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Hello everyone. I'm Brian
Zerman with Becker's Healthcare.

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Thank you for tuning in to the
Becker's Healthcare podcast series.

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Today I'm pleased to be
joined by Oliver Gillis,

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c m o of Ori Oliver, thank you so much
for talking with us today. Uh, to,

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to begin here, can you just take a moment
to tell us more about yourself, uh,

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and your role at OrthoFi?
And also I believe you have
a, a book coming out soon,

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um, level the Curve, if I'm not
mistaken. Can you, can you talk, um, to,

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to our listeners just a
bit about that as well?

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Yeah, thanks for having
me, Brian. Um, yeah,

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I am the Chief Marketing
Officer for OrthoFi,

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a company that 10 years ago started
with the mission of making orthodontic

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treatment more accessible and
affordable to patients. Um,

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and you know, that has been
a, a fabulous journey. Uh,

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it's been 10 out of the 25 years that
I've been in the dental industry. My,

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um,

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specialty and passion is
helping practices to again,

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connect patients with high quality care,

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whether it's aligners or orthodontic
treatment or as we're getting into now

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in the general dental space, um, high
quality restorative care. And, uh,

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I've been focused on that. I've, uh,
you know, my career has been, you know,

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built on analyzing data and this book
that you referenced that was just

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published, um, last month, um,

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through Forbes Books is all about how a,

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an orthodontic specialty
practice can build, um, a,

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a growing and sustainable patient base
using some of the universal principles

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that I think we're gonna
be talking about today.

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Excellent. Appreciate you, you
sharing that background with,

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with our listeners there.
Let, let's dive in.

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I wanna pull out some of
that expertise, Oliver.

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So case acceptance rates are obviously a,

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a major challenge for
dental practices. Can,

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can you talk a little bit about
the, the factors, the, the,

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the trends here that are preventing
patients from accepting recommended

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treatments and, and,

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and then what sort of effect does this
have on outcomes as well as the effect it

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has on, on, on the dental practice itself?

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Yeah, great question.
Um, obviously, you know,

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macroeconomics always
has a guiding force on,

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you know, case acceptance. Um,

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right now we're a little bit of a
lull through some of the uncertainty.

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That said,

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a lot of people are too quick to
latch onto economy as the sole reason

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affordability and the economy are linked.

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But affordability is also how fees are
presented. And fees, let's be honest,

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are one of the main reasons why people
accept or don't accept treatment,

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especially in the dental
practice environment where
they are not coming in with

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the express intent to get some
form of electric treatment.

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They're often finding out
at their dental visit, um,

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often a hygiene visit that
they need additional care.

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So there's a little bit of
that extra surprise vehicle.

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What we've learned over the last year
and a half of putting together this, uh,

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wonderful, um, project and,

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and this great solution that we're
building is that there's a lot more to it

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than just the, um, economy or even
the fee presentation dynamics.

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What we've seen is that there
are, uh, a handful of factors,

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really four factors that are,
are moving the needle here.

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Number one is the whole fee
presentation experience is often

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highly disjointed,

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and that is because practices
are cobbling together a number of

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vehicles to try to get this case
accepted and these finances approved and

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accepted, um, from a number
of different sources.

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They're often going into their management
system to present the fee as a whole

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fee. Then they're waiting to hear a yes
or a no from the patient before deciding

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whether or not to, um, get them to
apply to a third party lender. Um,

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we'll talk about approval rates on
that as sort of the second thing,

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but if that doesn't work, then they're
gonna go and do a different thing.

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And it's a very disjointed experience
that when you're thinking about influence

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mechanics is not really ideal.

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You're waiting for people to say no
several times before you may get to the

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final result. Um,

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so that's really the first thing
is that disjointed experience.

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The second part of of this is the
fact that the actual, you know,

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offers themselves are very limited.

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There are historically
relatively low approval rates,

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and even if the patient is approved,

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what is very common out there in the
dental market is that you've got lenders

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that are constantly promoting and
pumping these high approval rates, 80%,

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85% approval.

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But what they're not telling you in the
fine print is that those approvals often

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are partial approvals where the patient
may be approved for 10 15 or maximum

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20% of their total cost, um,

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which is great for the lender to
be able to advertise the approval,

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but that doesn't get the case accepted.

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And so there's a lot of that misnomer and
clever use of, of, of success metrics,

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which doesn't end up turning
into case acceptance,

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which to be honest with you at most
is around 30 to 35% out in the dental

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market. Um, the offers themselves
are often not very compelling.

