How to Grow Production with an In-Office Dental Membership Plan

The Transcript

Art Wiederman, CPA: Hello everyone and welcome to another edition of The Art of Dental Finance and Management with Art Wiederman, CPA. I'm your host. My name's Art Wiederman. For my first time, listeners of which we have many every single time we publish. I am a dental division director. Actually, my email I'm looking at right now says I'm director dental division at the CPA firm of Eide Bailly, which I've been very excited to be a part of our firm. HMWC merged with Eide Bailly. Let's see, in a week or so from this broadcast, it'll be two years away. Time flies when you're having fun and it's been a wonderful ride. What a great, great CPA firm. And I love all the people there.  

I'm a dental division director at Eide Bailly and we've been doing this podcast about three and a half years now, and it's just an absolute labor of love and joy. And my objective in this podcast, folks, is to help you to be more successful. And today is one of those days where we're going to help you to be more successful. I have been a proponent of in-house or in office dental plans for many, many years. And we talk about that. I talk about that in my lectures. I talk about that on this podcast. And my guest today is Brad James from Kleer. And Brad and his team provide the platform for dental practices to have an in-house dental membership plan.  

So I always tell the story of my good friend Gary Takacs he and I he's the Godfather, the guy that did the first podcast and got me into podcasting. And Gary owns a practice in Arizona with a couple of his dental partners. Gary's not a dentist, but with dentists, and he tells the story on stage. And I've been on stage with him a dozen times or more of how one of his one of the patients, the practice, the CEO of a company has 100 employees. And those 100 employees were covered by dental insurance. And they were talking to the CEO of the company who was frustrated with the dental insurance and the cost and the limitations and all that stuff. And Gary says, well, in our practice, we have an in-office membership plan. And it's, you know, I don't know what it was 252 I was $295. And, you know, we cover this and that, and that's what Brad and I are going to get into. And the owner of the business says basically, well, you know, you're telling me that if I write you a check for my 100 employees for like $30,000, that I can provide a better solution and a better result for their dental care. And Gary basically said, yep, that's how it works. And the guy says, Done.  

So we're going to talk about going to employers. We're going to talk about how an in-office membership plan works. We're going to talk about a little bit about the economy and why this might be a good time to do it. So we'll get to Brad in a couple of minutes.  

First, I want to again tell you about my wonderful, wonderful marketing partner, who Lorraine Kent and her team at Decisions in Dentistry have been on this journey with me for most of the three and a half years that I've been doing it. They have amazing clinical content, 140 continuing education courses at a very, very, very reasonable price. I know what the prices are and they are very, very, very reasonable for you to get your CE done. Unbelievable clinical content go to their website www.DecisionsinDentistry.com.  

My mothership is the Academy of Dental CPAs, 25 CPA firms across the United States that represent over 10,000 dentists. I am a member of Eide Bailly. We represent over a thousand dentists in our practices, in our offices across the western United States. My cell number is 657.279.3243 and my email is aWiederman@EideBailly.com. It's a couple of things you want to remember. You still have 1 to 2 years to apply for the employee retention tax credit. If your practice suffered a 50% reduction in revenues for the second quarter of 2020 versus 2019, or a 20% reduction for any of the first three quarters of 2021 versus the same quarter in 2019 or the fourth quarter of 2020 versus the fourth quarter of 2019. Doctors we have gotten just for the about 100 dental practices, well over $4 million in credits. It's money the government is offering. And we have a lot of happy customers. So let us know if it's something that you haven't looked into. We'd be happy to help you.  

Very important that you listen to this, guys. If you received more than $10,000 from the HHS Provider Relief Fund between January one of 2021 and June 30th, 2021, you must, I repeat, must report on the HHS portal the information that they require. Please make sure that you do that. You have until September 30 of this year to report. If you do not report for the third reporting period, they will ask you for the money back. And for many of you in reporting period three, we're talking six figures. And if you're a multiple practice owner, it could be seven figures. So you need to do that. Okay.  

Let's get to my guest and my friend Brad James, who is Brad is the director of strategic partnerships for Kleer and Kleer does in office membership plans helps has helped thousands of dentists to do that. And we're going to talk all about how does it work? What are the benefits? We are seeing doctors who have these plans, they're able to grow their production.  

One of the things I always talk about is and we'll talk to Brad about this is how many of you are members of this little group you might have heard of Amazon Prime? I think that's a membership plan. They do pretty well last I checked. So we're going to talk about being member of a membership plan. Brad is from Philadelphia, so he is a Phillies fan. So I am required by law, as you know, to talk baseball will do a little bit of that. So, Brad James, welcome to the Art of Dental Finance and Management.  

Brad James: Thanks for having me on. I'm excited to be on. And it's funny that you bring up Amazon when this is right around Amazon Prime Day. I know that's like a two day Christmas in mid-July. So a lot of people are prepping for that.  

Art Wiederman, CPA: Well, well, here's all I know. All I know is that every day there are at least 2 to 3 Amazon packages at my doorstep. I don't know what they are and I don't ask. So yeah, that's just kind of how this works. So Phillies fan, huh?  

Brad James: Yes. Yeah. 28 world champs.  

