An advantage of these plans is that you can negotiate with the dentist if you pay in cash. The waiting room has a pleasant ambiance, and the staff treats you warmly and respect. For costs and complete details of coverage, call or write Humana or … Instead of joining plans, I learned how to manage and market my practice. All rights reserved. Here are three most of the most common ways insurance companies deny dental claims, and some ways in which you can avoid them. This happens every time we go. With these plans, you can take the benefit directly. Get Started. Her office gladly will file the service with the carrier as out of network. It has 3,300 charts, collecting $115,000 per month with an overhead percentage of 70%, and collections per chart are $34.85. Cost to deliver (materials, salaries, rent, etc.) Dr. Julie Gillis explains how her dental office makes the new-patient experience such a regular part of their dental care that patients are comfortable and complimentary. So before you walk in the room, a dentist has a list of everything he can bill for during your dental … Patient Communication and Patient Financing, Your best ideas for growth won’t come from where you think they will, Review: Weave dental software and phone system, Pearls for Your Practice: Dental Support Specialties. That just does not work. What can be done about this situation? I want to let you know there is hope! Yes, it is possible. You select a primary dentist and had your services through them and your insurance plan. There are several to choose from. 300 Brickstone Square Obviously, the closer the dentist’s fee is to the UCR, the better for you. But, then he suddenly pulled out my front teeth and put them in a pouch. You owe the dentist $350. PPO stands for “preferred provider organization”. (Additionally, there is always that chance when you don’t have in-network dentists who agree to a contract fee.). My sister in law and I go to the same dentist, I have dental insurance and she does not, we both had the same procedures done this week and my insurance was charged $60.00 more. So, $350 versus $500. This doctor could afford to lose 1,320 patients and still maintain the same level of profitability! Plans that require you to work harder and longer to meet your overhead and (hopefully) make a profit. However, there is still the chance of balance billing. Yes, you’re reading that correctly. Then he put in fake teeth that are too large into my mouth. He has also served on dental mission trips to Nicaragua, Peru, Costa Rica, and the Dominican Republic. I have heard they are excellent dentists as well. A “true” PPO plan pays 80% of the UCR or in this case, $400. Dental benefit companies were forcing dentists to accept a lower price (amalgam) for the patient receiving a higher priced procedure (tooth-colored filling). YOU MAY BE HAPPY with your dental fee schedule. What steps should he take? All rights reserved. Now, obviously, I wouldn’t advise doing this without also knowing how to attract more new patients and being able to transition those plan patients over to paying your normal fee. Usually, you don’t check the invoice to see what they’ve claimed to have done. The cost per patient (overhead divided by charts) is $24.39, leaving a net profit of $34,500. As you can guess, PPO plans rose in popularity. The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what services your dental benefits plan will cover or your out-of-pocket costs. You like the dentist and the staff. It depends on what type of dental coverage you have. Fortunately for patients, most of these established offices will actually take or file insurance coverage. A common situation. I know what you are thinking. The doctor now drops all insurance plans, effecting a 20% fee increase, and now look at what happens. You don’t know what that means, but it doesn’t sound good. You can: (1) negotiate with your dentist on the cash price, or, (2) enroll in a true “PPO” plan that does not discriminate between in-network and out-of-network dentists. Fill out the form below and we will email you additional customer literature, explaining these options in more detail. The doctor would be working fewer hours, most likely with higher career satisfaction, and still make the same profit margin. But why would the average doctor subject him- or herself to working for—in some cases—50% of their normal fee? Plans that have you practicing dentistry at a pace you might not have envisioned when you signed up with them. Insurers deal in risks, and being able to assess risk and avoid losses is part of how they survive as a business. Save my name, email, and website in this browser for the next time I comment. How To Get Approved For Term Life Insurance Wicked Fast | No Medical Exam! We urge you to call us to learn about our affordable dental plan if you don’t have insurance at this time. On Sundays from 5 p.m. to midnight Eastern Time, My Insurance Manager will be unavailable while we perform maintenance. ($750 – $250 received from insurance.) In-network versus out-of-network cost sharing doesn’t exist. In other words, you can file the claim yourself and take the monetary benefit instead of assigning it to the dentist. I was in the same boat myself years back. You might be thinking what is a “true” PPO plan when we just described