Minibook
Table of Contents
Create a call flow outline
● Start with a good call flow process
● Key tips for handling billing calls effectively
● Key tips for handling calls on insurance benefits
● Key tips for handling calls on remaining balances
● Strategies for improving phone answering and scheduling systems
● Enhancing the patient experience
● Communicating effectively with your patients about in-network and out-of–network insurance
● Carrying out benefit checks for out-of-network insurances
● Record insurance details in your practice management system
● How to help patients when there are no benefits for out-of-network insurances
● Create dental membership plans for patients with no dental insurance
● What constitutes a dental emergency?
● Identifying true dental emergencies that need same-day treatment
● Less urgent concerns to be scheduled ASAP
● Effective phone workflows for new patients
● Effective phone workflows for existing patients
● Smart ways to schedule new patients quickly
● The importance of blocking hygienist appointments on your schedule
● Implementing the hygiene block schedule
● How is the hygiene block time used?
● Scheduling new patient dentist exams
● How to handle new patient dentist exams
● Put a treatment plan in place straight away
● Streamline processes with insurance codes
● Make sure patients feel welcomed and valued
● New patient exams with the dentist and assistant—when to schedule these and how to do them
● Creating records and starting any necessary treatment plans
● How to schedule new patient comprehensive exams
● What should happen at comprehensive exams?
● Key procedural steps for a comprehensive exam
● Checking benefits at comprehensive exams
● Setting the fee for a new patient exam
● The difference between a failed, broken, and rescheduled appointment
● What can you do to prevent failed and broken appointments?
● Training patients to keep appointments
● What should you do when a patient breaks an appointment for the first time?
● What should you do when a patient breaks an appointment more than once?
● How do locked accounts work?
● Missed appointments—key takeaways
● Creating a quick call list for patients
● Useful tools for keeping track of patients looking for an appointment sooner
● Making and sharing notes
● What should be documented?
● Where should this information be documented?
Technology & Lab Services
10 Smart Ways to Improve Patient Experience At Your Dental Practice
—An Insider Guide
Increase patient satisfaction and get new clients by streamlining your
dental clinic systems
Creating a first-class customer service experience at your dental practice is essential for securing new patients, and maintaining the loyalty of current ones. But how do you do this? What steps should you take?
In essence, it all comes down to having a set of smart systems, procedures, and processes in place that make people feel valued—and make life easier for your front desk and dental team too.
So here are 10 tried-and-tested tips for creating stellar customer service experiences for both new and current patients.
When patients call your dental clinic, their reasons are often urgent and important. They might be anxious, in pain, or dealing with an emergency. Or it may be the first time they are calling—in which case, first impressions really count. Whatever their reason for calling, they expect a prompt and reassuring experience, not long waits or unanswered calls.
To provide the best customer service, dental practices must be accessible and responsive, creating the smoothest and most professional experience possible for callers. But how do you know if you are delivering a high standard of customer service? Here are four key questions for evaluating your dental practice:
1. Is your front desk team there to answer the phone when people call?
2. Do you answer calls promptly?
3. Are you accessible and responsive when people ask for an appointment?
4. Do you respond by scheduling an appointment quickly?
Identifying any potential issues through these questions can help inform your improvements. Here is a general guide on how to create a better customer experience.
A good call flow outline is essential for any dental practice. It should include:
● How to greet patients and what questions to ask for gathering key information.
● How to answer insurance inquiries accurately.
● How to promote dental discount membership clubs to patients.
● How to handle billing inquiries.
● How to identify and deal with dental emergencies.
● How to be responsive when dealing with requests for prompt appointments.
● How to record and document calls efficiently
A call flow outline is crucial for ensuring consistency and empathy. This should include greeting the patient, confirming their information, identifying their needs, and handling the call warmly. Depending on the type of call, there could also be questions about insurance, billing, or scheduling.
We’ll be breaking down all of the below in the following chapters, but here is a quick summary:
Scheduling appointments
Scheduling appointments in a seamless way requires a clear process—especially with new patients. This includes gathering necessary contact and insurance information, plus identifying referral sources. Building rapport with the patient and sharing the unique qualities of your office can also help to create a better, more welcoming experience.
Knowing the basics for setting up an appointment is crucial. It is important for your front desk team to understand which procedures the dentists perform, the time required for these, and if you use any block scheduling.
Understanding whether blocks are saved for certain types of appointments is also important. Maintaining a ‘short call’ list for patients who want to come in sooner—and informing patients about your no-show or cancellations policy—can help to manage appointments better (and prevent cancellations).
Cut down on cancellations by reminding patients of the importance of keeping their appointments and the protocol for canceling in advance of 24 hours. Then, this time can be used for another patient.
Insurance inquiries
For insurance inquiries, it is essential to have guidelines to help patients understand in-network and out-of-network coverage. Maintaining an updated insurance provider participation chart can help your front desk team answer any questions clearly and promptly. If a patient does not have insurance to cover an exam and X-rays, you should be prepared to share the cost for these dentservices so the patient knows what to expect.
Dental discount membership club inquiries
Additionally, some patients without dental insurance might want to know about dental discount membership clubs. Having this information ready—including an outline of benefits and costs—can create a better customer experience and get more people on board.
Billing inquiries
When dealing with billing questions, it is important that your front desk team knows how to accept payments over the phone and quickly review the account if a patient has questions about a bill. Your front desk team should also be able to explain the financing plans offered by your practice in a way that is clear and accessible.
Dental emergencies
For emergency dentistry, having a checklist to help triage the patient is vital. This can help determine if it is a true emergency or something that can wait. If the patient perceives their situation as an emergency, it is essential to show empathy and gather more information in order to comfort them. It’s also crucial to prepare insurance providers ahead of time.
A clear plan for offering same-day emergency service is also important. This includes knowing how to handle emergencies that need immediate attention and explaining which of your office locations are available for them.
Call documentation
Consistent call documentation is also essential. Using a system to record conversations allows any staff member to assist patients effectively when they call back, and it means the patient doesn’t have to repeat the same conversation over and over again.
In short, making your dental office more accessible and responsive to patient needs requires having a set of tools and protocols to handle patient communications efficiently.
Now let’s look at some of these call types in more detail.
