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June 29, 2015

Electronic Payment Processing – Are You Getting Ripped Off?

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 4:58 am

imagesI recently did a survey of current clients asking them what percentage of gross receipts were attributed to credit cards. 35-40% seemed to be the number. Very few patients pay by cash anymore–it’s either a check or credit card. So on a million-dollar practice–certainly a nice practice but nothing unusual these days–that would represent $400,000. The average published processing fee of a credit card company is 3% of the sale. That is the amount the practice pays to the merchant service provider.  In this example, that would be $12,000.

But when I examined expense reports to analyze the total amount of processing fees charged to the practice, it was often more than 3% – sometimes between 4 and 4 and 1/2%. Why should that be? There are a number of potential reasons:

• The true costs associated with processing are not disclosed.

• The electronic processing and merchant service industry is mostly unregulated when it comes to     billing and sales practices.

• There is an extremely complex and cloudy system by which processing costs are determined.

If your analysis shows similar results, I would strongly suggest that you contact Schooley Mitchell. It is the largest independent payment processing consulting organization in North America. Here is how they work. They monitor your credit card statements on a quarterly basis to identify all of the bogus or seemingly incidental fees that creep in. Fees like interchange rates, dues and assessments, monthly access fees, front end authorization fees and back end capture fees.  The cost for the analysis they provide is on a 50% contingency basis: their fees are self funded out of the savings generated from reduced processing expenses. They claim to consistently save their clients 40% if they switch to a new credit card provider or 30% if the client chooses to stay with their existing credit card provider.

Schooley Mitchell has a strong incentive to do a good job. The more they save you, the more money they make. You take no risk. They will either save you money and self fund their fees, or give you a no-cost validation that you are receiving the best overall value for your existing services.

There is another very important reason to revisit your electronic payment processing protocol. In the United States, the migration from magnetic stripe cards to embedded chip cards is underway. The liability for fraudulent transactions is changing along with the switch to chip payment technology. Currently, banks absorb the majority of fraudulent credit card costs. But as of October 2015, if a customer pays for services with a fraudulent chip embedded card–and your practice processes that transaction without a chip embedded terminal–you will be liable for that transaction.

It is a different world out there my friends! Forewarned is forearmed.

June 15, 2015

Don’t Compromise – Part Two

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 5:12 am

I was in a client’s office a few weeks ago and I overheard one end of a conversation where someone at the front desk was trying to explain to a patient why there was a $35 charge for a broken appointment. As you can imagine, the conversation did not end well. This relatively inexperienced staff member broke two cardinal rules: never disrespect or disappoint a patient and never use the word “policy” as the explanation or answer to a question. Dentistry could easily qualify as a business where the average lifetime value of a patient is $15,000. How insane is it to lose that patient over a $35 charge for a broken appointment?

The above situation doesn’t happen when the doctor has created an exceptional workplace culture. That means an environment where employees love their work and are empowered to do whatever it takes to please a patient and make them happy. That means an office where the doctor has built a team and not just a group of people that work together.

I recently wrote about how difficult it has become to assemble that team. The value of building that team was reinforced in a recent article in Dentaltown authored by Howard Farran.  “When we plot highest net income with all the variables that can be associated with it, we don’t find it related to where you went to school or what institute you did some training at; we find it linked to longevity of the average staff member”. Interesting.

I don’t want to sound like a broken record. You need to do whatever possible to build that team. One of my mentors – the incomparable Seth Godin – says this so eloquently. “Building an extraordinary organization takes guts. The guts to trust the team, to treat them with respect and to go to ridiculous lengths to find, keep, and nurture people who care enough to make a difference”. Amen.



June 1, 2015

Compromising Is Not An Option

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 7:05 am

Discussions about staff continue to be an ongoing part of practically every monthly meeting or telephone call with my clients. This is not something new, but it seems to be on the rise. Staff performance, staff incentives, bonus plans, job descriptions, complaints, HR issues–the list is endless. Our conversations are happening because of the critical nature of these issues. Building and maintaining a quality, customer-service oriented, loyal, and talented team continues to be the biggest challenge–and a key ingredient–for the establishment and growth of the superb dental practice.

