Published in Dental Economics 12/16/21 

Outsourcing benefits are numerous

Is it possible for your practice to function at peak performance when you’re short staffed? Dentists know firsthand the stress and frustration of working without some positions filled. The consequences of being short staffed can be costly. Overburdened team members are less productive and less efficient as job satisfaction, morale, and engagement decrease. When team members feel excessive stress and frustration, it’s impossible for them to provide a remarkable patient experience for every patient.

One option to relieve the situation is to hire an outsourcing company. There is a common misconception that outsourcing is expensive. That could not be further from the truth, especially when you consider the consequences of a team unable to complete essential tasks or provide patient experiences that reflect your practice philosophy.

I speak from firsthand knowledge about working with an outsourcing company. When you engage these services, not only is team stress relieved, but it creates the time needed for team members to serve patients calmly and thoroughly. With an outsourcing company, you’ll be assigned a dedicated team specialist to represent your practice. This person works with your team to accomplish tasks that they don’t have time for, such as filling the schedule, insurance verification, accounts receivable, hygiene recare and reactivation of patients, follow-up on unscheduled treatment, and appointment confirmations. The list is endless.

There is no guesswork involved about value because you will receive an accountability report showing detailed results. Remember—either the owner rectifies the situation, or the team member will. If you’d like a referral, email me at nancy@diydentalconsulting.com.

– Nancy Clark-Crossin

Don’t listen to everyone else

A good way to describe outsourcing is, “I’ll pay you to do this part of my stuff so I can make more money doing this part of my stuff.” So, why doesn’t everybody outsource? A friend once told me how he finally decided to outsource. He is self-employed and as his business grew, he still found himself doing things like mowing the lawn. The decision to outsource was easy for him, but admittedly change can make us feel uneasy.

If you’re thinking about outsourcing, it’s important to be honest. If you’re holding on, find out why. For 20 years, I took pride in the work I did in the dental office. In fact, I had so much pride that I didn’t want anyone else to take over my job and mess it up! Yes, the work needs to be done, but the question becomes—is pouring hours of work into that specific task the best use of your employees’ time and skills, and is it really what’s best for the practice?

During the past 15 years, I’ve encountered many objections to outsourcing. A few of the most frequent comments include: “We just aren’t busy enough to outsource.” “I’m about to retire so I don’t need to spend the money.” “I’m just starting my practice and don’t need more bills right now.” “We can do it ourselves and we’ll do it for ‘free.’” “My team members pushed back on the idea.” And, “I know what’s best for my practice, but my team member has nothing good to say about outsourcing.”

You need to take many things into consideration. Do you want to be busier? Will outsourcing help you accomplish your goals? The busier you get, the harder it is to make time for research and decision making. Retiring dentists should position themselves for a healthy and prosperous sale.

Many teams are shocked when they realize how much time they dedicate to insurance verification. This is something that can be easily outsourced to save the team time and stress. Many decisions are based on feelings rather than facts. When deciding to outsource, I recommend having a dependable process in place to properly measure your return on investment. Outsourcing can serve your office in many ways.

– Jodie Pearson

Control accounts receivable

My business motto is to provide excellent patient care and customer service along with quality dentistry. Ensuring that patients have an amazing experience is key to a successful practice. But we all know there are many behind-the-scenes duties that need attention to have a successful business. These tasks are often put on the back burner because we’re focused on patients, on the phone, or on the schedule. These are all crucial to stay in business, but if they’re consuming all the team’s time it might be worth considering outsourcing.

Outsourcing is becoming more popular not only because we’re busy with patients, but because of the hard reality of our industry’s growing dilemma, which is a shortage of qualified employees. While there are many tasks that practices can outsource, the one I want to discuss is accounts receivables (AR), which is the first thing I often see get pushed to the wayside.

