8.31.12 Issue #547 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter
 

Beat the Competition: Reinvent Your Practice
By Sally McKenzie, CEO

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To paraphrase Plato, necessity is the mother of reinvention. As it turns out, the last few years have prompted many small business owners to reinvent themselves. A recently released Citibank survey revealed that a majority of respondents, 53%, have reinvented their businesses to stay afloat during the challenging economy. In doing so, they focused their attention on expanding products and services as well as improving technology and personnel.

Nearly every respondent indicated that they took other steps to keep up with the competition. In fact, 88% reported that they increased their personal knowledge about their field of business, and 70% increased face time with customers. In the coming months, the majority of survey respondents plan to increase marketing efforts and introduce new products or services.

What does all of this mean to the small business owners in dentistry? Plenty. For those of you whose favorite mantra is “I just want to do the dentistry” - great. Seize the opportunity to reinvent your practice, starting with an expansion of your services. Virtually every recognized leader in the dental profession has long urged practitioners to become proficient in at least some of those areas that they have historically referred to specialists, including endo, ortho, perio and others.

As the survey also showed, knowledge is power. Small businesses that are succeeding are making the effort to better understand the business itself and their customers. It is here that dentists have huge potential for growth. Most doctors, regardless of where they are in their dental careers, find the business and personnel side of the dental practice to be extremely challenging. What is perhaps most frustrating is that the doctor may be a truly superior clinician, yet the practice is struggling because the business systems and staff are weak.

There are 20+ practice management systems that require ongoing attention in most dental offices. However, two areas in particular - employee accountability and staff training - are critically important. They both dictate the effectiveness of your customer/patient service and impact virtually every other practice system. But what does “employee accountability” mean? It means that staff members understand clearly their responsibilities and the doctor’s expectations. There’s no “Well, I thought that was her job” or “I didn’t know I was supposed to do THAT.” Thus, when issues, concerns, or questions come up with patients, coworkers, insurance companies or practice systems, staff know who’s responsible and how to respond effectively to address the situation. The problem: Many doctors think employee accountability automatically happens in their practices. It doesn’t.

Breakdowns in employee accountability commonly occur because time and again doctors mistakenly assume that staff intuitively know what to do and what the doctor expects. After all, the doctor reasons, “I know how to do my job. Staff should know how to do theirs.” It is an assumption that we see routinely in troubled practices and it spells disaster. Consider this very familiar example:

“Dr. Liz” hired a new business employee, “Emily.”  Emily was brought onboard largely because of her previous experience, so Dr. Liz didn’t think she would require any training. Emily had worked for “Dr. Sam” who preferred to handle virtually all patient interactions from treatment presentations to treatment financing, which is a kind way of saying he was a micromanager. But Dr. Liz’s style is more hands off. She simply assumed Emily would know that her job requires treatment presentations as well as discussing financial arrangements with patients. During the interview, Dr. Liz asked Emily if she was comfortable talking to patients about treatment. It was a vague question, and Emily affirmed that she was. But the doctor never specified what “talking about treatment” meant. Both wanted the arrangement to work out and neither asked more specific questions.

Upon realizing that Emily wasn’t carrying out key responsibilities of the job, Dr. Liz made some general references to “taking care of patient education things,” and “making sure patients know their options.” Again, they were vague references to responsibilities that Emily was to be accountable for, but employee accountability doesn’t just happen and it can’t be assumed. Ensuring employee accountability requires specificity. 

You cannot run your practice, let alone “reinvent” it, if employees do not know what you expect. Tell them in writing in the form of a job description. From there, establish performance measurement systems to enable you and the employee to determine their effectiveness. And finally, train them to succeed in your practice.

Next week - Cha-ching! Making sure that “face time” pays off.

For more information on this topic, visit my blog: The Lighter Side.

Interested in speaking to me about your practice concerns? Email sallymck@mckenziemgmt.com
Interested in having Sally McKenzie Seminars speak to your dental society or study club? Click here.
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Belle DuCharme, CDPMA Instructor/Consultant
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3 Major Keys to Treatment Acceptance
By Belle DuCharme, CDPMA

Anyone that presents treatment to patients, whether it is the doctor or the support staff, understands the frustration when the patient does not schedule and “wants to think about it.” But if you look at it from the patient’s prospective, there is a lot to think about. Discretionary income for many is less these days than before the recession kicked in. While most people want good health and good teeth, the rationalization of whether it is the best investment of family funds can cause derailment in the ability to make a decision. Thoughts of whether there is a less expensive alternative or just to leave it to chance and deal with it later come into play. 

Patients differ in personalities, values, and resources to pay for dental care. As a Treatment Coordinator for many years, the lesson learned is that patients often leave the office not having all the information necessary to make such an important personal decision. It isn’t that they weren’t educated or informed; it’s that they need to know if it is the right decision for them and for their family. Parents often postpone healthcare indefinitely so that funds can be spent on their children, and the elderly often think it isn’t prudent to put money into long lasting dental care when they most likely won’t be around to get the full value out of it. Sometimes patients don’t ask the questions they need answers to, even though they are asked “Do you have any questions about what we have discussed?” The conversation can be directed toward the following unasked questions and the recommended answers.

1. How do the treatment options differ in cost?
Preparing separate printed documents for each treatment option showing the estimated cost for each helps in the comparison of product to product. Information in the form brochures helps the patient to reference the information at home. When discussing the proposed treatment with family members it helps to have written information.

