The Dental Billing Podcast

The Power of Dental Office Systems with Front Office Friend

• Ericka Aguilar • Season 6 • Episode 7

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Ever wondered why so many dental claims get denied and overlooked? This episode takes you behind the scenes of dental billing and claim appeals with Morgan, popularly known as Front Office Friend, who brings an impressive 11 years of experience in the dental field to the table. Morgan's lifelong love for dentistry drives this insightful discussion as we dive into the state of the dental industry, including a startling study that reveals only 33% of all denied claims are ever appealed.

Running a dental practice isn't all about the teeth, as Morgan showcases in our enlightening chat. Her valuable advice on managing insurance aging reports and establishing robust systems within dental practices is sure to make your operation run smoother. Highlighting the importance of financial policy discussions with patients prior to treatment, Morgan emphasizes how this simple yet significant step can prevent misunderstandings and streamline the process.

The conversation doesn't stop there, as we delve into her inspirational journey of authoring The Front Office Handbook. Inspired by her personal need for lists and checklists, Morgan provides insights into the importance of staying updated with the latest trends and technology in the field. Finally, we examine Morgan's vibrant presence on social media where she continues to enrich the dental community with her insights. Tune in to gain a wealth of knowledge from this seasoned professional in the dental field.

Connect with Morgan: frontofficefriend.com

Want to learn Dental Coding and Billing? Join here:

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Would you like to set-up a billing consultation with Ericka or Jen? We would love the opportunity to discuss your billing questions!

Email Ericka:
ericka@dentalbillingdoneright.com

Email Jen:
jen@dentalbillingdoneright.com

Perio performance formula:

(D4341+D4342+D4346+D4355+D4910)/(D4341+D4342+D4346+D4355+D4910+D1110)


Want to know what your fee should be for D4346? Send Ericka an email to ericka@dentalbillingdoneright.com


Speaker 1:

Morgan, welcome to the dental billing podcast. I we spoke last week and I was like you need to be on the podcast, people need to know about you, so I want to introduce you to our listeners, friends. We have Morgan, also known as front office friend, on Instagram. You can find her on Instagram. You can find her on Facebook, linkedin, pretty much all social. You can also visit her website, frontofficefriendcom. And I'm really excited to talk to her because I actually just recorded an episode.

Speaker 1:

I discarded it. I created this solo episode on dental billing checklist and I don't remember how you and I I think it was a potentially mutual client that you were going to introduce or you have introduced, thank you. And we just kind of got to talking and you mentioned your book and it is a one wonderful resource and we'll talk about that a little bit later in this episode. As I was going through it, I was like, oh my gosh, this is full of a ton of checklists that people need and I just did a solo episode. So I was like, no, no, no, we need to interview Morgan and we talked about how she came up with all of these checklists. Before we do that, before we get into the episode. I want to know a little bit more about you as a little girl. Tell us where you grew up and what you were like as a little girl, and if you could live anywhere in the world at this point in your life, like where?

Speaker 2:

would that be Okay? So, yes, my name is Morgan. I grew up and I currently live in Salt Lake City, Utah. I was born and raised here, I've been married for just over nine years, I have two kids and I've been in the dental field for just about 11 years now. And when I was a little girl, I was always so fascinated with going to the dentist and I would look forward to it every six months and after our dental appointments, you know, my brothers and I, we would go home and we would play dentist where I would pretend to clean their teeth with little pens and just, you know a little. You know the cats were on, of course, but you know, I just I've always loved the dental field.

Speaker 2:

I was really active growing up. I did a whole bunch of different sport and I grew up playing the piano. So I, you know, played the piano for 25 years. I love the outdoors. Every summer we go water skiing and hiking and I love to take my kids to parks and libraries and museums and, yeah, we just like to live an active lifestyle.

Speaker 1:

You sound like the fun mom. Like you sound like the mom. That is, like you guys are always doing something and it just seems like it would be super fun to be a part of your family.

Speaker 2:

Oh, thank you, I try to be. I love just getting out of the house and doing stuff and learning and it's just, it's fun. Kids make it a lot of fun.

Speaker 1:

Absolutely Okay. We know where you grew up and what you were like as a little girl. You could live anywhere in the world right now.

Speaker 2:

Oh, my goodness, so hard. You know I love Jackson, wyoming and the Cheetan's. That's one of my favorite places to go. It's, you know, about five or six hours, you know, away from where I live, so we try to go at least a couple times a year. Yeah, so I'd love to live in, like Jackson, wyoming during the summer and then maybe Florida by Disney World in the winter.

Speaker 1:

Be in an area of the country depending on the weather Right.

