Dayna Johnson has helped dental offices from around the country easily transition down the path to paperless using her years of experience as a dental office manager and Certified Dentrix Trainer. As one of the country's most trusted consultants, she gives a straightforward and complete assessment for each of her clients. No two dental offices are alike, and Dayna channels her passion for going chartless to help each of her clients fulfill their goals and increase their profitability. For more information, visit www.raedentalmanagement.com or her blog at thedentrixofficemanager.blogspot.com.

Dayna Johnson

	So you're thinking about purchasing practice management software... but do you know the top things to take into consideration before you take the plunge? Here are the top 10 things to keep in mind before you invest.

	1. The purchaser is usually not the one using the software  

	Who is the person with the checkbook? The doctor. Who will have their hands in the software, using it every minute of the day? The front office team, the dental hygienists and the dental assistants. The doctor went to dental school to cut hard and soft tissue, and that is their primary role in the practice.   

	2. The entire team should be involved in the demo  

	The team will be using the software, so everyone should be included in the demo. The systems you perform every day should be the most important points to talk to with the sales rep.   

Related reading: The best practice management software for your office

	3. Don’t buy bells and whistles, buy nuts and bolts

	The sales rep will want to show you all the cool things the software will do, and has probably rehearsed the sales pitch repeatedly to make sure they don’t skip over that one feature that everyone is raving about.  Come prepared with a list of the most important tasks your team does on a daily basis so you can see how the software handles those core systems-and then move on to all the bells and whistles.

	4. Make sure it’s compatible with your imaging software

	Your team could spend hours of unproductive time working with imaging software and practice management software that don’t talk to each other. If cost is the only thing standing in your way between imaging software that doesn’t integrate with your practice management software and the one that does, pay the money and go with seamless integration. Your team will love you and will spend less time managing images for claims and your referring doctors, so they can spend productive time working on keeping your schedule full.

	In some instances,  dental practices change software because they feel the new system will fix everything. However, if you have account ledgers that are a mess now, you will have account ledgers that are a mess in the new software. Humans cause messes, not software.

	The most important thing is that you understand what patient data will come over and what it is going to look like. Ask how your patient’s account history will look, how the prior data will be recorded on the new reports and if any of the clinical data will be transferred. Having as much information as possible will help your team know what to expect. Knowledge and communication with the conversion team is critical to a successful transition.

	7. Just because your office manager used it in another office does not make them proficient

	It also does not make them an authority to make decisions on converting to new software. Remember purchasing new software or converting your software should be a team effort, not one person’s decision. 

Trending article: How technology is really changing the dental workflow

	8. Know your state laws on documentation rules

	Some states require electronic prescriptions, some require signatures on the health history and some states have completely mandated digital records. Find out what requirements you need to follow in your state and make sure the new software you are looking at can accommodate all the requirements.

	9. You don’t get a 30-day free trial with practice management software

	Nowadays you can get a free trial with almost anything so you can test the waters before you buy it, but with practice management software you can’t just turn it on and off. The only way you could do a trial would be to run two software programs side-by-side. This would cause double entry, and an enormous amount of work for your team.

	10. You might just need training on your current system

	Oftentimes an office is switching software because they believe their current software will not do what they want it to do. Most of the time this can be solved with training. Invest the time and money into training your team to optimize your software, learn the functionality you are not using and discover new things you are not using. This investment will be well worth it. 

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Ten things to keep in mind before you make any big changes.

Top 10 things no one tells you before investing in practice management software

	In 2003, my dental practice converted from an archaic DOS-based dental software to the impressive and robust Dentrix practice management software. To say the least, I was completely overwhelmed. Two years later, in 2005, I still felt like I hadn’t even scratched the surface of my new powerful software’s potential, so I applied to become a Certified Dentrix Trainer in order to learn everything there was to know about the Dentrix program. What better way to learn than to get a certificate?

