Our interview with Leslie Icenogle of Dental Implant Auxiliary Training talks about how dentists offering implant services can dramatically increase their profit utilizing proven systems and education.

Leslie has over 30 years of experience in this space and provides our listeners with some outstanding advice.

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Bill Orth:

Hello everyone. This is Bill Orth with Kickstart Dental Marketing, and thank you for joining us on our consultant network. Today, we have Leslie Icenogle of Dental Implant Auxiliary Training, and also insurance billing outsourcing. Thank you very much for joining us today.


Leslie Icenogle:

Thank you Bill.


Bill Orth:



She brings over 25 years experience in the dental industry, having been an implant coordinator and a practice manager. And now you’re primarily working as a consultant and also a speaker to audience across the US on various topics regarding dental. You know what, before we get started today Leslie, why don’t you give us a few details on how you got started in your consulting business and the various aspects?


Leslie Icenogle:









Yes. Thank you. Actually, you mentioned [inaudible 00:00:48] than in oral surgery and implant coordinating for so many years and that’s back when implants first became popular in the United States in the mid eighties. And what I’ve found is that a lot of dental team members were not very comfortable with the implant process as a specialty practice, working with referrals. I noticed right off that if a hygienist had an implant or was comfortable with an implant, you would have more referrals of implant cases. So I realized right off that it was the lack of comfort with the auxiliary as to why patients were not getting referred for needed implant treatment. So that’s already had a huge impact on referring the patients out for an evaluation to see if they’re an implant candidate or not.







So basically I started my consulting business about six years ago. We do primarily work with specialty practices on the six month Step to Success program on growing the implant practice, which does help educate the restorative team so that they get that comfort level. And there’s not a little feeling in their stomach when they have that on the schedule, they’re more competent and talking to patients and educating patients about it. So I also work with the general dentist practice too, and educating them directly if they just want to increase their restorations, or maybe they want to do the placement and restoration themselves. So basically I saw the void of education in that area is why I started to consult.


Bill Orth:

Gotcha. And now why don’t you tell us a little bit about the insurance aspect too. And we’ll get into both of these in a little bit more detail.



Leslie Icenogle:








Yes. And I’ll tell you, I have been speaking on medical insurance and the dental practice for years, and the most common response I would get is, oh I just wish you could do this for me. So about two years ago, I decided why not? Let’s just go ahead and start doing it for the dental practitioners and take that frustrating path off of them. Insurance companies are really becoming more of a challenge and more time consuming than they were in the past. So we do the verification of benefits on the patient, the practice’s specific form, if they would like. We post the explanation of benefits, make sure that the proper write-offs are being made. We also file and call on the accounts receivable. That is fun.






And [inaudible 00:03:13] you can really see somebody’s accounts receivable go down fast. And when a doctor gets their cashflow tripled, the next month they’re super excited and it feels really good to help eliminate the frustrating path from the front office and improve the doctor’s cashflow. So one of the added benefits that our clients are telling us is that they’ve actually seen an increase in case acceptance because their team is more available to build relationships and talk with the patient. And one of our goals is to help reduce the turnover because it’s so high in the front office. And usually when you ask a team member why, it’s because of insurance.


Bill Orth:







Well, I mean, that’s a very unique opportunity that you have here. You’re actually working in two of the hottest trending aspects of dental right now. From a dental implant over the last several decades, it’s really trending towards the number one solution for tooth replacement. I know that when I was much younger, those weren’t the options. It was a bridge or dentures seemed to be the thing. And I know that implants, there’s been a lot more growth as far as expansion of insurance coverage and also just the longevity and the aesthetics of a dental implant rather than the other solutions seems to be more of the forefront. Even to the point where it’s actually a main focus in curriculum and dental education these days, which it wasn’t in the past.









I saw this unique thing a couple of months ago as one of my clients several of them who weren’t doing dental implants are now growing. It seems to be a very popular profit option and a very valuable solution to be offering for their clients or their patients. But I saw this interesting fact that over 70%, just over 70% of adults, by the time they reach 44 years old, have at least lost one permanent tooth via accident, gum disease, a failed root canal, or tooth decay. So I’ve seen this large growth in dental implants.


