up the Collection Misfits
It is the best of times and
the worst of times. More patients are seeking dental services. They
are better educated about dental opportunities available. Reality
TV is showcasing dental miracles regularly, and more patients are
looking for their own “extreme makeover.” But while
interest in dentistry is soaring, payments may be sinking,
as a number of dental practices feel the pinch of a consumer culture
in debt up to its dentition.
delinquent accounts. As every dentist
they are the collection misfits that somehow continue
to dodge and dive below the radar, sucking profit from the practice
like a summer swarm of mosquitoes feasting on fresh flesh.
In some cases they are the emergency patients that never returned.
In others they are the practice hoppers that make the rounds bashing
the last dentist and complaining about the current
dentist. In still others they are nice patients who never seem to
have their acts together. You know the ones; they forget appointments,
don’t return calls, but eventually get around to paying their
bills, apologizing all over themselves the entire time.
few others really don’t care if they pay you or not, they’re
more worried about the bank repossessing their car or house or the
hit from the utility company that charges interest for late payments.
Some delinquent accounts will belong to long-term, loyal patients
that have found themselves in the throws of a catastrophic
situation. Regardless of the circumstances or personal
decisions that lead to a delinquent account it is money owed to
first line of defense against delinquent accounts is a clear financial
policy. The policy is in writing and has been given to every patient.
It establishes clear payment parameters. It does
not put the practice at risk by extending interest-free loans to
patients. It provides specific options for patients. And it is not
routinely circumvented by Dr. Lets Make a Deal who decides to privately
negotiate payment plans with patients. But the policy can only shield
the practice so much.
actuality, even the most effective collections systems are not immune
to the occasional payment scofflaw. And virtually every practice,
except those demanding cash up front, has to chase down these financial
misfits, some of which can be more slippery than others.
the lucky member of the dental team who finds themselves saddled
with that nasty responsibility that accompanies delinquent accounts
…follow-up. It’s the stuff legends
are made of, the most unsavory business task in the dental practice.
Few are up to the challenge, and fewer still are properly trained
to handle the job well. But with the right personality and clear
objectives, delinquent account calls don’t have to feel like
a life sentence to the Valley of the Shadow of Death.
week, from delinquency to dollars in hand.
you have any questions or comments, please email Sally McKenzie
in having Sally speak to your dental society or study club?
Time To ‘Sharpen The Saw’
Dr. Nancy Haller
you have more tasks in your day than time to complete them?
you feel backed up with more and more to do?
you often feel you don’t have any time for yourself, or your
family and friends?
you stretched to ‘the limit’?
If you answered ‘yes’, your work-life balance
has gotten out of control.
the best seller, The Seven Habits of Highly Effective People,
there is a story about a Woodsman feverishly trying to cut down
a tree. When asked why he didn’t stop to sharpen the saw to
ease his workload, he replied, “I don’t have
time…I’m too busy sawing”.
you’re honest with yourself, the irony of that tale is self-recognition.
At one point or another, we all have worked frantically
rather than purposefully. In part it’s because the
pace of life has accelerated.
there have always been conflicts between work and personal life,
but technological changes and the way we do business
today are different than even just 20 years ago! There are more
working women who juggle child-care and job demands. Business competition,
longer work hours, more time in the car, more traffic, the deterioration
of boundaries between work and home all add up to increased pressure.
balance does not mean that you have an equal balance between
the number of hours you spend at work and those you devote to home
or personal activities. Life is much more complex and fluid. Priorities
shift throughout our life, and responsibilities change from day
to day. But your work and personal life need not be in competition
either. The foundation of effective work-life balance requires
equilibrium between what you do (achievement) and what you value
(enjoyment). Without both, life is unrewarding.
out of the trap of “as soon as”, and stop postponing
the things that are important to you until that magical
“some day”. When you ‘sharpen your saw’
you will be a person that not only gets things done, but
also enjoys the doing. In turn, this attracts people to
you. They want you on their team and they want to be on your team.
your work-life balance needs re-balancing, take some time to identify
and explore your values…the things that bring you
the most joy and passion. Base your life on the values that are
consistent with how you want to live your life.
is a sample list of values. Read through them and add more. Then
circle the top 20. Put the list aside for a day then go back and
narrow the list to 10. Make notations as to why a particular value
is so important to you. What purpose does it hold in your life?
personal and professional self-care a priority.
assess your emotional, psychological, and spiritual health on
a regular basis.
appropriate accommodations or adjustments -- such as limiting
your caseload or consulting with peers and experts -- in light
of professional stressors and risks that you are experiencing.
sources of support and use them. Avoid isolation.
regular vacations or other appropriate breaks from work. The dentist
is the fundamental “tool” of dentistry,
and you need to keep yourself sharp.
realistic and reasonable expectations about workload and your
capabilities at any given time.
opportunities for intellectual stimulation inside
and outside of dentistry.
carefully the substances and/or processes you use for relaxation
consultation when professionally or personally challenged.
I listened to the flight attendant review the safety guidelines
on a recent business trip, there was yet another metaphor –
‘if oxygen should be required, put your mask on
first then assist others”.
It’s time to ‘sharpen the saw’.
you have any questions or comments, please email Dr. Haller at firstname.lastname@example.org.
DOES YOUR OVERHEAD
My Continuing Care System
Debbie Rae, RDH, MBA
currently pre book appointments 6 months out for their next prophy
etc and we are on the Dentrix
system. When someone does not pre-appoint, or somehow falls off
the Continuing Care “bandwagon”, how do we avoid them
disappearing for long periods assuming they are actually interested
in continuing care?
