10.15.10 Issue #449 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Key Systems Spell Success in the “New Normal”
by Sally McKenzie CEO
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Patients are whittling down the extras and focusing on the fundamentals. They are more judicious in their purchases. They are focused more keenly on needs rather than wants. They are looking for greater long-term value.

For dentists, there has never been a time in which key practice systems have been more critical to profitability than in today’s “new normal.” There are 22 systems that directly impact your success and productivity, and each should be carefully evaluated and scrutinized for effectiveness. We covered three last week - the following are three more systems central to building longstanding, trusting relationships with today’s cautious patients.

1. Service, Service, Service
As you’ve likely heard many times before, there are three things that matter in selling property: location, location, location. Similarly, there are three things that matter in selling dentistry: service, service, service. This is a “cautious consumers” market, which means they are looking for reasons to not spend money unnecessarily. It is essential that practices make it easy for patients to invest in their dental care and appreciate the value of the investment. For some practices, that may require altering your philosophy for the sake of better patient service, at least for the time being. For example, many dentists are philosophically opposed to accepting insurance, but doing so means offering a critical service to patients that may be the determining factor in their decision to proceed with treatment. The financial reality is that those practices accepting insurance have not been hit as hard by the recession as those that don’t.

 Additionally, pay close attention to what the patient is asking for, and give the consumer the service they want. If they want their teeth cleaned, schedule an appointment. If they want to see the doctor, schedule a doctor visit. Provide prompt service. Set aside time for new patient appointments in the schedule to ensure any new patient can be seen within one week. Give the patient what they want to get them in the door. You don’t want your business staff telling callers “No, that’s not how we do things here.”

2. Ring In The Patients
Speaking of what staff are saying to patients, what’s your philosophy for how the telephone is handled in your practice? If you haven’t considered this, I’m willing to bet that you’ve lost more patients than you can begin to imagine for lack of telephone training. 

I see this issue time and again in dental practices. The dentist looks at the open appointment times, dwindling new patient numbers, sinking production, and blames the weather, the politicians, the economy, any outside circumstance s/he can come up with. It never occurs to her/him that the dedicated, hardworking business employees have horrible telephone skills. And it’s not because they are incapable or unwilling, they simply have never been given the opportunity to learn how to maximize the telephone lines for the good of the practice. Telephone training is fast, easy, and one of the most cost effective measures you can take to immediately improve your current patient schedule. Trust me, until you hear it for yourself, you have absolutely no idea how calls to your practice are handled.  If you want to know how the phone is being answered in your office, go HERE to order 3 mystery new patient calls.

3. Write Your Own Ending - Scripts
Most people would never deliver an important presentation without careful preparation and practice. Patient phone calls should be viewed as equally significant. What’s more, preparation ensures that those on the frontlines can anticipate and manage objections, cancellations, and many other patient scheduling challenges that arise during routine phone contact. The objective is to politely educate the patient so that they will take the desired action - but that requires careful preparation. 

The employee should know the scripted presentation so well that it comes across as a completely natural conversation. The staff member must be prepared to spell out the facts for the patient clearly and concisely. Make sure your staff are not just speaking off the top of their head, so there is no chance for error or omission. In addition, others handling phone communications should rely on the same scripts so that consistent messages are relayed to patients in each phone interaction.

The economic circumstances are what they are, and for most practices there’s simply no ignoring the “new normal.” It requires far greater attention to the 22 key practice management systems. But I can virtually guarantee that those who invest the time and energy in doing so will find the “new normal” just as satisfying and financially rewarding as the “good ‘ol days.”

Interested in speaking to Sally about your practice concerns? Email her at sallymck@mckenziemgmt.com. Interested in having Sally speak to your dental society or study club? Click here.

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Nancy Caudill
Senior Consultant
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Balancing the Payments Daily?
By Nancy Caudill, Senior Consultant McKenzie Management

Case #390
Dr. Sam Brassfield

When Dr. Brassfield called the office, his primary concern was “lack of systems.” His focus wasn’t on the necessity to make more money or create less stress, work less days, etc. but for improving or creating systems that can be maintained throughout the life of the practice, regardless of the revolving door of team members.

McKenzie Management analyzes over 20 systems over a period of 12 months for our clients, or 10 systems over a 6-month period. The systems that are targeted depend on the needs of the practice. Managing the daily closing of the practice is always one of the systems that doctors request.

You Don’t Know What You Don’t Know!
Dr. Brassfield had no idea what steps were being taken at the end of the day to verify that the transactions being posted were correct. He knew how much money was going to the bank because a “Deposit Slip Report” was given to him, along with a “Daysheet” each day. However, he really didn’t pay much attention to it. Instead, he was more interested in his daily bank account balance that he checked online.

Here Is What He Didn’t Know
Now, before I disclose this information, I want to make this statement so there is no misunderstanding. Jane, his Practice Coordinator (he only employed one business person), was as honest as the day was long. At the same time, she “only knew what she knew” as well. The person before her, who was trained by the person before her, trained her! It is very possible that at some point in the past the correct procedures existed, but over time the system became “watered down” and now has no flavor at all.

  • The credit card payments were not reconciled with the computer print-out for CC payments
  • The cash was not balanced
  • The checks were not balanced

So what WAS she doing? She was taking the cash and checks out of the drawer at the end of the day, diligently writing down all the checks she had onto the bank deposit slip, adding up her cash and adding it to the top of the bank deposit slip, putting it into an envelope and sealing it up. She gave it to Dr. Brassfield and he took it to the bank on his way home. 

