Write-offs at the dental office: do’s and don’ts of writing off payments

You know that feeling when you take an IOU from someone, but then they never pay you back?  That’s what a write-off in a dental office can feel like. A write-off represents the amount you will not collect for the work you produced. Write-offs give you a way to track lost income, and you want to minimize them for a healthy practice. 

When it comes to collecting from insurance claims or patients, it can sometimes feel like too much effort to get what you’re owed, especially when either party is being difficult (we’re looking at you, insurance companies!). This is when many dental teams will write off the unpaid fee, or take the financial hit. 

Dental ClaimSupport’s billers work to reduce insurance claim write-offs, doing everything they can to get denied claims appealed. Through years of working on this process, we see dental teams struggle to collect from the patient as well. 

If you’re writing off money due from insurance AND patients combined, you could be missing out on a lot of money. In this article, you will learn the dos and don’ts when it comes to writing off insurance claims, patient payments, and payments for special people in your life (friends, family, etc.).

With this information, you’ll know the right time to write off an amount, or when to work a little harder to get what you’re owed, whether it be from insurance or patients. 

Write-offs from dental insurance claims: Do’s and Don’ts

Let’s start with the big one: insurance claims write-offs. 

We aren’t talking about PPO write-offs here. Sure, you will have contractual write-offs if you charge standard office fees to a patient, yet you participate with their insurance. 

That’s just part of doing business and shaking hands with the insurance company, and the patient does deserve that in-network discount and write-off. What we are discussing here is writing off amounts you’re owed, just because insurance wouldn’t pay.

We know what you’re thinking. “Sometimes insurance just won’t budge! I can’t spend hours on hold with an insurance company!”

And this is all true. Dealing with insurance is a huge pain. When your insurance claims are denied, and you’ve tried to get them appealed, it can be tempting to just write it off. But here’s what you should do instead.

Do:

First of all, you should try to appeal your claim more than twice. Sounds annoying, right? Well, it’s worth it to get that money you are owed.

1. Make sure you’re providing as much information as possible to the insurance company

 It’s common for claims to be denied due to lack of evidence (attachments such as x-rays, intraoral photos, narratives). Make sure you’re including all of this information in your appeal.

2. Have someone who can take the time to sit on the phone with insurance companies

A huge reason dental teams give up on getting claims paid is they don’t have the time to call insurance. In an ideal world, you have someone on your dental team, or you have outsourced to someone who is dedicated to getting your claims paid. 

This is a time-consuming process, so the responsibility needs to be handed to someone who has time to devote to claim appeals. 

Don’t: 

It can sound a little cliche, but hey: Don’t give up! There shouldn’t be a fear of “annoying” the insurance company as there might be with tracking down a patient for payment. 

Trust me, insurance companies have enough money. Get what you’re owed. 

1. Do not let insurance companies dictate your dentistry

Even if you have to call 10 different people at an insurance company, do not take no for an answer. If you have given all of the information to the insurance, and the patient’s benefits are active and verified, you should be paid. 

This means you need to understand your patient’s benefits so that you can square off with the insurance company (jeez, we sound like we’re talking about Fight Club) - be sure that you have taken the time to verify the patient’s insurance with your verification software. 

2. Do not let insurance claim write-offs stop you from working hard to avoid future denials

Insurance companies will work hard to make sure they don’t have to pay you. Among the many downgrades, alternate benefits, and exclusions to your patients’ policies, it can get really frustrating.

If you’ve educated your patient on the fact that they will owe you even if their insurance does not pay their portion, you shouldn’t have a problem. However, on the occasion that this does happen, and you do end up writing off an insurance claim that you couldn’t appeal, don’t get discouraged about working hard to avoid future claim denials.

Write-offs due to uncollected dental patient balances: Do's and Don’ts 

Write-offs from patient payments you can’t collect are a bit stickier. You’re dealing with real people and their personal money. Let’s be real, going to the dentist isn’t cheap. You want to keep your patients happy and schedule future appointments, but you also need to be paid for services rendered.  

Ideally, you get paid by patients before they leave your dental office, after their appointment. But some offices struggle with collecting up front. 

Do: 

There are a few things you can do to get patients to pay unpaid balances. 

1. Try your best to be kind and understanding

If you’re rude when you call a patient about a late payment on a dental bill, they’re less likely to pay it. Make sure to clearly explain why they owe what they owe and how much their insurance covered. This way you are offering a logical explanation for their bill. 

If you’ve billed them because you did not accurately calculate their out-of-pocket cost when they originally came in, let them know you made a mistake. Hey, it happens. It’s not ideal, but taking ownership of this mistake can go a long way with a patient who owes you money.

