Wednesday, November 14, 2018

End-of-Year Tasks: Part One

It’s the most wonderful time of the year……to prepare for next year! 

As the end of the year rapidly approaches, there are important tasks that need to be done at your office to prepare for 2019. Over the next few weeks, we’re going to talk about some of these tasks to get your office ready for the new year.

Let’s start by talking about office fee schedules. It’s important to review your office fees on an annual basis. You can evaluate and compare your office fees to others in your area by using a guide like the National Dental Advisory Service Fee Report Book. This can help you to see how your office fees compare to other dental offices in your zip code and if you should consider raising your fees. Raising your office fees can improve the revenue for the practice, but you also don’t want to price yourself out of the market.


Updating the Office Fee Schedule
Once you have made a decision about how you want to update your office fee schedule, you can choose to increase your fee schedule by a percentage or by a dollar amount using the Auto Changes button in Dentrix. Open the Office Manager and select Maintenance > Practice Setup > Fee schedule Setup. Select the fee schedule you want to change, then click Auto Changes. 



You can choose to update all procedure codes, or you can enter a procedure code range. From this screen you also have the ability to increase (or decrease) fees by a percentage or a dollar amount. 



You can also manually edit individual fees by procedure code.  Open the Office Manager and select Maintenance > Practice Setup > Fee Schedule Setup. Choose the appropriate fee schedule, then select View/Edit. Select a procedure code from the list, make changes to the AFTER column, and then click Save.

Updating Insurance Fee Schedules
When you are thinking of updating fee schedules, it’s also important to request an updated fee schedule from all insurance companies your office participates with.  Depending on the insurance company, you may have to call or e-mail the provider relations department or you may have to send a written request. Once you have received the updated fee schedules from the insurance company, you can edit your fee schedules in Dentrix to reflect the insurance fees. 

Open the Office Manager, and select Maintenance > Practice Setup > Fee Schedule Setup. Choose an insurance fee schedule, then select View/Edit.




Select the code you want to edit from the list of procedure codes. For example, if you wanted to update the fee for an adult prophylaxis, select D1110 and click in the AFTER field and enter the updated fee (in dollars). You can move on to the next procedure code to update, or if you’re done, choose Save, then Close.





One thing to keep in mind when you update or edit a fee schedule, is that when you enter or create a new treatment plan for a patient, the updated fees will be reflected. Patients who have an existing treatment plan will not reflect the updated fees. 

Taking the time to update your office fees and requesting information from your insurance carriers so you can update your insurance fee schedules, will result in higher production and collections for the office. I find that making this a part of my end of year routine ensures that it gets done consistently on an annual basis. 

Join me next week when we’ll discuss more end-of-year tasks. 

If you have questions about this or other topics, 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, November 7, 2018

Over the Counter Collections

Collecting payment from patients at the time of service is very important. Many procedures we do in the office incur a lab fee and expensive materials and so it’s important for your office to cover its cost. How do you track if you’re collecting at the time of service?

Payment a patient makes for services rendered that day are considered to be over the counter collections. A good goal for your office is for over the counter collections to be 35-45% of your monthly production.

To differentiate over the counter collections verses other payments, you can set up additional payment types in Dentrix. For example, you probably already have cash payment, check payment, and credit card payment set up in Dentrix. But did you know you can also add OCC (over the counter collections) cash payment, OCC check payment, and OCC credit card payment as options, too?

To add payment types, open the Office Manager, and select Maintenance > Practice Setup > Definitions. Select Payment Type in the Definition Type drop-down list. Type the name of your new payment type (for example OCC Cash) in the Definition Text field, and then click Add




Repeat these steps for the other over the counter payment types you want to add. Then train the staff who enter patient payments to use these new OCC payment types when a patient is paying for a procedure done that day.

Once you have the OCC payment types set up, you will be able to differentiate them from other payments on your daily and monthly reports.

The over the counter collections should be monitored monthly. At the end of each month, run a report to show collections based on payment type. A good report for this would be the Payment Summary Report in the Practice Analysis. In the Office Manager select Analysis > Practice, and then select Reports when the window opens. Set the desired Date Range and check the Payment Summary option.



This report will give you all the payments, separated by payment type, for the selected date range. Now you can total all the over the counter collections payment types and divide this by the monthly production. This will give you the percentage of the over the counter collections.

By generating this report on a monthly basis, you have a good gauge of whether you are collecting enough from patients in the office at the time of service. Remember, a good goal is to have 35-45% of your monthly production should be from over the counter collections.

If you aren’t reaching this goal, you may want to examine why:


  • Are patients being presented with a treatment plan prior to the appointment date so that they can be financially prepared?
  • Is someone on the team uncomfortable asking a patient for money and therefore not collecting?
  • Have patients been properly informed about the office policy regarding paying at the time of service?

Addressing any issues in this area can help to improve your cash flow and your bottom line.