If the treatment is in phases such as would be for implants, the patient has some time to save for the restoration. In some cases a long-term interim prosthetic will keep the patient in the loop with the thought of replacing it at a specified date. If the patient wants to get a second opinion from another provider, let them know that you will cooperate with sharing the x-rays and other pertinent information. This is an indicator that there may be a trust issue between the patient and the practice. Sometimes it comes from not knowing what the treatment “should” cost in the current market.

2. Which treatment will last the longest?
This information is critical to providing value to good dentistry. Long-term value realized in good dental care is one of the best investments a person can make. Demonstrate how the service and product is meant to last a long time and that you will warranty the product against defects for a year and prorate the value if the product fails within five years. When comparing long-term value of an implant versus a bridge, show that implants by average last 35 years compared to a bridge which has an average of 5 years of life and does not retain the bone, etc. On the treatment option sheet write the estimated long-term value of the service and the responsibility of the patient to keep routine maintenance visits to be considered for the warranty.

3. Do all the treatment options solve the problem?
If the patient needs an implant and a crown but wants the third option of a “flipper” or interim partial because it is affordable, spell out that this option will solve only part of the problem. The flipper is to fill the gap but is not functional as a tooth and is a short-term solution. Write on the treatment plan how many “repair” visits or adjustment visits you allow in 6 months and a timeline to replace the flipper. Patients often expect that if you do a service, even though it has a high failure rate, you will continue to replace or repair it. If it is determined the treatment has a guarded to poor result, then it is a gamble to do the treatment at all and will most likely result in an unhappy patient.

Follow-up to patients who are “thinking about it” or have requested records to get another opinion is vital to treatment acceptance. If you do not keep yourself in front of the patient and counsel them in their care, they will lose the connection with your office and will gravitate to where their needs are met.

Want more training in treatment acceptance? Contact McKenzie Management today and sign up for the Treatment Acceptance Training Course.

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

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Nancy Caudill
Senior Consultant
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Playing the PPO Insurance Game and Winning
By Nancy Caudill

“Oh what a tangled web we can weave”....or something like that. This poetic statement sure does apply to all the dental offices that are trying to make sense of playing by the rules associated with PPO insurance contracts. The objective of this article is to help you have a better understanding of how to effectively work with PPO plans that you are contracted with.

What is a PPO?

To quote Wikipedia: Dental insurance companies have fee schedules which are generally based on Usual and Customary Dental Services, an average of fees in your area. When a dentist signs a contract with a dental insurance company, that provider agrees to match the insurance fee schedule and give their customers a reduced cost for services, this is considered an In-Network Provider or Participating Provider network (PPO). Depending on your specific plan, if you seek an Out-of-Network or Non-Participating Provider, any difference of fees will become the financial responsibility of the patient unless otherwise specified in your dental policy.”

What does this mean to you? If you elect to participate with a PPO plan in order to either compete in your marketplace, acquire new patients or keep the ones that you have, because their dental coverage changed to a PPO plan, you must play by their rules or you don’t get paid. These options serve a purpose in the industry and put patients in the chair that you may not have had without the plans. But always read your contract carefully before you sign on the dotted line. It is very clear what you can and can’t charge the patients for, as well as how much you can charge the patients.

What is Covered and What is Not?
As you may know, 26 states have passed laws stating that you can charge your office fee for non-covered procedures. So what is a “non-covered” procedure? This is a service you perform that is either specifically listed on the Fee Schedule as “non-covered” or is not listed on the Fee Schedule at all. If it is listed on the Fee Schedule with a fee and indicated as a “covered benefit” then you must charge the patient this amount for the service. I encourage you to check with your state society for specific guidelines for your states. Not all states have adopted this law as of a month ago.

Here is an example of when the patient is responsible at 100% of your fee: You want to provide veneers for your patient for cosmetic purposes. Veneers are a “non-covered” procedure as indicated on the Fee Schedule OR they are not be listed at all. This is a procedure that is not dictated by the PPO plan regarding your fee for this service, so the patient is responsible. You would charge your “office fee” for this service.

Here is an example of when the patient is responsible at 50% of the PPO fee: The PPO covers veneers on their plan at 50% of THEIR fee and their fee is $500/tooth. You can only charge the patient $500 per tooth, and the patient is responsible for $250/tooth. If your “office fee” for a veneer is $900, you must write off the difference of $400, or you simply only charge the patient $500, depending on whether you post the PPO fee or the office fee on your patients’ ledgers.

Is $500 a reasonable fee for a veneer? You would probably say no. But if you want to provide this service for your patient AND you are participating with this PPO plan, this is what you are contracted to charge the patient. Even if the patient is willing to pay more than their 50%, you cannot, by contract, charge the patient more.

Another example occurs when the procedure is covered, yet it is denied. The PPO plan specifically indicates in the contract that it does not cover a 1-3 tooth scaling and root planing on the same day as a prophylaxis. However, your hygienist treats the patient for both procedures to save the patient time in their busy schedule. When the claim comes back, the comment on the “Explanation of Benefits” is that the scaling and root planing were denied because they were performed on the same day. Unfortunately, you must write this off. It is a covered benefit; it was just performed on the wrong day! To play the game, your hygienist should have performed the scaling and root planing on another day to comply with the contractual stipulations.

Understand the rules. When your Insurance Coordinator is confirming the eligibility of your patients, ask specific questions to help you and your hygienists understand what is covered, not covered or restricted.

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

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