The Bio-Engineering Co.

Are more than 15% of your exam patients “Will-Call-Back”?  Do too many of your exam patients not start treatment?  Do you think that you might not be doing your best to start every exam patient?  If so, this pearl can help you ferret out the reasons why you have fewer starts than possible.

Ideally, 100% of your exams should start is some type of treatment—but life is not ideal.  There is a certain percentage that does not need or can't afford treatment—probably 1-3%.  There is a certain percentage that gets turned off because you do not present the kind of exam that makes them feel like starting treatment.  This is due to the doctor’s and/or TC’s personality that establishes remorse instead of rapport and/or because the exam is poorly conducted—this can reduce your exam starts by 5-25%.  There is also a certain percentage that can get lost in Observation Recall because of poor follow-up—this can reduce your exam starts by 9-22%.  Thus, some practices can only start a maximum of 50% of exams while others can start as many as 85%; most practice fall somewhere in between.  If you want to determine your overall percentage, take the total (for 24 months) of your Full + Ph-I + Limited starts (but not Ph-II starts who don’t have a second exam) and divide that total by the number of new-patient exams for the past 24 months.  For example, if you had 800 new-patient exams and 520 total starts, you start 65% of your exams, which is probably typical.

As noted, there are many reasons why your new exam patients never end up in treatment, but could if you resolved your problems.  Presented chronologically they are:

1) You and/or your TC don’t have the best personalities and/or have not taken the necessary steps to account for that.  To help resolve this, refer to: http://www.thebioengineeringco.com/index.php?option=com_k2&view=item&id=242&Itemid=766

2) Your ability to sell your patient/families on your practice is weak.  To help resolve this, refer to: http://www.thebioengineeringco.com/index.php?option=com_k2&view=item&id=202&Itemid=766

3) You are doing too many exams from welfare or insurance cases that will not pay for all or a realistic percentage of your fee.  To help resolve this, review your cases for all insurance companies (or welfare) sources and determine those that clog up your daily exam slots on your schedule.  Either do not accept patients from those sources or only give them an exam at an unpopular time—and/or—only give out one of those unpopular exams every week or two.

4) You are not protecting your starting appointment slots in your schedule, using them for patients already started, making them unavailable for the TC to use for new starts.  To help resolve this don’t allow any team member, except the TC, make appointments in those starting appointment slots.

5) You don’t follow up on Will-Call-Back patients very well and they will just fade away.  To help resolve this, refer to: http://www.thebioengineeringco.com/index.php?option=com_k2&view=item&id=233&Itemid=766

6) You do not have control of patients placed in Recall Observation and they are getting lost.  To help resolve this, refer to: http://www.thebioengineeringco.com/index.php?option=com_k2&view=item&id=182&Itemid=766

In most practices, the second greatest reason patients don’t start is lack of Observation Recall control in 6) above.  But, the greatest reason why exam patients don’t start is because they aren’t convinced and become Will-Call-Back (WCB) patients that the TC does not diligently follow up upon.  To resolve this, refer to the PDF attachment “TC Diligent Control of Will-Call-Back Patients” using the attached “TC, Exam Outcome Control form”.  Also included is an effective "Will-Call-Back Procedure" and its Tracking Log.

If you want the best overall approach, including all forms,verbage and procedures you can purchase the "New Pt. Experience TC Kit".

Are you looking for a new partner or associate?  Do you typically teach other orthodontists in your practice?  Do you feel a need to protect your practice from your own employees?  If so, maybe this pearl can help you avoid embarrassment or legal problems.

Many orthodontists are beginning to realize that there are people out there who are not very nice, and through ignorance or intent to do harm can embarrass or harm you and your practice.

If you are searching for an associate or partner you will be vulnerable to these types of people and need to protect yourself.

If other (unknown) orthodontists typically visit your practice you will also need to protect yourself.

And in general, if you want your team to resist any attempt to accidentally or willfully harm yours or your practices reputation, you should have them sign a non-disclosure agreement.

This agreement not only protects you from them, but them from each other.

It is sort of a team HIPAA agreement.

See the attached Word file and edit/adapt it to fit your situation.

Are you sure that whatever collections coming in the door are getting to the bank?  Are your miscellaneous charges making it to the bookkeeper to bill?  Most doctors think that they have this under control until it is too late.  Maybe this pearl can help put your mind at ease.

