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Protecting Dentists and Their Practices, Jack McKinney, TDIC

October 7, 2025 by John Ray

Protecting Dentists and Their Practices, Jack McKinney, TDIC, on Dental Business Radio with host Patrick O'Rourke
Dental Business Radio
Protecting Dentists and Their Practices, Jack McKinney, TDIC
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Protecting Dentists and Their Practices, Jack McKinney, TDIC, on Dental Business Radio with host Patrick O'Rourke

Protecting Dentists and Their Practices, Jack McKinney, TDIC (Dental Business Radio, Episode 61)

Patrick O’Rourke welcomes Jack McKinney, Vice President of Sales and Service for The Dentists Insurance Company (TDIC) and TDIC Insurance Solutions, for a practical conversation about how dentists can protect their livelihoods before problems strike.

Jack explains how TDIC’s carrier and agency work together to give dentists comprehensive protection, from professional liability and property coverage to cyber, disability, and long-term-care plans. He also shares why dentists should never treat insurance like a one-time purchase, how business model changes such as teledentistry can affect coverage, and why TDIC’s peer-review process for nonrenewals is so unusual in the industry.

This episode is a reminder that running a successful practice isn’t just about clinical skill. It’s about understanding risk, staying proactive, and partnering with advisors who know the dental world as well as you do.

Dental Business Radio is underwritten and presented by Practice Quotient: PPO Negotiations & Analysis and produced by John Ray and the North Fulton affiliate of Business RadioX®.

Key Takeaways in This Episode

  • By dentists, for dentists: The Dentists Insurance Company (TDIC) was created by the California Dental Association to address rising malpractice costs and now provides a full range of coverage options.
  • Two entities, one purpose: TDIC is the carrier, while TDIC Insurance Solutions acts as the agency distributing TDIC and other carriers’ products to ensure dentists have the right fit for their practice.
  • Comprehensive protection matters: Beyond professional liability, practices should consider property, cyber, EPLI, workers’ comp, disability, and long-term care coverage to fully protect their business and income.
  • Be proactive, not reactive: Dentists should schedule regular insurance reviews, especially before acquisitions, relocations, or business model changes like teledentistry.
  • Unique peer review process: TDIC’s nonrenewal appeals are reviewed by a board of dentists, allowing for real-world context and fairness that’s rare in the insurance industry.

Topics Discussed in this Episode

00:00 Introduction to Dental Business Radio
01:11 Meet Jack McKinney: Insurance Industry Veteran
03:13 Understanding TDIC and Its Services
10:27 Insurance Needs for New Dentists
13:03 The Importance of Disability and Life Insurance
19:01 Buy-Sell Agreements and Other Insurance Considerations
21:33 Understanding Insurance Ownership and Risks
21:56 When to Revisit Your Insurance Policies
22:33 Teledentistry and Insurance Implications
25:34 The Role of Underwriters and Actuaries
26:45 Unique Appeals Process for Non-Renewals
27:41 The Rapid Evolution of Healthcare and Insurance
29:42 Cyber Insurance: Costs and Necessity
33:41 Long-Term Care Insurance: What You Need to Know
39:25 The Importance of Regular Insurance Checkups
41:26 Conclusion and Final Thoughts

Jack McKinney and The Dentists Insurance Company (TDIC)

Jack McKinney is Vice President of Sales and Service for The Dentists Insurance Company (TDIC) and TDIC Insurance Solutions, where he leads teams that help dentists protect their practices through comprehensive risk management and coverage solutions. With more than 35 years of experience on both the agency and carrier sides of the insurance industry, Jack is known for his expertise in professional liability, property, and casualty insurance, as well as his commitment to educating dental professionals on proactive protection for their businesses. Based in Sacramento, he continues to advance TDIC’s mission of serving the dental community with integrity and practical insight.

TDIC is a specialized insurance company founded in 1980 by a group of dentists to provide professional liability insurance and related coverage tailored specifically for dentists. It focuses exclusively on protecting dentists and their practices with comprehensive insurance products, including professional liability, employment practice liability, commercial property, workers’ compensation, and cyber liability, among others. TDIC serves a community of more than 24,000 dentists across 15 states, has earned an A (Excellent) rating from AM Best for over 30 years, and holds endorsements from several state dental associations.

The company emphasizes personalized service delivered by experts who understand the dental profession and offers risk management resources, continuing education, and claims support designed specifically for dentists. TDIC also provides online account management to simplify policy handling and bill payments. The company aims to offer exceptional protection at a fair price, backed by its longstanding history and commitment to the dental community.

Website | LinkedIn | Jack’s LinkedIn

About Dental Business Radio

Patrick O'Rourke
Patrick O’Rourke, Host of Dental Business Radio

Dental Business Radio covers the business side of dentistry. Host Patrick O’Rourke and his guests cover industry trends, insights, success stories, and more in this wide-ranging show. The show’s guests include successful doctors across the spectrum of dental practice providers, as well as trusted advisors and noted industry participants.

Dental Business Radio is underwritten and presented by Practice Quotient and produced by John Ray and North Fulton Business Radio, LLC, an affiliate of Business RadioX®. You can find the show on all major podcast apps and access the complete show archive here.

Practice Quotient

Practice QuotientPractice Quotient is the sponsor of Dental Business Radio. Practice Quotient, Inc. serves as a bridge between the payor and provider communities. Their clients include general dentists and dental specialty practices across the nation of all sizes, from completely fee-for-service-only to active network participation with every dental plan possible. They work with independent practices, emerging multi-practice entities, and various large ownership entities in the dental space. Their PPO negotiations and analysis projects evaluate the merits of the various in-network participation contract options specific to your practice’s patient acquisition strategy. There is no one-size-fits-all solution.

