The Dentist's Network #43, Dental Practice Management, Orthodontic Practice Consulting, Team Building, Business Consulting, New Dental Practice Startup Consulting, Practice Appraisals, Transitions


	Dental Insurance Paperless Practice Team Development

Sally McKenzie, CEO
McKenzie Management
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Crossing the Great Divide: Insurance

How often have you found yourself stymied by one seemingly easy question, a simple sentence that completely turns the tables on you? Consider this scenario. You present the necessary treatment plan to the patient. She clearly understands the need and is eager to proceed.

Then the Financial Coordinator steps in and unveils the price tag. The patient swallows hard and asks the question that she intuitively knows the answer to. “Will my insurance pay for that?” And there you are, standing at the great divide between the care the patient truly needs and the bare minimum that she too often settles for. Those six little words suddenly present a seemingly insurmountable barrier between treatment diagnosed and treatment accepted. For a split second you’re thinking, “Oh no, do we have to go there?” Yes, you do, and you should have gone there a long time ago.

Rather than trying to dance around the insurance issue, tackle it head on. Educate your patients about insurance limitations and other financial options just as you educate them about proper oral healthcare. Specifically, patients must fully understand that although standards of dental care have improved dramatically in the last 25 years, dental insurance coverage remains virtually unchanged. Most policies have a per calendar year cap that has not been increased in more than two decades—an important detail that patients often aren’t aware of.

I recommend that your Financial Coordinator sit down with the patient and review what’s covered in the dental plan. Discuss the calendar year cap, deductibles, co-pays, coverage for preventive care, etc. For example: “According to the information you provided and additional information I gathered from the insurance company, your employer has purchased a package for you that includes the following benefits and coverage.” Explain those to the patient.

“The plan your employer provides offers a small per calendar year balance of $1,000. This will help cover some of the care you need. In addition, your plan includes a deductible and co-payments.” Explain those to the patient.

Though it’s essential that patients understand the limitations of their insurance plans, it is equally critical that they recognize that those limitations cannot dictate treatment recommendations. A dental team cannot ignore gum disease or other infections of the mouth that may not be covered by insurance any more than a medical team could ignore infection or disease in the heart or lungs. As a health professional, you have an obligation to diagnose and prescribe the best care for your patients, regardless of what the insurance company says it will cover.

The six-month prophy versus necessary periodontal treatment is a good example of the common disconnect between insurance benefits routinely offered and treatment often needed by patients, and it causes significant frustration for practices and patients alike. The insurance plan emphasizes the benefit of two cleanings a year and the patient believes this is all they need unless the doctor and dental team regularly reinforce to the patient that neither the practice nor the patient can ignore bacterial infection because of insurance limitations.

Each time your patients raise questions regarding whether a procedure will be covered or why coverage was denied it is an opportunity to further educate them on the doctor’s commitment to diagnosing and recommending a level of care appropriate for the patient—not the insurance company.

However, managing the patients’ expectations regarding their insurance is only the first step. Help patients bridge the financial gap between dental care covered and dental treatment needed. Provide financial options, such as

treatment financing through CareCredit
a slight reduction in the total fee for procedures over $500 paid in full
building account credit in advance
paying for multi-appointment procedures in specific installments at the time of the appointment

The objective is to emphasize to the patient that dental care need not be limited by insurance constraints. And it’s essential that the patient feel that the Financial Coordinator is an ally and is trying to be genuinely helpful. To convey that message, the Coordinator must fully understand the benefits of the various financing options. Only then can you all lead Mrs. Patient to a financial solution that allows her to logically justify proceeding with treatment in spite of insurance limitations.

Sally McKenzie is CEO of McKenzie Management, a nationwide dental management, practice development and educational consulting firm. Working on-site with dentists since 1980, McKenzie Management provides knowledge, guidance and personalized systems that have propelled thousands of general and specialty practices to realize their potential. Sally can be reached directly at 1.877.777.6151.

Interested in speaking to Sally McKenzie about your management concerns? Email her at Sally@thedentistsnetwork.net.

