Dec 19, 2023 2 min read

Managing Overpayments – Stabilizing your RCM

Most dental practitioners spend a lot of time ensuring that they receive overdue payments as soon as possible. While this is obviously a necessary step to take, overpayments have also become a growing problem in the dental industry. Patients are often charged more than they should be for services and visits. Although overpayments can be made due to patient error, it is usually the insurance company that overpays. In both scenarios, overpayments need to be reimbursed without delays. How your practice manages the refund process will affect a patient's overall impression of their dental practitioner.

Some of the Most Common Reasons for Overpayment Include:

  • Out of date patient eligibility and benefit information.
  • Incorrect billing due to changes in coding not being tracked.
  • Incorrect estimation of copays and coinsurance amounts at the time of service.
  • Changes in policy between the time of the dental visit and the billing process.
  • Errors in billing.
  • Overpayment by the patient.

Avoiding Overpayments

Considering that prevention is better than cure, it is always advisable to avoid situations that could result in overpayment. One solution is for your practice to ensure that their coding is up-to-date and accurate. This can be done by regularly checking for coding updates and making sure that all claims are submitted with the right codes. Additionally, it is important to double check insurance information before submitting claims to ensure that the patient is not being charged more than they should. Other important ways include:

Estimating Your Patient’s Responsibility

Create a payment schedule for patients with larger balances so that the money can be collected over time. This will help your practice to track payments as they are made, which helps minimize overcollection. Establishing patient expectations and creating payment mechanisms to collect the payments or recurring balances, guarantees that your practice gets paid exactly what it is owed, nothing more and nothing less.

Checking for Patient Responsibility in Real Time

Before beginning the billing process, make sure the patient's benefit details are up-to-date and accurately documented in your system. To ensure you have the most recent information possible, check the patient's eligibility before each visit and dental appointment. Using outdated benefit information can result in incorrect billing, which can lead to patient overpayments.

Improving Patient Engagement

Patients are more likely to pay close attention to how much they owe when you involve them in the payment mechanism. Provide your patients with various payment options, as this helps increase their convenience. Patients are less likely to make payment mistakes and more likely to keep track of what they owe when they have control over their dental care payment process.

What to Do When Overpayment Occurs?

Notify your patient about the overpayment. If the patient plans to return, check with them about crediting the excess amount towards their future visits or services. However, the excess payment must be returned if the patient doesn't wish to use it for a future appointment. The next step is to quickly send the patient a check for the amount overpaid, along with a note explaining the situation of the overpayment.

Dental providers find themselves issuing refunds when there is a situation of overpayment. The manner in which a practice manages its refund procedure will affect the patient's overall dental care experience. In order to provide their patients with ease and convenience, practices need to view the refund process as a crucial part of the patient’s dental care experience. In conclusion, overpayments are a growing problem in the dental care industry. Though there may be multiple reasons, identifying overpayment scenarios and addressing the issues on time can go a long way in reducing the number of occurrences.

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