Connect with Practice Quotient

Website | LinkedIn | Facebook | X (Twitter)

Tagged With: California Dental Association, cyber coverage, Dental Business Radio, dental insurance, dental risk management, dentistry, disability insurance, insurance for dentists, Jack McKinney, malpractice insurance, Patrick O'Rourke, PPO Negotiations & Analysis, PPO network contract, PPO network contract analytics, Practice Quotient, professional liability, small business protection, TDIC, TDIC Insurance Solutions, The Dentists Insurance Company

Christine Taxin, Links2Success

January 16, 2023 by John Ray

Christine Taxin
Dental Business Radio
Christine Taxin, Links2Success
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Christine Taxin

Christine Taxin, Links2Success (Dental Business Radio, Episode 39)

Christine Taxin, Founder and President of Links2Success, was the guest on this episode of Dental Business Radio. She and host Patrick O’Rourke discussed medical billing in dental practices, Christine’s dental medical billing and coding training, some of the current issues in the field, the upcoming Insurance Extravaganza 2023 in Orlando, and much more.

Dental Business Radio is underwritten and presented by Practice Quotient: PPO Negotiations & Analysis and produced by the North Fulton studio of Business RadioX®.

Links2Success

When running a dental practice, clinical expertise and quality customer service comes first – but what about the behind-the-scenes work? Many dentists and team members struggle to keep up with the complicated world of dental billing and insurance claims while also remaining as profitable as possible.

Thankfully, Christine Taxin is here to lend a helping hand and shed some much-needed light on best practices for billing, staying current with yearly codes, taking advantage of medical/dental cross coding, and much more.

Yearly codes, collections, co-payments, patient privacy – there’s a lot to keep in mind when handling dental insurance, and the rules and regulations are constantly being updated as well. Maybe your team is regularly running into issues or even concerned about a future audit. Maybe you’re concerned about potentially leaving money on the table. Whatever the case may be, it’s time to receive guidance and training from a true expert in the field.

Christine Taxin is a member of the National Association of Dental Plans, is on the Dental Benefit Council of the ADA, and also fully licensed by the American Dental Association to share ADA CDT Codes. She can provide comprehensive training to your entire team that covers several important objectives and topics related to dental billing and coding, including the following:

  • State-Federal government regulations of dental/wellness benefits
  • How to successfully complete new insurance forms
  • Utilizing diagnostic codes to access maximum insurance benefits
  • Updating medical history forms
  • Navigating the various legalities of narrative writing and documentation
  • And much more!

Company website | LinkedIn | Facebook | Twitter

Christine Taxin, Founder and President, Links2Success

Christine Taxin
Christine Taxin, Founder and President, Links2Success

Christine Taxin is the founder and president of Links2Success, a practice management consulting company to the dental and medical fields. Prior to starting her own consulting company, Ms. Taxin served as an administrator of a critical care department at Mt. Sinai Hospital in New York City and managed an extensive multi-specialty dental practice in New York.

With over 25 years’ experience as a practice management professional, she now provides private practice consulting services, delivers continuing education seminars for dental and medical professionals, and serves as an adjunct professor at the New York University (NYU) Dental School and Resident Programs for Maimonides Hospital.

LinkedIn

About Dental Business Radio

Patrick O'Rourke
Patrick O’Rourke, Host of “Dental Business Radio”

Dental Business Radio covers the business side of dentistry. Host Patrick O’Rourke and his guests cover industry trends, insights, success stories, and more in this wide-ranging show. The show’s guests include successful doctors across the spectrum of dental practice providers, as well as trusted advisors and noted industry participants. Dental Business Radio is underwritten and presented by Practice Quotient and produced by the North Fulton studio of Business RadioX®. The show can be found on all the major podcast apps and a complete show archive is here.

 

Practice Quotient

Dental Business Radio is sponsored by Practice Quotient. Practice Quotient, Inc. serves as a bridge between the payor and provider communities. Their clients include general dentist and dental specialty practices across the nation of all sizes, from completely fee-for-service-only to active network participation with every dental plan possible. They work with independent practices, emerging multi-practice entities, and various large ownership entities in the dental space. Their PPO negotiations and analysis projects evaluate the merits of the various in-network participation contract options specific to your Practice’s patient acquisition strategy. There is no one-size-fits-all solution.

Connect with Practice Quotient

Website | LinkedIn | Facebook | Twitter

Tagged With: Christine Taxin, dental billing, Dental Business Radio, Dental Medical Billing University, insurance, Links2Success, medical billing, Patrick O'Rourke, PPO Negotiations & Analysis, PPO network contract, PPO network contract analytics, Practice Quotient, sleep apnea

Janet Hagerman, THE Case Acceptance Coach

November 2, 2022 by John Ray

Janet Hagerman
Dental Business Radio
Janet Hagerman, THE Case Acceptance Coach
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Janet Hagerman

Janet Hagerman, THE Case Acceptance Coach (Dental Business Radio, Episode 34)

Janet Hagerman, THE Case Acceptance Coach, speaker, author, and dental consultant, joined host Patrick O’Rourke to discuss strategies and tactics that dental practices can implement to increase case acceptance. She described a coordinated sales philosophy for practices, the use of “feel, felt, found” in patient consultations, emotion versus logic in buying decisions, the use of storytelling, and much more.

Dental Business Radio is underwritten and presented by Practice Quotient: PPO Negotiations & Analysis and produced by the North Fulton studio of Business RadioX®.

Janet Hagerman, THE Case Acceptance Coach

Janet Hagerman, THE Case Acceptance Coach

Janet Hagerman trains dentists and their teams to communicate more effectively with their patients, and each other. Her courses, articles, podcasts, books, coaching, and presentations help healthcare professionals clearly communicate the value of their services, leading to patient compliance. Janet helps dentists and their teams to Sell Dentistry – Ethically, Elegantly, Effectively.

Janet Hagerman is known as THE Case Acceptance Coach. Janet’s communication systems help dental teams to double their case acceptance and elevate their patient experience. A Medical College of Georgia graduate, Janet has spent over 30 years in clinical practice, solo and group practice coaching, and DSO corporate leadership. An international speaker, author, and consultant, Janet is the author of numerous articles, podcasts, and webinars, and the signature book/course “Selling Dentistry~Ethically.Elegantly.Effectively” ℠.

