You On the Giving End of Your Receivables?
It’s the soft patch in
the economy – still or maybe again. It’s those goofy
insurance companies. It’s the lack of time. It’s this
lame excuse, “Well, you know we’re in a blue collar
county and the factory shut down.” Or that inane justification,
“You know, our patients just don’t expect to have to
pay until they get a bill.”
it’s the fear of actually asking for money,
a weak financial policy, all likely compounded by a practice-wide
willingness to ignore all those “things” that cause
accounts receivables to
siphon profit from the practice. Accounts receivables is the total
amount of money owed to the practice from patients, insurance companies,
or other third parties, and it should never be more than one
treated like that dirty closet down the hall, many practices don’t
really want to look at it, so they just avoid opening that door
as long as possible. After all, who really wants to see in black
and white that they have some $150,000 or more in uncollected fees
eating away at their bottom line, dollars that
could be used for doctor and staff training, new equipment and technology,
perhaps even a salary increase or bonus?
it and maybe these people will actually pay off their bills by the
end of the year, sure, and maybe the tooth fairy will cover the
balances for the rest.
have seen accounts receivables as high as four times monthly production
in some practices. Often these are businesses that have long served
as dental lending institutions of sorts. It’s
so much a part of the practice culture that it is difficult for
the team to comprehend that it could ever be any other way –
even if the practice down the street in the same community, with
the same socioeconomic issues has practically non-existent accounts
receivables. What’s more disconcerting is that in many of
these situations, the dentist is paying little attention to how
high their accounts receivables are.
number one to getting receivables under control – get
an aged accounts receivable report monthly that
lists every account with an outstanding balance and date of last
all monies over 90 days delinquent. The percentage should not
be over 12% of your total accounts receivable.
the charges in the "current" column of the report. These
are uncollected monies produced in the past 29 days. Because the
practice should have a minimum of 45% over-the-counter
collections for the month, (if you are accepting assignment
of insurance benefits) there should be no more than 55% in the
current column awaiting insurance reimbursement.
run the report with credit balances because credit
balances need to be added back to the total accounts receivable.
the total exceeds your monthly production, it's a red flag indicating
problems in one or more of the following areas:
of financial arrangements
inability of financial coordinator to ask for money
wait to see red!! Get your systems on the receiving end today!
you have any questions or comments, please email Sally McKenzie
in having Sally speak to your dental society or study club?
to Hire a Coach? You’re Not Alone.
Dr. Nancy Haller
week’s question comes from one of our McKenzie Management’s
Practice Enrichment Consultants.
had my consult call with Dr. Smith today. He is the one who was
unavailable for your calls, and was not responding to your emails
and voice mail messages. He admitted to me that he is just "chicken"
to talk to you... fearful of what you may say or what your conversations
Is there something I could say that would allay his
fears or get people who know they need coaching yet are afraid to
go for it?
Thank you very much for bringing this to my attention. I imagine
your client is feeling alone and isolated. However, he is struggling
with a very human issue- fear of change, fear of being vulnerable,
fear of not being perfect. Unfortunately nothing sabotages
success as much as fear.
In her book, Feel the Fear and Do It Anyway, Susan Jeffers
poignantly describes the limitations that people impose on themselves
when they cave into their fears. People who never take any
risks ironically live with a dread of something going wrong.
They seek security above all else, but the effect is chronic insecurity.
It is actually easier, and infinitely more rewarding, to try new
things. The decision to incorporate more challenge into your life
brings a feeling of security because you know you can tackle anything.
we face our fears, we can’t grow. Without growth,
life is stagnant.
of the biggest obstacles to growth is perfectionism, a common
trait of dentists as well as other professionals. For many
high achievers, the message came in childhood when well-intentioned
parents tried to instill motivation yet delivered fear. I remember
being a seventh grade student and being introduced to biology. Although
I was blessed with a good brain, I hated dissecting bugs, worms
and frogs. I ended up with a ‘C’ in Science on a report
card filled with ‘A’s’.
with my overall accomplishments, I proudly awaited some form of
praise from my parents. However, the first comment I heard was,
“What’s this ‘C’ doing here?” I was
crushed - they didn’t even notice the good stuff I did. And
in a small and probably unconscious way, I learned the benefits
of being perfect – no one can criticize you.
suspect that like the client above, many who are reading
this also tend to judge themselves too harshly. And the
perception is that others will criticize them and find fault too.
However, as a ‘recovering perfectionist’ and coach,
my job is to offer a safe, non-judgmental place for change
to happen, to help identify strengths and talents, and
then to leverage those to overcome obstacles for greater success.
Coaching is designed to enable people to be ‘good enough’
rather than perfect. Imagine what it would be like to have
someone who accepts you as you are, and also helps you to see the
part of you that maybe you've forgotten; someone who will
stand with you and hold your vision so you can move towards your
is not a punishment but an opportunity. The process entails setting
goals for more effective action, and it provides the support needed
to make incremental but important behavioral changes. Coaching
is akin to having a ‘professional fitness trainer’…someone
who works with you on your agenda. A good coach is
someone who motivates by pointing out what you did well, someone
who encourages by aligning with your values and needs. A
good coach is someone on your side.
with fear, another significant obstacle to coaching involves
financial concerns. A study reported in the January 2001
issue of Business Wire followed 100 executives, half holding
positions of Vice President or higher, almost half between the ages
of 40 – 49, and one-third earning $200,000 or more per year.
