Alitta Boechler is a marketing manager at Sikka Software. She holds a Doctorate of Audiology from the University of Iowa and an MBA from the Jesse H. Jones Graduate School of Business at Rice University.  You can contact her at alitta.boechler@sikkasoftware.com or (408) 359-3014.  For more information about The Practice Optimizer CompanyÂ® please visit https://www.sikkasoft.com/dental/sikka-apps/practice-optimizer-dental/

Alitta Boechler, AuD, MBA

	Money can be mysterious and can also be the source of stress in your practice. How you manage money has a direct impact on your ability to serve your patients’ oral health needs.

This may seem at odds with your goal as a practitioner, as time in the back office looking at spreadsheets is not time spent with patients. However, when your books are in order, you will feel comfortable and able to focus better on your profession. So in preparation for the end of the year, here are some busted money myths to help you put your books in order.

	Continue to the next page to see the first myth...

	Myth #1: Patients and insurance companies will pay on time

	Your patients may have the best intentions of paying, but sometimes life gets in the way, or patients forget. Insurance companies may also need extensive communications before you receive your payment. This may seem like a chore with insurers and an imposition to your patients, but requesting payment can be done professionally which can help to communicate your value. Payment requests and billing may appear to be something that you can put off, but delays decrease the likelihood of payment and can cripple your cash flow. Which leads us to the second myth….

	Myth #2: Revenue is a measure of practice health

	Just because you are making money doesn’t mean that you are taking home enough to support the practice and your expenses. One of the best measures of practice health is actually cash flow, which tracks available cash moving in and out of the business over time. Cash flow allows you to pay salaries and buy necessities to keep your practice running. Without it, a practice will fail. A mix of revenue and debt is what keeps your doors open and patients in your chair.

	Speaking of debt, the recent financial crisis had the side effect of making debt look risky. The truth is that risk is something that can only be assessed based on your own market, financial situation and projected revenue and cash flow. If you are thinking about starting your own practice or taking on debt to finance growth or large capital expenditures, this is a conversation that requires in-depth discussion with financial planning experts and stakeholders. Always ask yourself, “what is my intended outcome of this debt, and can this debt achieve this goal?” This leads us to myth number four…

	Myth #4: If you build it, they will come

	Patients have a lot of options and can find many ways to evaluate potential practices online and through their social network. Make sure you are putting your best foot forward, monitoring review sites, encouraging word of mouth and making sure patients have a great experience. Know your skills, specialties and the geographical area you are a part of, and use these parameters to build your practice around a value proposition. For example, are you root canal or cosmetic experts, do your patients demand the latest technology or are they budget conscious, etc.? Use your statement to guide business decisions, like taking on debt, and market to the community. 

Articles

Money can be mysterious and can also be the source of stress in your practice. How you manage money has a direct impact on your ability to serve your patients’ oral health needs.

4 myths about money and the dental practice

	There is only a month and a half left in 2015, and you may be wondering where time went. However, there is still time to finish out the year strong for your practice and your patients.

	The following article will discuss five ways to wrap up your year and address any pending practice management issues that you might be experiencing.

	Keeping track of your accounts receivable can be a challenge, with clinical activities often taking priority. However, at the end of the fiscal year, it is a good time to count the past-due accounts from payers and patients. Those accounts that are 90 days past due are especially of note, as the longer the account goes unpaid, the less likely you are to collect money for your services. Your services have value, and you communicate your value through asking to be paid in a timely manner, so make sure you are monitoring accounts receivable and taking action on late payments.

More from Alitta Boechler: The importance of oral cancer screening in the dental practice

	You and your staff are undoubtedly busy, but make sure you check in with your staff regularly as they are the front lines in the office and may be aware of problems or concerns that you may not necessarily see. Due to their positions, team members often have insights and ideas but can be unsure of how or even if they should bring their ideas forward. This is a great time to put aside a few minutes for each team member and ask them how their year is going and if they have any suggestions for the practice. Taking the time to touch base will have the added benefit of strengthening the team and improving the communication flow. If your team knows you are engaged, they will engage with you.

