Chances are, your accounts receivable (AR) is not dialed in. Kiera provides very tactical, specific tips on how to get your AR cleaned up and start bringing in money you’ve already earned.
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Hello, Dental A Team listeners. This is Kiera and today is a very important topic But one the people like my rat rat rat, but guess what my rat rat rat is gonna make you a lot of money So I hope you're excited for it. So we'll take that rat rat rat into kaching Because it's dentistry party done and we're just gonna like help you out. I hope you guys enjoy hanging out with me This is my like nerdy geeky side that definitely loves and obsesses of being able to help you guys and it's been so fun I'm working with some people and teaching them about this and
getting them excited on how they can fix their AR ? is something that just like really, really lights my fire because doctors, you do the freaking dentistry, get paid for it. Can I get an amen out there? Like seriously, you do the dentistry and AR and making sure you're paid is something that I am so obsessed about. So, and this doesn't mean doctors, have to do it yourself. So I want us to get into the AR like the womp, womp, womp, it's annoying, but guess what? These are billing tips that work that are gonna make you a lot of money for work that you've already done.
This is like people like, Kiera, how can I make more money and not do more work? And I'm like, just take the money, the what you've already done. it's crazy. lot of people come in and like, Kiera, you're really going to be able to like, ? give us an ROI on your consulting. And I'm like, time. Why? Because I know your AR is out of control. have yet to meet a practice that has perfect AR. And if you are the practice email me, I'm going to give you a freaking shirt and we don't get out done on a team shirts anymore. So yeah, you should definitely email us. ? there are a couple of practices out there.
But most the time, AR is something that is not dialed in. It does not have a plan. And this is something that is going to be very tactical for you. So first step is AR. What is AR? It's the accounts receivable. Okay. And there's two parts to it. AR has the patient portion and the insurance portion. Okay. So when we do dentistry, we need to make sure we collect money and we bill insurance and then we make sure that we get paid for that. Now, insurance is such a sneaky little game and I get so annoyed by it I love to teach people this.
So we need to have it where there's like a few processes that make AR really good. So we're gonna break it down very simply. Number one, good information in means good clean claims going out. I'm always like, we send clean claims. Clean claims mean, clean claims, clean claims. Clean claims, clean claims. ? Clean claims. I'm gonna giggle saying it. I can hear the little jingle in my voice. Clean claims means that we...
have the correct information. So I've got the patient's name, the date of birth, the insurance information. That's all correct. I've got the group number and please for the love of everything, holy, do not make a million group numbers. Do not do that. Make sure AR are so messy and your insurance box is so messy. We just have it. We also need to have fee schedules that are up to date every single year. Please do that. We need to attach it. We do not want write-offs. So what this means, ? also another like, it's not a pet peeve. It's just like,
Oh, I'm sorry. You need to like listen to the podcast and implement this. Stop reporting to me your fees in gross numbers and do it in net. So many times I get on calls with people and they're like, Kiera, we produced like 2 million, but we collected one. And I'm like, ouch. And they're like, well, like our net was like, you know, 1.2. I'm like, so tell me you produce 1.2. Let's live in real land numbers, not the 2 million. Cause you're always going to be mad at me. They're like, well, I produced 2 million, but I'm only making a million. Well, yeah.
Because guess what? You didn't really produce two million. I know you want to say you did, but guess what? Insurance is what really is paying you. So we've got to do that. And I know you don't want to, but when you will do this and you attach the correct fee schedules to it, you are actually going be able to predict your numbers better and your money and your finances are going to get better on your personal side too. So hear me out. It was the worst day. was worse than Christmas getting a lump of coal. I took our production and it dropped us by 30%. And guess what? My goals are to produce 20 grand in a five out practice per day. You want to know how hard that was? I was like, I'm never going to make it.
But guess what? Because I was reporting in real numbers, me even as a TC and an O.M. we were able to schedule more correctly and get us to the actual 15 grand of true 15, 20 grand per day of true production that we were collecting. How much do think my business grew? ? a lot because we were actually producing incorrect numbers, not inflated numbers. So clean claims. We're back to that clean claims mean we've got correct information. We've got the correct ? all of the information is correct.
