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Brace for impact: Improving expense hygiene during COVID-19

Aug. 18, 2020
Even if you have always kept your practice costs in check, you may be surprised at the essential expenses, such as telecommunications and merchant services, that could still be reduced. Seth Tenenbaum explains what to look for.

By Seth Tenenbaum

Bills, bills, bills: How carefully do you scrutinize them before issuing payment? 

With financial pressures bearing down on dentists since COVID-19, chances are you’re giving each invoice a closer look. The data supports this cautious approach: the drop in patient volume illustrated through the American Dental Association Health Policy Institute polls is just one indicator of the need to rethink budgets. In one recent poll, respondents reported that volumes were just 71% of what they’d been before the pandemic.1 The resulting reduction in revenue, combined with added safety costs, should prompt all dental practices to rethink every expense.

Even if you have always kept your costs in check, you may be surprised at the essential expenses, such as telecommunications and merchant services (credit card processing), that could still be reduced. Here are 11 ways your practice might find money you didn’t know you had.


Watch for overlooked errors: Are you paying for a service you cancelled months ago? If you have more than one location, each with different levels of service, is one office being charged for another’s expensive plan? Have you changed administrative staff without a full briefing on what charges these bills should include? This is the time to put your invoices under a magnifying glass.

Reduce inefficiencies: If you have a regional practice, not only may you have individualized telecom plans for each location, you may even be working with more than one carrier. If that describes you, consider a single “umbrella arrangement” with one provider for all of your locations. Increase your efficiency and shave costs by paying one master bill rather than multiple monthly invoices.

Hang up on redundancy: For example, if your receptionist picks up every call and your answering service covers nights and weekends, you should be able to get by with a fairly limited voicemail system. Another example is if all of your offices are paying individually for call forwarding, move to a central system that forwards all locations’ calls to one main line.

Consider Voice over IP (VoIP): By moving all communications from traditional landlines to cloud-based VoIP platforms, you can often ring in new features, such as text and email alerts, at lower costs.

Remain vigilant: Be aware of your plans’ automatic renewal dates. You may have a 30-day window to modify or end contracts that are coming up soon.

Credit card processing

Investigate alternative vendors: Even if you are locked into a particular technology provider, that company may have agreements with more than one payment processing organization. It’s worth researching how their services and pricing compare.

Scrutinize monthly invoices: You may be surprised to observe a gradual pattern of increased costs, which often slip through the cracks. This is a good time to strip out the overage.

Be a magnet for change: For example, consider replacing any legacy physical payment processing terminals with virtual, cloud-based terminals that connect to a magnetic reader, such as equipment that enables card swiping.

Pay attention to transaction processes: Do your customers pay by swiping their cards or entering their information into a virtual terminal, or does your staff complete the process for them?  Your costs could vary depending on the steps involved and how virtual they are.

Are you locked in? Should you wish to change vendors, what is the financial penalty? Be wary of contracts with steep liquidation costs that are perhaps in the thousands of dollars.

Is your merchant services partner responsive? Are you consistently paid for large transactions within two to three days? If there are problems with a patient’s credit, does the service provider ensure that you won’t shoulder the burden?

Putting guidelines into practice

Even before one of our clients, a multilocation orthodontic practice, had reason to brace for COVID-19, it was determined they needed to improve their expense hygiene. The practice was overpaying for its telecom services and had more features than it needed. By bundling more services together through a master contract, the practice saved 35% on telecom costs. Moreover, some changes on the merchant services side enabled a 20% savings with the practice’s existing vendor.

The bottom line: The fallout from COVID-19 will hopefully be short-term. Filling the cavities in your expense reduction plans can help you gear up for the challenges. For best results with the changes you implement, continuously review your invoices. This will position your practice for healthy years ahead.


1. Carey M. Ninth wave of HPI poll shows dental care rebound tapering off. ADA News. July 23, 2020. https://www.ada.org/en/publications/ada-news/2020-archive/july/ninth-wave-of-hpi-poll-shows-dental-care-rebound-tapering-off

Seth Tenenbaum is a strategic partner with the Boston office of Schooley Mitchell, the largest independent cost reduction consulting company in North America, with offices from coast-to-coast. Tenenbaum can be contacted at [email protected] or (617) 655-6505. More information about Schooley Mitchell is available at schooleymitchell.com.