216: Cut 200 Admin Hours Monthly and Focus on Practice Growth

It really sucks that doctors don't have tools. And I think it's really cool that we built the tools for a million doctors so they can, if they want to, remain independent.

Hi, I'm Emmett Scott, and just like you, I've had my ups and downs in the dental industry, but times are changing. The DEO has built a map of how to succeed in one of the most challenging industries to navigate. On this show, we talk to dental industry leaders, solve problems, and get you the answers you need to face these challenging times and thrive. Welcome to DEO's Growth Secrets podcast for dental organizations. Now let's get started.

All right, I'm Jake Poole here, CEO of the deo, and welcome to a very special episode. I have with me here Steinpella with Lassie. So we've got a lot to talk about today. It's a special episode. Yes. First, let's hear a little bit about Lassie, and then we're hear about how in the world somebody like you got into dental.

Yeah, sure. So what we're doing with Lassie is, is supporting all the doctors that I think are listening to this podcast as well and helping them, like, run their business in a couple of hours a month, rather than now spending 200 hours a month billing the patients, like, processing the EOBs like by hand. We're building the platform for these doctors and giving them the tools. So that's all streamlined and done with software and AI so they can focus on the patients. And like many of your members, like the growth of the practice, of course.

So it all seems too good to be true because it's one of the biggest pain points in a dental office is this, you know, connecting to the insurances and all that admin. So you guys are tackling that. You're using eight to automate that. How far down the process are you guys in making that much easier?

Yeah, pretty far. Because, like hundreds of offices across the country, thousands of doctors are using the first version, like, of the platform and saving 80, 100 hours a month. And where we started is that's how I learned to build software. I bet we will talk a little bit more about how I ended up here with just like one job. And that's a very tedious one. It's the eighty hundred hours spent on posting EOBs and reconciling payments that come from all these insurance companies. And that, Jake, we have almost like fully automated right now. So it means that now we have a stack of paper. You have people like Jim Carrey punching these payments inside or outside of your office into a practice management system and deposit these checks in the bank. And we have that, like, fully automated.

Well, that's how we got connected because we have, you know, DEO members, our members of our community who tell us the most effective partners that they're working with. Yeah, and your name keeps coming up. You're saving massive amounts of time inside these offices. So before we get into the details of that, because I want to hear really specifically how you've broken down that entire process kind of with that, that tech mind, you know, surgical mind, you've broken that down. Let's talk about your background, because we say a lot inside of the DEO that we're starting to get the talent, the technology talent inside of our industry. It's really starting to happen. And I think you're really a huge testament to that. So give us a little bit about your background, where you came from, what you worked on.

Yeah, because I would have never expected to end up in dentistry myself. Coming from the Netherlands. Eight years ago, this mainly started because my dentist in Menlo Park, Dr. Kwon, who's also a DEO member, he knew that I worked in technology. So I came eight years ago. I worked for companies like Coinbase and Robinhood, where my role was to help grow these companies. So they were small, tiny businesses when I joined them. And then now Coinbase, 100 million people use it across the world. Robinhood, like, I think, crossed 220 million users. My role was a product manager focused on, let's say, building out a referral program so, like, more people would start, like, using Robinhood. So I spent my first years in America after I came from Amsterdam, helping these companies grow tremendously. Like, interesting because these products are used every day by people. So you work with super gifted designers and engineers and salespeople and marketeers building these products. And my doctor knew that, Dr. Kwan, and he said, hey, do you want to see how I run my finances? Because you build all these financial products. And I said, sure. So after a cleaning, because obviously I go twice a year to see him, he walked me to the back office, Jake, and then showed me these stacks of paper. And I'm like, wait, this is 2020? Because that's when we started working on this. And you still kind of cash checks into the bank by hand. And then you have people sitting there being a typist and like, that's crazy. These people should do other things. So that piqued my interest and I, quite frankly couldn't really believe that this was still Going on because my mom, to pay for college, she worked in a hospital in the 70s in the Netherlands, and that's what she did. So she brought bags of cash to the bank and did this reconciliation process and the finances in the way that many offices across the country do this right now. So I couldn't really believe this. And then I convinced Dr. Kwan, can I come work for you? So after I left Robinhood, he was surprised. It's like, are you sure that you want to come work in my back office? Yeah, I want to feel what this is like. So I spent a couple of months, nine to five, punching in, like ubs, billing patients, running his reports, running payroll. And then I realized, like, yeah, this is super interesting problem because Dr. Offices are the backbone for many communities across the country. I think there are about a million of them. And These people spend 100, $200 a month on doing paperwork they shouldn't be doing. And many of them, like, lose their joy, like being a doctor as a result of that. So I thought, super cool problem. And because of all the things I learned in building fintech and financial products, I thought I should go help them and build that platform.

Yeah, I think that happens often. We have a lot of. Dentistry is a big profession, and a lot of times you'll have a dentist as a partner, and then their spouse will work for a big tech company like Google or whatnot. And we run into this situation sometimes, and you're just always blown away by kind of how archaic some of the systems are inside of a dental office, and really just medical in general. And so I can imagine your tech brain or smoke coming out of your ears as you're watching that. This is 2020, and this is what's still happening. So what, you know, Robinhood and Coinbase are exciting. They're new, they're in the news. And then you go to like the back office of a dental practice. Like, are you just that tech? Like, you love technology that much, but that was still exciting to you, or were you like, like, how was that experience going from that flashy world of Robinhood to pushing paper in the back of an office?