If you don’t have a designated employee who works solely on insurance billing and tracking outstanding claims, then most likely you have a high AR. I recommend looking at your AR over 90 days. If it’s high, there are benefits to outsourcing. It will get your AR under control, put money in the bank, and free up your employees to focus on patient care and customer service.

There are several companies that offer this service. If your AR is neglected, I encourage you to consider finding a company that is the right fit for you and your practice.

– Candice Martin

Consider a membership plan

Outsourcing is an incredible way to expand the talent pool in every industry, and the dental industry is no exception. Clinical care must be provided in the office, and customer service must also be delivered in person. What other aspects of administration can we resource outside of the practice?

Have you considered adding a membership plan? Think about patients who do not have dental benefits, who are overpaying for their benefits, and who are disappointed in their coverage. Look at the write-offs that you take every month compared to your standard fees. Integrating a membership plan can be beneficial to patients and your business. This is not insurance and may not be referred to as insurance.

The patient will receive a courtesy on all procedures included in the plan—prevention, restorative, cosmetic, and elective. It is a marvelous way for provider and patient to choose optimum dental health care rather than an insurance company deciding what fits into their “plan.”

There are several companies who initiate and orchestrate membership plans, or you may choose to do it yourself. For many offices, it’s time to give patients the quality of care that they deserve rather than what the dental benefit plan allows.

– Theresa Narantic

Published in Dentistry IQ 10/20/21 

Caramel is not butterscotch

What are your employees are saying to your patients? My latest negative experience seems innocuous, but it’s not. It shows the blatant indifference toward customers that is pervasive in many industries. Whenever I experience poor customer service my first thought is, if only the bosses knew how their employees represent them, they would cringe!

I was ordering my guilty pleasure at an ice cream shop. This was on a Wednesday when there’s a special, buy one sundae and get one free. As a kid, my sister and I enjoyed butterscotch sundaes on Wednesdays. Reminiscing about this, I asked the employee, “Do you still have butterscotch sundaes?” He didn’t look up; he just pointed to the container marked caramel. I said, “Caramel is not butterscotch.” He said, “It’s the same thing,” and walked away.

We all want to provide memorable five-star experiences. Perhaps if we change the term “customer service” and use “human exchanges” we could ensure improved experiences. Human exchanges that make a difference can be memorable. Sometimes words are not necessary; simply a smile or an act of kindness is enough.

Are your team members allowed to say anything they want to your patients, vendors, and the public? More importantly, how do they interact with each other? With respect and kindness? That’s the true test because how you all interact with each other is how you interact with patients and the public. Start listening to how your team speaks to each other, especially those in authority, and more importantly, become aware of how you talk to your team.

If public representation is essential to you, and I hope it is, then you will carve out the time to lead and guide your team. Create the time to decide what are acceptable and not acceptable human exchanges. How people feel about you and your team before, during, and after their appointments is paramount.

– Nancy Clark Crossin

Verbiage is everything!

I was at a dental practice doing an evaluation when I observed the front office employee answering the phone. Let’s call her Sally. Meeting Sally for the first time, my impression was that she was a sweet, happy-go-lucky person. Here is one of several conversations that I observed:

Sally: Good morning! Thank you for calling Smiles Dental. How can I help you?

Patient: Hi. This is Joe Smith and I have to cancel my appointment for today. I know I’ve rescheduled a few times, but to be honest, the tooth isn’t hurting me and I’ve decided to go to the beach.

Sally: Hi Joe. Oh, no problem. I know it’s a gorgeous day! Heck, I’m jealous I’m not there right now. You have fun and call us back when you can and we’ll get that crown rescheduled.

Cut to the doctor sitting in his office with nothing to do and watching his bank account balance dwindling. Using the verbiage “no problem” when your patient is cancelling is a problem. There are proper responses, as well as practice policies that need to be created and implemented.

It’s vital to know how your team is representing you and your practice. In this situation, Sally has a casual attitude, which gives the impression that the doctor is totally fine with cancellations and that completing treatment is not important. So, make sure what your team is saying represents you correctly because after all, verbiage is everything.

