#3 – Keeps Front Desk Running Smoothly

a ‑ Handles Client Interruptions

Our office is very busy.  It’s not unusual for the phone to be ringing while you are talking with a client.  How do you handle 2, 3, or maybe 4 clients all wanting to tell you something different and all at the same time!

Here’s an example: Client #1 begins to schedule an appointment when Client #2 approaches the desk and is acknowledged with “Good morning #2, how are you today?  Great!  I’ll be with you just as soon as I finish scheduling Miss #1’s appointment.  Next, the phone rings.  “Will you excuse me while I answer the phone?  Thank you.  Ask the caller to please hold if they would like or get the caller’s name and phone number and return their call after finishing with the client who is at the front desk.   Now things are in order and the secretary can complete each client in order: #1, #2, and then #3.

Also, be sure to use a client’s last name unless you know them personally or they have given you permission to use their first name.  All clients over 60 should be addressed as “Mr./Mrs.” unless they ask otherwise.  Address ALL clients with a title by that title (Dr., Rev. etc.)

The ten most important customer service actions

1.  Calling back when promised

2.  Explaining what caused the problem

3.  Letting clients know who and what numbers to call

4.  Contacting the client promptly when a problem is resolved

5.  Giving clients access to talk to someone in authority

6.  Telling how long it will take to resolve a problem

7.  Offering useful alternatives if the problem can’t be solved

8.  Treating clients like people, not account numbers

9.  Advising clients on how to avoid a future problem

10.  Getting progress reports if a problem can’t be solved immediately

Now you should be ready to not only accomplish all the basic tasks at the front desk, but to work co-operatively with all the other staff at the front.  Here are some more ideas to help with this co-operation.

1.  When is your most productive part of the day?  Let the others know when you are at your best and need to concentrate on your work.

2.  Share your feelings with the others.  If something bothers you, let them know it.  If someone seems upset, ask her.  Be open and honest.

3.  Be flexible.  Everyone’s ideal day is equally important.  Give even more help than you expect to receive.

4.  Offer help routinely.

5.  Avoid doing and saying things that irritate the others.  When you share a work space, little annoyances can cause big problems.

b. Recognizes Client Referrals

One of the nicest compliments we could receive is when someone thinks enough of us to refer one of their friends. Each of us will work hard to find out from this new patient who referred them into the practice.

This name is entered into the computer and thank you letters are generated monthly to them.  We also make sure to document the referral in the computer, this lets the staff know that we have one of our best clients with us and gives us a chance to thank them personally for the referral.  This is the best way for our practice to grow.

Your task is to make sure that all new patient referrals are documented and that the thank you letters are going out.

c. How to handle non‑client children

When you have the opportunity, always discourage patients from bringing small children to the office with them.  Explain that we have no one to watch these children, and it is impossible to render the best dental treatment if the patient has to worry about the well‑being of her child while in the dental chair.  Also, it is possible for children to hurt themselves while left unattended.  Always ask the doctor if the parent wants to keep the child in the treatment room while she undergoes treatment.  If we do decide to render treatment with a small child in the office, the child must be closely watched, as our decision to render treatment might be construed by the mother as assumption of responsibility for the child’s safety.

When hygienists call several children in for examinations after prophylaxis has been completed, she must see that these children stand quietly in the treatment room and not touch the equipment or climb on stools, etc.  If they do not obey her, SHE MUST SEND THEM BACK INTO THE RECEPTION ROOM AND CALL THEM IN INDIVIDUALLY! Children waiting in the reception room must be constantly monitored by the receptionist, and not permitted to leave the office (if they are very small) or to enter the hallway and/or treatment rooms.

d. Asking a client to change a confirmed appointment

Sometimes a patient has to be rescheduled because of a sick hygienist or an emergency.  When changing their appointment at the last minute you must anticipate that the patient will be disappointed or upset.  If they are extremely upset and refuse to come back offer them a $20 complimentary fee reduction for their next hygiene appointment and be genuinely sorry for the inconvenience.  Note in the patient’s record and make a note in their next appointment to not move them again.

e. Defusing the Angry Client

Every practice has one every once in awhile.  Someone calls or walks in irate.

When an upset client walks (or calls) in, don’t look at it as an uproar.  Look at it as an opportunity to solve the problem.  Many people would have complained to their friends, neighbors, relatives, etc., left the practice ‑ and never said a word to us!

