Looking back on an article I wrote last year called “Going chartless: Breaking down the process into bite-sized pieces,” I talked about how your “core systems” need to be in check before you decide to take the plunge into chartless waters. Some of you went through the list and said to yourself, “Awesome, we’re ready to rock-n-roll!” But some of you might need to work on a few things on the list, and may not be quite sure where to start. Well, I’m here to help.
Let’s start with collections because in my opinion, everything revolves around collections. You can have an amazing month with production numbers exceeding your goals, but if it is sitting on your Accounts Receivable Report, it isn’t doing you much good. You hear most of the dental consultants talk about achieving a collection rate of 98%, and I agree this is a great goal to have and you should strive to meet it. However, today I’m going to focus on your over-the-counter collections (payment at the time of service). If you can increase your over-the-counter percentage, the 98% will be much easier to attain. Typical industry standards for over-the-counter collections should be between 35% and 45%. Of course, if you’re a specialty practice or your office does not bill insurance (yes, we are so jealous of this office), then our over-the-counter could be higher.
OTC collection begins with expectations
Over-the-counter collection isn’t something that just magically happens at the front desk. It starts with treatment plan presenting, and training your patients from their first phone call regarding your office policies. Patients need us to set the expectations of the office. If we don’t tell them what they need to do, they will just make up their own rules. The worst statement you can hear at the front desk from patients as they’re exiting the office is, “Wow, I didn’t realize my portion was going to cost that much. I thought my insurance pays at 100%. Can I make payments?”
One of my responsibilities when I was still full time at my office was treatment planning and case presentations. I might have be considered stubborn or hard-nosed, but no one got into my schedule without a financial arrangement. Period! Your patients need to know how much the appointment is going to cost, and approximatelyhow much their insurance company is going to pick up. If your practice management software cannot calculate accurately and print out a treatment plan estimate for you to give to your patients, then you will need to come up with a handwritten form. I’m fortunate that my dental practice uses Dentrix software, and we’re able to enter accurate insurance coverage tables, up-to-date PPO fee schedules, and print out this information for our patients. This estimate you give to patients should also have a disclosure statement outlining your office policy. For example, the patient portion is due at the time of service, whether you offer a discount for full payment, or if there will be any finance charge for late payment. Also, this written estimate you give to the patient should state that the insurance estimate is not a guarantee of payment, and that the patient is responsible for the full amount of the procedure regardless of insurance.
Having this written treatment plan estimate sets the expectations between the practice and patient. This way you will avoid that dreaded question mentioned earlier.
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Avoid misunderstandings with patients
How can you set the expectations of the office financial policy for a new patient so there is no misunderstanding? Most patients with dental insurance don’t have a clue about what their policy covers or what the reimbursement level is with the dental office. It is your responsibility with that first phone call to give patients a lesson in “Insurance 101.” After you’ve collected personal information, asked about previous X-rays, and how they were referred, then you need to ask, “Do you have dental insurance that will helpyou with this appointment?” Notice how I emphasized the word “help.” It is important to let them know in the beginning that they may have some out-of-pocket expenses, and even though exams and cleanings are paid at 100% in their benefits booklet, this may not be the case depending on the PPO status of the dentist, the maximum used, and other factors. You might set the stage during that first phone call like this:
“My experience with your insurance company is that their reimbursement will be close to 100% for tyour first visit, however, there could be frequency restrictions, deductibles, or other factors that could lower the payment. If you would like to provide me with your information now I can check your benefits before your appointment so you’ll have a better idea of what your out-of-pocket will be.”
I understand that checking on insurance benefits can be time consuming, however, making the effort can help increase your over-the-counter collection and make a huge difference in your accounts receivable. It can also help lower your overhead costs because you’ll send out fewer statements, make fewer collection phone calls, and send fewer patients to collection. Patients feel better knowing what their estimated portion will be. Trust me, they don’t like receiving an unexpected billing statement in the mail any more than you like sending it.
Author bio
Dayna Johnson, founder and principal consultant of Rae Dental Management, helps dental offices improve patient care, increase collections, and reduce staff headaches by implementing efficient management systems. With 18 years’ experience in the business and technical side of dental offices, Dayna’s passion for efficient systems is grounded in both personal understanding and professional expertise. She can be reached at [email protected]t or visit her website at www.raedentalmanagement.com. If you’re a Dentrix user, you can also check out her blog with front office tips and ideas at http://thedentrixofficemanager.blogspot.com/.
