Henry Schein & VOCO are excited to introduce Admira Fusion. As the world’s first purely ceramic-based direct universal restorative material, Admira Fusion creates a new material class in dentistry. Watch this video and learn all about this exciting new restorative material.September 12, 2016 | Category HR, Team Harmony
Does it seem like your employees are constantly texting and/or checking at their phones? Is patient care and service being negatively impacted? Do you longingly remember the days before smartphones?
The bad new is: it’s never going to be 1993 again. The good news is: there are some things you can do to help ensure your practice is not adversely affected.
Successfully navigating smartphone use in your practice will typically take some flexibility and understanding on both sides. While it can be tempting to install cell phone jammers or lock all personal phones in a cage, the best solution is a mixture of understanding and clear boundaries.
Start by thinking about your “absolutes”. One might be an employee texting in front of a patient, which should absolutely never happen. Another reasonable boundary might be when patients are present in the clinical area or the front office, no employee should ever be using their phone. You could also clarify expectations about the phone vibrating on a countertop, or a chirping phone in an assistant’s pocket.
Next, think about areas where you can be flexible. For example, employees checking to ensure that kids made it to school safely or checking or responding at certain acceptable times during the day.
Spend some time thinking about your boundaries. Draft your expectations in a clear policy and remember, the stricter the policy, the harder it is to enforce. Enforce your boundaries consistently and fairly with all employees. If discipline becomes necessary, as with any liability-producing HR event, please contact the HR professionals at Bent Ericksen & Associates or a labor compliance professional prior to taking action.September 5, 2016 | Category Practice Management
By Jeremy Behar, President and CEO, Cirrus Consulting Group
Imagine arriving at your dental practice to find a notice from your landlord stating that the building will be undergoing redevelopment, your office lease is being terminated, and you have 30 days to vacate the premises. Your first thought is “there’s no way this can be real. My landlord would not, could not, and cannot legally get away with this”. Wrong.
This very real and common scenario is a result of the landlord exercising their right to demolish the space as outlined in the “Demolition Clause” in your dental office lease. This clause permits your landlord to relocate you or terminate your lease if they decide to demolish, renovate, or redevelop the building or center you are practicing in. Often the definitions of “redevelop”, “demolish” or “alter” in the lease are highly ambiguous.
Negotiating the Demolition Clause in the Dental Office Lease
It is in your best interest to avoid signing a dental office lease with this clause present altogether, or at least attempt to have it removed. If the clause already exists in your lease, or your landlord won’t remove the clause and you still choose to move forward, there are ways to amend it so it works more to your advantage.
- Landlord Pays for Relocation Costs: If the landlord chooses to relocate you, put the onus on the landlord to pay for all costs associated with the move or the demolition of your office space, including covering demolition/construction costs, real estate fees, moving expenses, marketing, and other costs.
- Time Constraints: Try to negotiate time constraints that apply to the landlord for activating the Demolition Clause; the later the better. For example, maybe the clause can only be exercised 5 years or 10 years into the lease.
- Increasing Notice Terms: How much advanced notice will you be given to exit the space? Consider the amount of time required to relocate or rebuild your practice without having to rush into a new space that is not ideal. There is a big difference between having 30 days to vacate and 9 months to a year to vacate. Having time on your side before you are required to exit equals more time to find an ideal location and re-build your practice.
- Terms of Activation: Ask your landlord how much of the building will need to be renovated or redeveloped to activate the Demolition Clause. For example, perhaps it can only be invoked if more than half of the property is affected by the rebuild.
- Proof of Demolition: What proof should your landlord be required to provide you with upon the activation of the Demolition Clause? You want to ensure that the reason for eviction is because your landlord is rebuilding or demolishing the building. Common examples of proof include architectural drawings and building permits. This evidence ensures that your landlord is honest and is not evicting you needlessly, or for a reason other than a planned demolition or rebuild.
- Lease Termination Rights: In the event you are relocated and you do not like the space you are being relocated to, you should have the right written in to terminate the lease.
- Compensation: If the landlord invokes the right to terminate your dental office lease based on a redevelopment, they should be legally obligated to either pay to move you, or to pay for your unamortized leaseholds.
Huge Risk and No Reward for Your Dental Practice
The disruption to your practice, loss of business, and moving expenses associated with the Demolition Clause can easily make or break a flourishing practice. Due to the grave costs and risks involved, it is in your best interest to avoid signing a lease with a Demolition Clause in it. If this isn’t possible, try renegotiating the clause so that the onus is on the landlord to pay for any related expenses.
