From “No Way” to “Know-how”: Getting Through Tough Times With Information Management

In the wake of new realities, most dentists are feverishly working to maintain some semblance of normalcy, yet a growing number of worrywarts are talking about throwing in the cuspidor. Perish the thought, Doctors! As the demands of your practice and life itself are changing from one moment to the next, you can’t allow yourself to be paralyzed by the most troublesome prospects of tomorrow. Instead, you need to make a deliberate choice to be fueled by the challenges and opportunities to come. Although our nation is weathering its roughest storm ever, we Americans will surely prevail. But as the economy works to shake off the effects of traumatic fallout, your practice is crying out for some attention to its own economic viability. Let’s answer that cry together.

As I see it, the critical mission at this moment is to determine what actions you and your staff can take that will secure the staying power of your practice through whatever lies ahead. Right about now, when everyone is so focused on their lives and their livelihoods, the mere act of implementing positive changes in your practice will elevate the mood of your team and provide some measure of buoyancy for all of you…the very best medicine in such troubled times. 

LOSING TIME OR MONEY IS NOT AN OPTION 
If ever there was a time to maximize both productivity and profitability, this is it. And if ever there was a time to work smarter by harnessing the power of information technology, this surely is that time. The fact of the matter is that few practices today have the know-how to effectively manage the wealth of information stored in their practice computer system, which means that team members are not accessing or utilizing information technology to improve their job performance or the practice. By wading through a swamp of manual or digital data they don’t know what to do with, they can’t help but get bogged down in the process. But staff may not be to blame for an outdated modus operandi. Often, it’s a result of the doctor not putting much priority on the use of information technology or not providing adequate training for staff to make the most of computer software and system capabilities.

The fact of the matter is that new technologies require more skills and training than ever before. But the number-one reason why systems break down in a dental practice is a lack of professional training in dental business management and computer software. Wake up, Doctor. That’s self-inflicted sabotage! Why allow practice employees to run on empty? Given sufficient training, staff could have used practice management software—in just a few clicks—to straighten out problems like high accounts receivable; poor patient retention; cancellations and failed appointments that aren’t being filled or rescheduled; plus unscheduled treatment not being tracked. But instead of dwelling on what might have been, let’s just figure out how to set it right—right away. 

TURN 20/20 HINDSIGHT INTO FORESIGHT
Before trying to jump headfirst into information technology and make up for lost time, you and your staff need to stop looking at your practice management software as some bizarre relic from the space/time continuum that’s good for only limited data made available to a limited audience, during a limited time sequence, and only under the direction of some technogeek who knows how to tell it what to do. Instead, think of your computer’s practice management software as what I’ve termed a “Facts Machine”— a receptacle that holds information to address most any practice management question, problem, or obstacle you or your team might face. By providing instant access to all sorts of practice information, plus the ability to generate practical, user-friendly reports, your Facts Machine stands ready to distribute the logistical keys to most every practice management productivity and profitability issue.

Okay, so we all agree at this point that professional training is crucial to expanding the total knowledge base of your practice. Information management means how efficiently you and your staff can access and utilize information from your computer practice management software. Let’s take a quick look to determine if, in fact, information management might stop the madness and perk up productivity and profitability. 

TAKING CHARGE OF ACCOUNTS RECEIVABLE
Before getting to the mechanics of this area, I want to remind you of my Golden Rule for accounts receivable. Know the numbers, Doctor, at all times. You wouldn’t want to play a game and not know the score, yet you’d be amazed how many doctors don’t mind being clueless about their accounts receivable. This is one critical measurement tool that needs to be highly accurate and updated with every play. Here’s the scoop. . .

Accounts receivable is the total amount of money owed to the practice, whether that be from the patient, insurance company, or other third party. It should be noted that some system software generates accounts receivable reports that break down aged accounts into monies owed by patients and monies owed by insurance companies. In this case, the two amounts must be combined to get the true total of accounts receivable. And total accounts receivable should not be any more than 1 month’s production (the old 1.5 X production has been put to rest with electronic submission and quicker payment). 