Yeah. Well, if you really break it down, like, building a broker business like Robinhood is also not that sexy. Right. Because what you need to do is basically build a modern Charles Schwab that is actually technically very interesting. And from a growth perspective and a business perspective, very interesting. But at the core, it's building a broker business with, like, a lot of compliance processes, strict security, like engineering work. You need to Do. Right, because you're a broker business, like, handling people, straights, very, like, regulatory, like, heavy. And I saw this problem and I'm like, this is super interesting. Like, because I believe that you need to use technology to solve problems. Like, that's why I made the move from my tiny country, the Netherlands, and came to America. Like, basically the American dream. Right. I thought, like, I first want to work for a couple of years, like, learn the ropes of what it takes to get to a 10, 20, 100 million users and see what that's like building something people truly love to use, and then take that experience to a problem that I find, like, interesting. And this is the same as many other companies like Shopify built it for the surf shop, Square built it for the coffee shops. Like, from the outset, it might look, oh, that's boring and not sexy. But I think it's tremendously interesting that people spend hundreds of hours a month on basically being Jim Carrey in front of a computer. And then we will maybe talk about this a bit. Like, we saw that this was the right timing because it's technically not possible to build a platform and software that actually works, if you will. And I'm like, wow, that's exactly what I was looking for. A big problem that, like, is at the right inflection point and we can. We can solve, especially with what we've learned in the past.

Yeah. The best minds get excited about just solving problems. Right. And so it doesn't really matter where the problem is.

Exactly.

It's solving that problem. So, all right, take me back to when you were in that office and kind of walking through that process, because there's a lot of offices that are still using that process, believe it or not. That kind of probably numbed your mind, right?

80%. Yeah.

80% still using that.

Yeah. So there's a good government report or organization caqh. Yeah. And they monitor the digitization of, like, dentistry and doctor offices. And even, like, as of Today, like, almost 80% of the offices, like, process their payments manually and for the most part, on paper. Yeah. So all the accounts receivables that come in come into the mailbox or into the office through a virtual credit card. And then people spend a lot of time doing this work. It's unbelievable.

Okay, so walk me through. You're in the back office. You're kind of. You're doing this exact process. What are you seeing? What are you noticing? What are you realizing as you're diving deep into this?

Yeah. So like, with my. As you would call A tech mind. Like, we start breaking this down into, like, okay, we call it jobs to be done. So, like, like, what are the jobs that, like, are currently happening, like, there in the back? Right. Because many doctors and owners are not maybe fully familiar with this process. In dentistry, it's called revenue cycle management. Right. So like the. But I observed because as I just told you, I actually sat there in the back nine to five of two offices, actually, I haven't told that much. But I also worked for Dr. Shah in Scranton, Pennsylvania, who was a Castronologist, actually, because I wanted to feel, is it the same in a different profession? And like, what I did was basically you begin the day, like opening envelopes. Well, it starts actually with submitting claims. That is a lot of work, right? So you see, let's say 20, 30, 100 patients a day, and then they walk out. And then you need to submit claims with, like, insurance companies. Most offices need to do that. That is a couple of hours of, like, work and then a couple of weeks later, at least now, without having this automated, the insurance company like, sends back, like, stacks of paper. Right. Or them. And you need to open these envelopes so there's literally like a stack. And what you need to do is cash these checks into the bank account and then you have to look up all the patients that, like, are on that check. So there are about like maybe 200 pages of like, itemized invoices. Right. In dentistry, it's called. Are called EOBs. Yeah, you need to, like, type all the information that you get in on paper over into the erp. So I sat there and then I looked up Jake in the practice management system, and we received $80 for, like, Jake's, like, fluoride treatment. And there was $30, like, for his, like, exam. It took me five minutes. And because it was a $10,000 check, Dr. Kwan did well. I spent six hours basically, like, updating all the patient ledgers such that all the insurance, like, payments are squared out correctly. And obviously you're going to make mistakes because after six hours became almost delusional, of course, because, like, it didn't add up, right? So I didn't add up to $10,000.86. So I had to go back and then figure out where did I make a mistake? Did I forget a deductible? Like, maybe I incorrectly, like, wrote something off. So that baffled me that like 80 to 100 hours a month, depending on the volume of practice, goes into the process. Some have it slightly, like, digitized, where the money already comes into the bank account. But then you still need to go to the Delta dental website, download 200 pages in the PDF, and then go to town. So that's where it begins. And then you're not done. That's 80 to 100 hours. And then you need to spend 30, 40 hours a month on billing the patients because then you have a long list after you updated all the insurance payments with, let's say, 200 patients that then need a statement. So then what I had to do is review all these balances to make sure that they're correct by hand. So that took me a couple of hours. Then I had to manually generate statements, then sent these statements to the patient. That wasn't really like a clean way to kind of like, for a patient pay. So then they called me up and then I had to basically take that credit card and run that to like, the credit card terminal or they send a check into the office. So, yeah, that were like, what is 120, 130 hours in? I didn't do that alone, obviously, but with like, other people. And then you're still not done because then you need to run payroll most of the times. Right? Because. Because I think part of the DEO teachings is as well, that part of the compensation for the doctors and the hygienists is based on the actual production. So I have to figure out, okay, all my patient payments are now in. All my insurance payments are reconciled. And then they have spreadsheet because they need to figure out, okay, Dr. Jake, out of that production from last month, like, did 10% of it, and then Stein did the rest. And then I was like, this is crazy. And I thought, yeah, we should automate, almost like all of that. Yeah.

So was your mind just blown? You seem like a pretty measured guy. I don't know how excited you actually do get.

Oh, I can be a hype man.

Okay, was your mind just, like, blown? What you just described, like, you said you could probably find in the 1970s, right? I mean, yeah. Envelopes reconciling into. The only difference is you have a computer instead of maybe like an actual writing book that you could be reconciling to. So were you just like, okay, you're starting to get excited by now. I mean, this is a huge, huge, huge problem that you're seeing.