2. Offer a payment plan of some sort

3. Educate your dental patient on their insurance policy

Most dental patients do not understand their insurance benefits and what procedures are or are not covered. It’s up to you to explain (BEFORE their procedure) what their benefits cover. Patients are more likely to pay you upfront if you have already explained to them why they owe you. 

Educate them on what is covered, what’s not covered, why fillings and crowns are downgraded, deductibles, maximums, etc. Explain up front that if or when insurance does not pay the remainder of the procedure after the claim has been denied, the patient is then responsible. 

If they’re aware of this, they’re less likely to have a problem when you send a bill or call to collect payment over the phone, because you’ve fully explained to them why they owe what they owe and set this precedent up front. 

Don’t

Our “dos” were all about being kind and sensitive, which is important. However you are a place of business, and you did exchange services for expected payment. 

1. Do not send a bill in the mail without following up on it

It’s 2022. Paper bills in the mail are lost in the mix more often than you think. But even if you email your patient a bill, if a week goes by and it isn’t paid, follow up with a call. 

You should follow up on patient payments the same way you would with insurance claims: phone calls with all of the information from the insurance so that you can explain to your patient why they owe what they owe. 

2. Do not let it go just because you feel awkward

Money can be hard to talk about, but your business needs money from its patients to stay afloat. It’s not absurd to call a patient and tell them they owe you money. Most people will probably roll their eyes a bit but still pay you. 

If you have done everything correctly, you trust your dentistry, and you've handled everything right from claims submission to appeals, yet the claim still isn't paying, you can eventually get the patient involved with the insurance to try to help solve it.

This should be a last resort, but don’t write off the claim without trying to get it paid by the patient. They won’t be happy because they just received an unexpected bill, but if you clearly communicated to the patient that they will be responsible for the remainder of the cost if insurance cannot pay it, they will understand. 

If you do have a person who tries to dismiss the payment, kindly insist that it is what you are owed and offer payment options (like the payment plan we mentioned above). 

Write-offs from special patients (friends, family & staff): Do’s and Don’ts

You thought dealing with patient payments was sticky? Just wait until people you actually know personally get involved. 

Dental practices are commonly run by families or spouses. It’s not uncommon for the dentist to offer free or discounted services to family members and friends. But nothing is free, and all of the services rendered, medicine, and equipment used costs money. 

Do: 

1. If you are the dentist and/or business owner, give your close friends discounts on your services

Whether you are a dental team member or the head dentist, your family may be able to benefit from your services for free or a discount if they do not have insurance. No one is here to tell you to be a scrooge and make your family pay you to have their teeth cleaned, especially if they don’t have insurance benefits to help lower their out-of-pocket cost. 

But if you are not a dentist or business owner, make sure you talk about this with them before you assume you can offer this discount to friends or family members.

It’s up to the dentist (and business owner) to make rules on who will and will not receive discounts, but if you’re the dentist and have a close friend in need of dental work, performing this for free or discounted is kind and generous. 

Disclaimer: if you work at a practice owned by a DSO, you will likely not be able to give friends or family discounts on dental services.

2. Properly document any discount given to a patient if they are covered by dental insurance

If the patient has insurance, you will still need to file an insurance claim with the details of the discount included. The claim form should reflect the actual charged fee, noting any discount given and reported on the claim. The insurance will then also pay less on the claim.

If you misrepresent the actual fee charged, it will be considered overbilling, which could lead to your practice being guilty of fraud. 

Don’t:

As we said, it’s not really free. You’re still writing off your time, services, and equipment costs.

1. Don’t advertise amongst your friends that you offer certain friends free dental services

The more this becomes public knowledge in your circle, the more people are going to come to you asking for free or discounted dental services. Then, you’ll have to awkwardly tell them no. 

2. Don’t be afraid to set hard boundaries among not just your friends, but also your staff

If a team member comes to you asking if their friend can receive discounted or free dental services, don’t be afraid to say no. 

Even if they are your cousin who you hired to answer phones at the front desk, you have to decide hard and fast rules when it comes to friend and family write-offs and discounts. 

Do you have a designated biller to help reduce write-offs?

Write-offs at the dental office boil down to missed revenue. Sure, sometimes it’s because you’re doing favors for friends and family, and sometimes (rarely) insurance and patients just won’t budge. But if you follow these tips for how you should and should not handle writing off payments at your dental practice, you’re sure to collect more revenue. 

Dental ClaimSupport can specifically help you avoid insurance claim write-offs. Our billers love the appeals game and work hard to ensure insurance pays you what you’re owed.