Given, Now It’s Time to Receive
Many dental teams are brimming
with caring and compassionate and high feeling types who will gladly
bend over backwards to be helpful and accommodating to patients
only to nearly decimate the financial stability of the business.
How? Staff members – including the dentist –
unintentionally yet routinely send the message to patients that
it is perfectly acceptable not to pay for treatment until some later
date when they’ve paid all their other bills and they have
a few bucks left over to make a payment. Consequently accounts receivables
are threatening to drown the practice in a sea of red ink.
should avoid the temptation to engage in payment discussions with
patients as many fabulous clinicians forget that they are not equally
magnificent financial negotiators. Leave the job
to a well-trained financial coordinator who is fully prepared to
handle patients’ monetary concerns, questions, as well as
present payment options that will benefit the patients without bankrupting
accounts receivables well under control requires effective
collections. And effective collections requires someone
who is assertive, polite, tactful, confident, and goal oriented.
Mary may be a wonderful member of the team, but entirely too wishy-washy
when it comes to collections. If Mary is your only option, train
her. If Sue is better suited for the position assign the responsibility
to Sue and train her. The person asking for payment must understand
it is their job to collect from patients and be accountable for
ideal accounts receivables threshold of one month’s production
is well within reach if you take steps to clean up the typical messes:
– File insurance claims electronically and immediately.
Electronic claims submission significantly improves the payment
turnaround time. The financial coordinator should know the amount
anticipated from the insurance company. However, the patient should
be expected to pay the bill and receive reimbursement from the
insurance company. Too many practices that accept assignment of
benefit do not bill the patient until after the insurance company
pays. This implies to the patient that they are not fully responsible
for their bill – wrong message to send.
today – Make it practice policy to collect the
entire fee today unless specific financial arrangements according
to the financial policy have been made in advance for more costly
–If not daily, bills should be sent out weekly. Don’t
wait to send bills once a month. Include a self-addressed envelope
and state the date that payment is due. Bills that are 30 days
past due should include a personalized delinquent message. For
example, “Dear Mrs. Jackson, we did not receive your payment
on Sept. 15 as requested. If you are experiencing financial difficulty
please contact our office. Otherwise, we ask that you take care
of this account balance by Oct. 1. Sincerely Julie Moore, Business
Policy – Establish the policy, communicate it to
patients and staff, and live by it.
– Provide reasonable payment options in the policy, such
as patient financing, that make it easy for patients to agree
to treatment and even easier for the practice to receive payment.
– Make one employee accountable for collecting money, generating
accounts receivable reports, and following up on delinquent accounts..
that balk at the notion that you deserve prompt payment
are also more likely to be the last minute and no show patients
that wreak havoc on both your schedule and your bottom line. The
vast majority of your patients have been wondering when you were
going to get in line with every other business in the marketplace
today. They are more than willing to oblige with your prompt payment
you have any questions or comments, please email Sally McKenzie
in having Sally speak to your dental society or study club?
Dr. Allan Monack
Hygiene Clinical Director
It is perplexing that many general dental offices that I consult
with do not maintain the most critical equipment
in the hygiene department, scalers and curettes. They are often
dull or past their effective life expectancy, sharpened infrequently
or worse yet…sharpened wrong and I rarely see a sharpening
stone on the hygienist’s instrument tray. When the instrument
looses its edge so does the hygienist! It is critical
that the hygienist remove calculus and infected cementum efficiently
curettes and scalers can actually remove only the outer
layer and burnish the remaining calculus making it more
difficult to remove.
are a vast number of ways to sharpen instruments. Some of the techniques
include: moving flat stone, stationary flat stone, sharpening cone
(for curved cutting edges of sickle and curettes), the Neivert Whittler,
mandrel mounted stones, honing machines, and honing channel systems.
You must be comfortable with the technique you choose to employ.
A myriad of sharpening tools can be purchased to obtain great results.
following is a list of commonly used sharpening instruments:
This is a natural stone. It comes mounted or non-mounted. It must
be lubricated with light oil to be effective. It has a fine texture
and is used for routine sharpening. It comes in the most varied
shapes of any sharpening stone.
This is a synthetic stone. It comes non-mounted. It needs light
oil lubrication also. The texture can be fine or medium and is also
used for routine sharpening.
This is obviously a synthetic that is usually non-mounted. It can
be manufactured in many abrasive variables to satisfy many needs.
Usually, the standard types are fine and medium. The fine texture
is used for routine sharpening while the others can be used for
These come mounted and have grooves and curvatures that only allow
the instrument to sharpen in a correct manner. The texture is course
so it is easy to over prepare the curette or scaler and shorten
the effective life of the instrument.
eight strokes the scaler or curette commences to
be dull. It is strongly recommended that a sterile sharpening stone
be placed on each setup. You can use the guided sharpening instruments
to do major reshaping, but you need a small stone on your setup
tray to keep your instruments working at maximum efficiency. When
they become narrow and thin, it is recommended
to replace the instrument. An option is re-tipping. With the replacement
policy of most manufacturers, it is better to trade in the old instruments
than to re-tip.
