Our clients know that “A” patients can have $0 down payment, including case starts on patients with major lab fees such as exist with Invisalign, SureSmile, etc. They also know that many of those same patients can have monthly payment plans that exceed treatment time, yet we still see clients who will not accept assignment of insurance benefits for these same low risk “A” patients whose insurance companies do not pay the practice directly. Few (less than 5%) of our clients are participating providers for any of the various PPO insurance plans such as Delta, MetLife, Aetna, etc., yet every year they start many new cases for patients who are insured by these plans. We know that in most cases these PPO plans do not pay non-par doctors directly. Also, since the ACA has come on the scene, there has been a significant decline in the number of insurance companies, even traditional insurance companies, which honor an assignment of benefits and pay the practice directly. Welcome to the new insurance world folks!
If you have an “A” patient who has insurance (with details of coverage confirmed by office staff!) through an insurance company, whether a PPO/Managed Care or not, that pays the patient/parent instead of the practice, you may still accept assignment of the insurance benefit and, therefore, be able to make a financial arrangement with the patient on the uninsured remainder of the case fee. The point is to gain improved case acceptance!
Remember, being rated an “A” does not mean a patient/parent is perfect, but it does mean they are mature, in a stable personal situation, and they have excellent credit, meaning that they have the integrity to keep their promises about money. If your Treatment Coordinator does a great job of educating the patient that the insurance company will be paying them directly but that patient/parent has agreed to forward the money to your office immediately upon receipt of the payment, then you can count on an “A” patient to keep his/her promise. Will some fail to do that? Of course! But they are “A” patients and they respond appropriately to delinquency control activity. Will delinquency go up if you accept assignment in these cases? Of course it will – a little! However, the small increase in delinquency that you will experience, especially considering those delinquents are “A” patients, will be insignificant compared to the increased case acceptance from high quality “A” type patients and the increased production and net income that you will obtain. I should not have to mention this but if you were to do the same thing, accept assignment for a patient who has an insurance company that does not pay you directly, on a “B” or “C” patient, you will be in deep trouble almost immediately. The patient/parent will spend the money received from the insurance company and will become delinquent, usually seriously delinquent, before they have been in treatment 90 days. Don’t even think about it!
For those of you who have not yet switched, the Zuelke Automated Credit Coach (ZACC) is a wonderful web-based tool that in less than 60 seconds will give you a 100% accurate credit grade (significantly more accurate than having a staff person obtain and interpret credit reports) and a recommended financial arrangement limit for that particular patient/parent. The inquiry will not show up on a patient/parent’s credit report and it will have zero impact on a patient/parent’s credit score! Is it worth $6 to know, for certain, that your patient is in a mature, stable situation and has a high degree of integrity about money? Is it worth $6 to know, for certain, that your patient is in an unstable situation and has a long history of failing to meet his financial obligations? There are no monthly or annual fees with ZACC so give it a try. You will be impressed! www.getzacc.com
