Overview Flashcards
______ = owner is the business
sole proprietor
What type of tax schedule does a sole proprietor face?
personal level- 1040 Schedule C
Income for a sole proprietor is based on your _____. This is a(n) __________ (advantage or disadvantage?).
productivity and ability to collect
advantage
True or False: A sole proprietor faces unlimited exposure to personal liability.
True
True or False: A sole proprietor heads overhead expenses even when he/she is away from the practice (aka: it’s empty).
True = major disadvantage
True or False: Sole proprietors receive fringe benefit tax deduction.
False
______ = a form of co-ownership where expenses, office space, equipment and income may be shared
General Partnership
True or False: In a general partnership, all partners share equally in management and business decisions of partnership.
False, not ALWAYS
ex: partners with a majority (>50%)
True or False: Sole Proprietors have fewer fringe benefits than General Partnership owners.
False, SP> fringe benefits than GP
True or False: A general partnership must file a tax return.
True, information only
______ = a separate legal entity from the provider
Corporation
In a corporation there are more ______ formalities and possible ______ ______.
legal
double taxation
Which is better, a C Corporation or S Corporation?
S
“Yes for S”
“NoSiri for C”
___ Corporations maintain full deductibility of employee benefits.
C
In a C Corporation, the corporation _____ are taxed and then ______ are taxed = double taxation.
corporation PROFITS
…then…
shareholder’s dividends (payment to shareholder)
An “S” - aka _______ - Corporation maintains liability protection but owner(s) do not get ______ benefits.
subchapter
do not get tax deductible employee benefits
A _____ ____ _______ is very popular due to few administrative requirements, s-corp taxation characteristics, and great ______ protection.
Limited Liability Company (LLC)
liability
LLC’s are subject to ____ _____ tax.
self-employment
As a(n) _________, everything for your work is provided and fringe benefits are negotiated.
associate
As a(n) _________, you pay your own benefits, assume risk of doing business, and do NOT receive a W-2.
independent contractor
What is an “at will” employee?
no promised term of employment
contract can be terminated at any time
Who is more likely to be an “at will” employee?
STAFF employees
- not a good idea for dentist (employee) or dentist (employer) because patient care will suffer
Termination should be negotiated prior to contract signing. Termination notice is often ______ days but should be no less than _____ days.
45-60
no less than 30 days
What are three routes of termination?
- immediate termination for cause
- unilateral termination without cause
- breach by either party
What are three restrictive covenants? Are these enforced in Ohio?
- Non-Compete
- Non-Solicitation
- Non-Disclosure
* *Yes they’re enforced**
______ = patients cannot be asked or enticed to follow you to your new location
non-solicitation clause
______ = business trade secrets are protected and cannot be divulged or transferred.
non-disclosure clause
_____ = limits the ability to practice a certain distance from the office after employment contract terminates
non-compete clause
Non-competes will have a time restriction of _____ years.
1 to 3 years
Urban practices may have a non-compete of ____ miles; Rural practices may have a non-compete of _____ miles.
few miles
10-15 miles
True or False: Practices with several offices can only enforce a non-compete clause for the location at which you worked.
False, distance around ALL offices
Non-solicitation agreements are usually good for ____ years.
2
Non-disclosure agreements are usually ____ years.
indefinite
What is “Right of First Refusal?”
right to purchase employer’s practice if a bona-fide purchase offer is made by a third party to the owner
In the event of a sale of the employer’s practice, he/she will want to retain the right to ______ of the employee contract to the buyer.
assignment
What is the “cash basis” reporting method?
income is reported based on collections only
Total Revenue - _________ = Net Profit
Total Expenses
What is revenue?
income received from sales or service
Expenses are classified as either ____ or ____.
Fixed
Variable
____ Expenses include rent and insurance
fixed (do not depend on the amount of business)
____ Expenses include wages, lab fees, and supplies.
variable (depend on the amount of business)
____ are “what your business owns”
assets
______ are “what your business owes”
liabilities
What is the stockholder equity?
the net value of business
What is the “first step” in practice planning?
develop core values (beliefs) the owner holds to be important
True or False: the Mission Statement is a vision that should be adjusted periodically.
True
The ______ at sba.gov can help to create a formal business plan.
Small Business Administration
What is the SWOT analysis?
way to assess the environment inside and outside the practice: Strengths Weaknesses Opportunities Threats
Determine Strategies and Set ______. Then, Develop ______ and Measure ________.
set goal/objectives
develop methods
measure outcomes
Right out of school, new dentists should be able to produce _____ per hour. Experienced dentists should be able to produce _____ per hour.
$250
$750
What is the ratio of dentist/hygiene production that the average practice should seek?
70:30
Dentist:Hygiene
A high Dentist/Hygienist ratio indicates _____. A low ratio indicates _____.
high: weak hygiene program
low: few patients or high fee schedule
True or False: Aging practices typically have low ratios.
True
In general, hygienists should produce _____ times their compensation.
