Harnessing Your Potential

How Dr. Nikki Green is using valuable experiences gained as a clinician and leader to help other dental entrepreneurs live out their dreams.

Change often comes for businesses because of a pain point. For Nikki Green, DDS, the pain in her dental practice originated from walking by her front desk every day and seeing her talented team members overwhelmed with administrative burdens such as presenting treatment plans, working out financial arrangements – and perhaps most time-consuming of all – trying to solve reimbursement issues with insurance companies.

“Here we were, a supposed fee-for-service, non-insurance-dependent practice, but we wanted to advocate for our patients,” she said. “So, my front desk team members would spend hours a day on the phone with insurance companies.” 

Dr. Green reached out to JW Oliver, who was building an innovative outsourcing model to address those very issues. In 2017, Dr. Green signed on as SupportDDS’s first client. “Since that time, I have yet to see one of my team members in the office stuck on the phone for 20 or 30 minutes with an insurance company,” said Dr. Green. 

Indeed, her dental practice has benefited from SupportDDS’s services in a myriad of ways. Now, remote team members do everything from insurance verification, to recall report management, confirmations of appointments, and verifying whether patients have switched to new insurance carriers. Dr. Green has even used a SupportDDS team member as her executive assistant for the last two and a half years. That person manages Dr. Green’s email and Google Calendars, which are critical for balancing all her responsibilities. “Things can get a little challenging, so I need a virtual EA, particularly on clinical days,” she said. “Anybody who’s ever been a clinician knows that you might carry your phone around with you, and though it’s in your pocket, you’re not checking your emails, and you’re not really even able to return phone calls. So, it’s nice to have someone behind the scenes who is checking that for me throughout the day.”

Dr. Green believes in the services that SupportDDS provides so much that at the beginning of this year, she joined the organization as its Vice President of Partner Integration. In the new role, Dr. Green will leverage her 21 years of experience in the industry to help match today’s DSOs with services and solutions that will take their organizations to the next level. 

An entrepreneurial journey

Dr. Green’s entrepreneurial journey has included many different experiences – dentist, entrepreneur, business owner, business seller, and now a dentist partner in a large DSO.

She began as an associate dentist and worked for two very different practices. She started out in a high-volume Medicaid DMO-type clinic and spent six months there. During that time, she learned how to manage all types of patients, parents, and personalities in a busy, high-volume practice. Following that, she went to work for a high-end cosmetic, fee-for-service practice. Dr. Green was introduced to the business of dentistry while there and learned how to make a clinical practice operate like a business. 

For years, ownership was something that intrigued Dr. Green, but she was reluctant to go all-in on the idea. It was a fateful lunch in 2007 with a colleague who finally got Dr. Green to take the plunge into owning her own practice. While discussing a potential opportunity for Dr. Green to join her colleague’s practice, she got some unexpected advice instead. “My friend said, ‘Nikki, I would love to have you as my associate, but you’re ready to own your own place. You know how to do this. If the opportunity is out there for you to purchase your own, you should purchase your own.’ When I think back on that moment, I was fortunate to have someone who saw more in me than I did in myself. And at the time, I was scared and had no idea what was in front of me, but my friend gave me the courage to go ahead and jump in with both feet. So that’s what I did.”

In 2007, Dr. Green identified a practice in a busy area of Forth Worth that was owned by an older dentist looking to retire. Dr. Green bought the clinic, and in January 2008 stepped in as the owner. That first year was a formative time. Atop the challenge of leading a team and a business on her own, Dr. Green did so during a recession. But through successes, failures, coaching, and determination, she established a thriving group practice with multiple associates. Remarkably, she accomplished this while simultaneously supporting her husband in building his own large group practice, despite the 120-mile distance between them.

Two and a half years ago, she decided to sell her Fort Worth practice to Independence DSO, which proved to be a fruitful partnership in the rapidly growing dental market. The partnership also allowed her to pursue other exciting opportunities in the industry, such as her role with SupportDDS.

Integrating remote talent into an organization

Since 2017, Dr. Green has been at the forefront of leveraging remote employees to maximize professional and personal results. Throughout her business growth, she successfully utilized SupportDDS’s remote dental support services, which provided her with a unique perspective on how dentists and entrepreneurs can harness the power of remote talent to achieve their goals.

She is familiar with the most common questions that her colleagues may have when it comes to incorporating remote talent into their organizations. One of the first questions she often hears is, “How does it work?” Many DSO leaders are surprised to find out that SupportDDS remote team members mirror the office hours of the dental office. Not every remote services organization does that. 

“I know my DSO used to use an accounting team that was overseas,” Dr. Green said. “You might send an accounting question at 3:00 p.m. in the afternoon, but it didn’t get answered until 6:00 a.m. the next morning because they’re working opposite hours of what you’re working. That’s not the case with SupportDDS. Your remote team is available the same hours you are.”

