Tips: Practice Economics and Pay Raises

Educate Your Team about Practice Economics and Pay Raises
By Sally McKenzie, CEO
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The way your team members see it, you’re making plenty of money. They know what their salaries are and some even know how much the practice actually brings in each month. Yet, even though they think you’re rolling in money, they fully expect you to say the practice can’t afford it the next time they ask for a pay raise.

Of course, they’re forgetting to factor in a little detail known as overhead, but to them, that doesn’t matter. They begin to resent you because they don’t feel like they’re being fairly compensated. Many of them have been with you for years, after all, and think they should be rewarded for their service. Some employees might even see their contributions as more valuable than others, and simply can’t understand why you haven’t given them a well-deserved bump in pay.

The problem is, these employees’ perception of the practice is nowhere near reality. They don’t understand practice economics or what it takes to actually build a profitable practice. How can you change that? Start by being more forthcoming with practice information. Provide leadership and guidance so team members don’t fill in the gaps with what they believe is reality. Trust me, if you let them come to their own conclusions about the financial health of the practice, it will only lead to mistrust, resentment and discontent – all of which are common indicators of salary system shortfalls.

Sit down with employees and explain practice economics. Don’t wait to talk with them about falling revenues during their annual salary review, as you break the news that you simply can’t afford to give out raises right now. Instead, take the time to talk with them about the status of overhead and practice expenses during monthly meetings.

These monthly meetings are key to getting everyone on the same page about where the practice is headed. If revenues are down, use these meetings as an opportunity to figure out why and come up with a plan to get the practice back on track. Talk about all the areas that impact the practice’s profitability, such as number of new patients, collections, recall patients, production, treatment acceptance, accounts receivables, unscheduled time units, and uncollected insurance revenues more than 60 days old.

Remember, while you’re the practice CEO and are there to provide team members with guidance, giving updates on practice financials isn’t your responsibility alone. During these meetings, every team member should be prepared to report on the heath of the system they’re accountable for.

For instance, ask your Scheduling Coordinator to report on the practice’s actual monthly production as compared to the practice’s monthly production goals, the number of unscheduled time units and the number of broken appointments. This will help get everyone thinking about how to address any issues that are keeping the practice from meeting true success and profitability.

It’s also important to use these meetings to address any areas of concern you and your team members have. If the schedule has too many holes, for example, you can take this opportunity to talk about how you can fill those holes and increase revenues, whether that means reaching out to patients with unscheduled treatment, identifying patients with unused insurance benefits, evaluating the practice’s treatment financing options, examining case presentation techniques or encouraging hygiene patients with unscheduled treatment to move forward with care.

This will all go a long way in helping your team members understand the big picture of practice revenues and expenses, and why you might not be able to afford to give out raises right now. It also helps them see how important their contributions are to the practice’s success.

Remember, to build a profitable practice, you need to create a strong team focused on meeting practice goals. If your team members don’t trust you, they’ll be more focused on complaining about the lack of raises than doing their part to build a successful practice. They won’t believe you when you tell them you can’t afford to increase salaries, and that will only lead to resentment and possibly even staff turnover.

Educate team members about practice economics and involve them in finding solutions that will help the practice grow. This will not only give them a better understanding of the financials and what they can do to earn raises, it will also help them feel more connected to the practice – all leading to improved productivity and the increase in revenues you need to give out raises to employees who earn them.

Next week, Can you afford to give out raises?

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

Interested in speaking to me about your practice concerns? Email sallymck@mckenziemgmt.com
Interested in having McKenzie Management Seminars speak to your dental society or study club? Click here.
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Belle DuCharme, CDPMA
Instructor/Consultant
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On-Hold Times Affecting Your Profits?
By Belle DuCharme, CDPMA

“All of our representatives are currently assisting other callers. Please remain on the line and the next available representative will assist you.”

A familiar recording when calling insurance companies is sometimes all you will hear, unless you have the time to wait on hold. Waiting on hold can seem like forever and all you can think of is what you can’t get done as the frustration mounts.

Being placed on hold is just part of the day for those working claims in dental offices. The average wait time used to be ten to fifteen minutes, but my latest reports show that wait times have increased to two to four hours in some situations. This issue has not just affected healthcare providers; it also has affected patients who need to know their policy coverage prior to surgery or other treatment.

Is it safe to say that insurance companies don’t care about customer service? No. They do care, they just aren’t prepared for the backlash of the Affordable Care Act. With thousands more people covered than were prior to the Act, a huge surge of calls to the call centers has caused the customer service ratings of many insurers to plummet.

In a dental office, the Business Coordinator has an average 8-hour day to complete all tasks, with priority on the needs of patients and staff. When you have to place the insurance company on hold to answer the other line, they will not wait for you when they finally answer. Hiring another person to work claims is what most offices do because there just isn’t enough time in the day. The more network insurance that is accepted, the more time spent verifying eligibility and benefits. What you save by accepting more insurance is often eaten up by the costs to hire and train more people.

If you don’t check eligibility and verify coverage and benefits, you risk claim denials and very unhappy patients who now have to pay out-of-pocket for something they thought was covered. What can we do? Here are some suggestions:

• From your software, get a list of all in-network insurance companies and then the top 5 out-of-network providers. Make sure you have created a login and password to each of their online portals to get patient benefits. It is always harder to get the information when you are out-of-network, but it can be done. Type up the list and put it in a plastic cover at the desk of each person who calls for benefits.

