Re-releasing a Dental A-Team podcast favorite!
Tiff is on the pod to chat with Kiera about an office she just visited which needed some attention on its collections and accounts receivable. To give an idea of where this practice sits at, its collections are at 80% and case acceptance is at 56%. Tiff shares three points she touched on with this office:
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Three tactics to put into place to raise collections
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Establish tracking methods
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Spun complaints in a positive direction
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Transcript:
Kiera Dent (00:00)
Hello, Dental A Team listeners. This is Kiera. And today we are bringing you something so special. I am so excited because this is one of our most popular episodes from the archives. Whether you're hearing this for the first time or catching it again, I am so excited because it's jam packed with a ton of takeaways that you can start using right now in your practice. We have released thousands, literally thousands of episodes. And I wanted to start bringing a few of these amazing episodes back for you. So I hope you enjoy. And as always, thanks for listening and I'll catch you next time.
on the Dental A Team podcast.
speaker-0 (00:32)
and you guys don't worry. We say we travel in the Dental A Team, and this time you might actually hear proof of it because I have the one and only Tiffanie Trader back on the podcast. She is getting ready to fly home, just finish up with an office, and we definitely got her to podcast while she's at the airport. So Tiff, where are you at today? How is this podcasting going?
speaker-1 (00:54)
podcasting is gonna be fantastic because it is because I put it out there into the universe and I am I'm actually in DC, which is funny because it's funny because I thought I I thought I booked a different airport and I thought I booked an airport I had been to and then on the way here I was like, Yeah, I've surely never actually even been to DC and anyways it's been fun. This is how my life is.
speaker-0 (01:18)
So funny travel story about Tiffanie and airports. We always giggle about this. Tiff, do you want to tell about the one time like this is like real life consulting one one for you guys? Do you remember the time that you maybe missed your alarm? You set like twenty five of them, but that's fine. Like I've seen your phone and there are seriously like, Wake up, no, like really wake up. No, like you've got to get out of bed. Like that's all your alarms that you have. But like what happened that time? Because it was a really funny travel experience.
speaker-1 (01:42)
Here's the thing, Kiera. I just want to point out that I am in Virginia right now. It's
speaker-0 (01:47)
Yeah.
speaker-1 (01:48)
the only state that I have ever, ever, ever had any travel mishaps of any sort have been either coming to or leaving Virginia. I have Virginia stuck
speaker-0 (01:59)
Is your
speaker-1 (02:00)
here. I've gotten stuck here on a layover. Like Virginia just doesn't want me to leave, I think. So I slept through my alarm leaving New York, coming to Virginia.
because my flight was at six thirty in the morning, which is if you know me at all is not
speaker-0 (02:16)
It's okay. It's all right. We all make decisions that we shouldn't have done. And I'll be honest, sometimes when we're like booking the travel, we're like, yeah, that seems like a really good idea until we actually have to live the travel we booked for ourselves and we're like, That was a really bad idea. So
speaker-1 (02:30)
It was a poor choice.
speaker-0 (02:32)
You're
up late. I remember you were texting me late at night that night and I'm like, Tiff, your freaking flight leaves so early tomorrow and you're like, I'll be fine
speaker-1 (02:40)
Yes, but I was fine because I actually figured out that it was quicker to drive to where I needed to be than to fly anyway. So
speaker-0 (02:49)
Only after she missed her flight. So it was you know a win.
speaker-1 (02:52)
Because
I had to pivot. I had to be at an office that afternoon and I was like, shoot, how do I do this? So pivot or die is like what we live and breathe by. so I mapped it and I went and I got a car and the car rental guy was like, my gosh, this is absurd. so I drove a car from New York to Virginia and it was by far my favorite road trip of working experience because it was beautiful. I got this in so many I went through
It was like fall time, but I got snow, I got fall leaves changing. I have like every possible season.
speaker-0 (03:27)
It's
one of favorite stories that I definitely feel like needed to be recorded for all of our posterity to hear and all of you listeners. So this might be mine and Tiff's like journal time over here. But this is liter
speaker-1 (03:36)
I think I've I think I've now flown out as of today. I will have flown in and out of every airport in Virginia.
speaker-0 (03:45)
Well, I'm glad that you're able to get the last one knocked off your list today. but you guys, that's literally the day in life of a consultant. I think it's it's fun to point out the fact that like in offices when things don't go as planned, like literally pivot. I know Tip and I have many times, I mean the time that I almost got deported out of Canada, hashtag I was literally a one hour drive across the border, but no, I flew back down to New Jersey and then back trying to get across the border.