Most practices think that just because they have a computer that their income and charges are under control.  And for the most part they are, except when misused.  One form of misuse is allowing anybody to enter payments and charges into the computer; not good, only the bookkeeper should.  Of course another form of misuse is embezzlement, which is not that rare.

Then there are the forgetful misuses such as not keeping up with insurance payments and charges and forgetting to account for “direct deposits”.  Another is not to have a policy on post-dated checks; and many more.

The best way to make sure is to have competent staff using other-than computer controls for your financials.  Most practices think that this is a waste of time until they are embezzled or just have income disappear.  I can tell you of many stories of financial misuse my clients have had to deal with, but why bother.

The best way to test whether your people are doing what they should with your computer is to match a manual system to your computer system.  The manual financial control system is presented in the attached PDF.  Just go through each control step and equate it to your daily computer control.  If all of the steps are accounted for, fine.  If not, install a control to have it accounted for. 

For example, is a different person handling the income than the one posting it or putting the cash/checks in the bank?  Is the $ amount of cash/checks received equal to the amount posted and equal to the amount deposited?  There should be a daily control making sure that this is accounted for.

If you find that your charges and initial payments are up, yet your collections aren’t and this has been going on for months you need to check on: insurance payments, direct deposit payments, declined credit card payments, and also review the management pearl “The Embezzlement Virus”.

How to Create & Maintain your Dream Team.

See attachment.

Are you considering or wondering about an associate?  Are you in a quandary about associate compensation?  If so, maybe this pearl can help.

Compensation of an associate is simple when that associate is a partner.  The rule is that they get half of the yearly net (or 1/3 if three partners, etc.).  If the buy-in is for cash, this equal share applies immediately.

When the initial buy-in includes a salary differential, the partner still gets his/her equal share of the net, but receives less dollars/year than the original partner(s) until the buy-in of the practice is paid off, typically in 3-5 years, where hopefully the practice will increase its net.

BEWARE—taking on a partner, of any age, doesn't necessarily mean your net will increase.  You should never assume that the partner will help grow the practice, this is not a given—if you can’t afford a hit to your net up front, then you won’t in the future when it will be very difficult to change.

If you are an established orthodontist looking for an associate, it can be done in one of two ways:

1:  He or she can be hired as a yearly contracted associate, with a specific amount of days/year they must work for a specific amount of yearly compensation that is paid monthly.  The greater the amount of days worked, the greater the compensation.  Basically, it comes down to guaranteed per-diem compensation ($/year divided by Days/year).

2:  You can also pay them as per-diem associate, with no specific amount of days/year worked, but with a typical monthly schedule that can vary.

The per-diem compensation amount depends on numerous factors: your average per-diem production, your average per-diem collections, and your dollar net income.

To keep your associate productive (creating income-producing treatment) you must schedule him/her a full treatment day every day by making sure your receptionist keeps him or her busy.

You should try to have a production increase each year (fees, referrals, etc.), which will increase your daily collections and ability to pay your associate.  Of course, if you are semi-retiring, this is may not be possible.

If you have the usual 45% net, for the average $1,500,000 practice (who might need an associate/partner), your daily collections are about $10,000/day and your net is about $4,500/day.

Usually, an associate’s per-diem compensation is anywhere from $500 to $1,750 depending on their experience treating and years with your practice. 

Thus in this example, an associate that costs you $500/day will reduce your net by about 11%; an associate that costs you $1,000/day will reduce your net by about 22%; and, an associate that costs you $1,750/day will reduce your net by about 39%.

To have the best partner or association, you might want to employ the “Associate/Partner & Retirement” management kit.

Do you have any 2017 new year's resolutions for your practice?  Are they realistic enough to be attained?  Do you have a practical way of attaining them?  Maybe this pearl can help.

If you’re the type that gets inspired at the start of a new year, bursting with hope and energy that it will be better than the previous year, then this pearl is for you.  There isn’t anything that you can’t realistically attain if you truly want it and are willing to put forth the effort.  That effort can be complicated (improving any of your 9 major management systems) or uncomplicated (improving any of their dozens of sub-systems).  It all depends on what you want out of your practice management.

