How do you keep up with Accounts Receivable and Outstanding Insurance, every practice falls behind unless this is worked daily, and the Doctor and front office review the Accounts Receivable and Outstanding Insurance Claims at the end of every month. Often as long as there is money in the bank to pay the bills and the practice is collecting 95%, everyone is happy, Just remember there is an additional 5% still outstanding and those 5%’s add up to quite a bit of money at the end of a practice’s lifetime. The most frustrating thing to do is write off debt because it is to old to collect.
1) Most importantly, verify insurance before the patient comes in the door for new patients. For existing patients make sure you ask if they have the same insurance, “Mr. Smith do you still have __________(insurance name)”. Many patients get new insurance at the beginning of the year and they do not remember if they have told you or not. ASK!!!
2) Most of the Dental Practice Management softwares are great at figuring out what the patient will owe. However it has to be entered properly, with the coverage table, deductibles and maximums, then the software will give you the correct $ about to collect from the patient at time of service If insurance information is not put correctly then you will end up with a mess.
3) When the insurance check comes into the office post it, if there is a balance over $50.00 send a statement immediately, handwrite that the insurance has paid their portion and this is owed by the patient. A simple explanation can be made as to why they did not pay.
4) Twice a month run the Outstanding Insurance Report. All claims must be paid in 30 days or an explanation of why they have not been paid needs to be sent by the insurance company. Call on any claim that is over 21 days. Most claims are paid that quickly now days. If you call on these claims on a routine basis you will only be calling on 4 or 5 a day as they hit the 21 day mark. This has to be worked continuously.
5) Accounts Receivable – if you do everything right; Verify Insurance, Collect Patient Portion at time of Service and follow up on Outstanding Insurance, you should have very few statements to send out. But things happen, insurance does not pay for something, etc. Send statements once a month if you do not have too many, if you have a large # of statements then you can send A-L, and M-Z a couple of weeks apart. Send to anyone who has a balance over 30 days even if we are waiting on insurance. Do Not wait to send statement until the balance is over 60-90 days.
A word about insurance, we try very hard to accommodate the patient and help them with their insurance. We make calls to the insurance company trying to get an insurance situation fixed so they will pay the claim. Ultimately the practice has no power over the insurance company, only the person who pays them has any power. It is our job to “help” get the claim paid. We have seen staff make 5 – 10 calls to get a claim paid. Your limit should be 2-3, after that turn it over to the patient who is responsible for the balance, they will spend the time on the phone to get it paid freeing up staff time for more immediate things.