Yeah, yeah. And then two things I wanted to validate is like, Dr. Kwan seems a pretty tech forward. Doctor. Is it, is it, Is it him? Like, if I go down the road, like, do they have this, like, solved? So then I started looking into the numbers and we already mentioned caqh. Like they put out a really good report and at the time it was above 80% of the practices. Like do it like this way at best. Let's say they have a Delta dental website set up but like it still takes hours and hours and hours to close the books. I'm like this is wild. So then what I started to do, what you typically do in technology is like why is this not solved, right? Like why didn't someone else kind of like do this? And then we discovered Frederick, my co founder and I, he worked at Uber, he's software engineer by training also pretty measured mind as you can imagine. So like we together then figured out, yeah, it wasn't possible a couple of years ago. So there is a valid reason why it couldn't be solved because getting all these payments to come in digitally and not come in in the mail anymore just wasn't an option. And then a law passed, a federal law, the government stepped in basically now about 13 years ago and they said no more paper payments. People like you have to move to digital payments, to digital invoices such that computer in AI can read these things.

This is to the insurance companies that they're mandating mainly.

Yeah, and they obviously wanted that too because they spent a lot of money sending all these paper checks. And guess what, there's embezzlement happening with these checks because they get lost in the mail or they get lost in the office. Right. We know that's a real problem too. I think the ADA put a stat out that like embezzlement rate is like 7 to 10% of the payments every month. Like are uncategorized. Like we don't know like where they are basically. Yeah, yeah, that's what accountants also tell me. They just like write it off because it's not worth pursuing. So yes, like the insurance companies, like we're glad to adopt that because the all the operational costs involved in sending these papers, let alone the phone calls that go back and forth about EOBs and payments. Right. It's quite real how many times I had to call the insurance because the EOB wasn't clear or I didn't know where my EOB was and then I couldn't update your, your ledger and I couldn't send you a statement. And indeed 10 years later when we started exploring this because between a law being implemented and all insurance companies basically when you request a digital payment, it also offering to you. That started happening like around the time that we started like, working on this. So we said, because after I work 9 to 5 in Dr. Kwan's office, I said, hey, I think I can solve this, but I need to run this AR process myself, so can I come do that? And then we just started tinkering like I think any entrepreneur would do. Like, we would call up Delta Dental and request, hey, no more paper checks. Can that go into the bank account of the doctor? And then within a couple of weeks. Indeed, that worked. So that wasn't easy because it would take 50 to 100 hours if you want to do that for all your insurance companies. Because it's not standardized. Right. So it's not. There's one process that instantly enrolls you in digital payments, but we're tech people, so we started figuring out all these enrollment paths and then as we are, started automating that as well. So, like, we don't have to do that manually anymore. And then we realized, yeah, it's possible to get these digital payments and it's possible to get the eobs also in electronic file format. And then we started training a computer to, like, read all these EOBs electronically and started learning how to post these payments like an office manager would do. Because I did the job right, so I knew how these payments needed to be punched in and reconciled. And then we started training software to basically take what's in my brain. And we did it with a few other offices and trained the computer to kind of like do that. And then obviously it's a lot better because the software is never sick. Right. Like, it's very accurate because it's typically doesn't forget a deductible. It's very normal for me as a human that if I need to do that 200 times a week, that I make mistakes. Yeah. That's how this started.

Yeah. Wow, that's amazing. I mean, I can only imagine, you know, what you were, your eyes that were becoming wide open as you're going through this. So the big unlock, though, was the insurance company starting to digitize themselves, and that puts the data out there so that you can go in and, and get it. And then at that point, you recruited a business partner because you knew that you decided, I'm actually going to tackle this. I'm going to solve this problem.

Yeah. That's why we spent about a year doing research and just working in practices and talking to doctor offices and being one of them ourselves. Right. Because I wasn't from the industry, so I had to learn the job. That's how I'm Raised and you got to figure out what it's like to do the dirty work, if you will. So we can empathize really well. But at the time, like Frederick and I, my co founder, like I said, software engineers, he could build things. That was enough. So the two of us just started for one office. First it's like, hey, can we automate all the delta, like payment processing? And then it was basically, what is it, maybe 90% me and 10% the software. And then over the months it went down to me doing nothing anymore. Right. Like all these payments go straight into the bank account, like we can read them to see if they actually landed and then go straight into the practice management system in exactly the same way, like with write offs and adjustments and notes, as if I were to do this. And that's how we did it. So it just like went down from me doing everything by hand to then slowly but surely like fully automating it until everybody was like, yeah, this is exactly how I would do this. And then we started doing the next insurance company and the next insurance company. So then Cigna came online and Guardian came online and MetLife came online until, yeah, almost all insurances were figured out. And then we recruited engineers because we're in the heart of Silicon Valley with this company in San Francisco. So we have team members that they worked at all these companies that you have on your phone, like DoorDash, people that worked at Robinhood, at Coinbase, at Uber. So yeah, we're used to tackling these problems. And then we added more and more people that could help build the software.

Yeah, yeah, I mean, I love that you're also in Silicon Valley. I'm just imagining, you know, like Uber employees, you're like in this office next to Uber, next to Coinbase, next to Doordash. And then there's like lastly, the dental eob like insurance company. Are folks in Silicon Valley and your friends and all your buddies, are they also ever thinking about solving problems in an industry like dental? Because you naturally think about these apps on your phone like you said. But there's so many problems in a dental office or a medical office or a physical therapy office. Are they talking, are you guys talking about it a lot or like, what's the.