Speaker 2:

Exactly. Yes, that's why I do not want to be in Jackson in the winter. Exactly.

Speaker 1:

My sister actually just moved to Wyoming. She loves the snow and she loves, you know, the the cold winters and those are hard, cold winters, but yeah, yes, she loves it and so her and her honey and their one year old Doberman Pinscher, all living in Wyoming together and they are just loving it. So you're the third person that I've spoken to recently that has said Wyoming, and I just think it's attracting a lot of people to that state.

Speaker 2:

It's a beautiful state. Oh yeah, I mean so beautiful.

Speaker 1:

My sister sends me pictures all the time and it is beautiful. I just can't handle snow.

Speaker 2:

Salt Lake City. You know we have this snowing right now. You know we get the snow, we get the winter, but I can't do any more than that. Yes, exactly.

Speaker 1:

I have been to Salt Lake quite a bit and I've been there mostly during summers, so I've done the Lazy Rivers. They're still very cold and chilly, but it's super hot outside, so it's nice, nice, but there's a lot of nice Lazy Rivers over there. It's nice to visit in the summer, for sure. I want to share a fun fact, and I don't know if you knew this, but this goes right in alignment with what we're going to talk about today and I want to know your thoughts on this.

Speaker 1:

So I saw a study recently that said that 33% only 33% of all denied claims ever get appealed, and when I read that I was like, why is that? Because to me, that tells me that as an industry, as a dental billing industry, we are not doing well. If only 33% of all denied claims are ever appealed, I think it's because people don't know what to do, and maybe they make an excuse that it's too time consuming, but it's all in a day's work to us and that's a matter of task management. But that was my first thought. So what are your thoughts when you hear a statistic like that?

Speaker 2:

Oh my gosh, when I hear that. It's like the insurance is running the industry and they're winning the game because they're having their customers just pay the monthly premiums and then denying benefits and then all these customers are going without dental benefits that they're paying for. So, yeah, the insurance is winning that game and we're letting them right.

Speaker 1:

Yeah, because prior to that study or statistic, I read another one a couple years ago and I don't remember the details, but it was something about like $60 million of dental claims was denied in 2017. And only 5% were ever appealed. So it was like a ridiculously number and it shocked me because I thought why is it that we have all of these quote unquote experts in dental billing? Yeah, yeah, we have such a low industry number. So is it that we are just blowing off that task and people are just deciding that it's not worth appealing and they're making adjustments, which I do see that a lot as well.

Speaker 1:

I do a lot of account receivable cleanup with my company and we see a lot of unnecessary adjustments being made. And when we take a look at the adjustments that are being made and my team and I look at it together and we're like this could have totally been appealed. This cleanup should have been appealed when they wanted to include it with the crown, and I heard another study and I do believe that this is true. I don't know for sure, but a lot of insurance companies use artificial intelligence to tell them which offices are going to appeal and which offices don't appeal. So you'll find that offices that tend to appeal receive less denials, versus an office that never appeals, they get more denials. So what are your thoughts about that?

Speaker 2:

Yes, I believe that because I worked for an office in Washington and they weren't really appealing their claims. So I was having denial after denial after denial and it took me like three or four months of consistently appealing pretty much every crown claim to where they were paying for them and I had less, just less and less denials. And I have another office in California where I appeal pretty much every zero payment when it comes to major work. I mean, everything is appealed. I have appealed templates that are just set, ready to go. I change a couple you know a little bit and I rarely get denials. And that's just from personal experience.

Speaker 1:

And you find that when you first start with an office, their denial is higher than after hiring you. And now you're handling the billing and you're appealing all of the zeros, like all of those zero payments, all of those decisions you don't agree with. You're appealing them and you're finding that over time they go down the denial. I can't agree with you more.

Speaker 1:

I've experienced the same thing and so, friends, if there's a lesson to be learned right now in this episode, well, this is going to be the first lesson of many. The first lesson to learn in this episode is always appeal. When you don't agree with a decision, do not let it sit there, because, also, appeals have timely filing time frames for which you can appeal. So some are 30 days, some are 60 days, some are 90 days, you know. So you want to make sure that you understand what those time frames are for your top payers in your practice, because you don't want to risk out on that money because you took too long to get to that task. So that's where I kind of want to move into.

Speaker 1:

Next is talking about working appeals into your weekly task management, because I think a lot of offices get lost in the day to day hustle and bustle and then what I find is a biller will have a stack of claims that needs to be appealed or additional information. So talk to us a little bit about your task management. How do you manage the dental billing tasks that need to happen but tend to be swept under the rug, right?

