12.3.10 Issue #456 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter
 

Six Steps to Solvency
by Sally McKenzie CEO
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Here we are, closing in on the final weeks of 2010, and although faint rumblings of a recovery percolate on the financial horizon, we have been seeing a disconcerting return to high accounts receivables and well-oiled financial polices put on the blocks. Now is not the time to abandon effective practice protocols. However, a few adjustments may be in order. Follow these steps toward achieving financial solvency in your practice.

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Step #1 - Revisit the Financial Policy
A plan that is too rigid will not be effective in any economy. However, that doesn’t mean that you should return to the days of patient-dictated financial plans. Pay attention to what patients are telling you, and if necessary, make adjustments. Consider incorporating the following:

  • Establish a relationship with a treatment financing company, such as CareCredit
  • Allow patients to build a balance on their account before beginning major treatment
  • Allow patients to pay for larger cases in two or three installments over a specific period of time
    Offer a 5% discount if the case is over $500, paid in full, and will not be submitted to insurance

Step #2 - Maximize Over-the-Counter Collecting
Patients should be made aware (prior to their visit) of what is to be done and what fees they will be charged so they’ll be prepared to pay. Your financial coordinator/business administrator should be professional, matter-of-fact, positive, friendly, and should follow a well rehearsed script in explaining the services, the charges, and the payment options. Additionally, a printout of services provided – along with anticipated insurance payment as well as amount of patient payment – should be given to patients at every visit. If a patient does not pay, give them a return envelope and say, “This will make it easy for you to mail us your check when you get home.”

Step #3 - Send Bills Daily Rather Than Monthly
Every statement should include a due date (two weeks from statement date). Make sure that there is a space for the responsible party to write in a credit card number and expiration date as a means of payment. A self-addressed payment envelope should also be provided.

Step #4 - Anticipate Insurance Payments
Track insurance, specifically the available benefits as well as uninsured procedures, to calculate the anticipated insurance payment. Collect the patient portion at time of dismissal. After your software performs a validation process on each claim, claims should be sent electronically on day of service. Each week, generate a delinquent insurance claim report grouped by carrier so that one call can be made per carrier to check on all claims that are thirty days delinquent. Cash flow can be further enhanced by tracking and processing secondary insurance; keeping signatures on file so that after EOB (explanation of benefits) is received, the patient portion may be calculated and credit card automatically processed; auditing submitted claims and automatically aging them until they are either paid off or written off.

Step #5 - Follow-Up On Delinquent Accounts
Delinquent account calls should begin one day past the due date on the first statement. The manner and tone used will greatly influence the effectiveness of the call; therefore, set the tone as “working together to resolve this situation.” The caller’s key question should be, “When can we expect payment?” Enter highlights of the conversation into the computer to keep a record of collection attempts. On the same day, follow up the phone conversation with written confirmation. And finally - address the most critical collection obstacle…

Step #6 - Train Your Team
The number one reason for poor collections in most any practice is a lack of training. Provide results-oriented training designed to meet the following practice objectives: A 98% collection rate should be maintained for treatment being performed currently. For practices accepting assignment, over-the-counter collections should range between 40-45% of total production. Since it is feasible for a hygienist to treat 10 patients in one day, from whom the practice will collect zero dollars because insurance will pay 100%, it is essential that these measurements be averaged monthly to adjust for the ratio of insurance payment of benefits and patient payment. Practices that do not accept assignment should strive for 85-100% collections over the counter. Accounts receivable should be no more than 1 x monthly production. Finally, accounts receivable over 90 days should not exceed 12% of total accounts receivable.

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 Haller, P.h. D.
Leadership Coach
McKenzie Management
coach@ mckenziemgmt.com
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Manage Stress Before It Manages You
By Nancy Haller, Ph.D., Leadership Coach McKenzie Management

My last article talked about the warning signs of stress. Stress becomes dangerous when it interferes with your ability to live a normal life for an extended period of time. The stress reaction can have good or bad effects. It all depends on how you respond to the stressor. Of course there are multiple external circumstances that provoke the stress response. Going through a divorce, caring for elderly parents or dealing with a life-threatening illness are just a few of the difficult situations that will test anyone’s coping strength. Aside from those kinds of issues, many of us create a good bit of our own stress. We see crises as insurmountable. That ‘doom-and-gloom’ mindset produces the same stress response as if we were being held up at gunpoint.

You can't change the fact that stressful events happen. You can change how you interpret and respond to these events. Until you accept responsibility for the role you play in creating or maintaining it, your stress level will remain outside your control. The solution is to find effective, do-able stress management activities that you can participate in on a regular (hopefully daily) basis. These should be simple and inexpensive. Massages are relaxing but most of us cannot afford the time or money it would take to get one every day. Good stress management activities should be close to home and preferably free or very low-cost.

1.    Good self care. It is impossible to practice good dentistry if you don’t take care of yourself, physically and psychologically. Make good nutritional choices. Get enough sleep each night. Refrain from alcohol, caffeine and nicotine as these substances affect your ability to control actions and thoughts.  Exercise regularly to relieve tension and stress and to improve your stamina.  Set aside time to enjoy pleasant activities and hobbies. It might take a little bit more time to work these things into your schedule, but the rewards from doing so are well worth it.

2.    Strive for excellence not perfection. Research shows that perfectionists tend to get more stressed than people with more attainable standards. Expecting perfection from yourself and others increases stress. For one, you’ll always feel that “mismatch” between who you are and who you want to be. And, two, you’re sure to cause misery for those imperfect people in your life. Seeking improvement is great. Seeking perfection is a disaster.

