ADAA Business Beat Newsletter

Spring/Summer 2012, Vol. IV, No. 1

ADAA President's Letter: Office Conflicts... Think About Them

Featured Columnist: Integrating a Practice Marketing Suite with Your Current Practice Management Software

ADA's Council on Dental Benefit Programs Broadens the Definition of Porcelain/Ceramics in the CDT Code

Business Bytes: News for Dental Administrators

Forbes Lists Dental Assisting as Top Job for Young People

ADAA President's Letter:

OFFICE CONFLICTS . . . Think about them

By Claudia Pohl, CDA, RDA, FADAA, BVEd, ADAA President 2011-2012

We all work in an office – some big and some small – and it is a fact of life that when people work together, there will be conflict. So whether it’s the dental office, the faculty office at a school or a sales office that we dental assistants call home away from home, we need to be prepared for periodic conflicts and how to handle them. As a business assistant, it may even be in your job description to resolve them.

In all cases of conflict – and there are too many to enumerate here – conflicting thoughts and assumptions are usually at the core of the situation. These thoughts and assumptions often get in the way of positive action and cooperation. Clear-cut lines of communication often help to quash conflict before it starts. These are some of the more typical areas of conflict, particularly in a dental office:

A) Misunderstanding: “I thought you MEANT . . .”

B) Lack of Communication: I thought you KNEW”

C) Controversy: “I thought that was MY JOB / YOUR JOB.”

A) Misunderstanding. If you’re the one in charge and you give a direction, particularly in a new situation or to a new employee, you might want to conclude by saying something like “Okay, just to be sure I’ve been clear, tell me what you’re going to do.” If the other person doesn’t give you what you want, instead of repeating what you’ve just said, perhaps say something like “Sorry, I guess I didn’t say it clearly, let me try again.” I’m not trying to put words in your mouth, just trying to give you the idea that if you think about it there are positive, thoughtful ways to find out what others are thinking and ways to communicate with them to avoid conflict or hurt feelings. Sometimes we think we’re communicating clearly and we’re not.

Another way that’s effective is to restate what you think the other person is saying, like “what I’m hearing you say is . . .” Then he or she can correct what’s inaccurate and you can all be on the same page again.

B) Lack of Communication. The absence of clear expectations and job descriptions (which is pretty common in dentistry) can lead to a situation where “Everybody Knows” how to do it step-by-step – except that certain someone who hasn’t done it your way and perhaps doesn’t know about a certain step that you think is important. Communicate task procedures in writing in advance and it’s one less thing to have conflict about. Let everyone see them. Put them in a book in a place where they can be reviewed. Write job descriptions and don’t leave anyone out. If there are three or four assistants in the practice, perhaps each one has slightly different duties. Make sure that each one is described adequately.

C) Controversy. Is there anything that causes more sulking and ill will than someone (or more than one person) who thinks that he or she is doing someone else’s work or that someone is infringing on his or her territory? It happens a lot in dental offices, doesn’t it? Everything from the front office cleaning a treatment room to back office staff pulling charts or making phone calls to a hygienist polishing one of the doctor’s patients. An attitude of “that’s not my job” or “why should I do their work?” can cause lots of resentment in the work environment. Resentment from an attitude like this can breed faster than rabbits!

In a perfect world, we truly would be a dental “team” – helping out wherever needed, regardless of our job description! One of the best ways to foster a team attitude is to model it – be the one to start it in your office. Be willing to clean a treatment room if they’re running behind or bag some instruments. It’s amazing the affect that can have on the morale in the office.

As with so many potential areas of controversy, advance planning, thoughtfulness and empathy might solve the problem or divert it completely. Empathy plays a huge role in effectively dealing with conflict resolution. Some of us are naturally empathic and others need to try to develop empathy or at least take clues from the experts. Being able to put one’s self in someone else’s shoes and respond with that in mind can go a long way to minimizing the fallout when conflict happens.

There’s an excellent article about conflict resolution, ""We Don't Get Along, but the Patient Doesn't Know!' – Resolving Conflict in the Dental Office," on page 10 of the May/June 2012 issue of the Dental Assistant Journal, written by Ronda Savage, DDS (Dr. Savage is the CEO of Miles Global, formerly Linda Miles Associates, and a member of the Journal's editorial board). It’s information that you can use to help build your leadership skills as a manager or help all staff members to become better listeners and better communicators.

Take a little time to read this article in print in the Journal or at our website (the Journal is now online – and for the rest of the year is available to everyone – not only our members and subscribers).

Featured Columnist:

Integrating a practice marketing suite with your current practice management software

by Jana Berghoff, RDH

Practice management software is a key tool to helping your office run efficiently and your team work effectively. Integrating a practice marketing suite or patient communications software with your existing practice management software can further streamline your processes and save all team members time by automating many of the more tedious and time-consuming tasks. The new RevenueWell Practice Marketing and Patient Communications Suite is an online system that links with an office’s existing practice management software, and uses patients’ account, procedure, appointment and treatment plan information to automate many practice marketing and patient communication activities, saving time for dental assistants, office managers, hygienists and dentists—every member of the dental practice team.

