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Dental bill format for Public Relations

[Music] welcome everyone my name is and i will be your moderator for tonight susie henry is our speaker tonight and she'll be discussing the 13 dental billing processes that can make or break the financial health of your practice if at any point you have a question please type it out into the box labeled have a question and we will conduct a live q a at the end of the webinar to talk with other attendees navigate to your control panel at the bottom of your screen and click the chat icon henry shine is not offering ce credit for viewing or attending this presentation live or on demand susie welcome thank you thank you so much for having me i'm excited to be here um yes so i am i'm excited to talk to you guys about the 13 there's so many more than 13 right these are just a few that can hopefully help you guys you know get more revenue into your practice and make things run a little bit smoother um so i am with ess dental solutions um we are the top billing dental billing company um in all of the us we um we have collected more than 9.34 billion dollars from insurance companies um our our job is to bring in all those collections for you help your office run smoother and um to deliver peace of mind um the assist has won many awards um we we're the nation like i said we're the nation's leader in dental billing you know we we have a whole um plethora of people that are passionate about dental billing and love to help and bring in all those insurance collections for you um but when you think about ess a lot of times you think about just dental billing um there is so much more to ess than just that we offer a bunch of different services um so along with our dental core dental billing service we also have a credentialing service and fee schedule update service insurance verification and eligibility dental practice accounting and bookkeeping patient portion and also full schedule and all of these align um in my slides on how your practice can run better um so i just i'll talk a little bit about myself introduce myself to you all so you're not wondering who i am just talking to you and so i have been in the dental field for a little over 22 years um i started out as a dental assistant and then i worked myself up um cross-training and then i became a manager and then a few years back almost five years ago i started working for the assist um i have i call myself a dental nerd i absolutely love dental um those funny memes and all those things that come up that you see i just think they're hysterical and i try and show them to other people that really aren't like in the dental world and they just think that i'm crazy but um i'm absolutely passionate about it um so i am actually a success consultant myself i have two offices that i service and i do dental billing for and then i'm also a team leader um and my role as a team leader is essentially a regional manager um i work in the background with other success consultants to make sure that we are meeting all of our brand promises and helping um dental offices be successful so um we'll just go ahead and jump right into it um so there's three things that i really hope that you'll learn today one is how to develop the ultimate pre-appointment readiness plan um and then how to maximize your practices collections um we have winning systems that we really feel help and then why streamlining these processes will help you achieve your practice revenue goals um all right so our first one is um successfully credentialing all eligible providers with insurance contracts so we do have a poll here which is when do you start the process um for credentialing new providers so we have the pull up there so we'll just wait a couple minutes or not a couple minutes just a few seconds here to see um and let's see here all right so far no one's in the poll from what i can see all right well i guess i guess we're not doing that poll and that's okay um we feel like credentialing all providers is a huge step in the right direction to making sure that you're getting all of the insurance benefits that you need um sometimes when you hear the word credentialing it sounds really scary because it seems like such a big process um but it it really is so helpful because it helps you get a large database of patients so if a patient ends up you know let's say they have delta dental and they're calling around to see if you accept their insurance a lot of times patients aren't going to see you if you don't accept it there are some offices that are out of network and fee for service and everybody knows that um but yeah so that is you know really important um i actually have a sweet doctor that i've been working with who bought a practice um and she she had her own but she bought her a practice and merged it with another one and the plan was for her to you know wait a little bit and then credential after everything after the sale went through and then after all of that went through um she came she became into an unfortunate situation where two weeks after she started combining everything and working there the other doctor left and it left her with a credentialing nightmare um and so making sure that you are credentialing just as soon as you know that somebody's coming on board also another really important tool is sometimes we get those reverification documents in the mail from an insurance company and we all get busy and sometimes we just set those aside and if if you're not re-verify verifying as a provider you can get yourself in a sticky situation um so if you have tips and tricks on when you start the dental