NASDAQ:VVOS Vivos Therapeutics Q1 2023 Earnings Report $2.63 -0.10 (-3.52%) As of 11:17 AM Eastern This is a fair market value price provided by Polygon.io. Learn more. Earnings HistoryForecast Vivos Therapeutics EPS ResultsActual EPS-$5.00Consensus EPS -$4.25Beat/MissMissed by -$0.75One Year Ago EPSN/AVivos Therapeutics Revenue ResultsActual Revenue$3.86 millionExpected Revenue$3.71 millionBeat/MissBeat by +$150.00 thousandYoY Revenue GrowthN/AVivos Therapeutics Announcement DetailsQuarterQ1 2023Date6/8/2023TimeN/AConference Call DateThursday, June 8, 2023Conference Call Time5:00PM ETUpcoming EarningsVivos Therapeutics' Q1 2025 earnings is scheduled for Tuesday, May 13, 2025, with a conference call scheduled at 5:00 PM ET. Check back for transcripts, audio, and key financial metrics as they become available.Q1 2025 Earnings ReportConference Call ResourcesConference Call AudioConference Call TranscriptQuarterly Report (10-Q)Earnings HistoryCompany ProfilePowered by Vivos Therapeutics Q1 2023 Earnings Call TranscriptProvided by QuartrJune 8, 2023 ShareLink copied to clipboard.There are 6 speakers on the call. Operator00:00:00Good day, everyone, and welcome to the Vivos Therapeutics First Quarter 2023 Earnings Conference Call. At this time, participants are in a listen only mode. A question and answer session will follow management's remarks. This conference Call is being recorded and a replay of today's call will be available on the Investor Relations section of VIVOS' website and will remain posted there for the next 30 days. I will now hand the call over to Julie Gannon, VIVOS' Investor Relations Officer, for introductions and the reading of the Safe Harbor statement. Operator00:00:31Please go ahead. Speaker 100:00:34Thank you, operator. Hello, everyone, and welcome to our conference call. A copy of our earnings press release is available on the Investor Relations section of our website at www.vivos.com. With us on today's call are Kirk Huntsman, Vivo's Chairman and Chief Executive Officer and Brad Ammann, Chief Financial Officer. Today, we'll review the highlights and financial results for the Q1 of 2023 Speaker 200:01:01as well Speaker 100:01:01as more recent developments in VIVO's plans for the remainder of 2023. Following these formal remarks, we will be happy to take questions. I would also like to remind everyone that today's call will contain certain forward looking statements from our management made within the meaning of Section 27A of the Securities Act of 1933 as amended and Section 21E of the Securities and Exchange Act of 1934 as amended concerning future events. Words such as aim, may, could, should, Projects, expects, intends, plans, believes, anticipates, hopes, estimates, Goal and variations of such words and similar expressions are intended to identify forward looking statements. These statements involve significant known and unknown risks and are based upon a number of assumptions and estimates, which are inherently subject to significant risks, Uncertainties and contingencies and many of which are beyond the company's control. Speaker 100:02:05Actual results, including without limitation, The results of Vivo's growth strategies, operational plans, including sales, marketing, product acquisition and integration, Research and development, regulatory initiatives, cost savings plans and plans to generate revenue, as well as future potential results of operations or operating metrics, such as potential for future positive cash flows and other matters to be addressed by VIVO's management in this conference call may differ materially and adversely from those expressed or implied by such forward looking statements. Factors that could cause actual results to differ materially include, but are not limited to, the risk factors described and other December 31, 2022, and our other filings with the SEC, all of which are or will be accessible on the Investor Relations section of Vivos' website as well as the SEC's website. Except to the extent required by law, Vivos No obligation to update statements as circumstances change. Finally, please be aware that the U. S. Speaker 100:03:24Food and Drug Administration has given Certain Vivos Appliances 510 clearance to treat mild to moderate OSA. Any reference herein regarding Vivos treatment or The Vivos method should be viewed in that context. Treatment of patients with severe OSA is performed off label at the sole discretion This will clinical discretion of the treating doctor and is not part of the VIVOS treatment protocol. Now at this time, it is my pleasure to introduce Kirk Huntsman, Chairman and CEO of VIVOS. Kirk, please go ahead. Speaker 200:04:00Thank you, Julie. I want to thank you all for joining us on today's conference call. Just a moment, I'll turn the call over to our Chief Financial Officer, Brad Ammon, who will walk you through the highlights of our Q1 2023 financial and operating results. Once Brad is finished, I'll come back on and speak with you about the highlights of what we accomplished at Vivos during the Q1 and in the past few weeks following the quarter end, including our acquisition of product rights and patents from Advanced Facial Dentics. This has expanded our product portfolio even further, allowing vivos trained providers to treat a much larger percentage of their patients, which ultimately increases the revenue potential for VIVOS. Speaker 200:04:40I'll also talk about our progress with the FDA as well as ongoing R and D efforts. In more recent news, I'll talk about some of the actions we took to improve our organizational infrastructure and highlight how we took steps to increase operational efficiencies, reduce expenses and position us to take advantage of the growth opportunities that are available to us. I'm pleased to say that due to these initiatives, we can reiterate that we remain on target to achieve our goal of positive cash flow for the Q1 of 2024, which is a full quarter earlier than the target we provided you on our last earnings call in March. Our goal is to achieve this key target without having to raise any further equity capital if possible. Following that, I'll talk about our plans going forward in 2023, how we intend to build upon what we've already done and What we have planned for the rest of the year as well as into 2024. Speaker 200:05:34After that, we'll take your questions. Now let me turn it over to Brad to review our financials. Brad, Please go ahead. Speaker 300:05:41Thank you, Kirk, and good afternoon, everyone. Today, I'll review the financial highlights of our Q1 2023 financial results. For information on our results for the 3 month period ended March 31, 2023, I'll refer you to our earnings release, which was distributed earlier today and our quarterly report on Form 10 Q, which is available on the SEC filings portion of the Investor Relations section of the VIVOS website atbivos.com/investorrelations. At the outset, I want to say thank you for your patience as we switched auditors for the Q1, which led to a delay in our 10 Q filing. I am pleased to report that our relationship with our new auditor, Moss Adams, is off to a very positive start, we are looking for a smooth and productive relationship with them. Speaker 300:06:36Today, we report Q1 2023 total revenue of $3,900,000 compared to $3,600,000 for the Q1 of 2022. The overall year over year increase was due to higher revenue from VIVOS integrated provider or VIP enrollments as well as increased sleep testing service Revenue and increase in conference and training related revenue. This was offset by lower revenue generated year over year from Our VIP enrollments were up in the 1st quarter with 38 BIPs enrolled versus 32 enrolled in the same period last year. For the Q1 of 2023, We recognized VIP revenue of approximately $1,300,000 an increase of $400,000 or 42% in enrollment revenue compared to $900,000 for the Q1 of 2022. It should be noted that Q1 of 2020 to VIP revenue was negatively affected by a $300,000 adjustment that rose from the prior year impact of our change in revenue recognition policy. Speaker 300:07:55We also saw an increase of approximately $200,000 in revenue recognized from our home sleep test ring lease program as well as an increase of approximately 100,000 in conference and training related revenue. The increase in total revenue was partially offset by lower product revenue. During the Q1 of 2023, we sold 2,369 oral appliance arches for a total of approximately $1,700,000 compared to $2,965 during the Q1 of 2022 for approximately $1,900,000 And for the Q1 of 2023, we recognized approximately $200,000 and our billing intelligence service revenue compared to $400,000 in the same period the prior year. We also had approximately 100,000 and center revenue compared to approximately $200,000 during the last year's Q1. Gross profit was $2,300,000 for the Q1 of 2023 compared to gross profit of $2,600,000 for the comparable period in 2022. Speaker 300:09:08Gross margin for the Q1 of 2023 was 61% compared to 70% during the last year's Q1, primarily driven by higher costs associated with VIP enrollment and training as well as costs related to our new programs, including the sale and leasing of sleep testing rings. We continue to refine our sales, marketing and promotional efforts with potential VIPs not only to increase enrollment in revenue, but to improve our gross profits and margins. This includes utilizing targeted social media and digital marketing efforts specifically designed to drive sales. As of the Q1, we are now starting to see the benefits of these efforts with increased VIP enrollments on a year over year basis. Sales and marketing expense was $600,000 for the Q1 of 2023, a decrease of approximately $200,000 compared to $800,000 for the Q1 of 2022. Speaker 300:10:13This year over year decrease was primarily due to decrease sales, commissions and a reduction in associated sales related expenses. Importantly, G and A expenses decreased approximately $1,700,000 or 21 percent to $6,500,000 for the Q1 of 2023 compared to $8,300,000 for the Q1 of 2022, reflecting the substantial impact our cost cutting efforts are beginning to make. We believe these important efforts We'll reduce our cash burn as we seek to ramp revenues and move toward cash flow positive operations. Operating loss was $5,000,000 for the Q1 of 2023 compared to $6,600,000 for the Q1 of 2022. This year over year decrease in operating loss was primarily from lower G and A expenses due to expense cuts and the factors I just