Company website | LinkedIn | Facebook

About Dental Business Radio

Patrick O'Rourke
Patrick O’Rourke, Host of “Dental Business Radio”

Dental Business Radio covers the business side of dentistry. Host Patrick O’Rourke and his guests cover industry trends, insights, success stories, and more in this wide-ranging show. The show’s guests include successful doctors across the spectrum of dental practice providers, as well as trusted advisors and noted industry participants. Dental Business Radio is underwritten and presented by Practice Quotient and produced by the North Fulton studio of Business RadioX®. The show can be found on all the major podcast apps and a complete show archive is here.

 

Practice Quotient

Dental Business Radio is sponsored by Practice Quotient. Practice Quotient, Inc. serves as a bridge between the payor and provider communities. Their clients include general dentist and dental specialty practices across the nation of all sizes, from completely fee-for-service-only to active network participation with every dental plan possible. They work with independent practices, emerging multi-practice entities, and various large ownership entities in the dental space. Their PPO negotiations and analysis projects evaluate the merits of the various in-network participation contract options specific to your Practice’s patient acquisition strategy. There is no one-size-fits-all solution.

Connect with Practice Quotient

Website | LinkedIn | Facebook | Twitter

Tagged With: Dental Business Radio, dentistry, dentists, DSOs Done Right, Janet Hagerman, Patrick O'Rourke, PPO Negotiations & Analysis, PPO network contract, Practice Quotient, Selling Dentistry, The Case Acceptance Coach

Mark Lakis, Southern Dental Alliance

January 18, 2021 by John Ray

Mark-Lakis-DBR
Dental Business Radio
Mark Lakis, Southern Dental Alliance
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Mark Lakis, Southern Dental Alliance (“Dental Business Radio,” Episode 11)

Southern Dental Alliance CEO Mark Lakis joins host Patrick O’Rourke to discuss how his DSO allows doctors to be doctors and provide better access to care for patients. Mark also discusses the partnership operating model of Southern Dental Alliance and its advantages for both doctors and patients. “Dental Business Radio” is underwritten and presented by Practice Quotient: PPO Negotiations & Analysis and produced by the North Fulton studio of Business RadioX®.

Southern Dental Alliance

The mission of Southern Dental Alliance is to assist Founder Doctors with the day to day business functions of owning a company, without changing the integrity of the practices they have nurtured and developed. Our focus is to help great doctors, with great practices continue to grow and succeed. We want doctors to be doctors. We provide non-clinical support services to our Affiliated Dentists to enable them to focus on providing the highest quality of care to their patients.

The company has completed 14 acquisitions, expanded services in our affiliated practices, centralized administrative functions and built an exceptional management team to support further growth. We can help doctors run their offices more efficiently, make it possible for them to provide expanded care, increase access to care and make their teams life easier.

Website

Affiliate Practices:

  • Georgia:  Vital Smiles Georgia, Children’s Dental Center, PC, Aberdeen Dental Group, Coweta Dentistry Associates, Choice One Dental Care
  • South Carolina:  Carolina Dental Alliance, Carolina Dental Docs, Novus Orthodontics, Foster Orthodontics, Joseph Orthodontics, Choice One Dental Care of Greenville
  • Tennessee:  Zoo Crew Pediatric Dentistry

Mark Lakis, CEO, Southern Dental Alliance

In Mark’s current position as CEO of Southern Dental Alliance, he helped build the company from two dental practices with $7 million in revenue in one state to a fully functional regional DSO, with 43 practices in three states and over $70 million in revenue.

Prior to Southern Dental Alliance, Mark was President of Children’s Dentistry/Dentistry for Children, where we drove rapid revenue and EBITDA growth then led the company though a successful sale to private equity investors.

Prior to his experience in healthcare services, Mark had a highly successful career in the financial and operational management of global companies.

Connect with Mark on LinkedIn.

About Dental Business Radio

“Dental Business Radio” covers the business side of dentistry. Host Patrick O’Rourke and his guests cover industry trends, insights, success stories, and more in this wide-ranging show. The show’s guests will include successful doctors across the spectrum of dental practice providers, as well as trusted advisors and noted industry participants. “Dental Business Radio” is underwritten and presented by Practice Quotient and produced by John Ray and the North Fulton studio of Business RadioX®.

Practice Quotient

“Dental Business Radio” is sponsored by Practice Quotient. Practice Quotient, Inc. serves as a bridge between the payor and provider communities. Their clients include general dentist and dental specialty practices across the nation of all sizes, from completely fee-for-service-only to active network participation with every dental plan possible. They work with independent practices, emerging multi-practice entities, and various large ownership entities in the dental space. Their PPO negotiations and analysis projects evaluate the merits of the various in-network participation contract options specific to your Practice’s patient acquisition strategy. There is no one-size-fits-all solution.

Connect with Practice Quotient:

Website

LinkedIn

Facebook

Twitter

Tagged With: Aberdeen Dental Group, Carolina Dental Alliance, Carolina Dental Docs, Children's Dental Center, Choice One Dental Care, Choice One Dental Care of Greenville, Coweta Dentistry Associates, dental service organization, DSO, Foster Orthodontics, Joseph Orthodontics, Mark Lakis, Novus Orthodontics, pat o'rour, Pat O'Rourke, Patrick O'Rourke, PPO Negotiations & Analysis, PPO network contract, PPO network contract analytics, Practice Quotient, Southern Dental Alliance, Vital Smiles Georgia

Kevin Cumbus, TUSK Partners

September 4, 2020 by John Ray

KevinCumbusTUSKPartners
Dental Business Radio
Kevin Cumbus, TUSK Partners
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Kevin Cumbus

Kevin Cumbus, TUSK Partners (“Dental Business Radio,” Episode 4)

Kevin Cumbus, TUSK Partners, joined host Patrick O’Rourke to explain how dental practices are valued for purchase, the effect of insurance carriers on dental practice values, and various other factors impacting the value of a practice. Additionally, Kevin and Pat have a compelling discussion on the dilemma facing Delta Premier-only status contracted practices during a transition. “Dental Business Radio” is underwritten and presented by Practice Quotient: PPO Negotiations & Analysis and produced by the North Fulton studio of Business RadioX®.

TUSK Partners

TUSK Partners sells large solo practices and Groups to silent investors, DSOs and Private Equity Groups for well over 100% of collections. TUSK currently has over $100M of transactions under LOI and another $50M coming to market in the next 6 months.

