Is Your Dental Website Getting Results?

Here is a guest post from +Mike Pedersen.

I'm amazed at the hundreds of dental websites I have looked at that are difficult to navigate, make me work to take action, and are basically wasting air space on the Internet.

If you have a website already, I want you to really take a look at it EVERY page, and ask yourself this question. "What's the goal of this page, and am I making it easy for visitors to take action?"

When you take this approach to your dental website, you'll have an awakening. You'll soon realize there is a ton of room for improvement, which is a good thing, as it means with some changes you'll get more responses.

What Is Your Main Goal?

If you're like the dental clients I work with, you want your phone ringing. If so, does your website make it easy for a visitor to contact your office?

You may think it is, but I'll bet you it's not. You see... most of the dental sites I review do not have a prominent phone number. And worse off, many pages don't have it at all. This makes your dental site a complete waste.

With any marketing, you are paying to get more patients, and that is the same goal of your dental website.

The Second Goal Is...

When someone is looking for a dentist, they want to know how to contact you (phone number), and where are you located (address and map).

With that in mind, you MUST have a map on your dental website. There's no negotiating on this one. If you don't make it easy for visitor to see where you're located, you're dead in the water. Toast!

I would say of the dental websites I review, 80% of them do not have a map.

If you don't, I want you to contact your webmaster right now and get a map put on your homepage ASAP! Don't put this off. Get it up there and you'll see a boost in the number of phone calls you get.

So, if and when you decide to update/redesign your dental website, don't go for pretty, go for functional. Make it easy for people to call you and find out where you're located. Do this and your practice will prosper.

I hope this article has opened your eyes to what your website could accomplish.

Author Resource:

+Mike Pedersen is an Internet Marketing Strategy Consultant for dentists. His firm will also redesign your dental website if you are looking for that.

For more information, please contact info@dentalcpas.com

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Can Dentist Deduct the Cost of Washer and Dryer?

I was wondering if a washer and dryer is a deductible expense.  I work as an associate as an employee, as well as working at a nursing home once a week as a sole proprietor.

A practice that purchases a washer and dryer to have in their office for cleaning staff laundry is certainly deductible.

If you're asking about a washer and dryer that you use at home for ALL your clothes that might include a few uniforms each week, that would not be deductible in my opinion. 

Sorry.

This first appeared on Dentaltown.

For more information, please contact info@dentalcpas.com

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The Independent Contractor Status Draws Scrutiny in Dental Practices

The government does not hold any grudges against independent contractors. Employers who attempt to avoid paying employment taxes by falsely classifying employees as independent contractors are another story. The government doesn’t like anyone who evades paying taxes.

Independent contractors are valid in various industries given the proper circumstances, including dentistry. However, the government has and will continue to look for abuses of the classification where employers attempt to evade employment taxes.

People who wish to be considered independent contractors (IC) should arrange their circumstances so that their case as an IC is defensible. Some of these circumstances may include: being able to perform work duties freely in the facilities of the owner, getting paid by the project or service (not hourly), paying for their own materials or supplies, using their own equipment, hiring and paying their own staff and control the result of their product or service. If these circumstances are not in place with the owner of the business, the general IC may not be an IC at all, they may be an employee.

One of our client’s is a dental specialist. They don’t own their own practice, they work in offices of other practitioners. They bring their own staff, they control their work process and the outcomes, their services are billed separately, they decide the days they work and because they’re a specialist, the owner can’t supervise their work (tell them how to do it).  They also operate from their own entity so the contract is between two entities, an individual is not involved, other than the person providing the service.

Businesses must weigh the degree of the behavioral and financial relationships with workers when classifying them.

The potential consequence for the owner who misclassifies an employee as an independent contractor is that they could be assessed:

1. The employer’s portion of the social security and Medicare tax, and
2. The Federal unemployment tax, and
3. The employee’s portion of social security and Medicare tax (If the owner cannot prove the independent contractor reported the income on their return), and
4. Penalties and interest. If the owner had any employee benefit plans that should have covered the IC (health and retirement plans), there could be negative consequences there as well.

If you are an independent contractor, you are self-employed. To find out what your tax obligations are, visit the Self-Employed Tax Center on the IRS website.

You are not an independent contractor if you perform services that can be controlled by the owner (what will be done and how it will be done), you use the owner’s equipment and supplies, you service the owner’s patients or clients and they tell you when to work. This applies even if you are given freedom of action. What matters is that the owner has the right to control the details of how the services are performed. For example, a general dentist is working for another general dentist as an associate, the associate uses the dental staff, they are being supervised by the owner, they are told the hours they are working, they use the owner’s equipment and supplies, and this is the only office they work for. This associate would likely be classified as an employee.

If an employer-employee relationship exists (regardless of what the relationship is called), you are not an independent contractor.

