Episode 594: Billing With Ease

billing dental billing Oct 26, 2022

We’re continuing with our weekly introduction to 12 systems — something the Dental A-Team will dive into in full starting 2023. This episode focuses on making billing easy and healthy. Kiera and Tiff share tips on … 

  • How to set up a solid billing department, 

  • The two numbers that will tell you if your billing is healthy or not, and 

  • Why consistency in billing helps keep collections where you want them to be

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0:00:05.6 Kiera Dent: Hey everyone, welcome to the Dental A Team podcast. I'm your host, Kiera Dent, and I have this crazy idea that maybe I could combine a doctor and a team member's perspective, because let's face it, dentistry can be a challenging profession with those two perspectives. I've been a dental assistant, treatment coordinator, scheduler, filler, office manager, regional manager, practice owner and I have a team of traveling consultants where we have traveled over 165 different offices, coaching teams. Yep, we don't just understand you, we are you. Our mission is to positively impact the world of dental, and I believe that this podcast is the greatest way I can help elevate teams, grow VIP experiences, reduce stress and create A teams. Welcome to the Dental A Team podcast.


0:00:51.1 KD: Hello, Dental A Team listeners. This is Kiera, and you guys, I have the one and only Tiffany Trader back with me. We are doing our labor of love for you guys hitting these 12 systems, if you miss the last to be sure to go snag 'em, we are doing this over the next 12 weeks. Guys, this is helping you prep and prepare for the operations manual, get you guys organized, excited. We're doing the operations manual intensive in January for a three-month course, if you have yet to snag that, be sure to email me Hello at the dentalateam.com, because all of these systems, we're actually gonna help you get them completed. So Tiff, welcome to the show. Let's hit them with billing with ease today. How are you, Miss Tiff?

0:01:26.6 Tiffany Trader: I'm good how are you?

0:01:29.2 KD: I'm doing really, really well. It's been a good productive day-to-day, and I'm super thankful that you were able to have time to be able to do this podcast with me, I think I thought about doing one on my own, but we already started this together, we gotta finish this thing together.

0:01:44.5 TT: I agree. I mean, there's only 12, where you can get through 12 systems with ease. Today billing with ease, which is both of our favorite, right? Favorite least favorite months of the year, because I think that we like more fun things and that's okay. And we can make billing fun. And we work really, really hard, I feel like, to make billing fun and to integrate systems and tools that really make billing easy and almost kind of in a lot of ways, it takes care of itself if it's done correctly, and I think that's something that we've really excelled at, because you and I just... We would rather do other things, so we're like, "Okay, how do we make billing be easy as possible for ourselves, for systems, for teams, for all the pieces." I think it's gonna be really fun.

0:02:31.8 KD: Yeah. And if you guys don't know, Tiff has been dubbed the billing queen in our company. She's the one I come to for a lot of billing things. We also have quite a few billing experts. So we love Shasta with Paragon Dental. If you guys haven't reached out to her, she's fantastic. Be sure to let her know the Dental A Team sent you guys. Sarah O'Brien with Evolution Billing, we love Sarah. Sarah helps with a ton of things and then we also have quite a few other ones. We've got ESS, we've got Dental Claim Support. So we refer out to a lot of billing because I think billing can actually be something outsourced pretty easily in your practice. But you guys know if you outsource, you've gotta treat them like an employee. You can't just outsource it and say, "Oh, no big deal. It's out with Shasta and she's doing a great job."

0:03:16.4 KD: No, you've gotta be able to recognize this, run this. So Tiff and I are gonna walk you guys through today parts of what we mean by billing with ease. So again, remember guys, these are 12 themes that we have created for you guys to make your life really easy. Billing with Ease is going to be in March of next year. So that way in March, come March guys, you can check to make sure your billing department is actually rocking and rolling. Improve the protocols, figure it out, fix it that way it can truly be easy. But to Tiff's point, billing is my least favorite thing in the entire dental world because I freaking hate billing. I'm a very outgoing person. I am your killer treatment coordinator, Tiff's the same way, I would rather manage treatment, coordinating, scheduling, you name it, talking with people. But numbers are necessary.

