Phil Cole 0:05
Hello, and welcome to a KLAS Solutions dental education podcast the podcast series where we share knowledge and experience to provide you value to you in your dental practice. I'm your host, Phil Cole. And in today's episode, we're going to be talking about AR or accounts receivable. And we want to give you some perspective on how to control your AR. So today, I'm joined by Tera Wilson of KLAS Solutions. She's one of our business coaches. And she's going to be sharing some of her thoughts and experiences and expertise in the matter as well. So Tara, Hello, and welcome to the Podcast
Tera Wilson 0:39
Hi, thanks, Phil. Thanks for having me on.
Phil Cole 0:43
Not a problem. So give us a little just give us a little insight on your dental career so that everybody knows.
Tera Wilson 0:49
Yeah, absolutely. So I've been in dentistry about 27 years. I started as a dental assistant, and I was just the person I worked in a large office, it was a large FQHC. So I was a person who would just learn anything. So when there was something new coming up, I would volunteer for it. I worked front desk, I learned insurance coordination. I actually went to school to become a hygienist and then finish my bachelor's degree in business. So and since then have really gravitated more towards the business management side of dental offices.
Phil Cole 1:22
So I was I would say, pretty well rounded then when it comes to career. You know, you've also worked not only in just private practices, but you've also worked in large group practices as well. Correct?
Tera Wilson 1:37
Correct, yeah, so some experience in small offices worked in FQHC, which is more serving the underserved population. I've worked in a large DSO. So and then been here coaching with you for about the last three years. So yeah,
Phil Cole 1:55
Yes. It's, it seems like it's only been yesterday, but it's actually been a lot longer than expected. So. So I got a few questions for you, AR of course, we run across that we know when we're doing the coaching. And when we're doing the transitions, the accounts receivable is always a huge thing. So it plays a big part in the office. So I guess, to just get started, what are some of the what I would say metrics or guidelines when it comes around when you're talking about accounts receivable?
Tera Wilson 2:27
Right. So definitely accounts receivable is one of the first things that we look at when we go into coach. And I would say, typically, what we see is, it's not a lack of the front desk or the financial coordinator wanting to do a good job. It's it's more of a time issue. So really helping them block their time knowing what is what isn't good AR that's what I get asked a lot like how do we compare to other offices? So that's one of the first things we do is talk about, what are some guidelines and what are some metrics, the KPIs or key performance indicators that we're looking at, to measure the health of accounts receivable. So what we start with is looking at the different breakdown, and I look at accounts receivable as a whole, I look at it as a whole, and then I break it down between insurance, accounts receivable and patient accounts receivable. And that really helps us figure out kind of what direction we need to focus on in the office. But looking at that distribution, just starting overall, to see the health is we're going to look at what the distribution is between the different time timeframes. So your zero to thirty bucket. So looking at data service, zero to thirty, we want about 65% of that accounts receivable to be in that bucket. After that, the next thing I look at is the over 90 Day AR. So with that claims over three months old, we really want that to be less than 10% of the total accounts receivable. And then that remaining 25% would be in that 31 to 90 days, there are some valid reasons that things take longer than 30 days to get paid. You know, patients have secondary insurance claims. If maybe they gave us incorrect information, when they checked in there's there's a number of reasons maybe we didn't send the correct information with the claim in the when we first submitted it. So we need to submit some additional information. So there are some reasons there for for things to be in that 31 to 90 bucket. But we want to make that that minimal. We're really trying to keep everything in that zero to thirty days.
Phil Cole 4:25
Yeah, absolutely. I would say that probably when it comes to the transitions and stuff like that. Well, I know even with the coaching with our assessments, that ninety day bucket, though, tends to be the one that is always the large one. Is that would you say that through your experience? Of course now my experience is definitely different because I don't coach per se. But would you say that once it hits the ninety days that it's just kind of one of those things where they feel it's they feel defeated as though they're not going to get that, so they just let it go. Because it just seems like it just builds and builds and builds, you know.
