um in a practice for your Invisalign cases and I've made another video backwards that
was more for you can search it I'm trying to remember the keywords because I have a about 8
000 videos but I think if you look up Invisalign comma associate within my channel and that little
magnifying glass it should pop up that was more for the owner doctor's perspective because I've
been on both sides of it I've been the associate my husband's been the associate I've worked with
doctors who are the associate on their cases but we've also been the owners where we're paying
Associates to do it and it's really different when you're on the other side let me tell you so
taking that aside listen to the other one first listen to the owner's perspective because I think
as an associate if you understand some of the stuff they're going through maybe you'll be
more flexible now and got to keep in mind that Invisalign or any type of Ortho is a is the Long
Haul it's a marathon not a Sprint it's unlike any other dental procedure where either you can
get paid in stages like an implant somebody is going to place the implant that's a one or two
step procedure that's done very you know within a few weeks some you know and then there's a healing
abutment step and then there's a um you know then there's a restoration step so these are three
distinct endpoints where you could get paid right everything else like a crown yeah you're gonna
prep you're gonna deliver a couple weeks right a bridge you're gonna prep you're gonna deliver a
couple weeks Ortho you're gonna start you're gonna finish could be two years could be three years
could be four years could be one year I know most cases can be done in less than two years but a lot
of times you're dealing with compliance issues too um you know so unless you're keeping a super tight
rain and handle and you need to build this into your whole process and procedures and I have a
ton of videos on compliance with Invisalign again other keywords you can look up compliance comma
Invisalign virtual monitoring comma Invisalign because first of all I would never whether I was
an owner or an associate I would never start doing Invisalign without having a compliance
Loop not only paperwork and that's something that we have at straight smile Solutions we have some
you know just some rough drafts of some compliance paperwork that you can take
edit make your own you could have your own attorney create compliance paperwork
um you can ask your liability insurance if they have compliance paperwork you want to set up a
really airtight compliance Loop so that your patients realize and this is what we used to
do in our offices it's pretty standard in an ortho office in terms of how the processes work because
we deal with compliance every day right but it's not at all something that's in a GP office so you
know our front desk knows how to talk about it our doctors know how to talk about it our back
off is just part of what we do part of our Mantra so we make it Crystal Clear look this Invisalign
case is estimated to be 50 aligners which is you know at one week changes assuming you're doing
things doing things as recommended and things go predictably at most this is going to take 12 to 16
months so if this case goes beyond 18 months you know there will be additional fees of x per month
um we're just letting you know so it's really important that you come into your appointments and
get this done efficiently after this date you know you can whether you want to go with invisaligns
expiration dates I don't recommend that especially if you're doing five years um I think you should
create your own uh or or some other way you know after that there's gonna be additional
fees if you're non-compliant with this system and the non-complaints is gauged by the doctor
so you got to make sure they realize that you're keeping an eye on them you also need to check in
every week every two weeks with your virtually monitoring system so that means you guys need to
provide them and train them up on this this isn't something that comes standard you can pay extra
for outsourcing systems otherwise Invisalign has their own monitoring system it's not great it's
certainly not great it's kind of clunky but it's free so it's called Invisalign virtual my personal
favorite is one called in hand Dental which is you know cost about 100 150 200 a month for 30 40 50
patients I think it's I think you can do something a real limited version might be more like 150.