– Candice Martin

What is your team saying?

Team communication with patients can be one of the greatest pain points for a struggling office. Dentists often assume that every team member will reinforce the same message despite the fact they’ve done nothing to clarify what that message should be.

Team members have different interactions with patients than the dentist does. These can produce wildly different and confusing interactions for patients.

I recall coaching an office on a chilly day in November when this point was made apparent. I was able to observe how a team member responded when a patient asked if it was necessary to continue with her scheduled, biweekly hygiene appointments. The patient was a young, single mother who, due to financial hardship, had neglected her oral health for years.

After struggling for years, her luck had finally changed, and she landed a decent job—one complete with dental benefits! (I work in Canada, and the US insurance system is quite different.)

This young mother had been excited to have her first dental appointment in years in October, and she seemed OK with the recommendation that she needed four separate hygiene appointments scheduled two weeks apart to address the extent of her plaque buildup.

Her first appointment in early November proceeded without incident. I was there the day she came in for her second appointment. Since her previous visit, she’d learned that her dental benefits would not provide coverage for that many hygiene appointments and she would have to pay out-of-pocket.

With her new job, she had promised her kids a special Christmas. Paying for dental treatment in late November would leave her no money for Christmas presents. So, she asked if the remaining appointments could be put off until the new year. The admin team member was also a young single mother who had seen lean years at Christmas and could empathize with this patient. Thinking she was providing responsive customer service she told the patient it would be OK to reschedule her appointments.

Later that afternoon, the patient called and said she was moving her dental care elsewhere. The inconsistent communication had led her to believe the dentist was interested only in making money and had prescribed a treatment plan that was otherwise unnecessary. Inconsistent communication had broken the trust she had in her dentist.

The dentist was quite angry about the situation and the admin team member felt terrible. But the reality was the team member’s heart was in the right place. She had no intention of undermining the dentist’s diagnosis. I told the dentist that the problem was his team had not been trained in how to best reinforce his diagnoses. New team members were not properly on-boarded to understand the impact of their interactions with patients. Training and role playing were not parts of this practice’s system.

If you want your team to deliver a consistent message, you must train them to do so. Only then can you feel confident that your team is saying what you want them to say.

– Shawn Peers

It’s just a word, right?

How can we expect patients to value our services if we don’t? Whether speaking to a patient on the phone or in person, you should never ask if they “just need a cleaning,” or “just need a filling.” I once heard an assistant describe a Velscope screening as “just a light the doctor uses to see cancer.” Wow! There are several things that concern me about that wording. Teams need training to make sure their words are correct, and the message is consistent, regardless of who says it.

Using the word “just” undermines the importance of a patient’s dental health and urgent need for treatment. If we want patients to value our services, we must not minimize the perception of the doctor’s expertise or the procedure time involved. Stressing the importance of the procedure will help reduce no-shows or last-minute cancellations and increase case acceptance.

– Theresa Sheppard, RDA

Published in Dentistry IQ 8/17/21 

Embrace the future—because it’s now

The dental industry was catapulted at least five years into the future because of the changes implemented during COVID-19. Besides enhanced infection control that consumed most of our time at the beginning of the pandemic, many automated and contactless systems were integrated and are here to stay. These include:

Secure patient portals, where patients have easy access to everything from appointments, balances, prescriptions, insurance information, and the ability to contact the dentist directly
Online scheduling 24/7
Online intake forms
Contactless check-in/check-out processes
Teledentistry
Websites that offer patient information via a robust Q&A page
24/7 live chat option

These improved systems optimize convenience and efficiency, creating a time-effective experience that the 2021 consumer expects. But don’t assume that everyone prefers digital and contactless interactions. Statistics show that many baby boomers prefer human contact. This balancing act can offer speed and convenience without compromising patient relationships and patient care. Yes, consumers want things to be expedited, but not when it comes to one-on-one time with their health-care professionals. Patients want to know you hear them and understand their concerns. Only then will they put their trust and faith in you.

