Archive for the ‘New Patients’ 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

Are You Ready For A Second Location?

Thursday, September 20th, 2018

By Dawn Christodoulou, President/Owner of XLDent

After reviewing another month of stellar reports, you are feeling confident that your patient-focused style, team, and community presence have rounded up the best patients around. Adding an associate or two is sounding more and more like a great idea. You are confident that you have the know-how for business that is required for taking on the challenges with this type of expansion. Hopefully, there will be a doubling of profits in this venture – but watch closely for the doubling of risks too!

Just like in real estate, consider the location of the practice first. Is the community able to support another dental practice? Preferably, it’s one with a growing population of families. It’s worth considering buying an existing practice in a nearby area, because they already have a patient base established, and negotiations can include the selling dentist staying on for a few weeks to transition the practice. This can prevent a mass exodus of patients from the practice, while the new team is settling in.

When considering associate doctors to expand the new care team, word-of mouth recommendations are a great starting point. Dental school alumni and study club groups can provide some direction on potential candidates. Perhaps adding a specialist to your team and providing a wider range of services will be just the competitive edge your practices need. Don’t rush this part of the process. It will likely take multiple meetings and interviews to realize a good fit. You will want someone with a similar drive to grow the practice, and similar views on the best way to care for patients.

What about software? We would be remiss if we didn’t talk about the heart of the practice’s organizational structure, claims management, and record-keeping. There is a misconception that, if you have more than one location, you must have cloud-based software. This is not the case. XLDent offers a solution called “replication”, in which multiple offices are running instances of the database locally, as well as writing to each other database instantaneously. Staff has access to all records, patients can move freely between locations, and business operations can be done on an organizational level. This helps streamline day-to-day processes and can be especially helpful if your associate is on call for the weekend and needs to see the chart and x-rays for an emergency patient at the opposite office from where they usually go for treatment.

Goals for expansion can certainly be achieved with careful planning, management of risks, and an outstanding team beside you. Choosing a location, team, and business software to meet your needs will give your practice a strong foundation for growth in any direction.

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

DawnDawn 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.

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.

How Much is Enough?

Wednesday, June 20th, 2018

Guest post by Sally McKenzie, CEO McKenzie Management

Naturally, one of the first questions many dentists ask is, “How much should be budgeted for marketing?”  For startup practices or offices that seek to market and grow aggressively, 4-6% of projected production should be allocated for marketing. The typical dentist should budget about $30k to $50k for the first year. For established practices, 3-4% of projected production should be allocated. The typical established dentist should budget $20k to $40k per year.

New dentists commonly assume that because they have a large family or are active in their church these individuals will be the new patients that sustain their practices. What is not considered is this may amount to only 20 to 50 people. They don’t fully realize how many new patients they need each month to make payments on the practice, pay the staff and themselves.

Marketing is an investment in the success of your practice. If you cut the marketing budget or have an insufficient budget, you are cutting the flow of patients to your practice. Without patients there is no practice, plain and simple. Invest in your practice. Create a budget and spend it intelligently – which brings me to my next point.

Marketing is far more than a single ‘Campaign’ or ‘Event’

I have watched dentist after dentist throw thousands of dollars into so called “marketing campaigns”, convinced that this one will bring in all the patients they need. It’s the “silver bullet,” the answer to all of their struggles. The campaign kicks off. The mailers are sent, the ads are placed, the special offers are promoted, the radio jingles are playing, and, yes, the phone is ringing. The schedule is full. Ninety days later, it’s over and so is the rush of new patients.

What happened? Was the campaign really a waste of money? Why are there holes in the schedule again? Who’s responsible for this disaster? Who, what, why – many questions and concerns arise when lots of money is spent and limited return is achieved. I have a word of advice for you – STOP.

Stop looking at marketing as a one-time external event. Marketing is taking place in every interaction with every patient. It is what happens when your business staff answers the phone. It is what takes place when you explain a procedure to a patient. It is the layer of grime on your front door that no one on staff notices because they’re always going in and out the back. Marketing is the small stuff and the big stuff. It is the “whole package.”

SallySally 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

What New Dentists Can Gain from Losing

Friday, April 6th, 2018

Guest post by Nelson Kanning, DDS

Why would anyone boast about being a loser, especially if losing involved money? Who in their right mind would consider losing money a gift? Most dental practice owners and even associates would throw a fit at the idea of setting a goal to lose money. But, I’m proposing being a loser can make sense, particularly if you’re a new dentist.

Until recently it was hard to admit that being a loser is one of my greatest gifts. The majority of my experience with teams has been as a loser. High school football; we lost. I played for a Division I football team that was bowl champ the year prior to me joining. Then, we lost. Losing used to be tough. However, now I’m finding being a loser is a joy.