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So that's the third reason, is
that there's often, you know,

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predatory interest levels or very
high MDRs for the practice to pay.

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And so that is not really
designed well for the practice.

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And then the last part is the
actual metrics. Um, you know, the,

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the Drucker saying that you can't manage,

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what you can't measure is operating here
where very few practices have a clean

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view to their actual case acceptance.

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It's a lot of garbage in garbage
out in their management system.

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And we've seen even in
our beta test that, um,

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practices often are way lower in their
actual case acceptance than what they

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even thought anecdotally, um, because
the measurement, um, is not really there.

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So all,

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you put all those four together and all
of that is touching case acceptance.

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The other side effect of our current
environment where there's imperfect

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solutions and a disjointed
experience is that a lot of practices

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expect that they are
going to have a problem.

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And so they get into a bad
habit of a wallet sizing, right?

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Where they are looking at the brand
of the patient's shoes or purse or bag

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and deciding whether or not
they're going to present treatment.

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And then what often happens, and
we've even seen this in the beta,

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is that they will often present a very
small fraction of what the patient

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truly needs because they are expecting
that the patient will not be approved.

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I mean, a, that's not good
for the patient, right?

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If you're only telling them about a
fifth of the care that they need, and B,

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you're not even giving the patient a
chance to accept and say yes to a higher

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fee. One anecdote, by the way,

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we were in one of our beta practices and
the practice shared with us that this

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patient probably could use up to
I think $7,000 worth of treatment,

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which I mean, that's a, that's
a definitely a big number. Um,

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but instead of allowing our system
to show them the financial options,

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they opted to only present 700.

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The way that the workflow works in a,

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in a dental practice today has been
largely informed and, and informed

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by the lenders, right? Like the, the,

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the fact that practices have been
educated to only want third party

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financing for cash flow.
And the fact that, um,

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the workflow works the way it does, again,

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has been essentially formed
by the lender. So the, the,

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the most important stakeholder
that is the patient is a

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last consideration derivative,

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and the practice is the second
most important stakeholder,

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and they are behind the lender in
terms of the priority of this process.

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So that's kind of backwards and, and
it's understandable. The, the lenders,

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you know, have the control of
the money, and so it makes sense,

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but the workflow is not designed to make
it better and easier for the patient

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and better and more effective for
the practice first. So this is the,

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this is, as an industry, whether it's
our product or whether it's another,

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we really gotta take a, a, a look at

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who is this flow being designed around?

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And it should be designed around the
patient first and the practice second.

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Yeah. I really appreciate you
walking us through sort of the,

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this disjointed experience
that, that patients have and,

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and staff have as well trying
to, to execute on this. Uh,

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and I wanna dig in even, even deeper
here. Can, can you talk about,

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and maybe it's expanding upon
what you've already shared,

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maybe it's something new, but, but
different parts of the patient journey or,

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or clinical processes that,

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that could really be improved
here to increase acceptance. And,

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and I also would love it if you
could talk a little bit about the,

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the element of patient choice here and
why that is so important and why having

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choice matters to to patients.

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Yeah. Open choice is our, um,
you know, really proven concept.

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And we've tested this and proven this
out on over a million patient starts on

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the orthodontic side,

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and we're really trying to
bring the fruits of all of
this intelligence over the

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dental side. Um, the, the truth
is, open choice is very, um,

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you know, is already proven in other
retail environments. If you look at,

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you know, big high-end retailers
like Amazon, uh, Wayfair,

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apple,

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they are all learning and understanding
that presenting a total cost along

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with, uh, a pay as you go
option increases the total, um,

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acceptance of that particular
cost. So we didn't invent it.

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What we have done is we've really put it
into the dental environment and proven

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it over a million times. The concept
of open choice really is just this,

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that you wanna put the power in
the patient's hands and let them

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decide between options. It's the old
concept of, rather than ask a question,

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do you want to do something? Yes or no?

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It is which of these wonderful options
is best for you? And automatically,

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psychologically it already sets you off
on a better, uh, on a better path. Now,

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in order to do that, you need a workflow
that, that, that, that works that way.

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And, um,

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unfortunately we've been trapped in
this mode where you wait to hear no,

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then you apply and, and see if that
works. And then there might be a no there,

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and then there might be a break in case
of emergency third option. So again,

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it's set up, um, the,
the, the wrong, uh, way.

