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Hi, everyone. Welcome to Becker's Healthcare podcast.

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I'm very excited for this episode. I have

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a very special guest today, Rob Jerome. He's

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the senior vice president and chief digital officer

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at Heartland Dental. Rob, thanks so much for

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joining us.

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You're welcome.

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A lot to cover here. We we have

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a ton a ton of great questions for

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you, and a lot of things that certainly

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have an impact today in the industry itself.

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But before we get started, can you just

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give us a little bit of a background

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of your role, what you currently do, and

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just a little bit about your experience in

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in health care?

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Yeah. So, first, you can call me RJ.

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Everybody does. But, my my role so the

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chief digital officer role was created about three

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and a half years ago at Harland. And

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the way that I would describe it is

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the word digital is really important. And what

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it what it really

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refers to is digital transformation.

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And so Harland is a very high growth

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company. We are about a $4,000,000,000

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company. We support

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almost 1800 dental practices across the United States.

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And

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as we've grown,

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so has our need to evolve

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how we think about technology,

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how we implement technology.

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And so my role was created to do

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that. And I have a background.

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I was in the consulting in the software

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world for about 20 years, the better part

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of 21 years.

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And,

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Heartland was my customer. So I had this

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amazing opportunity to take all those experiences, how

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world class companies

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apply

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technology to solve for business problems, but also

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opportunities

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and come into Heartland,

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and apply that experience in this role.

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Yeah. And you've mentioned, obviously, so much 2

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decades,

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in in this space, lots of developments within

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that time frame.

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How have you seen

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technology

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change the way business is done

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within the dental world? And and what are

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some of those what are some of those

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changes that really have made a significant

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impact

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in your perspective?

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Yeah. Well what's interesting in those 2 decades

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or so, the majority of my time was

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not spent in health care. Not was mostly

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spent in manufacturing and distribution and frankly the

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public sector and the defense sector.

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But when I came into healthcare

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my observation was that there was this absolute

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massive opportunity for things like process automation

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standardization

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and Heartland is a company that really has

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led in those areas so for me I

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would say that that that you know an

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observation was that medical and dental specifically in

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some cases

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trail from a technology perspective

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other industries

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and so I just saw this massive opportunity

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to take the foundations of what Heartland has

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done from a technology perspective and just kind

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of maybe apply some of those lessons learned

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that other industries have have

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capitalized on and and apply to Heartland.

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Yeah. I just it's interesting because we were

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just coming off of our big, big dental

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conference in Chicago, and a and a lot

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of the folks were saying or one of

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the one of the one of the quotes

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that really stuck with me was, like, yeah.

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Yeah. We're just coming out of the stone

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ages. We're just coming out of the we're

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just starting to scratch the surface on what's

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possible with some of these technologies, which is

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really interesting,

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to me because I think one of the

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key things too is it's all about the

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patient. Right? It's making the experience better for

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the folks that come into the facilities themselves.

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How is this contributing to enhancing the patient

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experiences,

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and where have you seen those impactful outcomes

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yourself?

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Yeah. That's a that's a great question, and

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I would say there's probably

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50 ways that I can answer that question.

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I would say that when you think about

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Heartland and you think about our approach to

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technology,

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I'd say the foundation

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in everything that impacts our doctors and their

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teams and ultimately their patients

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goes back to, I'll say, our foundation of

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technology, which is really standardization.

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So, like, we have a standard practice management

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software system, which allows us to have all

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this this common data that we can then

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use to enable the dental practice.

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And so if I'm were to think about

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patient experience,

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I think about it through the lens of

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from the moment they walk into the door,

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through when they're in the chair, and when

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they leave. And when you think about some

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of the technologies that we've applied,

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somebody walks through the door,

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the business assistant could know say hey RJ's

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walking in and you know what

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he's coming in today for cleaning

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but 2 months ago he was in for

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Invisalign and there was a treatment plan was

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established for him but he never did anything

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with that let me have a conversation with

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RJ

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let me talk to him. And so if

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you think about that, we at the front

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end we've got the BA we're enabling them

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to have a better conversation with the patient,

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then they go to the chair and now

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when you think about things like artificial intelligence,

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clinical AI,

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now you've got the patient looking at a

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screen

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with doctor and seeing things that the naked

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eye can't see because artificial intelligence is more

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effective than human eye when viewing x rays.

