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Dental Consultants Best Reopening Tips

Dental Consultants Best Reopening Tips

Staff, PPE & PPP

Staff

 

Many dentists are making it clear to staff that if they cannot come back you will have to give their jobs away. There will likely be a fair amount of quality staff looking for work so this might be a golden opportunity to upgrade one or more positions if needed.

Let staff know you are eager to plan out reasonable changes so they feel safe and secure. If practice finances are an issue, ask staff to keep that in mind when making recommendations.

What you end up doing in terms of PPE and safety will in part depend on availability, changing protocols and finances. Do the best you can for you and your staff in terms of PPE and safety taking into account what your state board recommends. Many people are scared. You will be wise to educate yourself on PPE and safety so you know more than anyone else about all the regulations and recommendations. Then make a plan and execute it.

 

PPE and Safety

 

Links

 

ADA: Statement on Third Party Payer Reimbursement for Costs Associated with Increased Standards for Personal Protective Equipment (PPE)

ADA: Get the Return to Work Interim Guidance Toolkit

ADA COVID-19 STATE DENTAL MANDATES & RECOMMENDATIONS - Updated 4/28 4:00 PM

CDC Dental Settings

OSHA Link Guidance on Preparing Workplaces for COVID-19 

 

One dentist suggests a Level 3 mask is plenty or even a better option as it can be changed regularly, insuring a dry cloth on your face that will absorb humidity effectively while an N95 mask needs to be fitted which takes time. Once fitted, if the mask gets humid, it loses its effectiveness. Frequent replacement becomes a problem. Another dentist suggests the following is effective, repeatable and easy to do:

Level 3 mask. Gowns. Face shields.
Rubber dam.
Saliva ejector under the dam.
High vac held by the assistant close to the tooth.

 

Payroll Protection Program:

 

What expenses qualify for PPP loan forgiveness?


Payroll costs, including benefits. Payroll costs include salary, wages, commissions or tips capped at $100,000 on an annualized basis per employee. For employees earning more than $100,000, the correct amount to pay through wages during this 8-week period is likely $15,384.62 ($100,000/52 weeks X 8 weeks).

Employee benefits include costs for vacation, parental, family, medical or sick leave; allowances for separation or dismissal; payments required for the provision of group health care benefits including insurance premiums; and payment of any retirement benefit.

The amount of forgivable retirement contributions may be limited. Make payments for the employer funding, at a minimum, two times to reflect monthly contributions.

For family members, wages received should reflect the same amount of wages the family member received during the period before February 15, 2020. Employee benefits likely do not include individual health plans for owners and their family or Health Savings Account (HSA) contributions for the benefit of owners or their families.

Interest payments in the 8-week period following disbursement of the loan on mortgage obligations, incurred before February 15, 2020.

Only the interest on qualified debt obligations can be used for forgiveness, not principal. If you own your building under a separate legal entity, a building mortgage would likely not qualify here, but would rather be satisfied under the rent provision. If the building is owned in the operating entity, then the mortgage interest is qualified.

Practice acquisition loans, equipment loans, and build-out loans also qualify if they were secured by the business personal property and were incurred prior to February 15, 2020.

For tracking purposes, it is advised to pay interest and principal separately during this 8-week period to make sure this can be easily identified.

Rent, under lease agreement before February 15, 2020

Utilities, for which service began before February 15, 2020. Utilities are listed by the SBA as phone, internet, gas, water, electricity, etc. Both mobile and office phones should qualify.

 

When must funds be spent to qualify for PPP loan forgiveness?

 

Funds must be spent within 8 weeks of loan disbursement. Only qualifying expenses incurred and paid for within this 8-week window are eligible for loan forgiveness.

Employee and compensation levels must be maintained. Reductions in either category may impact forgivable loan allowances.

No more than 25% of your loan is used to cover non-payroll expenses, including mortgage interest, rent or utility costs. Consider opening separate bank account for the PPP loan and only pay qualified expenses from this account.

 

What other factors impact loan forgiveness amounts?

 

If your company also received an advance through the Economic Injury Disaster Loan program, this amount will be deducted from your forgivable allowance.



How do you request PPP loan forgiveness?

 

Loan forgiveness does not happen automatically. You will need to submit a request to your PPP loan provider.

Excellent record keeping is essential to qualify for PPP loan forgiveness.

 

What documentation is required to request loan forgiveness?

 

There is no standardized PPP loan forgiveness process. Thus, lenders may have their own requirements.

