Wednesday, February 12, 2020

Understanding the Reasons Behind Missed Appointments


Last week I wrote about a couple of different ways to handle missed appointments in your office. This week, let’s talk about some of the reasons why patients may miss appointments. Missed appointments can be costly for your practice. Not only do they cause lost production, but you are still paying overhead costs, like staff wages, with no production being generated to offset those costs.

If you can come up with solutions to these problems, you can reduce the number of missed appointments in your office. Here are some ideas of why patients may miss appointments, as well as some possible solutions:

Ineffective Communication

If your office is only leaving a voicemail on a patient’s home phone number, this may not be an effective way to confirm appointments. Consider using a service like Dentrix Patient Engage which offers alternate ways to confirm patient appointments via text message and e-mail reminders which are more convenient for your patients.

Unenforced Policies

In last week’s post, I mentioned having a clear written policy to communicate with patients the ramifications of missed appointments, such as a missed appointment fee. It’s important to have these policies in place, and to train your team to enforce them. If your administrative staff allows patients to cancel appointments without repercussions, it will undermine your policy. Train your team to be firm and professional when a patient calls to cancel an appointment. They need to reiterate the office policy to the patient and post missed appointments to the patient’s Ledger. With that being said, life does happen. Your administrative team should be compassionate in extenuating circumstances like a patient’s car breaking down or having a serious illness.

Under-valued Time

If you expect patients to respect your practice’s busy schedule, then you should extend your patients the same courtesy. Always strive to stay on schedule for your patients. You can’t expect them to show up on time and keep their appointments if you don’t do the same. 

Despite your best efforts, you will still have last-minute cancellations. As a way to combat this, keep a current ASAP List to fill those open time slots quickly. Add appointments to the ASAP List by changing the Schedule type in the Appointment Information dialog box in the Appointment Book.

Reducing missed appointments in your office can result in higher production for your practice. Understanding why patients are missing appointments and addressing these issues can help to resolve the problem. If you have questions on this topic or others, please e-mail me at vectordentalconsulting@gmail.com.


Charlotte Skaggs, Certified Dentrix Trainer

Charlotte Skaggs is the founder of Vector Dental Consulting LLC, a practice management firm focused on taking offices to the next level. Charlotte co-owned and managed a successful dental practice with her husband for 17 years. She has a unique approach to consulting based on the perspective of a practice owner. Charlotte has been using Dentrix for almost 20 years and is a certified Dentrix trainer. Contact Charlotte at vectordentalconsulting@gmail.com.

Wednesday, February 5, 2020

Missed Appointments - What's Your Approach?

A common concern among dental office managers is how to handle appointment cancellations and no-shows in the office. This is a challenge that is important to address because missed appointments can mean lost production and revenue for your office.



Here are some of my suggestions on how to deal with cancellations and no-shows.

Have Policies in Place

Have a clear policy regarding no shows and last-minute cancellations. Include this policy in your new patient paperwork to communicate it to your patients. Some examples of what you could include in your cancellation policy are fees applied to missed appointments and an office policy that patients with three or more missed appointments will be dismissed from the practice.

Use Dentrix Tools

Train your team how to use the tools in Dentrix to properly remove an appointment from the Appointment Book. No show appointments or appointments that are cancelled with less than twenty-four hours’ notice should be considered a broken appointment in Dentrix. Break appointments to move them to the Unscheduled List. Use Wait/Will Call for appointments that are cancelled with adequate notice. When you break  an appointment, it is tracked as a missed appointment in the patient’s Family File and the Office Journal. However, a mistake I’ve seen offices make, is rescheduling a cancelled appointment by simply moving it to another day. Doing this would not count it as a missed appointment in the patient’s Family File or the Office Journal. 