You can also view over the counter collections in the Practice Advisor Report. You are able to designate which payment types this report considers over the counter collections. In the Office Manager, select Analysis > Practice Advisor. Choose Practice Advisor Setup then Assign Payment Types as Over-the-Counter Collections. Move the payment type(s) you have set up as OCC into the right pane using the arrow buttons, and click OK to save.



Collecting from patients at time of service helps to maintain healthy accounts receivable. It also helps the office to cover overhead and costs such as lab fees and materials.

Is your office collecting enough at the time of service? Try using the reports I described to find out.


If you have questions about this or other topics, 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, October 31, 2018

Keeping Track of Patient Insurance Information

A patient’s dental insurance is ultimately their responsibility. However, we at the dental office often assume some of the responsibility of keeping up with the patient’s insurance because it benefits us in the long run. If you are able to accurately estimate what an insurance plan will pay, you can collect the patient portion at the time of service, avoid future payment problems, and consequently maintain a healthy accounts receivable.

As an office manager, I try to keep up to date with a patient’s insurance benefits, such as frequency limitations and any special coverage clauses. This is important because it goes a long way in helping the patient avoid an unexpected balance.

Take this situation, where knowing a patient’s benefits would be important, for example:

A patient has a bridge placed, but there was a missing tooth exclusion in their insurance coverage, their insurance denies the claim, and they end up with a large unexpected balance. This is not only upsetting for the patient, but it can be costly for your office as well. This balance may remain unpaid for a long time, or the patient may need to make payments on the procedure, which affects the office accounts receivable and accounts aging.

Insurance plan exclusions and frequency limitations should be documented in the Insurance Plan Note. You can enter this information in a patient’s coverage table. In the Family File, double-click the Insurance block, and then click the Coverage Table button.


In the Coverage Table window, click the Notes button to access the Insurance Plan Note.



Enter any information you have from the insurance carrier about plan limitations and exclusions. These should be notes that are specific to the carrier and not individual patients. These notes will display for all patients covered by the plan, and won’t print on insurance claims.



Similarly, it’s important for your office to keep up with how much of a patient’s maximum benefits they have used to avoid an unexpected balance. Now is the time of year when many patients have met their insurance plan maximum. Dentrix tracks how much an insurance plan has paid for a patient in your office, but what about insurance payments to another office?

For example, a patient could have used some (or all) of their benefits at a specialist office, or they could be a new patient to your office, but have previously used some of their dental insurance maximum at a previous dentist.

In a patient’s Family File, double-click the Insurance Block and click the Deductibles button.



 Enter any benefits used or deductible that may have been met outside of your office.



I find that keeping the deductibles met and benefits used for a patient updated is especially helpful in a case where you have referred a patient for a root canal. I know the patient will have used most of their insurance benefits at the endodontist office for this procedure. It’s important for that to be reflected when I print the patient’s treatment plan for a crown and build up on the tooth. By going in to their Family File and adding this information, Dentrix will calculate the correct estimated patient portion for the crown procedure, because it will take into account the insurance benefits that have already been used, and there won’t be any unpleasant surprises for me or the patient.

I find this time of year, it tends to be especially important to track how much a patient has used of their dental insurance maximum. You would need to contact the patient’s insurance company to find out how much the patient has used of their maximum outside of your office. If you use e-Services, you could use the Dentrix Insurance Manager for a quick and easy response.

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, October 24, 2018

Tracking Lab Cases - How I Divide up Tasks

If you send a patient’s case to a lab, it’s very important to have a good tracking system for those cases. It’s important for your office to know which cases have been sent and are being fabricated at the lab, which cases have been received back in the office and are ready to deliver to the patient, and which cases have been completed.

I have found that being able to track the progress of a case is important because when properly tracked, your office can know to not schedule patients for their return appointment before their lab case is back in the office. Unfortunately, I’ve seen patients come in for their scheduled appointment and their lab case has not been returned from the lab. That’s an unpleasant situation for everyone!

Dentrix has a Lab Case Manager which is designed to do this tracking for you. When you create a lab case for a patient, that lab case can be attached to an appointment. While it’s important to track when your lab cases have been sent or received, it’s also very important to keep up with them after you have received them back in your office. Once a case has been completed (seated in the patient’s mouth), change the case status to "Finished." This is important because the Lab Case Manager allows you to view cases by status: Sent, Received, Finished, or Archived.

Make sure that you have a plan for who in the office will change the status of a patient’s case to ensure accuracy in your tracking system. I like to use the “Received” status list view in the Lab Case Manager to find patients that we have a received lab case for, but who aren’t yet scheduled for an appointment. I can use this as a tool to call and get them scheduled.