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So now you think about that patient. They're

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like, wow, look at that.

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And that drives case acceptance and the patient

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is happier because they understand it then they

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go to leave and we think of when

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they go to leave.

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Okay,

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what do you care about the most? Well,

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okay, what do I owe you? What do

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I have to pay? So then you start

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to think about technologies associated with like insurance

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verification

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and eligibility. So when we think about technology

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and when I look at the most impact

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to the offices and impact to the patient,

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you gotta look at the whole system.

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Yeah. Those are the some of the things

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that we see. Yeah. Yeah. It's almost like

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a it's a symbiotic relationship. Everything works together.

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If one thing doesn't work, it affects the

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chain of things. I think that that's really

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key to it. It affects everything around the

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practice, I would assume. Absolutely. You can't look

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at technology in silos. We we are very,

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at Heartland focused on what we call our

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operation systems and we say systems, we're not

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talking about technology systems. We're talking about the

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things we know work in a dental practice.

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So then how do you apply technology to

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those systems? So along that I'll use the

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word value stream along with the steps in

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the process, where can technology enable that for

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both the patient, but also those doctors and

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those teams that are trying to do so

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many things on any given day. At the

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end of the day,

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their mission is to really provide world class

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patient care.

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Yeah. And and I was gonna touch on

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that too in the next step as well.

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How is is this piece, this technology piece

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also enabling

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the clinicians themselves,

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the doctors themselves? Right? Is it is it

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having an impact

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on on administrative burdens? We talk so much

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about burnout. We talk so much about how

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technology can help, how AI can help. How

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are you seeing that effect affect that as

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well in terms of workflows, etcetera?

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Yeah. So so I'll take a a macro

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view for a second, and then we'll talk

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about the the doctors and the doctors and

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their teams. You know, when you think about

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what it takes to operate a dental practice,

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our goal our goal is to remove the

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administrative burden. We want doctors to be doctors.

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So if the phone rings in the in

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the office and they can't get to the

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to the call, it goes to the, to

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patient services.

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And

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they

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they have about, I think, 4, 4,000,000 interactions

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a year. That's like 17,000

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or 18,000 a day. And when you think

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about that, that results in like 12,000 new

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patient schedules a week. Now what's my point?

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Yeah. We have technologies

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that's called like proximity scheduling. So when that

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call comes in and that that PSR representative,

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a screen will come up And if they're

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trying to get a patient in to see

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a dentist, see a doctor, and they can't

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in their primary location based on a map,

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we'll say, well, hey. There's these two other

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offices, Heartland offices that have openings.

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And so how does that help? That's helping

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fill schedules, and that that's helping where where

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we're trying to get new patients in. We're

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trying to, have our doctors be able to

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provide that patient care. They wouldn't know that.

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And so for us, we can facilitate that

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not just for one dental practice, but among

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the community of dental practices at Heartland. That's

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just one little example there.

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But when you think about if you go

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into the office,

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think about the BA behind that the counter.

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The person you go and you talk to

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when you go in and they take your

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insurance card, you know what I'm talking about.

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They they have very high turnover in that

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role and the person that's that is serving

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in the BA role,

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could have been working in retail the week

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before. They don't necessarily have a clinical background.

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They touch literally

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over 30 different technology systems.

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So what did Heartland do? We've consolidated that

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into what we call a common digital experience

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and so we've got a consolidated view

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of those applications. So we've simplified the job

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And so if you think about that, we

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remove the burden. They don't have to go

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to 15 websites. They don't have to go

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to portals. They just go to this one

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view that is aligned to a Heartland system.

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Schedule,

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produce, collect.

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And then when you think about the doctor

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and you talk about AI,

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now you've got and and and we are

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doctor led. So we have to be very

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clear that we don't see clinical AI as

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like replacing the doctor or things or overriding

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them. No. The doctor makes the decision.