um but they give you a dashboard patients are going to be prompted to take their pictures
um at a certain frequency every week every two weeks every line or every other aligner
these photos are going to come to you on a HIPAA compliant dashboard you're going to be
able to review them if you're working with a um additional orthodontist who's maybe there
to help you with your cases someone likes us straight smile Solutions there's tons of other
companies like us that are out there there's a lot of orthodontists that do this under the table over
the table you know just to help you you know it can go to them and you can get all kinds of
give feedback virtually that really really helps reduce the revisions and refinements and keeps the
patients on track so I strongly recommend doing that anyways that was a sidebar so set up your
systems create your accountability Loop is the first thing I would do before I even get started
because that's going to make things better for you the associate as well as the owner doctor and if
you're the one I mean a lot of it really depends on who who's the one that wants to do it is it the
patients that are asking the office is asking the owner doctor's asking but he's just not interested
or you the associate sees an opportunity you need to make additional Revenue you got to
realize a lot of owner doctors are going to be hesitant because again the billing structure of
Invisalign is not friendly you know that you have to pay your lab fee up front which I'm sure you
guys are all aware of but if this is an insurance case you're going to get paid in drips and drops
over two years so that means you're going to be cash flow negative on this case initially
you're gonna lose money when you start unless the patient has paid their portion of front which
very few patients can pay two three four thousand dollars cash up front I mean some can if you're in
an affluent area but the average American cannot so if you're you're going to be cash poor you're
going to be you're going to be in the red from day one and then eventually it's going to get
profitable over time well that's not best business for a lot of people and that's why a lot of people
don't want to get into it now I'm going to tell you the more cases you you scan the more cases you
work up the more cases you sell and if you there are some programs or once you start doing a little
more volume where you can defer those payments for four to six months you can ask your Invisalign rep
about it they occasionally have them to get you GPS started those are a slippery slope though I
don't right you know take them with caution and we definitely did it in one of our offices but
then all of a sudden you have a thirty thousand dollar bill and if you don't pay it within x
amount of time they're going to shut your account down you're going to get a big yellow banner and
they're going to stall your accounts you're not going to do revisions refinements it is a hot
mess it has happened to us by accident because some of you know you're an associate and you're
working with a variety of different owner doctors and maybe they're not paying the bills for you so
another tip if you are an associate you do not use your account you do not use your account you use
the owner doctors or offices account first of all that happened to me I was using my account and I
was associating a couple different offices so they would log in and they would pay their bill and it
was working pretty well until they stopped paying their bills and then all of a sudden I'm getting
notifications that I owe money to Invisalign like legal letters and they're shutting down my
account and office a is the one not paying their bills but office B was paying their bills but I
couldn't submit any refinements for either A or B now that's a liability for me absolutely not it's
under owner doctor's account okay that's that's number one like hard rule not under your account
so if they're saying you go take Invisalign you do it under your account that's a hard
note we both go take Invisalign I'll do the work under your account okay liability just went down
exponentially for you and not only financial but also the responsibility okay so that's number one
um number two you need to sit down and take this this owner doctor out to coffee and just kind of
work through all these these talking points you know whose account is it going to be under how is
this going to work do you realize that we're going to be cash negative initially on this case basis
who's paying the lab fee I mean really in your contract your associate contract it should say
a major procedure is what you're getting paid and how much of the lab fee you have to pay it should
mean no difference between Invisalign and your crowns Invisalign and your implants Invisalign
in your Bridges so they can't if you're getting paid 25 production you know plus 50 lab fees maybe
that's a little lowball or 35 production you know in all lab fees or whatever can't be different
for Invisalign as it is for other major procedures otherwise that's a no-go on my end's pass you know
um other thing you know yeah I mean you're the owner doctor needs to know it's going to come
in drips and drops they're going to be cash flow negative initially um if you're getting
paid on collections okay and especially if you're having to pick part or all of your love you that's
a that's a warning sign for you the associate hey that's great for the owner doctor but you're gonna
you are gonna be super negative they're gonna be pulling negative money out of your paycheck to
cover this until the patient pays I would never do collections for an associate just letting you
know I always did production I don't want to be the one chasing after the money I do the work I'm
going to get paid this is not my problem if y'all can't get the money or if you guys didn't set up
