Dental management Tag Archive

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Collecting Co-Pays and Deductibles

Are your front desk personnel trained to collect patient co-payments and deductibles at time of service? Do they know the amount of receivables due from each patient and their insurance company? If not, your practice could be losing a significant amount of income. Studies show that collecting payment from patients at the time of service maximizes your collection percentage and decreases collection costs. Taking steps now to collect every dollar earned will prevent your profits from slipping through the cracks. This article offers strategies to successfully collect payments at time of service and is geared towards helping your front desk staff achieve winning performance.

Attitude is Everything

A patient’s first impression of your practice is their front desk experience. Your staff should be greeting patients by name, while presenting a professional attitude and appearance. They should be polite, and possess strong customer service and communication skills. Front desk staff must feel comfortable asking for co-pays and deductibles and indicate that payment is expected at the time of service. Their attitude needs to be friendly, yet firm. The dentists in the practice need to be supportive of the collection policy and refer all discussions regarding financial matters to the appropriate personnel, rather than discussing with the patient. Your office should have a clear, written financial policy, which should specifically state when you expect payment. This will empower your front desk personnel and send a clear message to patients.

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Why go Paperless? What I have now works and doesn’t cost a thing.

Why go paperless?

Paper charts don’t just appear in the office for free. The paper folder and all the other papers cost about $2.50 each. If you have 2500 charts they cost you at least $6,250 to create and every time a new patient walks in it’s another two-fifty; cha-ching.

Other chart contents, like X-Rays and photographs can be even more costly. A set of bitewings with film, processing and mounts can be a dollar or two. A photo printed from the intraoral camera is $1.50 or more. It is reasonable to add at least another $2.00 to the cost of each chart for these contents adding another $5,000 to the cost.

Storing the records isn’t free either. A typical office with 2500 charts will need three or four full size lateral files to hold them all. Depending on how nice the files are they will cost about $4,000 and could be a lot more. They will take up office space costing another $550 per year. Plus all the “inactive” charts stashed away somewhere else?

So far our inexpensive paper files are costing us $15,800, but that’s not the total cost. There is the human effort to make the chart, type the label, arrange the contents, file new bits when they arrive in the mail, write the notes, pull the charts every day and then re-file them. And of course there is the daily ritual of the lost chart, which no one can find only to have it turn up days later either misfiled or hiding in a stack on the doctor’s desk. The human cost is at least $11,520 per year.

What we have is a paper chart system that is really quite expensive costing $15,800 to create and $11,520 per year to maintain for a total of $27,320.

Help with Going Paperless

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ADA Benefit Plan Analyzer


The ADA Benefit Plan Analyzer is a tool meant to help you analyze the financial impact of a payer’s rates to your practice. It is based on information and assumptions provided by you regarding the payer’s reimbursement rates and restrictions as well as your practice’s goals and its financial situation.  via CPS-APP12 – ADA Benefit Plan Analyzer 12 Month

Features of the Dental Benefit Plan Analyzer include:

  • Running analysis models based on actual practice data taken from the dentist’s practice management system. The plan analyzer automatically displays the top 20 procedures based on revenue and the average number of weekly hours they and their hygienists work.
  • Saving those results for future review and comparison.
  • Analyzing preferred provider organization and dental health maintenance organization benefit plans.
  • Configuring variable inputs like practice overhead; time spent by dentists not treating patients; number of estimated new patients; number of restorative operatories; number of hygienist operatories; and the capitated fee being offered by DHMO providers.
  • Installing the Sikka Platform Utility on one computer in the office and being able to run the analysis from any other computer or tablet with an Internet connection.
  • Reviewing plan score data based on the financial impact of adopting the plan and how the plan’s patients compare against cash-paying patients.
  • Viewing a visual indicator plan score for quick analysis.
  • Seeing available staff and operatory hours as well as the hours required to handle the estimated new patients.

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Saved by the Cloud… or not

saved by the cloud... or not

When you visit a medical or dental office in the future you won’t be handed a clip board and paper forms, all your personal and medical data will be stored on the cloud. The medical / dental office will merely request a download and all the data will be available instantly. No forms, no guessing about medications, no forgetting your last visit, no confusion about insurance.

Isn’t that great all your highly personal medical data will be available to anyone with access through the cloud!

That will be really great because we wouldn’t want out personal stuff available to any old hacker so we will have the same level of protection that people had for their nude photos or that Target had for purchases or …well maybe it won’t be so great.

As much as I love technology and see the incredible potential of cloud based data and want it to be safe and secure, clearly it is not.

As digital technology and electronic health records stored in the cloud continue to develop they generate legal, moral and philosophical questions our existing ethical framework is simply not equipped to handle.

Most of these ethical questions can be summed up as:

Who owns the data?

Patients? If you ask patients the immediate and unequivocal answer is that they do. That seems right, each patient should have control of their medical information. That is what the HIPAA privacy rules are supposed to address. Yet that is not how the system works.

Doctors? If you ask a dental practice management software company (PMS) who owns the data the immediate and unequivocal answer is that you do the doctor owns the data.
Yet again this is not how the system works.