Speaker 2:

So I think it's important to make sure that within an office, you're delegating the duties, you know so everybody in the office, they have their list, their job titles. So we don't want, you know, maybe the receptionist is just answering the phones and that's all they do. No, let's give them more tasks so all of that work doesn't fall on the office manager or the treatment coordinator. So, making sure the tasks are delegated so everything is being done and we're not overwhelming one person. And then with that, I kind of separated my tasks into daily, weekly and monthly.

Speaker 2:

Like the insurance aging, I run that twice a month. So I run that the second week and the fourth week of every month. And I mean, if you have, if there's an office where you have the resources and the bandwidth, the staff bandwidth, to run it every week, that's really good. A minimum of once a month. But the sweet spot is every other week, because you don't want to sit on the phone. Hey, did you receive this claim? Yes, it's processing. Okay, did you? You know, you want to make sure we're managing our time efficiently and doing that aging report every two weeks is like it's the sweet spot.

Speaker 1:

I agree, I agree, I agree I agree, I agree, I agree.

Speaker 2:

I print a new aging report every time I work on it. It usually takes me about a week to go through it. I will group the insurances by you know insurances I can check on the website versus insurances I have to call, and then I have appeal templates set up for different scenarios. So I have a buildup appeal letter ready to go. I change patient name, you know I change a couple of little things, but that's ready to go. I have one for implants and I have one for downgrades and or any zero payments. So I have multiple appeal letters already set up ready to go. So when I do have to appeal, I just I can send it off really easy, no problem.

Speaker 1:

That is brilliant. I absolutely love that, because we have a dental billing guide and our dental billing guide is basically the narratives. You know diagnosis codes, you know what attachments are needed Very similar to your book as well. Right, you know we don't have appeal templates in there. I love that you do. But I totally agree with you Every two weeks is the sweet spot and it's it's enough time in between the last time you ran the report to tell if there's been any type of difference. You know, like, if a claim right, so on and so forth. So I love that you do that. Walk us through some of the other, like do you have different days that you post payments? You know how. What does your weekly look like?

Speaker 2:

So my weekly it kind of varies. So I have a billing company that you know I run separate from from office friends. So as far as posting payments, that's just done as needed by the office. So I have one office where the doctor doesn't like to get any EFTs so I just post as soon as I get the payments and that way it's easier for him to track the bookkeeping and make sure the books, you know the bank account, is matching dentrics, which is so important that you know it's easier for him just to see bank deposit. So he likes it that way.

Speaker 2:

I have another office where they get EFTs and so I usually check those twice a week. I mean Delta's. They're always available and paid on Thursday so I just go when I always do Thursdays for Delta's and then at times it's Monday or Tuesday. So it just kind of depends. But depending on the office is just. It's always consistent so my doctors can plan on. You know, mondays and Thursdays I'm going to have a stack of EFTs to make sure you know they're in the bank and they match and everything.

Speaker 1:

I know my listeners are wondering because there's so many different methods to posting EFT payments and when you say you know the bank account and the and dentrics match, are your doctors giving you access to the bank account to see when it hit the account?

Speaker 2:

I have a doctor. He uses QuickBooks and if I miss a payment or whatever reason, he'll just screenshot that line item and QuickBooks and say, hey, you know this was missed, can you fix it? And so he uses QuickBooks. And how he does it? So the there's the daily deposit with the paper checks and stuff that he matches, and then he balances the EFTs by month. So making sure all of the EFTs that were deposited for the month of January, you know, match the entry. So that's how he does it and that's just what works for him.

Speaker 2:

But I think, whatever way or system that that you guys are doing it, it's just consistent and the system is documented. So it doesn't matter if a staff member is sick or if there's, you know, turnover or anything. The system stays consistent. So everybody knows what's going on, because it's too big of a risk to have the doctor in the dark where they're not. Oh yeah, money is coming in. We don't need to check practice analysis. No, that's, we can't do that. You know, because money is coming in doesn't mean your practice is healthy and we're doing things the right way.

Speaker 1:

You just said something that leads us right into our next topic, which is checklist, and you said it doesn't matter, you know somebody's out sick. There should always be protocol systems. I let's just call them checklist, because that's essentially what they are.

Speaker 1:

Right, yeah, and checklists should not be complicated. They should be simple and basically keep that individual on, on point for the most critical parts of that task. Right yeah, you need to list every single thing out. It's just what are the things that we don't want to fall in between the cracks for this task. So so now I want to ask you how did you come up with all of these checklists? Because your book is brilliant, thank you.

Speaker 2:

What is the name of your book? The front office handbook.

