09.29.06 - Issue # 238 Forward This Newsletter To A Colleague
Telephone Communications
Hygiene Goals
Treatment Acceptance Monitor

Turn that Perpetual Annoyance Into Profit
by Sally McKenzie CEO
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You’re trying to collect from Mr. Swanson and it disrupts your train of thought. You’re checking in patients lined up for their afternoon appointments and it’s buzzing at you.  You’re attempting to wrap up the 25 items on your “to do” list but are constantly tethered to it. Its incessant pestering is almost more than you can tolerate. And by the end of the day, you’re ready to snip the life clean out of it. The telephone, that perpetual source of irritation, frustration and disruption, it always rings at the wrong time. For some practices, it seems the thing is just ringing non-stop. How lucky they are, yet few realize their good fortune.

When the telephone rings, it is the opportunity for the practice to shine. However, many dental teams are often so focused on silencing that annoying sound that they give little thought to how this first contact with the patient is handled.

Consequently, seemingly innocuous “greetings” like the standard you’re bothering me now go away greeting, which is typically delivered as, “Doctor’s office, please hold.” Or the why would you think I would concern myself with such trivial details response, “Uh, I don’t know.” Or the it’s your problem, not mine directive, “You’ll have to …”  Or the slam the door in their face retort, “Nope, can’t do that, no appointments after 4 p.m.”  Or the no I never thought it was important to actually learn proper English answer, “We ain’t open till 8 a.m.” all come across as curt, abrupt, and just plain offensive to the patient.

What’s worse, many practitioners give little thought to how their office is represented to the calling patient. In fact, when it comes to “routine” telephone duty, the all too common attitude among practices is that it’s just a perfunctory exercise requiring little skill.

Before doctors and teams dismiss the first point of contact between the practice and the patients as inconsequential, consider this: Patients’ expectations are higher today than ever before. In a single phone conversation, actually in about 15 seconds, a patient assesses the competency of doctor and team, the quality of the dentistry provided, and whether this practice deserves her business and that of her family.

If your practice is suffering the effects of poor phone communication it’s likely the result of three shortcomings, all of which are easily addressed: lack of training, lack of standard operating procedures, and lack of preparation. Take just a few steps to ensure this all-important line between you and your patients isn’t inadvertently disconnected.

First, the individuals answering the phone do not necessarily need a dental background, but they must possess enthusiasm and come across as genuine and pleasant. They should speak as if they were talking to the person face-to- face using a clear, confident voice that conveys interest.

In addition, practices should establish a standard professional greeting, for example, "Good morning. Dr. Gary Mack’s office, Julie speaking. How may I help you?" The caller should never wonder if they’ve called the right number.

Consider the speaking habits and language skills of those representing your practice. Speaking traits and grammar missteps that are imperceptible or merely ignored in casual conversation become a source of annoyance on the phone. Many people have a tendency to mumble, speak too loudly, or consistently use incorrect grammar. Others speak so softly, they are virtually impossible to understand. Consequently, for the patient, phone interaction with the dental practice becomes a chore, rather than a routine call.

Ask employees who spend considerable time handling patient calls to periodically tape record typical patient conversations and assess their speaking delivery skills. In addition, ask fellow team members to objectively critique recorded telephone presentations.

Evaluate the presentations based on the following points: 

  • Does the individual convey enthusiasm, helpfulness, and genuine desire to assist the caller?
  • Does the business assistant show respect for the caller?
  • Does the employee speak using correct grammar?
  • 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, or nasally?
  • Is the rate of delivery comfortable – not too fast, not too slow?

Next week make the most of calls to the patient.

Interested in speaking to Sally about your practice concerns? Email her at sallymck@mckenziemgmt.com.

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How to Establish Hygiene Goals…and Reach Them!
A McKenzie Management Case Study

Nancy Caudill
Senior Consultant
McKenzie Management
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Dr. Sam Snyder - Case Study #246

Dr. Snyder contacted our office and was upset because his hygienist wasn’t busy.  He wanted to know how to motivate her to work.  This article is devoted to establishing a daily hygiene goal for his hygienist…and the process will work for you, too. 

Salary Based Goal
The industry standard on hygiene net production is 3 times their daily salary.  Here is how it works:

  • Helen the Hygienist makes $325 a day.
  • Her net production goal is $325 x 3 = $975.

There are a couple of factors that must be considered:

  • Helen does NOT get production credit for the exams – the doctor does.
  • When scheduling is done, it is based on gross production – not net production.  This means that the Hygiene or Schedule Coordinator does not have factual information pertaining to how many production dollars will be adjusted as a result of PPO adjustments, senior citizen courtesies, cash courtesies, etc.

Scheduling goals must be based on GROSS production numbers and not NET production.  In order to determine the gross production you must run a computer-generated report that reflects the production adjustments for the past 12 months and use this as a guide.

For example:  your report lists all the adjustments that were posted last year.  Some adjustments effect the production and some adjustments effect the collections.  Production adjustments are items such as bad debt write-offs, PPO write-offs, courtesies, professional adjustments, etc.   
The total production adjustments are $25,000.
The total production for the practice is $500,000.
$25,000/$500,000 = 5%

Add 5% to the initial production goal of $975 = $1,024 for the daily GROSS production goal

How To Schedule to Meet a Hygiene Goal

Building a “perfect” hygiene schedule is like creating a puzzle.  It only fits together correctly with the right pieces.  To determine what the right pieces are, we need to calculate the hourly schedule goal of the hygienist:

            $1,024 divided by # of hours worked per day (8) = $128/hour

We also need to determine the hourly value of the hygiene procedures.  For example:

Adult Prophy fee is $85.  If the hygienist performs this procedure in 50 minutes, the hourly rate for this appointment is $85/50 x 60 min = $102/hr.  If she needs 60 minutes, then she is producing $85/hr.  This is a $17 difference.

