| A | B | C | D | E | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | |
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2 | Team Member Performance Assessment | |||||||||||||||||||||||
3 | Office Manager | |||||||||||||||||||||||
4 | ||||||||||||||||||||||||
5 | Team Member Name: | Date of Hire: | ||||||||||||||||||||||
6 | Date of review: | |||||||||||||||||||||||
7 | Date of last review: | |||||||||||||||||||||||
8 | ||||||||||||||||||||||||
9 | Performance Rating | Explanation | Points Earned | |||||||||||||||||||||
10 | Exceeds Expectations | This rating indicates that you consistently exceed in your job performance. You go above & beyond the basic expectations in a given area. | 3 | |||||||||||||||||||||
11 | Meets Expectations | This rating indicates that you perform your job task at the basic level that is expected of you. You understand your job requirements & you meet all aspects of it with minimal supervision. | 2 | |||||||||||||||||||||
12 | Additional Development Needed | This rating indicates that you are not completely performing your job tasks at an acceptable level. This may be due to your actual time in the position, whereby more training is indicated, or it may be due to a greater commitment level needed on your part to develop within a particular job area. | 1 | |||||||||||||||||||||
13 | Below Expectations | This rating indicates that you require ongoing supervision in the performance of your duties. You fail to meet the basic job expectations, despite having been provided adequate training & feedback. | 0 | |||||||||||||||||||||
14 | Weight Factor | Not all things are created equal. While it is important to master all aspects of your job position, there are certain aspects of your position on the team which are more critical to mastering & implementing than others. Each job characteristic &/or task has been given a weight factor, from 1-3, reflecting its importance in the overall evaluation of your contributions to the team. Your points earned in each category will be multiplied by each weight factor to help determine your overall Performance Rating. | 1-3 | |||||||||||||||||||||
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16 | Below Expectations | Additional Development Needed | Meets Expectations | Exceeds Expectations | Comments | |||||||||||||||||||
17 | PERSONAL CHARACTERISTIC / JOB TASK | 0 | 1 | 2 | 3 | |||||||||||||||||||
18 | Dependability & Flexibility - The team can depend on you to be where you need to be; your personal days are well planned for; you seek to provide coverage for your position so as not to burden the rest of your team; you arrive to work on time & take allotted & necessary breaks; you recognize when you are needed the most & you make accommodations; you are able to accommodate & accept office & patient scheduling changes with ease. You only take allotted time off per handbook. | |||||||||||||||||||||||
19 | Professional Appearance – You arrive ready for work and are professional in your dress at all times; your hair is clean & always put back; your nails are neatly manicured & professional in length; your make-up is applied with good taste & appropriate; your jewelry is not excessive & is consistent with the guidelines provided in the team member handbook. | |||||||||||||||||||||||
20 | Organization & Neatness – Your work area is organized & neat; you are considerate of & respect your team member’s space as well as community office space; you respond to all emails before leaving; Daily Notes on the schedule are taken care daily. | |||||||||||||||||||||||
21 | Productivity & Quality of Work – You accomplish your work assignments in a timely manner; you complete your job tasks with accuracy & dependability; you pay attention to detail & have a strong sense of quality & how to achieve it in everything that you do; you are committed to & take pride in providing an excellent final product; you seek out ways to improve what you do as well as expanding your own capabilities when time permits. | |||||||||||||||||||||||
22 | Priorities - You are able to assess what is most important at any given time. You are flexible. You recognize the importance to sometimes putting your needs or plans for the day aside for the needs of the team. | |||||||||||||||||||||||
23 | Problem Resolution - You are able to recognize problem areas in the practice quickly. You can effectively isolate a problem. You don't allow staff situations to fester, or revenue situations to worsen. You proactively ask for help when needed. | |||||||||||||||||||||||
24 | Change - You may not welcome change but you understand that it is through change that growth will occur. You embrace change with an open mind and you implement new ideas enthusiastically, always with the intent of successful results. You encourage your team to do the same, always exhibiting patience, providing the necessary explanations, and training them through the process. | |||||||||||||||||||||||
