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Ranked the #1 DSO Podcast!
Welcome to The Group Dentistry Now Show: The Voice of the DSO Industry!
Navigating the Chaos: How Virtual Assistants are Transforming the DSO Landscape.
Cory Pinegar, CEO of Reach shares his thoughts on:
- The importance of call management.
- Leveraging virtual assistants for efficiency.
- Balancing technology & human touch.
Find out more about Reach at https://www.getreach.co/
You can also contact Cory at Cory@GetReach.com or on LinkedIn at https://www.linkedin.com/in/cory-pinegar/
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DSO Podcast: Virtual Assistants
Welcome to the Group Dentistry Now Show, the voice of the DSO industry. Join us as we talk with industry leaders about their challenges, successes, and the future of group dentistry. With over 200 episodes and listeners in over 100 countries, we’re proud to be ranked the number one DSO podcast. For the latest DSO news, analysis and events, and to subscribe to our DSO Weekly e-newsletter, visit GroupDentistryNow.com. We hope you enjoyed today’s show.
Bill Neumann: Welcome everyone to the Group Dentistry Now show. I’m Bill Neumann. And as always, we appreciate you tuning in. We are episode 225 plus, so somewhere around there and almost 230. So we’ve Really appreciate everybody following us, and whether you’re just listening to us, or you’re watching us on YouTube, or on groupdentistrynow.com, we appreciate it. We have with us Corey Penninger, who is the CEO of Reach, And Corey’s a pretty familiar face in the DSO space and in the dental industry. He’s been doing a lot of great things for a while, even though he’s relatively young. He’s been doing a lot, making waves and really helping support emerging dental groups and established DSOs with his virtual assistance. But Corey, it’s great to have you here.
Cory Pinegar: Bill, it’s good to see you again.
Bill Neumann: Yeah, thanks. What you been up to?
Cory Pinegar: The longer you run a business, the more you get used to the chaos of every day, but the flavor of the chaos is always different, but the chaos is always consistent. So continuing to grow, I really enjoy the game of business, the growth of business, the challenge of business, and trying to win a foot or an inch every day in the battle of getting better.
Bill Neumann: And when I said virtual assistants, you know, really what Reach does is virtual staffing for whether it’s the DSO itself or for the dental practices that support the DSO. Just some interesting info, and Corey, you know, sends me over his bio. So he acquired the company at 22. So relatively young to be acquiring a company, which is awesome. And you’ve done so much in such a short period of time. Tell us a little bit about Reach and a little bit about your background and what you’re doing there.
Cory Pinegar: Yeah. Well, number one, the acquisition is a very loose term. And Bill, I don’t know if you and I have ever even discussed it. So I was an early employee at Weave, which we all probably know well. And I got the opportunity to purchase the service arm of weave from them. It was probably doing a quarter million dollars in revenue back then and bought it for a dollar. They just needed to get rid of the assets so that they could be purely focused in on the software side, Bill. And so, they approached me about eight or nine years ago and the rest is history.
Bill Neumann: Well, that sounds like a pretty good acquisition for you.
Cory Pinegar: Looking back, it was a damn good deal.
Bill Neumann: but probably a lot of work to get it to where it is now. So maybe take us from you buying, which was, well, I guess it was just Weave at the time, right? And so then it was, take us through the dollar acquisition to where you are now.
Cory Pinegar: Yeah, so Weave had a service arm back in the day, and obviously they then built software that focused on patient engagement. And something that I find quite interesting is the unsexy businesses. I tell people all the time, and I really mean it, if there was a large-scale toilet cleaning or any of the port-a-potty businesses, I’m interested in being in it. I think there are essential services that are sometimes seen as grisly. And I’m sure you and I will chat later today, Bill, about AI, and AI really is the future. But we also realized that Amazon is to make an analogy of Amazon is going to automate as much as they can in the package delivery. It’s how they get efficient. But someone has still, I live in Salt Lake, and someone still has to go grab that physical good when I order it from the warehouse that’s a couple miles away, and they have to get it to my doorstep. And so what we do here at Reach is we help dental groups with overflow calls and scheduling, recare reactivations, unscheduled treatment calls, centralizing insurance verification or revenue cycle management, there’s so many things software is just not there yet at and that’s okay but can we help people get cost-effective and trained team members to be a part of their team so that these groups can focus on growing while also knowing the essential operations are continuing to take place
Bill Neumann: So you’re supporting thousands of practices right now. So when we talk about virtual assistance, what are the, you talked a little bit about some of the tasks that you have them doing, but what do you typically, when you work or engage a group practice or a DSO, what do you find are some of the more common things they need help with? I know some of them need a lot of help and others don’t, but.
