Podcast (Dental)

Benefits of Implementing Invisalign in Your Dental Practice

July 7, 2021

Dentists can become certified providers of Invisalign treatment. Invisalign is used as an alternative to braces for orthodontic treatments and is growing in popularity. The Invisalign trays are clear, removable aligners that gradually straighten teeth. They’re known for their convenience. Patients can easily remove them for eating, dental hygiene, or special occasions. For dentists, getting on board with offering Invisalign can open their practice to more patients and increased revenue.

On today's episode of The Art of Dental Finance and Management podcast, Art meets with Dr. Hardik Chodavadia of Enamel Dentistry to discuss offering Invisalign in your dental practice. Dr. Chodavadia outlines best practices for implementation including:

  • Initial steps
  • Equipment needed
  • Training measures
  • Financial aspects
  • Marketing methods 
Today's Guest

Dr. Hardik Chodavadia
Enamel Dentistry


Show Notes and Resources:

The Transcript

Art Wiederman, CPA: And hello, everyone, and welcome to another edition of the Art of Dental Finance and Management with Art Wiederman, CPA. I am your host, Art Wiederman. It's nice to be with you today. It's a we're just getting into the summer here in Southern California. And as you might have heard on the news, it's pretty hot here. I think Death Valley recorded one hundred and twenty eight degrees. We're recording on June 18th, twenty twenty one. It was one hundred and twenty eight degrees in Death Valley. And it's pretty warm out here. So trying to stay hydrated and inside as much as we can. But we're also recording podcasts that the weather doesn't stop us from recording podcast folks.

And I'm going to be talking about a topic on the business side of dentistry today that I really wanted to talk about for a long time. And I found myself a very, very skilled, articulate dentist. My guest today is going to be Dr. Hardik Chodavadia. He has he's a principal partner in a five office group in Austin, Texas, and he is a specialist in working with Invisalign. And we're going to talk about, you know, clear aligners Invisalign today. We're going to talk about the good, the bad, the ugly, mostly good, because we have a lot of our clients who work with Invisalign, have had great success, have built great parts of their practices with it. I do need to mention that this is a sponsored program by Invisalign and but it's a topic that I wanted to cover for a long, long time. And I've gotten the opportunity to do that.

We just covered sleep apnea in a previous episode. So we're going to talk about with Doctor how you would get into this if you wanted to, what you should do, what you shouldn't do. How does it work with the team? How do you charge? So we're going to kind of give you a how to work with Invisalign. We'll get to that in a moment, give you some information like I always do at the beginning of our podcasts.

Go to our wonderful partner, Decisions in Dentistry, their website is www.DecisionsinDentistry.com, look at all the great articles. There are over one hundred and forty continuing education courses that you can purchase access to that they update on a monthly basis at a very low fee. And, you know, their advisory board is a who's who of dentistry. And I've talked to lots of dentists who said some of their articles were very helpful to our doctors throughout the pandemic and coming out of the pandemic.

If you're looking for a dental CPA anywhere in the United States, by the way, I am a dental director at the CPA firm of Eide Bailly. That's Eide Bailly and I am located in Southern California. Eide Bailly has offices all over the western United States. And we at Eide Bailly work with about 800 dentists, again, mostly in the western United States. But I'm sure there are some east of the Mississippi if I were to take a look at the list. So if you are interested in working with us, my cell number, my cell number, not going to give my cell number. I'm going to give you my office number 657.279.3243. My email is awiederman@EideBailly.com.

If you're in other parts of the country and you're looking for a dental specific CPA, the Academy of Dental CPAs is my mother ship. Twenty four CPA firms across the United States that represent over ten thousand dentists. We're going to have our first meeting with the ADCPA in about four or five months from now in mid-October in Miami. And boy, I'm looking forward to seeing all my friends who I have not seen for two years. It's been really, really we've been missing them.

We have our dental series that we are doing for six local dental societies in Southern California. And you are welcome to join, because the great thing about webinars is it doesn't matter whether you're in Southern California or on Mars, you can get a hold of it as long as you got a computer that has Wi-Fi that works. I don't know if there's Wi-Fi on Mars, but I don't know, maybe I'll ask my guest today. Maybe he knows. We'll find out. But anyway, he's laughing at me now. Right.

So but anyway, our dental series, the next edition of our dental series is going to be really special, Wednesday, July 14th, from six to eight p.m. California time. A really good friend, Gary Takacs, who is well, well known all over the world. He has got the biggest dental podcast. And yes, folks, I must admit, his dental podcast is bigger than mine. He's been doing it for seven years, longer than I have. Gary is going to be talking about how to reduce your dependency on insurance. And I am so passionate about that. I can't wait for that. And we've got other great guests coming up throughout the end of the year the second Wednesday of every single month. So we're excited about that.

And the last thing I'll tell you before I start, we start talking to our guest is that, again, we're at you're going to hear this probably beginning of July, for most of you who received your PPP one loans, you have ten months after the end of your twenty four week covered period. You figure out what day you got your loan, probably April or May in twenty twenty add twenty four weeks to that and then add ten months to that. For most of you that's going to put you somewhere in the month of August or September of this year. So you have till August or September to file for forgiveness before you have to start making payments.

Now my understanding is, is that even if you don't file for forgiveness in that 10 month period and you start making payments, as long as you meet the requirements of the SBA and the Cares Act and all the rules they've put out, which has made my head explode for 15 months, as long as you meet those rules, if you made two or three payments, they still got to give you all that money back. So but we're trying to get we're doing these projects for our doctors, helping them with forgiveness and the Employee Retention Tax Credit, mostly by the end of July.