– Nancy Clark Crossin

Incorporate teledentistry

Tele-what?

We live in a social world. We are in constant communication by phone, email, text, FaceTime, and Zoom. Then why are we all not using teledentistry to connect with our patients? If 2020 taught us anything, it was that our practices, as well as our way of life, can change in a minute. We had to adapt, adapt, adapt! Businesses that were thinking outside the box and were not afraid to be bold were able to successfully move forward.

We have all had these patients in our practices: Mrs. Parker now lives in assisted living and it’s too difficult for her to get to your office. What do you do? Do you just let patients like Mrs. Parker go untreated until their perio complicates their medical condition, or worse, they have a serious medical emergency? Could you put some type of care mechanism in place for them?

Teledentistry: One dentist’s user guide

I suspect that many patients, especially the elderly or otherwise compromised, are a bit reluctant to go back to the pre-COVID way of life. Are you ready for the opportunities you can offer them, including teledentistry? Convenience is now a significant factor when making life decisions, not just for seniors, but for anyone with a busy schedule.

Teledentistry doesn’t change who you are, what you are, or what you do. Executed properly, teledentistry does not change the standard of care or the scope of your license. The only difference is the method used to treat your patients, as well as the number of patients you can reach. It allows you to deliver care without compromise. You are able to reach a variety of patients in many situations.

If you would like to learn whether teledentistry could optimize your patient care, feel free to reach out to me at theresa@theresasheppard.com.

– Theresa Parker Sheppard

Convenience reigns

The number one reason patients choose an oral health-care provider is whether the practice “takes their insurance.” Statistically, 70% of prospective patients use this as their primary decision factor. The next major factor is convenience, which is key in most of our decisions as consumers. Why are Amazon, Airbnb, and flying rather than driving so popular? The answer is simple: speed and convenience.

In an era where time is money, we need to apply other industry mindsets to our patient care when it’s appropriate. When we can effectively and efficiently add different disciplines under the same roof, both patients and the business win. Run some of these options through your plans and see what makes sense for your business model: orthodontics plus pediatrics; endodontics plus periodontics; oral surgery plus periodontics plus endodontics; or finally, general dentistry plus periodontics plus oral surgery.

The motivator here should not be to make more money. The outcome, however will be more revenue. Here are two things to consider:

1. More revenue does not necessarily mean more profit. There is a distinct difference.

2. Have you done the due diligence to know if you can sustain the additional disciplines in your business? Are you monitoring the number of patients you’re referring for procedures you don’t presently offer in your practice?

When you can offer more, deliver better-than-expected results, and bring convenience to your patients and prospective patients, it’s time to put the wheel in motion!

– Theresa Narantic

One-stop appointments

Quadrant dentistry is a convenient, cost-effective way to schedule patients with restorative needs. People with busy schedules appreciate being able to get their treatment done in large portions, in fewer appointments. Not only is this considerate of their time, but it’s a great way to generate more revenue. Quadrant dentistry will improve your net profit by increasing production while decreasing overhead. It will also make your schedule run more smoothly due to less patient flow and more productive days.

A good experience starts with the first phone call. Ask a lot of questions. Find out about their last dental appointment, and if they haven’t seen a dentist in the last six months, schedule a comprehensive exam and cleaning on the same day. This can all happen in the same operatory, so you have less room turnover. If a single filling is diagnosed, and if there’s time, take care of the treatment while the patient is in the chair. They will love not having to return to your office right away. If sealants are recommended for a child, let the parent know that you’d be happy to take care of that for them during the same appointment. These situations are a win/win for everyone.

Flexibility is key when you invite patients and their families to your office. One of the reasons people don’t schedule or go to another practice is because they can’t get their children in when it’s convenient. Group family scheduling for recall is a great service for your patients as well as an effective marketing tool. Advertising this on your website and allowing patients to schedule their own appointments provides convenience for busy parents.

