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5 Tips to Help You Reduce Stress and Grow Your Practice
By Sally McKenzie, CEO

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When you’re constantly stressed out, it can be difficult to see exactly what’s going wrong in your practice. You have no idea what needs to be fixed or how to fix it, which of course only leads to more stress – further hurting practice efficiencies and your bottom line.

Once you identify the source of your stress, you can take steps to make the changes you need to reduce that stress and grow your practice. An experienced dental consultant can help with that. To get you started, I’ve put together a few common practice stressors and what you can do to eliminate, or at least significantly reduce, them from your office.

1. A chaotic schedule. Some days you’re running from patient to patient barely able to keep up, while other days you find your schedule wide open thanks to last-minute cancellations and no-shows. You’re often double booked, which of course adds extra stress to your day, and there are times when you only have 30 minutes to complete a procedure you know will take an hour.  

If this describes your practice, I suggest you consider hiring a Scheduling Coordinator, especially if you have multiple team members going into the schedule to fill appointment slots. Train this team member to schedule your days to meet production goals, not simply to keep you busy. You and your assistant should also communicate procedure times with the coordinator so he or she doesn’t have to guess, filling in 60 minute appointments here and 90 minute appointments there. It’s also a good idea to have your coordinator come up with a plan to deal with last minute cancellations and no-shows.

Another tip? Consider using a hybrid scheduling system rather than pre-appointing all patients six months out. You’ll find your practice will deal with fewer broken appointments and the stress they bring.

2. Staff conflict. Tension among team members can make things pretty uncomfortable in a dental practice. It hurts team morale and leads to turnover, which, you guessed it, also leads to stress. While you’ll never eliminate conflict completely, there are ways you can reduce it.

Providing detailed job descriptions, for example, makes it clear who’s responsible for what so there’s never any confusion. And of course when you notice conflict among team members, you can’t ignore it and hope it goes away on its own. It won’t. Instead, sit down with the team members involved and work together to find a solution that not only diffuses the situation, but that also benefits the practice.

3. Fees. This is a source of stress for many dentists. They’re afraid if the cost of dentistry goes up, they’ll lose patients to the practice down the street. The problem is, if you haven’t raised your fees in years, it’s costing your practice big and keeping you from meeting your full potential. Undercharging patients by as little as 7-8% costs you thousands of dollars in lost revenue each year, and undercharging by 40% or 50% translates into a serious financial pounding. If that’s not stress-inducing, I don’t know what is.

I recommend you implement a solid fee schedule. Look at what other dentists in your area charge as well as the income demographics of your patients. Base your fees on the quality of dentistry and customer service you provide.

Consider adjusting fees twice a year. The first fee increase should be 2%, and the second 3% for an annual yearly increase of 5%. This might not seem like a lot, but even if you’re only raising fees $4-$5 per procedure, you’ll still notice a significant difference in your bottom line.

4. A weak team. Hiring the right people is key to a successful practice and lower stress levels, as is providing job descriptions and proper training so they can excel in their roles. Offering clear direction will help ensure team members understand what their contributions mean to the practice and how to excel in their position.

If team members are underperforming, it leads to inefficiencies, frustration and stress. That’s why training and continual feedback are so important. When your team members are confident in their skills, they’ll be happier and more effective – which reduces stress and improves your practice.

5. Low patient retention numbers. When patients don’t come back, it leaves you and your team members wondering what you did wrong. There are many reasons you never see patients again. Here are just a few:

-They didn’t feel connected to the practice
-The customer service was lacking
-They couldn’t afford the treatment you recommended
-They didn’t think the treatment was necessary

To up your patient retention numbers, I suggest focusing on patient education and customer service. Make an effort to build a rapport with your patients and look at every interaction as an opportunity to educate. Follow-up with patients after case presentations, and consider hiring a Treatment Coordinator to deliver those presentations. Offer CareCredit as a payment option and make sure patients understand why you’re recommending treatment. Patients will appreciate these efforts, making them more likely to come back and to accept treatment.

