SILKIN MANAGEMENT GROUP: Some Info for Tax Planning

August 1, 2012

Although Silkin Management Group is not an accounting firm, we still attempt to stay on top of anything that will affect our clients’ financial situation. Taxes certainly fall into that category. With the majority of Silkin’s clients being private practice owners in various health care fields, it behooves us to pass along what we find out regarding financial and tax matters.

Thanks to the extension of the “Bush tax cuts” through 2012, the current federal income tax environment remains favorable through year-end. Therefore now is the time to take advantage of this favorable climate because we don’t know what will change in 2013. Taxes could easily go up if there is a significant victory by the Democrats. We will present over the next week or so, on our various Silkin Management Group blog sites, some ideas that any of our readers might find useful in this area.

The traditional approach many people take is to defer income into the next year if they expect to be in a lower tax bracket at that time. This can be done by waiting until near the end of the year to send out billings and/or slowing down insurance submissions, etc. You can also postpone taxable income by accelerating some deductible business expenditures into this year. Deferring income may also be helpful if you are affected by unfavorable phase-out rules that reduce or eliminate various tax breaks such as child tax credits, education credits, etc.

But there is the other side of the coin to also consider, especially with a very contentious election season ahead of us. If the Bush tax cuts are allowed to expire at the end of the year (which is likely if you are earning over $250,000 a year), deferring income may not be the best way to go as you could be exposed to higher rates next year. In that case, you would want to look at ways to accelerate income into this year and deferring deductions until next year.

Again, we’ll present more ideas on this subject in upcoming Silkin Management Group blogs.

DAVE MCKEVITT
Silkin Management Group Consultant

Visit our website at www.silkinmanagementgroup.com” Like us on facebook at http://www.facebook.com/silkinmanagementgroup


SILKIN MANAGEMENT GROUP: Job Duties for an Exam and Consultation Department in an Orthodontic Practice

May 23, 2012

Several days ago we presented information on general job duties for a Personnel and Communications Department in a health care practice. You can access that article on the following Silkin Management Group blog site: Dept 1
Today we’ll continue our discussion of organizational structure examples by taking up another department in a health care practice that Silkin Management Consultants work with their clients on. We will use a specialty practice, orthodontics, in this example. We will go over the key job duties of an exam and consultation department of such a practice. These job duties can easily be adapted to the other types of health care practices that Silkin Management Group deals with including general dentists, veterinarians and optometrists.

Job Duties of the Exams and Consultation Department:

Overall In-Charge Staff Member:

• Keeps track of all patients and track of the thoroughness of all treatment including full ortho, limited ortho, TMJ.

• Removes all educational and financial barriers and gets office to accurately track the follow up care patients need.

• Makes sure adequate personnel are there, trained and productive.

Treatment Coordinator:

• Greets patients with enthusiasm.

• Seats them in exam/records room with medical history form and any additional information and X-rays.

• Records pertinent information on exam card.

• Takes necessary X-rays and makes patient feel welcome and comfortable.

• Sets up consultation room and seats patient for consultation and ensures consultation room is always in order.

• Monitors exam patients who will call back for appointments to start.

• Follows through with consultation procedure after Doctor’s consultation.

• Contacts patient after insurance predeterminations are received.

• Follows up on pending patients after records and consultation.

• Communicates with patients/parents clearly, answering all questions regarding treatment.

• Handles transferring patient’s records and forms.

Exam/Consultation Doctor:

• Orders and checks that X-rays are proper.

• Evaluates the following with the patient:

• Medical History

• Patient’s orthodontic/cosmetic problem.

• Determines if patient needs full or partial ortho treatment, TMJ, or should be placed in observation.

• Prepares for consultation with purpose of bringing about total patient understanding of their problem, maintaining excellent two way communication, interest and understanding.

• Passes patient over to treatment coordinator ensuring all understandings are communicated to her with patient present, to minimize miscommunication.

• Calls patient as needed to assist them in starting care under the direction of the Treatment Coordinator.

Collections Coordinator:

• Runs credit report.

• Contacts patient after insurance predeterminations are received.

• Handles financial arrangements so patient can start care as soon as possible.

• Handles insurance questions and calculates coverage to determine patient’s cash payments.

• Validates patient for paying and going on to treatment.

• Gets deductibles up front and co-payment.

Monitoring Production Statistic:

• Number of Patients Started on Care

• $ Value of Treatment Sold

Valuable Final Product of the Area:

• Patients Committed to Orthodontic Care.

