Due Diligence

My husband referred to a term recently that I wasn't familiar with, "due diligence". Because of the provocative nature of the term and my inquisitive personality I asked him what it meant. He replied, "In this instance I am speaking of our nation's present financial demise, largely influenced by investors who engaged in business transactions with little or no knowledge of what they were investing in. Consequently things are coming to fruition now that would have been revealed if "due diligence" had been exercised. Pertinent information such as conflicting business management philosophies, lack of commitment to the fundamentals of sound business principles, etc. would have been exposed. Instead, as the old saying goes, "after the horse has already escaped, it is too late to secure the barn door."

You might be wondering at this point, "What does this have to do with the practice of dentistry?" Quite frankly, it has everything to do with it! As in any other business, in dentistry we must practice due diligence in every detail, from selecting the right team members, to choosing the right labs, to tapping in to the latest technology, and absolutely in the area of effective management of dental insurance and accounts receivable control.

Think about it. Have you ever heard these words from one of your patients? "You told me that my insurance would cover 80%, otherwise I would not have done the treatment. Then I got a bill from your office for $800.00. So, I called my insurance company, and they tell me there is a waiting period of 12 months for those services. I thought you said you checked on my insurance! Well, guess what, I am not paying this bill!"

You see in the above scenario, the dental office obviously did not practice "due diligence". Otherwise they would have known that a waiting period existed, and benefits could have been estimated properly. In addition, the patient would have had a thorough understanding of what his out of pocket investment would be, prior to having the treatment done, enabling him to make an informed decision. Due diligence would have included the following:

•ü Establishing from the outset that the patient is responsible for all fees related to his treatment, not his insurance company.

•ü Confirming benefits prior to rendering treatment, to be sure of all plan specifics, including any waiting periods that would apply

•ü Properly advising the patient prior to treatment of his estimated out of pocket investment, and in this case explaining that his insurance would provide no benefit.

•ü Properly informing the patient of the circumstances of his dental condition, and the risks and consequences of delaying treatment until his insurance would cover it

However, in the example cited here, such is not the case. This dental office stands to lose greatly, the least of which is the $800 balance the patient is refusing to pay. What about the loss of practice credibility, or the future revenue that will never be realized from this patient, or other patients he might have referred?

In many practices today while every possible step is taken to insure delivery of the latest technology and safety in patient care, little or no attention is devoted in the area of proper handling of dental insurance and patient financial concerns. This frequently leads to misunderstandings, and patients who choose to exit permanently. Needless to say, this can have a devastating effect on practice growth and profitability.

Here at Warschaw Learning Institute, we believe in practicing "due diligence". In our latest course, "Dental Insurance: Survival Skills for Maximum Reimbursement", we teach "A to Z" common sense strategies to help overcome the challenges faced daily with dental insurance carriers and patients who have dental insurance. This is a process which can be mastered! Our course is designed to be completed online in a period of eight weeks. Students have the convenience of accessing the course 24/7, and the ability to enhance their learning process via e-mail and telephone contact with an instructor, who is there to offer support and guidance during and after the course. In addition, we provide our online forum, where students can share their personal challenges with colleagues in other offices, and receive prompt answers to questions and solutions to concerns from our knowledgeable instructors.

By Elaine Dickson