Patient Record Audit: Suggestions for Buyers
By Megan Urban
– Randomly select patient records and review for complete documentation, full mouth diagnosis, necessary x-rays, and regular maintenance.
– Review the most recent three to five new patient records for charted existing and diagnosed “ideal” treatment, perio charting, appropriate x-rays, and confirm if the patients have their next scheduled appointments.
-Review the three most recent endodontic patient records to confirm if buildups and crowns were treatment planned and scheduled, or if treatment has already been completed.
-Review the three most recent prophy and SRP patient records to confirm the accuracy of treatment is captured in hygiene notes, proper documentation, and x-rays.
-Review the schedule for the upcoming weeks/months for all providers including hygiene. See how far out the hygiene scheduled is booked. In a strong hygiene program with a good recall and scheduling system in place, hygiene should be booked out five to six months.
-Review the schedule for the previous week to verify how many no-show or late-cancel appointments occurred. How were the no-show and late-cancel appointments documented? How are they tracked? Were the patients charged a fee?
-Run the Active Patient Count Report to confirm the number of active patients.
-Print the Detailed Treatment Plans Report (or Unscheduled Treatment Plans Report) and research several accounts to verify if treatment is truly needed, or if it was done and the treatment on the report is actually a second or third option. Is there sufficient dentistry left for you to do?
-Look at the Accounts Receivable Aging Report to determine if the amounts owing are from insurance or from the guarantor/responsible party. Are patients accustomed to paying their estimated portion at the time of service?
-Look at the Credit Balance Report (or Unassigned Credit Report). Credit balances can result from prepaid treatment, unposted treatment, incorrect insurance adjustments, or may be due to the patient or insurance company as refunds.
-Look at the Outstanding Claims Report for claims over thirty, sixty, and ninety days. Are the staff members responsible for the accounts receivable on top of outstanding claims? Look at the account notes for claims on the over ninety-day list to see why these claims haven’t been paid. Were they submitted with the correct codes, narratives, and necessary attachments?
-Look at the Month End/Day Sheet Reports for the past several months to see the production to collection ratio.
Read MoreInterview Questions for Every Dental Practice Role
By Megan Urban, Practice Transition Advisor
Businesses across the country are struggling with staffing issues and the dental world is NO exception. During the pre-pandemic years finding great staff was a challenge, but since the pandemic began finding and retaining great staff has become a tumultuous experience. What follows are some interview questions that have helped dentists and their practice managers sift through their potential candidates – when you can get candidates. And the increased competition for workers has made this an employee-driven vs. employer-driven market. You’ve got to know your budget and get clear on what additional perks or benefits you may be able to offer in this now highly-competitive hiring process.
General Questions for Every Role – Dentists, Hygienists, Office Managers, Dental Assistants, Front Office, and Sterile Techs
1. What are you looking for in a team and an office?
2. What does self-motivation mean to you?
3. What in particular motivates you?
4. How do you organize your day?
5. In a perfect world, how many hours per day and per week would you like to work?
6. How do you deal with conflict in the workplace? Describe a specific situation and how you dealt with it. Would you do anything differently now that you have had time to reflect?
7. How would the previous dentist who employed you describe you if I were to call him/her? What about the other team members, what would they say? Would they say you were on time every day? Easy to get along with? Fun? Great with the patients?
8. What do you think are your greatest strengths? And what are your greatest challenges?
9. Describe a situation when a patient was upset and describe what you did to rectify the situation or help.
10. What are three things you liked most about your last two positions/offices? What are three things you would have changed and why?
11. Describe a great day at the office.
12. What work situations, tasks, or duties cause you stress?
13. Where would you like to see yourself in two years. Where would you like to see yourself in five years?
14. If you weren’t in the dentistry field, what would you be doing? What are you most passionate about?
15. What qualities in a person do you think are important for this position?
16. How would you set the pay scale for this position? What qualifying events or skills would warrant a different pay scale or increase in compensation?
17. What do you think a bonus should be based on?
18. What benefits are most meaningful to you?
19. What have you learned during the pandemic? How did it affect your short and long-term goals?
20. Did you work remotely? Was that easy or difficult for you? How do you feel about being back in an office, working with a team, and having interaction with patients all day?
Additional Questions for Specific Roles:
Hygiene
1. Describe your normal routine with new patients.
2. What protocol do you follow with perio?
3. What are your thoughts about Arestin, rinses, etcetera.?
4. How do you talk with patients about perio disease? What if they have been undertreated and you are now proposing perio treatment?
5. What is your favorite part of being a hygienist?
6. What have you done in the past to build and grow the hygiene department in an office?
7. How do you discuss unfinished treatment and recall? Provide an example.
8. What do you do if you have a broken appointment? In other offices have you been expected to work your own recall and try to fill your schedule?
