3.28.14 Issue #629 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

7 Signs You’re Busy, But Not Productive
By Sally McKenzie, CEO

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So what’s your definition of “busy”? A patient reception area that is full to the brim? A schedule that has you and your highly energized staff doing hallway sprints from 8 a.m. to 5 p.m.? Is it a day that keeps you and your team at the top of your game and on track with your goals?

The definition of “busy” means different things to different people. For some it is synonymous with stress. For others it means excitement and challenge. And then there are those who see “busy” as the precise balance between a fully engaged team and profitable practice. They, however, are the exception. 

In far too many practices, “busy” means frantic but far from financially sound. Why? Because the business team members are doing precisely what the doctor has told them to do. Keep him/her ... well ... busy. Yet, in spite of the persistent pace, production continues to lag and profits don’t measure up. And the doctor is at a loss to figure out why.

After all, just look at the schedule. There’s barely an opening to be found. Naturally, dentists will assert with utmost conviction that the “full” schedule is an obvious indication they are running successful practices. The “keep the doctor busy scheduling strategy” seems to be working - so why don’t the numbers back it up? In the dental practice, busy is often an illusion that doesn’t necessarily translate to productive. A busy-but-not-productive practice often has a number of tell-tale signs:

1. The doctor is booked more than three weeks out, and patients have to wait several weeks for even the most routine procedures.
2. There is little if any consistency in the time scheduled for procedures - 30, 60, 90, minutes.
3. The objective is simply to keep the schedule full.
4. The hygiene schedule is booked for months.
5. “Lunch hour” is a nice euphemism for 10-minute lunch breaks for the team to catch their breaths and grab their protein bars.
6. Patient retention is weak.
7. Revenues are flat.

I recommend you take your focus off of merely busy and pay attention to what it means to be truly productive. First: Define Goals, Objectives, and Priorities. The doctor must develop a clear picture of the practice’s financial demands and desires. It is the first and most critical step in understanding the importance of scheduling to meet daily production goals.

You need to consider the fundamentals, including the following: How much are your bills? How much do you need/want to pay your staff and yourself? How many hours per day and days per week do you want to work? How much vacation time do you want to take? What about costs for bonuses, retirement, continuing education, equipment and computer upgrades and maintenance, etc.? All of those financial needs and desires play a role in determining the practice’s revenue goals. How many hours per day and days per week do you want to work? How much vacation time do you want to take?

Next: Setting production objectives. Rule #1 in building a profitable dental practice is to ensure that the Scheduling Coordinator is scheduling to “meet” production objectives vs. scheduling and then “hoping” at the end of the day that the goal was met. Set scheduling goals based on your overhead expense - scheduling goals can sometimes be pulled from the air and then you’re scratching your head wondering why you’re not reaching the objective. 

Setting a production objective requires the practice to know its overhead expense. How much money does it take to pay the bills and payroll?  For example, let’s say that expenses and payroll total $46,500/month and your objective is to have overhead be no more than 62% of your monthly collections.

$46,500 is 62% of $75,000 in collections per month (46,000 ÷ .62). If you are collecting at a 98% collection ratio (collection divided by net production) you will need to produce $76,531/month (75,000 ÷ .98). If you work 48 weeks a year which is 4 working weeks a month and see patients 4 days a week, that would equal $4,783.19/day in net production.

The industry standard for hygiene is 33% of the practice production, which would equate to hygiene producing $1,578/day and the doctor producing the difference of $3,205 and working an 8 hour day, which equals $401/hour. If you are seeing patients on 10 minute units and there are 6 units in an hour, the doctor must have net production scheduled at $67/per 10 minutes.

Next week, from here on out, you’re productive not busy.

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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Technology and What It Says To Your Patient
By Nancy Caudill, Senior Consultant

What do you think your patients appreciate about your practice? This would be my list:

- Clean and uncluttered environment
- Friendly face when they walk in
- Seen by the doctor or hygienist within 10 minutes - and sooner is even better
- Option to watch TV and listen with headphones during long procedures
- Easy to understand treatment recommendations and consequences
- Clear financial arrangements with payment options
- Advanced technology for treatment

And last but certainly not least - technology! Technology can be applied to each of the above items.

Clean and Uncluttered Environment
Let’s start with the area that you may have set aside for children. No need to have toys that must be sanitized between each child (or should be) - there are computerized games that can be attached to the play area wall with game controls that are easy to wipe down and are just as entertaining as toys from years past. Take a look at your selection of toys and consider replacing them with computer technology and easier ways to keep clean. Needless to say, fewer toys also mean less clutter.

Just as our homes tend to accumulate “stuff” over the years, your office does the same. Walk through your office with an open mind and determine what is on walls, shelves and countertops that is not necessary for promoting dental health. If it is something that’s promoting your practice or dental health, is it current and displayed in a manner that is pleasing to the eye? Watch for brochures that are upside down, torn or simply worn out that are still in your plastic displays, they should be removed. Magazines that are over 2 months old should be discarded or donated. Magazines with torn or missing covers should be removed. You should stroll through your reception area a couple times a week just to see what the patient is seeing and make sure you are happy with what you see.

I personally have an issue with waste that is not removed from the treatment rooms, reception areas and restrooms nightly. If I am the first patient in the morning and the trashcan where I place my disposable coffee cup is full from yesterday, I have to wonder what else in the office is not as clean as it should be. The same goes for the trashcan in the restroom that still has trash from the day before. Trash should be removed from the premises every day after work.

A Friendly Face
A personal greeting is always better than a sign-in sheet. If I have been coming to your practice for five years and your staff at the front desk still does not recognize me, they can at least pretend that they do. Smile when patients walk in the door and greet them by name if you can. Technology makes it possible to have a photo in the digital patient file so you can quickly pull someone up and figure it out! 

Seen in a Timely Manner
Technology allows the business team to notify the clinical team when a patient arrives, using indicators in the digital appointment book. Wireless walkie-talkies allow the clinical team to communicate with the business team if they are running a few minutes behind schedule so the patient can be offered coffee, water, etc. as well as an apology for the delay. I find that patients are tolerant of a few minutes delay as long as they are informed of the wait.

TVs and Other “Audio Anesthesia”
Again, technology now places TVs on the walls and ceilings for your patients to enjoy during longer procedures. Yes, there are those who simply enjoy the peace and quiet or the whir of the drill. Encourage your patients to bring their own music. Be careful and don’t allow music, movies and TV to interfere with educating your patient.

Easy to Understand Treatment Options
There are many video options for educating patients that can be viewed on your monitor or iPad. Seeing is believing! And let’s not forget the intraoral camera and digital photos of the patient’s clinical needs.

Clear Financial Options
Financial institutions such as CareCredit allow patients to go online in your office to apply for assistance. Your patient can simply use the computer at the check-out area or use an iPad in the operatory to get instant approval. There is also an option for the Schedule Coordinator to “pre-approve” the patient.

Want your patients to talk about you to their friends and family in a positive manner? Use technology! People are impressed when you are cutting edge, and it’s important for you to “sell” your new technology to your patients in terms of how it benefits them. Chairside digital impressions eliminate the need for those “gaggy” impression trays with goop. The ability to fabricate crowns during one visit saves the patient time. 3-D cone beam technology improves your ability to make a more accurate diagnosis. Being able to “see” cavities and share the image with the patient improves case acceptance and trust.

Embrace and incorporate technology into your practice and be proud that you have done so! Teach your patients about your technology and express why you have added it to your tool box... “In order to exceed your dental expectations, Mrs. Jones.”

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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Secondary Claims, Claim Rejection Ruining Your Day?
By Belle DuCharme, CDPMA

Looking at the aging insurance claim report, you spot a few secondary claims that remain unpaid and there are several claims that are aging past thirty days. You know there is something wrong. If you received a denial of payment on any claims, those have to be addressed immediately to get paid. Time is not on your side as accounts receivables start to rise and claims that age past six months are subject to non-payment by many insurance companies. This can happen quickly when you file secondary claims.

In the course of the dental business day, patient, staff and doctor concerns are priority and the phone is ringing in its constant interruptive way and cannot be ignored - but unpaid claims are the source of revenue necessary to cover the overhead and must be included in the priority task list for each day. Delegate someone to answer the phone so you can make five calls a day on unpaid claims to keep the system healthy. If claims are submitted correctly there should be few to follow-up on, but in some practices with untrained business staff the aging insurance report is several pages long and now will take hours, days or months to clean up - and that is if you know what you are doing.

Coding, documenting and filing claims correctly are subjects too vast to cover in this article, but let’s look at some basics. If you are doing electronic claims with electronic attachments, make sure this is set up correctly with your software provider. All claims going out to insurance companies should be billed with the standard fee schedule whether in or out of network. Check the claim verification reports after claims are sent to make sure there are no rejected claims. When sending attachments you will have an assigned number for those attachments for future reference.

Learn the insurance terminology to understand how payment is determined. For instance, do you know the difference between the “billed charge” and the “allowed charge”? The billed charge is the amount billed by the provider of services (standard fee schedule) directly to the insurance company and is reduced by the claim payment system to the allowed amount, or contracted rate negotiated by the insurer and its network provider. If you are not a network provider the patient will have to pay the difference between the insurers allowed amount and the amount that the provider charges that exceeds the allowed amount unless there is an agreement otherwise.

The allowable amount is the maximum dollar amount that an insurer will consider reimbursing for a covered service or procedure. This is also referred to as “maximum allowable amount.” The dollar amount may not be the amount that is ultimately paid to the member or provider as it may be reduced by any co-insurance (co-pay) deductible or amount beyond the annual maximum.

When a patient is covered by more than one dental benefit policy, the term “coordination of benefits” applies. This can change from one insurance company to another so it is important to determine correctly which plan is in the primary position. This can get complicated when a married couple have their primary plans and are also covered by each other’s plans and the children are covered by both. The primary plan must be billed first and when it is paid the Explanation of Benefits (breakdown of payment) is then copied and sent along with the secondary claim so payment may be determined. The documentation sent with the primary plan must also accompany the claim. The secondary insurer’s reimbursement, if any, takes into consideration any outstanding dollar amounts for covered services received up to the allowed amount. In any case, the secondary plan will never pay more than they would have paid had they been primary.

In researching claim denials the reasons can be as simple as wrong date of birth, missing relationship to provider, no subscriber ID or wrong social security number. Check all fields in the claim body to make sure information is correct. Other mishaps concerning improper coding can cause your claims to be red flagged by the insurance company. Remember that a miscode of a procedure may be innocent, but from the insurance company's view it can represent fraud. Relying on the business staff to choose the right code for what was performed clinically can lead to errors in claim filing and subsequent claim denials.

Need help with understanding dental insurance benefits? Call today and sign up to take the Dental Front Office Training Course.

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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