151: Integrating the "Buy Now, Pay Later" Model into Your Dental Business

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When I was working as an associate right out of school, I never imagined

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You have this natural talent, this unique ability. Hello everyone and welcome to another episode of DSO Secrets. I'm your fearless host, Emmett Scott. And today I'm here with Jason hasselhun who brings 11 years of healthcare finance experience to Prima Health Credit as their Chief Revenue officer. And prior to joining Prima Health Credit, Jason was senior Vice President of Sales and Business Development at Greensky. We'll talk a little bit about that. Where he led the revenue growth of Green sky healthcare division from early market. Over 500 million in loan. He's also worked at Lending Club and CareCredit. And Jason, thank you so much for being on because I'm excited to talk about innovative solutions right now. Things that, well, let me step back. Things I used to call innovative solutions are now becoming necessities. We used to think about technology as wouldn't that be cool? And now it's like, well, I don't have any labor to do that. I need technology to solve these things. I think financing solutions for patients, it was kind of like, yeah, yeah, yeah, I got a little bit here and there. And now it's becoming, hey, this is critical in this inflationary environment. As the cost of everything moves up, people need a way to quote, unquote, lower cost. And one of the ways to do that is finance it. I mean, I often say I did not pay $1,300 for my iPhone, right? I pay $39 a month and then two years and blah, blah, blah. And you know, it's just all kind of built into this rolling monthly expense that I do. So anyway, great to have you on here. I'd like to jump right in. I mean, you've been in healthcare for over 12 years now and in dental for this last seven. What are the changes that you're seeing that you feel are critical right now?

Yeah, you know, I think the buy now, pay later model has really grown in popularity. I think the non recourse environment, you know, the typical cadence of funding where providers are getting their net capital in two days. That's what they're used to. Right. Risk is very low in that demographic. But the buy now, pay later, you know, to your point, with the inflationary environment with, you know, underbanked consumers or credit challenged consumers, you know, we look at the retail environment and buy now, pay later, right. Those are more based on wants versus needs. I think we can all agree that reactive health care, particularly in dentistry, external from the cosmetic elective environment, you know, reactive dentistry, where these emergent care needs, they need the care. Access to care is real important in that sense. And financials is always the barrier or the anxiety from a consumer standpoint of whether or not they're going to be able to get access to care, have the optimal treatment that the doctor's recommending for them. And it's a big point of anxiety. So, you know, dentists that sponsor their own in house programs, I certainly commend them, right. They're creating an avenue for these underbanked consumers to be able to move forward and in terms that they can be comfortable with in terms of evaluating their risk. And really what Prima is doing is complementing that industry and bringing a lot of industry structure and flow to that as it relates to the flow of funds and reporting cadence to make that very easy and seamless for them. You know, so that's one call out I'd make is, you know, it's not lost on the market to have an in house sponsored payment plan which is essentially its own version of a buy now, pay later model. Right?

Sure.

So I do compliment a lot of dentists that have had these models that they've sponsored themselves for years, bringing structure to that in terms of live reporting.

And I will tell you that's even brand new. I mean, in the beginning it was just CareCredit, let's say that's what it felt like. Right? And it was like you either qualify for care credit or you get nothing. And I think especially this audience has been more innovative in trying to stack other solutions. Even going down to your point of saying, well, maybe we'll finance this in house, you know, yes, maybe we'll have a discount plan and we'll combine that discount plan with a financing solution and just try to bring this down. And this is where I really commend those who are trying to be innovative is let's start getting customer mindset focused, right? Let's bring this down so that they can access this care. But then what starts to happen, I think this is your punchline, is, well, now if you're successful, you've got this huge balance sheet of loans out to consumers and that can start having a weight on just from a business perspective. So it's like I often say, entrepreneurs only fear two things, failure and success. And this is one of those ones where successfully doing in house financing can create millions of dollars of that you're not set to be able to finance and capitalize. The other thing that's a challenge, just being straightforward is I've got somebody on the front lines there. And especially in this environment where turnover is high, if I've got multiple places. Oh, sorry, you were rejected. Here, here, let me bring you over here, let me, you know, trying to simplify that conversation into just an approval, right?

Yes.

