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PO Box 5228 - Salem, Oregon 97304 503-999-3451 [email protected]
THE RIGHT FEE & THE RIGHT
INSURANCE RELATIONSHIP
BALANCING YOUR FEES WILL
HELP YOU REACH YOUR RETIREMENT
MOMENTUM Dental Fee Advisors
Corey J. Creamer
“The Dental Fee Advisor”
Charleston, SC
May 2, 2015
MOMENTUM Dental Fee Advisors
COREY J. CREAMER Dental Consultant & Dental Fee Advisor
Corey studied business and economics at Brigham Young University and Willamette University. Early in his professional career, Corey spent nine years in management at Costco Wholesale in Utah where he gained valuable experience in how to successfully manage high-income businesses. This knowledge and experience has helped Corey find ways to help dentists reach their goal and maximize their earning potential. Corey returned to Oregon to work with his father, Bob Creamer, at Creamer & Associates, PC, a CPA and consulting firm dedicated to serving the dental industry. Before launching his own company, MOMENTUM-Dental Fee Advisors, Corey spent 11 years developing and implementing the dental consulting and fee services for Creamer & Associates. During that time he has consulted with hundreds of clients to help them unlock their profitability potential, thereby improving their quality of life. As the President and owner of Momentum DFA, Corey specializes in analyzing the businesses of dental professionals. He advises on fee setting, fee rebalancing and revenue optimization to help keep the dentists competitive in their market while maximizing their profitability. He consults and works with dentists and their teams to help them run an effective and profitable dental practice. Corey has authored several articles for local, regional, and national dental publications. He has traveled the country speaking on his areas of expertise at dental seminars for state and local doctor seminars as well as for team events. Contact him at 503-999-3451 for information on the services he can provide for your dental practice. Corey is a devoted father of two and enjoys spending time coaching and being a spectator for his children’s sports teams. He also enjoys the outdoors and is an avid collector of items of historical value. He is a researcher and serves on the board of the Remington Society of America.
MOMENTUM Dental Fee Advisors
PO Box 5228, Salem, Oregon 97304 503-999-3451 [email protected]
THE RIGHT FEE & THE RIGHT INSURANCE RELATIONSHIP
-------------
BALANCING YOUR FEES WILL HELP YOU REACH YOUR
RETIREMENTCorey Creamer
Momentum Dental Fee AdvisorsPO Box 5228, Salem OR, 97304
MOMENTUM-DFA
EVALUATE FEES!
MOMENTUM-DFA
NO MATTER WHERE THEY ARE SET, MOST PATIENTS ALREADY THINK THEY
ARE TOO HIGH.
BALANCE FEES!
MOMENTUM-DFA
Most Expensive Least Expensive
CODE DESCRIPTION 1 2 3 4 5D0120 periodic oral evaluation C A E D BD0140 limited oral evaluation C D A E B Doctor AD0150 comprehensive oral evaluation C D E A B Doctor BD0210 intraoral - complete series E A B D C Doctor CD0272 bitewings - two films D C A B E Doctor DD0274 bitewings - four films D A C E B Doctor ED0330 panoramic film E A D B CD1110 prophylaxis - adult C E D B AD1120 prophylaxis - child C E D B AD1203 topical application of fluoride - child C D A E BD1204 topical application of fluoride - adult C E D A BD1351 sealant - per tooth E D C B AD2140 amalgam - one surface D B A E CD2150 amalgam - two surfaces D B A E CD2330 resin-based composite - one A B E D CD2331 resin-based composite - two B A E D CD2391 resin-based composite - one A B E D CD2392 resin-based composite - two A B E D CD2740 crown - porcelain/ceramic B A C D ED2750 crown - pfm B A D C ED2950 core buildup, including any pins A B C D ED3330 endodontic therapy, molar C D A E BD4341 periodontal scaling and root planing D C B A ED4910 periodontal maintenance D C B E AD7140 extraction, erupted tooth or exposed A D E C BD7210 surgical removal of erupted tooth E D A B CD9230 inhalation of nitrous oxide / anxiolysis B C E D A
WHO IS THE MOST EXPENSIVE?