25 | Personal Demeanor & Attitude - You have a positive attitude when at work; you smile often; you look to the positive side of things & you encourage others to do the same; you leave personal issues out of the office; when you are not 100%, you own your situation & you communicate your needs to your team members; you do not participate in negative talk that goes on between other team members; you take opportunities to turn negative situations into positive ones; you embrace change & recognize that it is a means to growth & improvement. | |||||||||||||||||||||||
26 | Software & Computer Usage – You have mastered all software programs necessary to perform your job; you utilize all aspects of the dental software for maximum efficiencies; when you do not understand how or why something works, you ask questions; you utilize the office computer for work purposes only. You secure your computer when you are not using it. You make sure all computers - except for the server - are turned off before leaving each day. You change the backup daily. | |||||||||||||||||||||||
27 | Promoter of Teamwork – You are a source of encouragement & appreciation to your team members; you are willing to pitch in no matter what the task to get the job done; you display good listening skills; you show sensitivity & empathy to the needs of others; you display integrity in your commitments; the team can depend on you to follow through with what you say you will do; you do not participate in gossip at any level; you speak honesty & truth at all times; you display confidentiality at all times. | |||||||||||||||||||||||
28 | Standards - You uphold the highest values of the office at all times. You understand that you are the example. You hold yourself to a higher standard of performance so that you can be the role model for the rest of the team. You set the standards for quality output from your team members by the example you set. You recognize that you get what you accept. You expect only the best from your team and are clear on what is expected of them. | |||||||||||||||||||||||
29 | Listening Skills - You seek first to understand, rather than always trying to be understood. You put yourself in someone else's shoes before passing judgement or making decisions that may affect another person. You understand the value of empathetic listening. Your listening skills inspire openness and trust among your team. You listen to the emotions of your team when needed, however, you always confirm facts and make decisions based on the facts rather than the emotions. You have good judgement in knowing when/how to let a situation settle before addressing it again. | |||||||||||||||||||||||
30 | Respect - You recognize the difference between power and respect. You do not seek power from your team, you seek respect. You further recognize that respect is not given, it is earned. | |||||||||||||||||||||||
31 | Recognition & Confrontation - You praise and recognize your team members frequently and publicly. You confront and address issues with team members quickly and privately. You recognize the value of sometimes giving credit where credit may not be due, and taking the blame when it may not be yours. You do not allow team members to criticize or confront other team members in public. you treat everyone around you with the highest amount of integrity. You praise down and complain up, meaning you express complaints and concerns to those above you, understanding that they are the only ones who can facilitate support and change. | |||||||||||||||||||||||
32 | Training & Support - You recognize that most people want to do a good job. You facilitate proper training, frequent communication, and feedback to your team members so that you are certain that nothing stands in their way of performing their job well. You communicate your training needs with those who can help you, and you are committed to follow through. You communicate frequently with each of your team members. You recognize that your teams' success is your success. You know what you don't know and are comfortable asking for help when needed. | |||||||||||||||||||||||
33 | Disciplinary Action & Follow Up - You do not tolerate sub-standard performance or behavior. You address issues specifically and quickly. You understand the importance of documentation when managing your team, and you make certain that all discussions are documented and signed. | |||||||||||||||||||||||
34 | Work Environment - You are able to create and/or encourage a fun work environment. You recognize that people who enjoy their job, and have fun are more productive. You recognize that there is a time for fun, and are able to create a serious environment when it is necessary to do so. | |||||||||||||||||||||||
35 | New Hires - You provide a complete orientation to your office for all new hires. You help them integrate and feel a part of the team quickly. You ensure that new hires complete OSHA & HIPAA training and complete new hire paperwork within 2 business days of being officially hired. | |||||||||||||||||||||||
36 | Staff Scheduling – You use good judgement when scheduling patients, request help when needed, and cut back on staff when necessary. | |||||||||||||||||||||||
37 | Employee Handbook – You have a good understanding of the employee manual and ensure that your team follows policies. You ask HR for clarification when you are unsure. | |||||||||||||||||||||||