9. Are you comfortable working when the dentist is out of the office? (If it’s legal in your area?).
Dental Assistant
1. Have you been involved with placing dental supply orders? Explain your process.
2. What have you normally done during downtime?
3. How do you talk with patients about unfinished treatment and recall? Provide an example.
4. What are your most/least favorite procedures?
5. Describe the perfect dentist to assist and why?
Office/Practice Manager
1. How would you describe your management style?
2. What are your thoughts about micro-managing?
3. What steps do you take when you realize that you have made a hiring mistake?
4. Do you enjoy being at the front desk or in an office behind the scenes?
5. What do you bring to a team to keep them motivated and smiling?
6. In your previous office did you have full responsibility for the accounts receivable? What was your average production to collection ratio?
7. In your previous offices, how would staff describe you?
Front Office
1. How do you welcome new patients to the practice?
2. What have your past responsibilities been? Which did you enjoy most?
3. How do you talk with patients about treatment costs? Provide an exact example of presenting treatment and negotiating a financial arrangement.
4. How do you discuss unfinished treatment and recall?
5. How do you describe a perfect schedule and how do you create it?
6. How do you fill any last-minute appointments?
7. Do you enjoy recall and scheduling?
8. How much experience have you had setting up insurance, submitting claims, and following up with insurance companies for payment?
Dentist
1. What does a perfect schedule look like to you?
2. What is your perio protocol?
3. How do you encourage patients to finish incomplete treatment?
4. How do you ask for referrals from existing patients?
5. What do you do at a new patient appointment?
6. What types of procedures do you most enjoy?
7. Are you comfortable being the only dentist working in the office?
8. What is your typical production per day?
9. How would your current/past dental assistant describe you? How would an owner doctor or office manager describe you?
10. What are your goals for each patient and each day?
11. Is this office located outside any current non-compete you may have?
12. Will you be able to legally bring any patients with you?
Interview Questions for Every Veterinary Practice Role
Businesses across the country are struggling with staffing issues and the veterinary world is NO exception. During the pre-pandemic years finding great staff was a challenge, but since the pandemic began finding and retaining great staff has become a tumultuous experience. What follows are some interview questions that have helped veterinarians and their office managers sift through potential candidates – when you can get candidates. And the increased competition for workers has made this an employee-driven vs. employer-driven market. You’ve got to know your budget and get clear on what additional perks or benefits you may be able to offer in this now highly-competitive hiring process.
General Questions for Every Role – Veterinarians, Vet Techs, Vet Assistants, Office Managers, and Front Office
1. What are you looking for in a team and an office?
2. What does self-motivation mean to you?
3. What in particular motivates you?
4. How do you organize your day?
5. In a perfect world, how many hours per day and per week would you like to work?
6. How do you deal with conflict in the workplace? Describe a specific situation and how you dealt with it. Would you do anything differently now that you have had time to reflect?
7. How would the previous veterinarian you were employed by describe you if I were to call him/her? What about the other team members, what would they say? Would they say you were on time every day? Easy to get along with? Fun? Great with the patients and the clients?
8. What do you think are your greatest strengths? And what are your greatest challenges?
9. Describe a situation when a client was upset and describe what you did to rectify the situation or help.
10. What are three things you liked most about your last two positions/offices? What are three things you would have changed and why?
11. Describe a great day at the office.
12. What work situations, tasks, or duties cause you stress?
13. Where would you like to see yourself in two years? Where would you like to see yourself in five years?
14. If you weren’t in the veterinary field, what would you be doing? What are you most passionate about?
15. What qualities in a person do you think are important for this position?
16. How would you set the pay scale for this position? What qualifying events or skills would warrant a different pay scale or increase in compensation?
17. What do you think a bonus should be based on?
18. What benefits are most meaningful to you?
19. What have you learned during the pandemic? How did it affect your short and long-term goals?
20. Did you work remotely? Was that easy or difficult for you? How do you feel about being back in an office, working with a team, and having interaction with patients and clients all day?
Additional Questions for Specific Roles
Vet Assistant
1. Have you been involved with placing veterinary supply orders? Explain your process.
2. What have you normally done during downtime?
3. How do you talk with clients about recommended treatment for their pets? Provide an example.
4. What are your most/least favorite procedures?
5. Describe the perfect veterinarian to assist and why?
Office/Practice Manager
1. How would you describe your management style?
2. What are your thoughts about micro-managing?
3. What steps do you take when you realize that you have made a hiring mistake?
4. Do you enjoy being at the front desk or in an office behind the scenes?
5. What do you bring to a team to keep them motivated and smiling?
6. In your previous office did you have full responsibility for the accounts receivable? What was your average production to collection ratio?