discussed. Speaker 300:11:16Net loss was $1,700,000 for the Q1 of 2023 compared to $5,300,000 for the Q1 of 2022. The reduction in net loss was due in part to cost cutting, but also during the quarter we recognized approximately $6,500,000 as a one time non operating expense related to the difference between excess fair value from warrants issued in our January 2023 private placement and the net proceeds we received. The change in fair value of the warrant liability over the quarter was $9,600,000 net of issuance costs of $600,000 Accordingly, the net impact of the private placement warrants For the 3 months ended March 31, 2023 was approximately $3,200,000 of non cash other income. Please refer to our 10 Q for further details regarding this. Turning to our statement of cash flows. Speaker 300:12:19Cash burn from operations for the quarter ended March 31, 2023 was $3,500,000 a decrease of approximately $2,600,000 compared to approximately $6,100,000 during the comparable prior year period. This is further evidence of the positive impact of our expense reduction initiatives. For the quarter ended March 31, 2023, net cash used in investing activities consisted of Capital expenditures for software of $300,000 related to the development of software for internal use, which is expected to be placed into service in mid-twenty 23 as well as a purchase of patents and other intellectual property in February of 2023. This compares to net cash used in investing activities of $100,000 in the comparable 2022 period arising from capital expenditures for internally developed software. As I mentioned earlier, in January of 2023, We strengthened our balance sheet by closing a private placement with a single institutional investor for net proceeds of approximately $7,400,000 The private placement consisted of shares of common stock and prefunded warrants together with 5.5 year common stock purchase warrants with an exercise price of $1.20 a share. Speaker 300:13:47The effective purchase price per share of common stock or prefunded warrants in lieu thereof and associated warrant was $1.20 per share. As of March 31, 2023, We had $7,000,000 in cash. With the financing we completed in January as well as the strategic initiatives we have applied To reduce our expenses, we continue to anticipate having the necessary financial resources to meet our capital needs, fund our operations and continue executing on our near term growth strategy. In the short term, we expect these changes will result in relatively flat revenues sequentially for the first half of twenty twenty three. This also takes into consideration our new ASC 606 6 revenue recognition policy. Speaker 300:14:40Afterwards, we anticipate top line quarter over quarter revenue growth will resume starting in the Q3 of this year. Further, as Kirk mentioned earlier, we believe these initiatives will allow us to accelerate our target time for reaching positive cash flow by a full quarter now in the Q1 of 2024. With that, I'll turn the call back over to Kurt. Speaker 200:15:05Thank you, Brad. The Q1 that we are reporting on here today may seem like a distant memory, We believe it represents a significant watershed moment for the company and our future. First, in early January, we announced FDA 510 clearance for our flagship DNA oral appliance product. This represented the first time in history That the FDA recognized any mechanism of action in an oral appliance other than mandibular advancement for the treatment of mild to moderate obstructive sleep apnea. No oral appliance product has ever received such a clearance and the significance of this breakthrough should not be underestimated. Speaker 200:15:46We fully believe that after several years of going back and forth with the FDA, they were finally persuaded by our submission of yet another round of compelling real world data, this time showing a remarkable 80% of OSA patients seeing their symptoms completely resolve after treatment using the DNA appliance and the VIVOS method. Now to be clear, this data showed that clinical OSA, meaning AHI scores of 5 or higher was no longer present in 4 out of 5 patients after treatment and with no further intervention required. As far as we know, such clinical results are unprecedented in sleep medicine and unparalleled by any other product or therapy. We expect the full financial impact of that regulatory clearance on our sales to be realized over time as doctors alter their treatment plans to include more DNA appliances. 2nd, on the heels of our announcement regarding the FDA clearance For the D and A appliance, we raised an equity tranche with net proceeds of roughly $7,400,000 from a single institutional investor. Speaker 200:16:57We immediately put this capital to good use in expanding our intellectual property and product suite through the acquisition of certain patents, trademarks and trade secrets from Advanced Spatial Dentics. We closed on this transaction towards the end of the first quarter. That acquisition not only ensures that VIVOS will maintain its technological and market leading position at the forefront of treatments But it also fills a gap in our product suite and offerings to patients or to providers and patients. Nearly 40,000,000 people in the United States suffer from TMD pain and related issues. Another 40,000,000 suffer from migraine headaches or have difficulty breathing through their nose. Speaker 200:17:50Our new patented unilateral bite block technology has been shown to be highly effective in treating such conditions. Also during the Q1, we accelerated the process of rightsizing our corporate staffing levels and reorganizing our management team in order to reduce our cash burn and push the company closer to cash flow breakeven, which as Brad mentioned, we now expect achieved during the Q1 of 2024. As a subsequent event, early here in the second quarter, we announced a reduction in force and further reductions in overhead. Again, we think these prudent and necessary actions will serve us well as we look to improve our results of operations. On the operations side, we made important progress in our current pilot tests with certain DSO organizations, known as DSOs, including the execution of new and existing pilots with 8 regional and national DSOs presenting over 1,000 locations nationwide. Speaker 200:18:52I'd like to highlight one particular DSO, which operates in all 50 states under the name Toothpillo. Over the past 12 months, Toothpillo has been making exceptional strides forward in cultivating a direct to consumer channel exclusively geared towards use of our VIVOS Guides products for pediatric guided growth and development. An estimated 16,000,000 children between the ages of 312 suffer from various orofacial and developmental issues Associated with ADD, ADHD, behavioral problems, scholastic challenges, Chronic allergies, mouth breathing, crooked and crowded teeth, bedwetting and breathing related sleep issues, all of which may be helped through proper oral growth and development. Toothpillo is a pioneering telehealth commercial partner of Vivos, And we are their exclusive oral appliance supplier. Toothpillo is set to redefine the field of pediatric, dental and orthodontic treatment with a particular focus on breathing related issues. Speaker 200:19:55This transformational relationship leverages Vivos' world class pediatric oral appliances, underscoring the role of our cutting edge products in advancing the delivery of dental and orthodontic care. 2Pillabose has strong national network of 48 vivos trained dentists that serve as virtual treating partners and a rapidly growing referral base of over 358 in practice providers. The synergy between Vivos' Premium pediatric oral appliances and 2 pillows software and highly skilled practitioners is creating a holistic, accessible and high quality telehealth solution for at risk patients aged 3 to 12. Over the past year, Toothpillo has been perfecting its Proprietary virtual care platform featuring a mobile app designed to facilitate seamless connections between patients and doctors. Despite not yet having launched its national marketing campaign, tooth pillows services have already been sought out by patients in 40 states, All through referrals with 64% of all new inquiries converting into paying patients. Speaker 200:21:06VIVOS is excited about our relationship with toothpolo, and we believe it not only showcases the effectiveness and versatility of our oral appliances, but also opens up a large and exciting new avenue for growth. We are confident that Toothpillos' success will further amplify Vivos' reputation in the industry, bringing us one step closer to our vision of training healthcare professionals and providing them with the very best treatment tools and technology available. Equally as important, Tooth Pillow is just one of several DSOs we have been speaking with and starting to do business with, and therefore, it serves as an example of similar relationships we hope to enter into in 2023 and beyond. Also today, we are announcing the execution of our first nonexclusive distribution agreement for a 90 day pilot with a nationally recognized durable medical equipment company or DME that serves hundreds of thousands of CPAP patients nationwide Who are seeking alternatives. If this pilot is successful, a national rollout is planned to follow, and we can provide more details at that time. Speaker 200:22:15Other similar agreements with potential distributors are in process. We continue to believe that the financial impact on top line revenue from these efforts will begin to show up in the 3rd and 4th quarters of this year. An integral part of this pilot is the treatment navigator program that we introduced last fall. This program was designed to effectively act as an extension of the VIP practice to help the dental office guide the patient through the many different steps of the patient journey, including coordinating diagnostic appointments, insurance pre authorizations, further education and generally coaching the patients through treatment under Not only does the treatment navigator program remove significant workload from the practice, It helps mitigate the challenges associated with employee turnover within the practice. Dentists pay VIVOS up to $8.95 per case for Treatment Navigator Services, which we expect will soon become a significant revenue contributor and profit center for us. Speaker 200:23:18We believe our latest rounds of cost cutting coupled with an intense