Speaker 1:

The front office handbook and friends, you can find this at her website, frontofficefriendcom, and it's brilliant. I think every office should have a copy of this because it is going to reduce redundancies, because when we have a checklist to look at and go, okay, how to appeal 101,? You know, here's the checklist, so talk to us about how you decided to write this book, why, and all of the good stuff.

Speaker 2:

Okay, so me personally, I am a list person. I love lists. I have grocery lists and chore lists. You know I'm just a very task list person because you know there's some days, some weeks where I'm just not with it. And yeah, you know, I have a ton of experience in the dental field. But sometimes I just need to be grounded and look at the basic checklist just just to make sure I'm doing the best that I can for my doctors. I just I need that list. So it doesn't matter if you're new or experienced, it's just nice to have a checklist.

Speaker 2:

And you know, when I was writing my book I was, I thought back to when I first started in the dental field, you know, 11 years ago. Basically all the tasks that I wish I knew and the information that I wish I knew when I started. I put those into my book because, you know, when I was working for my doctor, I was 18 years old. I had three or four months of experience running this front office that I was not qualified for. He had a lot of faith in me. Yeah, you know, looking back, it's like I know I could have saved my doctor so much stress from not being stressed out or just from doing these and money, oh my gosh.

Speaker 1:

Oh my gosh, I'm like wait through trial and error. We lost our doctors a lot of money.

Speaker 2:

Yes, and I, you know, looking back, it's like, oh my God, there's so many things I would have changed so I wouldn't have had to put him through that and that, and I, you know, luckily, the person he hired after me was fantastic and cleaned it all up. She was amazing. But looking back, it's just, I wish I knew this. I wish I knew the importance of reconciling, end of day, where I wasn't very good at it and I was like, well, this is dumb. I didn't understand the importance where now, you know, 10 years later, you know this is extremely, extremely important. Everything has to match and we need to have checks and balances. It's just. I think it's so important just to have a basic list, just the backbone, and just to make sure everything is being done. So we are managing effect where we're effectively in managing the business side of dentistry. You can't do the clinical side if we're not effectively managing the business side, because we're in the business to safety, exactly.

Speaker 1:

Oh my gosh, I even said that better. So walk us through some of the checklists that are in there, because I was going through them I was like why didn't I think of this, like it's just, it's so, so basic, but it's not.

Speaker 2:

Right, it's just the base, the backbone. You know just the things that have to get done and you know from working at a bunch of different offices I worked for really successful offices and offices that weren't up to that level and I noticed there were key differences in the successful offices and the not so successful offices. And you know the successful offices that I worked for. They had systems in place for everything. And you know I had assistants training me on the front office because they knew how it ran. They were cross-training. They knew like no, you have to do it this way. Or a hygienist would say hey, you know we need things done this way because this is how our office functions. And then I've observed and worked for other offices where it's just kind of chaos. There's no system and the front office person is running back and forth. What was done? What do we need to schedule for? Most basic?

Speaker 1:

things that we could avoid in just allowing the practice to flow throughout the day. And I mean it's just in my opinion. These checklists in your book support the revenue cycle, the dental revenue cycle. The better that our team understands how they affect their position specifically affects the revenue cycle as a whole. I think, clinical or administrative, we all affect the revenue cycle. So, yes, taking the guesswork out of that is so helpful in creating that cohesiveness among the team so that everybody understands how we're ebbing and flowing throughout this cycle.

Speaker 1:

So talk a little bit more about. Like, talk to me about the checklists, the actual checklists that you have in here.

Speaker 2:

The checklists. So I have daily, weekly and monthly checklists, so I can start with the daily. It's as simple as you know turning on the lights, turning on the computers, just you know. Just kind of that basic stuff. And yes, it's a given, obviously turn on the light, but sometimes it's just so, that is what it's not.

Speaker 1:

But it's not, let me tell you. Let me tell you my experience. So I've been a partner in two practices, okay, and one of the things that I like in my offices is consistency, and by that I mean the first thing you do when you walk in is flip the lights on. The second thing you do is turn the computers on. As an example, but how many times have I, even with a checklist in front of their desk, they forget to turn on a computer, or? And so having that checklist is helpful. It's not going to make it error proof.

Speaker 2:

But telling you common sense is not so common, I know, but then you know, having the checklist and physically checking things off, even if it has as simple as turning on the lights, turning on the computers, it just kind of gives you the energy to complete all these seemingly tedious tasks.

Speaker 2:

So there's a lot of tedious and miniscule tasks, especially when it comes to front office where, you know, come the end of the day, I checked off my list Like it's, today was a good day, you know, and as far as you know, kind of going back to doing the daily checklist, if you're an office that accepts assignment, assignment of benefit, you have to be getting insurance breakdowns.

