Thanks For Asking

2014-04 PST 1

Kathy Edwards, RDH, Margaret Boyce-Cooley and Dana Morano of the Practice Support Team

Q. What does a healthy hygiene Department look like?

A. A healthy general practice’s hygiene department should have 50-60 percent of their patient base receiving preventative care (1110), 30-40 percent in perio maintenance (4910), and 10-20 percent in active perio therapy (4341, 4342). In addition, 30-35 percent of production should be generated within the hygiene department. In a general practice, 90 percent of the doctor’s restorative schedule is a direct result of diagnosis made in the hygiene chair.

Typically, RDH staffing is determined based on the following formula: one hygiene day per week for every 250-300 patients. That range is determined by the strength of the periodontal program and the scheduling protocol for new patients. A strong perio program reduces the number of patients required per hygienist. Scheduling new patients in the hygiene column for initial assessment rather than the doctor’s column will also reduce the number of patients required for a day of hygiene per week.

Q. I know the back is running great, but I sometimes lose sight of the front and I’m beginning to think I’m overworking my front office staff. How do I know when it’s time to hire another person up front?

A. A single front office staff member will start to feel challenged when production reaches a steady $75-$80K per month. On average, when practices start producing in that range, a part-time person should be considered. The production range could be as low as $65-$70K/month if you have a high new patient flow (it takes more time to enter new patients into your system, transfer records, etc.) or you participate in five or more PPO plans. Many practices will consider adding a full-time person who can operate as a floater to be shared between the front office and sterilization/assisting.

There are several monthly reports you and your front office team member should review on a monthly basis. These include your month-end report; accounts receivable aging report; outstanding insurance claims report; and unsubmitted insurance report. The focus of the review is to enlighten the doctor’s knowledge of the front office progress and provide individual accountability to each staff member’s role in reaching practice goals.

1. Month-End Report – Evaluates how close you were to production and collection goals.

2. Is Accounts Receivable (AR) staying within ten percent of the total AR? AR over 90 days and outstanding insurance claims reports are worked together. It is important to know if there are system challenges that are creating outstanding or denied insurance claims versus uncollected patient balances. It is also important for the doctor to know which patients are not paying for services. This helps doctor and front office establish guidelines for emergency patients. It is not helpful to the patient to keep adding to their debt load when they are already behind with payments. Financial challenges should also be announced at the morning huddle. This reminds staff members to only provide treatment that has been pre-planned with a signed financial arrangement. Providing treatment without a financial arrangement discussion with the patient leads to future collection challenges. It’s not fair to the patient who may not understand their financial obligation, or to the practice now struggling to collect payment.

3. Unsubmitted Insurance Claims Report – Use this report as a double-check to ensure no claims have fallen through the cracks.

I’ve often thought if I were applying for a front office position, I would want to see these reports. They let you know what you are inheriting and whether there are effective systems in place. It also allows the front office team member an opportunity to show their value as they either get these numbers into the healthy zone or continue to keep them where they are.

Q. I am looking to bring a specialist into my practice to share the space. I want to work out how this relationship will function best since the specialist will bring his own staff and products but will be using my equipment. Is there a list of things I should consider?
A. Here are some questions to ask when bringing someone in to share your practice space:

1. How long are you hoping this arrangement will last?
2. Why are you interested in leasing space rather than starting your own practice?
3. What interests you in having a practice within my practice?
4. What does the term “professional ethics” mean to you?
5. How would you characterize your ethics?
6. What are your personal goals (short-term and long-term)?
7. What is your definition of quality dental care?
8. Do you have any interest in a partnership agreement in the future?

A good resource to check out is Office Sharing for the Dental Practice, by Boyd W. Shepherd, D.D.S., J.D.

Click here to see the original article.

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