If you can solve this complaint quickly, you can expect that:

1.  84% will remain as our clients if solved quickly

2.  54% will remain as our clients if solved slowly

3.  19% will remain as our clients if not solved

4.  9% will remain as our clients if they have a problem and don’t complain about it.

The first thing to do when someone is unhappy is to recognize it.  Most people aren’t skilled communicators.  It’s not their job.  It is your job.  Look for these signs that we have stressed someone.

  1. Loss of eye contact ‑ The client’s lips tighten and s/he won’t look you in the eye.
  2. Change in voice tone

a)      Louder, more demanding, frustrated

b)     Or speaking more quickly, quietly

  1. Changes the subject ‑ The client may feel uncomfortable and not believe you can help.  S/he will change the subject to avoid an uncomfortable situation.
  2. Uncomfortable body language ‑

a)      Keeps crossing, then uncrossing arms or legs

b)     Fingers drumming on table, chair

Quickly remove the person from the waiting area into a private room.  That’s the first step in damage control: keep it from spreading.

Then handle the walk‑in or call the same way.

1.  Begin by thanking our client for taking the time to alert us to the problem so you can correct it.

2.  By the time the client reaches you, they have built up a “head of steam.”  Reasons and explanations aren’t enough.  Their emotion must be acknowledged.  Do not disturb the client’s or patient’s release of emotion.  Allow him or her to vent all anger without any interruption.  Any effort to intervene will only incur resentment.

3. Even if you know where the client or patient is heading, do not anticipate his or her remarks.  People want to feel that they are understood and taken seriously.  Let them express themselves in their own way.

Make sure you understand everything.  Remain calm, positive, and businesslike.  Don’t allow yourself to be defensive or provoked.  Next, acknowledge how the client feels (“Mrs. Brown, I can see how much this has upset you!”)  Show that you care (“I’m sorry that this has upset you.”)  Show that you are on the client’s side without admitting fault (“let me see what I can do about this”) Take notes. Get all the details.  If it was our mistake, acknowledge it and apologize.  If the client was at fault, tactfully show them and ask if they agree with you.  Try to avoid saying the attack word “you.” Try “I would recommend” or “May I suggest.”

In either case, express in a personal way, how sorry you are that one of our long-standing clients became so upset.   If the client refuses to calm down, try to talk to them later (“Mrs. Jones, I understand how upset you are.  I don’t seem to be able to help you now.  Please let me call you back tomorrow and we can go over this together again.”)  It may not satisfy the client, but it will keep you from losing your temper. Again here are the principles:

1. Don’t interrupt

2. Acknowledge the emotion

3. Apologize for something at least “I’m sorry you are angry”

4. Get the facts and fill out PR form and give to your team leader.  She will complete this process.

5.  Use these phrases to help your client focus on their concerns.

  1.  “If I hear you correctly, it sounds like…”

b.“So you have 3 concerns and they are (summarize)

c.“I want to make sure I’m understanding you.  Are you saying…”

d.“What you’re saying is…”

e. “What’s frustrating for you is…”

6.  Follow these steps

  1. Review your information with client
  2. Contact all office staff involved to verify facts.
  3. Offer a solution to client
  4. End on a positive note
  5. Send a thank you

Sample Upset Patient Conversation

Here’s an example.  Mrs. Walker says, “The last time I had my teeth cleaned it cost $43.00.  This time it was $48.00.  I’ll bet it’ll cost more than $50.00 next time!”

You could reply, “I know your upset about our fees.  You’re probably right that they’ll be higher next year.  All of our expenses go up every year.  We try to keep our fees down as best we can, but I know dentistry is expensive.  If you’ve got any ideas on where we could cut costs, I’d like to hear them.  Also, if you would like for us to work up a way to budget your costs ‑ spread it out.  I’d be glad to help.

One of the more common complaints is about fees.  Here are some ideas:

1.  Never try to justify our fees.  It’ll just sound like excuses.  It’s okay to say, “Our fees are above average, but we believe our services are exceptional.  There’s no way to provide the highest quality staff and equipment for average fees.”

2.  When a client notices an increased fee, try “Our expenses have increased.  We could either have reduced our quality or increased our fees.  The doctors will never allow us to reduce the quality.  We want the best for all our clients.

3.  The doctors are doing everything they can to keep our overhead down, but the costs just keep going up.

Look for any underlying issue.  Sometimes the issue a client brings up isn’t the real problem.  When you solve the initial issue, be sure to finish with “Do you have any other concerns that I should know about?”