Don’t jeopardize your practice’s future by putting yourself at the mercy of the Demolition Clause. Have a leasing professional carefully review the details of your dental office lease before renewal or opening a practice to ensure your business is protected now and in the future from this clause. To learn more, request a free lease consultation.August 15, 2016 | Category Practice Management
What costs more: practice management consulting or a new car? That depends on the consultant and whether your taste in cars is more Tesla or Toyota. Chances are they’re in roughly the same ballpark. While it might seem crazy to spend your new car fund on something as intangible as consulting services, there’s very little chance a new car is going to make you money, unless you’re an Uber driver. On the other hand, a good practice management consultant will design and implement a coaching plan to grow your practice production. The key is finding the consultant that fits the needs of your practice, to maximize your return on investment.
Any major purchase process starts the same way, by establishing what you want the purchase to accomplish. If you’re buying a car, do you want to efficiently commute to work every day? Or do you want to enjoy leisurely drives and envious looks. Selecting a consultant requires the same analysis. Do you want to work more efficiently? Attract more new patients? Prepare your practice for a successful transition? The consultant you choose to work with should have a skill set that closely aligns with your individual practice needs. You don’t want to end up commuting in a Hummer. Read articles (and social media posts) written by consultants, check their references, ask colleagues for referrals, and talk to your local dental professionals.
The next step is the test drive. Schedule calls with each of the consultants who made your short list. Most will provide an initial consultation at no charge. Use this time to outline your current practice status and share your goals. The consultant can share their approach for your situation and you can determine if there’s a fit. Although the selection process rests in the hands of the dentist, remember that this is a decision that will significantly impact your team. Consider including the office manager or key staff members in your process.
Consulting is an investment in the long-term success of your practice, but it does not have to be complicated or expensive to be effective. Schedule a free consultation to learn more about cost-effective coaching from 360 Practice Development.August 1, 2016 | Category OSHA & HIPAA
On November 10th, 2015 the United States Congress passed a budget agreement. Part of this agreement was a provision allowing OSHA to increase fines by approximately 78%, effective August 1, 2016. This dramatic increase in fines was described as a “catch-up” based upon the inflation rate from 1990, when they were last raised, to the present. The new provision also stated that going forward, OSHA fines will be raised each year based on the Consumer Price Index (CPI). Any citations issued by OSHA are subject to the new penalties if the related violations occurred after November 2, 2015.
OSHA Director, David Michaels, stated that “Unscrupulous employers often consider it more cost effective to pay the minimal OSHA penalty and continue to operate an unsafe workplace than to correct the underlying health and safety problem”. OSHA feels that the extreme increase in penalty levels will make more employers “take notice” of the safety violations that may be present in their workplace and move to correct these hazards as soon as possible.
With the new fines now in place, serious citations increase from their current level of $7000 and move up to $12,740. Repeat and willful violations increase from the present range of $5000-$70,000 up to a range of $9,100-$127,400. For those states that operate their own Occupational Safety and Health Plans, all are required to adopt maximum penalty levels that are at least as effective as Federal OSHA’s.July 18, 2016 | Category HR, Team Harmony
Lost in the debate over generational differences is a critical component of successful employee management. While people debate the strengths and weaknesses of Millennials, Baby Boomers, and Gen X’ers, one aspect continues to surface across all generations: Appreciation (and more importantly the lack there of!).
Appreciation is the secret weapon for successful practices. On the surface, production and collections are high, employee turnover is low, employees are happy and engaged, and doctors have low employee-related stress. It all seems so perfect that outsiders conclude it must be plain luck.In these successful practices, a deliberate theme runs through the day-to-day interactions between doctor and staff—a theme of genuine appreciation. The appreciation takes several forms: saying “Thank You” when a job is done well, buying the employees lunch for no particular reason, lending a hand when things are busy, making time to listen patiently to employee concerns, and high-fives or pats on the back.
These forms of appreciation are categorized as: Words of Affirmation, Tangible Gifts, Acts of Service, Quality Time, and Physical Touch. Across all generations, industries, income and education levels, these basic forms of appreciation have incredibly positive effects on employee productivity and longevity. The pioneering research is outlined in the book “The 5 Languages of Appreciation in the Workplace”, by Gary Chapman and Paul White.