We've got our insurance verification done and we've got the fee schedules attached. So then when I'm giving an estimate, I'm estimating to the best of my ability. We do not send pre-Ds. I call them pre-denials. You can have your own opinion, but I really truly do not like pre-denials. They take time, they waste energy. And to me, guess what? I got the best information. I'm a thousand dollars. I'm an insurance coupon. I need to be a dang good treatment coordinator that's able to communicate this. And if the patient owes money, guess what? We've got to be really good at communicating that too. This is our best estimate.
I'm gonna do my absolute best. We called your insurance company. I've got the best insurance verification. This is the absolute best I can get today. We're gonna take care of that. And on the flip side, hey, worst case scenario is you're gonna owe this much out of pocket. Tell them that. Then they're not mad at you when you call them. like, hey, insurance didn't pay as much as we thought. But remember, worst case scenario, this is what it is. And I can work with you to get that collected, okay? So then from there, we make sure we have correct documentation as well. We need to attach the correct narratives.
? insurance or excuse me, x-rays, intra-orals, whatever we need to get that paid. Insurance companies are obsessed with not paying for you, but it's because they play the game. So just figure out the rules of the game. We have our fee schedules in there. We send the correct documentation and we send it out every day and we check to make sure none of these claims get stuck in our claim sender. Okay, so we wanna make sure it goes through the clearing house. It doesn't get stuck there. I feel like that's like the post office for claims. We send it through and we make sure all of them get pushed through to the insurance company.
and then we follow up. And now this is where I need owners of each of them. So we need somebody to make sure that all of our intake process is correct. We need someone to make sure that our, what we send out in our claims is correct. And we tell the clinical team what we need for every single claim. And then from there, we have one person who owns our billing department. AR needs to have a clear owner. Who is our billing person that works on this every single day? Yes, you heard me. Because the goal is to get our claims paid within 30 days. You can do it. It's doable, but you gotta have a process.
So that person then their job is I recommend we run the AR list at the beginning of every single month. Then we put it into an Excel spreadsheet or however you want to do it. I found that it's easiest in Excel and then we have it color coded. And I like it to be broken down so that way the biller, their goal is to get through every single patient. Yes. And I have seen 2,500 patients, 7,500 patients. Like it is amazing how many like line items we can get. Hopefully you're more like the 500 to 700 patients on that AR list.
Then what we do from there is we've got patient portion and insurance portion. And what we want to do is we want to actually get this really, really dialed in to where we are collecting at time of service, the patient portion. My hope is that your patient portion that's due is very minimal. And the only time we have a patient portion due is because insurance didn't pay as much as we expected them to. So we got to go collect. We've already collected the money before they go out. Please, for the love of everything, holy do not let your patients just be like, I'll pay you with an insurance pays. Absolutely not.
collect the money today. It is much easier to collect today and give a refund than it is to go chase money. I'd rather you get paid today, wait on insurance. That's fine. But be like, hey, we call your insurance. We estimate really, really well. This is how much we're going to collect today. And then, hey, if it's good news, great. We're going to be able to get you a refund. And if it's not, then great. We're not going to have to call you and ask for as much in the future. So this is what we're estimating. This is our best estimate. We've called your insurance company. We've done everything we possibly can to make sure it's the best we can. And I guarantee you, we're going to take great care of you.
Collect the money. Then when it comes in, what I like for the biller to do is to look, what did this insurance company actually pay? And then go update your fee schedule to the true numbers, because fee schedules are just very generic, but for your area and your zip code, we actually like, if insurance billers will go through and look at that and be like, on a crown, Delta Dental actually pays $758. You're like, yeah, right here, it's like 500. Okay, so $558, but we had 500 in there.