Leslie Icenogle:












Yes. And we’re just actually outliving our teeth. And so having a third set of teeth when you age with 50% of our population soon going to be over 65 years of age, it’s a very important service to offer the patient. And then also the education, I think that’s the best service that the auxiliary can offer their patients is the education, not only on the treatment but the consequences of non-treatment, which is extremely important as well. And I find that a lot of the auxiliary members have at least 28, if not 32 functional, beautiful teeth. And it’s hard for them to relate to the partially or the fully [inaudible 00:06:09] patients where I have seen it for 30 years and I see the problems that patients experience. So it’s really a great service that you can offer your patients, that they will never regret that they made that decision. So it’s very personally and professionally rewarding when you can transform someone’s life into functional. So yes, it’s a great service.


Bill Orth:






Well you know, I really liked your program too. We’ve talked about it a little bit. A six month program, coaching program and you’re going through a lot of aspects, but you keep highlighting one of the things that I think is very critical in this. When you get in their dental practice, the procedure itself, it’s all based on education and you really focus on taking that education to the actual patient when they’re making a decision on what’s the best option for my situation. I need to replace a tooth, what’s my best option doing this? And continuing that education, the benefits to it, so they can make a great decision for themselves.






And also what’s the best thing for them from a longevity standpoint and stuff like that. And I think that is something that is typically not a focal point from a dental practice standpoint. They’re just saying, this is what we recommend. And a lot of times there’s not the why we’re recommending this and stuff like that. So I think it’s a really good dynamic that that is a central focus of what you’re trying to do, not just with the dentist itself, but the associated team when going through procedures like this.


Leslie Icenogle:










Yes. And Bill, you really hit the nail on the head when you said that because the dentist, first of all, you have PPO networks and everybody really kind of straining them. They don’t have time to do the patient education. So being able to delegate that to a properly trained team member is not only better perceived by the patient, but also more cost effective because the dentist is getting paid to diagnose and treat, which is what they’re supposed to do. And also a lot of the dental teams are not aware that the congenitally missing teeth and the severely [inaudible 00:08:18] or the trauma cases are covered under the medical insurance. So you see a lot of coverage getting wasted, things that patients are entitled to that aren’t getting utilized. So that’s kind of important for the team to know as well.


Bill Orth:







That’s great. So when you look at your coaching program, I know that there’s some different variables, I wanted to sort of go over them a little bit. I know that you do some onsite work with the team. I’ve seen that you’ve done one and two day onsite, but you also do a lot of stuff via phone, tele-coaching as you’d call it, conference calls, continual monitoring and support. And you have a really great webinar series, for those of you we’ll share her website at the end, take a look at that. She covers really good topics in her webinar series, so we’ll talk a little bit about that. But typically, how is that from a proximity standpoint? I know that you speak across the country for your services and stuff like this. Is there a geographic boundary for the services, or can you work with practices throughout the US?


Leslie Icenogle:









I work with the practices throughout the US. I do have a full day program that come in and teach your team how to file medical insurance. Now the six month coaching does start out with two days onsite. Then I come back for a day onsite at three months and six months. Then there’s three hours of tele-coaching, the odd months, as well as monitoring. But you’re right, I do have a series of four webinars for those that do not feel they really need somebody on site, that goes over the roles of an implant coordinator, the financial discussion, the case presentation, scripting, and all of those wonderful things that will really make the team more confident to discuss the type of treatment with the patient and know the real risks of non-treatment. So yes, there’s a series of four webinars. You may find one of them convenient or you may want a series of all four, or the coaching typically does need some onsite just to see where people are. But of course, reviewing numbers and things ahead of time to see where we could be most beneficial to that since it’s in our team.



Bill Orth:








Okay. For those of you listening, before we get into the insurance billing outsourcing, I want to highlight that if you want some more information regarding what Leslie’s offering, you can find her at www.teamimplants.com. Like I said, you’ll find all of the details regarding the coaching, her availability to speak at different events, and also the webinar series that we just mentioned. You’ll find it a very dynamic thing, very profitable. So if you are currently doing implants or wanting to add that to your solutions as a practice, I definitely recommend you checking out that website and getting some more information.






All right. So now let’s transition a little bit to a very common headache, AR. Just aspects of AR, specifically insurance, is always the big headache, and it doesn’t matter what type of practice it’s something that impacts every practice. How can you help me get paid faster, more efficiently, stop the headache and the churn of my front office? And so let’s talk a little bit about that.


