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1206 Dental membership plan with Dave Monahan, CEO of Kleer, LLC : Dentistry Uncensored with Howard Farran


This is Carl from loops in when thousand eleven of dentistry, and censored, we discussed how surge tells ergonomic loop design can eliminate neck pain and strain check episode when thousand eleven or just search for surgical. It's just a huge honor for me today to bring back for the third time Dave Monahan the CEO clear because a passion for creating technology enabled businesses that improve people's lives priority drained clear. Dave served as presidency. L A fit links, a leader in the wearables market, where he created simple, affordable, and connected where we'll devices for medical and sports markets fiddling devices, enabled patients to monitor and manage chronic conditions and athletes to module improve their performance, and then he turned his sights to dentistry, and while it Microsoft from nine ninety two thousand six bayed, Veld, new products marketing partner strategies helping Microsoft and thousands of other partners into new markets. He's a graduate of the Pennsylvania, state university, and Loyola University and resides in the greater Philadelphia area. He's married. Yes. Three children when Dave is coaching or supporting the kids activities, he. Finds time to exercise travel play any sport of competitively. You know, I actually started running just recently running up my credit cards. That's the only. So it was oh, I'm bringing about the third time because these, these. Plans are just exploding. And everybody's talking about it would what's really change. Of they brought young learn Simar. Are how was this business going are you? Glad you went into it. Or do you wish you would've indicates now? Absolutely. I'm very happy that we've gone into it, and thanks for having me again, it's, it's an honor to be on three times. I'm yes. Just died. Just a quick update and we go and other things. But, you know, we launched the clear platform back in January of two thousand eighteen so it's been about fifteen sixteen months in we have over two thousand dentists on the platform. We are doubling our member base, and our revenue, every three months, there's nothing but sort of huge growth in front of us. So the reason is the sort of premise, we had coming into the market is proven to be true, and it's really a two sided, I proposition so uninsured patients want care, and we've seen that over and over again. They want coverage. They've looked at things like insurance in turn it down because it's too complex too expensive. But the net is a really value or a health, so about eighty five percent of. Patients actually Ty oral health overall health about seventy five percent tides quality of life. And so they really want care the issue typically is they're afraid of the costs. Then understand gloss. They don't have coverage so they stay away. And then on the dentist side will we're seeing is, it's just really driving people closer to the to the dentist when they join a membership plan and become more loyal, they visit more. They accept more treatment. So both sides of the value proposition, we sort of Sumed was going to happen has happened in to your point. The growth is just been through the roof. They then is always ask me when I'm out there, lecturing or getting emails, they say what do you think of these in-house insurance plans, and you and there's a big word there, you're saying membership plans, and they're asking me. What about these in house insurance plans? Can you talk about that distinction? What is the distinction of a membership plan in insurance plan? And then a lot of dentists I get all these emails forwarded me from their dental side. Siamese a start talking about the galaxies of, you know, you're having a an office insurance plan, but, you know, you need to baba. So, so talked the difference. She a membership plan an in house insurance plan. Yes. So that's just whatever misnomer, and somebody calls the insurance, it's not insurance. You're basically just offering a care plan to your patients directly without middlemen in the way. And so just a quickly, just give but don't say page typically up, don't practice will offer three dental membership plans once children wants for adults once repaired patients, and you can customize it in change based on your patient base. But that's sort of the standard and what you're doing is basically making an agreement with your patients, that if they pay you a monthly or annual subscription, you'll give them their cleanings or exams xrays is part of the subscription and typically you'll give discount out of the treatment twenty percent twenty five percent ten percent, whatever you want. But you give some discounts on other treatments. So it's not insurance. It's a very simple plan and an offering between you and your patients. And the reason that's really important is a number of reasons. One is the patient's pain you? They're not paying these shore, who's holding onto the cash or yoga creating all kinds of ministry and hassles between you and your patients. So it's directly your patient. They pay you in that screen on your side, obviously. But that's exactly what patients want. So in this world patients are used to things like Netflix in Newburgh, and so on where you have a direct relationship with the person, providing the services. They really value that an trust people providing services racked in the obviously a lot less hassle. So rather than having a ten page document they gotta try to interpret typically you have three or four lines that explain the plan. And so it's best it's exactly what your patients want. It's exactly what you need in order to prove forms in your practice. So when somebody says insurance, it makes me cringe a little bit because it's, it's not as shorts and then from legality perspective, just that you follow a set of rules. You're fine. You can offer membership plan to your patients. And we've looked at all states. We've done a deep legal analysis of this. What we've done is clear is structured around that illegal analysis, and there's a number of things you need to do. You can't just go into it blindly. So things like it needs to be hip and compliance. It has to be the patient is paying you directly. It can't go to a third party. You can't be creating a network of dentists in offering one plan that covers lots of dentists like a network of dentists. At insurance shorter would have got to be direct between you and your patients. So there's probably ten fifteen even twenty roles like that, that you have to follow. But we've built that onto the platform, so it's very easy not need to worry about it. And a lot of dentists at they're always asking is this, you know, is it a stock plan, or is it a custom plan? I mean it's go ahead. It's, it's. All right. Yeah. It's up to the dental practice. So we have stocked plans, if you wanna use them, but typically every dentist wants to change it a little bit or you'll change treatment protocol or whatever. So from a treatment standpoint on the clear platform the. Could decide design power, they would like and it can be customized our they liked. So I sort of mentioned most practices have a child plan, a adult plan, a perria plan. But we also service pediatric practices, and we have one pediatric practice that has three different children's plans. And they're all customized based on the age of the children. We some dentists who yellow, they believe in Florida fragility in other dentist. Don't they can do that? They can create the, the treatment protocol, how do they like you also can customize instead the subscription price yourself. You can set things like