Rollover Plans Aren’t Just for Cell Phones Anymore

Dental Insurance Picks Up the Rollover Trend

A recent dental insurance trend that’s becoming ever more popular, “maximum-limit rollover programs” let patients save unused dental benefits to use the following year. The plans are generally conditional on patients receiving regular preventative care. Not surprisingly, insurers limit the amount patients can roll over. However, the additional money can make dental implants or other complex care a more viable option for many patients.

This new strategy is aimed in part at promoting and rewarding patients who receive regular preventative dental care. It’s nice to see insurance companies realizing how spending more money on regular care will cost less in the long run.

Ameritas Life Insurance and Guardian Life Insurance began the tend a few years ago, and since then they’ve been joined by other major insurers such as UnitedHealth Group, Cigna and Starmount Life Insurance.

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Are Dentists Liable for Lead in Dental Products?

Dentists Must Do Their Due Diligence

With recent news that some dental prostheses may be contaminated with lead, a lot of dentists are wondering if they’re legally liable for the quality of their dental lab work.

Unfortunately, there’s no simple answer to that question. However, one thing is clear: if you, the dentist, haven’t done your due diligence in selecting a reputable dental lab, you could be held responsible for the quality of their products.

“The liability situation is the same as it has always been, each party, the dentist and the dental laboratory must do their due diligence to comply with existing laws and regulations,” said Bennett Napier of the National Association of Dental Labs (NADL). “The liability exposure is different in each case specific scenario depending on a number of factors.”

But what exactly does “due diligence” mean? Well, it definitely means that you’re not choosing a dental lab on the internet because they have the cheapest crowns available. It does mean that you’ve researched your lab. Ideally, you’ve talked to the owner, visited the premises, and heard good reviews from other customers. If not… well, just be prepared for the possible consequences.

We at The Wealthy Dentist have been investigating what dentists may be able to do to protect themselves.

1. Make your dental lab tell you where the work is coming from and what it’s made of. Remarkably, most dental labs are NOT required to pass this information on to the prescribing dentist.

Florida and South Carolina have recently passed legislation that would require such disclosure, and other states are likely to follow suit soon. The NADL is working on a universal form for dental laboratories. Ohio has a similar form; the state’s dental board recommends but does not currently mandate use of these forms.

Highlights from the Ohio State Dental Board Laboratory Prescription & Point of Origin Form

Type of Restoration: _______

Materials:
– Porcelain to High Noble
– Porcelain to Noble
– Porcelain to Base Metal (NP)
– Full Metal High Noble
– Full Metal Noble
– Full Metal Base (NP)

This case will be:
– Fabricated by technicians at our own dental laboratory.
– Sent to another laboratory in the U.S. to be fabricated (Lab Name & Location)
– Sent to an overseas/foreign laboratory to be fabricated (Lab Name & Location)

See the full Ohio dental lab form

2. Make sure you’re giving your dental lab a full prescription.

An alarming number of dentists don’t actually give their dental labs all the information a technician needs to formulate a dental prosthesis. When information is missing (for example, what specific metals should be used), the technician is left to make an educated guess.

A checklist form can help ensure that dentists are giving their labs all the necessary information.

The Ohio State Dental Board has also released prescription guidelines. This form outlines the minimal information that should be included in a dentist’s prescription.

  1. Form must include basic information on patient, dentist and dental lab, as well as type of prosthesis.
  2. Crowns and bridges: Shade prescription, shade mapping, and material prescription.
  3. Partial and complete dentures: Shade prescription. tooth material prescription, tooth mold (shape) prescription, design of partial denture framework.
  4. Orthodontics or occlusal splints: explicit definition of type of prosthesis and instructions.
  5. Any additional explicit instructions from the dentist.
  6. Point of origin information should be included.

See the full dental lab prescription guidelines

3. Check your lab’s credentials.

The NADL’s Napier offers the following advice to dentists: “Dentists as part of minimizing their liability risk exposure can look at working with dental laboratories that are Certified Dental Laboratories or DAMAS accredited dental laboratories where third party validation occurs to ensure the lab’s quality system includes material traceability of lot and batch numbers of materials used for a specific dental restoration.”

The National Board for Certification in Dental Laboratory Technology (NBC) has developed a form for use by Certified Dental Technicians (CDTs).