Here’s an example of how I’ve seen the Lab Case Manager tasks divided well among the team:
  1. When a patient comes in for their initial appointment for a procedure requiring a lab case (such as a crown prep or impressions for a denture) the dental assistant creates the lab prescription using the Lab Case Manager and attaches it to the case. She prepares the case for the lab to pick up. At that point the lab case status is changed to “Sent”.
  2. Either the dental assistant, or the front desk schedules the patient’s next appointment and attaches the lab case to the next appointment in Dentrix. This signifies to everyone in the office there is an outstanding lab case associated with this future appointment.
  3. When the case is returned from the lab, the front desk changes the case status to “Received.” There is an option in this window to choose who the case was received by, I recommend using that option. That way if there’s a question, it’s easy to know which team member received the case.


  4. When the patient comes in for their delivery appointment, the dental assistant changes the case status to finished.
I’ve found when the team understands the process and their role in it, you can maintain a clean tracking system for your lab cases. Don’t ever hunt for a lab case again! You’ll know exactly where your cases are when using a tracking system like the Dentrix Lab Case Manager. 

For more information about customizing the Lab Case Manager for your office, see the Setting up the Lab Case Manager topic in the Dentrix Help.

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, October 17, 2018

Entering Batch Insurance Payments in Dentrix

It’s Monday at 5:00pm and it’s been a long day at the office. We often have a lot of mail on Mondays since the office is closed on the weekend and there are a lot of checks to post. We’ve posted all the checks, closed out the day, run a deposit slip and…oh no! We don’t balance. Many times, it’s a small amount, (I’ve been off by a penny!) but it must be corrected. It can be very irritating.

Did you know Dentrix has a feature in the Ledger to help you post batch insurance payments? This can help you to avoid the annoying situation I just described. You enter the total amount of the check, then post to individual patient’s claims. The best part is Dentrix will not let you continue unless the amount you allocated adds up to the total amount of the check.

Open the Dentrix Ledger. You do not have to be in a specific patient’s ledger to use this feature.


First, select File > Enter Batch Ins. Payment. Dentrix will default to today’s date (a).  Then enter the total amount of the check, the payment type, check number and bank branch (b). Select the Insurance Carrier Name and choose the group plan (c). You will see a list of patients under that group with outstanding claims (d).

Select the desired claim to post (e) and then itemize the amount paid for each procedure (f). You have the option to update the payment table, enter necessary adjustments, and enter any deductible used (g). The claim status note is available if you need to make any notes regarding the claim (h).

I like to use the claim status note to indicate why a procedure wasn’t paid. For example, if fluoride wasn’t paid due to an age limitation. This is a quick and easy reference if a patient receives a statement and has a question on why a certain procedure wasn’t paid by their insurance. It’s much quicker than looking for the explanation of benefits.

Once that claim payment is complete, select Post Claim (i). Now you can move on to your next claim. Once you have posted the payment for all claims associated with the check, choose Next EOB (j). If the posted amount and the total check amount don’t match and you don’t balance, Dentrix will give you a warning that the amounts don’t match.



You can review and correct any errors while you still have the EOB in front of you.

The batch insurance payment feature in Dentrix is a time saver and a stress saver. There’re always a million things to do at the end of the day and Dentrix making sure you balance before you run the deposit slip at the end of the day can help make your life a little easier.

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, October 10, 2018

Setting Expectations for Staff

Regular training is so important. We know this in the dental office. Our doctors and hygienists must take hours of continuing education bi-annually. They’re constantly learning so they can treat their patients with the upmost quality of care. The rest of us, meaning administrative staff and assistants, can also benefit greatly from regular training.



One of the most important members of the front office team in the schedule coordinator. It’s always a good idea to have a training plan for the schedule coordinator so that she is constantly improving her phone skills and perfecting the art of scheduling to maximize practice production.
I’ve found that an effective way to train a schedule coordinator is to observe them as they work, listening to how they communicate with patients over the phone and in person at the check-in desk. Give them positive feedback and tips on where they can improve.

Additionally, an important part of training you schedule coordinator, for me is to letting them know what I expect.

Here’s list of four things I expect a schedule coordinator to be able to do, and what I do to help them be successful:

Multi-Task
The schedule coordinator must be able to multi-task. The phone is ringing, patients are checking in and out and they must be able to effectively handle these situations. This is important to find out in the initial interview. Ask the potential team member about their multi-tasking skills. If they are a person who likes to focus on one task at a time this may not be a good position for them. Set that expectation at the initial interview.

Answer the Phone
I know that sounds like a no-brainer, but it’s easier said than done. It’s important for the schedule coordinator to be well spoken and use proper grammar. They are typically the first person a patient speaks to and they are a representative of your entire office. Again, find out if they’re the right person for the position when you initially interview them.

