Do you pay your dentists a percentage of collections? Are you looking for the right report in Dentrix Ascend to help you do that? Depending upon how your dentists’ contracts are written to determine their compensation, you can customize a Power Report in Dentrix Ascend to provide you with the information you need.
Here is a sample guide you can use to pay your dentists:
Let’s say your contract shows a provider will be paid 25% of collections less lab fees on a monthly basis. To find collections for each provider, you will run the Applied Collection report (found in the Financial tab of Power Reporting). This default version of this report includes four filters:
First, you need to change the time frame from the 7 previous days, to reflect last month. To do this, click the X beside the Applied Date filter to delete this filter.
Next, look in the far left Available Fields column under Applied Date (YMD) and double click the Month field. This will add the month into the report.
Next, click the Month dropdown in the Layout column and choose Filter. Select Previous Month and click OK.
Next, scroll down the Available Fields and double click Patient to add it to your report. Now your layouts will include:
As you make changes to the report, you will see an alert letting you know it has been modified. Click the Refresh Report button on the far right to see the updated information.
Now you will have the following columns in your report:
Using the Total Collection column, find the total for a dentist. Let’s say it shows $100,000. You can see the name of each provider listed above the total, how much patients paid, any credit adjustments or charge adjustments that were applied and the total collection on patient accounts.
Here is a list of the adjustment types in Dentrix Ascend.
Now, take this $100,000 in Total Collection x 25% compensation = $25,000 to be paid to your dentist (less their lab fee).
Here’s a sample report (don’t be thrown off by the numbers in this example; it’s the format that’s important):
For future auditing purposes, save this report in Excel, with each worksheet labeled for a specific pay period and the document labeled using a pattern like Applied Collection Year Provider Name, for example “Applied Collection 2018 Dr. Salvatore Smith”.
This report will show payments that have been applied to a procedure. This report does NOT include pre-payments made that show up as unapplied payments. So, if a patient pays you $5000 today for a procedure that will be completed next month, the dentist that completes the procedure next month will see that payment applied when a team member manually clicks to apply that existing payment to the completed procedure.
This suggests that to make sure your providers are paid accurately your team must be regularly going through their unapplied payments and clicking to apply them. To learn more about applying a previously unapplied payment, read Applying unapplied credits in the Help Center.:
Best practices recommend that as each patient checks out after a visit, the team member handling their checkout should review their ledger; if they see a blue negative number under Unapplied Credits, they need to click on that number and apply the credit. (If the credit cannot be applied, clicking this number doesn’t hurt anything.)
In addition to performing this at every checkout, a second best practice recommendation is to run the Aged Receivables report at the end of the month, and assign a team member to go into the ledger for each patient that has an unapplied credit listed and click the blue negative number to clear out as many of these as possible.
By regularly applying pre-pays and running the applied collection report, you should be gathering accurate total collection numbers and paying your dentists accurately. Obviously, depending upon your dentist’s contract, you may need to customize a power report differently to meet your needs. Please call support for help with this.
How to Handle Patient and Insurance Refunds That Impact Doctor Compensation
If you are responsible for running reports to determine dentist compensation in Dentrix Ascend, you also need to understand (so you can explain to your doctors) how patient and insurance refunds should be handled.
For example, a patient pays $5000 for a treatment plan and the work is done and all $5000 is applied to the dentist who is paid 25% of collection, therefore $5000 x .25 = $1250. Next, a couple months down the road, the patient comes back in and is unhappy with something and the office agrees to refund the patient. This refund needs to come off of the dentist’s future collections.
Here is an example to show you how to enter adjustments correctly. Let’s say your patient had a crown done and paid for ($500 from the patient and $500 from the insurance), and then just a few weeks later, the patient is unhappy and wants a refund. The patient’s ledger shows that he has a $0 balance now, but the crown generated $1000 production.
To enter the refund, follow these steps:
1. Enter the patient refund charge adjustment. Click Charge (+) Adjustment. Choose Patient Refund as the type and set $500 as the amount. Leave the Payment date field value at the default [None]. In this case the patient or guarantor (it doesn’t matter) will receive a $500 refund.
2. Next, create another refund charge adjustment for the amount paid by the insurance company. Select the Insurance Over-pmt Refund charge type.
3. This results in new charges on the ledger that add up to the $1000 value of the crown.
4. Next, enter a credit adjustment. Click Credit (-) Adjustment. Choose the Credit Adjustment type in the amount of $1000 total. Manually edit the Applied amounts for the two refunds.
This results in the ledger going back to its previous balance. In the reports, however, the production decreased and the collection decreased as well.
This impacts provider compensation on the next payroll when you use the Applied Collections Report. The patient refund charge adjustment will reflect in this report, and that reduces the collections for the dentist. The patient refund charge adjustment will show up in the blue column labeled Charge Adjustments.
With this approach, you do not need to audit for refunds. The refund will be accounted for in your Applied Collections Report.
Auditing Your Collections Reporting
From a software perspective, if you follow these recommendations for using the blue link to unapplied credits and using adjustments to handle patient refunds, then your numbers will be accurate—and no auditing would be necessary. However, because user error exists, it is possible that someone can double-click into a payment and reapply all or part to a different date. In fact, this will occur when insurance payments come in different than the original estimate. If your office has a substantial number of outstanding claims that are several months old, you are at a higher risk for user error that can impact your numbers.
To provide you a guideline for auditing, we recommend that each time you run your Applied Collections report for each provider, that you document the total in a spreadsheet. Then you can run an Applied Collections report just a couple times a year to compare against your spreadsheet.
For example, let’s say you pay your dentists every two weeks, so you run an Applied Collections report twice per month:
Jan 1 – 16
Jan 17 – 31
Feb 1 – 13
Feb 14 – 28
Take the Total for each provider and enter it into a spreadsheet. In this example, Dr. Smith has $2400 in total collection for this payroll.
Here is a sample spreadsheet to audit each provider’s collections:
If you keep this updated, and have a sum at the bottom, then you can easily see what the total is for the first half of the year for each provider.
Next, you will run the Applied Collection report; but this time, you will use a date range of Jan 1 – June 30. Now, you’ll compare your spreadsheet against this applied collection report. If the numbers match, then that’s great! If the numbers are different, then you will want to dig into it to find out why.
Again, to dig into the details, you can edit your Applied Collection report to include patient names--and you can filter by date to narrow down where the differences occurred. Once you’ve confirmed why changes occurred, then you can amend your dentist’s compensation if necessary.
How Long Should You Continue to Audit Your Collections?
The answer depends on the lengthiest treatment provided in your office. If your normal treatment plans are completed within 6 months, then you would want to audit your applied collections report for perhaps 7-9 months because until you feel “safe” from the possibility of refunds, you would want to track for this.
If you have an orthodontist in your group and normal cases last 2 years, but 20% of the time there are cases that last 2 ½ years, then you may want to audit for 3 years.
Another important factor in maintaining accurate reports is having well-trained staff. If you follow best practices and regularly apply payments using the blue link Unapplied payments in the patient ledger, then you will find fewer errors that impact the accuracy of your reports.
Another way to increase your accuracy of reports is to train your team to edit PPO fee schedules when they identify that the insurance estimate is off. For example, when your team enters insurance payments, ask them to notice when the payment is different from what automatically is entered. If they see a difference in what the PPO’s covered fee is, then have them edit the associated fee schedule so that future procedure codes will show up with the correct insurance estimate.
(Article authored by J. Alldredge, J. Nesbitt 2017)