	The end of the year often means it is time to renegotiate fees. Although this may seem arduous, it is an important part of making your practice competitive. Without fees, it would be hard to keep a practice afloat, pay the staff and provide care to your patients. There are many tools and articles available this time of year to assist you in this process including: 

https://www.sikkasoft.com/product/fee-survey/

Related reading: Dental fees broken down by geographic region

	Make a plan to finish the year strong. Address any lagging problems, like those mentioned above, in preparation for a great start next year. Check your patient lists, who has unused insurance and promote hygiene for the holidays. Just because it’s November doesn’t mean it is too late to make a change. Once the holidays start, you and your staff will be even busier, so start tying up any loose ends now.

Trending article: The top 5 things you need to know about dental fees

	January will be here in the blink of an eye. What changes would you like to see for next year? Do you want to improve patient recall rates or maybe decrease no shows? Now is the time to start planning. Build a plan and set goals with yourself and your staff to make this happen.

	Your practice is a center for patient health, as well as a livelihood for you and your staff. Make sure you are ready for the end of this year so you can start January on the right foot. Practices may experience a wide range of challenges during the year. Now is a perfect time to wrap up any pending concerns and prepare for the New Year. When your practice is healthy, you will be best able to provide the highest level of patient care. 

Trending article: Sikka Software compares common procedures and associated fees in the dental practice

	Sikka Software provides a platform for small and medium-sized business healthcare apps. The company’s products help healthcare providers and other small businesses optimize their business via a series of easy to use cloud-based applications. With over 32 apps built on Sikka Platform Utility

with over 16,000 installations, Sikka Software is the leader in the US Dental, Animal Health and Hearing Care markets. The company is now supporting a real time optimization and information network with providers, patients, consultants, manufacturers and financial service provides.

	A privately-held company, Sikka Software is headquartered in Milpitas, California with offices in the United States and in India. More information may be found at www.sikkasoftware.com.

There is only a month and a half left in 2015, and you may be wondering where time went. However, there is still time to finish out the year strong for your practice and your patients.

5 ways to end the year on a strong note

As we enter the fall season, chances are that you have patients with remaining dental benefits who also require dental care. According to Forbes, only three percent of patients use all of their benefits in a given year. In fact, according to data collected by Sikka Software, patients, on average, use only 10.8 percent of dental benefits in a given year.

So what is stopping patients from maximizing their dental care? A big portion of those who need care and have benefits are not moving forward with the treatment plan because they may be concerned about copay costs. For major restorative procedures, dental insurance may only pay 50 percent

, leaving the patient on the hook for hundreds or even thousands of dollars.

This article will discuss how to communicate with patients about financial costs as well as benefit coverage, improving patient care and 

Speak openly about potential costs and benefits

There are many things running through a patient’s mind when discussing treatment options. One crucial question patients may have is, “Can I really afford this procedure?” This happens when the patient is weighing the cost benefit of the procedure in his or her mind. In this moment, you should provide the patient with the 

 he or she needs to make an informed decision based on his or her circumstance. What is the anticipated outcome of performing the procedure versus the outcome of delaying the treatment? What is the timeline for completing the procedure?

The patient will likely need detailed financial information to make an informed decision. Let them know what the procedure costs and how much of the fee will be their financial responsibility. Empower your patients to make an informed decision, because they may not know the risks of delayed treatment and will deny the procedure based on the price.

Related reading: The myth that patients should know their dental benefits

Next, ask your patients what they think might be preventing them for receiving quality care. This may be a challenging conversation to have with patients, as it requires a level of trust from the patient. They need to feel comfortable explaining financial barriers, transportation concerns or fears regarding the procedure. Make sure this conversation takes place in a private and comfortable setting with a trusted team member to facilitate communication.