Leslie Icenogle:






Yes, that is actually becoming very, very popular as far as outsourcing. And we do offer the medical and dental, but how we can help is the accounts receivable, you may have a team member that’s extremely dedicated and a great person come in in the morning and think, okay, I’m going to make 25 calls or get through this page of AR today. And then the day gets busy, they get emergencies and things happen and they go home without making those phone calls. So what’s unique about outsourcing is you have somebody, a specialist that’s on your team, that is making calls all day long without interruption. And so they can get more done. So you can see your 90 days disappear, your 60 days start to disappear very quickly because somebody is focusing on getting those results.










Another very time-consuming task for the team is the verification of benefits. Some dentists really like to know some specifics on codes, frequencies, and things like that. And we find that one verification can take up to 20 minutes per patient, depending on how much we tell the business at once. So the nice thing about outsourcing it is they’re not really paying a salary and all the taxes and stuff involved with that. It’s now become a business expense for your practice, so it’s less costly. So the medical field has been doing this for a while. You may have seen your own primary care physician go from having an insurance team to outsourcing it. They find it more cost efficient. So our goal, to get you paid faster, is to file the claims properly the first time, with the correct attachments, we know what code needs what for which insurance company, and we also follow up on those right away.












So we file up to four insurance companies, more if the patient has it. It’s typically two medical, two dental. We did have a recent client that does a lot of frenectomies, but didn’t realize those were covered under medical. She’s been with us for about five months now, and we’ve collected over $26,000 in medical benefits for her frenectomies. And I have a full list of procedures that are covered by medical carriers. If you want to contact me, I’d be happy to share that with you. So we get paid faster. We also utilize the medical insurance benefits and also really review those explanation of benefits. We don’t want a dentist tricked into taking a write-up that they don’t need to or an insurance company trying to down code a code. We really appeal that right away. And we actually work with an insurance collection agency. If the insurance companies are not doing what they are legally supposed to do, then we can send the insurance company to a collection agency.


Bill Orth:









Sure. Well, that’s awesome. You touched on a couple of points that I want to reiterate for our listeners out there. You know, you’re incurring an expense in this capacity as a practice anyway. The problem is, at least a lot of our clients, it’s a headache that they really don’t want to deal with. You know? So one of the unique things about your expertise, especially when it comes to AR, it’s the gaps in AR are the biggest crux to profitability, to a practice. I know that speaking with several people in the space, the dramatic drop-off from what happens after the 60 days. You get a very high pay rate in the first one through 30, and then it continues through 60. Once you get to that 60 to 90, you start to see a dramatic decline. And if you get out there towards the 120, it’s deemed in a lot of cases, not very likely that you’re going to actually get those receivables. And so-


Leslie Icenogle:

Yes, and-


Bill Orth:

Go ahead.


Leslie Icenogle:








Oh, and one issue that we’re finding too, is that a lot of dentists are inheriting these problems. For instance, if you purchase a practice and you now have their accounts receivable, and a lot of it is 90, 120 days, like you were just explaining Bill, it’s really hard to recuperate, especially with insurance companies. A lot of them are starting to go to this 90 day, timely filing. So you really have to stay on top of it. And a lot of times the team members are really, their heart’s in the right place, and they’re treating the patient and being that first person that the patient sees when they arrive, they don’t need to be on hold with an insurance company, fighting.


Bill Orth:







That’s great. Well, like I said, for those listeners out there, if you’re having a problem in this area, or you’re not even actually sure how well you’re doing in this area, definitely reach out to Leslie and her team of experts that can give you an assessment on exactly what those gaps are, how they can improve it, and possibly even just take that role and responsibility away from you, freeing up more of your time and your resources for other aspects and just improve your overall receivables and the focus on that aspect of your practice. You can find out some more information there at www.insurancebillingoutsourcing.com. Leslie, thank you so much for your time today. It’s been great having you. A lot of great information that’s going to be useful to our listeners and those people who have practices or involved in their practices. I really appreciate having you on the call today and look forward to being able to work with you in the future.



Leslie Icenogle:


Thank you. Thank you. And a shout out to Kickstart Dental Marketing. You guys do an awesome job, I get great feedback from clients. So thank you.


Bill Orth:

Thank you. Bye bye.


Leslie Icenogle: