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  Sally McKenzie's
 Weekly Management e-Motivator
  6.20.03 Issue #69

Patient Retention - Easy Come, Easy Go?

Sally Mckenzie, CMC
McKenzie Management

     So Long, Farewell, Auf Wiedersehen, Adieu, are your patients finding too many ways to say goodbye? If so, it’s certainly not the Sound of Music to your ears. If yours is a “revolving door” practice, I have good news and bad news. First, the good news, you have far more control over patient retention than you realize. The bad news, you have far more control over patient retention than you realize.

When things aren’t going as we would like or expect them to be, it's much easier to blame

external forces than to look at what we should be doing differently. The market is down, the economy is on a wild ride, and people are tightening their belts. No question, all of those factors do influence patients and, consequently, your practice. But you are not at the mercy of the outside world. There are steps you can take to dramatically improve your patient retention. The first is to determine if you’re losing patients by answering three simple questions:

  1. How many inactive patient charts have you shoved into a corner somewhere?
  2. Have you increased hygiene days per week in the last year?
  3. Is your hygienist’s salary more than 33% of what they produce?

If the number of inactive charts is enough to open a second practice or if you answered yes to question two or three, you have the opportunity to make significant gains in your patient retention rate.

Remember that it costs five times as much to land a new patient as it does to keep an existing one. Target those who know you or are at least familiar with your practice. Build patient loyalty, provide the very best in patient service, emphasize the value of your dentistry, and market to your existing patient base. The more patients you keep coming back, the greater your source for new patient referrals. Next week, six steps to maximize your patient potential.

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Building On The Theory

How An Ailing Business Foundation Can Cause
“Digital Chaos” Part 12

Mark Dilatush
VP Professional Relations
McKenzie Management

Technology Tool Box

#12 Insurance Systems

Last week I finished a discussion on your scheduling system as an integral part of your overall business foundation. Different ways to leverage your technology investment [see article]. This week I will focus on your insurance system and ways to leverage your technology platform.

The following is the foundation of your insurance system.

Job description – The written, discussed, and agreed reason for employment
Expectations – The performance you expect from this one “system”
Goals – Clearly attainable performance objectives in support of your vision
Responsibility – Who is ultimately responsible for this particular business system
Reporting mechanisms – Which reports they run to measure their performance
Accountability – Presenting the reporting results to the owner and the team
Statistical performance reviews – Compilation of reports for the business system(s) under the responsibility of a particular team member

Your Insurance Coordinator or one of your Business Administrators assigned to your insurance system should report the following at each of your team meetings.

  1. Total outstanding claims (aged 30, 60, 90)
  2. Total insurance dollars collected (for the reporting period – usually 1 month)
  3. Total insurance dollars submitted (for the same reporting period)
  4. Review (with clinical team) any claims that require additional narration, xrays, etc.
  5. Discuss new documentation requirements with clinical team as they are discovered.

If the above business foundation exists in your office, here are some ways to use your computer system to leverage growth, efficiency, and customer service.

  1. If you don’t already, start submitting insurance claims electronically. There are simply no more excuses. Submitting electronically is now a business system requirement.
  2. Get connected! Your insurance coordinator should have access to the internet. Verification of coverage and benefit information can be found on many insurance company web sites. Some allow you to view and even edit (add narratives) a submitted claim. These services will expand over time because it saves the insurance companies money.
  3. Always update your computer system’s bluebook (insurance tables) when a payment comes in. Doing so will make your estimation of benefits during the treatment plan more accurate and raise your customer service level!
  4. Always prepare the patient (prior to their appointment) for their responsible portion (assuming this is your financial policy). Updating the insurance information in your computer will make this accurate and predictable.
  5. Most practice management systems have multiple billing statement layouts to choose from. Review all of the available options. Choose the statement layout that clearly associates an insurance payment with the claim for which it was submitted. This will decrease the overhead of annoying phone calls after you send the patient a statement.
  6. Make sure your statements show at least 45 days of detail. Thirty days of detail is not enough to show the patient, especially if you see multiple patients from the same family.
  7. Prepare the insured patient. Tell them what to expect. Show them an example of a statement. All you have to do is add a patient called “Statement Example” and load some example procedures with sample payments.

Next week we will discuss more ways to leverage your technology platform in order to manage your insurance system with minimal hassle for you and your patients.

If you have any questions or comments, please email Mark Dilatush at

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Missed Past Issues of Our e-Motivator Newsletter?

Getting The Cold Shoulder


Giving Dentists And Their Staff Different Perspectives On Day To Day Issues

From The Coach,

Two weeks ago, I received a letter from Dr. Desperate [see article]. He has 4 ladies working for him, Lacy outwardly dislikes Stacy, and Stacy prefers not to defend herself. Dr. Desperate loves

them all “desperately” and wants everyone to get along. So he chooses to not believe the rumors, and refuses to do anything to resolve the shallow tension that is upsetting the tranquility.

Last week [see article], I received a letter from his older brother (not literally). He identifies with his brother’s frustration and admits to visualizing solutions which all turn out bad for his brother. In response to these imaginations, Dr. Desperate’s brother has opted to keep his practice small but manageable.

