Authored by Andy McCarty
Since its inception in 2001, the Academy of Dental CPAs (ADCPA) has expanded to 26 CPA firms across 30 locations but its goal, and the goal of its members, continues to focus on specialization providing dental clients with industry-focused consulting, accounting and tax services.
On a biannual basis, the ADCPA meets over the course of three days to discuss relevant topics that are occurring within the industry. As one of the founding members of the ADCPA, Baker Tilly attended the most recent event where various topics were presented by some of the leaders in the dental industry including practicing dentists, insurance providers and equipment representatives, among others.
While the topics discussed touched on many different aspects of the dental industry, many of which are discussed below, one thing that quickly became clear is the true dynamic nature of the industry and the need to have meaningful conversations with your dental CPA to stay abreast of the ever-changing environment.
Coding and fee transparency
Renowned dentist Dr. Charles Blair presented on various topics with a focus on proper reimbursement techniques for dental practices. With dental preferred provider organizations (PPO) still providing the vast majority of revenue for most dentists, the ability to properly document and adhere to the requirements of your PPO is more important than ever.
Many dental plans have increased in complexity, requiring enhanced linkage between medical diagnosis, dental diagnosis and ultimately the treatment provided. With the move to ICD-10-CM and its 70,000 diagnosis codes, the ability to properly diagnosis the patient and ultimately document that diagnosis through the proper coding can have a direct impact on the bottom line of your practice. Dentists and other associates should continue to gain familiarity with medical diagnosis that affect the oral cavity to take full advantage of the work being performed and ensure that maximum reimbursement is received through proper documentation of the diagnosis.
Along with coding, Dr. Blair also commented on the following;
- Increased momentum towards fee transparency: the question is no longer “if” but “when” total fee transparency will be mandated for all healthcare organizations including dental
- The industry’s trend towards multi-doctor practices
- Discount plans for noninsurance patients (see “Insurance alternatives”, discussed below)
- Corporate dentistry’s rapid expansion
In the end, Dr. Blair stressed practice owners look at the following to make sure they are doing enough to remain successful while fees stay stagnant and reimbursements get lowered:
- Review your new patient count and collections for each of the past three years and look for trends
- If the new patient percentage downward exceeds the collections downward, then the practice is “living” off recall and collections will follow after a couple years
- Check how far out the doctor is booked solid as this indicates the overall health of the practice. Ideal is 1.5-2 weeks solid, acceptable is 1.0-1.5 weeks solid, below 1.0 week solid signals possible trouble.
The age-old insurance revenue stream is going through a drastic change within the dental industry as various types of insurance alternatives are offering access to the previously un-tapped demographic of Americans who do not have dental insurance coverage. These insurance alternatives work with your dental practice to offer a plan aimed at increasing revenue by providing services to individuals who previously avoided care due to the lack of insurance coverage.
The types of alternatives to insurance come in all shapes and sizes, but most allow the practice to be in full control of the customized plan including pricing and procedures. A typical scenario might be two annual checkups at a 15 percent to 20 percent reduced rate for a monthly “membership” fee. Ultimately, this can result in seeing patients at a rate comparable or even better than what is typically provided by insurance providers. Because these patients are paying directly to the practice rather than through insurance, it can often create a stronger sense of affiliation to the practice which can help with patient referral rates and even increase treatment plan acceptance. And, the best part is, many of these plans can be tailored to work directly with your existing performance management software.
If your reimbursement rates have dropped significantly, or if you practice in an area where a sizeable portion of the population does not have dental insurance, an in-house dental plan might be a good option for you to expand your patient base and increase the net dollar received per patient. These insurance alternatives can get technical in order to ensure that the plan does not violate insurance laws, so before getting in too deep, be sure to do your due diligence and reach out to your dental CPA.
The changes to the dental industry are not isolated to the financial and regulatory portion of your business. Instead, innovation and technology are also changing the way you and your competitors practice. One of the most significant changes is in the ability of practice management software and your financial system to integrate together and produce both financial and nonfinancial data in the form of dashboards.
Dashboards provide real-time information on the performance of a practice whether it be the daily production, production by doctor or hygienist, collections, accounts receivable aging, number of new patients, acceptance rates, filled appointments and many other financial and nonfinancial metrics. In order to have a successful practice, you need to know how the practice is performing and you need to know quickly; dashboard tools allow you to effectively and proactively address trends and potential issues prior to them negatively impacting the practice.
Other exciting innovations on the practice and procedural side of dental practices include:
- Packaged patient financing options to give your patients the option to spread out their cost
- Phone and patient communication systems
- When properly implemented, these systems can dramatically reduce no-shows while also limiting the active involvement of your front office staff
- Web design, social media/marketing and search engine optimization technologies to increase awareness of your practice and aid growth
- Improved buffered local anesthetics that save the dentist significant time and provide a better patient experience
- Improved oral cancer detection devices that increase your practice offerings to patients
Whatever the technology, it is more critical now than ever that your practice’s written protocols and philosophy of care promote, and even embrace, the integration of changing technologies.
The dental profession is undergoing some serious changes and we're expecting the pace at which future changes occur to continue increasing. Doing your best to stay up-to-date will allow your practice to be proactive in how you respond to these industry trends and issues.
As a firm dedicated to the dental industry, we are committed to keeping dental practices informed and on top of industry issues through our quarterly Dental Bites newsletter, industry whitepapers and industry survey reports. If you’re interested in receiving our quarterly newsletter or our annual dental fees and compensation survey, subscribe to our dental publications.
For more information on this topic, or to learn how Baker Tilly dental specialists can help, contact our team.