And it would have been way better had I just driven. So I think also it's like looking at it. I mean, had we mapped it, now when people are booking travel, we're always thinking like, Could you drive there faster than flying? 'Cause there's always alternatives. So I love it. Welcome to Virginia. I'm glad you're coming home. Glad your office was there. Let's kinda like
speaker-1 (04:29)
office was in New Orleans. It's
fine.
speaker-0 (04:34)
Everything's fine, guys. Everything's fine. We are totally competent in dental offices and we're about like seventy-five, eighty percent competent traveling. We have that like twenty percent lack that we definitely are not great at.
speaker-1 (04:44)
It
just needed to hit Virginia as a state this year, so I got it in.
speaker-0 (04:48)
Good job, Tiff. So actually let's like deep dive on your practice you just came from. this is not the topic we were going to go on, but I just realized like we're talking about you leaving an office. Kinda walk us through some of the things you just implemented in that practice that you were in, just so people can kind of get an experience of what it's like having a consultant in their practice.
speaker-1 (05:05)
Yeah, I think that's fun. Yep. So this was and I love a bit or die.
speaker-0 (05:10)
Don't worry, we had a totally different topic, but like why not why not just keep with this consulting travel theme?
speaker-1 (05:16)
I like it. So yes. this is my second time in the practice. This was Ashley actually saw this practice probably like a year ago, I suppose. so she saw them first and Ashley's no longer with us, wildfires, crying, lots of tears.
speaker-0 (05:29)
Decided
to get married and move away and become a practice manager. It's fine. That office got real lucky. I shout out to them.
speaker-1 (05:37)
Yeah. So anyways, this is their third visit. So it's really cool to see the progression and the growth that they've experienced, but then also like the holdups that they've had. So it's like, yes, we've been consulting them for a little over a year now. but there's still so much to be done. So this week what we did yesterday and today was we focused really heavily on collections and AR because they're just
struggling a little bit in that area and they're having a hard time dialing it into where it's coming from. So it was really fun because we saw the issue and then what I did was I kind of worked my way backwards, right? Because I think in any practice you can find something that's wrong and then I can tackle that person. Right. So I can go straight for the billing representative and the office manager and be like, why aren't you collecting? Where's your money? But it's not just them.
that are the the only cause of that, right? So the only effect of the cause. So we backtracked, we looked at everything, we realized, hey, patients aren't always getting signed treatment plans. Like patients aren't even they're not always getting told what they're going to owe in the first place. So then when they're coming in, it's a little bit more difficult to collect because I noticed we have a crown you know, a crown was in last week and they paid a hundred dollars. And so if you know anything about
Crowns in dental insurance, typically a hundred dollars is not going to be the copay required. So I thought, okay, why is this patient only paid a hundred dollars? Well, probably because this patient was not prepared to pay the six hundred dollars that he had owed when he came in. So we kind of backtracked. So we figured out, okay, our collections percentage is low. It's about 86% for last month, and overall for the year they're hovering in the mid 80s.
I like to see ninety eight percent for my practices or higher. I usually tell my Medicaid practices, Medicaid slash PPO providers, ninety-three to ninety-five percent just because Medicaid takes so long. So ninety-eight percent is what we're looking for here in this practice. So eighty six percent was like, my gosh, how are how are we paying the bills? So we back chopped and we started implementing they did NDTR for us like a boss. We've done that twice to the guys don't know the N D T
speaker-0 (08:00)
And you're new, that's a perfect handoff. So next visit, date, time, recare. And I will say it's magic sauce when people do it. So good to know this office was which is great. It's good. Like Tip, I love that you're breaking this down. And I think offices should do this. Like when you find a gaping hole, don't go after it. Look at all the pieces that factor in to find out where is the true breakdown. So we already know that the handoff and the doctor exam
is spot on. We are crushing that. Our handoffs are good. Our doctor exams are great. So that's not the cause of the collections being low. Like good job Tiff of checking that box to ensure and I hope people are able to see that that that's what you're doing in this. Like you're assessing to find out where the breakdown is at.