We made them talk about it.

Okay.

Yeah, because it's for them a really cool problem to work on. Like indeed. Our friends, they, they work on ChatGPT, right? Or they, they build self driving cars that you can actually take already now in San Francisco. But they found this problem fascinating too because what if we can help a million doctors and hundreds of millions of patients every year that pay their doctor to do that, like, with a platform that, like, you can just use maybe for two hours a month, and then you're done, right? Then all. All the EOBs are processed, all the payments are posted, and you can focus on the. Even the denials, because that's where we're going next. Like, basically, if a claim gets denied and with AI Auto filing that, like, for you, so you can literally focus on growing the business like every business owner in any other industry now does, Right? All your time as an entrepreneur goes to, in this case, the patients. And let's grow the practice. Let's. I always joke because I love your. Your lectures at the DEO and your content, but I always walk away. They're stoked about, like, yes, I'm going to try all these things and all these playbooks, and then reality sits in on Monday because there's like, the grind of actually doing the admin work. So if we can get that out of the way, and I'm confident we can do that over the coming years, you can actually go home and say, hey, how do we grow the practice? How do we start an Invisalign program? How do we start an extra operatory? So that thinks for me the most exciting part, that you can start growing your business right now. And that excites a lot of people in Silicon Valley because AI plays a big role in this. So where at Robinhood, we needed, I would say, maybe a thousand people to go to a public company. Like, I think we with AI are one of the first companies that can automate a lot in our sales processes, in our engineering work, such that maybe with 200 people, we can serve thousands and thousands and thousands of offices, which that is very exciting for Silicon Valley people. So we're not working on the core AI technology because we use that, but the fact that you can apply it on a problem like this is, for engineers, super interesting. Or for salespeople, very interesting. Yeah.

Anywhere where you're just taking data from one spot, humans taking data from one spot to another spot, I imagine your eyes light up as an opportunity. And like you said, a lot of people feel uneasy about some of these technologies because they're so efficient. But like you said, when we have a DEO event where we kind of help dental organizations learn how to grow and build Systems, we give 10, 20, 50 different things that a group could do on a Monday morning.

You got it?

Guess how much they can get to.

Yeah.

Not a lot, because they're doing 10 hours a day posting EOBs and doing, you know, all this manual work. So if they could, you know, release that, it's not like they would need less people or less work. Yeah, they'd sort of work on different things.

You got it.

So there's a lot going on with you being able to just divert energy, really.

Yeah. I think it's a very good point to emphasize because we see this really as giving people superpowers, right? So, like, because I empathize with that, right? Like, if I worked in a practice and I would be initially pretty scared if I work in that office and say, hey, like, the AI or the computers are coming here to help. And there's initial reluctance, the same way as I imagine back in the days when people did paper charts, I heard all these stories and made appointments in a book. And then a practice management system came by and they were like, ho, ho. Like, is this really, like, working, etcetera? Of course it is. And that, like. But initially, like, I understand why you're a little skeptical. And that's what I've seen across hundreds of offices. Like, it is giving people superpowers. And, like, initially there might be. And that is an important lesson that we. We have to help the teams and the doctor, like, to coach the team, like, to this process of, like, hey, tell your team members. This is to give you superpowers, right? Like, we want you to do all these growth tips and tactics that, like, you learned at the eo. You don't have to be afraid that your job is on the line. That's exactly what we've been seeing, because it does give superpowers. And then what you see happening a couple of months in people when they, like, move offices, they actually then take lessee with them, the staff members, because they can't imagine a world where they actually have to stay in late, come in early. Because that's the reality, right? Because especially a lot of the driving officers, they are hundreds of thousands of dollars behind because they're having so much volume. So all the staff members are pretty, like, stretched thin and feel almost anxious or sorry to go on a vacation, because when they then go come back from Hawaii, there's this, like, stack of paper waiting. And then if you don't process the insurance payment, she can build a patient, she can run payroll. So I think that the fun thing is that a couple of months in, yeah, everybody almost is like, oh, is there a world without it?

Yeah. I mean, you see this with a lot of technology adoption. It's just, it takes a while for people to get used to it. Yeah, I think I just, you know, I talk a lot to some of these AI X ray companies inside the dental as well. Right. Where five years ago, six years ago, I think a lot of the provider dentists were worried that that was going to take the spot, the place of them. But what they're learning is it's just a tool to actually give them a superpower.

Yeah.

So a lot of these technologies ChatGPT as well. Right. Two years ago, what the heck's going on? Now all of us just use it to make ourselves better in the job. So that's the same thing here. So I think it's important that people know that that's where they're going. So I'm curious, as you see the opportunity, you call up your buddy, you get out, you're telling everyone, hey, I got this crazy thing going on here in this, this thing called dental. Where were some of the challenges you started running into? So how many insurance kind of portals and insurances were you dealing with? And from what we've gathered, it's not, it's not as easy as it might seem to pipe in there and get that information should be, but it's not. So what are some of the challenges?

