Patient Related Tasks
1. New patient intake
- Telephone call to attempt to get patient to register online
- Telephone interview to input new patient information prior to first appointment
2. Pre appointment activities
- Appointment reminder telephone call
- Verify completion of any pre-appointment dependencies, e.g. lab case due, pre-medication requirement
3. Ongoing collections
- Manage A/R status
- Help set goals
- Monitor and regularly report to dentist on status of actual vs. plan
- Manage monthly billing
- Call accounts with balances older than _____ days (client’s decision)
- Manage activities with collection companies
4. Ongoing patient contact
- Re-schedule missed appointments
- Call unscheduled recall patients
- Attempt to re-activate inactive patients
- Miscellaneous calls to reconcile account information, e.g., change of address, change of insurance, change of name
5. In-bound patient calls
- Appointment scheduling and editing
- Answer routine questions
- Refer necessary calls back to office
Insurance Related Tasks
1. Pre appointment activities
- Verify eligibility
- Check benefits
- Reconcile any problems
2. Post appointment activities
- Review claims and pre-authorizations
- Submit claims
3. Ongoing activities
- Review status of electronically submitted claims
- Reconcile and re-submit any claims not accepted for electronic submission
- Review and manage insurance A/R
- Post insurance payments (requires client to send copy of payment remittance) and pre-authorizations
- Review all denials and partial payments and, if applicable, pursue re-submission
- Input and maintain insurance plan information
- Input and maintain fee schedules information
- Oversee provider credentialing status with insurance companies
Audit Related Tasks
- Embezzlement audit
- Reconcile day sheets and deposit slips and identify irregularities to dentist
- Review all adjustments, refunds and write-offs and identify any irregularities to dentist
- Review audit trail report weekly for any pattern to adjustments
- Review accuracy of staff data input
- Review and report on key areas
- Review key metrics
- Review and report on defined metrics, e.g., open treatment plans, new patients, new patient revenue, etc.