Improving Collections with Dental Insurance Patients

Dental insurance has become commonplace in most practices today. Dentists who formerly debated whether they should accept insurance now focus on which plans to accept and how to achieve sufficient revenues in spite of low (and decreasing) reimbursements from insurance companies.

One aspect of dealing successfully with dental insurance is collections. In order to maximize income from patients with insurance, your practice should address two areas: claim submission, and the collection of co-pays and other out-of-pocket fees from insured patients.

Create an Efficient System for Submitting Insurance Claims

Many practices suffer financially from inefficiencies in the submission of insurance claims. Although revenues you have earned are seldom lost entirely due to inadequate systems, practice cash flow can be impaired significantly and costs associated with collections can cut deeply into income… not to mention the stress caused by having to go back and forth with insurance companies. There are several techniques for improving insurance collections:

• Submit claims daily. It may seem more efficient to “save up” claims for several days before submitting them, but every day lost this way has a negative impact on your financial situation.

• Have two staff members review claims before submission. A clerical error on your end will cause a claim to bounce back for resubmission, delaying payment by a considerable amount of time. Once the staff member responsible for filing claims has completed the necessary forms, a second team member should review them for accuracy.

• Contact the insurance company if reimbursements are one day late. There’s no reason to be lax when it comes to collecting from insurers. At the first sign of delay, contact them to (a) see if there’s a problem holding up payment, so you can fix it quickly, and (b) send the message that you will not tolerate a failure on their part to perform as agreed.

Establish and Enforce Clear Payment Policies for Patients

Even insured patients must often pay the practice directly, out of pocket, whether for co-pays or for fees not covered by their insurance. Make sure all patients understand that such payments are due at the time of service. If these obligations are not met, be prepared to initiate a “Rule of Three” collection effort—a reminder phone call once a week for three weeks, followed by an email a week for three weeks, and then a letter a week for three weeks. Few patients will withhold payment throughout this process.

With systems in place to bring about timely collection of monies owed to your practice on the part of both insurance companies and insured patients, you’ll be able to keep the cash flowing and the stress levels down.