Outsourced Insurance Verification and Billing Everything You Need to Know!

Hey, dental associates and new practice owners. Welcome to the Associates on Fire podcast. Powered by Practice cfo. This is the podcast that teaches you what you never learned in dental school, the financial side of dentistry. We cover topics from planning for ownership, buying a practice, to student loans, taxes and all things financial for the hungry to learn Dental Associate. So let's light it up.

Welcome everybody. We've got another episode of the Associates on Fire podcast. And just a quick reminder to everybody about our resources@ass Associatesonfire.com we have here at Practice CFO. If you don't know us, Practice CFO is a nationwide dental CPA and financial advisory service, an outsourced CFO service for dental practice owners and aspiring dental practice owners. And we created the Associates on Fire program as a free education platform for doctors with a special niche in a lot of our content for the aspiring practice owning doctors, that's associatesonfire.com, we've got about 20 hours of video on all things business for dental associates what they did not teach you in dental school. And then we have our podcast series, which today is another episode of that series. And then we even have free downloadable resources to help you, like checklists and timelines and other very valuable resources we have created in working with hundreds and hundreds of associates and practice owners, particularly around the transition process of buying a dental practice. And by the way, everybody, there's a lot going on in the landscape of student loans right now. Moratorium ends in August. This is 2022, August 31st. So gear up for your student loans to now be withdrawn your payments from your account again by the loan servicers. There are a few big things going on right now called the PSLF waiver and the IDR waiver. In our next podcast, we're going to do an episode specifically on what's happening in the student loan area. So very, very relevant information there. There's a lot of changes with the, with the student loan servicers taking place right now. There's that's creating some confusion and letters in the mail and what's happening with the servicer of your student loans. If you want to learn more about that, please tune in to our next podcast episode where I will be covering that for you. Okay, today we have a great episode. I'm highly anticipating this. It is on the subject of billing and in particular outsourcing your bill billing in your dental office to a third party. Now, right now, most of our clients practice CFO works with about 350 dental offices. Most of our clients have their billing in house Meaning that your front office team is handling all the EOBs. They're working with the insurance companies, they're collecting the money. There are some practices, and I think an increasing number of practices that are outsourcing that to a third party who knows how to do it very well. And they're paying a service fee for that function. And today I have with us Cosentis. And Cosentis is a consulting firm. They do a number of services, business consulting services. Well, one of them that they do, and they do it quite well is outsourced billing. Let me emphasize why this is so important, this subject. Consistent cash flow is the lifeblood, lifeblood of the practice, finances. It's like the great river that feeds the cities along its path. If there's disruption to that cash flow, it can jeopardize the key business functions like payroll paying vendors, practice debt, taxes, funding a retirement plan, and most important, paying the doctor. So it's important practice owners collect from the insurance companies and that and the patients effectively. So in this podcast, let me make an introduction. We've got all. We got three people. What an honor have three people, all with Consentus. We have Alex Gallup. Alex is a senior business consultant. He provides they. Consentis provides what we call revenue cycle management services. That's going to be a theme for us today. He also is a podcaster himself and a podcast called Kick, Push and Pivot. I've listened to some of it. It's some exciting content. We've also got Philip Bridges, who is also a senior business consultant with Cosentis. And then lastly, we have Kristin Garduno, who is very much in the trenches day to day overseeing a team of billers who provide that outsourced services to dental practices. Welcome everybody to the Associates on Fire program.

Thanks, Wes.

Awesome. Thanks for having us. Thanks, Wes. Happy to be here.

Why don't we jump into the subject at a high level this term? This is very much a business lingo, revenue cycle management. Tell me, what is revenue cycle management?

Yeah, I can take that one. And you touched on it a little bit there at the beginning, Wes, but you mentioned billing and outsourced billing. And actually when people think billing, it's probably what they're thinking of, more of a, a holistic thing with the whole revenue cycle. So when we talk about revenue cycle management, it's just the management of the revenue cycle, which is broken down basically to mean starting off with insurance verifications, going, moving into coding, then moving into essentially the billing and sending out the bills, collecting on those from insurance Companies posting the payments afterwards and then of course following up on the accounts receivable and denials and things like that on the back end. So that's kind of like the front, middle and end of a revenue cycle. And you know, historically I think that practices have had people in house to manage that. But I think more and more people are moving to services like ours that are using external experts encoding and billing to handle that for them both as a time benefit and just as you know, to just move that responsibility off so that they can use those internal stuff for, for other purposes. And also to collect more money ideally.

And to collect it timely I would say is a big function is that a lot of times I think dentists and a lot of small business donors don't fully understand how critical it is to collect timely. Now in sort of corporate world you have this thing called 2net30 I think it is where you basically give a 2% if you, if the vendor pays or the customer pays within 30 days and they're willing to give that discount because they know how vital it is to collect money on time. It saves in follow up time on your team and the sooner you have money in the bank, the sooner you can do something with that. So if a. So safe to say an effective revenue cycle management is collecting that money as quickly as possible to then channel it through all of the needs of the practice and ultimately ideally to support the doctor's lifestyle and their retirement plan. Okay, let's talk about insurance verification, which is one of those steps of the revenue cycle management process. I have some practices, it seems like, that do it and I have a lot of practices that don't necessarily do that. If I understand now, I'm not in a dental office, this is outside of the scope of what I, what services I provide. But you're basically verifying with the insurance company what the patient is eligible for before they even step foot in the practice. Is that, is that accurate?

Yeah, I can provide a little bit more insight for that. So we verify insurances three days before the patient's even seen. So when the patients, excuse me, when the offices are scheduling those patients, they're grabbing that insurance information on that phone call and then they're placing it in the practice management software for us to then verify and get them taken care of. Three days to four days is the sweet spot because if we find out that they are terminated, inactive waiting periods, anything that's going to prevent that claim from being paid, we are able to tell our clients three days ahead so that they can talk to their patient, either fill that spot, get, you know, not a lapse in production for that day, or the patient, you know, gets us the proper insurance information information and we get them all taken care of.

How important, Kristen, is it, do you believe that dentists do insurance verification?

It may be the most important part of the RCM cycle, unfortunately, because it is the most labor intensive as well. So and the reason I say that is because it impacts the insurance AR and the patient AR. It's the one thing that impacts both of the ARs if we were to separate it within the practice. So if it's not correct and if you're not getting the right payer and the benefits, then you're submitting to the wrong people. And then you go 60 days goes by and you don't even realize that the claim's not on file. And then secondly, you know, if the, if we don't do that and the patient's terminated, well, there goes the patient out the door. You're never going to see them again. Inpatient AR is impacted dramatically with that. And then also once again, accurate benefits gives the patient a better CO payment and that should ideally be collected at time of service. So when we were talking about cash flow earlier, you have that front load cash flow with the patient CO payments and then you have the back end cash flow with the insurance payments.

