Bulletin, May 2008

The Latest in Area Economic and Technical Trends
Exclusively to Clients and Friends of Advanced Practice Management

The Dental Dow Jones, first quarter 2008:


Comparing the first quarter of 2008 averages to those of the first quarter of 2007, we find that practice production is up 4% and collections are up 2%. Total exams are up just .8% with new patients being down 9%. Crown and bridge is down 3%. Downtime in the Doctors’ schedule increased from 6.3% to 8.4%. Downtime in the Hygienists’ schedule increased slightly from 11.4% to 11.8%.



This represents a slower start than in 2007. The first quarter of 2007 over 2006 showed production up 4.4% and collections up 4.6%. New patients then were up about 9% and there was a 2% increase in patient exams. As you may recall, statistically speaking 2007 got off to a good start but things faded a bit by the fourth quarter of the year.
There is so much bad news out there with gas prices and foreclosures, I half expected things to be worse. We’re not having a dental boom year by any means, but I couldn’t prove that there is a serious recession going on either.

Growth is definitely not a given. Even some very good practices are experiencing mild declines this year. Remember, even though the economy can have an effect, you have far more control over what happens in your practice than any outside factor including the economy, gas prices and Delta!


Over the years we have been seeing tighter accounts receivable ratios (as compared to production). Twelve years ago it wasn’t at all unusual to see accounts receivable ratios of 2.5 or higher. Now our client base averages under 1.3. Yet, collections percentages are gradually falling. The Dental Dow Jones showed an 88% average collections percentage verses about 90% the previous year. As Dentists increase their fees, Delta and other insurance companies aren’t keeping up, so PPO and Medical Assistance discounts widen.

Wasted breath and money walking out the door:

We see it over and over again; Doctors and hygienists present treatment but the patients “shrug it off” at the front desk (or don’t stop at the front desk at all). “I’ll have to check my schedule and get back to you…” Or, “I’ll call you after vacation…”, etc.

As you know, we are constantly working with our clients on the whole process…from new patient intake to the hygienists’ codiagnosis, briefing with the Doctors, the handoff to the front desk and the front desk making financial arrangements and scheduling treatment. All along the way, there is potential for treatment being lost or saved. The good news is that, by paying attention to this process, you can significantly increase your income.

For starters, for at least a two week period just keep track of treatment “shrugged off” at the front desk. You can do this on the computer, but I prefer just a simple notebook where you note the patient name, date, treatment recommended (and declined) and the reason why. This can really help underline for you and your staff the challenge and potential available to you.

Of course collecting money is an important duty of your administrative staff. Even more important, though, is helping patients to comfortably afford treatment. Most practices have far more of a production problem (generating adequate and consistent demand) than a collection problem per se. Patients need to know what their treatment will be, how much it will cost, and what their payment options are before treatment begins. Yet most offices cannot swear that they cover the bases 100% of the time. Be determined that you will, and with a little help from your friends (us) we will make it happen.

Expand your expectations— a visit to an extraordinary office:

Many already know about Drs. Steve and Chad Boger’s Dental offices. It is truly an exceptional practice. Dr. Steve has not participated with Delta or any insurance company for over 20 years. He has attended almost any significant Continuing Ed program (clinical and managerial) you can think of from Pankey to LVI.

Boger Dental just recently moved into the new facility in Plymouth. They have reopened their “Center for Professional Development” where offices from all over the country come and visit for a “Day at Boger Dental”. Unlike most Continuing Ed events, where you listen to a lecturer with a Power Point presentation, here you actually are visiting a working dental office. You have a “tour guide” and you and your staff will have plenty of access to their counterparts, the Doctors and other staff.

I feel that every Dentist could benefit by visiting almost any other dental office. We’ve learned from every office we’ve worked with. A visit to Boger Dental can be a truly exceptional Continuing Ed event which will expand your and your staff’s expectations about what is possible and help you to find what you want to be about.

Most Dentists want to do some cosmetic dentistry but very few dentists do more than a half dozen cuspid to cuspid veneer or crown cases per year. Many of you have already invested heavily in Continuing Ed for Cosmetic Dentistry (U of M Cosmetic continuing courses), etc. and seeing a practice deep into this area can help you get things going.

Confused about mandatory e-claim submission?:

As you may have heard, presumably effective July 2009 all dental offices and health care facilities in the state of Minnesota will be required to file their insurance claims electronically as per the Minnesota Department of Health. Insurance companies will have to be prepared for this as well.

Last we surveyed this, over 65% of practices were already filing claims electronically. However, with this upcoming deadline, there have been some companies who have been pushing new software and e-claim services for the sake of meeting the compliance deadlines which may not be strictly necessary. Moreover, most offices with dental management software are well capable of going with e-claims without having the latest version of EagleSoft, Dentrix or whatever. So there may be very good reasons to update your computer or software, but e-claim submission probably isn’t one of them.

The MDA is making provisions for Doctors who are not computerized or not doing electronic e-claims through their office to have their manual claims converted to confidential electronic claims. So they are working on back up for you.

As with all government rules we always say, “We’ll believe it when we see it….” These deadlines often are pushed back. We’re not saying don’t plan, but don’t rush either.

Moreover, many of you are paying too much for e-claims. If you are paying over 50¢ for e-claims, chances are you can get as good or better services for less. If you’d like a referral on this, call our office and we’ll discuss this with you. We’ve seen reliable services for half the price. If you’re doing 300 or more claims per month (and you may well be), this can add up to a nice extra chunk of change by the end of the year.

Yours Truly,