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Episode #480: My Journey Out of PPOs, with Dr. Bill Crinzi

the best practices show podcast Oct 03, 2022

  Your family, your future, and your team depend on this one thing: your decision to go out-of-network! And to reveal how it can be done, Kirk Behrendt brings in Dr. Bill Crinzi to share his personal journey out of PPOs and into a better life. Start slow, plan ahead, and don't be afraid! To learn how you can start moving away from PPOs today, listen to Episode 480 of The Best Practices Show!

Episode Resources:

Main Takeaways:

Start slow.

Don't be afraid of losing patients.

You don't need to be everyone’s dentist.

Be prepared to talk to patients about dropping PPOs.

Plan for the potential smear campaign from insurance.

Patients will return and be willing to pay for great dentistry.  


“The staff was looking to [get out of PPOs] even before COVID-19 hit. They knew things were kind of hectic, and they were like, ‘Let's get this together.’ We were spinning, but we weren't hitting bonuses as much as we were back when we first signed on, and they were seeing that things weren't great. So, they were all-in on it. They weren't as afraid as the leadership was.” (7:44—8:10)

“We started [with] maybe one or two patients. We would start having a little bit of discussion about, ‘You know what? We might be thinking about leaving. They're not letting us have a personal relationship with you. They're interrupting the care that we can give you.’ That kind of conversation, we had with our patients. And we couldn’t have it all the time. The hygienists were afraid they were going to run behind if we’re going to have this conversation with every patient. So, obviously, that was a discussion that we'd have in a team meeting. But for the most part, that was how we got started. And the fears kind of dissipated.” (9:09—9:49)

“You've got to have some thick-skinned people in the admin area because you will get some patients that'll get a little bit frustrated with, ‘Why did this happen? What happened?’” (9:52—10:02)

“For the most part, there are a lot of patients that if insurance didn't cover their treatment, they weren't going to have it done. And we tried — I mean, we knew that was us and how we presented. We had to create that value for the treatment that we were doing for patients. But there's still that small percentage of patients that'll say, ‘If they're not paying for it, I'm not going to do it,’ and they’ll go down the road to an in-network person.” (10:52—11:16)

“Once we got all our existing patients to come through the cycle once and they know the policy now — that was where the fear was with me. I didn't want to lose those existing patients. How dare they! They were my buddies. I had some friends that left. We had 20% leave. That’s what they told us was going to be happen, and that's exactly what happened.” (12:39—13:01)

“A lot of the experts tell you that when you're going out-of-network, don't send a letter to your patients. Make sure you have that one-on-one contact. We couldn't do that with 5,800 patients. There's no way you could do that. So, we had to send a letter . . . We sent the letter out, and that was our foundation of the patients who were going to complain about it. ‘We sent a letter out.’ ‘Oh, I didn't get it.’ ‘Well, we can look online. Is this your email?’ ‘Yes, it is.’ ‘Well, you did get it.’ And then, we’ve got it all over the reception area. People are seeing it as they come in. So, they know that we’ve gone out-of-network.” (17:04—17:53)

“We told patients that, ‘The insurance company may tell you that you can no longer see us.’ And I said, ‘This simply is not true. We can still have our relationship, and it’s going to be one-on-one now. It’s not going to be on the head of some consultant that's sitting behind a desk.’” (18:05—18:22)

“Back in 2018, I looked at a report. I looked at a month where we produced over $300,000, and $75,000 was written off. We said, ‘That's enough.’” (18:47—18:59)

“When patients call and they tell us they have Dixie Dental, we just tell them that, ‘We are an out-of-network provider. What that means to you is that we expect payment at the time of service.’ And that's basically it. All our new patients, they're just ingrained that — there is nothing special; there's no magic word after that. We had to retrain our old patients, yes. But now, we’re two-and-a-half years out on this. So, we don't have to retrain those patients anymore. It’s just office policy, and they're accepting it, and that's it.” (24:05—24:41)

“I was a little bit worried about losing patients — not from a revenue standpoint, but these are people who I thought liked me. And they don't care. I mean, they’ll have a nice conversation with you. But you know what? If insurance wasn't covering things, they go down the road. But when you did good dentistry and you take care of them, you show that you have good skill, care, judgment, and compassion when you're doing your treatment, those patients, they're coming back. They are coming back. It took a little while. They go down the road for two or three appointments, and then they come back. And they're very appreciative, and they're willing to pay a little bit more out-of-pocket because of that.” (28:22—29:05)

“If people leave, it’s our fault. We did something wrong along the way. We didn't communicate well to them. We didn't express the treatment plan or the needs that they need well enough, and that's why they left. So, it falls back on us, the leaders in the practice.” (31:07—31:24)

“You've got to like what you do, and you've got to like the people that you're working with, and you've got to continue your education.” (35:44—35:49)

“Don't be afraid. That's it. Just don't be afraid. I think, sometimes, you get beat down out there and you're worried about people not liking you and leaving — and that's going to happen. But if you're doing everything right, you're providing good dentistry, your team is caring and compassionate, those people are going to see that it’s not better somewhere else and it’s worth a little extra to come back.” (42:14—42:38)


0:00 Introduction.

2:15 Dr. Crinzi’s background.

3:39 Why the PPO journey is important.

4:45 Dr. Crinzi’s journey out of PPOs.

8:11 Starting the conversation with patients.

10:02 Common fears of leaving PPOs.

11:16 How Dr. Crinzi’s patients reacted to the change.

11:56 Does the fear of dropping PPOs ever disappear?

15:06 How to explain the changes to patients.

16:25 Dealing with potential smear campaigns.

18:29 Dr. Crinzi’s write-off percentage before dropping PPOs.

19:18 The morning huddle is the instrument for change.

20:04 Working 7:00 to 3:00 and appreciating life.

23:36 Are patients accepting of the change?

24:42 The benefits of dropping PPOs.

27:17 What most dentists get wrong about moving away from PPOs.

29:13 You don't need to be everyone’s dentist.

31:47 How important is alignment between three doctors?

33:41 What's next for Dr. Crinzi?

35:21 Advice for dentists.

38:59 Last thoughts on being out-of-network.

Dr. Bill Crinzi Bio:

Dr. William Crinzi is a graduate of Marquette University School of Dentistry and has been licensed in the state of Wisconsin since 1986. His academic career began at Saginaw Valley State University in Saginaw, Michigan, before entering dental school. 


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