And I don't think that you know, who we're hiring are from the car industry doing financing solutions like these are typically healthcare or customer service individuals that frankly aren't really comfortable with this whole conversation anyway. Like here, let me check your credit. Like that's not a natural. Oh, sorry, it sucks. Nobody wants to have that conversation. And I think a lot of them also are limited. I'm just laying out some issues here. They're also limited by the fact that they're like, man, I could never afford this. You know, I don't. So some of that barrier to traditional sales models and so forth, they just don't have those capabilities.

Right? Yeah, you nailed it. You actually, you're completely spot on with a couple of points you made there. You know, you definitely have a healer culture in dentistry offices, right. They put a lot of attention on the clinical process and outcomes. Right. And deep concerning for their consumers. And in consequence of that, believe it or not, is the financial discussions can get negated. Right. And they don't commit a lot of time and energy and structuring that at the point of application discussions. Because to your point, nobody wants to feel like they're selling anybody. Right. They don't ever be perceived like a car salesman or whatever that stigma might be. And really that's what the really enjoyment comes from this industry. Like even with my team and having observed over the years is when you can go in and you can guide them on how to present for being nothing more than just really transparent as far as consumer options and getting their comfort level, you know, even isolated down to a monthly payment amortized over a certain term, whether it's in house or in a non recourse environment, just being very good at presenting those options, not attempting to sell anybody. It's not a close, right? It's giving them informed consumer options, whether it be in a recourse environment, a non recourse environment, how they could move forward with care.

And I almost imagine like going in and grabbing the dentist and being like, do you believe in your care? Do you believe in your care? You know, then grabbing the staff. Do you believe in this care? Right. Like, is this really going to change their life? And if so, then why wouldn't we try to figure out a financial solution? Right? Because there is, I think to your point, there's this weird like, hey, this is really important what we do. And look, the doc just did another 20 hours of CE and this is going to help heal people's mouths and their lives and their health and the mouth body connection. So important. But like if you want to do it, you can do it, but if you don't, you, you know, it's like, wait, what happened to the passion once it got over to the financing side, right? It's like we kind of drop it because emotionally we're like, oh well, now we're in a different realm. It's like, no, no, no. This is all health care execution. This is all helping them get that care done. We just have to do the end to end work here. We can't just, you know, have it bifurcated that way 100%.

It needs to be a confident discussion in representation of the consumer. Right. And we guide to that with our salesforce and the, you know, there's thousands of customers that we interfaced over the years. Once you com. Once you're able to combat that, those discussions become much easier and the results are measurable and that's ultimately what you want, right? At the end of the day, it's about giving the consumer options they feel comfortable in moving forward and keeping that conversation very easy. Right. And once that's adopted and executed on. And what's really interesting about it too, because you'll hear from a lot of treatment coordinators which are very pivotal in these models, right? Because they're the ones that are sitting down with the, with the patients and having the financial discussions. You know, a big barrier is they just don't know how to open, they don't know how to lead into it. Right. Except are you interested in financing? Nobody really wants to voice that. They want to know what their options are and why in ways guide to the fact that you want to present the financing options very upfront and early in the conversation, not because you want to, you know, 100% of your revenue is generated through a third party arm it's because once you get really good at presenting that the consumer at that point will often identify how they're going to pay or move forward. And so it gives the treatment coordinator a lot of insight, is like, okay, their financial anxiety is relaxed. It's not an issue for them financially. Right. I don't need to spend too much time on this. Right. And they'll just be like, I'm going to use my credit card or health savings account, whatever they have lined up. It's the consumer that says, yes, they're very interested in that. To where it becomes a very excellent discussion and giving them options. And you know, you strive to make that process very easy from a third party lending standpoint with the application process. And you nailed it on all points.

Yeah. It's interesting because I'm seeing this pay later concept getting integrated into. So I mean, I can't buy something on Instagram or anywhere else where it's like, hey, do you want to use this solution to pay for that? Right. So we're definitely seeing, and I watch retail market because I feel like in a lot of ways it's way more innovative, creative, because it's a want, not a need. It pushes more of like trying to insert itself in. And I think if we can steal those ideas and bring them to things that we're a lot more passionate about than that, new shoes or whatever else for the backyard or whatever, this is real health care. If we can take those same concepts and not get out positioned, out strategized there, but provide those to the consumer. I was on my credit card and even my credit card now says, hey, do you want to break this payment into payments? And I'm like, wow, we're really getting down. But it's just like they're constantly trying to innovate down to the lowest cost to keep the consumer engaged. And I think all this has got to come down to healthcare. If we're going to compete, we've got to be able to utilize these things to make it as frictionless as possible for the consumer. Yeah.