At a minimum, we recommend documentation to support the following:

Employment levels and pay rates for the periods before and after PPP loan disbursement. Your lender may request to see:

IRS Form 940, 941 or 944 payroll tax reports

Payroll reports from your payroll provider

Income, payroll, unemployment insurance filings from your state

Retirement and health insurance contributions

If you do not meet the conditions of PPP loan forgiveness, your balance will accrue interest at a fixed rate of 1%. The repayment term for PPP loans is 2 years, though you have the option to pay off your balance early with no prepayment penalty. All loan payments are deferred for 6 months, but will accrue interest over this period.

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What Does A Dental Consultant Do? Charge?

Many dentists will tell you dental consulting works. If dental practice management firms had no worth or benefit they could not stand up to harsh economic realities for long. What a veteran dental consultant brings to the table are systems and protocols successfully implemented in other practices that have been improved and tweaked over many years. Top dental consultants talk and network with each other. They pay attention to what works and what doesn't work across all dental practices.

Marketing & New Patients

Practice management consultants generally have little marketing training or background. 

Note: Cambridge'a consultants are Certified SEO and Ad Words Specialists

Dental Office Systems

Key systems dental consultants implement:

  1. New Patient Phone Call
  2. Insurance Processing
  3. New Patient Experience and Patient Education
  4. Financial Arrangements
  5. Scheduling
  6. Confirmation
  7. Unscheduled Treatment Followup
  8. Reactivation
  9. Huddle
  10. Stat Monitoring
  11. Daily and Weekly Checklists
  12. General Policy Manual

Your Staff

You will not get much ROI from your dental consulting if your staff do not have your back. You do not beed a team of cheer leaders jumping up and down with enthusiasm, but you do need staff who are smart and take some pride and ownership in what they do. If there is more than the usual drama in your practice that needs to be sorted out before you will get any real results.

Staff Accountability 

What gets monitored gets done.

The "big" obvious numbers are important to monitor, but when you look at them they are typically already "in the books". You want your team to concentrate and be accountable daily on the "small" stats that bring about the "big" stats. How many practice owners know how many calls were made to unscheduled patients each day or overdue re-care or inactive patients? Many dentists vastly underestimate how much daily "outflow" is needed to keep a schedule full. How may dentists know what % of slots were open in their hygiene schedule each day? How many know how many NP calls there were yesterday, who scheduled and if they end up showing up? More importantly how many staff know considering it's their job to do?

The only way to monitor what gets done is with daily stats especially for your weak areas. For example, one employee should be specifically responsible for calls to patients who are unscheduled, overdue re-care or need reactivation. Other staff can and should help in coordination with the accountable employee, but that employee accountable reports daily on a spreadsheet like this: 1. # of calls or personal texts sent 2. # of contact
3. # of appointments with name and date 4. # of arrivals

It is the employee who is either making themselves valuable to you or not. If they are doing so, dismissing them will never enter your mind. On the other hand, if they are not making themselves valuable, you will be doing them and yourself a favor by giving them the opportunity to find a practice or other employment that is a better fit for them.  

Leadership

What most practice owners are missing is not how to book an appointment but how to be effective leaders. The best systems in the world are useless if the staff do not comply. Good leaders know how to get staff to willingly follow through and comply. Agreement among all team members is key. Your written office policies should contain those agreements and should answer most questions staff come up with. Doing so will save you much time and simplify the management of your practice. Staff non compliance is a sure sign of poor leadership. The primary reason practices underperform is staff non compliance.  Key traits of leaders. All it takes is discipline: 

  1. Always keep a cool head especially when "under fire"
  2. Realize that all mistakes are an opportunity for you and your staff to learn.
  3. Set a good example.
  4. Always be learning.
  5. Take care of yourself.
  6. Fight the impulse to address multiple issue at the same time. Frantic activity creates spotty results.

Cost

$35.000.00 is the average fee for a one year program with dental practice management companies you are likely familiar with. For those companies that require you and your staff to travel to their facility or seminar you also need to add in the cost of travel, staff pay and lost production from time away from your practice. 

Questions You Should Ask

  1. Do you and/or your staff have to travel or does the consultant come to you?
  2. Is the program mostly one on one consulting versus seminars or courses with multiple clients in attendance? There are advantages to both.
  3. If the dental consulting is one on one who will actually deliver the consulting? I recommend knowing who your specific dental consultant will be prior to signing on the dotted line.
  4. Is program based on a specific dental practice management system? You want to avoid cookie-cutter programs. Ensure the program will be tailor-made to fit your practice's specific needs.
  5. The cost (including travel expenses and downtime) is certainly not the only factor, everything else being equal, it is still a major factor to consider. It's unwise to pay too much, but it's worse to pay too little.

If you do a little homework it should be fairly easy to pick a reputable consultant that is a good fit for you and your practice.