2.5 to 3 times (or 33-42% of hygiene revenue)
True or False: the exam fee is included in both the hygienist’s and doctor’s production number.
False, doc only
What is the average overhead in a typical office?
60-65% of gross revenue
Payroll accounts for ____ % of overhead.
25-28
Payroll taxes and benefits are ____ %.
3 to 5%
Lab related procedures should be _____times the lab fee.
5 to 7 times
As a general rule, a practice should hire one front desk person for every _____ of monthly production or _____patients seen per day.
$40,000
10
How should front desk duties be divided? Why?
Treatment Coordinators
Hygiene Coordinators
Collections/Insurance
filling the schedule or collecting money…they can’t do both simultaneously. Which one will suffer?
True or False: Before adding another hygienist, add a dental assistant to help assist the current hygienist.
True, this is using good delegation strategies
How might a practice increase productivity?
extending hours increase patients utilize staff efficiently increase fees increase number of ops
What are Accounts Receivable?
money owed to a company by debtors
Accounts receivable should be _____ times the average monthly production.
1/2 to 1 times monthly production
____ credit policies will lower the accounts receivable.
strict credit policies
High percentage of insurance will have _____ AR. Why?
High
=waiting for insurance to process claims
True or False: Paper claims will increase AR. Electronic claims will lower AR.
True
For fixed prosthodontics, the patient’s fee should be ___ times the lab cost. Removable patient fees should be ____ times the lab fee.
fixed: 5-7 times
removable: 3 times
True or False: RCT increases production without lab fees.
True
Lab fees are a variable expense and are generally ____ % of revenue.
6-10%
How many new patients per month do you need to maintain and see growth in a practice?
25 new patients per month
this is NET amount: normal rate of attrition in a practice is 12-18% each year or ~10 per month. Which means you actually need 35 new patients
The average practice loses approximately ____% of its patient base each year.
12-18
True or False: Marketing is a necessity for practice success.
True
(opinion?…. my OHIO project site averages 110 new patients per month with zero marketing; the area is in high need of dentists)
____ marketing caters to existing patients.
internal
= entice them to refer new patients to the practice
True or False: Patients that are only interested in the price of treatment are generally not reliable longterm patients.
True
____ marketing involves advertising and promotional efforts outside the office to reach a new group of patients.
external
Which type of marketing is more expensive?
external
What is Branding?
the image of the practice presented to the marketplace. It is a way to set your practice apart from other providers in the area
ex: logo, office decor, ambiance, uniforms, website
Advertising must be ____ and not claim _____.
factual
superiority
True or False: Social Media should be avoided when creating an image for your practice.
False,
it can enhance a practices web presence and be used for marketing
What is the main goal when properly terminating a dentist/patient relationship?
avoid patient abandonment by giving adequate notice and opportunity to obtain service from another dentist
health should NEVER be put in jeopardy
True or False: It is a good idea to send termination notice via traceable and certified email.
True
When terminating a patient, what is the acceptable time that emergency services should remain available?
30, 60, or 90 days
True or False: Dental work in progress must be completed before the dentist/patient relationship can be terminated.
True, cannot be mid-treatment
True or False: the dentist owns a patients record.
true
True or False: You may charge a fee for a copy of a patients records if they are requested.
True
How long should patient records be kept?
4 years
What is the “Statute of Repose”?
a malpractice suit cannot be brought regarding dental care provided greater than four years have passed
What is the exception to the statute of repose?
4 years EXCEPT for minors…. keep records until they are 18years old then add four years
EHR should maintain the “chain of custody.” What does that mean?
records must define who has access to the record and is authorized to make changes to it. It must be documented properly.
You must know all laws and regulations, _____ is not an excuse.
ignorance.
What is the mission of the Ohio State Dental Board?
to protect the public- they are concerned with PATIENT safety
True or False: OSDB investigators do not make appointments.
True
Unannounced visits by the OSDB are random or _____ driven.
complaint
Practice investigations often involve: complaints, ____of Care, ____ Control, posting of licenses, and _____ Documentation.
Standard of Care
Infection Control
Continuing Education
Non compliance may lead to _____ or _____.
license suspension
license revocation
What is OARRS?
Ohio Automated Rx Reporting System - a tool for Ohio prescribers to combat the opioid epidemic and help save live in Ohio
Who monitors OARRS?
the Ohio State Board of Pharmacy
True or False: If you prescribe controlled substances, you are required to register with OARRS.
True!
Dentists must check with OARRS when:
- they know or have a reason to believe that a patient may be abusing or diverting drugs
- they prescribe an Opioid or _____ in excess of a ____ day supply
benzodiazepine
>7 days
Non Compliance to OARRS standards may result in fines up to _____ per day per violation.
$1000
What is OSHA?
Occupational and Safety Administration- concerned with EMPLOYEE safety
What are common complaints reported to OSHA?
- blood borne pathogens
- hazards communication
- general workplace safety
Non-compliance to OSHA regulations could result in fines up to _____ but usually the fines are _____.
up to $70,000
usually $800-1200
True or False: OSHA visits are rare nationwide.