Tera Wilson 5:05
A lot of times, what I see is they just don't have time, right? They haven't, they're, they're not effectively managing their time. At that front desk, you've got patients standing in front of you, you've got phone calls coming in different things that happened. And it just ends up being one of those things that it's not on fire. And usually, the front desk is dealing with fires throughout the day. So it's one of those things that they'll get to, and they just don't get to it. So it can be, you know, a couple of different things. And that's where we break it down and say, is it more of an insurance issue? Or is it more of a patient balance issue? And that's how we help determine what systems need to be put into place? To help them to keep that 90 day get the 90 day down? And then keep it that way? Okay.
Phil Cole 5:47
So I guess, I mean, when it comes to accounts receivable, what would you consider? Who would you consider being the major players to have a successful accounts receivable then?
Tera Wilson 6:01
Yeah, so obviously, a financial coordinator. You know, having somebody in the office, not that you will have only one person that's responsible for it, or that knows how to do it, you want, you want to have some backups, but definitely having people having someone who's accountable. So if the doctor has questions, they know who to go to. And that person, again, isn't responsible for making sure everything's done, but they're responsible for making sure that things are moving forward and that things aren't being missed. But to have it, kind of, you know, we've all heard that if everybody's responsible, nobody's responsible. So having somebody who's reporting out on that, in the huddle, the daily huddles in team meetings, who's really just kind of keeping an eye on it and making sure that it's moving forward. And then obviously, the doctor, for the doctor to know what's going on. Unfortunately, a lot of times, again, doctors get so busy that they just trust who's doing it. And if a lot of times we see if the bank account has enough money, they're not really focused on kind of what hasn't been collected. So really having the doctor they should know at any time, how much is in accounts receivable, I usually relate it to the team, this is what I see hits with the teams is looking at your average monthly production. And how much is that compared to? What's in your accounts receivable. There was one office that I was coaching in, they were doing so much dentistry, but they weren't collecting on it, they literally had three months worth of production sitting in their accounts receivable. So when you look at him and say you essentially worked for three months for free. That's, that's impactful, because nobody on the team wants to work for three months for free. So just relating it to how that affects the team, and really the impact that that can have on the financial stability of the office. Yeah, the other one, yeah, sorry. Go ahead. No, no. And then the other one is just the whole team, right. So it's not just the financial coordinator. It's not just the doctor, not just the front desk, the entire team needs to be involved in that. So talking about it in the huddle, if they've got patients that have a balance, do making sure that they're getting to the front desk, having that strong handoff, from the clinical staff to the front desk, if services changed for the day, and then making sure I would say reviewing that financial policy, and making sure that whatever's in the policy is definitely what is being adhered to in the office. So if you're if you're telling patients that they're signing that financial policy that says, you know, certain payment is due that day, that that the staff is, is doing that a lot of times, and COVID was a you know, we're getting further away from COVID. But that was just something where we were in survival mode. So a lot of offices got away from kind of their regular practices, and got a little lacks on those. So definitely a time to look at what's in that policy. Is it still accurate? And is it being adhered to if it's not accurate, and you're not adhering to it? I would definitely recommend that you update that financial policy. And then again...
Phil Cole 9:13
I was just gonna say, I mean, I think that's another big, big thing that is COVID kind of maybe brought out more than anything, is how many people did not review their policies did not review their employee handbooks. And so I mean, you know what I mean, I know this kind of getting off a little bit, but it actually is talking about the way it is AR is one of those things, right? I mean, how many times do we go into office and talk to them? Or when we're doing transitions and stuff and we asked for the employee handbook. Doctors don't have one or they say, Well, do you really want to see it? I haven't updated it for like 15 years. It's the same thing happens with the processes too, right? I mean, you just you have those financial policies, you have those processes, but you just you just let it go? And if you don't do anything with it, and then you wonder why you're at where you're at basically. Right,
Tera Wilson 10:06
Right, yeah, like you said COVID was just kind of everybody was in survival mode, some offices lost staff, some people are still having a hard time finding enough staff. So you're really just trying to do the day to day. So some of these kind of clean up things or things that that aren't necessarily directly related to the patient in front of you that they can be easy to overlook just out of necessity. So taking setting aside some time to really go over those things, I think is a positive. And then the last thing I think, for the team, is making sure that there's proper documentation, insurances are getting so so picky about the documentation that is submitted. So with, especially with perio scale, they're really, really cracking down on that. So much so that some of them are even asking for length of time of the appointment, because they really want to make sure that it's not a code that's being overused. So they are being very critical of that. So having a full perio chart, having necessary X rays, when you're doing crowns, things like that before after intraoral, photos, X rays, just to make sure that that you have everything you need, that's documented, you can't go back and document things after they happened when the insurance asks for it. So there's making sure that that notes are complete, and all of the X rays, photos, things like that are there.
