Helping your patients maintain a beautiful and healthy smile is only part of the job as an orthodontist. Maintaining your financial health is another focus area. Jackie Shoemaker, President of JMShoemaker Consulting, Inc., sat down with us to go over some of the financial numbers that are important for any orthodontist to know to ensure a healthy financial report.
Contract Adjustments. The Contract Adjustments Report shows the changes to a contract structure (the 30-60-90 day revisions) in a given date range. The report includes the patient name, operator name, date and description of the adjustment, and the fees that were changed. Shoemaker explains that there is nothing wrong with changing a contract structure, but the reason behind the change needs to be legitimate and clearly defined as it is a piece of your audit trail. A good description will let you know that the integrity of the age of the contract hasn’t changed. Shoemaker explains that non-essential adjustments can affect the health of the receivables, and could also affect delinquency calculations. Knowing why these aging adjustments have been made is crucial for the remaining reports she recommends running.
In Edge Cloud. To review any contract adjustments, from the Reporting window, select Contract Adjustments under Audit and click Run. When selecting your settings, run this report for a specified time period, and click View.
Credit Balances. Credit balances are defined as money that is owed to a patient or responsible party, and Shoemaker makes it clear that these balances need to be maintained just as you maintain your delinquent patients. You want to maintain an accurate receivables balance – and having credit balances lowers the value of your receivables balance. It is important to know both which patients and insurance companies need to be refunded, and to start paying those funds out as soon as you realize they are owed. In addition to knowing how much you owe, Shoemaker said it is important to know the statute of limitations in your state on how far back you need to be paying these owed amounts.
In Edge Cloud: From the Reporting window, select Accounts Receivable Aging under Financial and click Run. In the Subgroup section, click the arrow next to Financial, select Credit Balance, and click View.
Patient Delinquency. To get your delinquency percentage, you want to divide the total number of accounts over 30 days pasts due by the total number of accounts with a positive balance. Shoemaker says your goal percentage should be less than seven percent. You want to run the Accounts Receivable Aging Report to determine this calculation. When running numbers for positive patient delinquency, it is important to exclude insurance (you’ll see why in the next point) and to run the report as of the current day.
In Edge Cloud: From the Reporting window, select Accounts Receivable Aging under Financial, subgroup for all positive balances, and click View. The number of accounts with a positive balance is listed on the last page. This will be your denominator. Run the same report a second time, but this time, in the Subgroup section click the arrow next to Financial, select Past Due 30 Days, and click View. This number will be your numerator.
Insurance Delinquency. Insurance delinquency, determined with Non-Zero Balance Accounts Receivable Aging Reports, is very similar to the positive patients who are delinquent – you want to know your delinquency percentage on the insurance ledgers only, and this should be less than five percent. You will calculate this number in the same way you did for patients. However, you will use the Insurance AR Aging by Company report instead, which is under Insurance in your Reporting list.
If you happen to find a lot of insurance ledgers with a credit in the Amount Due column, yet a positive balance in the Balance column, this could be an indicator that the insurance contract structure does not match the way insurance payments are actually being made. Shoemaker warns this could skew your insurance delinquency.
In Edge Cloud: Run the Insurance AR Aging by Company Report, subgrouped by positive balances, to get the total number of patients with a positive balance. This figure will be on the last page. Run the report again but with the Past Due 30 Days subgroup. Divide the total number of accounts over 30 days past due by the total number of accounts with a positive balance to get your percentage. Remember, if the account is “paid ahead” they should be eliminated from the denominator of this calculation which requires a manual review of the Non Zero Report.
You can learn more from Shoemaker at the 2022 Users Group Meeting, January 27-29. Visit ugm.ortho2.com to get the meeting details and register.
Jackie has been improving practice profitability and staff financial skills for more than 35 years as the owner of JMShoemaker Consulting, Inc. She utilizes her unique combination of a foundation in corporate accounting, experience as a financial coordinator, and orthodontic software knowledge to focus on patient and insurance delinquency reduction, financial arranging, and accurate orthodontic accounting. Jackie is also the founder of AccounTrac, Inc., a payment compliance company where she and her team encounter the first-hand effects of patient delinquency, financial arrangements, and treatment-related concerns while collecting accounts for practices on a daily basis for the past 25 years.