– Sherri Dinkins and Teri Osborn

Meet busy people where they are

People are busy, and time is precious. Life has gotten so fast paced and demanding, so much so that companies have made consumer convenience their number one priority. Enter Netflix in 1997, which made the trip to Blockbuster obsolete. Then at the beginning of the 21st century, companies realized that consumers wanted not only convenience, but also instant gratification.

So, in 2007, Netflix started offering streaming services, so people no longer had to wait for the red envelope containing the DVD to arrive in the mail. In 2003, Amazon started Amazon Prime, where customers could get their purchases in just two days. Online ordering and delivery are available for practically anything today.

And did I mention that people are busy? The other day I forgot to make an appointment at the dealership to have my car serviced. Fortunately, they have a link on their website and with just a few clicks, I was able to schedule my appointment. There was no need to take time out of my day and call, only to be placed on hold or transferred.

I’ve been in the dental field for more than three decades, and our industry has gotten more and more competitive. It seems like there’s a dental office on every corner. So, how can you set yourself apart from Dr. Smith down the street? While the obvious answers are to provide quality dentistry and superior patient care, it’s a great idea to add consumer convenience.

There are so many ways to make the entire dental visit and experience a seamless and efficient process for your patients. These include two-way texting for appointment reminders, online scheduling, text or email links to pay bills, text or email forms in advance of appointments, text or email post-op instructions, text or email treatment plans with educational videos about procedure(s), and teledentistry. In this fast-paced and demanding world, patients will be grateful that you offer these options.

– Candice Martin

Technology for scheduling and check-in

One of the greatest lessons I learned from COVID-19 is that there’s a need for technology to reduce unnecessary human contact from our lives even as we desperately crave human contact. It’s a strange inconsistency. However, the truth is that both are attainable if we’re willing to consider the options. The challenge is getting the dental community to be open to the options.

Two areas where increased use of technology can balance this inconsistency is the use of online scheduling and automated check-in procedures. Some dentists love the idea of online scheduling while others, not so much. They believe these platforms hand over control of their schedules to their patients. They wonder what their day will look like when that happens.

While I understand the concern, it’s time to get on board. People schedule everything online today. They book vacations, shop, order meals, and schedule business meetings. They simply expect to be able to do moreonline, particularly new patients who come across your website at midnight and want to book that appointment now.

While there is still a place for scheduling patients in person before they leave your office, if you add online scheduling, know that you will not be handing control over to your patients. You will, however, be handing them convenience. The easier you make it, the more likely they’ll be to book an appointment.

Also, many offices are short staffed right now. Imagine a patient trying to check in for their appointment, only to be left waiting while the front office staff runs ragged, doing everything but acknowledging the patient in front of them. This is not an impressive start for human connection.

Now, imagine if that process were automated. Technology allows for digitized medical forms to be filled out in advance. Similar technology can be used to advise the office the patient has arrived and is ready to be seen. This is better than leaving someone waiting or be gruffly acknowledged by an overworked team member.

Now the challenge is to maintain that momentum by using technology to increase efficiency, reduce needless wait times, and adapt your practice to maximize convenience for your patients, while still maintaining that important human touch.

– Shawn Peers

Published in Dentistry IQ 6/23/21 

Take time to get to know patients

For some, the word “new” means exciting and filled with possibilities. For others, it implies that dreaded change is coming, and things will have to be done differently. Regardless of how anyone perceived new, our office implemented a mandatory new new-patient experience due to COVID-19.

To alleviate patient fears, we ramped up communication and focused on building trust. We implemented additional safety protocols, a contactless patient experience, and teledentistry, to name a few. Now that we have momentum, more changes will be much easier to integrate.

Upgrading your intake form and your “getting to know you” questionnaire will create an experience that immediately connects you to patients and allows you and the team to be more understanding and effective.

