Should you Switch to Non-Assignment?
Deciding to switch from a traditional dental practice to a non-assignment clinic takes work. We understand the complexities, challenges, and considerations that come with such a significant shift in the practice model. It entails reevaluating established norms, questioning the status quo, and venturing into uncharted territory.
We recognize that managing the delicate balance between providing exceptional dental care and navigating the complexities of insurance reimbursement is a constant challenge.
Our goal is not to advocate for or against a specific practice model but to empower dentists with knowledge and resources to make informed decisions. We understand the weight of this choice and the potential impact it can have on the dentist's professional and personal life.
In addition to understanding the difficult decision to switch to a non-assignment dental clinic, it is crucial to acknowledge the common pitfalls that often motivate dentists to consider this transition. These pitfalls, such as the ones listed below, encompass the challenges and frustrations experienced within the traditional insurance-driven model. Below are common pitfalls that push practice owners toward making the switch.
Insurance Claim Denials and Delays: Dealing with insurance claim denials or delays is a common challenge that dental practices face. Whether due to incomplete documentation, coding errors, or policy limitations, denied or delayed claims can significantly impact cash flow and leave accounts receivable unresolved.
Patient Misunderstanding of Insurance Coverage: Patients often need help to fully understand their insurance coverage, leading to confusion regarding their financial responsibilities. This lack of awareness can result in delayed or partial payments, leaving dental practices with outstanding balances that are difficult to collect.
High Deductibles and Co-Payments: Rising deductibles and co-payments have become a common trend in dental insurance plans. Patients may need help covering these out-of-pocket expenses, leading to delayed or partial payments. This can have a ripple effect on accounts receivable, as practices may have to wait longer for the full payment.
Financial Hardships and Unforeseen Circumstances: Life can be unpredictable, and patients may face unexpected financial hardships or unforeseen circumstances that impact their ability to pay promptly. Job loss, medical emergencies, or other personal crises can hinder accounts receivable, making it difficult for dental practices to collect the full payment within the desired timeframe.
Ineffective Communication and Follow-up: Poor communication and inadequate follow-up processes can contribute to unresolved accounts receivable. Suppose dental practices fail to send timely and transparent invoices, reminders, or follow-ups on overdue payments. In that case, it can lead to a breakdown in communication and prolong the collection process.
Lack of Efficient Payment Systems: Limited and outdated payment options can create barriers to timely payments. If patients cannot conveniently make payments through preferred methods such as online platforms or electronic funds transfer, it can result in delayed or missed payments, further hindering accounts receivable management.
Inadequate Staff Training and Resources: Insufficient training of staff members responsible for managing accounts receivable can impede practical collection efforts. If the staff needs proper knowledge about insurance processes, billing procedures, or techniques for handling patient inquiries, it can lead to errors, delays, or missed opportunities for collecting outstanding balances.
It's no wonder some practice owners move their practice to non-assignment. If this option is in your sights, review the following considerations:
Administrative Burden and Processing Time: Accepting assignment means the dental practice submits insurance claims on behalf of patients and receives direct reimbursement from the insurance provider. This can save patients the hassle of dealing with claims paperwork, but it places the administrative burden on the practice. Becoming a non-assignment provider shifts the responsibility of following up on claims submission and reimbursement to the policy holder, reducing the administrative workload for the practice. However, offering to submit claims by mail or electronically on their behalf is still expected.
Patient Responsibility and Cash Flow: By becoming a non-assignment provider, patients become responsible for paying the practice directly and seeking reimbursement from their insurance provider. This could lead to delays in payment from their insurace provider and require patients to have sufficient funds upfront to cover the cost when services are rendered. It's essential to assess the demographics of your patient base and their ability to manage out-of-pocket expenses before making this decision. A potential downside of non-assignment is the risk of increased accounts receivable if patients struggle with prompt payment.
Patient Satisfaction and Retention: Consider how becoming a non-assignment provider may impact patient satisfaction and retention rates. Some patients prefer the convenience of having the practice handle insurance claims directly, as it simplifies their payment process. Others may appreciate the extra points from using their credit card. It's crucial to communicate the change clearly to patients, emphasizing the benefits and addressing any concerns. Transparency information and exceptional customer service can help maintain patient satisfaction and retention.
Financial Analysis and Risk Assessment: Conduct a thorough financial analysis to assess the risks and benefits of becoming a non-assignment provider. Consider the impact on cash flow, profitability, and the ability to collect patient payments. Evaluate the costs and resources required for managing the administrative aspects of non-assignment, such as generating invoices and providing necessary documentation for patient reimbursement.
Ultimately, the decision to become a non-assignment provider should be based on carefully evaluating these considerations and your practice's specific goals, patient demographics, and financial objectives. It may be helpful to consult with dental industry professionals, such as practice management consultants or advisors, to gain insights and guidance tailored to your unique circumstances.