In my view, the model is essentially of equal importance to your point, because I did notice that too, even in my credit card statements. You can go in there and look and they'll give you the option of what you charge to pay it over time. And you're just like, wow, that's a genius. Yeah.

Starting to break it down. The pieces, to the pieces. The other thing that you brought up, I think we go, okay, I just need to find the right solution, you know, I E like I'm buying a product. But you talked a lot about training. It seems to me especially on scale with multiple locations that the training of the staff can almost be a bigger barrier than the right technology solution. What's your thoughts on how those interact?

That's great point. The technology is only going to be as good as how executable it is in terms of the offering and how it's presented. Right. And you do have to have somewhat of a little bit of a culture shift within a practice to ensure that they understand the value of how it can be as a tool for them in creating options for their patients and the technology that's behind that and make it not only either very easy application system right off their phone. Right. Putting it in the hands of the consumer and taking that out of the hands of the provider. Because these all are time bankrupt offices. We structured our solutions that it's in the hands of the consumer. The provider can still sponsor it if they want to. We leave that option open for them. But ultimately we want that information in the hands of the consumer. It's a much, much healthier compliance environment for the provider. I think a lot of providers do want that personal information in the hands of the consumer and let them drive that. We structure the technology so that all that coincides and making it very easy not only from a provider standpoint and their workflow and their time bankruptcy, but for the consumer as well. So. So the two and training. You know the way we look at this through our salesforce is it is a very consultative approach. We don't go in spending a bunch of time just talking about Prema Health Credit. We really want to analyze and dissect their model and ensure that we can help them and help guide them on how to present. Because the Prima Health Credit revenue arm, which is simply a tool for them to help drive capital. They have a business to run. Right. But aside from that and getting to that endpoint and training is extremely important and for the staff to understand the technology behind that and how it can simplify their workflow. Right. And what they're accountable for in a day. So they absolutely coincide in importance 100%.

Can we do a little bit of a role play here? Not it won't be a perfect one. And I know you're probably not a sales trainer here but assume that I'm the consumer. This might be a good way to kind of talk about how Prima works in a, in a real life scenarios. Okay. So sure. I've, I've been given the treatment Plan. You're the treatment coordinator. Right. So what would happen? And you know, you would say, hey, is this something you really want to do? Yes, I really want to do it.

All right, right. It's, it's really helpful when you tie in a generalized statement as it relates to your model and how you execute presentation, that you tie it into your entire patient base. In other words, a treatment coordinator that's well trained on this would probably lead in with, you know, we noticed that you have, we set you up for a crown. Your total investment is $5,500. A lot of our patients like to explore our Prima Health credit application, which provides terms up to 24 months of no interest or extended payment plans with payments ranging from xyz. They have a patient calculator as well that they can hone in on a patient payment plan and simply offer the application. And you're offering that in the sense that a lot of your patients go this route. We offer this to all of our patients. That way the consumer doesn't feel like they're being singled out. And like I'm diagnosing your checkbook. As you need financing. Right. You make it a part of your aggregate offering. Very upfront in the conversation. And again, right then and there, once you do that, the consumer is going to identify how they want to move forward.

Would you imagine, Jason, there'd even be like a little, a little sign or something that says a lot of our patients like to use Prima Health and you just kind of look into it or something like that and say, hey, do you want to do that? And would they, with within the treatment coordinator, turn around and like type in what's your Social Security number and that. Or would it be like a QR code that they would just take.

Yeah, actually right then and there. Both avenues. Perfectly appropriate to your point. Or they just send a simple text link right to their phone and just let the consumer know it's about a five minute application, if that. And they can apply right from their phone and once they're approved, it automatically updates in our dashboard. Okay. And then keep in mind, this is pre qual stage. So this application, what they're going through right then and there, allows them to say yes or no with no impact to their credit. That's a market standard, right. That all lenders are doing that.