Again, this can be adapted to any health care office. Silkin Management Group’s 400 page office policy and job description manual covers all job descriptions and example office policies for any health care practice. You can find out more about this manual and our services by visiting silkinmanagementgroup

GARY CRAWSHAW
Silkin Management Group Consultant

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SILKIN MANAGEMENT GROUP: Job Duties for an Exam and Consultation Department in an Orthodontic Practice

May 23, 2012

Several days ago we presented information on general job duties for a Personnel and Communications Department in a health care practice. You can access that article on the following Silkin Management Group blog site: Dept. 1

Today we’ll continue our discussion of organizational structure examples by taking up another department in a health care practice that Silkin Management Consultants work with their clients on. We will use a specialty practice, orthodontics, in this example. We will go over the key job duties of an exam and consultation department of such a practice. These job duties can easily be adapted to the other types of health care practices that Silkin Management Group deals with including general dentists, veterinarians and optometrists.

Job Duties of the Exams and Consultation Department:

Overall In-Charge Staff Member:

• Keeps track of all patients and track of the thoroughness of all treatment including full ortho, limited ortho, TMJ.

• Removes all educational and financial barriers and gets office to accurately track the follow up care patients need.

• Makes sure adequate personnel are there, trained and productive.

Treatment Coordinator:

• Greets patients with enthusiasm.

• Seats them in exam/records room with medical history form and any additional information and X-rays.

• Records pertinent information on exam card.

• Takes necessary X-rays and makes patient feel welcome and comfortable.

• Sets up consultation room and seats patient for consultation and ensures consultation room is always in order.

• Monitors exam patients who will call back for appointments to start.

• Follows through with consultation procedure after Doctor’s consultation.

• Contacts patient after insurance predeterminations are received.

• Follows up on pending patients after records and consultation.

• Communicates with patients/parents clearly, answering all questions regarding treatment.

• Handles transferring patient’s records and forms.

Exam/Consultation Doctor:

• Orders and checks that X-rays are proper.

• Evaluates the following with the patient:

• Medical History

• Patient’s orthodontic/cosmetic problem.

• Determines if patient needs full or partial ortho treatment, TMJ, or should be placed in observation.

• Prepares for consultation with purpose of bringing about total patient understanding of their problem, maintaining excellent two way communication, interest and understanding.

• Passes patient over to treatment coordinator ensuring all understandings are communicated to her with patient present, to minimize miscommunication.

• Calls patient as needed to assist them in starting care under the direction of the Treatment Coordinator.

Collections Coordinator:

• Runs credit report.

• Contacts patient after insurance predeterminations are received.

• Handles financial arrangements so patient can start care as soon as possible.

• Handles insurance questions and calculates coverage to determine patient’s cash payments.

• Validates patient for paying and going on to treatment.

• Gets deductibles up front and co-payment.

Monitoring Production Statistic:

• Number of Patients Started on Care

• $ Value of Treatment Sold

Valuable Final Product of the Area:

• Patients Committed to Orthodontic Care.

Again, this can be adapted to any health care office. Silkin Management Group’s 400 page office policy and job description manual covers all job descriptions and example office policies for any health care practice. You can find out more about this manual and our services by visiting silkinmanagementgroup

GARY CRAWSHAW
Silkin Management Group Consultant

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SILKIN MANAGEMENT GROUP: Job Duties for an Exam and Consultation Department in an Orthodontic Practice

May 23, 2012

Several days ago we presented information on general job duties for a Personnel and Communications Department in a health care practice. You can access that article on the following Silkin Management Group blog site: Dept. 1

Today we’ll continue our discussion of organizational structure examples by taking up another department in a health care practice that Silkin Management Consultants work with their clients on. We will use a specialty practice, orthodontics, in this example. We will go over the key job duties of an exam and consultation department of such a practice. These job duties can easily be adapted to the other types of health care practices that Silkin Management Group deals with including general dentists, veterinarians and optometrists.

Job Duties of the Exams and Consultation Department:

Overall In-Charge Staff Member:

• Keeps track of all patients and track of the thoroughness of all treatment including full ortho, limited ortho, TMJ.

• Removes all educational and financial barriers and gets office to accurately track the follow up care patients need.

• Makes sure adequate personnel are there, trained and productive.

Treatment Coordinator:

• Greets patients with enthusiasm.

• Seats them in exam/records room with medical history form and any additional information and X-rays.

• Records pertinent information on exam card.

• Takes necessary X-rays and makes patient feel welcome and comfortable.

• Sets up consultation room and seats patient for consultation and ensures consultation room is always in order.

• Monitors exam patients who will call back for appointments to start.

• Follows through with consultation procedure after Doctor’s consultation.

• Contacts patient after insurance predeterminations are received.

• Follows up on pending patients after records and consultation.

• Communicates with patients/parents clearly, answering all questions regarding treatment.

• Handles transferring patient’s records and forms.

