📍  I could never let my office manager go if she leaves. The business falls apart. I heard that on a call today with a three location group out of California. If that sentence hits a nerve, this episode's for you.

We are gonna be honest about the risk of building your practice around one hero and how to build a day that runs smoothly no matter who's at the front. Research, real dental examples and framework you can use this week. Hey friends. I'm Sarah Beth Herman. CEO of Dentistry support and your host here at No Silver Spoons. This podcast episode is all about practical leadership for real dental life. And dare I say, real dental business? I'll tell you what that California Dental Group shared about their main office manager, the top dog, where dependence on one person quietly drains production.

And the five practice priorities that replace chaos with calm, we'll talk phone conversion, eligibility at scheduling, not at check-in. And yes, the 2024 A DA claim form updates, some denial trends,  ar aging or dental billing, aging and burnout. You'll leave this episode with a checklist, a dashboard rhythm.

And a way to protect your best people and your piece. Research actually backs what I'm gonna talk about today, and I'm gonna link everything for you in the show notes.

Three locations, great clinicians, solid reviews, but the owner opened with we could never lose our main office manager. She remembers everything. She knows every patient. She knows the insurance, the phones, treatment estimates, refunds. What's gonna happen with somebody's birthday? What employee isn't doing the right thing?

When I ask what happens when she's out, he admitted that the schedule slows, recalls slip, and estimates get vague because nobody else feels confident enough doing eligibility or money conversations at her level. Patient's weight claims weight. Revenue, weights, payment posting, weights, collection, overall weights.

Here's what this team with permission to share anonymously described to me. they try to route most new patient calls to her when she's available. On days when she's not rings, stretch, and more calls hit voicemail.

That's a direct hit to conversion. Large data sets. In dentistry show that top practices answer a very high percentage of calls and convert the majority into appointments. The gap between average and top performance is the difference between an okay month.

And a strong one. Eligibility and treatment presentations. So their office manager keeps payer quirks in her head, waiting periods, frequencies, downgrades When she's off these treatment presentations, they get fuzzy. Now, the a DA is clear about this, begin eligibility and benefit verifications at scheduling so that the patients get accurate expectations very early.

Know what's happening early on. You don't wanna wait until someone is walking in the door before you're checking insurance claims and dental billing. Heavy clinical days pushed claim submission to whenever she can. So that sometimes meant days later because the office was so busy she didn't even have a minute to check claims.

Rejections always stack up for her return to office. Their over 90 day AR was equal to one month's revenue, and this specific practice where this head honcho is overseeing their revenue is 226,000 on average, we averaged it out over 12 months.

So over 90 days, an entire month of revenue, that is a classic process. Red flag benchmarks and dentistry really do vary. At my largest brand dentistry support, we believe that you should never have any claims aging over 30 days. And if you do, it should equal less than 10% of your overall claims that are sent for an entire month.

 But because these benchmarks vary based on opinion and those that work in the dental industry, anything in AR over 90 days is a signal to fix those upstream steps. When we talked about team morale.

They told me that smart and capable people hesitated to touch what her tasks were. Now, that's not loyalty, that's fragility, and it burns out the hero. Dental workforce research  documents, elevated burnout tied to workload and administrative friction. It hurts people and performance.

There's no villains here. Just a common pattern. Comfort in a hero today. Hidden risk tomorrow. Business calls this a single point of failure. When one person is the only path for a critical process, it feels safe until the day it isn't. Cross training and shared standards are proven to improve service quality.

And resilience across service industries. They also reduce turnover because people feel less isolated and more supported. That pattern holds in dental admin too, and that's just according to the Harvard Business Review. Zooming out the environment is tougher now. Surveys across healthcare show denials have climbed in 2024, and payers are asking for more and more documentation.

That means every missing eligibility note.  Payer ID or attachment becomes more expensive. Building process reliability isn't a nice to have. It's actually a protection for your dental practice. So let's ground this in numbers that you can watch in a 15 minute weekly dashboard. Number one is your phone answer and conversion top practices. Answer the vast majority of inbound calls and convert most new callers to appointments. Call analytics from large samples, meaning millions of calls, show a clear pattern, better answer rates and coachable scripting drive higher conversion and production.

So track your total inbound, your answer rate, and your percent scheduled from new patient calls. Even small lifts here produce outsized revenue changes. Number two is eligibility at scheduling the ADA's own materials emphasized starting verification at the time of scheduling.