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What's super interesting about that is
we've also seen that there's a bit of

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Stockholm syndrome, right?
Practices all experience this.

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When we ask them, they all agree
and experience that, you know,

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they often have to deal with what
to do when there has been, you know,

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when there's not an approval. Um,

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but what they think they need is just a
better lender that's gonna approve more.

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And what they really need is an
actual completely new experience and

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flow where all of this
happens within a certain flow.

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So you're not gonna have
one lender application that
goes to one lender and then

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a, a a, you know, acceptor or reject.

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We're gonna have all the lenders
in a network app, you know,

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where one application is gonna make, um,

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the practice understand what the
options are for every patient.

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And when that's not an option,

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there's gonna be a seamless compliment
where the patient is gonna have a

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financial option regardless
of their credit, uh, rating,

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and they're always gonna
be able to say yes.

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So the key is they need a whole
new workflow and experience,

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not just a better lender,
if that makes sense.

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No, no, it absolutely does.
But it, it sounds like here to,

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to create such an experience, uh,
to create such a workflow, uh,

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what immediately comes to mind for me
is technology's gonna be critical here.

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Correct. Um,

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can can you talk a little bit about
how technology can be leveraged in this

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space to, to sort of improve
case acceptance rates?

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And are there any best practices
here tools, specific tools that,

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that you wanna discuss or
recommend for our listeners?

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Yeah, so obviously the technology, I mean,

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there's a convergence between the
technology that we have available. Um,

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the fact is that we can,

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today one application can simultaneously
go out to a network of different

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lending opportunities to get,

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see who approves and by how much user
interfaces are able to display multiple

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choices, um, so that patients, you
know, have that open choice. Um,

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we have the control to display it in
the most patient, uh, friendly way.

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We have the ability to
take payments virtually.

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We have the ability to take
payments in real time, um,

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and get all these approvals. So
all of that technology convergence.

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And then on the back end, the other
technology that's available is automated,

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um, multi-channel messaging. So
we've talked a lot about, you know,

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getting that case acceptance when
they come in at that point of sale,

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but what we haven't talked about is
that automated pending management

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functionality that is also required
to maximize case acceptance.

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Not every patient is ready
to make a decision today.

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We're gonna make that far more
possible than it's ever been,

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but when they don't say yes
today, modern technology and, and,

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and other companies are leveraging
multi-channel automated messaging

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that follows the patient for,
in this case up to 90 days.

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And we're seeing some
really compelling, um,

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00:13:23,750 --> 00:13:27,880
results from that that is really
surprising, the patient. So for example,

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in our beta, um,

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right now we're seeing that
32% of our accepted cases

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were accepted between day
seven and 30 following their,

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their visit and their feed
presentation. In a typical practice,

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the follow up is lacking. It's, it's
not consistent, it's hard to do.

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There's just a lot of patients going
through and the team often is unable to

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sustainably kind of keep
behind them, um, in that way,

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but technology makes it to
where it's automated and simple.

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Yeah, I, I really wanna
hone in here on the,

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on the payment element of this
just because anecdotally and as,

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as a consumer broadly in
the economy, right, it's,

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it's never been easier to pay for stuff.

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It feels very convenient and easy to pay
for things that is not necessarily true

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when it comes to, to healthcare and,
and, and dental care, right? Uh,

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it's not always easy, uh, or convenient
to, to pay for things. But, uh, that,

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that said,

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can you talk about why these payment
technologies that you just laid out are,

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are just so important and, and,

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and having this streamlined sort
of different payment options for,

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for dental patients is so important?

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Yeah, I mean, when people want something,
you need to capture that moment.

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The attention span of the average consumer
is getting shorter and shorter and

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shorter and shorter.
And so, you know, when,

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when you have an environment where
it's disjointed and difficult,

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you may have a patient that is at the
peak of their desire for a particular

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treatment. And if that,

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if they can't consummate that
desire right then and there,

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there's a chance that you're
gonna lose that moment,

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you're gonna lose that window.

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And so offering technologies that are
mobile friendly that meet the patient

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where they are,

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where they're able to open a link to
review their payment options from a visit

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they might have had a
week or two weeks ago,

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and they're able to see their financial
options and say yes to them and actually

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make that payment right then and there
you are basically compressing the entire

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awareness, interest, desire,
action cycle into the,

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into the two minutes that
you have their attention.

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And that is mission critical.