Another big question, especially considering recent security breaches, is “How secure is the information?” SupportDDS uses Black Talon for security and is 100% U.S. HIPAA-compliant. Everything runs out of one secure building with firewalls installed. The remote workers do not work from home, so team members aren’t logging on to a practice management system from a home-based computer.

People also want to know about the remote team’s work environment. “JW and his partner have created an absolutely wonderful work environment in Zimbabwe,” said Dr. Green, who plans on visiting it in person this fall. “It’s a very Google style set-up. They are all working out of a 15-story high-rise building where there are coffee shops and cafes. There is a Christian ministry in their organization, so there’s Christian pastoral care offered. They also provide transportation to and from work. They’ve created a wonderful community there. The team members love their jobs. Their work ethic is like nothing I’ve ever seen because they love coming to work every day to help support us.”

Boosting your RCM

Dr. Green understands the challenges and pain points of today’s DSOs, because she has had to navigate them herself. She’s also seen firsthand the benefits of remote team members being incorporated into leading dental organizations. “We’ve got single practices and larger groups that have brought us in because they looked up one day and suddenly realized that their business had slowed,” she said. “When business was booming for the last few years, you could probably have a revenue cycle management problem and not even feel it. Because cash was coming in, patients were paying for things up front, and growth trajectories were looking good.”

But during the second half of 2023, a steady flow turned to a trickle for many dental practices. Sometimes even a single private practice dentist started to look at things and how their AR got to six months of production rather than the healthy one month or less of production that it is supposed to be. “Well, the reason it happened is because your front desk was just too busy and backed up presenting treatment plans, getting patients scheduled, and filing claims.”

There are two remote roles in particular that can help address those issues, Dr. Green said. The first is a dental coordinator, which SupportDDS has offered since its inception. This is a 40-hour-a-week employee dedicated to the dental practice. These team members have earned a university education and received boot-camp-style dental coordinator training for their role through SupportDDS. That training gives them the basics. They know things like tooth numbers, how to fill out an insurance verification form, how to look at and read an EOB, and how to do certain payment postings depending on the practice management software. Then, they’re placed with a SupportDDS client, who can virtually train them.

“I always recommend you have a champion within your office, someone who really understands and wants to help,” Dr. Green said. “Then you spend maybe 30 to 45 minutes each morning during the first week or two hand-holding and showing that new team member, keystroke by keystroke, exactly what you want them to do, and how you want them to do it. Then within the first couple of weeks, you have a 40-hour-a-week remote employee that you can delegate to with confidence.” 

A relatively new offering for SupportDDS is that of a well-trained revenue cycle management specialist. The RCM specialist does many of the same things that a dental coordinator might do – insurance verification, input of insurance, insurance breakdowns, building up of fee schedules, claims posting, claims filing, claims follow-up, claims resubmission, attaching narratives, etc. However, SupportDDS has a robust training program for their revenue cycle management specialists. 

“We’re saying to DSO clients, ‘We recognize you may have a revenue cycle management problem right now that you need help fixing. For instance, maybe you just lost a front desk team member who was an integral part of the revenue cycle management system. Maybe that team member was good at verifying and getting breakdowns of benefits and then filing initial claims. You don’t have someone readily available to train at a dental coordinator level. So, we’ll bring in a revenue cycle management specialist and take those things that they used to be doing at your front desk out of your practice, off your office team members’ plates, with a remote team member who is already RCM trained.”

Commitment to excellence

Dr. Green has a “commitment to excellence” that drives her to continuously stay at the forefront of dentistry, she said. She devotes hundreds of hours each year to ongoing education, with a particular focus on cosmetic dentistry and the latest advancements in dental techniques and technology.

Dr. Green believes in the importance of aligning herself with the best in the industry. She spent more than a decade of her career as a member of the prestigious Spear Faculty Club. This group comprises dentists who have completed the Frank Spear Mastery Continuum, empowering them to mentor and guide other doctors through the Spear Education process. “Throughout this intensive program, I’ve refined my expertise in identifying and preventing dental diseases, treating both simple and complex occlusal disorders, and mastering the art of crafting beautiful, natural-looking smiles.”

Dr. Green serves as faculty for Productive Dentist Academy where she serves the industry by helping other dentists unlock their full potential as clinicians, business owners, and leaders in dentistry. Dr. Green is on the Clinical Advisory Board for Independence DSO where she serves her DSO partners by helping the organization stay on the leading edge of innovation and clinical excellence.

Dr. Green also remains an active practicing dentist. She still enjoys her clinical days at her Fort Worth office while assisting her husband in building and operating his dental business in Abilene, Texas. She’s also energized in helping Dentists and Dental Business Professionals unlock their full potential by capitalizing on the exceptional talent available through SupportDDS. 

When you do what you love, though, the hours seem to fly by. Dr. Green wouldn’t have it any other way. “I’ve always loved the business side of dentistry,” she said. “I’ve always loved helping other practice owners figure out what levers they can pull to create some growth within their environments. And these opportunities give me a chance to do just that.”