Best Practices for Your Team . . . weekly

Last week, we focused on what was important or the “best practice” for your daily protocol.  Today, we want to move to your weekly systems.  I teach my offices about practicing on the business side of dentistry the same things you preach to your patients in the clinical side of dentistry . . .  “prevention will help keep you out of emergency situations.”  Living in a preventative rather than reactive frame of mind will reap tremendous benefits to your practice.

What I mean by that is putting systems in place and carving out time in your busy schedule to work your reports, follow up with patients and communicating with your specialists on a weekly basis. 

·        Treatment Coordinator – Your main focus is case management and following up with patients who have unscheduled treatment.  When patients walk out of the office without scheduling the crown on #30, you can’t expect them to call, you need to follow up.  The treatment coordinator should be working three reports every week.  You will need to carve out at least 2-3 hours a week of uninterrupted time for this.  

o   Treatment Manager Report – This is your chart audit.  I know some of you are still printing the Unscheduled Treatment Report … stop doing it!  The Treatment Manager is your go-to report for managing unscheduled treatment and one of the reports for keeping your schedule full.  For more details on this report, CLICK HERE.

o   Referred TO Report – When your clinical team is treatment planning and attaching the referral to a procedure code, that patient is automatically added to this report.  Anytime your patient must complete a procedure (i.e. implant placement, root canal, perio surgery) before they can return to your office for the restorative treatment, someone must be making a follow-up call to make sure that treatment is getting completed so you can move forward with that patient care. For more information on how to track referrals, CLICK HERE

o   Unscheduled List – This list should be worked by the hygiene coordinator and the treatment manager.  Follow up with these patients and get them rescheduled. Don’t let them sit on this report for more than six weeks.  For more information on this report, CLICK HERE

·        Hygiene Coordinator – Your main focus is following up with patients who are past due for their recare visit.  Yes, you should have some kind of automated system for sending email, text messaging, and postcards. However, you will still need to pick up the phone and make some calls.  Also, you might want to consider having a patient reactivation system for those patients who are severely overdue.   So how do you keep tight reins on your recare patients?

o   Continuing Care List – This is your go-to list for finding patients who are overdue.  To make this task more streamlined, create yourself some custom lists so you can filter down your lists and it is easier to delegate.  CLICK HERE for more information on this report

o   Unscheduled List – Just like the Treatment Manager, you must work this list on a weekly basis and keep it current.  Don’t let your recare patients sit on this list forever. Follow up with them and delete them off the list if they are not returning your call.  For more information on this list, CLICK HERE

·        Financial Coordinator – You have a big job … collecting the money.  Your team depends on you for results.  If you are not collecting 100% on the day of service, then your accounts receivable needs attention.  There are two reports you must manage on a weekly basis.

o   Insurance Aging Report – This unfortunately is the only report in Dentrix that you have to print (keep sending in your Enhancement Requests for an interactive report).  Insurance companies should pay you within 30 days . . . period!  This will require you to follow up on unpaid claims.  For more information on this report, CLICK HERE

o   Collection Manager Report – Contrary to what you might hear, the Aging Report is NOT your best report for managing patient accounts receivable.  The Collection Manager is much more interactive and will give you more up to date results of your true A/R.  For more information on this report, CLICKHERE.

·        Clinical Team – There are definitely things in the clinical area that need attention on a weekly basis, such as ordering of supplies, stocking rooms, maintenance of equipment and managing your in-house lab.  However, you can definitely help with some of the reports I shared above.

o   Continuing Care – The hygienists can assist with calling patients who are past due if you have an opening in your schedule.

o   Referred TO Report – The dental assistants can help follow up on patients who have been referred to specialists, especially if it requires ordering parts or scheduling lab time.

o   Lab Case Manager – If you are using the Lab Case Manager, you could make sure cases are set to come in on time or use it to track lab fees.  For more information on the Lab Case Manager, CLICK HERE.

Read back on last week’s article and put it together with this one and I can almost guarantee your monthly reports will be right on target.  This is how you manage a practice … by having systems in place for your daily and weekly tasks then you can celebrate when you review your monthly reports. 

My next blog will focus on the monthly systems and my favorite reports in Dentrix.

Best Practices for your team . . . daily

I have written many articles in my blog about all the different reports you should be looking at and the different statistics that are important to keep your eye on … but what is the “best practice” for these reports? Who should be looking at them and when? In the next three weeks, my goal is to give a guideline for these questions. I will be breaking it down into a daily, weekly, and monthly format and what each team member should be monitoring in his or her department.

This first week of the series, we are going to start with what you need to be looking at on a daily basis. 

·        Front Office or Back Office – Someone on the team needs to be looking at the daysheet and matching it up to what was scheduled for the day. This can be the office manager looking at the whole day or break it up with the dental assistant and hygienists looking at their own column of patients. You are looking to make sure that every patient who came in had the correct procedures posted and that nothing else was accidently set as “complete.”