Exam/Consultation Doctor:

• Orders and checks that X-rays are proper.

• Evaluates the following with the patient:

• Medical History

• Patient’s orthodontic/cosmetic problem.

• Determines if patient needs full or partial ortho treatment, TMJ, or should be placed in observation.

• Prepares for consultation with purpose of bringing about total patient understanding of their problem, maintaining excellent two way communication, interest and understanding.

• Passes patient over to treatment coordinator ensuring all understandings are communicated to her with patient present, to minimize miscommunication.

• Calls patient as needed to assist them in starting care under the direction of the Treatment Coordinator.

Collections Coordinator:

• Runs credit report.

• Contacts patient after insurance predeterminations are received.

• Handles financial arrangements so patient can start care as soon as possible.

• Handles insurance questions and calculates coverage to determine patient’s cash payments.

• Validates patient for paying and going on to treatment.

• Gets deductibles up front and co-payment.

Monitoring Production Statistic:

• Number of Patients Started on Care

• $ Value of Treatment Sold

Valuable Final Product of the Area:

• Patients Committed to Orthodontic Care.

Again, this can be adapted to any health care office. Silkin Management Group’s 400 page office policy and job description manual covers all job descriptions and example office policies for any health care practice. You can find out more about this manual and our services by visiting www.silkinmanagementgroup.com

GARY CRAWSHAW
Silkin Management Group Consultant

Like us on Facebook http://www.facebook.com/silkinmanagementgroup


SILKIN MANAGEMENT GROUP: Job Duties for a Personnel and Communications Department

May 22, 2012

Silkin Management Group consultants work with their clients on establishing proper job descriptions and office policies for their business. Clients new to Silkin Management Group receive our 400 page Office Policy and Job Description Manual as part of their program. This manual can easily be edited and adapted to most any health care office.

Part of the work Silkin Management Group consultants perform with their clients is establishing proper organizational structure into the office. We organize around 7 key areas of a practice with each of these areas broken down into their own sections. Today we’ll lay out the key duties of one of those areas, the personnel and communications section.

Key Job Duties:

• Ensures all communications/data in office flows to the right person and removes any blockages. This includes mail, verbal, telephone or otherwise.

• Keeps statistic board updated on all major divisional statistics to determine where communication blockages are.

• Makes sure adequate personnel are there, trained and productive.

Receptionist

• Greets patients with life and energy.

• Handles phone calls effortlessly and quickly.

• Creates charts for patients.

• Gets medical history and insurance forms from each patient/or updates records on each patient.

• Keeps short notice lists to fill canceled or broken appointments.

• Routes mail after sorting to proper person.

• Keeps patient files in order. Repots any misuse of files or lost files to Office Manager.

• Handles over the counter collections and gives money and receipts to Collections Supervisor.

• Ensures reception is kept clean.

• Keeps new patient log up to date and accurate.

Personnel Director

• Looks for and gets staff and doctor looking for future employees.

• Interviews perspective employees whether hiring or not so as to ensure there are adequate staff available.

• Hires people correctly with OK from Financial Planning.

• Creates personnel files and maintains them.

• Issues basic policy to new staff member and trains them on equipment they may use.

• Gives staff member a clear understanding of their job purpose and issues the statistics to measure it.

• Updates personnel files to reflect promotions, seniority and pay changes.

• Keeps organizing board updated and gets staff to understand and use it to keep communication lines clear and going to the correct person.

Efficiency Supervisor

• Reviews stats of individual staff to determine productivity problems.

• Interviews staff who have low statistics to help them handle the problem.

• Handles upsets between staff when they fail to do so themselves.

• Accepts and evaluates written reports regarding staff performance.

• Ensures and recommends upstat staff get bonuses.

Part Time Personnel

• Works in areas of the office at the direction of their immediate supervisor and the Personnel Director.

Monitoring Statistic:

• Number of Staff with rising productivity.

Valuable Final Product of the Area;

• Fully Posted and Functioning Staff

For more information about how Silkin Management Group can help organize your office and/or to find out about Silkin Management Group’s Office Policy and Job Description Manual, call us at 800-695-0257 or visit our website at www.silkinmanagementgroup.com

JONO LOBUE
Silkin Management Group Consultant


SILKIN MANAGEMENT GROUP: An Example of a Company Game to Increase Production and Net

May 14, 2012

In past Silkin Management Group blogs we’ve presented different games and bonus systems that Silkin Management Group consultants use with their clients to get the entire staff motivated and more productive. In today’s blog we’ll give another example of an actual proposal written by an office manager to a practice owner that resulted in greatly increased production and net for this Silkin client’s office and a great staff reward. The name of the office has been removed for privacy sake.

