fully trained on it too, so she's taking if off my plate. It's been beautiful. The thing is too, it's like we don't make them sit for two hours. We give them the option and that's what's nice. It's like you can leave and come back three days later, but at least you're not going fourteen days with a temp on. I had two of them on my front teeth back in 2004, and I didn't like wearing temps, so I kind of sympathize with the patients in that regard. I love it. Yeah, I mean, to be rigid and say we're only going to schedule if it's E4D and we're only going to do it this way, I don't think that's a good way to go about it at all, but it's definitely helped us for sure.


Howard F.:

Why did Nick Bachman go with E4D instead of Cyrac? Those are the two main systems.


Jake S.:

Yeah, good question. I mean, him and Dr. Beth, husband and wife, they worked out of a large practice in north central Indiana out by the South Bend area and they would always have E4D would come in there and demo or Shine would. The same thing with Patterson. They would come in there, so he just liked that one the most. Then he was familiar with Dentrix. He liked Dentrix with everything, so basically all our technology is all through Shine. As fun as that is sometimes, but it's all through Shine and all our supplies are through Patterson. It's like, if something goes wrong with it, you can't say that X-ray is from Shine or Patterson, and it's not our fault. It's their fault. It's less pointing fingers at everybody when you're trying to troubleshoot something.


Howard F.:

Now you're starting consulting.


Jake S.:

Yeah, yeah. I mean, I do a few things on the side for some of his buddies that graduated dental school. People ask suggestions and stuff, and it's not something I'm actively doing a whole lot of, but it's good to have and not need than to need and not have, so I started that up. Yeah.


Howard F.:

What is that website?


Jake S.:

I haven't started a website with it yet.


Howard F.:

Just word of mouth referral?


Jake S.:

Yeah, pretty much. Yeah. I have a handful of people that I work with, and I'm pretty busy with the two practices now especially, but if somebody needs something small or some advice or things like that, I'll send them an invoice just to screw with them.


Howard F.:

How do they contact you?


Jake S.:

Call, e-mail. They can e-mail me at jake@bachmanfamilydentistry.com is the perfect way. That's probably my most actively checked mailbox. Then we have AffordableColumbusDentistry@gmail.com. Those are the two best ways, of you can call my cell phone, 734-812-0881. Best way.


Howard F.:

What problems do you like to solve? I mean, when a dentist calls you up, they probably have a hundred different areas that they're concerned about. What areas do you like helping? Where do you find your talent is best expressed?


Jake S.:

I like making things more efficient so that you can take your staff and have them focus more on the patients. I mean, the biggest thing like I was telling, it came right out. I mean, the Renaissance was huge for us. YAPI, [inaudible 32:03], thank you very much for [inaudible 32:05]. I searched for a long time trying to find a good interoffice communicator. We had Lighthouse 360 at the time doing our text message confirmation, e-mail confirmation, brief call, and switched over to YAPI. It was a no brainer. The cost was the same, except there's so many things built in. Then I added [inaudible 32:30] designed an online payment portal, which is sweet. It's so awesome.


Howard F.:

YAPI fans for yet another practice management ...


Jake S.:

Practice interface.


Howard F.:

Practice interface. Gina is just maybe one of the most amazing dentists I've ever met in my life. Man, she is just crushing it out in southern California. I love her. I love her enthusiasm. I love everything about Gina. How much was YAPI and why do you like it so much?


Jake S.:

I believe it's $299 a month at this point.


Howard F.:

When you got YAPI, you no longer needed Lighthouse?


Jake S.:

No, not at all because Lighthouse was pretty much just doing e-mail confirmations and text messages. I mean, that was pretty much it really. Then it was the same price honestly at that point. I don't know what they charge now or if it's changed at all. They may have even added some things because, before I cancelled, they were saying that they were going to add communicator and all this stuff, but then finding YAPI. I mean, they do text message confirmations, and then it gets into everything where you can have a dashboard and it will tell you the status of who is in what op, do they owe money, have they reviewed your practice, is it their birthday, how long have they been in the operatory when the front desk checks them in, like how long have they been waiting to be seated.



