Episode 714: How to Put Millions in Your Pocket

 This episode is all about what billing correctly looks like. Kiera dives into tips for being the best stewards of your practice’s billing, including how to keep claims from getting stuck or denied, what to take out of accounts receivable, double-checking that provider, and more.

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Transcript:

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0:00:06.6 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 to 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.

0:00:50.4 KD: Hello Dental A team listeners. This is Kiera and hello everyone. I hope today is such a great day for you. I hope that you are just having an incredible time of your life. I hope that you really truly just enjoy this time. This year my word is joy, is my word for the year and I've just been thinking about it. I love the word enjoy because it literally means that we are in the moment of joy. And joy is different from happy. Joy is different from fulfilled, joy to me is that like, I guess that just state of being, of happiness, of fulfillment, of freedom. And so for that I just wanted you guys to really embrace that and I hope you truly are enjoying the life that you've been blessed to live. I hope that you are enjoying this time. I hope you're enjoying the days that you have because we never know how many days we have.

0:01:43.5 KD: We never know when our time will run out. For me I hope I live to... Gosh, I don't know. I used to say like a hundred and then I just met someone who literally no joke, my same age, said, I hope I live to be 200. No kidding... Like, not even kidding. Don't worry I like definitely am trying to get this person to either come to an event or speak on the podcast because I thought, something to think about. Living to 200 makes me think way differently. I just turned 37. I definitely have had a midlife crisis from 35 to 37. 35 I'm like, I'm halfway to 70. What have I done with my life? 37, I'm like, oh my gosh, I'm on the downward slope to 40 and in my mind I had always been Kiera who was like 20 to 30 and then like 80, 90, a 100 in the... I say nursing home, but just so you know Tiff and I's version of this is like on the beach with Jazzies, with Noss and I have cotton candy pink hair.

0:02:41.2 KD: Tiffany has... Spiffy Tiffy has cotton candy blue hair, anybody who wants to join in on this, you're welcome to. But man, that was like, I never imagined this middle of my life like 40 to 80. That's a lot of years in case you're wondering and didn't quite know how that's gonna be. So I'm in this midlife crisis thinking like I'll probably only live to a hundred. I'm gonna have the best time. Tiff and I are gonna be on our jazzies with noss, not because we have to be on a jazzy but because like it's just gonna be really fun to raise like complete mayhem for the people around us and have just a great time. Have people think that I'm like this little old lady and then like smoke them on the line. We probably won't even be driving when I'm a hundred let's be real.

0:03:19.0 KD: We'll probably have like drones that take us everywhere. But with that, the thought of living to 200 made me think at 37 I'm pretty darn young and at 37 I need to take way better care of my body. At 37, I need to workout more, I need to eat better because if I'm living to 200, shoot, this body's gotta get in some better condition. So I'm just planting that seed out there because I love to make people think differently through business, through life, through your position, through all the different things you're doing. So on that note, if I can help anybody out there to be 200 now I just wanna know, we'll put this out. I think Allison should put this on our social. How old do you wanna live till? I really wanna know and if you don't wanna go on social, just email me [email protected].

0:04:04.9 KD: I genuinely wanna hear from you. I wanna know how old do you want to live to? It's just a question and it's something that I like to think about because it would make me do things so differently. Just like how big of a practice do you want it to be? You're gonna do things differently if you want to go for like 10 ops or, excuse me, 10 practices and roll them up into a DSO versus a four op practice that you want to be specialty, boutique and niche. Two very different outcomes, two very different ways of setting up systems. Two very different ways of hiring team members. Neither dream wrong. How else do you wanna live? I just wanna know. And on that note, if this podcast has blessed your life, guys go leave us a Google review. Go leave us those five stars on your podcast wherever you're listening to this, it means the world to me because truly this is how I'm able to get our podcast out to the entire world. The goal is to have this podcast in the hand of millions. Currently right now you guys, there's like 80,000 of you downloading every single month.

0:05:05.9 KD: Don't worry, I just had a jaw drop for those of you who weren't watching the video, I am shocked, I am honored, I am in disbelief for all of you listening and being here. So just give yourself a massive like pat on that back. That's right. Give yourself a pat on that back and share this with someone today. It means the world to me. It's the greatest thing you guys can ever, ever, ever give me because, if I can serve and help more people, that is my ultimate mission to serve as many people as we possibly can and I can't do that without you. So thank you guys for doing that. Thank you for being those people. Go share this. And now I wanna teach you guys how to put millions in your pocket. That's right. I'm gonna teach you how to have like millions in your age, like what can we do for Biohacking, also, I'm gonna throw that out there.