speaker-1 (08:38)
And I think that's right. And as you're saying that, it made me think of like treatment planning, right? So doctors, you go in the operatory and if you just looked at a tooth and you saw this this piece of decay, right? No x-ray, nothing else. You just look at the tooth, you're like, okay, there's decay there. We need to get it out. Let's do a filling. Okay. So you do a filling, you get in there, because you haven't looked at the x-ray yet, you get in there and you're like, holy cow, that's not the only problem. So I think of it as like
You go in, you look at the tooth, but you also look at the x-rays and all the other evidence that you have. You look at you know, intra-oral photos, you look at structure, all of these items to assess what the patient needs on that tooth. So if you look at the x-ray, maybe the x-ray shows like all of this patient's pain is actually stemming from a huge abscess at the root of the tooth. Had we not looked at the x-ray, we might have just tried to fill it, right? So I kind of think of that of something like that when I go into practices. So I do see, okay, there's an
issue so we're we're bleeding money right so there's an issue but what's the root cause of it so I think that's great what you said Kiera because it made me think of that like it's really we go in and we dig for the root cause so overhead is high collections are low so what's the root cause so handoffs are working great the diagnosis is there the treatments there the schedule's pretty full right they're producing 120 grand with two doctors and two hygienists that's not bad per month
so we really diagnosed. So we ramped up treatment planning with the front office, ramped up treatment planning, which should ramp up over the counter collections, and then we tackled cancellations, which I think cancellations across the board, across the country, and all of my practices have been really high lately. I think it's just a product of the mentality that we're living in right now, and a product of what we've become. So that aside, we just set some new goals. So
Over the counter collections and collections in general, they I set them another goal. So their goal now is 98% by the end of the year. Okay, and remember they're at about 86% now. Case acceptance, they're doing dollar for dollar. So case acceptance, dollar for dollar is set at 75% is their goal. They're hovering at about 56% right now. And then I want to see cancellations at less than 10% every day. So they'll do that by week and they're tracking all of those items.
It is actually really fun to hammer in the collections because the front office ladies are like, I don't know what I don't know why she keeps saying collections, collections, why are you saying collections is an issue? We collect the money. We collect all the money over-the-counter. We we don't let patients leave without paying. And so I said, Okay, totally fine. So, what we did was we set, we created a new tracker, right? So I created a tracker for them for over-the-counter collections. If they do not
collect in full from a patient, they've got to put it on the tracker. So it's just in their Google spreadsheets, something the office manager can check in on, but it's going to hold them accountable. So number one, I saw that you know we had a few patients we weren't collecting over-the-counter 100% from. So there should be some names on there. Number two, they're not going to want to fill out the tracker and they're not going to want anyone to see your name on there. So hopefully it will ramp up that over-the-counter collections.
But then also they had a good point. If they feel like they're collecting over the counter correctly, maybe it's on the back end where it's like our claims, you know, our treatment plans are are not accounting for downgrades, and maybe our claims are coming in, EOVs are being paid, and we're left with balances, it will show. So I took the problem, diagnosed what needed to happen, implemented three items and three different goals that should help. And then
allowed them the grace and the space to say, okay, fantastic. We're gonna push real hard on these items to ensure that your over the counter collections is happening exactly how you're saying that it is, just because I want you guys to kill it. And the proof will be in the end. Right. So if I see that over the counter collections is better and now our overhead is decreasing our collections is higher, then I know we tackle the problem.
If it's not and it stays where it is, and we start saying, okay, it's actually left over after insurance, we actually tackled that problem as well because we've we have our insurance, the team who's doing the insurance verifications are gonna start they're putting down grades in now. so that should be resolved as well. But it was kind of fun to see where it's like sometimes we think we're doing something and we can say, like, I always do this thing, which always and never are never accurate, right? So like
always well whenever I think like I always do it I'm like okay so I don't always do it so I need to like back off and take a look at the area where I probably could improve. So as soon as I hear something that I'm like okay I totally get it. It's like a it's a defensive space and we do feel like we're killing it in that area and it's great if we are you might be so we're gonna put this into place to see that to show it. So let's prove that you are doing the things and it's not you on the opposite side of the spectrum.
We're putting attention on it and so no matter what, whether you were doing it before and you're doing it y now you're doing it even more or you're doing it the same as before or you weren't ever doing it, it's going to improve no matter what, because we're putting attention on it.
speaker-0 (14:01)
I love it.
speaker-1 (14:03)
That's what we did in this caucus.
