Archives for November 2017

Dental Practice Accounts Receivable – What’s Your Story?

November 16, 2017 by Hugh Duffy

Accounts receivable within every dental practice tells a story. And that story varies within each practice depending upon the approach you take. It tells how big of a bank your dental practice has become, especially when you look at the amount of money that is owed to your practice after more than 90 days.

So what is the amount of A/R that the average dental practice has on its book for more than 90 days? How does the average practice’s A/R compare to its gross production? To find this out, we took data from Sikka Software over the last seven years. The data we are using for this comparison has been collected by Sikka Software from more than 12,500 dental practices from around the United States.

Here are the numbers..

Average Dental Practice A/R above 90 days
2011 — $41,111.14
2012 — $48,579.92
2013 — $51,584.39
2014 — $52,571.54
2015 — $49,598.06
2016 — $47,736.21

Average Dental Practice A/R to gross production
2011 – 78.29%
sikka 2012 – 85.28%
2013 – 92.98%
2014 – 98.66%
2015 – 101.27%
2016 – 94.79%

Do you know what your A/R is for more than 90 days? Do you know how it compares to your overall gross production? These are key numbers for any dentist to know. After all, they directly affect the health of your practice.

Z - Dental Practice Ninjas Andy Cleveland, dubbed as the A/R Ninja, is tonight’s keynote speaker on this exact topic at a dental study club locally and has been nice enough to invite us as well. While Andy’s insights won’t be shared publicly, each Dental Accounting Association will be fully briefed so we can drive down AR.

If you are looking to shrink A/R, there are many tools like SIKKA, TekCollect and the tactics that you deploy within your dental office.

Selecting a Dental CPA

While working with a local generalist CPA is convenient, a general CPA does not have the time, interest or in-depth knowledge of the dental industry to provide tools or guidance on managing Accounts Receivable. For example, Dental Accounting Association members utilize tools like SIKKA and TekCollect to better manage AR and shrink it proactively.

If you are searching for a higher level of expertise, visit the Dental Accounting Association website to locate a Dental CPA nearby or contact us and we’ll make an introduction for you.

Aggressive Tax Savings for Dentists

November 9, 2017 by Hugh Duffy

There are very few financial advisors (and even fewer dentists) who have ever heard of cost segregation depreciation. Dentists are constantly requesting tax advice from their CPAs as well as their financial advisors. Since they are high-income earners, they want the best people advising them about tax write-offs and how fast they can get them.

Most CPA’s and Dentists know the guidelines for section 179 depreciation, which involves a quick write-off for depreciation for equipment and other non-real property related assets. When the question is posed about cost segregation depreciation, they are at a loss and often feel that it does not apply to a small dental practice.

Cost segregation depreciation is a quasi-science for financial experts that provide this service. Many CPA’s do not realize that it is cost effective for a small office building. In years past, cost segregation applied to larger, more expensive commercial buildings (think manufacturing plant, auto dealer, utility, skyscraper office building, mall, etc.). As a result, very few CPA’s recommend cost segregation depreciation and most don’t really understand it very well.

Cost segregation depreciation is well understood and accepted by the IRS. The tax savings are significant for a dental practice if the service is provided by the right experts. And because the rules are complicated, cost segregation is done by boutique firms that do this full time.

Cost segregation actually came about as a result of Hospital Corporation of America suing the IRS…and winning! The Supreme Court of the United States heard arguments from opposing counsel and ruled that there are building components qualifying for shorter depreciation periods…5-years, 7-years and 15-years. This is simple mathematics for forensic accountants.

To provide aggressive tax savings for dental practices, the Dental Accounting Association works with a forensic engineering firm that applies all of the Internal Revenue Code to the advantage of the commercial property owner (the dentist). Specifically, they use IRC § 481(a), the “catch-up” provision. This little section of the tax code allows forensic accountants to give any commercial property owner a windfall tax refund. Without amending a single tax return, they can go back to January 1, 1987 and get your overpaid taxes paid to you in the current tax year. The IRS grants what is called “automatic consent.” For you, the taxpaying property owner, it means the IRS gives you all of those overpaid taxes simply by filing Form 3115. The forensic accountant that Dental Accounting recommends will provide that exact role at no additional charge.

So, if you own or lease commercial real estate of any kind, we can help. Each of our Dental Accountants will recommend the right forensic engineering firm to save you taxes. The service is so complicated that it is not done in-house by your local Dental CPA. The forensic engineers recommended by your Dental Accountant are highly trained in building componentization and applying the tax code to those components.