That shrinks day of surprises. It improves trust and it shortens Check-in. Put a verify before column rule in your team's workflow. Number three, claim timeliness and denials. Every single claim for your dental practice must be submitted within 24 hours, and you must have daily rejection work lists, timely filing windows and documentation requests have tightened for many, many plans, so getting clean claims out fast matters more than ever given the denials upward trend.

And you know what I'm talking about. If you've been in dental for any more than 30 days, denials are literally coming out of the woodworks. Number four is broken appointments and reschedules. Don't just track breakage. How many broken appointments did we have today? How many no-shows did we have today?

You need to track the percentage of broken rescheduled within two business days. A  guidance includes practical rescheduling strategies to protect your day without punishing your patients. Number five, your dental billing. You need to watch your over 30 days. Most people say watch your over 90 day slice really closely, but I'm telling you, anything over 30 days is a red flag.

There are various benchmarking resources used in dentistry. But they keep pointing to monitoring those old buckets and making sure that they are the smallest amount possible if they swell your upstream process, your eligibility, your estimates, your claim cleanup, your patient ar follow up. They all need work.

You can create your own metrics in your practice. You can say, Hey, we never wanna claim over 60 days, or We never wanna claim over 90 days. If you don't know how to control that or you feel like it is just insurmountable, you want to check into third party billing options.

There are so many out there dentistry support, my largest brand. We offer this service and we'd be happy to get on a call, no charge to you to help you design that SOP design, what it looks like to get that cleaned up and get your arms wrapped around it. Oftentimes I get on calls with offices and they'll tell me, well, how are you gonna clean up my old ar?

Well, what I'm gonna do first is wrap my arms around your current ar, which means zero to 30 days. And I'm gonna make sure that that is on point, because if I take my initial task of being, Hey, let's work on your old ar, then I'm not focused on your zero to 30 days. And all of a sudden now. Everything that was zero to 30 days once you've started on support with me is jumping into 30 to 60, and then 30 to 60 is going to 60 to 90, and you can see the pattern.

It's gonna keep going and keep going and keep going.

Cognitive load research tells us that humans missteps when processes live only in memory. Especially under time pressure. That's why checklists actually improve outcomes in medicine. That's why checklists improve outcomes in medicine and aviation in your front office. Checklists aren't micromanagement.

They lighten cognitive load and they make success repeatable. You're gonna hear me say this a lot. Checklists are not. Micromanagement, no matter who rolls their eyes at you, whoever is in your office working with you, they need to welcome processes and systems because the more you have those, the more you know you've gotten everything done that needs to get done.

And there is nothing more satisfying than checking off the last thing on a list, knowing you got it all. Even if you've memorized that list one day, you could forget one thing. And then it could create a trickling effect down the line.

Let's get into the five practice priorities. Now, these mirror the email that we sent a few weeks ago because repetition builds culture. These are five simple and memorable steps.  Number one, systems over heroics. If it isn't written, it doesn't exist. Start with one page. SOPs for new patient calls.

Eligibility at scheduling estimates or treatment presentations, claim submission, denial, appeals, refunds, patient AR outreach, schedule saves, same day treatment, add-ons, and membership signups. I know that was a big list of items, but you can rewind that part and listen to that list.

I'll also make sure it's in the show notes for you. Keep them in one shared folder that is linked in your task manager OR on the desktop of a shared drive or in a shared drive on your computers. Update when payer rules or a DA claim fields change, especially with the 2024 A DA claim form revisions.

There is a locum tenants reporting last SRP date and benefit plan payer ID codes that have been updated. Train to changes. Don't just announce them. Number two, patient first. Every step patient first isn't a poster, it's a call flow. Use coachable, invitational phone scripting, so the first call ends in an appointment, not in, we'll give you a call back or give us a call back.

Data from large scale call scoring programs show top offices answering more calls and converting more reliably. It's teachable. Pair that with a broken appointment protocol that automates a fast, friendly reschedule. Now you can measure your percent of broken, rescheduled. It's the heartbeat of access and trust.

Number three, financial clarity. Dare I say this is the most important. I don't know. You tell me how your patients feel when they have an unexpected bill. Verify benefits before you confirm the appointment and document. Plan. Quirks, waiting periods, frequencies, limitations, downgrades. Put this in a shared cheat sheet.

Patients say yes more. When money is clear and consistent, build a rhythm. Eligibility at scheduling. Then estimate, then treatment presentation prepared. As soon as the doctor diagnoses, then you can have a confident day of money talk. The a DA specifically points practices to move to a verification upstream.