	Now, I know that not everyone has the opportunity to become a Dentrix trainer like I did, but with a little self-motivation and some tips from me, you will be well on your way to being a “Dentrix super user.” Since I am working with dental practices every day, I have the unique opportunity to see what features they are using, what features they are not using, and what features they have no idea even exist. My goal today is to give you my top 10 you might not even know exist.

	Maybe this sounds familiar … you have a folder on your desktop with all of your office’s letters you send out to patients, including collection letters, welcome letters and letters to specialists. When it is time to send a letter, you edit the date, enter the patient’s name, address and salutation, then sign the letter and scan it into the document center. That process sounds like a lot of work to me. Why not add your custom letters into the Quick Letters or Letter Merge with the proper merge fields and let Dentrix do all the work for you? The best part is it will automatically put a note on the Office Journal and you can “Send to the Dentrix Document Center” without scanning (see #5 on the list).

	Have you ever been sitting in the comfort of your home watching the weather forecast and hoping that the power doesn’t go out … and then suddenly there’s nothing but darkness? You check the office and the power is also out there … so how are you going to let your patients know not to come in? Has your doctor ever been out of town and received a call from a patient requesting a drug refill but he or she has no way of checking the last prescription or the patient’s last visit unless he or she goes into the office? Both of these two common scenarios can be solved just by registering for Dentrix Mobile. It’s included in your Dentrix customer support plan so there is absolutely no excuse for not using this service.

	I wrote an article called “Get it out of your head and into the computer” back in April 2014. The theme of the article was speaking to office managers who store all their verbal payment agreements in their head. What I am seeing is this is still happening, but I am also seeing new doctors purchasing practices with a significant amount of the accounts receivable over 90 days past due or new office managers taking over a practice where there has been no management of the accounts receivable. Using the Payment Agreement feature in Dentrix will not only help you get organized with patients who are making payments, but also allow the entire team to see on the ledger what the arrangement is with the account.

	Do you know where your new patients are coming from? Are they hearing about you from friends, Google Search or the ValPak flyer that cost you $15,000 to send out? Your marketing dollars depend on where patients are being referred from, so you should know where to continue spending money and where to stop. When a patient refers a new patient, do you give him or her a thank-you gift? Would you like to track if you gave the referral source a Starbucks or Home Depot gift card last time or be able to track a referral source’s gratuity history? Tracking referrals and gratuities in Dentrix is super easy and gives the doctor a lot of good information about where to spend marketing dollars … but I find most offices never use this useful tool.

	This will save your team a ton of time in unnecessary scanning, wasted paper and hard drive storage space. When you scan a document into the Document Center, it takes many more steps and the file size of a scanned document is about 100 times larger (just a guess) than that of a file sent electronically through the Dentrix Document Center printer driver. Anything you want to print can be virtually printed to the Document Center for file storage. This is such an amazing yet underused feature.

	Close your eyes for a moment and imagine if you could see your patients on time, complete 80 percent of your production goal before lunch, get out for lunch on time and finish your day without pulling the roller skates out of the closet. This can be a reality if you create it. Take control of your appointment book with Perfect Day Scheduling. When you use perfect day scheduling, your team knows exactly how to schedule because you have mapped it out for them. There is no room for error.

	Every dental practice has production and collection goals they need to meet in order to keep the financial state of the business healthy. I always encourage doctors to share these goals with the team and be transparent with the key performance numbers with the team. There are several places in Dentrix to watch and monitor your practice goals so the team can strategize and work together on exceeding the goals. You can monitor your goals on the monthly calendar, Practice Advisor Report and the Daily Huddle.

	Have you ever been on the phone with a mom and she wants to know when her three kids and husband are scheduled next for all their future appointments … but you’re not sure what’s the most efficient way to find all these appointments for the entire family? Try the More Information button and I can guarantee you will fall in love with this super-quick search tool. You can find the More Information feature on all Dentrix modules. When you are selecting a patient anywhere in Dentrix, you will see it at the lower left corner of the window.