True
What is the Ohio EPA?
Environmental Protection Agency- concerned with infectious waste disposal
Sharps containers must be properly ____, _____, and _____.
labeled
weighed
shipped
True or False: You must identify, quantify and document all infectious waste
True
If less than ___ pounds, infectious waste can be disposed of in the regular trash.
5 pounds
(gross!!)
The EPA ______ make appointments. Visits are ____.
may or may not
very rare
Fines from the EPA may lead to ____ per day per violation.
$1000
What is the BWC?
Bureau of Workers Compensation- covers work place injuries by providing medical and compensation benefits
The BWC provides workers comp insurance to about ____ of Ohio’s work force- with premiums paid by the employer.
Two-Thirds
True or False: Dental Office employees must be insured through the BWC.
True
How often must you renew your prescriber license? Who enforces this?
every three years
the Drug Enforcement Agency (DEA)
True or False: Practitioners are only liable for their own professional malpractice when they are the business owner.
False, always liable for own malpractice
Who will “make a promise to defend you in a medical malpractice lawsuit” and to pay if there is a judgement against you?
Insurance companies (malpractice insurer)
Insurance covers practitioners for errors of ____ and errors of _____.
commission
omission
What is an error of omission?
error from something you did not do; e.g. failure to diagnose or recognize a condition
What is an error of commission?
error from something you did do; includes all procedures you are licensed to perform
How long does it take for a malpractice lawsuit to be brought forward?
6 months to 1 year+
Who is covered under malpractice insurance?
- you
- your dental hygienists and assistants while practicing under you
True or False: Malpractice insurance will cover general anesthesia.
False, unless you are an oral surgeon or have a special license
Malpractice insurance will not cover _____.
fraud
In a “$1million/$3million” or “$2million/$4million” contract, what would the first number cover? Second number?
First: per occurrence (single claim maximum)
Second: aggregate for the year (yearly total)
What are the two basic malpractice insurance types?
occurrence
claims made
With _____ coverage, it only matters that you had coverage when the incident occurred.
Occurrence
With _____ coverage, it only matters that you have coverage in effect when the claim is filed.
Claims made
If a claim is made today for an incident that occurred 5 years ago: which insurance coverage (5 years ago) would still protect you?
Occurrence ( you had it when the incident occurred)
You’ve been practicing for 6 years. 1 year ago you bought malpractice insurance. If a claim is made today for an incident that occurred 5 years ago:, which insurance plan would protect you?
Claims made (you have the insurance now)
Which malpractice insurance type would require tail coverage?
claims made (tail coverage is expensive)
Which insurance type will gradually increase in cost?
Claims made- lower initially and then increase
How much is occurrence coverage?
$1500, to $2000 annually
What is the purpose of the State Insurance Insolvency Fund?
it provides coverage for you if your insurance company becomes insolvent (unable to pay debts owed to you)
True or False: An EFDA can be a hygienist or an assistant
True
True or False: EFDAs can place composite or amalgam.
True
True or False: An EFDA can place desensitizer or fluoride.
True
No more than ____ EFDAs can practice under the direct supervision of the same dentist.
2
EFDA permits must be renewed every ____ years and must have current _____.
2
CPR training
How often do hygienists have to renew their license? How many hours of CE must hygienists take?
Renew: every 2 years
24 hours CE every 2 years
What are hygienists permitted to do?
- remove calculus from crowns AND roots
- perio SRP and soft tissue curettage
- Sulcular placement of medicine
- polishing of crowns or restorations
- removal of sutures
- pit and fissure sealants
- radiographs
- bleaching (except with lasers)
What are the levels of supervision for a dental hygienist?
Direct - dentist physically present
General - conditions must be met, dentist not required to be present
Which procedures are NOT allowed to be performed under GENERAL Supervision?
- procedures where patient is anesthetized
- subgingival curettage
- definitive root planing
- sulcular placement of prescribed materials
- pulp testing
- whitening (bleaching)
- suture removal
Which procedures ARE allowed under general supervision?
- impressions
- caries susc. tests
- bite registrations
- application/removal of perio dressings
IF a hygienest has worked at least ____ year(s), a minimum of _____hours in practice, and has completed a ____hour course approved course they are allowed to work under general supervision.
1 year
1500 hours
4+ hour course on medical emergencies
The dentist must have examined a patient within the past ____ in practice.
1 years
Procedures that require direct supervision:
admin of local anesthsia
admin of nitrous
How many hygienist are allow to practice under one dentist at a time?
FOUR
True or False: Dental Assistants can administer Nitrous Oxide.
False. After they pass requirements, they can MONITOR only
How does a dental assistant become certified to monitor Nitrous Oxide?
- pass a 6 hour course given by an approved OSDB sponsor
- pass a written exam
- have current (within 2 years) CPR
- No more than 1 basic and 1 certified dental assistant may monitor nitrous at any given time
