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4.4.08 Issue #317 Forward This Newsletter To A Colleague
Failure Remedies
Insurance Processing
Case Study

Curb Appointment Failures in Three Steps
by Sally McKenzie CEO
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Reduce overhead, increase production, enjoy success. No problem, right? I love three-step formulas, especially the ones that promise to lower stress, improve my life and make me rich. They are so uncomplicated and so straightforward. The only problem is that most of the time those seemingly simple formulas require a multitude of not-so-simple sub-steps. And that is usually where we get bogged down and give up. Shelve another good idea because it’s just too darn much work.

In the dental practice, appointment reminders often fall into this category. Sure, everyone wants patients in the chair at the appointed hour. After all, that translates into more money for the practice. The concept sounds so simple. Call them. Confirm them. Greet them when they show up on time as directed. But the truth is that it is labor intensive. And with so many other competing demands on dental teams, it can be very difficult to commit the time, energy, and staff to ensure that the recall system is achieving results. 

But what if you could follow a simple three-step formula once and have a recall system that puts patients in the chair without putting more stress on your staff? And what if that simple three-step process didn't cost you a single penny? Now before you click the red X in the top right corner to close off this newsletter because you think this is all too good to be true, read on. You will be glad you did.

Elexity, which is known for its personalized patient reminder services, is now offering a completely free patient communication package for dental practices. And when I state completely free, I mean it. There’s no hardware you have to buy, no software to purchase and no costly support contracts to deal with. In about five minutes and three simple steps, you'll be on your way to reducing no-shows and cancellations, improving patient retention, increasing production and decreasing overhead.

Here’s how it works. Visit The site will describe all the features of this complimentary service. In the top right-hand corner, click on, “Create a free account.” From there you will input basic information about your practice, including your name, address and email address. Just two more simple steps to complete and shortly thereafter you'll receive an email from that will give you the link to download this web-based patient communication service onto your office’s computer server.

The package offers many complimentary services. First is the Automated Appointment Confirmation system. This is an email/text messaging confirmation system that allows you to confirm patient appointments by notifying them through email or text messaging. The message is sent with your office email address and contact information, so patients recognize that it’s from you immediately. 

The fact is that most of your patients are using email and text messaging routinely, and would prefer that your office confirm appointments using these methods. It’s fast and efficient, and allows them to quickly indicate if they will be able to keep their scheduled appointment. The system also identifies those patients whose email addresses are not in your system. The next time you update routine patient contact information you simply collect the patients’ email addresses as well. 

The best part of is that there is no burden on your dental team. The program synchronizes with your practice management software to identify upcoming appointments. The email and text messages can be sent out four weeks, two weeks and two days in advance of the appointment. Your office is given a daily report as to which appointments have been confirmed and which will require additional follow-up. It’s fast, easy and efficient, which seems to me like a good way to reduce stress, improve your practice and just maybe put a little more money in your pocket.

Next week, reconnect with forgotten patients in three easy steps, of course.   

Interested in speaking to Sally about your practice concerns? Email her at
Interested in having Sally speak to your dental society or study club? Click Here.

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Belle DuCharme CDPMA
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Preparing for the Predictable Storm of Insurance Processing

In the story The Wizard of Oz, Dorothy is picked up by a tornado and deposited safe and sound somewhere over the rainbow. Not so on the night of Friday, March 14th, when the OMNI Hotel and World Conference Center housing the exhibitor booths for the Hinman Dental Meeting in Atlanta, Georgia, were slammed by a Category 2 tornado pushing winds of 130 miles an hour. The devastation was in the millions of dollars and several people were injured in the neighboring area.

When the storm passed, we tried to make sense of it all and one thing was certain: There wasn’t any warning of the severity of the approaching storm. It is difficult to predict natural events like tornados.

What we can do is to protect ourselves from the predictable by preparing for it. Although it is not life-threatening like a tornado (but still stress-producing), you can predict that patients with dental insurance will question diagnosed treatment and scrutinize the payable benefit like crime scene investigators. Prepare for the storm by doing the following things before a patient arrives for an appointment:

Verify patient information and eligibility by insurance website, phone or fax:

  • Subscriber name
  • Patient name
  • Subscriber date of birth/patient date of birth
  • Subscriber identification number or social security number (whichever is applicable)
  • Employer group number and division number
  • Employer name and address
  • Eligibility date and any treatment waiting period

Verify insurance plan coverage:

  • Deductibles
  • Yearly Maximums/amount left for year—very important at end of year
  • Coverage and percentages for preventive, basic, major (perio, endo, ortho, implants)
  • Frequency limitations for x-rays, prophy, fluoride, periodontal services, anti-microbial applications, crown and bridge, orthodontics, etc.
  • Prior extraction limitations
  • Alternate benefit coverage (coverage for fixed bridge would be applied to implant restoration)
  • Anticipate what codes will be used to maximize the benefits available on the plan

Being prepared with a scripted response will help you communicate confidently.
The following dialogues are examples of scripted responses.

Question: “I don’t want anything done unless my insurance pays for it. What will my insurance cover?”

Answer: “I understand how you feel. You want a benefit from the policy that you have paid for. According to the benefits listed on this document I received from the insurance company, this procedure is a covered benefit. It must still meet the qualifications for coverage under your policy, though, which is why we have taken the necessary x-rays and photos of your teeth. You have not paid the deductible of $50.00 this year, so that will be subtracted from the total benefit. The policy states that this procedure is covered at 50%. The total cost for the procedure is $850.00. Your policy is estimated to pay 50% of $850.00 which is $425.00 minus your yearly deductible of $50.00. Your estimated co-payment is $475.00.Your plan will pay an estimated $375.00.”

Question: “Why doesn’t the insurance pay more?”