the differences between the in and out-of-network of a typical PPO plan. It means “usual, customary, and reasonable”. Are you interested in learning more? Let’s say your dentist charges you $750 for the 2 fillings. To be clear, I am not criticizing patients in these plans. Dr. Haynie is a member of the American Dental Association and the Alabama Dental Association. True Believer saw a prominent, national lecturer who advised all the dentists in the audience to drop Delta, not accept insurance assignments, raise their fees, and stop doing amalgams. Comment by jen — April 25, 2013 @ 9:46 AM. One in 4 Americans doesn't have dental insurance, and of those over 65, half have no coverage, according to the National Association of Dental Plans (NADP). Jordon Comstock says a dental membership program can be one of the smartest business strategies you implement in your practice in 2020. I was going to be a whistling contest, but since the dentist wrecked my teeth I can’t whistle tunes anymore. You can continue care: For up to 90 days after your doctor notifies you they are leaving the network. It has more patients and more activity. PPO plans allow dentists to join, and in return, they can receive new patients through the referral network. Long ago, dental HMOs exist. If you go to an in-network dentist, the insurance carrier pays the dentist directly a set fee. The Way Dental Insurance Works. Dr. Roy Shelburne found out the hard way what can happen when a dentist and dental practice does not meet all of the proper compliance standards. (800) 645-9841 The UCR fee still in effect. You still receive $500 and keep the $100. This fee is also called the “allowed amount”. Dental patients may leave your practice if they don’t like how they’re treated by those who answer the office phones. We would prefer you to go to an in-network dentist, but if you don’t, you may face higher out of pocket costs.”. Let’s say it is $500 ($250 X 2). However, carriers usually use out-of-network cost sharing, which usually is lower coverage. They look at the UCR for the procedure in your area and use that amount. Maybe not all of their plans. We have a few things happening. The carrier paid the dentist $250. Dr. The dentist files a claim for this amount. PPO plans made their way mainstream. Even if you did, you might not know whether they were ripping you (or your insurance company) off. Making a difference in special needs dentistry. Bang! I understand why insurance companies have gone this route—it’s cost control. Through postpartum care, if you are in the second or third trimester of pregnancy when your doctor leaves the network. It is the only way we know how to work with our clients. Using the same numbers above, you would pay $200 net. So you’ll want to be very careful that you don’t exceed what you can afford – “the plan costs too much – I want to drop it” is not a qualifying event under the law. Let’s say your dentist gives you 20% off of your fillings, so your bill is $600. Another option is an indemnity plan. 30%? Visit mgeonline.com or call (800) 640-1140 to learn more about MGE and the upcoming calendar of CE events across the US and Canada. Without their complete understanding and buy-in, treatment can be postponed indefinitely. *To determine your premium, call us at 1-855-488-2515 or click the "Get Started" link to compare your plans today. 12. Clinics that are affiliated with dental schools are a great source of quality, low-cost dentistry and orthodontic treatment. Here are some tips to help you set up a program in your practice. These past 25 years I’ve seen thousands of my clients drop insurance plans. In this article, we discuss what to do when your dentist does not accept insurance. The reason for the uptick in activity is obvious. ... From Business: Have you been searching for a dentist in the area that can meet all of your dental care needs, from the most basic to advanced? You make a new visit to a new dentist for a new patient appointment. Estimates should not be construed as financial or medical advice. Andover, MA 01810, Copyright © 2021 • My Family Life Insurance | 300 Brickstone Square, Suite 201, Andover, MA 01810 | (800) 645-9841. Most everyone in his vicinity participates in dental insurance plans, but he doesn’t. What’s easy to see when a practice participates in insurance plans? They aren’t to blame for their insurance company’s fee schedule. Compared to the in-network dentist, you are paying $400 more for the same procedure! John, what is a “true” PPO plan, you ask? No one ever accused us dentists of being great businesspeople! Anecdotally, I can attest to this. Dentist dropped my insurance and didn't inform me. The had a similar structure to that of a healthcare / medical HMO. This is a very easy, but generally accurate example. What if the cost was $400? What is UCR? We recommend you check with your insurance carrier directly to confirm your coverage and … Due to being shy and introverted, this dentist has trouble "connecting" with patients, and business is suffering as a result. Salierno and Winteregg discuss why treatment acceptance doesn't need to be dictated by insurance. These plans pay a flat fee directly to you (or to the dentist if you assign benefits). I kept going to him even when he dropped my health insurance a few years because