	Are you sure you have batched and sent off all your insurance claims from last week? How about last month? Use this second pair of eyes to double check and make sure all your claims have been sent out. Not only will this give you peace of mind, but also keep your accounts receivable out of the 90-day past due column.

	Do your patients often ask what a “resin 2surf, post” or a “Crown-porc fused noble metal” is? Or is your practice in an area where English is not the primary language for many of your patients? If you would like to create a treatment plan that your patients would more easily understand and helps them understand what each procedure is, then start using patient-friendly descriptions. With Dentrix G6.1, it is even easier to use because you can edit these descriptions in the procedure code edit.

	Have fun experimenting with these features and working toward increasing your level of efficiency and customer service. 

In 2003, my dental practice converted from an archaic DOS-based dental software to the impressive and robust Dentrix practice management software. To say the least, I was completely overwhelmed. Two years later, in 2005, I still felt like I hadn’t even scratched the surface of my new powerful software’s potential, so I applied to become a Certified Dentrix Trainer in order to learn everything there was to know about the Dentrix program.

The top 10 Dentrix features you probably aren't using

	As technology continues to advance, more and more tools are being introduced that make our lives easier both personally and professionally.

	A new product that is being showcased at 

the American Dental Association annual session in Washington, D.C.

, is being advertised to help make the dental practice more productive and efficient.

 and can help the dentist stay up-to-the-minute with what is going on inside the practice. Rather than having to flip through charts or guess which patient is in each operatory and which exam room is up next, Simplifeye brings everything to the wrist without having to look at the schedule, including patient history and any medical alerts for that patient.

Related reading: 40 MUST-see products at GNYDM and ADA

American Association of Dental Office Managers meeting in Nashville

, I learned about the product and saw it first-hand. Impressed by the technology and the applications it could have for the dental practice, I recently sat down with Simplifeye’s Ryan Hungate to talk about the company and its product.

	Hungate is no stranger to dentistry or technology as the orthodontist was also pivotal to Apple’s retail design strategy as he details in the video interview you can watch by clicking below:

More from the ADA: How the ADA, the leader of a field historically dominated by men, came to be governed by women

As technology continues to advance, more and more tools are being introduced that make our lives easier both personally and professionally.

Simplifeye helps dentists stay up-to-the-minute with their practices

	It’s a dark and stormy night in the small town where your dental practice is located. It’s also one of the first late, late afternoons you’ve worked in the practice since it relocated from the center of town to a new location out by the lake.

	There have been some strange rumors about why the previous dentist moved out of the location so quickly, but it was such a good price, how could the new owner turn down such a spacious three-operatory location … with a lake right next to it … and some abandoned buildings on the property … and some funny little stones sticking out of the ground near the lake? I mean, what’s not to love about this location?

	Just as the dental practice is getting ready to shut down for the night, you hear a scream from just outside the front door. Each your coworkers has gone completely pale. It’s dark outside. It’s pouring rain. Suddenly, you hear another scream and a badly injured person comes bolting through the door.

	You’re the only medical facility in the area, so you know you can’t turn this person away. You ask what happened. All she can do is look at you and sob softly.

	You know you have to do something. Sure, you’re going to help her … but what ICD-10 codes are you going to use to bill for the treatment? Hey, your practice didn’t start doing medical coding just because it sounded cool, right? This is your time to help a damsel in distress … and also show off your new coding skills.

	In this article, we’ve devised five ways the damsel could be injured by Freddy, Jason or any of the other psychos who are running loose in the area where you’ve just moved your practice (it doesn’t look like such a good deal now, huh?). Read on to see her injuries and the ways that ICD-10 codes have actually anticipated that this type of injury might happen.

	Not only did Jason chase her around the lake, she also seems to have taken some pretty nasty cuts at the hands of his chainsaw. Seriously, who chases someone around with the chainsaw (yes, yes, Texas, we know all about your massacre)? She’s bleeding pretty badly but you’re able to sew her up and assure her that Jason won’t get her again.

