MOUNTAIN VIEW DENTAL (MVD)
OPERATIONS MANUAL
Essential daily operations of MVD that require constant updating to reflect current MVD policies and operations. Below are about 20 different operations conveniently laid out in a Table of Contents. Attachments, illustrations and scripts accompany descriptions.
Contents
INTERNAL SYSTEMS
A1. Procedural Time Studies
A2. Appointment Components
A3. Production / Practice Goals
A4. Power Cell Scheduling TM
A5. Telephone Call Slip
A6. Key Practice Expanders
INTRA-OFFICE COMMUNICATIONS
B1. Staff Meetings
B2. Morning Meeting
B3. Customer Experience Meetings
PATIENT SCHEDULING and MANAGMENT
C1. Development of PowerScripts
C2. Patient Confirmation
C3. Patient Cancellation
C4. Broken Appointments
C5. Emergencies
C6. Late Patients
C7. Scheduling School Age Children
C8. Family Scheduling
C9. Office Running Behind
C10. PowerScripts Box
THE END
INTERNAL SYSTEMS
A1. Procedural Time Studies
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Position(s) Responsible (Who):
Assistants
Purpose (Why):
To determine how much chair time is needed for most frequent productive procedures.
Timing and/or Frequency (When):
Need to do once a year or when adding new procedures or providers. The benefit is to be more efficient with our time.
Procedure (What & How):
1. Choose a procedure
2. Begin timing when patient is seated and continue until patient leaves.
3. Record timing information
4. Determine total chair time.
5. Determine doctor’s time.
6. Determine assistant’s time.
7. Repeat steps 1-6 four times for same procedure.
8. Total, then, divide by 4 to find an average time.
Recommended Scripts:
NONE
Related Attachments:
See pages 61 to 64, page 66, 67 and 68 from Levin Group, Inc. (Total Practice Success – Management Year 1 - Phase 1)
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Procedural Time Study Worksheet (On-the-hour start)
Time # ____ Procedure _____ Seated at _____ Dismissed at _____ Total Chair Time ______
Actual Time (0pt) / 1-Min Intervals / Anesthesia / Assistant / Doctor / Hygiene Chk / Out / Notes:01
:02
:03
:04
:05
:10
:15
:20
:25
:30
:35
:40
:45
:50
:55
:00
:05
:10
:15
:20
:25
:30
:35
:40
:45
:50
:55
:00
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Procedural Time Study Worksheet (On-the-half-hour start)
Time # ____ Procedure _____ Seated at _____ Dismissed at _____ Total Chair Time ______
Actual Time (0pt) / 1-Min Intervals / Anesthesia / Assistant / Doctor / Hygiene Chk / Out / Notes:31
:32
:33
:34
:35
:40
:45
:50
:55
:00
:05
:10
:15
:20
:25
:30
:35
:40
:45
:50
:55
:00
:05
:10
:15
:20
:25
:30
Sub-totals (minutes) / =
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Composite Time-Study Sheet
Procedure ______
Time Study / Anesthesia / Assistant / Doctor / Out / Chair-time Totals / (Hygiene Check*)#1
#2
#3
#4
Averages (rounded)
* The hygiene check is not counted in chair-time totals, but should always be recorded for informational purposes. Productive assistant time while the doctor is doing the hygiene check is recorded in the assistant column. If the assistant is not performing a productive task with the patient while the doctor is performing the hygiene check, then that time should be recorded in the “out” column.
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A2. Appointment Components
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Position(s) Responsible (Who):
Front Desk
Assistants
Purpose (Why):
To schedule patients for the appropriate amount of time, along with the doctors and assistants.
This will allow overlapping of appointments for better patient flow and doctor’s time with patients.
Timing and/or Frequency (When):
Yearly, whenever procedural time studies are reviewed or change.
Procedure (What & How):
To develop appointment components for common procedures using symbols indicating time required for anesthetic, doctor’s and assistant’s time.
This will help to schedule patients for the appropriate amount of time.
Recommended Scripts:
N/A
Related Attachments:
Sample: Symbols: , Anesthesia l, Dr. Time X, Dental Asst.
A3. Production / Practice Goals
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Position(s) Responsible (Who):
Doctor
Purpose (Why):
Practices that set, clear, measurable, written production goals, are many times more likely to attain a high level of production than those who do not set goals.
Production goals should be shared with the staff.