MOMENTUM-DFA
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
D0120
D0180
D0230
D0274
D1120
D1204
D1510
D2160
D2332
D2392
D2740
D2752
D2931
D2954
D2970
D3221
D4341
D4910
D5211
D5510
D5640
D5751
D5850
D6241
D7210
D7310
D9310
D9630
D9951
D9974
PERCENTILE PLOTTED FEE CHART
DrDr--FF
Chart of Randomly Selected Doctors’Fees & Survey Average
SurveyAverage Survey
Average
Visual Charting of Randomly Selected Doctors’ Fees & Society Average
Most Expensive Least Expensive
CODE DESCRIPTION 1 2 3 4 5D0120 periodic oral evaluation C A E D BD0140 limited oral evaluation C D A E B Doctor AD0150 comprehensive oral evaluation C D E A B Doctor BD0210 intraoral - complete series E A B D C Doctor CD0272 bitewings - two films D C A B E Doctor DD0274 bitewings - four films D A C E B Doctor ED0330 panoramic film E A D B CD1110 prophylaxis - adult C E D B AD1120 prophylaxis - child C E D B AD1203 topical application of fluoride - child C D A E BD1204 topical application of fluoride - adult C E D A BD1351 sealant - per tooth E D C B AD2140 amalgam - one surface D B A E CD2150 amalgam - two surfaces D B A E CD2330 resin-based composite - one A B E D CD2331 resin-based composite - two B A E D CD2391 resin-based composite - one A B E D CD2392 resin-based composite - two A B E D CD2740 crown - porcelain/ceramic B A C D ED2750 crown - pfm B A D C ED2950 core buildup, including any pins A B C D ED3330 endodontic therapy, molar C D A E BD4341 periodontal scaling and root planing D C B A ED4910 periodontal maintenance D C B E AD7140 extraction, erupted tooth or exposed A D E C BD7210 surgical removal of erupted tooth E D A B CD9230 inhalation of nitrous oxide / anxiolysis B C E D A
WHO IS THE MOST EXPENSIVE?
? ?
MOMENTUM-DFA
Most Expensive Least Expensive
CODE DESCRIPTION 1 2 3 4 5D0120 periodic oral evaluation C E A D BD0140 limited oral evaluation C E D A B Doctor AD0150 comprehensive oral evaluation C E D A B Doctor BD0210 intraoral - complete series A E B D C Doctor CD0272 bitewings - two films D E C A B Doctor DD0274 bitewings - four films D E A C B Doctor ED0330 panoramic film A E D B CD1110 prophylaxis - adult C E D B AD1120 prophylaxis - child C E D B AD1203 topical application of fluoride - child C E D A BD1204 topical application of fluoride - adult C E D A BD1351 sealant - per tooth D E C B AD2140 amalgam - one surface D E B A CD2150 amalgam - two surfaces D E B A CD2330 resin-based composite - one A E B D CD2331 resin-based composite - two B E A D CD2391 resin-based composite - one A E B D CD2392 resin-based composite - two A E B D CD2740 crown - porcelain/ceramic B E A C DD2750 crown - pfm B E A D CD2950 core buildup, including any pins A E B C DD3330 endodontic therapy, molar C E D A BD4341 periodontal scaling and root planing D E C B AD4910 periodontal maintenance D E C B AD7140 extraction, erupted tooth or exposed A E D C BD7210 surgical removal of erupted tooth D E A B CD9230 inhalation of nitrous oxide / anxiolysis B E C D A
WHO HAS OPTIMIZED FEES?
E
MOMENTUM-DFA
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100 %
P E R C E N T I L E P L O T T E D F E E C H A R T
0
100,000
200,000
300,000
400,000
500,000
600,000
700,000
800,000
900,000
1,000,000
Actual 40th 50th 60th 70th 80th 90th 95th
REVENUE OPTIMIZER GROWTH CHART
$686,522 711,188 715,639 723,268 740,294 770,237 839,321 916,572
24,666 29,117 36,746 53,772 83,715 152,799 230,050
4% 4% 5% 8% 12% 22% 34%
0
100,000
200,000
300,000
400,000
500,000
600,000
Actual 40th 50th 60th 70th 80th 90th 95th
PRACTICE PROFITS
24,666 29,117 36,746 53,772 83,715 152,799 230,050
$247148 271,814 276,265 283,894 300,920 330,863 399,947 477,198
10% 12% 15% 22% 34% 62% 93%
PATIENT FEE PERCENTILE CHARTING
20%
30%
40%
50%
60%
70%
80%
90%
100%
D0120D1110
D2331D2543
D2652D2782
D2940D3221
D3348D4260
D4321D5212
D5720D5810
D6020D6090
D6740D6930
D7270D7960
D9940
REVENUE OPTIMIZER GROWTH CHART
$ 1,500,000
$ 1,700,000
$ 1,900,000
$ 2,100,000
$ 2,300,000
$ 2,500,000
$ 2,700,000
Current 40th P rcntl 50th P rcntl 60th P rcntl 70th P rcntl 80th P rcntl 90th P rcntl
PRACTICE PROFITS
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
Curre nt 40t h P rcnt l 50t h P rc nt l 60t h P rc nt l 70t h P rcnt l 80t h P rc nt l 90t h P rc nt l
INCREASE CASH FLOW
Adjusting fees can generate additional revenue and cash flow to meet the financial needs of the practice and allow the practice
to continue to offer optimal care. This is done without additional chair time or
overhead.
