In Part 2 of this two-part conversation, we move from theory into the real-world details that quietly put dentists at risk every single day.

My guest, Evan Sampson, is a healthcare attorney who has served as general counsel to one of the largest dental support organizations in the country. He brings a rare and invaluable perspective at the intersection of dentistry, law, payer audits, and regulatory enforcement — and in this episode, we get very specific.

We unpack what actually makes certain procedures, CDT codes, and clinical scenarios high-risk from a fraud, waste, and abuse standpoint, even when there is no malicious intent. Evan explains how dentists inadvertently get flagged as outliers, why payer audits are often data-driven rather than complaint-driven, and how documentation gaps — not clinical skill — are what ultimately create exposure.

This conversation goes deep into:

• Why up-coding, unbundling, and weak surgical extraction documentation are some of the most common (and expensive) pitfalls

• How payer audits are triggered, what auditors look for, and why Medicaid claims carry disproportionate risk

• Why dentists should write progress notes as if a regulator, payer, or board investigator will read them later — because one day, they might

• The legal realities of fee-for-service, out-of-network billing, professional courtesy, discounts, and when "good intentions" can still create compliance problems

We also spend significant time on a topic every dentist encounters but few are trained to manage: difficult and high-risk patients.

Evan shares how to identify red flags that may not be obvious at first, when it is appropriate to terminate the doctor-patient relationship, and how to do so without exposing yourself to allegations of abandonment. We discuss unruly patients, non-payment, mid-treatment dismissals, refunds, releases, and why protecting your license sometimes means making uncomfortable — but strategic — decisions.

This episode is ultimately about risk reduction, professionalism, and self-preservation. Not practicing defensively, but practicing deliberately. Tightening the details. Building a culture of compliance. And understanding that most dentists who get into serious trouble never thought they were doing anything wrong.

If you care about protecting your license, your livelihood, and your future — this is an episode you don't want to skip.

Most dentists think of compliance as a background concern—something administrative, abstract, or handled by "the office."
In reality, it's one of the highest-risk, most overlooked areas of modern dental practice.

In Part 1 of this two-part series, Dr. Melissa Seibert sits down with Evan Sampson, a healthcare attorney with over a decade of experience advising dentists and healthcare organizations on fraud, waste, abuse, regulatory compliance, and risk mitigation.

Evan has served as General Counsel to a major dental support organization and held senior compliance leadership roles within the largest municipal hospital system in the United States. In this episode, he pulls back the curtain on what compliance actually looks like in day-to-day dentistry—and why well-intentioned clinicians often put themselves at risk without realizing it.

This conversation reframes clinical notes as legal evidence, not just charting formalities. Together, Dr. Seibert and Evan explore how common documentation habits—templated notes, vague progress entries, auto-populated language, and inconsistent coding—can quietly become liabilities during audits, payer disputes, or board complaints.

You'll hear a candid breakdown of:

• What fraud, waste, and abuse actually look like in everyday dental practice (and why most of it is inadvertent)

• Why documentation and coding errors are among the most common sources of exposure for dentists

• The legal risks of upcoding, unbundling, and inaccurate procedure representation

• Why surgical vs. simple extraction coding is so frequently audited

• How "write it once and forget it" charting can come back years later—with real consequences

• The mindset shift dentists need: writing notes as if they will be read aloud in a courtroom

• Why the cover-up—or "fixing" notes improperly—is often worse than the original mistake

• How compliance, when done well, can actually reveal missed revenue and operational inefficiencies

This episode isn't about fear-mongering. It's about clarity, ownership, and professional maturity. If you're a dentist who cares deeply about doing the right thing—clinically and ethically—this conversation will fundamentally change how you think about notes, coding, and responsibility.

And this is just the foundation.

Part 2 will go even deeper into consent, adverse events, and proactive strategies to protect yourself, your license, and your future.

If you've ever thought:

• "I didn't know that could be a problem."

• "That's how we've always charted."

• "The front desk handles the coding."

This episode is required listening.