Each month, the financial coordinator should run an aged accounts receivable report, which should be reviewed by the doctor. Every account with an outstanding balance should be listed and should furnish the date of last payment (noted as patient payment or insurance payment). The report should “age” receivables as follows: monies 1 to 29 days past due (this “current” column indicates monies produced in the past 29 days that have not been collected); 30 days past due; 60 days past due; and 90 days past due. While some reports also provide totals for 90 to 119 and 120 to 150 days, all monies over 90 days delinquent should be totaled and divided by total accounts receivable, which should not exceed 15%.

Armed with this information, your financial coordinator knows exactly what customized message should go on a patient statement, and what should be said in a follow-up phone call. Notations should be made on the computer system as to what message was sent, and what was said by practice and patient in each delinquent payment phone call. This component of collections works so well that some feel it’s like raiding a piggy bank.

THE ALL-STAR PRODUCTION BY PROVIDER REPORT
Sometimes referred to as a Treatment Procedure Report, or Production by ADA Code, or Practice Analysis, the Production by Provider Report is an indispensable tool. It is the means to making use of data such as: average daily production for dentist(s) and hygienist(s), compared with daily goals; the number of bite-wing x-rays, compared with the number of adult and child prophys; the number of units of crown and bridge per day, compared with those of last year; perio treatment percentage of total hygiene production (the goal is 33%); and number of comprehensive exams each month (the only true measurement of number of new patients), which should not be less than the number of recall patients still on last month’s past due recall report.

MORE THAN A SIMPLE RECALL REPORT 
In addition to listing which patients are due for recall and which have not yet made appointments, by looking at recall interval and frequency this easy-to-generate recall report can also be used to determine the number of hygiene days actually needed per week. If 100 patients are on 3-month recall, for example, 400 hygiene appointments will be needed to ser­vice those patients.

COMPUTER SCHEDULING: POETRY IN MOTION
You’ve got a 3-hour opening next Monday … 3 solid hours of nonproductivity you could be using for a four-unit bridge. If your scheduling coordinator had been trained to use your practice management software’s scheduling system, she could just press a few keys, and voila, the computer could have scanned through jillions of bytes of data and found those patients in need of a 3-hour opening for a four-unit bridge! Suddenly, the cost of training her to schedule on the computer doesn’t add up to a hill of beans.

TREATMENT PLAN PROPOSAL OR WASTED PITCH?
Before getting to the benefits of information technology on the treatment plan, let me just remind you that a listing of tooth numbers with treatment needed is not a treatment plan. When you propose a treatment plan to a patient, that plan should include the number of appointments required to complete the treatment, which procedures will be performed at each appointment, chair time and doctor time needed, fees for each procedure, and how those fees may be paid out. Now that’s a treatment plan worthy of presenting to your patient and valuable enough to be entered into the computer system. This means, though, that someone must be in charge of getting it entered. And that’s not all. As procedures are performed, they should be posted as completed on the treatment plan. The computerized treatment plan can then be tracked as to percentage completed and treatment that still needs to be scheduled and performed.

CONCLUSION
Well, the case is irrefutable. Most any software system that is even remotely up-to-date can have a huge impact on both your productivity and profitability. And in times like these, that can mean the difference between mere survival and stunning success. Considering the fact that your earning power is the most valuable asset you have, you might just as well make the most of it. In dental practice today—as in war today—there is simply no substitute for victory.


Ms. McKenzie, certified management consultant, is a nationally known lecturer, author, and consultant to the Council on Dental Practice of the ADA. She is president of McKenzie Management and Associates, which provides in-office analysis of the business, clinical, and hygiene department; conducts on-site staff training; and offers a full line of educational management books, audiotapes, and videos. Since opening McKenzie Management in 1979, Sally has developed the most expedient practice systems, methods, and technologies as well as the most effective management approaches for the dental practice. Additionally, Ms. McKenzie’s 34 years of experience and expertise are now available as on-tap resources for her new ventures: practicemanagement-online.com and dentalcareerdevelop.com. For information on what any of these companies can do for your practice, call Sally toll-free at (877) 777-6151, and visit her websites at: www.mckenziemgmt.com; www.practicemanagement-online.com; and www.dentalcareerdevelop.com.