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As a Practice Advisor for FPC, I enjoy teaching a practice how to manage their accounts receivable.  This can be a dreaded task each month if the AR is growing instead of turning. If the office is producing but not collecting efficiently on that production, cash flow will be limited.  When this happens, bills won’t get paid, supplies are restricted and payroll is affected.

Why do some offices struggle with month-to-month collections?  Some of the reasons may be:

• Insurance does not pay what is estimated.
• The patient walks out without paying in full or their co-pay, resulting in an outstanding balance.
• The patient defaults on an agreed upon payment plan.
• The Insurance was not billed in a timely manner or was billed without the proper documentation, causing a delay in payment.

Together with FPC patient billing and OTC (over the counter) office collections, an ideal collection ratio is 95-99%.  The AR should not include anything over 30 days.  This would mean that the AR should be no higher than the average monthly production.  If your office is struggling with collections, here are some suggestions:

• Develop and implement a strong financial policy and stick to it. If you need to replace your current one, make sure all patients are notified at their next appointment and require a signature of acknowledgment. Make sure your staff fully understands the financial policy they will be enforcing which includes collecting the patient’s portion at the time of service.
• Use the insurance estimation feature in Aspire to provide your patients with a clear “estimate” of what their insurance will pay and what they will owe. All patients who are presented with a treatment plan need to sign and date it for future reference.
• All insurance claims need to be submitted in a timely manner with all proper documentation and attachments.  If you are not currently using the NEA fast attach feature in Aspire, ask your Practice Advisor to help you with setting this up.
• Aspire aging and insurance tracking reports need be ran consistently every month. Refer to the FPC Success Calendar for suggested schedule. Make sure all outstanding patient balances are being paid for as agreed upon. If there is a missed payment, call the patient.

I can’t stress enough how important consistent account follow-up is to the revenue recovery process. Of course, FPC is helping you with this as well.  Together we make a great team!

• Properly train your staff how to collect and answer billing questions should they arise. If your staff is knowledgeable, your patients will trust their collection efforts.

ACCOUNT FOLLOW-UP

When running your aging report, insurance tracking, or referring to the CARA report (found in E-Tools), I recommend focusing on the “Largest” and “Oldest” accounts first.

Largest-These accounts owe the practice the largest amount of money and will most likely not pay in full.

• Play detective. Find out why the balance is so large. Maybe there is an outstanding insurance claim needing attention or the insurance denied the claim due to no coverage.  Know exactly what you’re talking about before calling the patient.  If you make sense when explaining their balance, they are more likely to understand your request for payment.
• Set up a payment plan that will both benefit the patient and your office. Getting the balance paid sooner will help the patient save on finance charges and lower the AR sooner.   As a last resort, offer payoff incentives such as a cash discount.  Getting at least 80-90% of the balance paid in full is better than nothing and will still result in lowering the AR.

Oldest-These accounts are over 90 days.

• Once again, play detective. There is a reason for every balance. If you are cross-referencing with your insurance tracking report, you can see if there is an outstanding claim.  Remember, there is a time limit for filing claims after the treatment is completed.  These claims must be taken care of before they expire.
• If the balance is the patient’s responsibility, find out why they haven’t paid. Sometimes, a friendly phone call is all it takes. For those patients avoiding payment, the worst thing you can do is avoid communication.  If you’re not comfortable discussing collection options with your patients, delegate the task to someone who is. The longer these old balances sit there, the harder they are to collect.
• Now run your 60 day and 30 day overdue reports and repeat the process, but only if you have finished the 90 days. The more recent the treatment, the easier it is to collect.

Start now!  Even the largest AR can be cleaned up and managed. Once systems are in place, collections will become routine and part of your everyday effort to increase cash flow and profitability.

By Kevin Brady

All dentists want a practice with high performance, productivity, and profitability. These three P’s represent the standard by which successful dental practices are measured. There is, however, another “P” that many dentists forget, which is arguably the most important—patients. 

Happy patients lead to positive outcomes and accelerate the other Ps. Enhancing customer service and public relations are key to running a thriving dental practice. To accomplish this requires dentists to devote more time to patients and provide them with what they need to complete their treatment recommendations. By incorporating current, proven, safe, and secure technology into the dental practice, staff can focus more on patient care.

Performance indicators Recall is the performance enhancement engine of most dental practices. When patients commit to and show up for regular recall appointments, dentists are able to diagnose potential issues early. These appointments allow time for patients to express their concerns and discuss what needs to be addressed with their teeth. In order to have an effective recall program, the practice needs a good hygiene program to encourage patients to return at six-month intervals. This means the practice has enough staff to see both recall patients and those coming in for more time-consuming dental treatment.

