139: The Opportunities of Automation in Revenue Cycle Management

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Hello everyone, and welcome to another episode of DSO Secrets. I'm your fearless host, Emmett Scott. Today I am here with Sina Amiri, VP of business development and partnerships at Zentist. And welcome, Sina, thank you so much for being on today and excited to just talk a little bit about this world of automation. Like, we definitely want to take things to the next level. You know, as I've been talking with my team and you know, the question keeps coming up is as labor costs keep moving up, what is the business strategy associated with that? You know, where do we need to quote, unquote, cut costs? I'm curious some of your thoughts on this, but one of my concerns is some of the first places people go to cut costs. I've seen this with private equity and others is a lot of their growth capability, right? So they're like, hey, we're not going to be able to grow as quickly, et cetera. My concern is, well, that's reducing the impact of your vision. So I don't love to go there. I mean, sometimes it's necessary. You don't have any cash or whatnot. But the place that my brain goes is to the extent that labor cost is moving up, automation needs to make up for that difference. Right. And what automation allows you to do is continue your growth while maintaining the same individuals. I think a lot of people freak out at the lower levels because they'll be like, hey, if I automate, then that means you're just going to eliminate a bunch of people. And those are my friends and my family and whatever it might be. Right. But to me, again, if you're growing, what that means is, no, I just don't have to add a bunch of people to the team anymore. So anyway, curious your thoughts. I mean, solving labor costs, yeah, it's

a tough problem, right? Because what we saw prior to the pandemic was in some markets, shortage of dental assistance. In some markets, a shortage of Hygienists. And through the pandemic, you had hygienists that decided to retire or want to work the front desk rather than be chairside. So when you think about automation, I think the first question to ask is, at the end of the day, what business are you in? Right. And what are the strategic functions that you're best in? Class act that if you automate, will it eliminate the quality of the patient experience or will it actually improve it? Now, automation, I know, you know, can strike fear in some individuals that are working in the practice level and having run a private equity back. Yeah. So, you know, whenever you throw the word automation, people worry about their jobs. Right. Especially since, you know, the press tends to amplify what the meaning of automation is for the future of the workforce. And so one of the things that I often discuss with doctors is if you look at where you can save money in a practice, right. There's a finite number of expense buckets that you can slash. So whether that's supplies, lab expenses, wages, which historically were 28%, I mean, supply

and lab expenses is not a large percentage. That's the thing that always gets me is dentists will compare, you know, their supply expense, and it's kind of like comparing pennies. You know, I mean, labor is really where the biggest opportunity is. And I'll just throw in, like, the way I think about it is I want to be able to pay my best people as high as possible. Right. So any money that's leaking out to activity that is really could be automated is probably also on individuals that are either not at their highest and best use because they're doing things that I could freaking automate. So why am I having them do that? It's a really expensive thing. Or it's individuals that aren't bringing a ton of value. I have to tell you this one story. My son, he's working at Chick Fil A and he's like, I'm only making at the time, let's say $10 an hour. And I said, well, you got to solve harder problems. And he's like, what do you mean? I said, what's the problem you're solving for Chick Fil A right now? He's like, well, I'm over French fries. And I'm like, okay, so the problem you're solving is that the French fries have to be moved from this frozen basket into the oil and then out and into. It's like, that's not a really hard problem. Right. And so I think of, like, you Know, when people get concerned about their careers, my advice would be go solve harder problems because then you'll never have a problem in your career. But also, I think as a business owner, make sure your highest and best people aren't solving french fry problems. You know, it's like, what else could they be doing that moves them to that next level? I was just meeting even with executive team members and as you scale and grow, I think, you know, you have to like revisit this stuff where I had them sit down and I said, okay, I just want you to take the week, write out things that are really taking up some of your time, little things, big things, and then ask yourself, is it worth it for the company to pay you at your wage to do those activities?