Speaker 2:

Like that. It's so important because you know accepting assignment, assignment of benefit, I feel like it's a form of financing where you are allowing the patient to come in, get treatment, get work done, and then you're going to go to a third party to get payment. So you're going to get payment later. So you need to do your due diligence to make sure that the office is going to get paid, yes, if you're not going, if you're not collecting it at the time of service. So insurance breakdowns and you know verification is so important, making sure we're confirming appointments and scanning in all the documents, shredding all the documents when we're done to make sure we're, you know, hipaa compliant and stuff like that and you know posting all the patient payments and insurance payments.

Speaker 1:

So that's just kind of a broad breakdown of the days, the daily checklist and yeah, because a lot of times you know we tend to and all of us have done this where you know the day gets away from us and we will naturally not intentionally, but we will forget or we will allow that pile of scanning the documents we scanned in filled up because it's not on our checklist, right, like it's not on our daily. So in our mind we go oh, that's a when I have time, and I think the daily tasks that we have throughout the day is dental front office members, we're billers, but at the end of the day we're front office, right. So, yeah, tend to create in our mind our own when I have time list Rather than this universal standard. This is how we do business, this is how our day flows checklist right, exactly, exactly, and a part of my daily checklist.

Speaker 2:

I have appointment checklist and it's stuff it's essentially the term I've heard is like scrubbing the schedule. So you want to make sure we're going through and making sure the patient are they due for x-rays? Do we need to update their health history? Are they due for all this? Because we need to check this stuff and know it. You know ahead of time, so not, and it's not to only do what insurance covers. It's so we can prepare the patient to pay whatever it is they need to pay, regardless of their insurance coverage, and we need to make sure we're collecting the deductible and we're collecting at the time of service. It's these small tasks that we can do ahead of time and before the fact, because it takes less time to do it before rather than having to play clean up afterwards. It's easier to come from patients in as opposed to a month or two after their appointment.

Speaker 1:

And I just did an episode called chart prep and routing slips and in that I talked about the chart prep checklist.

Speaker 1:

And I think you hit the nail right on the head when you said you know it's more than just getting a breakdown of benefits right. Like for me. My checklist has things like do we have the right just double check? Do we have the right fee schedule attached to the patient's account? Are UCR fees being put on the claim form but not in the patient's ledger or account? Like. Those are the little things that I think we can do in addition to insurance verification. Do your job and then some. And that's how I feel about this chart prep checklist that you're talking about. You know, in addition to insurance verification, insurance verification and then you know, fee schedule, do we have the right to schedule? And then some. How do you feel about the daily prep checklist going beyond the insurance verification and what do you include in that?

Speaker 2:

So when I'm preparing route slips, so there's the hygiene side and then the doctor side, because I prepare them differently. So with the hygiene side I'm going through and I'm checking their exam and the bite wings and the fluoride. And you know I want to make sure that the frequencies are that I have them down and my insurance breakdown. Are we one every six months or one to six months of the day, twice a year or twice every calendar? You know there's difference between those three terms. And is there a preventative copay? Does it apply to the deductible?

Speaker 2:

I'm going to check if there's an outstanding balance. You know that let's just collect it while patients here, let's save a statement. What I found is it's easier to do things ahead of time. Just do it ahead of time and then it saves you so much time in the long run. You know it's tedious, there's a lot to check through for each appointment, but let's take this 30 seconds, one minute now, so we're not having to spend one hour, two hours down the road where it takes month. You know it costs money to send a statement. It costs.

Speaker 1:

What we're, I think, is what 15 bucks when you're taking shortcuts now you're costing the company or the business or the practice because the practice is a business you're costing the business more money in lost productivity in the long run. And Friends I know a lot of you listening to this podcast are not business owners. But there is one thing that I want you to understand Businesses make profit and they also take losses, right, so this is called a profit and loss statement. This is something that business owners use to gauge how well we are doing when we're talking about lost productivity, when we're talking about forgetting to collect the deductible oversight.

Speaker 2:

Yes.

Speaker 1:

So when we don't do that, these are not losses that are showing up on the profit and loss statements.

Speaker 1:

These are silent financial losses that we are responsible for based on how efficient we are, and efficiency is everything to productivity, because efficiency means you know to do something with the least amount of attempt, to do something Right With the least amount of attempts. Right, so you can be efficient and effective at your job. But I would much rather have an efficient co-worker, somebody who's getting it right the first time, rather than efficient and effective because you can be effective. You can submit a claim five times and get it paid, but you didn't do that efficiently, right. Right, it was paid effectively, but it wasn't efficient. So I'd rather you be efficient and effective. So I think that that goes right along with this. You know your front office handbook, because this is going to help eliminate those redundant like I said earlier redundancies. More efficiency, effectiveness, just taking the guesswork out of what to do next, right, right and having it.