	I mean, the sheriff shot him, so he’s dead, right? Right? You send her on her way and use ICD-10 code W29.3XXA (contact with garden and outdoor hand tools and machinery, initial encounter).

	The madman has locked the victim’s husband inside a room and the only way she can learn the combination to help him escape is to look on the back of her wisdom teeth where the madman carved two of the four numbers on each of her wisdom teeth while he had her sedated (seriously, who thinks of this? Apparently the people who came up with the movie 

. In order for her to see the numbers, she has to manually pull out her own wisdom teeth.

	Yeah, she isn’t feeling very good when she finally makes it to your practice (and where’s the guy she got out of the room by doing this anyway? Geez.). You help plug the holes where her wisdom teeth used to be and use ICD-10 code M26.34 (vertical displacement of a fully erupted tooth).

	The disfigured madman laughs maniacally as he throws acid on the victim’s face, saying, “Now you’ll like me!” Come on, you’re a guy and she’s a lady. No way she’s going to look like you unless you put a blonde wig on, dude. She stumbles into your office and you help put bandages on her face and ease her pain.

	Luckily, you have ICD-10 code T20.40XA (corrosion of unspecified degree of head, neck, and face, unspecified site, initial encounter) to use for your billing purposes.

	Bob the Builder has gone mad, I tell you … MAD! Not only has he moved into the abandoned buildings by your dental practices (what are the odds?), but he’s also tired of people asking him if he can fix it. He screams, “No, I can’t!” as he stalks his prey, including your patient tonight, who just happened to wander into the abandoned building looking for her lost puppy. He used a nail gun to send a nail right through her jaw.

	She was able to pull the nail out (she’s very tough) before she came into your practice. You ask her if she was a recent tetanus shot then help sew her up, using ICD-10 code W29.4XXA (contact with a nail gun, initial encounter) to not only help her, but your practice’s bottom line as well.

	So the sheriff’s office finally tracked the killer into the abandoned barn behind your practice (that, ironically, was filled with old sharp blades and machinery of all kinds). They decide the best way to get him out of the barn (and maybe finally do away with him after they’ve already killed him six or seven times) is to set the barn on fire. What could possibly go wrong with that plan?

	Well, little do they realize that there are also multiple cans of jet fuel stored in the barn as well (what are the odds?) and the explosion is intense, sending a propeller blade into your patient’s face and knocking out several of her teeth. Luckily, you’re there to help her through the pain and use ICD-10 code X01.4XXA (hit by object due to uncontrolled fire, not in building, initial encounter) to send the procedure off for billing.

	It’s a strange location for your office, but at least you have ICD-10 knowledge to help you through the odd occurrences happening near your practice. Stay tuned … there might just be more strange happenings and corresponding ICD-10 codes very, very soon. Cue the evil laugh here.

It’s a dark and stormy night in the small town where your dental practice is located. It’s also one of the first late, late afternoons you’ve worked in the practice since it relocated from the center of town to a new location out by the lake.

The top 5 most gruesome horror movie injuries  - and the ICD-10 codes that could save the victims' lives

	Is what you're getting ready to buy really going to help your business and your patients? Here are five ways to find out.

During my 22 years in dentistry, I have been both the trainer and the trainee when it comes to implementing new technology in the dental practice. People who know me see me as kind of a computer geek.

	The satisfaction of getting a new computer, network or piece of technology to work was the thrill of the hunt. It’s amazing sometimes that it all works together.

	The miracle that all the technology works together is actually not a miracle at all-it takes planning and professional help. It doesn’t just happen. There are five critical things to consider when purchasing a new piece of technology, whether it is for the clinical or business side of your practice. These five things will not only help bring this miracle to life but also make sure your team is as efficient as it can be:

More from Dayna: Going paperless in the dental office

1. Research the product before you buy –

 I have been to multiple dental practices where the doctor has picked up a new printer/scanner/copier/fax machine, brought it to the office, dropped the box on the desk and asked his office manager to install it and have it working by the end of the day. This happens with many products, such as computers, monitors, Wi-Fi routers, signature devices and printers. There are many details to consider when purchasing a new piece of technology.

