12.15.06 - Issue # 249 Forward This Newsletter To A Colleague
Collections
Hygiene Production
Team Activity

Collect on Patient Expectations
by Sally McKenzie CEO
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Certainly, the spirit of the season of giving is one that should continue throughout the year, but even St. Nick has a limit, as well as clear guidelines, and probably a written policy for handling the multiple requests for special favors and demands for exceptions.

First, there are well-established limits on the holiday. Everyone knows that Christmas is just one day out of the entire year. No one is expecting a bounty of beautifully wrapped packages on April 11, August 19, or any other day except December 25. Second, the long established naughty or nice policy leaves little room for interpretation. Take your cue from Father Christmas, who’s perfected the fine art of educating his audience as well as managing their expectations.

Most people are more than willing to follow established guidelines if they know what they are. And when it comes to your collections, this is one of the critical systems that requires you to educate your patients as well as manage their expectations.

While many offices have made significant strides in establishing and upholding financial procedures, there are still far too many practices that don’t have solid collections policies. It’s like Christmas everyday for the patients, and doctors are trapped doling out thousands in “don’t-have-to-pay-today” dental care.

Consequently, reducing accounts receivables and achieving a 98% collection rate are working their way to the top of the list of must haves this holiday season in more offices than there are lights on the Christmas tree at Rockefeller Center. Take the following steps to wrap up your accounts receivables and get collections jingling all the way:

1. Find out what your accounts receivables are at this moment. You have to know where your numbers are so you can establish your collections goals. It should never be more than one month’s production. In other words, if you typically produce $50,000 per month, patients should never owe you more than that amount at any given time, and preferably, they owe you less.

Generate an aged accounts receivable report monthly that lists every account with an outstanding balance and date of last payment. Total all monies over 90 days delinquent. The percentage should not be over 10-12% of your total accounts receivable.

Examine the charges in the "current" column of the report. These are uncollected monies produced in the past 29 days. Because the practice should have a minimum of 45% over-the-counter collections for the month, there should be no more than 55% in the current column awaiting insurance reimbursement.

Always run the report with credit balances because credit balances need to be added back to the total accounts receivable. If the total exceeds your monthly production, it's a red flag indicating problems in one or more of the following areas:

  • Insurance system
  • Billing system
  • Financial policy
  • Presentation of financial arrangements
  • Consistent inability of financial coordinator to ask for money

2. If you don’t have a financial policy, set the holiday cards aside and promptly focus your attention on developing a draft. Establishing a written financial policy is a priority because it’s the number one essential tool in managing your patients’ expectations. Staff input in developing the policy can be helpful, but as the owner and CEO of your business, you decide what’s in the best interest of the practice.

Don’t allow patients to carry balances.  A “must have” for today’s dental practice
is offering financing, such as Care Credit, to patients. Determine how long you are willing to wait for payment. Having a policy that extends credit to patients indefinitely is too lenient and is a liability for your practice. A policy that is too strict, such as one that does not accept insurance and/or does not provide any payment options, can be a deterrent to patients.

3. Signs at the front desk or casual references during conversation do not make a policy. This one needs to be in writing, and it should be routinely given to every new patient and periodically distributed to existing patients. In addition, before any major treatment plans begin, review the financial policy with patients and ensure that they understand their payment options and responsibilities.

When patients know what to expect in terms of your financial policies and collections procedures, no one will expect you to hand over your dental care in a lovely package with all the trimmings, no matter what the season.

Next week, the number one reason financial policies break down. 

Interested in speaking to Sally about your practice concerns? Email her at sallymck@mckenziemgmt.com.

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

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Jean Gallienne RDH BS
Hygiene Consultant
McKenzie Management
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Evaluating The Hygiene Department’s Production

Where is your hygiene department not producing as much as the industry standards recommend? Most hygiene departments are not producing enough when it comes to periodontal disease and selling ancillary products. It is the industry standard that 33% of the total hygiene production should come from selling ancillary services and interceptive periodontal program.

Is your hygiene department within these industry standards? To uncover the results, generate a “Procedures by Provider” report for the month and add the amount produced for all ancillary services and interceptive periodontal therapy program services such as periodontal maintenance, root planing 4 or more teeth, and root planing 1-3 teeth. Next, divide this by the total hygiene production not including periodic exams. This formula allows you to track what your hygiene department is producing.  If you are at or above 33%, that is great. However, if you are not, there are a few places that may be decreasing your productivity in this area.

If the dentist and/or hygienists are introverted in their personality or have a fear of rejection, they may have difficulty in reinforcing the treatment plan. They may also have difficulty recommending interceptive periodontal therapy treatment to patients. This results in the hygiene department performing prophy after prophy.

If the hygienist or dentist wants everyone to like them in addition to being  introverted, they may be too lax with a patient who is not following through with their interceptive periodontal therapy program. They also can have a difficult time telling a patient that they have some form of periodontal disease. 