focus on creating new revenue streams will allow us to achieve our stated goal of achieving Positive cash flow by the Q1 of 2024. Our prior reliance on Vivos trained dentists To create demand from within their practices is now being augmented by vivos actively driving new patients into their offices through multiple Distribution channels, including primary care and specialty medical doctors, medical equipment suppliers, Large employers, men's health clinics and more. We deliver more qualified new airway patients to VIVO as we deliver More qualified new airway patients to VIVOSTRAIN providers, our value proposition to potential new providers becomes more compelling And attractive, it's a virtuous cycle that creates the potential to organically fuel our growth. We expect to begin to see the impact of these This past year has produced the single largest advancement towards proving the efficacy of our technology with multiple studies And peer reviewed papers being published in top quality journals, professional journals. We are pleased to announce Today, the recent execution of an agreement with Stanford University to begin a randomized control trial where our DNA appliances will be directly compared to CPAP. Speaker 200:24:50Additional university based clinical trials on VIVOS products are currently in process and are expected to start before year end. Currently, there are no less than 5 additional new papers showing significant clinical results that have been submitted in our pending publication. The cumulative effect of this research is to establish beyond any reasonable doubt that VIVOS possesses the single most advanced and effective treatment for breathing and sleep disorders on the market today. One final note on our product development front. For some time now, we have been actively engaged in the development of a patient driven mobile app that will assist clinicians in collecting key diagnostic data and in monitoring patient compliance and progress, while also empowering patients to take charge of their own health and wellness. Speaker 200:25:40For example, patients can participate in taking periodic records, providing feedback and actually receive coaching and interaction with their providers. The mobile platform also allows for remote delivery of certain clinical services such as myofunctional therapy, breathing exercises, Important notifications and more. Our surveys and provider feedback leads us to believe that there is strong potential demand for such a product and that it can be commercialized and highly profitable for both VIVOS and VIVOS providers, while also taking a load off of dentists and their teams. We plan to have a beta version of the app ready for testing by the end of this month and expect to have a commercial product available by the Q4 of this year. Now in closing, we have the evidence based technology and products that can now address the needs of patients across the full spectrum of Price points and needs. Speaker 200:26:38We have the FDA clearances. We have the nationwide network of trained providers. And now we have a growing brand awareness amongst both providers and patients. Through our new distribution networks, We will soon have access to more potential new patients than ever before. We believe the combined effects of our internal cost operating cost reductions and the strategic revenue initiatives outlined above will yield significant top line revenue growth and allow us to become self sustaining in the Q1 of 2024. Speaker 200:27:15This concludes our prepared remarks. Now we'll be happy to take questions. Operator? Operator00:27:22Thank you. And a confirmation And our first question comes from the line of Scott Henry with ROTH Capital Partners. Please proceed. Speaker 400:27:52Thank you and good afternoon. I guess cash flow positive In the Q1 of 'twenty four would be fantastic, so if you can achieve that goal. So I just wanted to drill a little bit into the assumptions. I know you expect flattish revenues in the first half of this year, but what sort of revenue run rate do you think Would allow you to achieve that goal? Speaker 300:28:24We believe that at $8,000,000 run rate per quarter, we can hit that goal, Scott? Speaker 400:28:31Okay. Thank you. That's helpful. And When I look at the expense items, obviously, sales and marketing was Way down. And I know there was layoffs recently. Speaker 400:28:51I want to hone in, first, is that sales and marketing level of $600,000 is that what we should think about going forward? And second of all, that G and A of $6,500,000 I imagine that's where the bulk of the cuts are going to come What should we think about as a G and A once all the cuts and everything has taken effect? Speaker 300:29:16Well, if you look at quarter over quarter, Scott, last year we were at $8,300,000 In Q1, we were at $6,500,000 in G and A expenses in the Q1 of 2023. The marketing expenses stayed roughly flat. We were down about $100,000 quarter over quarter. As those take place, we believe on the personnel costs, we're going to have $500,000 a quarter go against that G and A expense. So that's roughly what We will save in terms of salaries, wages, taxes and benefits. Speaker 400:29:58Okay. Thank you. That's helpful. Just a couple other small questions. Arches were down in the Quarter and if you calculate Arches per dock, they were down significantly. Speaker 400:30:18How should we think about that number? I mean, I know the business model is always changing and the accounting is changing as well. Just trying to get a sense of how we should think about that number as far as Arch's, how we should interpret the Q1 2023 results and how we should think about that number going forward? Speaker 200:30:40Well, first of all, I think there's a certain element of the macroeconomic economy, Other companies in the dental space have struggled with some of that and some of the results of that. So there's that, that plays into it. There is a little bit of seasonality in Q1 that plays into it. But There was also an event that took place that was a little bit unfortunate towards the middle to later part of Q1 where there was Some market confusion over a product that made similar claims to some of our products out there in the marketplace. This product did not have FDA clearances, did not have research, did not have a lot of things behind it. Speaker 200:31:30It was a totally different type of product, But there was some market confusion over that. And frankly, a lot of our providers until we were able to Wrap our minds around that and really address that directly. We just saw and And we've seen a little bit of a softening in the sales of our Arches from that standpoint. But That seems to have passed. Things have picked up again here, and we're optimistic That we weathered that storm a little bit there and that, that contributed in especially in the latter part of the first quarter And into the Q2. Speaker 200:32:13So we are seeing now where as we drive demand Through some of these distribution channels that we're talking about that have never been there before, we have new ways of helping doctors find patients to treat. And it appears to be significant Revenue opportunities for the doctors and their new patients, and so we're very optimistic. So it's going to be come a point where The old model where we just relied upon dentists to source their own cases through their own practices and To do that, we're taking the bull by the horns and we're driving patients to our very best providers. So we are actively pursuing Through our treatment navigator, our Airway Alliance and our distribution networks that we've talked about, we're actively Working to drive patients into their offices, and that's a very different kind of paradigm shift that we've Forced into the marketplace. So as you go forward, I think we hopefully will see those numbers pick back up as Some of these other distribution channels kick in. Speaker 400:33:30Okay, great. Thank you. Final question, Kirk. Brad set a pretty high bar for you of getting to $8,000,000 a quarter. How do you expect What are the levers you're going to pull to get to there from here? Speaker 400:33:48How much do you get from the AFD acquisition? And is it the DMEs? Just big picture terms, what are the levers you got to pull to get from here to there? Thank you. Speaker 200:34:03Thank you, Scott. I think that's a great question. And all I can say is that There is a huge challenge in the CPAP community and the CPAP world with patient compliance and with patients abandoning their treatment. And when patients abandon CPAP, which 90% of patients who get 90% of patients who are diagnosed with OSA get CPAP machines. In the 1st 90 days, a fourth of them will stop using their CPAP and eventually about half Are known to stop using their CPAP machines. Speaker 200:34:45So there is a huge, huge number of people. It's in the millions People out there in the United States, Canada and around the world who have tried CPAP and are intolerant to it. They don't use it. They won't use it. They can't use it for a variety of reasons. Speaker 200:35:03Some of them psychological, some of them physiological, some of them just Preferiential, they just hate having it. But what do those people do? Well, we've now unlocked The secret, if you will, to how to access those patients and what to do, we've established some really clear And very, I think, reasonable and market based distribution agreements with people that know where those patients reside and who they are. And we're going to be going after them. And there's So much of that out there. Speaker 200:35:44It's really hard for us to say at this point how many of those patients will come in and convert into VIVOS therapy, but we And our distributors are very optimistic that, that number will far exceed what we've been doing in the past, and we're very optimistic about So it's not inconceivable at all for us to hit those numbers or exceed those numbers as we go forward. Now Whether that happens in the Q4 of this year or the Q1 of next year or the time frames that we've given It's hard to say, but we're as we look at it and we're in the trenches every day with these distributors, We're very optimistic about it, and we'll see what happens. I mean, as we've talked before, it's time for this company to put up. And so we're moving every resource we have to make this happen And to demonstrate that we can grow this company. So that's why we're optimistic. Speaker 200:36:46So Yes, this is a it's a