4.24.15 Issue #685 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter
 

How Poor Phone Communication is Costing You Money
By Sally McKenzie, CEO

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Mrs. Jones just called your practice, hoping to find her new dental home. She has three children and keeps a very tight schedule during the work week. She tells your office assistant, Sarah, she prefers a practice that not only has Saturday morning hours, but that also allows her to bring in all three kids at once. Sarah sighs, and tells Mrs. Jones you no longer offer Saturday morning hours and that even if you did, she’d have to wait months to get an appointment for her entire family. She then thanks Mrs. Jones for her call, hangs up and goes back to the important task that pesky phone call just interrupted.

If this is how calls are handled in your practice, you have a huge problem. Instead of telling Mrs. Jones about your flexible early morning and weekend hours, and assuring her you’ll be able to see her entire family on a day that’s convenient for them, Sarah has pretty much guaranteed Mrs. Jones and her family will never step foot in your practice.

Yes, in just a few short minutes your well-intentioned office assistant cost you thousands of dollars in lost revenue. Not only will Mrs. Jones not be calling your practice her new dental home, neither will any family or friends she might have referred to you. And if that’s how Sarah handled this call, you can bet Mrs. Jones isn’t the only potential new patient she has discouraged from making an appointment.

Don’t get me wrong. Sarah isn’t sabotaging the practice on purpose. She just hasn’t been properly trained to handle these phone calls, and doesn’t understand how important it is to connect with patients over the phone.

When the phone rings, your team members shouldn’t view it as a disruption to their day, or a nuisance that keeps them from getting real work done. They should see it as an opportunity to provide exceptional customer service, whether they’re talking to a busy patient who only has a few minutes to schedule an appointment or an angry patient who is upset about a billing error.

Remember, the person who answers the phone represents your practice and should be armed with written scripts for various situations. He or she should be professional and courteous, and speak in a clear, friendly voice. And, unlike Sarah, team members who answer the phone should provide solutions to the problems and concerns that potential and current patients have. These calls are an opportunity to grow your practice, not to set up roadblocks. Never tell a patient “no” or you “can’t.” If you do, the patient will find a practice that can.

Poor telephone skills not only cost you new patients, they also hurt your relationship with current patients. When patients call to schedule treatment, they don’t want to be rushed off the phone by a seemingly rude team member who has better things to do, or put on hold for 15 minutes because the person who answered the phone is simply too busy to take their call. They want to schedule an appointment or find a solution to a problem.

If they don’t receive a warm greeting and exceptional customer service when they call your office, even loyal patients might start looking for a practice that actually wants to talk to them, leaving you with falling patient retention and production numbers.

While it’s important to use proper techniques when answering practice phones, team members need the same skills when they’re reaching out to recall patients or following up after case presentations. Calling these patients won’t do much good if the team member dialing the number isn’t armed with the proper script or information about the patient and what’s keeping them from going through with treatment. These are sales calls, and without proper training your team members will have a difficult time getting patients on the schedule.

Patients are buying the benefits of your services, not the services themselves. During follow up calls, your Treatment Coordinator should address concerns and talk to patients about the benefits of recommended treatment. Use words that encourage patients to schedule treatment, such as definitely, absolutely, let me recommend and I assure you. Like anyone else in the practice answering or making phone calls, the Treatment Coordinator should be trained to smile while speaking, and to talk clearly and professionally so patients can focus on the message instead of trying to understand what the person on the other end of the phone is trying to say.

Proper telephone techniques are critical to your practice’s success, and if your team members don’t use them it’s costing you big. But it doesn’t have to be this way. I can help you turn it around. I offer telephone assessments designed to evaluate the effectiveness of a dental team’s phone skills, enabling you to determine what you need to change to create positive results. I also offer telephone training to help you make those improvements and better understand the value of scripted telephone conversations and what they can do for your practice, from growing patient retention numbers to a more robust bottom line.

