Insurance Untangled

Naren Arulrajah

Are you tired of feeling chained to insurance companies and their restrictive policies? As a dentist, you have the skills and expertise to provide top-notch patient care, but insurance dependence may be holding you back. By reducing your reliance on insurance, you can take control of your practice, increase profitability, and provide the highest quality care without limitations. Join us weekly as we dive into a topic related to insurance negotiations and working with insurance providers. Our expert guests share their insights and experience, providing practical tips and strategies for getting the best possible outcomes. Whether you're a healthcare provider, an insurance industry professional, or someone looking to learn more about insurance, our podcast is for you.

  1. 6d ago

    The Next Billion-Dollar Opportunity in Dentistry

    Why is the future of dentistry moving beyond teeth — and into sleep, airway, breathing, and whole-body health? In this episode of the Insurance Untangled Podcast, host Manjali Kulathunga sits down with Dr. Rad to explore one of the biggest emerging opportunities in modern dentistry: integrating sleep and airway services into the dental practice. Dr. Rad explains why dentists are in a unique position to recognize signs connected to sleep-disordered breathing, airway issues, bruxism, dry mouth, periodontal problems, and overall patient health. While many patients struggle with sleep-related issues without ever receiving the right evaluation, dental teams often see warning signs every day during routine visits. The conversation dives into why many dentists overlook sleep and airway dentistry, what holds practices back, and how simple systems, training, screening, home sleep testing partnerships, medical billing support, and patient education can help practices introduce these services responsibly. Dr. Rad also shares how sleep dentistry can create a stronger and more sustainable practice model without simply adding more patients, working longer hours, or becoming more dependent on insurance-driven dentistry. Whether you are a solo practice owner, a growing dental team, or a practice leader looking for new ways to improve patient outcomes and build long-term value, this episode will help you think differently about the future of dentistry.

  2. Aug 7

    Fighting Back: Fee Negotiations and Taking Control of Dental Insurance

    Why do so many dental practices feel like insurance companies control their fees, their write-offs, and their profitability? In this episode of the Insurance Untangled Podcast, host Manjali Kulathunga sits down with Tessina Bullock, President of Verus Dental, to discuss one of the most frustrating challenges dental practices face today: managing insurance fees without allowing insurance companies to control the financial health of the practice. Tessina explains why many practice owners mistakenly believe PPO fee schedules are fixed, negotiations are impossible, and insurance write-downs are just part of doing business. In reality, practices may have more opportunities to negotiate, strengthen their systems, and protect their revenue than they realize. The conversation dives into what practices need to understand before starting the negotiation process, including office fee schedules, frequently billed procedures, contract structures, write-offs, downgrade codes, provider leverage, and how to find the right contacts inside insurance networks. Tessina also shares why dental offices must stop allowing insurance companies to "train" their teams, how denials and claim requirements can be challenged, and why understanding contracts, documentation, and legal rights is essential for protecting revenue. From PPO negotiations and umbrella networks to IPAs, claim appeals, and knowing when a plan may no longer be a good business relationship, this episode gives dental leaders a clearer path to take back control. Whether you are a solo practice owner, managing multiple providers, or trying to reduce dependence on PPO-driven revenue, this episode will help you think more strategically about insurance participation, fee negotiations, and practice profitability.

