Dental A Team Podcast

#972: How to Cut Your AR in Half!


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Tiff and Kristy share not only how to cut down your accounts receivable, but also how to develop systems that will keep your AR low. They discuss time management, clear job descriptions, protocols, and more.

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Transcript:

The Dental A Team (00:01.752)

Hello, Dental A Team. I am so excited to be here with you. I have Kristy back here with me today, and we are excited to talk to you about a really fun subject today. It's not always the top of the fun list. think billing gets pushed down in the fun category, and a lot of people put a lot of stress on it, which I totally understand. But Kristy and I are here today.

 

to bring some fun to the billing department and to bring some fun around how to make billing work within your practice. Kristy, thank you so much for being here with me today. How are you?

 

Kristy (00:34.658)

Good! It's a good Monday!

 

The Dental A Team (00:37.955)

Good, I know. Our Mondays get busy here at the Dental A Team. They are our meeting days and our project days and they just, they get chock full of so much stuff every single week and we absolutely love them. We get to spend a lot of time prepping for our client calls and our client visits. A lot of us have client visits coming up soon and just getting all the things together. So Mondays are always a little chaotic. Kristy, in your...

 

In your experience, you've got a wealth of knowledge, a wealth of experience behind you. What was your favorite position or your favorite space to work when you were in practice?

 

Kristy (01:16.704)

interesting. Favorite Space was probably really helping getting patients the care they deserve, filling that patient advocate role. here's the thing, I know we're talking about AR today. If we

 

If we aren't cognizant of a patient's budget, we're really not doing good by them. So being cognizant and finding a way to fit it, you know, the care they need within their timeline and their budget is, it's rewarding.

 

The Dental A Team (01:50.047)

I love it. I totally agree with you. think making sure that we're giving them the best experience all the way around, no matter what is the best space to live in within a dental practice. can get homes fulfilled us. It gives us a purpose and a reason to be there. And on those notes, I think you're absolutely correct. If we don't know what the patient wants, what their desires are, what they can do, and we end up down a path.

 

that might not be the right fit for them and ends up not being the right fit for us because we end up in situations where we have high AR, outstanding claims, outstanding bills, all of those pieces. I also know one of the biggest reasons that people leave a dental practice or write a bad review, I have so many practices that are like, don't put me on swell, I want to have control over who gets reviews and who don't.

 

And I just think everybody should get a link for review. So I love advocating for that company and for within our marketing. But I know that the biggest reason that we're afraid of something like that and that people that patients leave their practice is for billing inconsistencies or billing issues. So really having standards and protocols and just everything wrapped around the billing department is so imperative and so important because even down to that patient advocate space.

 

When you're that patient advocate, which is also sometimes, you know, patient coordinator, front office check-in, like all of those are kind of wrapped around similar spaces within the practice. But when you're sitting in that space, Kristy, so many times you are walked into a really hard conversation because there was confusion over previous billing or you're the one that's responsible for collecting today's balance that's due or outstanding balances. And so you kind of walk into really uncomfortable situations because

 

you're not sure what it is sometimes, the patient doesn't know what it is, and sometimes that patient comes in upset. So knowing how to diffuse those situations too, think Kristy is a really great space and just builds that relationship as well. I think I love your answer.

 

Kristy (03:50.149)

Thank

 

The Dental A Team (03:51.193)

That's my wrap up there. So today I've brought Kristy here to talk with me and chat with me for you guys today about really cutting your AR down and hopefully building systems that keep it so that your AR doesn't get high. And just so you guys know, doctors, your AR is your accounts receivable. So this is money that's supposed to be coming to you, but hasn't made its way through the door yet. And so we're trying to get that money through that door into your bank account to help your overhead ultimately.