● Share estimates based on pre-treatment authorizations and clarify that these are not guarantees.
● Outline the sources of your information and the steps taken to obtain them.
● Ensure patients understand that insurance estimates are subject to change based on various factors, such as other dental work done during the year.
Discussing prices for treatment over the phone can be challenging, especially when the patient hasn’t had an examination yet. This is because different treatment options and necessary preliminary procedures can complicate cost estimates. That is why encouraging patients to set up a consultation is the best approach for accurate pricing and treatment planning.
Depending on your type of practice, you could also explain that your office offers quality service at midrange prices. You could also emphasize the value of a consultation. Providing information on consultation costs, especially for uninsured patients, is also important.
- Clearly state the remaining balance and ask for the patient’s preferred payment method.
- Quickly research and resolve any questions about the bill.
- If further investigation is needed, take the patient’s contact information and follow up promptly.
- Clear notes should be taken to ensure smooth communication if the call needs to be transferred to another team member.
The goal for billing calls is to get patients into the office for consultations to discuss fees and treatment plans in detail. For insurance benefit discussions, provide estimates and schedule appointments for further review with the dentist if necessary. For remaining balances, set up payment plans or other arrangements to handle outstanding balances. This ensures that patient questions are answered clearly and that care can continue.
Insurance benefit calls often involve questions about what the patient’s insurance will cover. When patients call with these inquiries, it’s important to provide clear and accurate estimates based on pretreatment authorizations. However, it’s also crucial to communicate that these estimates are not guarantees.
Various factors can affect the final dental coverage amount. Ensure that your staff explains the source of their information and the steps taken to obtain it. By doing so, patients can better understand the complexities of insurance coverage and feel more confident in the information provided.
Implementing effective strategies for phone answering and scheduling can significantly enhance your patient experience. Here are some key strategies:
1. Training and protocols: Ensure that all front desk team members are trained to handle calls professionally and empathetically. Develop clear protocols for different types of calls, including emergency calls, scheduling inquiries, and billing questions.
2. Use of technology: Invest in a reliable phone system that includes features such as call forwarding, voicemail, and automated appointment reminders via text. An integrated practice management software can streamline scheduling and record-keeping.
3. Availability: Ensure that someone is always available to answer calls during office hours. Consider using an answering service for after-hours calls so urgent inquiries are addressed promptly. Making sure that patients feel you are always there for them can cultivate customer loyalty.
4. Patient reminders: Use automated systems to send appointment reminders via text or email. This reduces no-show rates and keeps patients informed about their appointments.
5. Feedback system: Implement a system for collecting patient feedback about their phone and scheduling experience. Use this feedback to make continuous improvements.
A smooth, accessible, and responsive phone answering and scheduling system is just one aspect of enhancing the patient experience. Here are additional strategies to consider:
1. Personalized care: Treat each patient as an individual. Personalize interactions by using the patient’s name, remembering past conversations (via a note taking app on your system that allows you to keep a record of what customers have said), and addressing their specific needs and concerns. Show empathy when patients are nervous or distressed.
2. Comfortable environment: Create a welcoming and comfortable environment in your office. This includes a clean and pleasant waiting area, friendly staff, and amenities such as free Wi-Fi and refreshments.
3. Clear communications: Ensure that all communication with patients is clear and understandable. Avoid using medical jargon and take the time to explain procedures, treatment options, and costs thoroughly.
4. Follow-up: After treatment, follow up with patients to see how they are doing and to address any additional questions or concerns they may have. This shows that you care about their wellbeing and are committed to their health.
5. Patient education: Provide educational materials and resources to help patients understand their dental health and the importance of regular check-ups and treatments. This can include brochures, videos, and information on your website.
Part 2: Communicate insurance information to patients clearly and
When it comes to dental insurance, a lot of patients will call and ask, “Do you take my insurance?” This question can mean different things, including:
“Can your clinic file the insurance?”
“Is your office in-network or out-of-network?”
To prevent patient frustration and uncertainty, you have to know how to answer these questions effectively. Because while some practices may require cash payment for their services and then ask the patients to submit their own insurance claims, this is rare. Most clinics will file insurance for the patient— especially if there is some type of out-of-network coverage.
So the most useful information you need to convey to your patients is:
● What are the in-network and out-of-network dental benefits?
● What percentage does insurance pay for preventative care like exams, X-rays, and cleanings?
As long as the dental insurance covers out-of-network preventative care, this can give the patient a chance to set up an appointment to have an exam, take an X-ray, have a cleaning, and see what their treatment needs are.
You can then go ahead and make a treatment plan for them, as well as create an estimate of insurance benefits. This way, remaining fees can be determined for the services that are required. All of this can be explained to the patient before the treatment is carried out, giving them peace of mind and clarity.
One challenge for dental clinics is being able to tell a patient if the office is in-network or out-of-network.
It seems like this would be simple. But in reality, sometimes a clinic is in one dental network but there is a third-party administrator who also links other insurances to your dental office. This is where things can get complicated for both your front desk team and your patients.
So, for instance, your front desk team may think that you are out-of-network but you are actually an innetwork dental office. This means they might be giving out the wrong information to potential patients—and losing them as a result. You want to avoid this at all costs.
Alternatively, a dental clinic may think they are in-network, but because they have multiple dental providers and multiple dental locations, the insurance company may have failed to credential all of the locations or providers.
In this case, if the patient is seen for services and it’s supposed to be in-network, their dental insurance may treat it as an out-of-network claim (if it was at one of the locations or providers that wasn’t on the insurance credential list).
Because of these variables, when the patient asks the dental office if it’s in-network or out-of-network, it’s easy for your clinic to give an answer that may not be consistent with how the dental insurance ultimately treats the claim. So what do you do?
It’s a good idea to train your front desk team in the following script:
“We will be happy to file your insurance. However, please note that we’re in-network with a lot of different insurances. Because many of these insurances are paid under different plans that you may or may not be in-network with, we recommend that you please call the toll-free number on the back of your card. This way, you can get the right information from your insurance company.
Most insurances will cover your preventative care for exams, X-rays, and cleanings. So we recommend that you get all the information you need, schedule an appointment, and then our benefits specialist can call you prior to the next visit if you do not have coverage at our office for this visit.”