Is, is insurance verification like a, like an ounce of prevention is worth a pound of cure kind of thing where if, because you're not, if you're not verifying ahead of time, the follow up, the, all of the effort in order to collect and then maybe even write off and you think about having to write off for treatment that was already done, the lost supply costs, the loss payroll costs. Is this an ounce of prevention kind of thing to do? Verification?

Yeah. What we kind of explain it is the first domino. It's the first domino to the rcm. So if that is, it's definitely a prevention measure to make sure that you are billing to the right place, you are giving the accurate information. And if you don't hit that right, then the claims are going out incorrectly, the CO payments are not accurate and then everything else trickles down. You can catch it of course on the insurance ar, but who wants to touch claims twice? Right? Get it done right the first time and you save a lot of time and labor and effort and cash flow problems.

I think, I think if doctors knew that there was an efficient way to do insurance verification, they would probably all do it.

How, how do you make that efficient? What is Cosentis? What is your team, Kristen, doing to make that an efficient process in with the dental practices you provide services for?

I think, I mean, one of the best things that we can talk about now is, you know, using technology to, to create efficiencies. Right. And so we also are an automation company, so we're automating and, and pulling a lot of these codes off of the web portals and things like that. It's kind of a copy and paste. So we have a robot doing things that they, you know, they really can't create errors. And if there is an error, then it kicks back to a human and then it's corrected. So automation is a big deal when it comes to insurance verifications. However, you know, there's always those insurance companies that are never going to be automated, right, like the, the unions and, and things like that. So, so then you have to create really good SOPs and really good standard procedures. You always want to use the website portals first. You want to use the fax facts and you want to call at the very, very last resort because you will be on hold for over an hour to talk to a representative. So you want to make sure you're creating those processes that build. Well, automation is very big. And then, you know, standardizing plans once again using your, your practice management software, how it's supposed to be ran. You know, you shouldn't have 20 different plans in there for one group, right? You have to have it clean, you have to have it clear, and that's what our team can specialize in doing.

Yeah, and I'd say just to add on to that, Wes, it's. I mean, the efficiency for the dentist and for the practice is a lot of times just that they don't have to do it right, so they skip that part of their day and they can use that 45 minutes that they would have been on hold with an insurance company or something like that to, you know, to do some more scheduling or some more patient outreach or whatever it may be. It's just, it creates efficiencies there by just having that time back in their day.

So let's go through Hypothetical. I am Dr. Reed West Reed, and I come to you and I say, hey, Team Centus, I, I'm thinking about outsourcing my, my billing to you. We are currently not doing detailed verification.

Explain to me what the onboarding and transition process would look like for you to take over this.

Sure. I think that one. I'll take that one. So.

So first question is, I have to ask how is your front desk team gathering insurance information? And in a perfect world you're going to say, oh, they do it on every single call. They grab that information and they put it in the appointment note. In a not perfect world, they actually grab that when the patient comes in for their appointment. That's the first thing we'd have to change if that's the case, because that's something we have to have before ahead of time. So first is establishing that process is your team. Whoever's scheduling the new patient appointments, they need to get this PDF, which we would supply of information. And it's, it's the typical thing, if anything is if any of your team members are used to working with insurance, it's nothing fancy. So they need to grab that insurance information and they need to put it in the appointment note because we have access to the schedule by then. So we'll grab it from there. If the patient is an existing patient, then we will grab it from their patient file. No need to give us anything. It's already linked to the patient's chart. We'll grab it from there. And then what we do is we prep is what we call an entire day of insurances. So let's say today is Tuesday. So our clients that have this service, we are verifying Friday, currently today. And so we'll completely verify that entire day. We'll send you a recap summary at the end of the day. These three patients have been terminated. We'll also notate it on a schedule, turn it bright yellow, bright red, whatever the communication strategy is to draw attention to that. We even have certain clients that want us to call the patients and say, hey, we're preparing for your appointment on Friday. We'll notice that your insurance is terminated. Did you have new insurance you wanted to use? So we have a bunch of different options and we go through this extensively in the onboarding phase, but. And then afterwards, when we verify the entire day, we put the insurances into the patient's chart, upload the PDFs is what I mean. So if we're talking Dentrix, it's the docusenter. If we're talking Eaglesoft, it's the smart doc. We'll upload that, they'll have the PDF reference form and any facts back materials we have gotten. And then we also do link it into the practice management software, updating maximums, updating percentages, waiting periods and things like that. That's kind of what it looks like on a medium level, I wouldn't say high level, but it Gets more granular than that.

Then to confirm is are you the one calling the patients to get the insurance information to do the verification or are you coaching the front office team to collect that information and then you on the back end are doing that verification with the insurance company? And maybe a follow up to that question is, do you ever contact the patient or the insurance companies directly in the verification process?

Yeah, so great question. There's a couple different paths there. So first and foremost, our client will allow us or not allow us to talk to their patients. And that's completely okay. So we establish that in onboarding and if they don't want us calling because they know Susie Q has been at the front desk for 20 years and they only want to hear from Susie. We understand that we work with clients everywhere. So first of all we need to establish that. Do you want us reaching out to your patients? Secondly, for new patients, we're going to coach the front team to collect that information while scheduling that is the most efficient process. The only reason why my team would contact the patient is if it's an established patient and we have gone through and we said, oh, they terminated two months ago, let me call the patient if I have permission for this client and get this updated. So that's the reason why we would contact the patient. In regards to insurances, when it comes to verifications, there's other things in regards to insurance ar, but for verifications, that would be the reason.

Speak about technology just for a second on the technology. You know, there's a growing list of practice management softwares. The old desktop versions are still there, especially for Dentrix and Eaglesoft, although now there's Dentrix Ascend and there's Eaglesoft. Is it Fuse, if I recall, which are the online versions of it? And they are improving by the day, I think. And eventually I think we'll get there to where people are much more comfortable. There's the data conversion process and all of that.

Is is the technology platform, primarily the practice management software. And you're getting access to that either through a remote desktop or through an online access. Do you have your own technology on your side that somehow feeds data or that the doctor or doctor's team needs to access to provide you information? Explain to me how you're leveraging technology to create a seamless process between you and the doctor's office on the rcm?