If the one-on-one time with the staff decreases, performance may suffer and patients may become uneasy about accepting recommended treatment that wasn’t effectively explained to them. One way to solve this dilemma is to use a third party partner to assist the staff in various aspects of running the practice.

Claire Ficsor, DDS, owner of Windermere Family Dentistry in Littleton, Colorado, believes that using a third party partner makes her practice better. “It frees up my staff to do what they’re supposed to do and what they’re good at: scheduling, getting patients in for treatment, and focusing on patient care, which is what it really should be about,” said Dr. Ficsor.

Productivity indicators A full patient schedule along with healthy collections is indicative of high productivity. In fact, according to the ADA’s Practical Guide to Expert Business Strategies, “Controlling the schedule requires constant vigilance, commitment, and training. It is the foundation for the success of the entire practice.”1 It takes valuable staff time to maintain this schedule and work with patients and insurance companies to collect payment. When staff are concentrating on reminding patients about appointments, preparing monthly invoices, and communicating with insurance companies, they aren’t focused on patient treatment and business building tasks.

Here are several signs that the practice is busy, but not productive:

•  The main objective is to keep the schedule full rather than focused on patient care.
•  Both the hygiene and dentist schedules are booked for weeks or even months, forcing patients to wait long periods of time for even routine procedures.
•  There is no consistency in the procedure schedule—patients are booked for 30, 60, or even 90 minutes.
•  Staff skip lunch breaks to catch up.
•  There is low patient retention.
•  Revenues are flat.1

Technology can help staff maintain a full patient schedule through automated email, text, mail, and phone call reminders to help patients with their appointments. These software programs also provide practices with crucial statistics, such as appointed and completed versus missed appointments, to increase productivity.

Some dental business partners do more than just furnish the software. They also provide advisors to analyze reports generated by the software and suggest changes to enhance the productivity of the practice. Dr. Ficsor said having these advisors to help her practice made all the difference. “My software company provides a practice advisor that helps my team and me set up and manage these valuable services,” she said.

The time involved to keep up with changing insurance rules and regulations can be overwhelming to an already busy dental staff. One solution is to outsource patient and insurance billing and posting, scanning of explanation of benefits, and collections follow-up to an experienced third party dental business partner who can accurately file insurance claims in a timely manner. When selecting a dental business partner, it’s crucial to ask a lot of questions.

Verify that the partner has experience and is not just an overnight startup with no relationship with insurance companies.

Another productivity indicator is the quantity of patient referrals. Satisfied patients refer others to the practice. Happy patients believe the staff truly cares about their dental care and goes the extra mile explaining treatment options. “It’s always good when a patient comes in and it’s about them,” said Elizabeth Lawrence, office manager at Precision Dental Care in Dry Ridge, Kentucky. “We greet them and tell them, ‘We’re going to help you. We’re going to make you better.’ It’s not all about late payments or past due things.”

Patients appreciate any additional services offered by the dental practice, such as flexible scheduling, financing, automated insurance billing, and e-tools that give them online access to their dental information. Lawrence appreciates that their dental business partner’s program is all inclusive. “It’s got everything in it from accounts receivable to support staff to charting—the list goes on,” she said.

Protecting patients When practices use technology partners to enhance performance, productivity, and profitability, it’s important to make sure to company and the product protect and safeguard patients’ data. In today’s world where data breaches are the norm, patients might be reluctant to use any e-tools or other online services. Alleviate these concerns by ensuring that the dental business partner protects patient data through modern AES encryption and other secure online methods.

Poor performing dental practices experience a myriad of problems. For instance, there may be staff issues that lead to high turnover. High turnover results in reduced efficiencies within the practice since dentists spend more time training new employees and less time with their patients. Patients notice the constant staff changes and increased waiting time.

In order to have a high performing, productive, and profitable dental practice, focus on the fourth “P”—patients. The solution is to work with a strong, experienced, dental business partner who allows dentists and their staff to focus on more productive and goal-oriented tasks when they take care of the business tasks.

References 1. American Dental Association (ADA). The ADA Practical Guide to Expert Business Strategies: Advice from Top Dental Consultants. 2014.

The current health-care landscape is producing a stressful environment for dentists and their staff. Dental professionals find themselves dealing more with regulatory requirements and people-related issues instead of patient treatment plans. What’s the solution? To become more productive and efficient in running the practice. By taking advantage of the various technology support services that help practices run more smoothly, dentists will have more time to practice their craft and spend time with patients.

Read the full article on Dentistry IQ or Download a PDF