It's only an estimate, so make it as accurate as possible

Are you looking for a more accurate way to accommodate the difference that the insurance company calculates for posterior composites? What about the fact that perio maintenance is in the perio category but is usually paid at 100%? Would you like to be able to give your patients a more accurate out-of-pocket estimate? If so, then using the Payment Table will make you very happy. 

The Payment Table overrides the Coverage Table so it is perfect for those procedure codes that fall outside of the default coverage table. Here are some examples:

• Posterior Composite Downgrades – most insurance companies do not pay for composite fillings placed in molars, but they will pay for the equivalent of an amalgam filling. For example, you would take the fee for the D2140 (1 surface posterior amalgam code) and multiply this fee by the coverage %. Then in the Payment Table you would enter the D2391 (1 surface posterior composite code) and enter the fee you just calculated. This amount will override the coverage % and give your patient a more accurate estimate. I have seen some offices create a little “cheat sheet” in Microsoft Word for all the downgrade coverage and save it to the desktop for easy access.
• Nightguards (D9940) – they are located in the Adjunctive category, which is typically covered at 80%. However, in my experience with nightguards, they are usually paid at 50% or 0%. 
• Perio Maintenance (D4910) – this code is in the periodontal category which is typically covered at 80%. However, the D4910 Perio Maintenance is usually covered at 100% like a prophy.
• Crown Lengthening (D4249) – this code is also in the periodontal category. However, in my experience, it is covered at the same percentage as a crown (50%).
• Onlays – In the Dentrix default categories in the Coverage Table, they have onlays grouped in with the Basic Restorative at 80%. However, onlays are covered just like a crown at 50%. Instead of moving around your coverage table groupings, you can just add onlays to the Payment Table.

The Payment Table can be updated manually by going to the patient’s family file or the Office Manager > Maintenance > Reference > Insurance Maintenance and clicking on the Payment Table, or you can update the Payment Table while entering in insurance payments. If you are using the Fee Schedule Method and attaching fee schedules to the insurance plans, do not use the update payment table during insurance payment entry for your contracted plans unless it is one of the exceptions listed above. Only update the payment table during insurance payments for insurance companies with which you are not contracted. 

If you are unsure if you are using the Fee Schedule Method or you want more information on fee schedules, click below to read more on fee schedules.

Fee Schedules, the method of choice for PPO plans

Fee Schedules - your questions answered

Dayna Johnson, Certified Dentrix Trainer

Dayna loves her work. She has over 25 years of experience in the dental industry, and she’s passionate about building efficient, consistent, and secure practice management systems. Dayna knows that your entire day revolves around your practice management software—the better you learn to use it, the more productive and stress-free your office will be. In 2016, Dayna founded Novonee ™, The Premier Dentrix Community, to help cultivate Dentrix super-users all over the country. Learn more from Dayna at www.novonee.com and contact Dayna at dayna@novonee.com.

Get the info out of your head and into the computer

When you have worked in the same dental practice for many years, you have a tendency to store a lot of information in your head, right? I find that is especially true when it comes to your accounts receivable. Being a financial coordinator in the practice, it is your responsibility to know the status of the accounts … but so often when I am teaching on collections, I hear, “Oh, I just know this family is making payments” or “The doctor said it was OK for him to make payments”. What if this information was in your practice management software so you could easily manage it? What if this information was in your practice management software so you, the financial coordinator, could take a vacation and not worry about someone else managing the accounts receivable while you were gone? What if your patient’s billing statement reflected his or her agreed payment arrangement? This can all be a reality.

Using the Dentrix Payment Agreement feature allows you to get the information out of your head and into your practice management system where it belongs. If your office accepts payments (even if your office does not accept payments, patients often slip into a payment plan out of necessity), this information will streamline your collections.

Entering in the payment agreements into Dentrix will help you manage your accounts in three huge ways.

1. If you have read my articles about patient collections, you know that I use the Collection Manager Report for managing accounts receivable. This report allows you to enter columns of information that will show you Payment Agreement Balance, Payment Agreement Amount Due, and # of missed payments. Having this information at your fingertips can be extremely helpful on this report because you don’t have to do any research about the account balance. You can see that the patient is on a payment plan and if he or she is current with payments. Read More . . . on the Collection Manager Report.
2. When you create a Payment Agreement, it will light up the Payment Agreement Summary section on the Ledger so anyone who opens the ledger will see that the account is on a payment plan and the status of the payments. If there are missed payments, this will show up in red in the Past Due section. This will be extremely helpful if the financial coordinator is on vacation and relying on other team members to collect money at the time of service or field phone calls.
3. When you send billing statements, if you have entered in the Payment Agreement, it will accurately reflect the amount due from the family. The billing statement will show the total account balance and, in the PLEASE PAY THIS AMOUNT box, it will show the agreed payment amount. Also, if the patient has missed a payment, the billing statement will show a past due amount at the top of the statement to draw attention to this missed payment. If you are not using this feature, you might be writing on the statement, which takes more time out of your schedule.

