When I speak with dentists who have dipped their toe in the waters of treating obstructive sleep apnea (OSA) in their practice, the number one reason they say they quit doing it or are not doing more is …

“I couldn’t get paid!”

You may be committed to helping patients achieve better health through treatment of OSA, but it’s challenging to make it financially possible. Here are three tips that will make dental billing for obstructive sleep apnea more consistent and predictable:

Use Practice Management Software to Simplify Dental Insurance

Understanding how to succeed in the complicated system of medical billing is a game-changer.

We have all figured out how to streamline our approach to making sense of dental insurance, but the rules are different for Dental Sleep Medicine (DSM). You should use a segment-specific software platform (DS3, NiermanDentalWriter, or other) for your SOAP notes and communication with physicians and payers.

These platforms ensure that you include the right notes, tests, patient status, and history to get paid. DSM and medical reimbursement are under the jurisdiction of rigid documentation of processes, protocols, and standard practices. Choosing the most effective DSM practice management software is the first step to payment because it will not let you forget to harness critical information.

Make It Easy for Patients to Say Yes to Treatment

My second piece of advice is the most difficult to implement because it requires a change in behavior. Talk less about co-payments, deductibles, and the patient’s responsibility than you may be used to in dentistry when dealing with obstructive sleep apnea.

As an example, consider this: When you visit your doctor and they suggest an x-ray, draw blood, or order a specific test, do you usually say, “How much will that cost?” No, you don’t. We know that tests and medical treatment recommended by our physician are necessary and not usually optional to achieve optimal health.

Plus, we know that their treatments will be covered by our medical insurance (after the deductible and with certain co-payments). As dentists, we are expected to have significant upfront financial discussions about how much the patient will have to pay out of pocket because of the different nature of dental insurance.

Unfortunately, this same approach when applied to a sleep apnea appointment may backfire. Treatment of sleep disorders can be life-changing, so it’s beneficial to the patient if you focus less on dollars and more on care outcomes.

When we get detailed about the financial arrangement, upfront copayments, and deductible discussion, patients think we are still treating them as a dentist, not as a medical care provider. Make it easy for patients to say yes by leaving out the money talk. Many will have good coverage and can make the treatment a possibility.

Outsource the Details to a Competent Billing Company

Hire a billing company to do the dirty work. Third-party billing companies (Four Pillar, Nierman, Pristine, Dedicated Sleep, GoGo, Brady) typically charge a small per claim fee around $50 and 8-12% of the paid amount. This fee is worth every penny.

I have seen far too many revolutions from the administrative teams in dental practices when they were forced to try to figure out the weird, ever-changing rules of insurance reimbursement.

Billing companies are experts. Plus, the cost as a percentage of sales works for medical practices, so why shouldn’t it for dentistry?

Treating patients for OSA with Oral Appliance Therapy (OAT) is easier clinically and technically than making bite splints in centric relation. And yet the minefield is littered with the remains of dental teams who tried to do the billing themselves.

If you only did one case per month, subscribed to a cloud software solution, paid a billing company their fair share, and risked not talking so much about money, you would still help patients get healthier, feel very fulfilled, and make more money than you are now.

That success can breed more success. You just might add $100,000 to your annual revenue! Curious how you can start incorporating treatment of sleep apnea into your practice workflow?

I’ll be holding a live, three-hour virtual course, “Treating Sleep Apnea In Your Practice With Oral Appliance Therapy,” on Friday, May 21st, 2021. Registration for my course is easy at Pankey Online.

Join me from 2 pm to 5 pm EST to learn more about the medical background of sleep conditions, marketing sleep appliance therapy, and more in-depth techniques I implement to transform medical billing.

Can’t wait to see you there!

Sign up for free at Pankey Online to access complementary and paid CE-granting webinars spanning hot dental topics like sleep apnea treatment, equilibration, and indirect bonded anterior restorations. 50+ cutting-edge courses at your fingertips …

Providing healthier mouths to patients and doing more fulfilling dentistry (and making more money as a result) are admirable goals most practices have. I have written a couple of times about techniques that help us improve case acceptance: creating curiosity and co-discovery, listening, the learning ladder, and more.

This brief overview is an attempt to see the process as a journey for the patient and to consider their perspective:

Patient’s Journey: Eighteen Inches at a Time

It Starts in the Head

Patients first listen to the facts about dental care, their need and wants, issues or diseases that they have, and potential treatment solutions. Sadly, facts are not enough.

Developing great listening skills, caring, and trust help patients come to see you as their health advisor. This requires an eighteen-inch ‘Journey to the Heart’! It is there that caring and trust live. The emotional connection is very important in case acceptance. To ignore it is to minimize your success. But that too is not enough.

The patient must schedule, keep appointments, and pay for recommended treatment. This ‘Journey to the Wallet’ is the next eighteen-inch trip the patient must take. It is the execution of the plan from their perspective.

Valuing dental care and oral health is demonstrated by their checkbook and what they spend time and money on. Still not done?

