Many patients come into a dental practice with the notion that insurance will cover everything. This needs to be set straight during their first visit. In fact, the word “insurance” is a misnomer. What the patient has is really a dental benefit plan, which could cover all or a portion of their treatment. The coverage is never guaranteed, and there are dozens of ways in which payment could be denied even for a preventive exam and cleaning visit.
The patient also needs to be aware that the dental benefit plan they have is a contract between their employer and the insurance carrier. The dental office has nothing to do with it. The full terms of the contract are in a document that their employer’s Human Resource Department would have. In the absence of this contract, the dental office can only provide an estimate of what the insurance payment might be. This cannot and will not be 100% accurate, regardless of the software or methodology used for the estimate.
Essential Steps for a Patient’s First Visit
During the patient’s first visit, obtain the full residential address of the patient, as well as their residential telephone number, work telephone number, and cell number. Also, obtain the name of their employer as well as the state in which they are employed.
Along with the Health History Form, include a separate Financial Policy Form that explains the financial policies of the office and clearly defines what the patient’s responsibility would be. The Financial Policy Form must achieve the following:
* Inform patients that they must pay their estimated portion at the time service is rendered (i.e., on the day of their visit).
* Inform patients that the dental office provides an estimate of the patient portion. It is not guaranteed to be accurate. Indicate clearly that any balance will be billed to the patient after the insurance pays their portion, and any credit will be issued to the patient within 45 days.
* Make sure all patients sign an agreement that they have read the financial policy and are responsible for any amounts not paid by insurance, for any reason whatsoever. If the patient is a minor, the parent or guardian becomes the guarantor.
* Do not seat a new patient in the chair and start any dental procedure until you have verified his or her insurance information.
Other Tips for Improved Collections
Estimate the patient portion accurately, and then add 10% to your estimate. Test your software for a variety of insurance plans and procedures to make sure it provides a good estimate. It is better to have a credit on the patient’s account and then reimburse, rather than having to bill the patient for a small amount.
Refrain from making your financial policies so tight that you drive patients away. Accounts Receivable Management Software Many practices get frustrated by Accounts Receivable issues, make an emotional decision to put in place stringent financial policies, and are proud of the fact that they collect close to 100%. Unfortunately, by virtue of these policies, they may have driven away significant business and are completely unaware of the consequences of their actions. Keep in mind that 98.5% of $1.00 million is greater than 100% of $800,000.
Your goal in managing accounts receivables is to maximize total collections, while minimizing uncollected payments. Many dental offices lose between $10,000 and $50,000 annually, year after year, due to deficiencies in Accounts Receivable management. By managing patient expectations, you reduce the amount of money you are leaving on the table and improve the odds of collecting nearly all the money earned in your dental practice.