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.