Trending article: Why insurance coordinators need to be flexible in today's world

A patient may have financing options available through your practice or through other options like 

. Let them know the types of payment and financing options available as well as when the payment is due.

Trending article: How to streamline the insurance aging report

Many patients may have left the clinic before a conversation about financing fully took place, or they requested time to make a decision with family members. Make sure you reach out to those patients and communicate with them regarding expiring dental or 

 benefits. Emphasize the importance of completing their oral care plan to improve health and decrease the risk of further complications.

As a dentist, you have insight into the type of care your patients may need to anticipate in the coming year. How much longer will a filling last, or if treatment was delayed, when should it be scheduled next year? Talk about how much patients might need to save for the future, including in their Health Savings Account, and begin to schedule treatments as soon as necessary.  To improve preventive care, move patients from a reactive model to one of ritual care, where regular cleanings are the norm.

Trending article: What does the future hold for dental insurance? [VIDEO]

, patients may base their decisions on financial costs rather than consideration of their oral health. Dentists and office staff need to be prepared to navigate the often difficult conversations about money. Ensure that the providers and support staff are prepared to speak about financial options to cover out-of-pocket costs. Your patients will have elevated quality of dental care, and your clinic will gain additional revenue from both dental insurance and from over-the-counter payments. There may be many reasons that a dental patient is stalling on having a procedure completed, so be prepared to speak to them about their concerns and find solutions to barriers for care.

More information about Sikka Software, as well as national data trends, can be found at 

https://www.sikkasoft.com/apps-for-healthcare/dental/

diGiacomo, R. (2015). Is dental insurance worth the cost? Bankrate. Retrieved from 

http://www.bankrate.com/finance/insurance/dental-insurance-1.aspx

Investopedia (2012, June 21). Do you need dental coverage? Forbes. Retrieved from 

http://www.forbes.com/sites/investopedia/2012/06/21/do-you-need-dental-coverage/

As we enter the fall season, chances are that you have patients with remaining dental benefits who also require dental care. According to Forbes, only three percent of patients use all of their benefits in a given year.

Dental benefits: Use them or lose them

The dentist’s office is the first line of defense for oral cancer diagnosis.

	Approximately 60 percent of the population receives regular dental care1 and these visits are a unique opportunity to look for signs of cancer growth and discuss changes the patient has experienced in his or her mouth.

	There are two ways dentists look for oral cancer: The first is a visual examination of the mouth and the second is through the use of adjunctive screening tools such as 

 and ViziLite. Without vigilance, cancer diagnosis may be delayed which often translates to poorer outcomes and higher mortality rates. Oral cancer that is detected early has an 80 percent five-year survival rate compared to the overall five-year survival rate of 59 percent1.

	Sikka Software collects data from thousands of practices across the nation. Data is collected in accordance with privacy laws. This article will discuss trends in technology based screening under CDT D0431, adjunctive pre-diagnostic testing.

Related reading: The top 5 reasons to really think about oral cancer

Oral cancer incidence, signs and symptoms

	According to the New York Times, one in 99 people will develop oral cancer in their lifetime. This translates to approximately 45,750 oral and pharyngeal cancers annually with 8,650 deaths2. Cancer is often associated with heavy drinking, use of tobacco products, UV exposure and more recently, HPV163. According to the 

 HPV16-related oral cancers can be particularly challenging to identify as it tends to be in the back of the mouth and patients tend to be younger than the traditional oral cancer patients. An increase in smoking among women has possibility contributed to the move towards equalization in oral cancer gender ratios, although men are twice as likely to get oral cancer than women2.

	Oral cancer can be difficult to diagnose as there are generally few physical symptoms in the early stages. Visible physical changes may appear similar to other pathologies, like canker sores, increasing the challenge of diagnosing cancer early. A visual exam of high risk patients has found to reduce mortality 34 percent, however, 25 percent of cancer patients are not considered high risk2, opening up the debate for the place of technology-based screening tools in the clinic.