0:05:51.8 KD: I'm still not done with this living till 200. I just wanna throw it out there because I believe this podcast community is absolutely brilliant. So if any of you are Biohackers or have life hacks of what you do to have more energy in life, to feel better, to have more stamina, please email me. This is a genuine ask. Please email me [email protected]. I would love to actually interview you and I would love to start hearing because this is a journey I'm on personally. I'm here on the podcast to serve you guys and also to meet really cool people to give me life hacks, practice hacks. So if any of you are that way or if you know someone who's a super strong guru at it, even if they don't wanna be on the podcast, I would love to just pick your brain. So please truly email me [email protected].

0:06:32.9 KD: Maybe I'll do a podcast on how to live to 200. Huh? Could you imagine? All right, I'm gonna have to spruce up my life. And my vision and my dream maybe Tiff and I will be 200 on Jazzies. Oh my gosh. But truly someone email me. I know this podcast family is huge diverse and I believe in the power of the group. So on that, thank you whomever you are, just do it right now. [email protected]. So I'm gonna teach you guys how to put millions in your pocket and that is through something super sexy and that is through billing correctly. Oh Kiera, so like such a high note on this podcast down to maybe the low of the low but it's not because what I found is if you just bill correctly and you bill what you do, it will literally put millions in your pocket.

0:07:19.2 KD: I am probably hired more often to help billing in practices than almost any other topic. It's usually office management, growth and billing. Those are typically the three things that people come to us for. And if you're in one of those categories, you should definitely reach out 'cause we're freaking gurus, geniuses at it. We help you, we train you, we give you the systems. Peeling back the curtain of what it looks like to be one of those clients is we genuinely figure out what your needs are. There's no A to Z cookbook that we have over here. It is what is your practice? What are your needs? And then we create a plan with you and we train your office manager to be an office manager with leadership skills, with KPI tracking, with looking at numbers, with being able to look at the business like a business owner.

0:08:03.3 KD: If you're on growth, it's how do we systematize your practice to stamp out in other locations while maintaining the individuality and the practice, the private practice feel, but being able to exponentially grow. If you're wanting to have more cashflow, how do we look at our P&L? How do we get our team on board to look at these numbers and not think that we're just trying to grow for growth but to grow, to be able to serve more people and to get your team bought into these numbers to build leadership teams for you, to teach them how to look at KPIs and to build KPIs and to set up weekly and monthly meetings and quarterly meetings, how to do that. Or if you're like, Hey, I don't know how to bill, great, [chuckle] we're here for it. We have an online course plus we have lots of ways to teach your team...

0:08:43.7 KD: What should you be looking for? What does billing look like? That's what it looks like to be within our consulting company. It's the truly hands-on. Let's do it with you and if that resonates with you, reach out [email protected] or click the book a call and we will do a free strategy call with you. We'll give you some free tips and advice and if it's a good fit for us, rock on, work with us and if not for you or for us, awesome. It was super fun to connect and meet with you. So it's truly no risk book the call, it's time. So getting millions in your pocket for billing is something that I just see of so many mistakes people make and it's one of those things where I'm like if you just bill correctly, you will have millions in your pocket.

0:09:24.1 KD: So with that I'm gonna just kind of go through a couple of different things that can really help you, what does billing correctly even look like? And the first thing is set up. We need to make sure that we have the same carrier across the board. Let's not do multiples. So if we all know that they're working at this employer don't have multiples of that employer plus the same carrier because it gets very, very confusing and then we have to check hundreds of them versus just one of them to make sure the address, the phone, the payer ID are all correct. And incomplete carriers are often attached to insurance plans and then that denies your claims because it was incorrect just from the setup. So, so many people think it's on the billing backend but on the setup front end, if you take the time to do these things correctly, I promise you millions will come back into your pocket through billing.