So if you had a 50 percent or greater reduction in your gross receipts, net of patient refunds, probably in the second quarter of twenty twenty, you could, even though you have filed for forgiveness, qualify for tens, if not hundreds of thousands of dollars in employee tax credits. We have in our dental group I think we're close to 100 of these that we've done. Now not everybody had a 50 percent reduction. Some of our practices are smaller and the numbers don't make sense. But we have. We have generated millions of dollars, and I'm not exaggerating in government refund. So if you have whether you have or have not filed for forgiveness, if you had a 50 percent greater reduction in your revenues in the second quarter of twenty twenty versus twenty nineteen, give me a call. I think we can get you some free government money. We do a complementary analysis to see where you stand and if it makes sense, we go forward.

All right, folks. Well, again, when I started in dentistry as a CPA in 1984, that was George Orwell's book, 1984. That's when I started. Then I got married in 1985. And that's still going really well. Thirty six years. And I've been a dental CPA 37 years. And, you know, when we started, general dentists did what they did. Specialists did what they did. And times they have changed. And that's the real world and that's how it works out there. And one of the things I see in working with the dentists that I work with in our practice here in Tustin is many of them have implemented clear aligners. And the vast virtually all of them use Invisalign and they are all very happy with what they've done.

So I want to talk to you today with my guest about Invisalign, about what does it do? Should you implement this in your practice? And if you do, what are all of the dos and don'ts and the best things and the best practices. So my guest is Dr. Hardik Chodavadia. He's a partner, as I mentioned earlier, in Enameled dentistry, which the name of his practice, he and his partners have five locations in Austin, Texas. So he's got lots of experience with this. Dr. Chodavadia went to Penn State University for his undergraduate education and became a dentist in twenty fourteen after attending the University of Texas Health at San Antonio. So Dr. Hardik Chodavadia, welcome to the Art of Dental Finance and Management.

Dr. Hardik Chodavadia: Thank you so much for having me Art and I appreciate the introduction. It makes me sound and feel fancier than I am I think so.

Art Wiederman, CPA: Well, you told me you were fancy. You're not allowed on my podcast if you're not fancy. So you guys have five offices in the Austin area, right?

Dr. Hardik Chodavadia: Yes, sir.

Art Wiederman, CPA: So I had the experience of going to a game. I'm a my fans, my listeners know I'm a USC fan. And for those of you in South Carolina, that is not University of South Carolina. That's the University of Southern California Trojans. I'm a my alma mater doctor was Long Beach State University. And again, we haven't had a football team in thirty years, so I've adopted USC, so I flew with my dear friend, Dr. Phil Potter and his son Michael, who used to be in the band USC. I flew to Austin. I'd never been to Austin. And I sat there with one hundred and five thousand of my closest friends and wow, you guys are passionate about football, aren't you?

Dr. Hardik Chodavadia: Yeah. You know, I think football is almost like a way of life down here. You know, I like to think that, like, the happiness of the city almost depends on the success of the football team to a certain degree. Definitely. You know, half of my family went to the University of Texas. So definitely the people around me are a lot happier if that football team is doing well.

Art Wiederman, CPA: My wife's brother went to the University of Texas, one of my best golfing buddies went to the University of Texas. It's a fantastic school. I get to walk around the campus and I mean, but I'll tell you what. When you got the governor of Texas and Matthew McConaughey up on the big scoreboard doing hook em horns every five minutes, I didn't think, we didn't have a chance. And pretty much Mr. Ellinger and his friends wiped the floor with us after about the first ten minutes of the game. But who knows? Hopefully it's a new day, but we'll see how that goes.

So as much as I'd like to talk football with you for the next 45 to 60 minutes, it's not going to happen. Tell me about your journey. We know you went to school in San Antonio went to Penn State. But tell us about your professional journey and how you get to where you are today.

Dr. Hardik Chodavadia: Yeah, absolutely. You know, so specifically, you know, with clear aligners, you know, I graduated dental school in 2014. We had some education, a university course, which I actually teach a little bit from in front of the line that kind of helped us dabble in it. And, you know, to be fair, you know, it was a good course. But at that point, you know, when I was in school, I was more focused on how can I prep a class two then you know, how I was going to fit a clear aligners. So maybe, you know, not as much focus, but I after I graduated at my first associateship, I worked with a big group that did a decent amount of Invisalign, so I didn't do much, but I took over a couple of cases from the previous associates. So, you know, it was it was good to dabble, but I didn't have as much understanding of ortho overall and Invisalign specifically.

And we had a couple of really good courses that kind of helped me feel a little bit more confident about that. And then we ended up, after my first year moving to Austin and opening up our first practice. One thing that I learned really quickly is the patient population that we treat here in Austin is a lot different than what I treated in suburban Dallas. You know, a lot of the majority of my patients are twenty five to thirty five, like really, really young professionals. A lot of just generally like really healthy stuff where I was doing tons of crown and bridge and stuff like that. And that was significantly less, a lot of early perio, some operative and stuff like that. But we found quickly that there was just a demand for clear aligners. Invisalign was, people know, brand name, and so there was a demand for it within our practice. So it was one of those things where it's OK, we got to figure out how to do this because people want it, you know.

Art Wiederman, CPA: If you've got a practice like you're saying, you've got twenty five to thirty five year olds, usually when I'm a little older than you are, Doctor, I'm a little older than most people that I talk to, we used to call those folks yuppies, young, young. I don't remember what that means. But yuppies are young professionals who are moving up in the world. And so these are people that want to look good, that want to have to make an impression on customers or clients, get jobs. So having straight teeth is a big deal, right?