I mean two things you need to have. Because like I was fortunate and lucky to be part of other big breakthroughs and innovations. Right. With like Coinbase and Robinhood, it follows kind of like a similar like model where you need a really good world class engineering team. So like you are correct that setting up all these digital payments, getting the correct EOBs, reading them in the correct way, writing them into the practice management system and then in real time checking what is in the bank matches what's in the, in the, in the practice management system and matches what comes from these insurance companies and then accurately being able to give people to do lists of like here are the patients you need to bill requires world class product management and engineering work. So I think that that's why the people that are in our team could have worked on these companies. So the people we recruit in 10, 15 years from now, they are unstoppable. They're really fun to see them solve these problems. So I think that's one part I got lucky that my co founder is an exceptional product leader and engineer and we assembled a team of people that are really, really good. So I think this is fairly hard engineering problem to solve to get the data correct and then build great products because we work with people that are very busy. Right. And you know that like most offices, they already are glad that they made it till the end of the day because they run a small business. So you need to build software that's very easy to use. Right. So like the dashboards need to almost feel like you're using doordash because there isn't much time and there's stress and there's patience checking out. And so like that's one part and then the other part. Yeah, you need to be able to be good in understanding the needs of a practice. And that's why I myself flew to the first hundred offices that we onboarded together with Frederick and Jeffrey, the founding engineer, because we really tried to understand what are the problems you're facing, how does this fit into your existing workflow? Because Lessee initially only did the insurance EOB posting to make it a really good product, we skipped the rest of the. And that really taught us like how to do the intake conversations, how to together discover is this a good fit or not for your practice. Right. And you need to be world class in that as well. And I got lucky that I worked on growth for the past like years. So I knew that a referral because I worked on Robinhood's referral program is the most valuable and fastest way to grow. Right, because it means that you like Robinhood, that means that you want to tell your friends about it. So I figured out fairly quickly, Jake, that if you make one doctor really happy because the product works and that's happening in your community too, where people actually say it's not unhyped, it is actually working. I figured out that that is the way to go. So we built that strategy out of like let's do an epic job in the next onboarding we do and be fairly meticulous in the onboarding calls and straightforward and say, hey, tell us what your setup is and then we will tell you in exchange. I think we're a good fit or not right now. Maybe we should wait six or 12 months. And figuring out that puzzle requires also really, really good salespeople that actually want to help you and are interested in building a long term relationship. So I think getting that right was the second part. And then you win the trust and then you keep on doing a good job. And that's how we got so far and will grow fairly quickly to thousands of offices like next.

So give me in layman's terms exactly kind of what you're. So you're going into the insurance portal Yes, I guess there's a few systems, right? There's the practice management system, which you're getting the name, you're going in the insurance portal, your bots and your technology is going there, finding that patient, finding that record, matching it up, then going into the bank to match up as well to make sure. So maybe give us a layman's overview.

So it starts first with getting rid of the paper payments, right? Because most people still get quite a lot of paper checks from insurance companies going into like the office. And then with these paper checks come these stacks of like itemized invoices called EOBs. And the first thing we do, because there are three steps to get all of the AR automated, is getting rid of the paper checks. So what we do basically is like we do an intake conversation or an onboarding and we basically get all the info we need from a practice because we learned we should do that for you because it's a lot of work and very tedious. So what we literally do is we get the tax ID number from a practice. We get like a void check of the bank that they want the money to go into, just all kind of stuff that we didn't take. And then we go to work behind the scenes and making sure that like weeks later, for the most part, the paper checks don't come in anymore, but the money comes straight into your own bank account. So everything is there. And that's why many people say, hey, after I implemented this, all of a sudden my money moves four times faster.

So is it safe to say everyone that comes on board with you are getting paper checks or some people already a little bit down the road there.

I still have to meet first practice that's actually fully paperless. Yeah. Now you see more and more adoption of efts, right? So like, typically for the bigger insurance companies, like most offices have already set up this. They have set up EFTs. They then still have to go to the Delta Dental website and download ubs. But I would say almost every practice that we onboard still has paper checks or something worse called a virtual credit card. And for those of you not familiar with it, what they do is an insurance company sends you like a piece of paper with a credit card number on it. You'll have to run that to the credit card terminal to cash it. And then you pay the merchant fee, which is typically multiple percent. So almost every office still has that. And then the first step we do towards automation is the grunt work to kind of like get rid of like that for the Most part, the industry is in a, in a, in a state where there are maybe a handful of insurances that are not compliant with the law yet. So like there will be a very tiny stack left even after we like went to town, if you will. But like for the most part this is a solved problem. So that's step one.

I mean, by the way, just that, just that. Making the world a better place.

Yeah. Right. Definitely. One tree at a time.

Yeah, yeah, that's, that's just, I mean that's a whole problem in itself. That's just phase one. That's just step one.

And that's why I'm also back to why people in Silicon Valley so excited, I care more about like why like our customers are so excited. Right. For people listening that like I laugh, that I keep on hearing, this is a no brainer. I think we can all be proud if like together we got rid of all the paper payments and that, that we've done something similar. And I think that excites a lot of people. Yeah. Because it was not that long ago that paychecks all came in on paper. And now for 90% it's kind of digital. Right. But that's a solved problem. Cash like 90% plus of the people pay like digitally right now. And we're in the same spots that we can do for this industry where it was for 80% on paper. And when we're done, we kind of laugh together. It's like haha, remember the days that like we opened envelopes, we cashed checks in the bank account and then like you know, spent hours and hours moving the paperwork around. Yeah. So I think that alone, I think one of the reasons why I'm so excited to like get it done together is that for starters, because we can later say, okay, we got rid of this stuff. Yeah.

I mean just. But wait, there's more. Right? Like that's enough right there.

