Bridging the gap between patients and providers in the dental field with Shelbey Arevalo
In this episode, Shelbey Arevalo shares her powerful mission as a national dental advocate and consultant. She has spent over 15 years in the dental industry and now dedicates herself to bridging the communication and access gap between patients and dental providers. Through her nonprofit, National Dental Advocacy, she offers services that include virtual consultations, billing and coding support, and direct advocacy in complex dental cases.
Shelbey explains how misunderstandings between providers and patients often arise from poorly trained support staff or unclear communication, not from any lack of care by the dentists themselves. She emphasizes her commitment to unbiased advocacy, helping patients navigate billing questions, treatment plans, and provider searches with full transparency.
Her unique position as both a certified patient advocate and a dental billing expert allows her to improve outcomes for both parties. From assisting patients virtually at appointments to working with mobile dentistry providers in California, Shelbey’s work is deeply personal and passionately executed. She hopes to scale the nonprofit, train new advocates, and create a fully funded, nationwide service model.
The conversation closes with advice for patients: assume good intentions, ask questions, and know your dentist likely cares more than you think.
Resources Mentioned:
Website: www.nationaldentaladvocacy.org
Phone: 707-ASK-NDAP
American Dental Association courses: www.ada.org
Sleep apnea and cross-coding billing training
Host
Shelby Arevalo, thank you so much for being on the podcast.
Shelbey Arevalo
Thanks for having me. I'm excited to be here.
Host
Awesome. So we've never had the opportunity to talk to someone in the dental space. and I don't know much about the dental care. mean, I four kids myself and I just know I pay cash. tell me how you got into it. It sounds like something you probably bumped into and what it entails.
Shelbey Arevalo
Yes, yes, so I am very much proudly a dental advocate as I would identify myself right So I have been in the dental industry I like to say pretty much my whole life because I got into it my senior year of high school, so
It's really, you know, I just, that's what I know, right? And so because I've been in the dental industry for so long, yes, patient advocacy is something that quote unquote I did, I bumped into, right? It was a passion that got triggered along the way of my journey.
Host
And what exactly is it that made you realize that there was a hole in the market where people needed this kind of help?
Shelbey Arevalo
Yeah, that's a great question. And it's something that I always remind myself so that I keep it in the forefront of my mind because I work with providers. So I currently am also a dental consultant. And so I am able to see all sides of that patient experience. So I am always consistently seeing a disconnect.
And there is patient perspective and there's doctor perspective. And I honor both of those, right? And what my goal is is to bridge the gap and to really create a seamless, happy experience because I see so much of that disconnect on the provider side, frustrations, things of that nature. But then, you know, we also have the patient side.
similar things. And so the goal is of the nonprofit that I started is to just create trust and transparency and really just to bridge that gap and just make things more clear and convenient really.
Host
So what is it that the patients don't understand about the providers and vice versa?
Shelbey Arevalo
There's a lot of disconnects that could potentially happen, right? And so a lot of it could even come down to the person on the telephone that's scheduling their appointment, right? That is not necessarily the provider, right? And so there are so many things that could happen that unfortunately the provider will get the blame for, right? And sometimes it comes down to...
someone just articulating their words properly, right? And making sure that they're explaining the patient's situation properly. that doesn't always happen, right? You're not always gonna have that qualified individual that is able to represent the provider. Sometimes you do, right? Sometimes you have a rockstar team, but that team might be doing something that they don't realize
is not correct, right? And so again, it just takes taking a little bit more of those extra steps, if you will, to make sure that the patient understands fully and, you know, the provider is the doctor, right? They are there to treat patients. They're not there. They don't know things about dental insurance, right? They don't go to school and study codes and things of that nature. So that is why I created this program so that they could
have a reliable and biased source.
Host
Got it. So you're a reliable unbiased source for both the provider and the patient. Is that what the goal is?
Shelbey Arevalo
Ideally, of course, right? Yes. Regardless, whatever information that we say, ultimately we stick with the facts, right? We stick with the facts. And so ultimately, yes, we don't pick sides. So for example, we have a patient that needs help finding a provider, right? We don't have favorite providers or anything like that, right? We get the patient's needs, we assess their needs and...
You know, we give patients a list, a detailed list of the area that they're in based off of the needs that they have. And we give the patient, you know, full range to basically select a provider. You know, and the provider can feel confident that we have that, meaning we don't have any special agreements, if you will, right, with anybody. We are...
We are built for the patient, but we are a source that can be trusted by both.