Art Wiederman, CPA: There you go. Mr. Harper, he's the starting D.H. in the All-Star Game. Now, the All-Star Game will have already been gone by the time this is published. But I remember when Bryce Harper was 15 years old on the cover of Sports Illustrated. And. And he's basically delivered the goods from. From that. So I went to veteran stadium, the old veteran stadium. It's now what Citizens Bank Ballpark is. That was called now.  

Brad James: Citizens Bank Park.  

Art Wiederman, CPA: Right. So I was invited to speak by Benco Dental in Philly and I told them, you know, I said, I don't speak anywhere unless I get to go to a ballgame. I stood on line, Brad, for four innings to get a Philadelphia pretzel, and it was the best four innings that I ever missed in a baseball game because it was the best pretzel I ever had.  

Brad James: Yeah, the Philly soft pretzel is no joke. I know a lot of people. I got cheesesteaks all the time, but I really think the best snack in the city is definitely a soft pretzel.  

Art Wiederman, CPA: Well, I'll tell you what. If you can tell the people in Philly, if they could come up with a not with a with a really tasty pretzel that has no carbs, I will eat it every single day. So there you go. I wasn't. Let's get into our topic. Tell us about your professional journey and a little bit how you got to be where you are today.  

Brad James: Sure. So, I mean, just to give some quick background of what I did in college and where my major was and it will be relevant to the story. So I was a biology major in college and my first job out of college, I essentially worked for a company that helped check companies, businesses that had any type of Salesforce projects or Salesforce. For any listeners that are unfamiliar, it's a customer relationship management platform, also known as CRM and is a multibillion dollar company. A lot of people might be familiar with the Salesforce building, which is, I think the tallest building in San Francisco. But yeah, yeah. So essentially I worked for a company, like I said, that helps any types of implementations from the recruiting standpoint all the way through delivery.  

So there were all types of businesses that we worked with, small, medium sized businesses, enterprise businesses, you name it, if they use Salesforce for their CRM, our job was to essentially get wind of that project and to start to position ourselves against some of our competitors. And I worked a lot on the business development side. And basically what I liked, I really, really liked working with healthcare companies. And B, my favorite was start ups. So any type of pretty tech start ups with a handful of employees that were all really smart individuals, whether it was operations or they were technical from a coding and development standpoint. I just really, really liked working with the startup companies.  

So when it was time for me to move on and I was evaluating the market in the Greater Philadelphia area, which is where I'm based out of them, where Kleer's based out of I was doing my research and I really wanted to work with a company that had some type of healthcare prowess but also was a smaller, grittier startup. And as I was looking through, you know, I stumbled across Kleer. I did some of the research. I applied to the job as a sales development representative, and the rest is history. And I'm it really is. I'm not a big, you know, start up type of person, but it really is nice to know that, you know, I stumbled upon a company with a lot of smart, driven business professionals. We have a lot of people with Microsoft backgrounds, IBM, Comcast. So it's been a really fun ride for the past four and a half years and I'm excited to continue that ride.  

Art Wiederman, CPA: Well, it's nice to be with smart people who know how to work computers and help people, and that's apparently what you do. So give us a little bit of a history about I know in office membership plans have been around for more than four and a half years. How have they how did they start? How did they evolve?  

Brad James: It's really interesting. I mean, we've talked to all types of prospects and customers and even some partners like yourself where they claim to have had a membership plan of some form for the past. We've heard as much as 20 years ago, so they've been around for quite some time. I know someone I don't personally know. I'm actually but I'm familiar with the name Christopher Phelps. I know he was the one that really, I feel like brought membership plans to the forefront and really started that movement, if you will. And it seems like it's really gained steam in the past five or so years.  

And COVID, you know, the pandemic and the current state of the economy really acted as a catalyst with its with its I guess, with the amount of practices that have adopted membership plans. It's really we've seen it jump from when we got started in 2018. Probably 10% of practices had them. We were actually educating a lot of these practices on the concept of a membership plan and why they want to implement it. And fast forward to now, ADA released a report last June that showed that 24% of practices having an in-house membership plan. You can probably safely guess that that number is somewhere around 30% now. So it's really encouraging to see it's growth throughout the industry and that dentists are accepting it.  

Art Wiederman, CPA: And let's talk about and again, folks, you all have listened many of you listen to me for three and a half years. I don't do advertisements for my guests. This is a real thing. If you have not looked at an in-house membership plan, it is something that you need to look at. But what I'm seeing after the pandemic, Brad and I'd love to hear your comments about that, is I'm seeing that, you know, reimbursements from insurance companies are going down. They're not going up, costs are going up. I mean, you know, PPE and employee costs, I mean, employee wages are up significantly in not only dental practices, but everywhere. We have eight and a half percent inflation in the middle of 2022. So all of these things are prompting dentists to look at their relationships with insurance companies and say, hmm, is this not feeling the love as much anymore? And here's an option. I mean, what are some of the reasons you're seeing this growth in the in-house membership plans? I mean, I know that's one of them, maybe some others.  

