Monday, May 27, 2013

Collection Accounts . . . not fun, but necessary

I have worked in two different dental practices in my career and, since I have been a Dentrix trainer, I have observed the different methods of how dental practices deal with the accounts they send to collection. It seems like there are many different philosophies and methods when dealing with collection accounts. Today, I want to spell out a few things that I recommend you do when sending an account to collection.
  • Take the account out of the general population. What I mean by that is make sure this account does not come up on your Accounts Receivable Report, billing statement run, or finance charge generation. You definitely do not want to be sending any more billing statements or applying any more finance charges to this account. To do this in Dentrix, I would suggest changing the account billing type to Sent to Collection." The billing type in Dentrix is attached to the entire account. You can change it from the Family File by double-clicking on the box that contains the billing type (see image below) or on the Ledger where you can set up Payment Agreements. Then when you run a report or generate billing statements you can exclude this billing type.

  • In addition to taking the account out of your general population, I would also inactivate the account so it does not come up in your regular searches. When you inactivate an account/patient in Dentrix, change the status to Inactive, take out all continuing care types, and reject any unscheduled treatment plans. This will ensure that the patient will not show up in the Continuing Care lists or the Treatment Manager Report.

  • My recommendation is to dismiss the patient from the practice. I realize this might be a bit harsh, but if this not done, you are still considered his or her dentist. If this patient calls for an appointment, you legally cannot deny him or her. Of course you can collect cash at the time of service, but this patient/family has already cost you about 40% in fees to the collection agency. The dismissal must be done in writing. If you would like a copy of my dismissal letter, I would be happy to share it with you if you e-mail me directly at

  • The last step is where I see the most difference in philosophy ... whether to adjust off the balance or leave it on the account. If you adjust off the balance at the time you send the account to collection, you would need to make a positive adjustment to add the balance back in and then make the collection agency payment to offset the adjustment. If you do not adjust off the balance at the time you send the account to collection, make the payment on the account and an adjustment for the fee the collection agency charged when you receive the payment. In my office, I keep the balance on the account until I receive the payment from the collection agency. I would check with your accountant to see how it should be done in your practice.

Hope this helps and gives you a more set protocol on how to handle collection accounts.  Hopefully you dont have to deal with this situation very often, but when it does come up, it is good to know what steps need to be taken.

Wednesday, May 22, 2013

Top 10 Note Spots in Dentrix

Dayna’s top 10 note spots in Dentrix
  1. Patient Note – This note is located on the Family File. My recommendation is to use it for light-hearted information about the patient or family such as vacations, kids, pets, etc. The reason I use it for this type of information is because it will print on the Patient Route Slip.
  2. Insurance Plan Note - This note box is located within the Insurance information, inside of the Coverage Table box. This should contain insurance frequencies, NG coverage, fluoride coverage, exceptions, and limitations. This information can then be seen on the patient chart in the Treatment Plan panel under the Insurance tab. Having this information accessible to your clinical team can help them treat their patients with same-day procedures.
  3. Appointment Book Note - This note box is seen by everyone in the practice, so it is a great central place to let a team member know to do something or use it like “sticky notes.” Integrate it into your morning huddle routine and have everyone on the team get in the habit of looking here for his or her messages, such as clinical notes not finished, reminder to call a patient, clinical narrative needed for a claim, etc.
  4. Appointment Note – This note box is for this appointment only. It stays with this appointment and also prints on the Route Slip. Examples might be remind patient to bring NG, pre-med called in, new patient information, etc.
  5. Office Journal – This note documents all administrative phone conversations, letters, or follow-up for the patient. The Office Journal is located on every Dentrix module, so it is easily accessible. It is also located on the Continuing Care report, Collections Manager, Unscheduled List, and Treatment Manager Report.
  6. Patient Alerts These are notes that you will use to flag yourself. These notes will pop up when you open certain modules. Examples might be medical alerts, financial status, and scheduling concerns.
  7. Procedure Note This note box is located in the clinical chart and is located on the procedure code. This is the best spot for the clinical justification because it will follow the procedure code from treatment plan to completion and will become part of the patient’s history. This note box also transfers directly to the insurance claim for the Remarks for Unusual Services narrative required by insurance companies.
  8. Clinical Note This is for your notes pertaining to what you did during the patient’s appointment or any clinical follow-up after a procedure. The most efficient way to implement Clinical Notes are to create custom templates to use in your office. Remember, these notes should be only clinical in nature. If you want more information about creating clinical note templates, CLICK HERE to read my blog titled “Where do I make my notes . . . Clinical“. Also, you can e-mail me directly and I will send you a step-by-step info sheet on how to create custom clinical note templates for your office.
  9. Guarantor NoteThese are typically more sensitive notes about the account or financial issues. This note box only shows up in three places in Dentrix – ledger, billing statements, and the collection manager report.
  10. Statement note This is a custom note you could put on the patient’s billing statement. You are limited to characters, so make sure you abbreviate.

My goal when I am working with an office is to create efficiency, consistency, and security and this is why I teach practices and team members to document specific things in these specific areas. There is nothing worse than redundancy.


Monday, May 13, 2013

Your daily motivation . . .