More so than salary, benefits, or work hours, appreciation has the greatest impact on employee morale and turnover. Implementing appreciation in your office is easy, intuitive, and fun. Grab a copy of the book (which is a very quick read) and start your practice on the path to success. To learn more about appreciation and other secrets to HR success, request a free consultation.
July 4, 2016 | Category Practice Management
By Jeremy D. Behar, President & CEO, Cirrus Consulting Group
Picture this. You’ve built or bought your dream dental practice, amassed a loyal patient roster, and are enjoying the fruits of a successful dental practice. Having found a space that works for your business, you feel lulled into a sense of security by what you thought was a good and solid dental office lease.
Suddenly, without warning, you receive notice from your landlord that the dental practice you have worked so hard to build is being relocated to another location to make room for the accountant next door who is expanding. You realize that the office lease you thought was designed to protect your interests, is actually riddled with clauses that the landlord can exploit to their advantage — in this case it’s the “relocation clause”. So, what does this mean for you and your practice?
What is the “relocation clause”?
To start with, the relocation clause gives your landlord the right to relocate your dental practice to another location in the center or building. Landlords generally exercise this right when they have a tenant interested in expanding into the space or are willing to pay higher rental rates.
A more attractive or lucrative offer may give incentive for a landlord to invoke the relocation clause and request that current tenants vacate their space – with typically 30 days’ notice – and move to a new location. As dental practices are expensive to maintain and difficult to relocate, a hidden relocation clause can pose major problems for a tenant. In fact, relocation can easily add up to hundreds of thousands of dollars in unexpected costs.
The most effective way to avoid an unexpected relocation is by identifying this clause in advance, and negotiating it out of your lease before you sign it. If it cannot be removed, often it can often be re-drafted in a way that is more favorable to the tenant.
Can’t remove it? Improve it
The best defense is a good offense, and with a planned, strategic approach, often the terms of your dental office lease can be renegotiated with your landlord. Consider some of these remedies to altering a relocation clause in your favor:
Landlord is Responsible for All Expenses: Negotiate the terms of the clause so that the landlord becomes responsible for all costs associated with the move, including marketing materials and stationary, moving expenses by trained dental movers, demolition, renovation, and the build-out of the new space. Put the onus on the landlord to conform the space to your needs, not the other way around.
Rent Abatement: Ensure you will pay the same or comparable rent in the new location.
Comparable Location: Add language that will ensure the new premises will be comparable with the original space in terms of size, configuration, view, and foot traffic.
Sufficient Notice: Demand a sufficient notice period in order to adequately prepare your staff, patient roster, and build-out of the new space to avoid any practice downtime until the new location is ready.
Limit the Number of Relocations: Because landlords can exercise their right to relocate you indefinitely, negotiate the language so you can only be relocated once during your term.
Lease Termination Rights: Finally, try to negotiate your option to terminate the lease should the landlord relocate you to a less-than-adequate location.
Better yet, avoid the problem altogether
Starting or buying a dental practice is always exciting, but before you break out the bubbly and sign your name on the dotted line, it’s imperative to conduct a thorough review of the details in your dental office lease. A dental office leasing professional can vet out any hard-to-spot risks like the relocation clause in the lease, and devise an appropriate lease negotiation strategy to improve the terms of your lease agreement before it’s too late.
A strong lease can set you up for success by offering security and long-term practice location protection so that you can focus on practicing dentistry without having to worry about packing up your business down the line. To learn more, request a free lease consultation.June 21, 2016 | Category Coding and Insurance
For many dentists, more than 50% of their practice revenue is generated through Preferred Provider Organization (PPO) plans. Thus, it is important to compare PPO plans prior to enrollment as well as periodically after enrollment to ensure practice profitability.
As a starting point, compare the in-network reimbursements across your top grossing procedure codes. It can be helpful to use a spreadsheet to compare in-network reimbursements paid by each PPO plan. Use your office fees as a benchmark to calculate the in-network reimbursements as an average of your office fees. Rank each plan from highest to lowest according to the average in-network reimbursements. Factor into your ranking whether the insurance carrier is willing to negotiate in-network reimbursements and how often they are willing to negotiate.