38 | Time & Attendance Reports - You review time clock punches weekly for accuracy, and make corrections when needed. You report absences to HR the day they happen, and put a note on the team members time clock that they were absent and why. | |||||||||||||||||||||||
39 | Team Meetings – Your morning meetings start on time, engage the entire team, and help the team be more productive. You recognize the importance of supporting the doctor and owners, and work to address all concerns quickly. You provide open & honest communication; you communicate your thoughts clearly & professionally & always with respect to others in the group. | |||||||||||||||||||||||
40 | Patient Relations - Your team greets patients with enthusiasm & warmth; patient amenities are offered consistently to all patients; patients never feel rushed in your care; you never put working projects in front of patients; you have a keen understanding of customer service & you go above & beyond to service customers at all times. | |||||||||||||||||||||||
41 | HIPAA Compliance – You understands & follow HIPAA requirements & recommendations at all times; patient information is always held confidential & caution is made with regards to discussing protected information within the office; you obtain Release of Record Forms before providing patient information to any other service provider; you obtain Release of Record Forms before providing a patient copies of their records. | |||||||||||||||||||||||
42 | Answering The Phone – You are professional, friendly & always courteous with every phone call; you follow the New Patient Information Sheet as outlined when taking new patient calls; you never ask a patient to hold without finding out who they are & what they need; the phone is never an interruption to your day & is viewed as the ultimate means to the success of our business. | |||||||||||||||||||||||
43 | Overall Understanding of Dental Procedures - You have a good understanding of all dental procedures; you can explain the basic processes of all procedures to patients with confidence & credibility; you can answer patient questions regarding pre- & post operative expectations based on your knowledge of the procedures; you recognize your limits & know when you must refer questions to the clinical team. | |||||||||||||||||||||||
44 | Treatment Presentation - You are able to build relationships with patients quickly and help them to understand their need for treatment, you are able to motivate them to accept treatment, you ask for a commitment from the patient, and you make clear financial arrangements that adhere to office guidelines. | |||||||||||||||||||||||
45 | Referrals & Reviews - You ask patients to refer their family & friends; you ask patients to give us an online review; you respond to any inquiries or negative reviews. | |||||||||||||||||||||||
46 | Appointment Lists – Every week you make sure that your office is current on contacting all patients that are due for continuing care, and you reach out to patients that have not been seen for a hygiene appointment. Your broken appointment list is kept current by making sure there are not any appointment on there that is more than 2 weeks old. You document all correspondence in the patient Office Journal. | |||||||||||||||||||||||
47 | Unscheduled Treatment - You make sure that patients with unscheduled treatment are being contacted. You make sure patients are contacted when the office has a special that applies to them. You document all correspondence in the patient Office Journal. | |||||||||||||||||||||||
48 | Gift Cards - You make responsible decisions with how to use your patient gift cards. You accurately track all cards, and submit the reconciled spreadsheet every month. | |||||||||||||||||||||||
49 | Posting & Check Out Procedures – You post completed treatment accurately & quickly; you always check to make sure that the correct provider has been credited for procedures; you submit insurance immediately after posting; you post patient payments timely & with accuracy using the FIFO guidelines; you are able to collect patient portions at the time of checkout with confidence; you post broken appointments using the correct code (cancel vs. no show vs reschedule), always posting to the correct provider. You conduct audits daily to ensure that your team is accurately posting procedures and adjustments. | |||||||||||||||||||||||
50 | Checklists - You and your team utilize the checklists in all areas of the practice to help you and your team be efficient and accountable. You turn your checklists in on time every week. | |||||||||||||||||||||||
51 | End of Month – You audit all transactions to ensure procedures and adjustments have been posted accurately, all New Patients have a First Visit Date, First Procedure Date, and appropriate Referral Source, and that all deposits have been taken to the bank & balance with Dentrix. Your end of month reports are turned in by 10:00am on the 1st business day of the month with less than 10 errors. | |||||||||||||||||||||||
