Archive for the ‘Financial Arrangements’ Category

Building a Caring Collection Team

Tuesday, November 6th, 2018

By James V. Anderson, DMD, CEO/Founder eAssist Dental Solutions

Many dentists don’t charge enough for their services because they don’t have a real sense of what they should charge.  They don’t want to scare their patients or appear greedy.  Their fees were set years ago, sometimes at the practice inception, and they may raise some once a year, every four years and many not at all.   It is an inconsistent system based on what the insurance is paying at UCR or what the competitors are charging for the same service.  Because of these variables, the dentist is often confused as to whether the charge is fair or not.

Other businesses set their charges based on costs to operate the business (overhead) and what the market will bear.

Dental office managers will tell you to “keep the doctor away from the desk” because they are apt to give discounts or free services when they don’t need to.  This is far too common in the dental profession, but it doesn’t have to be this way.

Building good solid relationships with patients includes great service and dental care – and in turn, payment for the services rendered.  When the dentist gets involved with collections, it becomes a hit and miss result depending on their personality and comfort level with the patients.  “Throwing money at the source of your stress doesn’t make the stress go away.”  You still have to pay your bills.

First step is to do a sound fee analysis based on current data for your geographic area at: https://www.dentaleconomics.com/articles/print/volume-108/issue-4/macroeconomics/the-dental-economics-annual-fee-survey.html and then adjust them accordingly to be at the 80th percentile.

Second step is to have firm but friendly financial arrangements and options available for your patients to choose from. These options would include outside dental lenders: https://www.carecredit.com/dentistry/ and short term 90-day same as cash plans in-house to patients with good standing credit.

Third, have a support team: https://dentalbilling.com that doesn’t include the dentist to collect and follow-up on unpaid insurance claims and unpaid patient portion of the accounts receivables. Outsourcing this service will free up your team to spend more time with patients on positive outcomes of treatment acceptance and appointment/scheduling control. Professional billing experts can set up your computers with PPO fee schedules so patient estimates are far more accurate.  Your front office person(s) does not have the time to do this chore.

Having a dedicated collection team who works insurance and patient portion the way you want is far more successful than the “hit and miss” system, with all its inconsistencies, that causes patients to leave your practice.

Dr. Anderson headshotJames V. Anderson DMD is a practicing dentist in Syracuse, Utah and is the CEO/Founder of eAssist Dental Solutions, the largest national dental insurance billing company (www.dentalbilling.com) in the U.S.    

Dr. Anderson understands the challenges facing today’s dental teams and since 2009 has been providing proven solutions to dental/medical insurance billing, patient portion billing, accounting for dentists and related management services. 

He can be reached at james.anderson@eassist.me

3 Types of Problem Patients Who Are Actually Hurting Your Practice

Monday, August 13th, 2018

By Sally McKenzie, CEO of McKenzie Management

Attracting and keeping patients is a vital part of any dentist’s success. It doesn’t matter how talented you are clinically if you don’t have any patients to treat. To meet your financial goals, you must build a strong base of loyal patients—but you also need to attract the right kind of patients.

Unfortunately, there are some patients who actually hurt your practice. Here are three types of patients who often end up doing more harm than good, and the changes you can make to help them become the type of patients every dentist wants in their practice.

1. Patients who are always late on their payments. Patients accept treatment, then forget they actually need to pay. They usually pay eventually, but only after team members spend valuable time sending reminders and calling them on the phone.

How can you get patients to start paying on time? First, establish a clear financial policy. When patients make an appointment, make sure they understand when payment is expected. Don’t leave any room for confusion. I also recommend offering third party financing from a company like CareCredit. This enables patients to pay in small chunks each month, making the cost of dentistry much more manageable. You get paid on time, and patients are also more likely to go forward with treatment they otherwise couldn’t afford.

2. Patients who don’t value the dentistry you provide. When patients don’t value dentistry, they don’t make it a priority. So if something else comes up that conflicts with their scheduled appointment time, they don’t feel bad about canceling at the last minute or simply not showing up at all. These broken appointments bring chaos to your day and often keep you from meeting production goals.