are you allow your patients to pay on a monthly basis? They had to pay all up front. You can even exclude procedure category. So let's say you want to include everything some orthodontics you could do that. You can add specialists to the plan. So let's say you have relationships with three different specialists, you could add them to the plan. They're offering get straight to your patients in. There's a direct relationship there, you're sort of passing specialists onto them in that becomes a value proposition of your plan, so it can be negative go through a number of other things. But the net is it can be customized for. Your practice. But if you want to go straight forward to just sort of do what's sort of common practice with do we have templates as well. You can follow so on dental town. If you do a search for player, there's several threads on there and dentists they love doing dentistry. But I mean I cannot tell you how many dentists the day after they retired they still never sent one inch claim. They still couldn't tell you how many people called their office less. They couldn't tell you the return on asset for any year. They prided so you don't really like this stuff. So they ask a lot of questions that they don't sound like how offices handle the bookkeeping are signing payments entered than there yet credit. How does how does it work technically? So, basically think of clears the platform that connects your practice in your patients with the membership plan. So we provide everything from the, the dentist when you're setting up your plan. We have a full registration. Application. Very simple, very easy design. We give you a consultation with a clear success manager, who will get you at help design the plan. How you want? And then, once you launch you have something, we call the clear dentist portal and on Dennis portal. That's where you can see everything you can see who's joining you can see their payments. We connect the back end of clear to your Bank account. So the all the funds flow straight through into your Bank account, you can I invite patients from the portal. You can do things like your credit Google ads from the portal. You can track your renewal. So when Renault was coming up. Let's say you know, twelve month membership plans ninety days prior to the, the membership expiring. For a patient, you'll get a notification, the patient will get a notification. It will automatically process that renewal wouldn't and made in let you know, the renewal process. So the net is you're through a number of other features just like that than it is the platform manages, the membership plan for you, once you launch it, basically need to do. Do is teach patients about it. I promote it in your office, you can promote it outside your office. And then, once they join you basically use the, the portal in the platform to manage it, all in on the patient side. They have a portal as well. So once they join, they can log in, they can see their benefits they can manage the payments. They can even add family members they can invite friends to join so thick. It is very sort of robust in comprehensive Llosa, platform that really meets the needs of the dentist, and of the patient in it's all on a Matic, the practice hasn't needed to a whole lot to manage. It will if you listen to the people talk about your product on dental town that the they love seems like the open dental user says, so easy. Do you, do you think I'm clear works better with some practice managers systems than other? I know you want to get all the venture eagles off. I know you want to get them all. But if some kid just walked out of dental school star. In your own practice. In said, do you light your business Verson? Do you like what are these pressure in software is better than the other? It's I can't say I like one better the other. I get opinions. What's interesting is our base of customers dental practices. If you look at the mix of management software that they're using it's very similar to just the overall market percentage. So we have opened down away, we've Detrick so on. And so it's a very similar mix. I haven't heard actually that one practice management system works better than the other. So that's actually the first I've heard of that. Now, we do typically get a lot of positive comments about open dental because it's very easy to access in the things are hidden. And it's just like a much more, obviously open platform, so I'm not surprised by it, but that's I, I've heard one of Benjamin software is better than the other relatives clear. So who do you think is your product champion in the dental office? You think the dentist is recommending? Enclosing clear is the hygienist office manager, the financial wind is this really come up and happen. So it's really and we provide all this guidance. I it's three people are critical. It's whoever's at the front desk, and greeting patients is sort of step number one. And so the process of here's the process we have in place in. It's all documented. We have a playbook for practices to properly promote their membership plan. So when somebody walks in, you, h in uninsured issues, the concept that we provide brochures to practice he handed brochure, you explain it to some, some patients that point at ready to buy, they get the value and all that stuff, and they sort of by right there. Others as let me think about it. They'll go into the back. We actually have a call a sorry, a script for hygienics to talk to the patients when the patients in the chair just introduce this membership plan gives their perspective on it the dentist when they walk in to do the checkup. We also have a little script that they can use to talk to the pay. And obviously everybody can customize and talk to in their own way. But what we found is, if, if it's repeated, and it's across the board. It's the front desk. It's hi Janice ended Dennis. And then when the patients welcome back out the checkout, the person's front desk, mentions that, again, that's the best way to sell so that reinforce it across the group. Now, if I had to pick one or the other who's the, the, the base champion of, of a membership plan to see office manager is typically, the, the number one person needs to be behind it, organizing, it, make sure everybody's on the same page by a coordinated sort of plan is the best and on. There's one clear throughout that. I'm a very long and a very common question is. Is this more for indemnity dental insurance offices are PPO's, or what, what, what does that what is your fee scheduled PPO's, Medicaid? What does that have to do with your product? Nothing. So now we're definitely not indemnity playing. We're not a PPO nothing like that. So, so the net is when you create a membership played you control everything you control what the treatment protocol, is you, and you decide what's included in the plan. You decide what the discounts, are you set the office fee schedule. So typically, what our practices do is provide their fee schedule their just their standard fee schedule. They have in the office will upload that into the platform, and then they'll just take a discount off those standard fees, and they decide that the practices sides typically twenty percent some are ten percents. I'm going to thirty percent but it's all off to the practice decide it's not indemnity. You want these patients coming to your office. When will we say is when pages engaged or coming in a number of things happen? They become more loyal to the practice. Obviously the visiting more they'll accept more treatment, and then just as important as all that is coming in and getting treatment and get doing their cleanings though, renew the agreement in the in the membership at