credentialing process um please share your ideas and um you can go ahead and jump it in the i believe the q a will be better um better suited so um that way we can all learn from each other but esis does have a credentialing service that we we have found that is very effective sometimes it takes a long time to to get someone credentialed so starting to do it as soon as possible is really really key um all right moving along um okay so the next one we're going to talk about um verifying patient benefits and so i do have another poll um which is when are you verifying your patient's um insurances um there's a day of appointment two to three days in advance or do you just simply not verify um at all so we'll give this just a few minutes to see and while you guys are doing this poll um i really think that insurance verification is kind of like the meat and potatoes to your practice especially if you are accepting insurances um okay let's see if there is oh here we go we've got um 5.4 due at the day of the appointment oh my gosh that's awesome 86 do it two to three days in advance and um 8.1 do not verify um okay so completing insurance verifications and um basic eligibility checks so why is that important um it's really important to get those because you can collect the estimated patient portion at the time of service you can decrease the denials and follow-ups and upset patients in your practice and you maximize your office collections i'm actually going to use myself as an example when a few years ago when i was working in a practice you know i really wish i would have had e assist or somebody to really kind of help me streamline the process because we would verify patients the day of service and the patient would bring their insurance card in and then they'd be in the waiting room we'd be copying it and then we'd be calling the insurance trying to get that breakdown sometimes we'd be sitting on hold for a really long time waiting for that eligibility check um and they didn't always have the access that we needed on the portals so the patient would get called back right there they're called back in the chair and we're still waiting on hold with the insurance company we don't we don't know what's happening with their insurance then the doctor goes in does the exam and we still don't have the information um and it's all it was a little bit embarrassing sometimes because we'd be so rushed and i would almost feel a little panicky um and so you know making sure that you're doing it we recommend doing it three days in advance um the the reason we do that is because it gives you time that if a patient has max benefits or a waiting period or um there's so many little scenarios that can happen frequency limits you'll know those prior to the patient's appointment so let's say something happened and the patient wasn't able to come because of being maxed out or whatever and they had to cancel instead of them walking out of the dental chair empty-handed and you guys just didn't do anything you would know in advance and you would hopefully have time to fill your schedule and get that you know taken care of so um and it's it's just nice to find out so you can have really accurate treatment plans um you know that's what we all want we want to make sure that we're giving the correct treatment plans for the patient and the patient wants to have the most accurate treatment plans possible um all right and then this also i feel like these kind of go hand in hand in putting um information into your practice management correctly and accurately you know we none of us want to wake up and make mistakes right but when you're feeling rushed or you're trying to get things in we're human and accidents can happen i would say um from what i've seen putting like inaccurate information in like a digit being off or something little is probably one of the biggest things we see as far as insurances and not paying on claims um denials or simply claims just not being on file um making sure that you have a copy of the insurance card front and back is key and scanning that into your practice management system that way if something would ever happen and the denial came back you would be able to cross-reference the insurance card and the id number also a photo id so you can make sure you have their legal name um for example my name is susie but i my real name is suzanne and so if my dentist were to put susie henry my insurance probably would kick that back because they they wouldn't recognize me under that name so legal names date of birth id numbers um address group number parity all of that um 65 of offices in the us are insurance driven and so making sure that everything is entered correctly is is super super key um all right moving on um also making sure that you're matching the appropriate cdt code um for the service provided so um i'm not sure if you guys might want to put in the chat like what your favorite source of cdt codes are um i love um coding with confidence it's i feel like it's like my um demo bible um that's the one that i like to use um but as we know the ada changes things often um they'll have deleted codes or new codes that they're doing so making sure that your front staff and or that you have a a new one every year um things are changing all the time um and then you know making sure that your whole staff is knows where that book is so that if you guys need to reference something you have it um let's see here i am going to um yeah so please let us know what you like to use if you if you are using anything and if you aren't um i recommend investing in something that that your whole team can use um it it helps improve