Host
So how do the patients even get in touch with you to begin with? How do they find you? And then what kind of services does the nonprofit as the advocate side, what do you offer for?
Shelbey Arevalo
Yeah, yeah. So we are in our infancy stages, as I like to say, as a nonprofit, right? So there is so much room for growth and potential. And I am building this program to meet the needs of the people purely. So it is purely my passion project. And it is something that it's very personally motivated. And
I believe that by making it a nonprofit, I am allowing more access, right? I don't ever wanna say no to any patient. And so there could be many different avenues where they might be able to get in touch with us. I'm involved in the advocate community. If they go to my website, they're interested, they could easily schedule a consultation and get on my calendar within the next...
two days if someone wanted to. It's a complimentary 15 minute consultation. And I'm very honest. again, the idea is to be a resource for patients regardless if I am able to help them in that moment. So the idea is we're building a platform and a website where patients can come and get resources where they don't have to do a Google search.
Right? And it's all in one safe space. And so along with that, right, there's tons of little projects, you know, as a nonprofit that is really exciting that we get to create. And so I'm really, as I'm helping patients, I tell them that they're helping me. As I'm helping patients, they're helping me build this program, right? And so I'm all ears, right? What is it that patients need?
right, and I'm building the program to fit that need in whatever capacity that means, right. So in California, because this is where I'm at, right, this is home base, this is where a lot of the focus is as far as doing the physical work on the ground. So as of now, I do a virtual advocacy, right. So I'm helping patients in many different states at this time, and it's purely virtual.
Shelbey Arevalo
There will be times where I may assist a patient virtually and attend their dental appointment if they need me to, right? And actually verbally talk to a provider if they need me to talk for them, right? And so that is a service that I offer. Now in California, what we're working on is trying to get mobile dentistry into these care facilities. It is a newer
I'm part of the dental industry, mobile dent.
Host
What kind of care facility?
Shelbey Arevalo
skilled nursing, assisted living, any type really. Any facility that wants a mobile dentist, right? As a national nonprofit, like a human being, we all need dental care, right? And so we ideally would love to, hey, have mobile dentist for everybody, right? But the reason why we focus on that community is because they...
are usually not, they don't have the ability to have transportation, right? They have mobility problems and things of that nature. My father is physically disabled. He's in an assisted living and I'm completely responsible for taking care of him. And you would think someone that is, you know, in the dental industry would have an easier time, you know, facilitating my dad's care, but he's wheelchair bound.
in an assisted living. I'm just like you, right? And I'm a single, not like you, you're not a single mom, but I'm a single mom and I have a child and I have all these things, lots of life. And it's very hard to get my dad to an appointment in general. And you go to the dentist and they have a series of visits. I'm a dental consultant, I know how that series goes.
And it's just devastating to get to that appointment and it takes so much leading up to that just to say you need to be referred out or come back for another day. And here I am, I have to take off another day of work kind of thing, right? And so I really am speaking to myself as a consumer. I am who I am trying to help. So the goal is...
on the grounds in California is to really create this awareness, if you will, of this kind of silent, creeping, like, it's like, it's like no one's really talking about it. We all know that the issue is there, right? We all know that there is a lack of access. So it's like, what can we do? What can we do about it kind of thing? And I'm hoping that as time goes on and as I'm gathering resources right now, I'm working with a provider that's in San Francisco.
Shelbey Arevalo
She's a mobile nonprofit dentist. And so right now we are working on getting her into facilities, right? But the mission will always be primarily with the patient. We always stand with the patient primarily, but we will have partnerships in order to help facilitate treatment, if you will, right? If that's what the patient's request is.
Host
So is that the number one thing that you're focusing on advocacy? Like when are people calling saying, I just don't have access to care when they call you and schedule these consultations? Is that the?
Shelbey Arevalo
There are so many different requests. mean...
Host (13:30.6)
So tell me a little bit about what kind of clients you're talking to. What are they asking you about? I think it's great that the mobility is a piece of it, but it sounds like that's actually not the biggest slice of the pie when it comes to the people who are inbound coming to you.
Shelbey Arevalo
Sure!
Shelbey Arevalo
When it comes to patients that have the ability, because here's the deal, the whole point of my nonprofit is to be a voice for the voiceless, right? And so as of this time, I am getting clients that I would say, again, I'm a national nonprofit. I'm always going to have my doors open to everybody. So you have a dental concern, you call us and we can see if we can help you. Anything from a bill, right? You have a question on a bill.