And that's step one out of three. What's next? So the next step and that because to your point, some offices have already set this up, but you will be surprised if we do an audit. And still hundreds of dollars are spent a month on virtual credit card fees or sometimes thousands of dollars. So like that's step one, step two, and that's where most of the work like needs to happen in a practice is then okay, the money is in the bank. But that doesn't tell me like let's say $10,000 like which patients got paid from their debt. Insurance company reconciling the reconciliation. Yeah. Or The EOB posting is I think the slang, like four days. But I promise layman terms. So like, and what the insurance company does is like they send you an itemized invoice, if you will. So they say you got $10,000 and here are 200 pages of explanations, explanation of benefits that will explain who got paid what amount of money. So you got basically $10,000 check. And then 200 pages of like itemized invoices. Good luck. And then what you need to do for the most part, and some have this partly automated, but it's still hours and hours and hours of work. Then I have to go into, let's say dentrix, right, the practice management system. I have to look up Jake. And then, okay, Jake came in three weeks ago. And then I need to like update like all these like numbers. I need to say $31 for the fluoride treatment, 80 for the propy. He did not got paid out for whatever the exam or something like that. And then you need to do write offs. We'll skip that part for now. But like you spend five minutes, basically 200 patients is like a lot of like hours of work. And that is where the most like hype I think is right now, where people are most excited that we got that done. We get rid of that. So the second part, what we do is not only make sure that the money goes into your bank account, but like we are able to get these itemized invoices, these EOBs, like electronically directly from the insurance company. Right. So we either get them to an insurance portal, like to a clearinghouse, like sometimes directly from the insurance company. At this point in time, we're so sophisticated that we get it from as much sources as we can. And then what we do, and this typically is a couple of weeks after we do that onboarding, then the first electronic EOBs are starting to come in. They're called ERAs, Electronic Remittance Advices. And then what we do is we trained together with the office. So like it's not us. That's the thing. Cool part. You can customize this. We then ask the office, like, how do you want these payments to be entered? So like how do you have your ledger set up? Like do you always write off a fluoride treatment? They teach us the rules that the people in the office currently use to kind of like square out all these ledgers and you can fully customize that. So we don't have an opinion about that as long as it's within the requirements of the contract. You have with an insurance company, because we obviously don't want to do things that are outside of the terms. But you can customize it the way you want. So basically you're training the AI in the software to do what you did by hand updating 200 ledgers in exactly the same way as you did before. And then you shaved off 60, 80 hours a month on dirt because you don't have to do that anymore in real time. All of a sudden all these ledgers are up to date. So if you walk in in the morning, then like, yeah, you have everything like squared out, basically. So I think money is then in the bank, all these ledgers are updated. And then the software these days is so sophisticated that you can also run a constant reconciliation to make sure that the $10,000 in the bank matches everything that's like in the, in the system.

Does it ever not match up?

It does. And then in that case, like, we will flag that for the practice. So that gets into where you can start applying the lessons or managing your business, if you will. So we set up a dashboard for all these practices and that's then the third part of this process. So step one is you roll them off paper payments, money goes into the bank. All these ubs come in electronically. We together train the software and we're known for going at great length, right? So sometimes this takes weeks if you want to spend months customizing the software. And like, we're, we're fine with doing it. And then that's like automated. And then the third part is we then start building to do lists for you so you can start optimizing your practice. So we can, we say, hey, Here are the 10 patients that got a denied claim and we think that you should appeal it because the crown got denied, because they want an X ray to be like uploaded again. And then the team finally has time to, to kind of like do that. Because that's typically one of the first things that go out of the door, right? Like you are already lucky that you processed all your insurance payments, got everything cashed. There's not that much time to appeal to any claims. So then we started automating that too. That like a practice that every day can go see a list of like, hey, here are extra revenue generating opportunities. Here are patients that you need to send a statement. That's all automated then as well. So that's the current status quo. And then the cool thing is this is just the beginning, but we can

go there like next, how many insurances were you dealing with? How Many different. Because you have to do a custom kind of software. Custom. As you built this for every single insurance.

Right.

So how many were you working with?

I think we automated this process for by now tens of insurances we have almost coverage for. I would say like 80, 90%. Depends on the practice. Right. Because as we know across the country, each practice has a different insurance mix. But I would say on average you can go from everything done on paper every month and being behind on AR to like for 80, 90% of your insurance AR, like being your money is there within days, so four times faster and all your ledgers are updated and you literally get to do's to do to like manage to practice. Yeah. So it's small stack left.

Were there any that were harder than others? Was it like. I mean, because I actually. Were there some that actually gave you a hard time to even get in the system and communicate with them?

Not really. Because by law they are required to offer a practice these like digital EOBs, right. And the EFTs. And we're helping after all everybody, right. Like the doctor can get their fun back and like their team back to do things that they need to do. The patient benefits because they get quicker and more accurate. Patient bill, which is one of the next things we're working on is why not the most requested features, like don't tell me, the 20 patients that need a bill generate 20 statements. Do that in plain English with AI because we know all the codes. Right. Our software understands all of that. You can send a link like you would do with Shopee or with like a Lassie app and then right away pay the patient. But insurance companies benefit from this too because the phone calls are gone, the paper checks are gone. So like we so far had not that much like issues like getting that like information. Some insurance companies are just behind. Right. Like they do not have the infrastructure set up or in the early years. And that's getting better is the quality of the actual EUB is not like good enough. But we're currently at a point where it's by any standards 10 times better than people doing this as an alternative.

So there's probably a lot of tech challenges in all of that, I'm sure.

Yeah, that was a whole podcast series, weekend records and all the technical challenges we have to overcome.

Give me, give me the juicy stuff. Give me the hardest thing that you solved and give me your low point where you're like, I don't, I don't know if you ever thought you weren't going to be Able to do it or like where it was like, this is so hard. Why am I even trying this?

Yeah, it's a good point. I mean, every entrepreneurial journey kind of like has like highs and lows. Right. And you need to be slightly delusional like many people listening to start a business from scratch. Right. So I feel exactly the same as many people. I think let's start on the technical challenge. Like the hardest part to solve is like train the computer to like post and reconcile payments in the same way as someone in the office would do. Like that logic, as we call that is just like tremendously complicated to do because as many people know, it is actually a really complicated job to square out the payments correctly. So that was the hardest part.