the end of the year, which is critical. Did a long term success of the membership plan. So it's, it's almost the opposite of some of those types of plans where, you know, it's fully in your control when you really, really want the patient to come in into the office. You know, just listening to Dennis talk, you can really tell how far behind it is cottage industry than, say the S and P five hundred like you go to dentistry, and everybody's always talking about new patients, new patients, your patients. Once you go to the fortune five hundred were their life when I was born the average life expectancy on the S and P five hundred was sixty years now. It's down to twenty years, and nobody is Southwest Airlines are chase Bank is trying to get a new per customer to fly Southwest Airlines. They're trying to do. They're all about loyalty programs. I mean, Costco, even went, so far as the Senate. If you're not a member, we won't even let you in our store, and they were showing soul price was showing everybody how that you don't wanna do marketing. Sam Walton was the first one to cut marketing. He goes. When you tell mom that you have a going out of business L fourth of July sell all this crap. She go, he it's an expensive marketing program that you got to raise your prices, we're gonna do every day, same same low price pricing, and they put all their marketing money on programs. So how does he membership plan increased patient loyalty? And why do you think patient loyalty is more important than marketing marketing marketing? Nailed it. I mean, that is the value of a membership. Play is the loyalty you get for your members. And what happens from the loyalty? So the reason membership plan creates loyalty. And by the way, you do this and other ways tree people special. Right. Thank you for coming in your office, shake their hand. Look in the eye. Just whatever you can do to make them feel special is gonna create loyalty. But the reason a membership plan creates loyalty is remember, these patients are uninsured patients. There's the view of the world is I'm on the outside of the ropes looking in into dental care, and the, the odds are stacked against me getting a deal and feel good about it. So what a membership plan does gets closer to your practice gets them to commit to your practice. It also makes them feel special. It makes we actually measured. We would talk to consumers uninsured consumers who didn't have any coverage at all. And then after they had to membership plan we asked him to explain to feelings to us, this is amazing. How are these are the types of feelings that came out of it? I feel good about myself. We're like you feel good about yourself. Why is that? And they would say I now have covered the care, I deed. And that makes me feel good. Now, we're like, wow. We never thought that right? And then we say, okay, what, what else do you feel? They said. I feel financially savvy like, really financially savvy. Oh, yeah. I bought into this plan and I'm getting a deal. Right. And this feels good that I can commit treatment and get the things I, I've, I won it feels good to be out getting sort of making a financially savvy decision. Here's another one that came up. I have peace of mind, and we're like, all right. Explain that one. They just say, I have covered. So if I need it I can use. I don't have to wait forever. Right. I can just go win and get the things I need done. So that's what happens from a sort of structural standpoint, people feel good about, you know, getting access to a planet in taking care of their oral care needs. And then we always tell practices to take it beyond that make it personal. So we have so practices. You walk in the door. If you're a member, you get a little gift when you walk in the door, and it doesn't have to be a lot. He's just be something small you're saying is on thicky about you. I care about you, and that will drive loyalty, another guy said before it just greeting people in thanking. In shaking, their doesn't have to be get the gift is. I appreciate you. So those decided to hold our level of loyalty than what we see is, when somebody feels the patient feels you'll good about things in a trust you, and they feel closer. Now, they're in the other side of the rope. They accept treatment. They come in boring. They accept treatment in your case acceptance goes up quite a bit and to your point, you don't have to be spending a lot of marketing money, they go fine. Yell new patients. It's writing your charts. I just a matter making people feel more comfortable in in get them to make the decision to accept the treatment. It is. It is just truly amazing. I mean, you, you, you go meet at us, and he's worked in a small town of five thousand people from twenty five to sixty five he's got twenty new patients a month for his whole life. And you ask them, a sixty five, what do you need buddy? He's like, well, I need new patients like how the hell could you need new patients in a town of five thousand you've been here, forty years? They just don't understand, neither the get rid of their, their, their this amazing person upfront because she asked for a dollar raise and they're like, no, you're making sixteen an hour, I could fire you hire someone for twelve you can get a homeless person but I don't know if you're gonna make money off that so loyalty is just everything. And, you know, just loyalty loyalty, Southwest Airlines, you punch card ten punches you get a free chip. And then the dentist say to me. I talked about membership plans and my seminar. They say, well, the reason I like the people that don't have injured because they're paying these higher fees. And now your best idea to me is to give those guys a discount. They say I don't like, you know, started thirty years ago with hi-fi indemnity delta. And then they switched that to lower fee, he peo-, and so now they're down to they only loved their cash patients, then here's some stupid Howard guy saying, we'll do a membership planning give those guys a discounts. They're like that's crazy. What would you say to that guy? Oh, yes. So I get it. It's a leap. I get this. I get the sort of push back, but we actually have the data and what we see is, if you compare membership play patient to talk about uninsured for a second. I'll talk about a short and amend it as well. But when you compare membership plan patients just a typical uninsured a typical membership plan patient will come in about one point five times a year where typical uninsured patient comes in once every two years so point five times a year. So they'll come in what we see is to retire more. They'll visit more when they're ended chair they'll accept fifty to seventy five percent. More treatment as a membership plan patient versus uninsured in the as part of that the net revenue, obviously goes up in similar way, so that he goes up fifty to seventy five percent for those patients, the leap, you need to make as a dentist is one isn't a actually, this is an elite I just help then is take a look at their data. So I looked at a lot of different practices data and what you see is uninsured patients. Don't come. In anywhere the year as much as the dentist think they do. They think they're coming in all the time, and there, actually are not. So that's number one is check your data. And then number two is then, check the case acceptance on news uninsured patients. So leafy need to make is if I give let's say ten fifteen or twenty percent discount, what I'm gonna get in return is more patients coming. In more often accepting a lot more treatment. Like I said, we see it in the data, but I know it's hard to make you just need to be able to make that leap, and it's based on when somebody has covers if