Archive for the ‘Insurance’ Category

Do You Have a Disaster Plan?

Sunday, May 20th, 2018

Guest post by Dawn Christodoulou, President/Owner of XLDent

Every day, news reports show us the devastation that can be brought to any doorstep by Mother Nature or other unplanned situation. Our best defense against this is to ask ourselves, what is our plan if such a thing were to happen to our dental practice?disaster plan checklist (002)

Your answer should be a disaster plan. This is something that should be in writing, reviewed at least annually, naming a specific person (such as your Office Manager or another person) entrusted with following the practice owner’s wishes, bringing some semblance of order to the chaos to come.

There are many examples of disaster that can throw your practice into a tailspin.

Fire, flood, or other natural disaster:

  1. Make sure dental staff members are accounted for and safe. Have a designated staff member (and a back-up person) activate your prepared, written Emergency Action Plan with appropriate contact information for the office team and patients.
  2. If you are aiding in the cleanup process, be sure to wear appropriate personal protective equipment (PPE) to protect against water-borne illnesses and aspiration of materials.
  3. If possible, make arrangements to pay staff right away to help them cover basic needs for food, shelter, and any medical treatment they may need.

Theft or embezzlement:

  1. Review protocols surrounding passwords and security. Every staff member should have their own login credential assigned and known only to them. For example, XLDent practice management software recommends security groups which clearly identify staff members and access permissions.
  2. Review security logs. This is where you will find record of every transaction performed for each staff member’s login. It’s good practice to periodically review these for inconsistencies.

Unexpected illness or death:

  1. Make sure Standard Operating Procedures are written and up-to-date. They may be needed in the event a staff member’s duties are to be completed by another member or even by a temporary replacement hired from an outside agency. Be familiar with local dental staffing agencies that may be a resource for temporary administrative and clinical employees.
  2. Know who is designated to handle the estate of the doctor and if there is a document (such as a will) to provide a path for transfer of ownership.

One area not yet discussed is your practice data. Your disaster plan should include a data recovery section. Data recovery is critical to keep your business going after a disaster event has occurred. In many of the examples, office computers and equipment may be damaged or lost. Knowing your data is safe and secure is peace of mind you don’t want to risk. A reliable managed data backup option is XLDent’s XLBackup.

In all cases, remember your best bet is to be prepared. With a proper disaster plan, an unplanned sequence of events can quickly be turned into a planned response for you and your team.

To connect with XLDent, call 800-328-2925 or email xldentinfo@xldent.comDawn

Dawn Christodoulou is the President/Owner of XLDent. She has more than 25 years of experience computerizing dental offices and helping both new and established practices streamline electronic workflows for increased efficiency, improve patient engagement, and achieve maximum profitability. Dawn is also a member of ADA SCDI Working Groups 11.1 Standard Clinical Architecture and 11.9 Core Reference Data Set.

Collections and Your Practice: Success with Patients and Insurance Companies

Tuesday, March 20th, 2018

Guest post by Dawn Christodoulou, President/Owner of XLDent

Practice collections have started the trend towards a steady drop in what dentists are collecting for their work. Without a thorough understanding of insurance benefits and collection policies, paired with a good communication strategy, the ripple-effect on staff morale and productivity can exacerbate this decline.

Insurance Collections

Submitted claims is a first step to insurance collections. If weeks pass before anyone confirms that claims were received and being processed, that time has been lost. Insurance carriers do not make a habit of contacting dental practices to let them know if additional critical information or documentation is needed. Electronic claim services embedded in a practice management software are your first line of defense. For example, in XLDent, with one-click, claim status tracks claims instantly; easily avoiding costly delays.

Fee Schedules XLDent.TND.Blog.Electronic.Claims.Status.3.21.18.jgep (002)are a critical part of making sure your office is making accurate contractual adjustments. EOBs are not always the easiest to decipher, especially for staff with little or no experience with insurance billing. Ensure your team is prepared with payer contract details and fee schedule information so they can post accurate adjustments. Patients will appreciate attention to this detail too, so that your treatment plan estimates are as close to accurate as they can be.

Patient Collections

Every practice should have a written financial policy that lays out the terms involved with insurance processing – what is filed, by whom, and where the responsibilities lie. Payer structures and guidelines can change, so review this policy annually, and adjust it as needed. Any changes should require an updated review and signature from your patients.

It’s no surprise that Standard Operating Procedures (SOPs) guide your practice through critical business processes, and collections are no exception. Establish a collection’s timeline, which includes number and frequency of communications, and consequences for non-payment. Practice administrators should adhere to them, but not without exception. Administrator’s should bring any individual patient concerns or circumstances that need review to the practice owner for further discussion.

Think about how patients want to interact with your practice nowadays, including making payments. XLPortal is a comprehensive solution allowing patients to not only make payments online, but also verify and update medical forms before an appointment, view upcoming treatment plans, and more. Convenience can often be a compelling factor in getting that payment sooner rather than later.