your reimbursement it helps improve your treatment planning um there's times where i'm like oh is that the right code i'm not sure i'll open up my book take a look at it and i have like full examples sometimes it'll give me like an example narrative to use if needed so making sure that you're just staying on top of it is super key all right moving on to number five which is sending clean primary and secondary claims with all the supporting documentation um obviously this is a huge one for your to maximize your insurance right um so i always think it's a really good it's really good to kind of have like a cross-check system um so you want to make sure that you're holding everybody accountable right you want to make sure that all those claims go out clean the first time and when we say clean we mean that that insurance company isn't going to come back and ask for more information um you want to make sure that you are billing with the right claim format um right now it's recommended that you use the ada claim format of 2019. um you can check with your practice management software for any updates if you aren't using that um bill office fees to the insurance companies that we recommend that as well um the reason is is you see our rates we want to make sure the insurance companies you're not just sending your your fees or i'm sorry the insurance fees because um then they're going to think that their prices are are low and we all know we want to be reimbursed more from insurance companies so um sending your ucr fees is is key um and then um sending claims under the correct rendering provider now hygienists they are not rendering providers um they don't need to be listed on the claim it can be the doctor that is actually doing the exam they are the rendering provider so sometimes things get missed though and like dr joe gets filled with dr jim's and that can cause a huge issue so um have somebody kind of be like your cross checker right somebody that looks at the claim before it gets sent for accuracy um so if you guys hold your teams accountable for accuracy we would love to hear tips and tricks on how you do that um all right um and then sending claims daily um we've had some some offices come to us that have a huge backlogging claims that haven't been sent that's just money just sitting there right money's sitting there waiting that can be processed and paid um and so you know that really it it causes two issues one you're not getting paid for the work you're doing and two um i had i had another practice it had been they were super short staffed it had been about a month since they had set their claims and they had patients calling saying hey um my insurance hasn't received the claim and so making we recommend doing it within 24 hours making sure those claims are going out within 24 hours of treatment or the next business day um and then you know like we also want to make sure that if you do accept primary and secondary that you are sending the secondary claims same so like if you get that that primary insurance payment and then you're ready to send it to the secondary insurance making sure that it's going to them making sure that you're sending claim claims clean i feel like that's like a tongue twister sending claims clean making sure narratives are being sent you know pre post-op x-rays for all the necessary things um chart notes those are all um things that are going to make it so that we don't have to we as in your front staff or ess don't have to do as much follow-up and um you're getting that money in your pocket quicker all right um and then these kind of go hand in hand as well is resolving rejected and denied claims um you go and you send your electronic claims right turn the compute turn off your computer for the day and you walk away um a lot of times if you go back in the next day there might be a couple rejections um so you want to make sure you're working those rejections just as if you would a claim um every time i send my i send my claims daily for my offices i check the day before is rejected claim um i want to make sure that nothing's in there sometimes it's literally the smallest little thing that will reject a claim um and if you're not following up on those constantly those will get those will slip through the cracks um and then um you want to make sure that um like sometimes you'll get one where the pair has determined that they don't qualify um you know you have to make sure that you're sending those as well even if the pair says that you like sometimes like remote light or something will jump something back and say frequency limit met well i'm still going to send that claim right to make sure that that is accurate and then we'll get that denial um and then when you get denied claims um don't just deny them right a lot of times you can still get reimbursement for them um sometimes they just need a little extra tlc tender loving care um so if you if you aren't working your denials regularly um you know that's again money and that's not going in your pocket so knowing when an appeal is warranted um and then having like like a backlog of of appeals that you can grab if you need um i've got a little cheat sheet for me that i keep so that i know that okay they appeal or they denied for this reason i'll send the appeal to my practice and say does this look right have the doctor approve it and send it off um so those are those are something that you want to make sure that you're constantly doing to keep the revenue coming in all right um the next one is post insurance insurance oh i can't even talk today post insurance payments timely um this is another one that we see where a practice