you'll comfortable they trust you. They're more loyal and they'll commit to more treatment, more visits. He am I want to talk about what you just said for a minute because. It's obvious to us, but it might not be if you're twenty three and just graduated last Friday with it's called selling invisible. When I go buy an iphone or a diet coke. Everybody knows what that is. And the person doing the transaction, I don't need to trust or have relationship, but we're dentists we sell the invisible. And when I go to you, and you say, I have four cavities I mean, how do I know that's true? I anything so when someone is referred to you by a friend, and we, we had the, the owner of Facebook is Mark Zuckerberg his dad's a dentist is dad's come on the show. Same now in times u three ED's and unit secondary. And when I asked Ed, I said, what's the best way to advertise your practice on Facebook? He always says. The check yet when someone comes in your office, you give them a free toothbrush after a cleaning wanted to give them a free dollar toothbrush when they check in on Facebook because this average versus one hundred forty followers, and they say, oh, well, my, my good, buddy, Dave, he goes to Howard, today's Zanele it. So that's good for you. So then when they come in there, revert, and I say, you got three cavities. They're not thinking, do I trust this guy? Hell is referred by Dave? So now just about. Oh my God. Is it going to her? Can you put me slave how much is it gonna cost? When are you going to do it, blah, blah, blah, blah? So when you do all this marketing dollars for these new patients strangers, and they'll do something like cleaning examined x Ray for nineteen dollars. And so, they'll come in, and then at the end of the exam for ninety dollars say, oh, you have four cavities or two hundred and fifty. It'll be a thousand and the immediately think, oh, I get it a twenty dollar cleaning and ninety two thousand dollars or the dentistry, and they walk out the door. Then I turned that Dennis. I say get on your practice manual system and show me your case acceptance rate. They have no idea how to even figure that out. They don't know how to track it just clueless. So all you need to remember is that you just want one patient. The thinks you're, you're a good guy and your offices a good team. And they trust, you and build from there. You don't want to do all this group on crap and get all these people that come in don't know you from anything and every time you're presenting treatment, you're on the defense because they think you're selling. So, so loyalty. I mean, you, you want to make the people who trust you the most loyal and forget about the eight billion other people that live in six other continents, focus on the people that have made a relationship and trust you. So I couldn't agree more. I mean we work with a lot of practices in. I've yet to see somebody show me, a new patient generations, whatever special type of thing that actually worked over the long haul, they are almost all in the door out the door, and they typically accept very, very little treatment, and well, we do actually when we worked with practices, we get rid of those specials. We just tell them don't don't want for the special offer. The membership plan you're going to get the type of patient. You don't want all patients with the right type of patient. If somebody really wants to commit to you, it'd be loyal to you, they're going to commit to a membership plan over the long haul and they're not going to, you know, to your point of the special, Susan going to keep the door, turning but yeah, it's a it's funny when you talk about it for that. You're sort of, is sort of perspective. I just sort of based on my previous background. It's just known these things have just known it's just sort of a basic fact that these are the things you do. In order to create a long-term valuable business, but in the industry, it's, it's worst. Him. Some good light. I say twenty or twenty five percent of dentists are getting it and move forward. And the other is hopefully are gonna come along as well. So a lot of dentists, you know, if they're into business they what shark tank and, you know, that's the, that's the big dental business show. So the first question Mr. wonderful. How do you make money on the deal? So it's really simple. We don't make money unless dentist makes money. So we don't have any front fees, no implementation fees. Nothing like that. So we basically just take on average. It's about four dollars per patient per month of patients that are on the platform paying a subscription to the dentist. What we'd like about that model is our interests are aligned or not just going to draw drop software on the practice and leave. We actually have a success team. And there's really three steps to success team. The first is they meet with you. They talked to you. They understand your practice understand, your patients any help you design the plan, and they have experienced working with thousands of practices. So the they give a lot of good insight in so to help you design a plan to meet the needs of your practice and your patients once that groups done their handed to a launch team. And the launch team's goal was to get that practice to add the first ten members within the first, depending on the size of the practice that can be ten days that could be twenty days, thirty days, you know, forty days, but the night is get the practice us to selling the plan. Make sure they're using the scripts made sure they have all the materials out on the in the office. They're advertising has needed outside of their office and things like that. And just getting going comfortable moving forward. What's the practice gets tenders patients than they're handed over to will be called the growth team? And the growth team basically says, okay, how are we gonna get this over hundreds or even thousands of patients and make this thing work for you at a, a long-term in, in a high value way? So the net is I know it's a long answer to your question. But we think is really important that we need to be a line to the interest of the practice. So we don't want any money up front. We just want to get paid as you get paid. And the dentist, ask would see advantage disadvantage of them. Just doing it themselves. Why, why do they need a company like clear to do this? I mean, isn't this something they can just do by themselves? Yeah, we get that question number of times, jump into the to the chase and I'll go through some details. What are best practices are once you tried to do it on their own? And then. So I, I can't tell you how many practices, we've had common say, I got the fifty patients on the, you know, my membership plan or seventy five and it started collapsing on me, and there's a number of reasons starts to collapse. It's just hard to track everybody in when they bought when the renewables are what benefits they have, whether they paid what they've not paid just and then also critic experience for the patient that feels good. And they feel confident we've seen a lot worse paper base you print something out, and you fill out a form. And then somebody takes it behind the desk, or somebody takes information in the patient doesn't see where it goes and they leave with pretty much nothing. But a brochure in feel like okay, what did I actually by there? I'm not sure exactly what, what actually would happen. So the net is a number of reasons to use the platform versus doing it on your own. One is just the administrative side of it costs a lot money did missed a plan. It's also also gets difficult. Renewal rates what we typically see in the main. Plans is Renault rates in the twenty five to fifty percent