Document Missed Appointments on Reports

Post a procedure code for a missed appointment to the patient’s Ledger. You can use the American Dental Association procedure code D9986 (missed appointment) for this. You can choose to charge the patient, or not based on your written office policy. But it can be beneficial to post the code to the patient’s Ledger for several reasons:
  • Posting the code gives you the ability to run reports on how many missed appointments you've had within a particular date range.
  • The missed appointment will be posted on the Day Sheet so the office manager and the doctor can easily see which patients missed appointments that day.
  • When sending billing statements, patients will see the missed appointment posted to their Ledger. It lets them know your office is tracking this and it’s an issue you take seriously.
Once you have posted the code to the patient’s Ledger, add a procedure note with the details of what happened. You can easily do this by double-clicking a procedure in the Ledger to open the Edit or Delete Procedure dialog box and entering the note in the Notes field. Having missed appointments listed on the Ledger with the date and notes of what happened, make it an easy place for everyone in your office to look for this information.

If you do post the missed appointment code to the patient’s Ledger, it’s important to note that posted procedures will update the patient’s last visit date. In Dentrix G7, there is an option in the Procedure Code Editor, called Do Not Update Patient Visit Dates, which I recommend enabling for this procedure code. Otherwise reports and your active patient numbers will be affected.

Missed appointments are a concern for office managers and can negatively affect the production and revenue of the practice, so it’s very important to have clear policies and procedures to handle them.
Another important question to ask is “Why are patients missing their appointments?” If you can address this question, you will be well on your way to minimizing the number of missed appointments in your practice. 

If you have questions on this topic, please e-mail me at vectordentalconsulting@gmail.com.


Charlotte Skaggs, Certified Dentrix Trainer

Charlotte Skaggs is the founder of Vector Dental Consulting LLC, a practice management firm focused on taking offices to the next level. Charlotte co-owned and managed a successful dental practice with her husband for 17 years. She has a unique approach to consulting based on the perspective of a practice owner. Charlotte has been using Dentrix for almost 20 years and is a certified Dentrix trainer. Contact Charlotte at vectordentalconsulting@gmail.com.

Wednesday, January 29, 2020

New Dentrix G7.3 Feature: Add Required Attachments to Claims Automatically

One of the things that can be difficult for administrative team members to remember is which procedures require attachments in order for insurance companies to process your claims.

If a claim gets sent to an insurance carrier without a necessary attachment, it can cause a delay in receiving insurance payment, or a denial altogether. You generally have to wait for the insurance to send you an explanation of benefits and a request for the required attachment.

Once you send the required attachment, you have to wait another four to six weeks before you finally receive payment. These types of payment delays can be costly for your office and unnecessarily increase your accounts receivable.

Dentrix G7.3 offers a new Automatic eClaims Attachments feature to automate your workflow by automatically including required eClaim attachments for certain procedures, and warning you if the required attachments can't be found.


Once set up, this exciting feature will help to eliminate errors like the one I described above, and it also saves you the time of adding necessary attachments manually. The quicker your office can be paid by insurance companies, the better, and this new feature can really help to speed up the process of getting paid. 

This new feature in Dentrix G7.3 could also be hugely beneficial if you have team members that are not familiar with which procedures require attachments or who have limited experience or dental knowledge. As you work with different insurance payors and learn their requirements, you can customize Dentrix by adding or updating which procedures require attachments, and what those attachments should be.

As you customize Dentrix with the required attachment information your carriers are looking for, you can work to towards eliminating delayed and denied claims, and help your office get paid faster.

Watch this short video that introduces the new feature, and make sure you upgrade to Dentrix G7.3 and put it to use!

If you have questions, please e-mail me at vectordentalconsulting@gmail.com.


Charlotte Skaggs, Certified Dentrix Trainer

Charlotte Skaggs is the founder of Vector Dental Consulting LLC, a practice management firm focused on taking offices to the next level. Charlotte co-owned and managed a successful dental practice with her husband for 17 years. She has a unique approach to consulting based on the perspective of a practice owner. Charlotte has been using Dentrix for almost 20 years and is a certified Dentrix trainer. Contact Charlotte at vectordentalconsulting@gmail.com.