By integrating with an office’s existing practice management software, RevenueWell can help dental offices get more value from their existing practice management tools. Practice management systems like Patterson Eaglesoft have a tremendous amount of intelligence and patient information built into them. RevenueWell helps practices make the best use of this data by mining it for the right triggers and automatically communicating with patients on the dental team’s behalf, increasing productivity.

Patient communication software has the ability to completely automate most types of common patient communications, for example, sending welcome packets, birthday cards, holiday cards and thank-you letters. The service does this by analyzing patient's data and then sending them in timely e-mails, postcards, letters, SMS messages and automated voice calls based on the practice's settings.

Some of these communications, like appointment confirmations, birthday cards, welcome packets and post-op instructions, are focused on improving the practice’s operations and delivering better patient care. For example, RevenueWell’s automatic post-op instructions feature will monitor patients’ accounts for common treatments like fillings, root canals and crowns. It also automatically sends the patient an e-mail with post-op instructions as soon as they leave the office.

Other automatic communications are possible with a practice marketing suite aimed at bringing patients back into the office for recommended treatments and maintenance. This includes:

Recall and reactivation communications that use a combination of e-mail, SMS and direct mail messages to ensure that patients stay current with their hygiene appointments.
Expiring insurance benefits reminders that prompt patients to use their insurance benefits before the end of the year.
Video treatment plan follow-ups, an industry-first feature that automatically follows-up with patients who have had a treatment plan created for them but didn’t yet make an appointment to start dental care.

Helping Patients Reach You Online

The same patient communication software that automates communications can also help you maximize your online presence and bring new patients into your office. RevenueWell takes a comprehensive approach to solving online challenges that frequent dental businesses; it increases the office’s online visibility by distributing its business profile information to over 150 search engine, directory and social media websites. This places the office in front of over 90 percent of all people searching for dental services online. The system then enhances these listings by automatically collecting online patient reviews and placing them on popular search engines like Google, Yahoo! and Yelp. Having a way to effortlessly and systematically capture such patient feedback goes a long way in getting the practice noticed and selected among other similar providers in the area.

Automation also helps provide your patients with the tools to get the information they need, when they need it and reduce the number of calls to the office. RevenueWell extends the office’s front desk into the online world with a HIPAA-compliant “patient portal,” which lets patients review their account, request appointments, access forms and documents, access their treatment histories and even make payments online. This drastically increases patient satisfaction.

With Patterson Dental's support of the RevenueWell Suite, offices can be confident using this tool to automate dentistry-specific workflows and patient communication processes for higher production, lower overhead costs and increased patient and staff satisfaction.

Jana Berghoff, RDH, spent the first 23 years of her professional career working in the clinical dental setting and in practice management. For the past 12 years, she has worked to bring technology to dental offices as a technology advisor, sales consultant, and now corporate technology marketing manager for Patterson Dental. Contact her by e–mail at jana.berghoff@pattersondental.com.

ADA’s Council on Dental Benefit Programs Broadens the Definition of Porcelain/ceramics in the CDT Code

New nomenclature applies to all porcelain/ceramic CDT codes including D2740 for crowns and codes for inlays/onlays

In response to requests from 3M ESPE and the dental community, the ADA will broaden its definition of porcelain/ceramic materials in its CDT Code for insurance reimbursement, allowing 3M™ ESPE™ Lava™ Ultimate Restorative to be classified as a porcelain/ceramic. The change will be effective January 1, 2013, making it possible for dentists who use the material to easily file for insurance reimbursement, including using CDT code D2740 for crowns.

3M ESPE describes Lava Ultimate restorative as formulated from a blend of approximately 80 percent nanoceramic particles embedded in a highly-cured resin matrix using a proprietary 3M manufacturing process. The material is available for chairside milling using CEREC® or E4D® systems or can be ordered as a finished restoration from Authorized Lava Milling Centers, Jensen Milling Centers and Straumann CARES® Digital Solutions.

At the time the material was launched, the ADA’s CDT Code nomenclature did not yet reflect the advances in material science that Lava Ultimate restorative represents, resulting in challenges with selecting the proper CDT code for insurance reimbursement. However, following a formal request from 3M ESPE, the ADA has now broadened the material definition of indirect porcelain/ceramic restorations. With this change, Lava Ultimate restorative will fall under any CDT code defined for ceramics, allowing for the same rate of reimbursement as other ceramic materials. The new CDT Code definition reads:

Porcelain/ceramic: Refers to the pressed, fired, polished or milled materials containing predominantly inorganic refractory compounds — including porcelains, glasses, ceramics and glass-ceramics.

Business Bytes: News for Dental Administrators

New research finds oral cancer may be most costly to treat

New research coming out of Delta Dental of Michigan’s Research and Data Institute (RDI) finds that in the United States, the cost of oral cavity (OC), oral pharyngeal (OP), and salivary gland (SG) cancer may be the most costly cancer in the nation to treat. Details of the study has been published in BioMed Central’s open access journal Head and Neck Oncology.

The project, which involved key partners including Thomson Reuters, Delta Dental of Wisconsin, Vanderbilt University and the University of Illinois at Chicago College of Dentistry, began in March 2010.