high bar, but we're very optimistic about it right now and that's our that's where we stand today. Speaker 400:36:57Okay, great. Thank you for taking the questions. Speaker 200:37:00You bet. Operator00:37:04Our next question comes from the line of Lucas Ward with Ascendiant Capital Markets. Please proceed. Speaker 500:37:12Thank you. Hi, guys, and congratulations on meeting your business goals on getting closer to your goals. I'm also interested in the revenue aspect. I was wondering if you could quantify the impact of sales through the DME and the DSO channel like near term or In a few quarters, just so we can understand like how big that really is. Speaker 200:37:45Yes. So thank you for that. I think on the last call, we've been talking about DSOs now for a year and a half. And what we've learned and we said in the very beginning that the opportunity with DSOs was huge. There's 40,000 dental offices across the United States that have corporate ownership in these organizations called DSOs. Speaker 200:38:08So the opportunity is huge. But these guys are also very cautious and it's a slow boil for that and that's been exactly what's happened. The opportunity as we now get into where some of our pilot tests are maturing and feedback is percolating up to the C suite in these DSOs, We expect to start to see more expansion of that, but it is still going to be a very cautious rollout and a slow boil. I expect that To be the case for another probably 12 months. At some point, we'll reach a tipping point with these guys, where they will all collectively realize The opportunity that's before them in managing sleep, which is multibillion dollar opportunity for these DSOs. Speaker 200:38:54The fact that we now have a product suite with simpler, easier, better price points for DSO type customers, patients, I think makes it infinitely easier for us to crack that market. On the DSO front then, I would say Expect it to be still continue to grow. We're still signing on new relationships. There are innovative new models such I mentioned tooth pillow. I highlighted that because they're kind of an innovative direct to market type DSO or direct to consumer type DSO. Speaker 200:39:28And I would say that they will continue to contribute. And frankly, if you talk to the guys at Toothpillo, their goals for what the number of children they expect to be able to address in the 1st year It's just off the charts, but they have established a baseline with influencers, social media influencers lined up, Famous individuals with children that have been through treatment now and have had tremendous results. We've published a Few papers, we're publishing some more on the efficacy of what we're doing with children. So We have a pending FDA clearance on that, that we're hoping to get here real soon. So we have a number of things that's going to drive that market. Speaker 200:40:20That's the first thing. On the DME front, again, The magnitude of that opportunity is staggering. And it's hard to say just exactly how to quantify that. I can By the time that we convene our next earnings call, I think we'll have a much clearer picture of what that's going to entail. But When you think about the condition that these millions and millions of patients are in, who've been diagnosed with sleep apnea, who know they suffer from it, but who are Unable for a variety of reasons to use our CPAP machines, they really don't have any other options. Speaker 200:40:58Short of some type of radical surgery or an implant like Inspire or something else, it's very difficult for them to know what to do or how to treat their condition. And VIVOS represents a huge alternative first line of defense type opportunity. And I think we're creating relationships with payers We're creating relationships with employers and we're creating relationships with these DME companies that are all going to be in a position to refer Patients in the VIVOS providers across the country, the fact that we have a network nationwide, the fact that we now have Lower price point products and services, the fact that we have a differentiated technology is all very, very appealing to these groups. And I just think we're kind of at that inflection point where it's hard for us to predict, But we're cautiously optimistic about what we're seeing and the feedback we're getting. And as Scott rightly We pointed out the bar has been set pretty high and we're shooting for it. Speaker 200:42:04So but I would say that by this time By the time we report on Q2 and we start talking about what's going on with these new relationships, We'll start to be able to grasp what this is going to mean. But I think it's a definite inflection point for us And we expect revenue and volume to increase dramatically here as we go into the second half of the year. Speaker 500:42:34Okay. Thanks, Kirk. One more question. You guys have mentioned that the AFD acquisition fills out an important Product gap for you guys in terms of having more economical solutions for providers, Could you give us an update on the sales traction of the AFD devices? Speaker 200:42:56Yes. That's going to be an easy Those are not yet reflected in any of our financials or returns. We these products are A little bit technical. They're a very different kind of technology than what we have in our Historically. So what we've had to do is create a whole new training program. Speaker 200:43:21And what we do know is that because These products have been used by the Advanced Facial Dentics doctors. They've been used for years years. And There's really several 1,000 patients that have benefited from the use of these products. So we have a very good grasp on what the products do, How efficacious they are and now it's time for us to train our doctors, retrain them on certain how to use products like the pod and the sleep pod and other devices. But these products, They're simpler. Speaker 200:44:02They require less chair time than our traditional products do. They don't do all the things that our traditional products do, which is an important distinction. But from a doctor standpoint, They can fill and meet a need. They can fill a gap and meet a need at a very, very cost effective way with minimal chair time and very high levels of patient satisfaction. So as we mentioned, before, The product offering was a little bit binary in that a patient either agreed to an $8,000 to $10,000 treatment plan Well, we really didn't have anything to offer. Speaker 200:44:45It was really the doctors, if they were going to take the case on, they were going to get paid well for it or they weren't going to do it. Now The doctor can say, well, Mrs. Jones, if you're not quite ready for this treatment, we've got several other options for you here That might be more appealing. And while they don't do the same thing that the more expensive treatment does, We can still give you some relief and maybe relief from your migraine headaches, your TMD pain, your Congested nasal passages, there's a number of different ways in which the patients can be benefited At a much lower price point. So instead of that patient walking out the door, feeling like they couldn't afford the treatment, now they walk out the door with having Spent $1500 to $3,500 and it's affordable and it's again, it might not do everything, but It's going to get the patient a long way to being better. Speaker 200:45:49So we feel very good about that. Our provider network is very excited about this. There's a buzz out there around the pod and what its potential is. We have started some research at some universities With the pod, we're in the process of starting that right now, as I mentioned. And so we've got some very exciting things to come on that. Speaker 200:46:12But I think it's the ability to offer a very cost effective treatment Protocol or treatment modality that will actually make the difference for our doctors. It gives them something else to do with patients who may not yet be ready to afford or pay for. Even with insurance benefits, there's still an out of pocket portion there, And it just gives them an alternative. So I think that we're going to see some and that's rolling out even as we speak. That's being rolled out right now. Speaker 200:46:46We finished our training Preparations with videos and online training, all of the Resource materials that needed to be done and created for that, and now it's being rolled out to our provider network. So again, Q3, Q4, you're going to start to see the impact of the new product lines more fully realized in Q3 and Q4. Operator00:47:19Thank you. Okay. Ladies and gentlemen, there are no further questions at this time. I'd like to turn the call back over to management for closing remarks. Speaker 200:47:29Well, thank you, everyone, for being here today. We as you can probably tell, we feel like this is an exciting time in our history. We Truly believe that someday we'll look back and see this particular time as A watershed moment in the history of this company, and we're excited about what the future holds in store. We appreciate all of your support and the patience you've had as we've gotten to this point. We look forward to sharing our continued progress with you in the future. Speaker 200:48:04So thank you very much, and have a great evening.Read morePowered by Conference Call Audio Live Call not available Earnings Conference CallVivos Therapeutics Q1 202300:00 / 00:00Speed:1x1.25x1.5x2x Earnings DocumentsQuarterly report(10-Q) Vivos Therapeutics Earnings HeadlinesVivos Therapeutics announces agreement to acquire operating assets of SCNApril 17, 2025 | markets.businessinsider.comVivos Opens New Sleep CenterApril 16, 2025 | baystreet.caHere’s How to Claim Your Stake in Elon’s Private Company, xAII predict this single breakthrough could make Elon the world’s first trillionaire — and mint more new millionaires than any tech advance in history. And for a limited time, you have the chance to claim a stake in this project, even though it’s housed inside Elon’s private company, xAI.May 2, 2025 | Brownstone Research (Ad)Vivos Therapeutics Signs Definitive Agreement to Acquire Largest Sleep Center Operator in NevadaApril 16, 2025 | globenewswire.comVivos Therapeutics price target lowered to $5.50 from $6 at Alliance Global PartnersApril 2, 2025 | markets.businessinsider.comVivos Therapeutics’ Earnings Call Highlights Growth and ExpansionApril 1, 2025 | tipranks.comSee More Vivos Therapeutics Headlines Get Earnings Announcements in your inboxWant to stay updated