Dental Restoration Disclosure Form
This case was manufactured by:
CDT Name: ___________________
CDT Number: ___________________
at ___________________(Dental Laboratory),
in ___________________(City, State, Country)
using the following FDA registered materials in the final restoration:
____________________________
____________________________
[Place Identalloy/IdentCERAM Sticker Here]

See the complete CDT dental restoration form

4. Stay current. It’s quite possible your state is considering new legislation for dentists and dental labs. You might consider setting up a Google News Alert to keep you informed of the latest news; just use “dental lab” and your state as keywords.

Can you suggest any additional resources? We’d love to see what forms you’re using with your dental lab. Just send us an email at DrWeeklyNewsUpdate@TheWealthyDentist.com!

Dental Practice Management: North Carolina Senate Bill Wants Dentists To Do It Themselves

Senate ruling on dental practice managementLast week in our post, Dentists Beware: The Government May Want To Tell You How To Manage Your Practice, we reported on the story of the North Carolina Senate and Senate Bill 655, which would require the North Carolina Board of Dental Examiners to examine all business contracts entered into by dental practices in their state.

Dr. Clifton Cameron, a dentist in North Carolina reported to the Fay Observer that, “Senate Bill 655 would give the Dental Board complete control of how dentists in North Carolina run their practices so they can keep fees charged to patients artificially high and insurance acceptance artificially low.”

We wrote that we couldn’t find the reasoning behind such a move by the NC Senate and Board of Dental Examiners, but the Board did post the following to their website:

“The Board has become increasingly concerned about the expanding scope and nature of management company services and agreements, and their impact on the control of dental practices by the licensed dentists.

The bundled services offered by management companies typically involve some combination of (1) administrative management services; and (2) financial management services.

Based on its knowledge of the operations of dental practices, and after reviewing management arrangements with dental practices for almost ten (10) years, the Board has identified features of management arrangements which it has determined to be highly likely to create a situation where the ownership, management, supervision or control of a dental practice is impermissibly conveyed to an unlicensed person or organization because either separately or when bundled, those features interfere with the licensed dentists’ professional decision-making and their exercise of clinical skill, judgment and supervision in the dental practice.”

After we ran our original story, several doctors commented. A New Jersey dentist wrote:

“In New Jersey, the state board already forbids outside management. My partner and I spend about 20-30 per week running my business instead of on continuing education or, patient care.

The real argument isn’t whether or not I could be one of the practices recruited by management companies, but the unfair advantage it would bring to my practice over anothers’. Lower overhead, decreased fees, increased insurance acceptance, large marketing budgets would destroy competition and lower practice values and access to care.

Management companies specify laboratory selection, supply selection, employee selection, and continuing education budgets. While they bring lower overhead, they take money from the practice as well. If you fail to be attractive, your practice cannot contract with them.

Giving this advantage to a small percentage of dentists is unfair to the majority of dentists that do not wish to join or would not be accepted. I have 10 dentists within a 0.5 mile radius. We can’t all be Aspen Dental Centers. The other 9 practices would suffer, and that wouldn’t be fair.

This is about the only aspect of dental life in New Jersey that makes practicing here worthwhile. Defeat it. Resist, North Carolina!”

Another dentist responded with:

“Have they gone mad over there? Sounds like there’s something they are not telling us about…It sounds like the insurance companies are in bed with the politicians again….”

Indeed, it could be a game changer that would impact North Carolina dentists and how they manage their dental practices. The North Carolina Office of Research, Demonstrations and Rural Health Development reports that there is already a severe shortage of primary health care providers in North Carolina, particularly in the State’s rural areas.

But perhaps this isn’t about patient care at all — or making dental practices transparent.  Perhaps this is about lawmakers just playing politics.

Dental Marketing: $151,200 with Google Offers and Groupon

This is the final article in our dental marketing series on Internet dental coupon marketing.  Today we boil it all down to just how profitable this new dental marketing vector can be.

First, let’s start with a quick review of the offer and the results:

1. The basic offer — $59 for a $421 dental package.
2. That’s an 85% savings to consumers who buy within the allotted time.
3. The purchase window was 23 hours.
4. The number of offers (dental packages) available was 300.
5. The number of packages sold was 51 — or 17% of the available offers.
6. Total dollars grossed in the test was $3,009, which was split evenly — $1,504 each for Mt. Tabor Dental and Google.