Brad James: No. I mean, it's certainly a huge reason why like if we're just analyzing the motives behind why a lot of practices are just getting in touch with us in the first place, it's probably around the third highest like lead gen motive is that they're the practices are planning on dropping insurances and that they want to work with Kleer but I mean it's just a really interesting dynamic where dentists have been disgruntled with insurance companies for a while and that is not an indictment on necessarily on the insurance companies. You know, we've seen that it can be profitable for some practices, but for a lot of them, like you said, the reimbursements are declining and they certainly did themselves no favors. When it came to any type of help that they could give those practices during what is a black swan event, a pandemic once every hundred years or so? And like you said, now they're being squeezed with costs. I think really the assembly line dentistry of seeing a ton of volume when you're in growth mode and just being insurance and network with all these different insurances, I don't think that that is going to be sustainable moving forward as you're seeing that these margins are becoming more and more thin. And I mean, if you just look at macroeconomics right now, you're looking at what companies are doing, there's tons of layoffs.  

As it stands today, if you look at private equity, venture capitalism, where all these all of this money was being thrown around for years and years pretty recklessly and giving companies these absurd valuations, you're now seeing that pivot from growth to making sure that there are companies that they've invested in are now cash flow positive. So, I mean, that's really where the practices need to start to be when it comes to the big picture, you know, what can we do to make our office as recession proof as possible, which actually dentistry, if we're looking at the financial crisis in 2008, we saw that there was not much of a debt with patient visits. So health care is always no matter what, people are going to be sick. People are going to be chipping their teeth. They're going to want their cleanings. So dentistry is definitely in a good start spot with that regards. But what can you do to build more predictable recurring revenue to mitigate any type of risk when it comes to decline in patient visits, decline in new patients to your office? And that's really where not only do practices want membership plans as an integral component and piece to dropping insurances and getting some type of independence from these insurers. But I really think on top of that, the practices that we see that really get it, they see this as an enormous opportunity to build more predictable revenue, to build more patient loyalty, to increase case acceptance. They really see the big picture here. So that's kind of my spiel on where we stand today, going from pandemic to now potential recession and how it pertains to dentistry.  

Art Wiederman, CPA: And bringing up recession. And we're going to we're going to harp on this all through 2022, folks, is, you know, Goldman Sachs says that there's a 30% chance that we're heading towards a recession. That's what people are saying. And a lot of a recession is really in the minds of Americans. If they think you're going to be in a recession, they'll stop spending. And that puts us into a recession. And by the fact that we may be on our way to an economic slowdown, recession, whatever you want to call it. This is why it's so important for you to work on your business, to look at your metrics, to make sure that those patients who haven't been in in 18 months get a phone call and say, listen, Susie, I'm worried. It's about looking at your relationship with the insurance company. It's about looking at a in office membership plans. It's not just in-office membership plans, folks. It's everything that you have to look at to make your business successful.  

So what I want to do, Brad, is I want to get into the I want to get into the weeds about how this works. And a little bit later, we're going to talk about, you know, the benefits as far as like the comparison of this to like an Amazon Prime. But I want to I want to talk about kind of the, but let's do ABC in-house membership plans for I'm not going to say dummies because my listeners are the smartest dentists in the country. That, by the way, there's record of that. I don't know where it is, but I'm sure it is. My listeners are the smartest listeners of any podcast in dentistry, so we're not going to say in-house membership plans for dummies. We're going to say in-house membership plans for smart business owners who are dentists who want to be successful. So let's say first of all, I mean, you know, we know that patients who are in network with an insurance plan are probably not candidates. But let's start with who's eligible? Who can we go to with this?  

Brad James: Yeah. So we always tell practice's the best opportunity right off the bat are your current uninsured patients, whether they're active, whether they're dormant. They're always a great opportunity. And if we're just drilling down a bit deeper and figuring out and filtering, you know, who are those uninsured patients that you really want to target? The first are small business owners that typically don't include employee benefits as a part of their compensation package. The second and probably the most popular are retirees. So anyone that's had. Some type of down coverage their entire life. They're used to having that benefit. And then also it's stripped away from them as soon as they retire. They might start looking at some of those individual insurance plans, which is probably the worst case scenario for the practice in terms of profitability.  

So retirees, small business owners, and then the third one are just millennials or gig economy workers. It's a reality. We're seeing more and more of them pop up with applications like Uber, Lyft, Cat, like I'm trying to think GrubHub. You're seeing more and more people go away from these jobs to where they have more flexibility, more freedom with their time, and they can really select their hours. So those are the three components that we're really seeing a lot of popularity with these membership plans.  

Art Wiederman, CPA: Okay. So Brad, let's start you know, I come to you, I'm a dentist and I say, hey, I heard this sounds good. I want to do this. Give us the basics of what is it, what is it? Cover, how does it work?  

Brad James: Sure. So a lot of you know, if we're just comparing it traditional to traditional insurance or other third parties that administer care plans such as a discount plan, I think what's the most important aspect to understand about a membership plan is that the practices are in full control. So they set the treatment protocol, they set the pricing, the procedural discounts. They are finally able to design these care plans that are the best for their patients, and who's better to select what's best for their patients than the providers that actually had those one-on-one relationships with the patients. So practices full autonomy and when it comes to actually designing these care plans. The like I said, the practice, they get to set their pricing.  