area because it's hard to track. And then once somebody comes up for newly got a call on, you gotta get the credit card information. Typically, they say I'm not going to renew until I come back into the office. Let's be three months or six months from that time. So on our platform, we've auto renewal. So when you sign up by plan your into an auto renewal program, you can opt out if you want, but pretty much nobody does. And so when you're twelve months renewal comes up, it renews on it'll notify, we've legal reasons for legal regulatory things we need to follow or as by renewing that membership. But we take care while his things we send notifications is needed. But renewables I happened in the Renault rain on our platforms over eighty percent. And we have practices that are in the nineties, and you can do that just by following a few simple sort of best practices. We provide things like compliance and regulatory issues trying to create something main delay the typical client is very, very difficult. And so just be able to protect the date. To be able to meet the state regulations. There's data privacy regulations outside a hip on this consumer laws. You gotta follow, so there's a lot. You gotta follow from compliancy standpoint. The other is just having all the materials prepared for you. So if you're gonna create your own membership plan, then you need to start creating market, materialism, brochures, you need to create a place in your website, landing page. I you got to create a process for people to patients to purchase. We take care of all that is all out of the box, if you can get going in minutes, so you don't have to spend a lot of time doing all that work is spending, a lot of money, getting ready. And, and there's a bunch of other things like just the playbook sweet provide. So we have a playbook on how the implemented successful membership plan. It's really simple. Step by step, Missouri. Exactly how to do it. We have a renewal guide. How do you maximize your renewals and is a step by step guide and things like that? So I think the net is could you do it? You could will be incorrect. It probably won't probably be a lot of issues with it. And then you will also pobably will have some regulatory issues than than we see very consistently renewal issues with the manual lines. So this one guy, writes to this plan clear has really been helping. I've had quite a few longtime patients finally decide to do propose work. They have been putting off for years. I was skeptical and someone stressed about the discount. And why was I discounted? When those people were perfectly happy, paying my full fee. It dawned on me, though, that yes, they came in for the hygiene, visit and paid, but there is no guarantee that we're going to come back in six months duty. Anyway, your your, your biggest fans are posting about this on dental town. That's why we had back. Yeah. We see that all the time, and that it's funny to me that it's a surprise at that happens because we know what happens is happens every day on these membership plants. It's just a matter of people seeing it. Right. And and seeing it live in their practice. But like I said, we're seeing acceptance rates fifty to seventy five percent higher for membership. Plan patients than than on short. And what, what? I don't know how to what to call it. It's almost you've active opportunities in late and opportunities in the active opportunities. I might have like a major pain. I gotta get take care of so I get taken care of. And if somebody's uninsured, they're going to do those things, but the late night, -tunities where I can put something off if an part of membership plant a lot of times they put his off. They are part of membership plan the often move forward with the with the treatment. Yeah, this one guy is writing the truth about in-house membership plans is that you can use them to get off PPO's, HMO's and Medicaid and Medicare. I'm do you. Is that part of the I mean, what, what are your if some good, I said, I wanna do this because I'm trying to get off PPO's, do you think that's a good strategy? Or are you say no, no, that's, that's not. That's not even. Right. What would it that? It's I, I would not suggest it if you had a high percentage of insured patients, if you have a small percentage, you can manage it and I wouldn't do it overnight. So what we see successful practices. Do is they'll drop the worst of their PPO's and replace it with a membership plan, and they'll do that over the course of time. So they might announce it, you know, six months in advance twelve months in advance, you're not going to accept that particular insurance in, if you like we have this membership plan for you to move over in, like I said, it's typically the worst of the worst on the insurance side. If somebody said, I'm gonna just sorta wipes the slate clean not shorts anymore. And I put my measure plan to place. I'd say they're going to face a bit of a daunting challenge in the short term, because that insurance is being subsidized by an employer and the employee or the your patient, isn't seeing the full cost of that plan. So the idea that they need now, pay full price for membership plan versus some subsidize value for insurance plans going to be difficult to make that happen. Now, I'll foreshadow and say the day is coming when that will be a perfectly legitimate strategy is drop insurance for membership plan. We were going to have some features in functionality coming that'll naval that to happen. But as of today, it's, it's it'd be difficult. I be- I've been cautious in the in at work it over time. Not, not just sort of snap by figures before with the another issue that we're having is, you know, this is the internet. So it's international there's two million. Dennis around the world. There's a quarter million on dental town from every country on earth in whenever you go to Asia Africa. The, the insurance bows reminded me I think a lot of dentists in America. Don't even realize that they don't do this in China and China's out five people for you, but when I'm luxury in China, it hurts their brain to wanna know why will if you drink Coca Cola and Hershey. Chocolate bars all day. Why should that your government are employer? Pay for your dental work, they call it perverse incentives, and when, and then the other day somebody from New Zealand put together a law proposal law that all dentistry, brief three New Zealand, and every dentist. I know from New Zealand that was emailing me the link to this articles like, oh, so, so now the zero incentive to quit drink and mountain dew and just even brushing their teeth with lollipops in two zero I mean, I don't understand how this insurance thing, it's really gotten bad. Like like when people say they want free healthcare. Well, why, why would you switch from a breakfast of cigarettes and coffee to a great fruit? If all your cancer was free. I mean, incentives matter, and I really think incentives. It's one of the reason the twenty richest countries are broke from all these free health insurance. And then when you go to these people say, well, at least make him do a ten percent co payment. They look at you like you're some kind of criminal, like how could you how could you want this versus to pay? Well, maybe because he had a cigarette and a Cup of coffee every morning for breakfast. A Taco Bell for lunch. I mean incentives matter, but it's but, but back to the United States where eighty percent of our listeners are there's something about the culture in the United States, that when it comes L care, if they don't have insurance the they can't spend. It's like, well, I don't have insurance. But then they go by an F one fifty pickup truck for ninety grand in