Hi, everyone. This is Erica Spicer Mason with
the Becker's Healthcare podcast series. Thank you so
much for tuning in today.
For today's discussion, I'm thrilled to be joined
by Cissy Mangrum, senior vice president of revenue
cycle management at Specialty Dental Brands, and Marcy
Sweet, vice president of marketing at Dental Exchange.
They're going to share with us their perspectives
on the financial landscape in dentistry right now.
Cissy and Marcy, without further ado, welcome. Thank
you so much for joining us today. Thanks
for having us. Yeah. Thank you for inviting
us.
Really happy to have you on. And before
we get into the meat of our discussion
today, wanted to see if you'd both like
to share just a little bit more about
your professional background, your current role, your organization.
And, Marcy, perhaps you can get us started.
Sure. Marcy Sweet, VP of marketing with Dental
Exchange. So Dental Exchange has connectivity to all
dental payers, within the industry, which allows us
to be really flexible with different types of
clients, whether providers or DSOs,
to ensure that we have the flexibility to
partner with all of the dent all of
the dental practice management software companies
to ensure that we can get clients paid
faster.
Wonderful. Thanks so much, Marcy. I think you're
gonna have really great perspective
on the RCM landscape and dentistry right now.
So excited to hear more about that.
But, Cissy, please tell us a little bit
more about yourself.
Hi. Yes. I'm Cissy Mangrum, senior VP of
revenue cycle with Specialty Dental Brands.
I started my career in clinical side and
then moved to the operations
running,
medical clinics from small to large medical practices
for 14 years, and then I moved over
to operational rep cycle
from a corporate's perspective
because of the, information
that I had that I could translate
operations,
clinical,
and revenue cycle.
I've been doing this,
for almost 20 years. And about 2 years
ago, I entered into the dental industry.
I came on board with specialty dental brands
two and a half years ago,
and,
they are a large specialty dental,
DSO. We have
pediatrics,
orthodontics,
and,
OMS.
And so I'm very excited to be with
this group.
Our partners are amazing.
We have
251 locations,
and, we're across 26 states.
Fantastic. Thanks so much, Cissy. And just like
I commented on with Marcy,
the perspective you're gonna bring to the table
for this discussion, really important. So glad that
you have that knowledge from the clinical side
and operational side.
So I I think that might lead us
nicely into the first question. And, Cecilia, I'd
love to get your take.
Can you offer listeners
just kind of a high level overview of
the current financial landscape in dentistry? You know,
what are we seeing as the primary pain
points for practices and DSOs,
and how does RCM really factor in?
Yeah. Great question.
As I thought about this, this is there
are 2 areas that I think is impacting
the DSO world right now, and one is
the economic challenges and inflation.
From an RCM perspective, it is hitting home
in our DSOs and dental practices.
One aspect of this is the patient portion
for dental services impacting our DSOs and dental
practices. The most in some specialties,
the patient portion is 20 to 30%, and
others, it can be up to 60 to
70%.
Understanding how to approach better patient financing options
and patient responsibility is a high priority for
our DSOs, especially here at a specialty dental
brands. Every DSO in dental practice right now
is seeing a decrease in patient
visits, which I believe is directly related to
the financial impacts of the dental services.
Therefore, it's super important that we have some
form of patient financing
offerings to our patients.
And then from a second aspect that I
think is soup that is a primary pain
point for our DSOs and dental practices is,
really, it's our payer agreements.
It's crucial to review our payer agreements right
now and prioritize communications
with our payers to negotiate better rates.
If if our DSOs
and dental practice haven't already started this,
they need to start it. It's super important.
We recognize that costs are rising for our
payers,
but costs are also rising for us, for
our DSOs and our doctors.
And so it's
extremely important that if you're not looking at
your payer agreements now, you should be looking
at them and getting them up and rolling
to increase your allowables and increase the reimbursement
for our doctors who are rendering these services
to these patients.
So those are the two areas that I
see right now that are pain points in
the RCM aspect.
And then how do how how does revenue
cycle factor into this?
I look at revenue cycles operational revenue cycles.
So it's essential
in helping our DSOs and practices becoming more
efficient by optimizing our RCM processes,
standard operating the procedures,
credentialing,
and implementing technologies and tools to, ensure faster
payment.