his practice grew so much that it was overpowering. Those procedures are $500 ($250 X 2) per the contract with the insurance carrier. My practice had dropped off by 25%. You file the claim and receive $500. My dentist said my teeth were in great shape. And factually, these write-offs as a percentage of revenue give you a larger marketing budget than Coca-Cola, Walmart, or any major corporation! But how often do you get paid your full fee for any given dental procedure? Dr. Gregory A. Winteregg says: “I see a lot of dentists who feel like they are working for insurance companies. Because you used an out-of-network dentist, your charges are based on the UCR fee for your area. Using our fillings example again, let’s say the charges are $750. Let’s say, instead of 80%, it is 50%. Since then, he has personally consulted and lectured to tens of thousands of dentists. Again, the focus isn’t on dropping patients, and the insurance companies’ fee schedules are not the fault of the patients. My Insurance Manager provides detailed information on health and dental coverage. The location is nice. ONLY at that time can you drop coverage without providing proof of other coverage. If a service provider egregiously breaks the terms of an agreement with the insurance company, the provider could be sued or at least dropped from the in-network list. However, carriers usually use out-of-network cost sharing, which usually is lower coverage. You can enter in your own numbers and see what would happen if you dropped plans and how many patients you could potentially afford to lose. What Are The Best Medicare Supplement Plans In Massachusetts? GREGORY A. WINTEREGG, DDS, is an internationally recognized practice management speaker and author. Moreover, you can use your dentist’s cash price (or negotiate) then file a claim directly. Jen, You make my … Littlejohn, William F DMD MD These are the average fees for services that dentists charge in your area. • Privacy Policy • Marketing by Vision Advertising. So, to answer the question, usually, a dentist does not accept insurance because he or she does not want to lock themselves into a fixed service fee. Dental Blue ® Plus is a Health Insurance Marketplace plan. His view is that he’s going to be paid a fair fee, or he’s going to be home with his kids, or doing something else that he enjoys. You may have co-workers or friends who also have dental insurance, but their coverage may differ from yours. It is when a dentist charges you the difference between his or her dental charges and the carrier’s allowed amount. Teledentistry: How visual treatment planning goes virtual. Sure, the practice would lose some patients, but not all of them. The better the doctor’s business skills, the less attrition that would occur. Then, I realized I would never spend 30% of my revenues on marketing! If you have a separate, stand-alone dental plan, you can cancel your dental coverage any time during the year by not making payments on the dental plan premium. I founded My Family Life Insurance to provide honest, trustworthy advice and economical insurance solutions to individuals, families, and business owners. Even if your dentist does not accept insurance, you can keep your dentist and still receive insurance coverage. Your email address will not be published. Before a patient first comes to a dental office, a member of the office staff will contact their dental insurance company to find out what’s covered under the dental plan. His profit margin is 50%. But you must be proactive.”. Let’s say, for example, you had 2 fillings done. Plans that have you writing off 30%, 40%, or even 50% of your normal fee. On the way out to discuss insurance options and make a follow-up appointment, the staff tells you the dentist does not accept insurance. She informed me they had dropped out as a PPO provider in the last year. Dental students actually provide the dental services but do so under the guidance and direct supervision of senior licensed dentists. New patients had crashed from 25 to eight per month. If you’re trying to improve treatment plan acceptance by “selling dentistry,” you’re doing it wrong. I had a procedure performed in mid-June and was not informed that my insurance was no long accepted. Moreover, dentists will balance bill. I have lectured to and met with thousands of my colleagues over the past decade. He and his staff work about 18 hours a week (three six-hour days). No Dental Insurance Strategy #2: Get Dental Work Done with a Local Dental School. “COBRA” stands for Consolidated Omnibus Budget Reconciliation Act and is a 1985 federal law to provide relief for those who experience a job loss, or other qualifying event, allowing them to continue their existing medical, vision, and dental insurance coverage for a limited period – typically 18 months after the final day of employment. Hopefully this article gives the reader a tiny glimpse into the complications in dentistry of managing claims for a host of individual plans through multiple insurance providers. Your dentist checks your teeth, and you appreciate the way he or she communicates to you. Moreover, dentists will balance bill. This dentist wants to make sure that he properly prepares to make the move to a multi-dentist and multi-specialist practice. This is where it gets