Andy Cleveland
“The Collection Agency Ninja” Andy has been in the patient revenue cycle management space for over 25 years in multiple capacities.
Medical debt in dentistry has long been a challenge for both patients and practices. With recent changes in legislation and credit reporting, dental teams need to understand the new landscape of patient collections and how to navigate it effectively. On a recent episode of The High-Performing Dental Team podcast, I sat down with Andy Cleveland, an expert in accounts receivable collections, to discuss what these changes mean for dental practices and how we can ensure our teams are paid for the services they provide.
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Understanding the Changes in Medical Debt Reporting
If you’ve been in dentistry for a while, you know that accounts receivable can be one of the biggest pain points in a practice. Recent bans on reporting medical debt to credit bureaus have led many collection agencies to shut down their healthcare collections divisions. I received a letter from Trojan Professional Services about this and knew I had to get Andy on the show to explain.
Andy shared that in July 2022, medical debts under $500 could no longer be reported to credit bureaus. By January 2025, this expanded to all medical debt, regardless of amount. The goal of these changes is to prevent medical bills from negatively impacting a patient’s ability to secure loans for essential items like homes and cars.
While the law removes the ability to report unpaid balances to credit bureaus, navigating medical debt in dentistry doesn’t mean we stop collecting. Practices should still pursue unpaid balances through internal billing, payment plans, and third-party collection agencies. The key is shifting from punitive measures to proactive financial policies.
Why Your Practice Needs to Collect at the Time of Service
One of the biggest takeaways from my conversation with Andy was the importance of collecting payments at the time of service. Once a patient leaves your office, the chances of getting paid drop significantly. Delays in insurance reimbursements or patients deprioritizing dental bills make collection efforts harder.
Why do offices struggle with this? Andy identified two main reasons:
- Lack of Training and Verbal Skills – Many front office team members feel uncomfortable asking for payment. Without confidence or proper verbal skills, opportunities to collect at the time of service are missed.
- Turnover and Inconsistent Systems – High staff turnover often leads to inconsistent financial policies. New team members may not be trained properly, creating confusion and ineffective collection strategies.
To combat this, practices must establish clear financial policies and train their teams to confidently discuss patient financial responsibility. Navigating medical debt in dentistry requires a proactive, not reactive, approach.
The Role of Collection Agencies in Today’s Climate
Does the inability to report medical debt make collection agencies obsolete? Absolutely not. Andy emphasized that while credit reporting was a tool, it was never the main motivator for patients to pay their dental bills. Most people simply don’t want to deal with collections. They avoid phone calls, legal risks, and the stress of escalation.
Collection agencies remain essential for recovering unpaid balances. A reputable agency understands the nuances of healthcare collections and approaches patients professionally and respectfully. If your practice struggles with outstanding debt, finding the right agency is key. Andy stressed that a good agency should align with your practice’s values.
Steps Your Practice Can Take Today
If your practice is dealing with growing patient balances, here are three actionable steps to tackle the issue:
- Train Your Team on Financial Conversations – Ensure front office staff can confidently communicate financial expectations. Role-play scenarios where they ask for payment and address patient concerns.
- Implement a Strong Financial Policy – Set clear guidelines about when and how payments are collected. Require deposits for larger treatments and provide pre-treatment estimates with a clear explanation of patient responsibility.
- Work with a Trusted Collection Partner – If you have overdue balances, consider partnering with a collection agency that specializes in dental debt. Finding the right fit is crucial, as alignment with your practice’s values ensures success.
Final Thoughts
At the end of the day, navigating medical debt in dentistry isn’t about punishing patients—it’s about ensuring your practice stays financially healthy while continuing to provide excellent care. By being proactive, training your team, and setting clear expectations, you can reduce accounts sent to collections and keep your revenue cycle strong.
If your office is struggling with collections, I recommend reaching out to Andy Cleveland. His expertise can help your practice implement strategies that maintain cash flow. Visit CollectionAgencyNinja.com to learn more.
Let’s stop letting unpaid balances pile up. Train your team, create strong policies, and confidently tackle navigating medical debt in dentistry!ith confidence!
