We have a patient who had his wisdom teeth extracted, back in June of 2016. At the time, the office was out of network with his insurance. He had primary and secondary coverage, both were out of network. Since starting with the practice in May 2018, I’ve been doing a lot to collect on patient balances. The prior front desk did not follow through with most claims or communicate patient balances with the patients. This patient has a significant balance and I need to collect or send the patient to collections. When speaking with the patient’s mother, she feels that our office messed up and we need to eat the balance. I have tried to do my best and help this patient, I have contacted the insurance companies to check on the claims and because the office was out of network, they will not release the EOB’s. The primary insurance company did tell me that the patient was sent a check in the amount of $850.00. The patient did not notify the office that a payment was made and cashed by them. Since the office was out of network, we did not have a copy of the primary EOB to submit to their secondary. The patient also had made a payment arrangement with the office. The patient is refusing to pay the balance and says that if we send her to collections then she is going to write bad reviews on social media and our google site. Any advice you can give is appreciated.

ANSWER:  Wow – that is a tough one! I am sorry to hear that you are dealing with this issue. Here are a few of my thoughts.

Ultimately, the patient owes the money. I understand that but you have to determine how important is it to collect that balance (or should I say, your dentist needs to decide). I am not saying that you should write it off because she threatened to write a bad review, however, in a way, it has been sitting there since 2016. At this point, it seems like a lost cause and if it were my office, depending on the size of the balance, I would probably write it off. That being said, you have to see what the doctor wants to do. I think that your office is correct in that she owes and that you could send the patient to collections, but you have to weigh out the chance of them paying it and the cost associated with going after the money. I also think that your office dropped the ball with letting it sit there for so long, which I know is not because of you, but your doctor might want to factor that in when deciding what to do.[mepr-show if=”loggedout”][/mepr-show] [mepr-active memberships=”629,630,37388,37393,37672,37676,37670,37668,37674,44674,232156″ ifallowed=”show” unauth=”message” unauth_message=”Answer hidden, please login or purchase a membership to view.”] Another option might be to have the doctor call the patient to discuss options with her. If your doctor really feels the balance should be collected, the call from the doctor may be more successful in moving the patient in the right direction.

One final option might be to split the balance with the patient. Whenever I had a patient that I felt owed the balance but I could see that we needed to potentially take some of the responsibility, I would explain that to the patient and tell them that I think it is fair that we write off half and they pay half. At least you get paid some of the outstanding balance that way.

If you and your doctor really feel that it is important to send her to collections if she does not pay, then I understand that too and don’t hold back from doing it because they threatened a bad review. Just be prepared for it by having a response ready and patients ready that you can ask to put out good reviews to bury it if she posts it.

Then finally, make sure that you learn from this past issue so this does not happen again. When cleaning up old balances, you can find great examples of where the office dropped the ball and then write policies to ensure that it hopefully does not happen again in the future.[/mepr-active]