Timing and/or Frequency (When):
Yearly
Procedure (What & How):
- Previous year’s production
- Determine % goal for growth
- Add previous year’s production to % of desired growth = This year’s goal
- Determine the number of days to be worked over the next year
- Divide this year’s goal by number of days to be worked = Daily goal
- Multiply daily goal by number of days to be worked each month = Monthly goal
Recommended Scripts:
None
Related Attachments:
Doctor’s Daily Production-Goal Worksheet
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Calculating Doctor’s Production Goals
Month/Year / Daily Production / # Days Worked / Monthly ProductionJanuary, 2____
February, 2____
March, 2____
April, 2____
May, 2____
June, 2____
July, 2____
August, 2____
September, 2____
October, 2____
November, 2____
December, 2____
Total
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A4. Power Cell Scheduling TM
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Position(s) Responsible (Who):
Front desk staff and assistants.
Purpose (Why):
Improve production and efficiency by designating blocks of time to reach a specific amount of production.
Timing and/or Frequency (When):
Ongoing
Procedure (What & How);
1. Calculate daily goal.
2. Determine doctor percentages.
3. Calculate doctor production – 80% of doctor production should be reserved for power cells.
Recommended Scripts:
NONE
Related Attachments:
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Sample Showing Time Reserved for Power Cells – from Levin Group, Inc. work folder.
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A5. Telephone Call Slip
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Position(s) Responsible (Who):
Front Desk staff
Purpose (Why)
To record information about a new or emergency patient that is gathered during the initial phone contact with the patient.
Timing and/or Frequency (When):
Whenever emergency patient or new patient calls or comes in to set up an appointment.
Procedure (What & How):
Could fill out paper telephone call slip or could make electronic note on computer.
Recommended Scripts:
John Doe (new patient) called at 8:00 with emergency. CC: sensitivity to bite L/L posterior. Agreeable to 12:00 appointment with the understanding we would see him when we could fit him in to relieve discomfort only. CMC 10/21/09 8:15am
Related Attachments:
Telephone call slip (from Levin Group, Inc. work notebook page 159 - Total Practice Success – Management Year 1 - Phase 1)
*Paper or electronic notes must be initialed and dated.
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Telephone Call Slip
Telephone Call Slip / Appt. Time______Patient’s Name______
Parent or Guardian’s Name:______/ Adult Child: age ______
Background______
Address ______
______
Home Telephone No. ______/ Work Telephone No. ______Cell Phone #______
Referral Source ______
Other Family Patients? No Yes: Names ______
Reason For Call Emergency Consultation Other ______
Emergency C.C. ______/ Patient Appointment Needs
Hurting? Off/On Constant / 1. Consultation? Diagnosis Discomfort
Sensitive? Hot/Cold Pressure
Where? ______/ X-ray? No Yes; Requested date ______
Swelling? ______/ Dr. ______Telephone ______
Temperature? ______/ 2. Emergency? No Yes
Mobility? ______
Taking Pain Medicine? ______/ 3. Other? ______
Medic Alert? No Yes ______
Financial: Dental Insurance No Yes If Yes,
Insurance Company: ______
Policy Number: ______
Guarantor: ______
Guarantor’s Employer: ______
Comments:
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A6. Key Practice Expanders
Position(s) Responsible (Who):
Business Manager
Purpose (Why):
To be able to track and analyze various Key Practice Expanders which tells on a monthly basis if the practice is on track to meet its goals.
Timing and/or Frequency (When):
Fill out and review forms monthly.
Procedure (What & How):
- Measure Key Practice Expanders identified on the tracking forms
- Complete forms monthly
- Determine whether or not you are on target to meet production goals
- Analyze numbers monthly to keep doctor informed of trends
Recommended Scripts:
None
Related Attachments:
Tracking Forms
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INTRA-OFFICE COMMUNICATIONS
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B1. Staff Meetings
Position(s) Responsible (Who):
Doctors conduct meeting. All doctors and staff must attend.
Purpose (Why):
Vision statement. To have all departments on the same page. Go over notes from previous meetings. Discuss and strategize financial matters, production, collection, new patients, promotions, etc. Also inform on new techniques, continuing education. Updates on progress reports.
Timing and/or Frequency (When):
Last Thursday of each month. Starting at 7:45 (for the 15 minute morning huddle) then promptly at 8:00 the STAFF MEETING begins and ends promptly at 9:00. The meeting is for the entire staff monthly (8:00 to 9:00). There will be a monthly meeting at 1:00 to 2:00 during lunch hour for the doctors and one specific department (i.e. Hygiene, Front Desk, Assistants).