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The likelihood that they're gonna remember
all that and maybe revisit that on

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their next dental visit six
months later is close to zero.

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And it's also very unlikely that the
practice is gonna remember that they need

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to follow up with that patient,
um, on their next visit.

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00:15:43,580 --> 00:15:47,310
Yeah, and I'm sure that rings true for
a lot of folks, a as consumers, right?

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I know I, I've shared this on the,
the podcast I believe before, but, um,

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anecdotally for me, if,

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if it doesn't have Apple pay
and I'm online looking at
it and I've gotta like go

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get my card and fill out
a whole bunch of stuff,

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if it's not very convenient or
doesn't capture me in that moment,

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I'm less likely to do it. I think that's
that's true for a lot of folks, right,

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Oliver?

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That's right. In, in every, in every
corner of your consumer experience,

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this is just one of the corners,

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but in every aspect of
your consumer experience,

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if you search your own
behavior, um, you'll,

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you'll see that that's universally true.

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Excellent. So, so you've given we,
we've covered a lot of ground in a,

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in a relatively short period of time,

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but as we come to the
close of the conversation,

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I'm wondering if you can share any other
specific success stories you've seen

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here or notable outcomes you,

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you can share from your experience with
OrthoFi partners that have adopted this

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technology and input it to use any
specifics you can share with our fo our,

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our audience.

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00:16:41,150 --> 00:16:45,580
Absolutely. So if you talk about the
proven concept of open choice, you know,

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what you'll find in the OrthoFi solution,

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which up to this point has
been largely, um, you know,

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specialty related, right?
So specialty practices,

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we are in over 1100
locations and you know,

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for the last 10 years we've
been tracking results.

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And what we can report is that
the average practice on, you know,

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the OrthoFi solution is seeing
same day conversion rates over 40%,

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which is over two times
the industry average.

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So this concept works in
terms of like the, the,

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the dental version of this that can
be used not just for aligner cases,

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but for any elective dental
treatment is currently in beta.

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And we're seeing some
really exciting results.

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So practices that are utilizing
this fully for every case are

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seeing their short-term case acceptance,
um, at, you know, around 40%.

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And that's just in the first,
you know, seven to 10 days.

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We still are collecting data on all
the case acceptances that are gonna be

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coming in over the next 30 to 60 days.

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So we're still collecting what
will be an improving data set. Um,

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and the other thing I
mentioned is, you know,

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we are seeing that evidence that that
automated pending management is having a

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really big impact. Um,

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00:18:00,660 --> 00:18:04,000
so that's why we expect that these
numbers are only gonna improve. Um,

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so some very,

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very exciting early results
and more and better to come.

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And looking forward to hearing about
those more and better to come, uh,

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00:18:13,650 --> 00:18:16,210
a as time goes on here.
Oliver, thank you so much for,

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00:18:16,510 --> 00:18:20,010
for being with me today and, and, and
thanks a and, and congratulations on,

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00:18:20,010 --> 00:18:23,130
on having the book published. I think
that's, that's fantastic. Is there any,

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00:18:23,230 --> 00:18:24,410
any quick closing thoughts? Any,

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anything left you'd like to share
with listeners before we sign off?

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00:18:28,660 --> 00:18:30,230
Yeah, just in general, you know,

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what I would ask everyone out
there to think about is, you know,

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really consider this issue of analyzing
what it is that is going wrong with

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their case acceptance and
really questioning is it
really just that I need to

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00:18:42,510 --> 00:18:47,390
shop a new lender or is it that I
need a new patient acquisition and

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conversion workflow? And if you come to
the ladder, um, we do have a solution.

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It's called accept care. Um, we
are, um, excited about launching it,

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um, later this summer. Um, if
you are interested in, you know,

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00:19:01,310 --> 00:19:05,830
being a beta user, um, you
know, we, I, I would, uh,

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00:19:05,830 --> 00:19:10,830
encourage you to contact us and
or to visit accept care.com. Um,

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we are gonna be, you know, taking, uh,
interested practices into the last,

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um, phase of our beta and
then obviously, you know,

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into launch later this summer. So.

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00:19:22,940 --> 00:19:26,300
Excellent. Oliver, thank you once again
for being here. I also, of course,

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wanna thank our podcast sponsor OrthoFi.

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00:19:29,000 --> 00:19:32,620
You can tune to more podcast from
Becker's Healthcare by visiting becker

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00:19:32,620 --> 00:19:33,820
podcast.com.