Dr. Hardik Chodavadia: Exactly. And we found that that was, again, in demand services that people wanted to talk about it. And so that kind of forced us to be like, OK, we need to figure out how to do this. One interesting thing, and it's kind of helped us scale doing Invisalign in our practices is obviously the low hanging fruit is the people that come in to talk to you about it. Right. And they're like, OK, easy, you want to do it, let's do it. Let's figure out how we can make it happen. But I found the longer that we've done, and the more cases that we do make, my conversation shifts from the easy, which is like, hey, let's have straight beautiful teeth to more of the functional health benefits to aligning those teeth. Right. And that to me, as also just like as a dentist, is a much easier conversation to have. And I feel like I'm doing a different type of service, but definitely calls to the type of dentistry that I like to do as well.

So, you know, it took some time and doing courses and obviously making a ton of mistakes because unfortunately, I'm not particularly risk averse, which I know accountants do not like very much. But it took a lot of a few times I need to get to not be as callous. Nothing bad. Right. But kind of be more aware of what I'm doing and really hone in on what I should do and can do as a GP should if that makes sense.

Art Wiederman, CPA: And that's good advice because especially for young dentists, listening is, you know, you're going to get all kinds of opportunities to all do different types of procedures. One of the things I've learned, Doctor, as an accountant is I do what I know and I bring in the cavalry when I don't know. So let's talk about let's say we have a dentist out there that's been thinking about this. And again, and I say this over and over in my podcast is, you know, we're going to give you some good information.

This is not a technical course like going to Koyes or Sphere or going to a clinical course. But this is a call to action. If you are interested. We want to give you just kind of an impetus to look more into it. So if a dentist has got a good practice going on, when should they consider this? I mean, what, is this for everybody?

Dr. Hardik Chodavadia: I would say I mean, I think everyone has an opportunity that they can integrate into this into their practice and do reasonably well. But you, in my opinion, as someone who's done it both ways, where I've dabbled and really dived in to commit to making it a big portion of my practice, you're going to have a lot more success, just like you would with anything else if you really commit to making it a part of your practice. There's some like economics of volume and things like that that really help

Art Wiederman, CPA: We'll definitely get into that.

Dr. Hardik Chodavadia: Yeah, but in terms of just, you know, I felt like for me myself, it was a confidence thing, right. Where the more confident that I got, the better I was able to present that. And it required me to do the cases in the first place to build that confidence. Right. And so we committed earlier on to being like, hey, let's make this a part of our practice, let's try to do it. And then once you get it under your belt a little bit, then you can do that. It's a lot tougher if you're dabbling doing a case here, a case there. And, you know, we found that originally when that's what we were doing, we weren't getting as much success as I would have liked to.

Art Wiederman, CPA: So let's talk to somebody who's thinking about it. They had in their mind, they listen to his podcast. We have thousands of people every week to listen to this podcast and oh, wow, this is great. Maybe this is the kick in the pants I need to do this. What's the first step? Where do they go? Do they do they go take courses? Do they read a book? You know, how does this work? Well, probably don't just read a book.

Dr. Hardik Chodavadia: How do they do this? There are some good books, actually, I can't remember off the top of my head, but the best place to start. So honestly, I leaned on Invisalign as a company because it's in their best interest for us to do this right we're their core customer. Right. So. You have a territory manager, probably whoever's listening that's in your region, that's main job is to make you successful at doing this. Right. And so I am super annoying to my territory managers, but I lean on them and I like have them get me the resources that I need to get better at it. Right. And so that's where I would start. Find out who your territory manager is and be like, hey, I want to start doing this. Help me. What should I what courses can you connect me with locally and what should I do remotely that I can to get better at it.

Art Wiederman, CPA: Does Invisalign have I mean let's say they sign up. Do they have training?

Dr. Hardik Chodavadia: They do. And I think it's decent. I would personally I would do the online training that the in-person courses OK, but do the online training, you can get certified for it. It's like a day and then it gives you the baseline knowledge to sort of get started. You know, if you are really wanting to get started, there's and I know we'll probably discuss this later, but a lot has a multitude of products, which can be confusing. But if you're just wanting to get started, there was a specific direction that I would personally point you towards that kind of streamlines the experience and stops you from making the mistakes that I did clinically and diagnosis wise as well.

Art Wiederman, CPA: So what would that what direction would you suggest someone would take?

Dr. Hardik Chodavadia: So Invisalign has a really cool product called Invisalign Go. So streamlined platformed, that's, in my opinion, designed to create an easier experience for the clinicians that may not have as much experience. And that's typically what I steer a lot of our associates to kind of look towards when they haven't had much experience. It's a product that kind of it's limited in what you can do with it, which is good, because when you can do anything, that's where you can get into trouble, right? Yeah. So it limits you for certain movements. It's a limited amount of trays and there are some really, really cool tools that Invisalign has that helps you screen patients before you even start talking to them potentially about the treatment as well.

Art Wiederman, CPA: So I'm going to let you talk some technical dentistry here. And I promise folks, he's like licking his chops now. He's ready to go. I promise I won't answer you with the Internal Revenue Code sections. I won't do that. But let's talk about Doctor. You know, obviously, it's a specialty procedure that general dentistry, a general dentist going to do. So when you look at a case, when you look at a patient that wants to straighten their teeth, OK, right. Where do you draw the line? In other words, talk to doctors and just say, you know, you've got a lot you've done hundreds, thousands of these. I don't know how many you've done. Right. Where do you draw the line? What where do you say I can do this case? And where do you say no, I need to refer this to the orthodontist.

