Your Control Center out of a Tailspin
We do love our technology -
our computers, our cell phones, our PDA’s, digital cameras,
our MP-3’s - but when we place a call to a business we want
a living, breathing person to pick up the other
end. We don’t want the faceless drone of voicemail or, worse
yet, a menu of possible buttons to push. We want a friendly helpful
individual who is professional and happy to provide necessary
assistance so that the problem can be solved, the question
can be answered, or the issued can be addressed. We don’t
want to press one and then three and then
before we ever actually talk to a human being.
few dental practices fling patients into a recorded system unless
the practice is closed or the office is short staffed and no one
can pick up the phone promptly. The bigger concern for dental practices
is not the faceless drone, it’s the real live person answering
the phone. If you were to ask a few friends or family members to
call your office today and report back to you how well their calls
were handled would you feel confident or concerned? How
well would your number one link to your patients measure up?
In reality, most of you considering those questions probably have
no idea. After all it’s just the phone, right.? Wrong. That
would be like an airline pilot saying, “it’s just air
traffic control.” The phone is the control center
of the practice, but if you’re not paying attention to how
traffic is handled, you have no idea how many of those calls have
crashed and burned.
In the business of dentistry, the voice on the phone is the voice
of the practice. If that voice comes across as unprepared, rude,
or unprofessional, that is exactly how the practice is perceived.
The positive enthusiastic welcome and helpful demeanor from a smiling
face ring loud and clear to the caller, so too does the tension-filled
tone and unspoken words that seep through gritted teeth, “who
are you and why are you bothering me now.”
Patients can be alienated in 20 seconds or less
depending how that “typical” phone transaction is handled.
Virtually without exception, poor phone communication is the result
of three things: lack of training, lack of planning, lack of
standard operating procedures. Follow three simple rules to
ensure that when patients ring your practice it won’t trigger
the alarm bells.
When you answer the phone be genuinely warm and pleasant. Speak
as if you were talking to the person face-to face. Use a clear,
confident voice. Convey enthusiasm and a positive
demeanor. If you are in the middle of a tense conversation or situation
when the phone rings, take one ring to collect yourself, but don’t
let the phone ring more than three times before answering, preferably
no more than two.
Use the practice standard greeting. That should include identifying
yourself and the practice. For example, "Good morning.
Dr. Gary Mack’s office. Julie speaking. How may I help you?"
No one should ever have to ask if they've reached your office. However,
if there are two or more employees at the front desk, conclude your
greeting with, “How may I direct your call.”
Tape record typical patient conversations and assess the speaking
delivery skills. In addition, team members should be given
the opportunity to objectively critique the recorded telephone presentations.
(note: If you record the patient’s portion of the conversation,
most states require that you inform the patient that the call is
being recorded for educational and training purposes.)
the delivery of phone conversations based on the
the voice easy to hear, not too loud, not too soft?
Are the words clearly articulated?
Is the vocal tone pleasant, not gruff, shrill, nasally?
Is the rate of delivery comfortable – not too fast, not
the individual convey enthusiasm, helpfulness, and genuine desire
to assist the caller?
the business employee show respect for the caller?
Does the employee speak using correct English?
week more tips to keep your phones ringing.
you have any questions or comments, please email Sally McKenzie
in having Sally speak to your dental society or study club?
Procedures You Can Bill to Medical Insurance
Dr. Allan Monack
Hygiene Clinical Director
are treatments you may be performing on your patients that the patient
can submit to their medical insurance. Not every medical
insurance provider will pay on dental procedures. However, if a
dental procedure is necessary due to a medical condition or trauma,
it may qualify as a medical reimbursement.
are many dentally related surgical procedures that are already covered
medical insurance, such as impacted third molars. There is an indication,
however, that more dental insurance providers are requesting
a rejection of the service in question before allowing
a submission for payment from the dental carrier.
order to submit a claim to a medical carrier you need to include
a diagnosis code (ICD-9) and a service
code (CPT). Many medical insurance providers will also
accept a CDT-4 as a service code because it is the codes used for
Medicare billing (HCPCS). Below is a list of some dental procedures
that may be allowed by the patient’s medical provider.
Struck by sports equipment
525.11 Loss of tooth due to trauma
Note: Accident reports need to be documented with the claim.
Include date, location of accident, injury description, treatment
rendered, and future considerations. An example of future treatment
may be the need for an implant if the tooth re-implantation fails.
830.0 Disc Displacement without reduction
873.63 Fractured tooth no exposure
E826.1 Bicycle accident
Note: Accident reports need to be documented with claim.
PERIODONTITIS (DIABETIC PATIENT)
V12.2 History of diabetes
523.4 Chronic Periodontitis
Note: May require physician’s letter documenting systemic
DISEASE WITH RAMPANT CARIES
710.2 Sjogrens disease
521.02 Dental caries
Note: May require physician’s letter documenting systemic
523.3 Acute pericoronitis
524.3 Ectopic eruption
Note: Attach report
780.53 Hypersomnia with sleep apnea
Note: Usually requires report of sleep study. CPT codes are
for anterior repositioning appliance (21089)
523.8 Gingival hyperplasia
E936.1 Adverse side effect of medication (Dilantin)
Note: Usual treatment is gingivectomy per quadrant. (CPT 41820)
307.81 Tension headaches
Note: Attach a letter of medical necessity. Bruxguard (CPT 99070)
should obtain a medical insurance booklet of CPT and ICD-9 codes
and the ADA CDT pamphlet if you do not already have them.