MOMENTUM-DFA
WE’RE TALKING REAL DOLLARS
In 2014, for doctors for whom we facilitated a
Fee Analysis & Revenue Optimizer project,
the average potential revenue growth was $92,000 at the
70th percentile.
MOMENTUM-DFA
MAINTAIN YOUR FEES!
After setting & balancing your fees, adjust them at least annually.
You hurt yourself and your peers by failing to stay current.
MOMENTUM-DFA
“Quite often, I have dentists tell me that their fees aren’t the highest and they’re not the lowest. They are just right. Kind of like the bedtime story of Goldie Locks and the Three Bears. This is not just a children’s story it is a marketing no-no. Either be a low-cost leader or be among the highest priced. Wal-Mart or Neiman Marcus. Hyundai or Mercedes. As part of your brand-building strategy you must pick the side of the fence to be on. Being in the middle means nothing to consumers, and it’s hard to build a story around being the most ‘in the middle’.”
Joel HarrisAuthor of “Break Through Dental Marketing””
““THE DANGEROUS MIDDLE”“THE NO-WIN MIDDLE”
MOMENTUM-DFA
MOMENTUM-DFA
DEVELOP PATIENTS WHO
RECOGNIZE QUALITY CARE
AND VALUE YOUR SERVICES.
MOMENTUM-DFA
EDUCATE YOUR PATIENTSEDUCATE YOUR PATIENTS
Patients should have a Patients should have a realistic understanding of realistic understanding of
the limits & intent of the limits & intent of insurance, why it is in their insurance, why it is in their best interest that you donbest interest that you don’’t t participate with their plan, participate with their plan,
and the true cost of and the true cost of dentistry. dentistry.
MOMENTUM-DFA
Which Practice Do You Want?Practice A
3200 patientsBooked 5 weeks
Produces $1,200,000Collections $950,000Doctor works 5 days
Doctor nets $205,000
Practice B1500 patientsBooked 2 weeksProduces $1,000,000Collections $950,000Doctor works 3.5 daysDoctor nets $420,000
MOMENTUM-DFA
What #What #’’s Do You Focus On?s Do You Focus On?Jim
Collections$1,500,000
PhilCollections
$775,00Steve
Collections$850,000
MOMENTUM-DFA
THE REST OF THE STORYTHE REST OF THE STORY
JimCollections$1,500,000
Net Profit$275,000
PhilCollections
$775,000
Net Profit$320,000
SteveCollections
$850,000
Net Profit$405,000
MOMENTUM-DFA
Be careful of the numbers you Be careful of the numbers you focus on.focus on.