Through the use of Thomson Reuters MarketScan® Research Databases and information from Delta Dental's RDI, the study retrospectively analyzed claims data of 6,812 OC/OP/SG patients with employer-sponsored health insurance, Medicare or Medicaid benefits. It concluded that on average, total annual health care spending during the year following diagnosis was $79,151 compared to $7,419 in a group comprised of similar patients without these cancers. The research also determined that the average cost of care almost doubled when patients received all three types of treatment including surgery, radiation and chemotherapy.

“The results of this research are significant in helping us to fully understand the cost burden of these three particular head and neck cancers on patients and health care providers,” states Dr. Jed Jacobson, chief science officer at Delta Dental and a lead contributor to the study. “To our knowledge, this is the first study of its kind. The information will be a great asset in determining the cost-effectiveness of any new technologies and early detection systems that could potentially help decrease costs, and more importantly, lower the mortality rate of these cancers down the road.”

The project examined other factors including:

Indirect costs associated with OC/OP/SG cancers from diagnosis, treatment and recovery. Indirect costs can include absenteeism and worker productivity, as well as the disabling and disfiguring side effects of treatment.
The cost burden of oral cancer on taxpayers who fund Medicaid and Medicare.
The comparative value of preventive care for these oral cancers versus treatment.

“Most oral cancers require costly and disfiguring medical intervention, and even then the five-year survival rate is approximately just 60 percent,” states Jacobson. “Yet when the cancer is detected early, the survival rate increases to 83 percent. This study allows us to get a better handle on the cost impact these diseases have and how we can combat them better.”

Head and neck cancers have always piqued the interest of health care providers, patients and insurers because of the high morbidity, high cost of care and high mortality rates associated with them. Yet, it has largely remained an unexplored area when it comes to research and backing up these conclusions.

“The actual study of the social, psychological and economic impacts of these cancers has been understudied,” states Dr. Joel Epstein, former professor of oral medicine and diagnostic sciences at the University of Illinois in Chicago, now adjunct professor, director of oral medicine at City of Hope in Duarte, CA. “These are the reasons we decided to conduct this important research and be able to shed more light on the cost burden of treating head and neck cancer.”

Dr. Fred Eichmiller, science officer at Delta Dental of Wisconsin agrees. “This research has been long overdue and now provides a greater depth of information and knowledge that in the long run can benefit millions of people.”

ADA statement examines how funding affects access to oral health

The American Dental Association released the third in a series of papers that examine the challenges and solutions to bringing good oral health to millions of Americans who, for multiple reasons, lack access to regular dental care.

Breaking Down Barriers to Oral Health for All Americans: The Role of Finance explores how the availability of financing affects people's oral health, various methods of paying for care, and recommendations for improving the system.

“When people are able to access oral health care, they are more likely to receive basic preventive services and education on how to attain and maintain good oral health. They are also more likely to have oral diseases detected in the earlier stages,” said ADA President William R. Calnon, DDS “In contrast, lack of access to oral health care can result in delayed diagnosis, untreated oral diseases and conditions, compromised health status, and, occasionally, even death. Unfortunately, access to oral health care eludes many Americans. While certainly not the only factor, financing is a major factor in people's ability to access health care.”

Increased funding alone cannot “fix” a dental financing system that is rife with inefficiencies and shifting policies and that is overly tilted toward costly surgical intervention in disease that could have been prevented. Acknowledging this, the paper provides eight recommendations that aim to eliminate unnecessary, costly and preventable dental disease over time.

The government can use tax policy to encourage small employers and individuals to purchase dental benefit plans in the private sector or develop cooperative purchasing alliances, such as the state exchanges created by the Patient Protection and Affordable Care Act. Cost sharing (copayments) should be eliminated for diagnostic, preventive, and direct restorative procedures. Necessary care should not be subject to unreasonably low yearly maximums on coverage.
Maximum plan benefit fees should be set in an open and transparent manner, with appropriate scrutiny from attorneys general, insurance commissioners and providers.
Medicaid and CHIP should reimburse for dental care minimally at rates that are acceptable to sufficient numbers of dentists practicing in the covered area to provide care to those eligible patients who seek it, as consistent with federal law. State programs should base these rates on the ADA Survey of Dental Fees or an equivalent database.

Forbes Lists Dental Assisting as Top Job for Young People

Forbes published an article in March 2012 listing the top 15 jobs for young people in the current market. According to the data analyzed by jobs expert Laurence Shatkin, PhD, author of 150 Best Jobs for Your Skills, dental assisting tops the list:

Topping the list at No. 1, dental assistant came out as the best job for young people in the current market. The position requires only moderate-term on-the-job training and entails preparing patients and dental equipment and keeping track of inventory and medical records. Earning $33,470 annually, 17.6% of these workers are younger than 25, and the function is increasingly in demand. The job is expected to grow 35.7% and boasts 16,100 openings each year.

The ADAA Board of Trustees and membership wish to acknowledge and thank Patterson Dental for its generous sponsorship of the ADAA Business Beat.

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