		Is it compatible with my practice management software?

		Does this product contain the proper drivers or can I install them?

		Does it work over Wi-Fi so my entire team has access to it from all workstations?

		Do I need a converter so I can plug it into my existing computer?

	If you don’t know how to answer these questions, consult an expert hardware technician who can help guide you to the right product.

Related reading: What value-added services can do for your practice and patients

savvy, have it installed professionally – The dental practice I worked in only had four treatment rooms, but we had 14 computer workstations that needed the power of a hard-working network. When you implement a new piece of technology, there will be hardware specifications that need to be met so that it works properly and will continue to work for the life of the product. Here are some specifications to consider if you are considering a self-guided installation:

		Can the network support this new product (drive space, memory, etc.)?

		If you install a product that has some kind of output (images, X-rays, etc.), do you know where to point the data so it gets backed up every day?

		How do you share the data over the network so all workstations that need it have access to it?
		 

Training is an investment in your team, the productivity of your practice, and the implementation of this new piece of technology. Of course, not every piece of technology requires a professional trainer. If you install a new all-in-one printer, you probably don’t need to bring in a trainer because your team already knows how to use the product. So how do you know if you need to bring in a trainer? Ask these questions:

Related reading: What $10,000 could do for your practice

		Is the new technology something that is new and has never been used before?

		Are there reservations within the team to implement the new technology?
		 

	If you answered “yes” to any of the above questions and do not have an expert on staff, you need to set aside a budget and time to have your team trained professionally.

	Team training does not have to be expensive and inconvenient. There are online courses, webinars, live online training and lunch and learns. Of course, nothing beats having the trainer come into your practice to teach you on your own equipment. Having the trainer in your office allows for customization, troubleshooting with specific issues and live Q&As with the team.

More from Dayna: 24 practice management ideas to improve your dental practice ... in 90 seconds or less

4. Give all team members a hands-on experience –

 I advocate cross training and making sure the team is familiar with all equipment and technology in the office. This not only makes for a much more productive and efficient team but also lets your patients know you keep your employees educated and up-to-date on all your equipment. After you have installed and trained on your new product, set up a learning session for each team member.

	For example, if you just installed a new electronic form system, make sure each team member follows the steps from start to finish so he or she has a clear understanding of how it works and what the patient experience will be.
	Another example: If you just purchased a new voice-activated perio chart system, let each team member try it so he or she understands how the patient will feel when using it. This helps create awareness and understanding for your patients.

	If it is a more complex piece of equipment, like a digital pano machine, all clinical team members should know how it works and the admin team should know the benefits and how to discuss it with patients.

What would Dayna do ... about offering health insurance for dental practice employees?

 Technology is constantly changing, and you must stay up-to-date with any software and hardware updates. Some practice management software companies come out with large feature updates that need team training but some updates are just driver updates that don’t require training at all. My recommendation would be to have a quarterly technology “refresher” course for the team. Someone on the team can be designated as the trainer for the next meeting and determine what equipment or piece of technology is on the agenda, then decide if you need to bring in a professional trainer or if you are just going to do a webinar.

	Technology leads our dental practices and is constantly changing. Every dental practice needs to have a technology map of the practice and learning days set up for the team. Work with your hardware technician and trainers to help you customize a plan that works best for your office.

More featuring Dayna: Why dental practices need annual practice management software training

The satisfaction of getting a new computer, network or piece of technology to work was the thrill of the hunt. It’s amazing sometimes that it all works together.

5 critical things to consider when purchasing technology for the dental practice

 sat down with Teresa Duncan, the insurance editor for 

, to talk about a subject that seems to be coming up more and more for speakers around the country: What to do about insurance write-offs.