I’d say this revelation happened about six years ago. I was sitting in the audience at the American Academy of Cosmetic Dentistry’s (AACD) annual scientific session in Seattle. During one of the opening sessions, I became curious about the awards being given to offices who participated in their Whitening Challenge. Offices who participate in the AACD Charitable Foundation’s Whitening Challenge agree to donate a portion of profits from their whitening to the Give Back a Smile program, which restores the smiles of survivors of domestic violence. And one office received the award for donating the most profit from whitening to the AACD. That office’s benevolence inspired me. Their team was excited about the program. The doctors felt good about the service to their patients and to a much greater cause. That day, I realized that program had to be part of my practice.

It seems fit, here, to reveal that dentistry is my second career. Through my twenties, I made a living as a professional fundraiser asking people to donate money to leadership programs, support scholarships, and buildings for a private liberal arts college. During that time, I was always fascinated by the joy the donor received knowing their money was making an impact for someone deserving. The Whitening Challenge has given me that same feeling of joy. It is a whole lot more fun to give money away freely than it ever was to ask for money.

Does donating increase my bottom line? Who knows. But ultimately, who cares. You’re not a dentist solely for the profit. Remember, you said it yourself in your interview: “I really want to help people and make a difference.” Boom, here is your chance. Finding a cause for your practice, like the Whitening Challenge, can make instant connections with skeptical patients as well as entice new patients into our chairs. It has given my team a cause they are proud to stand behind and excited to share with our community. However, it mostly reminds me that when you do the right thing, despite your overhead, your monster loans, and your financial ambition, being a loser just feels good.

AACD.Blog.4.7.18.Kanning (002)Nelson earned a BS at William Jewell College, with an emphasis in Leadership and Biology. After graduating, he served two years as a leadership trainer and capital campaign consultant for Sigma Nu fraternity. Although he enjoyed his mission-driven work in the non-profit sector, Nelson decided to pursue his original desire for a career as a dentist.

Dr. Kanning served on the AACD Charitable Foundation Board of Trustees from 2015 to 2017 and served as the chair from 2016-2017. His office has participated in the Whitening Challenge since 2013 and won the Bright White award in 2014 for donating the most whitening proceeds of all participating practices in that year. Since his office has started participating in the Whitening Challenge, they have donated nearly $25,000 in whitening proceeds.

 

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.

Getting Patients in the Door for a New Startup

Tuesday, March 6th, 2018

Guest post by Brian Baliwas, DDS

Four years ago, I took a risk as a new grad and joined a group practice in San Francisco to try and build a patient base of my own. A few trusted mentors supported the idea and gave me the confidence that building something for myself straight out of school was a good idea.

I saw a staggering FIVE patients in my first week. My days were full of hygiene and down time, but I kept a positive outlook throughout it all. I knew that if I did good work and treated people like family, this slow start and double-digit patient count would be temporary.

Like any dental startup, the priority was getting patients in the door. When I wasn’t with patients, I brainstormed different ways to market my practice with a limited marketing budget. Today, my patient count is in the quadruple digits, and I believe social media has played a significant role in that growth.

Social media gives dentists an opportunity to show potential patients something no other type of marketing can: a glimpse of who they are behind the mask. Dentists who treat social media like traditional advertising and post about whitening specials and Invisalign discounts miss out on the opportunity to really convey their personality and practice philosophy.

In addition to growing my practice, social media has allowed me to connect with people I may have never met. Aside from patients, I’ve met other dentists, specialists, dental students, laboratory techs, and dental product reps. I use it to stay connected with people I meet at conferences. I even met the person mentoring me towards AACD accreditation, Dr. Adamo Notarantonio (@adamoelvis), through Instagram!

The question you must ask yourself when starting a dental social media account is: what do you want to share and who are you targeting?

If growing a practice is your goal, don’t get caught up focusing on irrelevant numbers. Patients don’t (directly) care about your follower count, follower to following ratios, how many likes you received, or other meaningless social media statistics. Focus on content and providing information they would find valuable. Nothing else matters.

If you have a great personality and provide honest dental care, your future patients deserve to know! Take pictures of your office, staff, patients and dental work (with permission), volunteering, CE courses, hobbies, humor, family, and individuality. Share who you are… and then share some more.

AACD.BLOG.3.7.18.BrianBaliwas.photo (002)Brian Baliwas (@sfdentalnerd) received his DDS degree from the University of the Pacific Arthur A. Dugoni School of Dentistry, where he graduated with high honors and was elected to join both Omicron Kappa Upsilon and Tau Kappa Omega dental honor societies. He is an active member of the American Academy of Cosmetic Dentistry and the Academy of General Dentistry, and maintains a fee-for-service private practice in San Francisco, California, with two locations near Union Square and the Marina district.