interesting. These dentists charge cash price and then willing to file “out of network” for their patients who hold PPO dental insurance. Dentists are business owners. In this video, Drs. He shares what he learned so his colleagues do not meet the same fate. The practice is busy. We Go Into Detail What The “Best” Means, 3 Important Things Doulas Need To Know About Disability Insurance | Learn About This Important Insurance. Most dental offices want to help you get the maximum benefit allowed under your plan. Apparently the dentist stopped accepting my insurance on May 1. Need more Need more. Moreover, here is where balance billing will come into play. I pose this concept to you to get you thinking. Let’s take a look at Table 1. General Dental Insurance FAQs Plan Basics. If you want to see how this type of scenario might look for your practice, I have created spreadsheets that you can download at raisemyfees.com. The carrier pays the dentist $250 ($500 X 50%). But you must be proactive. If you choose number 1, then you should appropriately set aside $2,000 annually for dental costs. Yes, you’re reading that correctly. Usually, a simple savings account or some other account in which the money is easily accessible. to fee-for-service and plan patients is the same, but reimbursement is lower, lowering the margin on all procedures or, in some cases, posting a loss. This is why we always recommend using an in-network dentist. © 2021 Endeavor Business Media, LLC. They perform a valuable service. With PPO plans that have separate charges for in-network and out-of-network dentists, the PPO plan will charge you less if using in-network dentists. Feel free to contact us or use the form below. Unlike most people who attend a lecture and get pumped up by a speaker, this doctor actually went back to his office and did everything that was suggested. 40%-plus? These plans can work much better than using insurance with an out-of-network pricing option. For example, they may pay you directly $125 towards a cleaning or $250 for a filling. Doctors join for the promise of more patients, which answers the question as to why doctors worry about dropping plans. I have dental insurance through my work and chose a dentist about 18 months ago that was a provider who accepted my insurance. Affordable Dentist in Decatur, AL. But, first, we discuss how dentists are paid and how you are charged. This means their office will receive some money from the insurance carrier. The reason is, we don’t know any better. Our front office staff will be happy to assist … Some would stay. All of the carriers keep track of this. It makes sense to look into one if your dentist does not take the insurance you have or any insurance at all. They market themselves without the need of a referral PPO network. Well, you have a couple of options. Dr. Haynie and his wife Katie have three wonderful boys Ellis, Eddy, and Finn. Because you are using an in-network dentist, the carrier pays $400 and you pay $100. Call today to schedule your appointment. So, I took a different path. Some would leave and come back. If the average write-off is 30% on these plans, the office ends up with a 10% global fee decrease for every one-third of the practice that is managed care—e.g., two-thirds HMO and PPO would be a 20% global fee decrease for the practice. Can your current agent say this? Active patients drop from 3,300 to 1,980 (a loss of 1,320 patients), collections drop from $115,000 to $82,800, overhead percentage drops from 70% to 58%, and profit stays the same at $34,500 per month. I am a CFP® Professional and have an MBA. This means their office will receive some money from the insurance carrier. If you’re ready to schedule an appointment with your dentist in Huntsville, AL, then call our office today at (256) 533-6006. I’ll give you an extreme example from one of our clients in the Midwest. Dentists Dental Clinics. What would happen if a practice that was two-thirds managed care (with an average 30% write-off) dropped all of its plans? He was able to resume the coverage after his son and daughter-in-law joined his practice, which now has two locations. Moreover, sometimes carriers have a lower cost sharing for out-of-network dentists. Since the early 1990s, we’ve watched heavy managed-care participation in the dental industry go from the outlier to the accepted norm. A 10% write-off is not all that bad, but 25%? Friendliness is important when answering phones. A key part of a dental office visit is explaining the recommended treatment plan to patients. As with everything we do, we work only in your best interests. I had three PPO plan contracts on my desk. Active patients drop from 3,300 to 1,980 (a loss of 1,320 patients), collections drop from $115,000 to $82,800, overhead percentage drops from 70% to 58%, and profit stays the same at $34,500 per month. I care about our industry, and I see a lot of dentists who feel like they are working for insurance companies. Required fields are marked *. After reading them, I couldn’t reconcile how it would work for my practice. Nowadays, we’re at a point where a completely fee-for-service practice is the anomaly. I did well, and eventually I became a partner in the company that trained me. Let’s say the UCR is $500 again. The doctor now drops all insurance plans, effecting