Linda Drevenstedt

1. Control your overhead by taking action in two areas:

• Increase production with your current resources of facility, people, and procedures ... OR
• Reduce expenses and control costs in all areas.

2. Crunch your numbers monthly, quarterly, and annually.

• Numbers to crunch monthly:
• Production daily or hourly per provider; compare to set goals
• Collection percentage over a three month span: Benchmark = 97-98%.
• Accounts Receivable ratio: Benchmark = .7-1.0
• Insurance outstanding over 90 days: No calculation, just look to see if is at "0", the benchmark
• Recall percentages: 75-80% of active patients seen in last six months.
• New patient numbers
• Treatment acceptance percentages
• Periodontal procedures percentage of hygiene revenues:   Benchmark = 30-33%
• Numbers to crunch quarterly:
• Overhead

3. Develop your clinical efficiency.

The 2010 ADA Survey of Dental Practice states you will increase your production by 26.1% with the use of two dental assistants, and by 70.1% with the use of three chair side assistants. From the consultant here, that is only if you train and delegate to the letter of your current state law all expanded duties

4. Fire or fire up your staff.  

Staff is your largest expense. Poor performance drains overhead. Get them the training they need to improve performance, or let them work somewhere else.

5. Review your overhead percentages:

• Salary ratios: Overall 20-24%
• Lab:   8-10%
• Dental supplies: 5-6 %
• Facility: 4-6% for renters; 5-8% for owners
• General administrative: 6-10%
• Marketing: 2-5%
• Doctor salary: 20-25%
• Retirement, reinvestment, and capital expenditures: 20-25%

6. Get your hygiene department profitable.  

Hygiene salaries should be 30-33% of their production. Their periodontal therapy procedures should be 30% of their production. They need a radiology protocol to follow.  

7. Base any raise for a staff member on these things:

• Your local economy - growing? slowing?
• Your practice annual revenue trend over the past five years - growing? flat? declining?
• Local demand for staff - are there jobs for them to go to if they don't get a raise?
• Local wages - Check with local placement agencies, local accountants who work with other dentists, your colleagues, and surveys from dental industry sources, i.e., RDH Village for hygiene and DANB for assistants.
• Overall Consumer Price Index and the Dental CPI: www.bls.cpi.gov
• Staff performance - grade them A, B, C, or below. A's get the highest percentage, B's the next, and C's get cost of living (CPI %). Anything lower than a C, gets NO Raise and a 90-day improvement action plan. This is ONLY if the practice has increased. If the practice has been flat or declined, DO NOT GIVE RAISES.
• Do this every year.

8.  Learn to control open time.  

Reduce broken appointments in hygiene especially. Someone at your front office must "own" the hygiene schedule and keep it full. Double book "iffy" appointments. Dismiss chronic appointment breakers.

9. Have your fees balanced and increased annually.

10.  If you are on PPOs, you MUST be clinically efficient, have a quality but low-cost lab, and have high treatment acceptance.  

11. Increase new patient flow.  

Today spend no money on yellow pages and most money on a great website with search engine optimization. Use social media to enhance your website placement. Ask for referrals and have great internal marketing.  

12. Use competitive bidding to negotiate the best price for all equipment, technology, products, and services, especially capital expenditures.  

Once per year get a competitive bid for dental supplies, technology support, marketing, etc.

In tight times and with the increase in discounted fee insurance reimbursement, overhead control is critical to your long-term success. People are your most valuable asset, invest in them first to see how they can help you ... Control the Overhead Monster!

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Jan Keller

Getting paid on time is vital to the success of any dental practice. You can increase your chances of making sure this happens with patients by following a few simple guidelines.

Communicate your payment and collection rules clearly to patients. Provide written confirmation of how patients have agreed to manage payment of their treatment. Use a Truth In Lending (TIL) form for all negotiations and include clear written information regarding your expectations. The patient should receive a copy of the TIL form while you keep and file the original form.

Tip: Make sure billing statements include a telephone number customers can call or website address customers can access with billing questions and a pre-addressed envelope.

Tip: The faster statements are sent; the faster you will receive payment. It is best to give the patient a billing statement (not just a walkout statement) on the day of service showing them treatment, their payment and any balance statement, including a personal thank you for their prompt attention to handling their account.

Follow through on your payment and collection terms

If your policy is that late payers will go into collection after 60 or 90 days, then you must stick to that policy. A team member designated as the accounts receivable coordinator should call patients who do not follow through with the payment negotiations. Accounts of those who exceed your payment deadlines should be penalized and/or sent into collection, if that is your stated policy. Trojan (www.trojanonline.com) offers professionally written letters that can be sent to your patients to help with your collection efforts.

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