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hey everybody dr. mark Costas here founder of the dental success Institute and author of the book pillars of dental success and in today's quick video we're going to be featuring my good friend and dental speaker dr. Aaron Nicholas and dr. Nicholas has been dubbed the Monday morning dentist because when he gets up on stage he always gives great gems and tidbits about how you can immediately take his advice and bring it to your office first thing Monday morning after the seminar to implement for great results okay so in this particular video dr. Nicholas is going to be talking about how to get your collections up to ninety nine percent of everything you produce okay how to install some really really effective financial policies for your patient base and to immediately decrease your AR and now these are things that are quick and easy it seems like common sense but as you guys know common sense isn't always so common so dr. Nicholas has a great way of explaining how to get these these great systems in place immediately Monday morning as soon as you get back from your practice after seeing him at a seminar and along those lines dr. Nicholas will be one of our featured speakers at the 2015 dental success summit scheduled for March twentieth and twenty-first in Scottsdale Arizona so if you're interested in coming or you're interested in learning more about the awesome speakers lineup just scroll down in this email and you can click the button and learn more about the event this is going to be an amazing event the lineup is absolutely amazing plus you get to be at the beautiful scottsdale resort i'm not sure where you coming from from around the world but the weather is going to be awesome there's great golfing in Scottsdale you get 14 CT credits just for showing up and really guys this is one of those events that could be a potential game-changer for your practice so I look forward to seeing you there there is what we call the super early bird price that we've had in place just as a special thank you for your subscribers that follow us on a regular basis so if you register for the event before black friday at midnight pacific standard time you will get seventy percent off the normal ticket price of nine hundred ninety seven dollars that brings your ticket price all the way down to two hundred ninety seven dollars now for the quality of speakers and the amount of content that you will be provided the amount of really implementable advice that you're getting for two hundred ninety seven dollars in a beautiful place with 14ct credits it's really just an amazing deal so mark your calendars make your registration today to make sure that that you get it at seventy percent off and I look forward to seeing you there alright guys have a wonderful week and I look forward to talking to you soon bye so we got that maintenance piece figured out now it's time to get back to the original problem I got a ten percent or a nine-point change % overhead in supplies and I went to my person that were supplies and I said hey Roz I need you to go and find an online supplier to offer our supplies to get the best deal you can do so she went on and she found a company she said here's the deal we're going to use these guys great we ordered two months later 9.25 to like eight point nine eight point eight I mean it was moving but it wasn't we were put lots of effort in nothing was happening and I just got completely frustrated and so I just went in back and I pulled out a sheet of paper and I looked at what I collected last month and i multiplied it times eight-point-five percent and I put that number at the top of the paper and I walked back into the lab I said Roskam here and i put it up on the counter and I said see that number there that's how much money you can spend this month here are the rules it supplies only so equipment doesn't fall under that and you can't run out of anything if you think you're going to run out of anything come talk to me but those are the rules and she looked at that number she said oh my gosh how do you expect me to buy buy supplies for this entire office is that little bit of money unlike Rossi you've never tracked it before you don't know how much money you're spending she goes give me another five hundred dollars i said no let's start here so so this is my very sophisticated inventory supply at 8.5 she was under easily dropped it to eight after two months under that easily 7.5 under that seven under that at seven she comes to me and says dr. Nicholas I have some samples coming there's some suture material and if you'd like it it will cost a seventy-five percent less than what we're currently paying for sutures and I was elated and horrified at the same time it's like this hasn't been happening if you guys haven't been looking at costs she hadn't because she had never been accountable for how much she was spending she was our supply lady but she was never accountable for the budget and that's why all of a sudden she's starting to look at costs seven half seven six and a half six you can read that up there it says five percent okay that was this January okay at the end of January we had an overage 447 dollars she looked at me and she goes can I roll that into the next month now she had said this a couple of times and I said to her no I'm not the cell phone company we're not rolling your minutes over okay however if you need more money i will let i will certainly make sure that happens the other interesting thing that happened was when some people were asking for some stuff there were equipped rather than supply she's like no you can't have it and of course my hygiene Department comes to me goes I have to have this I can't do my work without this and Roz is like I can't keep under budget if you do that I'm like Roz that's equipment not supplies so that's fine just go ahead an order she goes oh and then she started pulling stuff out cool well this is equipment to right I'm like no that's time that supplies don't game me okay so we are kind of have to have at that division now the other thing is I know that I have friends that sometimes will run stuff through the office to take home and if you're going to play this game with your staff you kind of gotta play it straight yeah a guy it's only fair you know so she does a great job at five it's a little tight in February we were actually over and so we let them bump up a half a percent and we're going to do another round of cost-cutting I got more more samples coming in to look at and try and so we'll see where it ends up but this simple idea when I tried all those other things is what made it happen okay it's a monday morning idea for me because monday morning you go in you figure it out you put it up on the wall you tell them the name of the rules we're done okay so idea number one so we were moving along and the practice is doing great I've been in practice 25 years for the last ten years we have collected between 99 and 100 four percent of production which is kind of fun for 10 years and it just been going along great our accounts receivable was at one-half of one month production which is stellar okay the industry standard is I think somewhere around ninety eight percent and a month to a month and a half in your accounts receivable and then all of a sudden that accounts receivable started moving up moving up and I kept looking at it it got to a month it got to a month and a half and that's when I woke up I'm like okay this is this is not an aberration this is a trend something's different what's going on so I started looking around and what I realized was what was going on was that we weren't having effective financial arrangements anymore my office manager of 13 years had retired and moved to South Carolina and the system that we had in place wasn't being worked and it wasn't being worked because she wasn't there and she was the one that was making herself accountable and that's it worked out for us so for us as we look at patients we see all patients