Monthly Archives: August 2015

Balancing PPO Participation

For many practices, PPO participation is their biggest “expense” after staff wages (or even greater than wages in some cases). Historically, practice collection percentages have been 95%+ (of gross production). Now it’s not uncommon to see collection percentages of 70%-80%…and sometimes less.

Most dentists join a PPO in the hopes of gaining and retaining patients. No dentist likes to lose patients and when you do lose a patient because you’re “not on their network”, it can be a powerful inducement to sign up for the PPO.

Once you are participating with a PPO, it’s easy to feel there is no other choice. But, please note the data below. Most PPO’s have participation of 45%-60% of offices in this particular survey. Granted, that’s the majority of offices. But for any of the individual PPO’s noted, 40% – 55% of offices aren’t participating. So for every plan you feel you must have, keep in mind there are a lot of Doctors that are surviving without having it.

And, if you aren’t participating in any PPO’s but your practice is foundering, maybe some participation would be worthwhile.

Insurance companies have the upper hand but things don’t have to all go their way! You do have power. Don’t assume that you have to be participating as much as you are. For most practices, a reasonable mix of PPO’s is what makes most sense. As practices mature and succeed, they are likely able to cut back on PPO participation. And, if you’re mostly busy, it doesn’t make sense to work at deep discounts.

Decisions regarding PPO participation involve serious risks and rewards. Too often Doctors will sign up with a PPO too quickly, or when they decide to leave PPO’s, leave them too recklessly. Every office must carefully consider its PPO participation. Smart moves here can add more to your bottom line than practically any other thing you can do. These stats are from a survey of 59 East Coast offices’* PPO participation:

PPO % of Offices Participating:

  • BCBS 54%
  • MetLife 46%
  • Aetna 51%
  • Cigna 58%
  • United Concordia 58%
  • Other 61%

Number of Listed PPO’s Responding Offices Participate With:

  • 5/5  =  26%
  • 4/5  =  16%
  • 3/5  =  14%
  • 2/5  =  14%
  • 1/5  =  9%
  • 0/5  =  21%

44% of offices participated in 2-4 plans, with 30% participating in 0-1 plans and 26% participating in all 5 plans.

Do You Want More New Patients?

To Move the Numbers, You Have to Do a Number of Things

Of course, almost every dentist wants more new patients and everyone is looking for the quickest, fastest way to do it…the “Silver Bullet”. As you probably have heard Bill say many times before, “It is possible to get more new patients but you have to actually do something.”

Let’s talk about a recent case history—by recent I mean over the last 2 years. This practice has worked hard on a number of fronts: they polished up their website, got updated photos, made sure their online directories were straight, kept somewhat active with Facebook, experimented with Pay per Click and “Conversion Factors” on the website (e.g. offers and testimonials).

The staff was coached on “New Patient Readiness” making it more likely that patients’ phone calls or website visits turned into patients inside the office.

They even did call tracking to find out when new patients were calling in and the success rate in converting them.

They also used all the features on their digital communication system (in this case Demand Force).

The net result was the patients increased enough that now they’re getting over six months “extra” new patients per year (and their Continuing Care numbers are going up too). Practice production is up over 15% this year.

For most solo practices, an increase of 6-10 new patients a month is all they want or need to keep their practice cruising. For this Doctor, it wasn’t just one thing. It wasn’t all that expensive or hard though either.

That’s why we believe in “Checklists”. We use Checklists to insure Continuing Care effectiveness, Collections effectiveness and so on. When our clients work with our “New Patient/ Marketing Checklist” and complete it each month, we see the best results. Every office should have a person in charge of their marketing efforts—if you’re serious about bringing in new patients, you have to designate a person to be in charge of that, just like there should be a specific person in charge of Continuing Care, Collections, etc. That’s how you insure that those advances on many fronts actually happen. Otherwise, they’re just good ideas (Thank you notes aren’t sent, reviews aren’t tracked or added to, website visitors aren’t converted into patients, etc.).

Are you serious about giving your marketing a push? Call me and we’ll come up with a specific plan for your office. It’s my job to support your staff, coach them and give them the advice they need to be successful. I also keep them accountable but I’m accountable too. Together we can make things happen.