This is a serious issue for owners who are either intentionally or unintentionally misrepresenting relationships with workers. In cases of abuses, the owner is the party that will likely take the beating.
I recall back in the late 80's when I had a stock broker tax client where all the brokers of this small firm were being treated as independent contractors. The IRS audited the brokerage for several years for the very issue being discussed. The brokers had to submit returns to prove that they were reporting their income correctly and paying the Self-Employment tax while the brokerage firm got slammed for hundreds of thousands of back payroll taxes, penalties, and interest. Ultimately, the brokerage went belly up, many people became unemployed and many clients had to find new brokers or move their money to the brokerage where their broker landed.

We've had similar stories on a much smaller scale where IRS reclassified independent contractors as employees and made the client pay back payroll taxes, interest, and penalties. I have only heard of one case where the independent contractor themselves got audited and reclassified as an employee and they got hammered income tax wise because schedule C expenses became miscellaneous itemized deductions subject to limits and their self-employed retirement plan deduction got thrown out.

The bottom line is in just about every audit of a business, one issue the agent must take a look at is the employee vs. independent contractor issue to ensure employers aren't trying to evade employment taxes.

For more information, please contact info@dentalcpas.com

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PPO 101 for Dentists

Here is another great post from our friend Sandi Hudson at Unlock the PPO. 

Sometimes we get calls from new dental school graduates or dentists getting ready to buy their first practice and they have questions about how PPOs work. Insurance seems to have a language of it’s own and if you are looking to learn the jargon, here’s the basics:

When you are In-Network with a PPO you are considered a “Preferred Provider” with them. You sign a contract stating that you agree to a specified fee schedule which is lower than your regular fees. In exchange for the discount, the insurance company promotes your practice by listing you as a Provider with their customers (your potential patients). You will be subject to reimbursement based upon the rules of the plan including a yearly maximum of benefits, potential waiting period on some services and frequency limitations. Depending on the state you practice in and the type of policy involved, many insurance companies require the dentist to adhere to the negotiated fee even if it pertains to a non-covered service or the patient’s yearly maximum has already been paid out. This is important for procedures such as veneers, implants or ortho because the policy may exclude coverage but will still prohibit you from charging the patient your regular fee. It is important that you know which procedure codes your office utilizes the most as those are the fees you will assign most priority during fee negotiations.  If you are unsure if your state allows you to charge for non-covered benefits visit our blog on this topic.

Assignment of Benefit means that the patient has agreed to have their benefit check sent directly to your office and you, as the dentist, agree to accept their benefits from the insurance company. If you are a Preferred Provider, the insurance company will automatically send you the check. If you are not a Preferred Provider, most insurance companies will still allow you to accept AOB even on an Out-Of-Network basis. Patients often prefer this option because the dentists waits for the insurance check rather than the patient.  Some insurance companies will not send the check directly to the dentist for out-of-network claims.

If you choose not to become a Preferred Provider yet provide services for a patient utilizing their benefits, that insurance company will consider you to be an Out-Of-Network Provider. As an OON provider you will bill your full fee to the insurance company and they will pay their designated percentage typically based onUCR (Usual and Customary). UCR is considered the maximum allowable charge the insurance company will consider for a service. So even if there is 100% coverage on a code, they will still pay up to a particular amount which is their designated UCR. Be aware that UCR is different depending on your area and each insurance company. Some employers also choose a higher UCR level when purchasing an upgraded plan so even with the same insurance company you may see different UCRs depending on the policy. When your fee exceeds the insurance company’s UCR you may then bill the patient for the difference between UCR and your fee. This is another area we examine with our services as we want your practice to fall close to UCR with the procedure codes that matter the most.  While most policies are paid based on UCR, be aware that there can be downgrades to plans for seeing out-of-network providers so researching benefits on top employer plans in your area is important.

In a totally Fee-For-Service practice, the dentist chooses to collect payment in full from the patient at the time of service. The patient then submits a claim form to the insurance company and the insurance company pays any due benefits directly to the patient. The dentist is paid directly from the patient, not the insurance company.

There are benefits and restrictions with all models of practicing dentistry. To see a quick pro and con listing visit our PPO vs Non-PPO page.  You may also contact us toll free at 855-327-9125.

Choices

How do some practices make PPOs work better than others? Much of it boils down to choices regarding practice style. A typical solo dentist who takes PPOs usually does so to keep cash flow rolling until the schedule gets busy and then other options can be considered. When the practice has been built to a level where the schedule is consistently full, this is where choices become more individualized.

Building a PPO Practice

The dentists who have busy PPO practices grow by making good business decisions about how they manage their overhead and patient flow. When the schedule gets full they recognize that they can increase capacity in a variety of ways. Rent stays the same each month so utilizing the office from 7am to 7pm means that a PPO patient can be seen more profitably because existing space is being managed more efficiently. Practices looking to grow in this way also consider adding a partner or associate to increase capacity and create good systems to maximize their staff and facility. Some increase productivity by utilizing expanded duties staff to delegate duties. I know many dentists who provide quality care to their patients with this model by being efficient and smart about overhead but you must recognize that high write-offs require you to manage well and have proper systems in place.