  3. Jul 31

    The Art of PPO Fee Negotiation

    Why do so many dental practices accept low PPO reimbursements as if they have no other choice? In this episode of the Insurance Untangled Podcast, host Manjali Kulathunga sits down with Benjamin Tuinei, President of Veritas Dental Resources, to discuss one of the most frustrating and financially important challenges dental practices face today: PPO fee negotiation. Ben explains why PPO fees are not always as fixed as many practice owners believe, and how that mindset can quietly cost practices thousands in lost revenue, unnecessary write-offs, and reduced profitability. The conversation explores where reimbursement opportunities are often hiding, why many practices miss them, and how the right negotiation strategy can help dental teams increase revenue without simply working harder or adding more production. Ben also breaks down common "insurance games" that can lead to unnecessary income loss, confusing contract terms, credentialing issues, and payer communication challenges that leave practice owners feeling overwhelmed. Whether you are a solo practice owner, managing a growing team, or trying to reduce your dependence on PPOs, this episode offers practical insight into how to negotiate smarter, protect profitability, and take back more control over the revenue your practice has already earned. Topics discussed include: • Why PPO fee negotiation matters for dental practice profitability • The mindset shift practice owners need around PPO reimbursements • Where hidden reimbursement opportunities are often found • Why many practices leave money on the table without realizing it • Common insurance tactics that increase write-offs and reduce income • How contract and credentialing issues can affect revenue • First steps practices can take to negotiate from a stronger position • Why PPO strategy is a leadership and sustainability issue • How better fees and stronger systems can protect long-term practice health Connect with Benjamin Tuinei: President, Veritas Dental Resources Insurance Untangled is dedicated to helping dental practice owners navigate growth, operations, insurance, billing, leadership, marketing, and profitability through conversations with industry experts and successful practice leaders.

  4. Jul 24

    The Experience that Keeps Them Coming Back

    Why do some patients stay loyal to a dental practice for years, while others disappear after just one visit? In this episode of the Insurance Untangled Podcast, host Don Adeesha sits down with Kelly Fox-Galvagni, Owner of Smile Potential Dental Coaching, to explore how patient experience plays a powerful role in retention, referrals, and long-term practice growth. Kelly shares why creating a great clinical outcome is only one part of the equation. From the first phone call to the final follow-up, every interaction shapes how patients feel about the practice, the team, and the care they receive. The conversation dives into the habits, systems, and leadership decisions that help dental practices create a consistent experience patients remember, trust, and want to return to. Kelly also discusses how stronger communication, team alignment, and intentional patient touchpoints can improve retention without relying only on marketing or discounts. Whether you're a solo practice owner, leading a growing team, or working to improve patient loyalty, this episode offers practical insights into building an experience that keeps patients coming back. Topics discussed include: • Why patient experience directly impacts retention and growth • The moments that shape a patient's decision to return • How dental teams can create more consistent patient interactions • Why communication matters before, during, and after the appointment • Building trust through small details and intentional systems • How leadership influences the patient experience • Practical ways to improve loyalty, referrals, and long-term practice success Connect with Kelly Fox-Galvagni: Smile Potential Dental Coaching Insurance Untangled is dedicated to helping dental practice owners navigate growth, operations, leadership, marketing, patient experience, and profitability through conversations with industry experts and successful practice leaders.

  5. Jul 14

    Why Only Half Your New Patient Calls Are Actually Converting

    In this episode of the Insurance Untangled Podcast, host Don Adeesha sits down with Perrin Desportes, founder of Next Level Executive, to break down the math behind real, sustainable revenue growth for dental practices. Perrin shares the simple revenue equation every practice owner should understand: opportunities, conversion rate, and average treatment value. He explains why so many practices focus on just one of these levers instead of improving all three, and how that gap quietly limits growth. The conversation dives into phone conversion rates, revealing that industry wide, only about half of new patient inquiries actually convert into booked appointments once you factor in answered calls and follow through. Perrin also addresses case acceptance without the sales pressure, offering practical ways to help patients say yes to treatment while keeping the experience trustworthy and low pressure for both patients and staff. Whether you are running a solo practice or scaling a group, this episode offers a clear framework for identifying where revenue is being left on the table and what to do about it. Topics discussed include: The three part revenue equation: opportunities, conversion, and average treatment value Why focusing on only one lever limits overall growth How phone conversion rates impact new patient flow Increasing case acceptance without feeling salesy or pushy How scheduling and broken appointments affect financial performance Where to start if you can only focus on one lever for the next 90 days Common mistakes practices make when building or scaling a group Connect with Perrin Desport: Next Level Executive Insurance Untangled is dedicated to helping dental practice owners navigate growth, operations, insurance, billing, leadership, compliance, and profitability through conversations with industry experts and successful practice leaders.