on the latest earnings announcements and upcoming reports for companies like Vivos Therapeutics? Sign up for Earnings360's daily newsletter to receive timely earnings updates on Vivos Therapeutics and other key companies, straight to your email. Email Address About Vivos TherapeuticsVivos Therapeutics (NASDAQ:VVOS), a medical technology company, develops and commercializes treatment modalities for patients with dentofacial abnormalities, obstructive sleep apnea (OSA), and snoring in adults. It offers The Vivos Method, a non-invasive, non-surgical, non-pharmaceutical, multi-disciplinary treatment modality for the treatment of dentofacial abnormalities, OSA, and snoring. The company also offers VivoScore Program, a screening and home sleep test in adults and children. It markets and sells its appliances, and related treatments and services to licensed professionals, primarily general dentists in the United States and Canada. Vivos Therapeutics, Inc. was founded in 2016 and is based in Littleton, Colorado.View Vivos Therapeutics ProfileRead more More Earnings Resources from MarketBeat Earnings Tools Today's Earnings Tomorrow's Earnings Next Week's Earnings Upcoming Earnings Calls Earnings Newsletter Earnings Call Transcripts Earnings Beats & Misses Corporate Guidance Earnings Screener Earnings By Country U.S. Earnings Reports Canadian Earnings Reports U.K. Earnings Reports Latest Articles Amazon Earnings: 2 Reasons to Love It, 1 Reason to Be CautiousMeta Takes A Bow With Q1 Earnings - Watch For Tariff Impact in Q2Palantir Earnings: 1 Bullish Signal and 1 Area of ConcernMicrosoft Crushes Earnings, What’s Next for MSFT Stock?Qualcomm's Earnings: 2 Reasons to Buy, 1 to Stay AwayAMD Stock Signals Strong Buy Ahead of EarningsAmazon's Earnings Will Make or Break the Stock's Comeback Upcoming Earnings Palantir Technologies (5/5/2025)Vertex Pharmaceuticals (5/5/2025)Realty Income (5/5/2025)Williams Companies (5/5/2025)CRH (5/5/2025)Advanced Micro Devices (5/6/2025)American Electric Power (5/6/2025)Constellation Energy (5/6/2025)Marriott International (5/6/2025)Energy Transfer (5/6/2025) Get 30 Days of MarketBeat All Access for Free Sign up for MarketBeat All Access to gain access to MarketBeat's full suite of research tools. 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There are 6 speakers on the call. Operator00:00:00Good day, everyone, and welcome to the Vivos Therapeutics First Quarter 2023 Earnings Conference Call. At this time, participants are in a listen only mode. A question and answer session will follow management's remarks. This conference Call is being recorded and a replay of today's call will be available on the Investor Relations section of VIVOS' website and will remain posted there for the next 30 days. I will now hand the call over to Julie Gannon, VIVOS' Investor Relations Officer, for introductions and the reading of the Safe Harbor statement. Operator00:00:31Please go ahead. Speaker 100:00:34Thank you, operator. Hello, everyone, and welcome to our conference call. A copy of our earnings press release is available on the Investor Relations section of our website at www.vivos.com. With us on today's call are Kirk Huntsman, Vivo's Chairman and Chief Executive Officer and Brad Ammann, Chief Financial Officer. Today, we'll review the highlights and financial results for the Q1 of 2023 Speaker 200:01:01as well Speaker 100:01:01as more recent developments in VIVO's plans for the remainder of 2023. Following these formal remarks, we will be happy to take questions. I would also like to remind everyone that today's call will contain certain forward looking statements from our management made within the meaning of Section 27A of the Securities Act of 1933 as amended and Section 21E of the Securities and Exchange Act of 1934 as amended concerning future events. Words such as aim, may, could, should, Projects, expects, intends, plans, believes, anticipates, hopes, estimates, Goal and variations of such words and similar expressions are intended to identify forward looking statements. These statements involve significant known and unknown risks and are based upon a number of assumptions and estimates, which are inherently subject to significant risks, Uncertainties and contingencies and many of which are beyond the company's control. Speaker 100:02:05Actual results, including without limitation, The results of Vivo's growth strategies, operational plans, including sales, marketing, product acquisition and integration, Research and development, regulatory initiatives, cost savings plans and plans to generate revenue, as well as future potential results of operations or operating metrics, such as potential for future positive cash flows and other matters to be addressed by VIVO's management in this conference call may differ materially and adversely from those expressed or implied by such forward looking statements. Factors that could cause actual results to differ materially include, but are not limited to, the risk factors described and other December 31, 2022, and our other filings with the SEC, all of which are or will be accessible on the Investor Relations section of Vivos' website as well as the SEC's website. Except to the extent required by law, Vivos No obligation to update statements as circumstances change. Finally, please be aware that the U. S. Speaker 100:03:24Food and Drug Administration has given Certain Vivos Appliances 510 clearance to treat mild to moderate OSA. Any reference herein regarding Vivos treatment or The Vivos method should be viewed in that context. Treatment of patients with severe OSA is performed off label at the sole discretion This will clinical discretion of the treating doctor and is not part of the VIVOS treatment protocol. Now at this time, it is my pleasure to introduce Kirk Huntsman, Chairman and CEO of VIVOS. Kirk, please go ahead. Speaker 200:04:00Thank you, Julie. I want to thank you all for joining us on today's conference call. Just a moment, I'll turn the call over to our Chief Financial Officer, Brad Ammon, who will walk you through the highlights of our Q1 2023 financial and operating results. Once Brad is finished, I'll come back on and speak with you about the highlights of what we accomplished at Vivos during the Q1 and in the past few weeks following the quarter end, including our acquisition of product rights and patents from Advanced Facial Dentics. This has expanded our product portfolio even further, allowing vivos trained providers to treat a much larger percentage of their patients, which ultimately increases the revenue potential for VIVOS. Speaker 200:04:40I'll also talk about our progress with the FDA as well as ongoing R and D efforts. In more recent news, I'll talk about some of the actions we took to improve our organizational infrastructure and highlight how we took steps to increase operational efficiencies, reduce expenses and position us to take advantage of the growth opportunities that are available to us. I'm pleased to say that due to these initiatives, we can reiterate that we remain on target to achieve our goal of positive cash flow for the Q1 of 2024, which is a full quarter earlier than the target we provided you on our last earnings call in March. Our goal is to achieve this key target without having to raise any further equity capital if possible. Following that, I'll talk about our plans going forward in 2023, how we intend to build upon what we've already done and What we have planned for the rest of the year as well as into 2024. Speaker 200:05:34After that, we'll take your questions. Now let me turn it over to Brad to review our financials. Brad, Please go ahead. Speaker 300:05:41Thank you, Kirk, and good afternoon, everyone. Today, I'll review the financial highlights of our Q1 2023 financial results. For information on our results for the 3 month period ended March 31, 2023, I'll refer you to our earnings release, which was distributed earlier today and our quarterly report on Form 10 Q, which is available on the SEC filings portion of the Investor Relations section of the VIVOS website atbivos.com/investorrelations. At the outset, I want to say thank you for your patience as we switched auditors for the Q1, which led to a delay in our 10 Q filing. I am pleased to report that our relationship with our new auditor, Moss Adams, is off to a very positive start, we are looking for a smooth and productive relationship with them. Speaker 300:06:36Today, we report Q1 2023 total revenue of $3,900,000 compared to $3,600,000 for the Q1 of 2022. The overall year over year increase was due to higher revenue from VIVOS integrated provider or VIP enrollments as well as increased sleep testing service Revenue and increase in conference and training related revenue. This was offset by lower revenue generated year over year from Our VIP enrollments were up in the 1st quarter with 38 BIPs enrolled versus 32 enrolled in the same period last year. For the Q1 of 2023, We recognized VIP revenue of approximately $1,300,000 an increase of $400,000 or 42% in enrollment revenue compared to $900,000 for the Q1 of 2022. It should be noted that Q1 of 2020 to VIP revenue was negatively affected by a $300,000 adjustment that rose from the prior year impact of our change in revenue recognition policy. Speaker 300:07:55We also saw an increase of approximately $200,000 in revenue recognized from our home sleep test ring lease program as well as an increase of approximately 100,000 in conference and training related revenue. The increase in total revenue was partially offset by lower product revenue. During the Q1 of 2023, we sold 2,369 oral appliance arches for a total of approximately $1,700,000 compared to $2,965 during the Q1 of 2022 for approximately $1,900,000 And for the Q1 of 2023, we recognized approximately $200,000 and our billing intelligence service revenue compared to $400,000 in the same period the prior year. We also had approximately 100,000 and center revenue compared to approximately $200,000 during the last year's Q1. Gross profit was $2,300,000 for the Q1 of 2023 compared to gross profit of $2,600,000 for the comparable period in 2022. Speaker 300:09:08Gross margin for the Q1 of 2023 was 61% compared to 70% during the last year's Q1, primarily driven by higher costs associated with VIP enrollment and training as well as costs related to our new programs, including the sale and leasing of sleep testing rings. We continue to refine our sales, marketing and promotional efforts with potential VIPs not