If you want to take on the worthwhile challenge of improving any of the 9 major systems (1-Team Organization, 2-Team Hiring, 3-Team Training, 4-Team Scheduling, 5-Tx Quality Control, 6-TC Programs, 7-Goal Attaining & Reporting, 8-Associate & Partners, and 9-Financial Control)—see the attached PDF and get started.

If you want to take on the lesser challenge of improving any of the sub-systems of the 9 major management systems, see the attached PDF to get started.  Simply choose the sub-system that you desire and recreate it to fit your needs.  You will probably find that while cleaning up these sub-systems that you will automatically improve the level of sophistication of its major system.  And once your overall level of practice management improves you’ll feel confident with your management abilities and want more.

Do you know whether your website has ever been hacked?  Are you aware of what hackers can do to your expensive website and its data?  If not, maybe this pearl can help.

Websites are becoming an integral part of the management of your practice through marketing, making appointments, and the like.  The more sophisticated your website, the more destruction a hacker can cause, especially if your website contains private patient or practice data.

See the attached PDF to learn more about hackers and what you can do about them to protect your site and patients.

In 2014 my DeanBellavia.com website was hacked and literally destroyed.  Since then I have had my Webmaster create anti-hacking software to protect my new TheBioEngineeringCo.com website.  Once perfected it worked...and is still working.

To date, hackers have tried to hack my websites over 100,000 times and every hack failed.  Most hackers are from Russia, France, Germany, China and the Middle East.

Firewalls and the usual anti-malware didn’t help me from being hacked—the new Anti-Hacking Program does!

To protect your websites from hacker damage, check out the following site; it is inexpensive and it works:

http://shop.heavenknows.biz/hacker/malware-control-services.html

By the way...during the recent October 2016 attack on North America, they tried to hack my website 1087 times and failed every time.

Are your Goal-Attaining systems all that they could be?  Are your monthly practice goals Realistic?  Have you accounted for the programs required to attain your goals?  If not, maybe this pearl will help.

Lets face it, making system changes in your practice isn’t typically met with great staff zeal.  But if your team is a part of the entire process, your success is more probable; the A~D~D~I~C~T approach is designed to do just that.

Sooo...Analyze the attachments below to see how the A~D~D~I~C~T straightforward approach works, Decide how you want to improve your Goal-Attaining Systems to fit your needs, Design your Goal-Attaining System, Implement that Goal-Attaining System's design, Critique the effectiveness of your implementation, and Tweak what needs to be improved.

Refer to the attached PDF to learn how to A~D~D~I~C~T your Goal-Attaining Systems and their many supporting sub-systems.

Are your financial systems all that they can be?  Have you accounted for the necessary sub-systems required to make your computerized financial systems more effective?  If not, maybe this pearl will help.

Lets face it, making system changes in your practice isn’t typically met with great staff zeal.  But if your team is a part of the entire process, your success is more probable.

Sooo...Analyze the attachments below to see how the A~D~D~I~C~T straightforward approach works, Decide how you want to improve your Financial Systems to fit your needs, Design your Financial System, Implement your Financial System designs, Critique the effectiveness of your Financial Systems, and Tweak what needs to be improved.

Refer to the attached PDF to learn how to A~D~D~I~C~T your Financial Systems and their many supporting sub-systems.

Are you considering a partner or associate?  Might you like to know how to go about obtaining one?  If yes, maybe this pearl will help.

Lets face it, making system changes in your practice isn’t typically met with great staff zeal.  But if your team is a part of the entire process, your success is more probable.

Sooo...Analyze the attachments below to see how the A~D~D~I~C~T straightforward approach works, Decide how you want to deal with a possible associate or partner,  Decide on a partner or associate, Implement that relationship, Critique the effectiveness of your relationship, and Tweak what needs to be improved.

Obtain your "Associate/Partner & Retiring Management Kit" to obtain the best possible partner or associate (also see the attached PDF).

Use the suggested Management Pearls to create the sub-systems that will enhance your partner or associate relationship (see attached PDF for listing).

Refer to the attached PDF to learn about the nine A~D~D~I~C~T MAJOR practice systems and their dozens of supporting sub-systems.

Obtain your A~D~D~I~C~T straightforward guide to "Self-Optimize Your Entire Practice"