My sister has run two full marathons and one half-marathon and I have been there as her cheerleader for all three events. During the full marathons, I met her at different mile markers to give her fuel, energy drink, or just a “LET’S GO RAYCH” to motivate her on to a successful finish. What if you had a coach like this in your dental practice to be there for you at different points throughout the month and give you a snapshot of how your month was shaping up, as well as give you some motivational tips to help you on to a successful finish at the end of the month? Well ... you do. This daily motivationally coach is called “The Daily Huddle Report."

In my last blog, I said you had a personal practice management consultant with the Practice Advisor Report because this report will give you footnotes with management tools available in Dentrix to help you reach your goals. The Daily Huddle Report is like your personal trainer.  After you have entered in your office goals for production (Office Manager > Analysis > Practice > Setup > Goals), the Daily Huddle Report will give you a day-to-day picture of what happened yesterday, what is scheduled today, and what is left remaining for the month. You can see clearly what needs to happen to meet your production goal for the month. 

It is not just limited to production. The Daily Huddle Report gives you a bird’s eye view of five key performance indicators ...

         Production – This first section shows you what was billed out yesterday, what is scheduled today, what you have schedule on your books for the rest of the month, and what your goal is for the month.

         Collection – This next section shows you what was collected yesterday and your monthly collection rate so far for the month.

         Case Acceptance – This breaks it down by day so it will show you what was diagnosed yesterday and what was accepted yesterday, then it gives you a M-T-D total.

         New Patients – Remember new patients in Dentrix are calculated by first visit date so make sure this is accurate on their Family File in order to get accurate numbers here. This section will show you how many new patients you saw yesterday, how many are scheduled today, how many you have had through the month so far, and how many new patients are on the books for the remainder of the month.

         Scheduling – This section will break your schedule down into smaller pieces and show you what the unfilled hours are for the doctors and hygienists. Being able to see at a glance how many unfilled hours you have left in the month can give you an idea of the potential revenue still available to create in the month.

Even if your office does not have a daily huddle meeting each day, this resource can be extremely valuable for your office manager, scheduling coordinator, and doctor. This is what practice management is all about . . .

For more information on the Daily Huddle Report, check out these other blog posts:


Wednesday, May 8, 2013

Your own personal practice management consultant at your fingertips

The Practice Advisor Report in Dentrix has been out for a few years and I hope you have implemented this amazing reporting tool into your practice management routine. It is like having your own personal practice management consultant at your fingertips whenever you need him or her. This report tracks the key performance indicators that dental practices should be monitoring for managing the health of their practices. During the recent Train-the-Trainer meeting, I learned a few new things about the Practice Advisor Report that I would like to pass on to you.

The most valuable thing I learned was how it pulls information from your continuing care system. This information is located on the Continuing Care section of the report.

·         Patients seen with CC visits within the last 12 monthsThis is considered your patient retention rate. Many dental consultants, including myself, consider this an extremely valuable number and the Practice Advisor report keeps track of this automatically for you. The industry standard is above 85%. Keeping an eye on your retention rate lets you know if you might be slipping in certain areas like confirming appointments or managing your Continuing Care lists.

·         # of patients seen with Appt Scheduled - This is the number of patients that were seen for CC and have a next appointment scheduled, CC appointment not restorative. This lets you know how many patients scheduled their next CC before they left the office.
Another important piece of information I learned about the Practice Advisor report is how it calculates unfilled hours. Before you look at the unfilled hours calculations, make sure that your Provider setup on the Appointment Book is accurate. This is something that you need to keep up-to-date at all times. If one of your providers takes a day off, make sure you change it on his or her schedule in the Provider Setup so it will reflect this change in hours on the Practice Advisor report.

·         Dentists and Hygienists # of production days – This number comes from the provider setup, not the schedule.

·         Dentists and Hygienists Daily and Hourly production – This calculation comes from the total production (total production not net production) and divides it by the number of production dates and hours in the provider setup. The system considers a full day at 5 hours or more and a half day under 5 hours. With this being said, if your hygienist works from 8 a.m. until 1 p.m. and you only want her to be calculated for a half day, put her in the provider setup for 4 hours and 50 minutes.

·         Unfilled Hours – This is the one everyone gets stuck on and it was explained so well at the Train-the-Trainer meeting that I hope I can give it justice. It takes the total available time (number of minutes in the provider setup) minus the total scheduled time (number of minutes in the appointment book). In other words, if you looked across the schedule at all operatories horizontally and there was nothing scheduled, this is considered an unfilled time unit. In the provider setup, it knows which providers are scheduled for that day and it looks for empty spots. If you schedule an event, this is still considered unfilled time.

The last piece I want to talk about is Case Acceptance. This number can vary depending on the type of office and specialty. I hesitate to give industry standards because this number varies widely. However, it is good to know how the Practice Advisor will calculate the case acceptance and also know that this is a “moving” number. For example, if you treatment plan something in January and it is accepted in March, the report will recalculate the January case acceptance number to include this treatment. What this means is that the Y-T-D number will change.

·         Amount of Treatment Diagnosed – Any treatment that is treatment planned that day, including the Reason box on the appointment. This includes all hygiene procedures.

·         Amount of Treatment Accepted – Any treatment that has been diagnosed and completed in the same month, any treatment that has diagnosed and the case has been marked as accepted will be calculated as accepted. Remember this also includes all hygiene regardless of whether it was set complete on the appointment book or posted to the ledger.

This is an amazing report and I hope that you will use some of these tips to implement the Practice Advisor into your monthly routine. For more information on this report, check out Knowledgebase article # 49693 for an online tutorial available in the Dentrix Resource Center.