Kevin Cumbus, President

Kevin Cumbus is President and Co-Founder of TUSK Partners. TUSK Partners helps dentists START, GROW and SELL their DSO or Group Practice. TUSK provides Sell-Side Advisory Services, Capital Solutions and Strategic Consulting. Since 2016, TUSK has worked with over 120 Group Practices and DSOs nationwide with over 1,000 locations and over $1 Billion in revenue.

Connect with Kevin: Kevin on LinkedIn TUSK Partners on LinkedIn Facebook

Patrick O’Rourke, Host of Dental Business Radio

Patrick O’Rourke began his career in operations management at a dental & vision insurance company in Florida, which after several acquisitions and mergers, is now MetLife. He spent five years at Humana in Atlanta selling in the large group segment (100+ employees). In addition to several awards throughout his career, he has earned many professional certifications.

Understanding the nuances involved with all aspects of risk management helped business partners rely on his expertise to guide client recommendations. He is an insurance insider that has built dental networks, worked in operations management, designed dental plans, and opened markets.

In 2013, he founded Practice Quotient, which specializes in dental insurance PPO network contract analytics and reimbursement guidance, representing the dental provider.

As a national public speaker, Patrick educates doctors on how dental managed care participation impacts more than 50% of practice revenue, the importance of diligent contract management, and how to develop criteria specific to a patient acquisition strategy for choosing the best carrier business partners.

About Dental Business Radio

“Dental Business Radio” covers the business side of dentistry. Host Patrick O’Rourke and his guests cover industry trends, insights, success stories, and more in this wide-ranging show. The show’s guests will include successful doctors across the spectrum of dental practice providers, as well as trusted advisors and noted industry participants. “Dental Business Radio” is underwritten and presented by Practice Quotient and produced by the North Fulton studio of Business RadioX®.

Practice Quotient

“Dental Business Radio” is sponsored by Practice Quotient. Practice Quotient, Inc. serves as a bridge between the payor and provider communities. Their clients include general dentist and dental specialty practices across the nation of all sizes, from completely fee-for-service-only to active network participation with every dental plan possible. They work with independent practices, emerging multi-practice entities, and various large ownership entities in the dental space. Their PPO negotiations and analysis projects evaluate the merits of the various in-network participation contract options specific to your Practice’s patient acquisition strategy. There is no one-size-fits-all solution.

Connect with Practice Quotient:

Website

LinkedIn

Facebook

Twitter

Tagged With: Delta Dental Insurance, Delta Premier, dental industry, dental practice valuations, dental practices, DSO, Kevin Cumbus, Pat O'Rourke, Patrick O'Rourke, PPO Negotiations & Analysis, PPO network contract, PPO network contract analytics, Practice Quotient, specialty dental practices, TUSK Partners

Patrick O’Rourke, Practice Quotient

May 13, 2020 by John Ray

Practice Quotient
Dental Business Radio
Patrick O'Rourke, Practice Quotient
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Practice Quotient
Patrick O’Rourke, Practice Quotient

Patrick O’Rourke, Practice Quotient (North Fulton Business Radio, Episode 233)

Practice Quotient helps general dentistry practices and other specialty dental practices maximize the reimbursement they receive from dental insurance carriers. Founder and CEO Patrick O’Rourke joins the show to discuss how his firm helps significantly improve the profitability of their clients. The host of “North Fulton Business Radio” is John Ray and the show is produced virtually by the North Fulton studio of Business RadioX® in Alpharetta.

Patrick O’Rourke, Founder & CEO

Patrick O’Rourke began his career in operations management at a dental & vision insurance company in Florida, which after several acquisitions and mergers, is now MetLife. He spent five years at Humana in Atlanta selling in the large group segment (100+ employees). In addition to several awards throughout his career, he has earned many professional certifications.

Understanding the nuances involved with all aspects of risk management helped business partners rely on his expertise to guide client recommendations. He is an insurance insider that has built dental networks, worked in operations management, designed dental plans, and opened markets.

In 2013, he founded Practice Quotient, which specializes in dental insurance PPO network contract analytics and reimbursement guidance, representing the dental provider.

As a national public speaker, Patrick educates doctors on how dental managed care participation impacts up to 50% of practice revenue, the importance of diligent contract management, and how to develop criteria specific to a patient acquisition strategy for choosing the best carrier business partners.

To connect with Pat, you can email him directly or call 470-592-1680.

Practice Quotient

Patient Quotient, Inc. serves as a bridge between the payor and provider communities. Their clients include general dentist, oral surgeons, and other dental specialty practices across the nation of all sizes, from completely fee-for-service-only to active network participation with every dental plan possible.  They work with independent practices, emerging multi-practice entities, and various large ownership entities in the dental space.

Their projects evaluate the merits of the various in-network participation contract options specific to a practice’s patient acquisition strategy. There is no one-size-fits-all solution.

While their team is comprised of many individuals, both clients and carrier representatives always interact with the firm’s leadership team.

For more information, go to https://www.practicequotient.com/.

 

North Fulton Business Radio” is produced virtually from the North Fulton studio of Business RadioX® in Alpharetta. You can find the full archive of shows by following this link. The show is available on all the major podcast apps, including Apple Podcasts, Spotify, Google, iHeart Radio, Stitcher, TuneIn, and others.

Renasant Bank has humble roots, starting in 1904 as a $100,000 bank in a Lee County, Mississippi, bakery. Since then, Renasant has grown to become one of the Southeast’s strongest financial institutions with over $13 billion in assets and more than 190 banking, lending, wealth management and financial services offices in Mississippi, Alabama, Tennessee, Georgia and Florida. All of Renasant’s success stems from each of their banker’s commitment to investing in their communities as a way of better understanding the people they serve. At Renasant Bank, they understand you because they work and live alongside you every day.

Show Transcript

Intro: Live from the Business RadioX studio inside Renasant Bank, the bank that specializes in understanding you, it’s time for North Fulton Business Radio.