Phil Cole 11:29
And I think that we you know, we going back a little bit when you talked about the doctor, you know, being involved and knowing. I mean, it's kind of goes back to where why we have KPI management, you know, and why we just have the ability to keep that in line, because AR is one of those that essential key performance indicators that you have to pay attention to. But there's other ones out there as well, that you have to because like you said with that office three months going by that I mean, that's just a I mean, you don't see practices in the in the dental industry go under, right, it's a point 08 failure rate. So I mean, it's the banks love dental offices, because they just don't fail. But when the ones that do fail, you know, you and you see stuff like that, that you're just so unaware of your key performance indicators or anything like that, when you see that they're not handling anything, not doing morning, huddles and not having team meetings, you know, once a month and stuff like that. You it doesn't I mean, it's just one failure after another right to get to get where they're at.
Tera Wilson 12:46
Right, Right...And, you know, a couple other of the metrics I we we went past that, but like you said, there are a number of metrics, not just accounts receivable, but there are a couple more with accounts receivable that I definitely recommend. So knowing what your average days to collect on claims, I think that's important. And that that's not one that I think that's really easy to get. But that is one that we focus on quite a bit. How long is it taking from data service for you to average closing those claims. One office that that I worked with, they were upwards of 80 days. So from date of service until that claim was closed, their average for their entire office was 80 days, we brought that down, it really should be depending on the number of direct deposits, depending on the number of checks you're receiving from insurance companies, it should be anywhere from 20 to 30 days. Obviously, if your direct deposit lower days, if you have more checks than those do take a little bit longer to come in. But really any average to collect over 30 days, I would really take a look at processes. And what that is you're you're kind of loaning out some money there that that I think would be helpful to be in the bank account instead of sitting with the insurance company. So and then the other thing is looking at the collection ratio, looking at how much of that adjusted production, what can be collected, how much is being collected? And that really goes back to is that insurance? Is it patient? Is it a mix of both and working on those processes. But knowing what that that collection ratio is, is I think imperative.
Phil Cole 14:18
So what would you say is the what I would say what's the biggest risk that you that you face or that you see when you're working with offices as it relates to basically what I'm thinking is is just the the overall management of the AR What do you feel is like the probably the standout topic or item?
Tera Wilson 14:39
Right. And you know, as one of the business coaches I also do the assessment so the lead into our coaching programs and taking a good look at all of the KPIs. We look at over 120 KPIs. I can almost tell you with certainty if the accounts receivable is really out of whack. There's only one person who's doing accounts receivable. So, I think the biggest risk for offices is only having one person who knows what's going on. It's a risk for the office, it's a risk for that person, quite honestly. And you know, what we normally find is the person who is in charge of the accounts receivable or in charge of the financials. They don't want anybody else to help because they want to keep it to themselves, but it's more out of like a job security thing, or they feel like if somebody else gets involved, then they're not going to do it. Right, they're going to be responsible for it. So it's really just a kind of a it's easier just to do it myself. There can be some some embezzlement issues with that, too. That's not typically what we see, what we normally see is it it's more of a job security issue. So I think talking with staff and and you know, it's a protection for them as well. You don't want only one person knowing what's going on with your your financials and having control of that. It also puts you at risk. If you don't that person gets sick, or they have a sick child, or I never like to say gets hit by a bus, I like to say if they win the lotto, and they don't come back, then you're you're kinda it really affects your accounts receivable, I can also tell if the monthly collection ratio, if there's huge ebbs and flows to it, I can tell when people take vacation, if there's only one person who's doing it, I can tell when they're on vacation, or I can tell when they've been out of the office, because claims don't get sent out money doesn't get posted. There's just a hiccup in that cash flow for the office. And that's a whole other issue.