Cory Pinegar: Number one reason that we get hired is people need help in forming a call center. And there’s kind of two main, I would say two plus main reasons people are building a call center. Number one, inbound. Most groups are missing over 30% of all of their phone calls. And that’s not from after hours. The majority of that is during business hours. And then the second thing is most people, because their staff are so overwhelmed at the front with so many different tasks, verifying insurance, checking patients in and out, unscheduled treatment calls and recare calls don’t take place. And as we all know, you could be booked at your locations six plus weeks out. But the schedule, no matter how good we are, 24, 48, and 72 hours before, begins to deteriorate to different levels. And so can we then help fill those doctor column and hygiene column openings with unscheduled or re-care patients that drive productivity, but also clinically help provide a lot of good?
Bill Neumann: So that’s one of the things you feel is really holding some of these groups and practices back is the fact that they don’t have people, they’re missing a lot of calls, right? Is that kind of one of the big things that you see?
Cory Pinegar: I think we can kind of go down this rabbit hole, Bill, but when I When things break in business, we all know that there’s generally one or two causes, but it’s people or it’s process. And when I look at the typical dental front desk, the system is broken. You have between one and three people in a typical sized practice that sit up there and they are answering inbound phone calls. They’re doing confirmations. They’re handling texts. They’re taking payments. They’re checking patients in. They’re checking patients out. They’re working on treatment planning. They’re verifying insurance. They’re on hold with Delta Dental for 35 minutes. And we’re expecting all of that to happen efficiently. at a large scale business, you have a finance department, you have a sales department, you have a support department. And we blend all of that and more into one and we call it a front desk. And so they are bound to have things that operate inefficiently because they have so many tasks. And so as a group begins to grow, when you’re at five, 10, 15, 20, and even more, and you realize that the average practice is missing over a hundred phone calls a month, There is a lot of meat left on the bone that is not being capitalized on.
Bill Neumann: A lot of those calls are missed during business days. Yeah. Okay. So talk a little bit about, beyond that, you’ve got, I think you layer that in with staffing problems, right? Just finding the people to actually do the work. So you have the people that are missing the calls because they’re doing other things. And then you have issues with just trying to find people to actually work the front desk. I mean, this has been, seems like an ongoing problem. I know we blame COVID a lot for it, but it even feels like it was before that even. It seemed to start before that. And then, of course, you’ve got the rising costs as well. So the people that you do find are asking for more money.
Cory Pinegar: And where we are at today as a business, Bill, is because or where we have innovated ourselves is when I purchased the business from Weave, we had our office in Utah. Up until recently, we had over 30,000 square feet in Lehigh. And at our peak, we had 300 people in office making these inbound and outbound calls and doing insurance verifications. And then as you said, COVID, I agree, was probably the straw that broke the camel’s back. It’s not the total sum. But I think that is where, as we commonly hear, people say there was the great resignation. People are more fickle and less loyal to their employer today. And then at the same time, I think all of us are driving home from work, going through In-N-Out, or going to another place, and we see the wages. that these groups are having to offer to get talent in. And so we’re battling with higher levels of turnover and then vastly increasing costs. And as groups, we all know that reimbursement rates have not significantly gone up compared to costs in the last 20 years. And so where virtual assistants and our team is primarily based in Latin America help is you can pay people really well for where they live relative in the world. Our base pay in Brazil puts someone in the top 25% of earners countrywide. So we can go hire really good, great English speaking talent at a fraction of the cost. And then these groups can get the cost savings, but at the same time, they’re getting someone educated and committed to being a part of these groups in the long term. And groups right now, as you and I know, and all of us know, are feeling the pinch of compressed margins, debt, and these loan repayments are more stifling than ever with the changes and then all of the other rising costs, we have to play the game different. If we just think we can find marginal efficiency, But if you can take cost-effective labor, that’s relatively half of the cost, and then have them go work in these areas that are not properly being capitalized on, you can get some massive lift within your group.
