Collecting at the Desk—Help!

A concerned dentist asks the question:

“I would like my front office team to be able to collect the money owed including the coinsurance from the insurance estimate. Can you advise the best way?  Please help them understand what to do to collect at the desk.”

The question as to why the accounts receivable was so high was answered with:  “We don’t always have the time to get the insurance break down so we just tell the patient we will bill the insurance and then send a statement afterwards.  When patients get the statement, they don’t like the fact that they weren’t told how much they would have to pay so we write some or all of it off to make them happy.”  

While this may sound like customer service but it is highly misguided business errors.

Per Delta Dental Insurance (https://www.deltadental.com/) companies, one of the largest in the nation, the following statements are taken very seriously:

• Accepting your insurance as payment in full and disregarding your coinsurance, copayment or deductible results in overbilling the insurance company. It’s against the law in many states and is viewed by the dental profession as unethical. It’s also a violation of the dentist’s contract with Delta Dental.
• Dentists are not reducing their fee when they do not collect patient payments. Instead, these dentists are charging inflated fees to the insurance carrier to make up for the money they lose from waiving the coinsurance/copayment amounts.
• Enrollees who knowingly agree to the dentist’s scheme are participating in this deception.

The front office team did not know that they were committing overbilling and deception.  When explained to them that it was not an option to write it off but a contractual agreement that included the patient as a participant in payment for their services they agreed they needed to collect.

By working with their dental software company they were able to set up the insurance company fee schedules so that they could do treatment estimates based on the plans benefits(always bill insurance with your full fee).  Once they were able to print out a financial/treatment plan estimate for the patient it was far easier to demonstrate and to ask for the coinsurance amounts.

Good customer/patient services is not discounts and fee waivers especially when your fees are at the correct UCR(Usual, customary, reasonable) for the area.  Providing valuable services should be communicated by the clinical and supported by the front office team.. If you don’t communicate value of the services that you have provided how do you expect your patients to value what you do?