Yeah, I can probably speak to that one a little bit. I. The great thing about what we do in our platform is that we're completely software agnostic. So Whatever software that you guys are already working with, we can work with what you got. We're not coming in and saying we have to completely upend everything that you're doing. You have to switch to our system systems, blah, blah, blah, nothing like that. We do have our favorites, you know, the big three. There's Open Dental, Eagle Soft and Dentrix. Those are probably the most. The three that we see the most often and are the most familiar with. So there's a little bit less of a learning curve there on the front end versus if you have some, you know, smaller, smaller software or something that we're a little less familiar with. But I'd say that probably the most important part, or the part that we enjoy the most is when we find out that their software is on the cloud. We can certainly remote in, you know, just to, you know, use one of their computers or essentially be like a virtual employee. And we can remote in and just use whatever software you already have. But it makes things so much easier when it's on the cloud.

Yep, that's. That's the beauty of software these days that are on the cloud. The only disadvantage of that is everything it has a subscription basis instead of paying for one time. You know, that's the nature of these technology companies. But the advantages are very strong. Some that are emerging, I've seen curve a little bit more lately. There's a number of them that are emerging to service the large group practice, which I want to address that here in a little bit as well with you guys. Let's focus a little bit more on the problems that we're finding. Doctors are experiencing at their front desk with their team going through the billing process on your website. You explain a lot of these problems. For example, just a lack of bandwidth at the front desk to be able to handle all of the billing need. High turnover rate among the staff, especially these days where everyone feels like the grass is greener on the other side in another dental office where they're offering an extra buck or two an hour. What about uncontrollable ar? Just not being able to collect on it and your AR balance is increasing and difficulties with scalability and growing quickly and being able to manage that RCM process at the front desk. What are some of the more pronounced problems that you're finding in private practices around the billing that you're attempting to solve for?

I can jump in here really quick.

I think almost every single thing that you just listed to me usually comes back to a lack of manpower for various reasons. So one big One that we see quite often is simply. So let's say it's a practice manager or an office manager that's been at an office for 15, 20 years and it's time to retire, we run into that quite often. So they haven't necessarily come up with a backup plan or, oh, there's my dog. They haven't had a backup plan, or they don't necessarily have the ability to have a backup plan because a person that they would typically have maybe move into that role is too busy doing, like Alex was saying, some outreach or scheduling or something like that, because they also don't have someone to fill her position. So number. I mean, in the past, I'd say two to three years, that is by far the biggest thing that we've been running into.

And kind of another point to what Phil was saying is that these practices have rcms designed around one person, and that's never good. When your cash flow into your practice is dependent upon one human being with faults and errors and a life and personal things, it's never good. So, you know, whenever, you know, when we come on and most of the office managers are kind of like, oh, well, I do it this way. We're like, yes, we understand that, but this could be a more scalable way. What do you think about this? Right. So it's not designed around one person. And I think that's one of the. The largest benefits. You don't ever have to worry if that person takes vacation or. Or goes somewhere else for another dollar or two, because we're seeing that so dramatically right now. Just grass is greener, like you were saying, Wes.

Yeah, that's a good point to hit on for sure. Is that to kind of understand what. What the benefit. One of the benefits of this RCM managed process is is that you don't any longer have just one person that's doing each part of these revenue as part of the revenue cycle. You have, you know, maybe one person that's handling your insurance verifications, another person that's doing your coding, another person that's doing your accounts receivable, different person doing your billing, payment, posting, things like that. So essentially what you're getting is a team of experts versus, you know, Susie Q in the front trying to do it all by herself.

You know, I see that as fictional.

Susie Q.

Yes, Susie Q. She's a hard worker.

We like Susie Q. Oh, we love Susie.

We need Susie Q to help us.

But this is outside of my scope. But if you're constantly having a change in Susie Q's at the front office. I can imagine that just creates enormous struggle at the front desk. Because I think if I'm correct, the insurance companies are very particular about how the claims are submitted. It's almost like they're looking for ways to reject it. And they don't necessarily play nice all the time or maybe any of the time. And that probably varies by insurance carriers, I'm sure. And so every time somebody comes in and you hire somebody, there is a learning curve in doing that. Unless they come with a lot of experience, of course, but that's often not, not the case, or it's just really hard to find somebody who comes with three, four or five years plus of experience working with the insurance companies and a dental office. So that continuity is absolutely huge. Because if you can have that non disrupted as a dental office and you can focus on your patient experience and not on billing, your patient experience, but on the patient experience. When you're focused on billing, it's almost like you're having to work on your own experience. And as. And if you're working on your own experience, you're not able to really be free to focus on the patient experience. And that's going to clog the whole system and the brand and the, just the whole flow for your people come your patients coming in. So a question on this. How do we create, how do you create consistency? How many people do you have at Consentus working there for dental offices? No doubt you'll have some turnover, as every company does, but if you're a group and you have sort of reviewers and managers, it almost feels like you're able to create consistency even if there is some occasional Turnover. Are they W2s or 1099s? How does that affect the consistency that you create to your, your clients?

Yeah, I mean, that's the goal too, right? To focus in on patient care and not billing. That's why doctors go to school. It's not, it's not to fight with insurance companies, I assure you that. But yeah, we all of us are Cosentis W2 employees and the way that we can create continuity because of course we do have turnover. I can tell you I've been in the dental industry for over a decade. I can tell you our turnover is far less than within offices because we find those very unique and special people that love the RCM and only want to deal with the rcm. I'm one of those people. I know we're weirdos, but so we have, we do have far less turnover than you would think in a company our size, we have a couple of hundred employees between, you know, medical and our dental, medical and dental billing division. And also there are times where we have to shift clients because sometimes maybe this, this account manager, you know, they have too much on their plate. And the AR that we're tracking every single week for them is not decreasing where we need them to. So we do have to shift clients from account manager to account manager every once in a while. I try hard not to do that because they develop really close relationships. I mean like account managers have gone on cruise vacations with their clients before. It's pretty, a pretty best friend relationship when you're bringing in people money. But we do create SOPs for our clients as well. So standard operating procedures. So we kind of create this, this book, if you will, that this office does this this way for claims and insurance verifications and insurance ar, and when we come across, you know, this particular situation. So we are creating very detailed standard operating procedures that most of the time have never been created for that particular client because Susie Q. Had it all in her brain, no one else needed to know it. So that's how we can create some continuity within. Within hiring a professional service versus keeping it in house.