52 | Patient AR - Your office sends statements weekly. Your office calls patients who are delinquent with their payment arrangements. You sent patients for pre-collection letters that still have a balance after the 1st statement if they have not paid within 30 days. You write off patient balances once they have progressed to full collections. | |||||||||||||||||||||||
53 | Credit Balances - Your office sends refunds patient credits after auditing patient ledgers. You do not have any credit balances more than 6 months old. Goal is for credit balances to be no more than 20% of previous month's collections. Score 2 if meets these requirements; 3 if exceeds. | |||||||||||||||||||||||
54 | Insurance AR - Your office sends claims daily and checks the report to make sure claims went through. Your 30+ day claims are followed-up on weekly with updates in the status notes. Your 90+ claims report is 1 page or less. | |||||||||||||||||||||||
55 | Total AR - Your 90+ AR is less than 10% of your total AR (after taking out ortho). | |||||||||||||||||||||||
56 | Lab Cases - You review all lab statements to make certain that charges were made accordingly. You check patient ledgers to ensure that the correct services were billed out. You follow up with lab errors before approving payment. You identify invoices that require reimbursement from team members or doctors. You send statements and invoices to bookkeeping within 48 hours of receipt. You ensure that when applicable, cases are made in house to save on fees. You make sure that ProVerus approved labs are utilized whenever possible. Lab expense goal is <4.5% of Net Production (Production - Adjustments) | |||||||||||||||||||||||
57 | Office Expenses - You shop around to make sure the office is buying supplies at the best available price, and that we are not making unnecessary purchases. Office expense goal is <1% of Net Production (Production - Adjustments). Office must be at goal to be rated a 2 or below goal to be rated a 3. | |||||||||||||||||||||||
58 | Accounts Payable - You pay all office bills on time, mark on the bill when it was paid & how, and send to bookkeeping within 48 hours of authorizing payment. | |||||||||||||||||||||||
59 | Office Production - Every team member contributes to the office's ability to produce and be profitable by the way they interact with patients and team members, their attention to detail, and their willingness to maintain a win/win mentality. If the office is more profitable, it can afford to pay team members more. Monthly Net Production (Production - Adjustments) Goal vs Actual. Office must be at goal to score a 2 and above goal to score a 3. | Goal $________ Current YTD $_______ Previous Year $_________ | ||||||||||||||||||||||
60 | Office Collections - Collections is an intregal part of any business. All team members contribute to how much the office collects in different ways. The assistant contributes by ensuring that clinical notes are complete & accurate, handoffs are done every time, and that patient balances are checked at every visit. Monthly Net Collections (Collections - Refunds & NSFs) Goal vs Actual. Office must be at goal to score a 2 and above goal to score a 3. | Goal $________ Current YTD $_______ Previous Year $_________ | ||||||||||||||||||||||
62 | AVERAGE PERFORMANCE RATING | 0.00 | ||||||||||||||||||||||
63 | 0 - 0.99 | Below Expectations | 1.76 - 2.5 | Meets Expectations | ||||||||||||||||||||
64 | 1.0 - 1.75 | Add'l Development Needed | 2.6 - 3.0 | Exceeds Expectations | ||||||||||||||||||||
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66 | Pay increases are based upon the following: | |||||||||||||||||||||||
67 | The Practice's ability to support the increase. This is determined by analyzing the current labor percentages in the practice & overall practice profitability. | |||||||||||||||||||||||
68 | Individual job performance & overall contributions to the team. This is determined by the results of the team member's performance assessment. | |||||||||||||||||||||||
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71 | Pay Raise To Be Given? | |||||||||||||||||||||||
72 | Increase %: | From: | To: | $ - | ||||||||||||||||||||
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74 | PLAN OF ACTION FOR PERFORMANCE IMPROVEMENT | |||||||||||||||||||||||
75 | Below is an Action Plan provided for you to improve in all areas that currently do not Meet Expectations of your job position. Failure to show a commitment to improvement may prompt a more serious discussion of your desire to keep your current position. | |||||||||||||||||||||||
76 | Follow Up Meeting scheduled for: | |||||||||||||||||||||||
77 | Action Plan for Improvement on any area scored less than 2: | |||||||||||||||||||||||
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80 | Dr. and/or Manager Comments: | |||||||||||||||||||||||
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83 | Employee Comments: | |||||||||||||||||||||||
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86 | Employee's Signature: | ____________________________________ | ||||||||||||||||||||||
87 | Dr. and/or Manager's Signature: | ____________________________________ | ||||||||||||||||||||||
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