 

and by increasing your collection. So we really don't want a lot of money sitting out in that AR, in the accounts receivable, that outstanding collections. We really don't want a lot of money out there, but it is also flip side of that unrealistic. Many of you are like, I shouldn't have any AR. I should 100 % collect. While that is, you know, the dream, it is very unrealistic. So there will always be something outstanding, even if you're a free for service practice, in my opinion, there's always going to be something outstanding. So

 

Just building those systems and those protocols is going to be absolutely fantastic. And for you doctors that are listening today, which I hope you guys are here because I hope you're ready to cut your AR down or keep it from ever increasing, I want you guys to know the back end side as well, because I don't want you to be afraid of your billing department anymore or afraid of money. A lot of doctors, I think, steer away from even looking at bank accounts or overhead or...

 

Any of that I think we do in our personal lives too, just because there's so many misunderstandings. So if you can get involved in conversations like this today, really know the expectations of different spaces like that. I really think that it helps to build your confidence in moving forward and keeping those ARs from getting any higher. that's my caveat for today, doctors. I want you listening, I want you taking notes, and then want you taking it back to your team, because this is gonna take a whole team to get a lot of these things done. Kristy.

 

Where do you see the biggest hang up in practices you have worked with? You've worked in many practices, you've consulted many practices in your current clients too. Like, where do you see the biggest hang up when it comes to accounts receivable and that outstanding money? Where do you feel like, gosh, it's really just stuck here if we had to say one space.

 

Kristy (06:04.576)

one space. Honestly, probably in the insurance realm, verifying and getting the correct breakdown so that we're giving the proper estimates and therefore collecting the proper copays, right?

 

The Dental A Team (06:20.264)

I totally agree. Yeah. And I think that's a space that gets really confused. And I think doctors get very confused about it. Like, what is that supposed to look like? What should I be doing? What should I be expecting from my team? How can they get it all of those questions? So I totally agree. We have so many different podcasts on so many different aspects of that. We have so many clients that are working on all of those pieces as well within their consulting with us. But I agree that

 

You have to remember whatever you put into the system is as good as the information you're going to get out of the system. So while it's a computer, while it's software, like it's supposed to, you know, at one point be smarter than us, like it can only be as smart as we can make it. And so the information that you're putting in is going to spit out the information that you're going to get out of it. And if we're rushed, if we don't have clear clarity on what's expected or

 

clarity on what's the most important. Like things get muffled, things get confused. So I think when practices have high AR or to keep them from getting high AR, I always recommend like three basic things. The first thing is time management. We'll dive into time management. The second is ensuring you know what's the most important. So how do we figure out what's important and what's not important? And then the third is having really clear systems and protocols.

 

to be able to use. Those three things, you guys, if you have time management on your side, you can decipher what's important, what's not important, and you have really simple protocols and standards that you consistently use all the time, that's going to propel you to really have cut AR or no AR, or little, I should say minimal AR in the future. So.

 

Kristy, what are some areas that you've worked with your clients or you've worked with in the past that you can say, gosh, these really work in the time management realm? Where do you see things working over there for you?

 

Kristy (08:21.58)

Yeah, for time management, honestly, I think it's about dedicating the time and getting it into your schedule. We like to call it, you know, putting that power hour and really diving in and creating that time to focus on the AR.

 

The Dental A Team (08:36.616)

Yeah, yeah, I love a power hour because you can let it.

 

Kristy (08:43.694)

Okay, sorry.

 

The Dental A Team (08:46.026)

way because I think a power hour, I love power hour, I've used it in multiple facets. I used it in my personal life as well. Power hour, you guys, is so simple. It blows my mind every single time at how well it works, and I utilize it for all kinds of positions in the practice, but I think it's amazing for the billing rep position. So, Kristy, I love that you mentioned that the power hour, literally you just split an hour into like four chunks or two chunks, but you always make sure

 

that you've got it scheduled. So your time management piece, right, is making sure that you've got it scheduled somewhere. And then you've got your list of things that you're going to be doing within those 15 minutes. And you've got some sort of timer handy, even if it's your watch, if it's your phone, like whatever, you're gonna set for 15 minute timer. So you guys, it's that simple. And you're gonna say in the first 15 minutes, I'm gonna do X, and Z.

