How to Send Statements and collect on Patient Balances – Without being the bad guy?

In the dental office, we work really hard to do our best to verify patients’ benefits.
We enter the insurance correctly in the system.
We get the most accurate estimate for the patient’s out of pocket amount.
We work out payment options with patients prior to them getting the treatment.

Yet, there are times that no matter how well we do at this, there is still a balance on the back end of the process. Whether the insurance did not pay what was expected, something was not covered like we thought, or something changed in the treatment plan, there are times when our patients end up with a large or unexpected balance.

How do we handle unexpected balances?

There are some things that should be considered before automatically sending the statement to the patient.

First, make sure that the math is right and that everything was entered correctly. There are times where things are entered incorrectly or percentages are wrong and those should be checked and fixed so that the statement reflects the correct balance. Some patients’ accounts can get quite confusing and it can take someone that is good with numbers and a lot of patience to make sure everything matches up. We never want to send a statement or attempt to collect a balance from a patient until we are very clear of the reason why there is a balance in the first place.

 

Next, understand that no one likes to open an envelope or an email to find a bill that they were not expecting, especially if it is a significantly large amount. Having to pay an unexpected bill, especially for dental work, is not something that most people love to do. Therefore, recognizing this pain point and doing whatever we can do as an office to make it as painless as possible will go a long way. We have to put ourselves in the shoes of the patient when preparing to collect a balance or send a bill and understand that it won’t be something they are excited about. In fact, many people actually have a negative physical reaction when talking about money so we must understand that the person who is normally easy to deal with might not be quite as amiable when there is anything having to do with money.

Now, we must decide what our next step is going to be to make it as easy as possible for the patient to receive the news of the balance and to pay it.

Every situation is different, depending on the type of person we are dealing with, the size of the balance that they owe, the reason for the balance and how we communicate the balance. We need to take all that into consideration when deciding which of the following actions we may want to consider taking. Recognizing that everyone is human, and we are doing our best to help them learn about the balance and pay it, will help in improving the AR for the dental office.

Here are a few recommendations to consider in this area, prior to popping the statement in the mail or in an email:

  1. Consider the size of the balance and how the person might react. Some people might flip out over $25 and others might not even blink at a bill of $100 or more. There are some people who want to know balances down to the penny and then some that just trust our office and will pay easily without any explanation. We know our patients best and if we feel that this balance will cause an issue with the person, we should consider a phone call or a way to be accessible to them to discuss it. I suggest maybe a phone call to let them know why there is a balance and let them know the statement is on the way.
  2. Consider when to send the statements. I would suggest attempting to send statements at a time when the patient can have the highest chance to reach the office if they have questions. For example, send them early in the week so they can call the office when they get it during the week, rather than sending them on a Thursday so they get it over the weekend. If a patient gets upset by an unexpected balance over a weekend and can’t reach the office to discuss, not only does it give them time to sit and stew in their upset but sometimes, they get so frustrated that they turn to other means to share their upset, like a review for the office online.
  3. Choose your presentation carefully. I am writing this article during the Covid-19 quarantine where most dental offices are closed, most people are not working, and financial concerns are real . There are a lot of questions now about whether to send statements or not to our patients. Ultimately, if the patient has a balance, they should get a statement. However, with the financial issues happening, not all the patients will be able to pay the balance right now. The caring way to handle this is to write a handwritten note on the statement saying something like, “if you would like to discuss this balance, please give us a call” or something that shows you care and that you are there to work something out with them.

Finally, like with any business, the patients are responsible for their balances. It is our responsibility to make sure they pay but also that we do it in such a manner that we not only have the highest chance they pay but that it is done with care and compassion.

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