Speaker 2:

You know, if you have free time, let's. Here's a list of what you can do during that free time.

Speaker 2:

A downtime checklist, yes, yes. Whereas if a hygienist has a cancellation, hey, let's put her to work, she can start. You know we have a list of patients. She knows the breakdown we have. You know, in my book I have the insurance index where it lists, you know the common term. So let's get our hygienist cross-trained so she can help. Let's get the assistant cross-trained. So together, you know, as a team, we're working. You know we're working together. Yes, there's a front office and a back office, but that just, it's just a separation, it's just a separation of duties. Together, we're an office, we're a team, we're working together for this one common goal of running an amazing practice where everything is consistent and proficient and efficient. Because I'm a big believer in work smart but also work hard, let's work smart first. Yeah, we're not having to, yeah, play a whole bunch of cleanup, catch up at the end of the day, or guesswork or anything.

Speaker 1:

That's where I think that's where the cleanup and catch up get stuck is, because there was again. Everybody in their own mind has their idea of what downtime looks like. You know, there is no such thing as downtime friends in a demo office.

Speaker 2:

Sorry, but if there's downtime, then that is time to work on the schedule and or even back office, if you're sharpening instruments or if you're stuck in rooms or front office. There's always work to do on the insurance aging report. There's always something to do. So yeah, having it just.

Speaker 1:

And I think that's where the balance, most balances, matter. And I don't know about you, morgan, but I find that offices and rightfully so, right, like nobody wants to work a report and go to the doctor and go okay, doc, here's all the money you have to return to the patients or here's all the money Back. We just want to go after money that's owed to the practice but I find that, you know, as we do, a our cleanup credit balance report is just way off because nobody ever works that report and, like you said, there's always something to do, right Work to run and work Exactly Always, always something to do, and in my book I also have a new patient checklist.

Speaker 2:

So when you're making new patient appointments, these are the criteria that we absolutely need you know when they make their appointment, because we don't have any of their information. We need to make sure we have, you know, their name, date of birth, subscribers, information for their insurance, subscriber, date of birth, and we're getting that ahead of time on the phone when they make their appointment, so we're not having to scramble when they come and they're in their back in the office, you know, in the in the operator. Okay, so you're, we just took an FMX, but you're not due. For once, you owe us $108. You know what I mean. So it's we're just planning to do things ahead of time and just be more efficient with our time that way.

Speaker 1:

Honestly, because we have this mass exodus in dentistry post COVID, right, and the offices are hiring a lot of individuals with no experience in dentistry right now.

Speaker 1:

That is the thing, because people with experience are looking to take advantage of the work from home positions because they have the experience to do so.

Speaker 1:

Right, the individuals that are now working at the insurance companies they used to have a front office experience, now they don't and also the people working in front office tend to not have experience these days because or very little or you're finding a lot of assistance being transferred from the back. So I think that you know, this front office handbook is going to be extremely helpful to offices that just need that guidance as to like the office manager who needs to hire someone but also doesn't have time to do a lot of training. You know can use these checklist and these guides as make sure that you keep this with you and when you come in to the office, follow this protocol or follow this protocol, and the beauty is that you also give this in a word format so that the office can make it their own, for example, if they want to add to the checklist or if they want to remove something that maybe doesn't apply to them. You've made it, these templates, so that they can add or delete or adjust, so I think right as well.

Speaker 2:

It's customizable and you know, one of the things that I've noticed between the successful practices versus the knot is that whatever systems they have, they're documented and it's consistent, because I think one of the biggest keys to six for a successful practice is consistency in the systems. So, however your office is doing it, document it, have it down so you know if the office manager has a quick has to quit or there's a medical emergency. The doctor also needs to know what's going on. The doctor needs to know how the practice is doing. You've got to be running practice analysis and you know, looking at your collections percentage, look at our practice analysis. This is our collections percentage. How many statements did we send? Do we need to adjust our treatment planning or do we need to be a little bit more diligent about collecting at the time of service? So there's just these little reports and the stuff that we need to look at regularly so everybody knows what's going on and if you find that over time a system isn't working for you, update it, change it, document it, just keep it consistent. You know I work, so I have an office here in Utah. It's actually the dentist I worked for nine years ago where I wish I knew all this stuff I did, yeah, so it's cool. I kind of have this little you know redemption thing. I can like help him out this time, you know.