So my goal as an RCM leader is
to ensure that our teams work smarter, not
harder. If you hear me talking to other
places or anywhere, you hear me say that
all the time. Smarter, not harder. Therefore,
the focus for, you know, RCM team should
be providing practices with more efficient processes and
technology to ensure faster payment and cleaner claims.
So RCM leaders and DSO
practice leaders also need to be open to
several different solutions.
It's okay to have multistep processes
and provide solutions to the practices in DSO.
So many times, RCM leaders or DSOs think
they need to do one solution for their
organization.
And the reality is in our our landscape
at this time is that you need to
be open to multiple solutions.
We are the experts. The RCM
leaders are the experts in identifying these solutions
and to help our practices. So sometimes those
solutions could be decentralizing a function or centralizing
a function or outsourcing a function.
So for example, for us, we have a
3 scaled model where we decentralize
some areas, centralize other areas, and outsource other
areas.
And we have for example, we work with
Legacy Healthcare and Ascent Healthcare as an outsource
function for insurance AR
follow-up,
and that helps our teams and our practices
focus on patient care and our outsource partners
focus on the AR follow-up.
Yeah. Cissy, thank you so much for that
overview. You've outlined such important
considerations here, like the economic challenges and inflation
that practices and DSOs are facing.
And then I loved how you really underscored
that piece of advice of
having practices and DSOs review their payer agreements,
how it's crucial to really start looking at
these now if they're not already.
And then, of course, that other piece of
advice to being open to multiple
solutions or tools to support revenue cycle management
and especially working smarter and not harder. So
really great overview, really appreciate those insights.
And I I wanna touch on something next
with that kind of really factors into all
of the challenges you just mentioned, which is
practices and DSOs leveraging technology like automation,
in their RCM processes.
So would love to know from you, Cissy,
if there are any specific success stories you
can share there and how
automation is making a difference in RCM. And,
Marcy, I I'd love to get your take
on what you're seeing in the field as
well.
For me, automation right now is a buzzword
in RCM. Everywhere you go, everyone's talking about
automation,
and that everybody has some form of it.
However, in my experience within the dental industries,
we still have a long ways to go
to fully realize the potential of automation.
Where I do see automation and technology making
significant strides, at least here at SDB,
is areas like verification of benefits, payment reconciliation,
claims submission,
reporting through clearing houses, such as Dental Exchange.
While there's still a lot of progress
for us to be made, we are moving
in the right direction. And we've made some
major strides with,
partners,
for our verification,
benefits with BBK
Dental Automation. I mean, it that has taken
us from
a manual process to an automation process and
helping to resolve about 70%
of that process, which is huge in a
clinic.
Our payment platform with Centus, Roomit AI, they're
helping us.
This is a big thing, helping our reconciliation,
helping our payments to be more streamlined. So
our posters have the information and reconciling on
a daily basis.
We're working with National Dental Support, and they
have,
an RCM
platform, which is called my RCM, and we've
been working with them to build out,
an AR and reporting platform that is gonna
be above
all the others that I have seen so
far, and it's pretty amazing.
And then the one of the best things
that I could say for us
is that the claim and reporting with Dental
Exchange, they have been an amazing partner,
especially through the Change Healthcare
changeover,
being able to work with them to ensure
that
we didn't lose revenue and that we actually
increased our revenue this year was a major
factor because we worked very closely with Dental
Exchange.
Each of these platforms
are
are needed
and are have been a great benefit here
at Specialty Dental Plans. And I would say,
you know, I'm pretty tough on these platforms.
And if you were to talk to any
of these people on the in these,
in these platforms to these AIs, they would
say, yeah. She's she demands a lot. And
I think you have to as a revenue
cycle leader.
You can't just let the AI,
technology platform say they can do things. You
really have to press them. You really have
to work with them. They really have to
work with you.
And I think because I do that and
these technology platforms work with me, we have
a great strategic partnership, and we're seeing some
really good results.
Yeah. And,
to your question, Erica, so at Dental
Exchange, we're really trying to help dental take
the paper out of their process.