So it's essentially an annual or monthly subscription that a patient is paying directly to the practice, not to a network. So to the practice. And what's included in that monthly or annual subscription is all of their preventive and diagnostic care. So their hygiene visits, their cleanings, their oral exams, X-rays, whatever the practice wants to include in this bundle, they can. So let's just say the average practice has two cleanings. Regular exams is needed, X-rays as needed, and maybe they include fluoride, maybe they don't. Another perk, in addition for being the member outside of that preventative diagnostic is that they'll give that patient, say, between ten and 20% off all other procedures. So what you're really doing here is you're incentivizing the patient to a pay out of pocket and a subscription model that they're used to on the consumer side that is specific for their membership plan.  

So let's say it's $360 for the year or $30 a month for that patient. That patient now gets to come in, visit the office. They get their cleaning and they leave. But if they accept any treatment, then they get ten or 20% off whatever the practice sets, and then the patient gets some savings off of that. And there's all types of benefits, patient loyalty. We're seeing increases in production collections, case acceptance. It really is the best deal not only for the patient who's clearly receiving some savings and whatnot, but it's also a really good deal for the practice.  

Art Wiederman, CPA: So I want to just something popped into my head. So it covers most of them, cover preventative cleanings, X-rays for it if you choose. What about it? Because perio is huge these days. I mean, what about SRPs? So SRPs are probably are not generally covered.  

Brad James: So when it comes to power, so the average so we work with close to 7000 dentists and I would say every single practice probably has a different membership plan. But if we're just talking about if we're just talking about a vanilla average membership plan, they typically offer three care plans for dental general dentistry. It's a children's plan, an adult plan and a perio plan. And we hear from Periodontist all the time. I do three carrier maintenance visits at Dr. Smith's office that Dr. Jones is office. They do four pair maintenance, they have full customization so they can create whatever they want, want to include. It's not like and I'm just going back to general adult dentistry here. It's not like I know orthodontia is excluded from a lot of these insurance plans. They can include orthodontics if they wanted to as a 10% discount. So there is all type of versatility and creativity and autonomy that you're really providing for these practices to do what they want and to really give them some independence.  

Art Wiederman, CPA: So you had mentioned a 10 to 20%. I don't like the word discount in a dental office. I like the word courtesy. I always tell my listeners, you get a discount at a discount store. We're not a discount store. So we get my courtesy and I'm not I'm just saying is we give a courtesy to them whatever you want to call it. And so what's your sweet spot? I mean, 10%, 15%, 20 to what? Do you have a recommendation for people who are setting up one of these plans?  

Brad James: There's definitely different strategies. There are some practices. So I would say that it's kind of bifurcated. So we see the one practice that will give a slight discount for their preventive. So they won't really discount their subscription plan that much, but will incentivize the patients to want to join by giving them steeper discounts on procedures so maybe more towards 20%. Or on the other side, we'll see a practice that heavily discounts are preventive and hygiene care and then they get slimmer discounts, maybe 10% off procedures. We've seen both work. If we're just talking about the sweet spot for, say, procedures, it's anywhere between ten and 20%. That's really small, but it's tough to say with regards to what types of savings for the actual subscription. I mean, I would say the average for our practices is somewhere between 303 60. There's always outliers and we have plenty of practices that charge for 50 a year, planning practices that charge to 40. So there's a lot of variation with that. And when it comes to Kleer, we help them when it comes to setting their pricing.  

Art Wiederman, CPA: But it probably also depends on what part of the country you're in. I mean, you're probably going to charge a higher fee in Los Angeles or New York or if. Philadelphia. Then you might in a, you know, in Iowa or somewhere else like that. So.  

Brad James: And also like patient demographics or just like what type of practices you run. Are you a fee for service, cosmetic practice or your drill and fill that wants to see a bunch of patients, whatever it is? You know, that really affects pricing as well.  

Art Wiederman, CPA: You've got all kinds. So take it take a second and tell us a little bit about Kleer and what you guys do and and then we'll give the folks your information if they have some questions about what you do. So talk about Kleer and how it works if they were to work with you.  

Brad James: Sure. So essentially what we do is we provide the platforms so the software and services to make sure that these practices are successful as possible. Because I would say about a third of our customers, we're doing the membership plans themselves for quite some time. And then they hit some type of pain point where whether it's too many patients on their plan or it is an administrative headache and they wanted to outsource it or work with a third party to lessen the load for the front office team, especially now when so many practices are struggling with turnover and retaining talent.  

So like I said, we provide the software and services we really consider ourselves partner with the practices. So we have a support team, a success team. We provide them with free marketing materials and we have a large enough customer base where we can really give them feedback on what is the most optimal pricing, what are the best tips and practices to make sure when it comes to implementation and administration, what's going to be the most successful? And on the software side, there's tons of processes that we ought to be. We make reporting and visibility extremely seamless on the platform so that we have a nice dashboard that's easy to understand. And that's essentially what we do for our practices we work with in all 50 states nationwide, only within the US. And, and yeah, we have some new exciting product features that are coming out in August. So essentially what we're going to be doing is will be integrated with practice management software. So that's a big one that we're getting ready to roll out behind the scenes.  

Art Wiederman, CPA: Are you integrate I mean the major ones Dentrix, Eagle Soft, Open Dental or more.  

Brad James: More so all three and some more.  