Testing for sharpness can be achieved in a variety of manners. Some
examples include: a plastic test stick or a light to check for reflection
of dull surfaces. Test the sharpness of your curettes and scalers
frequently during the procedure and correct dullness as soon as
you discover a dulling of the instrument. The hand instrument is
placed on the plastic stick at a fifteen degree
angle and the curette should engage the stick. Check along the length
of the working end. You can be dull near the tip and still be sharp
in the middle of the curette. Light reflection can quickly discover
areas of dullness by reflecting light off of the working edge of
the scaler or curette. The edge of a dull instrument will be wider
than a sharp edge and reflect more light. It is
easier to detect dullness with the reflective light than the plastic
stick. However, they take up more space in the operatory and don’t
belong on the instrument tray.
There is nothing like having the proper equipment to make your life
easier and save you time. Keep the curettes and scalers in peak
condition. It will save you time, be more comfortable for
your patients, and give you the best chance to reverse the
inflammation caused by the irritants found in the calculus
left on roots and cementum by inadequate removal.
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
Trust Between Patient and Doctor
Previous Dentist Said I Didn’t Need a Crown on That Tooth.”
Belle M. DuCharme
RDA, CDPMA, Director
The Center for
Dental Career Development
do not know much about the clinical end of dentistry but they do
know when people are treating them fairly and honestly. Patients
need to assess the doctor and his practice as being worthy of their
trust before embarking on a course of treatment.
Dental Business Training Program, let’s look at the case
where the doctor was running behind thirty minutes. His next patient
sat in the reception room quietly waiting his turn. When asked if
any one had told the patient of the delay, it seemed everyone was
busy to notice. Looking up the patients’ account,
we find that he had been charged $100.00 for a failed appointment
two months ago. He had apologized and paid the fee. In total, he
had spent $12,000.00 in the last three years in the office for restorative
and cosmetic procedures. Recently, his wife had joined the practice
as a new patient. This is an example of a patient who trusts the
practice, yet was being ignored in the reception room. Studies show,
if a patient is not seated within five to ten minutes of his arrival
he starts to become anxious. Patients need to be told, within this
period, of possible delays. Showing commitment
to the patient and a respect for his time builds
trust. A large component of trust is a doctor’s
clinical ability and his knowledge of the latest techniques and
technologies. Just as important is the honesty conveyed by the doctor
and the staff to the patient. I came across a quotation in a communication
publication, author unknown, that states :
accept ideas more readily from those whom we view as authoritative
and trustworthy and from those who treat us with respect and concern
than from those who appear ill-informed, manipulative, or inconsiderate.
Credibility affects the success of persuasion.”
trust is a multi-leveled process of treating patients with integrity
from the first phone call through treatment presentation, acceptance,
delivery and placement into the recall system. A breach in any area
can cause the patient to leave the practice. The main factors in
establishing trust with a patient are as follows:
Patients trust that you are a licensed and professionally qualified
dentist who will make an accurate diagnosis and deliver excellent
Confidence. You, as a dentist feel 100% confident
in your treatment recommendation and your ability to deliver the
care the patient needs.
Frankness. The patient feels that you are giving
them the total picture and not keeping important information from
them about the treatment or options available.
Fairness. In my experience, many issues having
to do with trust are linked to the patient’s perception
of the value they are receiving versus the cost.
my next article, I will explore the ways in which the dental team
can build trust based on the above bullet points.
more information, call THE CENTER FOR DENTAL CAREER DEVELOPMENT
M. DuCharme, RDA, CDPMA
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your overhead expenses
your accounts receivable
you need to know about cash flow is in this
information-packed book written by
Sally McKenzie, CMC
It is our office policy to charge $25 per hour for broken appointments
without 24 hour notice. In the past I always sent a warning letter
for the 1st occurrence, even though it is stated as policy in our
new patient letter. I recently told my staff, no more warning letters.
My time is valuable. I feel that I am busy enough now, that if the
patient doesn't like it, I can afford to lose them. Yesterday a
patient phoned, upset about the charge. She was charged $50 after
forgetting to come to a 2 1/2 hr appointment. She wanted to speak
with me. How would you handle that?
I would advise not to charge for broken appointments because it
can cause the anger you are seeing with this patient and you legally
can’t collect it anyway. While I understand where you are
coming from....completely, i.e., the rules are the rules and it’s
not fair what they are doing, there is a more subtle way of getting
them out of the practice than punishing them (which is how they
view it). My experience in consulting with practices that have done
what you are doing, i.e., letters, only begins to spread a reputation
that is negative. While you may be very busy now, there may come
a day when you won’t be because patients have left the practice
because you are so rigid. My suggestion is to speak with her and
listen to why she “broke”, “failed” the
appointment. It is important for appointments to be confirmed the
day before and speak to a patient. If the patient has not shown
up within 10 minutes of their appointment, your receptionist calls
and keeps calling till she reaches the patient to find out the reason.
On the 2nd occurrence that she feels this patient has lied to her
as to why they haven’t shown up she would say, “Mr.
Smith, obviously we are having difficulty scheduling an appointment
that is convenient for you and your office. We don’t have
any open appointment times now but I have your information here
and should we have an opening I will give you a call.” Providing
you are not in the middle of treatment, this patient may not be
called back but this is a non confrontational way of dealing with
it than charging the patient.
Hope this helps.
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