In a recent article I talked about how your “core systems” need to be in check before you decide to take the plunge into the chartless waters. Some of you went down through the list and said to yourself “Awesome, we are ready to rock-n-roll, but some of you out there might need to work on a few things on the list, but not quite sure where to start. Well, I am here to help.
Let’s start with the 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 think that this is a great goal to have and you should strive to meet this goal. Today I am going to focus more on your over-the-counter collections. If you can pull up your over-the-counter percentage, the 98% will be a lot easier to attain. Typical industry standards for over-the-counter collections should be between 35% – 45%. Of course if you are 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.
Over-the-counter collections isn’t something that just magically happens at the front desk. It starts with treatment plan presenting and training your patients from the first phone call they make as a new patient. 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 question you could hear at the front desk from a patient as they are 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 at my office when I was still full time was treatment planning and presentations. I might 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 approximately how 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 patient then you will need to come up with a hand written form. I am fortunate that my dental practice uses Dentrix software and we are able to enter accurate insurance coverage tables, up-to-date PPO Fee Schedules and be able to print out this information for our patients so they know how much they are required to pay at the time of service. This estimate you give to your patient should also have a disclosure statement on it outlining what your office policy is, for example; the patient portion is due at the time of service, if you offer a discount for full payment, 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 the patient. This way you will avoid that dreaded question stated above. How can you set the expectations of the office financial policy for a new patient so there is no mis-understanding when they come in for their first visit? Most patients that have 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 the patient a lesson in “Insurance 101”. After you have collected the patient’s personal information, asked about previous x-rays and how they were referred then you need to ask this question; “Do you have dental insurance that will help you with this appointment?” Notice how I emphasized the word “help”. It is important to set the tone in the beginning that they may have some out of pocket and that just because 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, maximum used and other factors.
You might come up with something like this to set the stage during that first phone call:
“My experience with your insurance company is that their reimbursement will be close to 100% for this 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 prior to your appointment so you will have a better idea of what your out-of-pocket will be.”
Increasing your over-the-counter collections makes a huge difference in your accounts receivable and also will help lower your overhead costs because you will be sending out fewer statements, making fewer collection phone calls and sending fewer patients to collection. The patients feel better knowing what their estimated portion will be. Trust me, they dislike receiving an unexpected billing statement in the mail just as much as you dislike sending it.
A little side note: if you are working toward going chartless in your office this might require you to purchase a few more pieces of equipment or subscribe to some new electronic services, so let’s work on bringing in some more money into the practice. Your doctor will love you for it!
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