The Group Dentistry Now Show: The Voice Of The DSO Industry

Sheri Jolly, CEO of DSE Practice Solutions and Dr. Barry Quinn, Owner of Comfort Dental Braces located in Ohio and Missouri join the Group Dentistry Now Show.

Sheri and Dr. Quinn discuss:

How did DSE Practice Solutions start?
Human resource outsourcing
Revenue cycle management
Using a call center
Why Dr. Quinn chose to partner with DSE Practice Solutions.

To find out more about DSE Practice Solutions visit www.dsepractice.com or you can email Sheri – sheri.jolly@dsepractice.com or book a consultation HERE.

If you like our show, please give us a ⭐⭐⭐⭐⭐ review on iTunes https://apple.co/2Nejsfa and a 👍 on YouTube.

Our podcast series brings you dental support organization and emerging dental group practice analysis, conversation, trends, news and events. Listen to leaders in the DSO and emerging dental group space talk about their challenges, successes, and the future of group dentistry. The Group Dentistry Now Show: The Voice of the DSO Industry has listeners across North & South America, Australia, Europe, and Asia. If you like our show, tell a friend or a colleague.

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Full Transcript:

Bill Neumann:

I’d like to welcome everybody back to the Group Dentistry Now Show. I’m Bill Neumann and, as always, thanks everybody for listening in today. We appreciate it. Without an audience like you, we wouldn’t have the next two guests that I’m really excited to talk to. Without further ado, we have Sheri Jolly. She is the CEO of DSE Practice Solutions. Sheri, thanks for being here.

Sheri Jolly:

Thanks for having me.

Bill Neumann:

This is going to be fun. We have Dr. Barry Quinn, who is the owner of Comfort Dental Braces. Dr. Quinn, thanks for being on the Group Dentistry Now Show.

Dr. Barry Quinn:

Thank you for having me.

Bill Neumann:

Sheri, I will start with you. Can you give our audience a little bit of background on you, so personally, your bio, how you got started in the dental industry? Then maybe we could talk to Dr. Quinn, get his bio. Then we’ll start to talk about DSE and go from there.

Sheri Jolly:

Well, I fell into the industry of dentistry. When I was a young person, I was tired of working in restaurants, and so I got a real job, a real grownup job at a front desk at a dentist office when I was 19. I just mastered and moved on to the next task, to the next task, to the next task. I was a dental assistant, I was a chairside assistant. Later on in my 30s, I did go back to college and finish my degree, but I ended up in management in dental practices.

I started DSE as a problem that I needed to solve as a manager in a dental practice. That’s how we came all the way to the late 90s to 2016 when I started DSE. It was basically, I’ve been in all parts of the practice, I know how the practice works. The industry has changed so much from my starting point to now. That’s what DSE is about, is just moving with the changes, solving the new problems that are coming on, and helping the industry evolve.

Bill Neumann:

Okay. We’re going to dig a lot deeper into what DSE does in a second.

Dr. Barry Quinn, talk to me a little bit about your background. I believe you have a number of locations now in Ohio. How did you get involved? How did you get involved in dentistry and then now why all of a sudden do you have a group practice?

Dr. Barry Quinn:

Well, yeah, the dentistry part, that was just the route school took me. Wanted to be a dentist since I was younger and was just good at science and math, so kept going. I graduated McGill University in Canada in 2002 and then went on to get my orthodontics in 2005 from Jacksonville University.

In 2007, I found out about Comfort Dental, and I really liked their group setting. They’re a franchise-based groups, so the vast majority of dentists are owners. There are some associates, but it’s to lead towards ownership. So I really liked the group setting of Comfort Dental, and I joined in 2007 in Denver, Colorado.

Then in 2018, there was the opportunity to build some offices in Ohio because they didn’t have an orthodontist. They had approximately 45 general dentists with 13 offices and no orthodontist. So I said, “Okay, I will come and build here.” I had two general dental partners who were building it with me. That’s really where I got to meet Sheri because the management part was a little bit too much for me to handle by myself. Really, working with Sheri has just very much made things happen. It would’ve been too much for me to handle all by myself.

Bill Neumann:

All right. That’s a great lead-in to Sheri and what DSE is. You mentioned it a little bit during your introduction, which is you were working in a dental practice and you had issues. DSE really was the solution to some of the problems you were having. Then I guess you left the dental practice and went out on your own.