Schedule Appointments
Another no-brainer, right? However, scheduling appointments effectively is a lot more difficult than most would imagine. There are nuances to scheduling depending on the doctor. For example, the doctor may want more difficult high production procedures scheduled in the morning and less taxing procedures in the afternoon, so they aren’t doing difficult procedures at the end of the day when they’re tired. I recommend spending time with the schedule coordinator, helping them to understand each provider they will be scheduling for. When you're working with a new schedule coordinator, do this daily. Explain how providers would like appointments scheduled and why. Look at future days in the schedule with them and point out what looks good and what doesn’t. This will help them to learn what the office expects in the schedule. You can also use Perfect Day Scheduling in Dentrix to create time blocks for specific providers and procedures. This can also be helpful when scheduling.

Be Able to Say No 
Many times, patients want to dictate to the office when they want to come in. While I always want to accommodate patients, the schedule coordinator controls the flow of the day. It’s important for them to be able to guide the patient to an appointment that works well for the office, as well as for the patient. To help your schedule coordinator with this, you could create a phone script for them to refer to. When I have a schedule coordinator that struggles saying no, I sit with them and have them listen to the way I speak to patients. This can help them to learn what to say and how to say it.

As an office manager, it’s important to give your team the tools they need to succeed. Work with your individual staff members. Let them know of your expectations, and look for opportunities to give positive feedback on the things they are doing well, and things you have noticed that could be done better.

Provide regular training opportunities. You can do mini training sessions in your morning huddle. This is a good time to talk about what they did great yesterday or what may have gone wrong. Positive reinforcement is a great training tool. When the team gets a pat on the back, they’re remember to keep doing something the right way. Taking the time to set expectations, and then setting aside time to observe and train your team can improve the patient experience in your office.

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, October 3, 2018

How I Handle Cancellations

When patients come to the front desk following an appointment, they often will schedule their next appointment. But because that appointment can be six months or more in the future, they may at some point between now and then have the need to cancel or reschedule that appointment. Dentrix can handle appointment cancellations in different ways based on the situation. Here are two different ways to cancel or reschedule an appointment and my thoughts on when it’s appropriate to use them.

Breaking an Appointment 

Breaking an appointment is what I consider to be a negative cancellation--if the patient is a no-show or cancels within 24 hours of the appointment. Each time an appointment is broken, it counts as a missed appointment in the patient’s Family File. Dentrix tracks the date of the last missed appointment and keeps a running total of how many appointments the patient has missed.



When scheduling appointments for patients, the Missed Appointments number is a good reference for the office to look at because you may not want to give a patient with lots of missed appointments a prime appointment time, like late in the afternoon.

When you break an appointment, the patient’s appointment is moved off the schedule and Dentrix places it on the Unscheduled list. You can use the Unscheduled List as a resource to fill holes in your schedule. If the patient wants to reschedule their appointment at the time they are canceling, I would still recommend breaking the appointment first, so that Dentrix tracks the missed appointment. Then schedule the patient a new appointment.

When you attempt to schedule an appointment for a patient who already has an appointment on the Unscheduled List, Dentrix will alert you that the patient has an unscheduled appointment and ask you if you would like to view the patient’s appointment list.


It’s important to answer “Yes” to this message.  Choosing “Yes” opens the Family Appointment List for the patient where you can view any unscheduled appointments.


Choose the <Unscheduled Appt> from the list and click the View Appt button. The appointment information window will appear with the unscheduled procedures. Then you can choose to Pinboard the appointment and reschedule the patient.

The reason it’s so important to answer “Yes” when Dentrix asks if you would like to view the patient’s appointment list, is because when you reschedule the appointment the way I described above, the appointment will be moved off the Unscheduled List. I find that many offices are just creating new appointments instead of rescheduling them through the appointment list and it results in their Unscheduled List being inaccurate. Patients continue to be on the Unscheduled List for appointments that have already been rescheduled. The Unscheduled List is not a functional tool for the office when this happens.

Wait/Will Call

If a patient calls and can’t make their appointment two weeks from now, I don’t consider that to be a negative cancellation because the patient is giving the office plenty of notice. If the patient can reschedule, you could simply move their appointment to the Pinboard and find another open time for their appointment. If they are unable to reschedule at this time, use the Wait/Will Call option. Double click on the patient’s appointment, then in the appointment information window, select Wait/Will Call.


This will remove the patient’s appointment from the Appointment Book and move them to the Unscheduled List. This gives you the ability to follow up with the patient to get them rescheduled. When you view the Unscheduled List, it shows whether the appointment was broken or marked as wait will call. 


When you are contacting patients to reschedule, I recommend contacting the Wait/Will Call patients first, since they had given you advance notice when they cancelled their appointments. Dentrix does not consider appointments marked as Wait/Will Call to be a missed appointment in the Family File, so use this feature when it’s not a negative cancellation.