Next week, 9 ways to improve your telephone techniques

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

Interested in speaking to me about your practice concerns? Email sallymck@mckenziemgmt.com
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Belle DuCharme, CDPMA
Instructor/Consultant
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Do You Need an Insurance Coordinator?
By Belle DuCharme, CDPMA

Staffing expenses are usually the highest expense incurred when operating a dental practice. Being able to afford to hire more staff when the need arises must be approached realistically and never out of panic or desperation. A common scenario is for a practice to grow beyond the one person at the front desk being able to handle it all, and a new team member is needed to accomplish all of the tasks at hand.

If there are more than 20 patients being processed per day at the desk, it is time to look at hiring another full time employee with a definitive job description. The job description now becomes two, with the Business Coordinator as the Financial/Insurance Coordinator and the new hire as the Scheduling Coordinator (the first in line to answer phones and collect and enter patient data). If the practice sees 40-60 patients a day and is involved in more than 10 Preferred Provider Networks, the feedback I receive from practices is that an Insurance Coordinator is also needed because of the time it takes to verify benefits, appeal dental claims, sit on the phone waiting to talk to a representative, entering insurance checks in the system and doing the write-offs by contract and entering and updating insurance fee schedules.

More practices lose patients over miscommunication involving dental insurances and billing than they do in actual clinical dental care. There must be diligence to collect co-payments and applicable deductibles (as contracts stipulate) from patients to ensure adequate cash flow to keep operations in the black. The Insurance Coordinator is often the one to give this information to the Financial Coordinator if not involved with the check-out. Achieving treatment acceptance involves being able to explain the coverage and financially prepare the patient for out-of-pocket costs. This takes time at the desk and is often cut short by phone interruptions and patients needing to be checked in and out. This is the reason the Insurance Coordinator is needed, to complete the patient check out process.

Being involved as a PPO provider is a personal decision. It is important to be aware of patient perceptions in your demographic and whether this decision is best for your situation. The following is recent information from the Delta Dental Plan Association:

Although almost 85 percent of the total population has medical coverage, only 57 percent of the total population has dental coverage, among those without dental benefits, “lack of insurance” was the most commonly cited reason (44 percent) for not visiting the dentist. The most commonly reported individual health-related service not received because of cost is dental care.

Eighty-one percent of individuals with dental benefits reported seeing a dentist twice a year or more, while only 34 percent of uninsured individuals reported the same frequency of seeking preventive care. Furthermore, people without dental benefits are less likely to have tooth-saving and restorative procedures (fillings, crowns, root canals) than those with benefits but more likely to have extractions and dentures. Those who currently receive dental benefits place a high perceived value on their coverage – as indicated by their reported willingness to pay up to three-and one-half times more to acquire such a benefit. 

Since the 1960s when dental insurance was first offered by employers, the maximum per calendar year has not changed with the average still being $1,000 per calendar year or fiscal year. Statistics show that more people visit the dentist who have insurance than those who don’t. A dentist who is not a Preferred Provider in a network of insurance companies can lower the revenue into the practice considerably. A patient might say, “Why doesn’t my dentist accept my dental plan?” The opportunity to attract more patients is there, but because of the constraints on optimum care and the reduction by 30% or more of the dentist fee, the PPO network dentist must rely on volume and efficiency to survive.

Quality care comes at a quantified price, and the dentist’s efforts to control some costs are not sufficiently successful to achieving the goal. Good dentistry cannot be sacrificed to be profitable in the PPO network. Volume of patients would dictate that the dentist must work out of two to three rooms at a time and perhaps double up on hygiene days or hire another dentist. Operational costs become larger issues and stress levels shoot up.  

According to PayScale.com, the median salary for an Insurance Coordinator is $16 an hour (December 2014). This is considered a full time position in practices with heavy PPO network numbers. This person is mostly concerned with checking and filing insurance claims, attaching narratives and other documentation, following up on unpaid claims, verifying insurance eligibility and other duties as described above. Follow-up on unpaid claims often requires up to 20 minutes on the phone per issue. If no one is working this system, your over 90 day accounts receivables is going to be very high.