MOMENTUM-DFA
UCR vs. Insurance
UCR fee $ 96Expense of 56Net profit = $ 40Net on 20patients = $ 800
UCR fee $ 96Adjustment 30Reimbursement 66Expense of 56Net profit = $ 10Net on 20patients = $ 200
MOMENTUM-DFA
UCR vs. Insurance
UCR fee $ 96Expense of 56Marketing 20
Net profit = $ 20Net on 20patients = $ 400
UCR fee $ 96Adjustment 30Reimbursement 66Expense of 56Net profit = $ 10Net on 20patients = $ 200
MOMENTUM-DFA
UCR vs. InsuranceUCR fee $ 100200 ABC insurance patients
Production $ 20,000 (200*$100)
Expense of 55Total expense $ 11,000 (200*$55)
Net profit $ 9,000
MOMENTUM-DFA
UCR vs. InsuranceUCR Fee StructureUCR fee $ 100200 current ABC insurance patients
Production $ 20,000Expense of $ 55Total expense $ 11,000Net profit $ 9,000
Reimbursement $ 65100 new ABC insurance patients
Production $ 6,500Expense of $ 55Total expense $ 5,500Net profit $ 1,000
on new patients
MOMENTUM-DFA
+ 100 New Patients w/ Ins.Contract
UCR vs. Insurance
UCR fee $ 100200 ABC insurance patients
Production $ 20,000
Expense of $ 55Total expense$ 11,000Net profit $ 9,000
45% profit margin
Old PatientsReimbursement $ 65200 ABC insurance patientscollectible production $ 13,000Expense of $ 55Total expense $ 11,000Net profit $ 2,000
New PatientsReimbursement $ 65100 ABC new patientscollectible production $ 6,500Expense of $ 55Total expense $ 5,500Net profit $ 1,000
New net profit $3,000Note that they actually produced $30,000 worth of dentistry
with just a 10% profit margin.
AFTER ADDING INSURANCE CONTRACT
MOMENTUM-DFA
BEFOREINSURANCE CONTRACT
UCR vs. Insurance
Example 1Production $ 1,000,000Insurance Adjustments $ 0Collections $ 1,000,000Overhead 60% or $ 600,000Profit percentage 40% or $ 400,000
MOMENTUM-DFA
UCR vs. InsuranceExample 2:Production $ 1,000,000
UCR $500,000 & PPO/Insurance $500,000 PPO/Insurance Adjustment +/-30%PPO/Insurance Adjustments $150,000
Collections $500,000 + 350,000 = $ 850,000Overhead 60% or $ 600,000Profit percentage UCR 40% or $ 200,000Profit percentage PPO 10% or $ 50,000Combined Profit percentage 25% or $ 250,000
MOMENTUM-DFA
UCR vs. Insurance
Example 3Production $ 700,000Insurance Adjustments $ 0Collections $ 700,000Overhead 60% or $ 420,000Profit percentage 40% or $ 280,000
MOMENTUM-DFA
UCR vs. Insurance
Example 3Production $700,000Insurance Adjustments $0Collections $700,000Overhead 60% or $420,000Profit percentage 40% or $280,000
Example 2Production $1,000,000UCR $500,000 & PPO/Insurance $500,000 PPO/Insurance Adjustment 30%PPO/Insurance Adjustments $150,000 Collections $500,000 + $350,000 = $850,000Overhead 60% or $600,000Profit percentage UCR 40% or $200,000Profit percentage PPO 10% or $50,000Combined Profit percentage 25% or $250,000
(65% or $455,000)
(35% or $245,000)MOMENTUM-DFA
INSURANCE STRUGGLEINSURANCE STRUGGLE
MIKE TOM JOHN JACKMIKE TOM JOHN JACK
MOMENTUM-DFA
THEY TOOK CONTROLTHEY TOOK CONTROLMike
2010 $565,000
2011 $750,0002012 $787,0002013 $825,000
2010 to 2011+$185,000 or 33%
2010 to 2013+$260,000 or 46%
Tom2010 $810,000
2011 $1,025,0002012 $1,205,0002013 $1,303,000
2010 to 2011+$215,000 or 27%
2010 to 2013+$497,000 or 61%
John2010 $702,000
2011 $787,0002012 $810,0002013 $836,000
2010 to 2011+$85,000 or 12%
2010 to 2013+$134,000 or 19%
Jack?
MOMENTUM-DFA
Again,Which Practice Do You Want?
Practice A3200 patients
Booked 5 weeksProduces $1,200,000Collections $950,000Doctor works 5 days
Doctor nets $205,000
Practice B1500 patientsBooked 2 weeksProduces $1,000,000Collections $950,000Doctor works 3.5 daysDoctor nets $420,000
MOMENTUM-DFA
ANALIZE YOUR FEES, REBALANCE &
PROPERLY SET YOUR FEES.
THEN DETERMINE THE RIGHT INSURANCE RELATIONSHIP FOR
YOUR PRACTICE
MOMENTUM-DFA
Thank You!
Corey CreamerOwner & Consultant
Momentum Dental Fee AdvisorsPO Box 5228
Salem OR, 97304