The Other Direction

When the schedule becomes full, the decision can be made instead to decrease insurance participation rather than add additional capacity and/or staff. Dentists who make this decision typically do not want to deal with insurance any more than they have to, prefer to not to increase their hours or do not want to add a partner. They recognize that there are ways to continue seeing more patients and be profitable but the practice style required to achieve these results is not the way they want to practice. They find dentistry more enjoyable by having fewer insurance restrictions, keeping a smaller staff and usually less administrative work. These dentists prefer to gradually move towards independence from insurance as patient flow allows.

Our goal isn’t to persuade anyone about which type of practice to pursue. Dentistry can be enjoyable and profitable with a variety of practice styles. Our services are designed to attain the results most beneficial to your chosen style of practice, whatever that style may be.

You can see the original article here.

For more information, please contact info@dentalcpas.com

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Heads Up Dentists– More Delta Changing Coming!

Here is another great post from our friend Sandi Hudson at Unlock the PPO.

Many dentists are already aware of the changes that recently happened with Delta in California. To summarize, new contracts with Delta in Cali are being required to participate at the PPO level as opposed to signing up as a Premier dentist only. This is the case even for associates who are hired at a practice that is currently Premier only. This created a huge issue for dentists in California who were buying practices from a dentist that was a Premier provider because the purchasing dentist was not allowed to sign up as a Premier provider. Why is this an issue? Because Delta PPO fee schedules are typically 15-20% less than the Delta Premier fee schedules. There are VERY few policies that are strictly Premier policies, the vast majority are PPO/Premier option policies. This means the policy is written so that the patient has the option of seeing either a PPO or a Premier contracted dentist but Delta pays the dentist at the lowest rate they participate with. For example, if a practice has $300,000 a year of Delta production with a Premier contracted dentist and a new buyer purchases the practice and is required to be a PPO contracted dentist rather than Premier, that $300,000 of production will get paid at about 15-20% less with the new owner than the previous owner. A new owner that is already challenged with practice and student loan debt can unknowingly realize after the fact that their Delta collections just got an automatic fee schedule decrease on the exact same production with the exact same patients because Delta will no longer allow them to sign up with the Premier fee schedule.

Up until recently this issue was isolated to California only. We saw a post on DentalTown a few days ago from a dentist buying a practice in Pennsylvania who was told the same thing, that they could not sign on as a Premier provider only, so my partner, Lisa, did some investigating to see if this trend has now expanded beyond California. Initially all provider relations reps in Pennsylvania indicated that this was NOT the case however after multiple discussions with a supervisor it turns out that it’s on a case by case basis. If an area doesn't need a Premier provider (as defined by Delta) they can’t sign up for Premier only. In Pennsylvania, it will be the exception to the rule that a provider will be able to sign up with Premier only. If a doctor had not participated as a Premier provider in a prior location there is no chance at all of becoming a Premier provider only in Pennsylvania.

There are different regions within Delta and the Pennsylvania Delta region includes the following states: AL, CA, DE, FL, GA, LA, MD, MS, MT, NV, NY, PA, TX, UT, WV and District of Columbia . Our understanding is that the states listed above are the ones that may begin to limit participation choices.

Only 3% of all Delta policies are Premier only and these are more commonly small businesses who purchased the original policies decades ago. All policies that are being sold to new clients by Delta are DPO/PPO policies and they no longer have any incentive to add Premier providers and a strong incentive to add DPO/PPO only providers. We are seeking more details in writing and will post them as they come available. If you personally are told that you cannot sign up with Premier only, we’d encourage you to post that on this thread to help give early warning to all. When Delta’s own Customer Service and Provider Relations Dept in PA had no idea that there had been a massive change in their own business model until a query was made, it is likely this may occur in other states as these changes begin to happen.

How does this affect you?

1. If you are purchasing a practice, particularly in one of the states listed above, and the selling dentist is a Premier provider only, get a Delta recruiter to put in writing that you can be strictly a Premier provider should you purchase the practice. If the area you are purchasing a practice is no longer allowing new contracts to be written for Premier providers then the value of the practice is no longer the same because all of the Delta revenue will be paid out on a lesser fee schedule after you purchase the practice. Do NOT take your answer from the provider relations department reps with a phone call. Get it in writing. The only thing worse than having your new practice’s Delta revenues downgraded is not knowing about it ahead of time and potentially overpaying for a practice.
2. If you are a current owner dentist in one of the states listed above, are relatively close to wanting to retire/sell your practice and if you are a Premier provider then realize that the value of your practice may shift when you are ready to sell. If no Premier contracts are being written in your area, the value of your Delta production will not be the same for a new owner as it is for you.

If your Delta makes this move there are two choices moving forward. You can accept the PPO/DPO option and collect less for the same patients or you can choose not to participate with Delta which will cause all payments to go directly to the patient, requiring you to collect in full from your Delta patients.

We have unfortunately worked with several new practice owners in California who were not aware of these changes until after they purchased their practice. The potential impact is big so be sure the experts you are working with clearly understand the changing landscape.

You can find the original article here.

For more information, please contact info@dentalcpas.com

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