  6. Jun 11

    Beyond Insurance: The Hidden Habits and Systems That Protect Your Practice's Profitability

    Why do some dental practices grow into successful multi-location groups while others struggle to scale beyond a second office? In this episode of the Insurance Untangled Podcast, host Don Adeesha sits down with Courtney Staiger, CFE, to explore one of the most overlooked threats facing dental practices today: fraud, embezzlement, and financial vulnerabilities hiding in plain sight. Drawing from her experience investigating fraud and helping businesses strengthen internal controls, Courtney shares the warning signs practice owners often miss, why trust alone is never a financial strategy, and the systems every practice should have in place to protect revenue and reduce risk. The conversation dives into common embezzlement schemes, the importance of segregation of duties, how to identify red flags before they become costly problems, and practical steps dental leaders can take to create a culture of accountability without damaging team trust. Whether you're a solo practice owner, managing multiple locations, or preparing for future growth, this episode offers valuable insights into protecting the business you've worked so hard to build. Topics discussed include: • Common fraud and embezzlement schemes in dental practices • Warning signs owners and managers often overlook • Why internal controls matter, even in close-knit teams • Creating accountability without creating distrust • Financial safeguards every growing practice should implement • The role of leadership in reducing organizational risk • Practical steps to protect revenue and strengthen operations Connect with Courtney Staiger: LinkedIn: Courtney Staiger, CFE Insurance Untangled is dedicated to helping dental practice owners navigate growth, operations, leadership, marketing, and profitability through conversations with industry experts and successful practice leaders.

  7. May 28

    How Do Successful Dental Groups Run on Data? The KPIs, Metrics, and Operations Behind Profitable DSOs

    When a dental practice grows beyond one location, the things that used to live in your head suddenly need systems, dashboards, and clean data behind them. Without that foundation, growth slows, problems hide longer, and decisions get made on instinct instead of insight. In this episode of the Insurance Untangled Podcast, host Don Adeesha sits down with Vincent Cardillo, founder of Mava Dental Advisors and a 25+ year veteran in scaling dental service organizations. Vincent led one group to #14 on the Inc. 500 list with 12,896% growth, and today he provides outsourced C-suite services to emerging dental groups through Mava and their proprietary performance platform, Pronto. Don and Vincent unpack what actually changes when a single practice becomes a group, why most owners struggle with the same five gaps (org chart, accountability, SOPs, training, and numbers), and how to coach yourself out of the "I'll just do it myself" trap. Vincent also breaks down the four KPI buckets every group should be tracking — financial, operational, clinical, and culture — and shares a powerful insight: focusing on just two metrics (missed calls and percentage of new patient calls booked) can grow your new patient count by 20% in three months without spending another dollar on marketing. In this episode, you'll learn: The five biggest operational gaps owners hit when scaling from one to multiple locations Why promoting your most loyal team member into management can backfire — and how to handle it How to have the honest "what do you really want?" conversation with long-tenured staff The four KPI buckets every dental group should track (financial, operational, clinical, culture) The two metrics that can lift new patient numbers 20% in 90 days Why benchmarks matter more than dashboards How data-driven groups build the confidence to open practice #2

About

Are you tired of feeling chained to insurance companies and their restrictive policies? As a dentist, you have the skills and expertise to provide top-notch patient care, but insurance dependence may be holding you back. By reducing your reliance on insurance, you can take control of your practice, increase profitability, and provide the highest quality care without limitations. Join us weekly as we dive into a topic related to insurance negotiations and working with insurance providers. Our expert guests share their insights and experience, providing practical tips and strategies for getting the best possible outcomes. Whether you're a healthcare provider, an insurance industry professional, or someone looking to learn more about insurance, our podcast is for you.