In preparation for this blog post, I re-read an article about staffing that I published in the Spring of 1997 in the Journal of the Massachusetts Dental Society. I had just started my consulting business, and my thoughts for that article were solely based on my 29 years of experience running my own dental practice. To my surprise, there was not much of anything that I would change. But 18 years later–and over 650 dental client relationships later–I realize how much more difficult it is today to mold that perfect staff.

1. Our society has become extremely mobile and transient. In the world of today, both spouses working is the norm and not the exception. If one spouse gets a promotion, it may involve relocation of the entire family unit. So you can lose a great staff member through no fault of your own and you are suddenly back to square one.

2. A competitive benefits package has become quite costly. Healthcare costs have skyrocketed and bear no relationship to inflation. So offering employees a good medical insurance plan is absolutely essential if you hope to attract quality people. Combine that with the costs of pension, vacation pay, holiday pay and sick time/personal days (now often mandated by State employment laws), and you realize that the dollars start to add up.

3. Terminating an under performing employee has become much more complicated. Over the past five to ten years, there has been an exponential increase in the number of lawsuits accusing dentists of harassment, discrimination, and improper firing. This fear of litigation may paralyze the doctor and prevent decisive and necessary actions. There has never been more of a need for an exquisite and well-written office policy manual. There also needs to be a sophisticated understanding of HR issues, especially the necessity for meticulous documentation.

Fortunately, there are some positive to offset these negatives.

1. The power of the Internet is amazing! Google, Facebook and Twitter have made it infinitely easier and quicker to find qualified staff. Our world has become incredibly connected.

2. Doctors can now purchase EPLI insurance and greatly reduce or eliminate the fear of financial ramifications from frivolous employee lawsuits.

Over the years, my favorite ad for finding great employees is what I call an “in your face” ad. It used to be placed in the Classified Ads section of your local newspaper. Now it gets posted to craigslist and you get replies instantly. It is designed to attract the very best people. These people are most likely working in another dental practice in your general area where they no longer feel challenged or appreciated.

” Busy general practice seeking the absolute best dental assistant in the Metrowest area. If your clinical skills, team building skills, and communication skills are not excellent, please do not respond to this ad. This is a full-time position with benefits. Money is no object. Compensation will be commensurate with ability and experience. All resumes will be kept in strictest confidence. E-mail your resume to______________.”

In spite of how difficult team building may seem, please don’t settle for average. Strive to build an exceptional workplace culture in order to attract, motivate, and retain top talent. Culture attracts, culture retains, and culture drives performance.






May 18, 2015

The Magic of Call Tracking

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 6:09 pm

Acquiring a consistent stream of quality new patients is an absolute necessity–and a key ingredient–for the continued growth and success of a dental practice. My hope would be that at least half of your new patients come from referrals from within your existing patient base. There is no greater validation of your entire customer service experience than when a satisfied patient recommends a friend, business associate, or family member to your office. And, of course, we know exactly how that new patient found your practice. There is no mystery.

The rest of your new patients find you from offline or online marketing campaigns. Offline marketing refers to TV commercials, radio ads, billboards, and mailers. Online marketing refers to organic search on Google/Yahoo/Bing, paid advertising on Google (Adwords), and of course all forms of social media like Facebook or YouTube. In contrast to internal marketing initiatives that produce referrals from your existing patient base, these external marketing programs can cost significant amounts of money. The challenge as marketers is to be able to measure the effectiveness of any of these programs in order to see where you get the best bang for the buck.

I have a strong bias for online initiatives. Online search is very specific. Someone has decided to look for a dentist or a dental procedure. Your goal is to be there and show up so they can find you easily. Offline programs require you to constantly put a message out there– 24/7 – spending lots of money and hoping and praying that someone will be motivated to call because you have stimulated their interest. Very different.

Call tracking has been around for many years. A unique telephone number is attached to the marketing or advertising message. When someone calls that number, it is call forwarded to your office telephone number. You can track the volume of calls to measure the effectiveness of the program. The calls can also be recorded to analyze your staff’s ability to convert the calls to actual patient visits.

I like the concept of using call tracking for online marketing. The call tracking platform works by inserting a small piece of code into the backend of your website. The code recognizes where the call is coming from–from anywhere online. In other words, the telephone number that shows up on your website is dynamic,  and it changes to reflect the referral source. You can have as many unique telephone numbers as you wish – each assigned to a particular online marketing program – and the number on the website changes based on where the call is initiated. The recorded calls will then provide you with useful marketing intelligence:

• What search terms did they type in to reach your website?

