Dental Practice Transitions - What are my first orders of business?

Check List for New Dental Practice Owners
Buying a Dental Practice is exciting, and setting yourself up for success is important in the first month. Here is a list that will be helpful in organizing business to-do items that will smooth out the transition from old doctor to new doctor. 

1. Secure Financing for the purchase.
2. Attorney to review final agreement, and make adjustments. 
3. Set up Business Checking Account with a Line of Credit attached. 
4. Lease - Must be moved over to the new doctor. I recommend consulting an attorney or The Business Advocate (See listing under Professional Services) to negotiate terms.
5. NDAS Fee List - This is a list of UCR (Usual & Customary Fees) for your zipcode. Your Practice Transition Broker will have access to this. Request a copy for your zipcode. The fees are listed by %, and you want to compare your fees to at least the 70% column, if not more. 
6. Identify what PPOs the practice currently participates in, and order ALL insurance PPO applications. Fill them out ASAP for credentialing, review (compare to NDAS) and file fees. This is very important, and must be done as quickly as possible. Insurance companies credential you by location, so if you were credentialed some where else this does NOT transfer to your new location. The Insurance companies take 4-6 weeks to process applications, even if you were credentialed some where else. The longer this takes the more write offs you will have to take, to keep your new patients happy. 
7. Hire a CPA & Book keeper - Request them to set up your Quickbooks (List of Expenses). Dental Practices are usually set up on a Cash Basis format. This is important so you are able to look at your P&L (Profit and Loss) statement, and see where your business is month to month. 
8. Set up a vendor for Visa, MC, AMEX, Discover... whichever ones you will accept. Make sure that ALL credit card terminals are switched over to you, so payments are not deposited into the previous owners account. 
9. Hire a Payroll service. ie. Paychex, ADP, Intuit
10. Create a letter to ALL of the Patients introducing yourself. These letters commonly consist of a half page from the previous dentist endorsing you, and handing the practice over to you. The other half a page is a paragraph introducing yourself to the patients. Your photo should be included on this page next to your paragraph.  
11. Update computer system with all of your current information, Name, Lic.#, Tax ID, DEA#, NPI#, etc... Print out an insurance claim to confirm all information is properly listed. 
12. Change over all services to you. ie. phone, cable, internet, electronic insurance claims clearing house, register with dental software & support...
13. Website - Contact the developer and update the website.
14. Sign up for outside Patient Financing Sources; Care Credit, Chase, Spring Stone...
15. Give your new team a phone script on how you would like them to answer the phones, and field questions about the practice transition. **The team must sound like your biggest fans to instill confidence in the patients!
16. W-9, fill this out and give it to your Admin team. They will need to fax/file this with EVERY insurance company. They will also need to enclose a copy in all paper claims for at least a month. **If this is not done then insurance companies will pay under the old doctor, and they will request ALL payments back, and then they will reprocess all the claims under you. A minor accounting, and cash flow nightmare. 
17. Order new; Letterhead, envelopes, business cards, postcards, appointment cards, and recare cards.
18. Review; Welcome letter, Recare cards, treatment consent forms, tx refusal form, records release form, financial policy and forms, dismissal letter, collection letter, office policy manual, OSHA/WISHA manual is current and updated to you (Harris Bio Medical), current CDT code book.   
19. Create a Marketing Plan; Val Pak, Direct mail post cards, radio advertising, SEO (search engine optimization) of your website & paid Google advertising, buses, sandwich board on the sidewalk, local newspaper, ask current patients for referrals, etc...
20. Chart Audit A-Z- Admin team to review every active chart for over due hygiene, and uncompleted treatment. Admin teams calls each patient to schedule these appointments. ex.. Doctor is concerned that you are 1,2,6 months over due for your cleaning appointment... when would be a good time to get you in? Doctor asked me to give you a call. He is concerned that your fillings, crown.. were diagnosed 6 months ago. What days and times work best for your schedule?
21. 60-120 days pull the Insurance Pending report to make sure insurance companies are not holding payments due to lack of information. Your Admin team should be on top of this, but it's best for you to review it with them so they know they are accountable. Cash flow is very important for you to sustain and meet your monthly obligations. **Patient portion must be collected at time of scheduling or time of treatment, unless a payment plan or outside financing source has been previously arranged. 

When purchasing a practice it's best for the transition to be clean. The old doctor leaves, and you come in and take over the team & patients. This is best because the team will emanate what culture you set, and the patients will connect and create relationships with you. 
If this is NOT clean, your new team will have a hard time respecting you as the new owner/boss. The other problem that frequently arises... is that patients generally want all of the major restorative to be completed by the old/original DDS. YOU, the new DDS must be the producer for this restorative production to pay for your new practice and financial obligations. 

Written By: Kat Johnson-Britsch

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