Yeah. And what's interesting is that, you know, repetitive tasks are great for automation, right? Creative tasks are generally not. And study after study has shown that if you are assigning people to creative tasks, difficult problems that have not had a blueprint historically, it's extremely difficult for machine learning AI to be able to automate that. And if you look at technology companies, the average salary per employee tends to be at the highest of any industry. And the reason for that is because they've automated, as a technology company, a lot of the tasks that they themselves do. And as a result you have less employees earning a higher wage, and that generally gets associated with a better quality of life. And with regards to revenue cycle management, we often find that claim follow up is an area where it's not done very effectively. And because it's a repetitive task that generally requires some degree of knowledge with regards to how each of these payers is going to reimburse you, those tasks oftentimes are good for automation. The challenge is that if you're looking to have somebody perform those manually, if that person goes on holiday, let's say your office administrator. Right. Goes on holiday, very rarely is a temp administrator going to be able to fill those shoes. And that's primarily because they're not familiar with your PPO mix, they're not familiar with your, with your fees. And when I managed clinics, I often found that when I had front desk staff, you know, go away for a period of time and I put a temp in, my AR would increase dramatically. Right. Because not only are they not familiar with your practice to that extent, but they also are not as careful with regards to the money coming in and going out because it's not their money.

So you lack consistency. Correct, Right. I mean, that's the thing that like factory automation has over us just generally is when we look at the different quote unquote machines helping get our product out the door, they can get sick, they can get pregnant, they can have bad days. Right. The other factories don't have to. I mean they have to make sure they oil them and take care of them. But they're pretty predictable. Humans are not as predictable. And don't. You can't just download the software and then you're up and going. You know, one of the things going back, one of the things I've heard is that the things that cannot be commoditized, the thing that cannot be automated really falls into three buckets. Leadership, relationships and then creativity, I think they're good ones to think about. As far as one personally, are you doing the things that are leadership, relationship and creativity oriented? Or we could call it strategic innovation, whatever it might be. And then is your team and those who aren't doing leadership, relationship and creativity activities of those activities, how could we support them to be out of it? Because as you were talking, I'm like, if you want to have really great employee retention, have them always doing leadership relationship creativity jobs. Like that's also just very engaging job. You know it is.

And if you look at humans, you know, we're generally not fond of tasks that are repetitive and mundane and we want to do the creative things because we're wired that way. And I feel that in a lot of practices and DSOs people get assigned repetitive tasks because leadership hasn't figured out how to automate. And there is a price to innovation. Right? Because with automation, oftentimes it does require multiple iterations prior to you being able to perfect it. And with machine learning models you actually have to train the machine learning models. And with regards to random SQL management, what we've done at Xentus is create a rules engine. But it's taken us a long time to get the rules engine perfected to such a point where we're confident in our ability to be able to collect on these claims. But even when we do a new deployment at a new DSO because of the different contracts that they have with payers and the different fees that they've negotiated, there is a ramp up period that happens. And what I find unfortunately with a lot of DSOs is particularly emerging ones because they're so busy acquiring clinics or building clinics from scratch, oftentimes the management and the leadership doesn't allocate sufficient resources and bandwidth to automation and digital transformation projects. And as a result there is, you know, a lot of DSOs that I feel quit the initiative too early.

It's also outside of like our core. Why, you know, like, none of us started a supporting dentists and doing locations because we're like, you know what's going to be the best part of all this? Trying to collect money. Like, I am so excited to build out the team that's going to figure out how to work with these insurance companies, how to collect co pays. Like, that's just going to be so awesome. So it becomes this like, side note that is absolutely necessary. I mean, it's the fuel of the business, right? But it's so freaking hard. And then it's so unrelated to the whole reason you ever got into this, right? It's kind of like frankly it or anything else, like, no one's like, you know what's going to be the best part? Having all these workstations and having to figure out how to keep them up all the time, you know, and hopefully not get ransomware and attack. Like, no one started with that. Why? You know, it's probably a good thing because that wouldn't be very engaging. Everybody is like, I've got this cool brand. I feel like I'm bringing something unique to the marketplace. I think I could support dentists in a unique way or give them some autonomy in a unique way, whatever. I mean, that's where your core focus is. And then there's just like all this stuff that's like super necessary, right? But not at all exciting or engaging. And. And why is revenue cycle management so hard in healthcare too? I mean, all my buddies in other industries, like, they can get to a hundred million and be like, on QuickBooks, you know, there's like, yeah, I've got a couple SKUs. I sell product, whatever it is, you know, revenue recognition's like pretty simple. Dentistry, it's like, I don't know how much money I made unless I have a full team.