Sheri Jolly:

Yes, in a nutshell. It’s traditional in a practice of a certain size, basically up to a certain size, that the main biller is also the office manager. I was in a growing practice, where it was becoming increasingly difficult to either be the biller and make sure that the money was … had my hand on the financial part of it, or actually manage the day-to-day parts of the practice. There are a lot of things the bigger a practice gets that you have to manage. There’s equipment, staff, vacation, all of these things that a manager gets tasked to do. I started being conflicted about which job I had to do today, and I couldn’t do both of them at the same time.

The problem I ran into was more patients came in with more different types of insurance plans, and so we weren’t necessarily getting more per patient. The workload was … when I wanted to hire somebody and I wanted to make the numbers work and make a presentation to my boss about hiring someone to take over some of this load, it was not going to result in a huge amount of increase in revenue. It was really just going to keep me from burning out.

That is because insurance reimbursements were not increasing, but the amount of time that it takes to manage insurance was increasing. So it needed more manpower, it needed more hours. I always have been very … use the technology that’s available to you, use it to its fullest, don’t do anything the hard way. It was still kind of like, it’s costing us more money to do this and how are we going to make it work, because our patients were all calling us saying, “Hey, do you take my insurance?” Almost every patient that called us, a new patient, was like that.

I started researching how to solve that problem, how to not burn out, how to manage the insurance without letting another part of the job suffer. I found out that there were companies out there that were dental billing companies. That was our sole task when we started was this dental billing company. I found out the technology they were using, and I figured out how to use it. That’s where we started. Now, we help all kinds of burned out office managers and keep them from being burned out. That’s really where we started.

Then we have grown in the last six years based on pain points that our clients had. Because I ran a practice and I ran several practices and big and little practices, I knew the pain points. When somebody needs someone to answer the phone, we found it. When somebody needed somebody to verify benefits, we found it. That’s how we turned into basically a full-service service organization. We fill in the gaps in the administrative and business processes for practices in the United States.

Bill Neumann:

Dr. Quinn, when you started working with Sheri and DSE, was it on the billing side? Is that really when things started?

Dr. Barry Quinn:

It was actually right at the beginning. I was introduced to Sheri through the two general dental partners that I have. They’re the doctors who run the overall franchise of Comfort Dental. I do the braces part in Ohio. Sheri was doing some billing and some other tasks at some of their locations. Really, when I was introduced to her, it was going to be multifaceted. It would be to help with creating a call center to help with hiring the initial staff, to setting up all of the insurance contracts and billing. So it really was from day one, let’s start building the template.

She had quite a few of the buckets. I always liken it to being a juggler. How many pins can you juggle? Can you juggle five, can you juggle six? So how many can you hand off so that you can do what you are best at best? She really was with us from the start.

Bill Neumann:

Dr. Quinn mentioned a lot of things besides just the billing and insurance side of it. Tell us what else DSE does.

Sheri Jolly:

Well, we do credentialing, which is a big headache for a lot of people. We can do some customized problem-solving. I have helped people design a department before. I have trained their staff.

I say I, but it is not just me. It is my team. We have 28 people on our team. It’s hybrid consulting/service. Sometimes we do it for you, and sometimes we teach you how, but we are usually in the HR circle. We are in the billing circle. We’re in the training circle. We’re in the management. Sometimes, Dr. Quinn and I will have meetings about this location that we should do this here. So little bit of strategy and management of practices. Basically, all of the gaps in management that any practice is experiencing, we can jump in and fill that for you.

Bill Neumann:

That makes a lot of sense if you can look at as groups scale up, they typically are started by clinicians. Then as you start to scale up and you need more and more services to support these multiple locations … I love Dr. Quinn’s analogy to the juggling and the pins up in the air and not necessarily … being really good at maybe a couple of those specific tasks. Then the others, you want to give to somebody that’s much better than you or have somebody teach somebody at your organization that can do that. You’re really there. You think of the S in DSO, the support side of it. You are the S, and you can do various things. That’s great.

As far as the type of clients that you have, would you say it’s mostly emerging groups, larger groups? Who do you work with?

Sheri Jolly:

Well, at the beginning, it was small groups and startups, but as we have gotten bigger, we have started working with emerging groups. I feel like that is where everybody wins the most is when we get groups like Dr. Quinn’s group and other groups where they’re emerging into maybe from three locations and they’re trying to go up. That’s usually where we usually make the most positive impact is when they have independently running locations and they need everything to be going the same way. That’s usually where we can really help that. We can them scale into operating as a bigger entity, instead of three individual entities or two individual entities. That’s really where we see the most positive effect. But we do have big groups and small groups. Like I said, we started out with individual startup practices, one-doctor practices, and we still have a few of those on our list.

Bill Neumann:

You mentioned you had around 28 team members. Do you have people of those team members, are they experts in certain areas? Is that how that works?