 

In the second 15 minutes, I'm gonna do ABC. In the third, and so on and so forth, and you're gonna set that timer for those 15 minutes where your billing rep is going to, you guys do this as well, you're gonna set that timer, and at that 15 minute mark, you're gonna take inventory and you're be like, okay, what did I get through? Did I get through the top most important items? Do I need to shift one down to the next 15 minutes or am I ready to move on to the next set of most important items? So.

 

I love that Kristy. So we have the power hour. What other things have you utilized?

 

Kristy (10:12.718)

yeah, Putting the block schedules into the appointment book so everybody knows that you are dedicating that time and working specifically on AR.

 

The Dental A Team (10:12.81)

sketchbook.

 

Kristy (10:29.022)

And I would also say be sure that we detail this because AR can be broken down into two different categories. We have the patient AR and the insurance AR. you know, dedicating time. And I would say, you know, weekly dedicating time to work on these and specific timeframes.

 

The Dental A Team (10:46.174)

Yeah.

 

The Dental A Team (10:49.802)

I totally agree. I love that. And I think we think block scheduling and we think patient schedule only. And it's so interesting to me to consider any kind of system or protocol. Like there's so many spaces where it can be dropped, like copied and pasted into another aspect of life. And when we think about block scheduling, which we have talked about so much for patient schedules.

 

we can now copy and paste that into like even our personal lives, you guys, if I wanted to get crazy with it. But really, if we look at the positional duties, like what is it that I need to do as a billing representative and how do I block my schedule to fit that? I'm going to think, okay, just like thought, doctors, I made you go think, where should I do a root canal? Like where should my high priority pieces be? My high income procedures, where am I going to put those? Where should I do root canal?

 

flip-flop that over to your billing representative, right? And we're not gonna like call on patient balances at 7 a.m. So where is it likely that I'm gonna be able to call on patient balances? So I'm gonna build my schedule using time management skills that I know how to do because I know how to build a patient schedule. So if I start thinking of my duties, the things that I'm responsible for in whatever position I hold, even treatment coordinator, whatever position it is,

 

If you take that same thought process, look at the duties that you're responsible for, and then figure out how do I manage this in my day, what makes the most sense? So do I want to start my day at 7 a.m. or 8 a.m. with patient calls? Gosh, probably not. Or is it smarter to maybe check on unpaid claims at that time? If you start unpaid claims from 8 to 9 a.m., that's your power hour.

 

Right there, 8 to 9 a.m. I'm working on unpaid claims and I'm divvying it out by the 15 minutes or whatever, right? Or maybe by week, first week I'm doing zero to 30, second week I'm doing 31 to 60, et cetera. But if I'm divvying those hours out, I know the insurance companies are gonna be open at 8 a.m. no matter where I'm at in the country, right? If it's 8 a.m. Pacific, it's now 11 a.m. East. So I know no matter where I'm at in the country, if I start at 8 a.m.

 

The Dental A Team (13:05.931)

I can get a hold of the insurance companies. Then I move on to a patient, then I move on to statements or whatever, but I'm power blocking and utilizing locked scheduling rules to get the same results in my position as what I'm looking for in a patient's schedule. So you can literally copy and paste that over and manage those times. But something, Kristy, that I think gets lost in translation sometimes, you can think, power block, I'll time manage, sure.

 

But the second piece, right, first piece is time management, learning how to manage your time, learning how to see that. But the second piece, I can't time manage if I don't know what my duties are. So if we don't have job descriptions, if we haven't been taught how, you what are the results that are driving my position? Because those results that are driving my position that are within the job description, that's going to allow me to be able to see what's the most important thing. Because, Kristy, you said earlier too,

 

getting the information in is gonna affect the information out. But then we sit in this space, I think, of like trying to figure out, do I get the verification? Do I call on unpaid insurance claims? Do I call patients? Do I send statements? And we're just like, my gosh. And so how do you help doctors to be able to help their team really figure out what that driver is and to be able to say, this is the most important thing or this is where I can time manage these pieces because I can see

 

What I'm responsible for, how do you help doctors to really be able to help their billing departments figure that out?