Your first meeting with a new patient is more beneficial if you know a few things before walking into the operatory with them.

• Does the patient know their dental needs?
• Has the patient had a traumatic or unpleasant dental experience?
• Does anything bother the patient about their smile?
• How healthy does the patient consider him or herself? Does that match their medical history?
• How does the patient prefer to receive your findings?
• How does the patient learn best, and what is their current dental knowledge?
• Is keeping their teeth for a lifetime a priority for them?

This list should be customized by the dental team. Asking specific questions on the intake form yields significant results, and helps you connect with patients on a deeper level. Now is a perfect time to create a more meaningful and beneficial patient experience.

– Nancy Clark Crossin

Help alleviate fears with office personality

The constant challenge of champions is whether to get by or get better. Have you reevaluated your new new-patient experience? You already know that many people are not anxious to visit the dental office. Those of us in the dental profession have done everything we can to ensure a safe environment. There are new protocols such as preappointment questions, invasive temperature scans, and questions upon entry. Patients are greeted by people clad in full-body personal protective equipment. The reception rooms are devoid of amenities. Plastic barriers separate visitors from employees.

What are dentists doing to counter the increase in anxiety and the absence of a warm, caring environment?

Here are five tips to regain relationship building.

1. Your administrative team’s phone skills are more important than ever. Remember that tone and how they ask questions are crucial to conveying concern.
2. To help patients, laminate nametags with photos of each team member to wear on the outside of their PPE
3. Let patients know the numerous steps you’re taking for their safety via your website, or a letter displayed in your office.
4. Display photographs and short biographies of the team in the reception room so patients can learn more about the people behind the masks and face shields.
5. Remember that humor and kindness when guiding patients through the new no-touch technologies of checking out and rescheduling are always appreciated.

– Jeanette Kern, DDS

Nice gestures make a difference

After all the uncertainty of the last year, those in health care want to help patients get past the hurdles of fear, complacency, and procrastination. For decades we’ve been hearing about the significance of incredible customer service in the dental industry. People will buy what they want and be loyal to service providers who make them feel valued. It has been a struggle during the pandemic, but we’re now seeing a patient resurgence.

Some offices that I work with now have a team member or the doctor call patients to do a wellness check. These calls are to simply let patients know that the team cares, and to offer their assistance where they can. Patients appreciate these calls.

The short-term effect is that patients felt cared for, appreciated, and valued. The long-term effect is that the team instilled value and trust. As a consumer, where will you place your dedication? Would you spend your time, energy, and money with people you trust? Would you spend more money than you might usually spend because you see something as high value? Would you tell all your friends, neighbors, relatives, and coworkers about the experience?

Experience and value are key to the new new-patient experience. Have some candid conversations with your team today to explore how you can be a step ahead of this experience for your patients.

– Theresa Narantic

Go above and beyond to stand out

Many dental practices have a process they follow for intake, diagnostics, evaluation, and case presentation for new patients. In March of 2020, not only did existing procedures and protocols vanish, so did existing patients. As health-care providers, we know how to think on our feet. So, when offices reopened, we had to develop a new new-patient experience.

During the past year, we’ve been bombarded with information from experts. Our patients also have more knowledge about disease transmission, PPE, and social distancing. This awareness can be a double-edged sword. On one hand, patients expect to check in from the parking lot, see masks on everyone in the receptionist area, have their temperatures taken, and fill out questionnaires. Rather than waiting in a welcoming reception area, team members covered in PPE immediately escort patients to the clinical area.

While this may give patients a strong sense of security, we’ve lost much of the personalization that can be cultivated at the first visit. To develop a lasting relationship, you need to go above and beyond to set yourself apart as a quality practice. Since patients cannot see your smiles, they must hear and feel them. You must look patients in the eye and speak with them, not to them. The team must be able to address patient concerns in an understanding manner. Now more than ever, you must learn to hear what patients are telling you.