If you would like a second opinion on a treatment plan, coding questions, right? Billing questions. As a billing specialist, have access to the national, basically what doctors are allowed to charge, I have those numbers. So we make sure that patients are being overcharged. And there are patients that have
oral maxifacial pain. like, for example, I have patients that I'm working with and they have not been able to get help for over 15 years. They've like over 30 providers and they just keep getting the run around and they're in excruciating chronic pain and they just need help and there's no one there to help them.
Host
Why does that happen? Why does somebody see 30 providers in 15 years and no one can help them with their pain? Why does that happen in the first place?
Shelbey Arevalo
Well, I think a lot of it is because now that I've been this patient's advocate for going on three months, I've seen firsthand and I think a lot of it is to be honest, fear and just not knowing the unknown. And so a lot of providers I feel like are seeing this patient's case and they get scared and they don't necessarily know. And so instead of saying that,
or giving the patient resources, they just refer the patient out.
And so the idea is that those patients, because this happens every day, all day long, can come to our nonprofit and we can hopefully be that missing piece for them. That's the hope and the dream. And they get that personal one-on-one help, right? These poor patients, it's not even finances are even an issue. They just want to get out of pain.
Host
Mm-hmm.
Host
And so with a situation like this, I think it's a nice case study for us to jump into. What would you do? What are you doing? And how does that affect their outcome? And what does it actually look like on a day to day basis?
Shelbey Arevalo
Sure, great question. The way that I've designed the program is to make it, you know, like we're just kind of like a lifelong partner, right? So she's enrolled in our membership program. It's $35 a month. And so basically what that enables her to is discounted services and services within that membership. So that'll include two advocacy calls, whatever that may be, two.
And again, you're getting discounts and hopefully in the future we have partnerships where we're able to give patients a welcome kit where they have free goodies, right? That's the idea, free dental goodies. And so in particular, right, when we have these patients that are more complex, you know, the idea is we get funding where I don't have to charge patients. The idea is I don't feel like patients should have to pay for this, right? Patients...
shouldn't have to pay to just get help like this. So the idea is to get funding so that this can be paid for. But that's, you know, we're in our infancy stages. And so a patient like, you know, the ones that I have will, when it comes to a complex case, it has to be done in phases and stages, right? I don't over promise. And I am always completely transparent as far as what that.
Host
So what are you actually doing? Are you doing the research and like crossing off? Is it this? it this? it?
Shelbey Arevalo
Everything. Yep. So with this case study, and she's given me permission to talk about, right, everything that has, she's given me permission and she is in a lot of help. She really wants help. And so she's willing to share her story. So yeah, so basically with, you know, patients that have
Complex cases as an advocate. I need to first sit. I have to figure out okay. They're shoes, right? I have to really get a good idea of what's going on And so with her it's a lot of researching. It's a lot of trial and error, right? so I've now sat with two she's been through two provider visits with me and one just completely canceled her on the way to the appointment and
It was almost like I gave them too much information. So here I am as an advocate thinking I'm doing the right thing, but I'm transparent with my patient and I'm like, okay, we're gonna have a new approach, right? This was not the right approach now. And so that's what I mean by trial and error. as a patient on the receiving end, when we have these complex cases, she's wonderful, she's great to work with, she's patient.
We just take it a day at a time. And so right now we're going through basically providers in her area and going through the list. so this week for her, I'm working on a new area of providers offices, basically that she's given me the green light to research. So I have a list of providers to research. I will call these offices and basically give them just kind of like an idea of the patient.
and the needs and basically figure out if they may potentially be a good fit. And ultimately I gathered my, the findings that I have, right? I put my dental consultant eye on it too, right? Do they have a website, right? What are all the things that are patient facing, patient value that I would think, hey, that's gonna be a great fit for that patient, right? And I will compile this all for the patient and
Host (20:06.1)
Mm-hmm.
Host
and what where.
Shelbey Arevalo
you know, if it needs to another consultation, sometimes it needs that right. With this particular patient, I've spent hours on her case and most of it is donated time. There, you know, there are times where, you know, with her specifically, there are charges per hour, like $150 an hour. That is the highest fee. Because she needs, you know, anyone that needs me to be virtually there.
That's pretty much the highest threshold, but sorry, I'm rambling, feel like. Apologies.