Great. That's a big issue right there. One of my curiosity driven questions right now is because you work with so many dental offices, I imagine you know these insurance companies very well and your collective knowledge as a company, as a group of billers, probably gives you an advantage over the private practice where you've got one or two people who know the insurance companies. And so you're probably able to have this sort of think tank internally on how to address these nuances across the insurance companies. Do you find that because of that level of depth of knowledge, that almost sounds like I'm making a value proposition on your behalf, but it, this just logically makes sense to me in the same way, like I know dental offices across the country, we work with hundreds of them. So when I'm talking to a dental office and I talk about their labor costs and how they're paying their associate or their supply costs or whatnot, I feel like I've got some great context and backdrop in order to give advice on that. And so same thing here. Do you feel like you're able to increase or I should say decrease the amount of the number of denials because you know what the sticky spots are when you're submitting these claims? Is that a safe statement? Anything you want to elaborate on that.

100% I think that's a huge part of it. I mean, you know, having somebody that's an expert at coding or a certified coder, somebody who's worked with, you know, maybe 10, 15, 20, maybe even more insurance companies in their life and have very. A lot of experience of, you know, why certain things have been denied in the past and have created those standard operating procedures to alleviate those denials. You know, we've already gone through the trial and error.

Right.

So Susie Q. Doesn't have to. So.

Yeah, and another thing that I'm. We're really driven on is data. And so, you know, whenever we look at these across all of our clients, we can find averages, right? We can say the average PPO practice is writing off this much. If they're producing, per 100 grand, they're producing. Right? So we know, like when I talk to new clients and when we do kind of the proposals that Alex and Phil do, I. I say, oh, you're writing off 34. That is way too high for an average. You know, when you're a PPO provider, I understand you take Medicaid, I understand you take all these things, but that's still too high. So when we have the database that we have with all these different states and different insurance plans, because they are regionalized to some, to some point, you know, some of these carriers are really heavy in certain areas. We have a. Our consulting level gets to a much higher, higher level than you would just in kind of a spear group in Colorado. Right. You just know this little section, but we know the nation.

And going back to that question, are your team members 1099s or W2s with Cosentis?

Yeah, we're all W2 employees, so that is definitely a benefit versus some other RCM providers in the space that will use 1099 workers. You know, having those, those in house employees, kind of like you said, Wes, is just great for that continuity and just, you know, the, the ability to have control over the situation is a lot more with a W2 employee.

And I suspect another advantage of that is if they're employees that they are all syncing up, coordinating together, they're a resource for each other. Or if they're 1099s, essentially the outsourcer is pairing you up with somebody who's offering to do that. And that somebody may not be operating with the rest of the. The team. Where I know for me, if I had my CFO advisors all be independent contractors, they're not going to necessarily be getting together to have trainings to make sure they're following the same processes to use best in class thinking, etc. So good. Thanks for sharing on that one. Here's a, a question going back to the insurance companies. Should doctors be raising their fee schedule even though they know the insurance company is not going to honor that in their reimbursement rates? In fact, the insurance company might be decreasing what they're reimbursing. Should the doctors still be raising their fee schedules regardless?

Wes, do you mean negotiating higher, higher fees or their UCR, their usual.

Their UCR, sorry. Should they be raising their UCRs even though the insurance companies are not increasing their reimbursement rates?

I mean, they almost have to because insurance companies are not increasing their rates. Right. And, and sometimes decreasing. And you know, with the new laws that have. Not new laws, but the laws have passed in the last five years that if it's a non covered benefit, the insurance companies cannot dictate the fees that are charged. So in order, you know, to kind of make up for some of the rates that you are decreasing, UCR should be your standard, it should cover it should give you a good profit margin. It should be relative to your region. You know, obviously our Montana clients and our LA clients don't charge the same thing. So. Absolutely. I mean, you are, you're running a business. You're trying to promote and hire and develop people and keep the doors open to treat more patients.

UCR's got to make sense on this subject really quickly. It's a bit of a tangent, but I think it's so relevant right now. With inflation on the rise, doctors tend to, to not stay terribly current with their UCR fee schedule raises. And I am, I tell doctor, you have got to stay on that. You can't let four or five years go by without raising your fee schedule because then it becomes difficult to do so in a big jump to get current, you might go from being in this top 60th percentile in three or four years, being in the bottom 20th percentile. If you're not doing that and those incremental adjustments up every year aggregate up to mean make or break in the practice in some ways because your overhead costs are fixed or they're actually going up, you're paying your staff more, your staff aren't going to just work year after year with no expectation of an increase typically. And your supply cost, everything's, everything is going up. You know, we, we raise our fees to stay current with inflation on a yearly basis, everything goes up. So, so doctor, you've got to do that as well. Just stay very, very current on it. It should be an annual process within your practice. Let's talk quickly about some industry trends. Can we do that?

I know. Well, I know what I don't know, which is I don't know a lot about coding, but I do know that there are books out there on coding. Effectively, of course, you have to follow an honest coding policy, but there's also some gray areas on how things are coded from my understanding and based on what treatment is being done. How does Cosentis stay current on the latest billing and coding?

Do I call them techniques?

Sure, yeah. I mean, we take CE courses just like the rest of the industry too. Right. So there's many CE courses that are offered also. We take courses on some of the trickier insurances. So sometimes, you know, for example, we, I just had a few account managers do dental cal, which is California Medicaid, of course, a refresher training course. Last week it was eight hours of training. So we're training just as much as the next person. But then we also have all of our clients and we're seeing EOBs coming back. So we're also learning trends that way when we're actually seeing the direct feedback from them as well. So we're, we're training, we. You know, I also provide additional courses. I did a, you know, medical cross coding classes. We get 20, 22 coding books just like the rest of everybody. But the difference is, is we have time to look at it because we're not scheduling and answering patient phone calls and doing all these things. So we have our resources with our CE classes and the updated coding books. And then we also do internal trainings as well.

Yeah, I would say I'll just add something on to there as well is that we started off as a medical billing company and then added dental over the years. So one of the things that we do differently than a lot of RCM companies as well is we have that expertise in the medical side as well as the dental side, which I would say, I don't know, Kristen, maybe you can can vouch for this, but I would say probably a 95% of the practices that I speak with, they're not doing the medical part of it just because it's too difficult or too time consuming or they don't know how to do it. And it's literally just money that's being left on the table. So just having that knowledge of how to do the medical and dental cross coding bill for the medical as well as the Dental insurances seems to be a huge value add.

Yeah, no, that's absolutely true.

