11.26.10 Issue #455 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Reports in Hand = Cash in the Bank
by Sally McKenzie CEO
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Remember the good ol’ days? You know, the ones in which your schedule was booked for months, the patients were flowing like Champagne from a fountain, and you were rolling in the green - or at least you thought you were. Then came the recession; it put a cork in the bubbly, made Swiss cheese of the schedule, and as for cash flow, accounts receivables went from so-so to “uh-oh.”

The truth is, you probably have little or no idea what your receivables were before the economy hit the skids, because you were most likely racing through your days too quickly to give nary a glance at the figure. And, after all, enough patients were paying up front and in full. Ah yes, the good ol’ days.

By the time 2008 rolled around, practices had come a long way in educating patients about payment expectations. Gone were the days of patient dictated payment plans - “I would like to pay $50 a month on my $1,200 bill that way I’ll have it paid off in just two years. No problem, right?” Practices put their collective feet down and said goodbye to the banking biz. Policies were not only adopted, they were actually implemented. Business staff became more comfortable with confidently explaining financial policies to patients, and patients were more willing to accept them. Then economic circumstances changed, and dental teams panicked.  

Two years later, it’s time to hit the pause button on practice panic and pay attention to what I’m about to tell you. We all know that the economy has undergone a series of changes and challenges over the last several months. That being said, the expectation remains: Practice collections should yield 98% for treatment currently being performed. Should you be sensitive to your local economy? Absolutely - but not at the expense of the practice’s financial solvency. It’s time to issue a collections correction and get your accounts receivables back on track. But before you dig out, you have to dig in - into key practice reports that is. These are your guide to cash in the bank.

The Accounts Receivable Aging Report
This report should include all credit balances and all debit balances. It is vital to understand how many dollars are outstanding 30, 60 and 90+ days. Because practice costs for tracking and collecting old balances can far exceed the actual value of the account itself, this report should be printed monthly.

The Outstanding Insurance Claims Report
Identifies how many dollars in outstanding claims there are in each category: current, 30, 60 and over 90 days. This report is crucial because the longer dollars remain outstanding in claims, the more costly it is to the practice. Print this report monthly. Many of today's software systems allow you to track daily.

The Accountant Earnings Report
Details exactly how many dollars are being written off in each category: accounting adjustments, insurance plan adjustments, professional courtesies, pre-payment courtesies, etc. This report should be monitored daily and monthly.

The Production by Provider Report
Allows you to track individual provider production for each dentist and hygienist. It is important to track individual production numbers to determine productivity. Typically, hygiene production should produce approximately 30% of the total production in an office.

The Production by Code Report
Gives you an opportunity to track how many times a specific procedure is done. This can be used to determine productivity, treatment acceptance rates, and much more. Also, if the practice is utilizing special techniques, tracking the production by code will help to determine effectiveness, i.e.; tooth whitening, periodontal aides, crowns, bridges, and implants.

The Treatment Plan Report
Identifies how many dollars are being presented to patients. Utilizing this report effectively can identify your success rate in treatment acceptance. The formula for this is: Dollars recommended divided by dollars accepted equals case acceptance rate. Your case acceptance percentage should be at least 85%.

Now that you’ve carefully reviewed these key practice financial reports, you have a much better understanding of where your practice financials stand, and you are ready to take action.

Next week, six steps to solvency

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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Imprive your hygiene performance one day... in your office

Belle DuCharme CDPMA
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Shoppers - Are They Really Looking for the Cheapest Care?
By Belle DuCharme, CDPMA

“It is a waste of my time to answer the questions of a shopper, they are just looking for the cheapest price and don’t care about quality.”  Jane D, Office Manager

How often a patient continues to shop around after receiving a treatment plan is often unknown unless the patient says to you, “I am going to get a second opinion.”  It is easy to assume their decision is swayed by the cost of the care and not the quality of the product and the expertise of the service. If you haven’t enhanced the quality of the products you use, then you haven’t established market value. For instance, if you say to the patient that you are providing white fillings for $380 a tooth, it doesn’t sound impressive but maybe it does sound expensive. Think about what is involved in making this filling

 “We are providing the best available composite material on the market, known for its durability and strength against fracture. We will be matching the color of this filling with your other teeth so it is as natural as the tooth you had originally. You will be able to chew normally on this tooth as soon as the numbness goes away. With proper care this filling(s) will last for many years.”

Dental services are provided in a sterile field by trained and licensed professionals. The patient is receiving a product and service with long term health value. It is up to the practice to be able to create an environment to deliver this message.

If you haven’t enhanced the value of your service to the patient, then you will be shopped for a second opinion. From the initial point of contact you are building trust by answering the patient’s questions, greeting the patient with a caring and helpful attitude, seating the patient on time and conducting yourself professionally. If there is tension in the office from friction between staff members or the doctor is in a surly mood, the patient will quickly pick up on this and will become cautious about having care in your practice. This lack of trust, not the suspicion that your fees are too high, is the main cause of “shopping” another practice.

When a person phones your office asking about your fees for a particular procedure, it is up to you to decide how much time you want to spend on this call.  Generally, people who have been quoted a fee at another practice call to see if the fee they were quoted is reasonable. The patient has doubts, and in order to resolve these reservations they call offices nearby to “shop” for answers.

