work that you enjoy with fewer headaches relating to managing accounts with open balances.
Remember to discuss your financial policy in full with each patient. It’s also helpful to have patients of record review and sign your current financial policy on a regular basis, since it’s likely that they don’t recall every form they saw or signed when they first came in for treatment. Also, every patient should sign a treatment form, with informed consent or informed refusal where applicable. More information about informed consent/refusal is available in the “Managing Patients” module of the ADA’s Guidelines for Practice Success; please see the “Informed Consent/Refusal” article in the Policies section of that module.
Make sure your financial policy clearly expresses what payment is due at the time of service, even for cases involving routine care. You’ll also want protocols to validate patients’ eligibility, coverage and remaining benefits for the plan year for those patients who qualify for some level of coverage or reimbursement through a third-party dental benefit plan. If applicable, your policy should clearly state that any remaining deductibles and estimated copayments are payable at the time service is provided.
Make sure your financial policy clearly expresses what payment is due at the time of service, even for cases involving routine care.
Financial responsibility for healthcare costs, such as dental treatment provided to children whose parents are divorced is typically outlined in the divorce decree. Since it’s not uncommon for parents to share responsibility for taking children to these types of appointments, it’s a good idea to have the parent who is not financially responsible for any out-of-pocket dental costs to agree, in writing, that he or she will pay for care if the former spouse fails to cover those expenses.
The patient should know the full cost of treatment, including the amount he/she is responsible for after any estimated payment by their dental benefits plan. He/she should also be aware of the practice’s financial policies. Once you’ve confirmed that the patient understands, remind them when payment is due at the time of service and advise them of the amount that will be due on the first date of treatment.
The patient should know the full cost of treatment, including the amount he/she is responsible for after any estimated payment by their dental benefits plan.
Having a system in place and following procedures consistently will reduce the amount of staff time spent on collections. This will help avoid uncomfortable, unpleasant, and sometimes even contentious, back-and-forth conversations with patients who might question whether your fee is “really worth” the work that you’re doing. Surprisingly, this happens more than you might think, even with patients who seem to share your philosophy about maintaining good oral health.
There are many options for developing a financial policy. Some practices develop their own, others work with a financial or business advisor to develop one, and others ask colleagues for suggestions and other resources. Regardless of your approach, it’s advisable to have your lawyer review your policy to ensure that it’s in compliance with any applicable federal and state laws and regulations.
Resources:
• “A Dentist’s Guide to the Law: 228 Things Every Dentist Should Know”, https://ebusiness.ada.org/productcatalog/404/Managing-Your-Practice/A-Dentist%E2%80%99s-Guide-to-the-Law-228-Things-Every-Dentist-Should/L756
Overdue Accounts
Despite sharing your philosophy about the value of maintaining good oral health, patients can still fall behind on their payments.
If your staff reports that collecting fees is requiring more time or becoming more difficult, make it a point to review your internal financial policies and protocols as well as the written information you give patients about those policies. It could be time to update or even rewrite those documents so patients fully understand their responsibility for paying for services prior to, or at the time of, treatment. While you’re doing that, also make sure your financial policy accurately details the procedures staff should follow when collecting fees from overdue accounts for treatment already provided, including complete documentation of any patient promises to pay the balance.
If you accept assignment of benefit from patients with some type of dental benefit coverage, make sure you collect the anticipated amount that the patient is responsible for at the time of service. Don’t wait to collect the private pay portion of the bill until after the third-party payment has been received. Try to make it a standard operating procedure that you receive payment of benefits from any third-party dental benefit administrators within 7-10 days of submitting the claim. All claims should be paid, with funds deposited, within 30 days. Submitting your claims electronically will greatly help in reducing the payment cycle.
If you accept assignment of benefit from patients with some type of dental benefit coverage, make sure you collect the anticipated amount that the patient is responsible for at the time of service.
Sometimes, there might be a balance due from patients after you receive the payment of benefit, even though patients have paid their estimated portion of the bill at the time of service. When that happens, immediately send the patient a statement indicating the balance due. If this happens frequently, consider amending your financial policy to have patients sign a pre-authorization form that allows you to charge their credit card for any balance due after receiving payment from a third-party.
Practices that store patients’ credit card information should comply with the Payment Card Industry Data Security Standard (PCI DSS). It requires maintenance of a secure environment, including data encryption, firewalls, anti-virus protection, as well as other requirements. More information is available on the ADA’s Center for Professional Success.
A dental practice that does not comply may be subject to financial penalties and be vulnerable to payment card data breaches. Dental practices that accept credit and debit cards should review their credit card service provider agreements and review their network security requirements for their individual situations.
Generally speaking, the best way to manage accounts receivable is to issue and mail weekly statements to all patients with balances on their accounts; this would include those who have a balance due following payment of a dental benefit. Each statement should include a due date. Past due statements should include a tactful message letting the patient know that his or her account is in arrears.
Accounts that are more than 30 days past due require extra attention. In these cases, the best approach is to have your financial coordinator, business administrator or office manager contact the patient by phone to request payment. No one likes to make — or receive — this type of call. But this approach usually works well because patients are talking with someone they’ve met and connected with in person. One of the ways to make this phone call more successful is to be proactive. Inform the patient who is establishing a payment plan how you handle the balance in the event that the expected payment does not arrive as planned. Let the patient know that a phone call will be made five days after payment is due.