Spend time educating patients about the value of the services you provide. This education can come in the form of images from an intraoral camera, radiographs, videos and even brochures. Make sure patients understand why maintaining their oral health is important to their overall health, and the possible consequences of not going forward with recommended treatment. I also suggest confirming with patients two days ahead of their visit, giving you time to fill open slots if they have to cancel.

3. Patients who show up once never to be seen again. Patients come in for their new patient appointment, you think the visit goes great, but you never hear anything from the patient again—and you have no idea why. Patients don’t come back simply because they didn’t have a good experience. Once patients are in the chair, focus on building a rapport. Ask them about their families, their jobs and their oral health goals.

Patients are the lifeblood of your practice, but sometimes they can actually cost you money and create extra stress. Making the necessary changes will help turn these problem patients into the loyal patients your practice needs to thrive.

Sally

 

Sally McKenzie is CEO of McKenzie Management, www.mckenziemgmt.com, a full-service, nationwide dental practice management company. Contact her directly at 877-777-6151 or email sallymck@mckenziemgmt.com.

 

 

Bridging the Gap Between Case Presentation and Acceptance

Friday, July 20th, 2018

Guest post by Dawn Christodoulou, President/Owner of XLDent

Patients come through your door all day with problems ranging from periodontal disease to missing teeth. The biggest challenge isn’t in performing those treatments, it’s in getting a patient to agree to them. As a clinician, your role is much more than just doing the work, it’s listening to problems, educating, and demonstrating.

In most cases, the relationship between you and your patient must start with trust for the patient to feel confident enough to go through with your recommendations. No matter how large or small the proposed treatments are, there’s a personal element to each involved. A patient needs to hear and believe there’s a problem, before ever considering the solution.

One way to do this is to use visuals. Electronic dental charts and digital photos are good to start with. They show problems clearly and offer a focal point for your discussion. Focus less on the filling, and more on the recurrent decay or new caries that are seen and possibly felt right now by the patient. This step of the acceptance process should center around their goals and solving the problem (with your proposed treatment).

Understand barriers to acceptance and address them head on. Dentists think more times than not that the biggest roadblock to acceptance is money. In reality, this is true in some cases. However, it’s likely followed by fear or lack of understanding. Listening to your patient will bring you the most success at this stage. Get in the habit of repeating back what you’ve heard to confirm and reaffirm the barrier.

For example, you might say, “Mrs. Jones, if I’m hearing you correctly, your main concern is how much this treatment will cost. Is that correct?” Don’t be surprised if you get a response like this: “Well, I am worried about that, but I’m also just not feeling any pain right now on that tooth.” We can safely assume Mrs. Jones hasn’t truly seen or understood the problem, thus she doesn’t see the need for the solution. A repeat of the patient education and more focus on the problem is probably necessary.

The process of gaining treatment acceptance is much like crossing a bridge – each step connects to the next until you reach the other side. There comes a point where the patient understands the problem and can connect your solution as a means to solve it. The process of case presentation has a direct effect on a patient’s willingness to make that commitment.

To connect with XLDent, call 800-328-2925 or email xldentinfo@xldent.comDawn

Dawn Christodoulou is the President/Owner of XLDent. She has more than 25 years of experience computerizing dental offices and helping both new and established practices streamline electronic workflows for increased efficiency, improve patient engagement, and achieve maximum profitability. Dawn is also a member of ADA SCDI Working Groups 11.1 Standard Clinical Architecture and 11.9 Core Reference Data Set.

Collections and Your Practice: Success with Patients and Insurance Companies

Tuesday, March 20th, 2018

Guest post by Dawn Christodoulou, President/Owner of XLDent

Practice collections have started the trend towards a steady drop in what dentists are collecting for their work. Without a thorough understanding of insurance benefits and collection policies, paired with a good communication strategy, the ripple-effect on staff morale and productivity can exacerbate this decline.

Insurance Collections

Submitted claims is a first step to insurance collections. If weeks pass before anyone confirms that claims were received and being processed, that time has been lost. Insurance carriers do not make a habit of contacting dental practices to let them know if additional critical information or documentation is needed. Electronic claim services embedded in a practice management software are your first line of defense. For example, in XLDent, with one-click, claim status tracks claims instantly; easily avoiding costly delays.