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In Part 2 of this powerful series, Dr. Melissa Seibert continues her in-depth conversation with cosmetic dentist and AACD leader Dr. David Eshom, exploring the deeper psychological, business, and interpersonal frameworks that underpin a thriving fee-for-service practice. Together, they unpack the realities of transitioning away from insurance dependence, the emotional traps dentists fall into, and the communication strategies that safeguard both the patient relationship and the dentist's peace of mind.

Dr. Eshom offers decades of wisdom on how to recognize patient readiness, how to present comprehensive treatment without triggering defensiveness, and how to gracefully identify patients who may not be ideal candidates for complex care. He shares the subtle behavioral cues that differentiate collaborative patients from those who may become litigious, overly exacting, or misaligned with your practice philosophy—and how to exit these relationships ethically and respectfully when needed.

The episode also tackles some of the profession's most pressing realities:

• Why the insurance model forces dentists into ethical and financial corners

• How to communicate a fee-for-service structure without alienating patients

• The psychology behind presenting conditions and consequences—not pressure and sales

• Why slowing down for deeper exams ultimately accelerates practice growth

• How to block your schedule, restructure hygiene exams, and build time for meaningful conversations

• The importance of discernment: knowing when a patient is truly a "yes," when they're a "not now," and when they're a "no"

Dr. Eshom also walks through his workflow for large aesthetic cases—from shade decisions to motivational mock-ups and trial smiles—while highlighting how these tools improve clarity, set expectations, and reduce risk for both patient and provider.

The conversation concludes with a reflective discussion about building a freedom-based business, attracting aligned patients, and creating a practice model that delivers exceptional dentistry without compromising your wellbeing, your values, or your clinical standards.

If you've ever wondered how to elevate your practice beyond the constraints of insurance, identify ideal patients, or cultivate a career defined by autonomy and fulfillment, this episode is a masterclass in sustainable, relationship-driven dentistry.

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Register for the live meeting: https://www.theelevatedgp.com/ElevationSummit

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n Part 1 of this two-part series, Dr. Melissa Seibert sits down with cosmetic dentist and AACD residency preceptor Dr. David Eshom for a powerful conversation that reframes how dentists think about photography, diagnosis, communication, and case acceptance. Drawing from more than 20 years of comprehensive cosmetic dentistry, Dr. Eshom reveals why extraoral photography—not intraoral cameras, not radiographs—is the single most effective tool for building trust and helping patients clearly see the value of comprehensive care.

Together, they break down a step-by-step new patient workflow that seamlessly blends diagnostics with psychology, showing how simple point-and-shoot photography placed at the beginning of the exam can elevate patient engagement, differentiate your practice, and eliminate the pressure-based communication styles that leave patients feeling skeptical or overwhelmed. Dr. Eshom explains how co-diagnosis—rooted in permission-based dialogue and visual storytelling—helps patients recognize their own conditions, understand consequences, and ask for solutions rather than being sold to.

This episode dives into:

• The most overlooked use of photography in dentistry: real-time conversation with the patient

• How to structure a new patient visit that fosters trust, clarity, and long-term case acceptance

• Why facially generated treatment planning is so effective—especially for patients who "never knew" what their smile looked like

• Communication strategies that shift patients from an "insurance model" to a value-driven mindset

• How simplifying photography (yes, even with an iPhone or point-and-shoot) makes comprehensive exams dramatically more effective

• What to say—and not say—when presenting conditions to avoid making patients feel judged or pressured

• How this method empowered Dr. Eshom to build a fully fee-for-service practice and drop every insurance plan

This conversation is practical, strategic, and deeply grounded in human psychology. If you want a proven communication system that elevates your new patient experience, improves case acceptance, and builds lifelong patient trust—all without feeling salesy—this episode will reshape how you practice.

Join Elevated GP: www.theelevatedgp.com

Register for the live meeting: https://www.theelevatedgp.com/ElevationSummit

Download the Injection Molding Guide: https://www.theelevatedgp.com/IMpdf

In Part 2 of this powerful two-part series, Dr. Melissa Seibert sits back down with renowned oral and maxillofacial surgeon Dr. Scott Bolding, whose orthopedic-driven approach to TMJ diagnostics and surgery is reshaping how dentistry understands joint disease. If you've ever wondered why TMJ patients get "punted" from provider to provider, why MRI-based diagnosis never became mainstream, or how degenerative joint pathology silently derails orthodontic and restorative outcomes, this episode will fundamentally change the way you think.