will come to us and they're a little bit behind on their posting best practice is to post insurance claim payments within 24 hours of receiving it um so you know you go you grab the mail out open up the checks um you want to make sure that all of those are posted within 24 hours into your practice management system that way you're balancing with your bank account um the other day i was posting paying a payment and i had like 20 checks to post and i went and i added up all my checks then i looked at my practice management software and i was off by two cents and i was like oh my gosh what am i going to do i had to go through all my payments right again because i wanted to make sure that i balanced so making sure that your front staff is also balancing accurately some people may just say it's just two cents right but when you think about it it is just two cents you want to make sure that your bank account and your practice management are completely aligned and that there's no errors um at esses we have accountability services where we we have to balance and so um i'm really grateful for those tools that we have so that um we can make sure everything's being posted timely and accurately um and then and then also we always leave detailed posting notes so that um if you ever needed to go back and look at a payment you can see exactly what's been posted and why and you know why if there was a deductible or whatever in there um it's it's pretty cool so all right um and then um eight if you are using efts um efts are wonderful they're they're great a lot of times some insurance companies will reimburse you within three days of receiving the claim so um but you want to make sure that if you are doing efts that you're reconciling the um practice management the merchant and the merchant statements with your bank so let's say i pulled a delta check and it was 1500 and i just go in and i post that eob if it hasn't reached your bank what good does that do right um and so we not losing track of your payments so having some sort of a uh system in place will really help to make sure that you are um reconciling all of your payments um we've seen it where um we received the eob it says it was paid but then it was sent to the wrong bank account or not even received by the office at all um despite the insurance company claiming that it was sent so um again you know we have our accounting department that will go in and they all say okay this eob is ready to be posted because it's it hit the bank account and then and then we post it the next business day um all right um we will move on from that so um here is another poll which is how often do you follow up on outstanding insurance claims um i feel like this is a biggie for lots of practices and it's one that i think can probably get out of hand pretty quickly it can start like a little you know bud and then turn into a big well wild fire pretty quickly um all right so we'll wait and see what you all say and then we'll dive into it a little bit more let's see here all right i'm gonna see if we've got the results up oh here we go okay so um 45 said once a month 50 said twice a month and five don't follow up okay great all right so um following up on claims regular regularly um is super super key right um these are the kind of the benchmarks that you this is like a super healthy practice that you want your offices to be at your current insurance aging should be around 66 plus you're 30 to 30 days 10 to 25 61 to 95 to 10 and 90 plus less than five if you have more in your over 90 than you do in your 60 or even your 30 then you probably have an insurance ar problem um that's okay right all you have to you have to work at it right so at ess what we do is when a claim hits 30 days we start following up on that claim every 14 days so 14 days 10 business days um we put detailed notes in there and we call on that claim we appeal those claims we work to make you guys get every dollar that you owe that you are owed um not all practices come to us in a pretty package like this and so just know that it's achievable and you can get there our goal is to get the over 90 near zero um and we've seen that time and time again and um you know there's some offices that frankly you're so busy right you've got a lot going on you have patience and all this stuff happening in your office and you don't have the time to follow up on those claims so making sure that you have a person dedicated to your insurance ar that's going to help maximize your insurance collections and really um help your processes run smoother sometimes it's really just the tiniest thing on why a claim wasn't paid and you just need to call and get it corrected or if it's not on file you know enter straight into the portal and then you get your funds quickly um so you know lots of tips and tricks on how to work your aging but you know we recommend doing it every two weeks so twice a month really um and making sure that every time that you call an insurance or you follow up on that claim you have a note in the system so you know if let's say i was working your insurance ar and you know i ended up not working there a month later somebody could follow up on my work just as if they were there so having a really good flow um all right um next is audit patient ledgers for accuracy um before sending statements um again we see sometimes where you just batch all right just every patient balance you send that statement and you send it off to the patient um so we recommend before you're sending those statements to have detailed notes as to why the patient has the balance it could be from that posting note that you have explaining okay they