Keep Collections and Patients Healthy

Sally Mckenzie, CMC
President
McKenzie Management
sallymck@
mckenziemgmt.com

      Effective collections begins with the basic understanding that your patients expect to pay today. Make it easy for them to do so and not only will they pay they also will be more open to pursuing both necessary and elective treatment.

Provide the financial policy to all new patients in the patient packet. And periodically remind existing patients in writing. This can be handled through regular efforts to educate patients on new services offered by the practice. Consider this, if you are introducing or expanding whitening or

other cosmetic dentistry services, use the opportunity to educate patients on your specific financial options. They learn about both the expanded services your practice provides as well as the convenient payment options available. In addition, before any major treatment plan begins, sit down with the patient and review the financial policy with them to ensure that they understand the various options and their payment responsibilities.

When dismissing the patient, make it a point to educate them about the extent of the treatment received. Provide details. For example, “Mr. Collins, today doctor performed fillings on three teeth that involved seven surfaces including medication in each tooth and anesthetic.” When the patient is given the opportunity to understand the extent of the dental care provided they develop a greater appreciation for the value of that care.

Remember, you don’t get what you don’t ask for. Often patients don’t pay because they have been trained to expect a bill from the practice. In asking for payment, do not imply that paying is an option; rather it is the form of payment that is the option. “The charge for today’s restorative treatment is $368. Will you be paying with cash, check, or charge? As a special service to our patients, we are happy to submit your insurance claim and the payment will come directly to you.” Insured patients should be expected to pay all of their payment responsibility when services are rendered unless their portion is over $200.

It is not unreasonable to expect full payment for charges of $200 or less, as long as you communicate that expectation to your patients politely and in advance. However, for more costly procedures, be prepared to provide convenient payment options that are beneficial to both the patient and the practice, for example: Consider offering a slight adjustment in the fees, such as 5%, for more costly procedures paid in full. Refer to this as a bookkeeping adjustment not a discount.

“But you’ve always billed me …” There will be a small percentage of patients that will object to the new policy. They can be handled with a gentle, direct explanation. “Mrs. Jones because the practice is a small business we cannot extend credit to patients. However, in an effort to ensure that patients continue to have convenient payment options, the practice has partnered with CareCredit (or other patient financing company). This company can provide zero interest loans for up to 12 months for qualifying patients. I am happy to make the arrangements for you.”

Be consistent. Avoid the temptation to allow Mrs. Jones to just slide by. Before you know it, Mrs. Smith is slipping through the policy, then Mary Jane, and you have once again undermined your ability to maintain an effective financial policy.

If you have any questions or comments, please email Sally McKenzie at sallymck@mckenziemgmt.com.

Interested in having Sally speak to your dental society or study club?
Click here

Coaching vs. Counseling

Dr. Nancy Haller
Executive Coach
McKenzie Management
coach@
mckenziemgmt.com

Dear Dr. Haller,

I’ve been hearing a lot about ‘coaching’ and don’t understand why it’s so popular. Isn’t it just another word for counseling?

Sincerely,
Dr. Chicago, Illinois

Dear Doctor,

Great question! You are right about the popularity of coaching. Referred to as executive coaching in business circles, coaching is the fastest growing consulting practice in the United States. From the viewpoint of corporate leaders and shareholders, the real reason that organizations use coaching is to improve business results. Whether it is increasing customer loyalty, retaining high-impact employees, or managing the change that is inherent in business today, coaching enables leaders to impact bottom-line benefits - growth in revenues and profits.

Executive coaching, like psychotherapy, is aimed at helping people to develop. Coaching and counseling appear alike in that you meet and talk regularly. However, the difference is that people who turn to coaches are highly functional, often star performers, despite the fact that they still have room to improve. Therapy on the other hand often occurs in the arena of dysfunction. Based on the medical model, it presumes that the “patient” has something wrong with him/her and the therapist’s job is to “fix” them.

With this common misunderstanding about coaching, it is natural that managers and executives are sometimes reluctant to engage an executive coach. They equate coaching with psychological counseling. Rightly so, they don’t want someone probing into their childhood issues, resurrecting painful emotions about the past, diagnosing what’s wrong with them.

Thomas Leonard, founder of Coach University, a virtual university for personal and business coaches, makes the following distinctions between coaching and therapy:

Coaching is about:   Achievement   Action   Transformation   Momentum   Intuition   Joy   Performance   Synchronicity   Attraction   Creating

Therapy is about:   Healing   Understanding   Change   Safety   Feelings   Happiness   Progress   Timing   Protecting   Resolving

My experience has been that most achievement-minded people believe that “hard work and doing it on your own” are the keys to success. If you are reading this article, you already are successful. Getting through an arduous academic training program took a lot of resiliency, and you had to do it on your own. However, the very things you learned about being a good dentist may not be the things you need to know about running a business or leading employees. Now you are both a dentist and CEO! Business leaders, entrepreneurs, and self-employed professionals often find themselves stretched outside of their experience range, frequently with no one to talk to about important issues. A coach, as an outsider with no political investment in your practice, is free to address challenging issues in a constructive manner. To quote many of my clients, “it’s lonely at the top” and “I’m not sure who I can trust”.

Coaching entails working with people who already have a measure of success in their lives but who want to improve aspects of their skill level, productivity, or to realign with their dreams and personal values. The foundation of a good coaching relationship begins right there – identifying where you are now and where you want to go, with specific goals and action steps to close the gap. Coaching is not something done to you, but with you. The coaching process is a partnership between you and the coach.