Try using these Dentrix features for the different types of cancellation situations you have in your office. I recommend using the Break Appointment option when patients no-show or cancel within 24 hours of their appointment. I recommend using Wait/Will Call option if the patient is unable to reschedule at this time and they have given the office at least 24 hours’ notice. 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, September 26, 2018

How to Handle Partial Insurance Payments

Insurance companies are becoming more and more particular about the type of attachments and documentation they require to process a claim. For example, I was in an office recently that had submitted a claim for a crown with a periapical film. Typically, this type of x-ray would be adequate, but the insurance company sent an explanation of benefits back to the office stating that to process a claim for a crown, the office must submit both a periapical film and a bitewing x-ray.

These types of situation happen daily. Sometimes, when you send an insurance claim for a crown and a crown build-up, the insurance company may pay for the crown build-up, but not the actual crown until additional information has been received. If the insurance company is paying for one procedure now and waiting on additional information before it pays for the second procedure, you should post the payment for the crown build-up when it’s received and not hold the payment until all the procedures have been considered.

When this happens, you want to keep the crown procedure as an outstanding claim to the insurance for two reasons: 1) you can continue to track the outstanding insurance claim for the crown using the Insurance Aging Report in the Dentrix Office Manager, and 2) if you were to post the payment for the build-up and post a $0 payment to the crown, the patient’s ledger would reflect a larger patient portion of the balance than is actually due.

Dentrix has a solution for these types of situations. When you receive a partial payment for an insurance claim, split the primary claim to post payment to the paid procedures and leave the procedure that requires more information as an outstanding claim.

There are a couple of advantages to splitting the claim:


  1. If you were to post the payment for the build-up procedure, but post to a $0 payment for the crown, the entire claim would then be closed. It will no longer appear on the Insurance Aging Report, so you lose the ability to track it and it could easily slip through the cracks. By splitting the claim, you are still able to track it.
  2. Splitting the claim keeps the original narrative in the remarks for unusual services. You may need to refer to the narrative on the original claim if you have to appeal the claim, and by having a record of the original narrative you’ll know what you wrote and what information you may need to add if further action is required by the office. 
  3. The original sent date will be accurate, and any claim status notes you made on the claim will remain with the claim. I wrote a blog post in August about the value of using insurance claim status notes. Once you’ve spent time tracking insurance claims and making notes, you would want to ensure those notes are saved.

To split a primary claim, open the patient’s Ledger. Click once on the claim you want to split so it is highlighted. Then select Insurance > Split Primary Claim.  Select the procedure(s) to be moved to the new claim, then click the down arrow to move it to a second claim.



Once the procedures are split into individual claims, you can post payments to the claims as you normally would.

The ability to split insurance claims is a feature that I find particularly useful that many offices aren’t aware of. Splitting claims helps to keep accurate claim tracking during times when insurance companies request additional information.  If you have questions on this or another 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, September 19, 2018

Give Your Hygienists Tools for Success

Hygienists play an important role in a practice. They can be an asset as producers for the office. As office managers, if we can give the hygienists tools to be more efficient with the software, they could have more time to spend on patient care, explaining treatment, and ultimately creating more production for the practice.

During the patient’s appointment, there are certain tasks we expect a hygienist to perform. One important task is to chart the patient’s existing restorations and treatment plan procedures. Having a hygienist chart and treatment plan effectively can help the front office create a treatment plan to present to the patient. I think it can be helpful for the hygienist to chart and enter treatment in the operatory, that way the front office team has an opportunity to review the patient’s treatment plan before the patient comes up front.

Here are a couple of ways to help your hygienist chart and treatment plan more effectively.


  1. Procedure Buttons
    Procedure buttons can save the team so much time when they’re charting. Think of these buttons as short-cuts. Instead of having to scroll through procedure categories to search for a specific procedure code while they have a patient in the chair, it’s much faster to select an icon from the procedure buttons list.
    As an office manager, you may be very familiar with the ADA codes and where to find them, but typically hygienists are not. Procedure buttons can help hygienists to select the correct code for the procedure. I’ve seen offices chart a crown code for the wrong type of material because the hygienist wasn’t familiar with the ADA codes. Creating procedure buttons can help to decrease these types of errors.

    In Dentrix you can create a customized set of procedure button
    that works for your office. Once you’ve created the customized buttons your office uses the most, they are accessible from any workstation in Dentrix, meaning the team can chart existing restorations or treatment plan procedures quickly.

  2. Auto-State Button 

  3. The Auto-State button in the Patient Chart provides a fast and convenient way to chart procedures. The hygienist can chart multiple procedures that will have the same status (treatment plan, existing, existing other) using less mouse clicks.
    To use the Auto-State button, choose the light switch icon in the Patient Chart and then choose the procedure status, for example, EO (existing other). Dentrix puts a box around the selected status. Once activated, all the procedures you chart will be assigned this status.

    Think of the Auto-State button like the Caps Lock button on your keyboard. Once you turn it on, all the letters you type are capitalized. Similarly, once the Auto-State button is turned on, all the procedures you chart will be assigned to the selected status.

