In my mind there is no difference among them. Each of these things brings patients in the door and has a cost and some aggrevation associated with utilizing them. Getting patients in the door today and in the future is the primary concern for most if not all of us (if it’s not, let me know! we need to talk.). Let’s look at each of these new patient conduits in turn and I’ll explain exactly what I mean.

1) Medicaid: If you’re not taking Medicaid in your practice, you are wrong.
What’s that? Medicaid doesn’t pay for braces in your state? Well that doesn’t let you off the hook. If you can sign up and be a Medicaid provider and be listed on the website then you should do so because it will bring you patients.
“But Medicaid doesn’t pay enough to make it worth my while” I can hear you saying. So? It’s not about how much Medicaid pays. It’s about patients in the door and their friends and family and the people they meet at Walmart. Not to mention, if you have empty chairs then Medicaid pays plenty. No matter what they pay.
“But ‘those people’ never show up, don’t brush, don’t comply, I don’t want them running off my paying patients, yadda, yadda, yadda…” I hear every day all day from orthodontists. Somehow this is acceptable to say in orthodontic circles? Somehow prejudging certain people (i.e. being prejudiced against them) for random “reasons” is ok? Shame on us for allowing this to be the case. Shame on you for thinking like this. Shame on your professors for telling you it is so. This is bad for business and bad for society. People are people and prejudging anyone for any reason is stupid and unacceptable. Who are “those people” anyway? Well in this case it’s Medicaid eligible patients but from what I have seen “those people” can be anyone who isn’t like us because of race, religion, language, geography, economics or some other arbitrary “difference”. I also don’t want to ever hear people talk about “quality new patients” as this is just “those people” by a different name. Get over yourself and your myopia. There are millions of patients who want what you are selling if you’ll only get out of their way and treat them with respect.
“Medicaid patients never score enough to qualify” is one of the biggest complaints I hear and many orthodontists say this is the worst thing about Medicaid. Funny. That doesn’t add up because you just said that Medicaid doesn’t pay enough. In that light you might say that the limited number of people who score enough to qualify for state aid is a good thing for you because that means you only take a limited fee in those few cases (and really isn’t taking care of those in most need what Medicaid is all about?). In my mind this limited number of reduced fee cases makes accepting Medicaid superior to being a provider for many insurance plans from a business point of view. So stop griping about patients not scoring, stop judging them and realize that the instant a Medicaid patient doesn’t score enough for state aid, they magically become a private pay patient if only you will give them a chance.
“It’s different where I live! Those people can’t afford to pay for braces” I can hear you practically yelling at your computer. Oh yeah? Interesting. Do they have divorce where you live? What about cell phones? Ok then. When people get divorced and remarried where I live they often have some kids that are on Medicaid and some that are not. If you don’t take Medicaid, guess how many of those kids you’ll get to see as new patients? 0.0% is the correct answer here. Also, if they have cell phones where you live, that means someone has to pay for them. If people where you live can afford to buy a cell phone and pay a monthly bill, well, they can afford braces. Or you should make it so they can. If not you, someone else will. And if we don’t make what we do affordable can we really complain about PCDs doing Ortho?
2) Invisalign: It’s simple. I don’t like paying the lab bill. I would rather pay a few bucks and use braces. Heck, I would rather that all my patients pay in full too but what has that got to do with anything?? I have embraced Invisalign for one reason and one reason only. New patient flow. It helps that the product has improved greatly and that I have many friends and colleagues who can do almost anything with Invisalign to guide and help me but it’s all about new patient flow. Patients want it. I want them to come to my offices. Done deal. Now I just have to work to become as comfortable treating with plastic as I am when I treat with brackets and wires. That will take time and be aggravating but anything worthwhile usually is.
3) Being a provider for insurance companies: People ask me all the time “Should I be a provider for XYZ insurance company” and I simply cannot answer that question. Insurance companies vary from one to another, from state to state and from employer to employer. More often than not, the employer is the one who sets the benefit level so there are wide variations even within the same insurance company in your area. My answer to this often asked question is, “If being a provider for XYZ insurance company brings you patients that you would not get otherwise and you are not at capacity then become a provider”. It’s that simple. If you get more new patients then it’s worth it to be a provider. Is being a provider a pain sometimes? Yes. But being without patients or going broke is worse.
4) OrthoSynetics: Though they offer a wide variety of services, the main reason I use OrthoSynetics is because of the new patients Angela Weber’s marketing team is able to drive to my offices. Understand that a couple years ago, as an orthodontist in traditional practice, I basically told all the dentists in Arkansas to take a hike by bringing in hygienists and then suing the state dental board. Since then I’ve gone to a multi-specialty model and added several locations. How did I do that? Where did the patients come from? Well, for starters I spent a lot of time and money on marketing. I am really good at marketing (well, actually I suck at it compared to a marketing professional like Angela and have no more business directing her than a PCD has business telling an orthodontist how to do Ortho) but she still got good results even with me as a handicap. I finally quit trying to tell Angela what to do and thinking that I was good at marketing. I let her and her team do my website and branding the way they wanted to as I should have from the beginning. What happened then? 30,000 hits a month on my practice website and a tremendous amount of engagement once they get there that leads to an unreal number of sign ups, that’s what happened. A social media marketing campaign that drives most of those 30,000 hits to my website also happened. Control over my very own, huge patient base is the upshot. Increased growth in my practices is the end result. All this makes me sleep much better at night. I don’t worry at all about where our new patients will come from and that is a fantastic place to be. Do I have IT problems now and then? Absolutely. Do I have a billing issue from time to time? You know I do. But I’ll readily admit that I had these problems to some degree or another before I became an OrthoSynetics client. The difference being that when you’re flush with new patients coming from a referral source that you control, the rest is small stuff that we will continue to work on.
It’s all about new patient acquisition and control of the patient base. The wars of the future will be fought over fresh water and new patients. Are you ready for battle?

One thought on “Medicaid, Invisalign, Insurance & OrthoSynetics Are All The Same To Me

  1. Thank you Ben. A great reminder never to judge. When I opened my practice I was told, “You’re going to open over there by the apartment buildings? Are you aware of the kind of people who live in those apartment buildings?”. I was quick to sharply say that the “kind” of people who live in those apartment buildings is me because I grew up in them. Because we have a degree beside our names doesn’t make us better than anyone else or entitled to anything. Each person who walks in our practice is a human being and you are damn right in saying shame on us for judging them based on a type of insurance they may have or an area in the city where they may live. And the irony is that my most compliant, kind and grateful patients and the ones we have the most fun with happen to be the ones who live in the apartment buildings.

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