The best way to tackle collections head on is to start with the basics. There is always an opportunity to turn declining collections around, and practices just starting out should strive to establish successful procedures from the start.

To connect with XLDent, call 800-328-2925 or email xldentinfo@xldent.comDawn

Dawn Christodoulou is the President/Owner of XLDent. She has more than 25 years of experience computerizing dental offices and helping both new and established practices streamline electronic workflows for increased efficiency, improve patient engagement, and achieve maximum profitability. Dawn is also a member of ADA SCDI Working Groups 11.1 Standard Clinical Architecture and 11.9 Core Reference Data Set.

Insurance “Coupons” Put Patients in the Chair

Wednesday, July 15th, 2015

Coupon use is growing. According to an analysis by The Neilsen Company, “more affluent households dominate coupon usage: 38% of ‘super heavy’ users and 41% of ‘enthusiasts’ come from households with incomes greater than $70,000. Households with incomes of $100,000 and up were the primary drivers of coupon growth…”

So, what does this have to do with dentistry? It is a reminder that attitudes toward money – specifically spending and saving – have changed significantly in recent years. Moreover, those most tuned into the value of the dollar – the better educated, higher income households – are also those most likely to understand the importance and value of your dental care.

However, as consumer savvy as this population may be, the majority of them don’t realize that they are likely losing $500, $250, $700 in your office. How? Many, many patients have dental insurance plans with unused benefits that are poised to go to waste come year’s end.

Dental insurance companies make millions of dollars off of patients who never use their insurance benefits because unbeknownst to the consumer, many of these plans provide coverage up to a certain dollar amount annually. Insurance companies aren’t going to encourage customers to use benefits, and it is rare that patients actually know what they have left in benefits. Most are too busy to sift through their policies to determine what might remain on them, which makes informing them about the benefit an excellent win-win opportunity for patients and dental practices.

Take these steps:

1.  Generate an “unscheduled treatment plan report.”
2.  Identify those patients who still have unused insurance benefits.
3.  Prepare and send a special letter to each patient.  ( I have templates for this if you or your office needs assistance)
4. Add a P.S. that says, “Take your insurance dollars further with interest-free patient financing. Ask ‘Jessica’ in my office for all the details.”

I can virtually guarantee that every patient you notify will thank you for calling this to their attention. Whether they take advantage of the opportunity or not, they will appreciate the fact that you took the time to educate them on this important insurance detail.

 

 

No Need to Fear Insurance

Monday, July 1st, 2013

Many dentists starting out in their careers fear that their practice will be dependent on insurance. Insurance is largely demographic driven. However, in this these economic times, taking insurance, at least a few of the better plans, is an excellent way to quickly build a solid patient base. The practice can still be primarily fee-for-service, but it is important that the new dentist make an informed decision based on demographic information about the community.

 

Making insurance work for the new practice requires that it be treated as you would any other practice payment system. Co-pays and deductibles should be collected from the patient at the time of service. Additionally, once a year the fee schedules must be updated for each preferred provider organization that the office is affiliated with. If the fee schedules are not updated in the practice’s computer system, over time the practice is billing the insurance provider for less than what it could be. For example, XYZ PPO had an exam reimbursement rate of $55 in 2012, but in 2013 that rate was increased to $60. Yet a practice will continue billing the insurance for only $55 because the business team hasn’t updated the fee schedule, the years go by, the fee schedules change, and the practice loses money it can never recoup.

In or Out of Network

Thursday, January 3rd, 2013

When it comes to insurance, oftentimes you will hear the terms “in-network” or “out-of-network.” Dentists who are “in-network” have agreed to a personal contract with a benefit plan. These contracts have restrictions and requirements and usually dictate adherence to a reduced fee schedule. Therefore, patients who chose an “in-network” dentist typically will pay less of their own money toward treatment than those who choose an “out-of-network” dentist. In addition, an “in-network” dentist usually is paid directly from the insurer and payment is sent to the office.

 

An “out-of-network” dentist has not signed a contract with the insurer of a particular plan. However, patients may still choose that dentist and have some of their fees covered, but they may pay more out of pocket. Also, plan payment checks are usually sent to the patient, not the dentist. The plan pays the patient, and then the patient pays the dentist. Or the patient pays the dentist and is later reimbursed by the plan.

 

A dentist who decides to become “in-network” may choose to do so because a large population of patients are on the plan, because s/he likes the security of receiving payment checks directly, or because the fee schedule seems fair. A dentist may decide to stay “out-of-network” because a smaller population of patients uses a particular plan. The dentists may be content with patients receiving payment checks. Or s/he may not be comfortable with the fee schedule. Be sure you have a very clear understanding of what specifically is dictated in the contract before becoming an “in-network” dentist.