Related reading: Common misconceptions about oral cancer prevention

	The national average of number of adjunct oral cancer screenings billed under CDT D0431 per clinic has risen sharply. From 2012 to 2014, clinics performed an average of six to seven tests each month. In contrast, the number of screenings has rapidly risen to nine tests in the spring of 2015. Although this is a short-term trend, it is far above the previous average. It is possible that this trend is due to an increase in HPV16 related cases, which are difficult to diagnosis visually due to the fact that they are often found in the back of the mouth2.

	When compared to number of patient visits, the number of oral cancer screenings is small. During the first four months in 2015, the average number of patient visits was 114, while the average number of oral cancer screenings was eight. This indicates that while dentists may be watching for signs of cancer, they are not as frequently using technology and billing the CDT 4D031 code. Dentists may not complete this type of testing because of cost concerns, level of cancer risk to the patient and time constraints.

More on oral cancer: The link between oral sex and oral cancer

	The average monthly revenue generated by a dental office from the oral cancer pre-diagnostics code was around $200, but sloped down to as low as $150 in 2013 and 2014. Revenue rose in 2015 back up to around $200, consistent with the increase in number of screenings performed in clinics.

	Dentists are the front line of defense for detecting possible oral cancers. Although oral cancer can be challenging to diagnose in the early stages, dentists are the most likely to note changes in the mouth during regular examinations. Finding these changes are critical as early detection greatly increases the change of five-year survival. The ADA recommends that clinicians remain vigilant for changes to in the mouth that may indicate the presence of cancer. However as the large-scale efficacy of adjunct screening tools remains in question4, there are no current published guidelines for use.

Related reading: Oral cancer awareness survey reveals greater need for education, screening tools

	Sikka Software provides a platform for small and medium-sized business healthcare apps. The company’s products help healthcare providers and other small businesses optimize their business via a series of easy to use cloud-based applications. With over 32 apps built on Sikka Platform Cloud with over 14,3000 installations, Sikka Software is the leader in the US Dental, Animal Health and Hearing Care markets. The company is now supporting a real time optimization and information network with providers, patients, consultants, manufacturers and financial service provides.

Alitta Boechler is a marketing manager at Sikka Software. She holds a Doctorate of Audiology from the University of Iowa and an MBA from the Jesse H. Jones Graduate School of Business at Rice University. You can contact her at 

 or (408) 359-3014.  For more information about The Practice Optimizer Company® please visithttps://www.sikkasoft.com/dental/sikka-apps/practice-optimizer-dental/

1 Tarkan, L. (2009, February 2). New oral cancer tests: crucial or wasteful? The New York Times. Retrieved from 

http://www.nytimes.com/2009/02/03/health/03cancer.html?_r=1

2 The Oral Cancer Foundations (2015). Oral cancer facts. Retrieved from 

http://www.oralcancerfoundation.org/facts/

3 British Dental Health Foundation (2015). Facts and figures- mouth cancer action month. Retrieved from 

http://www.mouthcancer.org/facts-figures/

4 Rethman, M.P, Carpenter, W., Cohen, E.E.W., Esptein, J., Evans, C.A., Flaitz, C.M., … Meyer, D.M. (2010). Evidence-based clinical recommendations regarding screening for oral squamous cell carcinomas. The Journal of the American Dental Association, 141(5), 509-520. Retrieved from 

http://jada.ada.org/article/S0002-8177(14)61524-5/fulltext#cesec60

American Dental Association (2015). Clinical practice guidelines. Retrieved from 

http://ebd.ada.org/en/evidence/guidelines

The national average of number of adjunct oral cancer screenings billed under CDT D0431 per clinic has risen sharply. From 2012 to 2014, clinics performed an average of six to seven tests each month.