So you did it to me and I said, okay, sure, I'll do it. And then we just kind of sit here for five minutes. I would type that out, they would

type out the application, they would get a pre Qual instant decisioning of whether or not they could move forward in a non recourse environment or a recourse environment. Okay.

Specific to the would they know which one or they don't?

They would. Yep. It comes right back to the, it comes right back to the treatment coordinator as to what they're pre approved for. And then the consumer gives the consent to go to long application. When we say long app or hard app, that's when they actually get a bureau poll on their credit and what we can justify as a true approval. Right. The integrity rate from pre qual to approval is about 95%. There's always a 5% variance in terms of fraud rules or bureau blocks that the consumer might have on their on their credit report.

So just so everybody has this jargon down, recourse versus non recourse. You have both capabilities within the Prima health application.

Yeah. So yeah. Our big vision here was to create a one app ecosystem. Right. There's a lot of lenders that have to use multiple lenders and I don't think that's ever going away. To be very candid with you. We want to create an environment that you could look at us as literally the sole revenue arm from A to Z. Whether it's your prime, near prime, super prime or underbanked in one single application. If you're opted in for all of our, for all of our solutions, your approval environment is going to go up dramatically and I look at it in 2 cents. You'll have a non recourse ARM which you get your standard cadence of funding in two days. Right. Minus the merchant fees. You're also then creating an annuity arm. Right. It's a buy now, pay later ARM where you're getting your capital over time. Right. We're managing that portfolio for you. All your real time data is right in front of you as it relates to your dashboard and evaluating both revenue arms to ensure it's capital line, use your business appropriately. But everything from a transparency standpoint and this is a first to market offering from us is we do our part of our technology is real time reporting in dashboard. You can refresh that screen and you can just watch the capitalization for those

who want to understand the finance a little bit deeper. So what's happening then is the patient is doing the application. If you guys can fund it with a bank on the back end then that's a non recourse meaning I'm getting paid as the dentist immediately within that two day period of time. And whether they continue to pay or they don't pay. The non recourse means you'll never come back and say, hey, Susie stopped paying. We need that 2,000 bucks back. Right. That's on the bank. They've taken that risk.

Exactly.

In the recourse solution, you're going to say, hey, listen, couldn't get them funded here, but I can fund them here. But we're basically going to, we'll do the administrative piece, but you're, and you're going to get the payments coming in. So we'll take care of it. It's one step solution. But if they stop paying and we can't get them to pay, then you are at risk. And that's where it's a recourse that is you're at risk if they stop paying. Right.

You nailed it. Yeah. Okay, so there is, you know, the recourse element of the doctors do carry more risk and I get no different

than if I was doing my own financing.

Exactly.

Except you guys are administering it for me instead of me having to build out a team myself.

Well, and in the event that the consumer would default on that option, we're handling the servicing and the collections on that in our cadence. And again, it's a very, it's a very, what I'll call a very soft collections environment. Right. This is healthcare Life does happen. Our servicing department, our collections department are really good about working with the consumers, you know, and helping them never get to a state where they actually default. And that's one thing I'm really proud of here, is that we've really brought that model to market where we're going to provide every flexible option to the consumer to ensure that they can get caught up in their payments and meet the obligation of their term as it relates to their dentist as well, who's also evaluating that and evaluating us and our ability to collect on that. And what I tell Dennis is, you know, if you can collect 80 cents on the dollar in a recourse environment, you have a very healthy model. Even 70 cents on the dollar when you look at the math, doesn't equal, doesn't equal losses in the sense that you're never going to make capitalization in that arm. It's just, it's them willing to how much tolerance they have for the market in that sense. But if you can aim for anywhere from a 15 to 20% default rate, that's actually very strong in the market.

Yep. I was going to ask that question as kind of, you know, what do I need to plan on? And you know, somewhere around an 80% collections, is that fair or.

I think that's very fair. And that's, that's a good metric to go off of in this environment because at the end of the day they are going to default. They just like they default in the non recourse environment. But the dentists don't see it because the banks are dealing with.