No, that's a good point. There have been a number of seminars on what treatments dentists can do that can be billed under the medical side. And I think dentists do typically avoid, have avoided that only because they're not sure entirely how to do it. That does require a different set of, not, you know, different knowledge set than on the dental side, but to be able to do that. And perhaps if I recall, it's maybe, maybe sleep therapy or tmj. I don't recall exactly what they are, but I know that there is this space within dental that can be billed under medical. And that is also an interesting feature I did not think about with Cosentis is that you have that ability to do, to do both in, in house. How about this industry? This is always an interesting subject. Just this couple weeks ago, a report came out from the adea, the American Dental Education association, the voice of dental education. But they did a survey among graduating classes out of dental school asking where they're going, where they want to go. And I think it was like 30% are going off to specialty programs. And of the remaining 70%, about half are wanting to do private practice and half are wanting to do, half are wanting to do large group practices. DSOs, or more newly emerging term is DPOs, dental partnership organizations. But they're basically large group practices that centralize a lot of their services. And, and there are some of those associates that are graduating that want to stay there permanently because it's, it's just a sort of a. Feels like a safe platform to have consistent predictable income, help pay those student loans, etc. And some people want to go there to sort of cut their teeth, build out their clinical further and then move into, into private. But safe to say that these DSOs, DPOs are definitely on the rise in the industry.

How do you feel about that trend perhaps? Has this affected you? Do you service them? How has this impacted the life at Cosentis?

Yeah, I mean, I always said, you know, if I, it was, if I was ever a doctor, I think I would do the DPO model. Right. It feels safer. I'm not all that much of an entrepreneur and what, I don't know kind of scares me. So it's nice to have that kind of safety net. And it's two different types of people, right? You, either you're choosing to be a business owner and, or you're choosing, you know, to work as a dentist. And, and I Think that, you know, you can do both routes. You know, learn, you know, like you said, go to a dpo, dso, learn what you can about the business and then establish your own private practice if it's not for you. But then there's also this pretty big movement of doctor owned groups as well. The bigger ones, not just, you know, they own 51% instead of the 49 it was before. Personally I think that'd be the route I would go. But that, I mean, seems like a really great stepping stone for these new docs that are graduating every single year. The way it impacts us is some of these are they have their own say in their rcm. We have worked with some of the bigger guys and it, you know, this guy is a majority owner and they're going to let him choose how he wants to run his rcm. So we work with them and then we get a lot of referrals, right. So they know a big network of owner dentists. And so, you know, there's Sometimes we have 10 of the same, the same larger DSO and different owners. And as for, you know, centralizing, you know, if a group practice wanted to come with us, you know, like 20, 25 locations or something along those lines, we definitely work with them. Onboarding them is strategic and timely. But you know, those, those organizations are harder to infiltrate because you have a lot of people that need to sign on and agree to that. But once we have it and once we're in there and once we have things centralized, then sometimes, you know, they can do an roi, a reduction of force, or they can put them in strategic positions to increase your production. Anytime we're taking labor off of their plate to bring in collections, you should be increasing production. So you've got to bring in, you know, have a good ratio of hygienists to doctors and develop that. Right. You can't. Hygienists really bring in a lot of production that gets diagnosed. So anyways, a lot of things to evaluate and get these people that are great with patient coordination, communications and increase your production, get treatment plan acceptance up there, get people on the schedule if it falls apart. So kind of relieving some of that as well. I went off on a tangent there, but it's all interconnected so closely.

That was good. I have one, one small thing to add to that because I think what we, when we first start working with some large group or multi practice, multi unit practices, even though they may have some sort of centralized management system, what we find typically is each location is collecting at a different rate in, in terms of revenue cycle. So we can be really instrumental, especially in the beginning, for creating some financial consistency just by transitioning some of the, looking into some of the locations that are maybe doing better, figuring out why, looking at the ones that aren't performing as well and trying to create that consistency instead of them trying to copy and paste an individual person, that is quite literally impossible. So that's something we run into almost immediately when we work with those kind of clients.

Do you find that when you bring on a dentist that there was ineffectiveness, slash inefficiency in how well they were billing before onboarding with you and that there was literally money left on the table because of that?

Absolutely.

I think that's every single client.

Yeah, every single one. That's one of the metrics that we put into our proposals is just, you know, okay, based on our findings, this is what you guys are collecting. This is your percentage right now. And just by switching to us, it's going to increase by X amount. So a lot of times that increase basically just pays for the service itself too.

So. And then what is that X amount, if I can ask?

I mean we've seen anywhere for as from, you know, as low As I think 65% we've seen before, Kristen. Maybe even lower than that. Just a lot of write offs and yeah, probably even lower than that. I'd say typically it's probably around like 75% to 80ish percent.

And to clarify, when you, when you're using that number, you're saying that's the amount of AR that is being collected and therefore the remainder is not being collected due to inability to follow up, inability to get the insurance company what they need, follow up from the patient, that kind of thing, or ineffective verification ahead of time. That's, that's what you're referring to when you say 75% is, that's what you're often seeing in a dental practice of the ar. They're actually collecting. Now that's collectible production, meaning the amount that they should actually be collecting on. What typically are. Is consentis able to raise that to.

Yeah, this is a great question and something I track very, very closely with all of our clients. It depends on the service level. So if we are doing our service where it does include patient collections and insurance collections, Our average is 98%. If we're not in control of the patient collection side, then we're, Our average is 95%. We are always in control of the insurance. That's one of that's the one thing that's always in all of our service levels is the insurance. So if we can't, you know, send statements, call on past due account balances for patients and we're closer to 95, but if we are in charge of that, it's 98.

Got it. That's a good point of clarification that you have. It sounds like two options. A, we will handle the insurance side, only the insurance side, your office handles the patient side, or B, we handle all of it.

We actually have four. Yeah, we actually have four different service levels, but essentially it's, it is broken into insurance and patient. And then sometimes, you know, insurance verifications for whatever reason. Like for example, we actually just onboarded a client that has automated insurance verifications. They have a cloud based software and it's, it's great, it's, it's fantastic how he has it running right now. So we're not doing their insurance certifications. We can't do it better than that robot that they've got going on. You know, we might be taking that in the future just to decrease their prices, but we're not taking it right away. So for example, that's another service level that we have.

I'm with you. So you can custom tailor a bit your proposal for a doctor's specific needs.

Cool.

Okay. That's actually really helpful. And I have heard that a lot, both on the medical and the dental side, that there is a lot of money that's left on the table because A, they're just not able to collect on it or B, the time value of money lost from taking so long to collect on money that moves from the 30 day bucket to the 60 day bucket to the 90 day bucket, eventually gets to the 120 day plus bucket. And good luck collecting on that. Which leads to my next question. At what point do you think a doctor should send if they should? Maybe as a separate question, what appears like a non collectible amount to collections for this would be on the patient side.