·        Back Office – The clinical team needs to make sure that there was a clinical note written for every patient you saw in your chair that day. If you are chartless, the easiest way to do this is to filter the view with completed work and clinical notes in the patient chart on the progress notes tab. For more on this, CLICK HERE for more information.

·        Office Manager – There are a couple of management statistics I would check on a daily basis because it will make reviewing the monthly numbers a whole lot easier if you have monitored it throughout the month. All these numbers can be found on the Daily Huddle Report, CLICK HERE for more information.

o   New Patients – Make sure every new patient who is entered has a referral source so your doctor knows how the patients are finding his or her office. Also, this is a good time to write out your thank you notes to referral sources and your new patients.

o   Case Acceptance – How much was diagnosed vs. how much was scheduled? If this is low, check to see if the treatment plan was scheduled and not marked as completed.

o   Collections - If collections for the day were low, why?

o   Production – Are you on track for the month?

If you look at these numbers on a daily basis, then you will have a much better chance for success of meeting your monthly goals. You also have time to make adjustments in your schedule and systems if you don’t wait to the last minute.

Get creative with your patient chart

When you are traveling down the path to paperless, the computer IS your patient chart and the clinical documentation becomes one of the most important pieces of the puzzle. You no longer have your blue and red indelible pencils to draw in the existing fillings, put Xs on the missing teeth, and mark up the tooth chart the way you want it. The goal with an electronic chart is to make it look as accurate as possible so when you are discussing the treatment plan or when the doctor walks in for the exam, there are no assumptions and there is no misguided information.

Let’s get a little creative and learn some of the tips and tricks you can do with your Dentrix software to make the patient chart look as accurate as possible.

Remember when you were treatment planning that occlusal pit composite filling or the MOD that covered the entire mesial cusp and you could get out your colored pencils and color away? You can do the same thing in Dentrix. Just click on the Cusps/Pits button and select the paint type you want. If the filling has already been treatment planned and you want to change the look of the filling, just right click and click on Edit Surface Painting.

Remember in the paper chart you could pick up your pencil and draw in a lingual bar retainer or circle something you wanted to remember? With the Chart Notations, you can do exactly that. On the tool bar, select the Chart Notations icon and then select the color and size of pen you want. Use your mouse to freehand draw on the tooth chart. If you want to erase your drawings, then select the eraser tool.

What about the patient who had 4-bi extractions during ortho when they were a teenager? You don’t want it to look like they have missing teeth. What about the patient who has a large diastema between 8 and 9? Using Conditions can create a visual picture of the patient’s mouth. Here are some common conditions to use:

1.      Drifting Mesial– Use this for missing teeth when the space has been closed. This paint type will put arrows to show the space has been closed.

2.      Open Contact – Use this for diastemas and open space between teeth

3.      Unerupted – Use this condition when the tooth is below the gum line. Using this condition will also cause the perio chart to skip the tooth.

Here are some other blog posts on clinical charting:

CLICK HERE for video on treatment options
CLICK HERE for a great way to review clinical notes

The clock is ticking . . . June 1st deadline

The clock is ticking to your June 1st, 2015, deadline for Medicare enrollment. Yes, you heard me correctly. Your office has until June 1st to choose which type of Medicare enrollment is best for your practice. I first wrote about this back in October 2014 when I got the news and it was one of the least-read blogs of all time. For those of you who didn't read it, CLICK HERE to be re-directed.

We all know how government paperwork can be, so don't dilly dally around and lose track of time. If you want me to send you a Medicare enrollment guidance information sheet, I would be more than happy to do so. Just send me an email to dayna@raedentalmanagement.com and in the subject line put Medical enroll.

Top 10 Blogs of 2014

1. Get Creative with Your ASAP List

I was working with an office recently and they have a program specifically for patients who do not pre-appoint. These patients are mostly retired and have very flexible schedules. They don’t want to tie down their schedules in four or six months so they just say, “Call me when you get an opening.” This office had a manual tracking system for these patients but wanted to find a way to incorporate this into their Dentrix system. Since you cannot put a patient on the ASAP list unless they have a scheduled appointment, we had to come up with something creative … so we gave these patients a specific status that we could search for within the Continuing Care system.CLICK HERE to continue reading

2. Top 5 reports every doctor should look at

I received an e-mail from a doctor the other day who had a situation that needed attention. Her clinical team had started posting procedures in the patient chart and had accidently posted a root canal as “complete” rather than “existing.” The root canal was not only posted to the patient’s ledger, but it was also sent electronically to the insurance company and paid. The patient called concerned about the EOB that he received and wondering why the office had billed his insurance company for a root canal he never had. When the doctor asked me what kind of safeguards she could put into place for her clinical team, my response was that this issue was an administrative boo-boo, not a clinical mistake. CLICK HERE to continue reading

3.  "Can you write me an excuse note for school?"