Yeah. What's really interesting, Emmett, with regards to healthcare is this, right? In other businesses, if you walk into a Starbucks and you order a latte, you're paying for that latte directly, right? And if you're not paying for it directly, it's going on a gift card or some other form of payment. But in healthcare, the patient isn't always the payer. In many cases, most often or not the payer because of this disconnect between the patient that is receiving the benefit of the service and the company or the institution that's providing it. The complexity here is that there's different stakeholders And I don't want to call it middleman or woman, but the reality is that it's very difficult when you have multiple parties that are responsible for paying for that service that don't all benefit 100% from that service when it's delivered. This is where the rules become really interesting and difficult and the transparency starts to lack because then all sorts of games can get played.

I was just imagining Sina as you were talking, what if we had going out to eat insurance and you got there and there wasn't even a menu up on the board. It was just like, hey, I'd like this. You didn't know what was covered. What was it? You just got a bill later that's like, hey, you went out to eat, you know, three months ago, here's your bill. I mean, that's the insane. And then it's like, as the retail, you're like, I don't know, I have a contract. I might get paid this much for the food, I might get paid that much. I got to figure out how to keep my costs. It is pretty crazy what we're dealing with on, like the collections, the whole revenue side of our business models. It's super complex compared to like, it's always this much for a cup of coffee or whatever, a pizza. Right. You're never like that. Business isn't like, I wonder what they're going to pay this time, or I hope they don't cut their cost by 5%. Yeah.

Depending on the patient walking in, or in this case, the consumer walking in the restaurant. Right. You would never think that the patient would have to. Depending on their demographic profile and their dependence, they would be impacted by what services they can receive. And so eligibility within the RCM REM cycle management industry is a tough problem in dental because historically there has not been the infrastructure in place to be able to obtain the necessary information from these clearinghouses in a sufficient way. And even then, if you don't update your fee schedules, as an example, right. In your practice management software, and you're not aware of denial rates when you submit that claim, if you don't have that analytics and that knowledge at your fingertips, the denial rate can be high for certain types of claims. And one of the things I find difficult for practices that are doing RCN manually is given the degree of changes that are happening on the payer side of the industry and the contracts, especially when you're acquiring right practices like credentialing, that becomes an issue. And so there's so many moving parts that it's very difficult, particularly for an emerging DSO to be able to keep tabs on that as the rules of the game change. And this is, can you kind of

flowchart out for me because I'm not in the day to day of the revenue cycle management. I've got a great team but. And they could tell you, tell me but what is like typical revenue cycle management. And then this will allow you to kind of plug Zentas. But like how does zentest work? Just kind of. If I Could you visually paint two flowcharts for me.

Yeah.

That would help me understand where the world is as far as automation on this.

Yeah, sure. So, you know, RCM really starts with eligibility and verification. Right. And this is where to our example of, you know, consumer walking into a restaurant for a dental practice. It would be you have an appointment tomorrow, you're going to see Dr. Smith, you're the patient. And the question is, depending on the treatment plan that you're required, like what is the insurance company going to cover and what are you responsible for? And most payers are providing you with an estimate of that coverage. So you can.

Isn't it like sitting on the phone forever too? And like. Or getting on a portal and getting very. Because they haven't, if I understand they haven't standardized the back end of this information either. Right.

Fantastic question, Evan. So one of the problems we've solved at Zentist is there's a lot of time wasted in these call queues and you're calling these pairs and many times they're not allowing you to ask questions regarding more than two claims at a time.

That's what I've heard. So you can't match the information. Right.

So you're calling. Right. And you have let's say for that particular day, 20 different patients coming in. And it's taking up significant resources on the part of your administration team to do eligibility. And the other issue is that many times when a third party is making a phone call, there are payers that will provide limited information to third parties. And so with regards to the time wasted. Right. Both on calls as well as on portals. So the other issue is with portals, as many of the portals that you see that are provided by payers, they provide some information, but not all information. So this is where, for example, you would download an eob which is an explanation of benefits. And the challenge with downloading EOBs is that depending on the payer, that EOB could be available at a certain interval of time. And can you manually log in 80 times and be Checking that portal every hour. What we've deployed at Xentus are bots that are able to log into the insurance portals to download the explanation of benefits and essentially visualize all of that data on a dashboard for the providers.