flight at DisneyWorld. So this kind of satiate s- that psychological western civilization mind that you. Have dental insurance even though it's not dental insurance and its membership plan. The need this in their decision making because it's just so illogical. Yes. So, yeah. I think the. Comment on the health that you were inside because I have some experience proprietor lights there. But I agree with you hundred percent. We need incentives to keep people healthy. It's never going to happen unless there's incentives. And by the way, I think the I know people hate them, but the move towards high deductible plans, I think is actually the right plan about talking about dental talk about medical. We'll tell you. We're talking about because it's such a it's such a big part of US healthcare, and it's the least understood even by the providers. So I think what happened was the perverse part of it. Is that health insurance started covering everything, right? Why should health insurance be covering by you know whatever you know by the penicillin pills, right? They shouldn't it should be if I have a cash catastrophic accident. Yeah, it's going to cover me. But if I'm not taking care of myself, and I need some medications. I don't think insurance should cover that I think that should be on your own dime. So the high deductible plans, I think, is trying to shifted towards you know what if I don't take care of myself, I'm going to eat into that five thousand dollar deductible. And I'm paying it out of my pocket therefore, I'm going to try to be more healthy, right? And it's an economic solution to it. I think the other way to do it and is hit history here, as well as you and send people based on if they're willing to start taking steps in the right direction. So I some sort of chronic condition willing to take steps in that. Russian which might include going to monitor my actively, I'm gonna step on skill once a day, and I'm actually going to take actions to, to move myself into right direction. I'll get incentives based on that. I'm with you one hundred percent if people want full coverage, every everybody gets everything covered. And there's no penalty for being unhealthy for just going to go bankrupt. The country is going to basically swallow whatever choke on, it's a healthcare Bill. Dental and you go to these countries, let let's go to candy. So the closest neighbor with socialized medicine will everybody loves the healthcare, granite. Well, let's break that down, first of all one percent of Americans are Canadian spend the night in the hospital on any given year. So ninety nine percent. Of course they didn't use it that you. And but what you said. You know, they'll go drought fifty bucks at a Mexican restaurant have Margaritas, but they expect to go in, because I have a sniffle and they wanna antibiotics and they, they think all that should be free. And in insurance is about an actuarial risk analysis versus moral hazard. I don't buy insurance to change the oil in my car and gas it up and, and, and clean the window. I only have it in case, I have an accident and healthcare took that actual risk analysis of a unforseen accident and said, no, let's just pay for every little piece of the car. If you want to change your air filter, your oil filter, whatever you wanna do your boss, or a bomb it should pay for it. You know, like why? And then, and then when I asked him, I don't patients. Well, why did you get that knee replacement because it's fifty grand Measor fifty hips are one hundred and she'll say, well, I don't know. The doctor said I should do it. I said, well, how much was oh, I don't know Medicare tigger. Well, if he were. Said look, grandma it's fifty grand and you're portions ten percent. So give me five grand half of them would have said hell no, take buffering. And then they went into why the utilization so high that costs. And then if she had patient percent, she might sit there and say, well might portions five thousand. Whoa, we're in big expensive, Phoenix. I'm gonna call my sister who lives in slimy, hands us, then she finds out that the fifty thousand dollar knee in slimy. Kansas only forty thousand so she dry, so she flies officer lanes to go spend a week with her sister to save him. But, but you whenever you talk about these reforms in socialized medicine from Canada to England any they, they look at you. Like, are you just a bad guy, or you like a main, evil person? What would other what other things do you think are confusing to you for your background in insurance? Well, the thing that amazes me is how the, the issuers don't move and change. I mean, I guess I mean it's just the way they are. But the net is just trying to get them to do anything differently, or incent people in a different way or sort of change the system. They're just not going to do it because obviously, they've been making money for a long time, and they continue to make money. There's no reason to change if ObamaCare scare them. I don't know what's going to scare them and they just keep ticking, you move down the same path. So I feel like it's just gotta come from the outside that you sign to see that there are people out there, like the large employers are now taking things under their own control enduring self insurance. So I don't think it's going to change from shores is gonna change from the outside, as people paying the Bill that are going to end up changing it. When you think about, it's the employers who pay the Bill, for the most part, plus the US government, but the government, obviously isn't going to do too much either. So that is to me, the changes come from the employers in it's become a almost backbreaker for a lot of businesses to, to try to form. Afford healthcare is actually encouraged that the starting with people like WalMart and Amazon. And Microsoft are now taking action to improve it as you're seeing some of these alliances. But there's now thousands of employees aligning with each other to try to take this on. So I can't let you read my mind. That was my follow up question. What would you think about Basil's in chase and Microsoft on getting together? And starting a think tank on this what we're what do you, what do you think they're thinking? And what do you think that may come to that? So I think it's awesome. I think it's exactly what needs to happen. And the reason is, they're paying the Bill, right. And they should have a say on how things happen, you know what they're trying to do the trying to get rid of the middleman with China that trying to hold the healthcare providers accountable, so trying to measure the results. I mean, think about that our second if you didn't have a business where you help people accountable measured results how you get results. Right. And they know that they run successful company, so in here, so that is what had percents. Behind it. I think it's absolutely the right move. And I think they are going to solve the problem own their own doing directly in his plenty of now is getting easier to get hold of date. It's easier to measure. It's easy to create relationships with healthcare providers in it used to be. So I think they are going to figure it out. Here's the parallel, by the way, the dental, the, the dentist need to do something similar, right? Dennis half to some point stopped accepting insurance or stopped accepting what the ensures giving them. And this is part of the membership plan thing ain't go direct, and there's no reason not to do. It is getting the critical mass move in the right direction. And we're seeing on the players side in healthcare. I think we're gonna see and hopefully will be part of it with Dennis on the against the dental insurers. And then another, I want to