Always try to work out a solution that involves the client (“We can lick this together.”)

Always follow up with a letter a few days later that reviews the problem and the solution(s) that you’ve instituted as a result of the suggestions the client made.

f. Why People change dentists

A recent Lou Harris poll pinpointed exactly why a patient or client may leave you.  Here’s what they uncovered:

The professional:

Didn’t spend enough time                        51%

Wasn’t friendly                                                42%

Didn’t answer questions completely        40%

Treatment didn’t work                                      38%

Wasn’t knowledgeable and competent               37%

Didn’t explain problems simply               30%

Wasn’t up to date                                             29%

Didn’t treat you with respect                            27%

Wasn’t always available when needed     27%

Fees weren’t reasonable                                    25%

Refused to accept second opinion           10%

What’s interesting is the low priority of money. And the high priority of CARING.

Strategy:  It pays to take the time to be a mind reader with your patients or clients.  To spend the time to understand what it’s like in their shoes.  The minute you switch viewpoints back to your own is the minute you start losing people.

One of the low points in any day is when you receive a call from a client who expresses dissatisfaction with us and wants his/her records transferred to another dentist.  Here are some tips to help.

  1. Stay calm.  Be friendly and helpful.  Sound concerned.
  2. Start with “Mrs. Jones, I’m sorry that we didn’t provide you with the care you expected.  Can you tell me what we could have done better?”
  3. If s/he doesn’t want to say, then say “I understand how awkward this is for you, but we want to do our best for our patients.  Anything you could tell me would be helpful.”
  4. You may even be able to change the client’s mind by your caring, tactful conversation.
  5. This conversation MUST be written down in detail, transferred to the clients’ treatment chart (AFTER it has been duplicated for the new doctor), and the chart placed on Dr. Smith’s desk.
  6. Make a note of this lost client(s) for the monthly statistics.
  7. When the folder is returned from the doctor, break it down and place it in the inactive file.

g. Dental Shoppers

When someone calls you on the phone and wants to know how much is  ______, answer them if you can.  You can quote the fee on a cleaning, denture(s), partial dentures, and crowns.  You can’t quote a fee to fix a broken tooth, treat a painful tooth, do a filling, etc.

You could say to the client who calls and asks for a fee that varies: “Mrs. Day, the fee can vary based on the extensiveness of the treatment.  The doctor will need to see you to tell you your choices and what the fee would be.

If the client says our fees are high compared to Dr. “X”, you could say “Miss Carleton, we are very proud of our fees.”  When the client asks why you can answer “Our fees reflect the quality of the equipment and staff here.  We believe we provide an outstanding service for a moderate fee.”  If the client continues to argue, is this the kind of client we want?  Feel free to suggest that this client visit our office of her/his choosing.  Urge her to compare more than fees.   If she is our client, offer to send her x‑rays to another dentist of her choice for a second opinion.  Follow this statement with “If you would like to return to our practice anytime, just call and I’ll make all the arrangements.  We’ll be glad to have you back.”

PRICE     =    COST


Some shoppers are looking for a gullible office that will provide them drugs. Listen for these warnings:

  1. Wants medication, but no treatment.
  2. Asks for Percocet, Dilandid, or a similar potent narcotic – and refuses other medications (allergies)
  1. Wants large quantities of narcotics: 20-30 tablets
  2. Doesn’t have an address or telephone number

Convert shoppers to clients

When you have answered the caller’s question, ask “Would you like to make an appointment?”  Offer to take the caller’s name and number to follow up with them I none week. 

