Broken System or Broken Staff?
“Define your business goals clearly so that others can see them as you do” - George F. Burns. Time and time again I hear the same lament, “We had to let her/him go, it just wasn’t working for us.” For Doctors Do and Dun it was clear that their Business Coordinator was failing at everything after having her at the desk for a year. Everyone complained about the schedule being chaotic but not profitable, and bottlenecks at the desk with people checking in and out were causing complaints from patients who had to wait for their turn to check out. On top of everything, Dr. Dun noticed a cash flow problem that she hadn’t noticed in the past and treatment diagnosed wasn’t getting scheduled.
“Our only solution was to let her go and hire someone else.” It seemed obvious that the Business Coordinator was not doing her job, even though she said she was experienced at the front desk when hired.
The doctors questioned who to hire so that the mistakes wouldn’t continue to happen. As they pondered the profile of the right person they were asked if the position had a job description that described the job duties and areas of accountability, such as scheduling for production goals and keeping accounts receivables under 10% at 90 days aging. They answered “no” because they felt that might insult the applicant. After all, “an experienced front office employee should know what their duties are.” The assumption here is that the person who was let go did not know what she was doing.
Upon an analysis of the practice systems (or lack of systems) the following was noted:
1. No hiring system with job descriptions or written hiring protocols that required Employee Assessment Testing or temperament testing was in place.
2. No production/collection goals in place. “Keep the schedule full” was the directive.
3. No scheduling instructions or templates to guide the correct placement of the patient in the schedule based on a scheduling goal were in place.
4. No regular or systematic performance reviews to help identify areas of improvement in place.
5. The doctors did not understand the relationship between the scheduling system and collections and treatment acceptance, leaving the Business Coordinator scrambling for moments to present treatment and also collect for daily charges.
6. The scheduling system was broken in that it was creating the bottleneck, not the Business Coordinator, and needed to be analyzed for patient flow in the check-in and check-out process.
7. The aging accounts receivable system was in delinquent status with 44% of the monies owed in 90 days past due. Contributing to this problem was outstanding insurance claims over 30 days that had not been followed up to clear for payment.
8. The recall system was not being worked with outbound calls to patients who were overdue for appointments. The Business Coordinator did not have the time management skills to prioritize her day nor did she have the authority to delegate tasks to other team members. There was no recall system in place with a guide to making these calls.
9. The treatment acceptance system was broken, as the entire process was the responsibility of the Business Coordinator - who clearly did not have the time to spend with patients because she was the only one checking patients in and out and fielding phone calls.
10. There was a lack of team approach to the systems in the practice because the doctors did not have a knowledgeable understanding of the critical responsibilities of the Business Coordinator position.
The doctors would need to understand that the new hire will have to do “clean-up” of the accounts receivables and the aging insurance report, plus keep the practice moving forward. This is a prescription for failure if the lack of systems that created the problem is not addressed.
Professional Dentist CEO or Office Manager Training is the prescription for success to create systems of scheduling, collecting, insurance billing and follow-up, recall, treatment acceptance and days free of stress associated with broken systems. Fix the systems so your practice can reach its true potential.Forward this article to a friend
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