For more information about how Silkin Management Group can help your office achieve greatly increased production and net, visit our website at www.silkinmanagementgroup.com

DAVE MCKEVITT
Silkin Management Group Consultant

PROPOSAL

Situation: The need to increase profit margin at ABC.

Data: Growth has been successfully stimulated at ABC by creating a 1 year staff games. In the past 3 years the game has resulted in an increase in services, production and management profit margin

See the attached grid which lays out the profit margin as follows:

o Management profit margin: The difference between average monthly collections and average monthly operating expenses.

o Owner profit margin: The difference between average monthly collections and average monthly operating expenses and owner/associate salaries.

My solution will be based on the projected grid for the upcoming year. This results in the following:

o increase in collections of $225,800

o “owner profit” margin of $15,000 per month.

o Record “management profit” margin of $50,000 per month.

The last two years when the staff won a similar game, production wasn’t adversely affected by the time off the staff received.

o Last Year – Feb stats up, March stats down.

o Year before – Feb stats down, March stats up.

The cost of winning the game the last two years was approximately $25,000. As you can see from the grids, the added profit margins more than paid for the game plus large increases in management and owner profits. Thus the game was financially very successful.

I surveyed staff to see the game that they preferred Each person preferred the last years’ game reward rather than the previous year. Two years ago we voted to go to Maui and ½ staff went one week and other ½ went the following week. Last year only 2 staff were They preferred this because it gave them freedom to go where they wanted and not voted by group, freedom to spend money allotted per individual preference and it was easier and more sane to run the office while staff was gone.

Overall, the game I propose is not quite as profitable for the clinic as the two year ago game, but more than last year’s game.

My solution promotes staff thinking a bigger game for themselves and the office. I feel this will reflect in a “go for it” attitude to win the game and get us back into “incredible growth” again.

SOLUTION: Goal: Service $1,533,333 and with collections: $1,380,000

o 5 paid days off

o $1,500 expense account

o No restrictions on where to go

o To be done over a 6 week period, schedule to be determined by Office Manager.

o Must be an employee all of this year and full time (26 hours +) to get full reward. Part-time will be pro-rated.

o Operating expenses not to exceed an average of $65,000 per month. (This increase in operating expenses takes into account reserves and pension fund which wasn’t done in previous average operating expenses.)

 

  • o Announce at Tuesday, January 17, staff meeting for maximum use of game.  Not to wait any longer.

 

I actually feel if this is approved that the goals will be surpassed, not just met.

 

Total clinic cost game $30,000 and vacation leave $6,150 = $36,157

Approved____________________

Disapproved_________________________

 

 


SILKIN MANAGEMENT GROUP: Some Points on Analyzing Your Practice or Business – Part 2

May 4, 2012

In a recent Silkin Management Group blog, we began a series of articles designed to help practice owners, whether Silkin Management Group clients or not, evaluate their practice. These articles are based on key functions that belong in any office of any size, or really any business. Without these functions properly in place any business will have difficulties to one degree or another.

Silkin Management Group consultants use these points as well as many other in-depth tools to properly analyze a practice and develop a step by step practice implementation program to resolve existing issues in a practice in a prioritized orderly fashion. You can access the first article in this series by linking to this Silkin Management Group blog site: Eval 1

Today we’ll cover some key functions in the area of promotion, marketing and sales.

• Do you do any marketing or promotion to existing patients/clients?

• Is your marketing and promotion done by your own staff in-house or by outside parties?

• What kind of results are you getting and how do you know you’re getting those results?

• What kind of statistical tracking do you do on your different promotional efforts to evaluate what is working and what isn’t?

• What promotional marketing do you do to get new patients/clients?

• Is this done in-house or through external sources? How effective are each?

• Are you satisfied with the results?

• Do you have a method to evaluate your satisfaction with the results?

• What portion of your income is accounted for by new patients/clients versus existing patients/clients?

• Do you have an effective internal marketing program?

• Do you get lots of new patients from referrals?

• Does your staff know how to ask for referrals?

• How effective is your treatment plan acceptance?

• Do you have a way to monitor the effectiveness of your treatment plan presentations?

• How do you go about following up on large treatment plans and selling additional or new services to existing or old patients?

• Do you keep in communication with your old clients or customers? If so, how?

• Do you keep a file or record of past patients/clients?

• Do you have an effective reactivation program?

There are many more areas that Silkin Management Group consultants delve into in the area of marketing, promotion and sales to create a good flow of new patients, treatment plan acceptance and increased production and income without spending much on marketing. Expensive external marketing is not needed to bring in new patients, retain existing ones and reactivate past patients/clients. For more information about this visit our website at www.silkinmanagementgroup.com

JONO LOBUE
Silkin Management Group Consultant


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