Everything Dental Blog March 2018

We Both Thought the Other Was A dentist

An insurance executive was sitting next to me at a dental coding lecture. We both thought the other was a dentist until I asked the speaker a question. After the speaker responded to my medical coding inquiry, the insurance executive complimented me on my insight and introduced himself. I was quite surprised that he was not a dentist. He went on to ask me where my practice was located and if I was a panelist of his company’s PPO. When I told him what I do for a living, he was so surprised.

The irony of two non-dentists, fully engaged and sitting next to each other in a room filled with successful office managers and dentists was fortuitous. We had a polite conversation throughout the day and he was gracious enough to answer some questions for me. We discussed everything from practice overhead, increased staffing costs, technology and our thoughts about the state of America’s healthcare and access to care. On a break, I asked him why the annual dental benefit hasn’t increased for decades. I explained how overhead, human capital, technology acquisition and integration costs were weighing hard on participating dentists. I told him that many owner/dentists make less today than they did several years ago. I demonstrated how the annual dental benefit fails to cover basic restorative and preventive dentistry (one crown and two hygiene appointments). He smiled at me and said, “I get this question all the time. Why should the annual benefit be raised when the average card-carrying patient uses less that $800 of their $1500 benefit?” He went on to say; “Did you know, that a third of adults with dental insurance fail to make a single claim every year and millions of dollars of approved dentistry, never gets done and is never submitted for reimbursement?” After that enlightening explanation, he continued with the usual “The employer controls the depth and amount of coverage that the employee receives”. While he and I have much different perspectives on comprehensive dental coverage, the left side of my brain (analytical and competitive) understood his response. It was the right side (emotional intelligence) of my brain that continues to believe that greed and profit are the obstacles to stellar healthcare for all.

The take away for dentists and practice managers.

Know your numbers. Focus on preventive and restorative dentistry. Improve your clinical team’s non-clinical skills. Make training the centerpiece of your employee development program. Training is critical if you want to develop your personnel and go from good to great. Become a thoughtful treatment planner and a gifted treatment presenter. Study dental insurance guidelines, reimbursement policy, and third-party financing.

Business has always been a game of numbers.

Many clinicians underutilize the precision and speed in which they can access their data. Monthly, weekly, daily and by the minute reporting can significantly improve decision making and identify positive and negative trends in real time. Every organization is unique and the frequency in which they analyze their reporting is subjective. However, systems improve when they are monitored. Goals are achieved when you manage your success.

Every team member must have a mission or goal for themselves. It can be as simple as answering the phone by the second ring or completing Wednesday’s patient insurance verification by Monday afternoon. It could be using the intra-oral camera on every patient or identifying one new Perio patient a week. For other offices, the goal may be to sell ‘All on Fours’ or simply treatment plan more implant cases. Every person and every office can improve.


Let’s assume you have 1500 active patients. In a perfect world, that would equate to 3000+ hygiene appointments plus exams and radiographs. Conservatively speaking, you will generate $400,000.00 of preventive revenue and those efforts will identify another $600,000.00 in restorative and operative work for the dentist. In this example, you would have produced $1,000,000.00 worth of dentistry for the year. Your average patient spend is $666.66.

*$1,000,000.00 divided by 1500 patients =$666.66 per patient.

If you could increase the average patient spend by $100, this is what would happen

$766.66 X 1500 = $1,149,990.00

In the first example (at a 70% overhead) the dentist would yield approximately $300,000 in annual income. In the improved scenario, the dentist would yield approximately $344,997.00.  Almost $45,000 more

My two cents

Every business has an obligation to its constituents and to its workers. We want to provide our employees with a supportive and inspiring workplace so they go the extra mile for our customers. Today, the consumer is king! Patient reviews and social media posts can harm or turbo-charge your brand. Exceeding your customers’ expectations and providing excellent customer care is critical in the Likeable Economy. Check out these two books from authors Dave Kerpen (Likeable Local) and Gary Vaynerchuk (The Thank You Economy) who explain how social media is a powerful tool.

I urge everyone to ask themselves, “Why me?”. Why should someone come to your dental office instead of the other one down the street? Do patients come to your office because your clinical outcomes are superior? Are patients attracted to your practice because you have a familiar name and are listed as a provider on their dental insurance plan? Maybe they’re attracted to your office because it’s conveniently located and there’s plenty of parking? Is it your web presence, phone etiquette and customer service that attracts new patients?

A Few Tips –

Receptionists/ Appointment coordinators and Office managers:

  • Seek out a training program for phone skills and customer service.
  • Join AADOM (American Association of Dental Office Managers) and enjoy a network of professionals who provide education, experience and support.
  • Share ideas and solutions with other office managers at CE events and participate in online social media groups.
  • Complete all insurance verification and patient administration 48 hours before the patient’s appointment. This will enhance treatment planning, scheduling, operations and case acceptance. Prepare financial solutions, for those costly cases, in advance of the patient’s appointment.
  • Schedule all treatment – all the time.
  • Be the Czar of going chartless. Paper-less dentistry is worth the initial challenges and resources.
  • No patient leaves the office without their next recare appointment
  • Always be coordinating approved dentistry and outstanding treatment recommendations


  • Consider expanded duty certification (limited by state guidelines)
  • Consider CadCam certification
  • Become proficient at making whitening trays, sports guards, and night-guards
  • Work towards using procedure tubs and trays and instrument cassettes.
  • Be a patient ambassador – make it your job to create an amazing patient experience.


  • Execute on adult sealants, varnish, and fluoride treatments.
  • Take intra oral camera images on all patients (have them ready for the Drs. exam so that you can identify ‘hot teeth’ or areas of concern)
  • Perio Chart everyone (follow office protocol) *investigate voice activated and other assisted charting devices


  • Focus on implants, whitening, indirect restorations and clear aligners.
  • Streamline processes and strive for greater efficiency.
  • Work towards producing more ‘Same Day Dentistry’. If you see it and the schedule permits it, do the work now! *The schedule should be built so that you have some flexibility.
  • Invest in technology and equip that swing room that is currently used as a storage room. A swing room allows you to go from one patient to the next without waiting for operatory cleanup and disinfection. If you save ten minutes seating six patients during the day, you will gain an hour of productive work!
  • CadCam dentists, emphasize indirect porcelain restorations in lieu of composite restorations. They look better, last longer and wear twice as long.
  • Execute on previously accepted or approved treatment that remains unscheduled and undone.