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  12.30.04 Issue #147

Success in 2005 Begins with 15 Minutes

Sally Mckenzie, CEO
McKenzie Management

As another year drifts to a close, many of us are lamenting how quickly it has passed. The days of perpetual busyness leave little time to savor the successes or to step back to assess the possibilities. Often the moments we have are spent on the run dashing from one patient to the next, one project to the next, one crisis to the next. With a familiar sigh at the end of the day, the week, the month, and now the year, the common refrain is heard, "Where did the time go?"

However, standing at the dawn of a New Year means that 12 months and 365 days await, and there is no time like the present to commit to making the most of every waking moment in 2005. I don't suggest packing more work hours on to your day or more patients into your schedule. What I want you to consider is carving out 15 minutes a day and two hours a month to increase your production - without working harder or longer. I want you to improve your patient retention - without giving away your dentistry. I want you to energize and enhance your team without handing over control of the practice. And, above all else, I want you to reduce your stress - without the use of chemical relaxants.

Daily and monthly business meetings are among the most cost effective practice improvement techniques you could implement in 2005...provided that you make the commitment to actually hold a meeting rather than hold court. Dentists and teams will often claim that their meetings don't work. The reason, according to the team, the doctor is doing all the talking - directing actually - and the team is not encouraged to offer input. Conversely, the doctor will claim meetings never work because they turn into group gripe sessions or, on the flip side, no one participates.

Typically these meetings have either no agenda or an agenda that is handed out during the meeting, or staff are not expected to report on their specific areas of responsibility, or the doctor feels he/she has to report to the staff, or the staff feel this is the one time they have the doctor captive and will not release him/her until they've had their say. Indeed, those meetings are grossly inefficient and counter productive. There is a better way.

Beginning on Monday, commit to take 15 minutes to make the most of every day in the coming year. Schedule the daily business meeting to start 15-20 minutes before the first patient arrives. Use that 15 minutes to frame a productive day and energize your team; here's how:

  1. The scheduling coordinator distributes copies of the daily schedule and the next two day's schedules to every member of the team. Make personal notes regarding each patient, including births, deaths, marriages, patients they have referred, etc.
  2. Note the amount of scheduled production for the day. Identify patients with unused insurance benefits.
  3. Identify those patients that have outstanding balances/financial conditions that could affect treatment scheduled for that day.
  4. The doctor and clinical staff identify where in the schedule emergency patients should be placed.
  5. The clinical assistant evaluates the doctor's schedule to determine where potential traffic flow problems might occur and if additional assistance will be needed for specific procedures.
  6. The hygienist reviews individual patient charts for periodontal therapy that should be discussed as well as any unscheduled treatment plans that can be reinforced with the patients.
  7. The doctor wraps up on a positive note emphasizing the contribution that each team member makes to ensuring that patients are given the highest level of care and consideration possible.

Next week, 24 hours in 2005 that will change your practice.

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

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Visualize Being A Better Leader In 2005

Dr. Nancy Haller
Executive Coach
McKenzie Management

We are on the threshold of a new year. It is a time of anticipation, a time of looking forward, a time of fresh opportunity. You feel enthusiastic and hopeful. Resolutions are abundant. Although the road of good intention is paved in gold, talk is cheap.

For goal setting to be successful, you need a plan...a blueprint to guide you. To increase goal effectiveness, set S.M.A.R.T. goals:

  1. Make your goals Specific.
    I want to enjoy my work more is an admirable goal but frankly far too vague. What stands in the way of greater professional happiness? If you could wave a magic wand, what would be different? Before you can improve career satisfaction, you must identify the exact change(s) you need to make. Focus on those things YOU have control to change.
  2. Describe goals in Measurable terms.
    Let's say that you want to book more appointments. Again, a bit vague because it's difficult to measure "more." Can you handle one additional patient per day? 10 per week? 20 per month? Rather than using a general term such as "more," be finite in your goal. If you are not sure, set a minimum number along with the preface "at least" least five more patient appointments per week.
  3. Establish the Actions that will enable you to accomplish your goal.
    Maintaining a good attitude is another worthwhile goal yet it lacks clear direction in regards to the behaviors that are necessary. When you show others a "good attitude," what will you be doing? Perhaps it is "arriving to the office at least 15 minutes before the first appointment of the day," or "remaining calm no matter what happens."
  4. Be Realistic.
    You cannot change things overnight, but you do have the ability to move forward expeditiously toward long-term goals. Think of goal setting like a staircase, each step building on the previous one. You don't go from the first floor to the second in one are elevated one step at a time. So too with your goal. Manage your expectations and be realistic about what you can do, one behavior at a time.
  5. Set Time frames for goal achievement.
    To track your progress, it is important to evaluate yourself periodically. A good span of time tends to be 30 days, or one month. Review your goals and the commitments you made for behavioral change. Be objective when you assess yourself. Ask others for feedback to know if you are working on the right action steps.

Research shows that the more you align your goals with these criteria, the more successful you will be. However, for goal setting to be lasting, use visualization. Imagine yourself successfully living your plan. Visualization is like daydreaming but with a lot more detail.

Get a picture in your mind's eye of what you want your practice to be. What does it look like? It is important that you put yourself in the "driver's seat" of your inner video. See yourself as a highly effective leader. You are the one who sets the vision, mission and goals of the team. You push your staff toward high performance standards while facilitating a supportive work environment. You use good listening skills and enable others to express their views. You recognize and praise employees for their efforts. You encourage all team members to participate in discussions and decisions. You provide feedback to your staff with honesty and kindness. You emphasize task accomplishments while helping the group to create an informal, relaxed climate. You know the value of positive office dynamics.

