The Dental Billing Podcast

Built to Get Paid Series - Bonus Episode -Documenting the Journey So You Don't Make the Same Mistakes

Ericka Aguilar

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I want to share something with you this week that I don't usually talk about.

For years, Jen and I carried an idea we couldn't shake. We knew dental billing better than almost anyone, and we kept saying the same thing to each other. Somebody needs to fix this. Eventually, we realized that somebody was us.

What followed was not a clean, easy story. We flew to Arizona and locked ourselves away to get everything out of our heads and onto paper. We sat across from one of the most respected people in dentistry and got advice that was brutal, the opposite of what I wanted to hear. We turned down money that was on the table because we wanted full control, no holdbacks. And there was a stretch where it got so quiet that someone close to us asked if we had given up.

I'll be honest with you. There was a moment I wondered if I'd made the wrong call.

In this week's episode, I'm taking you all the way behind the scenes. The offers we said no to, the advice that changed everything, the doubt I rarely admit out loud, and the moment a room full of dentists showed me it was all worth it. I'm documenting this whole journey on purpose, so that you can learn from it too.

Interested in a Demo of Dentiq - The Billing Command Center? Get on the interest list here:

https://4063-dentiq.systeme.io/waitlist



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https://www.dentalbillingdoneright.com/the-dental-billing-toolkit


Download "The Most Underused Codes in Dentistry - And How to Get Them Paid" checklist here:

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Schedule a billing chat with Ericka:

https://calendly.com/ericka-dentalbillingdoneright/30min


Email Ericka:
ericka@dentalbillingdoneright.com

Email Jen:

jen@dentalbillingdoneright.com







Gratitude And Toolkit Origins

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Before I get started with this week's episode, I wanted to take a moment and thank all of you who have been loyal listeners of the podcast. And I read all of the messages and respond to all of the messages myself, specifically the support that we received after we released the dental billing toolkit, which I have to be honest with you, was not intended to be a 325-page operations manual for a billing department. I sat down with the intention of writing maybe a 10-page resource, put something together that could give you some direction, right? It wasn't intended to become what it did, but I'm glad that it did because it has helped so many of you. And the support was overwhelming. And I just want to say thank you for that support. We have received feedback, like you can charge whatever you want for this. I would have paid $1,000 for this. This is amazing. I can't believe you gave all this away for only $49. It feels so good to know that my work is appreciated because when I sit down and write out a podcast episode, for example, I do it with the listeners, all of you in mind. I try to anticipate questions. And I've done hundreds and hundreds of live speaking events, hundreds, friends. I've lectured in over 30 states throughout the US with an average audience of 100 to 150, specifically talking about dental billing. I am pretty good at anticipating what might be going through your head at any given time while I'm recording an episode. And so I try to anticipate those questions that might be floating around. I say all of that because when I launched the dental billing toolkit, it was literally with all of you in mind and based on the many, many conversations that I've had around systemizing your billing department, treating your billing department like a business within a business. And friends, if I tell you I wrote that book in less than seven days, it literally was just pouring out of my head. Now, did I use AI to help me? Yes, I did. I'm not going to mislead you, but I did not allow AI to take over my thought process. I could not stop. It was something that I knew I had to get out there, and I'm glad I did because the feedback I've received was just amazing. So I just wanted to take a moment to thank all of you for the support. And we are going to continue to do trainings on the dental billing toolkit. We're putting together a webinar on how to implement the strategies within the dental billing toolkit so that you can take that information and implement that into your practice and scale your billing department. Okay. So last week we talked about the command center. And I talked to you about what we built. And this week I want to do something a little different. I actually want to take you behind the scenes and walk you through the journey of where my business is now because it is experiencing an evolution. It's evolving yet again. And I want to document this season on purpose. I want to be able to look back and see the evolution that's happening inside my business today. While it's still happening, while I'm still in the messy middle, and I want to document the hard parts and the good parts, and I want you here

Business Evolution And Faith

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with me for it. And before I say anything else, God has been the center of it all. Every step of the way, He's the reason I got to my goal of creating and launching this software. That's the foundation everything sits on in my business. Now, Jen and I have been working on this concept for years, you guys. We know dental billing inside and out because we live there. We see the bad faith denials, we see the money that offices leave on the table without even realizing it. I always tell dental practices when I have an opportunity to speak to them that the financial losses, the financial leaks, these are silent. These are not losses that make it to your profit and loss statement. These are losses that never show up because you can't see your blind spots. So you get comfortable and you