Phil Cole 16:37
Well, we have that we have that right now, with one of the offices that we're coaching, a death. And that's exactly it. The doctor is at was supposed to get me some reports for some other processes, not just the coaching. But I mean, two weeks, two weeks of of just stagnant nothing. Of course, you know, you feel for them and stuff. But it's just a prime example, once again, is like Okay, so all reporting is just shot. I know, it's not dealing with the AR in this situation. But once again, I also have another an ex coaching that we have that basically, same thing, we're looking for some reporting and stuff for the transition. And it's kind of like, okay, you can't call this day, this day, this day, because they're not in there. And it's like, okay, well, so I got to where I ended up waiting. And I got to play phone tag on when I can get those reports because only one person is got the insight and doing that. And so it becomes really a huge, I mean, it becomes a huge thing. But I agree with you 100%, nine times out of 10 out of all the years, and all the offices that I called on it, I will tell you nine times out of 10 You're absolutely right. It's job security. But I also feel like it's a breakdown on the process, right? Like if, if they don't have a clear designated process, what ends up happening then is one person takes control, so that they know it's getting done properly or my way. And that so to me, it's not only job security, but it's also the breakdown of just the process. They're not file, they don't have a process. So no one else can do it besides person that's created their own per se.
Tera Wilson 18:36
Right, right. And it's hard because you do want you know, dentistry is full of type A people. I've worked with a number of people done a lot of interviewing over the years and a lot of hiring in dentistry is full of type A people and that's actually the person that you want in charge of your AR you want that detail person who's going to dig into it, but just for their protection and for the doctor's protection as well. Just not having them be the only person who knows what's what's going on. I'll tell you the most the most I'll say outrageous. One I saw was an office where it was a person who was working remotely, and she was doing billing. But she also administered payroll, and she administered their accounts payable, so she had complete control, complete oversight. No one was looking into what she was doing money coming in and money going out. That was some embezzlement. We did We did find that. And that's a that's a dangerous place to be in and I've I felt for that doctor because they really trusted this person. And I think you know, that was something. We were looking at a few different things, but we actually found it on the p&l because the admin wages were higher than the hygiene wages, and they had less admin staff. So they're non revenue generating staff or I was collecting a lot more in payroll. So that was a that was a thing that I think for me, I just had so much compassion for that doctor because the doctor just didn't even see that coming and completely trusted this person. And that's a that's a hard thing for them to stomach. But yeah, having having one person who's got complete control coming in coming out. That's, that's a dangerous place to be.
Phil Cole 20:27
When we had Prosperident on with our podcast earlier episode, they were talking about, you know, we've always said it's one out of every two, I think he but if I remember correctly, he said, it's over 60% of dentists are embezzled from and stuff. And I mean, I think that you and I both can agree that through our career, dentists are habitual, trustworthy people, right? Yeah. And if the end, they also are people that feel good, that fall into the trap of feeling comfortable. So if the person's doing good, then then great, and they've kind of I shouldn't say fall in love, but they they let that trust grow more and more. And then it seems to be that they give the, the, the areas of concentration, put on that person's shoulders more and more. So like what you were saying, as as money in and money out? I, you know, I've heard from all a ton of experts, you never give the same person money. And yeah, we see it all the time. That that is that that person is like, she's been with me 30 years, she'd never do that. And then the next thing, you know, she's the one that's, you know, 400 $500,000 embezzled? You know, but I think that that's, like you said, I think that's just a, like, huge thing. Never give the person that's bringing the money in or taking care of the money in the same responsibility of handling the money out.
Tera Wilson 22:01
Right, right. Um, and I think, you know, dentists, I will say, I can almost say with 100% certainty, all of them that I've met, didn't get into dentistry because they wanted to own a business, right? Like, they want to do dentistry, that's their passion. That's their love. That's where they focus. They are business owners, but I don't think that's where their passion and then where their focus lies. And unfortunately, a lot of dentists, you know, are like, well, if I've got enough money in the bank account, I'm not really worried about anything else, everything must be going well, you know, they're comfortable, they have what they need. So really, I think that's part of with the business coaching, the piece that I like to is, is really helping the doctors understand, like what reports they should be like, it doesn't need to be super overwhelming, or, you know, being so deep in it, that you lose that passion for dentistry, or lose that clinical time. But really just knowing what's happening in your business and, and feeling comfortable with that and knowing who to go to to ask questions and having enough people that there is that oversight, and those those checks and balances. It's kind of like a peer review, peer review for your admin staff.