7. In your previous office, how would the staff describe you?
Front Office
1. How do you welcome new clients and patients to the practice?
2. What have your past responsibilities been? Which did you enjoy most?
3. How do you talk with clients about treatment costs? Provide an exact example of presenting treatment and negotiating a financial arrangement.
4. How do you describe a perfect schedule and how do you create it?
5. How do you fill any last-minute appointments?
6. Do you enjoy scheduling? What do you enjoy about it?
Veterinarian
1. What does a perfect schedule look like to you?
2. How do you encourage clients to accept treatment for their pets?
3. How do you ask for referrals from existing clients?
4. What do you do at a new patient/client appointment?
5. What types of procedures do you like to do?
6. Are you comfortable being the only veterinarian working in the office?
7. How would your current/past veterinary assistant describe you? How would an owner veterinarian or office manager describe you?
8. What are your goals for each patient and each day?
Overcoming the Mental Hurdles of Owning your own Veterinary Practice
By Perhaps, you are a few years out of school with DVM credentials under your belt. Maybe you have been working as an Associate Vet and your confidence has grown to the point where you’re ready to take the next step with your career – owning your own practice. However, the mindset of this prospect can seem overwhelming and daunting. Most of your schooling has trained you for the practice of medicine, with the bare minimum of business course offerings. You spent more time focused on diagnosing parasites and animal dermatology than on economics classes and how to manage a business.
Perhaps you’ve heard through the grapevine that some of your fellow vets from school have taken the leap and purchased their own practices. Now you’re curious about purchasing your own practice and what your life would look like. But you’re not 100% sure that this is the right move for you. You are confident as a veterinarian, but not so much as a business owner.
Some of the questions that we field when working with potential buyers are the “what if” scenarios. What if the stock market crashes and I’m stuck owning a business that’s now underwater? How can I finance the purchase price of a practice while I still have student debt? What if I wait until I start a family and buy a house first before owning a business? On a good note, maybe the one positive part of living through the pandemic is that it has proven that being a veterinarian is not only an essential service but one that is resilient to major upheaval where other businesses have failed.
Undoubtedly, the financial aspect of owning a business is the biggest obstacle that every business owner faces. A good veterinary transition broker will help you understand the long-term potential of positioning yourself as an owner instead of staying in your current role as an Associate Veterinarian. Brokers are there to guide you through the complexity of purchasing your own practice. They can also act as a consultant on how to build your business and succeed. Our brokers at Omni Practice Group want you to be successful and that continues after the purchase of your practice with consulting services that we offer.
And yes, life will throw things your way that nobody is prepared to deal with. But having a plan in place gives you peace of mind to help you focus on building your business instead of worrying about what the future holds. Nobody wants to reminisce with classmates at a class reunion with regret about what your life could have been like. The should-have, would-have, could-have scenarios tease all of us with decisions that we wish we made earlier in our careers.
If you are ready to take the first step and start the learning process on how to begin your next journey, reach out to one of our experts and we can schedule a one-on-one meeting with you.
Read MoreGoodwill in Dental Practice Value
By As many of you know, in the purchase of dental practices, typically the biggest contributor in determining the purchase price is “Goodwill”. However, are you aware of the aspects that make up Goodwill? Of course, it includes the patients and the reputation of both the business and the selling dentist. But it’s also based on patient retention, which is the practice’s hygiene program or recall.
Savvy buyers and practice owners understand that the repeat or retained patients are critical to the ongoing success of the practice. It is also important to lenders that are working with buyers. If the selling dentist has a bulk of patients coming in for large cases and the collections are high, that is commendable; however, a new buyer will be concerned that the patients have completed all treatment leaving them nothing to do and eliminates the chance for the buyer to meet and retain the patients.
All dentists focus on getting enough new patients, as they should, but what happened to all the new patients that were treated over the years? As a buyer, recall is consistently an area of opportunity. Even if the practice’s recall isn’t where it has the potential to be, consider what can be done. Take a look at this example:
Let’s say that the practice averaged 15 new patients per month for 10 years and these patients were seen on an average of twice per year in hygiene or recall, you would need approximately 514 days of hygiene if an average of 7 patients per hygienist per day were seen. Some practices may see more patients in hygiene, but some may be scaling and root planing appointments after which these perio patients may be coming every 3 to 4 months. Dentists may work around 180 to 195 days per year so they would need approximately 2.75 hygienists. That means if the practice retains at least 85% of those patients, it will need more and more hygiene days each year. Is this happening in the practice that you are considering buying?
I have analyzed hundreds of practices and found that the average potential for increased collections from goodwill or patient retention is $30,000 to $150,000, depending on the size of the practice. I know it’s usually a high priority in any practice but needs a little tweaking that can bring big increases. And this doesn’t include potential increased collections from diagnosed treatment from all those periodic exams!
Savvy buyers need to know that every practice has areas of opportunity and here is one for you to capture.
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