John Ray: And hello again, folk. Welcome to another edition of North Fulton Business Radio. I’m John Ray. And we are coming to you, yes, still virtual Business RadioX studio. No, we’re not in Renasant Bank quite yet. But hopefully, one of these days soon, we’ll be back in our studio there. But in the meantime, we still love the folks at Renasant. They’ve done a great job with the PPP loans and other help for small business. I know that myself because I worked with them on behalf of clients. So, check them out, renasantbank.com. If you want to go into the branch, you can, but you need an appointment ahead of time. So, give them a call or go to renasantbank.com for more information. Renasant Bank, understanding you. Member FDIC.

John Ray: And now I want to turn to an old friend, Patrick O’Rourke is with Practice Quotient. Patrick, how are you? And welcome.

Patrick O’Rourke: Doing awesome, John. How are you?

John Ray: I’m great, I’m great. So, Practice Quotient, tell us about your firm, tell us about you, tell us about what you do and how you serve.

Patrick O’Rourke: Okay. Well, I’m Patrick O’Rourke. I’m the founder and CEO of a firm called Practice Quotient. Everybody calls it PQ for short.

John Ray: I like that.

Patrick O’Rourke: Yeah. Practice Quotient doesn’t roll off the tongue, I guess. So, I was thinking like intelligence quotient, practice quotient. I thought that was quite clever, actually. My wife thought it was silly, but there you go. So, at any rate, our business is called Practice Quotient. And what we do is, really, the formal technical term for what we do is that we do manage dental care network contract analysis and negotiation.

Patrick O’Rourke: What clients and what most folks understand that to be is that we analyze PPO contracts, and we make sure that they’re suitable for our clients, our clients being general dentists, oral surgeons, periodontist, endodontists, anybody in the dental space, prosthodontists. We have some orthotists, and anybody that’s submitting CDT, which are there’s medical codes and the dental codes that have their own codes. So, we analyze all the contracts. And then, we make sure that they are a win/win for both the provider, i.e., our client, and for the network or payer, i.e., the insurance company. And so, I’d like to think that we’re a bridge between the provider and the payer communities.

John Ray: What you’re talking about is something extraordinarily important to a dental practice; yet, this is not something they cover in dental school, right? I mean, what best practices are when it comes to the insurance carriers that you offer through your practice?

Patrick O’Rourke: It does seem to be the case. They do not have any classes in contract reviews, statistical or actuarial analysis. No, they don’t. Or even credentialing or any of the other stuff that’s involved. We don’t do credentialing, but there’s a lot that’s actually involved with this decision, and it’s a very big decision. And so, no, they don’t teach it in dental school. I don’t know. You’d really have to go to intern school, I think. It’s a bit different, and it’s incredibly time-consuming, but it affects it, not a good portion, I would say it. It can affect up to 50% or more of the reimbursement of a dental practice or dental specialty practice.

Patrick O’Rourke: And so, you have to understand, because this is one of your biggest … It’s top two of your costs if you’re in plans. PPOs can be very useful. It just depends. There’s no one-size-fits-all solution. So, every practice kind of has its own patient acquisition and retention strategy, if you will. And well, what is that? And so, sometimes, I ask clients, and they’re like, “I don’t know.” And that’s kind of the wallet. There is one of the symptoms of, well, you’re losing money.

Patrick O’Rourke: So, if you’re outsourcing, if you just sign up for every single PPO, then what happens is you’re always on discount, you’re always on sale, right? Because if you think about what we’re doing here or what the deal is, the proposition is the dental insurance companies go to the providers, and they say, “Hey, listen. Usually, you charge $100 for this service. And if you give us a discount of 30%, we’ll pay 70,” which is great.

Patrick O’Rourke: Terrific, right? “Don’t you want new patients? And then, we’ll send you all these new patients, and we’ll give you the promotional consideration of being on our website”, woohoo, with dozens and dozens of other names, particularly in Northern Metro Atlanta. And you have the patient convenience of having claim paid as a network. You’re getting the added bonus of the full weight and breadth of Fortune 500 companies, marketing power, steering patients your way.

Patrick O’Rourke: And so, that part of it is definitely true. Now, if you’re in a managed care friendly area like, say, a New Yorker in Southern California, it’s critical that you’re in network, but there’s still fee for service, only practices. So, being in network, your dental insurance isn’t like medical insurance. It’s really a big misconception among consumers, and really, the providers as well. Medical insurance, you have to go and network if you want really any coverage.

Patrick O’Rourke: In most cases, like certainly, in HMO, but even your point of service plans. Dental PPO is a PPO by definition. Has out of network coverage, right? And dental PPO, PPOs are by far and away, it’s not even close, 85% of the entire market of dental insurance. And so, you know, it’s a very limited benefit. It’s usually 100% coverage for your preventive. So, I think, you know, office visits, X-rays, routine cleanings, then 80% for your basic, which could be, I think, extractions and fillings, and then 50% for your major works, I think, crowns, dentures, and plants, that type stuff.

Patrick O’Rourke: And that’s the most common plan. And it’s the same in or out of network in most cases. And so, people can go out of network. It’s not really a problem because you only have a thousand-dollar max. But, you know, the consumers, the number one reason why people don’t go to the dentist, or access, or health care is because they don’t have dental insurance, which I personally think is silly. But I’m not going to change the world, just me and you.

John Ray: Right. You know.

Patrick O’Rourke: We have no reason not to go to the dentist if you don’t have dental insurance, just use your HSA, your FSA.

John Ray: Right.

Patrick O’Rourke: And, you know, the number two reason is they don’t know how much it’s going to cost even if they have dental insurance because dental insurance to me is really easy and kind of it’s my bread and butter. I’ve been doing it for 20 years. But, you know, to Johnny Lunch Bucket, when you’re selling the employer group benefits ,and you’re doing an open enrollment meeting, and you just explain the medical benefits, what’s your prescription copay, how is a maternity work, and here’s your deductible, here’s your HSA and your FSA, you know, like their eyes have already glazed over, you know?

John Ray: Right.

Patrick O’Rourke: I’ve done hundreds, if not thousands of these open enrollment meetings. And the only thing I want, Johnny Lunch Bucket, remember, when he walks out of that door is he better go to a participating provider. And so, I say it over, and over, and over again, a different voice, and then we write it, and I say, we, the insurance industry, put on EOBs, put on all the marketing material. And so, you want to steer all of the members out from the insurance company to your participating providers to ensure your cost of care is manageable. In theory, you also want to make sure they go into quality providers. And you want to reward your providers for being in your network.