Phil Cole 23:11
Well, I agree 100%. And that's, I mean, why every coaching program that we do, KPIs are automatically the KPI management, or the overview once a month is automatically attached to that, so that they get used to that. And then of course, we offer it, but I think the same thing is to is, when it comes to the business part, you know, it doesn't have to be something scary or overwhelming. It's just a case in point of getting putting implementing that. So for example, with us and our CPA, you know, having those quarterly calls, having a weekly call just to Hey, got any questions for for this week, and making sure that you're looking at those quick p&l cells, you know, balance sheets, and so forth. So I know like with our p&l is our CPA puts in a lot of the percentages in the areas that were you that we want you to just take a quick look at. Benchmarks. Thank you very much. Yeah. The benchmarks to say, are you there? You know, if you go through that p&l And everything's looks good, then guess what your per se, your business side of things is done. Right? Right. But the same thing, the same thing applies with with the KPI management, when when they have a meeting with you are one of the coaches and go you go through the dashboard of the KPIs. Everything looks good. I think sometimes doctors fall into the habit of sitting there going, Well, why do I need you if everything looks good for three months? Because it is inevitable even in even in my business, right? You have witnessed it to where you you sit there and automatically think things are rolling, things are good. And then all of a sudden whammo, you hit the brick wall, something happens and now it's like Chaos, per se, and I shouldn't maybe that's overstating it, but a little bit of worry starts to set in or level of dysfunction starts to set in. And if you don't get back to those, to those principles, it only grows, you know, hence, ar, right? What I mean, 30,60, 90 days, why do we go with that? Why do we go down the road that much? Because if you don't stop it at the current in the, in the 30 days, it continues to grow? Where's if you don't have a good process, you don't have good habits? It only gets worse. Right?
Tera Wilson 25:38
Right, right. And I'll say, you know, of, of all the offices that we've coached, and over the years, all the people I've worked with, there's very few people who haven't, you know, financial coordinators, who haven't been very open to, like, they want to do their jobs, well, too, they just don't know, they just don't have the tools. So being able to set up those systems and the tools to be able to be successful at it, most of them are so open to yes, please help me, please give me the information, like I'm doing the best I can. But I know that there's more. So, you know, sometimes it's even, they don't even know how to run the report that says they're outstanding, over 30 Day claims. And that's a report, they should be running like every week to say how many of these claims are are over 30 days, there's really no reason for insurance claims to be over 30 days. So those need to be paid attention to like right away. So, so I will say most of the time, they're very, very open to it. And I think to your point of, you know, KPIs, if they all look good for three months, or, you know, they're rolling, and they're looking good, I don't think I you know, I'm a big believer in knowing what your baseline is. And you just have to be kind of intimate with those numbers and know what they are so that when something looks off, you're like, hey, that doesn't that doesn't look right. And I don't think you know that. Yeah, I don't think you know, that unless you know, what your, what your numbers look like. And I think when they are healthy, you're right. It's a quick, it's a quick glance, it's a quick look down your p&l. It's a quick look at the KPI management software to just say, like, is everything is everything going good? are we hitting goals? Are we getting close, and nothing's out of line. But then when you see that number, that is auto line are starting to go in a direction you don't like, then you start to dig deeper into it. So I don't think it has to be this big time consuming thing that takes clinical time away. But just being able to really know that side of the business.