By exceeding patient expectations, you will build a base of desirable patients, have fewer missed appointments, better case acceptance, and a thriving practice.

– Theresa Sheppard

Display reassurance and confidence

Did you take the new normal as an opportunity to create an even better experience for patients? Our office did, and we feel our optimistic attitude carried us through 2020 and into 2021. Let’s take the new-patient experience. Why are some people looking for a new dentist right now? It may be because of what their old office did not do. Maybe they were never contacted to reschedule their appointment during the shutdown. Maybe they didn’t feel safe returning to the office due to inadequate COVID-19 protocols.

Some of the things that we’ve found to be successful start with the new-patient phone call. Patients want direction and reassurance that they will be well taken care of. Remind them that you’ve always been a master of sterilization. Be confident so that your patients will follow your lead. Let them know the extra precautions that your office is taking, such as COVID-19 wellness forms that they fill out prior to their appointments, temperature checks, preprocedural rinse, and the use of hospital-grade foggers.

Know who is in your schedule so you can easily recognize new patients. Smile with your eyes and introduce yourself to make them feel welcome. Have your auxiliary go out into the reception area and welcome patients back instead of announcing their name at the door. Be sure your back is not to them so they can understand you through your mask. Last, remember to thank your patients for trusting you with their care. This could be your opportunity to turn a new patient into a lasting relationship.

– Sherri Dinkins and Teresa Osborn

Clarity leads to good experiences

Prior to COVID-19, we could gain new patients by being pleasant, professional, knowledgeable, and accommodating. While that’s all still essential, since the pandemic, we’ve had to add one more important element. The new new-patient experience now requires that we reassure patients about our safety protocols. We’ve established trust with existing patients. I recommend the following to gain the trust of new patients.

1. Add your COVID-19 protocols to your website. This shows that you’re serious about preventing the spread of the virus even before they call or request an appointment.
2. Explain that the office is following all CDC guidelines during the initial phone call.
3. Communicate what you require from patients and what they can expect when they walk into your office.

The results of explaining what to expect at their first appointment puts people at ease and builds the trust and reassurance that they need for a great new-patient experience.

– Candice Martin

Published in Dentistry IQ 4/14/21 

By Jeanette Kern, DDS

Risk management has many meanings in a dentist’s world and evokes several levels of emotion. It can mean your differential diagnosis of a patient’s condition and choice of treatment modalities, your human resource liability, your cybersecurity, your tax responsibilities, your legal situations, your insurance billing, and more.

These are only a few of the areas that dentists must be aware of. Throughout my career I’ve been motivated to continue my education to expand my knowledge and clinical expertise, as well as to manage my risks.

I reduced these risks in business by surrounding myself with the best professionals and then implementing their advice. I recommend that you hire experts in their fields. A dental-specific CPA will guide you about trends for maximizing current tax and government guidelines. A health-care human resources specialist is crucial, especially in these COVID times, when it comes to protocols and updated policies.

Dental hiring experts are aware of our needs, such as finding knowledgeable candidates, and hiring practices and pitfalls. During lease negotiations and practice transitions, a dental-specific attorney will protect you and your assets. Hiring these pros will reduce your risks and allow you to focus on what you do best—dentistry and patient care.

By Nancy Clark Crossin

Stop. Caution. Railroad crossing. Flammable. For external use only. These are just some of the warnings designed to alert and protect people from potential danger. Warning signs in the dental business are often insidious. Regardless of whether the signs are apparent, the business leader/owner’s responsibility is to protect the business, team, and patients.

When was the last time you identified your vulnerability in the following areas—data leaks and security breaches, HIPAA, OSHA, malpractice, and human resources compliance? For a more comprehensive risk management list, your insurance company can provide you with a self-assessment. Would your practice pass a risk management evaluation? Self-assessment is a start.