Art Wiederman, CPA: Wow. That's great. So if someone wanted to get a hold of you, Brad, and ask some questions about in-house membership or what have you, why don't you give out your phone number and an email address and we'll put it in the show notes also. And you know, again, folks, you know, Brad is a resource to help you to be successful. An in-house membership plan may or may not be right for your practice. But, you know, my late dad, his name was Irving Kline. I talk about him every once in a while on the podcast. He was my mentor, and he taught me several things. And one of the things he always said is, Arthur is one of the few people in the world call me Arthur. Everybody calls me Art. He said, Talk to people. Talk to as many people as you can. You learn so much. So talk to Brad if you if you want to find more out about this, Brad, how are we going to hold you?  

Brad James: Absolutely. So my email address, it's pretty simple. It's just Brad@Kleer.com. That's my email address. If you do want to send me a text message, my cell phone 610.639.6441. And again, we're always happy to just have the conversation. Or if you just want to learn more about the software, feel free to reach out to me.  

Art Wiederman, CPA: And if you're a Phillies fan, it's even a better deal, right?  

Brad James: Yeah, exactly. Yeah. At least the Eagles fans all.  

Art Wiederman, CPA: I'm an Eagles fan. That's right. There you go. Who's your quarterback this year?  

Brad James: Jalen Hurts, but we'll see how it goes.  

Art Wiederman, CPA: Yeah, we'll see. It's always an adventure in the NFL and in Major League Baseball. So I want to get into the topic of the Amazon comparison. And I've read lots of studies and I'm sure you have lots of information is that, you know, people who join membership plans, they tend to buy more. They you know, I mean, the Amazon comparison is perfect. So talk a little bit about that, how the Amazon Prime comparison would compare to an in-house dental membership plan for a dentist.  

Brad James: Sure. Yeah. So a lot of research, it's extremely consistent. And I mean, you got to think that all these business executives and c-suites know what they're doing. You know, we've seen that whether a business has a membership plan or a loyalty plan, savings plan, whatever. Jargon they're using. We're seeing that those consumers that are a member are spending twice as much as those we'll call them casual consumers or shoppers. And it really does apply to dentistry if we're looking at it for practice. You know, I understand on the front end and if we're just looking at the short term, it might be tough to look at a patient that potentially pays you 100% out of pocket. And now you're going to be providing a 10 to 20% courtesy, say, courtesy to them and me.  

Art Wiederman, CPA: Sorry.  

Brad James: So you're providing 10 to 20% courtesy for these patients, and you're concerned that you might be cannibalizing your cash paying patients. But if you're looking at the bigger picture here, we actually we have and are able to pull the raw data from the practices from our customers that want us that want to see their numbers and want to see their ROI, the return on investment. And it's extremely consistent. Just like we just like I mentioned earlier, when those member membership consumers or subscribers are spending twice as much. We're seeing that the exact average we're seeing it's a 2.1 times the increase in production and profitability for membership plan patients compared to other uninsured patients. So it's really interesting because you don't want to cherry pick. I understand practices want to do it, but imagine if you're shopping somewhere or I'm getting ready to fly later. So I'm an American Airlines AAdvantage member. If I saw that someone else was getting a discount and I wasn't just because I was dressed in a suit and I looked like I could do that, I could pay for it. You know, that's a not a great customer experience for both parties. So that's where no matter what. Provide the value for your for your customers. They're going to be spending more money. We have the data to show it and it's extremely consistent. And it works for a fee for service practices, practices that are heavily contra contracted with PPOs. It really does not discriminate based upon all the data that we've been pulling. Our membership plan patients are spending twice as much.  

Art Wiederman, CPA: So let's talk about Brad. Go into businesses in the community. I mentioned that at the top of the broadcast. How do you recommend people do that? Do you help them with kind of how to approach businesses in the area, what size they talk about, how a dentist who's they're frustrated, they're not making as much money as they want. They want to they want to look at an in-house membership plan as a tool to grow their business and grow their bottom line. So how do we go to the businesses in the community? What tools do you have? How do you recommend that people do this?  

Brad James: Yeah, so I'll just cover the tools first. So we actually do have what we call like an employer plan or excuse me, Kleer employer plan where we are able to allow the practices to run some type of radius search around their local practice area, around their practice. And we can send them a list of all the businesses that are listed and with the contact information, cell phone, email and LinkedIn of the main contact at each local business with within that certain radius search. So we provide that. But I think if we're just talking about best practices, whether they use Kleer or not, it's funny when they always look at the bright shiny object and they think, oh, let's, let's go out, let's hypothetically or let's knock on doors metaphorically and let's call some practice some businesses around us. And let's see if we can bring on all these groups and new patients. We actually think that the best way to kind of dip your toe here is. Ask your current patients. It's like the example that you said earlier about the CEO, you know, talk to your current patient base, see who is and see who's employed by a small business, see who owns a small business and try to understand, you know, do they include dental benefits a lot? And we did a ton of research. A lot of these small businesses are medium sized businesses. They see the value of dental benefits and they understand that it contributes to their employees overall health, their well-being, their happiness. It helps attract new talent. It helps retain talent when they have benefits. But a lot of these smaller businesses that have maybe tighter margins or they're not generating as much revenue, they have smaller budgets, they're not able to pay for 500 plus dollars a year for every employee for dental insurance. So this is a way when you're positioning the membership plan that's objectively more affordable for the employer, you know, make sure you're just you're gauging the interest with some of your current patients that are either employees or owners of these small businesses. And also, just one last thing I'll mention is we actually have the tack on the employer side where we can allow the business owner to set their own custom contribution levels for the membership plan. So if they want to contribute $100 a year for each employee, we allow all of our tack on the back side, automates that. So practices don't have to track that through Excel or in some type of messy, inefficient way. So we also have that to help out the practice.  