Patrick O’Rourke: So, that’s what’s in it for the insurance company. And just for your listeners, you know, you know this, but I’m from the insurance industry, so that’s kind of what makes us different. There are a couple of businesses or a couple of firms that do this across the country. And, you know, really, the big difference is I’m from the insurance industry. So, I help build dental insurance companies, worked with Humana for a while. I’m professionally certified in dental benefits, underwriting HIPAA, high tech Medicare, wellness, consumer-driven health care plans, several other things. None of which make me cool or hit at the neighborhood barbecue, unfortunately.

John Ray: So, what that means is you understand the inner workings and the architecture of these plans.

Patrick O’Rourke: That’s correct. Very good observation.

John Ray: Yeah. Because you’ve been there. And what I heard of, I mean, there’s a lot to unpack there, but one of the things I heard is, number one, as a dentist, you don’t automatically default to accepting every carrier that you possibly can. Say more on that.

Patrick O’Rourke: Yeah. And so, in most cases, you have different folks that are in different stages of their business. So, you know, if you’re a startup and you have empty chair time, an empty oratory, so down, at 20, flush down the toilet.

John Ray: That’s right.

Patrick O’Rourke: And so, you know, in kind of to your earlier point, if you just got out of school and you got a mountain of debt, and you open up your practice, the meter’s running and it’s your money, the bullets are alive. You’ve never owned a business before. Welcome to the entrepreneur club. You know, John, can you please get the man or woman their jacket? Now, you’re the butcher, the baker, the candlestick maker, the bookkeeper, the website person, marketing, the janitor. Oh, hey, listen, you’ve got to be a dentist, too, right?

John Ray: Right.

Patrick O’Rourke: And so, that takes an adjustment period, I think. And so, what’s important is cash flow. And so, you need to make sure, you know, step one is you need to survive. Then, you know, that’s a startup. You know, we don’t do a lot of startups, I think we’re not really doing any. I talked to a lot of folks, I’ve been to GRU over in Augusta, and it was very clear to me in the first 10 minutes, you know, I’m like, so here’s kind of the things that you need to think about. And everybody’s staring at me, you know, like I slipped into Portuguese.

John Ray: You’re like the skunk at the wedding, right? You’re bringing all the bad news.

Patrick O’Rourke: Right. And I’m like, you know, do you guys know what I’m talking about? Do you know what credentialing is? And they’re like, uh-uh.

John Ray: Oh, boy.

Patrick O’Rourke: You know, I’m like, so, here’s our contract works and what a network is. No, none of that, huh?

John Ray: Oh, wow.

Patrick O’Rourke: And so, I spent a lot of, you know—I did my talk, and then afterwards, you know, the kids had a lot of questions. I probably stayed there until like 11:00 at night, and answered all the questions, that I really feel like I was like throwing a pebble in the ocean. And so, unfortunately, there’s a lot of stuff, if you don’t do your own homework or you don’t have good advisers around you that you knew, you got to do what you got to do.

Patrick O’Rourke: So, if you’re just fresh out of school, you know, you’ve got to do what you got to do to survive. You learn a lot of things. Once you’re established, if you’re in a established stock, you know, to make this as simple as I can, when you’re looking at PPOs, it comes down to, well, how much access do you want to have as a participating provider to these various pools of discounted insurance patients, right?

John Ray: Right.

Patrick O’Rourke: This is on a scale of one to 10, you know?

John Ray: Right.

Patrick O’Rourke: And so, some clients look at it as access. Some clients look at it as how much discounting do I need to do in order to fill my schedule? Really, the same question, like we’ll give you the answer, but their perspectives are different, if that makes sense.

John Ray: Right. Sure.

Patrick O’Rourke: And so, you know, most of our practices and most of our clients, you know, tend to be top-tier docs. You know, they’re definitely established. And our job is to convince insurance companies to, you know, pay them more than they would usually pay, which I know this sounds crazy, but they’re just not in a hurry to do it, right?

John Ray: Yeah. Right.

Patrick O’Rourke: And so, we need to understand what it is about that practice that makes that practice important and a good partner for the carrier.

John Ray: So, now, if you don’t mind me interrupting, that was really an interesting statement you just made. I mean, so what you’re saying is, if I can put it in another way, you’re really a practice advocate with the insurance company. I mean, you advocate for that practice and why their business is important with the insurance company so that that insurance company will, in effect, pay more to do business with them?

Patrick O’Rourke: That’s correct.

John Ray: So, what does that mean for the bottom line of a practice? I mean, because you obviously help practices, as you say, accept less discounts, you help them pick the right kind of, I guess, portfolio, if you will, of insurance providers to do business with, right? What does that mean for a typical practice that you work with in terms of their bottom line? I mean, if you don’t want to use a real-life example, maybe you can use one that’s without a name, but it would be interesting, I think, for our folks to hear that.

Patrick O’Rourke: If I told you our actual batting average, John, you would probably use profanity and not believe me.

John Ray: Well, we’re not regulated by the FCC, so try me out.

Patrick O’Rourke: Oh, really?

John Ray: Yeah, that’s right.

Patrick O’Rourke: So, I’m going to have to give my official reply here, which is, it really depends, and this is true. So, every project is different, like where were they when they started out? Maybe they are on good contracts already. And so, we’re just doing a tune up. You know, for practices that are writing off, you know, half-a-million dollars, which happens every day, let’s just say that they’re pleased. You know, sometimes, I tell them like, look, if you’re not sending me a Christmas card at the end of this, I must have got hit by a bus, you know?

Patrick O’Rourke: So, it really depends on how bad off they are, whether anybody’s looked at these contracts. It depends on the leverage of that particular practice. You know, the projects, these projects are not easy. They are not short or brief, you know. So, they’re long-term engagements, where you have to understand exactly what the practice is doing and why. You know, this is a big portion of revenue, huge. I mean, this is it, like this is the whole enchilada. This is your wealth. And so, we need to understand how important the carriers are. We have to look at the contracts.

