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Dental: Billing and Accounts Receivable

With excellent patient care the top priority in today's dentistry practices, industry analysts point out that invoicing and accounts receivable practices just don't get enough attention.

Billing and accounts receivable functions work hand in hand. To keep the receivable column lean, billing systems must be consistent and on the mark. The literature on this subject abounds, and the following strategies represent some of the best the experts have to offer.

Tame the Receivables Column

Start by finding out why patients are behind on payments. In some cases, they may have been unable to cover expensive procedures, such as root canals, bridgework or oral surgery. Once this is resolved, use the following guidelines:

  • Be scrupulous in posting receipts. Record all transactions immediately, even if this means daily attention to the task. Check with responsible personnel frequently to ensure all receivables are posted, including those that fall outside of patient revenues. If staffing is too tight to do this consistently, consider hiring a bookkeeper or accountant.
  • Conduct regular in-depth reviews with accounting personnel. For example, it's smart to compare the practice's collection percentage and average collection period to established benchmarks, as well as to review ending A/R reports. This practice allows identification of positive and negative trends.
  • Purchase or update accounting software. The right programs will effectively track billing and receivables, which makes a huge difference in the bottom line. Many easy-to-use products on today's market enable almost any employee to keep accurate records. When implementing a new system, participate in any training or support program the manufacturer offers.

Collect What's Owed

An efficient collection system begins by communicating invoice procedures and expectations at the outset. Instruct personnel at the check-out desk to explain payment terms to the patients before they leave the office. After doing this:

  • Require immediate payment. This practice has become almost universal, for good reason. When insurance reimbursement, co-pays and deductibles are in the picture, delayed collection can spawn errors throughout the billing system.
  • Establish a consistent invoicing protocol. Invoices should be complete, with all services dated and itemized. Use a simple format with clear due dates and payment terms. Include contact information should the patient require assistance. Most important, send invoices the same day each month to keep the receivable flow steady.
  • When an account is delinquent, work with the patient to find a solution. Because providing patient care is the mission of any practice, many dental professionals prefer to arrange some sort of payment plan.

    One strategy consists of asking patients to sign an agreement with, for instance, a monthly payment of 10 or 15 percent of the original amount owed. A caution, though: All written and verbal communication concerning this sort of situation should be clear, friendly and non-threatening.

  • Fully document, track and back up telephone calls, correspondence and e-mails attempting to arrange payment on delinquent accounts. This includes a patient's promise - or refusal to pay.

Finally, when nothing else works, get tough. Sometimes, delinquent patients ignore telephone calls, polite letters and all attempts to resolve the problem for weeks, months and longer. The practice may have no other alternative than to turn matters over to a collection agency.

The procedure for this distasteful chore typically involves flagging offenders as "cash only" patients for subsequent visits, thus allowing them to continue care without further risk to the practice.

If delinquency continues, the practice may give a notice period (10 days, for example) before discontinuing services. When the outstanding sum is significant, small claims court can be an option.

For patients truly in need, however, practitioners may try extending payment terms, especially when the individual is trying to meet obligations.