Dentrix is certainly capable of printing a list of upcoming patients
due, or past due for
whatever period chosen. Although it’s convenient to print
the list of "target patients" who fill gaps in hygiene,
at some point the list becomes out of date. At that point is a new
list run, but all the critical info about phone calls made and cards
sent that was scribbled in the margins of the old list is gone?
Certainly it is possible to log calls in the computerized patient
journal. But then info can only be pulled for one patient at a time.
You therefore can't survey a giant pool of patients and begin your
calls with those who you know are most likely to schedule. Cards
on the other hand make for a nice way to track all that information,
but then we have to track the cards. Then there are calls. How many
is too many? Do we block the caller ID when we call? Home first,
then work? Leave messages or not? The hygiene questions seem ongoing
with no consultants ever having predictable answers. Can you help?
Dear Official Townie,
Management we teach our clients who have Dentrix
NEVER to print out a copy of their Continuing Care
List when they are working the recall system. I agree with you that
this list becomes obsolete the moment a patient
schedules an appt. All the notes regarding conversations or attempts
to reach the patient should be entered in Dentrix using the CC Status
and Office Journal.
Every time a contact is attempted, even if there is no answer (caller
ID nowadays) the Recall Coordinator is to change the status and
make an Office Journal entry. This is easily done
by highlighting the patient’s name in the CC list using the
Status and Office Journal in that window’s toolbar. Furthermore,
the CC window can be minimized and maximized to use the Appointment
Book or other Dentrix modules.
also recommend changing the original CC Status too. For example:
No Ph -send card
specifically teach team members to use the REMINDER type of Office
Journal note for ALL recall notes because it is a RED exclamation
mark and stands out in a patient’s Office Journal. BTW
this REMINDER note is where we teach our hygienists to enter the
“clinical reason” that both the doctor and the hygienist
discussed with the patient in the operatory as to why they want
the patient to return in 3-4-6-9 or 12 months for their next professional
cleaning. It’s not just that 186 days has passed
and their insurance will pay for it again, right???
This same clinical reason is handwritten on our McKenzie
Recall Notices that are mailed in an engraved envelope customized
to match the office stationary, self addressed by the patient, that
contains an ADA mini brochure that addresses a
concern or topic discussed with the patient during that hygiene
visit. ALL done in the clinical operatory.
this type of recall notice rather than cutesy postcards with a cartoon
character or a peaceful sunset, elevates the hygiene visit
to its level of importance and patients will keep pre-appointed
hygiene appointments or call to schedule one if not pre-appointed.
During our weeklong on-site visit to our clients’ offices,
we customize at least 6 or 7 CC setups so that all the Recall Coordinator
has to do is change the Due Date Range each month. These setups
list patients only WITHOUT appointments, specific
CC types, billing types that do not include patients in Collections
and in an order where all family members are listed together alphabetically
despite having different CC dates and/or CC Status.
Each week of every month a new CC list is generated, although NOT
printed, and a new set of patients is contacted. This process will
catch those individuals who do not respond to your
recall notices or attempts to reach them.
First week - Due this month
Second week - Due last month
Third week - Due 2 months ago
Fourth week - Mail retention and inactive letters
30 days in between contact attempts. The Office Journal note enters
the date automatically. Letters sent from Dentrix are automatically
entered in the patients’ Office Journal and dated. Clients
have found that patients respond quicker to a human voice rather
than a letter so we suggest calling at diversified times
throughout different days. Once you have exhausted trying to reach
the patient early morning, noon, afternoon and evening with no answer,
a letter is indicated. Two letters only, then either inactivate
or CLEAR their CC date out of their Family File. This will remove
them from your overdue CC lists. Patients can always be made active
again and should be told they would be welcome to return at any
future date. Remember,
an inactive letter is sent only after ... sending patients a reminder
notice, calling at diversified times, sending a retention
letter and then an inactive letter. Six or seven months
have passed since you began your initial efforts to bring them back
into the practice.
this information was helpful.
Debbie Rae, RDH, MBA
You Increased Your Hygiene Days Per Week In The Past Year?
To Have A Sucessful Recall System
By Sally McKenzie
patient retention is not guaranteed by preappointing, sending
postcards, letters, or even phone calls. But an effective use
of an integrated retention system can significantly improve your
ability to keep patients returning. This step-by-step guide to
the systems used by today's most progressive practices includes:
letters that get responses, telephone monitoring techniques to
ensure patient retention, tools to monitor your success, and scheduling
tips for a productive hygiene department.
Missed Past Issues of Our e-Motivator Newsletter?
are your thoughts on digital radiography?
X-rays remain a fundamental diagnostic tool of every dentist in
America. How you choose to take those images can greatly impact
your practice. I recently read in the June 2004, Dental Products
Report that more dentists were choosing to implement digital
radiography into their practices this year than any other technologies
available to them. I know that’s true of our clients. I think
digital X-ray is dentistry’s fastest growing technology. From
a dollar and “sense” point of view, we find that most
practices are already spending more money than it takes to own Digital
X-ray. How much are you spending on film, mounts, chemicals, duplicating
supplies, and labor? Let’s do the math! Based on the 1999
ADA figure of 45 cents per film for film, chemicals, and mounts,
if you took 2 FMX, 6 BWX, 5 PAs a day, your monthly costs are $526.50.
Most of the digital systems available today can be leased for as
little as $325 a month. So as you can see, you’re already
spending the money. Digital X-ray is ‘Replacement Technology’.
In addition there are benefits for your patients such as lower radiation
exposure, shorter appointments, improved education and understanding
through image visualization and you can spend more time chairside,
discussing treatment plans, and building stronger relationships.
Let me say, that if I owned a dental practice…I would have
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