The importance of oral cancer screening in the dental practice

	You can’t run your clinic alone. Whether you are a large center or a small clinic, you likely will need to manage both professional and support staff. You may need other dentists, specialists, hygienists, office managers and front desk personnel to be part of the team.

	This staff may come with a wide range of educational backgrounds and, depending on the

	individual positions, may require varying levels of supervision. This article will focus on

	tools to set goals and to track performance of the clinic’s staff and use the results to

	empower your workforce so you can meet your financial and clinical goals.

 has worked with dental practices to find ways to grow their businesses for

	the last 11 years. We make apps that help dentists set goals, find new sources of revenue

	and interact with patients. You can find out more about our products, including tools to set

	goals to track your clinic and staff’s performance, at 

Also by the author: Key statistics and best trends in dental practice management: 2012 to

1. Think about what you want to accomplish: 

Before you can encourage change, you must have an idea of what you want for your clinic. Think about how you want yourclinic to grow: financially, by number of patients or by more personnel? What wouldit take to meet those goals in the clinic? Also, think about the time it will take to scale up your operation.

: Once you have your general plan, set goals for individuals in the clinic that align with your overall goals. Whether your goals for the clinic are large, like growing the number of locations or providers, or small, like increasing financial security, you need to build a measurable roadmap for reaching those goals. Metrics may be varied. For a visiting specialist in a practice, you may find that you require a certain number of procedures to make the relationship feasible.For hygienists, their goal be may number of cleanings completed and rescheduled. The most important part of determining your metrics is to make sure your goals are measurable. If you cannot track progress, it is easy to get sidetracked and miss your timeline.

Related reading: Four ways to fill your schedule without blowing your advertising budget

	3. Share your goals: Your staff needs to be aware of your expectations. Make sure you sit down with each member and discuss his or her importance to the team and how he or she can facilitate growth. This is also the time to discuss what results or outcome will be tied to performance on the metrics.

	4. Measure performance: Keep track of performance over time to let your staffmembers know how they are doing. This also lets you know if you are on track tomeet your timeline.

Related reading: 4 ways dental assistants can increase their value in the practice

As your team members progress and meet your goals, have an incentive for their success that you have agreed upon together. This may be as simple as tying salary to performance or providing additional financial incentives for increased production or goal completion. Rewards will help engage your team members and make them feel included, incentivizing them to help you meet your practice goals.

	You have dreams for that practice, but reaching your goals can be challenging. Knowing where you are going and how you will get there is key to success. Your team will be with you every step of the way, and their contributions to the practice will be integral to reaching those goals. Each team member has something to offer, from increasing the number of booked appointments to building your marketing program to completing treatment plans. Using the goal-setting process with them will direct their efforts towards your trajectory.

Hot read: 7 steps to improving leadership in the dental practice

You can’t run your clinic alone. Whether you are a large center or a small clinic, you likely
will need to manage both professional and support staff. You may need other dentists,
specialists, hygienists, office managers and front desk personnel to be part of the team.
This staff may come with a wide range of educational backgrounds and, depending on the
individual positions, may require varying levels of supervision.

5 steps to developing your team

	Filling your dental appointment book is an important step in maximizing your revenue.

	Many clinics may have open spots either unfilled or from cancellations. Open slots mean

	your building, equipment and staff are all being underused, which costs you money. Worst

	of all, you miss an opportunity to generate cash flow for the business.

	Sikka Software has worked with dental practices to find ways to grow their business for

	the last 11 years. We make apps that help dentists set goals, grow their business and

	interact with patients. You can find out more about our products, including tools to fill your

	schedule, and track the metrics discussed below, by visiting 

	Find new patients via word of mouth: Word-of-mouth advertising can be a powerful

	method to grow your patient base. A positive referral from a trusted source can make the

	new patient feel confident he or she will receive excellent dental care at your clinic. Word

	of mouth is a relatively inexpensive form of advertising, but don’t be shy about rewarding

	those who refer others to your clinic. Bonuses like discounts, drawings and giveaways can

	reward the loyalty and enthusiasm of your client base.