His practice philosophy is centered on conservative, highly esthetic, comprehensive dentistry that utilizes modern technology and techniques. Dr. Baliwas also teaches part-time at UOP in the Department of Integrated Reconstructive Dental Sciences.

 

 

4 Ways Dentists Will Grow Their Practice in 2018

Monday, January 22nd, 2018

Guest post by Dawn Christodoulou, President/Owner of XLDent

I have to imagine that most every practice has a 2018 goal of growth. Now it’s time to start implementing your plans so changes can take hold and start producing results. Goals are a means to keep everyone motivated and pushing for excellence. Investing in new technology can certainly provide advantages that make you stand out from the crowd, and get new patients coming in your door. Current patients will take notice too, and feel confident that they made the right choice entrusting you with their family’s dental care.

Let’s first talk about recall. Maybe it’s not your strong suit, but it needs to be! Seventy-five percent of your revenue comes in through your hygienists, and getting people scheduled is the first major hurdle to making that happen. There are many ways to improve what you are already doing to reach patients, but perhaps you would rather this particular problem would solve itself? Automated patient communications are the answer to the time-consuming and challenging task of reactivating dormant patients and reminding scheduled ones to come in. Using a customizable combination of phone calls, emails, and texts, front desk staff can better utilize their time interacting with patients and focus on patient experience.

Many offices gain or lose staff after the holidays. Either way, the start of a fresh year is a chance to review standard operating procedures, especially if they haven’t been updated in a while. SOPs provide guidance to each member of your team, so they always know what part of the workflow is whose responsibility. Better to lay out practice expectations at the beginning, so that your new, or re-assigned, team member fits into your practice like a puzzle piece from the start.

Faster and mXLDent.Blog.1.21.18 (002)ore accurate payment processing, clearer insurance benefit coverage, and electronic insurance payments (EFT) are a few focus areas for those looking to streamline payer and insurance services. To maximize these options, integration of the service is a must. XLDent’s integrated ERA solution not only auto-populates the payment amount during the posting process, but also the contractual adjustments from Electronic Remittance Advice.

One of the best things to do when there is a slow-down and the winter doldrums set in is to retrain or “tune up” your team. Webinars are a great way to kick this off, but on-site and live web training are important options to consider as well. They give you a more hands-on training that isn’t quite the same as watching a video. Whether it’s appointment reminder automation or staff education, this year, set out with your best foot forward for growth!

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.

Strength in Numbers

Monday, December 4th, 2017

Guest post by Dawn Christodoulou, President/Owner of XLDent

The modern dental office is becoming fully integrated into the digital age, with the ability to capture and analyze much of the data it generates on a weekly basis. Close monitoring can guide the Practice Owner to reflect on which marketing methods are generating the most leads, how successful collection efforts are, and production trends.

In a matter of seconds, a KPI (Key Performance Indicator) should tell you whether your practice is growing, maintaining, or starting to decline. XLDent offers a brand new KPI Dashboard feature to help you gather this data quickly, and formXLDent.TND.Blog.Dec.2017.Dashboard2 (002)at it into easy-to-read graphs, giving you a window to the health of your dental practice. This Dashboard is mobile-friendly and accessible from anywhere, anytime.

An analysis of your Clinical team can tell you several things:

-Production is the most basic building block of your business, so these daily, weekly, and monthly totals are a great place to start looking for trends, peaks and valleys. They can be useful to determine whether you should think about adding more staff to manage your patient care without delays or protracted schedules.

-Is the hygiene team making sure to schedule the next recall appointment with the patients before they leave the treatment room? Recall metrics need to be clearly visible, concise, and up to date.

-Are your recommended treatment plans being accepted, scheduled, and followed through or are patients not feeling confident in your team? Perhaps you will need to add education for patients who are unsure if planned treatment is truly needed.

-Are overhead costs crippling your ability to run a successful business? The materials and equipment you choose (and the method they are deployed) should be reviewed periodically, so that modifications can be made, where appropriate.

An analysis of your Administrative Team will point out the following areas:

-The number of new patients coming into the practice each month. Are they referred from satisfied patients, calling you because of a successful marketing campaign, and is your office creating the best experience once they come in?

-Are your Collections being handled in a timely manner? Not everyone is comfortable asking patients to pay their balances, so it’s a good idea to seek out the right staff person to tackle this roll.

With all this information at your fingertips, performance goals can be set and achieved. Practice growth decisions should include clear expectations of what your team is capable of, and what systems and positions may need to be modified going forward. Keeping track of your practice’s growth, and potential, doesn’t need to be a major time commitment. The new XLDent KPI Dashboard can provide a window into where you’re headed in just minutes.

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.