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Do you post by procedure?

 

Outsourced dental billing companies often receive the question, “Do you post our insurance payments by procedure?” The answer should always be, absolutely! Whether you utilize a dental billing company or not, it is advisable for all practices to post payments by procedure. There are four primary benefits of posting payments by procedure.

 

 

1. Accurately and efficiently compensate your providers

 

 

Many providers are paid based on a percentage of collections for dentistry produced. If payments aren’t posted by procedure and only posted as a “total” payment, collections may be allocated to the wrong provider, and the provider that actually performed the services will not be paid correctly. Taking the time to post payments accurately to ensure reports are accurate is much less time consuming than trying to correct inaccurate payroll. 

 

 

2. Know exactly what was paid for each procedure

 

 

By posting an insurance payment by procedure, you know how much of the total payment was allocated for each procedure. Therefore, if there wasn’t a procedure paid for any reason, it can be easily documented on the ledger and any team member could easily explain to the patient what services caused the balance. This posting protocol applies to all dental benefits payments, whether in or out-of-network.  Posting an out-of-network insurance payment by procedure allows you the ability of developing a history of how much will be paid on the same services should the patient or a different patient insured by the group plan present for treatment. This enables the practice to more accurately estimate expected patient portions and can increase treatment acceptance. The more we, as the dental team, know about the patient’s benefits, the more likely the patient is to accept treatment. It is not easy for the patient to clearly understand their benefits, so that task falls on the dental team in many instances.

 

 

3. Maintain a current PPO fee schedule

 

 

Posting payments by procedure for the PPO plan will allow you to know exactly what the write-off should be for any procedure when the full fee, not the contracted fee, is entered on the ledger. You will also be able to easily determine when contracted fee schedules need to be updated by knowing exactly what was paid for each procedure and comparing to the fees you have entered in your software system. It is important to maintain an accurate fee schedule when in network. Remember, the primary reason for entering a contracted fee schedule in your software system is to communicate with the patient their estimated out-of-pocket expense when presenting treatment plans and making financial arrangements.

 

 

4. Accurately calculate the patient’s portion and PPO provider write-off for dual insurance

 

 

If you post by procedure accurately, you know exactly how much was paid for each procedure by primary and secondary plans. Your PPO write-off can be calculated for each procedure more accurately as well. Ledgers can get messy when the patient has more than one plan and the provider of service is in-network with one or more of those plans, so do yourself a favor and post by procedure. You will be glad you did when an account analysis is needed. 

 

In Summary

 

Posting insurance reimbursement by procedure has many benefits. We have discussed a few of the top reasons to follow this suggested protocol. Be consistent with your posting protocols. Document your protocols and train your team accordingly.

 

 

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