Imagine how you will feel as you experience positive responses to your new leadership behaviors. You affirm your strengths while continuously looking for ways to improve. Interactions between you and others are collaborative and respectful, even when there are differences of opinion. Despite emotional tension, you continue to dialogue about solutions. You remain flexible, open to new ideas. At the same time, you know when it's necessary to show courage, keeping the team and its members on course.

Remember to focus on strategic and tactical issues as well as on establishing candid and constructive relationship patterns with employees and associates. By setting S.M.A.R.T. goals and rehearsing mentally, you will enjoy your work more. Make it a very Happy New Year!

Dr. Haller is available for consultation and coaching. Let her help you with your 2005 goals. She can be reached at

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TIME'S UP For Maximizing Insurance Benefits for 2004

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

"Work expands to fill the time available for its completion."

Recently I instructed our Advanced Business Administrator Course to a very sharp lady who had been with the same practice for fourteen years. She told me that she knew very little about processing insurance and what to do when the insurance company asked for more information. She had not been involved in the insurance part of the business as her co-worker handled that area. But being promoted to the Practice Administrator she quickly discovered the co-worker took all of the information with her and she now needed to be armed with the information to protect the practice.

We thoroughly covered all aspects of gathering data, entering the information into the computer, documentation and e-claims. She had been quite stressed with what I call "the end of the year rush" from patients who were trying to get in to complete treatment that was diagnosed months ago. If you don't use the benefits, you lose them.

This time of year patients realize that time is running out for maximizing insurance benefits, using up flex plan money, cafeteria plans or claiming health expenses to the IRS. As we rush to try to accommodate these patients, the preparation or seat date issue for crowns surfaces to cause panic. Since some insurance companies pay on the seat date and some on the prep date, it is important before embarking on a course of treatment that you establish which is applicable and make sure the patient understand the difference.

The date of liability can be an important issue for a patient if he or she is close to maxing out his or her benefit dollars for the year. If the patient has a calendar year plan and is having a crown or bridge prepped in December but seated in January, which year's maximum will the payment be deducted from? You must know this if you hope to accurately inform your patient of his or her anticipated co-payment. Take the scenario of the patient who has a crown prepped in late December while covered by a plan that pays on the seat date, not realizing that his or her employer has plans to switch insurance companies in January that pays on the prep date. This could cause the patient to receive no benefits at all. The ADA claim for 1995 has a signature clause that states, "I hereby certify that the procedures as indicated by date have been completed and that the fees submitted are the actual fees I have charged and intend to collect for those procedures."

Technically, a crown or other prosthetic has not been completed until it is seated. Most insurance companies assume that the date on the claim is the seat date based on the signature of the doctor on the claim form. If the claim is paid on this assumption and the insurance company finds this to be false, money will have to be refunded. You then must try to collect the refunded money from the patient or another dental plan (as long as there are no wait periods for services on the new plan).

Presently, many insurance companies are asking for prep and seat dates on claims. The major reason is the ADA form 2000, which should be in use now. This 2000 form has new language on the signature clause of the claim form. The clause states "I hereby certify that the procedures as indicated by date are in progress (for procedures that require multiple visits) or have been completed and that the fees submitted are the actual fees I have charged and intend to collect for those procedures." You need to indicate which date is prep and which is seat or the claim will come back requesting more information.

Remember that there is no standard for payment on prep or seat date, many insurance companies pay on either depending upon the particular plan contract. To avoid the end of the year rush of filing these claims, get a letter to your patients in August or September reminding them that now is the time to make arrangements to complete their course of treatment before the end of the year rush. Insurance processing can be made easier and profitable for your practice. Set that as a goal for 2005.

For more information on advanced dental business training for your front office employees, email us at


Job Descriptions That Can Be Customized For Your Practice!

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  • Scheduling Coordinator
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  • Treatment Coordinator
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  • Hygienist

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Sally's Mail Bag

Hi Sally,

My husband and his partner are in the early stages of forming their own dental practice. They only have about 4 or 5 employees and one really works hard for them, another works really hard too but is very new and wants to be a team player. Then there is one who, on occasions, will come in late or will leave early for a good reason but it's always on a Friday. She is not the hard worker, let's put it that way. My feelings are they should reward those who work for them with an "End of the Year" bonus and the ones who do not work hard for them should receive a smaller bonus. If the ones who don't work as hard receive even a small one, and learn later that so-and-so got more then they did, they should realize why. What is your opinion on this? How would you suggest this be handled? Your time is greatly appreciated. Thank you so much,

Dr's. Personal Partner

Dear PP,

Reprimanding the ones who do not work to the level the practice expects should not be done by giving them less bonus money. By giving them any money at all you are still rewarding unacceptable behavior. A performance review needs go be done as soon as possible so the employee understands what they are doing that is not acceptable. Bonus money can not be made fair. How much do you give? And based on what criteria? If you feel you are paying employees a "fair" wage and their performance is what you expect, then no reward is necessary. However, if their performance goes beyond the practice expectations, then a reward is in order doesn't have to be money. Giving them Christmans/Holiday that they don't know the value is acceptable because it is the gift giving time of year. The perceived value is worth more than the value.

Hope this helps,


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