Data for dentists: How hard facts can help you grow your practice

	Manage no shows: Patients may not show up to their appointment, with or without notice,

	for a variety of reasons. Many clinics use reminder programs though few actively work

	beyond those reminders to fill spots that are left open. It is important to know what gaps

	are in your schedule and keep in mind those patients who may want earlier appointments

	or those with more flexible schedules like retirees. You may also want to keep track of

	patients needing particular procedures or equipment if time and space is limited. Patients

	will appreciate your effort in contacting them and facilitating their dental care.

	Don’t just plan; Schedule: As a dentist, you recommend treatment plans for patients who

	need oral interventions, but how often does the patient follow through with the plan?

	Ensure that at the end of each appointment, the next step of treatment is scheduled

	whether it be a root canal or semi-annual hygiene appointment. This will not only keep

	your appointment book full but also save your front-desk staff time in calling back patients

	Keep track: Keep track of your number of inactive and active patients and find out what

	percentage are coming back for general hygiene and scheduled appointments. Compare

	your data to national trends to set goals and benchmark your progress. Make sure you

	celebrate your wins in filling your schedule. Without tracking these metrics, it is difficult to

	measure the efforts the staff takes to keep your appointment book full.

	Revenue for your practice grows when you focus on two top points: the number of

	patients seeking services and the amount of services generated per patient. This blog

	focuses some discussion on the first point, driving up patient appointments and

	attendance. Filling your appointment book is critical for bringing in revenue to your dental

	clinic. Keeping your clinic busy involves recruiting new patients and maintaining your

	relationship with your current clinic base. Know your numbers on how your clinic performs

	in terms of attracting new patients, scheduling appointments and maintaining an active

	patient base then compare your success to national trends. There are many components

	to building a successful thriving practice; generating new patients and thoroughly

	engaging your current ones are two major efforts to focus on that will take you in the right

More on scheduling: Simple and effective tips to get your dental practice's schedule back

illing your dental appointment book is an important step in maximizing your revenue.Many clinics may have open spots either unfilled or from cancellations.

Four ways to fill your schedule without blowing your advertising budget

	Over the last four years, dentists have experienced significant changes to how they practice dentistry and the reimbursement they received for their services. These changes were experienced on a national scale.

 we collect information from dental practices across the nation to monitor trends and create benchmarks for successful practice management. Data is gathered in compliance of privacy laws and does not contain identifying patient or practice information.

The following graphics depict the most significant trends in dental practice management. Measuring and tracking trends allows dentists to understand the dental market, find new opportunities for revenue and grow their businesses. Practices can access complete national trends, as well get key reports about their own performance at 

https://www.sikkasoft.com/dental/sikka-apps/practice-optimizer-dental/

Year over year dentists have experienced a larger active patient load, where an active patient is defined as one seen in the practice during the previous 18 months. Starting at the end of 2014 and continuing into 2015, there was a significant increase, beyond what was seen in previous years, in the number of active patients. This may be due to higher employment rates and the affordable care act, leading to an increase in dental insurance coverage.

MORE LEARNING:	We partner with Sikka and tell you the fees on 20 procedures from around the country

Number of Patients Reappointed to Hygienists

Beginning in September 2014 and continuing into 2015, there was an increase in patients reappointed to hygienists. As hygienists are the professionals who clean and exam teeth, this leads to a greater number of opportunities to find and diagnosis dental concerns. This increase in reappointment is a chance to provide the market with increased quality of care, through identifying current and potential concerns, as well as grow revenue for the practice.

RELATED: The important role hygienists play with in-office whitening

An increase in diagnostic quantity can be traced back to two key changes in dentistry: an increase in active patients and the increase in number of appointments to hygienists. This increase represents the chance for more patients to receive appropriate interventions.