Patrick O’Rourke: You have to do all of the math, and then you have to go to, you know, what I call the market. And, you know, it’s not Wall Street. I’m talking about, you know, the relevant entities, and networks, and carriers that are in any given market, like we’re a national firm. We have clients from Anchorage to LA. Miami to New York, you know, but we’re based right here in Atlanta, Georgia. God bless Georgia. So, everywhere is different. So, the market in Atlanta is different than LA, or Chicago, or certainly, Boise, Idaho.

John Ray: Right.

Patrick O’Rourke: So, you have to understand all of that, then you’ve got to go out to all of these folks, and go back and forth, you know, then the carriers have to understand. And they’re all different, too, like, you know, I think that nobody wants to lump insurance carriers into some bucket. They actually care about different things. Their target client type, or patient type, or employer group varies as well. And their leadership, they’re all different.

Patrick O’Rourke: And so, they care about different things. And so, you know, we try to be as transparent as possible with the insurance carriers. And so, we give some information about the client, like this is why they’re awesome, right? And then, it comes down to numbers and we have an actual variable tool here that is just as good or better than anything the insurance companies have because that’s where I’m from. So, I had to build something.

Patrick O’Rourke: And, you know, whereas we’re using underwriting methodology based on that practice because they’re usually looking at a market. If you look at Atlanta, so they’re projecting claims out to be two or three years where we’re looking at more specific at the experience or the claims history of that specific practice. And so, you have to go out there. So, really, you’re 10 months into this thing before, you know, now, we’re going to start makes some decisions, right?

Patrick O’Rourke: And now, those decisions and the execution of these decisions are what takes the most time. And so, you have to then, you know, how are you going to execute? We usually have most of the game plan done at that point, but we’re very conservative here. And so, we’re very methodical. We want to avoid fire drills and, you know, minimize any turbulence. And by turbulence, I mean, you know, cash flow disruption, patient disruption, claims disruption, or most of all, if not the most important, staff disruption.

Patrick O’Rourke: Everybody needs to be comfortable and confident in what we’re doing and why. And, you know, so, it’s not like our—you know, we provide the guidance, and we do the math, and we provide all of the recommendations that are based on the direction that the client is giving us up to that point. Obviously, things change. Then, when we go and we sit down with the team at the practices, you know, it’s up to them to say yes or no with what their risk tolerance is going to be.

Patrick O’Rourke: If, let’s say, they wanted to—let’s say there is a major carrier, right? You know, I won’t use any names. Let’s just say you’re in a market, there’s a big carrier, and the carrier, you know, it’s 40% of your practice, right? The revenue volume. And then, we do the math. And they’re paying you 50 cents on the dollar. Well, that’s not good because your business overhead is, you know, 60, 65 five if you include your salaries, which you should. I’m sure your spouses want you to and your children.

John Ray: Sure. Yeah, they like that.

Patrick O’Rourke: Yeah. I bet your wife does too.

John Ray: Yeah.

Patrick O’Rourke: And so, if our business overhead is 65, then how can we take 50 cents on the dollar, right? That doesn’t make a whole lot of financial sense.

John Ray: No.

Patrick O’Rourke: And I don’t think you have to be Stephen Hawking to understand that, you know. But let’s say that we do the math, and then it’s 40% of the practice. Let’s just keep easy numbers. It’s a million-dollar practice. So, it’s four hundred thousand. And then, you’re like, well, okay, we’re getting 50 cents on the dollar, and we have 400,000 revenue at 50 cents on the dollar. So, that’s a ton of patients, right? That’s a lot of patients, you know. And the carrier is unreasonable. Let’s say that they’re in Atlanta just because we’re here and they go, you know what, John Ray Dentistry, you know how many dental practices we have in Alpharetta?

Patrick O’Rourke: So, you have plenty. I’m saying, tell John Ray that we appreciate all of his business and we’ll enjoy counting his money for years to come, but he either takes 50 cents on the dollar or he’s out. And we just say, you know, we’re always playing professional, like I understand, I do, like I understand the insurance carrier side. I’m like, okay, fair enough. And so, they then make their business decisions. Now, we come back to you. We’ll use you and call you Dr. John Ray, make your mama real proud.

John Ray: Yeah, that’ll come as a surprise, but anyway, go ahead.

Patrick O’Rourke: And so then, you know, I’ll come back to you, I say, “John, look, here’s the deal. So, we have a carrier X here is paying you 50 cents on the dollar, so you’re losing money, right? You understand this, right?” And then, you know, usually, the client has a few choice words for a little while. You got to wait for that to die down. And then, we say, “Well, you know, they’re not budging, and they’re not going to budge.”

Patrick O’Rourke: This is the worst-case scenario, but I think that this is really important content in case any of the provider community is listening, and even the payer community because we’re very consistent in this particular message. Rule number one is our clients got to break even, you know. So, we’re not losing money unless there’s a damn good reason why, you know. So, at any rate, so we go, okay, so you’re getting 50 cents on the dollar. We’re going to have to cancel that and terminate that agreement. You’re going to go out of network. This is what our recommendation is going to be.

Patrick O’Rourke: So then, we do a cost benefit analysis. And then, you know, then the client’s reaction is like, oh, man. Oh, that would be awful. That would be awful. What do you mean go out of network? That’s terrible. We’re going to lose patients, Pat. And I’m like, yeah, sure will. How many? They’re like, well, I don’t know. I say, “Well, I don’t know either.” If you think you’re going to lose half. They’re like, oh, half, oh, that would be a disaster. That would be a calamity. No, actually, it wouldn’t.

John Ray: Yeah.

Patrick O’Rourke: From financial perspective, you would make more money. You would. I don’t think you’re going to lose half because you told me that you were awesome for all of these reasons, right? Now, are you the Walmart of dentistry or, you know, like you tell me. And so, they either make the decision—it’s up to them, obviously. But, you know, most folks don’t hire us if they’re not going to kind of, oh, I got it, right?

John Ray: Sure.