 

Kristy (14:39.692)

Yeah.

 

Absolutely. So even with AR, there's the lag measure and the lead measure, right? So the lead measure part of it, I always feel is the verification process. So having somebody that's dedicated and is working ideally two days out in advance to get those benefit breakdowns. Obviously, our goal isn't to be insurance driven, but we want to be insurance accurate, again, so that people working and collecting over the counter have

 

that information and we're giving proper estimates and even making proper financial agreements, right? So first off, again, that pre-working ahead of getting the verification, but then also at time of, you know, it's one thing to treatment plans, but it's another to present and understand how the patient's going to take care of it with the financial arrangement. understanding

 

The Dental A Team (15:18.413)

Mm-hmm.

 

Kristy (15:40.114)

who's doing the verification, who's our treatment coordinators that are going to cement the financial plans. And then last piece of that is who will be doing the follow up. Who's doing the follow up on patient AR and who's doing the follow up on the insurance AR. So kind of just painting that clarity in the duties and then supporting each other in those blocked times, right? So each person has their dedicated time.

 

The Dental A Team (15:51.113)

That's it.

 

The Dental A Team (15:56.846)

Thank you.

 

The Dental A Team (16:07.852)

Yeah, exactly. And those job descriptions really narrow down to those results. Like, what is the result that we're after for the insurance verification, right? The result is that we're two days ahead on making sure that all the information is in the system. The result for the case acceptance is to ensure that we have, you know, 98 % case acceptance because we're living in a world of dreams, right? But we've got like 75 % case acceptance as our goal. So how do we do that?

 

and they all lead into each other. So what Kristy's like leading to, right, is if we can get that information right on the verification, now our treatment coordinator is able to present accurate or as close to accurate estimates as we can, which means that on the back end side of that, whether it's the treatment coordinator or checkout person collecting, they're collecting over the counter correctly, and our billing department hopefully has the least amount of money possible that they're chasing.

 

So I love that because it leads into one another. Now, sometimes you guys, your practice, you might only have one person or two people that are doing all three of those things. And that's okay too. You've got to figure out what are the most important things for my practice to know before a patient gets here? What are the most important pieces? Like, what am I going to be treatment planning? What kind of an estimate do I need to give to my patient?

 

that's the information that you need to get on your verification. So you might be able to really dwindle that down as compared to a practice that's got five or six part office people and they're doing surgeries and they're doing all on fours and they're doing an anesthesia in the office. Like all of these pieces that you might see other practices asking for, you might not need those. So really figuring out what is it that I need for my practice that I can get the right information and who's doing it.

 

The job descriptions are huge. When we know our lead measures, like what is it that I'm after? Now I can see, okay, is this affecting that? Like, is this going to positively impact that or is this busy work? Because sometimes we might get lost in, I don't know, confirmations, which are incredibly important, but is that my job? As a billing coordinator, right? Or if you've got two or three for an office who don't have...

 

The Dental A Team (18:19.893)

really segregated duties, I oftentimes will walk in and I'll see three or four different people, like, everyone's doing confirmation, like, well, we got to the appointments confirmed. Absolutely. But can one person do confirmations while someone else does something else? Because there are 5,000 things that we have to get done in a day. And if we're all doing confirmations, then we're probably only hitting five of the 5,000. So really figuring those spaces out.

 

making sure that it's twindled down so that somebody can say, okay, these are the most important tasks of my day today, and this is how I'm going to manage my time. Third to that is going to be the systems. You already, you know, alluded there and spoke about the systems of getting the information in. But then, Kristy, I think it's insanely important for a billing coordinator to have a system and a protocol for all of the other pieces. Like, I've seen so many practices I've walked in and they've got

 

I had a practice that had over $200,000 in outstanding claims, and I'm like, gosh, that makes me sweat, right? Because it's so stressful, and they're like, well, I call when I have time. Well, there's our time management space, and they don't know how important it is, right? So they don't know how to manage their time, they don't know when they should be calling, because they don't have it blocked out.