0:03:57.6 KD: So, most of the time a really good biller tends not to be me or Tiff. [chuckle] We tend not to have a billing personality. Most really good billers tend to be... They actually are kinda like Britt Stone where they've got a little LOMO instead of FOMO, they prefer to not be hanging out in the front crowd because they really gotta hunker in, look at the numbers, figure it out, be tactical and not make mistakes. Does that mean you have to have that personality to bill? The answer is no. Tiff and I have both learned to be incredible billers, but it's surely not the first thing on my list to do [chuckle] that I wanna do. So...

0:04:29.7 TT: Absolutely.

0:04:30.4 KD: Tiff, let's dive into like what are some of the things that people should be checking off their list to ensure that their billing department is truly up to par from what we see that we're looking for when we say billing with ease, this is what we're looking for and what we're wanting you guys to do.

0:04:45.7 TT: Yeah, I think number one thing to look for is structure within the billing department. I think one piece that we look at practices and find is that there's confusion or there's unknown or there's... AR is really high, there's not a lot enough collections coming in and if I truly look at it and break it down, there's not enough structure. So the lack of structure within any department is gonna cause chaos. Now imagine chaos in your billing department. It means your money's not coming in. So if we can build around some structure, one of the pieces that we teach within this Billing with Ease month but also just with consulting with us in general is to build out an action plan every month so that every month you've got a calendar built out of when you're doing which piece of AR, when are you calling on unpaid insurance claims, when are you checking to make sure all procedures are attached to insurance claims or procedures aren't zeroed out but they're written off and the write offs are correct.

0:05:44.3 TT: Like all of those things we tend to dump on the billing department and then our billers just kind of get to it when they can, right? Like air quotes when they can, but there's no structure to it and it's not laid out. So I think one of the biggest pieces there is providing that structure and saying, "Okay, Thursdays is AR day. So I'm gonna print the AR at the beginning of the month and on the first week of the month I'm gonna do zero to 30. Second week of the month I'm gonna do 31-60", and so on so forth. So for every Thursday I've got a chunk of something that I'm doing there and keeping those percentages in the areas that we deem necessary. So that's one piece of it. And I think also making sure that whatever you're doing in the billing department is benefiting the rest of the practice.

0:06:30.3 TT: So insurance verifications, making sure those are correct, making sure that you're updating information when EOBs come back in, learning how to do that, learning how to post the payments and do it correctly, making sure the write offs are correct, making sure member plans are correct and reconciled at the end of the month. All of those pieces fall into other parts of the practice so that your treatment coordinators are getting accurate treatment plans and your checkout girl can collect the right amount of money. All of those things. So all of that within March is discussed. Setting up the structure and the plans to ensure you as a billing representative of your practice can actually get to everything you're supposed to be doing. And that twofold on that you actually know what you're supposed to be doing, right? Because we're all kind of trained by the person who was there before or the person we worked with at another practice and then we get to somewhere else and somebody says, "Oh well what about, you know, what about the adjustments report? Like, is that correct?"

0:07:25.0 TT: You're like, "I don't even know what that means." So figuring out, figuring out what it is that you're supposed to be doing and then building the structure into it so that you can see it. So online payment, statements are sent out, all of those pieces we're kind of taking everything and putting it into place so that you can get it done and then you can easily report up to your management team, your leadership team, your doctor, whomever it is you're reporting up and saying, "Hey, this is done. This is what I've done, this is what I've collected, this is what it looks like." And we're kind of teaching you how to do that, so you're a leader of your own department.

