Tuesday, October 29, 2013

Throw a party with those unclaimed credit balances . . . not so fast

There is so much going on in the dental office in the fall. In September, I got my letter off to all my patients who have a treatment plan and still have unused insurance benefits. Did you? If not, CLICK HERE to point you in the right direction. This month, we have already started looking ahead to 2014 and planning out our office goals (CLICK HERE for more information on goal setting in Dentrix). Then, just this week, I sent off my annual check to the Department of Revenue for those credit balances for patients I cannot locate. What? You don’t know what the heck I am talking about? Every state has a law regarding what to do with unclaimed money. Check your state’s Department of Revenue website to find out the steps to take in order to be compliant with this rule. Since I live in Washington state, I am going to use that state’s information for today’s blog.

Let’s start from the beginning. Each July, I print a credit balance only Aging Report (this is the only time I ever print an Aging Report). The best policy is to take care of patient credit balances when they happen by applying them to the next visit, encouraging the patient to schedule treatment, or writing the patient a refund check. However, there are times when patients end up with a credit balance and you have attempted to reach them without success. In the state of Washington, these patients must receive a letter of due diligence by August 1. I created this letter in Quick Letters so it would merge in the patient’s information and balance.

After you have sent the patient a letter informing him or her of the credit balance and the date by which it needs to be collected, go through your credit balance report again and mark any patient you are going to send to the Department of Revenue, then total it up and write one hopefully not too big check. On each patient ledger, make an adjustment (I created an adjustment type called Sent to Dept of Revenue) to their account to bring their account to zero, change their billing type (I created one called Sent to Department of Revenue), then make sure their account is inactivated or archived. I created a billing type to get a report on all the accounts I have sent to the Department of Revenue and I don’t have to remember all the names.

This check to the Department of Revenue must be sent in by November 1 (state of Washington requirement). I adjust all the patient accounts on the same day, then run an Adjustment Only Daysheet to get the list of names. Next, I print a Patient List for each patient individually to send with the check. This will give the Department of Revenue the information needed to put on their unclaimed property website. To print this Patient List, go to the Office Manager > Lists > Patient List > then select each patient individually.

For those of you reading from the state of Washington, go to http://ucp.dor.wa.gov and click on “You are holding unclaimed property, report it to us.” Then click on the Detail Report form, fill out the information, total amount you are sending, and print the form. If you are reading from another state, I would search for Unclaimed Property (state name here).

Tuesday, October 22, 2013

The happy dental hygienist

Do you have a dental hygienist in your practice who navigates through the mouth as she perio charts in a different way than the default?  Would you like to create a perio script that only spot probes for those 6 week checks after SRP?  Then this video is for you.  Watch and learn . . .

Thursday, October 17, 2013

Don't just send it and forget it

I hope you have enjoyed reading all my good tips and tricks on dental insurance over the past few weeks. Insurance is such big issue in most dental practices that I feel it is worth talking about … even if it is not the most exciting topic. There is another piece of managing dental insurance that I want to discuss today and that is managing your pre-estimates. I don’t know if it is because of the economy or if insurance companies are mandating preauthorization’s more these days, but I am noticing more and more offices sending in pre-estimates for treatment. Many of you already know how to send out a pre-estimate for treatment … but don’t just stop there and think that you are finished. Here’s a checklist for better managing your patients’ dental pre-estimates.
  • Create and send the pre-estimate claim form from the patient’s ledger. From the ledger, click on the Treatment Plan page by selecting Options > Treatment Plan. You can define the color of this page so it’s not confused with the actual ledger page. To change the color of this page, go to File > Ledger Colors Setup > then choose your personal color scheme. Once you are on the Treatment Plan page, if the patient has treatment planned procedures on this page, you can simply select the line items and click on the insurance icon to batch the pre-estimate. If there are no treatment planned procedures you can add them from this page by clicking on Transaction > Enter Procedure.  Now you can attach any electronic X-ray or image and also document the clinical narrative in the Remarks for Unusual Service box and this pre-estimate is ready to go out with your next batch of eClaims.

  • Just like you would follow up on unpaid insurance claims, I would suggest checking on unprocessed pre-estimates exactly the same way. Go to your Office Manager > Reports > Ledger > Pre-Treatment Estimate Aging Report. Filling your doctor’s schedule might depend on making sure these pre-estimates are being received in a timely manner. (insert image)

  • When the Pre-Treatment EOB is sent to your office showing the itemized approval of the procedures, you will want to enter the pre-estimate just like you would a payment on an actual claim. Go to the Ledger > Options > Treatment Plan to switch to the Treatment Plan page (or you can click on the TX icon on the toolbar). Double-click on the claim form and click on Enter Estimate. Now you can itemize each procedure and what the insurance company is going to pay on each line item and document the reference number for this pre-estimate. It is important to receive your pre-estimates just like an actual claim because it will give you a more accurate out-of-pocket for your patient. Remember, it clears it off the aging report and closes it on the ledger.