 

Use the features that Dentrix has to offer. Get the information out of your head and into the computer. Let the computer do the work for you and free yourself from being the keeper of information. I realize that being the keeper of the information might sound like job security, but it holds you back from pursuing other adventures like going on vacation, taking on new roles in the practice, or training new employees.

Dayna Johnson, Certified Dentrix Trainer

Dayna loves her work. She has over 25 years of experience in the dental industry, and she’s passionate about building efficient, consistent, and secure practice management systems. Dayna knows that your entire day revolves around your practice management software—the better you learn to use it, the more productive and stress-free your office will be. In 2016, Dayna founded Novonee ™, The Premier Dentrix Community, to help cultivate Dentrix super-users all over the country. Learn more from Dayna at www.novonee.com and contact Dayna at dayna@novonee.com.

Top 5 reports every doctor should look at

I received an e-mail from a doctor the other day who had a situation that needed attention. Her clinical team had started posting procedures in the patient chart and had accidently posted a root canal as “complete” rather than “existing.” The root canal was not only posted to the patient’s ledger, but it was also sent electronically to the insurance company and paid. The patient called concerned about the EOB that he received and wondering why the office had billed his insurance company for a root canal he never had. When the doctor asked me what kind of safeguards she could put into place for her clinical team, my response was that this issue was an administrative boo-boo, not a clinical mistake.

As the doctor in the practice, I understand that you went to dental school to create beautiful smiles and improve the health of your patients. However, you are still a business owner and knowing what is going on in your business is certainly worth your time.

With that in mind, here are my five most critical reports every doctor should look at . . .

1. The Daysheet - If the doctor in the above story had looked at the daysheet, she would have noticed that the root canal was incorrectly billed out and it never would have been sent to the insurance company. Also, the clinical team can see if something was missed, such as X-rays, pulp caps, and buildups. The daysheet can be run from the Office Manager > Reports > Management > Day Sheet.
2. Audit Trail Report - This report is for your eyes only. You should have user IDs and passwords enabled in your practice. In the security rights, make sure you are the only person on your team who can access this report. My recommendation would be to look at this report on a monthly basis for any red flags such as <Deleted items> or <Initial Entry, Date Changed>. These entries would then require you to do a little more research or ask the team member who made the entries.
3. Adjustment Report – If your cash flow is not as it should be, this would be one of the first places I would look. See where the adjustments are being made. There are two adjustment reports you can run … one is by category and one is with patient names. The report by category can be run from the Office Manager > Management > Practice Analysis Reports > select your date range, Adjustment Summary and click OK. To run an adjustment report with patient names, go to the Office Manager > Reports > Management > Day Sheet, then select your date range, Adjustment Only Day sheet and click OK.
4. Provider A/R Totals Report – This report will show you your gross production, adjustments to production, net production, gross collection, adjustments to collection, net collection, and accounts receivable. If I was a business owner (oh right, I am J), I would want to know what is owed to me and what my net numbers are. You can find this report on the Office Manager > Reports > Management > Provider A/R totals report.
5. Collection Manager Report – I received an e-mail from a doctor last week in a state of panic because her front office team member had left abruptly and the office was receiving calls from patients about their balances and also receiving complaints that they had not received a statement. The Collection Manager Report is my favorite report in Dentrix and also a great, quick spreadsheet for the doctor to see what is going on with his or her accounts receivable. Go to the Office Manager > Analysis > Collection Manager, then select your parameters. Also, click on the Show Columns button and make sure you add in the Last Statement Date column so you can see if your patients are receiving billing statements in a timely manner. For more information on this report, CLICK HERE.

It is so very important that you stay informed about what is going on in your business. After all, it’s your livelihood.

Dayna Johnson, Certified Dentrix Trainer

Dayna loves her work. She has over 25 years of experience in the dental industry, and she’s passionate about building efficient, consistent, and secure practice management systems. Dayna knows that your entire day revolves around your practice management software—the better you learn to use it, the more productive and stress-free your office will be. In 2016, Dayna founded Novonee ™, The Premier Dentrix Community, to help cultivate Dentrix super-users all over the country. Learn more from Dayna at www.novonee.com and contact Dayna at dayna@novonee.com.