There are so many different aspects of revenue
cycle management that so many are still leveraging
paper, which, you know, to Cissy's point, to
be able to partner with our clients
and with the practice management software to really
build integration to make it easier for our
clients to work smarter and not harder, again,
just to echo what Cissy said earlier,
enables them to be able to have their
providers get paid faster. In in essence, it
then increases the patient satisfaction
because we're able to allow them to build
their clients effectively or their patients effectively to
say, you know, you owe this today so
they can reconcile more quickly. And as we
continue to build automation
even further
leveraging AI and different things like that, and
and also we're we've launched lots of APIs,
that allow for that connectivity for easier
file transfers to happen even more quickly
to be able to bring that automation to
our our partners
who are then working with all these DSOs,
to enable them to to be able to
process the claims more quickly,
throughout all those components of the dental RCM
process.
Thanks, Marcy, for for those add ons. And
it's interesting to hear about how you're still
seeing
paper based processes
and in dental practices and DSOs, you know,
so much,
so much that we hear in health care
today is how everyone is advancing in technology.
And and it seems like that's the direction
we're headed, but there's still some
room for playing catch up for sure. And
it's great to hear about the partnership between,
between Dental Exchange and Sissy's organization.
And, Cissy, I know you mentioned that
at least at specialty dental brands, you feel
like you're kind of still early on in
the automation process as you've seen some quick
wins,
and you're advancing, but would love to know
what other key opportunities you're seeing for automation
in dental RCM in the next few years
or beyond that. And what do you think
leaders should do now to really effectively prepare
their organizations for that future state?
Oh, yeah. So I love those questions because
this is, I think, is the mark. We
are we
are very close, right, with, dental automation. So
I I would say right now, our biggest
obstacle we're facing in dentistry is the PM
systems,
but it also represents our greatest opportunity as
well.
Our dental PM systems need to be more
open to partnering with vendors and improving
processes.
I think
for us, it's we are no longer gonna
afford manual processes and workarounds.
And our PMs say,
you know, the majority of our PM systems
are out there will say we're in development.
We're trying to develop a better product,
but we need our PM systems collaborate with
vendors who are excelling in those areas that
help with RCM.
You know? I say they're already solving the
problem. They need to be able to partner
and and strategically
come together,
to develop these key areas.
One of the things I I talk about
with people is that there are vendors out
there that are already doing it. And if
the PM systems
will open their doors and work together, it
it's gonna make the PM systems be so
much more robust. And so, like, I look
at stuff like Trulark for patient
scheduling,
BBK for verification of benefits, Perley for patient
communication,
you know, AR is NDS and InsideDesk,
and then, of course, Centus, and and, of
course, you know, Dental Exchange for clearing houses.
I mean, there are so many more. Those
are vendors that I have worked with, that
I've either worked with or encountered or have
seen, do amazing things.
And,
our PM system should focus on those clinical
aspects to to be top notch and then
work with those AI vendors and technology partners
to handle the other stuff.
Many PM systems
I see and I work just just for
our our listeners,
especially Dental Brands, we have 20 different
PM systems that we work on. So I
feel like I'm I I understand this a
little bit, but if our vendors and,
our PM systems will work with our vendors
and technology partners to handle the other aspects,
we could see leaps and bounds in in
the actual technology and AR within dentistry
fairly quickly within, you know, 2 or 2
or less years.
But, again, everybody has to work together, and
sometimes that's a little difficult. And I would
say if they would focus on those partnerships
and building those collaborative ecosystems, it's gonna make
a a big difference. I would say too
also, what can we as leaders,
do now to effectively prepare?
I'm I'm gonna say this for me. This
is easy to say
and extremely hard to implement.
Okay? So,
anybody who's listening is gonna go, oh, yeah.
Sure, Sissy. You can you you can say
that, but, I mean, how hard is it
to go, you know, get everybody on board
to do that? And it's hard. It's all
about, building those,
relationships, building those,
times to see the successes.
I would tell you that the RCM leaders
who prioritize
education of their teams about AI
and applications
in RCM,
this involves not only understanding that technology,
can also streamline operations, reduce errors, improve those
decision makings,
but it's conscious learning opportunities that help our
staff, our teams stay updated on the latest
advancement. And that's easy to say, hard to
do. And we we need to have the
buy in. Right? We need to have the
buy in from the doctor partners, the doctors,
the DSOs,
the operations team, the IT team.
