09.04.09 Issue #391 Forward This Newsletter To A Colleague
Hiring the Best Candidate
Collect More Over the Counter
Practice Communication

She Has Computer Experience, Just Not the Kind Your Office Needs
by Sally McKenzie CEO
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Experience. It’s a word that conveys different meanings to different people. When seeking employment, applicants naturally want to convince their prospective bosses that they would bring necessary experience to the position. Meanwhile employers – dentists specifically – often are in the difficult position of trying to fill vacancies quickly. Many don’t typically need a lot of convincing that the applicant with the pleasant smile and friendly demeanor is the one for their office, particularly when the applicant asserts that she/he has what it takes to do the job.

Take Dr. Carrel, for example. His business employee of 12 years decided it was time for a change of scenery and accepted a position out of state. That left Dr. Carrel frantically trying to fill the position. In walks applicant Amanda. She has worked as a receptionist and as a clerk in the children’s department at a large retail store, which must mean that she’s good with people and well organized – both very important qualities for this job, surmises a stressed Dr. Carrel.

During the interview, he dutifully covers the usual questions with Amanda, listening closely for those things he wants to hear. “Do you have experience with scheduling?” asks Dr. Carrel. “Certainly,” Amanda says, thinking to herself, I have to get in the shower by 7 a.m., make the train by 8 a.m., be at work by 9 a.m., at the gym by 5:30 p.m. so I can be out with friends by 8 p.m…“Yes, I am very good at scheduling.”

“Do you have computer training?” “Of course,” the applicant says emphatically, ticking through a variety of point and click responsibilities in her mind. I know how to buy and sell on e-bay, I have all the important websites organized in my favorites list, and I am a whiz at email. “Yes, I have lots of computer experience.” “How would you rate your experience in effectively communicating with others?” asks Dr. Carrel. “Very high,” answers Amanda. You should see my thumbs go. I can text message while driving, applying make-up, even during a movie. “I consider myself to be an expert communicator.” Amanda is hired, bringing all her “technical expertise” to the position.

While the scenario above may be somewhat exaggerated, it is not uncommon for practices to hire new employees that bring “experience,” “knowledge,” and “training,” in numerous areas, but oftentimes it’s not what the practice needs or what the job really requires. Practice needs and expectations have changed. Managing a dental practice has always demanded excellent customer service skills and knowledge of dental business systems such as scheduling, financial arrangements, insurance processing, collection and billing, recall etc.  But today the need for specific computer literacy is significantly greater. 

Even jobs that would not necessarily be described as “technical” commonly require computer experience or technical skills. Dental practice employees – both clinical and business – are often expected to understand and use spreadsheet, word-processing, and database software. Although an applicant may bring some computer experience, it doesn’t mean she/he has the compulsory knowledge to access and interpret necessary reports or compile spreadsheets.

Historically, a college degree in business was not a requirement to get a position in the dental business office and many people employed at the front office were former dental assistants or people who were trained on the job in another practice. And although most of Generations X, Y, and Millennials (those coming of age in the new Millennium) have been exposed to computers virtually their entire lives, if they do not go on to college or receive specific training, the skills often remain elementary. 

When hiring someone to manage a busy practice, formal business training and more than basic knowledge of computer software is essential. The practice management reports that can be generated by today’s sophisticated software will tell you virtually everything you must know about your practice: if it is growing or declining, what procedures are your “bread and butter,” what other services or products you need to market, how many new patients are coming in and how many patients are leaving, how many children you see and how many adults, what percentages of your practice is insurance and what is private pay, what percentage of the insurance base is this company or that, and so on.  The wealth of critical information is virtually boundless provided that your team knows how to access and use it. 

Next week, discover how prepared those applicants really are.

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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Nancy Caudill
Senior Consultant
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How to Collect More at the Time of Service

Struggling to collect from patients after treatment has been more difficult this year than in years past with the downturn in the economy.  If you couple that with lack of training of the person collecting the money, no system and no protocol, collections suffer.

Over the Counter payments are credit card, cash and check payments made at the time of service for those services provided that day. All other payments are made after the time of service, such as insurance payments, checks received by mail, credit card payments by phone, and cash payments brought in to pay on a previous service. The term Over the Counter can be misleading; to clarify, there are times that a payment is taken over the counter for services that were provided at an earlier time. Yes, it physically came in over the counter, but this is not an “OTC” payment because the service was not provided on that date.

What % should your OTC be? Standard in the industry is 45% of NET production for the month. This may seem too high to you if you are an insurance-driven practice. If you want to confirm exactly what yours should be, do this simple math equation:

Total insurance $ for the month / total of all $ for the month = % of insurance payments. 100% minus insurance % = patient payments. The practice goal should be that whatever is not paid by the insurance companies is paid at the time of service, better known as Over the Counter. Now that you know what % you should be collecting OTC, how do you know what patient payments are made OTC vs. mail, walked in or by phone? You will need to set up specific payment types to track this such as, check OTC, check by mail, etc.

Post the payment properly in order to calculate the percentage accurately. Finally, at the end of the month, here is the formula: Total of all the OTC payments / Net Production = % of OTC payments. How do you get this information? Two reports must be generated. A Payment Summary, Collections Summary or Accountants Earnings Report and A Production Summary, Monthly Daysheet, or Register.

Calculating the “net” production can be tricky because if you don’t have your adjustments set up correctly, your net production may not be accurate. If you are not aware of how to obtain your “net” production, contact your computer software support staff.