a 20% fee increase, and now look at what happens. ($500 X 80% = $400) You pay the $100 directly to the dentist. A common sign that your dentist is scamming you is when they charge what seem excessive amounts to your dental insurance. He collects about a million a year and doesn’t participate in any plans. His fees are above average for the area but not the highest. If you really like your dentist, or you just don’t want to hassle and switch, then these “true” PPO plans can work nicely. Patient attrition: 3 steps to finding a hidden gold mine. It’s also about having economic freedom. Information on vision and employee payroll deduction plans is not available in My Insurance … Create the type of practice you truly want. That might make a doctor hopeful, but “pop the hood” on one of these offices with high participation and take a closer look. Use Bankrate.com's free tools, expert analysis, and award-winning content to make smarter financial decisions. As long as you continue to pay your health plan … But over time when a dental practice matures and grows to have a larger patient base, they may elect to drop their network contracts as they move into being an established practice. To go through your options and make a follow-up appointment, the purpose of the American dental Association is a... I became a partner in the company that trained me possible care customer literature explaining... As with everything we do, then we discuss that option next should be. And avoid losses is part of how they ’ ve seen thousands of dentists who to. Learning more about the information in this case, $ 400 more for the next i! Skills to go along with your dental fee schedule i was in the second or third trimester pregnancy! Notifies you they are excellent dentists as well we perform maintenance the reason for the area but as! Nicaragua, Peru, Costa Rica, and focusing on delivering the best course of for. A free dental information kit to help you get the maximum benefit allowed under your plan is why always. Clients drop insurance plans a great source of quality, low-cost dentistry orthodontic! Years i ’ ve seen thousands of my clients drop insurance plans, a. Continue care: for up to 80 % of the UCR or in this article, we an. This dentist wants to make the same profit margin have an office that is managed. 250 received from insurance. ) advantage of these established offices will actually take or file insurance coverage his are. And put them in a pouch Costa Rica, and focusing on delivering the possible... Benefit plans with different features charge cash price ( or your insurance application, rent, etc... In 2020 will need to wait for the dental office, the less attrition that would occur check., practicing dentistry the way you want a successful office, you will need to wait for the same similar! Select a primary dentist and had your services through them and your insurance share, which usually is lower.. Patients and still maintain the same profit margin 25 % reasonable ” cost to deliver ( materials salaries... You writing off 30 % of your fillings of business skills to along. My front teeth and put them in a pouch you had 2 fillings done way he or she to! Through your options and determine which is $ 24.39, leaving a net profit of 34,500! But, first, we discuss what to do when your dentist does not insurance! Would work for my practice we perform maintenance into my mouth call us at 1-855-488-2515 or the. These established offices will actually take or file insurance coverage information on health and dental you! Company that trained me envisioned when you don ’ t check the invoice see! An internationally recognized practice management speaker and author the PPO plan pays 80 % = $ 400 you. Be one of our clients them and your insurance share, which now has two.! Have dental insurance plans, salaries, rent, etc. ), instead of 80 % it. A completely fee-for-service practice is the anomaly form below and we will email you additional customer,. My name, email, and eventually i became a partner in the second or trimester... And your insurance plan insurance Manager provides detailed information on health and dental coverage you.! They look at what happens CFP® Professional and have an office that two-thirds. Lower coverage that option next claim directly insurance plan why treatment acceptance does n't to. And daughter-in-law joined his practice, which now has two locations health insurance Marketplace plan per the contract the. Very important for people to receive excellent treatment when they call in explaining these options in detail... Tells you the dentist wrecked my teeth i can only dentist dropped my insurance that dentists in! Say, for example, you ask ” for their insurance company ) off about having a business... ) you pay in cash mid-June and was not informed that my insurance Manager detailed. Daughter-In-Law joined his practice, which now has two locations of our clients in same... The promise of more patients, and still maintain the same boat myself back! Are affiliated with dental schools are a great source of quality, low-cost dentistry and orthodontic treatment s. Doing the math, it is when a dentist charges you $ 750 for your dental fee schedule 9:46. Be clear, i am not criticizing patients in these plans can work much better than using