Dr. Hardik Chodavadia: Right. Um, you know, typically, if it's if they're a class one case, those are class one dental. Those are ones that I feel like relatively confident that's something that I could possibly do. Right. Any time there's class three or class two, that's where I start to have some hesitation because I'm really trying to do cases that are simple and that I know I can do quickly, because that's I mean, it's a part of the whole like number one, my psychological health, but also profitability as well. Right. And so typically, if I see a class one case and I'm like, OK, this is potentially something that I can do. We have scanners in all of our offices. So they have case assessment tools built into the scanners that help us give us basically the green light to be like, hey, this is this will be a pretty easy or simple case for you to do, or this is a case that you may. Have some trouble with so sometimes those are tools that we can use to help us kind of discern even inside of those categories, what cases that I feel would feel comfortable doing. And I used leaned heavily on those when I had it done, many cases to start out with.

Art Wiederman, CPA: So, yeah. And these scanners are just absolutely ridiculous as to what they can do. And we.

Dr. Hardik Chodavadia: Yeah, go ahead. What's cool is, you know, even if you don't have the scanner, there's a photo upload or app that that will allow you to take the photos and it'll actually do a case assessment, just like the scanner will as well. So that's I don't have a scanner at first. I just use my phone to take the pictures and then let me know. So but the scanners aren't saying that. That's like we want to do it. That's the way you want to go.

Art Wiederman, CPA: Oh, I mean, you know what's cool about the scanners? Because I think I mentioned in one of the previous episodes that we did is I just had a crown done. And I had I mean, I've seen scanners for a long, long time. I've been to the conventions. I've seen them all, but never in a real case, which was mine. And oh, my gosh, it's so impressive to the patient. Oh, this is cutting edge technology. And then they go back and they tell their friends, oh, my gosh, they took this and they were able to do the modeling of what my teeth are going to. I mean, you can do that with this, right? You can show the patient what their case is going to look like when it's all done. And then they can tell their friends. And have you seen that is a good marketing tool.

Dr. Hardik Chodavadia: It's huge. We all know internal referrals are going to always be your best, best patient, your best source and the easiest way to get patients in your door. And when you can, you have a patient see that you scan their teeth, they see that their model and you can do a chair side stimulation of before and after. There's not a there's not really a dollar value you can put on that because, number one, it breaks down barriers. Right, because I can show you essentially what your teeth are going to look like afterwards. And it's like, OK, well, I didn't even know I could do that. Right?

I have no idea how many times I've heard that when I've showed a patient that and they're like I had kind of wanted to do that, but I just didn't think it was a thing that we could fix that. And so it's hard to put a price on that. And, of course, you know, we the patients have seen that and be like, yeah, my dentist is awesome. He has this crazy machine. And like, I was able to see things and he was able to show me my teeth. And you know what I usually tell patients, especially with the scanners, like I like to go over the scanner, use the scanner as an educational excellence, like I want you to see what I see, because it helps me explain your teeth to you when we can be on the same level. We're seeing the same things. Right. And that's again, invaluable. Right. That's ways to build trust. And that's like, you know, as a dentist that's our number one job, is you need to build trust with the patient. That's the hardest thing to do.

Art Wiederman, CPA: And the other great thing about this is that I mean, and I've talked to my friends about this who have gone in and done and it's like, why do I have to go somewhere else I want why can't you do it? You know? And they know you. They know your team. They trust you. Like you just said, you've built the trust and you can do it in your office and they don't go anywhere else and anything else. So, you know, we talked about you were talking about Invisalign Go. What are the other products that a dentist might use with Invisalign?

Dr. Hardik Chodavadia: Sure. I can tell you the products we use regularly. We use Invisalign Go primarily. I use a comprehensive product, a little bit more freedom to do things. There's no restriction on the number of trays, very little restriction on the type of movement. You know, it's kind of that's your like the flagship product. Right. And then we have products like Invisalign Express, which really minor touchup cases you're looking at, you know, a few five to ten trays. Right. So really quick treatments, really small things that people patients want to do. And you can get it done very quickly.

And those are the primary products that we use. They have some in between Invisalign Go. They have is kind of similar to a product called Invisalign Moderate and Moderate is limited movements, limited number of trays. They haven't if you see a lot of children, they have Invisalign Teen, they have this Healthy Start, like they have a lot of really, really cool things that you can use for me, especially as a group with associates, new doctors, and trying to learn as the primary products. We try to keep it simple. It's typically Comprehensive Go or Express depending on the case.

Art Wiederman, CPA: Now talk about I mean, obviously orthodontia in a lot of people's minds is for kids, but obviously lots of adults have orthodontic work done, like you were saying. Twenty five to thirty five and older. All three of the Wiederman family members have had their teeth straightened. Yours truly is probably at the age of almost 62. Probably not going down that road, I think, but, you know, but again, people want the service and, you know, especially now coming out of a pandemic. they've got money and stuff like that. So talk about let's talk about how you market this service. In other words, you've got kids. You've got five offices. So I'm assuming that you do most everything in your offices. Right? A lot of stuff.

Dr. Hardik Chodavadia: We try to keep as much stuff in-house because like you said, we found just like everyone else is like, hey, why can't you do it? You know? Right. We started to bring in certain specialists and things like that. And we found that it's just people feel a lot more comfortable. And there's so many times where I'll refer to a specialist and I have awesome specialists that we work here within Austin. And the patients just don't go because they're just like, well, it's just like a whole thing and I'll have to go somewhere else. So having that available in house, even if it's at another location, we find that there's a lot more follow through with patients.

Art Wiederman, CPA: Now, what about so? So like I said, as far as marketing, do you do I mean, obviously you have a website, you do social media, what everybody does. How do you market this service to your patients? Is it who's talking to the patient when they come in? You have a new patient, right? You do an assessment and they need a couple of crowns. They need, you know, some whitening, whatever it's going to be. And then are you talking to them about this at the first visit? Second visit, how do you how do you approach the patient, especially a new patient? How does that work?