    During Dentrix training I suggest to hygienists they use the Auto-State button. It’s especially beneficial for new patients. They can use the Auto-State to chart all the patient’s existing restorations, then switch to the treatment plan status when the doctor comes in to do the exam.


  4. Probing ShortcutsAccurate probe depths are an important part of the patient’s record. Regular probing is important to catch signs of periodontal disease. Many offices have their hygienist probe patients once a year. Here are a couple of tips to share with your hygienist that can make the process of probing quicker. 
    Many hygienists use the number pad on their keyboard to chart probe depths. They can also use the keyboard to chart, bleeding, suppuration, and bone loss. When the cursor is on the tooth and surface they want to chart bleeding for, they simply need to press B on the keyboard (and S for suppuration and L for bone loss). Using the keyboard saves the hygienist from having to switch from the keyboard to mouse, which saves time when periodontal charting.

  5. Clinical Note Templates
    Using clinical note templates when writing notes is a huge time-saver. My favorite part about using templates is that they are completely customizable. They can be as detailed (or not) as you want them to be. Using clinical note templates ensures that all the clinical notes for a procedure are consistent throughout the office. That way you can be sure the clinical notes your doctor wants are included.

    For more information read this Dentrix Tip Tuesday post: Adding Clinical Notes using Templates and Prompts.
Hygienists are producers for the office. If we can give them ways to use Dentrix more efficiently and save them time, they can spend more time on patient care discussing procedures that can profitable for the office.  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, September 12, 2018

Questions To Ask When Scheduling an Emergency Appointment

Dental emergencies are always going to happen. How we handle scheduling those patients can dictate the entire day for the office.




For example, I visited an office recently where the doctor had four patients scheduled back to back for an emergency exam and X-ray. He only had 30 minutes scheduled for each of these emergency patients. One patient needed an extraction and two others needed a root canal. He didn’t have enough time to treat the patients within the 30-minute appointment and they had to be scheduled for another day. It was a stressful situation for the doctor, frustrating for the patients, and unproductive for the office.

I’ve found that if you ask certain questions when scheduling an emergency appointment, you can schedule an appropriate appointment length.

For example, if a patient has a broken crown, chances are they’ll need a new one. If you schedule enough time to do the new crown that day, the patient doesn’t have to come back for a separate appointment, and the office increases production.

Here are some of the questions you can ask a patient on the phone to better plan for their emergency visit. While I would never suggest trying to diagnose a patient over the phone, you can ask certain questions to give your clinical team more information and be better prepared.



  1. What type of symptoms are they experiencing and are they in pain?
    I would always schedule a patient who’s in pain the day they called. But often when they call, they aren’t in pain, for example they may have chipped a tooth. If they’re not in pain, it’s not a true dental emergency. I may try to schedule the patient the next day or at a time that is more convenient for the office.

  2. Is the pain constant? And is there sensitivity to hot or cold?
    These questions can help you determine if it may be an endodontic situation. If you refer out for root canals, it may be a good idea to find out what availability the endodontist has.

  3. How long has the tooth been bothering them? Where is tooth located?These questions give the clinical team an opportunity to look at the patient’s chart and X-rays ahead of time to be better prepared.

  4. If a crown came off, do they have the crown? Is the crown broken or intact?
    This helps to determine if it will be a re-cement or new crown and can help you gauge the amount of time to schedule.

  5. How old is the crown?
    This gives the administrative team an opportunity to research the patient’s insurance replacement periods.

  6. Did the tooth have a root canal?
    If an endodontically treated tooth is broken it may not be restorable. This may result in the patient needing to have the tooth extracted, so you can schedule the appointment length accordingly.

Asking these types of questions up front when the patient calls can be a little more time consuming, but it saves time and stress when the patient is in the office. I think it’s important to be as prepared as possible when treating patients. Getting more information from the patient helps the front office team and the clinical team provide the best treat possible to the patient. Document the information you gather during the phone call in the Office Journal so that each member of your team can access the information when they need it. 

If you have questions about this or other topics, please email 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, September 5, 2018

Scheduling Patients with Outstanding Treatment - Beat the End of Year Rush

Now that we’re headed into fall, it gets me thinking about all the things that need to be done at the office before towards the end of the year. There’s always a push at the end of the year for those patients who want to get treatment done that the doctor diagnosed months ago, and patients who want to use their outstanding insurance benefits before they renew in January.

This can be a very productive time for the office, but also a stressful one. You must find appointment times for all these patients. I recommend that you start scheduling those patients now. That way you can control the flow of your schedule. You can spread the patients out over the next few months, instead of trying to jam them all in December. December tends to be a shorter work month with the holidays and many patients will be out of town. It’s more beneficial for your practice to start scheduling these patients now, in the fall.