This keeps the communication between the insurance providers and the patients, meaning that your clinic isn’t caught in the middle if there’s a miscommunication. Your clinic can support your patients most by helping them determine if there’s some out-of-network benefits for preventative care, then helping them understand these benefits.
Then, if the patient is covered for an initial visit (whether it’s in-network or out-of-network), they can come in for a consultation. This way, the fees can be estimated before the work is performed, and the patient can make better, more informed decisions.
Once patients have had their initial consultation, their next question will be: “Does my insurance have a benefit for preventative care coverage? Also, is this preventative care available both in-network and out-ofnetwork?”
Trying to figure this out is important because many policies will cover most of the expenses for the initial exam, X-rays, and cleaning at most dental clinics. And if there is a small balance remaining, the dental office may even choose to discount the preventative care to make this initial visit easier for the patient.
After all, these initial visits are a great opportunity for patients to get to know your clinic and for you to get to know them. Then together, you can work out any future fees and the next steps for treatment.
It’s a good idea to record any benefits provided on an initial visit in your practice management software.
This means that information will be in your system for future patients with that same group insurance number and same plan. This creates a smoother experience for customers and also means your team won’t
have to waste time looking it up again.
If there are no benefits at your clinic, what are the other ways you could help a patient? For instance, are there dental membership plans or other schemes that can help?
A good initial workflow is to:
1. Help the patient get all the key information from their insurance provider.
2. Schedule them for an appointment.
3. Do a benefits check to see if there is out-of-network coverage for preventative care.
4. If there is only in-network coverage for preventative care, then make sure your office is in-network.
5. If your office is out-of-network and they only have in-network benefits for care, then make sure you’re
ready with alternative ideas for patients—and give them advance notice—so they won’t be surprised when they arrive.
In this way, you’re offering patients the best customer service and treating them as a valued individual.
Dental membership plans can have different structures. For instance, sometimes there is an annual fee that includes certain procedures, alongside a reduced fee for other procedures. With other plans, patients might have the option of paying monthly.
Having flexible payment options for patients—including annual and monthly memberships—means they are more likely to join the plan. Either way, it’s good to prepare a simple summary of the plan the patient can easily understand, for instance, via your website and as a front desk pamphlet.
When patients are considering signing up for a dental membership plan, it’s good to highlight that with many plans, the annual fee is cheaper than the monthly fee. Also, with dental membership plans, larger procedures may have a different fee schedule specific for the plan, or it might have the fee reduced by a certain percentage of the normal fee.
A typical script could be:
“Your annual fee of $X includes an exam, cleaning, and X-rays twice a year for $X each time. This fee can be paid annually or monthly. Plus, if you need a dental procedure, you will save X percentage off the regular fee. And if you just do two cleanings a year, you will save $X by being in the plan.”
Having a dental membership plan script that your front desk team can use makes it a whole lot easier to get people to sign up. You also want it to be simple for your front desk to find the start dates for the membership, and any other key details. A plan that can be explained easily encourages your patient to seek preventative care.
Part 3: Handling calls about costs effectively
What do you say to a patient when they call and ask, “How much does it cost for this type of procedure?”
How can you be sure what procedure is needed when you’re talking to someone over the phone without a consultation? Even dentures or implants have lots of variables to treatment.
For instance, dentists need to know what extractions will be needed before a partial is made. And what type of partial are they going to make? Is a bone graft needed before the implant? Is a core build-up needed before the crown is done? The list of considerations can be endless. If you don’t have all the information,
then you aren’t going to be able to provide an accurate answer about the costs of treatment.
So what’s the solution for your front desk team? Simple: encourage the patient to have a consultation to see what’s needed. A consultation provides an opportunity to carry out a full exam, plus explain to the patient the recommended treatment and the fees. This will help them know what to expect and understand what’s needed.
So how should you handle these calls effectively?
Depending on your type of practice and the circumstances of the call, you may want to tell the patient:
“We offer a quality, caring service and stay priced in the middle with our fees. But to make sure you get the right fee information, we highly recommend a consultation first. That way, we can identify your needs and give you the most accurate information.”
By recommending a consultation first, you can see exactly what the patient needs so you can answer any questions about treatment and fees. After explaining this to the patient, aim to remove any obstacles that they might have around coming in for a consultation.
So, for instance, if the patient has insurance, then there is probably a benefit available for a limited exam
and an X-ray. This can provide an incentive to come in for a consultation.
If the patient is uninsured, then make sure you have a plan for how to handle this. For instance, for some procedures like orthodontic consultations, dentures, or crowns, you may want to simply offer a free consultation. But if it’s a toothache and you aren’t doing free exams for this, then have a set fee that you can tell the patient so they have all the information in advance. For instance:
“Our emergency consultation fee is $X. That includes an exam and an X-ray. Once you have the X-ray and exam, we can fully explain what treatment is needed and the fees for these, such as fillings, crowns, root canals, extractions, implants, or partial implants.”
If the patient has an expectation of what the consult fee will be, make a note of this for the clinical staff.
So if the patient was told it would be a free consultation for braces, then make sure this is noted so there are no surprises.
The goal is to remove all obstacles to a patient coming in for a consultation and get them through the door.
This way, they can take their first step to getting the information they need about treatments and cost.
Dental emergencies never happen at a convenient time and patients will always remember a dental office that helps them in their time of need. Making that first good impression can lead to a relationship that lasts a lifetime.
One rule of thumb is to remember that if it’s an emergency in the patient’s mind—even if it’s not technically a dental emergency—then you need to show empathy and responsiveness. You also need to show a commitment to solving the patient’s problem as soon as possible.
This is why dental offices need to have good systems in place to prepare for emergency calls. It’s also good for the front desk to have blocked off times for dental emergencies, as this means patients can be seen sooner.
But how do you deal with emergency calls in an efficient way? After all, it’s hard when you don’t see the patient to know exactly what’s needed. So the more information you can get on the phone, the more you can help both the patient and the dentist.
But first, you have to find out if the patient is experiencing an actual dental emergency.
As we’ve highlighted, if it’s an emergency in the mind of the patient, then it’s an emergency. Accepting that something is an emergency for a person is the first step toward building trust in your clinic.