Next compare each PPO plan based upon the number of your current patients covered by each plan. You may be able to obtain a list of your insured patients and their specific PPO plan through your practice management software. It may further be worth comparing the total number of insureds under each plan within your area from a patient growth perspective. A few PPO insurance carriers are able and willing provide to you the total number of their insured members located within a specific geographic region. You may otherwise be able to approximate the number insured members through researching the larger employer groups in your area, their total number of employees and then identifying who they utilize to provide or administer their employees’ dental benefits.
Finally, keep in mind the varying limitations placed on in-network dentists and insurance carrier requirements for claim payment when comparing PPO plans. These limitations and requirements are often overlooked but can impact PPO revenue. For example, one of the largest PPO plans limits reimbursement of periodic exams to exam one per year. Thus, in-network providers may be unable to collect payment for a second exam when completed within the same calendar year. Another major PPO insurance carrier now requires a narrative explaining necessity to obtain reimbursement for a PA film. This requirement makes it more a difficult or, at least, a more time consuming process to obtain reimbursement for this common expense. Insurance carriers will likely continue to implement cost containment measures and it is worth evaluating the associated in-network limitations and the obstacles to obtain reimbursement when comparing PPO plans.
For more information on comparing PPO plans, request a free insurance management consultation.May 27, 2016 | Category Coding and Insurance
While many dentists are extremely frustrated with the low reimbursements they receive from Preferred Provider Organizations (PPOs), they are reluctant to drop a PPO plan for fear of losing current patients who are covered by the plan. While there is a risk of patient loss associated with terminating in-network participation, there are ways to potentially avoid, mitigate or off-set patient loss.
First, determine whether there is a possibility for in-network participation through a direct contract with another PPO insurance carrier. There may be an opportunity to participate in-network with a specific PPO plan even after you terminate your direct contract with the PPO insurance carrier. Many PPO insurance carriers enter into shared network agreements, whereby a dental provider may participate in-network with multiple PPO plans through another PPO contract. For example, a dental provider may be directly contracted only with Principal and participate in-network with Ameritas insured patients. It is important to keep in mind this may only be an option in limited circumstances. A PPO carrier with whom you terminate your direct contract may not allow you to participate in-network via a shared network agreement.
Second, PPO plans often provide out-of-network benefits. It is important to understand the limitations of any out-of-network benefits; especially if a portion of your current patients work for the same employer group with limited out-of-network benefit coverage. This information can help prevent loss of patients who are covered by the PPO plan by explaining to them the extent they can still utilize their dental benefits at your practice. Identify the current patients insured by the plan you intend to drop and develop a plan to communicate with them after you terminate in-network participation with their plan.
Third, evaluate options to participate with a few other PPO plans you do not currently participate in-network with. There may be PPO carriers that offer a competitive rate of reimbursement and are seeking dental providers for their insured patients in your area. This new or additional PPO participation may allow you to off-set patient loss by adding new patients to your practice and at higher rates of reimbursement.
It is important to evaluate your PPO participation on regular basis. Your cost of doing business increases each year and it may not make financial sense to continue participating with a specific plan that will not sufficiently increase reimbursements. The potential negative impact of dropping a specific PPO plan may be much less than you initially feared after you carefully evaluate the insurance plan and develop a strategy to mitigate and off-set patient loss.
To learn more, schedule a free insurance consultation.May 19, 2016 | Category Coding and Insurance
Coding correctly is critical for maximizing reimbursement, increasing cash flow, and minimizing any coding errors that could result in fines or worse. We consistently find $20,000 to $30,000 in coding errors during our practice analysis process. Test your coding knowledge with these 3 questions.
1. What code should be used for fluoride treatments?
2. When can you use code D0180?
3. What code should be used for an emergency visit to treat a patient in pain?
1. D1208 and D1206 (varnish) should be used for child and adult fluoride; previous restrictions to patients with moderate to high caries risk have been eliminated. Fluoride codes D1203 and D1204 were discontinued in 2013.
2. D0180 may be reported for established periodontal patients, patients showing signs or symptoms of periodontal disease, and for patients with risk factors such as smoking and diabetes. D0180 usually pays a slightly higher UCR than D0150.
3. D9110 can be used to report minor non-definitive procedures to reduce discomfort, sensitivity, or pain at an emergency visit. D9110 is a procedure code, not an exam code, so it does not use one of the patients’ limited exams for the year.
Perfect the process of coding and insurance administration in your practice. Request a coding review from your Henry Schein representative today.← Older posts