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  Sally McKenzie's
 Weekly Management e-Motivator
  8.20.04 Issue #128

Keep Your Control Center out of a Tailspin

Sally Mckenzie, CEO
McKenzie Management

       We do love our technology - our computers, our cell phones, our PDA’s, digital cameras, our MP-3’s - but when we place a call to a business we want a living, breathing person to pick up the other end. We don’t want the faceless drone of voicemail or, worse yet, a menu of possible buttons to push. We want a friendly helpful individual who is professional and happy to provide necessary assistance so that the problem can be solved, the question can be answered, or the issued can be addressed. We don’t want to press one and then three and then

six before we ever actually talk to a human being.

Thankfully, few dental practices fling patients into a recorded system unless the practice is closed or the office is short staffed and no one can pick up the phone promptly. The bigger concern for dental practices is not the faceless drone, it’s the real live person answering the phone. If you were to ask a few friends or family members to call your office today and report back to you how well their calls were handled would you feel confident or concerned? How well would your number one link to your patients measure up?

In reality, most of you considering those questions probably have no idea. After all it’s just the phone, right.? Wrong. That would be like an airline pilot saying, “it’s just air traffic control.” The phone is the control center of the practice, but if you’re not paying attention to how traffic is handled, you have no idea how many of those calls have crashed and burned.

In the business of dentistry, the voice on the phone is the voice of the practice. If that voice comes across as unprepared, rude, or unprofessional, that is exactly how the practice is perceived. The positive enthusiastic welcome and helpful demeanor from a smiling face ring loud and clear to the caller, so too does the tension-filled tone and unspoken words that seep through gritted teeth, “who are you and why are you bothering me now.”

Patients can be alienated in 20 seconds or less depending how that “typical” phone transaction is handled. Virtually without exception, poor phone communication is the result of three things: lack of training, lack of planning, lack of standard operating procedures. Follow three simple rules to ensure that when patients ring your practice it won’t trigger the alarm bells.

1) When you answer the phone be genuinely warm and pleasant. Speak as if you were talking to the person face-to face. Use a clear, confident voice. Convey enthusiasm and a positive demeanor. If you are in the middle of a tense conversation or situation when the phone rings, take one ring to collect yourself, but don’t let the phone ring more than three times before answering, preferably no more than two.

2) Use the practice standard greeting. That should include identifying yourself and the practice. For example, "Good morning. Dr. Gary Mack’s office. Julie speaking. How may I help you?" No one should ever have to ask if they've reached your office. However, if there are two or more employees at the front desk, conclude your greeting with, “How may I direct your call.”

3) Tape record typical patient conversations and assess the speaking delivery skills. In addition, team members should be given the opportunity to objectively critique the recorded telephone presentations. (note: If you record the patient’s portion of the conversation, most states require that you inform the patient that the call is being recorded for educational and training purposes.)

Evaluate the delivery of phone conversations based on the following points:

  • Is the voice easy to hear, not too loud, not too soft?
  • Are the words clearly articulated?
  • Is the vocal tone pleasant, not gruff, shrill, nasally?
  • Is the rate of delivery comfortable – not too fast, not too slow?
  • Does the individual convey enthusiasm, helpfulness, and genuine desire to assist the caller?
  • Does the business employee show respect for the caller?
  • Does the employee speak using correct English?

Next week more tips to keep your phones ringing.

If you have any questions or comments, please email Sally McKenzie at

Interested in having Sally speak to your dental society or study club?
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Dental Procedures You Can Bill to Medical Insurance

Dr. Allan Monack
Hygiene Clinical Director
McKenzie Management

        There are treatments you may be performing on your patients that the patient can submit to their medical insurance. Not every medical insurance provider will pay on dental procedures. However, if a dental procedure is necessary due to a medical condition or trauma, it may qualify as a medical reimbursement.

There are many dentally related surgical procedures that are already covered under a

patient’s medical insurance, such as impacted third molars. There is an indication, however, that more dental insurance providers are requesting a rejection of the service in question before allowing a submission for payment from the dental carrier.

In order to submit a claim to a medical carrier you need to include a diagnosis code (ICD-9) and a service code (CPT). Many medical insurance providers will also accept a CDT-4 as a service code because it is the codes used for Medicare billing (HCPCS). Below is a list of some dental procedures that may be allowed by the patient’s medical provider.

Diagnostic code:
E917.0 Struck by sports equipment
525.11 Loss of tooth due to trauma
Note: Accident reports need to be documented with the claim. Include date, location of accident, injury description, treatment rendered, and future considerations. An example of future treatment may be the need for an implant if the tooth re-implantation fails.

Diagnostic code:
830.0 Disc Displacement without reduction
726.8 Capsulitis
781.0 Trismus

Diagnostic code:
873.63 Fractured tooth no exposure
E826.1 Bicycle accident
Note: Accident reports need to be documented with claim.