Speaker 2:

But he was saying he had a really good system, that you know the previous office manager, susan, that she set up and he knew everything, what was what was going on and everything. And then he hired a new office manager and who changed a couple things because it isn't. Where did Susan go? I don't know. I asked and they didn't. I know I'm like why did you do that? He always lose the good ones. So but he was saying that, yeah, so this new office manager, she came in, she changed a couple things, but now he has no idea what's going on. She signed him up for EFT, we made these changes but we didn't really create a system and document it.

Speaker 2:

Now he goes. I don't know what's going on with insurance payments because she did this we didn't document it. So now he gave me his bank statements and I had to go through and make sure, okay, everything was posted. I do a little bit of bookkeeping with that, but just making sure the practice owner, the doctor, they need to know what's going on so they can protect their business because this is their baby, this is, and they don't get the whole lot of business school like business classes and dental school it might be, you know, one class for one semester or something like that, but having finder or a handbook or something, so even the doctor can come and reference it to make sure. Oh, you know, this is how to run practice analysis and this is what I need to be looking for, so we can make sure systems are the same, so you know they're protecting the practice from embezzlement. You don't want the credit balance report to get up to $200,000. You don't want that to happen.

Speaker 1:

And we have seen that.

Speaker 2:

Yes, yes, we have. We have seen that. I know there's not a lot of official informal education when it comes to front office. I just wanted to create a resource where you can help you learn as you go, because that's how most of us have learned dental from office is just from experience. So with this handbook, I go over how to send an appeal, and it's going to vary by insurance, but at least you have the backbone to where you can continue learning. You can continue growing. We're staying consistent and efficient and proficient and the goal is to run an amazing office. Consistent Because patients can tell. If there's a mess behind the scenes, they can totally tell the vibe. If you want to have a successful practice, you need to be able to train your patients to expect to pay at the time of service. If they get a bill in the mail, they know that they have two months before they get a final notice, we're going to send you to collection.

Speaker 1:

You're going to be responsible for it because we're going to give your insurance company 60 days to pay, right? I have a couple of points I want to make here, because you just brought up a couple of things. One did you know that the number one complaint on Google has everything to do for dental offices, has everything to do with their insurance? Because patients don't understand all of the red tape that we deal with. I don't think we're having the right conversations with them up front, like our financial policy conversation. It doesn't have to be an in-depth conversation, but it does have to be an intentional conversation. It cannot be just a piece of paper that the patients are filling out. It has to be highlighted.

Speaker 1:

I like to have my patient fill out their paperwork. I go over their health history with them, highlight anything, ask questions before the patient goes to the back, do some due diligence. But then I also like to go over the appointment policy and the financial policy. I intentionally have that financial conversation around. We will give your insurance company 60 days to pay the claim. Deny or pay, but either or you will ultimately be responsible for the balance. We will do everything in our power to get the claim paid. Ultimately, you are responsible. Do you have any questions about that?

Speaker 2:

Right.

Speaker 1:

In the event that, when, if and when that happens because it does happen, especially with these leased and borrowed networks and all of these schedule cherry picking that's going on within these insurance companies.

Speaker 1:

We don't know and it's hard for us to be accurate down to the penny I do happy dance when we are. It's very important that we have those checklists and those conversations and we have to consider those patterns Right, like if Google is telling us that number one complaint on Google is about insurance. That means we need to do better as an industry.

Speaker 2:

Right and educating our patients right, educating our patients and always having those conversations and being consistent so we can train our patients to kind of expect to pay. Not to compare a grown adult to a toddler, but with my kids, if I don't prepare my child like, hey, we're going to have this, we're not going to have chicken nuggets, we're going to have pulled chicken. You know what I mean. Preparing them ahead of time, I get less of a tantrum. So you know, and it's fine, and you know, in preparing our patients, we're going to do this if they don't pay. You know preparing them ahead of time so you don't get as much backlash or as of a hard time to pay.

Speaker 2:

But you need to train your patients to expect oh, I can't counsel within 48 hours or I'm going to be charged, I need to keep my appointment and if you're consistent at it they'll learn. Because if you're not consistent at it, they're not going to learn and it's going to feel chaotic to the patient, which puts them off, and it's like, oh, I don't have a good feeling when I go to this office because there is just pure chaos. The doctor might be the nicest person on the planet, but if there's just that vibe that's off. They can tell, and then now we're looking at. You know, now we have a patient retention problem.