• How did they find your site? Was it an organic search, or from another marketing campaign like    Adwords or a Facebook ad or even  a Facebook post?

• What page of your site were they on when they made the call?

Basic Google analytics can measure how many visits occur on your website. But adding call tracking greatly enhances your ability to refine this data, and measure how successful you are in converting visits into an actual telephone call. That then leads to the ultimate analysis of how many calls are converted into an actual new patient appointment.

Call tracking is relatively inexpensive. Your webmaster can add this for about $100 a month. I think you should give it a try.

May 4, 2015

Money Money Money

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 2:52 am

Remote deposit capture is a technology that was first introduced about 10 years ago, but only in the last few years has become much more available to dental offices. RDC is a service which allows users to scan checks and transmit the scanned images to a bank for posting and clearing. Requirements for users are a PC, an Internet connection, and a check scanner provided by your bank. Practically all banks now offer this service.

The bank’s software is downloaded into the office computer. Training is quick and easy. Basically, if you can read, you can do this! The checks that you receive at the practice are scanned and a digital deposit is created. The digital deposit is then transmitted over an encrypted Internet connection to your bank. The bank accepts the deposit, posts the deposit to your account, with next day availability of the funds. Four advantages come to mind.

1. Efficiency–it takes less than 5 seconds to scan a check, and when you have finished scanning all of the checks, a virtual deposit slip has been instantly created. Without this technology, someone has to manually record the dollar amount of each check on a deposit slip. This process typically includes counting the number of checks and adding the value of the checks–at least twice–to be sure that the deposit is accurate and balanced.

2. Convenience–the doctor or a staff member is no longer required to physically leave the office and go to the bank branch to make the deposit.

3. Reliability– RDC stores up to 60 days worth of check images. This will usually eliminate having to pay your bank “research fees” for problems associated with the deposit of any check.

4. Functionality – The RDC software interacts seamlessly with all of the major accounting software programs.

In my opinion, however, one of the biggest advantages of this technology is that it gives a dentist multiple options for finding better or more competitive banking relationships. Without this technology, you are pretty much limited to using a bank with a branch office in your neighborhood so that you don’t have to travel very far in order to make a deposit. Now you can potentially use any bank.

Let’s say that you want to take advantage of current low interest rates and refinance an existing loan. Maybe you need a new loan for expansion of your facility, or for the purchase of major technology, or to acquire another dental practice. XYZ Bank–located two states away–may have a fantastic low interest rate and generous amortization terms. That bank, however, will only offer that great rate to you if you give them your depository relationship. That’s how banks make money. With remote deposit capture, you are now able to expand your options and most likely save significant amounts of money. Go for it!


April 20, 2015

The Concept of Shrinkage

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 5:47 am

Whenever a bank considers the merits of a commercial real estate property–whether an apartment building or a mall with stores–they make their financing decision and loan allocation based on expected revenue. That revenue is always reduced by some kind of historical metric that accounts for shrinkage, because there will always be periods of time when an apartment is not rented or some store suddenly goes out of business.

Dentists tend to go ballistic when a gap opens up in their schedule affecting their expected revenue. Especially when it is because of a last-minute cancellation for a large block of time reserved for some profitable comprehensive dental treatment. Unfortunately, these kinds of situations go with the territory. People will always disappoint you, and there is no way to totally eliminate this behavior. The trick is how to reduce it. I have been around long enough to realize that success is how you deal with plan B.

I have never been a fan of charging for broken appointments. People always rationalize their actions and will not accept responsibility. The negative ramifications and publicity from someone bad mouthing your office for the charge is simply not worth it. And the amount of money you charge can never come close to replacing the revenue that was lost. Another strategy that doesn’t work is having people leave a significant nonrefundable deposit on a credit card to guarantee the appointment. This, in my opinion, seems unusually harsh and severe.

