Learning Dental Accounts Receivable With No Prior Experience
Learning dental accounts receivable with no prior experience is totally possible. I’ve done it myself! My second job in the dental field was as a “financial secretary”. Now, that definitely tells you just about how old I am, doesn’t it?! I don’t think the term “financial secretary” even exists in the dental realm anymore.
But the truth is, if I did it, anyone can do it! I have been successful in keeping collection rates at 99% – 102% in every practice I have managed. You can too! Just follow some guidelines and be consistent.
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I did have 3 years of dental front office experience prior to taking my “financial secretary” position. However, I had never sent a patient statement, never talked to a patient about a balance question, and never sent an insurance claim in my life.
To add even more confusion to this mix, my new position offered another fun challenge. The office had just undergone a computer conversion from an old DOS system to windows. We were operating off the old system and the new at the same time, with 2 separate computer.
My new employer had asked me to assist the Financial Coordinator with patient billing questions. Could I help with patient phone calls and answer questions about where balances were coming from, and to make sure account ledgers were correct. My Dental Office Collections Course can help you get your dental office billing systems down to a science!
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It wasn’t easy. I’m not going to lie. Being able to jump between two computer systems and understand what happened with each patient’s account, what converted, what didn’t convert.. wasn’t all fun and games!
One other issue that quickly jumped out at me, was there were posting errors. Charges were entered wrong. Codes were listed twice sometimes or incorrect codes in addition to correct procedure codes.
As patients called with questions, I would start out by telling each of them the same exact thing. “Please let me take your name and phone number. Let me take a closer look at your account. I really want to carefully review and audit your charges and payments. Could I please call you back?”
No easy task! But I sure did learn a lot! Like I said, if I can do it, anyone can!
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Learning Dental Accounts Receivable: Payment At The Time Of Service
The most important idea to get your head around in learning dental accounts receivable, is that less outstanding money is better for the practice. It is also better for the patient-office relationship. It will also save you, as the office financial manager, a whole lot of time and stress.
Payment in full at the time of service is always the preferred payment method. The more you need to extend in financing options, the more it is going to cost everyone.
There are those patients who will always request a statement and who will always pay. Then there are those who will “forget” their wallet, and request a statement. Often, these same patients will pay…. when they remember!
So what do we do? Offer incentives! A 10% pre-payment incentive for patients who pay at the time of scheduling is very motivating. And a 7% incentive for patients who pay at the time of service with no insurance coverage excites patients too. For those uninsured patients who have forgotten their wallets, let them know if they call back before the end of the day with their credit card, you can still give them a 7% discount!
What about insured patients? We can’t really offer them discounted services when we are billing an insurance company and waiting for payment. That’s just bad business. This can often be where the problems come in. When we are billing dental insurance and an insurance company doesn’t pay quite what we expected. Or maybe the insurance company does just what we thought they would do, but the patient does not. It goes both ways.
This is where your relationships with your patients and your billing practices really count!
Learning Dental Accounts Receivable: Insurance Claims & Codes
A book could be written to explain dental insurance codes, billing and follow up. In fact, I’m sure there are books out there that do just that! Basically, ever dental procedure performed has a matching dental insurance code that must be posted or attached.
Some procedure codes also have required attachments. All insurance claims have time limitations. Some insurance policies no longer pay claims over 90 days without receipt, and most are 12 months. There is so much to learn about insurance policies and their individual coverage!
Gathering information from a patient’s insurance company when they come in with new insurance cards is the first step! Call the insurance company and get coverage and claims information before treating the patient. This will help to avoid any collection problems later. Here’s an insurance verification form to help:
Insurance Verification Form[65]
Most insurance companies accept electronic claims today. You may need to reach out to your software company to make sure you know how to set this up. This isn’t an area where you want to make a mistake. Mistakes delay payment. Mistakes cost time. Sometimes they happen. So, don’t be too hard on yourself. Just a friendly warning to pay close attention to detail here.
CDT coding books are great resources to help you know when you need to submit x-rays, narratives, perio charts, etc. You can also google just about anything you are looking for. Take the time to send your claims right the first time. It will be worth it.
Be sure to send your insurance claims every single day!
Learning Dental Accounts Receivable: Insurance Claim Follow Up
In my opinion, any unpaid dental claim that sits in the over 30 day column is over due and warrants a phone call. I know that some insurance companies simply don’t pay that quickly. I still call them and make sure they have received the claim and it is actually in process of being paid.
