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08.19.05 Issue #180
Accounts Receivables - No Surprises

Sally McKenzie, CEO
The McKenzie Company

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You don't always get what you want, and, contrary to what Mick Jagger's been telling us for years, or should I say decades now, you don't always get what you need either. But one thing typically holds true, you usually get what you pay for, from software, to supplies and equipment, to dental materials, etc. And you don't want any surprises. You want to feel that whatever it is you are plunking your hard-earned cash on is worth the investment.

Your patients are no different. When the collections coordinator tells Mrs. Murphy that she owes $225 dollars for today's fillings, and Mrs. Murphy responds by bellowing across the waiting room, "TWO-HUNDRED AND TWENTY-FIVE DOLLARS FOR A DRILL AND A FILL?!", it's pretty clear that Mrs. Murphy is somewhat surprised. What's worse she doesn't really have any idea what she is getting for her money. Minimizing surprises for your patients is a matter of educating them on the treatment and establishing value. What's more, it can go a long way in reducing accounts receivables as well. Let me explain.

Although clinical teams give it little if any thought to it, they play an essential role in lowering the practice's accounts receivables. Clinical teams are responsible for building value with the patient by clearly explaining the treatment they will be delivering and what is involved. For example, upon seating Mrs. Murphy, Carol the assistant doesn't just say, "So, Mrs. Murphy, looks like you're in for a filling today, huh?" Rather, Carol welcomes Mrs. Murphy and explains clearly to her that today the doctor will be restoring four surfaces on two of her teeth, the procedure will involve the use of medication as well as anesthetic, and the patient can expect the treatment to last for approximately 40-50 minutes. Then Carol asks Mrs. Murphy if she has any questions or concerns, etc.

Clinical teams should approach the explanation in a manner that they are most comfortable with, but the key is to educate the patient and simultaneously maximize the value of the treatment - not minimize it. If the patient appreciates the extent of your specialized care, she's more likely to understand the value of your services. In other words, she knows what she is getting for her money.

Now when Mrs. Murphy walks to the front desk, the well-trained Financial Coordinator knows exactly the treatment the patient has received because the clinical team has communicated this essential detail to the front desk. The Financial Coordinator underscores the value by reiterating the treatment that Mrs. Murphy has received and confidently requests payment. "Mrs. Murphy, Dr. White performed fillings on two teeth, which entailed four surfaces, plus medication and anesthetic. The fee for today's dental treatment is $225 will you be paying by cash, check, or bankcard?" Don't leave the patient wondering what they are getting for their investment in your dental care, and they will be less likely to wonder if they should pay you now, later, or never.

At the same time, don't leave yourself wondering what your accounts receivables are at any given moment. You absolutely must know this number, and it should never be more than one month's production. In other words, if you typically produce $70,000 per month, patients should never owe you more than that amount at any given time, and preferably, they owe you less.

Generate an aged accounts receivable report monthly that lists every account with an outstanding balance and date of last payment. Total all monies over 90 days delinquent. The percentage should not be over 12% of your total accounts receivable.

Examine 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, there should be no more than 55% in the current column awaiting insurance reimbursement.

Always run the report with credit balances because credit balances need to be added back to the total accounts receivable. If the total exceeds your monthly production, it's a red flag indicating problems in one or more of the following areas:

  • Insurance system
  • Billing system
  • Financial policy
  • Presentation of financial arrangements
  • Consistent inability of the Financial Coordinator to ask for money.

Next week, when it comes to accounts receivables, it's time you made a statement.

Want to enhance your knowledge about Reducing Accounts Receivable? Take Sally's On-Line Training Course NOW!

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

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Getting Things a Positive Way

Dr. Nancy Haller
Executive Coach
McKenzie Management

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Once upon a time the Wind and the Sun had a conversation.

The Wind challenged the Sun to a competition. The bet was made, each believing he could succeed in getting behavioral change from the man on the street.

The Wind said, "I can easily blow away the coat from the man below."

So the Wind blew up a storm. But the stronger the Wind, the more the man clutched his coat, holding it tight around him.

Then it was the Sun's turn. With a smile the Sun beamed its warming rays down until the man took off his coat voluntarily.

We can all learn an important lesson from this little story. Using good human relations solves many problems, at work and at home. It's no secret that people need to feel in control and secure to be most productive. Unfortunately in our frantic pace to get things done, we're often too busy 'telling' instead of 'selling'.

Dental leaders who succeed know how to motivate their employees. They focus on the bottom line AND on employee morale. Morale and productivity are related. Morale is a tangible factor that affects and contributes to quality work and efficiency. Whatever motivates you may not motivate someone else. If you expect others to be like you, you'll be trapped into disapproving of them and being angry that they aren't doing what you want them to do. Resentment builds, creating tension and conflict.

The key to increased productivity and personal satisfaction lies in discovering what motivates the individuals in your office . Many dentists think that bonuses or salary increases are the key. Not true. The use of money to motivate people misses the point. Motivation is not really something one person can give to another. Motivation has to come from within the individual.

Remember, you can only guess what motivates your employees, your employees know . If you get into the habit of asking your staff what they want, the climate of the office will improve. Even better, productivity will be on the rise.