Fee Schedules XLDent.TND.Blog.Electronic.Claims.Status.3.21.18.jgep (002)are a critical part of making sure your office is making accurate contractual adjustments. EOBs are not always the easiest to decipher, especially for staff with little or no experience with insurance billing. Ensure your team is prepared with payer contract details and fee schedule information so they can post accurate adjustments. Patients will appreciate attention to this detail too, so that your treatment plan estimates are as close to accurate as they can be.

Patient Collections

Every practice should have a written financial policy that lays out the terms involved with insurance processing – what is filed, by whom, and where the responsibilities lie. Payer structures and guidelines can change, so review this policy annually, and adjust it as needed. Any changes should require an updated review and signature from your patients.

It’s no surprise that Standard Operating Procedures (SOPs) guide your practice through critical business processes, and collections are no exception. Establish a collection’s timeline, which includes number and frequency of communications, and consequences for non-payment. Practice administrators should adhere to them, but not without exception. Administrator’s should bring any individual patient concerns or circumstances that need review to the practice owner for further discussion.

Think about how patients want to interact with your practice nowadays, including making payments. XLPortal is a comprehensive solution allowing patients to not only make payments online, but also verify and update medical forms before an appointment, view upcoming treatment plans, and more. Convenience can often be a compelling factor in getting that payment sooner rather than later.

The best way to tackle collections head on is to start with the basics. There is always an opportunity to turn declining collections around, and practices just starting out should strive to establish successful procedures from the start.

To connect with XLDent, call 800-328-2925 or email xldentinfo@xldent.comDawn

Dawn Christodoulou is the President/Owner of XLDent. She has more than 25 years of experience computerizing dental offices and helping both new and established practices streamline electronic workflows for increased efficiency, improve patient engagement, and achieve maximum profitability. Dawn is also a member of ADA SCDI Working Groups 11.1 Standard Clinical Architecture and 11.9 Core Reference Data Set.

Encrypting Your Patient Identity and Health Information

Friday, April 15th, 2016

Guest post by Mark Hollis, CEO of MacPractice

In 2015 alone, the identity and health information of 35% of Americans was exposed – more than 111 Million patient records. More and more, dentists and patients are becoming aware that reported breaches like this effect them directly and can have grave consequences. If you think about it, most of us know someone who has had their personal information compromised and had to spend years recovering from a loss of their identity. Your patient’s identity theft can results in:

Fraudulent charges

Empty bank account

Lost home

Stolen Social Security benefits

Bad credit

Emotional stress, divorce, loss of business, etc.

Health care providers are required by HIPAA to protect EPHI with AES encryption ‘at rest’ on the server and backups, and on a network in the office (and between offices and over the Internet if that applies). The theft and sale of EPHI (Electronic Protected Health Information) is lucrative for thousands of hackers in places like Iran, Russia and China. No one can stop the attempts, but dentists can, at a minimum, use dental software with built-in encryption that makes EPHI indecipherable to a hacker or burglar.

A startling reality is that vendors are NOT required to provide encryption in their software. Other than MacPractice, NONE of the other leading dental vendors provide encryption in their software.

Patients are starting to ask dentists how their data is protected before providing it. In a recent survey, 50% of patients said they would leave their doctor if they were notified their data was exposed, as is required by HIPAA of all doctors who do not encrypt EPHI as well as their database password. In addition, HIPAA and States can assess millions of dollars in fines for non-compliance. This is truly a national emergency.

Encrypted software helps you avoid millions in fines for non-compliance, and qualifies you for HIPAA’s Safe Harbor. In the event of a breach, Safe Harbor can exempt you from having to send first class mail to all who are affected, notify HHS and prominent media, post a notice on your home page, and more. Practices that do not encrypt their patients’ data and report a breach rarely recover.

MacPractice encourages you to learn more about this important topic and how built-in encryption can protect you and your practice. You can download our free whitepaper, register for our encryption webinar and subscribe to our HIPAA web resource page.