I was at the mall yesterday shopping for some curtains for my mom’s new condo and the mall was bustling with kids shopping for back to school clothes, shoes, and backpacks. When I was working in a practice, we had a middle school directly across the street from our office and kids would walk over from school for their dental appointments. Since these kids were usually not with their parents, we would write them a note to take back to school so they could receive an excused absence. For a long time, our office would photocopy the excuse notes and write the name and date of the appointment on the note. Then I got smart . . . I added a new Quick Letter so all we had to do was click on the appointment, open Quick Letters, highlight the excuse note, and click print. My team thought this was the coolest thing ever!  CLICK HERE to continue reading

4.  2014 New Year's Resolution - Credit balance clean up

Today we are going to tackle the issue of allocating payments properly on the Ledger and fixing the provider credits. In Dentrix, you can apply payments to the patient and allocate the payment to the different providers. However, most practices do not split the payments accordingly and then the patient balances and the provider A/R is not accurate. To fix the patient’s ledgers can be bit of a project, but, if this is one of your 2014 New Year’s Resolutions, here is how you do it.  CLICK HERE to continue reading

5.  2014 New Year's Resolution - Clean up you database

Is your New Year’s Resolution for 2014 to clean up your Dentrix Database? Do you find that you have duplicate insurance plans taking over your system? Do you have several unnecessary or duplicate medical alerts that have nothing to do with caring for a dental patient or you have maxed out your 64 limit and you need to find a way to create some space? My focus on the next few blog posts will be to help you straighten things out a bit.  CLICK HERE to continue reading

6.  Re-Evaluate your PPO insurance plans

The beginning of the year is usually the time where the doctor and team are getting back in the swing of things after vacations and preparing for a new year. With all of the uneasiness in the insurance world, I have had many offices looking to re-evaluate their contracts with PPO insurance companies. But, if you are using your fee schedules and billing out the PPO fee to the patient and not posting adjustments to the ledger, how do you assess the amount of your write-offs? Use the Utilization Report for Dental Insurance or The PPO Analyzer report.  CLICK HERE to continue reading

7.  Opting out of virtual credit card insurance payments

The issue of using a virtual credit card for insurance payments has not only become a frustrating situation for the dental practice, but also costs the office money they don’t need to be spending. My friend and colleague, Jennifer Schultz, who is owner of The Virtual Dental Office Manager, is also having the same issues with her offices. She recently wrote an article on the same topic, CLICK HERE to read it.  CLICK HERE to continue reading

8.  It's only an estimate so make it as accurate as possible

Are you looking for a more accurate way to accommodate the difference that the insurance company calculates for posterior composites? What about the fact that perio maintenance is in the perio category but is usually paid at 100%? Would you like to be able to give your patients a more accurate out-of-pocket estimate? If so, then using the Payment Table will make you very happy.  CLICK HERE to continue reading

9.  Treatment Plan Estimates . . . personal and efficient

When I am working with an office, I love to customize things in Dentrix to make it personal for the office and the patient experience, but I am also a stickler for efficiency. If you have read any of my blogs about using templates, you know what I am talking about. Well, the same goes for when we are printing a patient’s treatment plan estimate. I want it to be customized, but efficient for the front desk. You can create customized print options and save these options when you are generating a patient treatment plan estimate. Below is a screen shot of the print page and a description of all the options from which you have to choose.  CLICK HERE to continue reading

10. Jump start your medical billing

Last week, I wrote about how to set up medical cross-coding inside your Dentrix software. However, medical billing is not just about setting it up in Dentrix. Today, I am bringing in Christine Taxin, a medical billing and coding expert, to give you some information and resources that will help guide you through some of the insurance rules you need to know.  CLICK HERE to continue reading

Challenge yourself to become a Dentrix Master and get recognized on the Wall of Fame

This is your year to become the best you can be in your career.  Challenge yourself to become a Dentrix master.  Join me on the Wall of Fame as I post up your accomplishments on my blog all throughout 2015.   CLICK HERE to start your success.

Watch my video to hear all the details . . .

 Wall of Fame



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Delta EPO's and Co-Pay plans, how to setup

Lately I have been seeing a few new insurance plans creeping up in the market. In Colorado, I have seen these new “EPO” Delta Dental plans that have a patient co-pay instead of the traditional coverage %. Then, when I was in Washington recently, the office showed me a plan where the patient pays a total dollar amount on certain procedures. These plans sound similar, but the setup is slightly different.

With the “EPO” plans, I would use the co-pay feature inside of the coverage table. The reason I would use the co-pay is that there is a different patient co-pay for every procedure code. View the image below to see the fields to use for this type of setup.

 

Then I have seen other plans where the patient pays $65 for the exam, X-rays, prophy, etc., or pays $800 for a crown, but nothing else is covered. In this situation, I would use the Payment Table because there is not a co-pay on every procedure code. Remember, the Payment Table will override the Coverage Table. Set the coverage % to 0 because anything that is not listed on the benefits sheet is not covered. See the image below for the fields to use with this setup.