Rev cycle impacts
all of these departments,
finance teams. We have to get the buy
in from everybody to get things to foster
that culture of innovation
so that our RCM processes are easier.
And then one of my things is building
the strategic trifecta. I love that word trifecta.
Basically, that partnership. Right? The the DSO partnership,
all the teams within the DSOs and the
practices, the AI vendors,
and then the PM systems,
having everybody on the same page going in
the same direction.
My firm belief is our dental
partners and our DSOs all across the US
have
a positive
outlook in saying that we are going to
do better. Every year, we're going to do
better. Right?
What we've gotta do sometimes is
to understand that we have to partner and
have those strategic
partnerships
to to get to the next level. We
can't,
try to do it all by ourselves.
My other thing is you gotta work really
closely with your technology leaders, our CTOs and
c CIOs. Like,
we have
a CTO,
here,
Dan Precigar, who's amazing. He's he's one of
our one of the best technology leaders I've
worked with. You gotta build with those individuals
to help build those technology infrastructures.
And,
also,
we've got we can't do it by ourselves.
Right? Everybody has to be on the same
page.
The very last thing I would say that
leaders should do,
to help prepare for the next steps is
it's okay to pilot.
It's okay to pilot initiatives.
Sometimes DSOs and dental practices say, oh, I
don't know if I wanna pilot things because
I I don't know if I will use
them.
The AI vendors learn a lot during pilots.
So
pilot if you can.
Look at the best strategic partners and be
tough on those AI,
vendors.
Tell them what you need, show them what
you need, and have them perform and,
provide you the things that you need. And
they work with the PM systems the same
way.
When they are
are challenged in those pilots, they can get
insights and make a necessary adjustment
so that they can roll out full scale
and also
benefit
our DSOs
because I'm all about working smarter, not harder.
Yeah. Sissy, thanks so much. I I hear
the excitement around technology. I know you said
in about 2 years, you're seeing
big things on the horizon. It can make
a big impact,
but that's also dependent on building relationships,
prioritizing
staff education, partnerships,
and not being afraid to pilot new tools
or initiatives,
such important points.
I really appreciate all the insights from both
of you, Cissy and Marcy, today. Are there
any final thoughts that you'd like to share
before we close our time together?
Well, from from my perspective,
sometimes RCM leaders are
are
more hesitant,
right, to do technology because it's a lot
of work. It really is. It's a lot
of work. It's a lot of testing. It's
a lot of,
buy in. It it sometimes it can just
easier just to do it the old way,
easier just to say, this is how we've
always done it.
But our world is changing, and how we've
done it in the past is not the
same as how we need to do it
in the future. So I I employ our
DSO leaders and our RCM leaders
to to really branch out and think about
what it could be for different technologies and
different ways to do things because
at the end of the day,
we have
we have to do the best that we
can do for our part doctor partners
and our leaders in our operations, and we
need to do it to the best of
our ability.
So don't be scared to branch out into
technology.
That's the last thing I'd say.
Yeah. And I think, I would add,
when DSOs are thinking that they have different
ideas or, you know, sharing with the vendors
that they're working with,
what's in their pipeline or what they're considering
or what their improvements are and that they're
trying to do, make sure you're explaining that
and show saying where your plan is. It
might not be in the next 6 months.
It might be greater than that.
Because I think with some, there's an opportunity
to be a beta as a vendor might
be building something and to be able to
participate in that, especially if they've got some
great thoughts and ideas of where there could
be some real real big successes there. And
knowing that your vendors are your partners and
here to help,
just make sure that those lines of communication
are kept open.
Such a helpful note to end on. Marcy,
thank you, Cissy. Appreciate the insights so much.
Really,
thankful for the time that both of you
made for us today on the podcast.
Enjoyed it. Thank you very much. Yeah. Enjoyed
it a lot. Thank you very much for
inviting me.
I'd also like to thank Dental Exchange for
sponsoring today's episode.
You can tune into more podcasts from Becker's
Healthcare by visiting our podcast page at beckershospitalreview.com.