You can find all the patients with outstanding treatment in the Dentrix Treatment Manager. The Treatment Manager is available from both the Appointment Book and the Patient Chart.


The Treatment Manager allows you to generate a list of patients that have outstanding treatment plans through filter options.



I like to generate a list of patients that is filtered by procedure code range. This allows me to search for a specific procedure codes like a crown or bridge and get an idea of how many patients have those procedures treatment planned, but not scheduled. Another reason I would search for a crown or bridge is because those procedures take two appointments two weeks apart. Many insurance companies pay based on the seat date so it’s important to get both appointments completed before the insurance renews.

Another useful filter is a minimum treatment plan dollar amount which can help you find high production cases. High production cases will result in higher revenue for the practice, so I like to contact those patients first.

You could also use filters to view only patients whose insurance renews in January. These patients are going to be motivated to schedule an appointment before their insurance renews on January 1st.

Once you have set your filters and generated a list of patients, you can display the insurance benefits each patient has remaining, letting you know which patients might be more likely to schedule. 

The Show Columns option allow you to choose which type of information is displayed for each patient. For example, if you wanted to contact patients with treatment plans and outstanding insurance benefits, I would recommend viewing columns for: 
  • Patient Name
  • Last Treatment Plan Date - shows you the last date treatment was diagnosed.
  • TP Total Amount - allows you to see the total amount, so you can contact the higher production treatments plans first.
  • TP Dental Ins Estimate - shows you the estimated insurance portion of the treatment plan. You can use this to educate your patients. For example, I could explain to a patient that the estimated insurance portion for the treatment plan is $1000. If the patient doesn’t use that benefit before January 1st, they will lose these benefits.
  • TP Patient Estimate - gives the patient portion of the treatment plan.
  • Pri Dental Ins Benefits Rem - shows the amount of primary insurance maximum remaining.
  • And if your office accepts secondary insurance benefits, you could also view Sec Dental Ins Benefits Rem as one of your columns.

Once you have the list of patients that fit the filtering criteria you’ve set, it’s nice to have all this information in front of you so you can answer any questions they have regarding their treatment plan when you contact the patient. The Treatment Manager also allows you to select a patient’s name on the list and go directly to other Dentrix modules like the Patient Chart, so you have easy access to their clinical notes if the patient asks you a clinical question. 

By starting this process now, using the Treatment Manager to filter patients who have outstanding treatment plans and whose insurance renews in January, you can contact patients and explain to them the advantages of using their insurance benefits before it renews.  By starting early, you have more control of your schedule, and can spread the production out over the next few months instead of trying to squeeze all the patients in December. If you have questions about the Treatment Manager please email 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, August 29, 2018

The New Patient Phone Call

When a new patient calls to schedule an appointment, I recommend getting as much information on that initial phone call as possible. I’ve found that this can help to provide the most comprehensive care to the patient at their initial appointment.

Here are some questions I like to ask a new patient on the phone and why:


  1. "How did you hear about our office?"
    This one’s easy. Tracking referrals can help the practice decide where best to spend advertising dollars. For example, if we placed an ad in a magazine, what was the return on investment? Internal marketing can also be beneficial for the office. Track which patients are referring their friends and family. Send them a thank you note. Some offices give a small gift or offer free teeth whitening to the patient with the most referrals.
    You can track referrals in Dentrix by entering in the Referred By source in the New Patient Information window in the Appointment Book.


  2. "When was the last time you had your teeth cleaned?" This helps to determine several things. If the patient had their teeth cleaned six months ago, it’s likely they will just need a prophy and not periodontal treatment. This helps to know how much time to allow for their appointment. Also, the patient may have had X-rays taken recently at their last dental office that can be transferred to your office.
    If it’s been ten years since their last cleaning, the patient may need scaling and root planing or more extensive periodontal treatment and the hygienist and doctor can be better prepared for that patient.
    Also, this question typically gives the patient an opportunity to tell you about their attitude toward the dentist. For example, they may say something like, “It’s been ten years since I had my teeth cleaned. I’m afraid of the dentist.” This lets you know up front that the patient has a fear and may require a little more TLC.

  3. Medical history questions such as: "Do you have any replaced joints? Do you have any heart problems like Mitrovalve Prolapse?"
    Getting this information ahead of time can help the office determine if this patient may have a need to pre-medicate prior to dental appointments. This avoids having to delay or reschedule the appointment which is annoying for the patient and lost production for the practice.

  4. What type of dental insurance do you have?
    There are so many types of insurance plans. It can be hard for dental professionals to keep up and understand all the requirements, let alone the patient. I recommend verifying a patient’s dental insurance benefits before they come to your office. This way you can find out if the patient’s plan allows them benefits at your office before they arrive for their appointment.

I’ve found spending the time to get this information before the patient comes to the office makes the patient’s new patient appointment go more smoothly. By asking these types of questions you can avoid the problems that may delay or cause the office to have to reschedule the patient’s appointment.