MarkHollis_headshot_2014

 

For more than 30 years, Mark has been helping doctors to run their practices more efficiently, first as a practice management consultant and now as CEO of MacPractice – the leading software for doctors who prefer Apple technology. Mark has spoken at seminars, trade shows, dental schools and more than 500 small business events at Apple locations. He is an established and well-respected leader on Cloud computing, dental and medical technology and Electronic Health Records.

He can be reached at markhollis@macpractice.com

Lease or Buy…(continued)

Friday, May 15th, 2015

In the last article, the many benefits of owning your practice were explained. Here, I will highlight the second and third steps in weighing the pros and cons of whether to own or lease your commercial real estate space.

Second Step: Learn About Today’s CRE Market

Since the recent real estate downturn, individuals and businesses are more cautious about real estate investments. Prudent investors are taking steps to learn about their current market climate, ensuring the best investment for the long term.

Traditionally, real estate decisions have hinged on desirable locations. In today’s CRE market, decisions should also include timing as a key ingredient. If you can secure your mortgage at historic low rates, you pay less in interest. You can search for local CRE properties online, but you should realize that not all available properties will appear. The best choice is to work with a local commercial broker who knows your area.

Third Step: Assemble the Team

⋅Navigating the labyrinth of loan options and finding the perfect building or location can be overwhelming. No matter, whether to lease or buy, is the best  choice for your practice; plan to surround yourself with experts who can assist in making the right decision. The following is a list of experts who  specialize in these decisions:

⋅Demographic consultant: Invest in this resource to learn the composition of the area: How many dental practices exist locally? Who is your competition?  Who are your potential customers? Once armed with this information, you can embark on your search for the perfect property location.

⋅ Accountant: A certified public accountant can help determine what your practice can afford and familiarize you with tax benefits.

⋅ Commercial broker: This team member helps you locate potential properties. Find your local realtor board at www.realtor.org to choose professionals    with area expertise.

⋅ Attorney: Engage your attorney if you need help with property negotiations.

⋅ Commercial lender: This team member guides you through financing options. Your best bet is to choose a lender that specializes in dental practice    financing. A dental practice financing specialist will understand your specific needs and can dive deeper into your balance sheet to help find the best  terms. With this type of specialty lender, you might even qualify for 100% financing, which goes a long way toward making your dream a reality.

The decision to buy or lease is one of the most vital you will make as a business owner. Arm yourself with details and expert opinions to make an informed decision and get your business off to a great start.

Screenshot 2015-04-24 14.15.33

JP Blevins joined the Live Oak Bank team in early 2011 and initially spent much of his time educating young professionals about financing and how to best maintain and grow their business. Assisting healthcare professionals in achieving the “American Dream” of ownership, JP is a Loan Officer and General Manager working exclusively with the dental and medical community nationwide.

JP can be reached by phone at 910.796.1674, or email jp.blevins@liveoakbank.com

 

Make an Informed Decision Whether to Lease or Buy

Thursday, April 30th, 2015

Whether establishing a new dental practice or taking steps to expand your practice, as a business owner, you face difficult choices. One crucial decision is whether to invest in commercial real estate (CRE) or to lease space. Before you decide, weigh the pros and cons of a lease vs. buy, take steps to learn the current CRE climate, and surround yourself with experts who can smooth your path.

First Step: To Lease or Buy?

A lease might appeal to you if future space requirements are uncertain, or you require cash for equipment and marketing. The upside of leasing is that it typically doesn’t require a large down payment, leaving you with cash available to focus on running your practice. Plus, you don’t have property ownership and maintenance responsibilities.

Lease arrangements have one major drawback: You aren’t investing in your future. As property values increase, your landlord — not you — benefits from the property’s investment. The landlord also might limit improvements you can make to the space. Retrofitting existing space for a dental practice could cost $150,000 or more. And, once you invest in improvements, consider that this is the space that you don’t own. If you outgrow the space, you will start over in a new location, losing your initial investment in the process.