Adult Prophy and 4 BWX is $130.  This appointment is also scheduled for 50 minutes.  The hourly rate for this appointment is $130/50 x 60 min = $156/hr.

Child Prophy, 2 BWX and FL is $113 and is performed in 30 minutes.  $113/30 x 60 min = $226/hr!  Did you realize how profitable a child Prophy is?  How your hygienists will be begging for the kids!

2 quads of SRP @ $215/quad and performed in 90 minutes is $215 x 2 = $430/90 x 60 min = $287/hr.

Now that we know what the value is of these procedures, it is easy to see that if the entire day is comprised of adult prophies and no x-rays, the daily goal will not be met.  However, if all the patients needed x-rays, we would.  But we know that only 50% of the patients are going to need x-rays since they are usually taken once a year so this isn’t likely to be scheduled.

The difference between reaching goal and not reaching goal is in the diversity of the appointments.  Let’s look at this example:

1.5 hours of SRP @ $430
3.0 hours of adult prophies with BWX @ $390
3.0 hours of adult prophies w/o BWX @ $255
0.5 hours of child Prophy, BWX and FL @ $113

Imagine how much more productive Helen would be with more children or more periodontal therapy!

Now that Jane has some facts, she realizes that she can’t fill her hygiene day with just prophies…she must leave room for other procedures.  She must orchestrate her day the way that she wants it in order to achieve her goal.  Give your scheduler the tools she needs to reach the hygiene goal.

If you would like more information on how McKenzie's Practice Enrichment Programs can help you IMPLEMENT proven strategies….. email info@mckenziemgmt.com.

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What Are You Doing to Determine The Potential of Your Practice?

Belle DuCharme CDPMA
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What I find lacking in most of the offices I work with is a vision for success.  I am not talking about magic or reading Tarot cards, I am referring to a written business plan for reaching short term and long-term financial goals.  Many dentists have one tucked away somewhere but have handed that over to an accountant or financial planner to store.  That is fine, but these professionals do not sit at the chair with you everyday and monitor your diagnostic techniques or your treatment acceptance rate. 

What is your daily diagnosis dollar amount for recall?  Have you set a goal?  What is your monthly new patient count?  What is your average treatment diagnosis for new patients and are they scheduled? Are you tracking your acceptance rate?  Your acceptance rate today shows up in scheduled production one to three weeks out unless you are booked out further (which is another issue that needs addressing).  If your scheduled day appears thinner than usual don’t look to that day for the answer, go back one to three weeks to see what was being diagnosed and accepted. If you are keeping records you will see a pattern.  Your business manager or treatment coordinator cannot book treatment that has not been diagnosed.  If you find that you are treatment planning and hearing verbal acceptance from the patient but not seeing them scheduled, look for answers from your business staff.  One business manager told me she sends in pre-determinations for all treatment including single crowns and resin fillings.  She either schedules four to six weeks out or agrees to call the patient when the pre-determination returns.  The reason she does this is to eliminate any question about what the insurance is going to pay.  Even when you receive this pre-determination the insurance companies make sure you understand that it is “not a guarantee of payment”.

I recommend doing the following if you are a net-work or out of net-work provider:

  1. Know the patients’ insurance plan, benefits, eligibility and calendar year maximum and dollars left for the year prior to them entering the office by fax, online or call to the insurance company.  Make sure the patient understands that you are not working for the insurance company and they have provided the information.
  2. Prepare a written treatment plan and payment option sheet on each patient no matter how small the treatment plan.  Give the patient a copy of these forms.
  3. With the information that you have received from the insurance plan, schedule all treatment and have in writing the “estimated” insurance payment and the amount of the patient co-pay and applicable deductibles understood by the patient.  The best time to get a commitment to schedule is right after receiving the diagnosis.  If the patient leaves the office without an appointment, you are sending a message that the treatment can wait and you are giving the patient and the insurance company the power to determine how long it can wait.
  4. If there is going to be a sizeable amount of out of pocket expense you must help the patient secure funding from a financial source such as CareCredit.

A simplified way of tracking your treatment potential is to create a monitor containing the following information:

  1. The number of treatment presentations given per month.
  2. The number of patients that proceed with the treatment. Subtract from the number of presentations.
  3. This equals the number of patients that do not proceed with treatment.
  4. Multiply the answer by your average case fee amount.
  5. This total will represent the potential available per month multiplied by 12 equals an estimated yearly additional revenue.

Scheduling is a major key to the success of all dental practices.  Every team member is accountable in some way for the success of scheduling.  The age-old questions of “Why aren’t I booked?”  “Why are we slow this time of year?” “Why did Mrs. Brown cancel, she has been on the schedule for 6 weeks?” can be answered by looking at the practice history and tracking monitors.  Creating a customized approach to your practice needs is one of the reasons why The Advanced Business Training offered at McKenzie Management is a sound investment for your practice.  The training provides all monitors, insurance questionnaires, payment option designs and treatment presentation skills you need to take your practice to a higher level of productivity and profitability.  Come join us today and create your vision for practice success.

For more information on McKenzie's Advanced Training for Front Office, Office Managers or Dentists email training@mckenziemgmt.com, call 1-877-777-6151 or visit our web-site at http://www.mckenziemgmt.com/.

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