Is that on the level of the stuff you were working on Robinhood, that's how hard it was. Was that kind of.

Yeah. Or another example people might know of is like Stripe as a company. That sounds from the outset very simple. But like building Stripe and getting all the nuts and bolts right is really, really hard. And I compare ourselves often to Stripe also because their business works very much the same is that all the invoicing we do at Lessee, like Stripe takes care of us. So like the bills that you get from Lessie for your fees are processed like by Stripe and they compute also everything for us. They keep all the credit cards on file. And your bank that you connect to, like classy to subtract your monthly fees. It's all outsourced, like to Stripe and we pay Stripe, I think almost like 3% every month. And I'm gladly doing that because imagine that at this point in time, I need an AR department to send out all these monthly statements, chase down all the payments from all of our customers. It's not really like worth it. But to get that right, the technology such that it works flawlessly is like really, really complicated because multiple bank accounts are involved, like anyway, like a whole like can of worms we can open there. And yeah, it's similar level problem. I think reconciliation is a very hard technical challenge because it basically. And we're not like 100% like there. Right. But like there is no office in the world that has it figured out with humans. But like in real time, everything that's in the bank account matches what is in your practice management system that comes from insurance companies and then soon QuickBooks as well. These four data sources that are always matching. It's just a really, really hard, like technical problem. Yeah, so.

So what about your low point?

Yeah, I mean, it was not on the tech side, actually. I think it was mainly like, any business, like, finding the first people that believe in you that say, I know this is coming and I am proudly being number one or number two or number four. There's a lot of work, and I don't blame the people. But, yeah, you need early adopters that say, I want to do this and I believe in this. I think that took me a long time to figure out, kind of like, okay, how do you win the trust of the first group of doctors? And then I knew that when we had their trust and I knew that the product would work, we gave them the product, they would tell their friends. And I think that is the hardest part. Yeah, yeah. I kind of.

I'm just laughing in my head. I mean, you got to recruit the doctors as clients and customers, but you have to recruit the engineers. And so you're going to your buddy who's working on doordash, and you're like, hey, I have something way cooler.

Yes.

Insurance EOBs with dental offices. And so.

But.

But as you probably explained it, they can see that there's a lot of opportunity.

Yeah. Because for them, the way, like, we see it is like, look, there are a million doctors in this country running their own business. It's the second largest group of small businesses in the country, and I would argue more important than the coffee shops or, like, you know, like, mean, I love coffee because I'm European, so I love coffee. But a doctor office is more important, I would say, than a flower shop or a coffee shop. And these people, they run the business like it is the 70s, and, like, we can build a platform for them that, like Shopify did for the surf shop, like Square did for the coffee shops, that helps these businesses with tools to run it in two hours, 200 hours. So I think that also took some time. Like, I think most businesses, you have to figure out, like, the pitch, but once we figured out, like, how to tell this story, the smartest engineers and, like, people on the business side were like, yeah, indeed. Yeah, this is indeed a massive opportunity. Yeah.

I think that's the coolest part, is there's a sense amongst everyone in this dental industry and folks that are working in offices. You know, we have all of our phone and we have Amazon and we have all this really crazy tech. We chatgpt and then, you know, everything's so advanced. And then we go into the office and. And we're like, this doesn't make any sense. Like, I just need that website to talk to that website and it would save me like three hours a day. And so there's a sense that, you know, we should be working with better technology. And to see that folks like yourself are coming into the industry and actually solving the problem, I think is really exciting because there's tons of examples of this kind of archaic process that's happening right now.

Well, and I think, don't undersell yourself, Doctor, because you're running a really cool business where you have, like, hundreds of people that come to you every month that, like, you can send away with, like, you know, something very special that is more valuable. Again, I love flowers. But, like, you know, taking care of people's health is something very noble and special and people pay for that like, every month. And it's a good business. Right. As we both know. So if you're owning a practice and you do a really good job for 20, 30 years, you can run a very profitable organization and leave your next generation with a network that's decent. So I think it's also really cool that these people run their practices. And that's also. You asked, what are the other motivations? Yeah, it's a cool problem. But I also love. My grandfather was a small business owner. He was a butcher, so no dentist. And I'm a business owner myself. And I think it really sucks that doctors don't have tools. And I think it's really cool that we built tools for a million doctors. So they can, if they want to, remain independent. Right. And if they say, leo, I want to serve my community, I'm just going to run it by myself and I can do what I'm trained for, which is the patients or I'm interested in the business. So let me actually work on that. So I think personally, they don't have to undersell themselves because they have run a pretty cool business.

It's very cool. And let's not forget what we're talking about here is, you know, the financial aspect and just collecting. But these are dental offices, actually. They're made to give treatment. Exactly. So, you know, a lot of the dental entrepreneurs and the owners of these organizations, they have to perfect and master dentistry or they have to master teaching other dentists how to master dentistry and then go in and try to figure these tech problems. This shouldn't be anything that we're worried about.

Right.

The tech stuff should just be taken care of. That way we can focus on giving quality healthcare to people.