Take a little time, but take control of the conversation by asking:

“How did you hear about our office?”
“May I have your name?”
“Who told you that you needed a crown (or other service)?“
“Did you receive a written estimate?”
“Were your questions answered about why you need a crown (or other service)?”
“We would be happy to provide you with a complimentary consultation in regard to your treatment, I have an opening at 2:00 tomorrow - will that be helpful to you?”

If the patient wants a price for a crown, quote a range that includes a periapical x-ray and possible build-up fee and say, “We must verify this quote with an examination and an x-ray.”

Shoppers are not necessarily looking for the cheapest option. They want to perceive that the value of the product and the service equal the cost. Think of shoppers as people who need dental care and need questions answered. If you take the time to help them you may end up with a new patient, or maybe you’ll just create goodwill. You will be surprised to hear that offices get referrals from people who have never been patients but were treated well on the phone.

To learn about scripting for other situations that require excellent customer service skills, take the time to improve your practice by signing up today for a training course through McKenzie Management. 

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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Nancy Caudill
Senior Consultant
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Your Future Is In Your Hygiene Department
By Nancy Caudill, Senior Consultant McKenzie Management

One system that fails in almost all general family practices is in the area of hygiene. Let’s think about the logistics for a moment. If you are a doctor with a practice that is ten years old and you have been averaging 20 new hygiene patients a month, that is 2400 patients x 2 visits/yr = 4800 appointments needed. If your hygienist is averaging 9 patients per day, you would need 533 hygiene days. Working an average of 192 days a year, this equates to 2.7 hygienists per day. Imagine if you have been working 15-20 years!

Why Don’t You Have 2.7 Hygienists Per Day?
Because you probably don’t need that many! Neither did Dr. Shively. It is not uncommon for McKenzie Management to work with an office that only has one hygienist after 10 years, because the one hygienist that they have is not busy enough to warrant hiring another one.

Reasons for Dr. Shively’s Weak Hygiene Department:

  • Lack of an effective periodontal program
  • Lack of a systematic follow-up program
  • Lack of understanding by the doctor regarding how important the Hygiene Department is to the growth of the practice
  • Lack of an assigned Hygiene Coordinator who is responsible for the success of the program

Periodontal Program
It is never too late to implement a valuable and needed periodontal program in a practice, just as Dr. Shively did. She prepared her entire team by inviting Carol Tekavec, McKenzie Management’s Hygiene Consultant, to her practice to get them started off on the right foot.

Just as important to a successful hygiene program is the follow-up. Your practice could have 40 new hygiene patients coming in the front door every month, but if you are losing 50 out the back door then your practice will never grow! We have to admit that dental patients do not walk around all day just waiting for their semi-annual visit to their dentist. Unless they have a toothache, the dentist is the last thought that crosses their minds. That is why we must remind them of how important their visits are.

  1. Contact your patients that are due for their hygiene visits by phone, email, text message or personal notices by mail. These are your patients with and without appointments. If they have an appointment, it is to inform them that you are looking forward to seeing them. It they don’t have an appointment, it is to inform them that it is time to call to schedule an appointment.
  1. Contact all patients that are 30 days past due by telephone, if possible.  These patients have already received an initial contact from you from the previous month. About 30% of the patients that did not have appointments will call and the other 70% won’t.
  1. The patients that are 60 days past due should receive notification from you by a nice letter on letterhead stationary indicating that you have missed seeing them for this very important visit in order to help them maintain healthy gums and teeth. Consider enclosing an educational brochure about the necessity of professional cleanings. If this is a periodontal involved patient, the letter should more directly address their specific needs.
  1. A past due recall report should be generated for patients 6 months past due.  These patients should be contacted by phone, email, text message or mail.  Again, restating the importance of their visit.
  1. At 12 months past due (this is 18 months since they were seen in hygiene last if their recall interval is every 6 months), it is time to accept the fact that these patients are not “active” patients in your practice. A nice letter should be sent to them requesting a response regarding their interest in maintaining their active status, have they left the practice, do they prefer to call when they need you, etc.

This letter should also include a statement indicating that as the dentist responsible for providing dental care for them, unless you see them on a regular basis you cannot be responsible for the maintenance of their dental health. These patients are now considered “inactive” and if you have paper records for your patients, their record should be relocated from the “active” A-Z records to the “inactive” A-Z records.

The Hygiene Coordinator
Dr. Shively recognized the importance of Job Descriptions for her two business team members. They worked well together but they were not efficient. They were both doing many of the same daily tasks without accountability. They invited the concept of specific duties so they could focus 100% on what they needed to do instead of trying to do it all at 50%.

As a result, one of the team members accepted this most important role of Hygiene Coordinator. She understood that the future of the practice depended on her ability to maintain the follow-up systems in order to “grow” the Hygiene Department from one hygienist to two.

The Future of Your Practice
Take a few minutes to evaluate your Hygiene Department based on the number of years you have been in practice. Put the pencil to the paper and see where you think that you should be regarding how many hygienists you should have compared to how many you do have. Run your Recall Report for the next 12 months and see how many “active” patients you have compared to the number of paper records you have on the shelves. You may be shocked!

Know that the future of your practice is in hygiene. It is as simple as this: The more mouths you look in, the more productive you will be and the more patients you will serve!

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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