speaker-0 (14:05)
So I think there's like a c quite a few pieces I wanna highlight from it is number one, I love that you talked about how you see an issue, but that issue is usually a symptom of a bigger problem. And so it was collections are low. And so you found three other areas to fix. I also love that you put tracking into place. And I also love that you took what people said of I'm always collecting and spun it into a really positive way. Cause some people be like, Okay, well, I get that you say you're always doing this, but the reality is we're not collecting. You didn't make them wrong. You said, Hey
I hear you. Let's actually track this and prove that you guys are really doing it. So like I'm on your team versus I'm making you wrong. And so I hope a lot of people listened and heard that. And I think that that's one of the beauties of coming in person. Because over the phone, I can't we can't move and navigate as easily as we can in person. In person we're able to see, okay, here's this broken piece. Let's go fix, let's look at the whole way up the chain to see where is the broken link. Because down below we know something further up is broken. But then we can get the in
entire team working on it. So you see quick, fast changes in a practice that are usually sustainable. So Tiff, I thought you did so many awesome things in it. And I know you tackled so many more pieces. Like that's just a quick, I mean, we're talking 15 minute synopsis right here where you're like, hey, I was there for a day and a half, but let me give you a quick 15 minutes. But I hope people took that. And so I'm like digesting this in for an office of how do you take this and make this applicable to you is number one, when you find a problem, look to see like what are all the pieces up ahead of that problem that got there.
To get to collections, what has to happen before collections? Insurance verification, inputting information, sending claims, getting the checks back from insurance. Are they getting lost in the mail? Do we have EFTs set up? How are we posting it? What about downgrades? What about our write-offs? Then you also looked at like, okay, what creates that copay amount for the patient portion? That's treatment plans. Are we giving every patient a treatment plan and having it signed and putting that copay amount or the amount that they owe in the appointment box so that way everybody knows and we just collect that?
Then let's go back even further and say, first and foremost, how's our case acceptance? Like, are we even having good handoffs to get the treatment that's diagnosed, to get the case acceptance, to get the schedule, to be able to then send it out. So that's why we love what we do. Like I just broke all that down. I'm like, that is what we freaking do, and we love it. We love it so much. But I hope you guys take it and diagnose that. And if you have a hard time seeing up that chain, Tiff and I are really good at seeing like, okay, here's the billing system, here's the case acceptance system, here is our new patient acceptance.
system like here are all these systems that could be impacting your collections. Let's look to see where it's at. Let's come up with some tracking. Let's give your team goals and then let's see magic happen. So if you guys are needing help with that, always email us Hello@TheDentalATeam.com. But gosh Tip like way to way to kill it at that practice. I love I love hearing your recaps after a practice.
speaker-1 (16:52)
Thank you. Yeah. And you're right. We did a ton more, especially on the collection side. but yeah, I love it. And I love the diagnosis piece and really seeing like the light bulbs go off and doctors and teams too. So and I think you're right. I think it it can be done over the phone. It just takes a lot longer. And and I think we do miss pieces because it's a biased opinion. I'm I'm relying on the team or the doctor to provide me the information. I'm not seeing it firsthand. So
It is much more effective when we're able to get in practice and probably I'd say the f first one in office is like, okay, this is a good starting point. Second and third in office are really where we really I mean, we dig deep on those suckers because we know we know the practice at that point. So totally. I love it. I love it.
speaker-0 (17:38)
So fun. Well, Tiff, as always, I love you headed to offices. I love you representing our company. And it's fun to see. So I hope you guys like take this into yourself. Put on the Tiffanie Kiera consultant hat. Look at your practice. See if you can uncover those spots and where it might be broken further up the chain. And if you can't see it or you also want to pick our brains, email us. Hello@TheDentalATeam.com. And as always, thank you all. Thank you, Tiffanie. Thank you all for listening. And we'll catch you next time
Kiera Dent (18:04)
I hope you all loved today's episode as much as I did. It is crazy to think that this many episodes have been released since we started the Dental A Team Podcast. And I started looking to say, my goodness, our listeners need to be reminded of some of the things they may have learned a year ago or two years ago or five years ago, because so many things in our practices weren't relevant back then when we heard them, but they are relevant today. And I would be doing you a huge disservice if I didn't re-release some of these episodes for you to remember, to refine.
to optimize and really truly if you ever need a topic or you're like, my gosh, I wonder if the Dental A Team has anything like this, go onto our website, TheDentalATeam.com, click on our podcast tab and you can literally search any topic. So whether it's overhead or hiring or firing or team morale or engagement or case acceptance or hygiene or associate onboarding or whatever it is, we have so many episodes for you. And so I am going to intentionally be
re-releasing some of the top best episodes for you, pulling back some of the ones that I needed to remember, some of the things that I feel for you to really, really relearn right now and to re-remember, or if it's the first time, welcome. I'm so happy you're listening to it, but I hope you truly enjoyed today's episode. I hope that you share this with somebody. I hope that you go and implement today because we only have one day. We only get today. And so making today the best that it possibly can be. If we can help you in any way, shape or form, reach out Hello@TheDentalATeam.com.
And as always, thanks for listening and we'll catch you next time on the Dental A Team Podcast.