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But the doctor now has this augmented capability

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to facilitate a conversation with the with the

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patient

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about about their dental care.

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And so you got to think about it

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holistically, but those are a few examples as

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to how we kind of remove the burden

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and we simplify the roles, but we also

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we focus on our core,

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our vision to be a world class company

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and the leader in dentistry

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by empowering those in the office to be

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doctors.

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Yeah. And I think that that's really the

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key piece is, again, focusing on being a

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doctor and then being able to carry that

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over to over to the patient and and

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really improve the patient experience. I think that

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that's really the the key piece is being

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able to improve the patient experiences along those

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along

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improving the experience for for the doctors as

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well. And I I want you to elaborate

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a little bit on on your role specifically

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as Heartland Dental, as an organization,

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really.

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What are you hearing from dentists on

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why

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having you folks and working with you is

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an advantage?

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And you mentioned, obviously, the the workflow piece

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and the the the pieces where you're able

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to make a difference for them. But why

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do they why should they work with you?

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Why do they want to work with you?

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And what have you heard from practices that

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already have you in in the offices that

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really work with you, on a detailed basis?

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Yeah. So I I think the first thing

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I would say in regard to that is

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is our size and scale. We we are

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the largest DSO,

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and and

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that size and scale allows us to, I'll

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say, leverage relationships with technology providers. We have

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a lot of influence in the industry, so

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we're in a position

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to be able to support doctors and their

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teams more effectively than others.

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I also think that going back to what

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I said earlier that we're doctor led, we

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don't do technology for the sake of technology.

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That in my view is a is a

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recipe for disaster. So that everything that we

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do

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is intended to make their lives easier. And

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we never forget that what what is the

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the the what is the business that we're

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in to support doctors and their teams?

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So I I would I would say that

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if you were to talk to some of

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our our doctors,

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they would get very excited about things like

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artificial intelligence, and us

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now working on automating the revenue cycle, like

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with insurance payment automation

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and,

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real time insurance, verification.

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They'll celebrate things like that. What they may

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or may not know is that in in

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cases like AI, that was studied for the

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better part of 5 years by our clinical

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team before we did a massive

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rollout. So my point is that we're very

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purposeful.

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We're we are an entrepreneurial company, we will

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take risk,

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but we're protective

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of the relationships that we have with our

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doctors because they

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they have to provide world class patient care,

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and they have to maintain the relationships with

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their patients. We don't wanna Yeah. Introduce risk

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by being reckless or doing technology for the

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sake of technology.

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Yeah. Absolutely. And you mentioned sort of the

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the rollout process. Right? Looking at things in

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detail. Hey. We we spent 5 years looking

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at this before we rolled this out for

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you to have access to it.

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It is a longer process itself. And what

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are you seeing sort of as the next

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big thing? Where are you seeing this going?

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Certainly everybody talks about AI and how AI

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will be more intelligent and become more intelligent.

356
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Right? But what do you what do you

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see as the next big thing? What are

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you excited about as as you look at

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this space?

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I'm extremely excited about, I'll say, the advancement

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in technology regarding automation of of the revenue

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cycle. And that's kind of a nebulous term,

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but for us, it's really the insurance payment

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automation

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like electronic remittance advice and and and, electronic

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payments automating

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advice and,

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electronic payments automating that. You would be shocked

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at how many dental practices

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literally have stacks of checks mailed to them,

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that are then reconciled and posted. So So

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that would be 1, and the other would

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be the verification of insurance. There's been significant

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improvements in technologies that allow for real time

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and accurate

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there's 2 ways to look at that, accuracy

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and completeness of verification of insurance, and we're

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studying all of those things now. I'm super

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excited about that because I think I think

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it's time. And I think the technology and

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capabilities have evolved and we can effectively solve

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for that. That will remove a massive

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administrative burden on the offices.