I have found success in reducing last minute cancellations by using a concept I call “the power of the doctor”. When the diagnosis is made and the patient agrees to treatment, the doctor–looking the patient directly in the eye–says the following to prepare the patient for any crown and bridge appointment:

“Mrs. Jones–I’m excited to be able to perform this treatment for you. But I want to let you know that we only schedule these appointments on certain days and at certain times of the day. You probably are not aware that there are many people involved in this appointment: I have a lab technician on call, I have a delivery person standing by to be sure the impression gets to the lab on time, and I have a ceramist all set to make sure that the color is perfect. So since so many other people are involved with this procedure, when you schedule this appointment with Jane, please be sure to do so at a time when you will absolutely have no conflicts in your personal schedule. Is that okay?”

When the patient answers in the affirmative, the patient has in fact made a promise to their doctor. This is very different from giving the impression that you are going to lose a lot of money if the person doesn’t show up. I have found this technique to be extremely successful in reducing last-minute cancellations and no-shows in the doctor schedule. But it has to be the doctor -not anyone else–delivering this message.



April 6, 2015

Changing the Rules – Again!

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 2:35 am

imagesWhen Google says jump, we all say “how high?” Google is the king of search.  The world searches for everything on Google – including where to find a dentist. Having your website position high up on your local Google Business Map is thus a major important marketing strategy. To be successful in this day and age, you simply have to be prepared to play in the Internet world. Warning – the rules as we know them are about to change dramatically!

On April 21, 2015, Google will begin using mobile-friendly compliance of your website as a ranking factor in searches performed on mobile devices. It is critical to their business that their searches – on all devices – lead to useful information. According to a recent Forbes article,  mobile devices currently make up approximately 60% of all Internet searches, and that number is increasing every year.

So if your website is not written with responsive design technology that allows it to be properly and seamlessly displayed on any smart phone or tablet, Google is going to penalize you severely. Your website will still be listed if you are not mobile friendly, but it will be positioned below sites that are mobile friendly. You take the risk of being pushed so far down on the page that you likely will not be seen. It is no consolation that the mobile friendly update only affects mobile search results and not searches conducted on desktop or laptop computers.

I would encourage you to run your site through Google’s Mobile Friendly test.  It takes less than a minute to find out the results. If your site fails the test, I implore you to call your website company and take immediate action. If you have any doubts about your webmaster’s ability to help you make the necessary upgrade to your site, I feel very comfortable encouraging you to call my good friend Tim Healy at TNT. His company has been making me look good since 2008!


March 23, 2015

Better to be Safe than Sorry

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 2:38 am

I have often written  about the importance of assembling a quality staff. Surrounding yourself with a talented, caring and loyal team is the key to success in any business. Creating and keeping that team intact is probably our biggest challenge as dentists. We live in an increasingly mobile society. It is the rule rather than the exception today that there are two wage earners in the family. So a great staff member may have to leave town because her husband was offered a new position. Or someone is having a third child and finally needs to be able to spend more time at home. Just when you finally have the perfect group in place, something unfortunate or unforeseen always seems to happen and you are back in the labor market again.

I want to write today about the importance of doing background checks and carefully following up on references for potential new employees. Knowledge of human resources (HR) goes hand in hand with proper staff development. Over the years I have witnessed some very damaging and messy situations that undoubtedly could have been prevented with better due diligence.

At the initial interview, you need to disclose to the applicant that it is the policy of your office to do a background check. And it requires a signed form that is separate from the application for employment. Listed below  are four companies that I know of that provide background checks. The cost is about $20, and you need to furnish the applicant’s Social Security number and date of birth.





It is absolutely amazing what these reports provide. Actually pretty scary that all of this information about our lives is out there and so readily accessible. You will see credit history, past employment, professional licenses, criminal record, education, workers comp history, driving record and medical history. When someone comes up squeaky clean, you will now have the necessary peace of mind if you are truly considering this person for a job in your practice.

Be sure to read the applicant’s resume very carefully. Check for lapses in employment or short job durations. Moving around a lot in a relatively short time period is a major red flag. When you do speak to references, you should ask “if the situation arose, would you rehire this person back to work in your practice?”

The bottom line is that it is very expensive to stumble and realize that you have hired the wrong person. Training takes a big investment of time and effort. It is important to do everything you can to be successful the first time around.


March 9, 2015

I Continue to be Impressed – No Pun Intended!

