Dentist Office Exterior

Thursday Troubleshooter: My fee-for-service practice is slowly declining

Oct. 24, 2013
This fee-for-service dentist is having trouble

QUESTION: My fee-for-service practice is slowly declining and I’m wondering if I should consider becoming a provider for some dental plans. My new patient numbers are down and case acceptance has decreased during the last few years. I have been practicing for 30 years, and I dread the idea of becoming an insurance-driven practice at this stage of the game. What do you recommend?

I am sure you’re not alone and that several of your colleagues are experiencing a similar situation in their practice. This is a good time to evaluate current systems such as new patient protocol, case presentation, follow-up on pending/unscheduled treatment, and marketing. If you follow the steps I suggest here, you should be able to continue practicing as a fee-for-service practice.

1) Review the following reports monthly — new patient referral source, new patient values, cases presented/accepted and case values, pending treatment (this is a big one!), and marketing analysis. (You must know what is effective and what is not.)
2) Schedule a full-day team meeting to discuss the findings from your reports, and develop a game plan for making the necessary changes in your practice. You will discover many opportunities for increasing your production. Most practices find they have a "sub-practice" (what Linda Miles calls it) within their practice. Once you reveal the sub-practice, you will find a gold mine.
3) Review and establish current goals with your team. These should include new patient, production, and collection goals. Once established, review them daily in your huddle. This focus alone can work miracles.
4) Create/modify and implement your marketing plan. If you are not marketing, either internally or externally, you will continue to see a decline in your practice.

ANSWER FROM MARY FISHER-DAY, Owner of The Dental Business:
For those of us who have worked in dentistry for more than a couple of decades, it's hard to accept that an insurance company can dictate fees. Unfortunately, it is a rare practice that can survive without participation in one or more insurance programs today. However, there could be other reasons for dwindling new patient numbers and a decline in treatment plan acceptance.

Take a minute and rule these out first. Do you have a new team member(s) who is unfamiliar with the way your phones are to be answered or how treatment plans are to be handled? If the answer is no, have you decreased or changed your hours? If the answer to both of these questions is no, then there is a high probability that a primary employer for your patient base has changed insurance providers and/or moved to a PPO plan. If this is the case, my recommendation is that you do some research. There are different plans within insurance programs and they pay at much different rates. As an example, look at Cigna Radius and Cigna Core. Research will show that Cigna Radius has a higher pay scale than Cigna Core. This is also true of Delta Dental Premier and Delta Dental Preferred.

If you have never participated in a PPO plan, it could be devastating to your bottom line to jump from no PPO to a lower paying option. Know your choices and choose your plans carefully. Keep in mind that your administrative team may not know to ask for options. If not, they will need your guidance. You do have choices.


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