Procedure (What & How):
Meetings will be scheduled 12 months in advance. Follow through discussed items. Doctor or Office Manager prepares agenda and posts it. Let people add items for up to 48 hours before meeting. Each Staff member rotates the duty of note taker. Summarizing main points and assigns tasks. Go over technique updates.
Recommended Scripts:
Role playing various scenarios.Related Attachments:
GENERIC MONTHLY MEETING AGENDA
From Levin Group, Inc. work notebook page 156
Total Practice Success - Management Year 1 - Phase 1
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ATTACHMENT: Generic Monthly Meeting Agenda
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- Vision statement
- Review of last meeting
- Front-desk report (including scheduling factors)
- Production figures
- Collection figures
- Collection-to-production ratio
- Number of new patients
- Improvements for the month and progress toward goals
- Technique update(s)
- Role-playing or other training activities
Related Attachments:
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B2. Morning Meeting
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Position(s) Responsible (Who):
Front Desk staff or Financial Coordinator.
Purpose (Why):
To discuss the schedules and how things may run for the day. Be prepared for whatever the day may bring (i.e. problem patients, who owes large amounts, etc.)
Timing and/or Frequency (When):
7:45 everyday
Procedure (What & How):
Front desk or Financial Coordinator will review the day’s schedule with the team. Hygienists are responsible for their schedules.
Sample agenda
Sign at front desk – See attachment
Recommended Scripts:
N/A
Related Attachments:
From Levin Group, Inc. work notebook, pages 145 to 150. Total Practice Success - Management Year 1 - Phase 1
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Agenda for the Morning Meeting
MTD* production vs. production goalToday’s projected production
MTD* collection vs. collection goal
Yesterday’s collection
Identify any openings or time squeezes in the schedule—review open blocks for next week
Identify emergency times
Identify number of cases presented
Cases accepted
Cases completed
Outstanding treatment plans—necessary case presentation for case acceptance
Review of financial and accounts receivable information
Identify new patients
Discuss problem patients (i.e., anxious patients)
Asking for referrals
Discuss patients who are overdue for procedures
* month-to-date
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B3. Customer Experience Meetings
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Position(s) Responsible (Who):
Doctor & staff
Purpose (Why):
To consistently address and review the strategies to improve the patient experiences in the practice.
Timing and/or Frequency (When):
The third Wednesday of each month from 8AM to 9AM
Procedure (What & How):
- Go over a customer service topic at the meeting
- Discuss and commit to implementing at least one new customer service strategy each month.
- Each team member is to bring Customer Service ideas to the meeting.
Recommended Scripts:
None
Related Attachments:
None
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PATIENT SCHEDULING and MANAGEMENT
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C1. Development of PowerScripts
Position(s) Responsible:
Dentists and staff.
Purpose (Why):
Verbal skills are an imperative part of making the practice successful. The best way to ensure the use ofeffective verbal skills is to develop and utilize scripting for different scenarios that occur within the practice.
Timing and/or Frequency (When):
As needed when situations arise needing communication of our office policies.
Procedure (What & How):
During the workday. Note common questions and situations that arise. Then determine what scripting will convey the benefit to the patient to comply with the outcome that is best for the practice. These scripts are not necessarily to be quoted, however, they are to be followed closely to ensure that patients are getting a consistent message and information. Keep scripts in one spot to use when needed.
Recommended Scripts:
To be developed for Mountain View Dental
Related Attachments:
To be developed for Mountain View Dental
C2. Patient Confirmation
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Position(s) Responsible (Who):
Televox and staff members.
1. Televox (outside automated call service) calls patients 48 hours before appointments.
2. In office: hygienists call patients the day before if they haven’t been confirmed by Televox.
3. Prevention Therapist call hygiene and prevention patients that have not been confirmed by Televox the day before their appointments.
4. Front desk staff will call if the “Status” bar shows there was a busy signal or “no answer”.
Purpose (Why):
To attain 100% confirmation of all patients.
Timing and/or Frequency (When):
Calls are made 48 hours before appointments initially and followed through up to the day of the appointment. Whatever is necessary to confirm the appointment.
Procedure (What & How):
Televox (outside automated call service) and/or office staff will contact patients to confirm dental appointments.