To initiate this evaluation, simply provide us with your contact information and we will put you in touch with a Dental CPA near you to quarterback this project and identify the potential tax savings.

If you are tired of overpaying taxes, this aggressive tax savings tool is rock solid and black ‘n white.

Dental Profit Coaching – Critical Numbers to Track

November 7, 2017 by Hugh Duffy

Within a dental practice, there are endless things to track and monitor. So where does one start to evaluate production, compare performance versus similar practices in the local area, evaluate pricing, and practice profitability?

As Profit Coaches for Dental Practices, our members within the Dental Accounting Association are asked these questions all the time. Here’s how we typically approach this process and how we monitor performance and production.

First and foremost, the Dental Accounting Association uses one standardized set of industry benchmark costs, one chart of accounts, and one business intelligence system (SIKKA) to evaluate production, standardize reporting, and evaluate pricing. That said, here are the key numbers to watch:

Dental Practice Overhead

Typically, the first place to evaluate profitability is examining dental practice overhead and getting control over areas to prune costs. While most aspects of overhead change infrequently, there are inflexion points when overhead can be reduced dramatically. These is worthy of a discussion with your Dental CPA for guidance and recommendations on how to cost reduce key drivers of dental practice overhead.

Profit and Loss Statement

While every business owner uses a P&L statement as a starting point to evaluate profitability, one key ingredient is that the underlying categories need to standardized and categorized so your P&L can be compared to similar sized dental practices. Comparing a typical P&L to another dental practice requires that expenses and categories are classified the exact same. Absent of this standardized approach, you will be comparing apples to bananas.

Within the Dental Accounting Association, we use one standardized chart of accounts so we are comparing apples to apples.

Personnel Costs

Most dentists know where they stand on this category but having outside comparisons never hurt.

To properly evaluate, personnel costs need to be broken down by departments; chairside, hygiene, clerical, etc. Second, outsourced services such as temps should be part of this category as well.

Other Key Cost Categories

Variable Costs (include dental supplies and lab fees)
Facility and Equipment Costs
Discretionary Costs
Owner’s Comp

Critical KPIs

sikka As part of the dental profit coaching, we like to review key performance indicators (KPIs) of the dental practice to compare and contrast profitability. The SIKKA software makes this process easy for us to evaluate this as well.

Fee Optimization

The last piece of this process is reviewing fees charged by procedure. This is where SIKKA software excels and helps us pinpoint opportunities.

Selecting a Dental CPA for Profit Coaching

While working with a local generalist CPA is convenient, a general CPA does not have the time, interest or in-depth knowledge of the dental industry to provide dental practice profit coaching. For that matter, they often don’t have all of the resources to take full advantage of all the tax breaks available for a dental practice. For example, our members provide boutique capabilities like cost segregation and/or put you in touch with commercial real estate experts who focus on the dental industry to save even more money at no additional cost to you.

Dental CPA’s are trained to take full advantage of the tax law for dental practices and they collaborate with other dental vendors to take it several steps further. Like operating your dental practice, there are economies of scale by working with dental practices and working with boutique providers for dentists. Your Dental CPA provides some of these boutique services in-house and will introduce you to dental experts at the right moments of your practice horizon.

If you are searching for a higher level of expertise, visit the Dental Accounting Association website to locate a Dental CPA nearby or contact us and we’ll make an introduction for you.

FREE E-Book – The First Few Transitions as a New Dentist – If you’d like to gain more insight into the lifestages of a dental practice and how a dental CPA can help you minimize your taxes while maximizing your wealth, request our free eBook. It’s free.

Oral and Maxillofacial Surgery Trends

November 7, 2017 by Hugh Duffy

Are more general practitioners keeping more procedures in house rather than referring them out?

That’s what some numbers compiled from Sikka Software data suggest.

Looking at the quantity of oral and maxillofacial surgeries per practice per month, numbers have risen sharply since 2010. A common theory floated about shortly after the 2008 recession was in full effect was that dental practices would keep more procedures in house in order to not lose the production. These numbers seem to buoy that theory.

In order to find these average numbers, we extracted data from Sikka Software that has been collected from more than 12,500 dental practices from around the United States.

Below are the average number of oral and maxillofacial surgeries per practice per month..

2010 – 24.92
2011 – 26.25
2012 – 26.5
2013 – 27.75
2014 – 29.5
2015 – 30.75
2016 – 29.25

How were these numbers tabulated? Sikka Software extracted data from each practice using the practice’s practice management software and specifically looking for one or more of more than 130 codes ranging from D7000-D7999 (oral and maxillofacial surgery section of the American Dental Association’s CDT codes). These codes include procedures such as extractions, biopsy of oral tissue and surgical extraction of lesions.

dental-practice-management Maybe you’re looking at this area of your practice and wondering how you can boost your numbers? Some of it may involve the extraction of teeth for implant placement. Some of it may involve oral cancer screenings. Boosting this area of your practice could mean it’s time to look at your treatment mix and see what you’ve added in recent years.

