12.9.11 Issue #509 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Keep Your Cool When Pressures Heat Up
By Sally McKenzie, CEO

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Certainly, running a dental practice can be a source of considerable stress. But when the season of last minute cancellations, no shows, holes in the schedule, staff irritations and frustrations - also known as the Holidays - is upon us, that stress can hit a fever pitch. Managing the day-to-day pressures that are an unavoidable fact of life in dentistry, especially this time of year, requires more than a little attitude adjustment, starting with acceptance.

Accept the unexpected and be ready to deal with it. When a patient is 20 minutes late for the appointment, accept the reality of the situation and be prepared to adjust accordingly. You cannot change that they are late, but you can change how you respond. If you learn to deal with “what is,” rather than becoming frustrated about what should be, you will have less stress.

Stress starts with how you think things are, how you think they should be, and how they are not the way you want them to be. It manifests itself physically in headaches, stomach problems, anger, anxiety and the like because people, especially those with perfectionist tendencies, have difficulty adapting to situations in which people and circumstances do not go as they believe they should. Consequently, too much of their energy is spent dwelling on those things they cannot control.

They focus on the need for the other person or the situation to change. “If I could just get so-and-so to do such-and-such,” rather than considering how they can adjust their response to the stressful situation. For example, the doctor needs a report on Wednesday. The employee responsible for delivering the report tends to procrastinate this type of work and most likely will not have the report ready, which will cause the doctor stress. Rather than encouraging a stressful situation, ask that the report be done by Tuesday; adapt to minimize stress.

Make your choice. When confronting stress you have essentially four choices:

1. Stay and do nothing
2. Leave either mentally or physically
3.Change your attitude
4. Change your behavior

The first two can be done on a short-term basis. Larger, more challenging situations have to be dealt with using 3 and 4. For example, if a team member is routinely coming in late for the beginning of the day meeting, causing disruption and stress for those who arrive on time, the behavior needs to change. First, the doctor must stop looking the other way and making excuses. Second, the offending employee needs to clearly understand that the expectation is for them to arrive at a specific time. Third, they need to be held accountable. In other words, if they disregard this fundamental requirement, then it should be reflected in their performance review and in some cases disciplinary action must be taken. In addressing the behavior and establishing guidelines for that behavior, the doctor can then adjust his/her own behaviors.

Let go of the irritations and frustrations and focus on the real goal. For example, a patient forgets to bring necessary paperwork to the office. It's very easy to become irritated. Rather than becoming stressed, put your energy into being resourceful and finding another way to address the problem. Focus on the real goal, which is to get the necessary paperwork.

Make the most of what you have. More time, more money and more staff will not translate into less stress - even though most dental teams believe that they would. We have to learn to do what we can with what we have, right here, and right now.

Address your fears. It is widely recognized that most of us stress about problems and situations that will never happen or over things that we have no control. Fear is the number one cause of stress. People are afraid of what will happen, what won't happen, or what might happen. The number one method to address fear is to gather knowledge and adjust your behaviors. Worrying about production, collections, new patients, team productivity, staff turnover, etc. does nothing but cause stress. Rather than worrying, take action to ensure that if adjustments do need to be made, you know exactly what steps to take to achieve the desired results.

Next week, are you the one causing the majority of stress for your team?

Want more of me? Click here to visit my blog, The Lighter Side, for more Dental Practice Management info.

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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Belle DuCharme, CDPMA
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Hiring for the New Year? Recruit Right for the Best Applicants
By Belle DuCharme, CDPMA

You can tell a lot about a practice by the advertisement that is placed to recruit a new hire. Since the people that represent your practice are your principle asset, taking the hiring process seriously is mandatory. Take into consideration that staff salaries represent the highest percentage of your total overhead - recruiting a new hire should be looked at as an investment with a measurable return. The following are examples of advertisements looking for business staff. These are based on real advertisements, but have been changed to protect the identity of the writer.

Dental front office person needed. MUST BE familiar with CurveDental, HMO and PPO Treatment Planning Case presentation. Top pay for the right person.

This advertisement does not state where the practice is located and what type of dental practice it is, such as general or orthodontic. The job position is not stated so it is hard to determine whether the person they want is the scheduling coordinator or an office manager. It does not state the days or hours of employment.  It says “familiar with” not skilled. I have seen people hired that are familiar with the software program, but not enough to post a payment or do a treatment plan.  What is “top pay?” Be careful with this perception, as it means different amounts to different people.  State a range that you can pay dependant upon skills and experience and practice overhead.

Our South Beach practice is looking for an experienced dental insurance coordinator and an administrative assistant. You must have a professional appearance and demeanor as you will be the face of our practice and the first person a patient sees when they walk in the door. Monday thru Thursday, 8am to 5:00pm. Exceptional verbal and written communication skills, along with a motivating, positive, upbeat attitude. Must be comfortable calling patients regarding accounts and familiar with sending, monitoring and tracking statements. Must have Dentrix experience. Other responsibilities include: contacting insurance companies regarding benefits, submitted claims, payment processing and x-rays/claim attachments, scheduling to production goal.

This ad states two positions, so I am not sure if they want two people or a person with two job descriptions. It sounds like a support person to the office manager. It states the location, hours and job responsibilities, however it does not state a salary range. This ad will have people calling that are expecting a more than average wage. It would help to include how many years experience desired or possibly a degree in marketing or business and or specialized training for the dental business office.