The results of their 6 – 12 month study showed an
average return on investment of 5.7 times the initial investment
in a typical coaching assignment or a return of more than $100,000,
according to executives who estimated the monetary value of the
results achieved through coaching.
hope that what I’ve written will help you and your client,
as well as others who are reading this. Face your fear,
and do it anyway. Coaching will give you confidence AND
financial rewards too.
Haller is available to speak to your dental society or study club
on subjects such as interpersonal communication, conflict management,
and team building. If you would like information about any of her
practice-building seminars, contact her at firstname.lastname@example.org
or 1-877-777-6151 Ext. 33
Executive Coaching Help YOU Be A Better CEO?
this test to find out ...
the Patient’s Perspective
are your biggest fears? Insects? Rodents? Hanging from an airplane
over open water? Being buried alive? The so-called reality show
FEAR FACTOR exploits peoples’ fears and contestants actually
volunteer to participate in this game of public traumatization for
a mere $50,000. Fortunately, dental phobia has
not been featured
on this program, but as dentists discover early on in their careers
many patients can be very anxious about the dental experience. There
are varying levels of fear, but when fear reaches the point that
it is irrational and causes the patient to avoid treatment, it becomes
who are extremely phobic typically have a history of negative
dental experiences. However, those experiences aren’t
necessarily painful. In many cases anxious patients are as much
or more afraid of embarrassment than they are of pain. They may
start avoiding the dentist because of a painful experience, but
they also often realize they need to return to the dentist. However,
they can’t bring themselves to do so because they are afraid
they will be scolded and belittled for their neglect.
other cases, fears are learned vicariously through parents, family
members, and friends. They may hear about Aunt Mary’s horrible
experience 20 years ago and decide to take ownership of
that incident almost as if it were there own. But typically
there is not just one reason why people become fearful. It tends
to be a cumulative effect.
the anxious or phobic patient can be almost as difficult for the
dentist as the experience is for the patient. Dentists frequently
are targets of comments such as, “Don’t take this personally,
but I really don’t like dentists,” from patients, friends,
or even family members. In other cases, it’s the question,
“Why did you become a dentist?” as if such a decision
surely must be the result of some early life trauma or closeted
desire to engage in tortuous activities. Anxious patients
are a common source of stress for dentists who are provided very
little training in managing and caring for them.
of the most critical steps a dentist can take in handling an anxious
or phobic patient is to listen to them. The fears
of the patient will be as individualized and unique as the patient
themselves. Taking extra care and time to build a relationship
with the patient first and address their dental needs second is
vital. It’s a process of gaining and keeping the patient’s
patients the opportunity to talk about their fears.
Ask them if they have had any negative experiences in the past,
if they have concerns about dental treatment, about injections,
anesthesia, drilling. The answers to those questions can be every
bit as important as the routine health history questions posed.
Not only will the patient’s stress level go down, so too will
anxious or phobic patients feel very helpless in the dental chair
and this can be particularly traumatic. Helping them to feel that
they have some control is critical. The most common
approach is to establish a signaling system in which the doctor
will stop if the patient raises their hand for any reason –
perhaps to ask a question or because they might want to rinse. The
key is to ease their fears by emphasizing they have more control
of their circumstances.
addition, it is vital that team members are sensitized
to the special needs of this type of patient. Putting the patient
at ease the moment they walk in the door will go a long way in improving
the entire experience. Dental teams should tune into the patient’s
body language such as breathing rates, perspiration, is
the patient unusually quiet or particularly boisterous. How is the
patient holding their body? Are they gripping their hands? Do you
see muscle tension?
and dental teams that take the time to get to know and understand
fearful patients often find that they become some of the most loyal
patients in the practice as well as the doctor’s greatest
source for patient referrals.
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Appreciate your e-mails here in South Africa - I run a large practice
and your tips are most helpful in dealing with a miriad of issues
that crop up every day. How do you deal with this one? - Mrs Demanding
''needs'' an appointment TODAY - THIS IS HER LINE, '' IF I CAN'T
SEE HIM TODAY I'LL HAVE TO GO ELSEWHERE''.
for your help,
Well...I think I might alter my answer depending on having some
more background information, i.e., how long she has been a patient,
what she wanted the appointment for, true emergency or is just a
"nose in the air" kind of demanding patient?
If so, I would say, "Mrs. Jones, I am sure you can understand
that Dr. Brian has committed to see patients, just like you, at
promised times today. There is not an open time for him to devote
his full attention to your needs. Now, I might have an opening today
should a patient decide to cancel or not show up. So as a courtesy
to you, if that happens, I will call you immediately. Now is your
cell phone number xxxxxx? In case that does not occur, let me look
at the next few days for availability and make you an appointment."
I'm afraid I would have to "kill her with kindness" and
hopefully she would see that she was giving me unreasonable demands.
Notice that I am not asking her a question, I am controlling the
conversation. If after the above she says, I will go some place
else. I would say, "I am sorry we have disappointed you.
I will be sure and let Dr. Brian know. Where would you like for
me to forward your records?"
line....if it just doesn't feel good ...let her go.
Hope this helps.
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