Roger P. Levin, DDS
Author's note: Since 1985, more than 25,000 dentists and specialists have relied on Levin Group's systems to increase their production, while lowering their stress. For more information, go to levingroup.com.
Often, dentists turning to Levin Group for practice management expertise tell us that, although they are busy, profits and doctor income remain disappointingly low. How can they improve these numbers without putting in more hours every week?
One problem-consistently identified by Levin Group business analysts and our consultants-stems from the lack of an effective collections system. Other major systems, such as scheduling and marketing, can also play a major role in this frustrating scenario, but a poor collection rate can still undermine everything.
There's no reason to settle for anything less than a 99% collection rate. If your practice falls short of this number (as most offices do if their collections system is poorly conceived, not used properly, or obsolete), you're letting a substantial amount of potential income slip through your fingers. Even successful practices could be much more successful if only they had a better track record for getting paid what they're owed.
The first step toward improving collections is to accept the fact that your practice really can attain a 99% collection rate. Many of the doctors and teams we work with sincerely believe they're doing everything possible to manage overdue accounts . . . until we introduce and train them in the use of more effective protocols. Here are some guidelines for improving collections.
There's no substitute for the advice and training that can be provided by practice management experts, but you can begin moving in the right direction if you try to follow these basic recommendations:
• Formulate, document, and implement strict payment policies. Working with your financial coordinator, define patient obligations regarding payment for services provided. These should be written out in plain language so that when you put these policies in effect, there's no confusion or room for interpretation.
• Generate scripting for communicating payment policies to patients. In our experience at Levin Group, many staff members feel uneasy discussing financial matters with patients. Knowing how important customer service has become and trying to build positive practice-patient relationships, your staff may have trouble finding the right words to inform patients about your policies. Scripting solves this problem, providing the right talking points for this delicate conversation.
• Tighten up your process for submitting insurance claims. Not all collections problems relate directly to patients. Although insurance companies are not likely to avoid reimbursing you altogether, they can delay the process significantly, creating cash-flow problems and consuming staff time that could be used more productively. Preparing, double-checking, and submitting claims every day, flagging accounts when they're just one day overdue, and other techniques can keep this part of your collections system operating smoothly.
• Offer payment options to appeal to all patients. Some people prefer paying cash for goods and services. A few still like writing a check. And many use credit or debit cards for almost all transactions. Your office should accommodate all such preferences. For larger expenditures, your patients may respond to the opportunity to earn a discount by paying the entire fee upfront. Another option for larger cases is providing outside financing by a trusted vendor such as CareCredit. This not only entirely eliminates the challenge of collecting but can also improve your case acceptance rate.
• Collect what patients owe when they arrive for appointments. Make it clear to all patients (with both scripting and front desk signage) that initial payments and copays must be paid before they are seen by you or the hygienist. If their accounts are past due, the front desk coordinator-alerted at the morning meeting and trained with scripting-can raise the issue face-to-face.
• Set specific times and targets for collections activities. Contacting patients who owe the practice money can easily be pushed aside by other, less unpleasant tasks. Based on the volume of overdues, staff members should be scheduled to pursue specific daily, weekly, and monthly targets (e.g., number of patients called, amount collected). Make this an absolute priority.
• Design a collection process based on the Rule of Threes. When contacting patients who owe the practice money, time is of the essence. The longer a bill remains unpaid, the less likely you are to collect. For this reason, you should initiate a nine-week process consisting of three weekly phone calls (starting the first day payment is past due), followed by three weekly emails, and finally three letters. This approach works in all but the most difficult cases.
If your collections systems aren't consistently maintaining a 99% success rate, you're losing money unnecessarily. For the most effective, longest-lasting solution, call in practice management experts. Meanwhile, these recommendations should help you increase earnings, not hours.
Roger P. Levin, DDS, is the founder and CEO of Levin Group Inc., a leading dental consulting firm. A nationally recognized speaker, Dr. Levin presents practice management seminars throughout the country.