Dr. Bolding unpacks the historical missteps that led to dentistry's decades-long avoidance of TMJ surgery—from disastrous 1980s implant materials to insurance fallout and a profession-wide retreat from joint management. He explains how this cultural shift created clinical blind spots that we still see today, and why the message of "TMJ will get better if you leave it alone" has harmed diagnostic rigor for an entire generation of dentists.

Together, Dr. Seibert and Dr. Bolding explore:

• How ligament injury leads to disc displacement—and when that displacement becomes surgically relevant

• Why MRI and CBCT are indispensable tools for modern diagnosis (and what specific radiographic findings clinicians should never overlook)

• How unaddressed joint pathology contributes to tooth wear, occlusal collapse, postoperative symptoms, and even failed orthognathic cases

• The truth about total joint prostheses today—far removed from the failed biomaterials of the past—and why custom joints offer dramatic predictability for patients with severe degeneration

• The critical need for comprehensive dentists to reclaim TMJ literacy and function as quarterbacks—not bystanders—in interdisciplinary care

Dr. Bolding also describes the orthopedic model for surgical decision-making, clarifying when joints can be repaired, when they cannot, and how airway considerations should influence mandibular advancement in joint reconstruction. The conversation closes with a call to action for dentists everywhere: joint-aware dentistry isn't optional—it's foundational to predictable outcomes in restorative, orthodontic, and airway-driven treatment planning.

This is a masterclass in the contemporary philosophy of TMJ management—equal parts clinical insight, historical context, and future-forward thinking.

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Description:
In this episode, Dr. Scott Bolding — leading oral and maxillofacial surgeon and airway reconstruction expert — dismantles the outdated belief that sleep apnea is primarily a soft-tissue problem. He explains why the bone dictates the obstruction, why skeletal repositioning is the true driver of airway patency, and how maxillary advancement, mandibular rotation, and hyoid biomechanics can radically transform patient physiology. You'll also hear how CBCT, DICE, and joint-first diagnostics reshape treatment planning for sleep apnea and complex cases. A must-listen for clinicians who want to move beyond superficial airway conversations and into evidence-based surgical frameworks.

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His interdisciplinary approach to dentistry is founded in both empirical research and clinical experience. He attended the University of Washington for both his undergraduate and graduate studies where he received his D.D.S. degree in 1995 and an M.S.D. and certificate in Prosthodontics in 1998.

For his entire career, Dr. Kinzer has been committed to furthering the art and science of dental education. His unique ability to impart complex clinical processes in a logical, systematic and clear methodology differentiates him from other Prosthodontists and makes him a highly regarded educator nationally and internationally. He is a full-time teaching faculty at Spear Education in Scottsdale, AZ. where he is also resides as the Faculty Chairman and Director of Curriculum and Campus Education. Dr. Kinzer is an Affiliate Assistant Professor in the Graduate Prosthodontics Department at the University of Washington School of Dentistry and an Adjunct Faculty at Arizona School of Dentistry and Oral Health.

Dr. Kinzer is a member of many professional organizations including the American Academy of Restorative Dentistry and the American Academy of Esthetic Dentistry, of which he is currently the sitting President. He serves on the editorial review board for several recognized dental publications and has written numerous articles and chapters for dental publication. He has been honored with the American College of Prosthodontics Achievement Award and in 2018, he received the Saul Schluger Memorial Award for Excellence in Diagnosis and Treatment Planning from the Seattle Study Club. In 2022 he was inducted into the World's Top 100 Doctors as part of the Interdisciplinary Cohort.

In his free time, Gregg cherishes spending time his wife Jill and their 6 children. He enjoys anything that he can do outside: golfing, hiking, running, skiing, and biking, in addition to a nice glass of wine.