Host
Well, from what I can extrapolate, it sounds like people come to you, they're finding you in different ways. You're figuring out how people are finding you because it's still a new entity and they come to you with problems. So sometimes it's a billing or an insurance problem. Sometimes it's being turned away by providers and sometimes it's that they feel like the treatment plan that they've been recommended doesn't quite align with what they were hoping or wanting.
Shelbey Arevalo
Yes.
Host
and they're seeing if there's another option or another way to handle the problem. And because of your vast experience in the dental field, you're able to either say that is actually the best course of action or you know what? You haven't been presented necessarily with all the options. Let's go over what you can do. Is that kind of how it works?
Shelbey Arevalo
you
Shelbey Arevalo
You got it. You hit the nail right on the head. Exactly.
Host
Talk to me a little bit about what being a dental consultant looks like and how that is also informing you on the advocate side.
Shelbey Arevalo
Yeah, so I feel like that's really what gives me my advantage, if you will. And I feel like that's why I have such a strong foot in the door. And I just am so passionate because I am living and breathing it every day, right? If if I'm not patient facing, I'm actually in these dental offices. And I have now taken, you know, this board certification and it's board certified patient advocate and I'm making it who I am, right? I'm making it
part of how I walk this earth. And so I go into these offices and I'm practicing what I preach. So we're making sure that systems are set up ethically. We're making sure doctors are charging patients properly. And transparency is key, right? That's it. Transparency is key. And just giving patients that five-star service.
I'm always coaching you treat every patient like they're that they're the most important patient of that of your day, right? So I definitely think it gives me a very very big advantage and I don't take it for granted And I know it's a very special place that I have and I'm very careful with that
Host
As a dental consultant, the dentists are the ones hiring you to come in and optimize their practice essentially. Is that what that is? And so you look at their marketing, their billing, patient churn. What are you looking at most of the time?
Shelbey Arevalo
Yes.
Shelbey Arevalo
Exactly.
Shelbey Arevalo
My specialty is billing specifically, so dental billing and operations.
Host
And what what kind of problems do you find that dentists typically have with billing where you clean it up and make it run smoother?
Shelbey Arevalo
Really big one is just lack of having a qualified biller. A lot of it is, there's a lot of missed opportunities out there. There are a lot of benefits that are not being utilized. And patients, they only know that they're being told by their doctor, right? And so a big one is appeals. There's 33 % of claims are appealed. That's outrageous, right? As a dental biller,
99 % of my appeals are getting paid, right? And so that's a huge thing that I teach, right? Is you don't take that as an answer. You don't take no as an answer from an insurance company.
Host
So here's now, now, now that I'm understanding both sides, what's kind of the most interesting thing that I'm hearing from you, if I'm, if I'm connecting the dot right is really the doctors, the dentists and the patients are more aligned than either of them think the dentists just simply don't know how to take advantage of the insurance that the clients are already paying for or receiving. And so they can't inform the patients.
or even bill them correctly. And so they're left either not getting the services that they want or not being or, or having to pay out of pocket for them. Meanwhile, the patients aren't getting the kind of care and options presented to them that would make it an easy yes. And so in informing both parties, you're trying to make dental care more accessible for everybody without stiffing the dentist because they can actually get reimbursed by the insurance for a lot of these services that they want.
Shelbey Arevalo
Okay.
Host
to provide for the patients. Am I understanding it correctly?
Shelbey Arevalo
Yep, exactly, perfectly, yes. Exactly.
Host
Okay, so that's interesting. And so I think because you have that specialty in billing and coding and understanding insurances and appeals, you appeal to both of them because at the end of the day, like if it increases the dentist's bottom line as while simultaneously increasing client satisfaction, patient satisfaction, it's like a no brainer win. And so the patients are also obviously happy.
Shelbey Arevalo
Got it right there.
Host
Do you feel like there's room in the market nationwide for more dental advocates? And if so, should they be specializing in billing and kind of learning that, you know, part of the business?
Shelbey Arevalo
Okay.
Shelbey Arevalo
you
1000%. I have not even started I haven't done a drop of marketing. Everything has been strictly referrals and I am I have a waiting list right now. So to say there is a need. That's an understatement. And so the hope is, is I create this nonprofit and I get to have more dental advocates right that work for for us and we're this awesome gov right and we're this go to it and the idea is
We're just here to be of service. My dream would be to be an add-on to other advocates, we're, you know, cause dental is such a focused group, right? And I know that there are some patient advocates that are just doing incredible work. And you know, that's not to downplay what I'm doing, but I just, know that there is a lot of incredible work that's being done out there. And I would love to just be an addition to that. If there's a dental need that their patient needs and
The hope is, hopefully, that it's completely funded one day.