Yeah, sure. So our standard is four months of statements. So we send the claim directly, I'm sorry, we send the statement directly after all claims have been closed. And then we send a 30 day, you know, 28 to 30 day checkup. 30 day, 30 day. 30 day. And then we do two for courtesy phone calls in that fifth month. So we would be sending this patient off to collections the beginning of the sixth month from the date of service.

How do you bill differ? How do you function differently between in network and out of network patients?

That's a. That's a great question. So when it comes out of networks, it's more challenging to work with because insurance companies do not want to necessarily send those insurance checks and the obese to the practice. The assignment of benefits is what we call that. And they'll send that sometimes directly to the patient. So, but most of the time, you know, when clients are out of network, they. They know this and they collect upfront from the patient, and they tell their patient, hey, you're going to be reimbursed. So how that looks differently for us is on the insurance AR side of things. We're calling on all of those claims to make sure your patients are getting reimbursed so they don't call Susie Q. And ask where their money's at. Right. We want to help that flow. So we make sure that those claims are being paid, and then we close the claim. And then we say, we put notes in the patient's chart that says, you know, they've been paid on this day, the check was cashed, patient's been reimbursed, close the claim, then it clears the ar. And so, you know, sometimes that's more of a challenge when you're out of network, because sometimes insurance companies don't want to give you those details. Handful of them. We have to kind of. Kind of fight a little bit. Sometimes we really just get that, yes, the claim is paid and that's it. And then the patient kind of has to call us if there was an issue or something along those lines in network. I mean, we can do anything and everything for them, right? We can pull EOBs, we can. All the payments are coming to the practice. We're posting everything, we're doing the contractual adjustments. So there's really not a whole lot we can't do there.

So I want to now take this from collecting to a reporting, and that's this. This starts to move into my scope. So I'll talk a little bit here. But reporting on your financial statements, reporting on your bank statement, your job is to make sure that what should be collected is being collected per the practice management software. Now, if I'm correct, that's where it ends for you, right? Because at that point, then it. It then really, the accounting software takes over. And again, Eaglesoft, Dentrix, Open Dental, none of those are accounting softwares. Those are practice management softwares, but they don't produce profit and loss statements. They don't give the data to your accountant or to your tax preparer, to your practice management consultant for full Profitability, reporting, it sort of stops there. It is not on your end or your job to make sure that it actually posts to their bank account and reconciles from the bank account to their practice management software. Correct.

Incorrect.

Really?

We absolutely do that. So whenever we have our clients that are really good at reconciling their day, sometimes our clients are like, if it's off a day or two, we don't necessarily, you know, don't necessarily really care about that, but sometimes our clients do. And the, and what I'm saying here is that their accountant will send us, hey, here's a screenshot of deposits for today. Make sure you post these today, or make sure you post these this week or something along those lines. And then we'll have the deposit date. So, and a lot of. And this is specifically around EFTs, the electronic funds transfer, because they are going in there automatically and EFTs are coming a long way in the fact that they will post on a certain day for us to see, but then the transaction deposit dates two days later. Right. So that's where it sometimes disconnects and that's where we play nicely with the accountant on the, on, on whoever our client is working with and say, hey, send us a screenshot for EFTs today. We'll line them up. We'll make sure we post those today, that one tomorrow. So we do make sure that we can reconcile there if we have an accountant to work with. Sometimes our practices don't have accountants on staff, or maybe they just, they just don't want to do that. And in which case, then we would post the EFTs on the deposit date. So sometimes, for example, MetLife is coming to mind. They'll say June 21st is the transaction date, but the deposit is the 23rd. But we'll hold on to that until the 23rd, and we'll post on the 23rd. We'll reconcile as good as we can without visibility into the account. When it comes to insurance checks, right, we're going to deposit that. We're going to provide a report at the end of every day and we're going to say, hey, we, we posted quantity seven checks for a total of $3,000 today. These are the seven checks we posted. And then the office can then do their deposit. You know, most of the time they're depositing right? Then they're in the practice or dropping it off at the bank. So as, as close as they, our clients want to reconcile, we can do it with them. It's just a more of a Partnership.

You know, I want to dwell on this a little bit more. I know we're 52 minutes into this, but this is really important. And if you're listening, doctor, and you sort of tuned out there, please tune back in because there, this is an important subject. Making sure that the money is actually landing in your account, bank account, and all of it is landing in your bank account. And it's been a real struggle for me as a part of our business, of course, is being a dental cpa. We're really an outsourced CFO and planner and advisor, but we're built upon a CPA bedrock is to reconcile between the practice management software and the bank for all collections, patient paid, insurance paid, but, but all of it. And really there, as far as I'm aware, there is no software. QuickBooks doesn't do it. Other softwares out there, Xero, which is a big one, doesn't do it. We use one called Accounting cs, another big one. They don't do it. No one really, really does that. And so embezzlement oftentimes can occur because a front office team member is able to somehow reroute collections to an unknown bank account and the CPA or the accounting firm never really knows about it. So. And for a period of time, and for some clients, we do offer a control procedure where we will, on a daily basis verify that what hit the bank account is reconciling back to the day sheets in the practice management software. But it literally increases the accounting work function by four a lot because you're in there every day. It's a very in the trench process. It's not just preparing financial statements at the end of the month based on what's hitting your bank account. And so that's been a continual challenge to figure out how to do that. Someday I'm going to create a software that does that and I'm going to go market that to the dental industry because there's a huge need for that. But Kristen, have you ever thought about or has this ever occurred where the doctor gives you.

Virtual access, view only access to the checking account and then you're able to log in and do that verification yourself on, on your side?

Yep, yep. We do have a few clients that have provided that for us. It, it's an option. You know, typically we like to work with their accountant more. So but we, we have done that.

Yeah, there's a software out there. I'm actually very, very interested in it. It's called Relay. It's not a software. It's Actually a bank, it's a bank called Relay. But what they've done is unlike any other bank. They designed their banking interface and their technology to focus on serving the client's broader team and meaning their cpa, their bookkeeper, maybe their tax preparer, or in this case also an outsourced biller, or even a front office staff member if it's kept in house. And those all, all of those team players that are outside of the practice, not just the Doctor and the Doctor's internal team, are all able to easily access the bank account with very restricted access based on what they actually need and to be able to create much more of a seamless working relationship across the board when it comes to the checking account. And it's a, it's actually a very innovative feature here because most banks, it's all set up for the business user, for the Doctor and then they try to grant this view only access to outside parties, but it's constantly getting disconnected, sometimes it's not very safe, etc. And I think that could be a great way to help solve some of this problem for people like you, Kristen and me to help the Doctor validate that what actually came in or was supposed to come into the bank account actually landed and to reconcile between the bank account and the practice management software. That's a constant struggle.