That said, it’s still good practice to train your front desk team to be able to make a distinction between real emergencies and perceived ones. To help define a true emergency, we have a few tips to help phone staff work out who needs to be prioritized to be seen right away.
When the patient is asking to be seen right away, get as much information as possible. If it’s an existing patient, you may then be able to pull up an X-ray to help you make an assessment. However, patients need to be seen right away if:
- The tooth was worked on recently and a crown was added.
- A temporary crown has come off.
- A final crown has come off.
- Part of an implant is out.
- The tooth was worked on recently for a filling or a crown and the bite doesn’t feel right.
- There is lingering pain that doesn’t go away.
- There was recent dental work, such as a filling or root canal.
- The tooth has been extracted and the patient is experiencing swelling or pain that’s the same or worse than before.
- A tooth was broken and is cutting their tongue.
However, it’s key to remind patients that usually the third to fifth day after an extraction is the worst for pain. That is why patients tend to call around the third day. You don’t want to promise medication to these patients because they will need an evaluation first. But do tell them that you’ll let their insurance provider know, as it may be something they can handle over the phone.
If the tooth is broken and is cutting their tongue, then get the patient in promptly. In the case of a tight schedule, offering a procedure like quickly smoothing an edge could be an option if the patient wants to be seen right away.
With emergency calls, you also want to ask the patient how and when the issue started. For instance, if they had an accident or suffered trauma to the head or neck, then that’s going to make it more of an urgent emergency.
1. “Are you hurting? Which tooth is hurting? When did it start?”
Then ask the patient to describe the pain. What makes it sensitive? Is it sensitive to chew or is there throbbing? Is the pain constant? Does the pain stop when they are no longer biting down and the tooth is no longer exposed to cold?
If the pain doesn’t stop when they aren’t biting or aren’t exposed to cold, then this is an emergency that should be seen right away.
2. “Is there swelling?”
If the answer is yes, then that would be an emergency.
3. “Is there a non-tooth related pain?”
If so, this could be:
- A cold sore.
- Mouth ulcers.
- Lesion or spot on the tongue or the cheek.
- Bleeding or soreness of the gums.
- Soreness from a full or partial denture.
- Muscle-related jaw joint pain
Make sure that your front desk team is trained not to feed people answers but instead try to get the actual facts. Just let the patient describe how they’re feeling and record that for the dentist.
When training your front desk team, make sure they know that the following are considered to be true emergencies that should be seen on the same day:
● Knocked out tooth.
● Recently broken tooth.
● Lingering pain.
● Swelling.
Although the following are considered less urgent, they should still be looked at as soon as possible:
● Cracked or broken teeth that may not feel pain and are not cutting the cheek or tongue.
● Issues with little to no pain.
● Pain that started a week ago or over time.
● Pain that goes away when not exposed to heat or cold.
Another thing to find out is whether a patient is willing to come in to wait for an appointment. While you don’t want to guarantee a time, this is a way to have a patient seen and for them to feel reassured that you are being responsive.
Although the following are considered less urgent, they should still be looked at as soon as possible:
● Cracked or broken teeth that may not feel pain and are not cutting the cheek or tongue.
● Issues with little to no pain.
● Pain that started a week ago or over time.
● Pain that goes away when not exposed to heat or cold.
Another thing to find out is whether a patient is willing to come in to wait for an appointment. While you don’t want to guarantee a time, this is a way to have a patient seen and for them to feel reassured that you are being responsive.
It’s good to have a process that allows you to greet a new patient in a warm and professional way when you answer the phone. Next, you need to get the right information from them early in the conversation.
Take a moment to ask some questions and build a relationship with the patient, and then take time to answer any questions and share information about the office. Having a form to fill out for new patients will help you go through the process and quickly write information down. This information can then be stored in your practice management software.
Next, make sure you secure an appointment for the new patient—that’s the most important goal.
When you first answer the phone, to find out if it’s a new patient, you may want to ask them, “When was the last time we saw you here?”If they are a new patient, make sure to get their contact information early in the conversation. This includes their:
● Name
● Phone number
● Email
● Insurance information
● Referral sources
A good way to get this information early is to say “In case we get disconnected, can I get your name and phone number?”
And in order to build a relationship with the patient, train your front desk team to ask open-ended questions to get to know them and find out their concerns. You also want to make sure you can help resolve their concerns about locations, appointment hours, insurance, or procedures. It’s also nice to have something positive to share about the office, for instance, “We have a comfortable waiting area with free WiFi and offer refreshments while you wait.”
Also, if you’re spending money on advertising, when you get a lead for a new patient, you don’t want to
take that initial call for granted. Ideally, you want to:
● Find out the referral source e.g. a social media advert.
● Convert the call into an appointment.
Finally, remember to thank the patient for calling and make sure all of their information is recorded in your system.
You also need to have a script in place for phone calls from existing patients.
Identify early in the conversation if the person is an existing patient and offer them a warm thank you for calling again to show that you value their loyalty. Also, it’s good to confirm the patient’s phone number and address early in the conversation to ensure you have their latest information.
Once those questions are answered and you have dealt with the inquiry, make sure you have a good closing line, like, “Is there anything else that I can help you with?” This shows a commitment to customer service and offering ongoing support. Plus, it can help you promote other services, offers, membership plans, and even dental products.
When it comes to scheduling new patient appointments, you want to be as accessible and responsive as possible. You also want to get new patients booked in as quickly as you can. So how do you do this?
Smart ways to schedule new patients quickly
There are two systems that you can implement for this:
1. The hygiene block.
2. The new patient dentist exam.
Many existing patients make their next cleaning appointment while they’re still at the dentist getting their current cleaning. This means that many hygiene schedules can be fully booked out for several months in advance, making it difficult to find space for a new patient who wants to schedule quickly for a cleaning.
Also, a new patient appointment can take more time than a regular visit and may not fit into available time slots, even if an existing patient cancels.
Because in addition to scaling and polishing, a new patient may need:
● X-rays.
● Periodontal measurements.
● General charting.
That is why it is crucial to have new patient hygiene appointment blocks in your schedule that are longer than hygiene slots for existing patients.
Hygienists also have the same issues when they’re trying to schedule periodontal therapy. Gum treatments can take longer than a regular routine prophy, and sometimes hygienists see a patient and then want them to come back for periodontal therapy as quickly as possible. But you don’t want to be looking months into the schedule to find an appointment for this urgent periodontal therapy for the patient.