Sheri Jolly:

Sometimes they are, and sometimes we make them experts. I have to say that one of the biggest struggles in any dental office is that on the clinical side, everybody’s trained and licensed and there’s criteria, tests they have to pass to get a license to practice. But in the front of the house, most of them are thrown in. They are just told to figure it out. That’s because the dentist doesn’t know.

What I have found by doing multiple cleanup jobs is somebody with a good attitude who didn’t really know the right thing to do, and we ended up having to do a cleanup mess or clean up a mess or clean up an overwhelming pile they didn’t understand how to staff. A lot of times, they don’t understand how to staff a workload, what one person can do, what one person can do with the right technology, that type of thing.

One of the things that we really focus on when we bring on team members and also when we join teams, is training and making sure that we’re all following best practices, that we spend so much time on training. I call it my rule-following heart. Sometimes people don’t love the rule following, but we do a lot of that.

Bill Neumann:

Dr. Quinn, I’d love to get a little feedback from you as far as what does the relationship look like as far as you and your team with Sheri and her team? What does that look like on a weekly and monthly basis? How does that all work?

Dr. Barry Quinn:

I think it’s pretty seamless because everybody who was on Sheri’s team who works with our team just feels like a part of one team. Sheri, the call center comes out of her office, but then when there are specific things to clinic, those calls get forwarded. So our front staff and her call center are very integrated.

Her team will do the insurance preparation and then put notes. We have a daily email that prepares for the day. They’ll have let us know what the benefits are, who’s active, who’s not, things that we may have to. So the communication is pretty seamless. That’s on the insurance and the call center.

Then Sheri’s team also runs our HR, so they basically know everybody, help with all of the benefits, and things like that. I’m a bit more involved now with payroll, but Sheri’s team was doing payroll before, so really everybody knows everybody. It just feels like one big team.

Bill Neumann:

No, that’s great. I’d love to maybe dive a little deeper in a couple of these different buckets. I think that’s what you call them, Dr. Quinn, buckets. I like that analogy. So call center, tell me how that works, Sheri.

Sheri Jolly:

Well, we receive all the incoming calls for all seven of their locations. Then because we use an electronic … it’s called a VoIP system, there are phones in every clinic that are extensions of the big phone system that we all use. Then every person at a phone is using the same system, basically. So there’s phones in every clinic and then extensions at every desk. Then when the calls come in, we have protocols of are they asking a clinical question? Well, if they’re asking a clinical question, they must talk to the clinic. We have a messaging system that’s up all day. They’ll message the clinic, whichever clinic it needs to be, because there’s usually multiple clinics open on the same day. We’ll say, “Columbus, we are sending so-and-so’s mother and she has a question.” Then they know before the phone rings who’s calling and why. That’s how we do that. Then we take incoming calls and we do outgoing calls mostly about appointments and things of that nature, if days open up, all that kind of stuff.

Then any time there’s a question about an account or a patient or a treatment, we just make sure that we have a protocol that we know who we’re supposed to ask and how long that person has to get back to us. On the clinic side, we’re supposed to get back to them, and they’re supposed to get back to us, depending on what the question is and who had to make the phone call.

Then everything goes in the chart, everything, all the communication goes in the chart. The key to all of that is just documenting every conversation.

Bill Neumann:

Dr. Quinn, were you always using a call center, or did you initially start off with taking the calls at the practice level?

Dr. Barry Quinn:

This is my first experience with anything like this. When I was in Colorado, I practiced for 11 years and everything just functioned. I was a franchise owner. I owned four offices with two other orthodontists. It was just standard. All calls came in, our front desk answered the phones like a traditional office. Everybody was in-house.

When I moved to Ohio, it started off with Sheri organizing our phones. I can’t remember exactly when we brought it fully to a call center. I think it was when we got to a certain number of locations. But yeah, ever since I came to Ohio, Sheri was pretty integral in setting up how we were going to operate a few of those buckets.

Sheri Jolly:

That’s actually basically what happened is as the clinics opened up and the more people we needed to answer the phone … When we had two clinics, we needed people in two places, and then three places. That’s when we turned it into all the calls come into one place, and we still have the same number of people answering the phones and nothing’s getting dropped because the clinics were not always open on the same day. So instead of making people drive to multiple locations, they went to one place and all the calls came in.

But cloud-based software is real important to that, being able to look at any locations, schedule in any locations, clinical notes, or anything like that was really a big factor in making that successful.

Bill Neumann:

Is there a certain number of practices where you recommend the call center, like a number of locations? Or does that really vary on the needs of the office?

