The ultimate and definitive solution…”; “total control…”; “easy to use…”; “fully integrated…”; “seamless flow of data …”; “revolutionary…”
Practice management software packages and dental technologies claim to do a lot. Some systems sound like they will lead you to the Promised Land of practice efficiency and productivity—everything from bringing new patients in the door to convincing them to accept treatment.
Lest you think that I am not a strong supporter of practice management software systems and technologies, rest assured I am, and McKenzie Management routinely recommends excellent systems and diagnostic tools to clients. But too many dental practices pour thousands of dollars into computer systems and technologies that should pay for themselves in increased productivity, only to achieve a mere fraction of the return on this major investment. Often, the reasons are 2-fold: lack of planning and lack of training.
As exciting and promising as new dental technology and software are, before opening the checkbook or whipping out the credit card, practices need a technology plan and a budget. In that budget is a line item for staff training so that the dental team can do more than just marvel at the amazing capabilities of your new computer technologies…they can actually use them.
GET YOUR PRIORITIES IN ORDER
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Illustration by Nathan Zak |
With your team, take a step-by-step approach to determine how the technology/computer systems can be integrated most effectively into the practice.
(1) Start with a technology vision for the practice. How do you want the team to use the computer system? How do you want the patients to benefit from the new technology?
(2) Conduct your technology/computer system inventory. Examine what you have in hardware, software, and networking capabilities.
(3) Set your priorities. The cost of technology has come down considerably, but it remains a significant investment for virtually any practice.
(4) Don’t try to do it all at once. Plan to integrate and expand technology in stages.
(5) Train staff over time, not overnight. Training dollars are much better spent if the instruction is conducted every 6 to 8 weeks over the first year so that staff can master one element of a system before moving on to the next. Many practices will try to cram as much information as possible into a few days so as not to sacrifice production. They forget that poor or ineffective training will cost far more down the road than a few hours of lost production today.
(6) Budget for technology on an ongoing basis.
Without a budget, the cash outlay for office technology can quickly become overwhelming for the doctor and the practice. But how much is enough? Dr. Lorne Lavine of Dental Technology Consultants recommends that practices set aside about 5% of their annual gross revenue for both business and clinical technology. On the business side, the typical budget would be about 1.5%. At that level, practices should be able to purchase the following:
• new computer hardware every 36 to 48 months
• practice management software, regular updates, and unlimited telephone support
• on-site professional technical hardware, network installation, and maintenance
• a minimum of 16 hours of on-site software training annually.
$10,000 TO $20,000 LATER…
You’ve invested in the systems, you’ve trained the team, now what? It’s time to put your information systems to work. Your practice management software should provide easy access to a few key system reports regularly. First, the accounts receivable (AR) report. Accounts receivable should never be more than one month’s production. The AR report shows the total amount of money owed the practice from patients, insurance companies, or other third parties. The report should include every account with an outstanding balance, the date of last payment, and a note indicating if payment was from the patient or the insurance company. Some software programs generate accounts receivable reports that break down aged ac-counts into money owed by patients and money owed by insurance companies. Those 2 must be combined.
The report also should “age” the receivables as follows: The “current” column indicates revenues produced in the last 29 days that have not been collected. You want a minimum of 45% over-
the-counter collections for the month, and no more than 55% in the current column awaiting insurance reimbursement. The report should give a breakdown of accounts for 30 days, 60 days, and 90 days past due.
Add credit balances back to the total accounts receivable. Total all money more than 90 days delinquent. The percentage should not be more than 15% of your total accounts receivable.
If accounts receivable exceed your monthly production, then that’s a red flag to you and your financial coordi-nator, indicating that problems need to be addressed promptly in one or more of the following areas:
• insurance system
• billing system
• financial policy
• presentation of financial arrangements, and/or
• inability of financial coordinator to ask for money.
In addition, the accounts receivable report provides the financial coordinator with necessary information that enables him or her to customize the messages on patient statements when using electronic billing and when making necessary collection phone calls. Notations should be keyed into the computer system as to what payment messages/expectations were conveyed in the statements and what the patients agreed to during follow-up calls.
CRM–CUSTOMER RELATIONSHIP MANAGEMENT
Your patients are your customers, and your computer system should help you monitor and manage that relationship effectively. Cer-tainly, patients come and go in every practice. However, knowing how many are quiet-
ly exiting your practice is information that is critical to measuring the growth of your business as well as the team’s effectiveness in build-ing lasting relationships. This is where the production report comes in. De-pending on your software system, it is probably re-ferred to as Production by Provider, Practice Analysis, or Production by ADA Code. To ensure that you are getting correct information from this report, members of your dental team who are re-sponsible for posting procedures to a patient ledger should use the ADA code 00150 for new, comprehensive examinations.
Each month, your scheduling coordinator runs the report for exactly the last 12 months. The report tells you specifically how many 00150s were performed in your practice in the last year. Write that number down. Next, run an overdue recall/continuing care report for the same time frame. You’re looking for every patient who was due back into the practice during the past 12 months. Write that number down. For example, your results may show 300 new patients and 200 existing patients overdue for recall. You’ve effectively calculated patient flow ratio. What’s more, you now know exactly who has not scheduled, and you can immediately implement a patient reactivation strategy.
Often, doctors have a feeling that patient numbers are down or that new patients aren’t returning. But it’s not until that feeling becomes a true patient retention problem that doctors take notice. Regularly monitoring the re-ports allows dental teams to take action long before they face a crisis. If patient retention is below 95%, address the shortfall.
INTELLECTUAL CAPITAL = PRACTICE CAPITAL
It is said that knowledge is power. It’s also money for your practice. Use your computer system to track unscheduled treatment using the Unscheduled Treatment Plan Report or similar report. To ensure that you’re getting an accurate picture, the treatment coordi-nator must enter all treatment plans into the system. If the correct data isn’t going in, it’s not coming out. Each month run the report and take these steps to assess the success of your treatment plan acceptance:
• Compare last month’s report to this month’s information.
• Compare total dollars unscheduled.
• Compare total dollars accepted but not scheduled.?
• Compare “missed appointment production” (available on some practice management software).
• Clean up old treatment plan items.
If your Unscheduled Treatment Plan Report indicates that treatment acceptance is below 85%, evaluate how well your practice addresses the primary obstacle to pa-tient follow-through: money. How easy does your practice make it for patients to pursue the treatment they want and need? Certain software programs allow you to determine almost immediately if a patient is eligible for treatment financing through CareCredit. Next to quality dental care, the best service you can offer is affordable payment options. Some systems will allow you to run a Production Forecast Report that can be used as an excellent tool to determine slow periods, so that you can develop a plan of action to address the potential production shortfalls.
CONCLUSION
From scheduling to recall to lab cases to treatment planning, your computer systems’ capabilities are powerful yet severely underutilized resources that should be enabling you and your team to point and click your way to higher profits, greater productivity, and significantly improved job satisfaction. Plan exactly how you will use computer technologies in your office. Budget for training and have a dynamic plan for regularly updating and incorporating new technologies into the practice. Then watch that multi-thousanddollar investment pay for itself.
Ms. McKenzie, certified management consultant, is a nationally known lecturer, author, and consultant to the Council on Dental Practice of the ADA. She is CEO of The McKenzie Company, which has provided success-proven management systems to dentistry since 1980 and offers a full line of educational management products at mckenziemgmt.com. She is founder of The Center for Dental Career Development, which provides advanced education to the dental profession online at dentalcareerdevelop.com or in La Jolla, Calif. To receive her weekly e-management newsletter, which provides targeted management tips, call (877) 777-6151 or e-mail sallymck@mckenziemgmt.com.