(Please note that effective January 1, 2005 will be CDT –
2005 codes.) Keep current and become familiar with diagnostic procedures
that can be submitted medically for dental treatment.
Most medical insurance carriers require preauthorization prior to
treatment unless it is an emergency procedure. When possible contact
the carrier before you initiate therapy. Ask what their requirements
are such as referrals from physicians, diagnostic tests, documentation
of a systemic disease, and any limitations in the plan. Most dentists
will not be in network. Find out what out of network requirements
author wishes to acknowledge the information for this article came
from the ADA CDT-4 , AMA CPT and ICD-9 and the American Dental Support,
LLC newsletter “Insurance Solutions”
you have any questions concerning your hygiene program submit them
to me at firstname.lastname@example.org
and I will answer them in future articles.
in having Dr. Allan Monack speak to your dental society or study
DOES YOUR OVERHEAD
Keys To Keeping Long Term Quality Staff
Belle M. DuCharme
RDA, CDPMA, Director
The Center for
Dental Career Development
is it that the average length of employment for dental office personnel
is about two years?” A dentist wanting to enhance
his business skills was recently attending The Center for Dental
Career Development’s Advanced Dental Business Program for
Doctors and asked this question. At the time we were discussing
how to hire and train dental employees. “Why
should I invest time and money in hiring and training only to have
this person leave in two years?”
I answered. “Typically, it is the office that does not spend
the time to hire the right person and to
training that suffers from turnover.”
I personally know several women who have been in the same practices
anywhere from five to twenty-five years. These are the responses
I received when I asked them why they were still there.
Fran - “I don’t make mistakes often, but when I
do, I know Dr. is not going to make me feel like I am about to
- “I have stayed with Dr. all of these years because he
values my input along with the rest of the staff
to make the best practice around. He is supportive of continuing
education and training on the computer system.”
- “I had worked in other offices and became discouraged
with the chaos until I came to work for Dr. ten years ago. He knew
what he wanted to accomplish in his practice and
gave me a clear picture of my job responsibilities.
I feel like I make a difference.”
- “I have been with Dr. for twenty five years this year.
During this time I have given birth to two children, put them through
college and now married off my daughter. Five years ago my mother
died of ovarian cancer and I had to take some time to grieve. Through
these life changes, Dr. has been supportive and
together we have worked through the rough spots of life. Because
she has allowed me to be flexible as changes occurred in my life,
my devotion to her and the practice has deepened over the years.
I feel I am the best office manager to Dr. and the staff because
of the relationship of trust we have developed.
I know it is not like this in other offices, I am just glad I got
- “I have been with Dr. for over five years. The office
I came from felt like a sweatshop or some kind of dysfunctional
clinic. When there was an error no one took responsibility and the
“blame game” was the every day occurrence. I was hired
to run the front office but it was a mess and there were no systems
in place and no one to go to, to get help. It was like “sink
or swim”. I was thinking of going back to school and studying
anything but dentistry, when I saw an ad for a Dental Office Administrator.
The ad was written so well and seemed to match my professional
goals that I had to call. I have been here ever since and
the thought of leaving never enters my mind. My only fear is that
my doctor will retire someday.”
right temperament, shared visions,
goals, respect, trust,
and flexibility. These are the keys to keeping
long-term quality staff.
you would like to learn how you can gain and retain
the best staff, email email@example.com
and inquire about our Advanced Business Training for Doctors.
M. DuCharme, RDA, CDPMA
YOU LIKE TO IMPROVE YOUR HYGIENE DEPARTMENT?
Clinical Practice Enrichment Program is
designed to improve Hygiene Clinical Skills and develop
and implement a step-by-step Interceptive Periodontal Therapy
Program that will immediately bring greater productivity,
with enhanced patient care. For more information...GO
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Missed Past Issues of Our e-Motivator Newsletter?
I have heard you speak several times and have always enjoyed you
and implemented many of your suggestions. I am in the process now
of taking your advice of getting a separate front desk person to
work just on recall. How many hours a week should I employ her?
Dr. Silver Springs Maryland
The number of hours per week is dependent on how many ”active”
patients you have returning for recall.
This is determined by generating a recall report of patients due
for recall, with and without appointments between today and one
year from today. Below is a “general” guideline for
you to follow:
< 500 patients –0 hours (Receptionist can handle the system)
600-800 patients – 9 hours
800-1000 patients – 12-15 hours
1001 to 1200 patients – 16-20 hours
1201 to 1500 patients – 22-26 hours
1501 to 1700 patients - 27-30 hours
1701 to 1900 patients - 31-36 hours
1901 to 3000 patients – 37-40 hours which would generally
be 2-4 hygienists
Let me know if I can be of more help.
If you have any questions or comments that you would like addressed
here in this mail bag, please email Sally McKenzie at firstname.lastname@example.org
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