You work hard to care for your patients. Once the work is done, let your practice management software do the work of tracking revenue, from procedure completion to billing, and beyond.
In this post, we’ll cover Open Dental Reports that help you manage and track activity at every stage of the revenue cycle, so you can stay focused on patient care as you continue to grow your practice.
Step 1: Tracking completed procedures not on a claim
Procedures Not Billed to Insurance Report
This report shows patients with procedures completed on the date/in the date range you select, where no claim has been created. Go to each patient’s account to take the appropriate next step.
- No claim has been created for the completed procedures
Create the claim and send it. You can select the procedures from the report window and click “New Claims” or create claims from the Account Module. If you select procedures for multiple patients, you can create multiple claims at once.
- There is no need to create a claim for the completed procedures
If there is no need to bill insurance in this instance, double-click to open the procedure and check the “Do Not Bill to Ins” check box. Once checked, procedures will show as “No Bill Ins” and will no longer show in the report.
* For procedures that are rarely or never billed to insurance (regardless of plan), go to Lists-Procedure Codes, double-click to open the Edit Procedure Code window, and check “Do not usually bill to Ins.”
- Claim was created for the procedure(s), but procedure showing (Unsent)
Double-click to open the Procedure Info window, and check in the Insurance Estimates and Payments grid to see if any duplicate estimates exist. If they do, you can open and delete the estimate.
Step 2: Tracking claims created but not sent
Claims Not Sent Report
This report shows claims created on the date/in the date range you select that have not yet been sent to insurance. It also shows secondary claims that are in “Hold” status until the primary insurance claim payment is received.
Manage all unsent claims through the Manage Module. Click the Send Claims button – the upper grid shows all items waiting to be sent. (NOTE: Preauthorizations waiting to send are also displayed – you can tell them apart because preauths will have 01/01/0001 as the Date of Service.) Right-click on a claim to go to the patient account to investigate further or take the necessary action to correct any missing information before sending. You can also validate and send claims from the Manage Module, using the Send Claims button.
Step 3: Tracking insurance claims without payments
Outstanding Insurance Claims Report
This report shows claims that have been sent to insurance but are still awaiting payment. The report defaults to claims at least 30 days old but this can be customized to show the claims you want to see. Narrow down by provider, carrier, or custom tracking status, and click Refresh.
Here are the reasons why claims will show on this report, and steps to troubleshoot (i.e. how to get them off of the report if they really don’t belong there)
- Claim payment has been received, but claim still shows on this report because claim status was manually set to sent-verified.
If payment has been received for all procedures on the claim and you are not expecting any additional payments, change claim status in upper left to Received.
- Claim payment has been received for some, but not all the procedures on the claim – claim was manually set to “sent-verified” to maintain visibility of expected amounts.
Do this instead: Double-click to open the Edit Claim window. First, click to select the specific procedure(s) where payment is expected but not yet received. Click “Split Claim” and split these off onto a separate claim that can remain open. Then, once you’ve confirmed that all other procedures on this claim have received payment, change Claim Status in upper left to Received, and click OK. This maintains visibility of amounts still expected from insurance, but closes the portion of the claim that has received payment.
- Claim payment has not been received.
Contact the insurance carrier for status on payment.
Step 4: Tracking insurance payments received but not finalized
Unfinalized Insurance Payments Report
This report should be run every day, to ensure that all insurance payments you’ve posted have been finalized. Once finalized, they will show up on your Payments Report.
TECH TIP: Making sure payments have been finalized is critical because once you’ve posted the payment to the claim, the claim will be marked as received, and will no longer show up in your Outstanding Claims report (you’ll lose visibility to the receivable). The insurance payment will also NOT show up in your Payments Report or Production & Income Reports until finalized. The only way to see unfinalized payments is to notice the note on the payment in the patient’s account or by running this report.
Step 5: Tracking patient receivables
This report tracks patient balances and aging. It defaults to run for all Billing Types, all Providers – simply uncheck to customize your report options. The “=Patient” column on the far right is the one you want to focus on – it’s the estimated patient balance owing after insurance and write-off estimates. If you have patients whose accounts are overdue and you want to prevent any further scheduling until their balances are reduced or paid in full, you can set up Automation to restrict patient scheduling.
If your office uses payment plans, also run the Payment Plans report, which shows any payment currently due, along with the principal balances still owing. This report can be run to show both patient and insurance payment plans.
Using these tools will help you manage your receivables so you can keep your focus on patient care as you continue to grow your practice! If you need help troubleshooting, please feel free to chat or give us a call.
View the webinar on these reports: Procedures Not Billed to Insurance, Claims Not Sent, and Outstanding Insurance Claims Reports.
Categories: Growing Your Practice