Looking for FRONT OFFICE/BILLING person for a Dental Office, we offer full time Job. With at least 5 yrs of billing experience, bilingual English and Spanish. Exceptional individual with front desk as well as dental assisting skills for office in south bay area. Excellent phone skills and desire to provide outstanding customer service. Experience with Eaglesoft, all aspects of dental insurance, and strength in case and fee presentations with high percentage case acceptance. Highly knowledgeable and skilled in financial arrangements.

Here again, we have an ad that does not state the job position. It does not state the days and hours, but does say full time. The assumption here is a 40 hour week, five days. Even though the ad boldly states “Front Office/Billing person”- it also states the candidate must have dental assisting skills. It sounds like the applicant would have to do two jobs and be highly experienced at both. Again, no salary range is offered but with the experience in both jobs required, I would expect this job to offer a higher than average salary.

The dental applicant must:
- Have at least 4 years experience in dental fields
- Production goal oriented
- PPO and HMO experience
- Enjoy working with people
- Marketing and PR Skills
- Strong ability to grow the practice
- Have excellent organizational and multitasking skills
- Must be familiar with CareCredit, Eaglesoft, and Demandforce
-Must work recall


This last ad does not give the location, hours or salary range. They are also not willing to train, as they boldly state that they will not accept applications from anyone not meeting their criteria. Many dental workers do not have marketing or PR skills, so they may eliminate an otherwise qualified applicant.

Want to learn more about the entire hiring process including personality, temperament testing and the right way to interview and test applicants?  Contact McKenzie Management today for our course in Front Office Business Training or Office Manager Training.

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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Frustrated with HIRING the WRONG people? Remove the guesswork. Employee Testing On-Line

Nancy Caudill
Senior Consultant
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Get Your Insurance Claims Paid
By Nancy Caudill

“Outstanding Insurance Claims” - “Insurance Claims Aging Report” - these are names of a very important report that you should be generating in your practice at least monthly and preferably weekly.

What is it?
This report creates a list of insurance claims that have been processed by your business coordinators after a patient has been seen, an insurable charge was posted and a claim was created.  Some claims are electronically generated and some are manually created - it depends on your practice and the situation.

Why is this report important? 
It is not unusual for me to visit an office that has $50,000 worth of outstanding claims that are over 60 days old.  This is not acceptable, as this is money that is due for services provided in your practice, and there is no one on your business team that is responsible for staying on top of these outstanding claims. This is money that is NOT in your practice but should be.

Who should be responsible?
Your practice should have one business coordinator that is responsible for managing the outstanding claims in your office. Typically, this person is also responsible for the Accounts Receivables, including daily statement generation that was discussed in my last article. However, if you have a smaller office with few patients, then you may only have one person in your business office that is responsible for everything, including this.  A larger practice may have an Insurance Coordinator that is only responsible for insurance eligibility, generating claims, maintaining the outstanding claims and responding to inquiries from the various insurance carriers. It can be a full-time position in a larger office that accepts the assignment of benefits.

Electronic or Manual?
All dental insurance claims should be generated electronically to save time. In addition, the clearinghouse will initially reject any claims that have incorrect social security or ID numbers, missing information and other important pieces of information that is necessary for the insurance carrier to process the claim. By rejecting the claim initially, it allows your Insurance Coordinator to correct the data and resubmit immediately, opposed to waiting until a call is placed to the carrier to determine why the claim is not paid.

In order to submit electronically, the practice must purchase this service from one of several companies that can be found through the internet or through your practice software company.  Prices can vary - some companies charge per claim and others charge a flat fee per month.  Determine which works best for your practice.

In addition to subscribing to a service for processing your claims, you must also subscribe to a service that will process your attachments, such as x-rays, photos, periodontal charting, etc. If you choose not to use this service, any claims that must have attachments to them will have to be handled manually by printing the claim, attaching the x-ray or other documentation and mailing the claim. This is not only time consuming but it delays the payment process of your claim, as electronic claims are processed more expeditiously than manual claims.

What should be attached?
If you want to expedite your claims quickly and avoid an inquiry, the attachments are vital to your success of managing the outstanding claims. It is noted that insurance carriers are rejecting claims for various reasons and are rejecting more now than in the past, in an attempt to delay the process or hoping that the dental office will not respond to their inquiry, therefore avoiding the insurance company from having to pay on the claim. It is all a big game, unfortunately, but one that must be played for many offices.

In order to get your claims paid quickly, send along with the claim a narrative as well as a photo or x-ray that will support the reason for the treatment. Why wait until the insurance company requests the information - send it with the claim initially!

Narratives are vital to the payment of a claim for specific procedures such as onlays, inlays and crowns. The insurance company is looking for a reason to either downgrade the procedure to a filling or deny it altogether. The narrative supports the treatment, since often the photo or x-ray will not illustrate the condition of the tooth.

Narratives can easily be generically created in the form of a checklist for reasons such as:  cracks, lost tooth structure, previous endodontic therapy, etc.  This checklist can be attached to the routing slip of the patient that is receiving treatment for a procedure that needs a narrative. The dentist indicates which narrative is applicable for the treatment and when the routing slip is brought to the front desk, along with the patient, the narrative is then included with the attachment on the insurance claim.  It is a simple matter of “copying and pasting” the appropriate narrative into the “notes” section of the claim before it is submitted.

What is my objective?
No outstanding claims over 60 days for sure, and to improve cash flow, no claims over 30 days. This requires attachments, narratives and a protocol for “dialing for dollars” to the insurance carriers or visiting their websites to determine why the claims are not paid.  Remember - this is money that is owed to the practice. Go get it!

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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