Process simplified: Insurance enrollment

On a regular basis, we attempt to evaluate certain services and processes, break them down into their basic components and let you evaluate whether or not those services are worth paying for.  Today, we take a look at getting enrolled with insurance plans, especially for new practices.  A number of services will handle this for you for a fee, but the question is this: Is the service involved enough that I need an expert to handle this for me? 

Simple conclusion.  Is the process time consuming?  Yes.  Is it complicated?  Not at all.  Here’s how the process operates:

Step 1: Gather a list of insurance companies and contact numbers.    

Of course, this varies by state, but here’s a good generic list of some providers that are generally found in every state and provide some type of dental coverage (along with information on how to get to their enrollment information):

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Marketing Monday: Closing time! (video)

Today, we bring you video of a key part of the consultation process: the doctor-patient interaction.  A 5-star facility and friendly staff are great, but the patient absolutely has to feel comfortable with the doctor in order to sign up.

As you can see from this video, developing that rapport and comfort level doesn't take long: only 3 minutes in this situation.  Also note the upbeat tone and lack of techspeak ("we're going to put braces on the top and bottom teeth" -- intense!).  With the pan and ceph done and quickly reviewed, most of the talk is conversational.

In quick succession at the end of the video, the doctor covers important topics like the term of treatment,  interval between visits and the fact that the financial portion will be handled with someone else in another place.

Obviously, the conversation needs to take place on topics and in a manner useful for both you and the patient, but this simple example lays out a good template for the flow of this process.

Special thanks to Dr. Dennis Buchman for allowing us to record and post this video.

Six tips for improving the consultation experience

Every practice has its own style, own culture and own atmosphere.  Some practices go for upbeat, bright and active.  Others prefer laid back and relaxed.  When you do a new patient consultation, you certainly want to convey all of that to the new patient.  As such, there is obviously no one way to conduct a new patient consultation.  You and your staff have to feel comfortable in order to make potential new patients feel comfortable.  

Given this, there are some overriding principles and techniques that have proven successful over the years that contribute to a better patient experience and improved batting averages.  Some of these may be obvious, but over time, they’ve been shown to work.

New patient results: analysis and solutions

At this point, you have gone through the process of computing your batting average.  Now, it is time to begin the analysis of that number to determine exactly where problem areas might lie.  You can perform this analysis over any period of time you choose.  Again, issue the standard note on time periods.  If you examine results for a short period of time, you are more susceptible to seeing unusual fluctuations that may be confined to that short term period only.  For example, you may have lost an entire group of new patients because the power in the neighborhood went out and you needed to reschedule those patients in the next month.  That month’s results would certainly not be a true reflection of the performance of the practice over a longer term. 

Let’s say that you compute your batting average for a particular quarter and come to a result of .667.  Further, we’ll assume that this breaks down into a numerator of 60 new contracts signed and a denominator of 90 gross consultations.  The question that we now have to answer is what happened to those 30 patients that did not sign.

Closing sales: Check your batting average

You know the situation well: you’ve put in effort, time and money into getting a potential new patient to come into the office.  Now, that patient and possibly that patient’s parent/guardian stand before you waiting for you to make your pitch to tell them why they should sign up with you and not that practice down the street.  You know the practice down the street: it’s the one with the waterfall and first run Pixar movies on 24-hour loop.  Sign this patient and that means good reviews on Yelp, Angie’s List and other social media; referrals which lead to another network of referrals which leads to reduction in reliance on media advertising.  That leads to more patients, more profit and less administrative headache.  Lose this patient and the flow of potential patients slows as this one tells all of his and her friends about the way your practice just didn’t add up.  Combining this patient, reviews and referrals, letting that patient walk out of the door means the loss of this year’s Christmas bonuses. 

Okay, it’s probably not that dramatic, but when you get a patient in for a consultation, you want to close him or her.  An orthodontic practice is not like a Macy’s, where thousands of people walk through the doors on a given day and you are trying to get a strong enough percentage to make a purchase.  You will get a select number of new patient visits during a month and you want to make as many of them count as possible.  And despite the extremes of the example above, one extra closed case can seriously have a multiplier effect on new patient activity in the future and you want to get as much of that 

In the end, getting a patient to sign a contract is a reflection of the selling effort of the practice.  So, how do you improve on selling cases?  We begin our examination of that topic by determining if there is a problem.  From there, if there is a problem, how big is it?  And no matter the size of the problem, how do you go about improving on results?