She knew that the credit card payments were deposited automatically into the bank, so she just took the signed receipts and put them in a separate envelope that she kept for them.  When the credit card machine reconciled at midnight, in the morning she took the reconciliation and placed it in the envelope, along with the other signed receipts for the month.

Here Is What Was Happening

  • Checks were given to Jane to pay on the patient’s account that were not posted to the patient’s ledger.
  • Patients were paying with cash and she posted it as a check. Since the patient was not given a printed receipt from the computer, they were not aware of the error.
  • Patients were making credit card payments and she would get busy and forget to post it to their account.
  • A check written in the amount of $100 was posted as $10 and vice-versa.

The good news is the amount of the monies going into Dr. Brassfield’s checking account was correct. The bad news is the patients’ accounts were incorrect. There were also occasions of credit or debit notices from the bank when a check was misread, causing the totals to be incorrect.

One hour prior to the office closing, start preparing the deposit for the day. The following steps should be taken:

  1. Print the Deposit Slip Report from the practice management software.
  2. Run a total of all cash, checks and credit cards for the day.
  3. Compare the total cash on hand to the cash that is listed on the computer’s deposit slip.
  4. Compare the total checks on hand to the total checks that are listed.
  5. Compare the total of the credit card receipts to the computer deposit slip. 
  6. Run a total from the credit card machine to confirm that it is the same total.
  7. On the bank deposit slip, write the total amount for the cash and checks and include a copy of the computer deposit slip with the cash and checks and place in an envelope with today’s date written on the outside.
  8. Staple the credit card slips and total to a copy of the computer deposit slip for the practice, along with a printed copy of the daysheet. Place on the doctor’s desk for review and then keep as long as recommended by the accountant.

Dr. Brassfield learned not to “assume” anything, and you shouldn’t either. Check with your business team to confirm that the proper steps are being taken to balance your payments every day and a deposit is being prepared to match the daily daysheet. You will be glad you did!

If you would like more information on how McKenzie's Consulting Coaching Programs can help you IMPLEMENT proven strategies, email info@mckenziemgmt.com.

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Belle DuCharme CDPMA
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Principles of an Ethical Dental Practice
By Belle DuCharme, CDPMA

As quoted from the California Dental Association code of ethics: “As healthcare professionals, dentists assume publicly-entrusted responsibilities founded on the principle of non-malfeasance - first do no harm. The American College of Dentists Core Values presents the many characteristics of being an ethical dental professional and has thus been adopted by the California Dental Association as its’ core ethical principles." 

State to state variances may change the code somewhat, so to simplify things we will look at some of the main ideologies of the CDA’s principles of ethical behavior.

Often the question comes up as to how much information in the form of a treatment plan should be presented to a patient on their first visit to your practice. A long list of diagnosed procedures and their corresponding fees has a shock effect on some patients, and may cause them to leave the practice before they have any service performed. It is an ethical dilemma because the patient needs treatment and it is the dentists’ duty to give the total picture. What good is it when the patient says, “That’s really expensive, let me think about it and I will call you back.” They seldom call back and often go into a state of limbo, seeing no dentist for a long time.

The principle of autonomy states: “Patients have the right to determine what should be done with their own bodies. Because patients are moral entities, they are capable of autonomous decision making. Respect for patient autonomy affirms this dynamic in the doctor-patient relationship and forms the foundation for informed consent. The dentist’s responsibility to inform the patient of contemporary standards of oral health care, the benefits and the possible harms is paramount to achieving informed consent.”

If, after all of that, the patient decides not to start or continue care, the decision should be considered with compassion. Diagnosing the pocket book of the patient and questioning their ability to pay for services is contrary to respecting a patient’s privacy and autonomy. Though money is always a factor, it is not always the deciding factor. Identifying the first areas of concern and addressing them as priority or Phase One, with the understanding that the patient plays an important role in the result, helps the patient understand their role in their total well-being.

“Compassion requires a consideration for the total well-being of the patient.” Relieving pain and suffering is a common attribute of dental practice, but further acknowledgment of a patient’s future needs is also a compassionate act.

Another area of the code of ethics that is brought up regularly concerns billing practices.  In Section 7: Billing Practices, it states that “a dentist has the obligation to submit any billing for services rendered or to be rendered in a manner which is not fraudulent, deceitful or misleading.”

7.A.1. Third Party Benefits: A dentist shall avoid any representation that causes patients to believe the dentist is a provider for the patients third party payer if, in fact the dentist is not.

You cannot “have your cake and eat it too” in this situation. It has been asked, if when a patient inquires whether you “take their insurance” that they are asking whether you are a provider on their network or not. Some offices say, “Yes, we take your insurance” when in fact they don’t. Many people don’t understand that with a PPO they can go to any provider, but the payout will be as an “out of network” versus an “in network” provider. Whether there is any difference in the percentage payout or difference in the fee falls on the dental office to gather that information if they want the patient to appoint.  

If the dentist is not a “network provider” then the script would be this: “Yes Mrs. Brown, we do accept assignment of benefits from your plan and from any PPO plan. That means we will bill them and wait for payment except for the deductible and any applicable co-payments. We would be reimbursed as an “out of network provider” because we are not a contracted provider on your plan. If you would like me to, I can find out if there is any ‘out of pocket’ expense for you on your first visit and any subsequent visits.”

With more pressure placed on production in practices, it behooves us to not lose sight of the ethical way we are treating our patients and what our true Mission Values are toward their care.

If you would like more information on McKenzie Management’sTraining Programs  to improve the performance of your team, email training@mckenziemgmt.com

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