Dr. Hardik Chodavadia: Right. So it all starts from the beginning. Right. Ultimately, if we want to be successful, like the whole team has to kind of be involved in kind of thinking about this throughout the patient's journey. And it starts with the paperwork. So our paperwork has a lot of questions that the questions to kind of try to help us kind of guide what that first appointment is going to look like. So they'll ask them if we want to gauge interest, if they are interested in straightening their teeth. They're interested in they have issues with their bite, things like that.

So then mentally for us, like my assistants, our hygienists and clinicians or dentists can kind of you can prime how you're going to have a conversation with that patient if there's something specifically they've mentioned. Right. If they've mentioned that, then the opening for that is very easy. Right. Because they are already kind of thinking about that. And that's you know, everyone can do that. The tougher ones are the ones where you see the benefit. Right. I think the statistic is like 60 percent of your patients have some level of mal occlusion that they could benefit from clear aligners. Right now that's like an Invisalign stat, right? So that's supposed to hype us up and see if we can do it on everybody. Right.

But that opportunity exists. But opening that conversation is tough. Right? And the last thing all of us dentists, we don't want to be salesy. Right. Like, that's like the main thing. We never want to feel like we're pushing things on to people. And so it's just, you know, it starts with the conversation about health. Right. And typically, you know, when the assistant is talking to them, they may notice. Okay, I see you have a bit of crowding here. Is that something that you've thought about? Or thought about correcting. Or the hygienist will talk about it while they're doing their cleaning.

And then a lot of the conversation, if there's crowding or adjustments to their bite, that could help the long term health. I always frame it an idea that's like my goal is to have to do as little dentistry as possible. Right. And then clear aligners could potentially be a part of that. If we can align your teeth and your bite, that gives your teeth a better long term prognosis to limit the amount of work that I have to do. And that's I feel like speaks to a lot of people.

Art Wiederman, CPA: I want to take a minute. So doctor again, you work a lot with this company, with Invisalign. If somebody has a question and they want to talk dentist to dentist, can they email you? Can they call you? How would they get a hold of you if they had any questions?

Dr. Hardik Chodavadia: Yeah, email me or message me on Instagram.

Art Wiederman, CPA: OK, what's your what's your handle on Instagram.

Dr. Hardik Chodavadia: It's just @harcho the first three letters of my first name, HARCHO as an ostrich. So that's Instagram is somehow the easiest way to get in touch with me. And it's just sad but I feel like emails they're lost.

Art Wiederman, CPA: I'm on Instagram. My goodness. There you go. Follow me at Arthur Wiederman. You'll see things I like. Yeah. Like my golf game haha. So anyway, all right. And then I'll give up, we'll put the doctor's email address in the show notes I'll use the same one that I sent to the invitation for.

So let's get into my favorite topic, Doctor, which is money. Okay. Obviously, you know all of our dentists. And again, the thing I love about dentists is that when I talk to dentists very rarely is the topic, how much money can I make? It's always about how can I do the best job for the patient? How can I best improve the quality of life of the patient? And you're the same way as I'm sure your whole group is. But, you know, I'm the CPA on the program, so I know that there is a cost to buy the trays from Invisalign. And they I think they give you a break the more you buy. Right. So let's start with what does it cost? What does it cost to get started in this thing?

Dr. Hardik Chodavadia: Um, I believe. And I could be wrong because, well, like you said, it's based on volume, so we pay a slightly different amount because we have a high volume, but I know there's some nominal fee to get credentialed to get started. And then per case, I believe if you're under a certain tier, then it's about eighteen hundred dollars.

Art Wiederman, CPA: That sounds about right to me. Eighteen, nineteen hundred dollars per tray. Is that, is it the same for an adult as it is for a child?

Dr. Hardik Chodavadia: It depends on the product. Right. $1800 is a comprehensive and this is why I really like Go as a product and why we use it a lot is that I believe is only it's thirteen fifty for the Go, which is a huge difference, you know.

Art Wiederman, CPA: So let's talk about how do we. OK, so because I will tell you one of my biggest frustrations is I go, well, you know, I think that I can't price it at more than thirty five hundred or four thousand dollars or they're on a PPO plan. Remember I said I don't like PPO plans. So to be profitable on those things. I mean, where do you think and again, I understand that a Invisalign case in Austin is different than an Invisalign case in Iowa is different than Invisalign case in Newport Beach, California, or San Francisco, California. But I mean, do you have a multiple you use, do you have like I mean, when if someone's getting started, if they're on a PPO, they're unfortunately stuck with whatever the PPO will write the contracted fee. But if we're talking a fee for service situation here. What advice can you give to dentists on how to price it? What do you what is your group? Look, I'm not here to tell me what your price is, but I how do you do it, do you look at the multiples. So how do you do that?

Dr. Hardik Chodavadia: You know, when we had had started essentially with using Invisalign as the product, we knew that we were trying to scale it. And so we were probably priced a little too low. But after scaling it and getting the tier discounts now we're well aware. Well, we're in a better position than we were. But initially, you know, we were charging kind of, I looked at the market rate. This is where the territory manager helps because they know how much everyone is charging. So I was like, I don't want to be the most expensive, but I don't want to be the cheapest either. I want to be somewhere in between while still maintaining a good profit margin. And so we looked at that because I really do believe that the service and quality of stuff we were offering is really good. But I also know that there some awesome dentists out there and I'm like, I'm not as good as that guy, you know?

Art Wiederman, CPA: We need to send you to a confidence course.

Dr. Hardik Chodavadia: It's so, you know, it was maybe a little bit more psychological than financial. But we still we looked at it like, you know, we have that like eighteen hundred dollar lab fee and so. What two times that is, what, thirty six hundred, is that about right?

Art Wiederman, CPA: Right, yeah, we're required by law to do math on this podcast, so yes that is correct, yeah.

