McKenzie Newsletter 411


	Increase Treatment Acceptance Run Your Hygiene Reports Key Insurance Information

Do You Need a Treatment Coordinator?
by Sally McKenzie CEO
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Dentists often assume that if a patient requires extensive treatment, they expect to hear that information from the dentist directly. While that may be the best approach in many instances, it isn’t in all. Oftentimes, low treatment acceptance is rooted in the patient’s lack of dental education and understanding. The dentist may firmly believe that Mr. Smith comprehends what is being proposed and will proceed with treatment, only to discover that he has multiple questions that he is trying to clear up with the scheduling coordinator on his way out the door. Mr. Smith didn’t really get this part or that aspect of what he was being urged to do, and he didn’t feel comfortable raising the questions with the doctor.

This is where a treatment coordinator can benefit the doctor, as well as the entire practice, tremendously. While the dentist must discuss certain issues to meet informed consent standards such as the nature of the problem, recommended treatment, potential complications from the treatment or complications if no treatment is pursued, as well as alternatives to recommended treatment, many other details can be addressed by the treatment coordinator. In particular, the big three: how much time will it take; how much money will it cost; and will it hurt.

For example, the treatment coordinator can spell out for the patient the number of appointments that will be necessary, what to expect at each appointment, and the length of time that will be required for each appointment. This person can also cover issues of concern that the patient might have, such as worries regarding pain or discomfort, and she can discuss the all important issue of treatment financing.

Patients perceive that the coordinator has the time to answer questions and listen to concerns. They can raise difficult or awkward questions that most would never consider posing to the doctor, such as: Does the dentist have enough experience with this procedure and are they good at it? Is there a guarantee attached to this type of comprehensive work? Have many of the doctor’s patients had this treatment? If you were me, would you have this done? What’s more, patients often see the coordinator as someone who can understand their financial concerns and their need for financial options.

Clearly, this isn’t a job for just anyone. Your treatment coordinator needs the right mix of personality traits, clinical expertise, and people skills. Assign the responsibility to a member of the staff or hire an employee who offers the following:

Quick to build rapport with patients
Has an understanding of dentistry and dental procedures
Believes in the doctor and his or her skills
Is well organized
Is able to comfortably discuss fees and financial arrangements with patients

Provide professional training for the treatment coordinator, and assign the individual the following responsibilities:

Educate patients about dentistry
Conduct case presentations
Complete new patient introductions
Follow-up on unscheduled treatment
Build insurance information files that can be accessed easily
Present fees for the recommended treatment plans and establishing payment terms with patients

In addition, beyond ensuring that you have the right person directly presenting treatment to patients, involve the entire team. As I mentioned last week, it can take as many as 12 conversations with a patient before they accept treatment. You want to make sure you and your team are seizing every opportunity at every appointment. For example, the doctor recommended that Mr. Smith get a crown on a cracked tooth on his upper right side. He’s been putting it off but has a hygiene appointment scheduled soon.

This is the opportunity to further educate Mr. Smith, starting with the confirmation phone call. The person who confirms appointments should have treatment recommendations readily available on each patient, so that Mr. Smith can be reminded that the doctor is concerned about the condition of that tooth on the upper right side.The hygienist reiterates the doctor’s recommendations and further explains the benefits of pursuing treatment. The assistant provides Mr. Smith with a brochure explaining the frequently asked questions about the treatment. And as the scheduling coordinator is making Mr. Smith’s next hygiene appointment, she asks him if he would like to come in next week and get that crown taken care of.

Each of these conversations is planned and follows a carefully formulated script. Moreover, at no point does the process become heavy-handed or pushy, but rather the entire team is able to emphasize that the care delivered is important to the health and well being of the patient. Everyone on staff should be able to effectively articulate the value of pursuing that care.

McKenzie Management offers a 1 day Treatment Acceptance Training Program performed one-on-one in La Jolla, CA. Call for more details 1.877.777.6151.

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.

Hear Sally’s FREE Podcast at The Dentist’s Network - HERE

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Nancy Caudill
Senior Consultant
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Hygiene Department Falling Apart?

