SURVEY RESULTS

Area Economic Dental Trends:

“Knowledge is Power” and we are on a mission to make sure you survive and thrive in a marketplace increasingly encroached upon by insurance/PPOs and large scale competition.

Our recent survey shows that PPOs are once again at the top of the list as far as issues you and your colleagues are facing. Yet in the last year, fewer than 5% of area offices actually dropped a PPO.

We are not purists. We feel that every office should have the right balance of PPOs for their area. We often see, though, that doctors are much deeper into PPO participation than they need to be. If you haven’t negotiated with your PPOs, you may be leaving money on the table. If you’re collecting less than 80%, you should seriously look into peeling back PPO participation. We can show you how you can lose the discounts and keep the patients!

Other Trends:

  • Metro Wages remain pretty much the same this year compared to last year. Outstate Wages are up 4%.
  • Digital Communications are now in 50% of the marketplace practices. We’ve seen this to be very handy. Patients like text confirmations. Email blasts help get the word out about the services you provide and help you keep on top of seasonal opportunities (back-to-school, yearend insurance/flex plan notices, etc.).

    The leaders in our area are (in descending order of market share): Lighthouse (33%), RevenueWell (21%) and Solution Reach (12%).

  • Despite the fact that Delta pushes hard on dentists charging at the seat, not the prep appointment, 59% of dentists in our area charge at the prep, 41% at the seat.

ADMINISTRATIVE TOOLS CHECK UP

Save Money! Run Smoothly!

When Heidi does her “Administrative Tools” check-up, she’ll look into things like:

  • Claims Processing (typically saving practices $150 – $300/mo.).
  • Credit Card Expenses: Many offices are spending more than they should on bank charges – banks make it complicated so you can’t really see what they are costing you.
  • Third Party Financing: Some options are better than others. Kinder to the patients and less expensive to you – think alternatives to Care Credit.
  • Answering Services. This is an old idea that is coming back again. We think it will help bring in more new patients.
  • Everything and every way to make your administrative staff’s job easier and save (or make) you money.

Just call (952-921-3360) Heidi to “Get it done!”

GETTING MORE FOR A DIFFICULT PROPHY

Right now, we can utilize regular prophies as a preventive procedure and codes 4341 and 4342 for more therapeutic procedures. A new code (D4346) potentially can close that gap and allow clinicians to report a therapeutic treatment of patients with generalized, moderate to severe gingival inflammation but without exhibiting pockets and bone loss. A “Difficult Prophy” code if you will.

Code D4346: Scaling in the presence of generalized moderate or severe gingival inflammation/full-mouth after oral evaluation. The exact description is the removal of plaque, calculus and stains from the supra and subgingival tooth surfaces when there is generalized moderate or severe gingival inflammation in the absence of periodontitis. It is indicated for patients who have swollen, inflamed gingiva, generalized supra bony pockets and moderate to severe bleeding on probing should not be reported in conjunction with prophylaxis, scaling and root planing or debridement procedures.

It sounds like the code will be effective January 1, 2017. Suggested fee: $230 Metro/$190 Outstate.

It is possible this code could close a CDT gap that presently exists. Stay tuned to see what insurance reimbursements are.

OPERA DDS

For Secure Communications Outside* the office and Effective Communications Inside the Office Intra-office communication is the most undervalued way to increase production and elevate quality of care.

Patients’ lives are busier than ever. Therefore, patients are looking for efficiency in their treatments. Practices which have incorporated “same day dentistry” – the concept of having extra capacity and doing what it takes to get treatment done the same day – have been shown to have an increase in office production of more than 30%.

To illustrate this workflow and how it successfully incorporates “same day dentistry,” imagine a patient, Doug, in for his routine prophylaxis. Doug broke tooth #3 a week ago and requires a crown for predictable restoration. Mary, the hygienist of 25 years, clearly recognizes this will most likely be the recommended treatment plan. Mary can, in one single message:

  1. Obtain necessary financial arrangements from the front desk.
  2. Inform the dentist that pulp testing and a crown is likely going to be their recommendation.
  3. Inform the team the patient would like to stay if there is an opening in the schedule.
  4. Alert an assistant to get a room ready for the same day crown.

The simple messaging continues with other members of the team, as:

  1. The dentist, who is currently in a meeting, can
    respond to the team immediately.
  2. The dentist can then page the assistant whom they
    would like to assist them in the procedure.

Communicating an anticipated treatment checklist by auxiliaries to the dentist prior to them engaging the patient can act like rocket fuel to “same day dentistry” and case acceptance. By having immediate and organized communication, staff can control the flow within the practice and increase the patient’s value of our services. Using custom checklist messaging, the practitioner can receive vital, pertinent information in a consistent order every time they are preparing to see a patient. Therefore, the dentist can enter the room already having a solution to the patient’s problem.

It sounds like a simple change because it really is that simple. But the impact on treatment planning and case acceptance is phenomenal.

Patients are happier because their needs are met immediately and concisely; Staff are happier because they are able to work without interruption, messaging only when ready and needed; Dentists are happier because they know everything happening in the office without having to check on people. For more about OperaDDS go to www.OperaDDS.com.

* “Opera Chorus” has fully HIPAA compliant email

WE BELIEVE IN INDEPENDENT PRIVATE PRACTICE

We believe that Independent Private Practice is the best way to deliver dentistry. It is best for the patients, the Doctors and the staff.

Private practices can be more selective with their continuing education and technology. They can also be more adaptable and efficient.

Most importantly, the people who make decisions about patients’ dental care are the ones in direct contact with them.

