Sixteen Critical Strategies to Increase and Maintain Practice Revenue

16 Critical Strategies To Increase Or Maintain Practice Revenue

There are a number of strategies to boost practice revenues, while trying to survive in a PPO environment. Listed below are 16 key strategies. By working on your practice, instead of in it, the dentist maximizes revenue results while avoiding trouble!

1. Add an unbooked operatory: Extra, unbooked operatory will lower stress, improve on-time performance, and provide “impulse” and “work-in” same day revenues. There is an 80-90-percent profit in working in an extra procedure today, since the overhead is fixed except for dental supplies and related lab expense, if applicable! That extra operatory won’t be used much during the day, but when it is, it’s extremely profitable. When the cost of the operatory is amortized over six years, it only costs about $30 per work day plus supplies to add a lot of revenue to the bottom line with an 80-90-percent profit margin!
2. Ditch a low reimbursement PPO: When participating in several PPOs, consider ditching the worst. Compare fees paid, then quality of patients in the plan, market share of plan and finally the associated clinical or administrative hassles. Decide which plan to drop in sequence, but prepare first. Notch up your diagnostic and communicative skills while adding a new service or two, plus marketing to make up for the loss of the PPO. In some cases, add a better PPO. Your staff members and you will feel so good afterward.
3. Raise fees annually and eliminate schizophrenic fee schedule: Don’t miss a modest increase in fees that can be acquired every year, routinely, without exception. If you raise fees 2-3 percent then you are only keeping up. If you rise above this percentage, you will raise your percentile in relation to others. Raising fees a fixed percentage floats all the boats. Some fees may be lower than optimum so some fees may need a 5-15 percent or more increase on a one-time basis. The rebalancing process yields high cash flows. Use an expert to get it all in place. With secondary insurance coverage, in some cases you may receive up to your full, unrestricted fee. PPOs control patient charges, but don’t control total reimbursement when coordination of benefits applies. Coordination of benefits is controlled by state law or the self-funded plan under federal law.
4. Increase conversion rate: Patients will be more accepting if the case presentation includes adequate time for explanation, empathy, intraoral photos, digital x-rays, study models and thirdparty financing for affordable payments.
5. Improve crown and bridge operative ratio: Many dentists don’t diagnose, sell, or gain proper patient acceptance for crown and bridge procedures. Merely check the crown and bridge units to operative unit’s ratio to check this important monitor. One crown per three operative multi-units is performed in the typical practice (exclude one and two surface operative units in this calculation).
6. Work “on” the practice, not just “in” it: Many dentists measure their worth by the amount of clinical work hours. Yet time spent for in-office training and outside of the office will pay off in spades. An old Chinese proverb says, “When the student is ready, the master will appear.” Open up your thinking and ditch the preconceived notions.
7. Expand procedure mix: The more procedures, the less patient flow is needed to produce a given revenue level. Many dentists get complacent or in a rut. They say, “I don’t want the hassle,” and decrease services offered. They literally become a “refer-o-dontist.” The more procedures provided, the busier the practice. Explore adding procedures such as simple oral surgery, occlusal guards, Invisalign®, sedation, cosmetics, mini-implants, automated endodontics, soft tissue program, etc., to increase in-office activity. The typical dentist performs about 90 different procedures a year, while the refer-o-dontist does 60. The decathlon dentist does about 120 procedures a year.
8. Maximize treatment revenues per visit: Present quadrant treatment and extend third-party financing to produce more revenue per visit. Longer appointments will reduce stress on the doctor and staff. The clinical goal is both high dollars-per-hour and high dollars-per-visit. This is an important concept in a PPO environment.
9. Define hygiene protocols: Establish protocols for proper diagnosis while increasing revenue. For instance, generally take two bitewings for children and four bitewings for adults. Establish when to take a pan plus bitewing combination and when a full series would be appropriate. Establish the criteria/age for switching from the child to adult prophy: for instance, use age 14 or when primary teeth are lost. Establish timelines for new patient exams and recalls with, and without, x-rays. In essence, have a plan that is concise and understandable for all staff that results in better care for the patient.

want to know what the write-offs are, and you want to file the full fee so that any increase in PPO plan reimbursement is always picked up. It is important that the full fee be on each claim form when there is secondary coverage for maximum reimbursement, up to your full fee.

10. Report the CDT-2015 codes properly: Dental offices don’t usually spend time studying the proper procedure codes. Always report exactly what you do. The typical practice leaves $100-$500 a day on the table by not coding properly or having an improperly positioned fee schedule. Report periodontal procedures properly, avoiding over or under treatment. CDT2015 has 72 total coding changes. Give the business staff the new coding tools when published each year.

15. Avoid the two top fraudulent practices: If you offer a 5-percent discount for cash, enter the actual fee charged on the form. For instance, if the fee is $1,000, but the patient actually pays $950, the $950 should go on the form to avoid an overpayment. If you offer an isolated fee co-pay forgiveness to insurance patient (for instance, a patient in need), you must disclose it to the third-party (insurance company). Enter “the patient is not participating in the cost of care” in the remarks section of the ADA claim form. Federal and State laws and PPO contracts have language prohibiting copay and deductible forgiveness.

11. Return an in-office, on-site consultation: When the office is required to shut-down for training by an experienced consultant, revenues jump. My experience is that the superior approach is for the staff to be trained onsite, without travel or other distractions – in your own office. But, offsite training is a plus. Spend money to make money. Don’t be cost-based, but revenue savvy!

16. Run daily reports: Conduct a daily review of all procedures performed versus what is charged out to detect errors and review production and procedure mix goals for dentist and hygienist.

12. Visit other colleagues’ offices to improve your own: A visit to a colleague’s office will yield many ideas and expand your thinking. It’s free, and your colleague will gain value in visiting your office. Approach a dentist in your study club for a swap today.

13. Effectively use the intraoral camera: Many offices have an intraoral camera; however an office may use it inappropriately or not at all. Take the time to train the staff in the proper use of the camera, as well as confirm that it is being used appropriately and routinely. With insurance, document, document and document.

A p p l y i n g these strategies to your practice will result in increased revenues and profitability, better customer service, improved clinical treatment and a better sense of self-worth. They

14. File a full fee on the claim form every time: ALWAYS file your unrestricted (full) fee on the claim form even when participating in a PPO plan. Why? You

are essential to thrive in a changing PPO and corporate marketplace. However, you must take the time to identify and implement them.

is to help you navigate the challenges of building and sustaining a successful dental practice.

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