If you choose to become a participating provider in dental benefit plans or accept assignment of benefits from plans, it is important to carefully read and understand each plan’s payment terms for both the patient’s portion and the dental benefit plan filing and reimbursement. Not only should you and your financial staff understand the terms, but it is critically important to be able to communicate the terms to your patients. Dental practices have the unique opportunity to educate patients on their dental benefits which can help reduce miscommunication and disgruntled patients. Many patients are under the impression that dental practices determine the patient’s payment portion and do not understand that dental benefits are determined and arranged by employers and the dental benefit plan. The following are financial considerations and recommendations for patients with dental benefits:
Practices that participate in a significant number of dental benefit plans often expect the practice’s accounts receivable to be higher and extend into the “over-90-day” category. Although dental benefit plan A/R is processed and collected differently than patient accounts, it is possible to set up a system to manage dental benefit A/R and collect on the accounts within a reasonable time frame.
When you recruit for the financial staff person for your practice, you should design the role and job descriptions around the financial consultation and collecting balances before or at time of service. Many practices will even tie certain incentives or bonuses to the financial coordinator position as a motivation to keep collections high and A/R low. The entire team should know the practice’s financial objective and should know how this goal impacts their roles. After all, practice collections have a significant impact on cash flow, which in turn determines whether the practice has the funds for payroll. You cannot give your dental assistant an “I owe you” instead of a paycheck, so why offer that option to a patient?
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