So having a hygiene block schedule is basically a way to save time on the schedule for both new patient and periodontal therapy appointments.
Here’s an example of the system and how it can work: let’s say you determine that on average, each hygienist needs to see one new patient or perform one periodontal therapy patient each day.
And let’s say that the length of the appointment needed for new patients or periodontal therapy is slightly longer than the routine cleanings scheduled in advance for existing patients. If the hygienists are the ones who typically schedule their patients and they like to set their own schedules, then let the hygienist put a new patient block for the required amount of time on the schedule for at least one year in advance.
This block should also be at varying times of the day and on different days to accommodate patients’ needs. Also, in order to keep the schedule continuously blocked a year or more in advance each month, hygienists will have to add another month’s worth of blocks a year into the future. This keeps the time saved on an ongoing basis and also keeps the schedule responsive to patients’ needs.
If a new patient calls then you can use that time reserved for them. Or if the hygienist sees a patient who needs periotherapy, the same reserved block could be used instead. These blocks need to be saved for those two purposes.
You also don’t want to release the block until a certain time period, maybe a week or less from the current date. It’s important to keep those blocks on the schedule for new patients and for periodontal therapy.
But now let’s say it’s within a few days of the appointment and the space hasn’t been filled with a new patient or periotherapy. When that happens, you can move a regular appointment into that space inside of that timeframe (if it’s within a few days or less). And if you find that you aren’t using all of the spaces, then ou can adjust the number of reserved spots to meet the needs of the practice and the patients.
Now, for new patient exams prior to cleaning, patients need to be reminded of this when scheduling hygiene appointments (especially if your hygienist and dentists like to do an exam and a cleaning on separate days).
So, the script for your front desk team can be, “We want to get to know you as a patient, including your issues and concerns. We want to figure out the best way to improve your smile long-term, together. That’s why we have special blocked off hygienist appointments for new patients—so we can spend more time with you.”
Then, in their first visit, you can create records and make a treatment plan. As every mouth is different, you’ll need different treatment plans, including for periodontal care. So you need to see what type of periodontal therapy is needed at the initial exam. For this reason, you don’t always combine hygienist appointments with the initial appointment.
The second tool apart from the hygiene blocks is the new patient dentist exam. For one, scheduling with the dentist and the assistant can be a great opportunity to get to know the patient. This can be especially useful if the patient indicates they have a priority dental concern. It is also a useful strategy for securing a new patient when there’s not enough time on the hygiene schedule to get the patient in quickly.
Also, it’s important to remember that many new patients may need periodontal therapy, so will be unable to start the cleaning at the initial visit with the hygienist anyway.
If your goal is to get new patients in for an appointment within two weeks or less, you may want to set a guideline. For example, if the hygiene schedule has no openings within two weeks, you can offer a new patient exam with the dentist. It’s just another avenue to help get the new patient in sooner and give them a choice based on the available schedule.
This will be especially helpful if the patient really wants to be seen urgently, as it gives them options.
Remind them that sometimes you schedule the hygienist to do the initial visit and sometimes you schedule with the dentist—it’s all based on what you have available.
So a front desk script could be, “You can have this time with the dentist, and you can have this time with the hygienist. Which time would you prefer?”
It’s a good idea to set scheduling guidelines for each dentist, so find out their ideal time for those new patient appointments. You may want to schedule these at different times of the day to work with the dentist’s flow.
For example, you may want to consider scheduling some new patient exams earlier in the morning or earlier in the afternoon after lunch, rather than later in the day. This is going to give you more opportunities to shift that new patient appointment.
To illustrate, imagine there’s a restorative patient that cancels. You could keep that slot for a new patient coming in that day, just in case they need restorative treatment. This way, they can get their restorative treatment on the same day as their initial appointment. This creates a smooth, speedy, and convenient experience.
Or if a hygiene patient cancels and a new patient is ready to have a cleaning, then you could give them the canceled slot so they can get their cleaning on that same day. Again, it just makes your dental practice seem more efficient.
Make sure to create slots for form-filling. Sometimes, new patients need to fill out certain forms and this can cause delays, but you can minimize those by asking them to do that ahead of time or come in earlier.
You may even be able to schedule this new patient as your first patient of the day in a second column. This gives you a productive start as you can have multiple chairs filled from the get-go. And these opportunities will be easier to utilize in general if the patient is there earlier in the schedule to have their records completed and ready.
When an assistant is present for new patient exams, this makes it much quicker and easier to create a treatment plan for a new patient. In fact, it should then take a similar amount of time as a hygiene appointment.
The assistant can help facilitate record gathering and charting, speeding up the process and freeing up time for the dentist. This means that the dentist should be able to come in and do a new patient exam in a similar amount of time as a hygiene appointment. Having an assistant present for those initial new patient examinations makes all the difference.
But what should the dentist and assistant do at a new patient exam? Essentially, you want to do the same as what’s normally done in the hygiene schedule for a new patient exam. Most likely, there are going to be many similar things that should be part of both, whether that exam is done in the hygiene or the dentist column. For instance, radiographs are probably going to be key, whether it’s panorex or bite wings.
You also want to make sure that your practice management software is updated with all of the patient’s dental needs and history, as well as their medical history review. Plus you’ll want to include a head and neck exam, oral cancer exam, and a periodontal screening.
Frequently, periodontal charting is done by the hygienist in the hygiene chair and, less commonly, in the dentist chair. The dentist may also want to do a spot probe or a PSR screening as part of an initial periodontal screening, just to make sure there’s a good initial plan for the hygiene appointment (especially if the dentist doesn’t have time to do the full periodontal charting on that day).
In short, you need some initial periodontal screening ahead of the patient’s hygiene visit. This way, you can plan for the visit, identify what type of cleaning is needed, and decide if you need to plan coordinated treatment with the periodontist too.
Another key aspect of a new patient appointment would be treatment planning, including identifying:
● What are the patient’s urgent needs?
● What restorative treatment needs to be done with the dentist?
● What periodontal treatments need to be done with the hygienist or the periodontist?
● Do you need to do any benefit checks with their insurance provider?
● Do you need to send any pre-authorizations?