But it is something to, I think, talk with your CPA about what is our process, bookkeeper, to make sure that Dentrix is reconciling back to our bank. Do you guys ever come across.

Accidentally, perhaps the discovery of embezzlement in an office in the course of your service?

Yeah, unfortunately it's not something that is rare to find in the dental industry, especially for, you know, those, those accounts that don't reconcile on their daily, like you were just talking about. So yeah, we definitely come across it. I, I do have to say that most of the time the doctors have a hunch and that's why they're coming to us. So most of the time, you know, when we're in the discovery calls, you know, Alex and Phil just say, hey, just, you know, heads up, this doc thinks that there could possibly be embezzlement. So then when I go in and you know, do the, or the audit and try to, you know, build a pricing out for them, I'm kind of hyper aware of some things and, and noticing and then we'll, you know, have a, have a private meeting and say, I also think this is happening. But I do have to say I would more often than not the Doctors know it's happening, and they're trying to figure out proof of it happening, essentially.

You know, I didn't even think about that. But as you explain it, I could see how the possibility of embezzlement is one of the motives for a doctor to approach somebody like you. Because we all know. You all know I know embezzlement is pervasive, and I've seen some, unfortunately, some pretty severe cases of it in. In prospects who come to us and explain what happened to them. And so we help put into some controls and try to coach the doctor on. On some things. There's so many ways embezzlement happens on the income side and the expense side that falls a little bit outside of our scope. And there's services out there that are specific specifically for that.

But.

But outsourcing it to some party like you, I can see can strengthen a process of oversight on an area where currently there may not be any oversight whatsoever for, For. For the doctor. I mean, for the team. All right, I think that's my last question before I just want you to share a little bit more about your company. Specifically. If, if somebody was interested, it's that a lot of, as you know, team members in a dental office have their way of doing things and they don't like to change. Their way of doing things tends to be very habitual, very.

Almost just, you know, just, just. We don't want change, doctor. We don't want change. We got the front office. Let us do our thing. Don't interrupt us. Even though there may be a lot of inefficiencies, there could be some embezzlement going on, money left on the table, et cetera, all the things we talked about today. How do you recommend the doctor communicate this to their staff? If they say, guess what? We're having a big shakeup, I'm going to completely alter your role. You're no longer going to spend 80% of your time doing billing and collecting. Instead, you're going to. You're going to work on patient experience and marketing and our internal processes and all of that. I'm sure there's a lot of hesitancy coming from the staff. How do you coach the doctor through that conversation?

That's a great question. I mean, there can absolutely be some hesitancy at the very beginning, but I think once it's really realized what exactly we're doing for them and what we're taking off their plate most of the time is the part of their day that they hate doing the most. So like for instance, if you were to go into literally any dentist office. Dental office right now and ask the front desk lady if they like doing insurance verifications, I could probably say with confidence that a hundred percent of them would say absolutely not. Worst part of my day, don't like it at all. So if you come to them and instead of, I guess for the conversation for them to have is not that this outside group is coming in and taking over your job, it's essentially that this outside group is coming in and making your job more enjoyable because you get to focus on the parts of your day that you actually enjoy and they're going to focus on the parts that you hate. And I think once that's communicated well, we typically have success. And if we come in there and have that conversation and there's still a ton of pushback, those are 10, 10. Those tend to be the instances where possibly there's some, you know, embezzlement going on or there's something that's not quite right because like, you know, they're, they're, you know, not letting us log into their computers or they're being very secretive with the numbers and things like that. Those are kind of the telltale signs at the very beginning of something that's not exactly right. Because once somebody understands were taking away the worst part of their day, it's usually they welcome us with open arms.

Yeah. I think there would be two motives why there would be reluctancy from the front desk. And those sort of. These two clarified in my mind as you were talking, Alex. One is that they are embezzling and they want to protect that because embezzlers oftentimes do this year after year and their lifestyle becomes dependent, dependent on the embezzlement. So they will kick and scream and fight and protect at all costs to protect that income stream to them in, in addition to what is their legitimate wage. The second one is if they reason is if they feel their job is in jeopardy now. But I agree with you. I can't imagine most of these team members are going to be like, hey, I love dealing with insurance companies and collections. I don't think that is going to be a motive for the vast majority of these, of these people. On that second one though, is it common that a doctor will reduce their labor cost their, their team because you take this over? That's a very practical question. It might be a hard decision for a doctor to do that, but from a business standpoint and a profitability standpoint, I think it's an Important one to, to ask.

Yeah, that's a tough one. Yeah, it's a tough one. Definitely. It's, it, it's a benefit and it's, and it's not. Right. So. But I do. What I would find is some people do come to us. Most of the time, the bigger guys with multiple different groups are looking for a reduction in force that would be, you know, what, what they're looking to, to centralize. But I also have to say that when doctors are coming to us, it's because their collection ratio is not great, their team's not doing a good job, or else why would they be looking, Right? So most of the time when we come on board and we're starting to increase collections and we're starting to create efficiencies, those people will actually see themselves out before the doctor has to do anything because they're going to say, you know, like, for example.

When we have these meetings and we have monthly meetings and data meetings with our clients, okay, well, last month you were collecting at 76%. This month we got you all the. Up to 94. Next month we're expecting 98. They're hearing these good things and these processes. Now you have one of two people, right? The front desk one is going to feel very threatened by that. One is going to think, oh, I have not been doing a good job and I know that I've kind of been slacking. I've not been doing what I'm here to do, and they're going to separate themselves. The second person is I, I tried my best. I had a lot on my plate. And I am so glad that these guys are increasing collections for my doctor because guess what? Now we're, we're getting bonuses. I'm increasing production. I have more time to train my staff. I have more time to market to specialty, you know, so you have two different types of people. And I think that we can all say for sure we want one of those types of people managing our practices. And it's not the one that's threatened. Right. We want that person that has innovative thinking and that can, okay, now these guys are doing a better job. What can I do better? That's who we want in our practice. So it tends to attract better people, I suppose, is what I'm trying to say.

Yeah, exactly. Go ahead, Phil.

Oh, yeah, I was just going to say, I think that's, that's such a great. Well said, Kristen, because that same person, also something we run into, maybe be number three on your list.

List.