Bill Neumann: So I think the other thing that we didn’t touch on, but it can be really beneficial, bringing on a team, somebody, a team member or several team members from Reach to really help out the front desk is, you’re actually freeing up these front desk people that may be doing three or four jobs, having them a little bit more focused, retaining them, they’re happier in their job. So you’re actually creating this better work environment for the people that you actually have in the practices so they can focus on what is more important than just answering calls. Not that that’s not important, but it just frees up a lot more time. So I think retention, we talk a lot about recruitment, but I think retention is another huge issue we hear a lot about.
Cory Pinegar: I mean, staff burnout is real. If you are chaotically busy all day long, you’re more likely to leave. And if you can go to your team and say, Hey guys, we’re going to pull back new patient phone calls and recare calls and texts from you guys so that you can be fully focused in with the patients in front of you. That’s what really makes the difference. Why does someone go to a dental group? Because they feel connected to the people, not just the dentist, not just the hygienist, but the people who are checking them in and out. And so give your team the time, allow them to be less burned out, but then you also get the specialization of people being really focused in on what they’re naturally good at.
Bill Neumann: So we’ve identified a lot of the issues. So what’s the next step for someone? All right, I know I have these problems at my practices. I probably need to free up my front desk people to focus on what they’re good at. And we know we’re not good at answering calls. Corey, what would you say is the best way so they would reach out to you? What’s your approach? How do you kind of handle things? You have a DSO or a group that reaches out to you. How do you start the process and evaluate who would be the right fit and a good strategy?
Cory Pinegar: Yeah, this is a great question. And I look at business as being or the sales process within our business in perfect form, being much more consultative or going to a doctor. When you go to a doctor, there’s 10,000 pills or solutions that they could possibly give you. But at the end of the appointment, after blood work and other questions, they’re going to come out and say, you need X or Y or Z. And we really want to understand the needs of the group that they’re facing. And there’s kind of two different solutions. Oftentimes, they may just need to embed dedicated team members within their individual locations to provide that support. And I’d say that’s about 50% of the options with the groups that we serve. And the other 50% is where they’re coming and saying, hey, I had a conversation with a group where they had 700,000 phone calls come into their practice over the last 12 months, practices. And 30% of those went unanswered. And so they then provided us the data and they know that they need to build an overflow call center that also does outbound activities that are often missed. And so that other 50% is, hey, we just don’t need to embed a dedicated team member into one of our groups. We actually need to build a centralized call center. And we all know that building a call center is a lot of work. You’re selecting software, you’re building the training. And so what we do at Reach for these emerging and larger groups is we build and operate their call center, where we do the managing, where we do the training, where we provide the reporting. We already have the pre-configured software where they can go, I have a problem. But then we can actually manage the service so that they can focus on operating their group while also knowing they’re getting that operational lift from the call center. And then they’re getting the cost effectiveness of the staffing solution because of Latin America that we can provide.
Bill Neumann: What kind of reporting do you typically send back or what kind of reporting is typically requested from the groups? What are they like to see?
Cory Pinegar: Every group and every board is different. I’ll be super honest. But, you know, at the core, what matters is how many patients are we scheduling? How many of those are new? How many of those are existing? Then did those patients show? And what is the production per visit? And so we can go in a month and say, OK, you spent $12,000 with us operating your call center last month. And then we can say, this is the number of appointments were scheduled. Here’s the show rates. And here from the accounting ledger within the practice management softwares is the actual return on investment. Other things that we can provide is, OK, what’s your abandonment rate? What is the utilization rate of these agents? But at the core, the ROI and the alleviation of missed call problems by reducing stress on the staff is really what people are looking for.
Bill Neumann: What are some misconceptions of the virtual assistants out there that you hear?
