8 Ways to Keep Your A/R Down and Your Collection Percentages Up
Dentistry is about helping our patients have beautiful, healthy smiles, but it is also a business with overhead.
As much as we would like to give everyone their beautiful, healthy smiles for free, we can’t. Collections and collection percentages matter.
According to a 2021 article by DentistryIQ, the average collection percentage for a dental practice is about 91%. According to every collection article I have read or course I have taken, our goal should be at least 98%.
So, how do those offices with lower percentages get those types of low percentages?
Aside from the obvious of just not collecting money, there is also a need for proper treatment plan presentation prior to treatment, lack of clean claim submission, no or minimal claim follow-through, and maybe the most important, lack of knowledge and/or resources.
How do we increase our collection percentage from the current number to the coveted 98%?
Believe it or not, it starts with the first phone call with that patient. It trickles through the entire team, from check-in to diagnosis by the doctor, treatment recommendation and education, treatment plan presentation, and check-out.
Let’s walk through eight essential steps to getting our collection rate up.
Step 1: Get Insurance Information from the Patient During the Initial Phone Call or Interaction
Whether a patient is new or established, get their insurance information at that first interaction.
You will need the patient and subscriber’s name and date of birth, as well as the subscriber’s employer name and insurance identification number, which could be a unique ID number or the subscriber’s social security number.
Step 2: Verify Coverage and Get a Breakdown of Benefits
Prior to the patient’s appointment, you will need to verify the patient’s coverage, get a breakdown of benefits, and get some basic history information. Nothing is worse than taking radiographs on a patient to find out they weren’t eligible for them, and then the patient did not want to pay for them.
I recommend creating an insurance breakdown form for everyone on your team to use when verifying coverage to ensure consistency in the information everyone is getting.
Step 3: Use Your Practice Management Software
Once you have the insurance information, enter it into your practice management software. Most programs will give you an accurate estimate of your patients’ out-of-pocket expenses.
You will need this when it comes time to present a treatment plan to the patient. After the patient is in the clinical area, the doctor will take and review radiographs, and an exam will be done.
Step 4: Treatment Planning
The doctor will recommend treatment and educate the patient on their needs and why. That recommended treatment can then be entered into your software. If you have entered their insurance information correctly, the program will do the math for you, and you can present the treatment plan to the patient.
During treatment plan presentation, it is essential not to assume that a patient cannot afford treatment. Present every treatment plan compassionately, answering any questions they may have and assuming that the patient wants the recommended treatment and can afford it. Make sure to remind the patient that this is an estimate and that it is due at the time of service.
You are not a bank, so don’t make it a habit to finance your patients’ treatment by allowing them to pay later or to make payments.
Of course, there are always exceptions, but as a general rule, the patient’s portion will always be due the day the treatment is completed.
Learn More About Insurance Collections
Step 5: Collect the Patient’s Estimated Out-of-Pocket Expense
The rubber meets the road once that treatment is complete and the patient is at check-out. Since you have already informed your patient of what their out-of-pocket is expected to be before them having the work done and they have had the opportunity to plan accordingly, you can feel comfortable and confident collecting right then.
Step 6: Submit a Clean Claim
A clean claim means sending all required information, radiographs, photos, and narratives as an attachment to the claim with the first submission. You will need to familiarize yourself with what insurance companies require as attachments, but most, if not all, major services will need attachments.
Sending a claim without the proper attachments will result in a denial and need for resubmission, delaying payment and adding to the office’s A/R.
Step 7: Collect the Insurance Portion
Insurance companies take about 7-14 days to process and pay a claim.
I recommend allowing insurance companies to pay the office via EFT. By allowing EFT payments, you can receive payment in as little as one business day.
Check payments can take 30 days or more to make their way into your mailbox, again resulting in a delay in payment and adding to the office’s A/R.
Step 8: Claim Follow Through
It is recommended that claim follow-ups occur at the 14-day mark. Go onto the insurance portals or call them to check the claim status. They can verify they have everything needed to process the claim or inform you of what may be missing.
If you need to resubmit anything, get the claim number and resubmit it; then don’t wait for the denial to come in the mail. Writing or entering the claim number on the resubmission is vital so it isn’t denied as a duplicate.
The bottom line is that the more proactive you are in getting the necessary details and using them properly, the quicker you can collect the money owed to your practice, and the higher you will be able to raise that collection percentage rate and keep it there. A little more work on the front end of the patient experience will allow for confidence in collections and less chasing of the money on the back end.
About the Author
Debbie Meadows, CDA, MAADOM
Debbie has been in the dental field since 1997 and is a Practice Manager and Director of Operations at a busy practice in Kentucky. She is a certified dental assistant with additional radiography and coronal polishing certifications, which she received from the University of Kentucky.
Debbie graduated from Western Kentucky University with a degree in Business and is a Lifetime member and Master of the American Association of Dental Office Managers. She co-founded the Kentucky DPLN Study Club of Dental Office Managers.