Marketing Monday: Positioning your practice for success

In a previous post to Marketing Monday Bart did an excellent job of identifying the most attractive segment of the orthodontic market.  In his blog post Bart pointed out that through extensive research and real world experience working mothers aged 35-45 years old is the best segment of the market to focus your advertising and promotional efforts.

In a much broader perspective identifying the target market is one part of an overall marketing plan.  Technically speaking developing a marketing plan is a 6 step process resulting in a plan that effectively communicates the value of your services to customers, builds a relationship with your customers and differentiates your organization from competitors.  The most critical step in the marketing planning process occurs in step 3; segmentation, targeting and positioning (STP). 

Tool kit: MPE Purchasing Collective

Update April 2, 2014: The MPE purchasing collective is now closed.  Thank you to all of the practices that have participated and are enjoying the benefits of the service.  Due to the current state of agreements with some practices, this service is no longer open or available to new members.

If you have participated within a large group practice, know someone who has been in a group setting or have heard about a group practice, you know that one of the main benefits of being in those groups is substantially reduced pricing for your supplies combined with improved service.  The pricing reductions are not insignificant – as much as 65% off major items like bands and brackets.  Vendors like these practices because one client means substantially larger sales with a reduced investment in selling.  The relationship has other benefits for vendors including reduced administrative costs resulting from centralized billing, limited cost to renegotiate prices and availability of large packages of information in one place.  Please note that when we discuss discounts, we are not talking about a standard 40% off list price that many vendors offer.  We are talking about the possibility of significant deep discounts on supplies.

Getting discounts for a group involves considerable administrative work to get them set up.  Contacting the proper vendors, making the best possible deal, managing billing, shipping and returns and ensuring a variety of products that satisfies the needs of the doctors while not being unsustainably large.  You also need a mechanism to be able to deliver to process orders and returns that is easy to use, proven and efficient.  Instead of ordering from each vendor individually, you need to be able to go to one place, order what you need and have all the vendors be notified automatically.  Ordering done.  Back to patient care.  We have that system.  We just need people who want to participate.  All parties come together in the MPE Purchasing Collective.

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MPE: The backstory - the exciting conclusion

You can check out part 1 of the story here.  Now, to the finale...

       When we last left our story, we had decided to raise capital to expand our services and affiliates at a much more rapid pace.  Now, a post on the vagaries of becoming a public company and dealing with life as a public company is a matter for its own blog.  That is not what we are discussing here.  I’ll sum up the process by saying this: lots of time, lots of lawyers, lots of headache, lots of distractions but unbelievable sums of money available to run your business.  By December of 1994, a company called Orthodontic Centers of America had been formed, raised about $18 million (after fees) and began trading on the NASDAQ.

With the extra funds, expansion began rapidly.  We could build offices almost anywhere we wanted (provided a doctor was available) and acquire the agreement to manage numbers of offices in one fell swoop (provided the other side wished to enter into an agreement with us).  When we went public, we were managing 75 offices.  With capital, that number quickly moved to 200 and in excess of that as we were able to raise more funds and add affiliated practices.

Podcast: New office development - what you need to know

When we bring you guests on our podcasts, we bring talented people with extensive experience in their field of expertise who are still deeply involved in their chosen area of focus.

In this production of the MPE Podcast Express, we are excited to bring you Derek Leonard and Dan Hassett of American Business Consulting (Link here).  Here, they discuss the in-and-outs, opportunities and ptifalls you'll see when it comes to new office construction.

Derek started in this area at OCA, where he started from an entry level position to become the top recruiter and project development person for the world's largest -- at the time-- orthodontic practice management company.  Dan has worked closely with Derek for the last several years and has developed into a skilled project manager himself.

Take a listen and, as always, if you want to know more, have questions or just want help with your own practice's issues, let us know by clicking here.  Enjoy!  (Click this link to go to the podcast.)