Dental practices may be often asked by their patients to just bill them for whatever insurance charges and to write the rest of the treatment off. It seems like a growing trend, according to Duncan.

“It’s definitely becoming a problem in our industry. It’s definitely a problem where there is a lot of competition and lot of PPO coverage like Southern California, southern Florida, and New York City. In these places, you will hear this question a lot,” Duncan said. “The bottom line is this it’s unethical to waive a copayment. It’s unethical to tell someone to send all of your friends to the practice because you will only charge what insurance charges you. The problem is that I hear it all of the time.”

It’s also becoming a problem because some dental practices are using this as a way to get ahead in their ultra-competitive area.

“I’ve had practices tell me that they can’t get ahead because they can’t compete against the practice down the street that is doing this,” Duncan said.

If you’re working in a dental practice that is waiving co-payments, Duncan has a very stern warning for you.

“What you’re doing is not only unethical, it’s also illegal,” she said. “Not only will the ADA not like it, your insurance company won’t like it as well. You’re setting yourself and your practice up for an audit if word was to ever get out about this.”

To hear more about the subject, as well as more of Duncan’s thoughts, please watch the video below.

What Would Dayna Do ... about the ethics of waiving copayments in the dental practice?

 answers a question about the upcoming June 1 Medicare deadline.

While many dental practices might think that the deadline doesn’t apply to them and only applies to medical facilities, that’s not the case, according to Johnson.

“If your dental practice treats patients over the age of 65, this is absolutely something you need to know about and you need to be informed about,” Johnson said. “There are three options that will be available. Knowing which option is best for your practice is absolutely critical.”

More from Dayna Johnson:The 3 most common battles within the dental practice ... and how to overcome them

In the video below, Johnson goes into detail about the three options and explains about each of the options.

If you have a question you’d like to submit to Dayna for a future edition of What Would Dayna Do?, visit 

What Would Dayna Do ... about the upcoming Medicare deadline?

 answers a question from a Texas dental practice about coding and billing for oral cancer screenings.

Each April, there is always a rise in the attention paid to 

 during Oral Cancer Awareness Month. However, more and more dental practices are realizing that oral cancer is a battle that is fought every day of the year, not just in April.

RELATED: 10 oral hygiene tips for patients with cancer

Click below to hear Dayna’s thoughts on the proper billing and coding for oral cancer screenings. If you would like to submit a question for Dayna to answer, visit 

What Would Dayna Do ... about the proper coding and billing for an oral cancer screening in the dental practice?

 for Modern Dental Business and Dental Practice Management, 

, an insurance expert and the insurance editor for Dental Products Report. In this video, Johnson and Duncan discuss two insurance-related questions.

The first deals with how a dental practice should do write-offs when a patient has a dual PPO plan and how to calculate patient plan. The second deals with a patient who asks the dental practice why he should be paying a co-payment when his wife didn’t have to pay for one at another dental practice.

Dealing with PPOs in your dental practice? Check out the PPO Analyzer.

Click below to hear the nuggets of knowledge from these two experts in their field.

What Would Dayna Do … about handling a dental patient with dual PPO plans?

 answers a couple of questions from a dental office manager based in Michigan.

The office manager writes, "Dear Dayna, I would like some advice on a 

. What are the rules on giving employees health insurance if they already have it under their spouse? Also, what are the rules about a leave of absence? How do we average hours for benefits when an employee has been on medical leave the year before?"

To help answer the questions, Dayna calls upon the expertise of Andrew Llama of 

. He says that he hears the question about spouse and health insurance often and reminds viewers that the rules for health insurance are governed by federal law and state law. He says, "Although you are not required to provide health insurance to your employees, if you have less than 50 employees, you must provide it to all employees if you have a group health insurance plan to avoid any potential discrimination claims."

RELATED: What Would Dayna Do ...	about calculating accurate dental insurance estimates?

In this installment of What Would Dayna Do?, Dayna Johnson answers a couple of questions from a dental office manager based in Michigan.