Stress doesn’t have to be the norm in your practice. Addressing these common stressors will help you create a more efficient, profitable practice that you and your team members are happy to come to each day.

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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Nancy Caudill
Senior Consultant
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Improve Cash Flow in Your Practice
By Nancy Caudill, Senior Consultant

Dentist Case Study #412

The doctor’s concerns: “Collections are down in my practice and I have no idea why. I’m really struggling with cash flow and need some guidance to get my practice back on the right track.”

This is a common problem for dentists who contact McKenzie Management for help. Let’s take a look at his practice stats:

Average monthly net collections: $76,000
Average monthly net production: $87,500
Accounts Receivable (not including credit balances): $143,000
Accounts more than 90 days old: $28,600
Over-the-Counter collections: $23,625

Breaking Down the Numbers
First, let’s define net collections and net production. Net collections is the total revenue paid from the insurance companies and the patients, less any refunds or NSF checks that are uncollectible, while net production is total charges to patients less any adjustments that affect these charges such as courtesy adjustments, insurance adjustments and bad debt write-offs.
When this doctor came to us, his net production was at 87%. A healthy practice collects 98% of net production.

That wasn’t the only bad news for our doctor. The Accounts Receivable to Net Production Ratio should be 1:1 or less (this report should NOT include credit balances, as it reduces the balance and gives a false total). So Accounts Receivable / Net Production = 1.0 or less. His was at 1.63.

Now let’s look at the percentage of accounts more than 90 days old. At a healthy practice, this is less than 12%. His number? 20%.

Over-the-Counter collections (the revenue collected at the time of service for a family practice that accepts insurance assignment) should be about 45% of net production. To better determine where this doctor’s collections actually should fall, we divided his total payments less the insurance payments by total net production. So $23,625 / $87,500 = 27%, which is well below the 45% benchmark. Bottom line: The doctor is not collecting enough money at the time of service, which negatively impacts all the other numbers.

Here’s how McKenzie Management helped him correct this problem and improve cash flow in his practice:

Because this doctor accepts “assignment of benefits,” it’s important that his Financial Coordinator is trained to determine, as closely as possible, how much insurance will pay for treatment – without spending time getting the pre-authorization. Why? Waiting on pre-authorization delays the scheduling process, and if patients have to wait a few weeks to schedule, there’s a chance they may opt not to go forward with treatment.

The doctor trained his Coordinator to place calls or request information from the insurance company’s website to determine the patient’s deductibles, limitations, waiting periods and maximum. If the plan is a PPO, knowing this information, along with the fee that is allowed, makes it possible for the Coordinator to pretty closely estimate how much of the bill insurance will cover. That means the balance can be collected from patients at the time of service, improving the practice’s collections rate and increasing cash flow.

The Financial Agreement Form
To ensure patients are prepared to pay when services are rendered, the Financial Coordinator now has them fill out a Financial Agreement Form when they schedule an appointment. The form includes:

-The patient’s name
-Services to be completed at the appointment
-Total fee for the appointment
-Patient’s expected payment at the appointment
-Patient/Parent signature and date

The form goes in the patient’s record, along with an appointment note that indicates how much the patient has agreed to pay. This also should be included in the Guarantor/Account notes in the computer for reference, as well as on the back of the appointment card. This serves as another reminder to the patient.

The form only takes a few minutes to fill out, but ensures patients know exactly how much they’re expected to pay at the time of service. There’s no surprises or confusion. Just remember it’s also important to make it clear that the number is only an estimate; once insurance remits payment, the patient will be expected to cover any additional balance. Patients should also leave the practice knowing that if the insurance company pays more than expected, they’ll receive a refund check.

The Results
After incorporating these changes, it took about six months for this doctor to reduce his Accounts Receivable to 1X his net production. His more than 90 days past due accounts fell to 11%, while his over-the-counter payments increased to 42%. And because his Financial Coordinator began collecting past due balances as well as the right amount from patients at the time of service, his collections to production percentage is now over 100%. What an improvement!

The truth is, many dentists struggle with cash flow. If you’re one of them, feel free to give us a call. We’ll give you even more guidance so you can achieve the same success.

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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