Phil Cole 27:38
Well, like when we sit when we're talking about our, you know, our practice health assessment for the practice that, you know, we analyze those 120 KPIs, we get like I always tell doctors, you know, there's three things that that assessment looks at it's what's what was working well, and what are you doing good, then we congratulate you on that, right, keep it up. Because it's working and don't don't mess with it. What needs to be tweaked, then tweak it, you know, to get it back to being in the good column, or things are going great. And the things that are broken, they just need to be fixed period, right. And that's, that's basically, kind of like with this AR, like you're saying, in just this category, that a lot of times it just needs to be tweaked, so that it can be working more efficiently and stuff. But you know, if you let things continue to just at the Tweak part doesn't get fit, you don't basically tweak it sorry, yeah, it eventually goes to what the broken state, it's that tweak is a huge thing, because it's one or the other, you can either turn it into good, or it goes into the bad cop. One of the ways so those are the things that with that assessment that we do is where I say I always tell doctors, that's the most important thing, because the broken part is just pretty much and I won't speak for you. I know you're the coach and the new assessment. But the broken things are usually the easiest thing because they just don't have processes. No system, they have no process. So it just you got to just teach them and implement it. Right. But this the Tweak thing, that's the most difficult because of the of what is it that's causing it, like you say with the AR with insurance versus patient, right? What needs one of them might be doing good, the other one is and but it's it puts it in a tweak category, what I would what I'm saying that right,
Tera Wilson 29:26
Right, yeah, absolutely. Because we want to figure out, you know, when we're coaching, I always tell offices, you know, they get nervous when when coaches come in, like, what are they going to make us do? They're gonna change this, they're gonna change that. And I always tell them on day one, like, I'm not here to mess with any of your systems that are working, the things that are working well. Fantastic. Let's keep going. I you know, I tried to learn from those things too, like what are they doing in their offices and in capture those best practices. So if it's if the accounts receivable is all on the patient side, not on the insurance side, we're not really going to focus Some that that process, but we're gonna look at what your collections like, are you collecting data service, do patients know what their co pays are? Are they made aware of that ahead of time, so, so really putting that emphasis where, where it needs to be, instead of just kind of making every office like a little class office or, you know, our, but helping them develop their systems that work for that work for them, I think is really important. And I, you know, I think I've seen recently, new doctors, you know, newer grads, maybe 5-10 years out of school, their purchasing practices for doctors that have been in practice for, you know, 30 plus years, and they have that front desk coordinator, or that financial coordinator that has worked with the doctor for, you know, maybe she's been there for 20-30 years, it's really intimidating for these doctors coming in. So not being able to feel like they can kind of dig into the process. We're a non threatening way to do that. Right. So one of the one I'll give an example of one of the things that we found from a doctor who purchased a practice, the front desk manager had been there for years had worked with the doctor, over 20 years. And their accounts receivable was just really, really out of whack. Patient balance over 90 was was awful. Come to find out after doing some digging the front desk coordinator or the person who had been there for years, she was incentivized, because she got a portion of whatever she took the patient to small claims court, she got a portion of whatever was recovered. So it was in her financial interest not to collect date of service, because she got kind of a bonus for what she collected when it got to over 90 days, and they went to small claims court. So we got that fixed really fast. Yeah,
Phil Cole 31:50
I did not know this one. So this one, this one's interesting. That's, we'll talk about this one after we get off the podcast.
Tera Wilson 31:58
So So I think, like I said, for the doctors who are coming in who are purchasing new practices that are have been long standing and have these systems in place, there's so many things, but that accounts receivable, that's an important one to really get aware of quickly. Because that is that's the money, you can do all the dentistry that you want. But if nobody's collecting on it, you're doing really great charity work. And there's nothing wrong with doing charity work, as long as you're directing where it goes, and you're selecting it. But you certainly don't want to have months and months sitting on your accounts receivable of dentistry that you've done that you have not been reimbursed for?
Phil Cole 32:38
Well, I think that that's when it comes to our buyer advocacy program. That's one of the things that we look at as an AR, and then you know, go to you in the coaches to you know, because it is, like you said, it's a huge importance. And when you're buying into a practice that has an out of whack AR No different than then adjustments, right. I mean, that's the other the other one shows, you're looking at a practice that's doing like I rent, we ran into one, and we told our buyer advocate or buyer to you know, I would stay away from this one, you do what you want, but it's your, ultimately your decision. But when you have a $3 million practice that has $1.2 million of adjustments. There's there's, there's issues. That's right, you know, I mean, so it's in to tear into that $1.2 million through adjustments. That's that's a huge bite. Right. Right. Like you're not doing that with a one call tight situation. So I think that's, that is absolutely huge.