comment on that question about the Dennis say, will, you know, I 'cause here's, here's the problem in their mind. The indemnity has gone from when I got school, you just Bill delta. And they just paid you whether it's a hundred times. Cleans Amazon actually eight percent for Giles fillings, fifty percents for crowns and dentures parcels. And then after about ten years now let's not do that. Let's we'll just give them tell you. This is the fee for billeting crown and that's been drifting down nicely for thirty years. So, so they love this, this fee for service people. And, and then when they wanna go drop that PPO, they say, well, you think Trump that PPO Nile, just say, well, how many patients are on that PPO? They don't know. What is the jazz average justna right on that plan? They don't know. You know, you want, you want to know your numbers first, and then you would want to drop the smallest PPO. I mean, you, you, you, you start with let's drop a plan that not even one percent of my patients have let's start there. But let's get how many were on that plan? How many of them had their records tranferred never came back. What if what if you dropped that one percent? And then you meld them are cold them about. In office. Membership plan. But it didn't you need to have a scientific approach forward on this. Absolutely I'd tear boy. I dropped the ones that have no patience on it. Very few patients. I'd also dropped the ones where I lose money. Right. Why, why accept that? And would I see your point about not knowing Dana, we asked practices, every day, one of our first questions to is how many patients do you have how many are uninsured? And they'll swear the uninsured patients are coming in off, but they don't even know how many uninsured patients, they have. So just even the most basic of questions is typically hard to get answered, and that, just amazes me. Give it that, that's sort of the lifeblood of their practice. So yeah, I'm not surprised to hear that the they don't know the day, the but hopefully I think over time there's some solutions out there now that can extract data better out of practice Vange software. You can view better and use it. So I think over time that'll be that'll become better. What I like about talking to you is that, you know these these dentists only know their own office. And then this issue, she comes up membership plans and again, they know their own office. How many offices have you worked with? Couple thousand. Yeah. So, so they just not gonna have that framework. I mean, they're, they're not gonna be able to see this issue thirty thousand feet like you do. What do you think the solo guy doesn't understand that if he gets a couple thousand offices at thirty thousand feet on just specific merchant plans, you'd think about this very differently? It's really just understanding what your patients are doing day in and day out. And how many how many you have how often do they come back? How many what type of treatment there accepting like it's the basics? It's like it's not even that complicated is just understanding the patterns of your patients and what they're doing day in day out, and it's, it's actually pretty easy view to see. So what we do we will good practices who don't see that would like to say. It is all just take an excel dump. It will just do a quick. Allison of it and show them. Exactly what's going on with their uninsured in the assured patients? So the net is I wish I could just show that to every practice with the snap by fingers. And then. Show when you put them into membership plan. This is what happens. This is the yellow so to the set forward, you'll take. And what happens is, you're not going to spend a lot of money on new patient marketing, you're going to just engage. Your existing patients gives you can see the benefit, you know, right away. I got verify personal time. I said, I'm podcasting this guy right now. What if questions I, I guy? What, what is the mission? The mission of clear is simple. Wh what is your mission? He's asking. It's to prove access oral care, that's the net. And as part of that an outcome of that is patients, get better oral care in Dennis practice, performance improves. So let me improve access to care, if almond uninsured patient, walk into a practice that access, you might think they have access to care, but to them, they don't they feel that they're on the outside looking in so we want to improve their access to their ability to get care. We're going to be moving that to other patient basis, I mentioned earlier the employer space, so about fifty percent of small businesses. Don't offer dental insurance to their to their employees. In the reason they don't offer. It is it Suka places too expensive. They just don't have time to deal with it. So what if we could simplify that make that a lot easier for small business? They actually provide in fun to care for their employees in the small business. We're gonna. Improve access to care. We want to do things I can't mention it yet, but we're going to be coming out, fairly soon with new services on top, not just the typical service, you would come into an officing in get care. But other services people can use at home, and we're gonna provide a level of care there that Dennis can offer to their patient, as part of the membership plan that makes easy again for their patients, get access to care. So in short, it's improve access to care that sort of the net of our mission. That is that is interesting. And then. Cases where does the name clear come from? So when we took a look at it did all the market research. So I don't think I mentioned, the beginning of the podcast, we're clear came from the because the second with the company came from market research, we've done will retort to patients and dentists and try to understand the issues. And then we said, okay, the net of all that research was uninsured. Patients wanted more access to care, one of the foreseeable simple, transparent access not a crazy complicated insurance in what Dennis wanted was easier ways of making connections with their patients, getting amid more often having to accept treatment, not show. You know not taking forty or fifty percent cuts from the shore. Like all that stuff was sort of yell came out of the market research, and we just said, okay, where the connect the two and what we realized that it was a connection to the two in the, the issues. Both sides are dealing with the natural thing came from. That is, let's make this clear. This is make it clear for the patient in their ability to get access to care in this make it clear for the dentists and their ability to improve. Performance of the practice by by offering more simple care to their patients. So that's where clue came from I noticed net flex Netflix. And let's see other Amazon prime. Amazon, will they said this they charge you for a year? So we know that's obviously a working biz models flip Amazon and Netflix village e every month and this Dennis asking, would you want a monthly plan that just rolls over every month like Netflix. So I never have to sign him up again or versus the yearly plan, where at the end of the year, I've got to go back and try to get this guy signed up talk about that. Yes. So they both come with pluses and minuses. So on a clip for you. Can you can do both of you do one or the other? But let me tell you we typically advise practices. Do both offer both and what you see is in this might change, depending on your demographics of your patient base? But about eighty percent of patients, fifty five plus we'll pay upfront annually, even if you offer monthly option, and this ecology of it is, I don't want anything hanging over my head. I grew up at a worldwide