Speaker 1:

And you know it's funny because that you say that I always say in my workshops that we as administrative staff, how well we run the office, we make or break our doctors. I mean, I can have an excellent clinician with a really bad team because leadership is weak and we are tolerating bad attitudes, and that is directly linked to the bank account, right? So you have doctors that are excellent clinicians, not so great leaders, which translates to a not so great team and then ultimately filters down to patients leaving because they don't appreciate or they can sense something is off. How come every time my copayment is different, or every time I talk to you, I'm being told a different number? And that's because there's no systems in place, right?

Speaker 2:

You have.

Speaker 1:

I've also seen because I've been around the block. I mean, I've been in the classroom since 1995. I've seen a lot of not so great clinicians. I'm not a dentist, but I know that you know when a patient has to come in several times for a filling to be adjusted or crowns are being delivered with open margins. I'm not a dentist, but I know what I'm looking at when I'm billing, exactly. Yeah, but I've seen those doctors thrive because they have amazing teams right. So I mean and then there's everybody in between it is so important that we understand Exactly what you're saying. You know we have to know how to keep things on track because patients will pick up and sense when there's chaos going on in the kitchen.

Speaker 2:

Yep Exactly, exactly.

Speaker 1:

So I mean we have covered so many topics and I think ultimately it all boils down to being intentional, with, you know, having your basics outlined, your checklist I love. In your book you know there's a section where the doctor's name, the tax ID number here NPI, like the things that were always. You know where's the tax ID number, where's the NPI number, right, having it in just one centralized place.

Speaker 1:

I think is great for the office and I love that you offered in Word so that the offices can customize their own handbook. Now just to clarify this is not an employee handbook, as in HR?

Speaker 2:

No, it is not. I mean, I have a small section for employee benefits, you know, just to lay it out, so it's always right there. But no, this is not an HR anything. You know, this is the front office systems and policies. I put that little page in there just to make sure, just as a reminder. This is not the HR. I am not an HR person. You do not want to be taking HR for me, you know. So it's my expertise and my niche is systems and so, and policies, procedures and documenting it, and that's, yeah, that's what this handbook is.

Speaker 1:

I think that this is, and I just wanted to clarify so that everybody understood. We are not talking about an employment handbook, full disclosure. We are. We are not talking about HR at all. We are all about systems. And there is. You remind me of a girl that I follow. She is not in dentistry, it's just I love systems as well. I'm horrible at systems, which is why I need team members around me that are really good with systems. Her name is Jordan. I forget but her. The name of her podcast is called System Saved Me. Oh, is it Jordan? Page.

Speaker 1:

Yes, yes, yes, I know she lives here in Utah Does she yes, I love her, and I was like gosh she has so many good ideas and I can literally just binge listen because I love systems. I just struggle with implementation of systems because I'm a total quick start and I struggle with the follow through and implementation. But I am all strategy and ideas all day long. But if you give me a checklist, I'm really good at following it. All the details drive me nuts. So that's why I appreciate what you put together so much, because, gosh, I wish I had something like this when I was new in dentistry, and I think that those of you who are new, you guys need her front office handbook. Thank you. So go check it out, friends, you're gonna love it. So I think, with that being said, let's close out with one last question. If you could give one piece of advice to a newbie in dentistry today, what would that be?

Speaker 2:

Oh man, be prepared to soak up information like a sponge constantly. The game is constantly changing. There are always new challenges, new rules, new laws. You know new criteria for coverage. You know there's new codes. Just be prepared to always be learning, always something new to learn. And even me, you know, I've been in the field for over a decade. I'm still learning and I'm still learning and trying. They're just like a big puzzle. It's always challenging and everything. So, yeah, just be prepared to always be learning. There's always the challenge, but it's so much fun.

Speaker 1:

I am just so happy to see the progress in dentistry with technology, with software, with practice management software. When I started in dentistry, there was no practice management software. We were on pegboard and these big scheduling books and I mean it's definitely evolved. And I'm just so happy to see that we're finally catching up with the other sectors in healthcare, with you know, as regards to technology. But I think that this is an exciting time for newer individuals to be getting into dentistry, because there's a ton of stuff happening right now. We're getting into the realm of artificial intelligence with billing, artificial intelligence with so much, and I mean it's just so exciting.

Speaker 1:

So I am so happy, morgan, that you were able to join me today on the podcast. I'm sure that the listeners are going to love, love, love this episode. I'm going to put the link into the show notes so, for those of you that want to get in touch with Morgan, you can reach out to her on Instagram, at frontofficefriend, and you can also find her on Facebook, linkedin, on her website, frontofficefriendcom. Feel free to go there and purchase that frontofficehandbook. You're not going to regret it, thank you.

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Ericka Aguilar

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