as a B and C patients and this is strictly to do with how they pay doesn't have to do it they're worth as human beings or anything like that it's strictly with how they pay so a patient's are the ones we'd all like to have a practice full of okay they are your grandparents okay they come in they do their work they tell you what a great guy you are they make you cookies for Christmas you know they send in their friends and neighbors this is these are the people you want unfortunately the whole world is not made of grandparents see patients are the other end of the scale they're the ones that will game you every time it doesn't seem like you can close the loopholes tight enough to keep from getting ripped off occasionally okay and that happens be patients are most of the world if you set up your systems so that they it's required that they pay then they'll do what they say they'll do most people if they say they'll do something we'll do it and that's most of you be patients the thing we're always trying to avoid is tightening our financial arrangements down based on our see patients and running off our A's and B's because of that so we're going along and what I realized was that my front desk was no longer really doing the whole financial arrangement thing so years ago we had created a financial arrangement sheet and I like things on different colored pieces of paper so I know what it is as soon as I see it so when we did this originally my staff said we'll put it on green greens the color of money that'll work so it got known forever as the green sheet okay and my financial arrangement sheet is probably very similar to yours and it says at the beginning and our office we don't want money to be a problem for you or us for your ease and convenience we offer several types of financial arrangements and then it has patients name date the procedure of the fee the estimated insurance payment and the patient's portion okay and now here's what the part things get interesting so option number one prepay three days prior it will give you seven percent off okay why because patients that prepay you don't move they're on their spot they don't switch their appointments around very often they're there they're coming in number two I don't have to send you a bill that makes my life a whole lot easier I want to worry about you coming in I did the work then you walk out and go oh I forgot my checkbook okay so i'm very happy to give you a seven percent will keep you discount for prepaying three days and vans okay option two if you pay us on the day of service i will give you five percent bookkeeping discount because i don't have to chase you okay you're going to pay me i'll have to send you a bill we're said and done everything's everything's finished now some people say oh now is this on the patient portion or is this on the entire procedure and my answer is yes whichever one you want I'm good okay no big deal then the next question is well now if you give that discount do you then submit less money to the insurance company ok this is the controversial point I'll tell you that right up front this is the way I feel about it this is a bookkeeping discount I'm doing this for you mr. and mrs. patient because I don't have to chase you for money i don't have to have you move around on my schedule for all these kind of administrative reasons ok d rettner cigna if you would like to pay me 3 days in advance I'd be very happy to extend to you the seven percent bookkeeping discount rather than having to send you three sets of x-rays and resubmit the claim two times to get paid ok i'm very happy to give you the same discount they haven't called me yet so i think we're okay right option 3 pay half the patient portion the first day remaining half of the insert date ok at that second insert date it gets paid before they go back ok i don't know about your offices but in my office work doesn't seem to fit if it's not paid for it's it's a thing ok we'll let them go back we'll take a look at it but we won't insert ok they really need to come back they need to pay that off before we're going to insert that option number 4 12 months same as cash so carecredit wells fargo you know whatever one works best in your area you know that standard thing you're usually taking what a nine or ten percent hit unless you can negotiate something better and again for the same reasons i like that the other thing with this too is once they open that credit up and they pay some of the damn they can just add to it and so it becomes a much easier process to finance further work in the future okay option 5 is Nicholas dental coverage we have kind of an in-office dental plan I'm going to talk about that a little bit later but the nice part about that is this is we still get paid the day of service okay and we're done so but we'll talk about that in a minute then the standard hey I know that my insurance is a contract between the insurance company and dr. Nicholas has nothing to do with it and then this is specific for us I'm not a participating provider in NE PP 0 and Delta Dental has recently started sending checks to our patients instead over to us so sometimes we make arrangements for patients based on their portion the check goes the patient the patient doesn't bring it in they kind of gobble that up and then we call them go we need the rest of the money and they say I'm sorry I spent it I can make a payment plan for you though house 20 bucks a month sound okay so it doesn't work for us so to try to get by this we're saying hey realize that you need to send that check to us as soon as you get it we will give them an envelope with a stamp it's addressed about three weeks after we submit that we're on the phone to the patient hage you get the check yet okay we're trying to as much as we can get them to stick that check in the mail and then still sometimes they won't build cash and go oh I didn't know ok this is that si si patient acting like a see patient and I'm not willing to make this policy so tight because I don't have that many of these patients and that many that act poorly that it's going to affect the rest of my patients so it kind of works it's not perfect but there is a certain costs of doing business so then the last part is the patient signature and just as important the staff signature ok this lets us know who did this patient talk to who made these arrangements if there's any problem with these this is the first step of accountability with this process ok the next thing that happens is we have a morning huddle every morning and for patients getting work done they have a chart and this green sheet needs to be on every chart and it needs to be for the procedure we're doing that day and it needs to be signed and both those things have not happened before okay we've had them on there and it's not for the procedure that day and we've had them not signed and both of these are problems so if we're in the morning huddle we noticed that's going on that has to be taken care before the patient comes back ok so that's the second part of the accountability the third part of the accountability is when I walk into the room do work that green sheet has to be out on the counter sign for the procedure that we're going to do okay if it's not I walk back out and my staff knows that I'll walk back out I'm willing I wanted to kill my production for the day I'm willing to it doesn't matter i won't do work for free I just won't if i choose to do work for free that's a different item okay but i won't do work for free so then it becomes a very hard if you don't have the hard conversation up front then it becomes a harder conversation when the patients and back they can get work done and all of a sudden there's this this hiccup okay i will apologize how give you tickets to the movie theater i'll get tickets for dinner I'll do whatever but I won't do the work okay I'll do anything to appease you but I want it to work so that keeps everybody honest okay so three places that there's accountability to make sure this thing you