pay for what I get and I just want to pay the Bill and I don't want this thing. Hanging out there now you shift all the way to the other end of the spectrum, and you go down towards the millennials and the gen Y and they love monthly plans. They don't have a lot of disposable income, they grew up in a subscription world. And so them it's very natural to pay on a monthly basis now by offer both of those you obviously cover the full spectrum. If you're got a heavy patient basis, fifty five plus that's, you know, that has a lot of supposedly incumbent, but you might not want offer monthly not wanna deal with it, because there are some hassles associated with that, but no matter which plan type you offer which payment plan type you offer when you're onto clear platform, the platform handles it, all it automatically does, the monthly payments charges it automatically reduced the patient at the end of the year. They paid on the annual basis it handles, all the notifications so you don't need to deal with all of that in what we see, by the way you want it from a failure. So the painted failure perspective, when somebody's on a monthly plan the failure rates about one point five percent over the course of those twelve months. So it's very low. It's not a big deal in what we do is, we'll flag those and make you away. For those in the follow. But the patient to get the it's typically has stolen or lost card on the renewal front when somebody pays annually and then we wait twelve months to charge their card in twelve months. What we see is about a nine percent issue rate with payment in the reason is over those twelve months, people lose credit cards. Right. They change credit cards. They have credit cards stolen. So there's this natural sort of at nine percent issue rate at the annual level. But once again, we flag, those notify, you, we notify the patient to get that card switch. So it's just a matter of seen report sort of reactive, but another dentist on ask will might practices all fee for service patients and they've, they've only got insurance. So why would I do this? If I already if all my patients already fee for service on insurance is Ernie advantage with that right now is in there isn't a big advantage, unless you want to try to drop some of those know the worst of the insurance, it would just depend on how many patients you have. On the worst of the insurance, I'd say right now, probably make doesn't make a lot of sense like I said until we come up with a solution for how you handle employers and get employers onto the plant. But for now I would say, yeah, if you've got one hundred percent insurance is on a lot of reason to move to a membership went, what was not smart enough to ask. I mean, what, what do you wish I would ask that I didn't ask? That's a good question and thought about it. I don't know if I have anything, I guess, those one feature I think, is really cool at our platform that I wouldn't expect you to ask. But we actually have a data scientist on our on our staff at he actually will compare your practice to peer practices of same size in Saint sort of make up and it will show you how you're performing relative to this practices on your membership plan, and it's a pretty cool. A little tool that sort of basically says, are you on average your average below average? It also measures whether you're plateauing or rising, so you may have gotten off to. Let's say good start. And then you start plateauing and your peers are ahead of you and it will flag it. So this data stuff, we're doing on the back end. That's just the started it to help practices really make their membership plans before while we'll tell you when I started dental town, I got the idea, ninety eight got up on our Saint Patrick's Day ninety nine and everyone else that started out there was about. In that race. And some of them had venture capital, private equity money, I mean, dental exchange got funded like twenty million dollars in everybody was trying to dissenter mediate, the supply rap and sell everything drive is twenty years ago. But I knew my homeys that, that, that Henry Shangrila that comes in once a week was his only connection to the outside world. And my gosh they, they didn't get rid of him. And here it is twenty years later, they the Amazon still doesn't even sell supplies. And these these people that are connected to the outside world, the all the dentist. I know that are doing two three four million dollars a year. It's because they're always they won't police an implant, and they'll, they'll pick the implant system based on the most amazing rep in there. And then they'll figure out like oh my God, there's like seven period is and three year old surgeons that are placed in one hundred implants year, and they all buy from this person, and at that point that he know what type of implant, it is. It's all. All about what you know. And who you know, and the networking, and so when you have a data guy like this, that there's no Dennis out there that can look at data from houses of practices, and the smart ones are the ones that want to see transparency in the marketplace and says, tell me what I'm doing right? Tell me what I'm doing wrong and day one. When my sales rep came in. I told my for now don't, don't ever come stand at the counter for an hour, while I'm doing a root canal make her an appointment, just like you would anyone else, and I want to respect them. And then over thirty two years when I needed, like a new amazing assistant, who would I go to I go to my supply, lady and say, well, you call on twenty offices who do you think the best dental assistant in town is and she'd tell you and then when it was about Indo? I don't care what she thinks of an Indo file. I'd say the best ended honest in my backyard. Brad Gettleman, is there any. Do you know what file? He's using. And she'll say, oh, y'all now or all find out, you know, so it's all. Oh networking. And if you can take advantage of data and get more from your little own bubble. And if you can learn to come outside your bubble and that was the biggest gift. I got just from dental lecturing, I had no idea. When I started dental lecturing August fourth in nineteen ninety that thirty years later, I would election in fifty countries, and I learned the most about my own country by seeing all the other countries and the first earliest questions I have is why is there? No dental insurance in Africa Asia central or South America. And why is everybody in America? Thank. It's just it just, it's just the God you have to worship and it's like it's not a God, you have to work. I mean I mean there's just so interesting. That that's what I love about the internet. It's really flattening. It's making the cost of knowledge, almost go to zero. Look at this podcast. I'm talking to you. You're talking to me. You're listening to it for free. The cost of knowledge is dropping zero, and you young millennials gotta get out there and look at the data don't spend thirty years to reinvent the wheel go out there. And, and just say, you know, if my mom who's been practicing could start, her own dental office tomorrow. What would she do differently and but think so much for coming on? And really, I hope you go and diddled town, you or your team and answer some of these questions because a lot of them are sold on the idea, and on you. The, the devil's in the details are trying to figure out what to do yelling. I'll get on there. And I'll start with the questions but he, I appreciate it. Towered. Thanks for having me on. I always enjoy talking to you, and it'd be important dental town. All right, buddy. Thank you so much for coming on the show today.

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