• Call first thing in the morning to avoid peak call times. If they are available on Saturday, call then.

• Try to bypass messaging by hitting the 0 (zero) or * (star) key to reach a live operator. This may or may not work.

• Search the insurer’s website to see if questions are answered there, although individual issues like benefits left for the calendar year won’t be there.

• If you can’t get through, search for contact information of someone higher up in the organization who might help put you ahead of the line.

• Complain about excessive waits to your state insurance department or insurance commissioner.

• Contact the patient and let them know you have tried for hours to speak to an agent and see if they can get through quicker from their end. Give them the list of questions for the insurance company.

As of now, 2016, Aetna insurance company will no longer give complete breakdowns on a phone call. They want you to request a fax first, and if that doesn’t answer your questions then you can call back. Some insurance companies are having you email your questions and then they will respond. This is not as quick as a phone call, but that is why you must verify coverage prior to the patient coming in rather than when they are there for an appointment.

Insurance companies are trying to help this situation by extending their call hours of operation and making email available. This is also being pushed by social media because claims processors and patients alike are very upset over this situation. For now we all need to stay positive and seek to remedy the situation within our offices. Hire help or create more time for your business staff to call insurance companies until the situation is under control.

For more help with training your business staff, call McKenzie Management today and sign up for customized business 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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Laurie Hardison
Senior Consultant
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Do Job Descriptions Really Matter?
By Laurie Hardison, Senior Consultant

Mr. Smith was scheduled for a crown on tooth No. 3, a procedure that was slated for two hours. Once he arrived, your assistant realized Mr. Smith wasn’t ready for a crown after all – he needed a root canal first.

Sound frustrating? It is, especially when you have no idea how it happened. You can see that your Hygiene Coordinator scheduled the appointment two months ago, but she doesn’t remember why she put it in the system as a crown. In fact, no one on the team seems to know how this mistake was made, which means you don’t know how to address the problem so it doesn’t happen again.

Unfortunately, these types of situations come up when you don’t have clear, detailed job descriptions. Without job descriptions, team members don’t know who’s responsible for which tasks. When something goes wrong you’ll hear excuses like “I didn’t do it and I have no idea who did” and “I didn’t know I was supposed to do that.” There’s no accountability, leading to plenty of frustration for both you and your team members.

If your practice had detailed job descriptions, everyone would know that, in this scenario, the Scheduling Coordinator is ultimately responsible for your schedule – even if another team member scheduled the appointment. Instead of involving the entire team, you could go directly to the Scheduling Coordinator to find out what happened. Maybe she forgot to review the clinical notes before the morning huddle, which likely would have alerted her to the problem, or maybe she didn’t have time to go over patient records with the assistant the day before to double-check for errors.

No matter what happened, if you know who to go to, you can determine the source of the problem much faster. You don’t have to waste time trying to figure out who to talk to when something isn’t as it should be, or call a meeting to address the entire team. You can direct your concerns to the team member who is responsible for the system and make sure the situation is corrected.

Developing detailed job descriptions will help set your team members up for success. I realize this is something many dentists don’t like to think about, but your practice will run much smoother once your team members know exactly what’s expected of them.

To help you get started, I’ve put together a list of tasks for a few common jobs. Keep in mind you might need to adjust these to fit your practice, but they can at least give you some guidance as you start talking about and developing job descriptions for your team.

The Hygiene Coordinator
This team member is responsible for growing the practice through the Hygiene Department and should spend time “Dialing for Dollars.” Train him or her to schedule the hygienist to meet daily production goals, which should be based on either three times the hygiene salary or 1/3 of total practice production.

The Scheduling Coordinator
Your Scheduling Coordinator is responsible for scheduling you to meet daily production goals – not just to keep you busy. This person is ultimately accountable for the schedule and should be tasked with following up on unscheduled treatment plans.

The Financial Coordinator
The Financial Coordinator is responsible for outstanding insurance claims, outstanding account balances and weekly statements. He or she generates claims daily, verifies patient insurance eligibility and confirms all insurance information in the computer is correct.

The Treatment Coordinator
This person is responsible for presenting treatment for all producers and following up with patients two days after the initial presentation.

Hygienists and Assistants
These team members perform specific duties associated with their clinical training.

Hopefully these short descriptions can help put you on track to develop effective job descriptions. Remember, every job description should include a definition of the job, the necessary skill set, and specific responsibilities and duties. They also should include performance measurements. These elements make it clear who’s responsible for which systems and who’s accountable when something goes wrong.

When you’re ready to develop job descriptions, I suggest sitting down with team members to get their input. This will not only help you craft better job descriptions, it will give team members more ownership of their roles. It also shows you value their opinion and the contributions they make to the practice.

While most dentists don’t like the idea of developing job descriptions, and some even think they’re a waste of time, trust me, they’re not. You’ll find team members are much more productive when they have the guidance job descriptions provide, which ultimately leads to less confusion and conflict in your practice, as well as a healthier bottom line.

Still not comfortable developing job descriptions on your own? Contact McKenzie Management and we’ll help get you started.

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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