Is there another way? You can explore your options with us by signing up for a course in Office Management Training and learn how to manage your practice to ensure success.

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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How Much Money Do You Owe Patients?
By Nancy Caudill, Senior Consultant

Credit balances are an aspect of expenses that many dentists are not aware of, and as a result their practices do not have a game plan to pay them. First, what is a credit balance? The simple definition is a negative balance on a patient account. Secondly, if the patient has a credit balance, how did it happen? This question has multiple answers:

• The insurance reimbursement was more than anticipated after the patient’s “estimated” portion was paid at the time of service.
• An adjustment was made on the account for entries such as incomplete treatment, courtesy adjustment, failed procedure adjustment, etc.
• The primary and secondary insurance companies did not coordinate the benefit payments, creating an over-payment.
• The fee posted to the account was lower than the allowable for the PPO plan.
• The patient has “prepaid” for upcoming treatment.

The Credit Balance List
Now that you have a list of patients with credit balance, what happens next? It depends on the reason for the credit balance in the first place. Ask your Financial Coordinator to generate the credit balance list, then have a meeting with him/her and do research on each account to indicate the following:

1. Is it an overpayment made by the patient and is the credit owed to the patient?
2. Is it an overpayment by the primary/secondary insurance carrier and the money is owed to the insurance company?
3. Is it prepaid funds by the patient for treatment that has not been performed yet?
4. Is the credit balance due to the insurance company paying more for a service than the amount posted to the patient’s account?

Let’s review each scenario mentioned above.

1. If the patient contributed more than needed at the time of service as part of the “guestimation” of their portion, the patient should be contacted to determine if they choose to keep the credit balance on their account for treatment to be performed in the future, or if they prefer a refund check.

Contact your state dental society or board and see what the guidelines are for returning credits to the patient. In California, for example, it is 30 days.

If the patient elects to keep the credit balance on their account, a note to that effect should be logged in the patient’s digital record. If the patient requests a refund, the ledger should be printed showing how the credit balance was created, and this “invoice” should be presented to the accounts payable person for reimbursement. Once the check has been written, an entry should be made on the patient’s account and attached to the “refund to patient” adjustment, indicating the check number and the date it was mailed.

2. If the funds should be returned to one of the insurance companies after an inquiry is made (typically it is the secondary that overpays), the same process as above is followed, using a “refund to insurance” adjustment code. The patient nor you should benefit from two insurance companies paying more than the fee for the service.

3. If the patient has prepaid for services in advance, a note should be made to that effect so there is no question.

4. It is common for the credit balance to be a result of the insurance company paying more for a service than the amount posted to the patient’s account.

With most practice management software programs, you have the option to submit your claim to a PPO carrier with your “office fees” and at the same time, post the PPO fee to the patient’s account. In fact, insurance companies encourage you to submit your fees opposed to the already discounted PPO fee. It is the only way they can keep up with what dentists are actually charging.

If your fee schedule for a PPO plan is not current, the claim is submitted with your office fee and the patient’s account is posted with a potentially inaccurate PPO fee. As a result, the insurance company pays more based on the office fee that was submitted. This creates an overpayment on the patient’s account.

As a practice owner, it is important for you to understand this money is not a credit balance that requires the funds to be returned to the insurance company. Instead, the fee schedule should be increased to reflect the correct amount on the patient’s account and a production code should be posted to the patient’s account for the difference between what the insurance company allowed and paid vs. the amount that was posted to the account. We use a production code because the original production amount was not accurate, so the production needs to be increased.

You can create an “in office” production code such as PPO and use this code when posting the correction. This will also allow the production for that provider to be more accurate.

The difference between an old PPO fee and the increase that the PPO plan is allowing is usually only a few dollars, but it should be corrected.

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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