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Forget the Fiscal Cliff - Create Your Financial Pinnacle
By Sally McKenzie, CEO

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At this writing, the powers that be in D.C. are still negotiating how close to or how far over the “fiscal cliff” the country needs to go before a deal is reached. Let Washington do what Washington does, and when they figure that out, let me know. In the meantime, I recommend that you turn your focus to reaching your personal financial pinnacle, rather than falling off some cliff.

Certainly, reaching the summit requires work as well as a clear plan and a laser focus on production. Consider this example: Let’s say that in 2013 you want to achieve $700,000 in clinical production. This calculates to $14,583 per week (taking four weeks out for vacation). If you plan to work forty hours per week, you’ll need to produce about $364 per hour. If you want to work fewer hours, obviously per hour production will need to be higher. Next, you’ll need to have two cornerstones in place:

1. Daily production goals 
2. A schedule to meet those goals 

Now keep in mind, there is more to reaching your financial pinnacle than creating goals and scheduling. Improving production goes hand-in-glove with improving case acceptance. But before there is case acceptance there must be effective treatment presentation. And that begins with effective diagnostic practices.

Never lose sight of the fact that the patient needs what the patient needs. Diagnose necessary treatment and address patient desires according to your professional practice philosophy, not what you perceive the patient can afford. From there, develop a treatment plan that includes everything needing to be done - appointments necessary, cost of treatment, estimated length of treatment time, and any treatment options. Once the treatment plan is developed, the next step is to present it, but keep in mind that the treatment presentation isn’t a conversation. Rather, it is a process that requires time and consideration, especially when presenting larger more involved cases. Let me explain. 

The first step is to introduce the procedure to the patient. Using a tablet PC, models, or other patient education tool such as Guru, provide the patient an overview of the procedure(s) recommended, such as crowns, bridge, or implants, and how they are used to replace decayed or missing teeth. From there, the process moves into the face-to-face discussion phase. The doctor explains the patient’s specific treatment options, risks, benefits his/her recommendations, and answers any questions about the procedure. Ideally this takes place in a treatment presentation room or other relaxed setting. Scripting is essential to ensure that the discussion does not become too technical or too graphic, and it enables the clinical team to anticipate and prepare for likely questions from patients. 

Once the doctor has answered all of the patient’s questions regarding treatment, the patient is turned over to the financial coordinator who discusses the practice’s financing options. The discussion should take place in an area where the patient can ask questions that s/he may not want a room full of other patients to hear. It is imperative for the patient to understand that payments can be made over time with the help of treatment financing programs, such as those offered by CareCredit

With an understanding of the procedures recommended, an understanding of the financial commitment and appropriate options, the patient should leave with specific documents in hand, including a treatment plan, a treatment financing plan, professionally printed materials about the procedure(s) recommended, as well as a list of websites the patient can visit to learn more. The patient should be encouraged to call or email the doctor with any additional questions that come up as s/he reviews the information. If the patient does not schedule, his/her record should be flagged for a follow-up call within the next few weeks. 

Recognize that patients may be interested, but they may not be ready to move forward at this time for any number of reasons. It will be essential that the doctor and clinical staff reinforce the benefits of the recommendation at subsequent patient visits. Reinforcing the need for treatment and providing additional opportunities for the patient to ask questions or raise concerns can be the deciding factor for many patients who are seriously considering pursuing treatment but need time to make the final decision. Remember, patient reticence is not rejection; it is an indication that the patient has additional questions, concerns, or simply needs additional time to consider the benefits of your treatment recommendation.  

Next week, scaling new heights on the way to your financial pinnacle.

For more information on this topic, visit my blog: The Lighter Side

Interested in speaking to me about your practice concerns? Email sallymck@mckenziemgmt.com
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Nancy Caudill
Senior Consultant
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What Happens at the End of the Day in the Life of Your Business Coordinator?
By Nancy Caudill

It is the end of a long workday and you are ready to walk out the door. You say “good bye” to Debbie at the front desk, who is busy finishing up her last minute tasks before she is out the door as well. Have you ever asked yourself exactly what she does at the end of every day? My guess is no. Maybe you feel that it is her area of expertise and not for you to ask, especially if she has been doing these tasks for several years. I invite you to sit down with your “Debbie” and tell her that you recently read an article in the McKenzie e-newsletter about end-of-day tasks, and you just want to make sure that everything is being taken care of.

Step 1 - One hour prior to the time estimated for your last patient to walk out your door, Debbie should be starting to wrap up her day. A quick “print preview” of the report from your practice software that shows all the charges posted for the day and the provider that they were posted to should be analyzed to confirm that all the production was posted and to the correct provider. For example, check to see if any exams were accidentally posted to the hygienist instead of the doctor. 

Step 2 - Confirm that all the electronic claims for the day have been submitted. Every software program has built-in reports that can be generated to confirm that patients with insurance plans and posted production had a claim generated. If unsure how to obtain this report, ask your software support person.

Step 3 - Avoid last minute cancellations or broken appointments. Take a quick glance over tomorrow’s schedule to make sure that all appointments have been confirmed.

Step 4 - The routing forms should be printed and pertinent information should be highlighted to bring the information to the attention of the clinical team during the morning meeting. If you are still using paper records, the routing forms are simply inserted into the record. No need to take the time to attach them with paper clips. The paper clips end up all over the floor! Reviewing the routing forms is a very important step in the communication between team members. Not only does it explain what the patient is coming in for, but also reviews other family member’s recall status, any medical alerts, unused insurance benefits, financial concerns, referral information, etc.

