Setting strong payment and collections policies

The goal for most practice owners is to send out as few billing statements as possible. This goal correlates with setting strong payment and collections policies and making sure staff is adhering to those rules, according to CDA Practice Advisor Sarah Gargani.

"There are two factors to consider: how to increase collections with current or upcoming balances and how to increase collections in follow-up," Gargani said. "There is a systematic approach that you as the dentist can instill at your practice."

Gargani recommends dentists and their staff set up an internal financial policy when it comes to current and upcoming balances.

Increasing collections with current or upcoming balances

The focus should be on deciding how the practice is willing to accept payments (payment in full, split payments, third-party financing, etc.).

"Ensure that the staff is aware of your financial policy and comfortable speaking with patients about their options," Gargani said.

A dental team could accomplish this by practicing together and role-playing. A critical step in obtaining true case acceptance from your patients is learning how to comfortably and confidently secure payment for treatment planned and rendered.

A dental office should also make sure it is checking eligibility regularly, Gargani said. Full breakdowns for new insurance or new patients should be obtained and eligibility should be received for any patient receiving an exam or treatment. This should include:

  • Remaining maximum.
  • Deductible met.
  • Pending claims.
  • Waiting periods.
  • Missing tooth clauses.

Communication with patients is key. Discuss copays with patients before their appointments, preferably at the time of the diagnosis (after exam) or when the appointment is scheduled. The best avenue for successful collection, according to Gargani, is to collect the copayment upon check-in at time of appointment, but following the appointment may work as well.

"If you are apprehensive that treatment may change, at minimum, reassure the patient how much you will be collecting upon exit," Gargani said. "If payment is missed at the time of the appointment, the best time to recoup that payment is immediately after the appointment."

At the morning huddle, the dental team can discuss copays or balances to be collected so everyone knows that the patient owes. Write and highlight any balances or copays to be collected on the patient route slip.

The front office can also run practice management reports to compare schedules to ensure that all treatment completed has been billed.

Increasing collections during follow-up

When it comes to increasing collections during follow-up, Gargani recommends dental teams create a follow-up tracking system. This will help determine who "owns" insurance accounts receivable.

"This could be one person or could be split up by provider with multiple owners, but someone should be in charge to maintain tracking," Gargani said. "An electronic spreadsheet or paper tickler file are great options for tracking."

Claims should be tracked and worked consistently. Gargani said dental teams should be diligent in their follow-through.

"Calendar time to work accounts and be consistent. Maybe every Tuesday your office manager works accounts receivable for four hours and targets 30 accounts weekly," Gargani said. "If a representative tells you a claim will be processed in two weeks, you should set your follow-up for two-and-a-half weeks later."

Also, make sure to determine what is needed (narrative, new X-ray, pocket chart, intraoral picture, etc.) to get a claim paid and track all notes for correspondence regarding claims. Sometimes there may be timely filing requirements – typically six to 12 months.

Any unsecure patient balance, a balance that falls out of the written financial policy, should be tracked for follow-up. This includes any balance transfer from insurance to patient responsibility. The practice will need to determine at what point a balance is either written off or sent to collections – how many calls need to be made and/or statements sent?

Practice financial protocols should be reviewed annually. Dentists should consider scheduling an annual staff meeting to review the practice owner's expectations and systems and identify bad habits. Re-train and role-play if necessary to improve communication and confidence when discussing finances with patients.

CDA recommends that dentists conduct research and understand the following laws pertaining to dentists who engage in debt collection activities on their own behalf:

  • Federal Fair Debt Collection Practices Act.
  • California Robbins-Rosenthal Fair Debt Collection Practices Act.
  • Civil Code Section 1788-1788.3.
  • Civil Code Section 1788.10-1788.18.
  • Civil Code Section 1788.20-1788.22.
  • Civil Code Section 1788.30-1788.33.

For more information on how dental practices should handle collection activities, visit cda.org/practicesupport.

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