Tuesday, May 31, 2016

Why don't my reports show the same numbers . . . grrrrrr!

“I have pulled up three different reports trying to find out what my accounts receivable number is and they all have different numbers,” says Nichole from a client office in New York. Renee from a different office states, “I have a patient who has a $6,000 balance and she has never received a statement and she did not show up on my collection report.” Sound familiar? I know these situations can be frustrating and it is easy to blame the software for differences in reporting. However, I want to take you through a few check points to make sure you are getting similar data on different reports and also walk you through what is different on reports.

If you have been reading my blog for a while, you know that my favorite report for managing your accounts receivable is the CollectionManager. There are some things to know about the Collection Manager Report . . .

  • This report only shows positive accounts receivable so if you are trying to compare it to an Aging Report or the Practice Analysis snapshot, you will not get the same numbers. The Aging Report can be filtered to show all balances, positive balances or credits, and, if you have a lot of credit balances, these two reports could show very different bottom line numbers.
  • The Collection Manager can be filtered down a lot to give you a very specific report or a very broad report and, depending on how you are matching it up to another A/R report, if you don’t select the same parameters, you will get different numbers.

If you are looking at the snapshot Practice Analysis report (Office Manager > Analysis > Practice), then you will also get a different ending balance depending on a few things . . .

  • This snapshot is affected by month end so, depending on if you are up to date with month end, will determine how accurate this number is and if it will match up to any other A/R report.
  • This Analysis snapshot cannot be filtered by billing type … so if you have balances in billing types like “Sent to Collection,” this will affect this number.
  • This report is only run by Entry Date (you cannot change this). If you are running any of the other A/R reports by Procedure Date, then you will get different numbers.

Most of the accounts receivable and collection management reports can be filtered by different parameters to give you different numbers. Here are the most common troubleshooting tips to check if you are matching up reports.

  • Did you select the same providers?
  • Did you select the same billing types?
  • Did you choose Entry Date or Procedure Date?
  • What aging category did you select?
  • Are you selecting the same date range or ending date?
  • Were there any other boxes that were checked that might have filtered out a particular patient from one report over another? In the first paragraph, I had an office questioning why a particular patient did not show up on the Collection Manager Report. It was because she had checked “If not billed since” on the filters so this particular patient had been excluded.

Hopefully this will help you understand how different each report is and why they might give you different numbers. Numbers tell a story and it is important to have as accurate report as possible.

Tuesday, May 24, 2016

Health History Update . . . it's about being prepared for anything

If your patient had a medical emergency and your team had to call 911, how long would it take you to pull up his or her most current medical history? Is the list of current medications and allergies buried among all your clinical notes or does your most recently scanned health history form have the words “no changes” all over it, forcing you to continue searching back to the next scanned document … only to find the words “no changes” all over this one as well. It’s not just about being prepared for an emergency … it’s about being prepared for anything.

During the time I was working in my practice full time, my doctor performed complicated surgical procedures and placed dental implants on a regular basis. We had a patient whose dental implant did not integrate and she had several complications during the healing time and, in the end, we ended up removing the implant because it was just not in the cards for her. She decided that it had been the doctor’s fault that her implant failed and I remember working with our malpractice insurance company trying to piece together all her documentation into a timeline beginning with her first visit.

In my opinion, the health history should have at minimum six pieces of critical information. If you are a more detailed clinician, there are other pieces you can add as well. Here are my top six pieces and a few alternates . . .

  1. Current medical conditions, recent surgeries and hospital visits. This should never say “no changes.” You should always have a list of what is current at this point in time. If they are diabetic last visit, they are more than likely diabetic now. List it. Don’t write “no changes.”
  2. Current prescription medications, over the counter medications and herbal supplements. If their medication list didn’t change from last time, never write “no changes.” You should have a date stamp with their current medication list every time.
  3. Current allergies, including reactions to local anesthetics. Again, if they are allergic to latex, then your health history update today should list Latex Allergy not “no changes.”
  4. Today’s BP and pulse. I had a doctor recently say to me, “I am not their medical doctor and my patients say they will leave my practice if I force them to take blood pressure.” Okay there are two parts to this comment. First, you are their oral health physician so start acting like it. Second, if your patient is going to leave you because you care, let him or her go.
  5. Emergency contact name, relationship and mobile number
  6. Physician name and contact info
  7. Tobacco use
  8. Pregnancy (this could go in #1 even though it is a temporary condition)

I love using the Questionnaire module in Dentrix because it is efficient for your clinical team. There is no scanning and you can use an iPad or tablet if you do not have a monitor in the treatment room that the patient can see. The Dentrix Questionnaire module will turn any paper form into an electronic form and the way it auto-fills information from previous appointments makes it about a 30-second task for the clinician. These electronic forms can be digitally signed and locked up into history for added security.