Dr. Brighton was hoping for "brighter" days ahead. His hygienists appeared to be "busy" front office ladies, but neither were focusing on the hygiene schedule at any given time. He had 6 days of hygiene a week, but wondered if he may need less. The practice pre-scheduled all recall patients into the future so the schedule looked full and productive, but was it really going to be that way when the time rolled around?

Number of Hygiene Days
An easy way to determine how many hygiene days are needed is to generate the Recall Report for the next 12 months for all patients with and without appointments. Determine how many appointments are needed based on their recall interval. Add to this appointment total enough additional appointments to manage the new patients, past due patients and scaling and root planing. Compare the number of appointments that you really need to the number of appointments that you have based on the number of patients seen per day x the number of hygiene days you have for the next 12 months. If you discover that you have too many available appointments compared to how many you will need, this is NOT GOOD.

Pre-scheduled Appointments
If all the hygiene patients are being pre-scheduled, this can result in an excessive number of last minute cancellations and no-shows. Patients who scheduled their appointments six months ago, indicated that they did not know if their work or personal schedule would allow for this appointment. Unfortunately, Dr. Brighton’s Schedule Coordinator would respond with, “Why don’t you go ahead and make your appointment and you can always call and cancel it if you can’t make it.” A better solution would be to NOT encourage those patients to schedule six months in advance when they indicate that their schedule is unknown at this time.

Hygiene Coordinator
Dr. Brighton employs two wonderful front desk employees who are very hard workers and very willing to do whatever it takes to make the practice successful. However, there are no job descriptions so neither one of them knows who is responsible for the hygiene schedule other than to call and confirm the appointments and pull the patient records for the next day. It is necessary to divide up their workload and “assign” one of them as a Hygiene Coordinator so she knows that it is her responsibility to manage the Hygiene Department.

Reports that are needed:

Past Due Recall Report for the past 12 months
Recall Report for patients without appointments that are due this month
ASAP List for hygiene patients that have appointments but would like to come sooner

All dental software programs are capable of generating a recall report for patients that were due at a point in the past but never made an appointment. This report is the heartbeat of the Hygiene Coordinator, as this list keeps patients from “falling through the cracks.” Calling patients that are on the list, in order to fill the openings in hygiene, is the ONLY way of managing these openings. If it is left to chance that a patient will call and schedule the appointment that is available tomorrow morning, it probably will never happen.

How many patients need to be called for one opening? As many as it takes! Calling one or two and leaving messages on their cell phones is not sufficient. Even if these patients return the phone call, they may not be able to take the appointment that is open. When placing these calls, it is vital that the Hygiene Coordinator make a note in the computer notes section indicating that this call was placed to avoid duplicating her efforts.

Inactive Recall Patients
It is also vital to reach out and contact those past due recall patients that haven’t been seen in the past 12-24 months by generating a well-written “merge letter” inviting these lost patients back into the practice. The letter should be printed on your letterhead stationery and include an educational brochure about the importance of professional cleanings and oral exams as well as a promotional offer.

How to Implement
Dr. Brighton’s Hygiene Coordinator was instructed to generate her 30-day past due recall report first and place telephone calls to each of these patients. The script was as follows when she received voice mail: “Hello Cathy! This is Carol at Dr. Brighton’s office. It is important that I speak with you. Please call me at 456-1234. I look forward to hearing from you.”

If Cathy answered the phone, Carol would then say, “Hi Cathy! This is Carol at Dr. Brighton’s office. He noticed that we failed to make an appointment for your professional cleaning and exam that was due last month. Do you prefer a morning or an afternoon?” It is important not to ask a question that can be answered with a “yes” or “no.” Should Cathy elect not to schedule, attempt to establish a time that you can call her again. “I understand, Cathy. It is a busy time for everyone right now. However, this is a very important appointment so I will call you again next month. Look forward to speaking with you then. Have a good day.”