had a deductible that we didn't know about or um they downgraded this code or for whatever reason that way if the patient were to call back and ask about why they have a balance you're not having to search through all the eobs and you have detailed notes so that anyone that answers the phone can answer that question for that patient um all right so here's our next poll which is how often are you sending patient statements um and then so we have once a month when i remember because that does happen um or just every few months i should have added another one in there is when i post insurance payments that should have been in there too but that's okay i skipped that one but i think we'll be able to get kind of a good idea of where we're at on here so we'll just wait a second on this all right and we'll see what those poll results are here in just a minute whoops oh my gosh let's see if i can go back okay um once a month was 89.5 and then every few months is 10.5 awesome okay so um i'm actually going to go back i'm going to talk about this a little bit more um we we on we think if you think about it um when you are are sending you know i'm going to i think i skipped a slide here so i'm just going to improvise um sending statements is super important for your for the health of your practice um we recommend sending your statements and then um calling your patients as well um a lot of times patients get a bill i've done it i think we've all done it right you get that medical bill and you're like oh yeah i gotta pay that put it down you forget about it and then you get that second bill and you're like oh whoops i gotta pay that bill right now um and i think people a lot of times do that it's unintentional they're not trying to not pay you they just get it and they kind of forget about it so if you have somebody that's dedicated to your patient billing service and getting all of that money for you it's super helpful um we recommend calling patients in between um and then after if they haven't paid after a couple statements sending a personalized letter from your from your dental practice um as a reminder letter um it doesn't have to come in a bill format you can just say hey you know it looks like you still owe 89 on your account so um we recommend that we also recommend having a special billing line that's centralized just for special for billing so that um when they call they're talking to the person that they they know they can talk to you about their bill and it's going to be able to help them um all right let's move forward oh you know it's because i skipped this i jumped ahead that's when i said i was losing my mind with my this is what it was so just sending statements and following up i feel like they just they go hand in hand um so here's kind of what i was talking about sending statements regularly calling in between um the other thing i was going to mention is um i know for me i don't always see my voicemails for a couple days two or three days and then sometimes it's a hassle to listen to my voicemails i would rather somebody text me any day of the week um so if you can find a system that's hipaa compliant and can do text that's a huge way as well to get patients to respond to you quicker um and emails um so yeah in the q and a if you guys would if you have any um success on how you get patients to pay your bills quickly um if you would share in the q a we would love to learn from you and and hear how you make that work um i have seen that the reminder letters are huge um like i said it's more personalized and it can really help bring that money and so if you're if you're not having success and you've tried two or three times without sending statements and calling you something got it a lot of times that letter is is key so all right um this is a biggie which is run re-care reports um and call on patients to get them back on the schedule um i was actually um pretty surprised to see this statistic that um the average patient retention rate is at only 41 um so that means that only four out of ten of your new patients coming in will come back after their first appointment i was pretty surprised i thought that was pretty low um ideally right 85 would be would be where you want to be um because we all know that the most expensive thing in your whole practice is an empty dental chair and so um running your recare and your unscheduled treatment plan reports regularly will help bring in those patients right um time goes quick i know that for me like i actually did get one from my doctor not that long ago from my dentist and it said it had been a year since they'd seen me for my cleaning please don't tell anyone because that's terrible i'm in the dental field right i should have it every six months but a year can go really fast for people especially if you're busy and you're kind of just not thinking about it and so if you have somebody that's calling regularly or um sending reminders to your patients um that's going to get people back in the door because again i don't think it's unintentional that people are doing that i think a lot of times it's just because they forget some people might be scared and so it's like hard to get them in but we want to make sure that we're constantly having those patients come back and you know new patients are wonderful they help build our practice and also it's awesome that having existing patients stay with you is amazing as well um i thought this was a really cool statistic too it's an american dental association states that a lifetime patient will generate at least 4 500 in revenue and that is not including referrals um i've seen people on like my facebook page say