Dr. Hardik Chodavadia: There you go. And so originally we were charging about fifty five hundred for our cases, which were a little bit on the high end for here, especially comparing to some of my colleagues that were really good at charging less. So we dropped our fee close to like around like five thousand. Right. And I felt and it was at a good point where I was like, we're still it's not the most profitable thing that we're doing by far, you know, but there's such a demand for it. And I felt like the volume that we can do to account for that.

Art Wiederman, CPA: So and you're finding that it has been profitable and it's added dollars to your bottom line?

Dr. Hardik Chodavadia: Absolutely. Especially, you know, the more cases you do, you earn certain tiers you start to get percentages off those cases, the case fee, your lab fee. But truthfully, the bigger advantage was I honestly found myself doing more general dentistry as a result of doing Invisalign. Right. Because once we were finishing aligning their teeth, people started talking about things like, well, my teeth are straight, but they've kind of worn down in different places. So can we do some, like, bonding afterwards.

Art Wiederman, CPA: Veneers or something.

Dr. Hardik Chodavadia: Not everybody. But I was doing a lot more cosmetic dentistry as a result of people doing clear aligners afterwards. And also we were doing a ton of general dentistry for people who want to do what really in a rush to get started with, like, hey, we got to get to a healthy first. And then a normal pace was like, yeah, I'll take my time with this patient is like, oh, we can do this. Well, let's get this done as soon as possible so I can get started on my case.

Art Wiederman, CPA: Well, here's another thing for right now is you might have heard we had a pandemic the last 15 months. All the weddings and bar mitzvahs and graduations have been put off and now they're starting to reappear. So I'm going to guess, Doctor, you probably get patients who go, OK, so my daughter, who was supposed to get married last year, now she's going to get married this year and God, I want to look really good. Can we do this, you know, relatively soon or quickly? You get some of that?

Dr. Hardik Chodavadia: All the time. You have no idea how many times it was like, well, my wedding is in November, so...

Art Wiederman, CPA: Can you straighten my teeth in the next six hours.

Dr. Hardik Chodavadia: We were at home for the last year or so. We could've helped you at any time.

Art Wiederman, CPA: Really? Yeah. There you go. Let's talk about integrating your team into all of this. So, I mean, how does it work in a traditional, you get a patient say they're interested. I mean, how does it what do you do? What does the team do? Do you do I mean, is there study models involved or they're not? How does it all work?

Dr. Hardik Chodavadia: So, you know, we have scanners in all of our locations and so we do things probably a little differently. I know more groups are adopting this, but we scan every new patient that comes into our office and then we physically go over the scan with them. Right. And this is the power in the scanner is that when I, the patients almost co diagnose with me. Right. When I pull up the scan, they're like, hey, what's that thing? You know, they're things that they're seeing that I didn't. And then that helps us have those conversations about, you know, bites and, you know, crowding and narrowing of the arch. And it helps our teams talk about our hygienists talk about it, because then you can level with the patient where you're looking at the same thing instead of, you know, looking face to face and having them look in the mirror and look at their teeth like that, right?

Art Wiederman, CPA: Yeah. How do you, so you go ahead and you scan their teeth and then you sit down and you show them, you know, what this could look like. And you're basically I hate to use the word, but we're going to use it, sell the case. Right. And then they decide to get started. And how is the, talk about how the team is involved? Hygienist really isn't involved in this at all. Much at all. I don't think.

Dr. Hardik Chodavadia: They are. I mean, honestly, they tee it up.

Art Wiederman, CPA: Yeah, they talk to the patients, but they're not. It's the dental assistant. So when they come in for their, do they come in for a monthly adjustment? Is it every two weeks, every six weeks. How often do they come in?

Dr. Hardik Chodavadia: I see my patients every eight weeks.

Art Wiederman, CPA: Eight weeks, OK.

Dr. Hardik Chodavadia: Our initial visit when they get that the aligners and that first visit a little bit longer with me and the assistant and then I have them come in every eight weeks and real quick, usually five, ten minutes, we make sure everything, trays are fitting well, things are going well. There's no issues, they don't have any problems. And then that that turnaround is pretty quick, especially when you stack up these and start doing too many of these little checks. I used to do six weeks and I found that I needed eight weeks, but because I felt comfortable the cases were tracking typically pretty well.

Art Wiederman, CPA: How long does your average case last? I mean, traditionally ortho cases are two years, but are these shorter or how they go?

Dr. Hardik Chodavadia: They're definitely shorter. The majority of the cases that I do are between six to eight months. Right? Yeah. And so, again, that's where limiting and limiting what you're doing and kind of picking the right cases in the patients is really key. And a lot of what I'm doing is relapse ortho cases where the orthodontist already did 90 percent of the work for me before, but the person didn't wear their retainers, right? So my job is a little bit easier, just kind of coming in and cleaning everything up on the back end.

Art Wiederman, CPA: Yeah, well, yeah. You mean not every one of your patients is 100 percent compliant with what you recommend that they do?

Dr. Hardik Chodavadia: Oh, no. Even with the stuff that I tell myself.

Art Wiederman, CPA: So how do you I mean, in other words, do you, I mean, again, back when the dinosaurs ruled the Earth and I started working with dentists in the 80s, the 1980s, not the 2000 80s, you know, you would get twenty five percent down and the balance over two years. Now, obviously, your cases aren't lasting two years. Do most people pay up front? Is there financing involved? How do you do this?

Dr. Hardik Chodavadia: It's a good mix. We do a quite a bit of financing. We use a third party financing group that we really like a lot that has a pretty good approval rate, even with lower credit scores. That for us I'm looking for I don't want to have too much of a crazy AR where I'm chasing down patients that are in tons of payment plans. Not to say that we don't, but we do a lot of third party financing where we get paid up front for a nominal fee. We do offer an office payment plans over 12 months equally is where we like to keep them. But sometimes my team gets mad at me like, hey, let's just make it happen. We're going to need to do.