Next, Carol will generate the past due recall report for 60 days past due and repeat the steps. This process continues until all the patients that are past due for the past 365 days have been contacted at least once.

Conclusions
Over a period of two months, Dr. Brighton’s Hygiene Coordinator was able to create appointments for 123 past due recall patients! The campaign was successful and he has reestablished a relationship with these patients who not only needed their teeth cleaned, but over 50% of them also needed additional restorative treatment, beefing up his production as well.

Give your business team the tools to do their jobs 100% by sharing these simple steps with them. If they don’t know how to generate these reports – call your software support office and learn. These reports are vital to a strong and healthy Hygiene Department.

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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Dental Insurance - Running the Same Old Tapes

Okay, so it is 2010 and we vow to have a better year - certainly anything can be better than last year. As patients phone in to make appointments, the subject of dental insurance comes into the conversation and your mind goes off to Hawaii or the Bahamas as you run the same old verbal tapes to the inquiring patient. “No, we don’t take your plan; however, we can file it for you.” Somehow, this line just doesn’t work for securing an appointment for patients who will not seek care with someone who does not “take their insurance.”

Let’s face it - we are still having a verbal contest with the insurance companies who have sold the policy to the employer with the promise of 100% coverage for basic care and 50% for major services. That verbiage still sells policies, so why change it. It falls on the dental office to throw in “you have a calendar year maximum of $1,000 (some policies go up to $2,000 pcy) and we will use that up for one crown and two regular prophys.” The patient then wonders why dentistry is so expensive that it takes maybe three procedures to go through their entire year of benefit dollars. It seems like the dental practice spends most of its time trying to defend its’ right to do the kind of dentistry that benefits the patient the most.

We in the business of dentistry know that dental insurance is not insurance at all. Real insurance is designed to cover catastrophic losses such as a life threatening medical crisis or a totaled car. Routine dental care is certainly not catastrophic, so “dental insurance” is the wrong terminology for the product the patient has purchased. Getting insurance companies to change the name of their product to Dental Maintenance Plan would benefit dental practices as they struggle to explain coverage to the patient, but that probably will not happen.

Into the New Year, keep your eye on providing the best comprehensive care but realize that it starts with the chief concern to gain the patient’s trust. These chief concerns are most often cleanings and broken teeth. If the patient’s referral was that of the PPO plan, then use it to the patient’s advantage and they will thank you. Here are some verbal tools that may help along the way to establishing the right connection and securing the appointment. This scripting is designed to give you words of communication to patients that helps the patient understand enough to make a decision to schedule an appointment in your practice. Taking the time with the patient on the phone is vitally important to making a positive connection resulting in an appointment.

Patient: “Do you accept or take my insurance?”
They probably want to know if you accept assignment of benefits. If the practice accepts assignment of benefits (you agree to receive payment from the insurance company) the answer would be: “We accept assignment of benefits from all dental PPO insurance companies after verifying your eligibility and benefits. Estimated co-payments and deductibles will be due at the time of service.”

Patient: “Are you a CIGNA (or other company) provider?”
The patient wants to know if you are a “contracted provider” - this will mean less out of pocket for them because you have agreed to charge the plan’s contract fees and not your usual fees.

If the practice is not a contracted provider you can state: “No, we are not contracted with CIGNA but we can file your claim to CIGNA and they will pay according to the contract they have with your employer. You will be responsible for any co-payment and deductible today.” OR - “You will be responsible for payment in full today and the insurance company will reimburse you. Do you have any other questions you would like to ask?”

If the practice is a contracted provider, say: “Yes, we are contracted with CIGNA (or other insurance company). Upon verification of your eligibility and benefits, we will provide a written treatment estimate. Co-payments and deductibles are required as services are rendered. Do you have any questions in regard to this information?” (Proceed to get insurance information.)

Want to learn more about the business of dentistry and making patient connections? Sign up today for one of McKenzie Management’s Advanced Training Programs customized to your office needs.

If you would like more information on McKenzie Management’s Advanced Training Programs to improve the performance of your team, email training@mckenziemgmt.com.

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