Yeah. In some ways like I don't care what your default rate is, non recourse, I got my money, that's your problem. But the recourse piece and I think too we have to start thinking about it's like oh well, 80%. Well I'd rather pay everything up front, you know and then I'd be at 100% or you could be at zero. You know, they could just walk out the door and find the person who's doing some kind of payment solution. So I think that's something too that we got to keep getting our arms around is that's why financing is so critical. It's better than zero.

Well, you make a great point too because I think consumers will base on where they're going to go for their care, on whether or not if they're shopping, you know, providers that are going to sponsor an in house program, knowing their current credit profile, they know they're not going to get approved and that might be a barrier for them even just to go in until they learn. Maybe through them picking up the phone is like do you guys sponsor an in house payment plan? I think if a consumer hears yes. And they know they're going to have options when they go in there. Yeah. And you know, and meeting.

Yeah. Even saying hey we, yeah, we do financing. And now on the, on the recourse side, how low of credit score and so forth. You know, as, as we know our different patient types. Where does that I guess bottom hit or where does it not work? Where maybe I still need an in house if I want to go lower than that.

Yeah. I think a doctor sponsored in house program, there is no fico, FICO floor. You know, they will allow, I think they'll allow anybody that's declined in a non recourse environment assuming that they can meet their requirements to get into that in house program. In other words, if they're going to collect 10% down or 20% down on the balance and then they're going to set their own term of, let's just say 12 months of no interest. Right.

So I can customize the, the, the recourse solution.

Oh absolutely. Doctors are doing that now anyway. What we do that with our servicing arm is we literally configure it so they don't have to worry about that. Right. So if they say, Jason, I want 10 down built into my offering for the recourse arm and I only want to offer 12 months, that is it. It's just set and standard. Right. They do the application.

But if I want to be super aggressive and I'm like, hey, I'm fine with 5% down and I'm fine with them going five years or whatever it is, I can do that. Or I could say, hey, if it's this much, then I'll go longer. If it's this much, I want it to be shorter. Those kind of things.

Yeah. We allow our technology to customize and configure whatever is going to work for the doctor's office based on their risk tolerance for their consumers. We literally. That is their decision, and we honor that.

Do they need to have a bank account or can they have a credit card?

Typically, it's a bank account is the route that we want to go. Okay. In terms of how we're going to facilitate our payments, we have our own patient payment portal where they can go in and they can make payments on their account that updates back to the provider portal. So they can see that, how current that book is and whether they're 30, 60, 90 days behind, that's really important, too, particularly in the ortho space, because it's a. It's a, you know, it's a static treatment model. Right. They got to keep coming back. They can go in and they can pull up a consumer real quick, knowing that they're on the recourse ARM and make sure that they're current in their payments so they can continue care or guide the consumer that they are behind in terms of awareness.

For a team that hasn't done the payment plans and having to book those each time, do you all integrate into some of the softwares or do you teach the team how to book that accounting piece or how does that work?

Both work. But typically, our technology and our platform, everything resides right in our platform in terms of their reporting, their transparency to their funding rates, how the annuity arm is performing as it relates to their losses and their capitalization.

Particularly if I wanted to look at Jason and how much he owes and I'm over an open dental or eaglesoft or something like that.

Yep.

How do I. How do I know in the practice management software what your balance is or does? Do I signal over to go look at my other portal or what, how's that?

If we're, if we're integrated, then their environment would obviously translate that. Right. If you're integrated in or if it's just specific to our platform, our platform conveys that as well and all our reporting cadence. So for their reconciliation efforts, which is really important in a buy now, pay later model because there's so much to keep track of, we completely take that work out of their hands. We house that. That all resides with us and that's at their fingertips. And performance of how, of how that revenue arm is performing. And that way they can make a decision whether they want to stay in the program and continue to use it or make a decision based on how losses.

So I could note either, depending on how I ran my practice management software, I could note somewhere that hey, look over in Prima Health, or I could have it integrated in where it says he's got $2,000 outstandings, making $200 a month payments.

Absolutely. And it's right at your fingertips. Right. And that way you can, you're managing, not only not are you managing the portfolio, you're managing your consumer base as well and into their current status in the recourse arm. So it's very important. Yeah.

Jason, I think we've hit on the front end of why we have to do this. I think anybody who thinks about just themselves, personally, I don't care what your income level is, you're looking, there's some purchase out there where buy now, pay later just works, right?

Absolutely.