0:10:10.3 KD: The second thing is doing complete patient information, the patient subscriber details are missing. And so we just need to check in when they come in to verify their insurance and verify their data. It's simple. Think about when we go to the doctor's office, they print out a form and say, is all this complete? Have them just verify. Highlight it for them, verify it, have it on MEDENTO, have it on an iPad. Things like that are going to help you just verify their patient information is correct. That way we can bill correctly. Then you also need to be setting up the PPO percentages. So having it like in-network or out of network, making sure we pull those PPO fee schedules in. We bill out our office fees on there, making sure our fee schedules are current because if they're not, we're billing the wrong amount, we're estimating the wrong amount.

0:10:55.2 KD: These things will definitely impact your billing. And then making sure group name and numbers are often are always put in, they're often missing. Just those few little things alone can exponentially churn your claims faster for you. If you could get to a 15 day AR, how incredible would that be versus a 30 day AR. Still even 30, 60, 90. Just these simple things. I can't tell you how many claims I watch, like it's like a game of ping pong. Let me send it to you, let me have you send it back to me. Let me send it here. If you're playing ping pong, let's cut out like seven of those steps and just check this simple setup, making sure that's correctly. Then when we have on there, when we're doing a like resubmission or any of that, like if we're resubmitting a claim or a corrected information, you've gotta be documenting that information on your claims and you also have to make sure that your attachments are added. Because if they're not added, the insurance company's gonna ping pong it back to you and then we're gonna ping pong it back to them and then ping pong it back like good night.

0:11:53.5 KD: We are in 2023, we are not in pony express but the way we act with our claims is like we are living back in the 1800s and sending mail via pony express. I don't know if they're in the 1800s. Don't judge me on that historical fact. Someone please email me and tell me that I was wrong. I would love to hear from you anyways just to say hi and to be corrected. So then once we go from there when we're posting treatment, this can help you exponentially. You've gotta have PAs for the required tooth number because those are oftentimes missing. Such a bummer like set that as your note template, have it as a pop-up, put it in there as a treatment. So like part of the treatment plan, if you're doing a crown prep or you're doing different things, just put in a PA as part of your explosion code so we don't forget to get the PA for it, making sure the team remembers to do that.

0:12:38.8 KD: We also need to know if this is an initial or replacement for Crowns, Bridges, Dentures because we can't have it be an initial if it's a replacement because the insurance company can actually deny claims on that. If it's a replacement, the patient might not know. So we just need to have it on there. That's a simple note template update where if you just put it in there and say this is an initial or this is a replacement with the date, put that in the note section, that can then help the claims process more correctly. We have to make sure that we also are doing the correct things, not doing limited exams for POST-OPs, a rescan, things like that, making sure the correct codes are associated with what we're actually doing. My best advice is post what you actually are doing.

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0:13:21.6 KD: Don't post things that you're making up and there's so many codes out there like I think the dumbest thing is when insurances say we won't pay except for on seat date, I'm like, yeah, that's cool.

0:13:33.4 KD: There is truly no code for a seat date. It's a made up code. But that's a great way for you guys to play a game with us that we're definitely are gonna play. So just make sure that you're actually posting correct treatment on there, making sure that the posted fees are the allowed amount. So you've gotta have your fee schedule correct, you've gotta make sure the posted fee is the right amount. So meaning if you can't [laughter], like I know in your office you wanna charge $3,000 for a crown, but I know delta's super sweet and they only pay you 600 if you're lucky, maybe 700, maybe a 1000. You've got to make sure that you've got the correct fee and it's below the allowed amount. So like if it's a 1000, we can't have this coming in at 3000 because otherwise our treatment plans are not correct, we're definitely going the wrong way, we're estimating the wrong amount.

0:14:19.7 KD: It's causing inaccuracy of treatment plans, it's creating problems with patients, what they're expecting to pay out of pocket. And then we're also having a lot of adjustments to absorb those false credits. So it becomes a truly an accounting nightmare if we're not having those fee schedules in there correctly. Now another thing is when we're submitting claims, we cannot be deleting these claims or posting treatment change or new claims being sent. I understand that these things can happen, but we need to correct it. We can't just delete it and say, oh, this treatment wasn't right, so we're gonna delete this and change it. I like it to be a running log so in case I ever have to go back, I can say what's going on there? So this, it like just delays everything. So make sure I know it's old school, I know it's dumb, but it's a very easy checklist to, at the end of an appointment, print a walkout statement for your patients and I used to just go through it.

