What’s in Your Fees? Understanding Dental Fees
Multiple Fees For One Procedure
Did you know that you can have more than one fee for a procedure? Yes, you can as long as the fees are separated by a category of patients. For instance, you may charge the D0150 comprehensive evaluation for a new patient, but you want to categorize a patient returning to the practice after 3 years being absentee as the same code but different category such as D0150A. When the claim is filed the A would be dropped by the software. When determining actual new patient count you would count the number of comprehensive evaluation codes on the practice management report. By having a separate category for new patients and one for returning patients you can get a more accurate reading of the patient numbers.
Charging Finance Fees Without a Patient Signature
Are you charging a finance fee without the patients signature on a financial agreement? In most states, this fee is not collectible unless the patient has been notified in writing and has agreed upon the terms. Many PPO contracts or language in the Processing Policy Manual prohibit an in-network doctor from charging a finance charge or interest rate on unpaid amounts. The laws do vary by state so wise to contact your state dental board or state dental association for proper protocols.
Check your Standard Fees Annually
Did you know that you should be reviewing your standard fees yearly for updates or increases? Some doctors don’t want to “gauge” their patients with fee increases but without analyzing costs to operate this is not a fair assumption. It is wise to make sure that your standard fees are higher than the practices highest insurance contracted fee. Payers most often pay the plan’s allowable fee or the reported practice fee, whichever is lower. Charging less than the highest contracted fee will reduce the collectible revenue for the practice, sometimes substantially.
Reference: Administration with Confidence: 2019 edition by Dr. Charles Blair, DDS