If you would like a sample Health History Update that I use in many offices in the Questionnaire module, email me directly at dayna@raedentalmanagement.com.

I created a video on how to create an electronic form in the Questionnaire module and you can watch it by CLICKING HERE. 

Thursday, May 12, 2016

Transform the way you follow up with over due recare patients

I learned the coolest thing today! Actually, I am rethinking the way I run the Continuing Care report. I know, right? If you have been reading my blog over the years, I talk a lot about the four reports to keepyour schedule full — ASAP List, Unscheduled List, Continuing Care List and Treatment Manager Report. Today, while I was working with a team on their hygiene workflow, we discovered something together that could completely transform the conversations you have with your hygiene patients when you are making follow-up calls.

As oral health clinicians, it is our fiduciary responsibility to inform patients of oral disease or infection so they can make educated decisions about their health and schedule them for their preventative maintenance visit. This education and communication with the patient is a full team responsibility, not just the clinical team. The front office team becomes part of the equation whenever patients are balking at scheduling their next visit or if they are following up with overdue patients.

The front office team does not need to know every clinical detail about the hygiene visit. However, having one little nugget of information to reiterate the value for the patient to schedule the recare visit can be critical. In previous versions of Dentrix, I would teach my front office teams to read through the clinical note from the hygienist and find something in there that would build value for the patient like “watching pocket #3,” “needs to floss more in lower anterior,” or “check margins on crown #30.” What happens a lot of the time is the front office team either doesn’t like going into the patient chart or these notes are still being written in a paper chart.

So where can the front office team build their own arsenal of “value added notes” so when they call the overdue hygiene patient, they can say something like, “You know, Sally really needed to see you in four months so she can check how the bleeding has improved in the upper right area” and the patient will say, “Oh yeah. That’s right. She did want to check that.” The motivational note in the patient’s continuing care is a perfect spot . . . and now it shows up on an awesome report.

If you are on Dentrix G6, you have a new amazing feature called List Manager. It’s like doing a Patient Reports by Filter … only on steroids. This List Manager will also allow you to put your Perio and Prophy patients on the same list . . . Whoo Hoo! 

Watch the video below and see how to create a new kind of list.

Monday, May 2, 2016

Inactivating providers and team members . . . is it still on the back burner?

Does it drive you crazy scrolling through the list of providers every time you are trying to schedule an appointment when ¾ of them no longer work at your practice? How about when it is time to print out your payroll reports and you are having to sort through a list of team members who have been gone for years? Would you like to clean all this up but not sure really how to do it or what ramifications it will have on your system?

Inactivating providers and team members is one of those tasks put on the back
burner and then just piles up for the next person to remedy. I think one reason it doesn’t get done is that all workstations have to be closed out of Dentrix in order for you to perform this task. My recommendation would be to do it at the same time you run month end since you have to dismiss everyone out of Dentrix for this task as well.

Once you are ready to inactivate some providers, then you get stuck because you have to choose a replacement. What does this mean? Who do I choose? Here are the most important things to remember . . .

  • When you choose a replacement provider, it does not change anything in history so don’t worry about the patient ledger being altered. Inactivating a provider and choosing his or her replacement will swap out anything in the future. For example, any future appointments will be changed to the replacement provider, any treatment planned procedures will be changed to the replacement provider, the default insurance claim provider may be switched and, if you have selected a specific continuing care provider, they will be replaced as well.
  • If you are inactivating your primary provider (PROV1 in the Family File), the replacement provider will take over in this role. This is common in a practice sale or transition. The PROV1 is used on many reports in Dentrix.
  • When you inactive a provider, all Time Clock data will be removed so make sure you have payroll reports as a backup.
  • If you are using Future Due Payment Plans, the assigned provider will be replaced as well.

I think once you understand that none of your history will be altered, it makes the process easier to swallow. The most significant change will happen if you are inactivating one of your primary providers because this will change the PROV1 in the family file and will affect some reports. Hopefully this helps and will allow you to move forward with this necessary task.