only to increase enrollment in revenue, but to improve our gross profits and margins. This includes utilizing targeted social media and digital marketing efforts specifically designed to drive sales. As of the Q1, we are now starting to see the benefits of these efforts with increased VIP enrollments on a year over year basis. Sales and marketing expense was $600,000 for the Q1 of 2023, a decrease of approximately $200,000 compared to $800,000 for the Q1 of 2022. Speaker 300:10:13This year over year decrease was primarily due to decrease sales, commissions and a reduction in associated sales related expenses. Importantly, G and A expenses decreased approximately $1,700,000 or 21 percent to $6,500,000 for the Q1 of 2023 compared to $8,300,000 for the Q1 of 2022, reflecting the substantial impact our cost cutting efforts are beginning to make. We believe these important efforts We'll reduce our cash burn as we seek to ramp revenues and move toward cash flow positive operations. Operating loss was $5,000,000 for the Q1 of 2023 compared to $6,600,000 for the Q1 of 2022. This year over year decrease in operating loss was primarily from lower G and A expenses due to expense cuts and the factors I just discussed. Speaker 300:11:16Net loss was $1,700,000 for the Q1 of 2023 compared to $5,300,000 for the Q1 of 2022. The reduction in net loss was due in part to cost cutting, but also during the quarter we recognized approximately $6,500,000 as a one time non operating expense related to the difference between excess fair value from warrants issued in our January 2023 private placement and the net proceeds we received. The change in fair value of the warrant liability over the quarter was $9,600,000 net of issuance costs of $600,000 Accordingly, the net impact of the private placement warrants For the 3 months ended March 31, 2023 was approximately $3,200,000 of non cash other income. Please refer to our 10 Q for further details regarding this. Turning to our statement of cash flows. Speaker 300:12:19Cash burn from operations for the quarter ended March 31, 2023 was $3,500,000 a decrease of approximately $2,600,000 compared to approximately $6,100,000 during the comparable prior year period. This is further evidence of the positive impact of our expense reduction initiatives. For the quarter ended March 31, 2023, net cash used in investing activities consisted of Capital expenditures for software of $300,000 related to the development of software for internal use, which is expected to be placed into service in mid-twenty 23 as well as a purchase of patents and other intellectual property in February of 2023. This compares to net cash used in investing activities of $100,000 in the comparable 2022 period arising from capital expenditures for internally developed software. As I mentioned earlier, in January of 2023, We strengthened our balance sheet by closing a private placement with a single institutional investor for net proceeds of approximately $7,400,000 The private placement consisted of shares of common stock and prefunded warrants together with 5.5 year common stock purchase warrants with an exercise price of $1.20 a share. Speaker 300:13:47The effective purchase price per share of common stock or prefunded warrants in lieu thereof and associated warrant was $1.20 per share. As of March 31, 2023, We had $7,000,000 in cash. With the financing we completed in January as well as the strategic initiatives we have applied To reduce our expenses, we continue to anticipate having the necessary financial resources to meet our capital needs, fund our operations and continue executing on our near term growth strategy. In the short term, we expect these changes will result in relatively flat revenues sequentially for the first half of twenty twenty three. This also takes into consideration our new ASC 606 6 revenue recognition policy. Speaker 300:14:40Afterwards, we anticipate top line quarter over quarter revenue growth will resume starting in the Q3 of this year. Further, as Kirk mentioned earlier, we believe these initiatives will allow us to accelerate our target time for reaching positive cash flow by a full quarter now in the Q1 of 2024. With that, I'll turn the call back over to Kurt. Speaker 200:15:05Thank you, Brad. The Q1 that we are reporting on here today may seem like a distant memory, We believe it represents a significant watershed moment for the company and our future. First, in early January, we announced FDA 510 clearance for our flagship DNA oral appliance product. This represented the first time in history That the FDA recognized any mechanism of action in an oral appliance other than mandibular advancement for the treatment of mild to moderate obstructive sleep apnea. No oral appliance product has ever received such a clearance and the significance of this breakthrough should not be underestimated. Speaker 200:15:46We fully believe that after several years of going back and forth with the FDA, they were finally persuaded by our submission of yet another round of compelling real world data, this time showing a remarkable 80% of OSA patients seeing their symptoms completely resolve after treatment using the DNA appliance and the VIVOS method. Now to be clear, this data showed that clinical OSA, meaning AHI scores of 5 or higher was no longer present in 4 out of 5 patients after treatment and with no further intervention required. As far as we know, such clinical results are unprecedented in sleep medicine and unparalleled by any other product or therapy. We expect the full financial impact of that regulatory clearance on our sales to be realized over time as doctors alter their treatment plans to include more DNA appliances. 2nd, on the heels of our announcement regarding the FDA clearance For the D and A appliance, we raised an equity tranche with net proceeds of roughly $7,400,000 from a single institutional investor. Speaker 200:16:57We immediately put this capital to good use in expanding our intellectual property and product suite through the acquisition of certain patents, trademarks and trade secrets from Advanced Spatial Dentics. We closed on this transaction towards the end of the first quarter. That acquisition not only ensures that VIVOS will maintain its technological and market leading position at the forefront of treatments But it also fills a gap in our product suite and offerings to patients or to providers and patients. Nearly 40,000,000 people in the United States suffer from TMD pain and related issues. Another 40,000,000 suffer from migraine headaches or have difficulty breathing through their nose. Speaker 200:17:50Our new patented unilateral bite block technology has been shown to be highly effective in treating such conditions. Also during the Q1, we accelerated the process of rightsizing our corporate staffing levels and reorganizing our management team in order to reduce our cash burn and push the company closer to cash flow breakeven, which as Brad mentioned, we now expect achieved during the Q1 of 2024. As a subsequent event, early here in the second quarter, we announced a reduction in force and further reductions in overhead. Again, we think these prudent and necessary actions will serve us well as we look to improve our results of operations. On the operations side, we made important progress in our current pilot tests with certain DSO organizations, known as DSOs, including the execution of new and existing pilots with 8 regional and national DSOs presenting over 1,000 locations nationwide. Speaker 200:18:52I'd like to highlight one particular DSO, which operates in all 50 states under the name Toothpillo. Over the past 12 months, Toothpillo has been making exceptional strides forward in cultivating a direct to consumer channel exclusively geared towards use of our VIVOS Guides products for pediatric guided growth and development. An estimated 16,000,000 children between the ages of 312 suffer from various orofacial and developmental issues Associated with ADD, ADHD, behavioral problems, scholastic challenges, Chronic allergies, mouth breathing, crooked and crowded teeth, bedwetting and breathing related sleep issues, all of which may be helped through proper oral growth and development. Toothpillo is a pioneering telehealth commercial partner of Vivos, And we are their exclusive oral appliance supplier. Toothpillo is set to redefine the field of pediatric, dental and orthodontic treatment with a particular focus on breathing related issues. Speaker 200:19:55This transformational relationship leverages Vivos' world class pediatric oral appliances, underscoring the role of our cutting edge products in advancing the delivery of dental and orthodontic care. 2Pillabose has strong national network of 48 vivos trained dentists that serve as virtual treating partners and a rapidly growing referral base of over 358 in practice providers. The synergy between Vivos' Premium pediatric oral appliances and 2 pillows software and highly skilled practitioners is creating a holistic, accessible and high quality telehealth solution for at risk patients aged 3 to 12. Over the past year, Toothpillo has been perfecting its Proprietary virtual care platform featuring a mobile app designed to facilitate seamless connections between patients and doctors. Despite not yet having launched its national marketing campaign, tooth pillows services have already been sought out by patients in 40 states, All through referrals with 64% of all new inquiries converting into paying patients. Speaker 200:21:06VIVOS is excited about our relationship with toothpolo, and we believe it not only showcases the effectiveness and versatility of our oral appliances, but also opens up a large and exciting new avenue for growth. We are confident that Toothpillos' success will further amplify Vivos' reputation in the industry, bringing us one step closer to our vision of training healthcare professionals and providing them with the very best treatment tools and technology available. Equally as important, Tooth Pillow is just one of several DSOs we have been speaking with and starting to do business with, and therefore, it serves as an example of similar relationships we hope to enter into in 2023 and beyond. Also today, we are announcing the execution of our first nonexclusive distribution agreement for a 90 day pilot with a nationally recognized durable medical equipment company or DME that serves hundreds of thousands of CPAP patients nationwide Who are seeking alternatives. If this