0:15:10.5 KD: One, it's a value system for your patient, but two, it was honest to good is my check to make sure I build everything out correctly. When I was walking a patient out. It's dumb, it's annoying, it's paper so you can even have it electronically, but just literally go through it line item by a line item of Hey Sarah, it was so fun to have you in our practice today. Today we were able to do this, this, this, this, this. I say it out loud as I'm going down the line item, obviously make sure you're HIPAA compliant, but that way it's a double check for me to make sure I didn't miss anything. So for you guys double... Again, whatever system or process you wanna put into play, add value for the patient. But the biggest thing is I'm making sure that I'm posting the correct treatment, I'm not missing things and I'm not having to go back and change it and change my claims because I didn't post things correctly the first time.

0:15:53.7 KD: So much of billing is just make sure it's done right the first time. And usually we need a check-in balance. So for the check-in for the setup, just put it on your route slip, check the boxes, every patient, send it off to the back. Then when we have it to the back, bring it to the front checklist that we did these things correctly. Put it in your note templates. These little things seem annoying and this is how you get millions in your pocket because claims aren't getting stuck, they're not getting denied, they're not sitting in over 90 and they're no longer being paid. So make sure that you're actually billing what you say you're billing, make sure you're setting it up correctly. And then the next thing is, make sure you actually have the correct provider attached to completed treatment. Oftentimes in practices, I understand the credentialing nightmare.

0:16:33.5 KD: I understand that we wanna have our providers there, I get it, I get that they're out of network, but you need to be honest, be honest, so that way we're not having to go back in time, we're not getting audited, we're not having to pay things back. Just keep your books clean. If a provider did it, bill that provider. If they're out of network, there's a lot of solutions that you can do. If you're an in-network provider, you can bill the in-network fee even for an out-of-network provider. So it seems the same for an EOB. You can also then put them in network and hold claims until they get credentialed and back bill. A lot of insurance companies do that. It's super annoying, but it's a way to be honest, ethical, and not have these denied or out of network. So just really truly make sure that we're doing these things correctly.

0:17:16.8 KD: And then I like to run Unsubmitted claims and check that every single week to see how many are there. I like to run it every single day afterwards, look to see which claims got stuck in the clearing house before we send them out. Fix that every single day. And the goal should be, I like tracking how many claims came back to us because that's gonna help me figure out why did these claims come back? What were the pieces that were missing on them and how can we actually fix this and make it better? So that way we fix the problems as they come through, as opposed to perpetuating the problem continuously. So doing these little things, there's so many more, but that's just like a quick overview. A quick highlight of ways to really enhance your billing department and truly put millions in your pocket.

0:17:56.3 KD: I have seen so many offices write off bad debt because we didn't have correct billing things in place. And that makes me so sad and so angry because I feel like doctors, you did the work, you should get the money for the work you did. Just like every team member should get paid for the work that they do, any team member would definitely wanna get their paycheck and us collecting money because we're billing correctly, I feel as a team's moral obligation to the practice and to the patients. So doing these things I don't feel is optional. I feel it is mandatory. I feel like we need to be more responsible. We need to find ways to bill, we need to be better stewards of our billing. We need to be looking into our billing and figuring out what is missing, what is lacking, and how can we make this better?

0:18:36.9 KD: And if you do this every week, every month, you're gonna be shocked. You'll be shocked at how good your billing is, how good these things are. Also like another tip, people don't do this and I don't know why. Take out your ortho, your payment plans, your membership plans out of your AR, so your AR is always accurate and we can make sure we're consistently following up on that. These are small tips to put millions in your pocket. And if you want help specifically for your practice, email us. [email protected], click the book a call, would love to help you. These are simple things, just like simple things help us live till 200. I don't actually know, I've never met anybody to 200, but it's a good thing to think about simple things. It's diet, it's exercising every day, it's being consistent, it's being diligent, it's being deliberate and it's reassessing to determine are the results we're getting what we want?

0:19:26.0 KD: And if not, let's change it. Same thing with your billing. Be deliberate, be intentional and get paid what you deserved. You truly did the work, it's time for us to get paid, to make it to where you're actually making money for the things you did. Not writing things off, not giving away free dentistry, not fighting with the insurance companies, not allowing the insurance companies to dictate it, but playing the games of insurance correctly, setting things up correctly, and then billing. So with that, my challenge to you is set this up, be diligent, get a little bit better, and if I can help you in any way, [email protected]. And as always, thanks for listening and I'll catch you next time on The Dental A Team podcast.

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0:20:06.3 KD: 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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