Dr. Lorne Lavine
Dental Technology Consultants
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Paper “less” Is More

Paper. It’s everywhere. In our charts, walkout statements, insurance forms… you name it—paper is a big part of daily life. It’s difficult to open any dental journal recently and not see some articles about how to develop a paperless or chartless practice; it’s the most popular lecture that I give. Many dentists dream about the day they can eliminate paper from their practices, but very few actually do it. One of the biggest hurdles to developing a paperless practice is the cost of it, because many paper-based systems need to be replaced by digital counterparts, often costing thousands of dollars in addition to the time and challenge of being trained on these systems. However, have you ever really sat down to consider how much it is costing you to keep your existing paper-based systems? There are many ways that you can actually save money in the long run by eliminating paper:

The paper-based systems actually have a direct financial cost. I’m not just talking about the paper that goes into your printer—that stuff is relatively cheap. What about the costs of the printer itself? A decent laserjet printer for a dental office will run around $500, but as anyone who uses a printer knows, the cost of the consumables (ink, toner, etc.) usually far outweighs the cost of the original purchase! If you want to know how much you’re actually spending on printing, there’s an excellent reference at PrinterDB that will show you not only the cost per page, but also total cost of ownership over the life of the printer. For some, it’s well over $3,000.

Another expensive paper-based system is recall reminders. The majority of offices are still using postcards to remind patients of upcoming appointments. Then, in many cases, they follow up with phone calls. The direct costs of the postcards and stamps can be quite high depending on the size of the practice, and often many hours each day are spent on the time and labor needed to send postcards and make phone calls. The digital counterparts require significantly less cost and time. Email-based systems, like DemandForce and Uappoint, text-messaging systems, like Smile Reminder, and phone-based systems, such as Elexity, are highly effective and efficient and, at around $200 per month, very cost-effective as well.

Charts are the bane of many practices. The amount of information that goes into a chart can be overwhelming. We all have charts that are so stuffed with paper that the chart is beginning to crumble. One overlooked fact of having charts is that not only do you need to deal with the charts, but you need space to store these charts. For new offices or offices undergoing a remodel, elimination of the shelves for charts can often translate into extra room for another operatory, digital panograph, or some other high-tech item that can generate more income for the practice. Conversely, if there are no charts, the practice could utilize a smaller space and save on the costs of rent and utilities.

The trick to eliminating charts completely is to find digital systems to replace the need for paper. One of the best systems to do this is Dentforms. The main selling point of Dentforms is that it can take all of the forms that normally require patient signatures (Informed Consent, HIPAA, Medical History, etc.) and convert them into digital forms that patients can sign with electronic signature pads. Not only that, they can also fill out these forms online long before they arrive at the practice…meaning that less time is needed for new patient visits so more patients can be seen during the day.

There are numerous other digital systems that can replace paper and thus allow the practice to develop into a paperless one. For example, although most practice management programs offer some basic progress notes, Easy Notes Pro takes it to the next level. There are free online-collaboration sites such as ddsWebLink that allow digital images, referral slips, and data to be shared between labs and offices, rather than duplicating or printing them out and sending them in the mail.

There is no doubt that developing a chartless or paperless practice can be challenging and time consuming. However, dentists should know that as expensive as it may be to become paperless, staying with paper is costing more in the long run. With a methodical and well thought-out conversion, any practice can enjoy the benefits and cost savings of being paperless.

Lorne Lavine, DMD is the Founder and President of Dental Technology Consultants. Dr. Lavine holds two prestigious certifications, the A+ Certified Technician designation and the Network+ Certified Professional. These designations demonstrate proficiency in computer repair, operating systems, network design and installation. Dental Technology Consultants provide dentists a full range of services relating to the implementation of technology.

Dr. Lavine can be reached directly at 1.866.204.339 or drlavine@thedentistsnetwork.net.

Louis Malcmacher
DDS MAGD
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Looking for Love in All the Wrong Places

As a practicing dentist and a dental consultant at the same time, I know exactly where dentists are coming from when they describe their daily challenges to me. Every dentist that I talk to wants to know how to get many more new patients, how to properly market the practice, how to be faster and more efficient clinically, how to reduce overhead, how to motivate more patients to bigger and bigger treatment plans and a whole host of other issues.

Dentists will spend all kind of money on books, tapes, consultants, marketing programs, newsletters and other things that they think may improve a particular piece of their practice. Most dentists who are looking for these solutions are always, as I like to say, “looking for love in all the wrong places.” Dentists often overlook the most obvious and impactful piece of their practice: the dental team.

