Fishbowl tracks all materials used in procedures, and it lets every practitioner know how many supplies are at each location
Endodontic & Periodontic Associates, Ltd. is the largest multi-specialty dental practice in the Midwest and has been in business for more than 40 years. They have eight office locations in the southern suburbs of Chicago and three offices in Northwest Indiana and are happy Fishbowl customers.
Business Challenges & Needs
Any dental practice that receives payment from insurance companies (and their patients) must be able to track and provide information to the insurance company on all procedures the dental office completes for which they expect to be reimbursed. The insurance company then pays the office based on standard costs they have calculated for each procedure. The actual cost each office incurs in providing care is irrelevant to the insurance company. So it is in the best interest of the dental office to be as efficient as possible in order to maximize their profit.
Prior to Fishbowl, Endodontic & Periodontic Associates was using QuickBooks® and wasn’t tracking their inventory on a usage basis, either by patient or by office. Without this information, doctors did not know if they were being efficient with their supplies and, thus, what they should do to increase their efficiency.
To determine inventory levels, the office staff would visually check their levels at the end of each month and then order however much they needed to bring inventory back up to the desired levels. But the actual levels were frequently guessed at, which often resulted in higher than necessary inventory at each office. Sometimes they would even run out of items required to perform procedures efficiently. Those procedures would have to be postponed and the missing materials had to be rush-ordered at great expense. But the amount of that added expense was difficult to determine without accurate inventory tracking information.
Additionally, the costs were not assigned to each procedure and therefore the real cost of providing the care to each patient was hidden. This made the creation of reports difficult and very time consuming to produce which, in turn, made it difficult to make the case to the insurance companies at year’s end that the cost to provide care for any given procedure had gone up. They needed accurate, easily created usage reports to make their case or find other means of reducing their inventory costs without decreasing the quality of patient care.
Finally, certain high-value dental materials, such as dental implants, would consistently turn up missing. Without accurate inventory tracking and usage information it was impossible to know the shrinkage on an item.
With the purchase of Fishbowl, they decided the best course of action was to store inventory for its Illinois and Indiana offices at one warehouse with only minimal inventory housed at the individual offices. Extensive processes were implemented that required each dental office to sign for all materials when delivered, both for basic supplies, office supplies, and for high-cost custom supplies, such as implants. And staff members were required to sign all Pick Tickets when they pulled together an order. Special reporting was created to track who the items were for, when they were scheduled to be used, and which doctor requested the supplies.
Now, when a patient is scheduled for a procedure the dental office has to request the materials a week in advance. The warehouse transfers materials to the office on an "as needed" basis the day before and the office signs for them. When the procedure is completed, any unused materials are transferred back to the warehouse and entered back into inventory. A warehouse worker then creates a Sales Order to the specific office for the items used during the procedure and the office is billed accordingly.
Every item that is received into the warehouse or transferred and then "sold" to the individual offices has to be signed for by an individual. Any discrepancies can be traced back to the source and the problem corrected.
With the majority of inventory now being tracked at the central warehouse, proper inventory levels were much easier to determine and the levels for most items went down, resulting in lower overall levels and costs. Stockouts at the office level only meant that more supplies needed to be sent from the warehouse, but the warehouse was able to eliminate rush orders because the inventory levels for the entire system were always high enough to meet any jumps in local demand.
With more accurate information, each office manager could pull up reports on actual usage of any item used in any procedure. The doctors were pleased with this new approach, in spite of the extra steps, because if they were careful and only used what was absolutely essential, then the cost for providing the care went down. This meant greater income for each doctor. Additionally, the new reports allowed them to see how their efficiency compares with that of the other doctors which resulted in each one making the effort to be as efficient as possible. As the supply chain manager states, "Doctors love to see savings. And our CPA loves it as well!"
Most importantly, the new information resulted in much more accurate reports for the year-end meetings with the insurance companies. Now, when the material costs for given procedures go up, the offices have the data to back up their requests for higher reimbursements. Additionally, with the required detail already entered into the system, the time to prepare and create the reports has gone down dramatically.