Wednesday, January 22, 2020

Setting up and Using Adjustment Types in Dentrix

It is so important to properly document and track any adjustments made to patient accounts. Arguably, the most important information for office managers is to know why money is being adjusted off patient accounts. In Dentrix you can run reports for adjustments, but if your team doesn’t know how to categorize adjustments properly, then those reports will be inaccurate.


Suggestions for Setting up and using Adjustment Types in Dentrix

  1. Create or customize adjustment types in Dentrix that are easy for everyone in the office to understand, and make sure they are specific. For example, I have seen an adjustment type in an office simply called “Write off”. In my opinion, this is too vague. Is it an insurance write off, a bad debt write off or a patient discount? Creating specific adjustment types allows you to analyze the adjustments being made in your office. You can customize adjustment types in the Office Manager. I would suggest you meet with your team to discuss the adjustment types you currently have in Dentrix and talk about adjustment types you would like to add or change.
    Note: It’s important for me to mention that if you delete an adjustment type, you must choose a replacement for it. This will affect patients who have this adjustment type on their account already. Similarly, if you change the name of an existing adjustment type, it will change the adjustment type on patient accounts where it has been previously used. 
  2. Limit the team members that have access to make adjustments. Clinical team members should not be making account adjustments, so they do not need password rights to do so. You can assign password rights in the Office Manager.
  3. Train your financial team members on how to correctly make adjustments, and when it is appropriate to do so. Show them the adjustment types you created or customized and let them know in which situations to use them.
  4. Have your team get in the habit of adding a clarification note (along with their initials or staff ID) for each adjustment they create in the Ledger. That way you know what’s going on and who to ask additional questions if needed.
  5. Run an Adjustment Only Day Sheet on a daily basis and take the time to review it carefully to check which adjustments were made. This allows you to catch errors quickly and take steps to correct them in a timely manner.
Dentrix G7.3 has made the process of making adjustments easier to do. When you are making a credit adjustment, only the credit adjustment types will be available to select from. If you are making a charge adjustment, only charge adjustment types will be available to select from. 


Additionally, you can now split adjustments by patient and by provider for more accurate accounting. 



Understanding which types of adjustments are being made in your office and why they are being made is an important part of being a dental office manager, because it is money your practice will not collect. 

For questions on this topic or others, e-mail me at vectordentalconsulting@gmail.com.


Charlotte Skaggs, Certified Dentrix Trainer

Charlotte Skaggs is the founder of Vector Dental Consulting LLC, a practice management firm focused on taking offices to the next level. Charlotte co-owned and managed a successful dental practice with her husband for 17 years. She has a unique approach to consulting based on the perspective of a practice owner. Charlotte has been using Dentrix for almost 20 years and is a certified Dentrix trainer. Contact Charlotte at vectordentalconsulting@gmail.com.

Wednesday, January 15, 2020

Using Electronic Prescriptions

I live in Florida, and as of January 1, 2020, a new law became effective that requires prescribing doctors to send all prescriptions electronically. Arizona, Iowa, Massachusetts, North Carolina, Oklahoma, and Rhode Island also have mandates that took effect January 1, 2020; and in September 2018, California passed a law that requires electronic prescribing for all medications.

Check the laws for your state. Is your practice required by law to send prescriptions electronically? It may be time to think about how your practice is going to implement this requirement into your daily workflow.

You will need to use a service to electronically submit prescriptions to pharmacies. I recommend using Henry Schein One ePrescribe, which allows you to send electronic prescriptions directly through Dentrix.



Some of the benefits of using ePrescribe include:

  • Great fail-safe features to prevent drug interactions and dosage problems.
  • You can set up team members as users and your doctor can determine rights for each user.
  • There are special procedures for narcotic prescriptions.

Another feature I really like about ePrescribe is the ability to view a list of all prescriptions a patient is taking, including those prescribed by other doctors. This allows you to view patient’s current and past prescriptions.

ePrescribe is very easy to set up and you don’t need to purchase any additional hardware.