(Click here to view the full ad)

What’s important to note in the results above are that 51 packages were sold for a gross income to Mt. Tabor Dental of $1,504. On the surface, this tells us that the practice now has about $29.50 available to service each of 51 new patients.

However, what most people don’t realize is the concept of “Breakage.

Not all the coupons will be redeemed with the allotted time period. The reality is that people forget to use their coupons, and breakage can run from 30% to 50%. Meanwhile the practice is using the cash immediately. (This is the same game that American Express has been playing with Traveler’s Checks for the last 60 years.)

I think we can safely assume a 30% breakage rate. This turns our 51 packages purchased to just 36, giving $41.77 to cover the service cost of each patient. Now most of you are now trying to calculate how much money you are going to lose on each of these new patients when you only have $41.77 to deliver an exam, X-rays and a bite-and-boil home tooth whitening kit.

Don’t bother!

The reality is that Mt. Tabor Dental has now identified 51 potential new patients who are willing to pay $59 each.

The average new patient in the US is worth about $975 in gross production in the first nine months of treatment. Take out delivery cost of 10%, 4% collections loss and 9% universal expenses (cotton balls) and your net marginal profit is about $750. Knock off another $50 to cover any additional initial delivery costs and you end up with $700 per patient in your pocket.

Assuming a 30% breakage loss on coupon utilization, you net 36 new patients at $700 net each for a total of $25,200. For those real pessimists in the crowd who will say that half of those bottom-feeding coupon patients won’t accept your treatment plan and stay for at least nine months, well ok, you just made $12,600.

Now do you see any good reason why you wouldn’t run this or a similar Internet coupon ad with Google or Groupon every month for the next year?

Think about a possible $151,200 net to your bottom line over the next 21 months…

Dental Practice Management: Scheduling a Comprehensive Exam

Dental Practice Management: Scheduling a Comprehensive Exam
What is the best dental practice management policy on length of a new patient exam?

51% schedule a minimum of 40 minutes for comprehensive dental exams, this survey found.

Only 27% of dentists said they perform comprehensive exams in less than 30 minutes.

“Actually, I schedule an hour and sometimes it takes longer The compete exam is THE single greatest internal dental marketing technique,” offered one dentist, a subtle comment for comprehensive exams being a part of an overall dental marketing plan.

Here’s how dentists responded to this survey asking what length of time they schedule for an initial comprehensive exam:

  • 4% 10 minutes.
  • 10% 15 minutes.
  • 10% 20 minutes.
  • 3% 25 minutes.
  • 22% 30 minutes
  • 51% 40+ minutes.

Here are some further comments on scheduling comprehensive exams from dentists:

It should be one hour …

“One hour. It’s COMPREHENSIVE. That cannot be done in less than 45 minutes. It means you are looking at radiographs, perio probing, restorative, occlusion, TMJ, health history, and oral cancer exam. I defy anyone who says that a “comprehensive” exam can be done any faster.” (Georgia dentist)

“For new patients, an hour max, but if I only give them 20 minutes of my time, I don’t get the case as often.” (Illinois dentist)

“Really should schedule 50 or 60 minutes on adults.” (General dentist)

“We schedule one hour initial exam for perio charting, radiographs, photos, models, charting restoration, and for getting to know the patient.” (Michigan dentist)

“We schedule an hour, but sometimes it takes even longer.” (California dentist)

It should be more than an hour …

“We schedule 1 1/2 hours for initial medical history gathering, interview, complimentary Velscope cancer screening, necessary x-rays and comprehensive exam. NO cleaning at this appointment.” (Minnesota dentist)

“I actually spend and hour and a half for each new patient examination. Not one gets into hygiene without a NP exam.” (Washington dentist)

“My first appointment is 1.5 hours in length with a pre-paid reservation fee.” (California dentist)

“My patient is scheduled for 2 hours. In that time we take photos, x-rays, models and intra-oral images as well as the full exam, interview and charting with the doctor.” (New Jersey dentist)

“We schedule 90 minutes. 45 minutes for the exam and 45 minutes for records.” (Florida dentist)

Note: Survey sample included 100 respondents.

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