Take these proactive steps to better manage insurance collections and maintain healthy cash flow.
Most dental practices maintain collections in two different areas: insurance aging and patient balance aging. While both of these areas deal with collections, they can also affect the reputation of the office. The quickest way to lose a patient is to give them the impression that you are not “playing fair” with their money. But, by implementing a proactive approach, you can show patients that you are presenting the best options for their care.
Proactive Step #1 – Verify all patients’ insurance prior to the day of the appointment.
It is amazing to think that some offices do not verify insurance at all. How do you know if patients have an insurance plan that allows them to use their benefits in your office? How do you know if they still subscribe to a particular plan?
Do you think that an airline employee would allow you on a flight and only check your ticket at your destination? Or better yet, call you a month later and tell you that you were on the wrong flight? You have arrived at your destination and received all the services you needed from the airline. So you would not be in a hurry to make amends on the outstanding bill, right?
Why would you let a patient come in for a cleaning, extraction, or crown and not know in advance how you will be paid? I know why. It’s all about time. It means that someone will have to call the insurance company or go online to look up the benefits package. Solutions like Dentrix Insurance Manager provide this service for you at a nominal rate.
Proactive Step #2 – Submit claims daily with all the supporting information needed for expedited processing.
Electronic claims are not just the way of the future; they are the way of today. It is a proven fact that you will receive payment on your claims twice as fast with electronic submission. Every day, if possible, try to send your claims electronically. And when you submit claims, make sure that you include the supporting information the insurance company requires. This may include:
- Crowns and Bridges: X-ray, narrative (the why), initial or replacement prosthesis
- Scaling and Root Planing: X-ray of treated area, perio chart
- Root Canal: pre- and post-treatment X-ray
Keep a list of what supporting information is required for each plan handy to alleviate questions or confusion. Dentrix eClaims can facilitate your electronic claims submission process.
Proactive Step #3 – Follow up with claims over 30 days past due every week. Make sure to document any conversation or information found on the insurance website.
The first question is when do you consider a claim overdue? Industry and insurance standards dictate 30 days. However, if you use electronic claims processing this number should be decreased to 20 days. In my opinion, monthly follow-up is not an efficient time-frame.
Some insurance coordinators run their insurance reports daily. This may be overkill, but we applaud their aggressiveness and tenacity. These are the offices that typically have only one or two claims over 30 days. Hurray for those go-getters!
My experience has proven that following up on overdue claims should be on your weekly task list. By following up weekly, you can catch the “non-received” and “additional information needed” claims faster and get paid in a timely manner. If you are consistently monitoring status reports on claims you submit electronically through Dentrix eClaims, you will catch the claims that require additional information in short order.
When you do have to make that call to the insurance company, I recommend that you document the name of the person you spoke to, the date and time, what was discussed, and the course of action. If the claim has to be resubmitted, document that as well.
It’s nice when you get the insurance aging under control and have that money flowing in on a regular basis. Then you can work on the harder part about revenue management—patient balances.
Proactive Step #4 – Have a written financial policy so everyone knows what the rules are. Ensure all arrangements are signed by patients and maintained by the office.
Your dental office needs to have a written financial policy which should be presented to all patients. Taking it a step further and having the patient sign it is an even better idea. When financial policies are signed, make sure to maintain a copy of that signed document. This signed financial policy is the rule by which all financial arrangements are made. Any time a question arises about how procedures are to be paid for, you should refer to the financial policy.
Your financial policy will be determined by the dynamics of your office. There are three things to remember when setting a financial policy:
- Make all payment options transparent and stick to them.
- Offer incentives so patients will pay early.
- Set the rule that no patients will be seen in the office until everyone knows what the payment arrangements are.
Proactive Step #5 – Send out statements more often.
For some offices, payments received from insurance companies make up the lion’s share of the practice’s collections. It is essential to get a handle on these collections and make sure you enter those payments correctly. Dentrix has tools that enable you to input insurance payments efficiently. Acquiring training in the appropriate processes for effective methods may be worth the investment.
Although insurance does cover some of the patient’s balance, they are still going to have to pay their portion. Ideally a co-pay should be collected at the time of service. By not collecting the amount due at the time of service, you will spend a lot of time and resources chasing that money.
If the patient has a balance after the insurance has paid, I advise sending a statement immediately. Most offices scheduled the task of sending out statements once a month. This can be a huge undertaking that can consume an entire day.
Consider sending statements out on a bi-weekly, weekly, or even daily basis. The task is less cumbersome, and you have money flowing into the office on a continual basis. Dentrix QuickBill allows you to easily maximize your statement processes.
Proactive Step #6 – Make the call.
Every office is going to have patients who make promises and then don’t come through with their payments. You might even need to go through a collection process to get the payment. Make sure you check your collection laws before beginning this process. The first step in the collection process is, of course, sending out statements. If you are not getting a response from your statements, your next step is to make a phone call.
Collecting money is the name of the game, so make it easy on yourself and collect as soon as possible. If there is money still owed after the claim is paid, send a statement immediately. Remain mindful of the collection laws and always give your patients the dignity and respect they deserve.
Being proactive requires forethought on the way you approach the collections process in your office. The whole team should be involved in keeping an eye on patient balances and following up in the huddle when there is a question. The most inefficient process in a dental office is chasing money that should have been collected when the patient was in the office.
Keeping these six proactive steps in mind will prevent that dreaded phone call to ask a patient to pay a bill. Additionally, it will let your patients know that you are on top of the game and will be diligent with their benefits.
For more information about managing insurance with Dentrix or to add these features to your service bundle, visit https://www.dentrix.com/products/eservices/ecentral/insurance-manager, https://www.dentrix.com/products/eservices/eclaims, https://www.dentrix.com/products/eservices/quickbill, or call 833.471.7253, option 2.
If you want to dive deeper into these topics, contact Denise at Global Team Solutions or call 844.664.4487.
By Denise Ciardello, Global Team Solutions
Originally published in the Dentrix eNewsletter, January 2019