LEARNING OPPORTUNITY:	How to maximize your practice's intraoral camera

Hygienists are working, on average, an increased number of hours nationally. In 2012 hygienists worked, on average 139 hours each month, or approximately 6.6 hours each business day. By comparison, in 2014 time spent in the clinic rose to 148 hours and for the first quarter of 2015, 157 hours. This translates to approximately 7.1 and almost 7.5 daily hours, respectively. This increase in hours may be due to an increase in hygienist reappointments as well as more active patients per clinic.

HOT READ: The 6 things every dental hygienist should be doing to grow professionally

Although the first half of 2014 saw the highest net production values per hour, there was a steep drop off in revenue starting in July 2014. Net income is after insurance adjustments, discounts, cost of goods, wages and other expanses. This trend has continued, with comparative low values throughout 2015. 

LEARNING OPPORTUNITY:	How CariVu from DEXIS has changed one dental practice

As with hygienists, dentists are also working more hours to keep up with the increase in demand for dental services. In 2012 doctors worked on average 139 hours a month or approximately 6.6 hours each day. In comparison, doctors worked 154 hours, 7.3 hours each day, in 2014 and 164 during the first four months of 2015, or 7.8 hours each day.

WHOA: 10 of the craziest impressions you will ever see

Just like hygienists, dentists are making significantly less net income per hour than the previous three years. The cause of this drop off in financial productivity by both dentists and hygienists, will be examined over the next few graphs.

HOT READ: The 10 worst ways that dentists try to save money

Fewer cash patients are being seen year over year at dental practices.  In 2012 an average of 69 patients were seen on average each month. In comparison, 59 patients on average were seen in 2014 and 57 patients on average for the first four months of 2015.  As cash, or fee for service, represents generally the highest payment rate for a given procedure, this is a key reason why net production is on the decline.

HOT READ: Experts debate if fee-for-service dentistry is becoming extinct

The number of patients seen using insurance is not only increasing but the proportion of those paying cash to insurance is steadily decreasing year over year. As with an increase in active patients, this is likely do to a larger percentage of the population having access to dental insurance either through employment or the 

An increase in adjustments is expected based on the increased use of insurance companies as payers for dental fees generated. Adjustments represent the difference between what a dentist would typically charge for a certain procedure versus what is actually paid by the insurance companies. These adjustments decrease the amount of income realized by the dental practice compared to fee for service.

A product that could help: Introducing the PPO Analyzer

Practice Net Production to Practice Gross Production

The end result of these trends is that although the dentists and hygienists are working more hours on average each month, their net production per hour and per patient represents a smaller percentage of the gross. This is due to the increased use of insurance as payment, leading to more adjustments and a smaller percentage of net production. Unfortunately for dentists, with the ACA and increase in employment, this trend is likely to continue into the future.

ARTICLE: How to get patients back into the dental practice

Dental practices are experiencing an increase in service demand, a decrease in fee for service patients and overall decrease in revenue per hour of work. This will likely have long term implications for how a clinic operates and how they provide clinical care to their patients.

Sikka Software provides a platform for small and medium-sized business healthcare apps. The company's products help healthcare providers and other small businesses optimize their business via a series of easy to use cloud-based applications. With over 32 apps built on Sikka Platform Utility® with over 14,300 installations, Sikka Software is the leader in the US Dental, Animal Health and Hearing Care markets. The company is now supporting a real time optimization and information network with providers, patients, consultants, manufacturers and financial service providers.
	
	A privately-held company, Sikka Software is headquartered in Milpitas, California with offices in the United States and in India. More information including may be found at 

Alitta Boechler is a marketing manager at Sikka Software. She holds a Doctorate of Audiology from the University of Iowa and an MBA from the Jesse H. Jones Graduate School of Business at Rice University.  You can contact her at 

 or (408) 359-3014.  For more information about The Practice Optimizer Company® please visit 

 Over the last four years, dentists have experienced significant changes to how they practice dentistry and the reimbursement they received for their services. These changes were experienced on a national scale.