● Do you need to talk about financing or dental membership plans with the patient?
Whether you have insured or uninsured patients, make sure you have your system organized so that it’s clear which codes are walked out on the hygiene and dentist schedules. This keeps everything consistent and cuts down on admin time. Then it’s just a matter of putting these systems in place.
Most important of all, set a goal of being as accessible and responsive as possible to your new patients. Remind new patients that your goal for the first visit is to get to know them, their concerns, and their dental health goals, as well as making a plan for any further treatment.
In summary, there are many ways to handle the new patient exam and this may vary from practice to practice. The key takeaway is that the combination of having an assistant and a new patient dental exam can play a valuable role in helping to get the patient in sooner—and it can turn them into a loyal customer.
First-time patients at your dental practice will tend to book one of the following appointments:
● A new patient examination (comprehensive or limited) with the dentist and assistant.
● A hygiene appointment.
● An emergency appointment.
Let’s look at each of these in turn and outline how you can streamline them for a more efficient practice— and better patient experience.
If a new patient doesn’t have a dental emergency, but they want to become an established patient in the practice, then you want to get them in as soon as possible. When you fail to do so, you risk losing them to another practice.
However, the issue is that new patients often want a hygiene appointment. Yet the hygiene schedules may be full, and even when an opening is available, you may not know if the patient needs a prophy or periodontal therapy until you see them. This can complicate the issue.
Also, the patient may want a routine cleaning but in the process, you may find that they also need fillings.
You won’t know what your patient really needs until you see them and do a new patient examination.
That is why having an initial appointment with the dentist and assistant can be a great first option for a new patient. It creates a chance for them to get to know your team and for you to get to know them. It also gives you a chance to offer them a warm welcome and impress them with your care standards.
So if the hygiene schedule is full, try to encourage the patient to come for a dental appointment instead.
Explain the benefits of this to them and try to find a time that suits them best. This way, they get to meet everyone, plus you can focus on their needs and concerns, then create a tailored plan for them.
Also, if the patient is new, then their initial dental appointment will usually include a lot of record taking, for instance, X-rays, medical history, and dental charting. And when you get this information, it can be very helpful for the hygienist too. This should be stressed to new patients calling for the first time—that an initial dental appointment is a much better first step than a hygienist visit.
Having a new patient see the dentist and assistant first helps the hygienist get the key information they need to offer the best service. A new patient exam with the dentist is also an opportunity to create a treatment plan for any restorative or periodontal needs. Plus you can ask any essential questions about insurance benefits before the treatment starts.
Whatever you find is most appropriate, you can start there, whether it’s preparing records for a hygiene visit or planning for a restorative treatment. All of this can be addressed at an initial exam with the dentist and assistant. And if there’s a need for oral surgery, an endodontic, or some form of urgent care, you carry out that too.
That is why it’s very important to communicate with the patient ahead of time that a new patient exam with the dentist is in their best interest, even if they just wanted a hygienist slot. You can tell them that:
“This is an opportunity for you to get to know us and for us to get to know you. We’ll get all the records that we’ll need for later—including for the hygienist—and we can customize a plan based on your needs.
What’s more, if you need any emergency treatments, we can schedule that in sooner rather than later. Bear in mind that urgent dental issues can sometimes be symptomless, so we won’t know what we need until we see you.”
If they have any urgent care, restorative care, or hygiene area care that’s needed, then you can make a treatment plan, review the benefits, and carry out the next steps in the most efficient way possible.
Typically, in a comprehensive exam, a lot of new patient record taking will be done by the dental assistant. This is why it’s important to create space in assistant columns for new patients. Make sure to save blocks on the schedule for this, or simply have an extra column and chair for new patient exams with the assistant and dentist.
One good practice is to call this a ‘ghost column’ or ‘second column’ and have it set aside as a time when the second assistant can do the records. It is also a good idea to have a rover assistant on hand to help too. It will take less time for the dentist to check these patients once the records and treatment plans are in place, making your practice much more efficient.
Then, once the patient treatment plan has been made, you always have the opportunity to move that patient into the hygiene column or to the restorative column if there is an opening that same day. Again, patients will be impressed at the speediness of your service.
With this in mind, you may want to look at scheduling new patient appointments first thing in the morning or right after lunch, so that you’re always on time. Plus you’ll have more opportunity after the records are done to look for openings the same day in the dentist or hygiene chairs.
Of course, to meet people’s varying needs, you should also have new patient slots at other times. It just depends on when the chair and assistant are available.
For this kind of appointment, you should:
● Get the records that you need related to the chief concerns of the patient.
● Make a treatment plan.
● Start to review benefits.
For your records, you will also want to obtain certain radiographs, such as a panorex and bite wing X-ray (if you don’t already have that), as well as intraoral photos. These are a big plus, as it’s very helpful for the patients to see what’s going on by looking at their own photos. It can really help them to feel closer to their treatment and understand the importance of certain procedures.
However, there’s often not enough time in the hygiene chair to do radiographs and X-rays alongside the cleaning. So in terms of patient education (which should always be centered in a good dental practice) this is a good opportunity to bring the person up to speed on their dental health via intraoral pictures.
You should also update their medical history, update the charting for any dental findings, and then record the chief complaint (if there is one). You should also chart any current needs, any other issues that you see, and other treatment needs. You can make a treatment plan at this time, too.
The treatment plan can be recorded as simple notes in your computer. Or you can formalize and streamline it via good practice management software, for instance, one that lets you group certain codes into specific treatment plan options. By making formalized treatment plans, you can even prioritize them by stages.This will provide good information for your staff that can help them when doing an insurance benefits check.
1. Make a treatment plan, including services, fees and insurance codes.
2. Encourage the patient to schedule a follow-up appointment (perhaps around three weeks later) so that you can save time in the system for the procedure.
3. Make sure that your treatment coordinator communicates with the insurance provider using pretreatment estimates, or checks benefits online to estimate patient copays.
4. Reassure the patient that you will check benefits for any procedures they need (especially if these will exceed a certain cost). Also reassure them that you will follow-up on this before their next appointment. This way, the patient has all of the benefit information they need prior to the
appointment, meaning that any necessary payment plans can be put into place.