0:08:02.6 KD: Hey, Dental A Team listeners, this is Kiera. You guys, I am beyond giddy about the fact that we are having a way for you guys to kick off your 2023 in the most epic way. That's right. I want you guys to go into 2023 with direction, with a plan and to actually get something done, done and done. If you've been looking at that operations manual, it is time guys. For three months every single week I'm gonna be doing a workshop with you and your team in January to get that operations manual done in three months. Guys, this is a value of over $10,000 that I know you're gonna freaking love because you're actually going to get it done. So if you wanna get your ops manual done in three months and kick off your January ultra strong, head on over to the dentalateam.com/opsmanual and I will see you January 5th for our kickoff.

0:08:56.7 KD: Absolutely. And Tiff, I think the biggest piece that you really honed in on is the billing department, 150,000% needs to be absolutely organized. And that's what this is because so often your AR gets sky high not because it's actually sky high but because no one's actually been working on it consistently. Because we get the common phrase of "I don't have time." And I'm like, how do you not have time? This is your paycheck, like this feeds your paycheck, how do you actually not have time for it? So I think it's really, really, really important for people to be organized. So like you said, Tiff, do you guys have it set up to where every January you make sure the fee schedules actually get updated within your practice? Is that a cadence that's in the calendar, we make sure we get those in January. Do we have a process for how we do insurance verification from the get go? That way we know 110% that the information going in is correct.

0:09:52.9 KD: Do we have a way that we're submitting our claims to make sure that they're being clean claims and we're not having errors when they come back? Do we have a process for how we're going to do that AR like Tiff was mentioning where we're checking our patient and our insurance portions on there? Do we have a way that we reconcile at the end of every single day to ensure that we didn't miss any procedures #kieradent where we build out a $0 crown because we just didn't have the right fee schedule in there? Like what the heck I wrote what? But it was because we didn't have a process to reconcile at the end of the day to make sure none of those procedures were missed. Do you guys have a process for when checks come in? How we enter those checks and make sure that they're there?

0:10:30.5 KD: What about our collection protocol? When do we send people to collections? Do we send people to collections? How long is that on there? When can we write off bad debt? To Tiff's point, what about your write offs? Do you have a way that you do these write offs to make sure it's clean and it's not just bad debt or office adjustment, like oh gosh, I wanna cringe every time I read that 'cause I'm like, "What the heck is an office adjustment?" Like what does this mean having those actually be organized? Having it be organized of how often we send statements to patients? All of those things are billing, and I don't think billing's actually hard to set up but I think it's just the maintenance and staying consistent with billing that will keep your life very easy. Like I've got an office right now and she has less than $4,000 of all, like we're talking 30, 60, 90 over 90, four grand is all that is patient portion outstanding.

0:11:20.2 KD: And I think that that is freaking killer. And I asked her how she did it and she's like, "Kiera, you make me email in in the most loving way every single Friday and I have to look at my numbers so that way I stay on top of it because I know I need to report to you". That simple thing took her from 30,000, 40,000, 50,000 inpatient portion to 4,000 and it took us about six months to get her there. But I saw that come through this week and I thought that is what organized billing should and can look like from my perspective. And that's why I think it can be billing with ease 'cause it's a system and once it's set up it truly can run that way as long as you've got people and checks and balances to make it run super effectively.

0:11:58.3 TT: I like the ease of organized billing. I love that.

0:12:01.1 KD: Maybe we should change it Tiff, instead of marching billing with ease, maybe it's organized billing.


0:12:05.6 KD: Guys, we're still in the process of naming these but billing with ease, I think I'd sign up for that rather than organized billing. So just know it's billing with ease because it's organized.


0:12:14.9 TT: There you go. We'll just add a subtitle.

0:12:17.4 KD: That's what we tend to do 'cause like why shorten the name? Let's just extend the link. But I think like if you guys are trying to get this set up, we gave you a ton of tools right now where you could just stick that in your calendar. These are the things you need to be doing. Are there other pieces in there? Yes. I feel like the best benchmark is 98% collections and your write off amounts. I think if I was checking anything those would be the top two numbers I'd be going after because my write offs will tell me if my insurance verification's correct and also what companies are paying and my collection ratio is going to ensure that I am actually collecting the money that we are producing. So those to me, Tiff, would be like okay if I'm gonna like really watch anything, I think those would be my top two and then followed by my third would be the AR percentages per portion of your AR to make sure that those buckets are all correct and making sure they're being worked every single month.

