Manage case acceptance by using your ledger

http://www.dreamstime.com/-image19842811Think about the most recent large case you presented. Did the patient nod and smile at you while you described the steps involved in bringing her mouth back to health? Did she say that she wanted treatment right away? Now, are you wondering why you haven’t seen her in your schedule?

Being successful at gaining case acceptance on large cases is critical for running a successful dental practice. Most general dentists enjoy the challenge of tackling a complex case so they can use their skills to the fullest. It’s also personally rewarding to bring a patient up to an acceptable level of health and watching this person develop more self-confidence and pride in their appearance. It’s also financially rewarding. As Steven Covey might say, the large cases are the ‘big rocks’ that help fill schedules and fill bank accounts. This is one of my favorite videos:

You can use the ledger to manage your case acceptance. Our group uses Dentrix dental practice management software which makes this tracking easy. First, you need to charge out your case presentation – create a no-fee code with the description “Consultation” or “Conference” since this will print on a walkout statement. Then, treatment plan this code in the appointment when you plan to present your large case. At the end of the month (or week) run a report to find everyone that has been charged out for this code. Look to see if there is a large credit on the account, indicating the patient paid some amount down for future treatment. Check to see that this patient has either completed the first steps of treatment or that they are scheduled to return.

What is your batting average?

At the end of each month, compare the number of patients that had a case presentation with the number that are moving forward with the treatment plan. If you present 10 cases and 8 accept, set up financial arrangements and schedule their first visit, then you can count these 8 as accepted and in progress. So, 80% would be your batting average. Calculating the batting average for each dentist in your group helps to provide valuable feedback and is an indicator of successful dental practice management.

The dentists can discuss their successful and failed cases and exchange ideas to improve. They also can use the failed cases as a call list to try to fill schedules later on. It makes a difference when the dentist calls. By simply taking the time to call the patient saying “I’m following up on a conversation you and I had last month where we talked about dental treatment for you – I wanted to offer to answer any questions you might have if you’re still thinking about getting that dentistry done – can I answer anything for you?” Usually, this starts a very nice conversation and hopefully the dentist wraps up by offering to have his treatment coordinator set up financial arrangements and schedule the visit.

Tracking orthodontic success

Orthodontists can use this same approach to track their success at gaining different types of cases. By charging out code D8000 Ortho initial exam or D8001,2 Ortho re-eval, again at no fee (most orthodontists aren’t charging for new patient visits anyway) and tracking the kind of case presented and accepted, the orthodontist can see his success rate with Phase 1, full braces, invisalign, etc. Some of this work is manual – looking to see if treatment has been started or scheduled takes time, but the feedback for the orthodontist is worthwhile. If a trend starts to develop – for example, successful at starting 70% of full braces cases, but only 30% of phase 1 cases then it makes sense to look at the phase 1 approach to look for ways to improve. Same for invisalign or even limited treatment on adults.

Tracking pediatric sedation cases

Another way to use the ledger is to track pediatric oral and IV sedation cases. Again, I’m targeting these cases because they are generally more complex and expensive than regular treatment plans. When you charge out D0150 comprehensive exam for children and compare that with the oral sedation and IV sedation codes, you can see your success rate for doing these type of cases.

Tracking wisdom teeth cases

This same approach makes sense for oral surgeons as well. Charge out the D0150 comprehensive exam for wisdom teeth extraction and then look in the ledger at end of month to see if the case is completed or scheduled. Again, for cases that do not schedule, your oral surgeon can take these patient names and make a follow up call to answer questions and try to get this patient into your schedule.

Tracking trends and comparisons

Using the ledger to track case acceptance and provide feedback to dentists is one of the most valuable coaching mechanisms available in dental practice management software. It can be easy for one dentist to blame a patient’s finances for his lack of success with these large cases – but when another dentist in the same group has a markedly better track record the conversation usually changes to asking “How do you do it?”  Because the reality of our economy is that patient finances really do affect large case acceptance -spending time looking at the black and white results can also open up some conversations about financial arrangements policy and options. Dentists may want to start to offer phased treatment – and then again, track their success.

I’ve been tracking large case acceptance for every general dentist and specialist in our group for over 6 years using Dentrix – so if you have any questions about how to set up this approach in your own office, feel free and contact me. I want to help you to run a dental practice successfully. A dental office manager has an opportunity to go above and beyond by establishing this type of tracking and then providing an end of month report to her dentist or specialist. I would be happy to share my sample spreadsheet for the codes we track depending on the type of dentist you’re working with.

Managing case acceptance is just one way you can run a successful dental practice. If you’re interested in new ideas on running a dental practice, please subscribe to my weekly blog:



One of the biggest challenges to managing a dental practice is managing dental insurance. With dental insurance handled, then dental marketing for new patients becomes a primary focus. In today’s day of online reviews, handling patient complaints well is essential. As your practice grows, hiring dental staff becomes more important. With 16+ years of dental practice management experience, I’m open to your questions to help you run a successful dental office.

Feel free to email me.

 

AUTHOR: Jill Nesbitt
jill@dentalpracticecoaching.com
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