Is a paper mentality driving up your A/R in a digital world?

You don't pull out your 70s-vintange typewriter to write a letter to patients. So why do so many practices hold onto a 70s-vintage mentality when it comes to the vital matter of managing Accounts Receivable? Paper claims were the gold standard in the 1970s. When they were, you could have 4-6 weeks of production out at any one time. In the past, consultants have used this number to soothe the wounds of practices who had 100-150% of monthly production out in Total A/R. Even then, it would have been appropriate only in a practice where every patient was an insurance patient. Unless you're a medicaid clinic, this simply isn't the case.

Even today, I still get asked, "Isn't 100-150% of monthly production in A/R okay?" There's not a font large enough for me to answer, "No!".

The clean claims you sent out this past week will be back in 2-3 weeks, max. Likely, your software cleans them up before they get out the door. So, even if you were fully insurance-driven, no more than 50-67% of your monthly production should out in Insurance A/R. Collect the appropriate co-pay at the time of service and the healthy range for Total A/R drops to 20-30% in most practices. Anything higher serves as a barometer that key systems are not working. Why is your A/R higher? The reasons a many. Here are just three insurance-related issues which could possibly be at the root of your problem.

You didn't collect the co-pay because you didn't know what percentage the insurance would pay for the extraction and PA. Perhaps you researched the benefits but didn't get them into your coverage book in time for your treatment plan module to correctly estimate the patient's portion. One patient was checking in when the emergency patient was checking out. There just wasn't enough time to calculate the co-pay by hand. You did research the benefits, didn't you?

You were too busy to verify history for your new patient so you're waiting for insurance to tell you if she has a balance. That logic boils down to this: New Patient, Suzie, will not be happy that she has a balance to settle for preventive services that are normally at 100% in your network, let's at least let her leave happy from her first visit without paying. It will be easier to break the news to her via mail than in person.

You let the first time emergency patient slip to the back without verifying that the insurance was valid. The patient handed you a card. It looked like a new card and the "Eligible From" date was just two months old. What you didn't know was that the patient's father had changed jobs a few weeks earlier and no longer has dental insurance.

The first scenario is a matter of benefits. The second, history. And the third, eligibility.

You don't worry much about it because your Total A/R is at 73% so you don't feel these three matters on Thursday will push your practice over the edge. But your A/R just increase by $750 on Thursday in ways your practice could have avoided. Because this happens in amounts of $200-300 an occurrence, the normal red flags may not go up when you review your monthly Outstanding Accounts by Responsible Party report. But twice every week, 4 weeks a month days like this swell your A/R by $3,000 a month. Much of that money will never be collected. A disproportionate number of the problems facing practices today are exacerbated by dental insurance issues. Why not take 2-3 minutes to self assess the insurance management issues is your practice today? There's not obligation and we won't contact you unless you supply your phone number or email address.

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