Art Wiederman, CPA: That was what I was going to ask you is what are you seeing? You said you work with about 7000 practices in the United States. Are you seeing are most of the employers who adopt these? Are they because you said 3 to 400 bucks a year? Right. The generally an average. I mean, some are less, some are more. But are you seeing in most cases, are most of the employers picking up 100% of the cost, or are they asking the employees to pick up a piece to go? Well, and I know that every like you said, every plan is different. But what's what do you see as a trend there?  

Brad James: You know, I don't have the best answer for that because I know we have employers on our plan. I don't know what the contribution level is, so I don't want to misspeak or talk about it. But I can certainly on the side, if you're adding notes to the show, I can ask our VP of Customer Success and figure out what our employer is contributing and whether it's just giving them access and not contributing anything, anything, or they're covering the whole cost. So I'll figure that out. That's probably good to know anyway, but appreciate that.  

Art Wiederman, CPA: So you had brought this up a little earlier, and this would be something that I've always wondered about as so. Okay. So I'm my name is Art Wiederman. My neighbor is Brad James. So Brad, I just went to Dr. Jones. We both go to Dr. Jones. I got a crown and you got a crown then. But wait a minute. My crown was 1350 bucks because I'm part of a membership plan and yours is 1500. How do we navigate the verbal skills in the practice? I mean, do you see patients being upset or are they actually saying, well, wait a minute, how did you get that cheaper rate? And I mean, that's a concern. Do you do you run up against that when you're doing the training for your new offices?  

Brad James: I would say. So we don't necessarily deter them. We don't tell them not to do that. But what we do is we recommend them to offer it to most or all of their uninsured patients. And one of the small reasons why you want to avoid that is that exact reason, just in case patients, you, our friends at the start get the talking over drinks or whatever it may be. And one is paying 20% less than the other one. Yeah, there could be some problems and some dissatisfied customers or patients potentially contacted that practice in the future. So I think a lot of it really drills down. You got to drill down on the loyalty. I mean, for instance, I brought up American Airlines earlier. I mean, I don't know who likes any airline company for any for any reason, but I don't I don't love American Airlines. But you know what? I am based out of a hub in Philadelphia where it's my best option. I'm in the rewards program. I some I save money on my tickets. I sometimes get a free flight when my miles are high enough. And no matter what, I'm going out of my way to book through American. Unless. Unless it's just not even an option. And hopefully for a lot of these dental practices, the patients are having a better experience than what I'm having with American. They see the value. And no matter what, when you're bringing that type of pricing transparency and you have these patients that are understanding that their dentist is now giving them a deal that they can't find anywhere else, they're going to see that instead of being loyal to a network with insured patients or discount patients, they're now loyal specifically to that practice. They understand they're getting a deal or a courtesy from the dentist, and that is where the the spending really follows behind. And that's where you see an increase in profits. And and that's honestly what we recommend to our customers.  

Art Wiederman, CPA: So I'm generally required, again, by law to know everything about everything because I'm the host, but I don't know everything about everything. So I have a question that I don't know the answer to. So let's say, Bret, I have a patient in a practice and they work for X, Y, Z Company and x, y, z company has ABC Insurance Company and that patient is contracted with ABC Insurance Company. So what if you off, you're talking to this patient about that plan and we know that if they're covered by an insurance plan, by an insurance company, the in-house membership plan is maybe not going to work. But what if the patient is says, well, wait a minute, I like your plan better and they're taking 50 bucks a month out of my salary? Can I do this individually and go to my employer and opt out of my plan? Do you see that happen?  

Brad James: Sometimes we do it really. And there seems to be some type of correlation in, you know, the amount of patients that they have enrolled. So like their actual adoption of the membership plan and is it an integral piece of their business component or their practice administration? Usually the practices that are really offering this to everyone, they see the value. As soon as they kind of get saturated with their uninsured patients, they say, All right, next step is to let's drop some of these unprofitable plans that don't make any sense for us. Maybe we're not seeing a lot of gross revenue out of that specific insurance plan and we're not even profiting on it on it anyway. So let's start to drop that and have these conversations with these patients during that time. Yes, actually. So one example is the doc, the dentist that we know that's out of Newport Beach that that we've had signed. Yes. About yeah. That doctor in particular, he and his wife, who's the practice administrator, they have successfully drop insurance plans and have leveraged their membership plan. And then the second one is actually a lecture. I was that one with Gary Takacs and he was the dentist that hosted the event with a Kleer customer. And he at the end of the event came up to me and told me how in the span of two months he had three patients that were Delta patients, and he got them from Delta onto their membership plan. I really think a lot of it, you know, no matter what, it's an uphill challenge, especially if they're employer sponsored. And we see 93% of insured patients are employer sponsored insurance plans. So no matter what, I think a lot of it is just having that candid, frank conversation with the patients, seeing if they understand the value in it. And yes, to answer your question, yes, we do have practices that are successfully transitioning some of those insured patients onto their membership plan.  