5. If the patient wants to discuss fees prior to scheduling the procedure, then you can book a second consultation in the office. This can be with an assistant (which would free up time for dentists), who will review fees with them. However, if the patient is ready to proceed then you can begin
with a simple step, for instance, taking a study model impression to start a denture.
6. If the patient doesn’t want to schedule a follow-up appointment then and there, ensure that your front desk team makes a note on the schedule for three weeks’ later to remind them to follow up.
Whatever system you use to check benefits, you will have all the treatment information needed to research and answer the patient’s questions about cost. But if it takes extra time to do that, you can ask the patient if they want to start treatment now or would prefer to do a second consultation, after you have completed the insurance benefits check.
Once the patient is ready to proceed, it is then just a matter of scheduling their treatment—whether it’s something that can be done that day in the hygiene or the dental column, or something that can be scheduled based on its urgency in either or both of those columns at another date.
Now the new patient is finally established in your practice. And in this initial meeting, you’ve really taken an opportunity to get to know them, make them aware of any dental concerns, and outlined the treatment options available to them. You have also prioritized their next steps, so that you can build an ongoing relationship.
Make sure to set an appropriate fee for a new patient exam based on what was done. For instance, did it involve X-rays or periodontal probing? This may also involve a limited exam if it was treatment planning without periodontal probing (and the patient can return for or periodontal probing later with the hygienist if it wasn’t done at that initial visit).
In summary, a new patient exam with the dentist and assistant can be a great opportunity for the patient to be seen by the dentist sooner. It also means that record gathering can be carried out sooner by the assistant.
Missed appointments can be a drain on your practice. They are also a lost opportunity to help a patient, so it’s important to understand them better and figure out why they happen. This way, you can learn how to prevent them.
To cut down on missed appointments, your two key goals should be:
● Retrain your patients about the importance of keeping their appointments (it’s crucial they know this time that is reserved just for them).
● Monitor your broken appointments, including any patterns or trends.
Firstly, let’s define the difference between the different types of missed or changed appointments.
A failed appointment is a no-show patient who isn’t there at the appointment time and has given no notice of this.
A broken appointment is an appointment that is canceled or changed with less than 24 hours’ notice.
A rescheduled appointment is when a patient calls more than 24 hours in advance of the appointment to change it.
Thorough documentation is necessary in overcoming this issue. You need to track the frequency and the reasons for missed appointments. You also need to keep a note of the reasons for why they are happening (which can involve calling patients who broke an appointment to try and find out the reasons why).
After all, you can’t really prevent missed appointments until you have better insights into how your patients think and feel about them. You have to get inside their heads before you can solve the issue.
So you need to find out, “What reasons are our patients giving for missing appointments?” And to know this, your front desk team needs to take a note of the patient’s reasons for breaking the appointment. This needs to be recorded in your practice management system so that you can keep track of patterns.
Your front desk team needs to make sure to ask the patient, “Please can you tell me why you need to cancel or reschedule? I need to record this in your chart so that I can pass it on to the dentist.” And then write this information down.
Then you can start to track patterns. For instance, are patients more likely to cancel appointments that take place at a certain time? A certain day? Or for certain procedures or checks? This way, you can put systems in place for managing this.
Beyond recording and tracking the reasons for missed and rescheduled appointments, you need to train your patients to behave differently so that they commit to keeping appointments. And you need to have a call flow system in place for doing this.
First off, prevention is key—make sure that when new patients register with your practice, they know about any policies you have around missed appointments. And make sure that they are reminded of this each time they call to book one.
So from the very moment an appointment is made, you need to politely remind the patient that:
● This is a valuable time reserved just for them.
● You need more than 24 hours’ notice to reschedule an appointment.
If someone breaks an appointment less than 24 hours before, then don’t simply respond with, “Okay, Brian, let us know when it’s convenient for you to come in for the appointment.” Your team needs to let them know that it’s important for them to keep this appointment—and try to encourage them to come in.
Instead, you could train your front desk team to say: “We were looking forward to seeing you. Can you give us an idea of why you’ve had to cancel?” Also, you should mention that other patients would have valued this slot but it’s now too late to get them in.
Make this a teachable lesson—let them know that these appointments are valuable and not easy to reschedule. Your tone of voice will be helpful because patients have to be able to hear your disappointment, so let it come through. You want to reduce missed appointments by changing people’s
behavior, which is partly done through getting them to see your side of the situation. Help them to recognize that they should have contacted you sooner about their appointment.
Also, don’t say, “Do you want to reschedule now or call back when you know a time?” Instead, it’s better to say, “Let’s reschedule your visit now.” You want to reschedule the patient straight away, especially if it’s a new person that you want to retain.
“Perhaps we never told you or maybe you forgot. But we typically have a broken appointment policy when there’s less than 24 hours’ notice. This means that we would have to lock your account and to unlock it, you would need to come into the practice in person to sign a form. I’ll make an exception this time, but I’m going to note it in your chart.” Then you can reschedule the patient.
You could also mention that many other patients are waiting for their treatment, yet it’s going to be practically impossible for you to call them in at such a short notice. Make sure that they know the effects of missed appointments on your team and other patients.
If the patient has a second missed appointment—and if it’s been noted in your system that you have given them prior warning of actions such as account locking—then you might want to go ahead and lock their account.
If a patient doesn’t call to cancel and simply doesn’t show up, then you can call them to express disappointment and take the same steps as above (depending on whether it’s the first or second time they’ve done this). If you can’t reach them on the phone, then you could send them a letter outlining the same information.
● Protect your appointment system from further cancellations or no-shows by asking them to pay a deposit over the phone (for instance, $25).
● Or lock their account and ask them to come in and sign an unlock form—or pay a deposit instead.
To summarize, there are a number of approaches that you can use with patients to change their behavior around missed appointments:
● Gently express your disappointment on the phone.
● Or express it by letter if you can’t reach them via the phone.
● If it’s a first no-show / cancellation / rescheduling in under 24 hours, then tell them that you won’t lock their account this time, but will keep a record in the system.
● If they miss their appointment a second time, then you could lock their account and explain that they will have to come into the clinic to unlock it via a signature.
● Alternatively, ask them for a deposit for future appointments.
● After unlocking their account, you could impose a 30-day waiting period before they can book again
Note that these tools aren’t ‘punishments’, they are just about encouraging behavioral changes that will keep your practice running more smoothly and benefit everyone as a result.
