In this training transcript, Dr. Rick Kushner outlines a comprehensive financial management system for dental practices. He advises staff to eliminate written prior benefit authorizations (PBAs) by estimating patient responsibility within 5‑10% accuracy and proceeding with treatment, noting that insurers cannot legally withhold payment for missing PBAs. He stresses maintaining detailed records of each carrier’s maximums, percentages, deductibles, and clauses to avoid repeated payment shortfalls. Kushner introduces a 12‑month interest‑free financing model sold as discounted paper (8‑10% discount rate) that is non‑recourse, with applications completed in‑office, and emphasizes that a high rejection rate (50‑66%) is expected. He contrasts this with pretreatment discounts and payment‑per‑visit (PPV) policies, urging strict adherence to PPV—no half‑and‑half pricing, no flexibility once the policy is set. He provides scripts for offering financing, handling patient refusals, and moving patients to PPV when necessary. Kushner also details operational practices: confirming appointments the day before, collecting small post‑treatment balances via phone without statements, and using a tickler system for follow‑up. Finally, he identifies the primary sources of outstanding balances—insurance claims, post‑treatment bits, and first‑visit services (initial exams, emergency calls)—and recommends telephone outreach for collection while focusing on patient activation over pure monetary recovery.
Topics
Eliminate Written Prior Benefit Authorizations (PBAs) with Accurate Estimates
Guidance to stop filing written PBAs by estimating patient responsibility within 5‑10% accuracy and proceeding with treatment.
Maintain Detailed Carrier Records to Predict Payments
Advice to keep a comprehensive database of each insurer’s maximums, percentages, deductibles, and clauses to avoid payment surprises.
12‑Month Interest‑Free, Non‑Recourse Financing (Discounted Paper)
Explanation of selling discounted paper at an 8‑10% discount rate, with in‑office applications, non‑recourse terms, and expected high rejection rates.
Pretreatment Discounts vs. Payment‑Per‑Visit (PPV) Enforcement
Comparison of pretreatment discounts and PPV, with a strong directive to enforce PPV strictly and avoid half‑and‑half pricing.
Appointment Confirmation Protocols
Procedure to confirm next‑day appointments on the preceding morning to fill scheduling gaps efficiently.
Collecting Small Post‑Treatment Balances via Phone
Strategy to recover minor outstanding amounts (e.g., $12‑$112) using telephone calls, a tickler file, and repeat follow‑ups without issuing statements.
Identifying Primary Sources of Outstanding Balances
Analysis that most receivables stem from insurance claims, post‑treatment bits, and first‑visit services (initial exams, emergencies).