Art Wiederman, CPA: Yeah. And we know I've seen you said that the production like doubles in plans in practices that have these plans.  

Brad James: Correct. Yeah. Production doubles and collections. Triple.  

Art Wiederman, CPA: So I was going to add, that works for me. I'm the math guy. I'm the numbers guy. So marketing, let's talk about marketing. Okay. So now I have an in-house in-office membership plan and we know and I got this off of your website and I've read it from other people. There are somewhere between 100 and 130 million people in this country who do not have who don't go to the dentist. They're not, you know, covered by dental insurance, all this stuff. How do we get to these? So we have the in-office membership plan. We're going to go we're going to try and get some of our, you know, the businesses to maybe, you know, get 50 or 100 employees to come and join the membership plan. But how do we market to the community? Do you have any ideas on how to get people to who are not patients? I mean, this is another whole angle of doing this, isn't it?  

Brad James: Of course, yeah. I mean, what we've covered in this conversation so far has been a lot of internal communication. So marketing to your current or dormant patients, you know, that's one thing. But externally, you know, whether it's through employer plan or just getting to your market in general, your local market, how do you get more patients to your practice and how do you get them on membership plans? I mean, I think it's I think there's it's layered ultimately, like there's not a silver bullet that will solve anything when it comes to the marketing, you know, work with a marketing company that you trust where you see so many patient communication or patient engagement platforms popping up. The ones that come to top of mind to me are like Medco or the next health of the world. They're the ones that also allow the practices to automate, say like text and email communication. That's certainly efficient as well. And then lastly, I think the membership plan and you know, I guess I guess it's kind of a shameless promotion, but the membership plans is no matter what, if you're attracting more uninsured patients, more insured patients, especially on the uninsured side, you don't want this leaky bucket of we see that the numbers are seven out of ten new patients only come once in. They're gone. You'll never see them again. So have some type of solution, like a membership plan to hopefully retain that patient for at least a year, because that's what you're doing. Whether they're paying a monthly subscription or annual subscription, you're getting them locked into a year. But there's all types of creative ideas on how these practices are effectively marketing. The one that I can really speak to is we have some customers that are in business centers or like in some type of shopping mall where there's a lot of local businesses or just a lot of foot traffic have some type of, you know, might sound gimmicky but have some type of poster that you can put in the front window that can really have some type of concise, succinct marketing message, whether it's the membership plan or whether it's some type of courtesy that you're offering to the patient, because no matter what, you're going to have eyeballs on your on your door, no matter what. If you're in an area of heavy foot traffic or just heavy car traffic, so do something there.  

Art Wiederman, CPA: I've seen a lot of offices and I've been in one or two dental offices in my 38 years as a dental CPA, where there's a little sign right at the front desk. Want more information about our in-house membership plan? And then the patient is going up to pay and they go, Yeah, what? Tell me about this in-house membership plan thing. And then do you also help Brad? And then we'll make some final comments and call it a call it a morning. Do you do you make some comments about what kind of training do that? Because it's really important that the front office team because it's pretty much the front office team, not as much the hygienist or the assistance in this particular situation, but how the front office team is trained to explain. And I, you know, I'll use the word sell. Some people don't like the word sell, but how do how do we train the front office to make sure that that the implementation is successful?  

Brad James: Sure. So just to give you some insight on how we operate, we will never move a practice forward if we've only talked to the dentists and not the office manager, because we've seen that's how some projects fail. We understand that the dentist needs to be on board and is probably the ultimate decision maker. But when it comes to successful implementation, implementation and team adoption, you need the office manager on board or the practice administrator, whatever title they have. So you need them on board. And when it comes to training, that's really where we're very unique in our approach from where we kind of consider ourselves shoulder to shoulder with the practices. You know, we have the planned consultation. So that's where we give that feedback on what we think is optimal pricing. We share best practices with them on what they should include, excluding with their procedures and other perks, like family plans or specialists being included or excluding from their membership plan. So we have the plan. Consult that step one and then step two is training. So that is where we talk to them through best practices, tips, talk tracks and how they should really have that conversation with their patients. A lot of it you shouldn't really feel like it's selling. Like if if you really understand that this is a good deal, not only for the patient, for the practice, it's great for both sides that our best practices, our best customers are extremely passionate when it comes to having that patient conversation. And when there's passion, people can sense that. And I think that's really where. When they have that confidence and we and we have the training and they're well trained, that's where we really see some nice enrollment and adoption from patients and from the team.  

Art Wiederman, CPA: That do more things for you. That popped into my head number. Number one is multiple. We have multiple practice owners. How does that work? In other words, is implementing a plan for someone who owns two or three, five, ten practices different than a single practice owner? It is, yes.  

Brad James: So we have a separate what we call a group practice portal that's completely separate from just a one location practice. And if they have multiple locations. We provide them with the software that makes it easy to report. That makes it easy for them to have visibility on each officer's performance. But I think the biggest thing is if you have multiple locations, you need to maximize profits because like you said earlier, let's say a practice in upstate New York and there's another practice in downtown Manhattan, they are going to have completely different pricing and fee schedules. So if you're looking to really maximize in your head and you own multiple locations in different markets, you want to make sure that you have different pricing because you don't want to leave money on the table anywhere. So that's where we get practices, that capability to easily set up different membership plans based upon location. And we also even have practices where they have several different owners under one roof and maybe one doesn't want to offer the membership plan, and no one does. Or maybe they want to set different pricing. We have that type of feedback as well and customers that do that. So that's something where our customer success team can give our customers the best feedback.  