Marketing Monday case study: the competitive market

        When it comes to advertising your practice, as you get into the process, you notice a lot of noise surrounding you.  Competitive advertising not only for the same service, but other services that might cause a potential patient to redirect his or her dollars to that service and delay the start of treatment.  

Historically, we have seen markets where attracting patients was relatively easy.  We’d go in with aggressive pricing, spread the message via various media outlets (some TV, some radio, some social media).  Because we faced a fragmented set of competitors who were either averse or unable to fund electronic media marketing, our message sat front and center for the potential patients in the market.  Strong results followed.  In fact, some were so strong that the doctor requested that we turn off the advertising shortly after opening to give him a chance to get caught up.  Some smaller markets like Montgomery, AL and Macon, GA fell into that category.  Other large markets with an underserved population seeking affordable treatment also proved to be fertile.  Miami, FL and Seattle, WA fell into that category.

Some markets did not lend themselves to such a neat solution.  Group practices with greater resources than an individual practice regularly advertised very low fees to attract new patients.  Like us, they had multiple locations to offer convenience to patients throughout the market.  Being heard in those markets was much more difficult.  What do you do?  For more on that, let’s take you to our Marketing Monday case study.

MPE: The backstory - Part 1

Today, I would like to present the history and background so that you know what kind of people comprise MyPracticeEngine.  Of course, when discussing history of any kind, there are usually varying accounts of the events comprising that history.  Individual eyes have their own individual interpretation.   No such biases exist in this story.  As such, in this version of the story, we shall refer to it as the “correct” version and as such, the official one.

Things all started in the mid 1980’s.  My father, Bart Palmisano, Sr., had his own accounting practice and I, Bart Palmisano, Jr., was an aspiring business person negotiating his way through the latter stages of high school and working for him after school and during summers.  One of his clients, an orthodontist, had built a practice in Florida with multiple offices.  The marketing side and treatment part of the practice generally ran pretty well, but the business side was nonexistent.  There was no monitoring of results, no controls over important items like cash, no reconciliations of important balances and generally no business systems.  As a result, more than one unscrupulous employee walked right into that business system void and out with over $250,000 in stolen payments.  The business was nearly bankrupt despite the strong satisfaction of patients with the treatment outcomes.

4 factors to note before sending another patient survey

In this post, we turn over the controls to Michael Cusimano, a colleague with deep experience in practice management and an MBA.  In addition to this article, we have some specific, usable survey templates that we'll get added to the tool kit in the very near future.  Of course, if you have any questions or need additional information, contact us.

To survey or not to survey, that is the question.

Most, if not all dentists and orthodontists aim to provide their patients with a great in-office experience.  The most common motivation to providing a great patient experience is that most doctors understand the value of a referral and realize that the key to a referral is great customer service.  The question offices struggle to answer is, "Do our patients think we're going a great job?"   Often times, in order to gain insight to what kind of job they are doing many dental offices decide to implement a customer satisfaction survey.  You know, those 3 to 5 question post-card sized surveys that ask "how'd you like us?"  The problem is that after a great deal of staff time, a sizable amount of money spent, and a decent amount of surveys completed, the unfortunate truth is that not much is learned.

In this blog post I'll point out the major problems with the typical postcard-sized customer satisfaction survey a large number of practices use to evaluate customer satisfaction.  I'll point out 4 pitfalls in detail below.  However, the core problem with producing or purchasing a customer satisfaction survey is that many offices do not have the resources to properly create and administer a customer satisfaction survey that will generate valid and reliable data that produces actionable information.  Furthermore, the expense and effort involved in developing a useful survey is often not necessary for many dental and orthodontic practices.  

There are 4 basic pitfalls/warnings related to simple postcard sized customer satisfaction surveys:

3 ways to increase daily volume without compromising quality

One of the most frequent responses we receive when proposing improving processes and systems to our clients is “your systems require seeing more patients in a given day.  Won’t that compromise the quality of care for my patients.”  At MyPracticeEngine, we know that your most important job is to provide the highest possible level of care and we are very sensitive to that fact.  As these improvements are proposed, a keen eye is directed toward ensuring sterling treatment and outstanding results.