Go update that so then we collect more accurately throughout the year. If we are really disciplined in this and our insurance biller will do this, your billing gets so much tighter and we have less money in our AR. Then we go through it, we go through every single claim. Now if your insurance is a lot in the AR, because we haven't worked it, you're gonna wanna work with the top pieces first. The most expensive, the biggest accounts, and I work insurance ones, and then I work patient ones. And I also am looking at the 90 days, and then the 60 days, and then the 30 days.
And then the zero, don't even like zero to 30. don't even touch that 30 to 60. Yes. 60 to 90. Yes. Over 90 for sure. I'm going to hit that. So you can sort your listing Excel of the biggest account balances. And we're going to call the insurance. We're going to call the patients because you feel like you made like a lot of progress. Also, we can look down at the bottom. Another thing too, is sometimes there's like $5, $10. If your insurance list is really big and your AR is really large, sometimes I recommend writing like below $10. Now this is your money. It's not mine. So you do what you want to do with it.
Sometimes I do recommend writing that off, but before we do it, we're to want to send statements to everybody, see if we can collect any of that. Then we have a set date where we're just going to write it off and call it bad debt. We're going to fix our processes moving forward. But if you will do this and you follow it and everybody follows it every single week, every single month, your AR is going to get cleaned up. So people are like, but it's so hard. And we have like one person who owns it. And I say like Tuesdays and Thursdays are insurance and Monday, Wednesday, Fridays are patients. And we call our patients and we do our insurance.
and we clean it up and we get the correct fee schedules and we make sure that we're following up consistently. We're hearing, excuse me, what they say on the ? claims. We're hearing what they are denying. Also, just because it's on a claim and they on an EOB and they say, you need to write this off. We do need to be really smart on insurance and we don't just say, we wrote it off. Absolutely not. We double check, we verify why was it written off? What were the reasons for it? Can we resubmit it? Can we get this paid? Is this a patient portion that needs to be paid?
Do not just write it off because the EOB says it was written off. So we do not do that. Then what I also recommend is we often wait till the end of the month. We talk to our billers and they didn't get through all their AR. Office managers should be meeting every single week with their billing coordinator and the biller needs to be reporting. Here's how much AR I've completed. This is where I'm at. This is my plan for the next week. I'm going to get through every single patient this month. Also, we do not just send statements out. People love to do this. I'm very pro.
We call first, we text and then we send a statement. Why not just call them right then and there and be like, hey, Kiera, great news. We got insurance paid, we owe this amount and I can take card when you're ready and get that all cleared up for you. Send them a text with the payment link. Here you go, this is the balance and they will pay it. Send them a statement that has a QR code to pay online. You guys stop having them write checks and send it to the practice. Make it easy, talk to your payment processor. I love Moola for this. They make it so easy for patients to pay and their fees are so low. So if you need it, tell Moola, The Dental A Team, sent you.
They're incredible and they're a great processor for you. But this is where it has to be. And I'm really big on what we need to have our goals be. So I like to make this simple. Our over 90 should be no more. All of our collective AR should be no more than one month's worth of collection. So if you're producing 100,000, there should be no more than 100,000 sitting in AR. you've got more than that, let's fix
the way I like the goals to be is I like it to be it's no more than 15 % is in our 30 to 60. And the reason why is because that's going to be pretty big. Now zero to 30, I don't worry about, but it's 15 % or less in our 30 to 60. Then it's 10 % or less in our 60 to 90 and less than 5 % over in our over 90. We want to make sure that it follows that. So that way you guys are able to, but great. And those are very generic and you can get those lower. The only thing that usually impacts are over 90 are usually payment plans and also ortho.
So if you have those in there, there are ways that we can discuss with you on how to get those out to clean up your AR, but you've got to have this structured. We've got to have this to where people are following it. And we need to get this in every single week and like truly work with our billers. And if offices will follow this, you guys, this is something that is not hard, but it does take discipline and discipline does equal freedom. And doctors, had a doctor and she was just like, Kiera, I'm not making any money. And I was like,
I don't understand because you have so much money in AR and your production's so great, but we're not collecting the money. So step one is we collect. Now, if your AR is also like ballooned out of control, we can fix it and we collect money when they check in and we make sure we collect on the checkout. So this way we're catching both sides of when patients are in the practice. And some people are weird about that. And I'm like, why are you weird about that? We know they have a balance and we're gonna collect it when they check in. Think about going to the doctor's office. So like perfect, they collect money as soon as you check in every single time.
