Handling Staff Changes

Staff changes in your dental practice are inevitable. People move, have life changes, and sometimes, just aren’t a good fit for your practice.

Make a habit of keeping records of your interactions with employees that aren’t a good fit for your office, so you have a paper trail.  When needed, it’s important to counsel staff on what they’re doing wrong and how they need to improve. Offer additional training in areas you find them struggling with, and keep a written record of these meetings and what was discussed.

It’s also a good idea to have the staff member sign off on this written record. This way you can protect your practice if you end up having to let the employee go. You’ll have written proof that you gave them chances to improve and gave them the necessary tools, but they ended up not meeting the expectations of your practice.

If a staff member makes the decision to leave your office, request their notice in writing. This way you will have proof the team member left by their choice, versus being let go, to avoid any repercussions to the practice, like having to pay unemployment. Remember to request that the staff member return property belonging to the practice, like keys to the office and uniforms.

When it comes to your Dentrix software, be sure to inactivate staff members (or providers in the case of hygienists and doctors) who no longer work at your office. Each user in your practice should have their own user ID for Dentrix. Never re-use a user ID! I’ve seen an office that had a dental assistant leave the practice, and instead of creating a new user ID for the replacement assistant, they simply changed the staff member’s name in Practice Resource Setup to the new assistant’s name. A user ID should be unique to each staff member because there is history associated with each user ID to allow you to see who did what in Dentrix.

I’ve also seen previous employees complain that they weren’t paid for the correct number of hours. If you use the Dentrix Time Clock, and each employee has their own unique user ID, it will be easy for you to view their clock in/out history to prove that your practice paid them correctly.

Keeping accurate employee records can help you to protect your practice.

For additional information, read these related articles about team management:

• Setting Up Dentrix for a New Associate
• Managing Employee Performance in a More Effective and Contemporary Way
• Building and Maintaining a Strong Team

If you have questions about this topic, 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.

3 Dentrix Tools To Help You Accurately Collect Payment At Time of Service

I always recommend collecting from patients at the time of service. If you don’t collect from patients when they are seen for treatment, it ends up costing your practice more money. It costs you money to send out statements. It also costs you money when your staff spends time contacting patients regarding their balances. And if patients don’t pay and you have to send the account to a collection agency, there are costs involved in that too.

Here are three of my favorite tools in Dentrix to help you collect accurately from patients at the time of service.

Coverage Table

Every insurance plan in Dentrix should have a coverage table associated with it. The coverage table is used to enter how much the insurance plan will cover for a particular procedure or group of procedures.

My favorite feature of coverage tables is that they are completely customizable. You can create your own procedure code ranges based on trends you see in your office. For example, if you notice a full mouth series of X-rays is being covered with a deductible applied, you can customize the coverage table to reflect that. This customization can be done for each individual insurance carrier or you can change your default coverage table in the Office Manager.

Payment Table

The payment table is one of my favorite features in Dentrix. It allows you to enter in the dollar amount that an insurance company will pay for a specific procedure code. This is extremely helpful for procedures that typically have an alternate benefit applied, like a posterior composite filling. It’s also extremely helpful if your office is out of network with an insurance company when the co-insurance percentages may not be accurate. Procedure codes and payment amounts can be entered in the Family File.

Or updated when posting insurance payments, using the Itemize by Procedure option. 

Override Insurance Estimates

If you know a procedure won’t be covered by insurance, (for example,  a replacement crown less than five years old) you can override the insurance estimate for the procedure. 

That way the patient is aware that the insurance won’t pay for the procedure and you can collect from the patient at the time of service.

Collecting accurately from patients at the time of service can reduce costly accounts receivables for your office. Using the features in Dentrix to help you calculate patient’s payment amounts can keep healthy cash flow and reduce accounts receivables. E-mail me if you have questions 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.

Understanding the Reasons Behind Missed Appointments

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

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

Ineffective Communication

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

Unenforced Policies

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

Under-valued Time

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

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

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


Charlotte Skaggs, Certified Dentrix Trainer

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

Missed Appointments - What's Your Approach?

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

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

Have Policies in Place

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

Use Dentrix Tools

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

Document Missed Appointments on Reports

Post a procedure code for a missed appointment to the patient’s Ledger. You can use the American Dental Association procedure code D9986 (missed appointment) for this. You can choose to charge the patient, or not based on your written office policy. But it can be beneficial to post the code to the patient’s Ledger for several reasons:

• Posting the code gives you the ability to run reports on how many missed appointments you've had within a particular date range.
• The missed appointment will be posted on the Day Sheet so the office manager and the doctor can easily see which patients missed appointments that day.
• When sending billing statements, patients will see the missed appointment posted to their Ledger. It lets them know your office is tracking this and it’s an issue you take seriously.

Once you have posted the code to the patient’s Ledger, add a procedure note with the details of what happened. You can easily do this by double-clicking a procedure in the Ledger to open the Edit or Delete Procedure dialog box and entering the note in the Notes field. Having missed appointments listed on the Ledger with the date and notes of what happened, make it an easy place for everyone in your office to look for this information.

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

Missed appointments are a concern for office managers and can negatively affect the production and revenue of the practice, so it’s very important to have clear policies and procedures to handle them.

Another important question to ask is “Why are patients missing their appointments?” If you can address this question, you will be well on your way to minimizing the number of missed appointments in your practice. 

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


Charlotte Skaggs, Certified Dentrix Trainer

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