To run an optimal, efficient front office means having the same process for all your patients, regardless of their insurance status. Things get messy when you create exceptions to the rule and expect everyone on the team to remember all the exceptions. How many times is your dental assistant filling in at the front desk because someone is out sick? Or you have a temp come in for a few days and teach her the most important things, but overlook the exceptions.
As these situations compound on each other things can get out of hand quickly, leaving your administrative process a chaotic mess.
Offering a membership plan and keeping the process the same for your membership patients is critical for ensuring that you don’t get stuck giving away free services, or overbilling. Thinking about members just like insured patients is critical to keeping everything aligned. It’s the same process, it’s just a different type of dental benefit.
Best practices for insured patients looks something like:
Pre-appointment:
- Asking the patient “Have your benefits changed?”
- Checking eligibility, remaining benefits, plan start date (for scheduling)
Day of appointment
- Confirm everything in the patient account is accurate – appropriate insurance company, group number, discounts applied, fee schedules applied, update remaining benefits, etc.
- Present treatment plans with accurate information detailing fees, frequency limitations, out-of-pocket responsibilities, discounts, etc.
- Collect all balances from the patient
- Reappointment for hygiene per the plan year, and schedule any accepted treatment.
Post appointment
- Ask for reviews, referrals, send appointment “save-the-date”
Let’s look at this through the same lens for Membership patients:
Pre-appointment
- Ask the patient if their benefits have changed, and mention you see they are on your membership plan.
- Confirm the patient is up to date with their billing for the membership plan.
Many times, practices create a dummy code for the membership plan and post it to the ledger on the day the patient joins the plan (or renews). In the PMS, you’ll want to look for the dummy code and confirm the date it was posted. Be sure the dummy code is posted to the appropriate patient on the account, and you’ll also want to make sure the patient is eligible for the services on the plan based on the date.
For monthly plans, you’ll want to look in your PMS to confirm that the number of months the payments have been posted are actually documented. It’s also not a bad idea to confirm in your payment system just to be sure the payment was actually collected.
Next, you’ll want to count the number of services the patient has used since they joined/renewed to be sure they are eligible for included services.
Skipping this step often leads to dental teams confirming payments were collected at some point, but not paying close enough attention to the dates and allowing patients to come in for services and walk out the door without paying when they were due for renewal. It’s a good idea to note on the appointment the plan renewal date for rescheduling purposes.
Day of Appointment: Confirm everything in the patient account is accurate
Most times this looks something like:
- Correct insurance company/employer is attached to the account
- Correct Membership Plan fee schedule
- Correct Discount is applied
- Correct Patient Alert is attached to the patient
- Correct Renewal Date is noted somewhere on the account/appointment
- Present treatment plans with accurate information
Once you’ve confirmed the patient’s account is up to date, the membership plan payments are current, and the patient is eligible, your treatment plans should populate with the accurate billing amounts and discounts.
- Reappointment for Hygiene
Since the renewal date is noted somewhere on the appointment, this should make it easy for the hygienist, treatment coordinator, or front desk to make future appointments.
Post Appointment: Ask for referrals and reviews!
Knowing that your patient just had a fantastic experience visiting your office since you were so well prepared increases the likelihood that they will refer their friends and family and/or write a review. Don’t be afraid to mention this to them at check-out. A simple “We love having you as a patient and would love to serve more people in your network. Please keep us in mind when your friends and family are in need of a dental home.”
Want to learn about how membership software can help you streamline this eligibility process?
Book a demo with someone from our team and we’ll tell you more!