Having a great dental team will significantly improve all aspects of your dental practice. Having a great dental team solves many of the issues and challenges that face dentists every single day. Do you want more patients? Your dental team should be out there asking everybody they know if they need a dentist, as well as asking every single patient that comes through the door to refer their own families and friends as new patients to the practice. Do you want to market your practice better and more efficiently? Great dental team members will carry your message with them into every single treatment room and accomplish that. Do you want to motivate patients to more comprehensive dentistry and more elective dental procedures, like Lumineers? A great dental team will take the time to plant seeds in patients’ minds about what dentistry can accomplish. They are the most effective communication tool you have.

A dentist might spend thousands of dollars on a computerized education system that will describe dental procedures when a talented dental assistant could do the same thing with a human and personal touch. That doesn’t mean that digital education materials aren’t useful. But if your dental team members are poor communicators and you buy them an educational piece of equipment, then what you’ll have is a dental team with poor communication skills and an expensive computer. Why not spend that money to motivate and improve the morale and communication skills in your office so that everybody can talk to patients more easily and with better leadership?

Do you want to reduce your overhead? A great dental team will certainly help you by streamlining many of the inefficient processes that occur in daily dental practice. Do you want to improve your cash flow and account receivables? A great dental team is the road to success in every dental office.

I see dentists wasting their time and money buying into all kinds of gadgets, toys, scams and supposed “systems for success” when they should be spending their time, energy and effort developing and motivating their valued staff members. When I am giving a lecture, I can see immediately who the most successful dentists are in the first two minutes of the lecture. The most successful dentists are the ones who have their dental team members sitting right next to them. If you as a dentist go to a lecture and want to learn about something new or want to institute some kind of a new system in your office, but go to the lecture alone, your staff members will not have the same enthusiasm or initial level of interest that you developed. Success in this scenario is going to be limited and most likely will not happen.

Look at your dental team members as the valued partners in success that they really are. Staff appreciation is one of the most overlooked, inexpensive and easiest ways to begin to develop a great dental team. In many major studies in employee relations, money is not the most important factor to employees. Number one is staff appreciation and number two is having a pleasant place to work. If your dental team members also realize that they are fulfilling a mission of improving peoples’ lives through excellent oral health, it gives them a great sense of purpose. You could pay a dental assistant $100 per hour, but if the work environment is miserable, your office will never be successful. You could pay your front desk team member $100 per hour but if you have never invested in developing the necessary skills to talk to patients, your office will not be successful. If you pay your dental hygienist $100 per hour but she is just a cleaning lady with no communication skills, your office will never reach its full potential.

Ultimately, dentistry is a people business. To be successful in this field, you have to love people or hire people who love people. Stress in dentistry is caused by the people who work in your office who are stressing themselves, stressing you and stressing your patients. And if your patients get stressed, they will stress you even more. Hiring the right staff is the first step along the road to a happy office. The next steps include working with your team members and constantly training them and yourself in how to do better clinical dentistry, how to be better communicators and how to achieve all of your goals together.

Hire, develop and motivate a great dental team by learning leadership skills and building your office from the inside out. It doesn’t help you at all to get 100 new patients per month if your team members do not have the capability or the interest to properly build relationships with your patients. You, as a dentist, typically spend 30, 40 or 50 hours per week in your dental practice—it is equally as easy to be happy there as it is to be miserable.

If your dental office is a place that loves to work with people, that attitude alone will solve many of the issues that have frustrated you throughout your career. When we consult with dental offices and turn around their team members and make them great and sincere communicators, the office becomes a stress-free, high-producing, low-overhead, fun place to work for everyone. It is amazing what a little appreciation and respect will do to motivate and build a great dental team.

Dr. Louis Malcmacher is a practicing general dentist in Bay Village, Ohio and an internationally known lecturer, author and dental consultant renowned for his comprehensive and entertaining style. An evaluator for Clincal Research Associates, Dr. Malcmacher is a consultant to the Council on Dental Practice of the ADA. For almost three decades, Dr. Malcmacher has inspired his audiences and consulting clients to truly enjoy doing dentistry by providing the knowledge necessary for excellent clinical and practice management. His group dental practice has maintained a 45% overhead since 1988. You can contact him at (440) 892-1810 or email dryowza@mail.com

You can also see his lecture schedule at www.commonsensedentistry.com, where you can find information about bulding the best dental team ever, sign up for his affordable monthly consulting programs, audio CDs, and free monthly e-newsletter.