The purpose of not comparing your OTC collections to total collections is if you  are doing a good job of collecting old debt, your collections this month may be higher than your net production. As a result, this indicates that there was more money coming into the practice that was not OTC as a result of production. It will reflect a lower % of OTC than it really is.

You now have the tools to calculate what the OTC should be. Here are some tips for how you can improve their OTC:

1) Inform your patients and re-educate them. If you have been allowing them to mail their payments in for the past 20 years, you have to change the way you do things at the front desk. When your Schedule Coordinator makes an appointment for Mrs. Jones, she says: “Mrs. Jones, here is your appointment card for your next visit. Your portion at that time will be $167 and as a courtesy, I wrote it down on the back of your appointment card for you.” 

This is a very subtle way of informing Mrs. Jones that you will be asking for $167 at her next visit. Does this mean she will pay? If she hasn’t been paying for the past 20 years, maybe not! However, when Mrs. Jones returns for her next visit and the Financial Coordinator checks her out, she will say: “Mrs. Jones, how did everything go today? I understand we completed the tooth-colored fillings for you. Your portion today is $167.”

2) How do you know how much to ask Mrs. Jones to pay? You guess. Too many front office employees get bogged down in insurance statistics. They lose focus of what they are really trying to do, which is to treat the patients with kindness and fairness, be as efficient as possible, and collect 45% OTC. It is all simply a “guesstimate” of how much the insurance company is going to supplement. Base the patient’s portion on 30-35% for fillings, perio and extractions, 60% for C&B and 90-100% for preventive. Throw in an additional $50-$100 at the first of the year for a deductible for everything except preventive.

“Mrs. Jones, I have no idea how much your insurance is going to help you with this.  How about you and I agree that your portion today will be $167 and if there is any difference after I hear from them, I will let you know. Does that work for you?”

Don’t have the Financial Coordinator become an insurance expert. The less the patient thinks she knows, the less they will expect her to know. This is a good thing! Share this article with your Financial and Schedule Coordinators.  Determine what your OTC should be…and increase your cash flow!

If you would like more information on how McKenzie's Practice Enrichment Programs can help you IMPLEMENT proven strategies, email info@mckenziemgmt.com.

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Belle DuCharme CDPMA
Instructor/Consultant
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Talking at Work: Productive or Just Idle Chit-Chat?

“From the treatment room, I see my staff standing around talking and laughing and I get angry because I am not paying them to gossip.” Jim Freed, DDS.

Hygiene

Having conversations with fellow team members at work can support the morale of the team, provide feedback for more efficiency, create a friendly environment… or it can destroy all three. Workplace talk is necessarily short and superficial for the simple reason that no one was hired to stand around and chit-chat.  To the contrary, correct or focused conversations at work serve very important functions to the success of the day in a dental practice.

The morning business huddle or daily meeting teaches the business system of structured conversation. This is an opportunity for the team to greet each other at the beginning of the morning and to discuss how each can contribute to the success of the day. A game plan is discussed in regards to the patients that are scheduled and everyone knows their part and the position they play. Conversations among the clinical team and business team can spark ideas, clarify confusion and build team loyalty and cooperation.

Workplace conversations between those who don’t often associate with each other during the work day can help soften divisions that might otherwise occur.  The battle between “the front and the back” has no merit when the people involved have the opportunity to air their concerns and ideas. For instance, the following scenario provides an illustration:

Millie Perkins was appointed in Dr. Sharon Clasee’s office for the repair of a front tooth. This practice does not have daily business meetings. During the examination, a treatment plan was drawn up which included not only the repair of the tooth in question (#7 MIL) but also the repair of #8, 6, 9 and 10. Looking at the schedule, Dr. Clasee said to the patient, “I have time today to do all of these teeth if you have time.”  Millie replied, “That would be convenient for me and I really want to look nice for my job interview.”

The treatment plan was entered into the computer as Dr. Clasee anesthetized the patient and then preceded with the treatment. There wasn’t any message sent to the front desk for Jane, the Business Coordinator, as to the change in the schedule as it was assumed that there was time before the next patient. When Millie was released to the front desk for check-out, a conversation ensued that could be heard in the back office. When presented the fees for the treatment, Millie said, “I had no idea it would be this much money, I am going to have to make payments. Can’t you get the insurance to pay more than that?

The Business Coordinator was upset that no one had communicated to her the change in the appointed treatment. Given the information, she could have come into the treatment room and properly informed the patient about her out-of-pocket responsibility.  Jane spoke to the assistant, Mary, about the patient’s reaction and Mary felt that it was Dr. Clasee’s fault for not clearing it with Jane first and not telling the patient how much it was going to cost. Neither Jane nor Mary talked to Dr. Clasee about what had happened for fear of being blamed.   Because there won’t be any positive outcome for this scenario unless it is addressed to Dr. Clasee, this lack of communication is a problem that will happen again and with the same negative results. The interchange between Jane and Mary will be accusatory and both will harbor negative thoughts about Dr. Clasee. This is fuel for gossip and idle chit-chat. 

As an employer and business owner, Dr. Clasee should encourage team communication through the venue of structured meetings. Giving the team a forum to exchange ideas on how to improve business and patient relations is critical to the success of the dental practice and to discouraging non-productive idle chat. Most likely Dr. Clasee is unaware of how the above scenario can affect practice growth over time. At McKenzie Management we are aware of the devastation that lack of positive communication can cause. Learn how to improve your practice today with the Dentist CEO Business Training or one of our other Advanced Training Programs customized to your practice. 

If you would like more information on Treatment Acceptance Training to improve the performance of your team, email training@mckenziemgmt.com.

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