The brother goes on to describe dentists in his brother’s situation as “conflict-phobic introverted technicians” who might better choose to not run a dental practice as a solution, and then admitted that the coaching suggestions to Dr. Desperate were well intentioned but unusable.

The Coach responds:

The ability to use the suggested solutions require that Dr. Desperate do something. He must decide to become an improved version of himself. Stacy and Lacy combating each other is not the problem. Dr. Desperate’s “conflict phobia” is the problem.

What would Dr. Desperate do if one of the feuding team members said...”Do something, don’t just stand there.” Would he do anything or just cry out “why can’t we all just get along?” The problem is not the team members, it is the leader who refuses to intercede on behalf of the team and provide leadership.

Dr. Desperate’s older brother has a solution which is to continue to hide, because all of his imagined options leave him losing the battle.

Doesn’t this strike anyone as odd that this person of education and achievement cannot visualize a single solution other than to hide, remain small and limit his natural potential?

Dr. Desperate has a phobia that he tolerates and his brother believes that the phobia is untreatable. Do these doctor's sound like members of the same family or what?

There are realistic solutions. Human nature makes some of these solutions very clear, but only to those willing to look with eyes open. Here are some truths for you to ponder:

  1. Dr. Desperate wants everyone to volunteer to get along because that is how he has survived through life. Give in, be quiet, and they will let you stay. From this perspective, he has no experience as a leader of anything, not even his family.
  2. Dr. Desperate’s older brother perceives himself and his brother as “conflict-phobic introverted technicians.” This is a family trait. If given the choice to be an extroverted confrontation lover, I am sure they might consider how good that might feel for a moment and then imagine more negative scenarios and again decide to remain a limited power in their own world.
  3. As for Stacy and Lacy, here are some hypothetical truths. Lacy has a colored past and doesn’t want to defend it because she knows there are some truths to Stacy’s beliefs. Regardless of the truth, these truths have no bearing on doing the job, and Lacy is free to tell Stacy to “act like a team member and not a union buster”. However, Lacy is afraid to defend herself, and this is her fault.
  4. Stacy is looking for control and influence. She picks on someone small and weak in order to demonstrate her “leadership” ability and deflect everyone away from the fact that her self-esteem is quite low and perhaps so is the quality of her work. She is a bully in every sense of the word. Picking on people who cannot or will not fight back is the M.O. of a very insecure individual.
  5. Team leaders (Dentists) earn the respect and allegiance of their team (office manager, receptionist, assistants, hygienist, etc.) by behaving in a very clear and decisive manner. Leaders must earn the trust of the team by telling the team where they are going and how they will get there.
  6. Before the leader can tell them where they are going and how they will get there, the leader must know their job and know the job of the team members, and set a consistent example of behavior, values, and character.
  7. Behaviors, values, and character consist of not blaming others, taking corrective action immediately, and moving on without delving on the past. They look out for the welfare of their employees, communicate clearly what they want, and insist that the job is performed according to the leader’s standards of satisfaction.
  8. Finally, there is the sense of team spirit that comes from good leadership. It generates an atmosphere of cooperation and camradery that makes coming to work everyday something to look forward to.

So, Dr. Desperate believes in “peace at all cost”, and his older brother believes in “why bother trying, just limit your dreams and you will make it through the day.”

If you are reading this column, something inside you desires that your personal greatness find expression everyday. It is my belief that you desire to be bold in your actions and would choose such boldness, if it were available.

Dr. Desperate and his older brother have shut down their dreams and vision. It is for this reason that they cannot see the truth. It is not necessary to appeal for justice, just tell them what you want.

To all those who share this problem, I offer the following solution: become the people you want to work with by setting the example. Yes, I know this is easily said, and yes, it is harder to do....but that is what coaching is all about: good coaches dispel the myths of Dr. Desperate’s older brother and bring forward Dr. Desperate’s behaviors that remain in the background of his personality such that new conditions of friendship and power can emerge, grow, and flourish. It can be done !!!

The Coach

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Maximize Practice Performance
Understanding How Personality Types Can Affect Practice Success

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Based on the Myers Briggs Temperament Type, each job position in dentistry, business, clinical and hygiene is discussed as to which personality types are best suited to fill those positions. Dentists will learn how their personality affects their ability to successfully manage the business and its employees. Included is the book Please Understand Me which provides the personality test and scoring form.

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The 5 Dysfunctions of A Team- Part V
Absence of Trust
It is only when you are truly comfortable being exposed that you will begin to act without concern for protecting yourself.
Fear of Conflict
When members do not open up the debate and disagree about important ideas, they often turn to back channel personal attacks.
Lack of Commitment
Commitment is about clarity and buy in.
Avoidance of Accountability
There's nothing like letting down your teammates that motivates people to improve their performance.
Inattention to Results
The goals and objectives that executives set for themselves along the way constitute a more representative example of the results that the team strives for ultimately.

"Hopefully we can come back to the center and visit soon! I also wanted to brag on our office! Yesterday, my hygiene department produced $2,025 in one day! We were so excited! Just thought I would let you know and thank you for all your advice! Our hygiene department rocks!!*

Alexis, Patient Coordinator
Graduate of The Center for Dental Career Development

*Note: Results are four months after receiving training from The Center

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· Patient Coordinators
· Scheduling Coordinators
· Treatment Coordinators
· Hygiene Coordinators

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