Lack of cash flow means someone isn’t getting paid

I had the pleasure of speaking at the Star of the North dental meeting this year and one of the courses I taught is titled, “Numbers Tell a Story . . . the 5 stats every office should monitor” and the one number that always brings the most discussion is accounts receivable. It is amazing the lack of awareness from the doctors and lack of an organized system from the team. Combining these two things results in disaster for the practice.

Recently, I had a doctor reach out to me after his supply rep ran an analysis on his numbers. Most sales reps have some kind of analysis they can run and I would encourage you to get in contact with your Henry Schein FSC, Burkhart rep or a trusted advisor like me who can give you an assessment of the current situation. This doctor was informed that he had over $400K in past due insurance claims. After I had a chance to assess the situation, I was able to confirm it and help him put a plan in place.

This situation is very common, and it makes me very sad and frustrated that the accounts receivable is not put higher on the priority list for task management. The financial coordinator for the practice said that she just always ran out of time to manage the accounts receivable and didn’t really realize it had gotten so bad. I am happy that the doctor was able to get some help before it was too late and that he was willing to do the work to turn things around.

Managing accounts receivable is a team sport and it does not fall on just one person in the practice to manage all the details. There needs to be oversight by the practice owner, a good management system by the financial coordinator and training for the entire team. There are five skills I instill in all my teams when it comes to A/R management.

  1. Good verbal skills during the very first phone call. We must remember we are training patient behavior even before they walk in the door. My philosophy is to be open and honest about the cost of treatment. I am not saying you should quote exact fees over the phone before the doctor has had a chance to diagnose. However, I feel that you build trust with your patients when you are comfortable talking about money with your patients.
  2. It is a value-added service and a benefit for the practice when you can estimate the patients out of pocket expenses as closely as possible. Now, I am not saying to sit on hold for hours locating all the details, but remember that our patients look to you for guidance and help with budgeting for their care.
  3. Communicate the patient’s out of pocket expenses with your entire team so anyone on the team can collect on the day of service. I don’t know how many times I have seen patients let go from an appointment because the front office team member was with another patient and the clinical team member didn’t know what to do so she just dismissed the patient.
  4. Everyone, even the doctor, should know how to collect money. I recommend having a little in-service training on how to use the credit card machine so anyone on the team can ask for money. Do not let patients walk out the door if they have a co-pay.
  5. Know what reports to use for managing your insurance A/R and the patient A/R. You must map out time in your busy schedule to work the reports, make phone calls, send billing statements (or some kind of reminder) and meet with your doctor to discuss the numbers on a regular basis.

The A/R is one of the top 5 numbers I think offices should be monitoring and should be part of the monthly team meeting. If the accounts receivable gets too far behind and there is a lack of cash flow, someone on the team is not getting paid and it is usually going to be the doctor. After reading this article, if you are interested in having an assessment and you are using the Dentrix core software, please reach out to me directly at