A computer probing system that helps the patient co-diagnose may be the answer to this inability to communicate. Having a system that explains to the patients about, probing, periodontal disease, and what the probing numbers and bleeding points mean is consistent and professionally done. The operator simply has to probe and the computer calls out the pocket depth as you step on the appropriate foot pedal. In addition, if there is bleeding or pus, the operator steps on the appropriate foot pedal and the patient will hear, “bleeding, pus”.  This is powerful in convincing patients of disease.

Many hygienists are leery of stating the health of the patient’s mouth as they see it. However, the patient needs to own their disease and be educated about everything going on in their mouth. It is very helpful to us as practitioners, as well as patients, that new technologies enable our computers to tell the facts to the patients.

Many offices are not probing, and are not sure how to start. What code is used to bill the insurance? There is no extra person available to record the pocket depths.  What charting should be used? What verbiage should be used when explaining the disease to patients? What if they question why we are probing? What if they question why we have not done this in the past? All of these are questions that will need to be answered.

A lot of the concerns above are more reason for utilizing a computer probing system, such as Florida Probe. There is no concern about having a person available to write the measurements down. The charting is automatically standardized amongst operators, the computer will have standardized verbiage when it comes to different staff members describing what periodontal disease is, how, and what to treat.

There are many ways to inform patients of new procedures that are being incorporated in the office. When a patient calls to make an appointment, the Scheduling Coordinator should be excited to tell the patient about the new commitment the office has made to screen all patients for periodontal disease. Have brochures that explain periodontal disease available to give the patients. Have research articles that are written with less technical jargon available in the reception room. Create a form letter that explains periodontal disease, and the commitment the office has towards treating it.

When it comes to using a computer probing system compared to manual, even if you probed in the past, the patient will more than likely perceive that something different is being done. They will perceive that probing is new technology and may not even ask questions, other than about the computer and the system you are using.

These are just a few of the concerns that come up when looking at why a hygiene department may not be producing to their full potential. Looking at your interceptive periodontal therapy program is a great place to start.

Interested in knowing more about how to improve your hygiene department? Email hygiene@mckenziemgmt.com.

Interested in having Jean speak to your dental society or study club Click Here.

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Dr. Nancy Haller
Dentist Coach
McKenzie Management
coach@ mckenziemgmt.com
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Aspire to Inspire: A Creative Activity for Your Office

Regardless of your affiliation, this is a spiritual time of year. At first glance, pairing spirituality and leadership might seem incongruous or perhaps even dissonant. However, spirituality is about finding meaning. This is an important role for leaders – attracting and retaining an excited and effective group of people, and
articulating purpose to inspire them about their work.  

There has been extensive global research on the importance of inspirational leadership. It involves creating and sustaining an environment in which people achieve excellent performance. Inspirational leaders design and maintain an atmosphere that engages people and gives them an energizing vision.

Now this can be done in many ways. Certainly, hosting an off-site retreat is a powerful means toward that end.  Yet that endeavor does require an investment that many dental offices may not be prepared to make. If you’ve dismissed team building because you think it takes too much time and money, you need to be creative. There are many ways to infuse energy into your office and inspire your team. Use this holiday season to take advantage of light schedules and festive moods. Here’s just one activity that can promote relationship building and communication. You may be amazed how it helps to connect team members in your practice.

Have you ever arrived early to a meeting and noticed that no one is really talking to one another? Or, if you have a larger team, there may be conversation but it’s restricted to a subgroup or clique of employees? Maybe they exchange a quick hello as they grab a cup of coffee but then there’s mostly silence as people find a place to sit. 

Inspirational leaders take advantage of this pre-meeting time. Simply utilize a VCR or DVD player and a television. Place it at the front of the room and provide a movie or show that might have a theme that is related to a principle or theme you are trying to instill in your team. 

For example, Sometimes it’s not about winning, it’s about trying your best.

The Disney movie, Twenty Below Zero, is a laugh-out-loud film that is based on the true story of the first Jamaican bobsled team trying to make it to the Winter Olympics in Calgary, Alberta, Canada. This Team (?) is a hilarious transformation from one that has “no idea” what they are getting themselves into, to a team spirit unsurpassed by even the best bobsledders in the world.

If your practice needs a ‘B-12’ shot of resiliency to get through tough times, the bravery, skill, creativity, and teamwork in Apollo 13 reflects these themes with great accuracy.

Choose a movie that you believe will trigger a discussion about the message you want your staff to embrace. The show can be something just as simple as an old TV series, or a newer, action-packed science fiction film. Ask your employees for a list of their five favorite movies and why each was so appealing to them. You’re bound to get some good ideas from their input. Plus, they’re more likely to meet this exercise with enthusiasm if they are involved in the planning.

Movies and TV shows are fun to watch, and they will no doubt bring back fun memories for your team members. The laughter that is heard will liven up the atmosphere of the room and help to wake folks up and prepare them for a fun and engaging team meeting.

For those of you who try this activity, email me your comments and movie list. I’ll send you one of our Ideas into Action leadership guidebooks as a thank you.

Wishing all of you a healthy, happy and inspirational holiday season!

Dr. Haller is available for team building and dental leadership coaching. She can be reached at coach@mckenziemgmt.com.

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