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And the the other opportunity I would say

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is in generally in generative AI, and people

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throw that term around and use it and

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use chat GPT. And there's all these technologies

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out there, but that that is I would

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argue that we are in the middle of

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a technology,

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shift,

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not in the beginning of it. People like

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to say, well, that's new. Well, it's it

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it may seem new, but it's we use

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it every day already. And so when we

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think of generative AI

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beyond, like, clinical applications, when you think of

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things like how we process invoices,

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how we perhaps could introduce AI agents into

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the that call center

401
00:14:10,320 --> 00:14:12,419
when we think about how we could introduce

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00:14:12,480 --> 00:14:14,959
AI agents into that those applications that the

403
00:14:14,959 --> 00:14:17,759
BAs use, making it easier. I have I

404
00:14:17,759 --> 00:14:19,919
have an operations partner. I I love when

405
00:14:19,919 --> 00:14:21,375
she says this. It's RJ. I just wanna

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ask the system a question.

407
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So making it easier for people to do

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00:14:25,855 --> 00:14:26,514
their job.

409
00:14:27,375 --> 00:14:29,154
Automated claims narratives

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through artificial intelligence. So think about that. If

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you do that well,

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00:14:33,460 --> 00:14:36,100
now you're developing a a narrative automatically that

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so what perhaps that will, reduce rejections of

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claims.

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00:14:40,740 --> 00:14:42,820
And so there's all of these things that

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generative AI will apply to, whether it be

417
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on the back end from an administrative perspective

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or actually in the office.

419
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I'm super excited about that and we we

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have a,

421
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I believe in an obligation

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to think about how we will use generative

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00:14:57,774 --> 00:14:59,634
AI effectively, but also responsibly.

424
00:15:00,495 --> 00:15:03,075
Patient data is something we take extremely seriously

425
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And so we we we need to make

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sure that we're continuing to protect that data.

427
00:15:08,779 --> 00:15:10,620
Yeah. It's I agree. And that's why I

428
00:15:10,620 --> 00:15:13,120
I think your process of saying, hey. This

429
00:15:13,579 --> 00:15:15,500
we have a rollout process. Right? We're not

430
00:15:15,500 --> 00:15:16,720
just giving you something.

431
00:15:17,045 --> 00:15:18,485
You're not just gonna get something that I

432
00:15:18,485 --> 00:15:20,485
think is great here. Use it. There's a

433
00:15:20,485 --> 00:15:23,045
process involved. We're not gonna just give you

434
00:15:23,045 --> 00:15:25,365
something that's not refined, that's not at a

435
00:15:25,365 --> 00:15:27,125
place where I would want to use it

436
00:15:27,125 --> 00:15:29,524
myself as a user. I think that's that's

437
00:15:29,524 --> 00:15:31,205
really key. And as you mentioned, so many

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00:15:31,205 --> 00:15:33,870
opportunities there. I think we could, probably keep

439
00:15:33,870 --> 00:15:35,789
going here for another hour or so, and

440
00:15:35,789 --> 00:15:37,789
I certainly have more questions, which, RJ, that

441
00:15:37,789 --> 00:15:39,550
just means you'll have to come back. That's

442
00:15:39,710 --> 00:15:41,649
I think I love to come back.

443
00:15:42,029 --> 00:15:43,250
We'll just have to elaborate,

444
00:15:43,870 --> 00:15:45,549
again, and I wanna thank you for your

445
00:15:45,549 --> 00:15:47,309
time, certainly. I wanna thank you for joining

446
00:15:47,309 --> 00:15:48,884
us today. I think this is a very

447
00:15:48,884 --> 00:15:51,304
insightful conversation. Thanks so much for being here.

448
00:15:51,445 --> 00:15:54,245
You're welcome. Absolutely. RJ, thanks again for joining

449
00:15:54,245 --> 00:15:55,865
me, and I want to thank our listeners

450
00:15:56,084 --> 00:15:58,404
for joining us today and certainly Heartland Dental

451
00:15:58,404 --> 00:16:01,365
for sponsoring today's podcast. Make sure to check

452
00:16:01,365 --> 00:16:03,467
out our other podcast on our site, and

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00:16:03,467 --> 00:16:05,007
we'll see you again soon.