Cory Pinegar: This is actually a really good question. You and I have done a lot of podcasts throughout the years, and this is a question I’ve not been asked frequently. I never would have thought as an entrepreneur that I would have gone down the international hiring route. I mean, Bill, when we were in COVID, we were having people come to the office when everybody else was working from home. Like we were bucking the trend. We were a day late and a dollar short to the idea of going remote. as a company. And I think the reason that I was hesitant to hiring internationally is when I had My only international experience is they were calling Wells Fargo or T-Mobile because of an issue. And you’re talking to someone on the other end of the line, and you have no clue what they’re saying because of their accent. And what I have found, because we realized we needed to staff different, we hired two individuals to start. It wasn’t a large scale pivot. We just said, hey, if we don’t change, we are going to be killed. And so let’s go hire a person out of Argentina and a person out of Brazil. And we have realized through the years of doing this that you can be incredibly picky on accents. You can find minimal to non-existent accents. And you can find people who are incredibly smart. I’ve got a person on one of my teams, and he went to the University of Chicago, the Booth School, to get his MBA, which is your number one MBA in the United States right now. He lives in Brazil. And the seven years before he joined us, he worked for Bain. And so now that is a very one or two or three percent example, but it shows you the level of education and the talent and the dedication and the minimal accents that truly can be found. I think when we think of outsourcing, we usually think of poor quality and thick accents. And so we are all adverse to it. And I was as well. And what I’ve realized is when you’re really picky and you can recruit and treat your people well, you can find these diamonds in the rough that are truly game changers.
Bill Neumann: I think that’s an important point because you’re right. We’ve all had that experience where we’re calling customer service, typically at a large organization, and you know you’re talking to somebody that’s not based in the U.S. And to your point, it’s not so much about that. It’s the fact that you can’t understand them because of the accent. which can be really frustrating and certainly is not a way a DSO wants to greet patients. So that’s, it’s good to know that those people are out there and you can find and you’ve been able to find them. And what about expectations of virtual assistants? What, what should a DSO expect from these assistants?
Cory Pinegar: Another great question. The best thing that I would expect is the same that you expect from your centralized team or your on-location team. I don’t want to sell a used car that I think, OK, we’re going to give 150% of the output. I think what you expect of your internal call center or revenue cycle management team or on-site staff from a metrics and performance standpoint is exactly what you can expect from your virtual team members. Now, what you do get, though, is you get half the cost and you get longer term retention. Our average team member is with us for over four to five years in a call center or front desk role right now. And the typical dental practice front desk is actually staying less than three years in their average role right now.
Bill Neumann: So longer retention was just something that I didn’t even think about. You talked about about half the cost. Anything else, any other benefits that you feel maybe that groups might not be aware of, of hiring a virtual assistant?
Cory Pinegar: I think, and you and I chatted about this a couple of weeks ago when we were getting prepared for this. I think there’s the second thing that people often don’t think about or, you know, from the math side, doesn’t jump out right away. But let’s just play out some math here from a cost perspective, because we know from a group, you know, viewpoint right now, costs are crippling. Groups are struggling. Debt repayments are high. And so if you were to take 50 team members and create a replacement of a centralized team, the average cost savings for a group per team member that we work with is about $24,000 a year in cost savings. And so if you were to, you know, one for one replace 50 of those team members, you’re looking at about $1.2 million a year in annual free cashflow savings. And let’s just use a 8X as the average sale price right now for one of these groups. And obviously there’s some higher and there’s some lower. You’re then looking at $9.6 million in enterprise value added for these changes. And so these are not just about answering phone calls. It can add a considerable clip of growth. while also alleviating pressure on the staff, filling doctors’ schedules. I really do believe when done right, it’s a win clinically, it’s a win for the people in the practice, and it’s a win financially for these groups, and they need a financial win right now.
Bill Neumann: How do you go about matching up your team of virtual assistants with a DSO or a group? Are the groups involved in the hiring process? How does that all work?
Cory Pinegar: Absolutely. The groups have to be involved in the hiring process. We, number one, will sit down with a group and say, what hours are you looking to cover for these roles? Does Spanish and English matter? Are they going to be more focused on scheduling new patients? Or is this more back office and insurance or revenue cycle management? We then go out and bespoke recruit every single one of our hires. It’s not just like we have a team at the ready. And the reason we do that is so that we can then find the right personality and soft skills to fill that identical, you know, that individual role. We then bring per hire that the group is making three to five people to them so that they can hear the accent. They can hear the personality and they can make sure that it’s going to represent them and their group well. they make that decision eventually on who they are going to hire and then we have a scalable training system where they can say okay in this practice we use dentrix and we are using bring central for our phones and we are using them to do insurance verification and new patient scheduling and our system provides individual levels of training so that it’s just not generic across the board but we can provide training specific to the group and even the practice level.