Collections Made Comfortable Seminar | Friday, November 6

Everyone On Your Team Has To Deal With Patients, Money & Insurance. Make Sure They Know How!

  • Presented by Shelly Ryan
  • Friday, Nov. 6th
  • 9:00am -1:00
  • Embassy Suites, Bloomington, MN

dental collections seminarThis Is A Must for Your Team! This seminar is almost always a sellout. Clients get first dibs! So CLICK HERE TO RESERVE YOUR SPOTS. $198 first person and $168 each additional. $20 discount per attendee if registered by September 15th .

NEW Special Segment: 2015 & 2016 CDT Codes

Learn which codes get the best reimbursement and when to use them; How to get better reimbursement for ERPT’s; And more!

Any Questions?

Please call APM at (952) 921-3360

click here to register

The Dental Dow: Still Cruising Through 2015

Bill Rossi, President of Advanced Practice Management

Bill Rossi, President of Advanced Practice Management

Comparing the first half of this year to last year for the sample mature area practices, we find practice production is up 6% and collections are up 5.5%, continuing the trend from the first quarter.

Total patient flow (as measured by exams) is up 3.5% with new patient exams up 6%. Crown and bridge is up 2.7%. The gross collection percentage for the sampled practices is 85%, consistent with last year. I guess we can be happy that it hasn’t slipped another notch this year.

The trend to fuller Doctor and hygiene schedules continues too with Doctor downtime reduced by 15% and hygiene downtime by about 5%. Back in the ‘90’s, 6% used to be sort of assumed background growth. Now, this is the best trend in many years and over 75% of sampled practices showed growth.

Goodbye, Joe! It Was A Pleasure Knowing You

As you may have heard, Dr. Joe Steven, lecturer, author and founder of “Kisco”, passed away May 22nd.

Shelly and I always enjoyed our professional collaboration with Joe. He was such a down to earth guy and practiced what he preached. Shelly travelled with Dr. Steven doing seminars all across the country. Many of you have told us you’ve enjoyed his “bread and butter” approach.

We, along with many others, will miss Joe and send our condolences to his team, family and friends.

Digital Communications: What Is It? What Good Is It?




Use of this technology in dental offices has almost doubled in the last three years. 38% of area dentists now have it.

  1. If you haven’t got it, you’re probably looking into it and it is worthwhile to look into.
  2. If you have it, chances are you’re not using it to its full capabilities. That’s worth looking into.

Contrary to what the sales representative will tell you, Digital Communication is not an all-purpose cure to cancellations and failures. It can help keep a practice busier but we cannot prove yet that it reduces no-shows. We do know, however, that it frees up front desk time and we also know that clients have benefitted from its many applications:

  1. Patients really like text and email confirmations—it’s part of showing people you
    are keeping up with technology.
  2. This gives your front desk team more time to make appointments because they spend less time confirming them.
  3. It gives you the capability of getting surveys from patients, which is good feedback but, as importantly, can help you get more testimonials for your website online reviews. We know that testimonials are important conversion factors for converting website visitors into patients. Think of your own behavior when you shop for hotels and how you look at reviews.
  4. Promote services such as Invisalign: Example: a client of ours from Rochester used an email and text announcement to promote their “Invisalign Day”. They feel that this was responsible for 15 patient Invisalign starts.
  5. Fill last minute openings: Examples: A client in Wisconsin emails patients (RevenueWell) when they have last-minute openings in the hygiene schedule. They offer whitening (bite-down trays from Patterson) to the first person to respond and fill the appointment. “Last minute openings. Come out and get that checkup you’ve been putting off and you’ll get free professional-strength whitening…” Another client in Houston, TX uses digital email and texting (Demand Force) to announce last minute openings in their hygiene schedule. Their incentive is free movie tickets. They said some patients actually wait to schedule when they know they can get free movie tickets. Not all bad because it means that there are a lot of patients eagerly standing by to fill last-minute openings. You should not overdo it, but if you even do this once or twice a month to fill 2-8 hygiene slots as a result, it is a pretty good payoff.

There are many applications for digital communications and they’re growing! My associate, Kelly Larson stays on top of the constant changes and keeps a summary grid of the various digital communication companies to help you compare their offerings. Generally, they charge about $300/mo. Most arrangements are month-to-month (companies are no longer asking for one or two year contracts).