  • If you have finished this last step, the patient has completed the treatment, and you are now creating an actual insurance claim, it will automatically insert the Pre-Treatment Estimate reference number onto the actual claim so you don’t have to look it up. Pretty slick, huh?

I hope this little nugget of information will help you better manage your patient’s treatment plans and pre-treatment estimates and keep your doctor’s schedule full and productive.

Wednesday, October 9, 2013

For the insurance bulldog in the office

Being a Financial Coordinator in a dental practice is a huge responsibility. It requires you to wear many hats including collection call expert, insurance bulldog, treatment plan closer, and bonus plan motivator. What I love about Dentrix is that you can manage all these responsibilities within your practice management software. However, the one task that I see get pushed to the side the most is managing the insurance money.  

Many offices reach out to me, asking me to help them use Dentrix to its fullest potential … and one of the reports I always check during my assessment is the Insurance Aging Report. This report is one of the best tools available for you to check on past due insurance claims and it should be part of your regular weekly management routine. The only unfortunate thing about this report is that you have to print it … and you know how I feel about paper reports (yuk!).

Here are some best practice tips for you to streamline the process of working this report:
  • If the patient has dual insurance and the primary pays in full, make sure you create the secondary and then pay it off with a $0 payment immediately. This will ensure that the secondary claim doesn’t sit on your Insurance Aging Report as an open claim.
  • When you need to check on a past due claim, make sure you are documenting all information or phone conversations in the claim status note box. These notes will print on your Insurance Aging Report for easy follow-up. (image here)
  • If an insurance payment was sent to the patient, make sure you apply a $0 payment on the claim to close it out and make a note in the claim status notes box.
  • If you are using the eCentral Insurance Eligibility feature, you also have access to electronic claim status and the archive of your transmission reports. When you have a DCN (Document Control Number) from the insurance company that they have received the claim, copy and paste this number in the claim status notes. This way, when you are calling on a past due claim, you have that DCN ready and this could prevent you from having to resubmit the claim.

Click below for more blog posts related to the Financial Coordinator’s job description:
Show Me the Money!
Holes in your doctors schedule?
Resubmitting a partial EOB . . . no problem!


Tuesday, October 1, 2013

Five tips on proper coding to insurance

Last week, I attended one of my favorite conferences of the year … the American Association of Dental Office Managers (AADOM) annual meeting. This conference is built specifically for office managers and is chock full of course for practice management, leadership, HR, technology, and personal growth. There were more than 600 attendees and the vendor booths spilled out into the hall.

One of the courses I attended was Dr. Charles Blair’s coding class, “Stay out of Jail – Avoid Coding Errors and Excel in Insurance Administration.” Go back to last week’s blog post and you can watch my video interview with Dr. Blair. Today, I want to give you the top five “pearls” I took away from his class.
  1. Code what you do – Even if you know the insurance company is going to downgrade to a lower procedure code, make sure you are billing the insurance company the procedure that you provide to the patient. Your clinical notes and the billing should match.
  2. Biopsy – Bill out the biopsy procedure at the time you receive the report back from the lab, not at the time you take the biopsy.
  3. Crowns prep or seat date? – If you are in-network, you must go by their rules. If you are out of network, you can bill by your rules. Double-check with your insurance contracts. If you can bill at the prep date, then do it. I have always billed crowns out at the prep date (we are out of network for all insurance companies) because this is when we incur the majority of our costs and this is also when I want the patient to pay.
  4. Bill D1110 based on dentition not age – We all know that insurance companies will not pay for an adult prophy until the age of 14, but what if your 11-year-old patient has full dentition? According to Dr. Blair, you would bill out the adult prophy and let the insurance company downgrade it.
  5. D0180 … not just for the periodontist – Many general dentists do not use this code because they believe it can only be used at a specialist office, but this is not so. Your office can use this code for any patient who has risk factors (smoker, diabetic, etc.) and possibly get paid a higher fee. You must also justify using this code with a perio chart.

Dr. Blair is an expert in coding and has many resources from which your office can benefit. My favorite is the Insurance Solutions Newsletter. For more information, visit his website by CLICKING HERE.