Despite what many think coming out of dental school, the life of a private practice dentist can be tough. We encounter obstacles and decisions that, if made incorrectly, can cost the office thousands of dollars.
Every day, we struggle to keep our overhead in check. We’re constantly battling with insurance companies to improve our reimbursement rates and actually get paid for the care we provide.
We’re constantly searching for new ways to drive patients to our practices, all while managing a diverse team in a dynamic office environment...and, of course, providing the best possible dental care to our patients.
Sometimes the best decision you can make for your practice is to step back and evaluate. Identifying inefficiencies, and fixing them, can make a dramatic difference for you and your practice.
After ten years in private practice, I recently did some practice-soul-searching, and I uncovered some improvements I could make. Here are ten ways that helped me improve my bottom line by almost $200k without picking up a hand piece.
Dentists typically order supplies weekly, if not daily, when they run low on a product. This is not very efficient.
The less often you order supplies, the more likely you will be able to take advantage of bulk purchasing discounts. Create a system where you are ordering enough materials to last for a month at a time.
You should create an inventory and ordering system for every material/supply that you use, no matter how mundane it seems. While buying in bulk requires a larger cash outlay, the discounts more than make up for it later on. Nearly all dental supply companies offer promotions throughout the year, so keep up with those to save even more money.
Secondly, make sure that you are checking those invoices and matching them to what is actually in the box. Many times I’ve found that materials are missing that I paid for, which would have resulted in lost money had I not caught it.
There are also several buying groups you can join to give you significantly better pricing on supplies. Some of these include:
As dentists we are trained from dental school to perform fluoride treatments only on our pediatric patients...why not include adults?
Typically, we don’t offer this to adults because it is generally not covered by insurance, so we think they will not want to pay for it. This is not true.
For your adult patients with existing restorations, or that are medium/high risk for caries, fluoride should be offered. It increases the lifespan of existing restorations and reduces the likelihood of new caries.
In our practice, we started offering fluoride to our adult patients who meet these criteria at a set fee. Fluoride treatment can be an excellent source of additional revenue that also benefits your patients.
I hear it almost every day from dentists who are frustrated that they are working harder for less. Our dependency on dental insurance has been rising over the years as more and more consumers are covered, and with increased dependency will only come decreased reimbursement rates.
So what do we do?
Certainty, dental insurance companies are not going to increase their reimbursement rates if you don’t ask. There are two approaches to negotiating these fees: the do-it-yourself approach and the hire-a-company approach.
For the do-it-yourselfers, I recommend picking a time each year to contact your specific rep for each insurance company. Call them directly and ask for a fee review. Before you call, you should know the top 10-15 most frequently utilized procedure codes for your office – if you look at the revenue generated from these codes you should see that over 90% of your total income comes from these top 10-15 procedures. Focus exclusively on these codes to keep your negotiations simpler.
Using a third party to assist you in negotiating your fees can be a huge advantage for private dental practices. We are often on an island with little knowledge of what others are being reimbursed and with little negotiating power. Third-party PPO negotiators know which companies are more willing to negotiate and they know what to ask for. Some third-party PPO negotiators are:
We all have our own philosophies on how often radiographs should be made. This is based on our own clinical observations as well as what we learned in dental school or throughout our career.
For most, a set of bite wings every year and a panorex or FMS every five years is typical. Some like to take a panorex more regularly or less regularly. Ether way, you should have a specific system set in place in your office and make sure your team is following it.
When I looked into my office’s recall appointments I found that often, my hygienists weren’t re-taking the panorex every 3-5 years as I wanted. Anterior PAs along with bitewings are a great way to diagnose additional pathology and the costs are often covered by insurance companies.
I then began having my front desk review the radiograph history when making reminder phone calls and add any needed radiographs to the hygiene appointments. This way my hygienist wouldn’t miss a needed radiograph.
Ensuring a proper radiograph schedule will not only help your patients, but, since radiographs are typically paid at 100% by insurance, it can be an easy source of found revenue.