The next eighteen-inches take us to a knee. Appreciation helps fulfill us as caregivers. Most rewards are best when they are balanced, financial, and behavioral: money and warm fuzzies, you get the idea. Money alone does not buy happiness (but it does help you enjoy your misery in some mighty fine places!).

The final journey takes us eighteen inches to the patient’s feet. When patients tell others about your practice and refer their friends, you have come full circle. This trust display is the ultimate compliment to you and your team.

Keep the Patient’s Perspective in Mind

Ask yourself the following and seek answers with your team to enhance patient health, your fulfillment, and mutual rewards:

·       Have you helped nurture movement toward the heart?

·       Did the patient accept and schedule treatment? If not, why not?

·       Were they able to pay with gratitude and appreciation? (borrowed from Dr. Pankey)

·       Did you ask for and receive referrals of their friends and family?

Remember, it’s a journey, not a destination. Enjoy the trip and check the map along the way. You, your team, and your patients will all be the better for it.

A journey is best measured in friends, rather than miles. -Tim Cahill

Our behavior directly influences the results we see in our life and career. In the dental practice, recognizing the need for conscious change and following through requires true self-discipline.

We all know what we need to do to improve our situation, whether that be in working on patient care or engaging in more education. The hard part is that even once we’ve gotten the information we need, we still have to implement change consistently.

Conscious Change & Practice Success

Discipline goes counter to human nature. In the practice, we know we should always be on top of things like scheduling a patient’s next hygiene appointment or asking the patients we trust most for referrals. These are the behaviors that require diligence and more attention than we may have on any given day.

It’s not easy to change. It’s not easy to commit to using intraoral cameras more often or anything else you have as a goal. The difficulty lies not in an individual failing, but in the structure of our brain.

Conscious change is a fight against our natural inclinations. It requires holding ourselves accountable to the behavior changes we want to implement.

Self-Doubt and Commitment

We also have to face the self-doubt that comes with change and handling any hiccups that occur. It’s painful to make mistakes, but even more painful to stay mired in old, stale behaviors.

One thing that helps is transparency and being held accountable by an external source. Project management software already does this well. It keeps track of our successes and failings for us.

We should be using this tool to identify our weaknesses and thereby improve our results. Once we notice what behaviors aren’t driving success, we can replace them or find avenues toward heightened performance.

How do you support behavior change in yourself? Let us know your thoughts!

Consistent case acceptance is a skill it can take years to develop. Part of the reason it can seem so challenging is that a patient’s true motivations may not be clear from the outset. We have to hone that sixth sense that can tell us what information or guidance would truly speak to a patient.

Two aspects of case acceptance in particular often go ignored because they either seem too obvious or are just not as fun to dive into: offering individualized options and making sure patients understand insurance.

Individualized Options for Case Acceptance

You may think the concept of individualized options is a no brainer, but that isn’t necessarily the case from a patient’s perspective. If you’re willing to provide this extra level of specificity, you can put many ‘maybe’ patients right into the ‘yes’ category.

We accept that car and other big purchases are often paid in installments, so why not do the same with a large investment like dentistry? Offering financing or other piecemeal payment options to patients is a game changer. It also makes comprehensive dental care accessible to a broader demographic. That in and of itself is valuable.

When dealing with patients, break the payment options down into easily understandable terms. Tell them the total fee, but decrease the stress by making it clear that there are different ways they can arrange to pay, including pre-pay, pay as you go, and Care Credit. Using a term like Care Credit is helpful because everyone is familiar with the idea of credit. When they ask for more information, you can lay out the details of payment plans.

Understanding Insurance for Case Acceptance

The real role of insurance is a mystery to most patients. Some may deliberately avoid understanding it because of how convoluted and frustrating it can be. They may have an entitlement mindset complete with the belief that the only healthcare they can indulge in is the kind covered by insurance.

Before you ever even look in a patient’s mouth, my advice is to have the insurance talk in low-stress language. Explain the actual definition of insurance and describe how dental insurance functions more as a maintenance plan. Use analogies to clarify the fact that just like with car insurance, its more of a backup fund than a way to pay for necessary yearly interventions such as a new tire or oil changes.

It’s a hard truth to swallow: acquiring more and more new patients won’t always lead to success or contentment. What we think will solve all of our dental practice problems can sometimes be the exact opposite of what we really need.

I remember talking with a dentist who had empty patches in his schedule that he was desperate to fill. He had also noticed that his practice did a half day less of hygiene than the previous year. He then made it clear to me that he needed new patients, but wasn’t sure how to go about getting them.

Before I dove into a solution that might not work, I clarified the problem. It turned out we were dealing with a very different animal.

The New Patients Conundrum

I immediately asked him how many new adult patients he was averaging per month in the last year. His answer was around fifteen. This piqued my interest and set alarm bells ringing. I told him that doesn’t make sense and explained the math.

Fifteen new adult patients per month should imply two one-hour maintenance visits for every person. That ends up totaling 360 extra hours in the schedule or 45 full days of hygiene. Clearly, this dentist’s problem wasn’t attracting new patients, it was keeping them!