3.    Make connections. Good relationships with close family members, friends, or others are essential for a healthy life. Accepting help and support from those who care about you and will listen to you strengthens resilience. Some people find that being active in civic groups, faith-based organizations, or other local groups provides social support and can help with reclaiming hope. Assisting others in their time of need also is beneficial.

4.    Talk with someone. Have at least one person that you are able to share your feelings with. Everyone needs some type of confidant. If you don’t feel comfortable going to someone you know, seek the help of a counselor or coach. An objective third party can provide new perspectives and options.

5.    Listen to music. When dealing with stress, the right music can actually lower your blood pressure, relax your body and quiet your mind. It is the rhythm of the music that has a calming effect on us.

6.    Meditate. There is a vast amount of scientific data proving the health benefits of meditation and guided imagery. The process of intentionally using your mind in creating positive sensory images produces healthy physiological changes in the body.

7.    Laugh at yourself. It shows emotional maturity and good psychological adjustment. Laughter also triggers healthy physical changes in the body. Humor and laughter strengthen your immune system, boost your energy, diminish pain, and protect you from the damaging effects of stress.

8.    Practice gratitude. Studies on gratitude indicate that the daily practice of being appreciative leads to greater alertness, enthusiasm, determination, optimism and energy. People who engage in daily gratitude exercises are less stressed and are more successful in achieving their goals.

9.    Determine what you can control (exercise, diet, dealing with anger) and what you cannot control (the economy, difficult patients, your hygienist’s personality). Keep things in perspective. Follow the advice of the Serenity Prayer – “Grant me the serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference.”

And if these ideas just don’t fit your style…

10. Breathe. Deep breathing is one of the best ways to lower stress in the body. Abdominal breathing soothes the nervous system and encourages health benefits. Those things that happen when you are stressed, such as increased heart rate, fast breathing, and high blood pressure, all decrease as you breathe deeply to relax.

Managing stress is all about taking charge - of your thoughts, your emotions, your schedule, your environment, and the way you deal with problems. The ultimate goal is a balanced life, with time for work, relationships, relaxation, and fun - plus the resilience to hold up under pressure and meet challenges head on.

Dr. Haller provides training for leadership effectiveness, interpersonal communication, conflict management, and team building. If you would like to learn more contact her at coach@mckenziemgmt.com

Interested in having Dr. Haller speak to your dental society or study club? Click here.

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Do you have money hidden in outdated systems?


Jean Gallienne RDH BS
Hygiene Consultant
McKenzie Management
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Knowing The Patient's Benefits, Concerns, And Motivators
By Jean Gallienne, RDH BS

How many of you are presenting treatment blindly with either a threat of what may happen if they do not follow through, or telling the patient what they need without really telling them why it would benefit them to have the treatment done? Rather than presenting treatment blindly, you want to know what is important to the patient, whether it is health, looks, or avoiding pain.

Once the patient’s motivators and concerns are determined, it is important that team members are also aware. Find a place that it will be noted in the computer, then approach the patient according to their motivators and concerns. Rather than asking the patient if they want a fluoride treatment, it is better to tell them that it is recommended for them to have fluoride. Then inform them why it will benefit them and not what may happen if they don’t have one. Most patients are motivated by staying healthy, and knowing how treatment will benefit them is the best approach.

When it comes to fluoride, there are many adult patients that would benefit from having a professionally applied fluoride. There are the elderly patients that have recession and are beginning to start their second phase of being in the “cavity prone years.” There are also the younger patients that have yet to make it through their “cavity prone years.” Both would benefit from having professional strength fluoride in addition to prescription strength at-home fluoride in order to prevent decay. There are also some patients that would benefit from a fluoride because of abfractions or areas that have recession and are sensitive to temperature.

How many times have you told a patient they need x-rays and they refuse to have them done? Your response to the patient may be: “Mr. Smith, if you don’t have the x-rays taken today then there may be a cavity, and that cavity can get bigger and result in the need for a root canal if left undetected.” This is one approach if the patient is concerned and motivated by pain.

For a patient that is concerned with health and refuses x-rays, it may be better to explain to the patient the benefit of having them. “Mr. Smith, by getting x-rays we will be able to verify that everything in your mouth is healthy. Not only your teeth, but the bone that supports the teeth.”

If the patient is concerned with money, the following verbiage may work best: “Mr. Smith with regular x-rays we are usually able to detect problems at an earlier stage of disease, and if you do need future treatment, it may help to decrease the amount of money needed to treat it by catching the disease at an earlier stage.”

What about the crown the patient needs and has had treatment planned for a couple of years now? Why are they not having it done – is it money, fear, pain? Once you have determined the reason they are not having the crown done, it is time to educate them about why they need to have it done. This is the time to ease their money concerns, whether it is insurance coverage, establishing a credit card plan with outside financing like Care Credit, or doing the dentistry in stages that works for them financially. If it is just left hanging there and the problem is not addressed, the patient may not even be aware of all of the different options they have when it comes to getting the work done and being able to afford it.

The same is true of fear and pain. Knowing what motivates your patients will help you with knowing how to approach them as the individual that they are. What is most important to them? Health, looks, money?  We all have different motivators and approaching others with what matters to them is what will help to get additional treatment done.

Also keep in mind the patient’s personality. An extroverted person will want to be approached differently than a person that is an introvert. The same is true when it comes to a person that is a feeler compared to a person that is a thinker.

There are many things to think of when approaching people with their dental health needs. Keeping all of this in mind will help prevent your patients from seeking second opinions or possibly leaving your practice all together.

Interested in improving your hygiene department? Email hygiene@mckenziemgmt.com and ask us about our 1-Day Hygiene Training Program.

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