Bill Neumann: What is the, what does that onboarding process look like? So we talked a little bit about the hiring, talked about the training. How long does that training take? And then, you know, what’s that onboarding kind of going from how they’re doing it now, office manager doing everything to, you know, bringing in your REACH virtual assistant, kind of them taking that process over, you know, how does that, what does that handoff look like?
Cory Pinegar: So the onboarding timeframe is roughly the same, but where the lift is, is the office managers not having to do all of the training by pulling up the chair. Now, where we do need our groups and practices to help us out on is what insurances are in and out of network. And how do you schedule emergencies? And what’s your cancellation policies? But we can help with that first 80% of technology and role specific training. And then the practices just have to do that last mile so that they’re not bogged into the training of many more team members. And no one has the time because everyone else has full time roles that they’re engulfed into.
Bill Neumann: So you mentioned technology. So this ties into something you mentioned earlier. You know, it’s every conversation’s AI, right? It’s either organic growth or AI. It seems to be those are the two things we talk a lot about in the DSO space, in the dental industry. Regarding AI and technology solutions, you’re right, we’re absolutely not there yet. You can’t just plug in an AI solution to answer all your calls. I mean, we may get there at some point, we’re not there yet. And we might not want to be there completely because again, we want that human touch. It’s one of those things that you think about dentistry in particular, A lot of patients are fearful of the dentist. They want to be talking to a real person. A lot of times that office manager or whoever is answering that call, you know, kind of that first line of contact, you know, there may be some apprehension. And so I think it’s certainly important. But let’s talk about the role of technology and AI and, you know, how you kind of look at that and at REACH.
Cory Pinegar: Yeah, I think it’s a great question. Um, AI is future. And what I don’t want our storyline to be is that it’s, you know, I think people right now in dentistry often are saying it’s one or the other. And my deep seated belief is it’s a mix of both and that mix and that ratio will continue to change. But at the end of the day, there are times just like all of us, if you’re United or you’re American or your Delta flight gets canceled. You can go onto the app and you can chat or you can call. And a lot of us still call in today to talk to someone. And Bill, you just nailed it. That dentistry is fearful for the most patients out there. I mean, my dad’s dad was a dentist and my dad hates going to the dentist. I hate going to the dentist. I, you know, and I live in this industry. And so I believe going forward, AI should be used to automate the things that don’t need that empathetic edge. But when someone needs to talk to a human to learn about their all in four implants, or when someone has a bill that they need explaining because they’re scared about the size that just came through in the mail, or they’re needing to schedule as a new patient and they have questions on their insurance, with simple online scheduling and hygiene reactivation, there should be great options. And the industry is going to rapidly evolve over the next three to five years and even more. But can you augment those two together to give people really good options? Bill, are you familiar with the company Klarna?
Bill Neumann: Yes.
Cory Pinegar: They have a really interesting story. I’ll have to text it to you after we finish up here. But they are a buy now, pay later company based out of Europe. And a year ago, they came out and said, we’re laying off our whole contact center and we’re freezing hiring for the rest of the year because we have AI that can do it all. And their CEO wrote a memo about 12 to 13 months after that original announcement said, we got it wrong. AI is still the future. There are costs to be saved. There’s service that can be better provided by AI and automation. But he said, when people need a human, people need a human being. And so they’ve hired back their entire contact center. And so I think within Klarna at its peak, I think was a 10 or no, like a 20 or a $40 billion company. And so the seesaw at the end of the day is not on one side. It’s generally more balanced. They look back at green energy. You know, in the early 2000s, I don’t think any of us would thought we would be as dependent today as we still are on fossil fuels. And I’m not here to debate if that is the right or wrong thing, but usually the seesaw of the world swings and then it balances back to more of an equilibrium. And so our goal here at Reach is to provide the best damn trained staff possible that can play well and augment AI as we continue to evolve.
