10.6.17 Issue #813 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Is Your Jam-Packed Schedule Actually Costing You Money?
By Sally McKenzie, CEO

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In my years as a dental consultant, I’ve seen practices struggle for many reasons. Lackluster recall efforts, subpar customer service and weak case presentation skills are among the various factors that contribute to revenue woes, but there’s another pain point that many dentists don’t usually consider – and that’s the schedule.

That’s right, the schedule. Not only can a chaotic schedule lead to stressful days, it can also cost you money. Just because your schedule keeps you busy (too busy most days, in fact) doesn’t mean you’re meeting production goals. And let’s not forget about the days when broken appointments leave gaping holes in your schedule. You arrive in the morning thinking you’ll barely have time for a break, only to find yourself with plenty of free time on your hands.

A poorly managed, hodge-podge schedule eats into your bottom line and ultimately damages your practice. Think I’m exaggerating? Here are three ways your out-of-control schedule is costing you money.

1. You’re losing patients. You might think most patients expect to wait a little for their appointment, but that attitude will send patients looking for a new dental home. Your patients are busy with work and family commitments, and really don’t have time to sit in your waiting area for 30 or 40 minutes while you get caught up. This will get old really quick, and if it happens enough it will prompt even the most loyal patients to schedule their next visit at the practice down the street.

And if you’re constantly running behind, you don’t have much time to spend with patients once they’re finally in the chair. They can tell you’re in a hurry, so they don’t bother to ask any questions. Instead, they just don’t schedule the treatment you recommend (at least not with your practice), and likely won’t be recommending your services to family and friends any time soon.

Most patients will understand if you run behind every now and then, but if it becomes a common occurrence, they’re going to start looking at other practice options. What can you do if your office is known for long wait times? Have a conversation with your Scheduling Coordinator. Make sure this team member has a system in place to avoid double-booking you, and make it a policy for you and your dental assistant to always communicate procedure times. If your coordinator only blocks out 60 minutes for a 90 minute procedure, for example, it’s going to put you behind for the rest of the day. Communication will help streamline your schedule and keep patients from spending too much time in your reception area.

2. You’re not meeting production goals. This is a common problem I see in many dental practices. Scheduling Coordinators simply schedule to keep the dentist busy, not to meet daily production goals. The dentist spends the day running from patient to patient, yet revenues aren’t anywhere near where they should be.

If you haven’t already, sit down with your team members and establish production goals. Determine how much money you need to bring in each day to meet your financial obligations as well as your personal goals. From there, provide your Scheduling Coordinator with the training and tools necessary to schedule you to meet those goals. Your days will be less stressful and your bottom line more robust.

3. There’s no room for new patients. New patients are critical to your practice’s success, yet when they call to schedule that first appointment, many are told they’ll have to wait weeks to see you. Even if they go ahead and schedule, many of these patients will keep looking until they find a practice that can see them sooner – and they may or may not let you know they won’t be coming in after all.

If this is a common scenario in your practice, it’s costing you thousands of dollars in undiagnosed treatment, as well as any referrals these patients might have sent your way. To make room for these important patients, sit down with your Scheduling Coordinator and determine, on average, how many new patients you see each month. Reserve that amount of time in your schedule and, if demand increases, make the necessary adjustments.

Doing away with pre-appointing also will help open up your schedule for new patients, not to mention current patients who are ready to go forward with treatment. If you pre-appoint six months out, it gives the illusion your schedule is full. Many patients who schedule that far in advance have no idea what they’ll be doing when it’s time for the appointment, and end up canceling at the last minute or not showing up at all – leaving you with open slots that could have been filled by new patients.

If you’ve pre-appointed for years, the thought of giving it up altogether might seem overwhelming. Consider implementing a hybrid system instead, and only schedule reliable patients six months in advance.

When your schedule is out of control, it’s not only stressful, it can be pretty costly. If you’re ready to streamline your schedule, start by taking my free assessment and then contact me. I’ll help you take your schedule back, increase production and grow your bottom line. 