The bottom line

Identify your vulnerability via a risk assessment.
Establish a plan and implement the steps to mitigate risk.
Make sure you have appropriate insurance coverage.
Reducing risk and protecting your practice is your responsibility.
You must be proactive to minimize risk. Do not jeopardize your reputation and everything you have worked for.

By Theresa Sheppard, RDA

When we think of a felony, we usually think of something sinister. Yet, dental practices commit felonies every day, they just don’t know it. Most felonies committed in dental practices involve fraud. This is why it is critical for the doctor and team to understand proper coding and billing. Ninety-nine percent of practices that get into trouble have no malicious or fraudulent intent. They get into trouble due to lack of training.

When I perform a risk assessment for a practice, I keep the following three concerns at the forefront.

Supervised neglect: This includes failure to diagnose and treat; allowing a patient or dental benefit plan to dictate treatment (such as performing a “bloody prophy” on a perio patient because the person refuses scaling and root planing); or delaying needed treatment.

Do we allow patients to refuse x-rays for an extended period of time, yet perform procedures? Can we perform a procedure that we know does not address the diagnosis or clinical need of the patient just because the patient signs a refusal? No! We cannot force a patient to follow our diagnosed treatment plan. But to do something less than that can be supervised neglect and well below the standard of care.

The standard of care: There is no actual regulation for “standard of care,” rather, there is a definition and expectation that a reasonable provider with comparable education would make the same decision. We know that oral pathogens contribute to many serious health conditions. Allowing patients to refuse perio treatments, especially those with comorbidities, not only puts the practice at risk, but can seriously jeopardize patients’ health.

Just as undertreating is beneath the standard of care, excessive treatment, such as taking x-rays because a patient is “due” rather than basing the x-rays on clinical need, can also raise a red flag. X-rays must be prescribed by the doctor per individual need.

Documentation: Documentation is what determines if you are defensible. This is where I consistently see the biggest risk. Some examples are seeing a patient for perio maintenance and billing for a prophy because “it’s covered by their insurance;” making a stayplate and billing as an acrylic partial, placing a base during a crown prep and billing for a crown buildup; and diagnosing treatment but not supporting documentation about x-rays, perio charting, or how you arrived at that diagnosis.

Not only is accurate documentation critical to correct coding, but it can reveal hundreds or thousands of dollars lost—legitimate revenue lost because something was left out. I can sum up documentation in two words: prove it. If something is not in your patient records, that means you didn’t see it, you didn’t say it, you didn’t do it, it didn’t need to be done, and it doesn’t exist!

Do not become too comfortable or assume that you know all the current codes and regulations. A practice risk assessment and team training in the area of risk management is essential to keep you and your practice protected and profitable.

By Theresa Narantic

Because dentists are in the customer service business, they often “do what they can” to make patients happy. Occasionally a patient will request that the date of service for their care be altered so that the insurance benefit will cover the procedure. Patients ask if the office can change the code of a procedure so that the coverage will exceed what the actual coding will allow for.

In order to make patients happy and let them feel like your practice is going above and beyond for them, they may ask you to consider waiving their deductible or extending a courtesy for the amount due by the subscriber. As tempting as it is to give into patient requests, think of the consequence. Making any changes on an insurance claim or altering accuracy (intentionally or unintentionally) is illegal! There is no alteration. It is either correct or incorrect documentation. Losing a license is not worth taking the chance.

How do we guard against potential insurance fraud?

Know the laws. Understand your state statutes.
Educate your team. When they know better, they do better. Lack of knowledge is not an excuse.
Educate your patients. Their policies describe their benefits. Patients must understand their commitment and obligation to their oral health, and those who are educated make better health-care choices.
Establish a routine for checking the work of each team member, including insurance claims, electronic claim submittal, insurance adjustments and PPO write-offs, primary and secondary submittals, and charting.

Insurance is one of the beasts that dental professionals must slay. Learn the loops. Understand the process. Get ongoing training. Remember that you’re committing fraud, whether innocently or intentionally, and the consequences can be huge.