Dr. Roger Levin recently talked about this in a recent Dental Economics article when talking about Phase II of a dentist’s career. You can read the entire article where he describes all three phases of a dentist’s career by clicking here. Link to http://www.dentaleconomics.com/articles/print/volume-94/issue-6/features/how-to-grow-your-practice-without-bursting-it-at-the-seams.html

“In Phase II, dentists become busy and reach a plateau where the practice is at an artificial full capacity and further growth becomes difficult. Unfortunately, these plateaus are significantly below the real production potential of the practice. The practice is busy, but mostly because it is not running as efficiently as it could, and therefore, not maximizing production. Once a practice is running at what is perceived as full capacity, the dentist usually has little time to devote to devising management systems to work smarter, not harder.

“Due to a limited education in business, most dentists do not fully understand how to implement effective practice-management systems. Therefore, they cannot make the changes necessary to help the practice reach its full potential.

“In Phase II, the practice is in a plateau with slight periodic growth. This periodic growth does not come from better systems, but rather from fee increases or occasionally adding new services. This potential growth is diminished in a challenging economy.”

Perhaps it’s time for you to look at your treatment mix, not only in terms of what you’re offering but also when is the last time you added to your offerings. Also, are you telling your patients what you can offer to them?

It’s important to not only know your numbers but also know what is producing those numbers in your practice.

Source – This article was provided for reprint by SIKKA Software. SIKKA is the leading provider of business intelligence software for the dental industry. The Dental Accounting Association, and the Dental CPA’s within this association, utilize SIKKA intelligence software to provide dental practice profit coaching and identify key insights for production improvement.

Dentists Net Production per Hour and Trends

November 7, 2017 by Hugh Duffy

One of the most important numbers for any dental practice to know is exactly how much the dentist is producing Z - Dental image - open mouth on a daily basis. When you consider that the dental practice is a business and the dentist is the highest-paid employee of that business, it’s important that the dentist is producing at a high level.

Using data from more than 12,500 dental practices compiled by Sikka Software, we have a good indication of how a dentist’s production in the average dental practice is looking. We’ve taken the average over the last seven years and put the numbers below.

Figure 1: Dentist net production per hour, 2010–2016
2010 – $251.31
2011 – $233.43
2012 – $191.35
2013 – $191.66
2014 – $195.04
2015 – $205.57
2016 – $216.24

Both dentist net production and hygiene net production took a massive hit in 2012. Neither have recovered to their levels of 2010.

So what does that mean for you? It means business today is different than it was at the start of this decade. Cash-to-insurance ratio as a method of payment is at an all-time low right now. Your patients are looking to see what is covered by insurance and hesitant to do more than what is covered out of pocket. That means it’s a great time to understand exactly how payment options like the ones provided by CareCredit and other financing companies work.

How can you keep your production at a high level? It’s a critical time for dentists to take a look at their annual budget, says noted practice management consultant Jan Keller.

“When preparing the annual budget each year, knowing the total office production is important in forecasting what both hygiene production and doctor production needs to be for the upcoming year in order to meet our budget and have a profit,” Keller says. “Have a plan in place as to how you will meet your production goals, then know each quarter the goal may increase.”

Z - Dental Office Keller also believes having a strategic plan is critical for today’s dental practice. “You have to have a plan in place to monitor this information,” she said. “You need to be asking questions like, ‘Where are we spending our money each month?’ ‘What can we modify or change if necessary?’ ‘What adjustments do we need to make in our spending to keep costs in line or what specific things can we improve upon to increase our production?’”

Keller also believes it will take a team effort to ensure production stays high at your practice.

“So many times, hygienists are performing more than a prophylaxis but are afraid to discuss the periodontal involvement because of the financial aspect.” Keller said. “The entire team needs to be comfortable not only with the fees of the practice but also in charging for the treatment they are delivering. Having team meetings to work on diagnosis and presentation skills in each department is so important to keep the production numbers high.”

Source – This article was provided for reprint by SIKKA Software. SIKKA is the leading provider of business intelligence software for the dental industry. The Dental Accounting Association utilizes SIKKA intelligence software to provide profit coaching and make recommendations to improve production. To learn more about SIKKA, simply visit www.sikkasoft.com.

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Archives for November 2017