If you have questions or if you would like an example of a new patient call-in sheet, please e-mail me atvectordentalconsulting@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, August 22, 2018

Dentrix G7 Health History - My Favorite New Feature

Dentrix G7 is here and it is awesome! It includes some exciting new features. One of my personal favorites is the new Dentrix Health History.

In previous versions of Dentrix we had medical alerts that could be edited in the Family File. Dentrix G7 has replaced medical alerts with a Health History module which is still accessible through the “red cross” button throughout Dentrix.

The new Dentrix Health History is much more comprehensive than what we had in the past. My favorite part of the Dentrix Health History is the ability to inactivate medical conditions. This is such a great improvement because you will have a comprehensive list of a patient’s past and present medical conditions. It’s important to have an accurate medical history for patients so that the doctor can see if the patient has a condition that could cause a contraindication with the treatment they are providing or a drug they are prescribing.

When you add a medical condition for a patient, you have the option to enter a both a reported date (when your practice became aware of the condition) and a start date (when the condition started) for the condition.


For example, if a patient has gestational diabetes, you can add that medical condition to their health history, with the start date of when they were diagnosed.

Then, once the condition has been resolved, you don’t want to simply delete the medical condition from their health history. It’s important for offices to keep a record of these medical conditions even if they no longer apply because they are a part of the patient’s medical record. Similar to when we had paper charts, we always wrote in pen, never pencil and we would never erase anything that was written in the chart.

With Dentrix G7, you can inactivate a medical condition, and doing so you still have a record that the patient had this medical condition in the past. If the condition were to reoccur, or a subsequent condition were to develop, you would have the date the condition was initially reported to your office.

To inactivate a medical condition, in the Health History module, highlight the condition, and then click the Inactivate button from the toolbar.


A warning message appears, letting you know that you this action cannot be undone. Click Yes to continue and inactivate the condition. The current date will be listed as the inactivation date for the condition, but this can be edited if needed.

Now you can keep a truly accurate record of the patient’s previous and current medical conditions. You can quickly identify inactive medical conditions by looking at the Status column for the patient.
The Health History module is just one of several new features in Dentrix G7. For more information, you can watch the Dentrix G7 new feature preview video titled Health History.

If you have any questions, you can contact 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, August 15, 2018

Maximizing a Provider's Time in the Schedule

It can be difficult for a new front office team member to learn the ins and outs of scheduling. It can be even more challenging if they have limited dental experience. To effectively schedule patient appointments, it’s important to understand where the doctor and assistant are during an operative procedure.

Scheduling is such an important task in the dental office. I’ve seen offices that are very busy but unproductive. The goal is to maximize the doctor’s time and be as productive as possible.

In Dentrix you can schedule provider time and assistant time. This can help a new front office team member to understand where a doctor can be double-booked to maximize their schedule and where they can’t. Using this system can also help a new doctor to know where they need to be and when to effectively manage their time.

You can adjust provider, assistant, and chair time within a patient’s appointment.
When scheduling a new appointment select the search button (>) next to Appt Length in the Appointment Information window.



The Appointment Pattern Time window will appear.  Select the time units, then whether those time units should be designated as Provider, Assistant or Chair Time.



In this example, the fist 10 minutes of the appointment is designated as assistant time for the assistant to seat the patient and place topical anesthetic. The next 10 mins is designated as provider time for the doctor to anesthetize. The next 10 minutes is assistant time while the patient gets numb, and the final two 10 minute time frames are provider time for the doctor to perform the procedure.

Scheduling using dedicated time units allows the doctor to be most productive because instead of waiting for the assistant to finish their part of the procedure they can be working in another operatory. For example, doctor could anesthetize a patient in one operatory and while waiting for that patient to get numb, they can work on another patient. I’ve seen this work well in offices, especially during procedures that require a lot of assistant time, such as a crown prep. While the assistant is making the temporary, the doctor can work on another patient in another operatory to be most productive. Time is money as they say, so it’s important for dental offices to be as productive as possible.

Time units dedicated to a provider (X) can’t be booked in more than two appointments at a time. This eliminates the doctor being booked in more than two operatories at once.

Not only can you can adjust appointment time patterns within an individual appointment, but you can also set them for specific procedure codes, so they will be pre-set when you are scheduling an appointment for that procedure code in the future.

Let’s take the crown code D2740, for example. In the Procedure Code Editor, you can select how the time units are set up for this procedure code.



Once you have allocated the Provider, Assistant, and Chair Time for the procedure, save your changes. And the next time you schedule that procedure for patients, it will be easy for your providers to know where they need to be, and you can better manage their time.

Scheduling appointments and properly assigning provider, assistant, and chair time can help the front office team to schedule more effectively. It gives them the ability to know where they can double-book a provider, and more importantly, where they can’t.

For questions on this topic or others, please email 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.