h. Hints For a Smooth Day

  1. Ask each client when you make an appointment “Are you available on short notice?”
  2. “Do you like to be called by your first name?”
  3. Calls to clients who have had treatment “Dr. Smith asked me to see how you were feeling.”  Be positive!
  4. Never get an insurance “preauthorization” only a “pre-estimate”
  5. Never ask a client a question unless you are prepared to answer the “no”  ‑ often it’s better to make statements
  6. Use the conference room to discuss finances
  7. Know when doctor or hygienist is running behind.  If more than 15 minutes call the next client so they can come a little later.  If already here, and we are 30 minutes behind, go to reception room and say “Mary, Dr. _____ has had an unscheduled emergency procedure and it will be 4:00 rather than 3:30 before we can begin your treatment.  Can you work with us or would you rather reschedule?
  8. True emergencies don’t negotiate for time
  9. When making appointment, put in Dentrix first, card 2nd.  This way you’ll never miss entering it into the computer
  10. If you don’t have a policy the patient will love it because you get theirs.
  11. Pts. will accept anything from you if they like and trust you, and it appears usual and customary.
  12. Inform before you perform ‑ no surprises.
  13. A doctor is judged by everything but his quality of care.
  14. Doctor and staff must be in total agreement on policies.  If doctor overrides policy, pt. will go for the jugular.
  15. Never be defensive when talking with a patient.
  16. Sell the benefits of change to your patients.
  17. Make all changes in writing
  18. Never move the same patient twice.
  19. Keeping the schedule full is your primary responsibility
  20. Don’t make it easy for clients to cancel appointments
  21. Leave openings in the hygiene schedule for new clients until 24 hours before the appointment.
  22. Never talk to a client about a concern without having the folder in your hand.
  23. You should always add some value to the client’s appointment.
  24. Never try to cram a client into fewer units than your dentist wants, unless he agrees.  It’s great to fill schedules, but not by creating nightmares.


i. Preparing for Dr Vacations

  1. Leave appropriate personal voice mail messages to reflect time out of office.
  2. Block time in Doctors schedule.
  3. Add additional hygiene check times to remaining Dr(s) schedules as needed
  4. Adjusts hygiene to work hours of remaining Dr(s)
  5. Make sure we have proper opening and closing coverage
  6. Alert all staff of schedule changes
  7. If staff want to work while their Dr. is on vacation, assign emergency column where needed or assign projects.
  8. Give working Dr(s) and secretaries vacation itinerary in case of emergency.

j.       Snow Emergency

1.  Follow schedule in policy manual

2.  Watch

Now you will be assigned the responsibility of coordinating all the activities of the secretaries at the front desk. When your team leader believes you have mastered this task she will sign you off.

kChecklist when you see a credit balance on the ledger

Does anyone in the family have a future appointment?

    1. If there is a charge for the future appt, then no refund.
    2. If it is just a seat crown, or follow up w/ no production, then they would qualify for a refund.

If no future appts, (or appt with no production)

    1. Check for each person in the family to see if anyone has a recent treatment plan.  The patient may have prepaid for work needing to be done, but hasn’t yet made an appointment.
    2. If no future appts and no tx plans, then need to check the ledger.  Do ledger and history and view all.  If patient has insurance, need to check if credit caused by duplicate insurance payment or secondary insurance overpaying.  Let ______________ know if this is the case.  When you are looking at the ledger and don’t see any personal payments, and the patient has insurance, this is a flag that there may be some sort of error in the insurance payments.
    3. Check the guarantor note to see if there is a note about the credit.  Some patients prefer to leave the credit on the account to use for the future.

Check if anyone on the account with the credit has an ortho account, and the credit occurred by posting the ortho payment to the regular account.

  1. Let ____________ know when you have determined that a refund check should be sent to the patient.

 l. Handling attorney requests

Occasionally we receive a letter or call from an attorney requesting a patient’s records. Here are the steps to follow:

  1.  Check the attorney letter for a signed release by the patient allowing us to share this information with the attorney.
  2. If there is no signed release, call the attorney and let them know you need a signed release.
  3. Once you have the letter and signed release, then pull the chart and give the chart & letter to Dr.
  4. Dr. will determine what he wants sent to the attorney.
  5. Make a copy of these records
  6. G-Note and set an alert “When receive attorney and or ins. Payments, then add charges.
  7. Create a business letter to the attorney letting them know exactly what is enclosed and that there is a $______ records fee owed to our practice. (This is a charge to the attorney, not our patient. See the table below to determine.)
  8. When the attorney sends payment to us, then we will put a charge on their account using code D9997 Completion of Reports. The payment is then also entered on the patient’s account, so the charge and payment will be the same.
  9. Note on the yellow tx sheet that the records were sent to the attorney
  10. File the request & signed release in the back of the left chart pocket for that patient.

According to the ODA – here are the allowable amounts we can charge:

For paper copies

$2.50 per page for the 1st 10 pages

$0.51 per page for pages 11 – 50

$0.20 per page for pages 51+

For x-rays: $1.70 per page

Also can charge for postage


If the attorney or other representative requests

For paper copies

$15.35 fee for records search

$2.74 per page for the 1st 10 pages

$0.57 per page for pages 11 – 50

$0.23 per page for pages 51+

For x-rays: $1.87 per page

Also can charge for postage

(Link is:

__________________________    _________________

Teamleader signature                       date