Art Wiederman, CPA: Exactly what you just do. So how has your team I mean, I know that you got started in this several years ago, but how does your team react to doing, you know, doing this work? Do they are they enthusiastic or are they, you know, talking, talking up with the patients? And what kind of training do we have for them on all of this?

Dr. Hardik Chodavadia: Right. Our team gets really excited about it. I think partially it's because we like you know, it has to start with you, right? So I get really pumped and then I'm like, we're going to get this, we're going to talk to Invisalign and they get excited. And when it happens, like, oh, man. And, you know, it's real. Like they need it. And they kind of see how I get excited to talk to patients about it. And I you know, we talk about it in our morning huddles and things like that. We really make it a focus. And I did Invisalign on our team members as well. So they kind of get the experience. And when patients talk to them they say I have it, it's good they can talk to them about it.

And then training wise, again, this is where the territory manager comes in. The territory manager works with our admin team with presentation, and they can talk about financing, financing partners and things like that. And they get a lot of them are trained to use the scanner, for example, so they can help train your team to learn how to scan. Right. You know, there's plenty of webinars, education that align app that are designed just for the team and themselves, not just me as a doctor. So I feel like we get a pretty, pretty good support. Again, I'm annoying and I'm very demanding.

Art Wiederman, CPA: You don't seem annoying. You seem nice.

Dr. Hardik Chodavadia: But, you know, I feel like it's like, you know, it's also good they're there to support us because our success is their success. Right. And so their best they have a vested interest in it. So I try to I leverage that relationship too.

Art Wiederman, CPA: Exactly, exactly. So if there's a problem, a problem with a product or something and again, you know, again, all my clients who use this product, who use Invisalign, I have I can't remember the last time someone said to me, hey, you know, this is not working. They're not I mean, they seem to have they're really good customer service. How's their customer service?

Dr. Hardik Chodavadia: Their customer service is great. It's a pretty big network. You know, on the back end, they have a support team that if you have any issues, you know, there's obviously a number that you can call and they can help you through. I've even had a few situations where there was a case that I talked to an orthodontist that day, that they work with that kind of talked me through what we needed to do. And then I know I've done this before, but their territory managers are like base number one, right? Literally, if I have a problem I text my territory manager and say hey, can you help me with this and they can point you in the right direction, they might not be able to directly help, but they can point in the right direction.

Art Wiederman, CPA: No, and I've heard that their customer service is really, really good. Any downside to doing this? Anything that a dentist should be concerned or worried about? Because I know there are going to be some that are just going to either not have the confidence that they can do it or not feel like they should do it or not feel like it's their job. But all the things you and I have just talked about is, you know, it leads me to believe that it's something they should at least look at anything to be careful about when you go down this road and start doing this,

Dr. Hardik Chodavadia: You know, the good thing is the worst thing you can mess up isn't too bad, right? Like, if I'm doing endo or something like that, I can mess up a lot worse than I can with ortho at least the case that we're doing. I think the biggest, biggest thing for me as a GP is make sure making sure I, I know my case selection and I like those cases appropriately. And then the downside is relatively limited. Right. And you have enough support for if something goes wrong, you can. I think the biggest thing is if you want to do this efficiently and profitably, you have to be OK with doing the volume. Right. And then educate yourself appropriately to do that. And luckily, there are resources on the align side and elsewhere that I thought have been very, very helpful. I mean, there's Facebook communities and stuff like that that are really supportive.

Art Wiederman, CPA: Yeah, talk about that for a minute. If somebody wants to learn more about this, I know the territory manager is what you were saying they should reach out to. But again, the younger folks out there who listen to this podcast and there's a lot of them, they are you know, again, I joke about the fact the reason I had children. I have two wonderful boys who are almost twenty seven and thirty two. And they, you know, like the other young folks in this world, they do a lot on social media. So you said, Facebook groups. I mean, what resources are out there for a dentist to get some help, answer questions and stuff like that?

Dr. Hardik Chodavadia: Um, you know, there's first and foremost, if a dentist, young dentist or older dentist, if you really want to do this well, there's a group called the ACA that's American Association of Clear Aligners, really awesome, super supportive, really open group that that has a ton of really great education. And they have the they do webinars every Wednesday and they're all recorded. And you can watch them all if you're a member. And I found those are extremely, extremely helpful and it's a great organization to be a part of if you really want to do a clear aligners as well and learn how to do it in the GP office. Right.

Art Wiederman, CPA: The American Association of Clear Aligners AACA, I assume they have a website. You could just Google it.

Dr. Hardik Chodavadia: Yep, they're awesome. Like that's really that group is what gave me the confidence to do more of it. Right. And, uh. And there's a Facebook group called the Aligner Nation that's really, really great, too, and it's just people talking about their cases or issues, things that things that have gone wrong, things that have gone rookie, or that have gone well and everything in between. So it's, again, a really good community of people on both sides that help do these clear aligners cases when it really comes.

Art Wiederman, CPA: So I guess the message as we wrap this thing up, Doctor, and thank you so much for your expertise and your knowledge on this. I guess as we wrap this up, it's like anything else. You do what you do, you do what you know. There's not a huge is there a huge learning curve to this? I mean, should the doctor, like, not sleep for three nights before he or she does the first case or how does that work?

Dr. Hardik Chodavadia: No, you know, I think for me, I'm just kind of go for it and be ready. Right. And if you feel ready, there's products that can help you guide you through it. If you use the appropriate things, you can just do it. I feel confident that if you get go through the certification, I think it's something that you can dive into doing without too much heartburn.