When we propose methods for practices to increase the patients seen per day, most initially look at the proposal and say “we can’t handle that.”  Once they put new processes into practice and get comfortable with them, those same practices report on the ease with which they can handle a new patient load.  

The process for increasing volumes can get intricate and very specific to the design of a practice, its patient base and staff, but here are 3 of the big suggestions that usually turn up your practice’s “bandwith” no matter what the particular circumstance:

The fixed cost nature of your practice

        Following up on a recent post, one of the most frequently asked questions we receive is “if I do increase my volume with a lower monthly payment, won’t the increase in cost from servicing these additional patients consume any potential profit?”  The answer is no.  The reason is because most of your largest costs are fixed in nature.

As we examine this more in depth, let’s look at the definition of “fixed cost.”  In standard economics-speak, a fixed cost is a cost that does not vary with the number of transactions or volume in a given practice.  To see how this affects your practice, I will take you through some of your major expense line items:

Marketing Monday: Monthly payment down, profits up

         Despite the occasional positive economic news out there, the world economy still is not flourishing.  Growth in the US is still slow and uneven.  Europe is getting its house in order.  Growth in China and India have generally slowed.  And if you are located in a place with a thriving economy, your practice growth is still potentially limited by competition.
  

So what can a practice do to achieve material long term growth in profit without investing funds in a potentially expensive and uncertain marketing campaign on electronic media?  Reduce your monthly fee and watch profits grow.

Tool Kit: Stats Analyzer

        At times, your practice reaches a certain size, level of stagnation or difficulty that you decide to bring in outside help.  Or, you may simply decide that you want to focus more on patient care and have others handle some of the business aspects of your practice.

Whatever the case and regardless of whom you decide to bring in, a part of the fee you pay will invariably be for that person to take your practice results and perform some analysis.  They will then provide solutions for you to implement.  But why pay for any of that when you have MPE Stats Analyzer?

Tool Kit: MPE Text Alerts

I’ve alluded to this in some of our early posts, but here’s a bit more detail on our text alerts system.  The product is based on two main tenets:

              1.   Reviewing reports and dissecting numbers can generally be a tedious task.  For a number of reports generated by practice management systems, consultants, DPMs, etc., you get a lot of information and have to sift through the data to get to what is meaningful.  With our text alerts, we do the sifting for you.

              2.   We live in a world filled with mobile devices.  That number is growing significantly.  Text messaging is a common, convenient form of communication.  Not only is it convenient, but it has become a favored form of communication among a lot of people.

So, rather than getting to your computer or having to find a website with reams of numbers, MPE Text Alerts tell you when there is something needs your attention and you get the information immediately wherever you are.  You can then spend more time focusing on your patients, your personal life or whatever pursuits you need time for.

Here’s how it works:

Introducing the MPE Tool Kit

Any good engine needs a set of technicians and tools to run smoothly. To this point, we’ve given you some insight and data from the technicians. Now, it’s time to bring out the tools. Today, we officially introduce the MPE Toolkit to help you improve results if they are where they are not where you want them to be or to give you a hand in taking results to another level if things are good, but could be better. Today, we will re-introduce one of the tools and introduce a new one. Over the next several weeks, we’ll add new ones to the kit. As always, if you have an idea for a new one or a suggestion as to how we can improve the current ones, please let us know. Check out the new set of links to the right. We’ll keep the links to our toolkit items there and add to the set as we introduce new tools.

Want patients? Here's who you need to impress.

In today’s exciting Marketing Monday installment, we discuss a fundamental concept underlying your marketing and how you design the business side of your practice.  You cannot advertise, market or effectively do business without knowing to whom you are directing your marketing or your services.  In sum, who is your target market?  Who will be the people that make decisions about whether or not to utilize your service and what factors push them to selecting one service provider over another?  This doesn’t affect just marketing.  I taught a small business startup class and in the 10 week period covering a broad range of topics, we discussed knowing the target market in about 8 of them.

In today’s post, we answer the question, “Who is my target market?”