I like when the bots are on my team.

Exactly. So that's a huge benefit.

So they're logging in, you're using the portal information and then pulling that into some kind of ui, some kind of display on the Xentes platform. So now. And I'm getting it specifically for my patients that are coming up.

Exactly. So we segment the views based on your clinic. Right. If you're for example a regional manager or VP of rcm, you may want to have the global view of all of your practices and what's happening in

terms of, you know exactly what I was going to ask next. Like am I logging in 70 times or is this like I can have an enterprise solution.

We built our technology to be an enterprise solution starting from the beginning. And so this is the one benefit of not having to keep track of multiple logins. And then obviously passwords for payer portals often change. And so we have built basically a password library where we will update and keep tabs on passwords that are changing. Because the other thing you'll find Emmett, really interesting is oftentimes when I was on the DSO side, you'd acquire practice and who's got the login information. Right, right, right. Many times it's not documented many times that Dennis bought the practice three years ago from somebody else. And so we find just maintaining those logins and passwords is a pain for a lot of these downloads.

So I can have a centralized team though. That's what you're really saying too. I don't have to have people individually at each practice doing this activity. I can now centralize verification and basically leverage into bots to help me get

this all done correct on verification. We currently don't address verification, but as far as being able to actually get the data from the payers that you need, we're doing that today. We sit nicely between the practice management software and the clearinghouse and we're practice management software agnostic, which is really important because oftentimes big struggle for DSOs is because you're acquiring practices and inheriting the practice management system. Very difficult to standardize RCM if you have multiple practice management systems.

So open Dental, Eaglesoft, Dentrix, no problem.

Planet DDS. We have a wide number of DSOs that are using mix of different practice management software that we currently support and we decided early on that it was important for us not to, from a change management standpoint, force the client to switch their practice management system because as you know, it's very, it's met with resistance and in a seller's market, good luck trying to convince a 62 year old, you know, dentist who's going to stay on for three to five years to learn a new practice management system. And so we are able to use rpa, robotic process automation for the practice management systems that we don't have an integration built with to still be able to pull that data. And from a posting standpoint it's important. Right, because once you know what the payment is, you have to then post that to the practice management system. And so there's a claim submission and the posting side also has to be automated.

Okay. So you give me information on the eligibility side, which is the first part of revenue cycle management. I like where you started with that. Then patient comes in, right?

That's right.

And then they might have some co pay and hopefully now that I've done eligibility more clear, I'm a little more clear on what that payment is. Right?

That's right.

And then now I'm billing insurance, correct?

Right.

Okay. Zentus helping me bill insurance or where does Zentas pick up next?

So legally, right, the clinic has to prepare the claim for submission because I'm not a dentist, so I can't tell you what codes you should have on that claim. What we can tell you though is when we have the claims ready for submission on your end, we submit it on your behalf, we run a validation engine against the claims. And what we're looking for are missing X rays, attachments.

Right, we're looking like almost like a compliance review then.

Correct. Now from a compliance standpoint, you know, we're only deciding whether or not based on what we know about this type of claim, what is the chance of it getting accepted on the first go down? Right, But I mean, so much of

compliance from a billing revenue cycle management is does it match up to what the, what the insurer is looking for? I mean, whether you're talking about PPO or Medicaid, if they say these are the things I need, you know, I've seen it with Medicaid where they'll pay you but then call it a fraudulent claim because you didn't send them everything, you're like, well, why'd you pay me then? You know, so, so anything that can help to review, you know, we have a lot of team members just doing that manually, but anybody who can help you review? It's all about the bots. Right.

Well, narratives. Right. Like near. If you're missing a narrative and you're submitting the claim, like you said, you may get paid on it, but on their end, by the way, they're using machine learning and AI. As you're familiar with what's going on today as far as companies raising capital to solve problems for payers, they're getting way more sophisticated in terms.

Yeah, I was just doing a webinar with Overjet. You know, at Adso they're working with Guardian to use their technology to review X rays and stuff. Right. So this is going to be battle of the Bots, like who's going to have the better bots to like make the argument, you know?