That's our biggest pet peeve. Our number one carnal sin is don't seat a patient late unnecessarily. That helps out big, and then at the end of the month, or end of the week, day, whatever you want to look at, it will track down what percentage of the day, week, month that your operatories have been used. I mean, it's awesome. It will show you some KPI on there too. I mean, the sky is the limit.



This is huge. The health history forms. On our website, we have the patient portal set up, so basically a new patient calls up. The front desk goes through and talks to them. They want to schedule. Our front desk marshal will have her go to our website, click on the link, fill out their health history, all their information. They hit submit, we get notified. Then when we get in in the morning, we can click, pull up, and verify all of it. Then when we hit transfer, it will put everything into Dentrix for you. I mean, just that alone had made our front desk so much more efficient. It's awesome. I mean, I highly recommend it for anybody. Even if your front desk is getting bogged down, it takes so much work load off of them. It's been great.


Howard F.:

YAPI can be found at YAPICentral.com, so W-A-P-I Central dot com.


Jake S.:

Mm-hmm (affirmative)


Howard F.:

What was it? It was yet another practice management.


Jake S.:

I think it's just Yet Another Practice Interface. I think.


Howard F.:

Yet Another Practice Interface. Was that it? Yeah, I think she's just amazing.


Jake S.:

Yeah. I didn't know this at the time, and then we did some research. We found out she's a practicing dentist down in California. Was a Dentrix customer and just designed that to fill in the gaps of where Dentrix is kind of missing the ball. Honestly, that's been awesome. Awesome.


Howard F.:

Yeah. I think her dad is one of the programmers, and her husband works. I think it's her dad and her husband.


Jake S.:

Yeah. Yeah, I think you're right. Then when you call there, you know I've talked to them a few times at the beginning with tech support and stuff, and they've been awesome. I mean, really good. Our front desk will call every once in a while, but as of lately, knock on wood, we've had to do nothing with it.



Then my next thing I wanted to do was ... It started with we wanted an office communicator to help out and make everyone more efficient and communicate. Then we wanted the online forms for our patients so that we could kind of streamline that and get rid of filling out paperwork in the office all the time. Plus, it gets the patient more engaged. I mean, if they fill out the paperwork, then hit submit and send it to us, the failure rate drops so much. I mean, they're dialed in. They've already plugged their soc in, their insurance information. They're pretty much committed as a new patient.



Then we got that on board. YAPI has that. Then I wanted an online bill pay feature and so, everywhere you look they wanted you to apply for a new merchant service account. Then it was like, if you have one set up already, you can't have two. There was all this goofy stuff going on with that, so then I was like if a patient can submit their soc and all their health history and all this protected health information through YAPI and their service and everything, I was like they've got to be able to send a credit card through it honestly. I contacted them and kind of sent them a template of what I wanted on the forum to make sure all of our payments would go through, so they created a custom form. Now patients can click on that on our website and click submit, and perfect. I mean, that was awesome. It didn't cost us an extra penny.


Howard F.:

That is very cool. If you go to dental town and you just do a search for YAPI, there are so many threads talking about how great that is.


Jake S.:

It's just like people question it too. There's noting to question. It's just great. Even if you just use it for text messaging and e-mails, that's fine. It's still worth it, but everything else is like a bonus.


Howard F.:

Yeah. On my iPhone, I just went to pull up Dental Town and typed in YAPI, and the first thread, "Yippee YAPI! Me so happy. YAPI - Worth it." You know, YAPI versus Lighthouse 360. Who else is using it? I mean, it just goes on forever.


Jake S.:

Yeah.


Howard F.:

I mean, forever. You can scroll down and see threads going back a decade on this. I mean, it's just an incredible source. What about time management?