If as a dentist I own the data, I should be able to exercise the basic rights of ownership including using or transferring the data. However current systems do not allow me to transfer the data to another dentist or to use it as I wish for analysis. Plus as a dental professional I am obligated ethically and legally to protect the data as confidential.

If I have the data but can’t access parts of it or more commonly can’t transfer parts of it do I really own it?

Public? One of the most significant benefits of large online data bases of medical information is the aggregation of data for medical research purposes. Already there have been important findings resulting in improved patient care based in data base analysis. It seems axiomatic that more data from a wide range of sources will ultimately lead to better results. That is a good thing, but.
Is it OK to use personal medical data in a study without the patient’s permission? What if the personal identifiers are removed?

Then there is the issue of privacy. The primary issue driving HIPAA privacy rules is that a patient’s information must be protected. HIPAA is not about speaking a patients name aloud in the waiting room, it is about electronic medical data and making it available to others is wrong. Wrong morally and legally. That seems to be obviously true on the surface. Our personal data should be held in confidence. But what if we choose to make it public by participating in a study? Do we still own that data? Who does; the researchers, the web aggregator or the public, as in the public good?

In an ideal world all our medical data could be accumulated in a huge national (or for that matter global) data bank. This mass of data would be used by benevolent researchers to delve into disease patterns and treatment outcomes to provide a vastly improved understanding of the human condition.

But of course in the real world we have fear, politics, hackers, bureaucrats, proprietary data bases, the nightly news and less than benevolent people.

Check out more articles on Dr. Emmott’s Blog >


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Managerial Discretion: Its Privileges and Obligations

managerial discretion

Credit for this article’s topic goes to Steve Cobb, Chairman of Henny Penny who shared with us this idea during a workshop that we recently did with his executives. An hourly employee stuffing sausages at a sausage factory is expected to put in 40 hours a week and get paid for 40 hours of work. Occasionally, if the supervisor wants him to work extra hours to meet a deadline of sausage shipments, the hourly employee might agree to do so and be paid overtime. When the hourly employee takes time off or goes on a vacation, he expects somebody else to be stuffing sausages while he is gone and does not expect a backlog of sausages to be stuffed left at his workstation. In contrast, most – if not, all – of you that read this article simply put in the hours needed – often, more than 40 hours a week – to get the job done. You have managerial discretion to prioritize your work and schedule it based on the combined needs of the business and your personal life. There are privileges and obligations that come with that discretion. There is value to underscoring both the privileges and obligations to your exempt employees and management.

I once sent an email to a group of employees in the office, expressing my frustration at a behavior that I had observed. These employees had total freedom in their work hours. They could come and leave at any time. They could take time off whenever needed. They had unlimited vacation time. Each of them had individual responsibilities, much of which was self-imposed and self-managed. All they had to do was to make sure that their work got done and do a good job of it. Yet, I observed that every afternoon they all left at the same time, around 5 pm. This bothered me. Did they all come to a reasonable closure on their day’s work at the same time? Did it just coincide with 5 pm? Or were some of them tired at 4 pm and did not feel comfortable simply calling it quits for the day? Likewise, did some of them have pressing work beyond 5 pm and did not feel obligated to stay late and get it done? Did the en masse departure – and, that too, at 5 pm – indicate a lack of comprehension of the privileges and obligations of managerial discretion?

So, what are those privileges and obligations? In contrast to a sausage stuffer that is expected to stand in a production line and stuff sausages, management has considerable discretion on the hours they keep, the quality of their work product, and the scheduling of that work. They decide when the amount of research they have done or data they have collected is adequate to make the decision. They decide when the report is good enough to be shipped out. They decide what needs to be done now and what can wait, or even simply ignored. If they need to attend to a sick child or leave early for their child’s baseball game, they do so and manage the impact. If they choose to work from home one day to get that project completed, they do so. With all that privilege come obligations. You are expected to err on the side of higher quality in your judgment of what is good enough. You are expected to work late, take work home in the evenings or work on weekends to ensure that critical projects are completed on time. You are expected to take on that extra workload when the unexpected happens, even though you already have a full workload. You define your hours not by the clock but by the work that needs to get done; and, it is always more than what the clock says.

work_hoursWhile the privilege gives you a lot of freedom, the obligations impose a workload that adds up to more than 100% of your time. And, the higher you rise in management, the more your privileges and your obligations, resulting in greater disparity from 100%. We have tried to provide a rough idea of that disparity in the adjacent picture. Is it fair to expect management to spend much more than 100% of a work week on a regular basis? Is this a recipe for burnout? Should this expectation be implicit or should leadership explicitly discuss this expectation with management? Would an explicit conversation lead to problems and resentment? If executive leadership does not exhibit this practice, can they expect lower level management to do so? In a private company with an operating owner, can the owner expect this behavior without he or she walking the talk?

We believe that management needs to fully understand this concept by cherishing the privileges and rising to the obligations. Top leadership raising awareness of these privileges and obligations will cause management to become intentional.

via Balaji Krishnamurthy, LogiStyle, LLC

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