We also believe that professional management support helps good practices be better and thrive in a competitive environment.

The outcomes your patients receive are a function of your Clinical, Behavioral and Managerial skills. It is nearly impossible for a private practitioner to keep up with all the advancements in clinical education and technology plus practice management. Good management leverages the time and talents of the Doctor and staff to get the best possible outcomes for the patients and production for the office.

THE DENTAL DOW—3RD QUARTER 2016

As you may recall, through June of this year practice production was up 5.7% and collections were up 5.2% compared to the first half of 2015. This was the second year of pretty good growth since the great recession.

Through September, practice production is up 4.1% and collections are up 3.4% compared to the previous year’s averages, which reduced the year’s positive trends.

Total Patient Flow is up 2.3% but new patients are down slightly (about 2%). Dr. and Hygiene Hourly Productivity is up about 2%, Exams are up 2%, but Doctor hours canceled are up about 6%.

Keep in mind that December, January and February are the best “Crown & Bridge” months of the year. Get ready to make hay when the sun shines (and the snow flies)!

Let’s make this last quarter a good one!

BEYOND RECARE AND REMINDERS

Make The Most of Your Patient Communication System:

With the ever increasing use of smart phones, we are experiencing a cultural shift in what is now considered “personalized customer service”. Rather than every patient wanting a phone call, patients today expect to be able to choose HOW they are communicated with. Since
your practice base is likely a mix of Baby Boomers to Millennials, we encourage you to provide a choice of email and text in addition to calls and direct mail. Fortunately, this has been made easier through patient communication systems such as RevenueWell, Lighthouse, Demandforce, Solution Reach, etc. According to our most recent survey, about half of you are now using one of these programs.

But, did you know that beyond the ability to systematize appointment reminders and contact patients when they are due for their next hygiene visit that there are a number of other benefits for both keeping in touch with patients between visits as well as attracting new patients and building your online presence?

Here is a checklist to make sure you are taking advantage of those additional perks:

Collect patient reviews on Google, Yelp, etc. (use post-appointment messages to collect feedback and direct patients to your social sites for reviews).

Feature patient reviews on your website (stream a feed of your reviews chronologically on your website for prospective patients).

Make sure your business information is the same as on your Google listing and website footer/ contact page (name, address, phone number – some services subscribe to a list aggregating service to help build your online presence so you want it to be consistent).

Make sure your important directory links are connected (Google, Yelp, Healthgrades, etc. – again for building your online presence).

Add link for your Patient Portal on your website to bring patients back to your website repeatedly to pay their balance online, request an appointment, etc. (Google likes to see repeat
traffic).

Develop your one-page website for additional online presence (most services offer you microsite which is optimized for search with all of your important office and contact information, as well as another place to see your reviews).

Subscribe to their social media content for ideas to keep your Facebook page fresh and up to date (not available through all services).

Keep in touch with patients after their appointment with post-op information and treatment plan follow up (not available through all services).

Personalize your birthday message with a team photo – or better yet – a video of you wishing them a happy birthday!

Use campaigns to customize messages to promote pertinent services/technology to subgroups of your patient base.

A FRONT LINE VIEW OF INOFFICE PLANS (ALTERNATIVE TO INSURANCE)

Over the years, as a front desk person, office administrator, Dentrix Trainer, and Consultant, I’ve been involved with over 20 offices with these types of plans.

I think most of you are familiar with these kinds of plans by now. Typically, the patient will pay a fee from $199 to $300 per year, which will include two regular checkups (and x-rays, fluorides, whatever is needed) and 15%-20% off additional treatment.

It’s been my experience that these plans really help encourage patients to return regularly for recall and to go ahead with treatment. We are gathering the data on this now, but it’s not unusual to see practice production per patient increase by 50% or even double for patients on these plans.

It’s sort of a “Costco Effect.” If you have a membership, when you go there, you want to get lots of stuff because it is such a deal. I also think it is a good idea because it is equitable. We give insurance patients a break (in effect) and there is paperwork and lots of hassles involved with that, waiting periods, limitations, exclusions, etc. Why not give patients without the benefit of insurance a benefit?

Moreover, some patients through the MNSure site are coming up with plans that pay very low for us and have many limitations and so are not a good deal. At least you can give the patients in these situations an alternative to buying a plan online that has a very lowfee schedule for you.

These plans are easier to administer than insurance. If you have a plan or are setting up a plan, I can help you line things up so you can track them closely.

 

NEW PATIENT FLOW AND PPO PARTICIPATION

We all know that insurance participation (namely PPO participation) affects new patient flow.
Practices with little or no insurance participation generally, not always, get less new patients than practices with more participation. However, is there a point where there are diminishing returns on increased PPO participation? That’s the question we looked into.

Anecdotally, it’s been my experience that practices that participate in almost every PPO available don’t necessarily get that proportionally a greater number of new patients. So, we asked our statistics guy, Anantha Santhanam, to look into our considerable database and sort this out.

As a marker for PPO participation, we use the collection percentage. With increased PPO participation, the collections percentage (gross collections/gross production) is going to be less than for offices with no PPO write offs.

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The graph shows that with zero or very little insurance participation new patient numbers are
quite low. However, when you get past mid-range participation (so that the collection percentage is under 80%- 84% in our area), the marginal increase in new patients for the increased write offs fades quickly.

img2

As with all things, balance matters. Balancing PPO participation is just as important as it used to be to have your fees balanced and set wisely. In fact, PPO participation decisions are beginning to trump fee setting as far as importance to your actual reimbursement levels.