It shortens the day and calms everyone. About six months ago, I started talking with a new practice that ultimately became a client of ours and is still a client of ours today. They shared with me that whenever they have a new patient come in, they have diagnosis by the doctor, a treatment plan is generated because the doctor's assistant will put that in, then they tell the patient they have to come back.

For a treatment presentation several days later, once they've made sure insurance coverage is figured out, they can bring their spouse, they have a whole presentation. When I looked at their ability to close treatment plans, meaning case acceptance, their case acceptance was at 12%. Every 10 new patients, basically one, almost two, if I was gonna be really generous.

Are accepting treatment plans. That's insanity. We had to close the gap. How did we do that? Well, this practice over the last six months has gotten a complete overhaul from the way eligibility is done to training on treatment, presentations, to understanding the science behind how we present treatment plans.

Financial clarity is everything. And number four. Clean and fast. Revenue cycles claims out within 24 hours. Rejections works daily and a weekly 15 minute RCM huddle to review your claims over 30 days. That's right, your claims over 30 days. Rising denials across healthcare mean that you cannot let small errors linger, fix the root cause in your SOP and retrain.

And number five, cross-trained and accountable. Two people can perform every critical admin task. Rotate who runs eligibility. Who closes claims, who manages refunds. Cross training improves service and resilience, and it reduces burnout because no one person carries the entire load. Research and service operations shows that cross training boosts quality and retention in real life.

It gives your heroes an actual day off. When one person holds eligibility phones, pretreatment estimates, treatment plans ar everything. They become the emotional shock absorber for the office. That is exhausting. Multiple studies on national oral health reports show elevated burnout in dentistry, especially when administrative burden is climbing and climbing and climbing.

Your best people can love the mission and still burn out if the system depends on them to hold it together. Cross training and SOPs don't replace your star. They protect them. They make vacations normal sick days, boring and growth. Sustainable. In every episode, I always bring up a that's good moment.

It's where we recap the main key points from today and from the email that you may have read a few weeks ago. If your practice collapses when one person rests, it wasn't strong. It was just lucky. Strength is. When your systems over. Heroics keep promises to patients when patient first shows up on the phone and at checkout.

When financial clarity turns awkward, money talks into confident yeses and when clean and fast revenue cycle keeps claims moving in ar low, and when a cross-trained and accountable team means two people can do every critical task that's not unloyalty. It's how you love your team and serve your patients without burnout.

That's good for people. Profit and peace. Your action plan this week, four steps before next week's episode. One I want you to write or refresh. Three SOPs. New patient call eligibility at scheduling and claim submission. Start there. Keep them one page each. Use chat GPT if you need to. Number two, run three numbers, answer rate, percent of new caller scheduled and percent of money in AR over 90 days.

Let's just start there. If the last one stings good, you found your next win. Number three, assign a buddy for your office manager on eligibilities and pre-treatment estimates or treatment presentations. Shadow two hours, then switch. Number four, start a 15 minute weekly dashboard with leads. Keep it human, not heavy, just trend lines and next steps across healthcare.

Payer denials rose through 2024 with nearly three quarters of surveyed providers reporting increases. Translation, clean data and on time. Claims are more valuable than ever. Your processes are your safety net.

As we close this episode, I wanna remind you that I am Sarah Beth Herman, CEO of dentistry support. We exist to take the weight off your admin world so your team can breathe and your schedule stay strong. We handle eligibility and benefit verification virtually RCM services with clean claim submission within 24 hours daily rejection, cleanup and ar follow up with clear targets.

We handle phone and conversion coaching, scripting, call scoring, and simple KPIs. So more first calls become first visits. SOP builds for your top 10 workflows and cross training plans. So two people can do every critical task.

Lastly, we provide leadership support to run that 15 minute dashboard without taking over your life it's endless really because with us handling everything offsite and your admin, that has to do with eligibility, phones and billing, you now can focus on leadership. If you're struggling to build these best practices or you're just ready to hand it to the experts, this is where we come in.

We'll set up the standards, train your team, help you protect your best people from burnout while you grow. I've posted a free training that walks through the five priorities. With scripts and everything that you need to know at dentistry support.com/freetraining. Every week here at no silver Spoons, we keep building same human tone, same practical next steps.

I'm cheering for you and your team. Thank you for listening, and I'll catch  📍 you on the next episode.