Since I graduated dental school over 10 years ago it seems that every practice management “expert” has strongly encouraged 60-minute hygiene appointments. They touted the benefits of your hygienist spending more time with your patients, educating them on outstanding treatment. I blindly followed this advice for many years, even though many times my hygienist finished early.
A few years ago I made a change and moved to 50-minute adult hygiene blocks, which allowed for 2 additional hygiene appointments per day. An average hygiene appointment generates $150-200 in revenue, so moving to 50-minute appointments can add $75,000-$100,000 in additional revenue to your bottom line in in a given year.
I can tell you that for my office, the 10-minute reduction didn’t generate a single patient complaint and we scheduled just as much restorative work out of our hygiene department. Turns out 50 minutes is plenty of time for a hygiene appointment.
Occlusal trauma secondary to parafunctional habits are rampant with our patients. One easy way to both help your patients and drive more revenue to your practice is by educating them on signs of occlusal trauma and of the benefits of an occlusal guard.
Bringing on an associate is not a decision that should be made haphazardly. There is a lot of information – and many opinions – available on the best time to bring in an associate.
There are two basic reasons to consider adding an associate: 1) your practice is simply too busy for you to keep up, or 2) if you are looking to cut back your hours.
An associate allows you to add more hours including nights and weekends that are VERY appealing to your patients. They also allow you to work fewer hours, but more efficiently.
I found that when I brought in an associate and cut my hours back, my production remained the same – my time was just utilized a lot more efficiently. This also allowed me to be open nights and some Saturdays which my patients LOVED.
Several SaaS (software as a service) companies have come into the dental marketplace in recent years that have the potential to make our lives much easier and improve profits.
Some of these services help with appointment confirmation and reminders, reducing the numbers of no-shows. Some of them make it easier for us to get unique online reviews. Some allow patients to easily schedule appointments online. Some do all of these.
There are subscription-based services to help with nearly every aspect of practice management and patient communication. While these services are generally not free, the benefits they provide typically outweigh their monthly fees many times over, and will allow you and your staff to focus on patient care and on maximizing the value from each patient. Some of these companies are:
Several companies have been created in recent years to help dentists with services that, for small offices, are better to be outsourced. An example of this is eAssist Dental Solutions.
This company provides a full service solution for managing your insurance claims. They file claims, follow up on claims, and are experts in getting you paid for the care that you provide. In return, they keep a small percentage of the claims they successfully process.
They do all the work so that you don’t have to spend the money hiring an insurance coordinator. There are many companies that provide similar services.
Another great area to outsource, especially for smaller dental offices is a call center. How often do you sit in your office and hear the phone ringing like crazy and cringe when you hear it go to voicemail because your front desk is already on the other lines? (It happened all the time to me.)
How many missed calls are new potential patients that you are often losing because no one was able to answer the phone? There are a number of dentistry-focused call centers – one being Breakaway Practice Solutions – that can help to answer those calls when you are busy or out of the office.
Uninsured adult consumers have a preventive dental care utilization rate of around 20%, compared to a 50% utilization rate for consumers that have some sort of dental plan. The number one reason cited should come as no surprise to any of us: cost.
Patients LOVE subscription plans because they allow them to budget their spending in monthly allotments. By offering an in-house membership plan you can drive more of these uninsured consumers to your office and build loyalty to keep the ones you have. A monthly membership plan gives you consistent, recurring monthly revenue and allows you to have more control over pricing.
I started using in-house membership plans for my practice a few years ago, and it has been the single most effective revenue-increasing decision I ever made. In fact, I believe so strongly in the benefits of in-house membership plans that I created this company to help other dentists create and automate their own plans.
DentalHQ can help you set up your plan, provide branded marketing materials, automate the tracking and payments of your members, and even drive more new patients to you through their patient marketplace. It revolutionized my practice, and I’m sure it can do the same for yours.
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