Insurance Denials And Silent Losses

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just accept that this is how the reimbursement cycle works, right? We've accepted the status quo. And what is the status quo? We've accepted denials without appealing them. And I can tell you that with confidence. I don't say things just to make an emotional statement, but I read the state of claims report that is released by Xperian every year. And the state of claims is a review of how claims are, I guess, in for lack of a better way of explaining, how claims are managed by the insurance companies, specifically denials. And I don't remember which year this was, but I want to say 2022. 59% of all denials in healthcare were upheld because nobody bothered to appeal them. So I want that to sit with you for a little while because going back to accepting the status quo, I say this with confidence. We've just accepted that insurance companies deny treatment and then we pass the financial burden on to the patient, or even worse, we just write it off. Because 59% of those denials were upheld because nobody bothered to appeal. So if insurance companies know that stat, why would they not issue unreasonable denials? And if we as a billing industry don't even know how to recognize what an unreasonable denial looks like, and I know this as well, because at every workshop that I host or speak at, I ask my audience who here can explain to me what an unreasonable denial technically looks like? And not a single hand goes up. Maybe there will be one brave soul that will attempt to explain what an unreasonable denial looks like, but they're wrong most of the time. So an unreasonable denial is when the benefits are available to the patient, yet not yet. And you have submitted a clean, valid claim with sufficient evidence proving dental or medical necessity, and they still deny the claim. So you submitted all the evidence. Benefits were available. Let's take SRPs. SRPs were done, patient was eligible, and Perio is a covered benefit. You receive a denial. The first thing you want to do is verify that you did, in fact, submit a clean valid claim with sufficient evidence. And if that is the case, you have received an unreasonable denial. But if you can't recognize that, you're fighting fire with a water gun. And that's how most billers function. They fight fire with templates, they fight fire with a water gun because we don't know how to fight fire with fire. So the first key to fighting fire with fire is to recognize when you are looking at a bad faith denial or an unreasonable denial. And you have to know how to push back on an unreasonable denial. You do not go through the appeal process three or four times and then celebrate that you fell for the delay game that the insurance company has in place so that they don't have to pay that claim right now, but they'll pay it after the third appeal. Friends, we have to put our systems together. We have to know how to fight fire with fire. As billers, we have to know that. So I'm saying all of this because these are the types of conversations that Jen and I have had over the years. And we have been working on this concept of taking everything we know about billing and just extracting it from our head and then creating a software that fights fire with fire. And that software is our brainchild. It is now live and it is called Dentee. We've been working on this for years. Again, we know dental billing inside and out, but all of that knowledge was stuck in our heads. And we had to get it out and turn it into something that people could actually use, right? So in January, Jen and I made a decision to fly to Arizona. It seemed to be in the middle. She's in Oregon, I'm in California, and she wanted to come to a place that was warm, warmer than Oregon in January. And we decided to isolate and basically barricade

Turning Billing Knowledge Into Software

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ourselves in so we could laser focus. We didn't want any distractions. So I want to get I want you to envision. We would come to my room to do the brain dumping, and it was such a mess. And we had sticky notes, small, medium, large. We had sticky notes all over the walls. I can't

Arizona Brain Dump To Blueprint

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even begin to tell you, like we knew we were on to something, and it just when you know you're on to something, it just kind of pours out of you. And we just kept brain dumping in no particular order. And that and that's the thing, right? In business, sometimes you just need to brain dump and then you organize your thoughts later. And that's exactly what we were doing. We were taking all of our experience, all of our billing knowledge. And Jen is a clinician, she's a hygienist. So she has a different level or vantage point than I do because I'm just the biller. So we took all of our knowledge out of our heads and got it down on paper and those sticky notes. And then we organized it inside of a Google Drive. And it was so satisfying because it was like at that moment, it stopped being something we talked about all the time. And we knew it was starting to be formed, right? So on our last day in Arizona, we took our idea to Howard at the Dental Town headquarters. For those of you that have followed me for a while, you know that Howard Faran and I are really good friends. And I thought, why not present this to my friend? Also, he happens to be one of the most brilliant humans on this planet, and get his thoughts. So we walked in to Dentaltown headquarters and presented this concept because it wasn't real yet. We presented this concept to Howard, and he did not give me the advice that I was hoping for. It wasn't what I wanted to hear, but it was