pilot is successful, a national rollout is planned to follow, and we can provide more details at that time. Speaker 200:22:15Other similar agreements with potential distributors are in process. We continue to believe that the financial impact on top line revenue from these efforts will begin to show up in the 3rd and 4th quarters of this year. An integral part of this pilot is the treatment navigator program that we introduced last fall. This program was designed to effectively act as an extension of the VIP practice to help the dental office guide the patient through the many different steps of the patient journey, including coordinating diagnostic appointments, insurance pre authorizations, further education and generally coaching the patients through treatment under Not only does the treatment navigator program remove significant workload from the practice, It helps mitigate the challenges associated with employee turnover within the practice. Dentists pay VIVOS up to $8.95 per case for Treatment Navigator Services, which we expect will soon become a significant revenue contributor and profit center for us. Speaker 200:23:18We believe our latest rounds of cost cutting coupled with an intense focus on creating new revenue streams will allow us to achieve our stated goal of achieving Positive cash flow by the Q1 of 2024. Our prior reliance on Vivos trained dentists To create demand from within their practices is now being augmented by vivos actively driving new patients into their offices through multiple Distribution channels, including primary care and specialty medical doctors, medical equipment suppliers, Large employers, men's health clinics and more. We deliver more qualified new airway patients to VIVO as we deliver More qualified new airway patients to VIVOSTRAIN providers, our value proposition to potential new providers becomes more compelling And attractive, it's a virtuous cycle that creates the potential to organically fuel our growth. We expect to begin to see the impact of these This past year has produced the single largest advancement towards proving the efficacy of our technology with multiple studies And peer reviewed papers being published in top quality journals, professional journals. We are pleased to announce Today, the recent execution of an agreement with Stanford University to begin a randomized control trial where our DNA appliances will be directly compared to CPAP. Speaker 200:24:50Additional university based clinical trials on VIVOS products are currently in process and are expected to start before year end. Currently, there are no less than 5 additional new papers showing significant clinical results that have been submitted in our pending publication. The cumulative effect of this research is to establish beyond any reasonable doubt that VIVOS possesses the single most advanced and effective treatment for breathing and sleep disorders on the market today. One final note on our product development front. For some time now, we have been actively engaged in the development of a patient driven mobile app that will assist clinicians in collecting key diagnostic data and in monitoring patient compliance and progress, while also empowering patients to take charge of their own health and wellness. Speaker 200:25:40For example, patients can participate in taking periodic records, providing feedback and actually receive coaching and interaction with their providers. The mobile platform also allows for remote delivery of certain clinical services such as myofunctional therapy, breathing exercises, Important notifications and more. Our surveys and provider feedback leads us to believe that there is strong potential demand for such a product and that it can be commercialized and highly profitable for both VIVOS and VIVOS providers, while also taking a load off of dentists and their teams. We plan to have a beta version of the app ready for testing by the end of this month and expect to have a commercial product available by the Q4 of this year. Now in closing, we have the evidence based technology and products that can now address the needs of patients across the full spectrum of Price points and needs. Speaker 200:26:38We have the FDA clearances. We have the nationwide network of trained providers. And now we have a growing brand awareness amongst both providers and patients. Through our new distribution networks, We will soon have access to more potential new patients than ever before. We believe the combined effects of our internal cost operating cost reductions and the strategic revenue initiatives outlined above will yield significant top line revenue growth and allow us to become self sustaining in the Q1 of 2024. Speaker 200:27:15This concludes our prepared remarks. Now we'll be happy to take questions. Operator? Operator00:27:22Thank you. And a confirmation And our first question comes from the line of Scott Henry with ROTH Capital Partners. Please proceed. Speaker 400:27:52Thank you and good afternoon. I guess cash flow positive In the Q1 of 'twenty four would be fantastic, so if you can achieve that goal. So I just wanted to drill a little bit into the assumptions. I know you expect flattish revenues in the first half of this year, but what sort of revenue run rate do you think Would allow you to achieve that goal? Speaker 300:28:24We believe that at $8,000,000 run rate per quarter, we can hit that goal, Scott? Speaker 400:28:31Okay. Thank you. That's helpful. And When I look at the expense items, obviously, sales and marketing was Way down. And I know there was layoffs recently. Speaker 400:28:51I want to hone in, first, is that sales and marketing level of $600,000 is that what we should think about going forward? And second of all, that G and A of $6,500,000 I imagine that's where the bulk of the cuts are going to come What should we think about as a G and A once all the cuts and everything has taken effect? Speaker 300:29:16Well, if you look at quarter over quarter, Scott, last year we were at $8,300,000 In Q1, we were at $6,500,000 in G and A expenses in the Q1 of 2023. The marketing expenses stayed roughly flat. We were down about $100,000 quarter over quarter. As those take place, we believe on the personnel costs, we're going to have $500,000 a quarter go against that G and A expense. So that's roughly what We will save in terms of salaries, wages, taxes and benefits. Speaker 400:29:58Okay. Thank you. That's helpful. Just a couple other small questions. Arches were down in the Quarter and if you calculate Arches per dock, they were down significantly. Speaker 400:30:18How should we think about that number? I mean, I know the business model is always changing and the accounting is changing as well. Just trying to get a sense of how we should think about that number as far as Arch's, how we should interpret the Q1 2023 results and how we should think about that number going forward? Speaker 200:30:40Well, first of all, I think there's a certain element of the macroeconomic economy, Other companies in the dental space have struggled with some of that and some of the results of that. So there's that, that plays into it. There is a little bit of seasonality in Q1 that plays into it. But There was also an event that took place that was a little bit unfortunate towards the middle to later part of Q1 where there was Some market confusion over a product that made similar claims to some of our products out there in the marketplace. This product did not have FDA clearances, did not have research, did not have a lot of things behind it. Speaker 200:31:30It was a totally different type of product, But there was some market confusion over that. And frankly, a lot of our providers until we were able to Wrap our minds around that and really address that directly. We just saw and And we've seen a little bit of a softening in the sales of our Arches from that standpoint. But That seems to have passed. Things have picked up again here, and we're optimistic That we weathered that storm a little bit there and that, that contributed in especially in the latter part of the first quarter And into the Q2. Speaker 200:32:13So we are seeing now where as we drive demand Through some of these distribution channels that we're talking about that have never been there before, we have new ways of helping doctors find patients to treat. And it appears to be significant Revenue opportunities for the doctors and their new patients, and so we're very optimistic. So it's going to be come a point where The old model where we just relied upon dentists to source their own cases through their own practices and To do that, we're taking the bull by the horns and we're driving patients to our very best providers. So we are actively pursuing Through our treatment navigator, our Airway Alliance and our distribution networks that we've talked about, we're actively Working to drive patients into their offices, and that's a very different kind of paradigm shift that we've Forced into the marketplace. So as you go forward, I think we hopefully will see those numbers pick back up as Some of these other distribution channels kick in. Speaker 400:33:30Okay, great. Thank you. Final question, Kirk. Brad set a pretty high bar for you of getting to $8,000,000 a quarter. How do you expect What are the levers you're going to pull to get to there from here? Speaker 400:33:48How much do you get from the AFD acquisition? And is it the DMEs? Just big picture terms, what are the levers you got to pull to get from here to there? Thank you. Speaker 200:34:03Thank you, Scott. I think that's a great question. And all I can say is that There is a huge challenge in the CPAP community and the CPAP world with patient compliance and with patients abandoning their treatment. And when patients abandon CPAP, which 90% of patients who get 90% of patients who are diagnosed with OSA get CPAP machines. In the 1st 90 days, a fourth of them will stop using their CPAP and eventually about half Are known to stop using their CPAP machines. Speaker 200:34:45So there is a huge, huge number of people. It's in the millions People out there in the United States, Canada and around the world who have tried CPAP and are intolerant to it. They don't use it. They won't use it. They can't use it for a variety of reasons. Speaker 200:35:03Some of them psychological, some of them physiological, some of them just Preferiential, they just hate having it. But what do those people do? Well, we've now unlocked The secret, if you will, to