Dental Claims Cleanup®, LLC
National Dental Billing Services


1810 Erie Blvd. Syracuse, NY 13210
800-652-3431

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Out of Control Overdue Patient Balances in Dental Billing

Posted on March 19, 2016 at 8:45 PM

Out of Control Overdue Patient Balances Working with practices across the nation provides us with trends and common struggles in dental offices. One denominator is that many offices have the patient balances over 30 days are out of control. It is our job to clean those up, but if we do not help the practice change their protocols there will be more balances rolling over as fast as we clean them up. Here is what must happen in the to make sure that your cashflow in healthy and the accounts receivable growth is minimized. 1. Correct estimate of treatment plan with a clear financial agreement. For this to happen 2 things are pre-requisites:you must have the insurance fees update and the plan breakdown in correctly, you must verify insurance coverage and call on plan breakdown once per year. This agreement needs have the following components to specify the following: A) your total price is… B) the in-network discount for the patient is… C) the estimated insurance is…. D) the patient’s portion that needs to be collected at time of service is… E) must tell the patient that once the claim resolves, there might be more that the patient owes….. F) the insurnace estimate is not a guarantee and is base don prior hisotry of payment, the insurnace will determine what the patient willowe and what the insurnace will pay…. The agreement is signed by the patient, patient gets a copy, and scan a copy to the patient. 2. You must collect whatever the financial agreement stated at time of service. We try to collect the copay before the procedure is done. We print the scanned financial agreements and have them ready for the am huddle so we can review with the Doctors what is expected to be done today and collected today. Someone is responsible to report on prior account balances to be collected at time of service. 3. Review in the am huddle balances to collect for each patient. This should include the prior account balance and todays copay. Review the next day what was anticipated to collect yesterday and what the team actually collected. If they did not collect what was expected, the Doctor needs to know why. You might find out that you have a weak link managing your money. 4. As soon as the EOB resolves, call the patient stating that the claim resolved and the insurance determined that the patient owes______ and you are calling to collect the balance over the phone to settle the account and avoid billing. 5. Follow this collection process: a) call patient after EOB was entered to collect balances, if you don’t reach the patient b) send out balance due letter with 10 days response demand c) if you don’t hear from the patient, send 1st notice overdue balance 14 days from balance due letter. d) if you don’t hear from the patient, send final notice with a 10 day response demand 14 days after 1st notice letter. e) if you don’t hear form the patient, call the patient: You will tell them that you are calling to interfere with an automatice collection agency process. The collection agency automatically takes over overdue accounts unless they settle the balance right now with you on the phone. You certainly don’t want this matter to interfere with the patient’s dental care or relationship with the office. So you are calling as a courtesy to a long standing good patient of the office. If they don’t settle over the phone tell them to mail the check in within 3 business days. f) if you don’t hear form the patient send to collection agency and allow collection agency to follow through with their collection protocol 6. run your AR reports weekly. Review with your team responsible for billing the outstanding patient balancing over 30 days and unresolved dental claims over 30 days. This is your supervision checks and balances that the team is resolving money owed to you and that your current systems are executed and effective. Obviously if you can not supervise, then you need to outsource dental billing.

Categories: accounts receivable, practice management, dental insurance

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