Sheri Jolly:

It varies on the needs of the office and the demographic and the call volume. It’s really the call volume that’s the issue. There are some places where the phone rings all day long, and they have an incredibly full front desk. Then there are other places where their staff can handle the call volume. A lot of it has to do with the type of insurance those patients have and the type of treatment that is done. It’s really not necessarily a size as much as it’s volume. If you’re getting a hundred calls a day, probably one person’s not going to be doing anything else but answering the phone.

Bill Neumann:

I’d like to pivot now a little bit. You mentioned human resources, and that’s always a lot of fun. What does DSE do for their clients when it comes to HR?

Sheri Jolly:

Well, we make sure that they have a system in place. Many times they don’t. Many times they don’t have any system. It’s just like, hey, I like you. Come work here. We go through all the protocols. We run a background check. We make sure they have all of the HIPAA and the OSHA training done, and we try to make sure that they’ve received actual training for their job, which means we have to make sure there’s materials to train them with.

Sometimes, we’re making training material. I know for Comfort Dental, we did. We made just basically how to use our computer system, a little tutorial for the new hires. I think we introduced a new system of how to … I think it was how to introduce a contract, and we had a little tutorial that everybody had to take. That’s what we do is make sure you actually have systems in place, make sure you actually have a handbook, make sure we know what you’re offering. Basically, we organize it in a way. We don’t actually make the final decision on hire. We basically tee it up for the practice. We find the people, we make sure the people get to the practice, and we make sure if they want them, that they have all of their ducks in a row.

Then, of course, the other HR part is occasionally I’ll get a call and say, “This happened in our clinic today. What should we do?” When I don’t know, I have a great number of resources in the field with HR certificates that I rely on. Usually, if we don’t know the answer, we go find the answer.

Bill Neumann:

You’re actually doing some of the staff hiring as well?

Sheri Jolly:

Yeah, we’re doing the staff … Yeah, like I said, we tee it up for them. The doctor, the clinic, and the team makes the decision. But yeah, we do-

Bill Neumann:

You’re doing a lot of the recruiting work, maybe. Is that right?

Sheri Jolly:

Yes, yes.

Bill Neumann:

Okay. Is that office staff? Is that who you’re recruiting?

Sheri Jolly:

Yeah, I don’t recruit doctors. The doctors recruit doctors, but the other staff, we do.

Bill Neumann:

Okay. Yeah, that’s great to know. I wasn’t aware of that, so that’s great that the audience understands that as well.

All right, revenue cycle management. We talked a little bit about the billing side of things. Would you mind just highlighting what you’re doing? Or maybe Dr. Quinn can talk a little bit about what is going on when it comes to insurance and revenue cycle management and how does that work from DSE’s perspective, and what’s left for the practice to … what do you need to do, if anything?

Dr. Barry Quinn:

Well, as a practice, you’re always going to have people make payments, give checks, a lot of those things. It still operates like a traditional office in that sense. But our insurance billing is done with DSE. We’re a state provider, so we’re with Medicaid. In Ohio, that can be pretty complicated because they have multiple providers for Medicaid. So navigating those waters was definitely a big learning experience. I came from Colorado, where there’s just one provider, so I was surprised to learn that there’s multiple and just getting all of that set up. DSE does the billing for us, tracking the dates, and just, of course, making sure that people are eligible and active through the whole process. Then our insurance checks can go to Sheri’s office as well. Depending on what an office’s needs are, more or less of those tasks can be taken by her group.

Sheri Jolly:

Yeah, I was going to say that we do the entire cycle, which means that even before the patient comes in, we’re checking their insurance and making sure they actually have the insurance they think they do.

There’s the clinic part, where maybe they’ll pay in the clinic, maybe they’ll set up their contract in the clinic. Then when they leave the clinic, we pick it back up, and we follow up and make sure the payments are being made and make sure that the insurance claims are being paid and all of that kind of stuff.

It is a complete cycle, and our part of it is everything outside of the clinic. When they walk into the clinic and they set up the contract, or if it’s a special case and they want to make a payment arrangement, then the clinic does that. But we do everything before they come and after they leave

Bill Neumann:

Dr. Quinn, I’m just curious. My next question is really the advantage of using DSC. Maybe I’ll start with you. Is one of the advantages having less staff, and/or the staff that’s there, are they more focused on things that they’re good at, which you hinted at earlier?

Dr. Barry Quinn:

I’d said it’s going to be different for every office. A big part of why I’m with DSE was the overwhelmed part for me. I had too many tasks to do when I came to grow this group, so having DSE and Sheri and her team was just able to give me peace of mind. Okay, these four things are being taken care of by them.