 

And then two, they're not understanding that this is one of the most important things that you could be doing in your position. So they're doing busy work. I've literally seen, I walked into a practice and I love this practice dearly. We've gotten so far. But I was watching the billing coordinator get interrupted because the billing coordinator was the only one who had the information in her head on the insurance metrics. And so the treatment coordinator would need her to do.

 

the estimates for the treatment coordinator, but then also she knew all the patients. So she was doing some of the like phone calls that were coming in and she was doing confirmations. And I was like, well, this is why you have $200,000 of insurance claims. Like it was wild. So that one, that one practice like encompasses all of these. The billing rep didn't know her job descriptions because she didn't know the most important pieces or she didn't know how to do them. So she wasn't doing them. She didn't know how to manage her time. And then the

 

The Dental A Team (20:29.266)

protocols just weren't set in place yet. So one of my favorite protocols is really making sure that you have at least one day a week that you've got dedicated time to work on unscheduled unpaid claims. And then also a separate, would do them on two separate days just because I don't like to do them all together. It's overwhelming for me, right? So I do one day of unpaid claims every week, some hours in there, and then I would do maybe two days later.

 

patient balances, calling on unpaid patient balances. So you can do them together. I don't care what you guys decide. That's how my brain works. But Kristy, that's how I like to do it, where it's like week one, you've got four different brackets, right, of unpaid money on both insurance and patient that you're working on. So I literally have practices, and the way I did it when I was in practice is that I just split it up by those four, right, those four brackets. So week one, I would do zero to 30.

 

week two, to 60, right? And so on. And then, Kristy, what I did as well is I started to rotate when those statements would go out or the reminders for those. So I'd be calling on one bracket and sending statements that same week for two brackets later so that hopefully by the time I got to them, they'd also received a statement. So they were getting statements.

 

phone calls, if I had to leave a message, I'd leave a text. Like this whole rotating system was put into place and I put it into place for a lot of practices and it's helped a ton of really being able to see how I needed to break out that week. And I think if I were to walk in to a new position and I didn't know that these were my metrics, I don't know that I would have been able to think, okay,

 

How do I take what my job is, what I'm supposed to do, and do it in a manner that I can get it done? So I would do those. one more piece I did forget, right? Splitting up the alphabet for your statements, you guys. Holy cow. Like, don't send them all at once, split them up. But Kristy, what else do you have? I know you work a ton on this stuff with a lot of practices. I see the emails and the texts like currently going back and forth and really dialing that in because dentists and doctors, owners, they don't really know that space.

 

Kristy (22:24.391)

Yeah

 

The Dental A Team (22:43.879)

So we've got rotating weeks, we've got patient and insurance, we've got all the pieces. What other piece do you feel like is super necessary to have within some sort of protocol for time management and all of those pieces?

 

Kristy (22:57.39)

Yeah, well, much like you, I love breaking it up. It serves for two purposes, right? Number one, it's more manageable for the team. And number two, it helps keep the revenue coming in all month long, right? And also you have to remember every time we send those statements, typically phone calls follow. So when they're doing them all at once, we're creating a huge load for the team. I like you identify daily, weekly and monthly duties and make sure I mean, I know we're

 

The Dental A Team (23:09.267)

Yes.

 

Kristy (23:27.344)

talking AR, but everything funnels into that, right? So make sure you're sending your claims every day, not once a week, not once a month, every day. Make sure we're posting every day those checks that are coming in. And I would also say weekly run your unclaimed or unattached procedures and any unsent claims, any unsent secondary claims, right?

 

The Dental A Team (23:34.899)

Yep.