Next week: 5 ways to streamline your chaotic schedule

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
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Outsourcing Insurance Billing, Pros and Cons
By Belle DuCharme, CDPMA

The decision to outsource dental/medical billing or continue in-house often comes from heated questions:
My collections are dismal, can there be a better way?”
“Will outsourcing save me money or cost more?”
“I am producing but losing in write-offs – are these write-offs necessary?”

Dental Office Managers are often resistant to outsourcing dental/medical billing because it represents a considerable portion of their job description, but this is “old school” thinking. In the past, for lack of a better way to do things, insurance billing and patient billing were part of the dental business standard. The Office Manager position has traditionally been a juggling act of patient care and administrative duties. That was business as usual, but it doesn’t have to be that way anymore. 

By outsourcing dental/medical insurance billing and patient billing, you have created a different culture that is more patient centered than administration driven. Time is opened up to contact overdue and unscheduled patients, present treatment plans, or just spend more time getting to know your patients.

Think of the jobs you already outsource for your dental practice, such as lab work. Unless you have an in-house lab and a trusted, skilled lab technician, you are outsourcing your cast prosthetics such as crown and bridge, partials, dentures, etc. You probably also outsource your computer IT issues to someone with the skills and knowledge that you lack. 

Dental insurance billing is getting more and more complex, especially with the addition of having to bill medical insurance first on many policies. Aside from clinical services, billing and revenue cycle management are the most important systems of your practice. Your cash flow depends on them, so the decision of how to handle these services shouldn’t be taken lightly.

Let’s take a look at what most doctors and administrators consider to be the major advantages and disadvantages that in-house and outsourcing options each present.

In-House Dental/Medical Billing


• Hands-on Control: When trusted, long-term employees are executing dental/medical coding and revenue management duties, doctors and administrators appreciate having hands-on control of financial operations. When there is turnover of key staff, however, there can be chaos, lost revenue and patient trust.

• Return on Investment: Once a practice has invested in training dental/medical billers and purchasing billing software technology, moving to an outsourced solution means losing lots of time and money spent. When there’s a valid infrastructure in place, it’s worthwhile to just refine existing processes. Measuring this is important to make sure there is a return and not just manipulation of numbers.

• Proximity: Should issues arise, the accessibility of your in-house billing department is a major advantage. If you outsource billing, make sure this entity is easy to contact and available to answer questions within 24 hours or less.


• Higher Costs:  Usually the expenses of paying billers’ salaries, employee benefits and purchasing technology systems add up to more than is commonly paid out to a third-party billing company. If you are paying an Office Manager to do dental/medical and patient billing, not only are you often paying too much, but your practice can suffer from neglect of her/his attention.

• Liabilities: Dental/medical billing departments can be breeding grounds for embezzlement, and general employee neglect without a keen eye on operations.

• Support Issues: If your billing department consists of only two or three staffers, your operations and cash flow can be halted when even just one employee gets sick or is gone for any reason.

Outsourced Dental/Medical Billing


• Less Expensive: Especially if you’re starting up a new practice or transitioning because of an employee’s resignation, outsourcing makes the most financial sense.

• Transparency: A dental/medical billing company should be able to supply you with comprehensive performance reports automatically or upon request. Since they are not directly handling money, only posting from EOBs you will have a better picture of total revenues.

• Peace-of-Mind Consistency: Your outsourcer will be contractually obliged to perform certain services for you, such as appealing denials, with a certain level of success. Plus, you never have to worry about staffing since it’s their job to support your needs year-round.


• Hands-Off:  It’s considered an advantage that outsourcing makes the management of billing someone else’s problem, but it’s difficult for more hands-on managers to give up control of the process to an outsider. If you can find a source that will work with you as part of your team and follow your requests, this will be a more desirable relationship.

• Variable Cost: Most billing companies charge a percentage of collections, so the more you bring in, the more you’ll pay out. This can make it hard to budget your practice’s expected billing expenses, since costs differ widely between slow and busy months.

• Hidden Fees: Read the contract carefully and understand what you are paying for. Are there set-up charges? Fees for things like printing statements or sending reports? What happens if you cancel your membership? Make sure the money you save by outsourcing isn’t offset by a multitude of “fine-print” charges.

Should you outsource? McKenzie Management can help you with this question, and all issues that affect your bottom line. Call today for information and training that can guide you.

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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