Well, what's interesting with Xentus is that we actually don't have any payer customers, so we're 100% focused on helping providers. And we're doing that by leveling the playing field when it comes to managing creative denials and having some degree of prediction. Because if you're going to submit a claim. Right. Why submit it if it's going to get denied? Wouldn't it be better to know that? And knowing that helps you save costs? So going back to your question earlier around, where can you save money? I can tell you that no practice I've ever come across has done a time motion study on how much time their staff is spending resubmitting claims. So your AR, by the way, can be 98%. You're collecting 98%, right?

Right.

Let's say you're only writing off 2% and that's very high most.

But is it taking four cycles to get that done or is it taking one cycle? Right. That's what you're getting at.

This is what I'm getting at. So we get a lot of DSOs that come to us and say, you know, I'm at 92%, can you get me to 93? And the question I asked them is what's your first pass rate?

Yeah, yeah. What's your cost of collection?

Correct.

Right. What's. I mean, that would be the other thing that they probably haven't ever calculated is total collections divided by total labor costs. Right. And, and everybody who's touching that to get it done, especially on those second and third passes, I like that. Yeah.

So that's a very important KPI to be looking at. Right. And I've talked to the larger DSOs. I'm talking about the top 10 that do or have Started to track that as a KPI. And what they quickly learn is that very difficult to scale your RCM function without any sort of technology related investment. Because as you acquire practice, you know, generally speaking, one biller could handle maybe $100,000 a month in terms of claims, we're doing over 200 million a year dollar rise at Xentus. And so the question is, if you're going to acquire, let's say a dental group, like how many more billers do you need to hire in order to be able to manage that acquisition?

Yep. Well, and the billers get good at one system. I mean, I'm just thinking, especially for people, if you're doing acquisitions and you've got multiple systems, you've got to figure out how to leverage that into some kind of standardized platform. Because now you got humans that have to either know multiple systems, which means inherently there's going to be mistakes, which is probably mean. Did you call it your pass rate?

I call it your first pass rate.

So the first time you send it, it's going to get worse if it's like, hey, we're great on opendidtle, now we're on Eaglesoft, like there's no way. Everyone's an expert in everything on scale. Maybe you have that one person or two people, but not on scale. So yeah, so you now you got to get like to leverage it up so that it's still for them the french fry move. Right?

That's right. That's right. Yeah. And that's a huge issue. Right. Because like as you said, if you're familiar with open dental and you go to a new UI from a different practice management venue, then it's like, I got to learn this and it's going to take me, you know, a week, let's say.

Yeah.

And so in the beginning when we started Xentis, you know, we were actually training our machine learning models to be able to learn the different practice management workflows. Right. But the challenge that you still have is those software systems get upgraded and there's vendors coming out with new releases and sometimes the UI is changing on those releases or the play module.

Are you guys staying up on all that stuff?

We have to. Right? We have to. So we're always looking for what's the newer version of the software, who's, who's deploying it. Can we get ahead of it and can we make sure that as far as the client is concerned, they see no difference? Because when RCM is working well, what's interesting is nobody knows it's working, right? It's not working. Everybody, including the associate dentist, right.

That's getting, that's what my CTO says about it is like the best IT team. You never have to call, right? I mean, absolutely. That's ideal.

So

as you're supporting these different components, you know, typically what kind of efficiencies are people seeing? Like where, what's kind of the low hanging fruit? If we just kind of brought this down to like, I've got a few practices, I put Zentus in, what am I going to see? And how soon is this? Like week one, week three, week 30? And what's the benefit?

Yeah, so the biggest reason why I find DSOs and dental practices in the beginning come to us, it's because they have aging, an aging problem. They have AR accounts receivable that has ballooned. And so we do an analysis of the 30, 60, 90, that's kind of the industry norm. But then what we're really looking for are what percentage of the time historically have your claims been paid at a specific interval that matches what the payer typically pays. And so what I'm saying is sometimes you're not getting paid because you're not following up with the payer fast enough. So although you're collecting the cash, you're collecting the cash too late. And in a private equity, you've got

a bunch of data now too, because you can be like the average and we'll introduce this term. But DSO in accounting as day sells outstanding. Right. So how, how many days to get paid? I mean you're able to look and say this insurer actually pays twice as fast as what you think. You're just terrible at your processes. Right. But they would never know that.

