When you work in the office every day, you hardly notice little things.  Know that the patients see everything!

  • Look for chipped paint inside and outside the office, dirty rugs, little bugs and cobwebs in the light fixtures.  Windows should be professionally cleaned regularly.
  • Have pretty plants outside the office – even in winter you can plant ornamental kale, etc.
  • Make sure that your equipment is in good repair.  Your staff cannot do their best service to your 
  • patients with inadequate equipment.  Repair any chipped paint on the equipment.  Upholstery should not have any breaks or tears.
  • Floors should be perfectly clean and new looking, even in the corners and along the walls.


Compare the payroll in each department – Hygiene, Chairside Assistants and Front Desk – from this past year with previous years. 

  • Aim for payroll to be 22-24% of adjusted collections. 
  • Notice whether increases in production have occurred with increases in payroll. 
  • Compare the number of doctor and hygiene work days from this past year against previous years.  
  • Fewer days in one or both areas may be the reason for lower production.
  • Fees need to be raised substantially to offset raises in payroll. 
  • Consider hiring a PPO Negotiator to try to raise your collected fees.


You want to know the number of all ADA coded procedures that were charged out this past year and compare them against the previous years.

  • Calculate the collection percentage by dividing the adjusted collections by the adjusted production for the year.  You want the percentage to be 96-98%.  If yours is not in that range, have a serious 
  • conversation with the staff person who is responsible for collections.  Just one percentage point is worth many thousands of dollars in profit for you. 
  • Run the Accounts Aging report and clean it up.  Write off bad debts in a way that it does not affect doctor or hygiene production. Send accounts to a collection agent as needed.
  • Run the Accounts Aging report just for credit balances.  Contact all patients with credit balances and offer them to have a refund, schedule an appointment for a checkup or treatment, or just 
  • leave it on their account.  Document all conversations with patients.
  • Run the report of Outstanding Insurance.  You should not have any claims over 60 days.  Have your staff members clean this up before it is too late to refile the claims.


Let all staff members know how much you appreciate them.  You really cannot do this without them.  

  • Schedule a half-day staff meeting to set new goals in all areas of the practice.  Show them how the practice has done the last few years with charts and graphs.  Do team building activities.


Promise yourself to be mindful about how you spend money at home and at the office. 

  • Spend less than you earn.
  • Pay credit cards in full every month – if you can’t, cut back spending until you can.
  • Fund your IRAs, 401Ks, and other retirement plans to the maximum.  You will not believe how quickly the years go by and you will wish you had saved more!

By Flossie Riesner, Consultant