Art Wiederman, CPA: So basically, folks, the message here is that in an office membership plan, we're not beholden to anybody. You can basically slice and dice this thing any way you want to do it. And the last question is the legalities of all this. You're in all 50 states. States have different laws. How do you manage to work that out? What did Dennis need to know about and I know you're not a licensed attorney, but I'm sure you're running this. How does a dentist have to navigate? I mean, I guess there's an agreement between you Kleer and the office. And then there's something that the patient signs, I guess a document, two parts of it. How do you work in all 50 states with 50 different sets of state laws? And there's federal law and there's baseball law. I mean, whatever the law we got, you know.  

Brad James: It's a it's honestly a great question. And we have prospects all the time that that kind of area, those concerns. So first and foremost, you have to make sure whatever you're doing is super compliant. I mean, that's just an obvious one. But when it comes to the membership plans, you know, there are definitely laws that pertain to it. I think first and foremost, to avoid stepping on toes. Do not call it an office insurance. Always avoid the term insurance. On top of that, we have spent I don't know how much money. So that's not that's above my pay grade. But we have done a lot of due diligence to work with several law firms and one that specializes in DMPO laws. So just discount medical provider organization. I forget what the MPO stands for, but we have done our due diligence to make sure that we are not violating any laws that are within states or federal laws. Now we can't promise complete compliance just because laws are constantly changing, but some states are stricter than others. For instance, Washington state and California are stricter. You know, I know California has something called the Knox Keen Act and Washington state has a whole other thing. But we actually work directly with Washington State's OIC to make sure that we're good. But a lot of it's consumer protection laws and there's other nuances that come to law, come to federal and state laws. But. Like I said, like you said, I'm not a legal expert. I just know that we've made sure that we've covered, cover their tracks and made sure that we are the best option, even legally, for practices.  

Art Wiederman, CPA: All right, Brad, great. Great information today. One more time, give out your contact information, your phone number and email and how people can get a hold of you.  

Brad James: Yeah. Email is Brad@Kleer.com. Cell phone is 610.639.6441. And if you come through the process, just drop Art Wiederman. Let either me know or whoever you're in touch with on this Kleer side, let them know that Art sent you and we'll give you 10% courtesy on our fees.  

Art Wiederman, CPA: That's very nice. We appreciate that. Brad James from Kleer Dental, we really appreciate your time. We are rooting for the Phillies because for me, it's very hard to be in Anaheim, Los Angeles Angels of Anaheim Fan. They just oh, they won the World Series once and we're hoping someday it happens again. But I don't know how to fill out the Phillies doing this year.  

Brad James: Well, I was just going to comment real quick on the Angels. I mean, you have two generational talents. And, you know, I don't know what's going on there. I mean, you could probably elaborate more. But for the Phillies, ever since we fired Girardi and we've had our interim manager and I mean, their record is like 25 and 12. Wow. Yeah, they completely came back. So it looks like the analyst with the Mets and the Braves and the Phillies, it's a pretty crowded division, but we'll probably have to settle for the wild cards. And the Mets and.  

Art Wiederman, CPA: The Mets are out of their minds. Well, as usual, we can spend all day talking about sports, which I need to start a sports podcast. This might be the art of dental sports. I don't know. We'll figure something out. Brad James from Kleer Dental. Hang on as I take the podcast out, if you would, please, folks. Again, thank you for the honor and privilege of your time. Thousands of people listen to this podcast every month. I get emails, I get calls. It's just an honor and a privilege to serve the profession that has allowed me to have a career for 38 years. It's just blows my mind. I remember the day I walked into the door of the CPA firm that I took over in 1984. I remember it like it was yesterday. So thank you again for that.  

Make sure that you go to our partner Decisions in Dentistry website. 140 continue education courses at a very reasonable price. Go to www.DecisionsinDentistry.com. Go to our website for the Academy of Dental CPAs www.ADCPA.org 25 CPA firms that represent over 10,000 dentists. If you are looking for help from me and my team, we don't you know, we're not licensed attorneys, but we do. You know, if we do, I always tell clients if we don't know the answer to your problem in the business of dentistry, I know where to get it. I got great resources like Brad and all kinds of people and everybody you know, you've listen to. And again, we got over 150 podcasts. I've got a library of dental business over the last three and a half years. My cell phone number, my cell phone, my office number 657.279.3243. And my email is awiedemann@EideBailly.com.  

Make sure that if you got more than $10,000 from January one through June 30th of 2021 from the HHS Provider Relief Fund that you get on the portal and file, if you get to October 1st, you're literally going to get a message that says, Dear Doctor, you waited too long, we're locking you out and you'll be getting a letter from us as to where to send your money back to. We don't want that to happen. So anyway, and with that, folks, that is another one, as they say in Hollywood or in this case in Orange County in the can. Brad, thank you very much for your time and your great expertise and for the Art of Dental Finance and Management with Art Wiederman, CPA. We'll see you next time.