How to Correct a Low Average Doctor Transaction (ADT)

Low ADT:  The target ADT for the practice is $160 to $175 and the doctors’ actual ADT ranges between $125 to $155.

Correction 1:

Forward-book the patient’s next appointment for medical progress/follow-up appointments, dental prophylaxis, preventive care appointments, follow-up bloodwork, etc. to ensure patients receive the healthcare prescribed by the hospital’s medical protocols of care and charge for all exams.  It’s not unusual for hospitals to neglect to charge for extended exams, medical progress exams, and hospitalized patient exams.

Correction 2:

Evaluate patient compliance with the hospital’s protocol for laboratory testing (related to preventive wellness care) and dental prophylaxis protocols.  Set target compliance rates for canine heartworm testing, fecal testing, senior wellness testing, and dental prophylaxis and compare the targets to the actual number completed.  Are there gaps?  For example, a practice has 4,000 active canine patients and set a heartworm testing compliance goal of 80%, or 3,200 heartworm tests (4,000 x .80); the actual number completed was 2,000, or a 50% compliance rate (4,000/2000).  To bridge compliance gaps, share ideas for effectively educating clients about the necessity of the care, update client educational materials about the topic so the materials are attractive and quick and easy to understand – think more pictures and fewer words.  Use the practice’s website, social media, and educational apps to help convey the message about the necessity for the care.

Correction 3:

Conduct a case review for missed charges to assess the consistency of billing for all of the provided patient care.  Pull a random sample of 20 cases each doctor completed in the past two weeks (10 outpatient and 10 inpatient cases per doctor) and compare the medical record for the care provided to the client invoice for the care billed.  Note any items that were provided but not billed and total the dollar value of the missed care to assess the frequency of occurrence and the type of healthcare items typically missed.  To reduce the frequency of missed charges, use a charge sheet to track care when provided, assign the responsibility of entering charges to the technicians, enter charges for hospital cases on a daily basis, and ask the client services staff to do a final review before check-out.

The average doctor transaction tells a story about the medicine and the finances in a practice.  A low or inconsistent ADT between the doctors signals a possible difference in the quality of care, or the inappropriate application of the practice’s fee schedule.  The ADT can also indicate an ineffective utilization of the nursing staff.  What story does your practice’s ADT tell?