Collecting the revenue you have produced

By Gordon J. Christensen, DDS, MSD, PhD

In this monthly feature, Dr. Gordon Christensen addresses the most frequently asked questions from Dental Economics readers. If you would like to submit a question to Dr. Christensen, please send an email to [email protected].

Q I graduated from dental school only two years ago, and I'm in general practice in a moderate-sized city. I enjoy dentistry, but I'm sure I'm not alone when I admit the money side of dentistry really bothers me. I don't enjoy talking to patients about it. I don't like money disputes, and unfortunately, my practice is building a significant accounts receivable balance. What can I do to make this disagreeable and uncomfortable part of my practice better?

A Your comments are very similar to my own feelings many years ago when I started my dental practice, and you are certainly not alone with your concerns. Unfortunately, most dental schools do not provide significant information on practice management, and most new graduates feel lost relative to your question.

I have some suggestions for you and for any other practitioner, whether young or mature, who is struggling with the money side of dentistry. I will provide my own experiences as suggestions to you relative to developing a practice management orientation that satisfies you and your staff. Good practice management does not just happen spontaneously.

Most dentists enjoy clinical dentistry but tend to dislike the financial aspects of practice. However, that attitude can be overcome.

Attend a practice management course

A great start is to take a course on dental practice management. There are numerous well-respected consultants providing courses in practice management. Among them are:

Banta Consulting
Jameson Management
Levin Group
Miles Global
Paragon Management
Pride Institute
McKenzie Management

After attending a practice management course, you may want to have a management firm come into your practice and provide guidance for improving your management policies.

Your business team

You must educate yourself concerning what concept of practice management you prefer, and then develop a business staff that fits that model. It is imperative to find excellent front office staff. The lead person in charge of your office finances, insurance interaction, statements, and collections should have the following characteristics – pleasant personality, proactivity, creativity, tact, honesty, organization, persuasiveness, persistence, experience, knowledge of business procedures, and dental coding knowledge and experience.

I know finding such a person is difficult, but not finding such a person is asking for financial trouble. An experienced lead person with the preceding personal characteristics will make your clinical life much easier and more enjoyable. That person will free you from most of the money hassles involved with practice.

Competent front desk business personnel are the major key to financial success in dental practice. Every effort should be exerted to find the right front office staff.

Establishing your office financial policies

Every community is different. I practiced in several locations during my career as I moved around the country helping set up dental schools. One of my practice locations was in a professional area, and we had very little trouble collecting the money that was owed. On the other hand, another location in which I practiced was in a newly built residential area that had many young couples with significant debt and many children. That community required greater effort to collect the revenue owed to the practice.

Don't contract with low-level benefit plans! Be selective!

Decide on which third-party payment plans you will accept, and learn as much about them as possible, along with your lead front desk person and his or her assistants and the clinical staff. You are not a bank. Decide on how most appropriately to collect the revenue due to your practice. Some tips follow.

Determining the best financial policies for your practice requires time, effort, and experimentation to find out what policies will work best for the community in which you practice.

Factors related to collecting the money owed to your practice
Computer knowledge

Obtain as much education as possible about your computers and their software programs. The companies from which you obtained the hardware and software provide initial and continuing education about their devices and programs. Additionally, updates come constantly. Stay on top of these changes. As each update is available, have a staff in-service education meeting to ensure that each team member knows the changes and how to implement them. Make sure that you understand how to interpret the reports, and that you find help to change them if they are not meeting your expectations.

Knowing as much as possible about your computer hardware and software is essential for financial success. Your software can actually significantly relieve you of financial stress if properly programmed.

Treatment plans and informed consent

Many dentists do not provide complete treatment plans. They often look only at those oral conditions that are bothering the patient. I suggest that you provide alternative complete treatment plans at various financial levels. An example could be fixed vs. removable, vs. implant-supported prosthodontics. Educated staff persons can provide complete information about potential treatment plans, and take care of informed consent before you finalize the treatment plans with patients.

Informed consent should include:

Alternatives for care for each of the patient's conditions
Advantages of each
Disadvantages of each
Risks of each
Costs of each
What happens if nothing is done

My experience providing complete treatment plans and various levels at which patients can initiate treatment has been extremely successful. Although patients may not accept the entire treatment plan, they almost always accept a part of the plan, and as soon as they get to know you and accept you, they will want to stay in the practice.

Complete treatment plans and informed consent fully explained to the patient including all aspects of the financial agreements are essential for excellent patient relations and collection of revenue.

Insurance claims

Your front office staff must know how to administer insurance claims, including the payments they provide for services, the deadlines imposed by the respective companies, how to best contact them with questions, and importantly, how to remain cool and tactful when dealing with them.

Communication

Thoroughly communicating your treatment plan to patients – the fees involved, the expected third-party payments, and the expected necessary appointments – is a mandatory communication skill. I also suggest communicating with patients during treatment and at the end of treatment. Tactfully showing them what is happening during treatment makes them much more appreciative of the effort expended. If no education is offered during treatment, patients cannot appreciate what they don't know or understand. Written instruction sheets about the treatment provided at the end of specific procedures help patients value their treatment.

Communication with insurance companies is also mandatory. Your staff should know every aspect of the plans you accept to avoid any misunderstandings. Meet with your team on a regular basis. Look over reports together. Determine what could be better in the financial aspects of your practice, and implement those changes.

Regularly scheduled team meetings to discuss financial matters, computer changes, software changes, and financial challenges ensures that all team members are informed about the financial policies and needs of the practice.

Summary

The financial aspects of practice are unpleasant to most dentists. Easing the financial frustrations of dental practice can be affected by hiring qualified front desk staff, establishing the best financial policies for your practice, joining only the best third-party benefit plans, developing and presenting complete treatment plans, and communicating constantly with staff, patients, benefit plans, and dental software companies.

Obviously, accomplishing high-quality dentistry that serves for a long time is mandatory, and patients recognize your abilities more than you may realize.

Gordon Christensen, DDS, MSD, PhD, is a practicing prosthodontist in Provo, Utah. He is the founder and director of Practical Clinical Courses, an international continuing-education organization initiated in 1981 for dental professionals. Dr. Christensen is a cofounder (with his wife, Dr. Rella Christensen) and CEO of CLINICIANS REPORT (formerly Clinical Research Associates).

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We have several educational products that can help you make the money part of your practice more efficient and effective, and make you happier with this part of practice.

A one-hour video by Lois Banta and Dr. Christensen will assist you in collecting money. It is V4766 Get the Money off the Books and into the Bank.
This one-hour video will help front office staff members know more about what you do. V4755 Understanding Dental Concepts, Equipment, Materials, and Techniques
Educate your patients with DP40 Simple Patient Education for Every Practice. These are 18 short patient-education videos on most areas of dentistry that also provide informed consent. They can be put on any server, iPad, etc.
The two-day PCC course taught by Dr. Christensen and his experienced staff provided in the beautiful Wasatch Mountains in Utah is entitled Balancing Your Life with a Successful Practice, and it will show you how to develop a truly supportive team and how to be successful clinically, financially, and with your family.