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Advice for handling billing calls

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Advice for handling billing calls

This blog is about advice to handle billing calls that occur when patients call the office.

Sometimes patients call about a billing question and the focus of this blog is on conversations that happen on the phone.

3 most common reasons patients call about bills

There are three main categories of conversations that can happen on the phone.

  • Maybe the patient wants to know the fee for for a procedure they haven’t had yet. Maybe they’re curious what their insurance will pay.
  • Maybe there was a pre-treatment or a pre-authorization done and they wanted to know what the benefits were from the pre-authorization.
  • Lastly, there may be a remaining balance  for treatment that was already performed and maybe the insurance is already paid or is pending.
  • The patient may have a question about their account and what’s owed for services received.

So those are three types of billing calls that you may receive about procedures they haven’t had, insurance related questions or fees for treatment that’s already been done.

1. Fees for Treatment calls

Generally, prices for treatment can be difficult to discuss on the phone.

Especially if there hasn’t been an exam because there’re lots of types of treatment options. There’s more than one type of partial, for example, and there’s lots of variables on what treatments would be needed.

Do we need to do a filling before we do the partial or do we need to take a tooth out before we do the partial?

You can imagine there could be some confusion if a patient is asking questions about what a procedure would cost when they don’t necessarily have all the information and the front desk is trying to answer the questions without all the needed information.

And then later when the patient is seeing the dentist, they could hear a different story and there could be some confusion and we want to avoid that.

The best option when a patient calls to ask about fees is to try to set up a consultation.

If it’s your practise philosophy, you may be able to say: “our office isn’t the most expensive office. We aren’t necessarily the cheapest office, but we offer quality, caring service and we tend to stay priced somewhere in the middle.”

Many procedures have different types of prices based on exactly what needs to be done and how your insurance benefits may help.

The best recommendation is to have a consultation

The best recommendation is: “come in, have a consultation so that we can get to know you and you can get to know us and we can learn exactly what needs to be done. And you can go over this information with the dentist to look at things and make a plan and go over any costs.”

Depending on what type of consultation is needed, the cost of the consultation might be free or the exam might be covered by the insurance.

  • If it’s something like an orthodontic consultation, you may want to have a policy to have free consultations.
  • If it’s for a consultation about other procedures, such as an implant or other procedure, many insurances have a preventative benefit, so the patient can have a limited exam and it may not be any out of pocket cost.
  • If they have questions about their insurance benefits, that can be discussed in another blog, how to check benefits for patients.
  • And if it’s an emergency visit, and the patient’s in pain and they may need to first do an exam to know what to do.  The first visit may need a prescription after the exam. 
  • If no further work’s done the first day, then we may want to have a few options for the initial fee. 
  • Maybe there’s an insurance benefit that covers the exam.
  • Maybe if the patient’s uninsured, and the office could offer  a set out of pocket consultation fee to use for uninsured dental patients who have questions about fees.

This could be a way to give the uninsured patient some idea of the cost that they could come in and have an exam and an X-ray and determine what’s needed as the best next step, which could be an extraction or maybe removing a tooth or a filling or a root canal or crown or implant.  But they could plan for a basic consultation fee to get all the questions answered.

But depending on what presents, it’s good to have some fee established for the consult when it’s a situation you do often-  whether it’s a free orthodontic consult, an emergency exam with a minimal fee for X-ray and treatment plan,  or a new patient exam.

So when they’re asking fees, you can try to set them up an appointment for a consultation and hopefully make it very easy without obstacles so that they can get their best information and not be confused later.

2. Insurance Benefit call

Second type of call is insurance related.

What is the patients  cost going to be after the insurance  benefits are checked for a pre-estimate  from the dental  insurance company?  

Many of the treatment plans can be made in the office and the benefits may be  estimated in person at that time- especially if you have benefit information in your practice management software.

If a patient’s had the treatment plan and insurance was checked after the patient left, hopefully we called the patient to follow up with them, or schedule a 2nd inoffice consultation to followup, especially for a larger procedure like orthodontics.

But let’s say a patient calls and there may be a question about the treatment plan and the estimate that was received by the insurance- this may be something that the front desk can handle without the financial coordinator calling the patient.

If the patient’s had a treatment plan and estimate information from the insurance is ready, you can make sure you include this. You could tell them, this is what we’ve received regarding what your insurance is estimated to pay.

Or if you’re checking the benefits online or what’s estimated in your practice management software, you could say, “this is what we saw as benefits” and share the sources of the information with the patient.

You could say, “this is what we did to try to get the benefit information and this is what we found out.”

Let them know you sent this pre-authorization or pre-treatment to the insurance, or you called the insurance and this is what you heard.

Or you’ve called the insurance about similar plans, and this is the information that they have said in the past.

Just let the patient know the source of the information that you’re gathering and then also let them know that.

Even the pretreatment letter from the insurance often says it’s still only an estimate.

Sometimes there’s other factors that come into play, like maybe other dental work was done during the year, and that may change the amount of what the dental insurance will ultimately pay, especially if reaching an annual limit. So it’s not a guarantee, it’s hard for the dental office to make the insurance pay..

Having that pretreatment from the insurance isn’t a guarantee that that’s what the insurance will pay. It’s just an estimate.

At our dental office we  are doing the best we can to estimate what the benefits for this procedure will be, and this is the copay we think you’ll have, but you may want to share the insurance number with the patient too if the patient wants to follow up and double check on some of those questions.

3. Cost for past due treatment call

The final type of call is to discuss costs for past due treatment.

If it’s a patient and there is a past due account, the patient’s had the treatment, the insurance paid, the balance is there, we know the fees are correct, then you may just simply say; “this is the balance. How would you like to take care of that?”

If it’s a collections call and the patient’s calling back  to pay a bill, try to collect with a credit card over the phone just for the patient convenience.

If they have a question about the bill and the amount, try to resolve it if it’s something you can research and try to get it done quickly.

If it takes some research to get all the answers, get the patient’s phone number and the email and make notes on the account about their contact information and when you will return the message or who will return the message.

Make sure that they get an update and make a note that you did update them, especially if the patient is being transferred to another staff member.

It’s good to have smooth transfers that are seamless for the patient. So having good notes about the patient was told is important.

Sometimes you can handle these things quickly on the phone.

Sometimes it takes some research and sometimes to follow up with the insurance or pull an EOB or dig a little deeper and you have to call the patient back.

But try to communicate and keep the patient updated to get their questions resolved as quickly as possible and keep things moving forward.

We know outstanding bills aren’t good for the patient and they aren’t good for the practice. So these are a few types of billing calls you may hear on the phone, questions about fees for treatment to do, questions about insurance, questions about fees for  previously completed dental work, but the goal is to get the patient back in the office where things are easier to discuss.

Handling billing questions

So for all of those, the goal is to get the patient in the office.

  • If it’s a question about fees for the treatment to do, get the patient in for a consultation to discuss the fees.
  • If it’s a question about insurance benefits, give them an estimate for the insurance and get the patient an appointment to do the procedure or to follow up and discuss the procedure more with the doctor.

A second consultation with the doctor about the procedure can be used just to make sure any further questions about the fees, the doctor can help clarify.

Finally, if there’re questions about bills for previous dental work, try to get the patient in to set up a payment plan or make other arrangements to handle past due bills.

In all instances, you’re trying to help get the patients questions answered and help get them to move to the next step of their care.

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