Dental insurance write offs are tricky. And require the dental front office team to be on their toes! As this is an area where we can easily make mistakes. For those who create the dental office financial agreements and maybe the treatment plans, this can be where the fun begins!
So, before we even enter our procedure codes, there are some decisions to make. Do we want to enter our office fee in treatment plans and in posting charges? Or do we want to enter the insurance contracted rate instead?
There are a couple of ways to post treatment and charges in dental software systems. I’ve been told that the most popular way to do this today, is to enter the PPO contracted fee into the patient’s treatment plan and ledger.
Offices who prefer this method report that they like this method because there is less room for error. And there isn’t a write-off to calculate. The treatment plans are correctly calculated. (Although downgrades are not part of the equation and are not calculated).
But insurance payments are easier to enter without the math and more accurate. Unless of course, the wrong PPO fee has been entered. Or there was an unexpected change in the patient’s insurance. Which does happen! And that’s a whole other ball game!
The Dental Practice Operational Manual Includes a Section Dedicated to Dental Insurance Benefits & Terminology & is a FREE Download With Your Dental Practice Operational Manual
My Preference - No Right or Wrong Here!
My Preference: Post Office Fees to Patient’s Account
Here’s why! I personally feel that the office fee should always be the fee that’s posted to patient accounts. And all that follows is strictly my preference and my belief. So, take it for what it’s worth.
- I believe the patient should always know and see what the actual office fee is. I personally don’t want patients to ever think a discounted service they receive because of a contract with their insurance is an accurate reflection of the cost of treatment.
- What if the patient’s insurance changes and we don’t update the info or fees in their treatment plan? The wrong fees post! This has to be carefully watched.
Watch Those Fees & Adjustments!
- Although the insurance claim forms can show the office fee, the patient statement and ledger will show the contracted rate. The patient statements will show the contracted rate. So, as their insurance changes, they could see different fees for the exact same procedure. And if they are talking to their relative and comparing statements, they see more confusion!
- The dental front office must be on their toes as far as having the correct codes and fee tables entered. Any cross-confusion or mistakes could be just as bad if not worse than an adjustment error. This type of error could affect patients globally rather than just on one ledger.
Monitor Adjustments Carefully
Managers and/or dentists need to monitor dental insurance write-offs too. Well, any write offs really! When I have worked in offices that contract with PPO insurances, I create spreadsheets for each individual PPO plan. Yes. More spreadsheets! I know. but trust me, you want this information! And once you get it all set up, it’s done! You just have to plug in the numbers. And the good news is, you know what’s going on and can make informed decisions!
The numbers inside this spreadsheet are just examples. Plug in your own numbers and watch the magic! The formulas are built into the calculator. So, as long as you plug in the right numbers, you’ll get the right totals. At least, if it all downloads correctly! But even if it doesn’t, these are simple excel formulas. And you can create these calculators for your dental office team. And then anyone can generate the numbers they are looking for in no time!