Here are five ways to raise motivation and contribute to enthusiastic faces on Monday mornings, not just on Friday afternoons.

  1. Be courageous. If you want to know the state of morale in your office and how to motivate your staff, the best way to achieve those goals is to ask them. You can do this informally in staff meetings. However, if you want candid, truthful feedback, consider the use of an anonymous or confidential process. There also are published questionnaires available.
  2. Clarity of direction is essential. The more people know what actions will result from their efforts, the more they will be energized. One of the most important responsibilities of being a leader is to be aware of what everybody is working on, and communicate how each individual's contribution relates to the whole.
  3. Build trust with your staff by allowing them to express feelings openly. Provide appropriate feedback by reinforcing positive performance. Establish a climate of respect by listening attentively, making eye contact and demonstrating sincere concern.
  4. Commit to a mission or vision statement. A winning world-class soccer or professional baseball team possesses morale. Everyone knows his goal, role, and the rewards. And each person strives to attain the mission. For morale to be high and for your practice to function at optimal levels that same commitment to a vision must be in place.
  5. Lead by example. You teach your staff not by what you say but by what you do. Be enthusiastic and serve as a role model.

Andrew Carnegie once said, 'You cannot push someone up a ladder unless he is willing to climb". But you CAN motivate anybody if you appeal to their interests and what's important to them . This requires listening, observing, and asking questions. Then set your actions from their point of view.

Team retreats are an excellent way to build morale AND revenue in your practice. Contact Dr. Haller at to learn how to personalize our team programs to your office.

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Patient Coordinator.What do they do?

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

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Getting patients to return for their periodic oral health examination is the most neglected system in dentistry. Systems that "get the job done" with minimal time and effort are usually instituted with little or no regard to their effectiveness. A recall system, which solely employs contacting every patient that is due via telephone, takes "uninterrupted" time and is rarely implemented, even though verbal contact is the best means of communicating with patients. For Business Coordinators who are actively checking patients in and out each day, this telephone process is too time consuming and never without interruption. Likewise, hygienists who rely on "down time" from treating patients to work on the system rarely devote the amount of time actually needed to make the system successful. Devoting "specific time" to maintain a successful system rarely occurs.

The time required to successfully operate this system can only be obtained by delegating the task to a person who is not involved in duties which routinely contain interruptions as most front desk positions do. This very important system requires its own job description and title knows as the Patient Coordinator .

The addition of another employee at this time may initially appear to be an additional expense for an already overloaded budget. And likewise, the overhead expense category for salaries would increase. However, an alternative approach is employing a Patient Coordinator a minimum of three hours a day for three days a week; a salary of $15.00 an hour for example, would cost the practice $135 a week, not including payroll taxes. Not many recall appointments would have to be scheduled to pay for this salary. The Patient Coordinators are soliciting patients to schedule appointments; therefore, they are able to directly increase the practice's productivity.

The number of hours that the Patient Coordinator would be employed is dependent on the number of active patients in your practice, i.e., an active patient being defined as a patient due for recall between today and one year from today. While this is not black or white, 15 hours a week would usually support up to 750 active patients. 16 to 30 hours a week would support 1,000 to 1,500 active patients and 40 hours a week would support a patient base of 2,000 or more. A Patient Coordinator employed full time would then be available to have all incoming telephone calls relating to hygiene scheduling transferred to her workstation. This would allow more time for the Business/Scheduling Coordinator to concentrate on the doctor's schedule.

The job description of the Patient Coordinator can vary depending on the number of hours employed. For example, at the minimum of three hours per day, their main assignment would be strictly making telephone calls to appoint patients who are not already scheduled, whether currently due, or past due. When consistent effort is applied in securing this "return business", an increase in production and patient base will occur. As this occurs, the hours the Patient Coordinator applies to the system would be increased.

A problem that often occurs with the addition of another person in the business area is delegation of "menial" tasks to the Patient Coordinator by the Business Coordinator. Duties such as, confirming appointments, pulling and filing of charts and preparing the daily schedule can affect the true purpose of the new employee's job description.

Another advantage of employing a Patient Coordinator is having a person devoted to filling cancellations and no shows in the hygienist's schedule. Business/Scheduling Coordinators have the responsibility of patient check-in and checkout, which consumes the majority of their time. When confronted with open appointment times in the doctor and hygiene schedule, they will make the doctor's schedule top priority. The Patient Coordinator's top priority is to ensure the hygiene schedule meets the daily hygiene production goal.

Developing a marketing strategy for the practice, which turns existing patients into a referral source, can effectively be accomplished in the Patient Coordinator's job description. However, their main responsibility is retaining the existing patient base. With this being the number one priority and having time to perform the responsibilities, they will greatly enhance the growth of the practice.

If you would like more information on training your Patient Coordinator contact The Center for Dental Career Development at

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Sept. 9-11 San Francisco, CA California Dental Association 916-443-0505 Successes Sally McKenzie
Sept. 22 El Paso, TX El Paso Dental Society 877-777-6151 Breakdown Sally McKenzie
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