hey does anybody recommend a good dentist if you're the one that's getting people back in the door over and over and over again good chance you'll be the dentist being recommended um okay and then um negotiating your practice fee schedules um i think we've all heard the word inflation lately right it's kind of a big a big thing in our country um our best practice is to know negotiate your ppo fee schedules every 18 months um you want to make sure that you're being competitive right you want to make sure that your rates are aligning with the people in your um area um and you need to adjust for inflation you know this the cost of supplies i mean everything has skyrocketed so you want to make sure that you're not undershooting yourself and that you're getting the reimbursement rates that you deserve um so making sure that you're negotiating those and um you know making sure that you're getting every dollar that you deserve um all right you know i hear here at assist are we always like to say that we are delivering peace of mind to practices um this i feel like i'm really just truly scratching the surface on all of the things that can help run a practice smoother there's so so many different things you can do to help your your practice become healthy um like i like i said those were just 13 of them um but we are here to deliver peace of mind to make sure that we're meeting all of our brand promises for you and um to make sure that you guys don't have to worry about the stress of all of the nuances of dental billing and all of that so um these polls aren't going to be like sent to everybody on here but there is a poll and it's would you like to have someone from our team reach out to you and schedule a consultation regarding our e-system the billing services um i promise there's a plethora of dental nerds like me that love dental billing and love to you know bring in all of that money i know when i have offices that i see that are decreasing or i see you know when they came to us their their collection ratio was in the low 80s and then you know three to six months after being with the asus their collection ratios in the upwards of 98 or better you know that is that's when i know i can go to bed happy and so anyway um all right so i think we are ready for um the q a thank you so much susie uh as a reminder uh everyone if you have any questions please type it in the box labeled have a question and we'll address it right now we do have some questions now suzy so if you're ready we'll get right into it i'm ready excellent uh so our first question is from danielle and she wanted to know do you have a sample of the final letter that lets people know if not paid they will be submitted to collections yeah yeah definitely um yeah assist we have letters um we always have the doctor approve on first to make sure that the wording sounds okay to them um and that is we always send a letter you know letting them know if we've exhausted all of our all of our tries you know between emails texts phone calls statements a friendly reminder letter couple friendly we'll let them know like hey you know we'll have to send you the collections if we don't hear back from you within x amount of days so yes and we always have the office and the doctor approve it before we send them out thank you uh our next question comes from stan and you want to know when accepting an eft does a credit card processor charge for the transaction as they do with a credit card so efts do not charge um a processing fee these virtual credit cards do um we do recommend opting out of virtual credit cards due to that processing fee but efts do not um so i personally both of my offices that i work do efts and i love it like i'll see a claim that i sent on monday and it's ready to be posted on friday and so um i think it's wonderful and then you don't get checks lost in the mail and there is no extra charge for it so thank you christina wanted them why do insurance state that they can't take cob from providers if secondary is medicaid um okay let me read your question it says they state the subscriber needs to let them know on medicaid um you know met okay medicaid is tricky right they're kind of like their own little ball game um a lot of times it's a hip-hop thing um so honestly i really don't have the right answer for you right now um if you let's see christina if you want to email me i'm going to give you my email um i will get the answer for you and email it to you because we have an amazing group of people that know it medicaid very well and they may be able to answer that for you so um my email is suzanne dot henry e-assist me go ahead and send me an email and i will get that question answered for you thank you susie uh heather wanted to know if e-assist gets trained with putting dental benefit information into curve dental please call us yes yes yes we use curve we've got lots of people that are curb experts um we can definitely help you with that curves we love curve thank you now monique wanted to know are you seeing a lot of insurance companies requesting narratives for dental procedures lately she's been getting a lot especially for extractions yeah absolutely um so much right insurance companies are asking for so much these days i always send chart notes with my every extraction i one of the practices i work for is an oral surgery practice so with every extraction i send the chart notes post the pre-op notes um i send as much information as i can so that they don't have to come back and request it after so yes we are seeing a lot of that thank you heather add another question and that's referring to our first poll question actually susie where