I think the front end conversation we all need a lot of help with. So it's nice that you're building out that scripting. I mean, I've heard of teams like taking their treatment coordination coordination people and putting them into sales trainings and so forth, which is awesome. But it'd be great to have that kind of built into the vendor partner relationship and then the back end accounting reconciliation. Seems like you guys can have a very sophisticated conversation too, whether that's the IT team or accounting to be able to say, okay, how are we going to get this all to work together and 100% and it sounds like too, I can adjust this as aggressive as I want to get the approvals, as aggressive as I want, or I can, you know, if I'm a little bit nervous, I could start off and say I don't want to do any of the recourse stuff. I just want to do the non recourse for right now, get my feet wet, get. And then, you know, maybe I'm in an environment where that's possible. And then slowly start giving a little bit of approval down at this other area. It sounds like your platform allows me to accordion like that.

Oh yeah. And typically you hit on a really good point there. They typically always want to start with the non recourse arm, right? That's where you build trust and performance. Credit policy is very important, a non recourse environment. They want you to prove that you can capitalize their business in the non recourse environment. And once you build that trust, then bringing in the recourse arm becomes a much easier discussion. And being them, being open minded and adopting that. Right. Because I never minimize the doctor's perspective on risk on that ever. It's very important and if I was in their position, I would evaluate that no differently. So yes, it is a longer process in guiding them to the value of that and ultimately executing on that once they start to adopt. And it's our job to ensure that they know exactly how that's performing in full transparency because they are carrying risk.

And where I would challenge anyone who hasn't tried a platform and to have the recourse. And you know, I can tell you internally we have our own, with our own team and so forth and there's all the challenges. So we're looking at these different solutions now because managing yourself has its own challenges. But what I will tell you is that one, patients pay better than you think, right? So all these horror stories that they won't is really administrative nightmares. Like they changed their credit card and you didn't have any way to follow up and you're like they didn't pay. You know, it's like, well, you change your credit cards too and you don't call all your vendors, you just wait for them to call you. You know, So I would encourage you to think about that. I'd also encourage you to start thinking about all these places you have dead spots in your schedule. And to the extent you could start filling those right, with patients who say, hey, if you gave me a payment plan, I would fill your dead spots. Well, what's that worth to you? I mean when you're playing against zero, something's better than nothing, right? So these are just kind of mindset things from a business. And let's be honest, if we're really in the healthcare business and we really want to have as much access to care, this has to be part of our strategic plan is how are we going to help people bridge that gap financially?

Well, I think in the current market environment too, I think a Lot of these entities are realizing they have to look at that to, you know, to sustain capitalization for their business. They just have to. Right. And, or they're smart to explore it, to see how it could fit into their models and you know, and that's what we're here for. So.

Yeah. Jason, anything else we should touch on? I mean we touched the gamut. I think if somebody wants to reach out to you, get more questions, what's the best way for them to contact Prima Health?

Oh, absolutely. Look, we have a national presence in our, in our sales force with the Green Sky Exit from the market. The majority of that talent now resides here at Premium Health Credit. So we're continuing our market presence and serving and serving our long standing relationships. The market feedback has given a great. In terms of the response that we're getting with what we're promoting out there and to filling that gap. It was really unfortunate with the Green Sky Exit. They were a top notch program, a top notch company. Really enjoyed my time there and we made a great run at it. The pandemic certainly hurt us and I think them recovering from that was a big challenge. But you know, I'm happy that the folks were able to come over here with Premium Health Credit and we're making another great run up to market.

Awesome. Awesome. So, so best way is through website, email. What?

Yeah, email's very appropriate. Obviously my phone number. But yeah, I'm not hard to find and I'm willing to talk to anybody about our solution.

And can you just spell out the website real quick?

Yeah. Www.prima healthcredit.com easily find us there. And, and then obviously my email which with my long complicated Last name@jhazelhuganhealthcredit.com All right, so, and, but yes, absolutely.

Awesome. Well, thank you so much. I appreciate you being on and providing some of these innovative solutions. Go check them out, those who are listening and those over on our Facebook page. And if you haven't been on our Facebook page, come over. You can ask additional questions. It's a DSO Secrets. And until next time, keep smiling.

I appreciate you. Thank you so much.

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