Step 5 - Print a copy of the next day’s schedule for everyone attending the morning meeting. This gives the team a place to jot down notes as well as the opportunity to see what their day looks like. Even if your practice is “paperless” there are still important “papers” that must be generated. As a result, you may be “chartless” but are far from “paperless.”

Step 6 - Now it is time to start preparing the deposit. All the cash and checks should be totaled and compared to the deposit report in the practice management software. If this doesn’t match, the discrepancy must be found and corrected. She then creates a report from the credit card service (either online or through the machine, depending on what type of service you are using) that lists all the credit card transactions made for the day. This total must balance with the computer’s credit card deposit. If it doesn’t, the discrepancy needs to be corrected.

The bank deposit is completed to illustrate the following: Total Checks, Total Cash and Total. A copy of the bank deposit form goes in the envelope with the deposit and a copy stays in the bank deposit book. All the credit card slips that the patient has signed (and make sure that you have a copy of each one) are matched with the credit card reconciliation and the computer-generated credit card deposit. They should all be stapled together and placed somewhere safe (3-ringed notebook, etc) in order to expedite the reconciliation of the bank statement. The envelope with the cash and checks is either taken to the bank by an employee or is given to the doctor to deposit. The cancelled bank deposit slip must be returned and stapled to the corresponding deposit slip in the deposit slip book to acknowledge that the deposit was made.

Step 7 - (alternative to step 5). Because patients may be making credit card payments at the end of the day, the deposit is prepared but not “closed” until the following morning to avoid having to spend additional time to complete the transactions before leaving. If this is preferable, this step must be performed before any transactions are entered into the computer.

I know you must be reading this thinking that this is what everyone does. I am here to tell you that this is NOT what everyone does. We have consulted with offices that never reconciled their cash, checks and credit cards to their computer’s deposit. Credit card payments made by patients were never posted to their accounts, cash was taken and posted as checks, etc. Don’t let this happen to you!

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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Are Your Staff Meetings More Like Sales Meetings?
Belle DuCharme, CDPMA

Dear Belle,

I hate our staff meetings because all the doctors talk about is numbers, production, collection and how we all could improve the practice by selling more dentistry. I am not a salesperson; I am a dental assistant who takes care of the patient when they decide to have treatment. Of course I tell them it would be to their benefit when it is. I love what I do but did not sign on for a sales job.    

Debbie, DA

Dear Debbie DA,

One of the mistakes that doctors make is not explaining to the staff the importance of good business systems in the dental practice. In order to pay all overhead expenses such as rent, supplies and your salary, the practice must make a specific amount of money. Unfortunately this is communicated to you in a way that you find offensive. The fact that your focus is on the patient shows that you are selling dentistry indirectly by showing concern and compassion and loving your work.

Production goals give the dentist a benchmark by which to measure individual output. Otherwise, how can you answer the questions: “How did we do today? Did we make goal?” (The amount calculated to meet expenses). Of course, to make this more palatable to the team, there is usually some kind of reward for service over and above the usual expectation. If the production/collection goal is attainable, it is a team effort of producing from the clinical end and collections from the business end. If one is weak then there is no tangible reward. For instance, say you encouraged a patient to have implant-supported dentures made after watching this patient struggle with ill-fitting dentures. You feel good about this, and the production numbers illustrate success.  However, the business coordinator did not collect in full for the service, so the collection numbers do not reflect positively. Multiply this by several patients and the fact that dentistry is being sold does not mean the practice is profitable.

Or perhaps the dentist or dentists under-diagnose by “watching” or allowing the patient to postpone treatment that would improve their dental health to the point that the business coordinator has little to schedule. Multiply this by several patients a week and the production numbers will be low. If the business coordinator is collecting 98% of what is produced then her/his numbers are excellent, but the clinical production end is weak so the numbers are low. Dentists often address these problems to the team at staff meetings instead of having a performance review with the business coordinator and improving the dentist’s treatment acceptance skills.

As a dental assistant you have an opportunity to build relationships of trust with patients. This trust should never be overshadowed by pressure to produce a number.  You are there to support the diagnosis by answering treatment related questions and educating the patient to make a decision based on informed consent. Promoting services and products only when relevant to providing excellent patient care is the best perspective to take.

Key subjects for staff meeting agendas for positive results would be:

  1. 1. How can the practice improve its customer/patient service/phone skills?
  2. 2. Are there services and products that the practice can promote in an educational and informative way instead of a hard sell way? 
  3. 3. What can the practice do to attract new patients?
  4. 4. What can the practice do to retain patients?
  5. 5. What can the practice do to market itself to the community?
  6. 6. What can the practice do to improve its online image or create a new image?
  7. 7. What can the practice do to thank patients for their continued support and loyalty?
  8. 8. What skills can the team learn to help with all of the above suggestions?
  9. 9. What educational courses are available for the team to learn treatment acceptance training?
  10. 10. How can the team work together to support and help each other to attain production and collection goals?

Want professional training to improve your production and collection numbers?  Call McKenzie Management today for dental Front Office Training, Office Manager Training, and Treatment Acceptance Training courses.

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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