the systems at the front the right way production production production production okay especially
with insurance because it's not going to come for a very very long time if they even get it
at all and a lot of times it's hard to chase the insurance down and then you're having to build
a patient for the remaining but you've already finished the treatment it's a nightmare okay so
production so let's go over that again we're going to recap always in the owner doctor's
account always production depending on your amount of production whether you're getting
35 or 25 should be how much lab that you're paying there's offices where I paid the full
Lab fee their offices where I paid half the lab fee there's offices where I paid you know none of
the lab fee but then my production was lower so that's you know kind of like a sliding scale how
you do it it really didn't matter to me um but I expected it to be paid more upfront so the other
question about the production that you need to keep in mind in in this is something that you're
just assuming you're getting it on the front end but you maybe not different offices I worked at
um you know recognize the production different ways some of them recognized it all as it you
know up front so if we did a start production was you know six thousand dollars you know but
collections hadn't come in yet so I would get you know 35 of that you know and then whatever lab fee
taken out so it was a nice plunk I get two grand in my paycheck just for starting the case that
was awesome right but they'd also maybe take out a thousand in lab fees I'd only get a thousand
but I was okay with that now if they are there are other offices I worked out where they recognized
the production at different intervals so you need to ask how is the production recognized
um there's other ones where they did 50 50. you'd get 50 the production at the start and
fifty percent of production at the Finish once you close the case that's kind of what I recommend
that owner doctors do because you really what you don't want to do is you don't want some hot Gunner
um associate coming in starting all kinds of cases doing crappy treatment plans and we'll
get to that in a minute um that don't even have any thought into them you know starting them and
then just about you know up and leaving up and leaving going someplace else and now you the only
doctor are now stuck with finishing all these cases and you already paid your associate all
the money you're never gonna be able to get the money back from them once you do it so just like
any other procedure be it a crown or a bridge you're not going to give all the production
until you deliver right well same thing with uh same thing with Invisalign you don't give
all the production until the case is finished the patient has signed off the doctor has signed off
that's why I recommend 50 50. so now let's say for example case is six thousand dollars
production you're getting paid say thirty three percent so that's two thousand dollars
production you're taking out some lab fees I don't know 33 50 so now you're getting
twelve hundred dollars production for that but it's gonna be 50 50. so you're only gonna get 600
at the start and 600 at the debut and that means if you up and bail you know during treatment and
you move to some other office you're not getting that other 600 the finishing doctor that gets it
that's fair to me in our office we're doing third or third so we're doing third at the start third
at the midpoint of the treatment you know and I guess doctor has to double check to make sure
it is indeed the midpoint you know a patient is 50 done um it doesn't mean 50 weight through the
aligners you have to kind of look at the progress It's a little bit arbitrary and another third at
the finish so they're getting even less on the front end which is good you know but this really
if you if you set up those kind of milestones and pay over time just like you're getting paid over
time the associate doctor is less likely to be a Gunner and start all kind of cases if they're
thinking about leaving so another thing to keep in mind is I've gotten screwed on this and so has
my husband and I won't go too much into details because he's still kind of dealing with this issue
where verbally it all sounded fine yeah you know I agree we'll do third third we'll do half half
um of the 33 or of the 30 yeah I'll pay half the lab fee fine we got all that worked out right
makes sense the issue was you know things happened he had to you know up and leave whether they are
firing you you know you decided to leave whatever and you need to make sure it's Crystal Clear and
written in writing what's going to happen to those patients because even though he was a
W-2 even though he was an employee they they said this was patient advantagement they said he had
to finish all the cases he started and it wasn't really the verbiage really wasn't in the contract
you sign but they were they had a lot more money than he did at the time he couldn't even afford
the lawyer to fight it you know and they were definitely gonna go get one it was enough cases
that it was worth it for them just to make them force them to stay on and finish their cases so
he had to come in once twice a month for another year or two out and still not even you could still
up you know get paid as he finished the cases but it definitely wasn't worth his time and he said
had he known he would have never started any cases you know because he didn't realize he was gonna
have to finish these cases you know I mean what if you moved across the country I've had other ones
where they're requiring the associates to pay back the money if they didn't finish the cases and now
they're having to write a check to their to their employer for twenty thirty thousand dollars just
to leave the practice so you got to make sure you not only verbally talk through this stuff