It's not weird for people to do that in healthcare. So let's collect on the intake and let's collect on the outtake when we're giving the treatment plans. These two areas are gonna fix AR and people are like, that's so hard. And I'm like, I would much rather collect money when they're in the practice rather than needing to call them. Also, another mode of thought is I don't ever give more than 1 % of collections in refund checks every single month. So refunds and credits can get really ballooned people are like freaked out about that. Cause maybe like collected too much, which is like,
High five, good. I'm not saying over collect, like, hey, insurance paid more like that's a win. But before we give those refund checks out, those are the ones I'm gonna call first to see, do they have unscheduled treatment? Like, hey, great news, your insurance paid more than we thought. Let's get you scheduled, let's use that credit for this treatment. So it's a great way to fill your schedule too. But hey, if there's a true credit on the account, let's just start writing 1%. So if we're producing 100,000, what's 1 %? You got it, a thousand bucks, okay?
So 1 % of that, we're gonna then write those refund checks back for that month. This way it doesn't hurt your overhead of time. Now watch because there are certain state laws that do require you to give refunds sooner than that. So check your state laws and make sure like whatever it is. There are some new ones that have just come out. So be sure to check that so you're compliant with your state laws. If there's nothing about it, 1 % is usually a pretty good frame of mind. So that was a quick down and dirty and I hope you enjoyed it. But really taking it from clean claims, you're welcome.
to fee schedules being entered in, to submitting claims and making sure they go through, to following up on our insurance, making sure that we're tracking that so everybody knows where our claims are at, what things are going on with that. And then from there, we're gonna make sure that we have ? every single week check in with our biller. And billers know we want 15 % in our 30 to 60, 60 to 90 is 10%, over 90 is no more than 5%, no more than one month's worth of collections total in our AR, and giving back 1 % refunds.
You guys, this is something I obsessed about. This is something we work with billers on. I have a practice in Oklahoma that we worked with. They had 2,700 line items of this and we just worked with our team and we cleaned and we cleaned it and it took us about two years and we were able to get them back into perfect collections, perfect processes. It took a while, but discipline, dedication and setting these things into place now are going to protect you and prevent this from happening in the future. Also, there are some great AI companies that you can use.
? Lassie is a great one that I've heard of. There's a few new ones coming up on the market. So if you need help with it, insurance verification, you can outsource. We have a lot of resources. So if you need any email Hello@TheDentalATeam.com. And if you're like, I need help, I'm drowning, I'm not making money. Let's talk. Profit production guys. it's the way we get more profit. We either increase our production, decrease our spending or increase our collections. Those are the three levers. So whatever those three we need to work on. And sometimes it's so hard because you're like,
But like I'm doing dentistry all day long, Carrie, I have time. You're right. You're supposed to be the dentist and the CEO. Let us train your team for you. That's what we love to do. Work with you and your team. So reach out. Hello@TheDentalATeam.com. Commit to being profitable this year. Commit to getting your AR in place. Commit to following these billing tactics. You guys, it is not hard, but it does require discipline. And we're happy to help you set it up. We're happy to follow through. We're happy to show you how to have the conversations. We're happy to show your team how to do this. We're happy to build KPI scorecards so you can watch it and utilizing analytics for it. So it's never daunting and scary.
It's disciplined dedication and dedicated time to make sure this happens. And usually team members get scared and it feels daunting. So it's kind of like the laundry. just like keep letting it pile up, but doctors, this is your hard earned money. And I don't believe it should be like laundry that piles up. It'd be, should be something that we are actively engaged in fixing and working through to make sure that you're getting paid what you need to be paid. So reach out. Hello@TheDentalATeam.com. And as always, thanks for listening. I'll catch you next time on the Dental A Team podcast.