If you are in your own private practice and you’re growing and you need more expertise, then that might be why someone takes it on. Or if someone’s just, your old business manager or your front desk person left who used to do everything and now you don’t know how to hire and train someone. So every office would have a different reason for jumping in on that. For me, it was really just I had too many things to take care of.

But, as you say, with the team members that I can bring on in clinic, I don’t have to worry about them being a jack-of-all-trades, focus on being the assistant, focus on being a friendly receptionist, focus on being those things. Then the insurance expert is outsourced. The billing, the collections department is outsourced. So that was really the way it went with us, where Sheri can have her super-specialized team, and I can focus on just getting the job done in clinic.

Bill Neumann:

That’s great. Sheri, anything to add to that?

Sheri Jolly:

I would just say that some of the other advantages that … to add on to what Dr. Quinn was saying, is the team that we put in place to help with Dr. Quinn, he didn’t have to train them, he didn’t have to do any of their HR stuff. I did all of that. He didn’t have to do anything except plug us in and tell us what he needed. We started out doing very little, and we do much more now because his group has grown.

But that’s really the advantage is you can plug in an existing department of whichever service you need, and you don’t have to build one. You don’t have to create one. You don’t have to hire and do all the HR stuff. You don’t have to be an expert at it. Usually, they know somewhat of how it works, but we have found that we just allow them to grow with ease because they’re not internally building structures. They already have the piece that they can plug in.

Bill Neumann:

That’s great. As we start to wrap things up here, and you mentioned it earlier, but I think it’s probably important. You’re working with a lot of different types of groups and also independent dentists that have a single location. Are you seeing a trend towards you working with larger groups, or what are you seeing out there? I’d love to hear just what your customer base looks like and what the needs that you see. Is there one thing that they tend to gravitate to more than others?

Sheri Jolly:

Yeah. For the most part, revenue cycle management is the biggest piece of it. The common denominator everywhere with the big groups and the small groups is just a lack of people to do it. We have done some cleanup jobs where it wasn’t based on a lack of staffing. It was some other issue. But most of the time, it’s just the lack of staffing. There’s a staffing issue. Most of it has to do with not really understanding what it takes to get the job done, how many people it takes, what technology it takes.

But staffing has, in the last few years, that’s the biggest trend. That’s the biggest pain point that most clients come to me with is that, “We had people who could do this, and now we don’t have anybody, or we have half the number of people.” That’s for the small doctors and the big groups as well. Their staff numbers are shrinking, and their payroll numbers are increasing. It’s very much like the insurance dilemma that I had six years ago, where the workload was increasing, but the revenue wasn’t. We’re seeing almost a very similar problem. DSE, that’s what we do. We solve that problem.

Bill Neumann:

Any final thoughts before we sign off here? This is actually really good. I know just based on what DSE does and what I hear from the people that visit our website and at the different meetings that we go to, that HR is a huge pain point. Revenue cycle management is another one. The call center solution is really interesting. I hear a lot more about using that solution. I think that all goes back to what you just talked about is you have a lack of staff. The staff that you have, you want them to focus on what they’re good at and not be bogged down with things that they’re not good at and don’t really help the patients or the clinicians.

Sheri Jolly:

If they’re good staff, you want to keep them. You don’t want to burn them out.

Bill Neumann:

Great point. Yeah. Excellent point. Dr. Quinn, any final thoughts?

Dr. Barry Quinn:

Not necessarily. Just if you’re a dentist, making sure to know your strengths. Sometimes, handing over a few of those tasks gives you the peace of mind to enjoy your life a little bit more than trying to manage every single aspect. Because it’s not easy, especially as you grow.

Bill Neumann:

Yeah, that’s a great way to sum things up. Sheri, if anybody in the audience wants to find out more about what DSE does, if they want to contact you, how do they do that?

Sheri Jolly:

Well, you can reach us at our website, which is dsepractice.com. That’s probably the easiest way to get ahold of us. There’s a contact us button, and there’s even a link there to make an appointment, to have a meeting, a Zoom meeting, with me. So with me or one of my staff members.

Bill Neumann:

It’s dsepractice.com. We’ll drop the link in the show notes. But I’d like to thank Dr. Barry Quinn for taking some time out of his busy schedule to be on the podcast, and Sheri Jolly, who is the CEO of DSC, thank you both for joining us today.

Dr. Barry Quinn:

Thank you.

Sheri Jolly:

Thanks for having us.

Dr. Barry Quinn:

Have a great day.

Bill Neumann:

Thanks everybody for listening in. I’m Bill Neumann, and until next time, this is the Group Dentistry Now Show.