They wouldn't know that. And most doctor owners, right, they're relying on the office manager to tell them what's the norm.

And the norm for them is what's the norm for them? It's not the norm across 200 million and billing or whatever?

No. And unless you worked in multiple DSOs, you also don't know, can this actually be done any faster? Right. So this is where understanding and having a vast amount of data really helps in terms of being able to understand are we efficient at collecting cash? And the challenge you have with private equity backed DSOs is oftentimes if you're allotted a certain amount of capital, there's covenants in place. And you can't always be calling capital just because your ARS balloon now to $800,000 across nine locations. And so the cost of capital is another area where we find PSOs are necessarily, we think, unnecessarily because of the fact that they're not collecting cash fast enough, calling capital for working capital reasons. And that's not at 4%. Right. Because in an emerging ESO, that cost of capital can easily be north of 10%. Yeah.

Or they're, or they're burning through their line of credit and they're thinking they need more line of credit than they do if they could just get their revenue cycle management to be better.

Exactly. And one of the initiatives we have going on at Dentist now is what we call claim pre funding. So what we're doing is an analysis of your claims data and we're basically then able to determine whether or not we can pre fund you prior to the insurance company paying you. And the types of DSOs that are very attracted to this are those that don't have a very large credit facility where they know that the alternative sources of capital are going to the bank and getting that line of credit at maybe 8%, 12%, depending on how good the relationship is with the bank and their credit history. And so they're using this sort of funding for things like, hey, I acquired a practice five operatories and one of them needs a renovation or I need to be able to bring in that VP of operations, but it's going to cost me 200 grand and I don't have that capital sitting around. And so can I expedite the money I'm going to be receiving from these payers? But will Xantus help me with that? And this is a pilot program that we have underway already with a number of DSOs, and we'll bring that to the market and then yeah, because your

cheapest capital is your own ar, right? I mean, to the extent that you can just collect your own ar, that's like the best capital. If I think I'm pretty good, will you come in and just like help poke calls and see? Because I might just want like to test, you know, maybe I'm that 92, 98, whatever I am percent person and I think I kind of got it down. Can I just have you say, hey, will you just assess and see if there's like real ROI here? Because obviously if you're going to cost me $5 and I'm going to save a dollar, that's, you know, it's like, yes, I'm saving a dollar, but it's not worth it. There's a diminishing return. But if like you're going to Cost me a dollar and I'm going to get $5. Like, yeah, I want to do that investment, you know, so.

So we do assessments all the time, Emmett, for dental practices and DSOs. And our goal, you know how there's a saying in industry like you bring on a consultant, you're going to find problems. Our goal isn't to necessarily able to poke holes in your model, it's just to help you understand from a scalability perspective, can you grow based on the current path that you're on?

Yeah.

And we work hand in hand with a lot of existing RCM and billing professionals at dental groups because what we often find is that they don't feel comfortable, quote, unquote, outsourcing, revenue cycle management. And so what we try to do is bring technology capabilities right to them so that they feel like they're, you're

more leveraging their internal processes than you are. They're not like saying, here, take the cena, tell me how much money I'm making. You know, and if this is, hey, here's my team. They need better tools and resources to be at their highest and best years.

Exactly. And so sometimes they'll augment what they have, other times they'll come to the realization that they would rather be doing patient collections and they would rather be focusing on another segment of AR and would like to just hand everything else over to us. And we're capable of doing that. But it all starts with the assessment. It all starts with understanding their workflows and understanding how have they set up their current department today and where is the best use for Xantas within that department.

Who's like, not your right customer.

So we haven't focused historically on a ton of solo practices just because we wanted to go where the puck is going. And we saw a tremendous amount of opportunity to help DSOs standardize RCM. So that's where we started emerging DSOs. We've now been able to work with some of the mid size and larger DSOs. I have a meeting next week. I can't mention the name but you know, you'd recognize them. Top five DSO in the country in terms of number of practices under ownership. We're having interesting conversations around giving them an API for rcm, which has never really been, I don't think, done before. And so that's very fascinating. And so I would say the type of organization or practice that's on an ideal customer are ones that are not open minded with regards to implementing new technologies because of fear of change. Right. So we assess Your change management.