Jake S.:

I mean, that's tough. Going through the course of a day, I'll have a plan of what I want to get done, and it's just that totally changes by the end of the day. You know, suction is not working in one of the operatories. Then you've got to go and fix that. Someone requested vacation, and then you've got to deal with that. Then you have the employees. You know, she's not doing this and trash has to be taken out. It's just dealing with all that stuff. That's the biggest time sucker out of all of it. Then it's like December/January, end of the year, start of the new year. We're totally slammed. I mean, that's been the struggle. Then having a second office. Trying to find a second associate to work down there to open up more hours down in that location. That's been the biggest thing honestly. Yeah, I don't know how you do it. Honestly, you film all these podcasts. Jeez, man.


Howard F.:

I know.


Jake S.:

Not enough time in the day.


Howard F.:

As far as staff and all that kind of stuff, I mean the bottom line is we're right at the playoffs of the NFL, and I don't care if you won the Superbowl last year. You're going to have 25% employee turnover, and for every Peyton Manning who is a franchise player that's been there forever, a lot of your players only play ... I think the average in the NFL is three and a half years, but I mean, you find a dentist who is seventy years old and they're still having a hard time finding and associate. Staff issues, I mean, it's a never ending thing.


Jake S.:

Yeah.


Howard F.:

It's the hardest equation in life. That's why they have government. That's why they have religion. That's why they have rules to obey your father. I mean, it's just people are incredibly complex. What else do you want to talk about?


Jake S.:

How do you train your associates? I mean, pretty much now I'm sure you get candidates applying all over the place, right? I mean, you were hiring not too long ago. We drove around and Dr. Bachman was like, "I meet all those criteria. I'm just going to go down to Phoenix. That would be awesome."


Howard F.:

Yeah, great weather. Actually, the best place to find an associate is actually on Dental Town. The classified ads are free.


Jake S.:

Really?


Howard F.:

The dentists that are on Dental Town, obviously they like CE. I mean, we've got three hundred and fifty courses. They're engaged. I mean, there's two types of dentists. Those that come home at 5:00 and pop a beer and watch ESPN and then those that get on Dental Town and argue about root canals until 3:00 in the morning. They just seem to be a more passionate group. They've taken a lot of online CE. I think they feel like they're in your fraternity when you're talking to another Townie. I mean, they don't even call themselves dentists. They call themselves townies. It's a really neat fraternity, and I think that's why it continues to grow fifteen hundred people a month. I mean, we're well over ... I think the last I looked was two hundred and seven thousand or something like that, but speaking of the obvious. I am out of time. I've got to get back for my next patient at 1:00. Thank you so much for spending time with me today.


Jake S.:

Absolutely.


Howard F.:

What's that?


Jake S.:

My pleasure. My pleasure. Thanks for having me.


Howard F.:

Yeah. I had fun and thanks for giving us all those links to all those websites and YAPI. Do you ever talk to Gina?


Jake S.:

I haven't, no. I saw you had her on not too long ago.


Howard F.:

Yeah.


Jake S.:

I listened to that podcast. I mean, I drive about 45-50 minutes from the north side of Indie down to Greenwood, so I listen to them. You know, not having a dental background. Honestly, I learned so much clinically because we would always say to the staff, "If you hear anything clinically come out of my mouth, just know I'm regurgitating it from Dr. Bachman." Otherwise, I learn so much listening to the podcast. It's been great. I mean, educational as it comes.


Howard F.:

You know, I've always noticed in dental lectures about the room. You split the room in half. Half of the room is just all dentists coming by themselves. The other half of the room is just one dentist, but he's got his spouse and two assistants and a hygienist and two front. Those offices where everybody is learning about dentistry. It doesn't matter if they're learning how to do a root canal or how to bill insurance or how to use YAPI. When the whole team is cross training and learning the whole thing, those offices do double the numbers.


Jake S.:

Oh yeah.


Howard F.:

I mean, a lot of dentists say it's expensive to educate your employees, and I'm like it's twice as expensive not to educate your employees, you know?


Jake S.:

Yeah.


Howard F.:

If the course is a hundred bucks for the assistant, I'd say it might cost five hundred bucks not to take her. You know what I mean? You've just got to take them.


Jake S.:

Yeah.


Howard F.:

Hey, Jake, thanks so much for your ...


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