0:13:07.8 TT: Yeah, I think so too. I think it'd be a daily collections for me and like entering, sending claims, entering AOB payments and the AR for sure. Making sure that all of that is accurate and within the AR I think and even within posting, I'm checking fee schedules, I'm making sure you know that it's all correct and that I know what I'm doing and that things are getting updated as I'm going rather than having to blanket change everything one time per year. So if I notice something's not right in the computer, I'm changing it as soon as I see that situation.

0:13:39.7 KD: Yeah. Totally. So I feel like, guys, you just were given a solid like quick checklist to see is your billing great? Are you guys actually making it easy? Do you make it hard? Are your collections there? Are your write offs there? Is your AR there? Are you guys updating your fees consistently? And if not, get into a habit or come join us guys. You can always reach out, but this is where protocols I think are paramount. You've gotta have your collections protocol, you've gotta have your AR benchmarks, you've gotta have what your collection percentage should be so people know, they've gotta know how do we actually look at this AR spreadsheet, how do we download the AR, update it, report on all of our claims to make sure we don't have outstanding claims? Like that needs to be set up and that's where I feel like protocols are super, super real for this part. And then it just becomes easy 'cause then you have a spreadsheet, report on it, look at it every month, review all the claims every single month, every patient in AR, look for trends and patterns and fix and adjust it for the next month. That way you can get cleaner and cleaner and cleaner billing. But this is why there are hundreds of companies out there that do billing, 'cause it's not that hard to do, but takes consistency to keep your collections where you want them to be.

0:14:51.6 TT: Yep, totally agree. Totally agree. I think that that's why our operations manual intensive is so important as a piece of the puzzle for the practices because if you do have those protocols into place, it's much easier for anybody to slide into that billing position and really make sure that they're optimizing their time and optimizing what they're doing within the department.

0:15:12.3 KD: For sure. So I would say guys, make sure your billing is really with ease. And if it's not, email us, [email protected]. You guys can join us for our ops manual intensive January through March where we're gonna be cranking on getting all these protocols done with you guys. Or if you need help more specifically, custom one-on-one, be sure to reach out. This is what we do for a living. Tiff and I literally our days are spent coaching your team on how to set up this billing protocol. We coach doctors, we coach your office on all these 12 systems and themes so that way you really can say yes, billing with ease. [chuckle] It is easy because it's organized and if you can't say that today, do something because I feel billing is top notch and will reduce a ton of your stress if you can get your billing on top of it. So Tiff, I think it was fantastic guys. You have a checklist, Tiff and I just went through the checklist, check it off, see how your billing department's doing. We gave you benchmarks for it and then if not, reach out for sure. But Tiff, thanks for being on the podcast on this labor of love with me today. I super appreciate it.

0:16:10.6 TT: Oh yeah, absolutely. I love podcasting with you. It's one of my favorites.

0:16:15.4 KD: Especially when it comes to billing, right? A podcast on billing.


0:16:18.0 TT: It's just duh. Duh, I've been looking forward to this...

0:16:19.7 KD: It's the only way to make billing better.

0:16:21.3 TT: All day.


0:16:24.2 KD: All right guys. Well that is your guys' labor of love in our 12 systems. Today was the system of Billing with Ease, giving you guys a quick simple checklist. Be sure to keep following along and join us next week when we talk about April or the fourth theme of five-star patient experience. And Tiff and I will be joining you guys next week to discuss that. As always guys, thank you for listening. I'll catch you next time on the Dental A Team podcast. And that wraps it up for another episode of the Dental A Team podcast. Thank you so much for listening and we'll talk to you next time.




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