about we're verifying the patient insurance benefits does she not want to know for the offices that don't verify are they fee for service you know that's a good question um because i don't know personally which ones answered what um if you are fee for service you know you not you're not necessarily going to always call and check on those benefits because it's kind of the patient's responsibility um if you are an in-network provider though like i said we always recommend making sure that you have up-to-date insurance eligibility and verification so that you can make sure you're providing the right services to your patient right so you don't have like your patient gets a crown and then you find out they had a a major waiting period you know that's just it's always like a little steam when stuff like that happens and so um i'm unsure on those people that answered the poll if they were fee for service but i would probably assume that so thank you our next question uh tiffany and susie is are you finding that insurance companies are limiting what they cover um i find that insurance companies try to limit what they cover um we sometimes we see them come back with the silliest little things as to why they are denying a claim um and we we will appeal it right we'll fight for it um i always feel like it's kind of like an insurance game right you're playing back and forth and um like i said i have like a whole plethora of appeals that i like to use um and i've seen lots of appeals get paid but yes insurance companies are being a little bit harsher on what they're sending back um but if you have all the proper documentation and um you just can go back with your ammo right and and hopefully get that claim paid thank you susie uh we had another question related to that first poll question from danielle and she wanted to wanted to know actually yes how often uh do you recommend that they re-verify insurance benefits yeah absolutely um so i recommend that every so every other appointment right that they're coming in for the if they're coming in twice a year for cleanings at least once a year you want to have a more of like a detailed eligibility right you want to make sure that um you're getting the max benefits and all of that but then if they're coming in every six months you can just kind of do like a re-check verification make sure you can find out what their benefits they've used for the year um those kinds of things so we recommend once a year really getting a more like an extensive verification and then um for their second appointment doing the standard one but if they're only coming in once a year we recommend doing it every every year thank you uh heather had a sort of a niche follow-up on that and her question was what if the person gets fired or leaves their job between the day you verify and then they come in for treatment well that would be really unfortunate huh um my goodness um you know where you're you're doing it three days in advance you would hope that your patients would be transparent with you um that's that's a good one that kind of stumped me a little bit um i i would say you know most of the time you're safe to to verify um 72 hours in advance if you are worried about that and and you may have that you could when those patients come in the door for their treatment let them know okay we verified your insurance with you know this insurance company um looks like you're you're all cleared are you still you know is every is everything accurate still kind of recheck the accuracy when they come in um that might be a good solution for something like that thank you our next question was why do providers avoid medicaid medical patients medi-cal um you know i personally am not very familiar with medi-cal um however i know we have people that are i just personally am not an expert on that and so i'm not sure if i'm the best person to answer a question about that um but if you if you have a question you can um reach out to us at assist and i bet somebody might be able to help you with that thank you susie vanessa had a question uh and she wanted to know do you have any tips on knowing what dollar amount for outstanding insurance claims is getting too high obviously we want it to be as low as possible but that's not always what's happening yeah i mean you know for me if your insurance ar is constantly rising your dollar amount is going high you know that's that's not good um the benchmark if you look at your dollar amounts and if 65 is in your current and you know that you want to make sure that your dollar amounts aren't constantly rising you want each bucket so the 30 bucket the 60 bucket and the 90 plus bucket with each bucket you want the dollar amount to be less less less and less um hopefully zero for your 90. and so if you're if your buckets are are higher than your bucket previous then you probably are are needing more help with your ar um you know we've seen we've seen offices that have upwards of 500 000 and they're over 90 right and so it's like that's that's something there where somebody needs to step in and really get those insurance claims paid and so um hopefully that answered your question it was kind of long-winded but i hope that answered your question thank you our next question do you have any suggestions on how to work with insurance when they do pay but it's the wrong company for a claim the wrong company as in can you repeat the question just i can understand it better yeah yeah do you have any suggestions on how to work with insurance when they do pay the wrong company for a claim so the companies might be yeah yeah so like maybe they accidentally paid the a wrong dental practice