When we see an athlete perform gracefully or an actor embrace a character, we're seeing the value of coaching. If a single performance or sports goal is worth using a coach to achieve, then how much more important are our lives, goals, and dreams? Working with a coach keeps you focused on what's important to you. That added focus almost always results in reaching more of your goals and finding greater joy in your life.

While it's certainly true that you don't have to have a coach, consider for a moment what you might do if you did have a coach, someone who

• Checks with you weekly about your goals and progress
• Listens for your possibilities
• Helps you identify actions to overcome blocks and barriers
• Encourages you to take steady steps forward
• Holds the vision of what you, your practice, and your life can be
• Celebrates your successes along the way

Could you use someone like that in your life? If you were to begin a coaching partnership now, what two areas would you address with your coach to begin working on together?

To summarize, therapy moves people from dysfunctional to functional. Coaching moves you from functional to exceptional. Effective leaders continuously engage in self-development. Learning requires support. Please let me know if I can be a support to you.

Nancy Haller, Ph.D.

Interested in having Dr. Haller speak to your dental society or study club?
Email her at coach@mckenziemgmt.com

The Frustrated Dentist

Belle M. DuCharme, RDA, CDPMA
Director/ The Center for
Dental Career Development
877-900-5775
belle@
dentalcareerdevelop.com

         A woman dentist came to The Center for Dental Career Development for the Advanced Business Training Course from an established practice in Northern California. She had been in practice for about ten years and the practice had been growing at what she felt was a steady pace until the last couple of months. Seeing holes in the schedule and not having “full” days for several weeks in a row had sent her into a panic mode. “I don’t know what we are doing different to cause this slow down to happen. My office manager says it’s just a temporary problem but I don’t know why this happened. I need to

understand the business of my practice and that is why I am here.”

After questioning Dr. Frustrated for several minutes I discovered that many things had changed in the practice to cause a shift in scheduled production. She had been a PPO provider for Guardian, MetLife and Delta DPO. In the last year she had dropped all three programs. Most of these patients had pre-booked hygiene. Upon finding out that she no longer was on the PPO network, they cancelled or just didn’t show up for scheduled hygiene appointments or treatment appointments. This caused chaos for the scheduling coordinator to move people into the “holes”. Being on the PPO network had provided her with “free” external marketing. She did not replace this marketing source. She had not been doing any internal marketing to build a better patient base because she had been so busy with the PPO network patients. She felt that her patients would stay with her regardless of the insurance situation. If she had implemented internal marketing and established a “value based” practice this would be true. Dr. Frustrated did not know what her patient retention rate was or how many active patients she actually had in the files. She didn’t know what percentage of her practice were on the PPO network before she dropped the plans. Upon speaking to the scheduling coordinator I discovered that hygiene was pre-booked solid for eight weeks with no blocked times for new patients or perio therapy. The scheduling coordinator mentioned that new patients had registered complaints about having to wait so long for appointments. She had not told this to Dr. Frustrated. The hygienists were not amused when told a patient needing root planings had to wait for more than two months for an appointment. Dr. Frustrated had cancelled staff meetings because she felt the time was “unproductive” and they were just too busy to “waste time”. There were no morning huddles for the same reason. Dr. Frustrated had cut herself off from her staff and their important feedback.

My immediate concern for this practice was to get a patient retention figure and an accurate number of active patients. I wanted to see a patient referral report so that we could study the sources of new patients. To my dismay, this information had not been entered into the computer on a consistent basis. It was “skipped over” by the scheduling coordinator because she was busy. It is now mandatory and she is accountable for producing this report monthly. We started a direct mail campaign in the local new housing areas. Dr. Frustrated starting calling her patients at night after difficult procedures. Thank-you notes went out to all patients and doctors who had referred patients. Starbucks™ cards or Blockbuster™ cards went out as rewards to multiple referral sources. Lunches were arranged with local specialists and other networking sources. A new greeting system for patients was started with the scheduling coordinator standing and greeting the patient by name. A wait time was announced to the patient and the patient was asked if they would like coffee or water. Several new internal marketing ideas were put into practice to replace the “clinic” feel that had been there before.

A chart audit brought several patients back to the practice for treatment. Personal calls and inviting letters were sent to desirable patients that were not scheduled. Many had said they thought that Dr. Frustrated was too busy and they were in the process of finding another dentist. They were thankful that they had not been forgotten.

Today, the practice is thriving and is free of PPO network nightmares. Insurance claims are filed for patients but they pay for deductibles and percentages at the time of treatment. Patients tell the staff how happy they are to be patients in a practice that cares.

Dr. Frustrated is no longer. Her new name is Dr. Aware. She now understands the business of dentistry.

At The Center For Dental Career Development in La Jolla, we teach you the systems that run your practice and how to measure the performance of each system. We replace “feelings” with the facts. For more information, give us a call today.

Keep smiling.

Belle M. DuCharme, RDA, CDPMA

Dear Sally,

I try to have a morning huddle about 5 minutes before the start of the day. But they seem to be unproductive. Do you have any tips on what should be covered and how to make them more productive?

Dr. Nebraska

Dear Doctor,

Items to be discussed at your beginning of the day meetings should include:

• Dr. Production for the day vs. goal
• Yesterday's production vs. goal
• Hygiene Production for the day vs. goal
• Yesterday's production vs. goal
• Today's New Patients
• Best Time To Schedule Emergency Patients
• Patient's with Financial Concerns
• Past due family members of Today's patients as seen from the computer routing form
• Have copy of and discuss next two day's appointment schedules
• Hygiene to identify who needs bite wings and FMX

To be more productive have a definitive agenda every day with the items above.

Hope this helps.
Sally

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