Host
Right, right. At least your side of the service for the patient so that they can actually get access to the services. Right. How long do you think it would take someone to learn enough to become an advocate with this dental specialty?
Shelbey Arevalo
Exactly. Yep. Yep.
Shelbey Arevalo
you know, when it comes to advocacy, for me, it was such a natural thing. And I feel like a lot of the advocacy groups, like the peers, they, it's like who you are, it's like who you are as a person, right? And so I feel like that's first. And it's just kind of something that you're born with, right? And you know, the rest comes after, I believe that, you know, you, anyone can really learn this if you care enough.
The coding is very hard, you know, that's something that I've learned over 15 years of experience, right? That's something that I continue to go to schooling for and get certifications for because it's constantly changing. But I really think that even a lot of people that work in the medical field, if you can just tweak it a little bit and you can, you know, apply that to dental. So there's definitely a lot of potential.
Host
When you say in terms of the coding and understanding the ins and outs of the insurance and taking courses, what kind of courses and what kind of certifications are you taking? And is it unique to dentistry?
Shelbey Arevalo
you
Shelbey Arevalo
Yeah, so I'm currently really into medical cross coding. So the idea is, you know, a lot of these doctors dentists, they are not comfortable billing medical insurance, right, which it I get it, right. But if we get comfortable and we tap into that, that's a huge, you know, benefit for the patient. So that is those are additional courses that I'm taking. So I am a sleep apnea billing specialist.
Sleep medicine is something that I'm very, very passionate about. And so again, a patient just has a slight inkling of, think I might, I'm having some issues with my sleep, right? I have insomnia. Let's call, I need some help, right? Maybe it's oral health related. You call us and we can literally help patients navigate that whole system. I have a case study that just successfully got his CPAP and now we're working on potentially getting him an oral sleep appliance. So it's just the best.
greatest feeling to be be of service to patients like that.
Host
And what are these courses that you take? Who are they really designed for? Because they're not designed for advocates by nature because the advocacy is so new. Who are they really designed to train?
Shelbey Arevalo
A biller, they're designed for a biller specifically. Yep, would be billing specific advocacy. right, it's for the biller, that's what the course is for. So there's courses like through the ADA, always, you know, it's pretty reasonable. It's a generalized course, but it's gonna cover all your basics and you know it's coming straight from the source, American Dental Association.
Host
And do you do you feel like if an advocate maybe they have experience as an advocate maybe they don't but they they know they want to do this and they have a passion for dentistry. Would you recommend them taking a course like that.
Shelbey Arevalo
Absolutely. Yeah. Absolutely.
Host
Okay, great.
and do you see this? know you said it's national. Do you see yourself staying in charge and hands on with this as you grow? Or is this, you just kind of want it to start it and hand it off at some point? Cause it's, I'm assuming if it gets into, say all 50 States, it's going to be a pretty big beast of a thing to kind of manage.
Shelbey Arevalo
you
Shelbey Arevalo
Totally. Yeah, the I mean, the idea is, of course, right? I have big, big dreams. The idea is I'm always going to be invested in some way, right? Of course. But I would like to create a self sufficient program. Ideally, I would like to create a program that has more automation that has more automation, right? I want to create a program that
is very easy and accessible to patients. And yes, where I am not so much hands in, right? But I have to my dues first, right? And I enjoy what I'm doing. I really do. And as I'm helping patients, they are helping me. They are helping this program and we're building our programs and our systems based off of these patients that I help.
Host
Okay. If there's one thing that you want that you could kind of impart patients knowing about their own dentists, what would it be?
Shelbey Arevalo
that he or she is more invested and cares a lot more about your dental health and about you as a person than you may think. And there is a lot that goes on behind the scenes, so much preparation and care for your visit the day that you show up. And so I just encourage patients to just give their provider a chance and to just always ask questions and to not feel like you can't ask questions, right?
you to ask questions.
Host
Absolutely. And if they wanted to get in touch with you, if somebody wanted to get in touch with you to learn more about advocacy or if they're a patient and need some of this help, is your website the best place to connect with them?
Shelbey Arevalo
website is the perfect place national dental advocacy dot org and also call 707 ask and DAP and Yeah, that's pretty much it
Host
Shelby Arevalo, thank you so much for your time, I appreciate it.
Shelbey Arevalo
Yay, thank you so much, it was a pleasure.