Patrick O’Rourke: It’s up to them. But, you know, I just give the facts. We’re neutral towards it. And the bottom line is, and this happens all the time across the country, so once they understand that, they see the math, and they’re like, man, half my income is gone. I’m losing money every time I see one of these numbers. The bottom line, you don’t want any more of them, right? You’re losing money, right? Because you’re doing a good job for them, now, you’re getting referred by your patients, right?

Patrick O’Rourke: And you’re getting referred by people that they work with because where does everybody usually spend all their time? At work. Where do they get that dental insurance? At work. And so, now, you’re a victim of your own success. You get referred in more 50 cents on the dollar, now, you’re losing more and more money, right? So, if you’re at 30%, the next year, it’s going to be 40%. What are you going to do when it’s 60%? So, that’s really one of the most important things. When I’m speaking, you know, across the country, I’m like, you can’t take 50 cents on the dollar, you don’t have to hire us, right? Just stop doing that.

John Ray: Right.

Patrick O’Rourke: But that’s the conversation, there’s naturally some anxiety. But, you know, if it’s planned out properly, then I’ll tell you, you know, we’ve done hundreds of projects at this point. And, you know, they never lose half of their patients.

John Ray: Yeah. So, you’ve got the experience to bring to that, and to help, you know, reassure a dentist that life is going to be good on the other side of this project. So, because of all the other projects you’ve done and all the other, I guess, testimonials that you’ve got from satisfied clients, right?

Patrick O’Rourke: Right. Yeah. We don’t have a sales team at all actually. We’re just, now, kind of raising our visibility and, you know, I’ve had some extra time to work on the website. We are exclusively referral-based. So, you know, it’s usually current client that sent you over to us. You know, current client or sometimes there’s somebody that’s involved in an advisory capacity at that practice that cares about their long-term financial success, like maybe a CPA or, you know, a wealth manager with some of the more top-tier dental consultants that are out there.

Patrick O’Rourke: But it’s somebody that’s really invested into that practice and has some sort of stake in that practice being successful. And so then, they call here, you know, they talk to my team, you know. But every single client has to talk to me first, you know. And so then, we have a conversation and I’m fairly direct, you know, in case that’s not immediately obvious. And we talk about it like, what are you trying to accomplish? Sometimes, we’re a good fit. Sometimes, we can help you, and sometimes not. But I’ll tell you that really right up front.

Patrick O’Rourke: So, you know, you never want to jump on a project or, you know, jump into something that’s going to be two years if you don’t understand what you’re getting into. So, you know, what I tell folks, I said, “Look, we’re going to be friends for two years, so let’s make sure everybody’s very comfortable and confident with what we want to accomplish together because at the end of it, if they’re not thrilled, then there goes our marketing plan”, because that’s how we get all of our clients.

John Ray: Yeah. Well, this has been great, Pat. Great stuff from Patrick O’Rourke. He’s the Founder, CEO of Practice Quotient, better known as PQ. Pat, this has been awesome. And we know you got to get on to work with your clients. So, how about before we let you go, give us your contact information. Folks that have heard this would like to be in touch, how can they do that?

Patrick O’Rourke: Sure. You can contact our offices anytime. We’re not close. We have full staff. We haven’t furloughed anybody. We’re at 470, is the area code, 592-1680. That’s 470-592-1680 or you can submit, and contact us, inquiry on our website, which is www.practicequotient.com, P-A-C-T-I-C-E-Q-U-O-T-I-E-N-T-.com. And if you wanted to email me, you can email me at porourke@practicequotient.om. And, you know, we’re here, we’re open, we’re in Eastern Time Zone. So, if you’re listening to this and you happen to be in Anchorage, you know, we’ll send you a link to my calendar, but we can accommodate before or after business hours. Also, one thing before we go, John, I have a question for you.

John Ray: Oh.

Patrick O’Rourke: Right. So-

John Ray: I’m the one that asks the questions here. Come on.

Patrick O’Rourke: I think it’s fair play.

John Ray: Okay. Bring it on.

Patrick O’Rourke: I get one question in.

John Ray: Okay.

Patrick O’Rourke: So, I’m checking out your hair, and I’m wondering, is John like cutting his hair at home? Do you have a Flowbee, or you’re doing it yourself, or what’s going on?

John Ray: You know, when you have headphones on, it kind of takes care of that. So, if I didn’t have headphones on, you know, it’s a natural beret, headphones on.

Patrick O’Rourke: Well, next time, I’m going to be on camera then because I look like Ted Hanson.

John Ray: There you go. I love it. Patrick O’Rourke with Practice Quotient. Pat, thanks for being with us.

Patrick O’Rourke: My pleasure. Thank you, John.

John Ray: Thanks. Folks, if you’ve got headaches that involve administrative tasks, bookkeeping, marketing, presentations, maybe you’ve got a virtual workshop that needs to be planned, well, go engage with smart and reliable Office Angel. They fly in with talent and experience and get the job done, and they fly out. And they’ve been working virtually for, I think they’re 17, 18 years old now, founded by Essie Escobedo. She’s a Chief Executive Angel over there at 770-442-9246.

John Ray: If you’ve got an issue that is holding your business back, give Essie a call and explain to her what you’ve got, and she’s got answers. And if she can’t help you, she always connects you. So, officeangels.us is the website. So, be in touch with Essie Escobedo, Office Angels. And folks, just another reminder that you can listen to this show on all the major podcast apps. We’d love it if you could go on any of your favorites there, whether that’s Apple Podcast, Google Stitcher, TuneIn, Spotify, iHeartRadio.

John Ray: Go on and give us a nice review. It helps us profile great business leaders like Patrick. So, check out any of those, any of those apps and more. And you can also, of course, go to northfultonbusinessradio.com and find our complete archive of shows. Follow us on social media as well, if you would, for LinkedIn, Facebook, and Twitter. We’re at North Fulton BRX. So, for my guest, Patrick O’Rourke, I’m John Ray. Join us next time here on North Fulton Business Radio.

Tagged With: dental, dental insurance, dental managed care, dental plan, dental practices, dental specialty practices, general dentist, general dentistry, general dentistry practices, John Ray, North Fulton Business Radio, oral surgeons, Patrick O'Rourke, PPO network contract, Practice Quotient, specialty dental practices

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