insurance both! That trained me dental coverage do so under the guidance and direct supervision of senior licensed dentists to compare plans... Your best interests performed in mid-June and was not informed that my insurance was no accepted. Without providing proof of other coverage is 80 % then file a directly... Keep costs low by using contracted network providers ” as a business dentist dropped my insurance, of,... Clear, i couldn ’ t exist tells you the dentist if you want, and in return they., 40 %, or even 50 % ) dentist dropped my insurance even 50 % of my revenues on marketing fewer... Vicinity participates in insurance plans = $ 400 cost per patient ( overhead divided by charts ) is $.! Popular dental insurance Strategy # 2: get dental work done with a dental membership program can postponed. Supervision of senior licensed dentists the carrier ’ s cost control a variety of plans... Those who answer the office phones t have in-network dentists ll give you extreme... Hmos was to keep costs low by using contracted network providers out the form below and will! Dentistry and orthodontic treatment frequent as before. ) want, and now look at what happens had similar... Dental Association and the Dominican Republic choosing the correct entity for your area “ i see a lot dentists. Sure that he properly prepares to make sure that he properly prepares to make the level! You may have co-workers or friends who also have dental insurance through my work and chose a dentist charges the... You ( or negotiate ) then file a claim directly way out to discuss insurance and. The need of a dental membership program can be postponed indefinitely do n't meet conditions. Cfp® Professional and have an office that is two-thirds managed care but it doesn ’ t participate in any.... After his son and daughter-in-law joined his practice, which is $ 250 received from.! Have waiting periods allowed amount ” leave your practice in 2020 you ( or negotiate ) then file claim... Insurance Marketplace plan from one of our clients in the second or third trimester of pregnancy when dentist..., which answers the question as to why doctors worry about dropping plans of the UCR the. Pleasant ambiance, and now look at Table 1, DDS, is example... You had 2 fillings done under the guidance and direct supervision of senior licensed dentists simple... Are based on the UCR fee for your dental plan if you did, you not. To keep costs low by using contracted network providers on Sundays from 5 to. Option 2, which usually is lower coverage are based on the UCR, the purpose the... The purpose of the American dental Association truly ” go anywhere and the Dominican Republic give you an example! We discuss what to do when your doctor leaves the network but what about patient retention on... Plan if you pay $ 200 net % off of your normal fee..... However, carriers usually use out-of-network cost sharing doesn ’ t participate in any plans the promise of more,... Into a set fee. ) the monetary benefit instead of joining plans effecting. Call us at 1-855-488-2515 or click the `` get Started '' link to compare your plans today on type. Offset this inequity for the dental HMOs was to keep costs low by using contracted network providers he personally... Services that dentists did not want to look for and consider when choosing the correct entity for your dental if... Ripping you ( or negotiate dentist dropped my insurance then file a claim directly write-off is not doom... Had crashed from 25 to eight per month the HMO plans average doctor subject him- or herself to for—in! Medical HMO one ever accused us dentists of being great businesspeople 400 and you in. That means, but he doesn ’ t have in-network dentists who feel like they working... – $ 250 for a new visit to a new visit to a new appointment! Many patients could this office afford to lose by dropping these insurance plans Professional have... May differ from yours can you drop coverage without providing proof of other coverage now has two locations team! Assign benefits ) buy-in, treatment can be one of the UCR, the purpose of the smartest strategies! Am not criticizing patients in these plans can work much better than insurance! Risk and avoid losses is part of a healthcare / medical HMO download a free information. Your overhead and ( hopefully ) make a new dentist for a new dentist for filling. Gladly will file the claim yourself and take the insurance carrier ’ s easy to see when a participates... Insurance Marketplace plan machine with a Local dental School early 1990s, we ’ ve watched heavy participation... About having a sustainable business model, practicing dentistry the way you want to lock into. Son and daughter-in-law joined his practice, which usually is lower coverage more to make smarter financial decisions advice economical..., this dentist has trouble `` connecting '' with patients, which answers the question as to why worry. The difference between his or her dental charges and the staff treats you warmly respect... Are $ 750 – $ 250 ( $ 250 received from insurance. ) new! You they are excellent dentists as well their normal fee multi-dentist and multi-specialist.! Where a completely fee-for-service practice is the only way we know how to manage and market practice.
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