If your goals are longer term, and you wish to use your property as an asset toward future retirement, consider buying. Purchasing property sometimes requires an up-front investment, but can often be mitigated by a lender who specializes in dental financing.

For new construction or purchased CRE, your loan can be amortized over 25 years, in some cases resulting in monthly payments similar to a 10-year lease agreement. Owning your property and building gives you a blank slate. You can develop and modify space as your office changes and grows. Or, you can allocate space to lease to other tenants, which generates a new revenue stream. Another benefit is that owning CRE property comes with multiple tax benefits.

Steps two and three will be highlighted in a follow up article.

______

Screenshot 2015-04-24 14.15.33

JP Blevins joined the Live Oak Bank team in early 2011 and initially spent much of his time educating young professionals about financing and how to best maintain and grow their business. Assisting healthcare professionals in achieving the “American Dream” of ownership, JP is a Loan Officer and General Manager working exclusively with the dental and medical community nationwide.

JP can be reached by phone at 910.796.1674, or email jp.blevins@liveoakbank.com

In or Out of Network

Thursday, January 3rd, 2013

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.

The Fee is Not ‘Bad News’

Tuesday, July 3rd, 2012

Does the cellular phone company proclaim, “Look! Bad News is Here!” when they send your bill? No. Does the grocery store clerk say to the customer, “I’m sorry Mrs. Jones, but you will have to pay for your groceries today”? Of course not. These are businesses that expect payment for goods and services delivered. And the dental office is a business where goods and services are delivered as well. Nonetheless, for some dental office employees asking for payment is practically painful.

 

Typically, employees that struggle simply aren’t sure how to broach the subject. What’s more, these employees don’t know how to emphasize the value of services provided or how to present payment options. This is where two essential tools come into play #1 – A clear yet flexible financial policy and #2 Scripts.

 

Consider incorporating the following into your financial options:

 

• Establish a relationship with a treatment financing company, such as Care Credit
• Allow patients to build a balance on their account before beginning major treatment.
• Allow patients to pay for larger cases in two or three installments over a specific period of time.
• Offer a 5% discount if the case is paid in full and will not be submitted to insurance.
• Make arrangements to bill the patient’s credit card on a recurring basis until the treatment has been paid in full. This is ideal for larger cases. Orthodontic practices often do this routinely. This system streamlines payment and posting while eliminating billing for your practice.

 

Next incorporate the use of scripts into financial discussions with patients. Scripts help staff to clearly educate patients on treatment recommended, treatment delivered, and treatment financing options that can bridge the gap between treatment diagnosed and treatment completed.

Avoid Sticky Payment Negotiations

Thursday, April 26th, 2012

“No problem, Tom. I’m sure Erin my financial coordinator can work up a little arrangement for you to pay – oh say, $50 per month?”

 

“Uhhh, how ‘bout $25, Doc?”

 

“Well, yeah sure. We’ll take care of you, Tom, you’re just like family.”

 

New dentists can find themselves in the awkward position of financial negotiations with patients, particularly when it comes to family and close friends. And that can put practice finances into jeopardy in no time. With so many things on the new dentist’s plate, it can be easy to forget that profitability and collections are the Siamese twins of dentistry. One doesn’t go anywhere without the other.

 

It’s essential that when it comes to financial plans and promises, new dentists assign this duty to a trained financial coordinator and establish a financial policy that they are comfortable with. Generally, offering patients a few payment options is most desirable rather than a laundry list of payment plans to choose from.

 

Most importantly, do not get into the habit of extending credit to patients. This will be very difficult to break as your practice grows. Rather, partner with a patient financing company, such as CareCredit.

 

Consider offering a slight adjustment in the fees for more costly procedures paid in full that are not covered by insurance, such as a 5% adjustment for procedures over $500 paid in full.

 

Require insured patients to pay a portion of their payment responsibility when services are rendered.

 

Do not accept post-dated checks.

 

Give patients the opportunity to pay in full within 30 days before assessing a financing charge on the account.

 

Sign up for an electronic billing service. And file all insurance claims electronically.

 

Interested in additional resources to help you manage the financials of your dental practice? Click Here.