And the cool thing, Jake, is that in four or five years now, because I'm doing this now for a couple of years. And I'm actually getting more and more optimistic how close we can get to two hours, not 200 hours a month. That sounds maybe like a crazy idea, but I would argue we already are doing it for 800 hours a month. Right. So we're well on our way because what we just talked about, the insurance AR process for the most part is automated, that there's 100 hours plus to go. But like, I'm pretty optimistic that. Because what is left, right, like patient AR and statements that we can get that down, that ballooning number. Right. And the time it costs to collect patient payments is going to be half an hour a month because. Yeah, the cool thing is with software you build a platform. Right. So this, this is the first step, but it's very easy for us not only to compute what patients owe bill, but let you quickly send out 200 statements and store the credit cards on files so you don't have to constantly ask for these things. Update the practice management system the moment the patient pays, send reminders with the software. So that's kind of safe. Like 40 hours payroll, we can start running automatically. I think we can also start similar to what Square did, like provide working capital to grow quicker because we know the insurance ar. Right. And the patient AR give them analytics and insights. Because we process the patient payments in the insurance ar, if we build out the full toolkit, I'm pretty optimistic that all the jobs that are now done by the staff, but don't forget also the owners because you all are also often involved in the reconciliation process and bringing things to the bank or looking at appeals or signing off on patient statements. So payroll. Right. Like a lot of work for most people, I think we can. This is just the beginning because we tackled one job and we obsessed over that to get it right because that technically was complicated. But yeah, especially with now this platform built and trusted by thousands of like doctors across the country. The next step is roll out these, like other tools over the coming years.

Well, that was going to be one of my last questions, which is what's the future of this? So it sounds like you're just going to keep going down the line of those jobs be done in this entire process. Anything else that comes to mind? I mean, there's just so much opportunity to streamline for a lot of the jobs out there inside of the, you know what we're doing.

Yeah.

What else comes to mind as far as the future of technology inside the dentistry?

Well, I would say we are as strong as our Last onboarding. So I think we're still very much focused on making sure that we get like 10,000 offices, like, help, 10,000 offices. Like getting this process, getting rid of the paper, right. And setting up the software. So that will remain like our main focus to getting that right. Because that's what we're known for, right? And getting the support you need because it's the same as working with anyone else. Like, you need to implement the software, but like you need support too, right? So people will need to pick up the phone and we have WhatsApp group set up with people and people can email us. We're known for like that. So our laser focus for now is getting that right. And then we talked about, like, patient billing will be automated for the most part, like payroll. But our goal of this company ultimately is to do it for any type of doctor office. So if we succeed, a million doctors can run on Lessie and 200 million Americans pay their small practice or their business like through Lessee in a very, like, simple way. Like by using the Lessee app or getting a link like you would get with like Shopee, for example. So if we succeed, like, that's the end goal or the mission of this business. That doesn't matter what type of doctor you are. If you in five to ten years from now say, like, hey, I want to run my own practice. It is as simple and easy. And I also, like Frederick calls this often fun as well. Like, people need to have fun at work, right? Like, you spend so much time there. But like, if that's. That's I think the end goal of this business. And yeah, that's going to happen. So I think that the best analogy here is Shopify. I, out of college, started a website where we sold suits and ties and shirts on the Internet. So I ran an E commerce store. And that was quite a lot of work, Jake, to have the product shipped from Italy to customers all across the world. And you have to compute taxes everywhere. And you had to build pretty complicated software to make that all work in the back end that people with one click of a button can kind of like order things. And Shopify made that kind of like, available to anyone. Right? So you and I, whatever, we start a. We decided to quit dentistry and we start a surf shop together in like Venice Beach. Like here. We could tonight spin up a website and then like start telling and then the software will take care of. Okay, we want to ship the surf pro to Germany. Like, we're not having to compute taxes anymore. And that's currently the case in dentistry. Right. Where people actually need to know what our write off is and then adjustment and kind of like all that stuff now happens with people and I think we can make it a lot less, like, a lot simpler. While maybe that's the last part here, the practice should be in control, right? So we don't want to have the final say which patients need a bill, how you ultimately want to run the books, right? I think that's still up to the practice, which, like, so our goal is not to, like, put it on autopilot, as in you lose control because you don't want to randomly bill patients. For example, I wouldn't want to get a bill at home that's like, incorrect, but, like, cutting it down to half an hour of work instead of 40 hours of work, like, is. Is what we're going after. Yeah, yeah.

Well, on behalf of all the people who had to open those envelopes and painstakingly and still are painstakingly, you know, reconcile against, you know, online portals and whatnot and the doctors who were, you know, getting embezzled and spending time, you know, tracking down money and lost checks, all this just is kind of madness. And 10 years we're going to look back and just be so surprised.

We were laughing.

We'll be laughing. So on behalf of all those people, thank you for tackling this problem in dentistry. And, you know, as somebody who helps these guys and gals grow and learn, I just think it's so cool that the industry is finally getting that level of technology where we can say we have the engineers from the doordashes and the Ubers and the Coinbases and the Robinhoods working on our problems. Yep, it's. It's very exciting. So it's just the beginning, like you said. So thank you so much for your work.

Thanks, man. It is really a joy to serve all these people is like, I get most joy about visiting these customers and they text me things that it changed their practice and it made their business easier to run and more fun and the team members having more joy. That's why we ultimately do this. Right? This is where we started this. I came to America to solve problems. And seeing that, like, actually in action and getting the laugh that I see for the products we build is at the core all that matters. Like, if we don't build stuff that people truly love to use, like, it wouldn't be so much joy. And I see that every day. So, like, yeah, you will hear from us quite a lot over the coming years. And I'm super excited to, like, help with this.

Well, check out Lassie.

Thank you, Stein.

And this will not be the last time that we see you.

No. Thanks for having me, Jake.

Thank you for listening to deo's Growth Secrets podcast for dental organizations. Continue the conversation on our Facebook group and meet other dental leaders. Get questions answered and the strategies you need to succeed. Plus, we have some free resources for you right there on the Facebook page. Remember, you're not alone. Let's do this together. Join DEO's Growth Secrets Group on Facebook. And until next time, keep smiling.