Howard Faran Advice On Funding

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exactly what I needed to, or Jen and I needed to hear at the time. It was kind of brutal. He told us not to take money from private equity first and foremost. He said that we should just bootstrap the entire project. He did give us an alternative to that. He also offered to get involved and fund the entire project and help us with his team of programmers, but we would have to wait until 2027 before they can jump in. And as much as I would have loved for Howard to be a part of this software, it that timeline didn't work for me and Jen. He did give us a solid game plan and pointed us in the right direction of finding the right programmer. And we followed his advice to the T. Now I want to be honest about this next part because this is a decision that I am super proud of. We had private equity guys who wanted to be a part of this. I was approached by a private equity investor. He's a private equity investor in dentistry, and he wanted to build something like what we are building now, but that would take control away from what Jen and I wanted to create. On paper, when you have a private equity guy come to you and say, hey, I want to fund all of this and I want to be a part of this, I think a lot of people would grab that offer and just feel like they've arrived. And Jen and I basically looked

Turning Down Private Equity Control

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at the offer and said, No, we wanted full control and no holdbacks, right? We didn't want to build our dream and then have to ask permission to run it. So we chose the harder road on purpose. And I would make that choice again and again and over and over again today. I'm not gonna pretend the road was smooth after that because it wasn't. I wouldn't be documenting all of this if it was all easy. This journey has definitely had its ups and downs, and there were times when it felt like it was never gonna come together. I mean, at one point, Jen's husband asked her if we'd given up on the project we started. That's how quiet it got. And I'll be honest with you, I started to wonder if I should have gone with one of the offers that were made to us, not for the money, but for the talent. We needed a developer who actually understood what we wanted to build. Someone who could see the vision the way Jen and I saw it. And that's the hard part about keeping full control. You also keep the full responsibility of finding every missing piece yourself. But then we found him. We found the developer who got it. And the moment we did, it was like we never skipped a beat and we got right back on track. I mean, friends, within a couple of weeks, Dentec was just brought to life. So if you are in that quiet stretch right now, you're you're also building something where the people around you are starting to wonder if you have given up. Just hold on. Sometimes the gap you're staring at is just a blank canvas, right? That the right person hasn't walked into yet. And that was that space for our developer. That

Finding The Developer Who Gets It

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was the gap that needed to be filled. And we didn't lose hope. We just knew it was not yet. And here we are today. Dentique is live and in beta testing, and our little brainchild is up and running. Jen and I are so proud of what we have built. And that leads me to this past Thursday because this was a moment it all came together. I had the privilege and honor to speak at the San Diego Surgical Arts Study Club. And there were about 50 dentists and their insurance coordinators in the room. I got to talk about billing and I shared the insurance commissioner audit findings. I showed them how insurance companies intentionally issue bad faith denials because they're counting on the fact that those denials typically never get appealed. I talked about that at the beginning of the episode. The audience was super engaged, questions all throughout the workshop. There was a moment that tripped me up. A biller in the room raised her hand and shared that she follows me on TikTok and that she has learned

Study Club Validation And Demo Invite

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so much. And her doctor was sitting right next to her, and he thanked me for everything I share on TikTok because they've seen a huge improvement in their billing department's performance. And that's the whole reason I do it. And it was right there in front of me the my purpose, my reason, my why. You guys, that's why I do stuff like this. I want you to win. So in the last 10 minutes I had with them, I did a brief demonstration of denteak and showed a couple of features. Then I closed by asking the audience if they wanted to see the full version because I was, I was only able to show, I think I showed two features, two or three features. And I had to close. Every single hand in the room went up. I even had a dentist come up and thank me for creating this. He told me he'd been wondering when we were finally gonna get a software that focuses only on billing. And he said he was glad that I did it. Then he asked me about pricing, which we haven't even gotten there yet. This was the validation Jen and I needed. We already knew this was necessary, but to see how interested everyone was and to watch a room full of people raise their hand for it, that, friends, was so exciting. So that's the season I'm in. I bootstrapped this software on purpose, and Jen and I remain in full control, and we built this software on faith every step of the way. And finally watching the thing we sacrificed for get the response we hoped it would get is so rewarding. So if you're somewhere in your own hard, messy middle right now, I hope this episode helps you. The brutal advice might be the best gift you ever get. So pay attention. And sometimes the offers that you turn down might be the freedom you get to keep. And that thing that you have been carrying in your head might be exactly what a room full of people has been waiting for. If you want to learn more about Denteak and you would like to see a demo of the power of Denteak and how it brings your billing department together, go to the show notes and sign up for a demo. I'd be happy to personally show you how powerful Denteak is and how it can transform your billing department into a business within a business. Until the next episode, friends, thank you so much. I appreciate all of you.