right is that you is that how you're gathering that question yes i think so unless daniel could give us some clarification yeah if you could jump in the chat and explain that a little bit more um hopefully i can help answer that i if i understand the question i think what you're saying is like let's say the insurance paid a check but it paid to the wrong provider the wrong practice um if you're calling on that guy that is what she meant yes okay perfect so if you're if you're calling on those claims right every 14 days every two weeks and they say oh yeah we paid that um you would want to verify okay is it the right address if it's the wrong address you need to let them know right away then they can avoid that checkout um let's say that provider accidentally like deposited that check that's on the insurance and you can fight for that you can let the insurance know now you sent it to the wrong provider so i that's something that you would just call and dispute with the insurance and get them to reprocess the check to your office but you would catch those right if you're following up on them every 14 days thank you and susie i think this might be our last question uh for our session and this is from tiffany and her question was do you find that patients call the insurance company and state that the procedure is covered but in actuality you have a prior authorization that states they will not cover that procedure oh yeah we've seen that for sure um you know i hate i i'm not here to bash insurance companies by any means but you know sometimes you're going to call one rep and they're they're going to tell you one thing and then the patient calls and they're going to tell that patient something else so if you have the documented prior authorization showing that it's not covered or you have that that really clean eligibility check showing that it's not a covered service um that's what i would present to my patient i would say look unfortunately i don't think that that rep was correct this is what i have from your insurance um and present it that way that way they can see the clear documentation um and then you know if they're still disputing it i would recommend that they call again and give them i would give them that prior authorization number um that way they can cross cross-reference that with the insurance company thank you and we had an actual final question come in as we were answering this one and uh the question was how to do we work with hmo patients who always come in only for periodic exams you know um hmo patients are kind of the same ballpark right as medicaid i mean if i i want to say right you get a look you get a little fee each month for like happy hmo patients um you know that's kind of like it's a hard question to answer because um basically if you're an hmo provider right you're going to work with them and a lot of times it's low reimbursement rates um so yeah that's i don't know i mean that's how i would do it i mean because you're an in-network provider with hmos right and so that's why you see those patients so i don't think i'm answering that correctly so i apologize thank you susie and we had a comment come in from rhonda and uh shoot has an observation that many times uh recently when they verify insurance coverage the patient comes in they file and then they're paid months later in some cases over a year the insurance company requests the money back because the insurance at that point had terminated in her personal expense she actually appealed it the patient appealed and she reached out to the insurance commissioner and the decision was upheld so we had to refund the money the patient is now making payments and rhonda feels that there should be a time limit on this oh i absolutely agree i mean that's that's terrible right um i love that you got the insurance commissioner involved because i think sometimes that needs to happen i have a couple claims on one of my offices that we are we involve the insurance commissioner sounds like you fought really hard for that and um you know i haven't seen that too much um sounds like hopefully that was just a one-off thing i have seen them come back and request a refund um but not for a termed insurance and so um that's that's a tricky one i mean especially if you have the eligibility check stating that they were you know insured at that time um yeah that's super unfortunate but yeah it sounds like you appealed it and got everyone involved and yeah i'm so sorry that's so unfortunate that that happened it's terrible goodness thank you susie and i think this might be our last question from vanessa that her office doesn't take hmo do you think that's a good idea for her to start um you know it it really depends on on your provider and how they want to run the practice um hmos are lower if i'm if i'm remembering right they're lower reimbursement rates um but you do get a little chunk for each patient that you see um so honestly i would i would research it in your area because it also depends on the area that you're in research it and see if it's something you think would benefit your practice and then talk to um you know that's what i would do personally is research it really well and see if it's something that you think would fit with your practice thank you susie again for the great presentation uh if anyone has any outstanding questions uh please email us at webinars at henryshine.com as a thank you for attending tonight's webinar everyone will receive the recording via email the next week thank you all for joining us and we look forward to seeing you all on our future webinars susie thank you again thank you everyone have a great day you