Wes is someone that's afraid to give up control. We have that said to us quite often when in reality that the person that Kristen's talking about is able to really have a better pulse and better control of the practice. Even if we are taking care of revenue cycle because we're, we're just pressing the buttons. So to, to combat that a little bit, we provide dashboards and we do weekly accountability meetings and we, we prove the work we're doing while keeping in direct contact with that person or the team of people. We really aim to be an extension of the team while that person that maintains control of all the more important.

Things become true, true partners and true team members with that person. That's a great point.

Yeah. In my experience, it's been less the case where these doctors are getting rid of people and more of a case of I just need to find more time, you know, to restructure this, these people's day. You know, my dental hygienist shouldn't be spending 30% of her day doing insurance verifications or something. You know what I mean? Like, they just have all these different roles within the business that the dentist finally says, you know, that, that 30% that they're spending on their day, they could be just more, way more valuable doing other things. So I'd, I'd say I see that more often than I just want to get rid of a person.

I. Yeah, I think bringing the billing in house, I mean, exporting it to, to outhouse, I'll say outhouse, exporting it externally to you, all.

Leads to a couple business management decisions. And one of, one of them of course is can you create a better, more effective revenue cycle management and increase your collections that way. But the second one is now that you have extra human resource time, extra time in this team up front, this team member, or if there's a couple people involved, then the next business analysis is are they able to pivot themselves to, to do something functionally different in the practice? And I think that's a very legitimate question to ask. That could lead to.

Offboarding those team members because some of them may be just very set in their ways. That's all they really know how to do at this point. They're not interested in retooling themselves to do something different. And there's always business functions to be worked on in a dental office. Always, always, always. Whether that's increasing your step by step processes, your functions, new marketing campaigns, internal marketing campaigns, all of that is absolutely critical, I think for a really healthy, functioning dental office. And you Usually don't have enough human resources to be able to address a lot of those business needs. But now you have some people at the front desk who have capacity to do that, since you have now removed a lot of this billing off of them. And some of them may be excited about that and may be able to learn, say, a process management software, for example, or get involved a little bit on what is marketing and branding and patient experience and things like that. But some are probably just going to be like, nah, this isn't my thing. Now you're taking away my bone. And I don't know where to go for other bones. I don't know how to re. Pivot to pivot myself in that case. I think it's important the doctor make, make the, the call and they find somebody who will do that, as difficult as it can be, especially if they've been there for a long time and been over the house for barbecues and parties and things like that. I know that can be really, really hard to do and that's not the first choice. But at the end of the day, you are running a business and you need to be profitable, especially with the competition that's pressing on the private practice these days. You've got to be a good, a good business leader. Okay, we're going to end off here with just two quick questions for you guys. Number one is to the extent that you can share on here, what are your fees for your services? And number two, where can people learn more about you?

Sure, I can speak to the first part of that. Fees for our services are based on a percentage of collections that we collect for the practice. And that's going to range depending on what, what the collections are. So the bigger the practice, obviously, the more collections and that that percentage that we collect that we charge them is going to drop. And then if it's a smaller practice, then that percentage is going to raise, is going to raise, increase. But it's just, you know, until we dive into the financials of the practice, it's really hard to say exactly what that percentage would be because we custom tailor everything that we do to each individual practice. So not only is it just a percentage of what we collect on them, but we also work into that percentage. What service level are you, are you choosing? Are we doing the entire revenue cycle for you? Are we only doing the insurance piece? Are we doing verifications? Are we not? So it's completely customizable. It's not, not one size fits all, so. But it is a percentage of collections that's how we, we base our, our fee schedule.

You know, again, it's tough and it's been, you know, there's been a lot of different size practices that we've worked with, but I've seen it anywhere as low as, you know, two and a half ish to as high as probably.

You know, nine or ten. I, we usually don't go much higher than that because then it just doesn't make any sense. And you know, at that point maybe we, we go into a flat rate or something like that to make it more palatable. But yeah, it's a pretty wide range. Just depending on the collections for each office.

I know I commonly see 4 to 7%. I, I'm not going to state where you guys are. You guys will have that very specific package that you're going to offer for a practice based on their profile. But in the industry, that's commonly what I see. Is it generally the same percentage for patient collections directly versus insurance collections?

No, it's going to be different because the collections are going to be quite a bit bigger. Right. If you're including the patient collection. So if we're doing the total revenue cycle, you're going to see much lower percentage rates. But if we're doing, you know, just the insurance portion, that's when it gets into the higher part where Alex was talking about like the 9% of insurance collections. That would just be insurance, not total. We've never had anything. 9% of total collections never got that high or else that client just really, it doesn't make sense. They don't want us and it's not a great client for, for our profile. Not that they wouldn't be a great client, but.

Well, here's a little pitch for you guys. You know, these group practices are on the rise. As you know, as we spoke about earlier. Whether that's three practices or whether that's 300 practices. Well, guess what? Every single one of them is centralizing their billing at some level, or at least they're planning to do so if it's not on their current agenda because of all of these efficiencies we've been talking about for the past hour that are gained from a central location that handles the verification and the billing. So from a business standpoint, I think it is a very good move. Now, it is going to be unique and personal to each private practice. If they have a very good solid system there, perhaps they don't need to. Others may be very chaotic. Or you buy a practice and the front office is the spouse of the seller and he or she retires along with the seller. And now you got a whole new like problem there you gotta solve for. So I might. I actually believe that the trend to use an outsourced servicer like you is definitely going to be on the rise for good and valid reasons. So many of which we spoke about about, about today. I thought this was really insightful and thank you all for being on this podcast. I liked how we got into some real details about the process, the the pros and the cons of maybe all of this and how this can help the private practice. Where can people learn more about you?

Yeah, absolutely. So I would just say coentus.com you can find us online and then you can find our phone number there as well. You can reach us directly if you want. Maybe Wes in the, in the info section once when you drop this podcast. We can drop our emails in the, in the bio as well or something like that. But yeah, I'd said just as a starting off point, probably just cosentus.com great.

And maybe just verbally, real quick, what is your email address, Alex?

Yeah, so my email address is a Gallup. So like the poll, it's a G A L L u p@cosentis.com and then Phil and Chris, if you wanted to.

Drop yours as well.

You know, let's do this. I'll go ahead and put all of yours in the show notes we just got. I want to grab one of you online in case somebody's maybe in the car and isn't able to to check out the show notes on on hand. But Phil and Kristen, Alex, I'll put all your email addresses in the show notes for people and thank you again for joining. I love to maybe rendezvous again in a year or two and see what changes have occurred in the industry and do this again.

That'd be great. Thanks for having us on, Wes.

Sounds great. All right, guys, thanks for the.

Sa.