Inflated Salary Estimates

[rsweeney]

Let's assume your fee for a crown is $1500. PPO contract will pay you $1000 a crown. You did a crown and you get paid $1000; you produced $1500 but only get paid $1000. But that's not the right way to calculate it. One can price $5000 a crown but get paid $1000 for only 20% collection. One can price $800 a crown and get paid $1000 for 120% collection!!!

Exactly, you hit the nail on the head. One's fees are ghost numbers if you accept insurance....collection is what matters. Don't forget lab costs. The lab I use charges $200/PFM. So..My fee (1000/crown)--> Insurance fee ($775/crown)-->lab cost($200)

Thus, I made $555 on the crown, but production data shows $1000. Almost 50% difference. Also, I would love a contract that paid $1000 per crown! If it is an 80/20 PPO and the allowable amount was $775, I can't tell you how many folks don't pay the $155 portion, or ask to be on payment plans, etc. This could segway into another topic of cash vs accrual accounting in which you could write unpaid stuff off as bad debt...aye yae yae...lets write a book!

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[yappy]

Exactly, you hit the nail on the head. One's fees are ghost numbers if you accept insurance....collection is what matters. Don't forget lab costs. The lab I use charges $200/PFM. So..My fee (1000/crown)--> Insurance fee ($775/crown)-->lab cost($200)

Thus, I made $555 on the crown, but production data shows $1000. Almost 50% difference. Also, I would love a contract that paid $1000 per crown! If it is an 80/20 PPO and the allowable amount was $775, I can't tell you how many folks don't pay the $155 portion, or ask to be on payment plans, etc. This could segway into another topic of cash vs accrual accounting in which you could write unpaid stuff off as bad debt...aye yae yae...lets write a book!

Why isn't that type of theft a prosecutable offense? I have never understood why people are so comfortable stealing health care services.

 

[KSDental]

The ADA lists the average salary for a general practitioner who owns their own practice at around 200k. Is this figure after practice loans, malpractice insurance, disability insurance, and health insurance are accounted for?

 

[Daurang]

The ADA lists the average salary for a general practitioner who owns their own practice at around 200k. Is this figure after practice loans, malpractice insurance, disability insurance, and health insurance are accounted for?

YES.

 

[Silent Cool]

The ADA lists the average salary for a general practitioner who owns their own practice at around 200k. Is this figure after practice loans, malpractice insurance, disability insurance, and health insurance are accounted for?

Excellent question--and kudos to you for asking it as a dental student.

 

[rsweeney]

Why isn't that type of theft a prosecutable offense? I have never understood why people are so comfortable stealing health care services.

I could hug you!

 

[Daurang]

I could hug you!

I had a cop (income $140k) verbally promised but never came back to pay his $500 copay for crown. Call him few times and gave me bunch of busy bs. How do you arrest a cop for stealing?

 

[Miley Cyrus.]

Can't you use a collection agency for non-payers?? I know it would be an expense, but it seems worth it.

 

[BWG]

Once you get very good at extracting 3rds, you can make an entire career of it as a generalist, like this guy:

http://drwisdomteeth.com/

I'd be willing to bet that while he is likely excellent at taking 3rds, the OMFS community will nail him to the cross when he has a complication. Of course, complications are bound to happen after doing enough 3rds...

 

[sampler]

I am a general dentist working as an associate for 3 years so far. Last year. I made about 300k in 2012; and about 400k in 2013...

What city are you in?

 

[thirstyscholar]

Can't you use a collection agency for non-payers?? I know it would be an expense, but it seems worth it.

Depends on your locale.

Rural areas, you're the blood sucker that bilked his cousin for a copay.

Urban areas, you might make 15 cents on the dollar.

Not worth it really. Unless you're diving in fountains for wishes.

Best if you keep a steady patient flow and expand even slightly to more paying customers.

 

[suarez 7]

So with all that said I assume it's better for the dentist that the patient pays up first so you collect money 100% of the time. However, is this the norm? I feel this might scare a lot of patients and they might not want to do it before getting treated. A lot of dentists at my school say they have to charge prior to any treatment. Even in my school the policy is that the patient pays before commencing treatment at our clinic.

 

[Daurang]

So with all that said I assume it's better for the dentist that the patient pays up first so you collect money 100% of the time. However, is this the norm? I feel this might scare a lot of patients and they might not want to do it before getting treated. A lot of dentists at my school say they have to charge prior to any treatment. Even in my school the policy is that the patient pays before commencing treatment at our clinic.

My front desk let them know their copay and the patient make appointment whenever they're ready. No rush and no pressure from us cause I am busy enough anyway. Most pay some on the first day and the rest on the day of completion. A few insist on paying all at the end and they do. A few either don't have or forgot the money at the final appointment but they eventually pay everything even a year or two later. In 13 years, the only two deadbeat patients that disappeared/stole from me have been those who's supposed to best know and uphold the law ...a lawyer and a policeman. Yes you can send the debt to collection agency and even ruin their credit. However, a lot board complaints and lawsuits, legit or not, do come from from these collection disputes...hardly worth the time and headache!

 

[Ferneezy]

wait...patient skips on the bill, you send to collections...they sue you in retaliation?

 

[Daurang]

wait...patient skips on the bill, you send to collections...they sue you in retaliation?

Didn't happen to me but, YES, they can whine with you for any reason or complain to the board for any reason or sue you for any reason. Don't mean they will win but just dealing with the board is just a PITA even if you did no wrong. The board is not there to protect you. It's there to protect the consumers so they have to respond to all complaints. Even if they find nothing wrong on your part, they will audit other files until they find something else wrong totally unrelated and then fine you. Big corporations will go heavy after deadbeats but it isn't worth it for small solo guys. I have patients who already paid $1500 (half) their 3-unit bridge but never return to replace the temp with the real PFM; what you gonna do? Force them in? Ruin their credit? What do you get out of it in the end?

 

[yappy]

Are there companies that buy their debt from you, maybe 30 cents on the dollar, from you and "goes after them big-time" so you don't have to deal with it?

 

[thirstyscholar]

Are there companies that buy their debt from you, maybe 30 cents on the dollar, from you and "goes after them big-time" so you don't have to deal with it?

Sure. But your rep gets killed in the process.

 

[yappy]

Sure. But your rep gets killed in the process.

I guess I've been sheltered. How is it someone can damage your rep if they don't pay their bill and are sent to collections? Wouldn't it be embarrassing on their behalf that they don't have their financial life in order, acted irresponsibly, and didn't have the life-skills necessary to avoid a collections process?

 

[Shunwei]

I guess I've been sheltered. How is it someone can damage your rep if they don't pay their bill and are sent to collections? Wouldn't it be embarrassing on their behalf that they don't have their financial life in order, acted irresponsibly, and didn't have the life-skills necessary to avoid a collections process?

Word of mouth, yappy. Remember we live in an age where the internet is a very powerful tool where anyone--I mean anyone--can write some fictitious review. They don't have to write what they did, just what they perceive you did wrong to them or something completely imaginary. Not to mention coming to your office and making a fuss, or doing some other kinds of crazy stuff. My best way to avoid something like this would be to avoid payment plans and stick with PPO, cash up front, or plans where you get paid for sure like CareCredit or Compassionate HealthCare where the risk goes over to the financing firm.