Answer: “This policy was purchased by your employer based on what the company can afford to pay. The insurance company has put a limit on what they want to pay out for major services. The crown is a major service. The deductible is subtracted yearly from procedures that are subject to a deductible. Crowns are subject to the deductible. That is why it is wise to have any other diagnosed treatment completed that is subject to the deductible before the end of the year. This policy has a maximum payout of $1,500.00 per calendar year for eligible benefits. Whatever is not used is not carried over to the next year. You lose it. It is wise to use this valuable benefit even though there is out-of-pocket expense to you.”

Question: “I get better coverage if I go to a dentist on my plan. I have to leave your office and I don’t want to.”

Answer: “Thank you. We appreciate you and your family and we don’t want you to leave either. You should consider that before making your final decision. The trust you have in us and the comfort you and your family feel when you are here is important and you may not find that in another practice. I know that costs are important to you as they are to us all. Your insurance is good here and there may not be that much difference in the out-of-pocket costs as you think. For instance, according to your plan, your professional cleanings and examinations will still be covered at 100% twice a year.

The difference in the dental benefit is $130.00 paid to us versus $85.00 that would be paid to a plan provider. You still pay us nothing. We can research the difference for other procedures that you will need prior to you having anything performed. If you decide to go to another provider and are not happy there, you are always welcome to return to our office.”

Want to learn more about preparing for the predictable? Call us today for information about our Advanced Training Programs for dental professionals.

For more information about McKenzie Management’s Advanced Training courses, email, call 1-877-777-6151 or visit our website at

Interested in having Belle speak to your dental society or study club? Click here.

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Nancy Caudill
Senior Consultant
McKenzie Management
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Are You Playing with a Pair or a Full House?

Dr. Jane Morgan—Case Study #47

“I am not making any money! I think my overhead is too high and I feel that the office is not organized. Maybe I need more team members but I don’t want to incur any more salary expense!” lamented Dr. Jane Morgan.

 Practice Statistics

  • 60 new patients a month
  • 1 full-time Hygienist with a Hygiene Assistant and 1 part-time Hygienist
  • 2 Associate Dentists (Dr. Morgan has a very limited patient base)
  • 4 full-time Clinical Assistants
  • 3 full-time Business Coordinators
  • Overhead 76% (goal is 55%)
  • Gross salary overhead (not including associates) 27%

Practice Facts

  • She has almost 2,000 “active” patient records. However, when reviewing the continuing care report or recall report for the next 12 months, there were 860 patients that were due with or without appointments. This means that the true “active” patient base was only 860 patients! All those patient records on the shelves create a false sense of security. 
  • Assisted Hygiene—The Hygiene Assistant was not performing her primary responsibility, which was to maintain the hygiene recall system. A successful hygiene department will be demonstrated in the growth of the practice. If you aren’t adding more hygiene days to your practice, your practice is not growing and, even worse, could be shrinking. Every 3 to 6 months you should evaluate how many “active” patients you have versus how many patients you are losing through your current recall system. Reports indicated that this practice was losing as many patients per month as were coming in! No growth! 
  • Four days a week there were 2 Associate Dentists working 8 hours. There wasn’t a daily production goal per doctor—only a daily practice goal. By not having a provider goal, there were no guidelines for the Patient Coordinator and the Scheduling Coordinator to follow when scheduling patients. These key people were filling “holes”—without considering the individual provider’s efficiency and productivity. The scheduled number of patients, the speed of the doctor and the type of procedures dictate how many assistants are needed per doctor. Because there wasn’t a system for a specific assistant to be assigned to a doctor it was difficult for the doctors and the assistants to become confident with each other’s style of working. Every doctor performs differently and uses different materials and instruments for the same procedures. Therefore, many times it was chaotic in the clinical areas with no continuity among clinical team members.
  • The business area was working without systems. There were 3 full-time employees without definitive job descriptions. A review of the typical day revealed that there was repetition of tasks because there was no system for accountability. Many important tasks were not being performed on a regular basis, causing a rising accounts receivable.


  • Dr. Morgan agreed to analyze the Hygiene Department with the thought of making the necessary changes. The Patient Coordinator’s role was changed to focusing on maintaining the recall system and managing all the follow-up. An additional full-time hygienist was hired to allow time for the hygiene department to perform periodontal therapy, freeing up the Associate Dentists to do treatment. This also allowed more attention to building patient relationships by the hygienists instead of the patients feeling like they were being “driven” through the department. More importantly, the continuity between the hygienist and the doctor regarding patient needs has improved considerably and more treatment is being diagnosed and accepted.
  • Each doctor was assigned one specific assistant so they could learn to work together as a team in unison with one another. The 3rd assistant, the Clinical Coordinator, was responsible for ordering dental supplies and inventory, assisting where needed and managing general patient flow in the clinical area, making sure that patients weren’t kept waiting and that rooms were set up and taken down. The 4th assistant (who was in training) was dismissed 
  • The business team was taught how to run computer-generated reports, reduce manual paperwork and be more efficient with time. This resulted in a reduction in staff with the two remaining team members in agreement that a part-time person was all that was necessary to complete the front office team.

Gross wage overhead for team members should be no more than 19 to 22% of net collections for the same time period. By educating Dr. Morgan and the team about what is “standard in the industry” for a family dental practice and by giving them the tools and empowering them to be able to make a difference, the team became involved in reducing the overhead. What was in it for the team?

  • A sense of ownership
  • Knowing that they were productive and goal-oriented
  • A better sense of self-worth in the practice
  • The possibility for revenues to fund future raises

There are times in a dental practice when less than a full house equals more! Are you playing with a full house?

If you would like more information on how McKenzie's Practice Enrichment Programs can help you IMPLEMENT proven strategies, e-mail

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