He was blown away by this realization, but it’s not uncommon for dentists to assume new patient acquisition is the problem. In reality, we need to think more like business owners and measure what is worth measuring. In this situation, my advice was to focus on figuring out why patients weren’t sticking around for the long haul.

How we see a problem can be a problem in and of itself. Once we recognize the true source of our frustration, we can take active steps toward a resolution. Hygiene is the core of a practice, after all, and deserves the right kind of attention.

Customer equity in the dental practice is the retention of existing patients and attraction of new ones. This ensures patients can have more of the dentistry they don’t realize they need. So how do you find and retain new patients?

Asking for New Patient Referrals

New patients come from a combination of invitations, referrals, and marketing. You can have much more control over internal marketing than external. This is the environment you create in your practice that incites patients to refer you to their personal networks.

You must create a safe, non-judgmental system for asking for referrals and having those important conversations in your practice. Most importantly, you must choose the right patients to ask, because some will be too difficult or unreceptive to the question. Some may also be patients that you don’t want extensive relationships with. In that case, you may thank them for offering, but make it clear you aren’t looking for new patients with a soft statement.

Asking for new patient referrals is made easy by the fact that you usually know immediately which patients will be receptive. These are the model patients who pay bills in a timely fashion, care about your suggestions, and are just generally amazing for whatever reason.

Identify potential patient ‘marketers’ in your morning huddle on a regular basis. Then pose the question to these patients in a casual, non-aggressive manner. You can be joking, vulnerable, honest, reserved … whatever tone you think will work best with that particular patient. The request should flatter them or feel good to them.

This is how you create and seize opportunities. It can also occur naturally if they compliment you, but there is no shame in being upfront about asking for referrals.

How do you handle patient referrals in your dental practice? Leave your thoughts in the comments! 

Making better business decisions for your dental practice comes down to four key goals: (1) doing more dentistry patients need, (2) helping patients have healthier mouths, (3) making more money and (4) stressing less.

Improving your success in any one of these areas will affect the others, which is why you should think of these various elements comprehensively rather than separately.

How to Do More Dentistry

If you feel that you’re not making enough or treating enough patients, the problem likely isn’t economic downturn. The truth is, if you have a strong system in place, external economic factors shouldn’t have a huge effect on how many patients return for basic treatments such as hygiene.

One of the most common issues practices face is the efficacy of their systems. You may be seeing plenty of patients but without a clear system for setting new appointments, you may not have a full schedule.

Retention is all about measurements. What this means is that when you track or record data, you’re more likely to pay attention to it. A great way to increase the number of hygiene appointments you have is to track how many your are scheduling and how many patients are showing up for.

Simply by measuring this information, you will be more likely to ensure appointments are made. The same goes for your staff who actually carry out scheduling and encourage patients to return. This will also help you better understand what appointment scheduling methods you should offer. Different people like to be reminded differently. Some prefer an email, some prefer a text, some prefer the date and time written on a piece of paper, and some prefer a call.

The lesson of retention illustrates a thought process that can be applied to all areas of your business. Essentially, remember that one size does not fit all and simply paying more attention can improve your success.

What do you think is the hardest part of running a dental practice? 

Struggling to move your desired amount of dental work off the charts and increase your case acceptance? Usually, the issue isn’t that not enough of your patients need treatment, it’s that they have been ineffectively diagnosed or haven’t accepted procedures for a multitude of reasons.

I’m here to show you three painless methods that will get more patients to say ‘yes’ so you can provide the best care possible.

3 Case Acceptance Methods to Increase the Odds

1. Emphasize a Patient’s Wants Over Needs

Focus on helping patients want better dentistry and a more complete solution. Humans inherently spend money on their wants over their needs. Americans spend much more on alcohol, tobacco, and gambling than on dentistry. Help transform their perspective of dentistry from a necessary evil to a desirable solution. Be patient. Allow them the space to understand the consequences of inaction. At some point, they will “want” to know a solution.

2. Develop Curiosity Over Passivity

Ask about the problem and stay in the question. Many patients will begin to come to their own conclusions if we develop their curiosity. Let them co-discover and view things using the intraoral camera or hand mirror. This gives them the chance to really learn about their mouth. Telling them what you see is passive education. Helping them figure it out is more active and creates ownership. Avoid discussing solutions or talking about problems excessively unless they ask.

3. Help Patients Take Ownership

Here’s the honest truth: Patients are not aware, concerned, or interested in the long term consequences of not seeking treatment. They mistakenly believe that having no pain or dysfunction equates to health. If all we do is give them an exam, develop a treatment plan, and tell them what they need, we will fail to convey the value of a procedure to their life. We have to continue to probe by asking questions about the problem and its progression. When they recognize the ultimate untoward outcome, finally taking ownership, we know case acceptance is on the table. A telling sign is when they ask, “what can I do about that?”

How do you increase case acceptance? We’d love to hear from you in the comments!