Tera Wilson 33:43
You know, I think we could have a whole nother nother podcast on adjustments and things like that, but I'll say this. You know, I sometimes when I look at fees, so that's part of our assessment as well, we look at the office fees, and we compare them based on zip code and where they are in the market. And for doctors that are really low, I get the pushback quite a bit, well, that's just going to make my adjustments higher. It's not, I'm not going to gain more from the insurance companies, it's only going to penalize my patients who have who have no insurance, which is a different discussion. But really having those adjustments and having the true value of the dentistry that you're doing is so important. I think it's it's important to make decisions on being able to decide what insurances you're going to participate with, if you want to go fee for service. And I know for your end on the transition side to really be able to value the dentistry that's doing there. So having fees that are you know, 5,10,15 years old, just because you want to keep your adjustments low but that's that's just an artificial number. And you kind of have your head in the sand about that. So I think even make the adjustments is Yeah, yeah, like I said, we could have a whole nother podcast on that.
Phil Cole 34:56
But, I was just gonna say I've got a couple questions on now but we're gonna stop Yeah. Because? Because you're right. All right. So then I guess, before we start going down the rabbit holes, yeah. Let's wrap it up. And how about give me say your top three things that you'd recommend dentists that are listening to this podcast do for their AR?
Tera Wilson 35:21
Yeah, I would say first thing is go run your AR report right now. Figure out what your balances are, what your what your buckets are, you don't even need to get too deep into what's insurance, what's patient, but I think just know what's out there and have a good, that's something I recommend running at least I mean, I think monthly is a little bit too far. If you can do it weekly. I really recommend that because that's it's going to be a good indicator of what's going on and being able to track are things getting worse, are they getting better and being able to try again, baseline metrics, just see where you're at today and make sure that you don't falls in line with those, you know, the 65% and the zero to 30 and less than 10%. Over 90. I can say in all the assessments that that I've done, maybe two, two officers have had their over 90 under 10%. So yeah, I would say that's it, that's one to get a hold of we talked about the collection ratio, I think that would be an important thing, that'd be the second thing I would recommend is figure out what your collection ratio is of the dollars that you can collect how much is being collected. So you want to know, I would look at it from a month to date perspective. But then I'd also look at it from a year to date perspective. And see kind of what that that long term collection ratio is, make sure that you're collecting the money that you can collect the dentistry that you're doing is being collected on. And then the last thing I would do is I definitely recommend a weekly meeting with a financial coordinator and the doctor. So again, just some of that oversight, if you've got a smaller office and you don't have multiple people that you can have, you know more than one or two people working on your your financial systems, then I would say definitely the doctor needs to know what's going on and setting that weekly meeting. They don't have to be really long it can kind of, you know, almost be just like a huddle between the two of them. You want to have open dialogue, no questions are off limits, there's no hidden, you know, accounts that we're not gonna talk about this one because it's it, you know, maybe the front desk person made a mistake, or just something's going on that it needs to be completely open and transparent. I like to say, you know, you can't leave anything in the junk drawer, like you got to talk about all of it. And then having kind of a running list of what are the top three concerns. So if you've got, you know, a few insurance claims that are out that she's the financial coordinator struggling to get paid. Like let's look at those and see what's what's going on with them and track them until they're done really focus on those. You know, maybe it's it's outstanding patient balances, you've got some patients that maybe aren't paying outstanding claims, patterns of rejections, I think that's an important one to make sure that you're looking at the rejections that you're getting from insurance. And what those patterns are, because that's something that goes back to the huddle back to the clinical team. So if they don't have the information, if the financial coordinator doesn't have that information to submit, not a lot you can do to fight those. And then the last one, we haven't talked about this much. We've talked a lot about money coming in, but patient credits, I think having talking about patient credits and making sure that those are in line, and that those aren't aren't getting out of hand. So I recommend talking about those those things on a weekly basis with the financial coordinator again, just so there's transparency and really, it's a support for them too. So....
Phil Cole 38:47
Yeah, I agree the patient credits that's another one. That's uh, we'll do that other podcast too, because we got to come up with two more episodes now that we've just said this one, so, but I really appreciate it. Thanks so much Tera for going over everything with us. So if you enjoyed our show today, please rate review us on Apple Spotify or wherever you get your podcasts. I'm Phil Cole, and thank you for listening today's podcast hopefully that you got a ton of information out of this. Once again, thanks so much and have a great day.