but you actually probably want to have an attorney create an addendum to your contract specifically
for Invisalign and how this is gonna it happens so often you guys people both owners and employees
are talking to me and they're like oh my God I had no idea I was gonna have to pay this back or what
am I supposed to do this this associate up and left and I don't know how to finish these cases
okay so you kind of get all the the touch points that I'm talking about things that you should
definitely talk about the accountability Loop how you're going to get paid it's not just about lab
fees how the payments are coming in Productions versus collection how it's recognized um et
cetera et cetera what happens if I leave early so another thing that can help you know and certainly
resources that if you obviously if you're on my channel you're able to see all the resources I
have but I have a whole Invisalign playlist it has over 200 I don't know 250 300 videos
if honestly if you watch all those videos you don't need to take any classes it's free I put
it all out there and no it's not necessarily in a organized order yet I do do webinars I've got
three going on this spring and this winter summer free some are 69 depending on who's hosting them
I don't get the money so that's just them to put it on and get the Z but um you know you can learn
a lot from those you can definitely go through all my videos um you know what's even better is
is signing up for our services for a month or two and just helping you on your first load of
cases but I have a fair amount of Associates that I work with that are where I'm hired by the owner
doctor to help them on their cases just to make sure it's idealized because they maybe don't know
Ortho that well the owner doctor the associates don't they think they know it but they don't
um you know some of them do now after a year or two they know it pretty well
you know and that way the owner doctor feels more confident because if the associate up and leaves
they know that these treatment plans were at least idealized so it's really easy if they have to do a
refinement all they got to do is just say go back to the previously approved treatment plan parrot
with a new scan so there's nothing that you don't have to even think about I mean obviously you got
to know something but you know for the most part you don't have to worry about it because you
already idealized the the setup the patient has already agreed to the setup you just keep going
back to the original plan you know and just just a reboot is all it is you don't have to go back from
scratch and then recreate the twin jackets really fast so if you do that then if your associate up
and leaves you already have amazing clinchex all you have to do is just repair it you know
so yeah this all you need is the accountability Loop set up and that's about it and anyone can
finish those cases you know any doctor in your office even if they have no experience
so yeah that's pretty much it those are all the things you need to know in terms of being an
associate doing Invisalign I mean nothing wrong with that and my suggestion is you get yourself
trained up you get the confidence going and I certainly would never do it in an office without
nitero they have to have an itera or they have to have an easy way to Outsource to a night tarot
be it a radiology Clinic next door or down the street or something like that that has an itero
but there's just no way to scale this I wouldn't even get started if I didn't have a Nitro it's
going to be a nightmare taking an impression so if doctor's willing to get you an itero if there's a
Dusty itero sitting in the corner bring it up say hey I would love to start scanning having every
single hygiene patient every single new patient scanned in our office so we can start looking for
opportunities the benefit of doing Invisalign patients is that the teeth get lined up better
patients have their teeth for more for a lifetime they're healthier for a lifetime the Restorations
um and big dental work Majors turn out better better occlusion better bite less wear less
breakage to good dental work that we do you know crowns fractures because we get the bite right
we upright molars so we can place more implants that's more production it's really just a win-win
for the whole office it's a win-win for the patients it's a win-win you know only from
function wise and keeping their teeth and being more healthy but also aesthetically you know a
lot of times patients don't even know that there's an easy way or or not that long way to get some
improvement in their Aesthetics and you'd be surprised when you bring it up or they may not
know that their bite is not a good for a reason you know and it's not balanced and that they're
going to have more wear on one side than the other they're going to get AB fractions attrition
they're more likely to have to have to get teeth pulled later fracture teeth things like that and
when you bring it up to them all the time they're like heck yeah you'd be surprised the more you
educate your patient as to the benefits and you don't want to be make it salesy like you should
get Invisalign you know you just say you should straighten your teeth here's one way to straighten
your teeth we do offer this in office but we're also happy to refer you out to an orthodontist
if you say it that way it doesn't sound like you're being salesy like you're trying to make
money all you're trying to do is help the patient and that's the direction you need to go with your
education and yourself all right hopefully that was helpful do check out the rest of the videos
in my channel for more education and sign up for our aligner and Invisalign training courses
coming on this winter and the spring I think the next one is um January 31st and we've got one on
February 28th and one in the middle of April the April one is the free one all right thanks