 

The Dental A Team (23:52.113)

Yeah.

 

Kristy (23:55.61)

And like you, I like the technology. Utilize your text to pay feature too. Like once we enter those payments, don't wait for the end of the week to send a statement or end of the month to send a statement, right? Send a text to pay right then or the next day. And again, it's chunking it out so it's more manageable.

 

The Dental A Team (24:03.463)

Yes.

 

The Dental A Team (24:11.635)

Yeah.

 

Kristy (24:21.775)

And also you can make your calls with insurance, break it up by insurance company, right? Being more efficient with our time that we have blocked out.

 

The Dental A Team (24:28.052)

Thank

 

The Dental A Team (24:31.74)

Yeah, I love that. And I would even put that in my power blocking, right? If I knew that I might even say the first 15 minutes is going to be Delta from zero to 60 outstanding claims and my second might be met life or something like that. So I love that just makes my brain go, okay, actually with that idea, I can make it even more efficient than what I have been doing just by adding Kristy's idea to what I've been doing. So thank you, Kristy I think that was brilliant.

 

I think there's so much meat today to consume. There's so much information packed into this short, like just under 30 minute podcast. So I hope you guys have been taking notes. I really, really want you guys to learn how to cut your AR in half if it's already there or how to keep it from getting high. Remember, your AR should be less than one month's total production goal. So if your goal is 300,000.

 

You better be under that 300,000. If your goal is 60,000, you better be under 60,000. Like it doesn't matter. You need to be under one month's production goals and or whatever your consistent average is. So go work on those protocols. You guys, have three action items. You need time management. So figure out some time management skills, work with your team and teach them the copy and paste method. You guys already know so much about block scheduling. Make sure your job descriptions and the duties.

 

Number one, are divvied out between multiple people. And number two, super clear. Even if you only have two front office people, you guys, and they always say, no, it's fine, we do everything, we work together and we get through it. I want responsibilities to each person. They can still flip-flop, they can do whatever they want, but they need to be held accountable to certain items. I don't care how many people you have up there. So number two, job descriptions. Number three, set standards and protocols, especially around your billing, you guys.

 

Start from the beginning for sure. Make sure that the information going in is accurate, but right away you guys, if you're trying to cut down your AR, get those standards into place and make sure that they are working on these pieces. Because the thing I see most often is that we don't have time because there are other things that are taking precedence. And to me, that just tells me they don't know how to figure out what the most important thing is. And you've got to go back to step two, job descriptions. Hey.

 

The Dental A Team (26:50.167)

Kristy, thank you so much for being here today. I knew you'd have some brilliant, brilliant ideas. love, I am like efficiency minded and I go there, but then you always stack something, layer it, something else on top of that, or I'm like, my gosh, even that again would make it more efficient. So thank you so much for being here. Thank you for bringing your ideas. And Kristy, is there anything departing statement that you want to leave our doctors with today?

 

Kristy (27:15.5)

No, just have fun with it, you know, and be in relationship with your patients. If there's a little balance afterward, make that quick phone call. I mean, it could be as easy as, hey, know, insurance, there was a little bit remaining. Did you want to add it to your last auto debit or are we scheduling it for one more month? You know, really be in relationship because ultimately it's about getting them the care they deserve and collecting for the treatment you're doing. So, yeah.

 

The Dental A Team (27:42.232)

You always have a nugget at the end. Thank you so much. Doctors, I hope you loved this. Take this information back to your team. Share this podcast with them. Team members, if you're listening to it you're like, actually, my doc needs to know what I'm doing, send it over to your doc. Let them listen to it. And you guys always, always, always reach out with any questions, any concerns. If you need help with the protocols or more ideas, hello.

 

Kristy (27:45.294)

Of course.

 

The Dental A Team (28:05.418)

At thegeneralateam.com, we are always, always, always open to sharing all of our information and getting those things over to you. Thank you all, and we'll catch you next time.

 

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Dental A Team PodcastBy Kiera Dent