This is where my Weekly Management System comes into play. We don’t want to print an insurance ageing report with all claims over 30 days and try to work through the entire ageing report. But instead, working only one specific aged category a week, will get it all done each month. This workbook is just one more great download with the Dental Collections Training Bundle!
What if they say they don’t have the claim? Confirm some things with the insurance company. Confirm you have the right claims address. Also check on the payor id #. Is that correct? Do you have the correct member ID on the claim? Correct and resubmit! Check it again in 10 day! Make a note somewhere to follow up again in 10 days.
Learning Dental Accounts Receivable: Patient Billing Questions
Patient billing questions can be the toughest part of learning dental accounts receivable. If a patient calls with a question, you might need to take some time to review their ledger and call them back. Just be sure to get back to your patient within 24 hours with their answers.
Patient ledgers can be tricky to read. Especially when someone is just learning to understand them. It’s a great idea to take the time to compare charges to the ledger postings. Does everything seem to be correctly billed? If you have any questions, check with the clinician about what was done and what was billed.
Many dental patients don’t understand or know dental terminology. I’ve had more than one patient say to me “I don’t know why this adult prophylaxis is on my bill? I only came in for a cleaning.” They fear they have been charged for some service they never received.
If you are in doubt, your patients will hear it in your voice. So, don’t try to hide it. Tell your patient that you will get back to them. There are some questions you want to clear up with the doctor. Most likely, they will find comfort in knowing you are checking with the doctor!
Above all else, be proactive in every aspect! It will pay off!
Learning Dental Accounts Receivable: Be Proactive
So, what do I mean? If you are in a dental practice that is involved at all with dental insurance billing, unexpected happenings will occur! Things you never saw coming. Insurance is just that way. Here are some examples:
- A claim is denied saying the policy terminated.
- A claim is paid at a less amount than expected.
- An explanation of benefits is received saying there is another carrier who is primary.
- An explanation of benefits is received saying additional information has been requested from the member.
How we handle this will determine how quickly the practice gets paid! Here’s the plan! First, call your patient. Hopefully you reach them at the first try. If so, let them know what you have received. Do not just send a statement! Call. Ask. Explain what you have and let them know what is happening.
Maybe you need updated insurance information and the patient will need to call you back. If so, make a note to call them back if you don’t hear from them within 2 days. Call them back in 2 days to let them know you really want to get their claim out to the correct insurance company and that time is of the essence.
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Insurance Verification, Benefit Tables, Patient History & More!
If a claim hasn’t been paid in a way that you expected, tell your patient why. Perhaps a procedure was downgraded or the insurance company has decided a procedure wasn’t really necessary (which they sometimes do). Let your patient know what their current balance is and if they have any recourse. Maybe this is just the way it is. Maybe they can appeal.
Sometimes insurance companies are looking for additional information from the member. Unless your patient responds immediately, this can be a slow drag to getting the claim processed. Enlist their help immediately. Maybe the insurance company has sent them a form to fill out or perhaps they just need a phone call from the member. Whatever it is, help your patient to get their claim paid as soon as possible.
Learning Dental Accounts Receivable: Be Kind
Have you seen that quote “In a world where you can choose to be anything… be kind”. It’s so important to be kind, especially in the area of money. What does it really mean to be kind? It doesn’t mean to let anything go. It doesn’t mean to give away the farm. That doesn’t help anyone!
What does it mean to be kind in collection discussions. I think it means to listen. Hear what your patient is saying. They really might not know that their insurance policy terminated or maxed out. They really might not know their ex cancelled their insurance policy. To me, being kind, also means, being the one to help. Help your patients to get their dental bill paid so they can move on to other things. If it’s necessary to make a payment arrangement after treatment, kindly work with them to get it done. There are times when it is just the right thing to do.
Learning Dental Accounts Receivable: Be Aware
Then, there are those patient accounts that you know you must be oh so cautious with! There are patient accounts that are definitely “prepay only”. It can often be an account that you have had to work with someone on to get paid. They have paid it in full and are finally clear. You don’t want to repeat that same process all over again.
So, what do you do when someone who has just paid off a balance needs more extensive treatment? Secure payment before treatment even starts. It really is the “kind” thing to do.
Life happens. So many things can set anyone back. Good people suffer from financial setbacks. Lost jobs, medical treatments, divorce, etc. They still need crowns, root canals, dentures. But unless your dental office has made the decision to finance or give treatment away, be sure you have payment secured before ever starting treatment.
It’s definitely a balancing act. Balancing healthcare needs and financial health of the dental practice.
When done well, everyone is better for it. Master this and you are giving much back to the world…
…asthedrillturns