If you're an individual practice and your wife's doing this job and she loves it and it keeps her busy and she doesn't want any efficiency. Don't call you right, Absolutely.

I'll still take your phone call to just talk about life. But as far as you being an ideal client, you know, it's one of those things where we can prove that our right. But if you're not willing to look at it right, there's a conversation to be had.

Yeah, I think it's good to call it out because, you know, frankly, there are people who are like, okay, yeah, that is where I'm at. Let's just be honest, you know, and. And others to be able to say, okay, yeah, where would be, you know, maybe this would work for me and maybe I should at least test it out. So anything else, Sina, we should touch on? And this has been like awesome to just kind of dig in on automation because I'm looking at automation a lot of different areas of my business model. I think with inflation you have to.

You absolutely need to. And it's scary, right? The inflation rate that we've seen in Dennis, it's insane. And before the latest, last, I would say five months, we didn't have consumer inflation to the degree that we have now. So what's happening is the employees are now asking for the increases in wages. On top of you not being able to find the staff. I just want to leave everybody with one final kind of thought. We decided a couple of months ago that we need to elevate the role of RCM professionals within DSOs. And we find that they are not getting enough support resources. Oftentimes when you go to these conferences, you don't even see RCM professionals there. And so what we decided to do is put together a revenue cycle manager in boot camp for DSOs. And we've been really excited to bring VPs of RCM and COOs and individuals that really understand dental insurance billing. We want to bring them together. The one that we have coming up is March 24th through the 26th in Miami. We're going to be organizing more of those and we're basically building a community and a support network for these individuals so that they don't suffer from career burnout, they don't get discouraged and leave the industry to go join medical or another organization.

Yeah, I mean, DEO is awesome. Focus primarily on kind of executive level. Right. You get into rcm like we need additional support there. So I love that idea.

You're excited for that?

Yeah. Have you thought about even creating maybe like a certification program? Because that would be cool.

Emma, you read my mind. So we're in discussions right now with a number of universities. So for those that attended bootcamp, they'll be getting a certificate from Xentes, but we want to make that more official. And so we're working with universities that are accredited to basically put their stamp on it.

I mean, how great for them, just career wise, right, to be like, hey, I'm certified in this capabilities. And frankly, it'd be great for us, you know, as owners to be able to say, okay, do you really know rcm? Right, right.

Because today, if you're hiring a biller and you get 55 resumes, how do you screen them is my question. There is no standard in this industry for selecting revenue cycle management leaders.

Yeah, that'd be cool to have a billing level certification and then kind of management level and I don't know, all the way up. Right. In capability. That'd be freaking awesome.

Yeah. And I started my career in the medical industry, so in the medical industry, if you work for hospitals and health systems, there are a couple of associations that have certificate programs that you can actually receive as a RCM professional. And so there is some degree of uniformity in terms of how people are looking for talent in medical. But unfortunately, bringing people from the medical industry into dental historically hasn't worked that well because they often get frustrated with the lack of infrastructure and the lack of standardization, and that's what they're used to in the medical side. And so Xantas is hoping to bring that standardization in that.

It's awesome. All right, how's somebody reach out to

you Cena so you can visit our website. It's www.zentist z e n t I s t IO and you can find me on LinkedIn under Sina Amiri. My Twitter handle is betterdentistry and you can also email me at S I N A dot. Am I R ientist IO?

Hey, brother, thank you for being on. Thanks for talking through automation with me because we got to solve this. Yeah, get everybody at their highest and best use too. Like that is a mission that I could tie into. I'm very passionate about really inspiring and educating entrepreneurs. And when you look at your team members, every one of them is an entrepreneur. I love the definition of entrepreneurship, that it's moving resources from one level to the next. And I think that's what leaders do is they help team members move up. So anyway, to the extent we can provide these kind of resources. If you want to ask also more questions, you can also come over to our Facebook page at DSO Secrets. And until next time, keep smiling.

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