Art Wiederman, CPA: And I have lots and lots of dentists that have done that. And as long as you know when to call in the cavalry and when to ask for help, that's really important because you I'm sure you have some really good folks in Austin that if you need help with something, they'll help you.

Dr. Hardik Chodavadia: Absolutely. Yeah. And that's the main thing. I feel like I've only been a dentist for seven years and everything that I've learned, I think the hardest thing, the hardest thing for me to learn, the most important was when to know to ask for help, like when to know I shouldn't do this and when I should ask for help.

Art Wiederman, CPA: Exactly. And that's like with any type of a type of a procedure, whether you're a dentist or an accountant or an attorney. Exactly. Any final comments, Doctor, that you want to make to our listeners who are either they're in it and you think they should remember or if they're just considering going down this road what they should be really thinking about?

Dr. Hardik Chodavadia: Yeah, you know, I think. Ultimately, as someone who did very little and now we do quite a bit of clear aligners, I think the main thing is if you want to do it, commit to doing it, to commit to learning as much as you can, just like anything else, that life is short. So learn as much as you can and do what you love to do. And I think if it's going to be a part of your practice, I think it can be a really fun. That's another key thing. People love doing this stuff, so it can be a really fun thing to do and embrace that.

Art Wiederman, CPA: Yeah. And the other thing is you're going to change people's lives for the better. Folks, I'm telling you, I've been a CPA for 37 years. This is about I'm going to say it again and again and again. This is about, this is not about fixing teeth or straightening teeth or doing root canals. This is about a better life, a better relationship, a better self-esteem. I mean, I guarantee you, Doctor, you've probably had patients who have come to you after this and they have said, you've changed my life. And you give them the confidence to go out and get that job or what have you and do all those things that's what happens. Isn't that I mean, don't you see that in your practice?

Dr. Hardik Chodavadia: Yeah, it's crazy. There's so many that we've seen that, you know, they're nice people, you know, people that are afraid to smile, that are now smiling again get new jobs, get a girlfriend, you know, all this crazy stuff after just because they feel good about themselves. Right. And it's hard to put a price on that. Right. Like, you know, we talk about just physical health, but mental health is an important thing, right?

Art Wiederman, CPA: Oh, exactly. Well, if I get a girlfriend, I lose half my stuff. So that's not going to work very well for me. Plus, I don't want to. I actually, my wife does listen to these podcasts and so I gotta be really careful. I'm just kidding. Anyway, Dr. Chodavadia, thank you so much. Again, if they want to get a hold of you, your Instagram tag is @harcho. And then if they want to email you, I don't know if we give out, what's your email address?

Dr. Hardik Chodavadia: It's it's D-R like doctor. And then same thing as my Instagram handle. So drharcho@enameldentistry.com.

Art Wiederman, CPA: So let me get that. drharcho@enameldentistry.com. I want to put this in the show notes. Very good. Dr. Hardik Chodavadia, thank you very, very much for your time. Hang with me till I take this out. I got some things to say at the end here, and I think we gave some really good information. For those of you who are interested in working with Invisalign, a lot of my dentists do that. And it can be a great enhancement to your practice, and especially when you talk to the folks at Invisalign. I'm sure they can help you with some verbal skills and how to get these patients to understand the benefits of the product and the procedure.

So, again, if you want to get a hold of me folks in my office in Tustin, I'm at 657.279.3243. You can email me at awiederman@EideBailly.com. Make sure that you go to Decisions in Dentistry website. www.DecisionsinDentistry.com. We will do a complimentary consultation for you. If you go and click the box on their website and you're interested in a dental CPA, you can come to me, you can go to someone at the Academy of Dental CPAs, which is twenty four CPA firms across the United States that represent over nine 10,000, we're up to ten thousand dentists and that's www.adcpa.org.

Don't forget to file for your forgiveness for your PPP one loan if you have or you haven't, and you had a greater than 50 percent reduction in your gross revenues and had a patient refund probably in the second quarter of twenty twenty compared to twenty nineteen, then you've got a great opportunity to get tens of thousands of dollars of free government money and it's we'll do all the heavy lifting for you. Again, give me a call, be happy to help you with that.

And listen to our podcast. We get some great shows coming up down the road. You know, we've got one on sleep apnea coming up. We've got some great consultants we're going to be talking about the new tax laws with what the Biden administration is talking about. If you are thinking about selling a property or stock or your business, your dental practice, you need to take a look at what the government is looking at. Their current proposal is potentially, you know, raising the rates significantly for anybody who sells after the twenty eighth of April. And that doesn't mean that that's what it's going to be, but that's what they're talking about. And so you got to be watching all of that in the moves that you make in the tax laws are going to change.

They always do. I've been I've been doing taxes for forty five years and they always change. The rules change. They always change them. It depends on who's in office and what agenda and how much money they want to raise and things like that. So again, make sure you stay on top of that. We can help you at Eide Bailly and we can also the members of ADCPA can help you. And with that, folks, I'm going to sign off for today's episode of The Art of Dental Finance and Management.

Remember my five word model all through this pandemic - failure is not an option. Work on your business, work on your practice. Find something. If you don't have the passion in your practice, find something to bring you the passion. Maybe what we talked about today, maybe adding Invisalign procedures to your practice is going to add that passion, get you excited again about dentistry. I don't know. But make sure you do, because folks, what you do as dentists in this country for the patients, the millions and millions of people, the one hundred eighty thousand members of the American Dental Association, what you do is just amazing work. And you help people, you help them and you improve the quality of their lives. And if you don't think you do, talk to some of your colleagues because you really do. So with that, this is Art Wiederman for the Art of Dental Finance and Management with Art Wiederman, CPA. And we'll see you next time.