Diagnostic code:
V12.2 History of diabetes
523.4 Chronic Periodontitis
Note: May require physician’s letter documenting systemic disease

Diagnostic code:
710.2 Sjogrens disease
527.7 Xerostomia
521.02 Dental caries
Note: May require physician’s letter documenting systemic disease

Diagnostic code:
523.3 Acute pericoronitis
524.3 Ectopic eruption
Note: Attach report

Diagnostic code:
780.53 Hypersomnia with sleep apnea
Note: Usually requires report of sleep study. CPT codes are for anterior repositioning appliance (21089)

Diagnostic code:
523.8 Gingival hyperplasia
E936.1 Adverse side effect of medication (Dilantin)
Note: Usual treatment is gingivectomy per quadrant. (CPT 41820)

Diagnostic code:
306.8 Bruxism
307.81 Tension headaches
Note: Attach a letter of medical necessity. Bruxguard (CPT 99070)

You should obtain a medical insurance booklet of CPT and ICD-9 codes and the ADA CDT pamphlet if you do not already have them.
(Please note that effective January 1, 2005 will be CDT – 2005 codes.) Keep current and become familiar with diagnostic procedures that can be submitted medically for dental treatment. Most medical insurance carriers require preauthorization prior to treatment unless it is an emergency procedure. When possible contact the carrier before you initiate therapy. Ask what their requirements are such as referrals from physicians, diagnostic tests, documentation of a systemic disease, and any limitations in the plan. Most dentists will not be in network. Find out what out of network requirements may exist.

This author wishes to acknowledge the information for this article came from the ADA CDT-4 , AMA CPT and ICD-9 and the American Dental Support, LLC newsletter “Insurance Solutions”

If you have any questions concerning your hygiene program submit them to me at and I will answer them in future articles.

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


The Keys To Keeping Long Term Quality Staff

Belle M. DuCharme
RDA, CDPMA, Director
The Center for
Dental Career Development

         “Why is it that the average length of employment for dental office personnel is about two years?” A dentist wanting to enhance his business skills was recently attending The Center for Dental Career Development’s Advanced Dental Business Program for Doctors and asked this question. At the time we were discussing how to hire and train dental employees. “Why should I invest time and money in hiring and training only to have this person leave in two years?”
I answered. “Typically, it is the office that does not spend the time to hire the right person and to

offer training that suffers from turnover.”

I personally know several women who have been in the same practices anywhere from five to twenty-five years. These are the responses I received when I asked them why they were still there.

Fran - “I don’t make mistakes often, but when I do, I know Dr. is not going to make me feel like I am about to be fired.

Sylvia - “I have stayed with Dr. all of these years because he values my input along with the rest of the staff to make the best practice around. He is supportive of continuing education and training on the computer system.”

Judy - “I had worked in other offices and became discouraged with the chaos until I came to work for Dr. ten years ago. He knew what he wanted to accomplish in his practice and gave me a clear picture of my job responsibilities. I feel like I make a difference.”

Sharon - “I have been with Dr. for twenty five years this year. During this time I have given birth to two children, put them through college and now married off my daughter. Five years ago my mother died of ovarian cancer and I had to take some time to grieve. Through these life changes, Dr. has been supportive and together we have worked through the rough spots of life. Because she has allowed me to be flexible as changes occurred in my life, my devotion to her and the practice has deepened over the years. I feel I am the best office manager to Dr. and the staff because of the relationship of trust we have developed. I know it is not like this in other offices, I am just glad I got lucky.”

Sammie - “I have been with Dr. for over five years. The office I came from felt like a sweatshop or some kind of dysfunctional clinic. When there was an error no one took responsibility and the “blame game” was the every day occurrence. I was hired to run the front office but it was a mess and there were no systems in place and no one to go to, to get help. It was like “sink or swim”. I was thinking of going back to school and studying anything but dentistry, when I saw an ad for a Dental Office Administrator. The ad was written so well and seemed to match my professional goals that I had to call. I have been here ever since and the thought of leaving never enters my mind. My only fear is that my doctor will retire someday.”

The right temperament, shared visions, goals, respect, trust, and flexibility. These are the keys to keeping long-term quality staff.

If you would like to learn how you can gain and retain the best staff, email and inquire about our Advanced Business Training for Doctors.

Belle M. DuCharme, RDA, CDPMA

McKenzie Management’s Hygiene Clinical Practice Enrichment Program is designed to improve Hygiene Clinical Skills and develop and implement a step-by-step Interceptive Periodontal Therapy Program that will immediately bring greater productivity, with enhanced patient care. For more information...GO HERE





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Sally's Mail Bag

Dear Sally,
I have heard you speak several times and have always enjoyed you and implemented many of your suggestions. I am in the process now of taking your advice of getting a separate front desk person to work just on recall. How many hours a week should I employ her?
Dr. Silver Springs Maryland

Dear Doctor,
The number of hours per week is dependent on how many ”active” patients you have returning for recall.
This is determined by generating a recall report of patients due for recall, with and without appointments between today and one year from today. Below is a “general” guideline for you to follow:
< 500 patients –0 hours (Receptionist can handle the system)
600-800 patients – 9 hours
800-1000 patients – 12-15 hours
1001 to 1200 patients – 16-20 hours
1201 to 1500 patients – 22-26 hours
1501 to 1700 patients - 27-30 hours
1701 to 1900 patients - 31-36 hours
1901 to 3000 patients – 37-40 hours which would generally be 2-4 hygienists
Let me know if I can be of more help.

Note: If you have any questions or comments that you would like addressed here in this mail bag, please email Sally McKenzie at

Office Managers
Financial Coordinators
Scheduling Coordinators
Treatment Coordinators
Hygiene Coordinators

For a FREE
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La Jolla, CA 92037


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This issue is sponsored
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San Diego Workshop Series
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 Date Seminar Instructor(s)  
 August 27
 9:00 - 4:00
How to Become an EXCEPTIONAL Front Office Dental Employee Belle DuCharme, RDA, CDPMA  

The Center for Dental Career Development has been approved under the Academy of General Dentistry, Program Approval for Continuing Education (PACE). Starting 10/19/03 through 10/18/07 members of the Academy of General Dentistry can receive AGD credits for all seminars and workshops sponsored by the Center for Dental Career Development.

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