Dealing With Patient Complaints: An Opportunity In Disguise

(Dentists, Please Share This With Your Teams)

dealing with patient complaints

We’ve written before about how getting positive online reviews can enhance web presence and is a strong “conversion factor” that turns website visitors into patients. With patients being able to complain online as well, we have a double-edged sword. A negative complaint can be seen by who knows how many people! Dealing with negative online reviews is a whole discussion in itself.

This article focuses on dealing with face-to-face patient complaints. However, if you get a negative online review, you can sometimes call that patient and use this same process. We’ve seen situations where the patient has taken the negative review down once their complaint was satisfied.

Naturally, if complaints are handled wrong, you can lose patients. More importantly, patients that complain are also more likely to be loyal patients and refer others if the complaint is handled well. If someone is dissatisfied they will probably tell others. I have heard over the years many different statistics on this, but you can assume for every complaint you hear there are other people who hear or voice the same complaint. Complaints are sort of your “canary in a coal mine” for patient relations.

Our statistics show that the typical dental practice loses about 12% of its patients per year. Probably about half of those lost are due to something the Doctor or staff did. The other half are due to factors beyond the practice’s control, like the patient moving or insurance changes.

Remember this six step process:
1) Prepare
2) Listen
3) Build Rapport
4) Develop A Solution
5) Confirm & Close
6) Follow Through

1) Prepare

Maintain an alert and upright posture. Pen in hand. Be ready to listen with an Adult state of mind.

  • Child (emotional)
  • Parent (judgmental and rigid)
  • Adult (rational and solution-seeking)

When a complainer calls, they are in an emotional (child) state. They may have rehearsed a speech in their mind. They feel abused, cheated, or uncared for. Therefore, the person hearing the “child” may unconsciously start adopting a parent state. That’s when you’ll hear things like “Our policy is…”; “You should have…”; “You don’t know what you’re talking about…”; “It’s your responsibility to know your insurance, etc.” By keeping an adult state of mind, you let the child vent then, eventually, through your own behavior, they will start to come to the adult state.

2) Listen

Take notes. Acknowledge that you are hearing; “Tell me more.”; “Then what happened?”; “I see.”; “I understand that could be very distressing.”

3) Rapport

Use the patient’s name. State your purpose, “I want to find a solution you are happy with.”; or “I’ll help you get to the bottom of this.”; or “We certainly want to do everything we can to make this right for you.” Restate the person’s complaint. “I’ve taken notes and what I heard you tell me was… Do I have that right?”

4) Solution

“Here are a couple of things we may want to consider.”; “Would it help if I found out about _____ for you?” And, of course, “What would you like to have done so we can resolve this?”

5) Confirm & Close

“So here’s what I am going to do.” (find out, fix, or make sure “it doesn’t happen again”). “How does that sound to you?” Make sure that you note any specific actions and timeline and who’s going to do what by when.

6) Follow Through!

Make very sure you follow up on your promises. Example: “Your fees are too high!” A typical response (usually proposed by consultants and dental journal writers) is, “Mrs. Jones, we only use the finest materials and for the quality of care we deliver, blah blah blah.” Or, “Dentistry is inexpensive when you compare it to medical or buying suits or some other things (that are implied to be less important, thus indirectly putting the
patient down.)

Instead: “Gosh, I can tell you are unhappy with this. Can you tell me more?”
“Well, Bill, it’s my job to help ensure that you are happy with our services. You obviously
feel our fees are high and I’d like your suggestions on how we can go about looking at this.”

The patient might feel the fees are high because they can’t afford things in which case, of course, you work with financial arrangements. They might feel they are higher compared to other offices in which case you might say, “Would you like us to check our
fees against other offices or show you what information we have about that?” Or, in many cases, the patient just may want to be acknowledged and they don’t really want you to do anything except understand them. If the fees are indeed high even compared to other offices, then you can explain why. “Our fees are a little higher than average and I wanted to explain to you why they are if that’s what you’d like me to do.” Then (and only then) you could go into things about the quality of the lab, the time the Doctor spends, the Continuing Ed or technology, and so on.

In Conclusion:

No one likes to hear complaints, but dealing with them tactfully is a critical “customer service” skill.