As more states are mandating electronic prescriptions, you need to come up with a plan for how your office will handle these requirements. Become familiar with the laws in your state.

If you have questions about ePrescribe, you can contact an ePrescribe representative at (833)907-1747.

If you have questions about this topic or others, please e-mail me at vectordentalconsulting@gmail.com.


Charlotte Skaggs, Certified Dentrix Trainer

Charlotte Skaggs is the founder of Vector Dental Consulting LLC, a practice management firm focused on taking offices to the next level. Charlotte co-owned and managed a successful dental practice with her husband for 17 years. She has a unique approach to consulting based on the perspective of a practice owner. Charlotte has been using Dentrix for almost 20 years and is a certified Dentrix trainer. Contact Charlotte at vectordentalconsulting@gmail.com.

Wednesday, January 8, 2020

Planning for the New Year


Happy New Year! As you are preparing your practice for the upcoming year, I suggest you reflect on the previous year. What worked for your office and what didn’t, and what does your practice hope to achieve in 2020?

First, have a meeting with the practice owner. What do they hope to achieve this year? By gathering that information, you can come up with a game plan to help them achieve those goals. Here’s some ideas of common practice goals and some thoughts on how you can achieve them.


Attract More New Patients To Your Office

  • Plan a new marketing campaign. This could consist of many things including a mailer introducing your practice or a referral reward program.
  • Consider becoming contracted with an insurance company to attract more new patients with that insurance plan.  Make sure you review the fee schedule carefully to be sure it will work for your practice.

Develop a More Productive Hygiene Department

  • Extend hygiene hours. Having an appointment available early in the morning or later in the evening can be very popular with patients because it’s more convenient with their work schedule. Adding just one additional appointment per day will increase your overall hygiene production.
  • Encourage your hygienists to do more procedures during each appointment. Hygienists can do many procedures to manage and improve the patient’s oral health:
    • They can place an antimicrobial agent like Arestin in periodontal pockets.
    • They can offer the patient a fluoride treatment. Even if insurance won’t cover the fluoride treatment, patients are often willing to pay for it.
    • They can regularly record patient’s periodontal probe depths and treat periodontal issues with scaling and root planing.
    • They can even place sealants for children.
  • Remember that your hygienists are producers in your practice, and there are many procedures they can do to increase their daily production.

Build a Solid Online Reputation

  • Use a reputation building service, such as Reputation Manager to send patients surveys to review their experience with your office. Requesting feedback can help to increase patient satisfaction and loyalty.

Reduce Cancellations and No Shows

  • Use a confirmation service, like Dentrix Patient Engage to conveniently send appointment reminders by text, e-mail or automated phone call. This saves staff time from making confirmation calls, and gives patients an easy option to confirm appointments. 
Once you’ve had a conversation with the practice owner and come up with your 2020 goals and how you want to implement them, have a meeting with the entire team. It’s important to have everyone on the same page and understand the direction the practice is heading.

If you have any questions, e-mail me at vectordentalconsulting@gmail.com. I wish you all a productive and prosperous 2020!


Charlotte Skaggs, Certified Dentrix Trainer

Charlotte Skaggs is the founder of Vector Dental Consulting LLC, a practice management firm focused on taking offices to the next level. Charlotte co-owned and managed a successful dental practice with her husband for 17 years. She has a unique approach to consulting based on the perspective of a practice owner. Charlotte has been using Dentrix for almost 20 years and is a certified Dentrix trainer. Contact Charlotte at vectordentalconsulting@gmail.com.

Thursday, December 26, 2019

Top 10 Posts of 2019

As the end of the year is fast approaching, I thought we could take the time in this week's post to reflect on some of the topics that have been popular with readers throughout 2019.



Some you may have read, some you may have missed, and some you just may need to be reminded of! Here's our top 10 posts of the year:










and our most popular blog post of the year...