Legal and Practical Issues of Dental Billing and Collection Practices

Dentists serve a vital role in the community's health and the population at large, yet most people will express dread at the mere mention of visiting their dentist’s office. 

These feelings often stem from going through a painful but necessary procedure in the past. Consequently, people go years without visiting a dentist to the detriment of their oral health. 

So, a dental practice needs to be a warm and welcoming place for patients and their families. A good patient experience goes a long way in building relationships and ensuring recurring visits. 

Complications arise though when you try to extend that goodwill to the billing process as well. Due to the nature of the American insurance system, this part of the patient-dentist transaction can become unpleasant for both. 

Dental Billing and Collection

As important as it is to exude a sunny disposition at all times, matters of billing and payment collection need a no-nonsense approach.

Legally, dental practitioners can take measures to collect unpaid dues from patients but not without following specific rules. For example, you have to be careful about frequency and timing when sending correspondence regarding outstanding dues. 

Unknowingly violating such laws can land you in hot water with state and federal authorities. And who has the time for that?

Successful payment collection requires knowledge. You need to be aware of certain do’s and don’ts regarding dental billing claims. Just like other businesses that extend credit, dental billing also requires adherence to rules governing consumer financing. 

But wait. Is my dental practice involved with consumer financing? In short, yes, it is. When a patient is treated and pays for it in the form of installments or through an extended payment plan, it comes under consumer financing.

If your dental practice offers payment plans with installments stretching more than four months, or if your practice has more than 25 such patients in a given year, the same rules apply to your enterprise as any other credit-based business.

Once you establish that your practice comes under the Fair Debt Collection Act, you should design your billing and payment system so as not to violate any protections offered under this Act. This will help you amicably collect payments owed to you.

The central provision of this law is that no business can give the consumer a false impression of who is responsible for collecting payments. That means making overzealous statements about sending a collection agency after someone might get you in legal trouble. Similarly, there are limits on how to communicate with the patient regarding dental billing. 

So, What Are You Allowed To Do?

Of course, you have a right to be paid for the services you have rendered. The first step you need to take is to establish a system of notifications and follow-ups for unpaid dental billing claims. Your correspondence chain should include:

• Email reminders sent periodically.
• Phone alerts sent through SMS or other instant messaging services.
• Phone calls to make sure that the intended recipient got your message.

Remember when we mentioned not to give false impressions regarding debt collection? The same point applies to written communication as well. This means no big stamps on the envelope in bright red colors telling the patient that they are now in a legal dispute because they are ‘past due.’

Patient rights and protections further extend to how often communication can be made. Therefore, your dental billing system should adequately schedule the time of day to make calls and the number of times in a week or month that notifications are sent. 

As with all medical procedures, dental billing also requires strict confidentiality over the payment status of the patient and the procedures they have undergone. Do not discuss patient information with third parties over the phone or any medium that leaves a trace.  Any unauthorized usage of patient information can result in strict liability on the medical practitioner as they are the custodian of that information.

How to Avoid Legal Issues with Billing?

The best way to cover your bases and continue to provide care to your patients is by investing in a billing service. Such services offer customized payment management flows so that dentists can avoid legal pitfalls while conducting routine practice. 

The best dental billing company performs all the functions of dental billing from when a patient registers for the first time with your practice till their treatment and payment completion. This process entails many sub-functions such as assigning CDT codes, scheduling and carrying out payment notifications, answering contested claims, etc.

A dental practitioner collaborating with a dental billing company can create a streamlined billing and payment process suited to them and their patients. Because ultimately, a dentist is looking out for their patient's best interests while managing a sustainable practice. 

The smart thing to do is to use expert know-how from the billing company and your own knowledge to create payment plans that increase cover for more patients. This way, more people will be able to access much-needed oral healthcare, and your patient roster will expand.

Finally, a good piece of advice is to take each unpaid dental claim as case-sensitive and pursue it accordingly. Often, the patient requires a payment plan that caters to their needs and an assurance that they will remain in good standing with the practice if they disclose their financial situation. Then the payments usually start rolling in. 

But most importantly, documentation, documentation, documentation. Leave no avenue unaddressed when registering a patient and who is responsible for their payment. This may be difficult when a patient arrives for an emergency procedure which is often the case with children and the elderly.

Wrapping Up

So, it’s better to have a dental billing service at hand to cover for you. With peace of mind, you can then focus on caring for your patients and building your practice.