Bill Neumann: Yeah, I’ll kind of emphasize the point that you’re making. I’ve seen some interesting surveys and some stats that have come out of a survey from Gartner beginning of, you probably know the survey I’m talking about or the stat, but middle… I think if it’s the one you’re thinking of. 42% of all AI initiatives have either been paused or have failed. This was a response from a survey that Gartner did with Fortune 500 companies. So 42%, these are big companies, sophisticated, very smart companies, and they had a lot of AI initiatives and they didn’t go the way they wanted them to, so they’ve either paused them or they outright have failed. So it’s not to say it’s not the future, but you swing too quickly one way and the solution and the people aren’t ready for it yet. And then I think you’ve got yourself a problem. So I think it makes a lot of sense. And I’ve seen some other surveys and stats that really kind of reinforce that. So I think AI can really you know, with that human touch, when it’s layered in with the humans. And yeah, I call a lot when I have issues when it comes to airlines. I’m, you know, I can’t and sometimes, sometimes technology, the app can help me, other times it can’t. It’s getting better, but still not really good. And when you’re in a sticky situation, you need a person to talk to.
Cory Pinegar: Yeah. And when you think about dentistry, people are calling in when they have extreme tooth pain. There was a moment when I had one of my crowns fall out the day or the morning before I was supposed to speak on stage. And, you know, my goal was to call practices until I could find someone who could glue it back in for enough time to get up on stage and do what I needed to do. And so you’re right that there is automation and automation is going to improve. But that human edge, the empathetic edge, as we call it, I actually think will be the differential going forward as things can become more automated. We as humans are sociable animals. It is what we are trained on because sociableness, if we think back to like our caveman days, sociableness and being liked is actually what kept us alive. It wasn’t being the smartest. It was actually being liked. And so for hundreds and thousands of years, we have been trained around human connection. And that’s not going to disappear. And so build both of those into your group and practice. And I actually think it will set you apart. Because we, as humans, want to connect. And especially when we’re scared, or things are going wrong, which is why people go into dentistry or go to the dentist. And so I think it’s going to make groups that much better and lucrative and attractive to their patients.
Bill Neumann: Some great points, great conversation. As we wrap up the podcast, any final thoughts? And then we want to make sure we have contact information and people know how to get in touch with you and learn more about REACH. But final thoughts from you, Corey.
Cory Pinegar: What we have seen post-COVID is a completely different world. And what I mean by that is staff resignations are higher, wages are higher, and continuing to go higher, and AI is changing the world. I think all of us are using open AI or perplexity or Claude every single day. And if we don’t play the game different, if we get stuck in what worked in the past, we ultimately will get killed. I’ll end with the story of IBM. IBM was one of your innovators, if not your top innovator in the United States in the mainframe server days, but they got obsessed with what worked in the past and didn’t innovate and change for the future. And today that has come to their own detriment. The world moves faster today than it ever has. I’m 31 and it is scary even for me. And so if we don’t play the game different, then we’re never going to get these different results that we want out of our own groups.
Bill Neumann: Great way to finish things off. Great conversation. I think this really will resonate not just with DSOs, but I think also with the private equity owners as well. And a lot of times they’re thinking AI and how everything can be You can leverage technology to do things faster and save money. And I do think it really is truly, truly a mix of the two technology solution and having a human touch. And if you’re having issues, finding staff in the U.S. or just want to free up the time, which I think is one of the biggest issues still, is freeing up the time for the people at the front desk to handle the people that are in the office and to handle, you know, the other challenges that they have and not answer or miscalls in a lot of cases, right? I think you mentioned it was about 30%. So it’s a huge number, huge, huge number. I mean, that alone, if you could answer those, those 30% miscalls, like, think about how that could change your practice. And then, you know, all the practices under your, your group. So I think it’s, it’s a great thing to focus on. And probably, you know, we talk about low-hanging fruit, and that seems to be like, probably one of the easiest things to solve for if you’re willing to do it. So, Corey, how do people get in touch with you? You’ve got a big LinkedIn presence. They can find you on LinkedIn. The website for the company is getreach.co, right? G-E-T, getreach.co. And they can find you on LinkedIn. Any other ways to find out more?
Cory Pinegar: Best way to reach out to our team is through our website. You can schedule directly with them there. And then my email is just Cory, C-O-R-Y, at our website, which is getreach.co, as you said, Bill.
Bill Neumann: Excellent. And we’ll have a special landing page link that we’ll put in the show notes where you can actually just schedule a call right from that link. But great conversation, Corey. Really appreciate it. A lot of fun and learned a lot. And thank you everybody for watching the podcast or you might be just listening in. Either way, we appreciate it. Until next time, this is the Group Dentistry Now Show.
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