Recommended Scripts:
Schedule coordinator: “Hi Mr. Smith, this is Pati from Mountain View Dental. How are you today”
Patient: “Fine”
Schedule coordinator: “Mr. Smith, I wanted to let you know we are looking forward to seeing you on Tuesday, at 3:00 for your appointment. If you have any questions that I might be of help answering, just let me know.”
Patient: “Thanks Pati, I’ll see you at 3:00 on Tuesday.”
Related Attachments:
From Levin Group, Inc work notebook pages 175 and 176
Total Practice Success - Management Year 1 - Phase 1
ATTACHMENT Recommended Scripts:
Confirmation of Appointments
New Patient Script
Scheduling Coordinator:Good Morning______, this is ______
from Dr. ______office. How are you today?
Patient:Fine. Thank you.
Scheduling Coordinator:______as you know, you have an appointment in
our office on ______for ______I
just wanted to call and see if you have any questions.
Patient: No I’m fine.
Scheduling Coordinator:Remember to bring in your new patient packet. Have you
had a chance to fill out the forms?
Patient: Yes. No problem.
Scheduling Coordinator:Great. Do you need directions?
Patient:No, everything is here in the packet you sent. Thanks!
Scheduling Coordinator:OK. See you ______Call me if you have any
questions.
Consultations
Scheduling Coordinator:Good Morning______, this is ______
from Dr. ______office. How are you today?
Patient:Fine. Thank you.
Scheduling Coordinator:______I just wanted you to know that we are
looking forward to seeing you on ______
Do you need directions to the office?
Patient: No. See you ______Thanks.
Major Procedures
Scheduling Coordinator:Good Morning______, this is ______
from Dr. ______office. How are you today?
Patient:Fine. Thank you.
Scheduling Coordinator:Just calling to see if you have any questions regarding your
appointment on ______for______
Please remember to take your pre-meds before the
appointment. Do you have any questions?
Patient: No I’m fine.
Scheduling Coordinator: OK. See you ______. Call me if you have any
questions.
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C3. Patient Cancellation
Position(s) Responsible (Who):
Front Desk staff, Hygienists, Prevention Therapist (when confirming after Televox automated call service)
Purpose (Why):
To encourage less cancellations. Also to have consistency when dealing with cancellations for the dentist, hygienist, or prevention therapist.
Timing and/or Frequency (When):
When a cancellation occurs.
Procedure (What & How):
Encourage patient to keep appointment. Remind patient how important the procedure being done is. Stress that there are no readily available appointments and that they may have to wait some time. If you cannot convince them, then reschedule.
Recommended Scripts:
Power Script 8 from Levin Group, Inc. work notebook.
Total Practice Success - Management Year 1 - Phase 1
Related Attachments:
Power Script 8 from Levin Group, Inc. work notebook.
Total Practice Success - Management Year 1 - Phase 1
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ATTACHMENT_ScriptpatientCancelling
Patient attempting to cancel during the confirmation call
Scheduling Coordinator:Good Morning ______, this is ______from
Dr. ______office. I’m calling in regard to your
appointment on ______for ______
Do you have any questions?
Patient:Oh, I won’t be able to keep the appointment. Something
has come up.
Scheduling Coordinator:I know that Dr. ______wanted to complete
your treatment as soon as possible. Is there anyway you can
keep the appointment? The next available appointment isn’t
until ______.
Patient:Well, let me check and I will call you back.
Scheduling Coordinator:That’s great. Can you let me know by 4pm today?
Patient:Sure.
Or
Patient:Just schedule me for the next available appointment
Scheduling Coordinator:I know you like early morning appointments and the next
available one isn’t for 6 weeks. Is there anyway you can
keep your appointment. I know the doctor would not want
you to wait that long.
Patient Calls to Cancel
Patient:Hi ______This is Kathleen Smith. I need to re-
schedule my appointment.
Scheduling Coordinator:I know Dr. ______was happy to see your name
on the schedule to take care of______. Is there
anyway of changing your schedule so that you can keep
your appointment.
Patient Cancellation After Confirmation
Patient:Hi ______This is Karen Jackson. I’m sorry but
something has come up and I have to cancel my
appointment.
Scheduling Coordinator:I know Dr. ______was happy to see your name
on the schedule to take care of______. Is there
anyway of changing your schedule so that you can keep
your appointment.
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C4. Broken Appointments
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Position(s) Responsible (Who):
Scheduling Coordinator