how to access those patients and what to do, we've established some really clear And very, I think, reasonable and market based distribution agreements with people that know where those patients reside and who they are. And we're going to be going after them. And there's So much of that out there. Speaker 200:35:44It's really hard for us to say at this point how many of those patients will come in and convert into VIVOS therapy, but we And our distributors are very optimistic that, that number will far exceed what we've been doing in the past, and we're very optimistic about So it's not inconceivable at all for us to hit those numbers or exceed those numbers as we go forward. Now Whether that happens in the Q4 of this year or the Q1 of next year or the time frames that we've given It's hard to say, but we're as we look at it and we're in the trenches every day with these distributors, We're very optimistic about it, and we'll see what happens. I mean, as we've talked before, it's time for this company to put up. And so we're moving every resource we have to make this happen And to demonstrate that we can grow this company. So that's why we're optimistic. Speaker 200:36:46So Yes, this is a it's a high bar, but we're very optimistic about it right now and that's our that's where we stand today. Speaker 400:36:57Okay, great. Thank you for taking the questions. Speaker 200:37:00You bet. Operator00:37:04Our next question comes from the line of Lucas Ward with Ascendiant Capital Markets. Please proceed. Speaker 500:37:12Thank you. Hi, guys, and congratulations on meeting your business goals on getting closer to your goals. I'm also interested in the revenue aspect. I was wondering if you could quantify the impact of sales through the DME and the DSO channel like near term or In a few quarters, just so we can understand like how big that really is. Speaker 200:37:45Yes. So thank you for that. I think on the last call, we've been talking about DSOs now for a year and a half. And what we've learned and we said in the very beginning that the opportunity with DSOs was huge. There's 40,000 dental offices across the United States that have corporate ownership in these organizations called DSOs. Speaker 200:38:08So the opportunity is huge. But these guys are also very cautious and it's a slow boil for that and that's been exactly what's happened. The opportunity as we now get into where some of our pilot tests are maturing and feedback is percolating up to the C suite in these DSOs, We expect to start to see more expansion of that, but it is still going to be a very cautious rollout and a slow boil. I expect that To be the case for another probably 12 months. At some point, we'll reach a tipping point with these guys, where they will all collectively realize The opportunity that's before them in managing sleep, which is multibillion dollar opportunity for these DSOs. Speaker 200:38:54The fact that we now have a product suite with simpler, easier, better price points for DSO type customers, patients, I think makes it infinitely easier for us to crack that market. On the DSO front then, I would say Expect it to be still continue to grow. We're still signing on new relationships. There are innovative new models such I mentioned tooth pillow. I highlighted that because they're kind of an innovative direct to market type DSO or direct to consumer type DSO. Speaker 200:39:28And I would say that they will continue to contribute. And frankly, if you talk to the guys at Toothpillo, their goals for what the number of children they expect to be able to address in the 1st year It's just off the charts, but they have established a baseline with influencers, social media influencers lined up, Famous individuals with children that have been through treatment now and have had tremendous results. We've published a Few papers, we're publishing some more on the efficacy of what we're doing with children. So We have a pending FDA clearance on that, that we're hoping to get here real soon. So we have a number of things that's going to drive that market. Speaker 200:40:20That's the first thing. On the DME front, again, The magnitude of that opportunity is staggering. And it's hard to say just exactly how to quantify that. I can By the time that we convene our next earnings call, I think we'll have a much clearer picture of what that's going to entail. But When you think about the condition that these millions and millions of patients are in, who've been diagnosed with sleep apnea, who know they suffer from it, but who are Unable for a variety of reasons to use our CPAP machines, they really don't have any other options. Speaker 200:40:58Short of some type of radical surgery or an implant like Inspire or something else, it's very difficult for them to know what to do or how to treat their condition. And VIVOS represents a huge alternative first line of defense type opportunity. And I think we're creating relationships with payers We're creating relationships with employers and we're creating relationships with these DME companies that are all going to be in a position to refer Patients in the VIVOS providers across the country, the fact that we have a network nationwide, the fact that we now have Lower price point products and services, the fact that we have a differentiated technology is all very, very appealing to these groups. And I just think we're kind of at that inflection point where it's hard for us to predict, But we're cautiously optimistic about what we're seeing and the feedback we're getting. And as Scott rightly We pointed out the bar has been set pretty high and we're shooting for it. Speaker 200:42:04So but I would say that by this time By the time we report on Q2 and we start talking about what's going on with these new relationships, We'll start to be able to grasp what this is going to mean. But I think it's a definite inflection point for us And we expect revenue and volume to increase dramatically here as we go into the second half of the year. Speaker 500:42:34Okay. Thanks, Kirk. One more question. You guys have mentioned that the AFD acquisition fills out an important Product gap for you guys in terms of having more economical solutions for providers, Could you give us an update on the sales traction of the AFD devices? Speaker 200:42:56Yes. That's going to be an easy Those are not yet reflected in any of our financials or returns. We these products are A little bit technical. They're a very different kind of technology than what we have in our Historically. So what we've had to do is create a whole new training program. Speaker 200:43:21And what we do know is that because These products have been used by the Advanced Facial Dentics doctors. They've been used for years years. And There's really several 1,000 patients that have benefited from the use of these products. So we have a very good grasp on what the products do, How efficacious they are and now it's time for us to train our doctors, retrain them on certain how to use products like the pod and the sleep pod and other devices. But these products, They're simpler. Speaker 200:44:02They require less chair time than our traditional products do. They don't do all the things that our traditional products do, which is an important distinction. But from a doctor standpoint, They can fill and meet a need. They can fill a gap and meet a need at a very, very cost effective way with minimal chair time and very high levels of patient satisfaction. So as we mentioned, before, The product offering was a little bit binary in that a patient either agreed to an $8,000 to $10,000 treatment plan Well, we really didn't have anything to offer. Speaker 200:44:45It was really the doctors, if they were going to take the case on, they were going to get paid well for it or they weren't going to do it. Now The doctor can say, well, Mrs. Jones, if you're not quite ready for this treatment, we've got several other options for you here That might be more appealing. And while they don't do the same thing that the more expensive treatment does, We can still give you some relief and maybe relief from your migraine headaches, your TMD pain, your Congested nasal passages, there's a number of different ways in which the patients can be benefited At a much lower price point. So instead of that patient walking out the door, feeling like they couldn't afford the treatment, now they walk out the door with having Spent $1500 to $3,500 and it's affordable and it's again, it might not do everything, but It's going to get the patient a long way to being better. Speaker 200:45:49So we feel very good about that. Our provider network is very excited about this. There's a buzz out there around the pod and what its potential is. We have started some research at some universities With the pod, we're in the process of starting that right now, as I mentioned. And so we've got some very exciting things to come on that. Speaker 200:46:12But I think it's the ability to offer a very cost effective treatment Protocol or treatment modality that will actually make the difference for our doctors. It gives them something else to do with patients who may not yet be ready to afford or pay for. Even with insurance benefits, there's still an out of pocket portion there, And it just gives them an alternative. So I think that we're going to see some and that's rolling out even as we speak. That's being rolled out right now. Speaker 200:46:46We finished our training Preparations with videos and online training, all of the Resource materials that needed to be done and created for that, and now it's being rolled out to our provider network. So again, Q3, Q4, you're going to start to see the impact of the new product lines more fully realized in Q3 and Q4. Operator00:47:19Thank you. Okay. Ladies and gentlemen, there are no further questions at this time. I'd like to turn the call back over to management for closing remarks. Speaker 200:47:29Well, thank you, everyone, for being here today. We as you can probably tell, we feel like this is an exciting time in our history. We Truly believe that someday we'll look back and see this particular time as A watershed moment in the history of this company, and we're excited about what the future holds in store. We appreciate all of your support and the patience you've had as we've gotten to this point. We look forward to sharing our continued progress with you in the future. Speaker 200:48:04So thank you very much, and have a great evening.Read morePowered by