When it comes to insurance, oftentimes you will hear the terms “in-network” or “out-of-network.” Dentists who are “in-network” have agreed to a personal contract with a benefit plan. These contracts have restrictions and requirements and usually dictate adherence to a reduced fee schedule. Therefore, patients who chose an “in-network” dentist typically will pay less of their own money toward treatment than those who choose an “out-of-network” dentist. In addition, an “in-network” dentist usually is paid directly from the insurer and payment is sent to the office.

An “out-of-network” dentist has not signed a contract with the insurer of a particular plan. However, patients may still choose that dentist and have some of their fees covered, but they may pay more out of pocket. Also, plan payment checks are usually sent to the patient, not the dentist. The plan pays the patient, and then the patient pays the dentist. Or the patient pays the dentist and is later reimbursed by the plan.

A dentist who decides to become “in-network” may choose to do so because a large population of patients are on the plan, because s/he likes the security of receiving payment checks directly, or because the fee schedule seems fair. A dentist may decide to stay “out-of-network” because a smaller population of patients uses a particular plan. The dentists may be content with patients receiving payment checks. Or s/he may not be comfortable with the fee schedule. Be sure you have a very clear understanding of what specifically is dictated in the contract before becoming an “in-network” dentist.

Are you getting the most out of your hygiene department? Many new dentists aren’t sure how to measure the effectiveness of their hygiene departments. Establishing performance measurements and identifying a few fundamental expectations can make a big difference.

Consider these:

• If the hygienist receives a guaranteed salary regardless of production the expectation must be that s/he produces three times her/his salary.
• In addition to a base salary, consider paying hygienists a commission for achieving additional production.
• Schedule the hygienist to produce at 3x her/his daily wage.
• Evaluate fees and determine if they are too low. Look at the procedures conducted in an hour to determine the production per hour costs. If the hygienist is paid $40 per hour and the cost for the prophy, not including the dentist’s exam, is $80, the hygienist is making 50 cents on the dollar.
• The hygiene salary should be less than 33% of her/his production, not including the doctor’s exam fee.
• Insist on periodontal assessment. One-third of hygiene production should be in interceptive periodontal therapy. Require the hygienist measure the total number of dollars produced in the 4,000 code and divide it by his/her total production. Report that once per month at the monthly meeting.
• Customize the time per patient based on patient need not on a standard one-hour allocation for each patient.
• Provide hygiene hours in the evening if patients are requesting late appointments.
• Evaluate the effectiveness of pre-scheduling. Practices using six month scheduling achieve only 76% patient retention and have a nearly 50% higher loss of patients than similar-sized practices that do not pre-appoint.

Establish expectations and performance measurements for hygiene and watch this department become a full contributor to your practice profits.

Still looking for pointers on effectively managing your Hygiene Department? Go Here