Let’s explore the account locking system further. ‘Locking in’ is a process where patients are informed that no further appointments will be made until they stop by the clinic to sign paperwork to unlock the account. Even after they have signed this, you may want to impose a waiting period before they can book future appointments.
The goal is to change their behavior pattern and prevent failed appointments—even if you’re not charging a fee for those appointments. In order to do this correctly, you need to train your front desk team to monitor missed or rescheduled appointments, take a note of the reasons, and log them in the system. Then you can run reports to spot any patterns.
Preventing missed appointments via patient re-education is a continuous process that requires constant front desk team attention and focus. Yet it’s also worth it as it can keep your dental practice busy and running smoothly.
● Make sure that patients know and understand how the appointment system works. For instance, more than 24 hours notice from the appointment time is needed to reschedule without having it classed as a broken or failed appointment.
● Express disappointment when a patient breaks an appointment.
● Record all broken, failed, and rescheduled appointments in your notes.
● Implement consequences for repeat offenders, for instance, temporarily locking accounts, asking
for deposit for future appointments, or imposing 30-day wait periods.
Also, take note of any patients who tried to change or reschedule an appointment but the appointment coordinator was successful in discouraging them. That’s because you want to reinforce desirable behavior by thanking that patient for keeping their appointment.
The key goal is to reduce missed appointments by educating your patients effectively.
Sometimes, you can’t see a patient as soon as they want. So what can you do? If it’s an existing patient, then how can you retain their loyalty? Or still encourage them to come in if they’re a first-time patient?
How can you make them feel valued?
This is where a quick call list comes in
Basically, a quick call list is a system that can make it easier to move patients to earlier appointments when they become available. A quick call system can help by first getting the patient an appointment and then making it a priority to move that appointment up sooner, if possible. It is a way to be responsive to patients’ needs when you don’t immediately have the appointment time they want.
First, you need to book an initial appointment, even if it isn’t as soon as they want. That way, their slot is secured and they’re in the system, even if it’s longer away than they preferred.
Then offer to call the patient to move up the appointment if an opening appears sooner. However, it’s important that you have a good system in place to track and manage this.
One simple way is to include a note on your system beside the patient appointment that says ‘sooner if possible.’ You may want to also include any specific details about the patient’s preferences, such as a morning or afternoon time slots, or certain days of the week.
However, you can also try other methods to help move up the appointment and make it a priority. For instance, many practice management softwares have an option of creating a quick call list. This way, when you schedule the appointment, you may be able to click on a tag such as ‘sooner if possible,’ then pin it to the scheduled appointment.
Then, when you have an opening in your calendar (for instance, from a missed appointment), and you’re looking for patients that want ‘sooner if possible,’ then you can run a report and match them to slots. This cuts down on lost appointments and it also shows excellent customer service that your patients will appreciate. They will see you as a proactive practice that puts their needs first.
While practice management software can be a useful tool for matching ‘sooner if possible’ patients to free appointments, it’s important that your front desk team is fully trained in this. Also, if your practice software does not accommodate this process, then there are alternatives.
For instance, a plain piece of paper can serve the same purpose. All you have to do is make a list of names for your quick fill list. And you can cross off names on the list after the appointment is moved up. It’s also good to include the basic information that you need, such as:
● The date of the appointment.
● The type of appointment the patient needs.
● The patient’s date, day, and time preferences.
Take time to consult with your front desk team to clarify which system works best for them.
Also, when changing an appointment, always remember to cancel any duplicates in the system. You don’t want patients who have already been in to be called by your front desk team on the date of their original appointment and asked where they are.
Whichever system you choose, your patients will be seen sooner and will be more satisfied as a result.
They will see your practice as a flexible and responsive one that has their best interests at heart.
Now let’s explore a key aspect of good dental clinic management—phone documentation. We will look at:
● Why it is important.
● What should be documented.
● Where records should be kept.
It is important that when a patient calls and asks a question, your front desk team responds seamlessly and consistently. This creates a much better patient experience.
Making and sharing notes about phone communications also helps each employee to recall previous conversations. Plus it aids with briefing other team members on what has previously been discussed.
Essentially, you want to maintain good communications between your front desk and clinical teams, so that nothing about a patient gets overlooked.
It’s much better if the front desk team has all the details they need to hand, so that patients don’t have to repeat themselves every time they call. This makes patients feel seen and valued, and prevents them from becoming frustrated. Part of building a relationship with people is showing familiarity with their concerns, rather than treating them as a stranger who has phoned up for the very first time.
Also, recording this information carefully and routinely helps to avoid any ‘he said, she said’ situations later, where the patient or team member doesn’t have a clear memory of what happened. This can lead to conflicts and complaints, which need to be avoided at all costs. If you document everything that is discussed with a patient, then there will be a more accurate record to refer to when it is needed in the
future.
You should document everything on a phone call that has significance. This can include:
● A billing question.
● Information related to a missed or late appointment and the reason why it was missed, or why the patient was late.
● Any questions that the patient has about insurance or procedures.
As a general rule, you need to train your front desk team to record anything relevant in a conversation, including any patient queries or concerns. Also, if a message is left on a patient’s voicemail to move an appointment time, it is important to document that the voicemail was left and which number it was left at.
Sometimes your front desk team will have to make a judgment about what to record and what not, but as a general rule of thumb, the more information, the better.
Also, for the sake of both follow-up and accountability, it can be helpful for the front desk team member to sign their name on notes, in case there is any need for clarification in the future. However, most practice management systems will automatically log who has left each note.
Most practice management software will have a place for patient note-keeping, although each system will be different. For instance, some practice management softwares such as Fuse have a communication center, which allows you to make an account note that can be referred to later by front desk or clinical staff.
Also, this communication center may show other forms of communication, such as text messages or letters sent to patients, or X-rays emailed. This can be a very useful way of tracking all communications with patients—as well as their records—in one central place. In short, you get a full overview of a patient’s current status and past experiences in the communication center, making it easier to join up information.
Essentially, you just need some form of software or note-taking system that is easily accessible during a phone call. And once you get your note-taking and documentation system up to speed, you will be able to create a better customer service experience for all of your patients.