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 2:01 am

Screen shot 2015-02-19 at 8.02.30 PMThirty months ago, I wrote a post about a company called Six Month Smiles. At that time, I was very enthused after attending a two-day course for general dentists that provided hands on learning for short-term orthodontics. STO is defined as cosmetically focused orthodontic treatment performed in less than nine months with aesthetic brackets and wires.

Five of my clients at that time attended the seminar with me and all of them were thrilled. Since then, another 10 clients have attended the course, and three more are signed up to attend the course in the Boston area scheduled for this coming April. I continue to hear rave reviews about the information taught at the course and the online continuous support and mentoring that is provided by experienced instructors to all attendees.  I felt then–and continue to feel now–that Six Month Smiles is often a better, quicker, and always less expensive option to Invisalign. Having options and the ability to present choices to your patients greatly enhances case acceptance.

Six Month Smiles has grown dramatically since I attended my course in 2012. They actually started offering courses in 2011, and as of today, over 6000 dentists in the United States have been trained and have completed 80,000 cases. A terrific and new updated feature is that you will very soon be able to use an intra oral scanner to send digital scans instead of traditional impressions. The company has also made major strides in progressive advertising and enhanced social media presence to make the general public aware of their name and what they do. I was told that in the last 30 days, over 5 million potential patients viewed their advertising, 2.5 million potential patients viewed social media posts, and 30 thousand potential patients visited the patient education section of the Six Month Smiles website looking for a provider in their area.

So as I said in my original post, if you are a restorative dentist who loves to create beautiful smiles and has an ability to visualize cases, this ortho technology can and will be a fabulous addition to your armamentarium. You will quickly be able to move teeth into proper position so that bonding, veneers, and more traditional crown and bridge or implants can now be performed. Click here for more information – you will not regret it!



February 23, 2015

There is a Telephone – And There is Weave!

Filed under: Uncategorized — Mayer A. Levitt, DMD @ 7:52 am

Phone and Computer 3For a while now, I have been hearing great things about a company called Weave. I did some research, and I would like to share my findings with my readers.

Weave has been in business for six and a half years. For the first four years of its existence, Weave served as a recall solution for dental practices, contracting with the practice to schedule overdue patients for continuing care. Two and a half years ago, Weave totally reinvented itself into a patient communication platform that syncs with all major dental practice software to combine calling, texting, and e-mailing into one system. Their growth has been explosive with over 1000 dental offices signing on in the last 12 months.

Weave is a VoIP (Voice over Internet Protocol) telephone system dependent on a reasonably fast Internet connection. There are dozens of VoIP companies out there. I think that VoIP has many advantages over a land based telephone company such as AT&T or Verizon: unlimited lines, unlimited long distance, unlimited local calling, plus the ability to record multiple messages.

But Weave has them all beat because nobody else can do what they do. Weave leases you special telephones that have been pre-loaded with their software. These are high-tech phones that deliver crystal-clear communication. The Weave app is installed on your desktop computer. Now when a patient calls the practice, everything about the patient and the patient’s family will automatically pop up on your computer screen. Your staff will know if the patient on the other end of the line has a birthday coming up, when their next appointment is, if any of their family members are overdue, or if there is an unpaid balance on the account – all without putting the patient on hold. Information that was once inaccessible because it was buried within multiple pages of practice management software is now available on every call the moment the phone starts ringing.

Weave provides true two-way text messaging just as you send and receive texts with your cell phone. It is wonderfully timesaving and efficient to be able to click to dial, thus controlling your telephone from the desktop. Weave also allows call recording, call tracking, advanced voicemail, and coming soon–a mobile app for your cell phone.

The bottom line is that Weave software helps you make more meaningful connections with your patients. It works seamlessly with your practice management software, pulling relevant data and presenting it in a beautifully simple way. Instant prompts give you everything you need to know about your patients to make them feel important and appreciated. And that leads to better outcomes for your patients and your practice.

Weave does not require a contract. They truly want and expect to earn your business every month. They provide 24/7 email customer support along with very comprehensive and detailed staff training that is included in the monthly charge.

In gathering information for this post, I spoke with five or six people in the Weave organization –at all different levels – and each one was more passionate than the other about their technology, the growth of the company and its future. I truly feel that Weave has the potential to become the dominant player – similar to what Care Credit did with outsourced patient financing. I would encourage you to call and schedule a demo of this amazing technology. And I would love your feedback.



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