Paying Dentists on Net Production

If you pay your providers on net production, we recommend turning on the Auto Post PPO Write-Off option in Settings and then using a custom production report.

Turning on the Auto Post PPO Write-Off provides the most accurate account of net production because since insurance adjustments are automatically entered into the ledger when claims are created, our reporting system captures gross production and the insurance adjustment and calculates net production all on the same transaction date. To gain the benefit of this feature, you also need to create the claim on the procedure date of service. That way the service date and the claim creation date are the same.  To view a video that demonstrates how this switcher impacts the ledger and day sheet, follow this link: The impact of the auto post ppo write-offs on the ledger and day sheet: Should you turn this on or off? 

Another significant benefit of turning on the Auto Post PPO Write-Off is that it will provide you a more realistic Accounts Receivable report. If the Auto Post option is turned off, then your AR Report reflects only the UCR fees and it is impossible to know how much you actually should be collecting vs. how much  you will end up writing off. With the Auto Post option turned on, you can more confidently look at your AR Report and know this is due to your office.

The only reason a dental practice may hesitate to turn on the Auto Post PPO Write-Off option is that they are concerned that their fee schedules are wildly inaccurate, and that by having to enter an additional insurance adjustment once the EOB is received, the ledger may look “messy”. Our recommendation in this situation is to invest time and resources to make your fee schedules accurate, and understand that an additional insurance adjustment into the ledger will occur and is nothing to be afraid of. 

The best report to show each provider’s net production is one you create from scratch using the Analysis Ledger Report Builder in the Financial tab.  

Add the following fields: 

• Location 
• Transaction date – choose month and year (if you pay monthly) 
• Provider - add them into rows and filter out unavailable spaces
• Primary Guarantor (use this because adjustments can be applied to guarantor)
• Production or Collection - and filter to include production only - add to columns
• Description - Category - add to columns
• Measure – Amount

Under Report options, add Grand Totals for rows and Grand Totals for columns

Here is a sample of what that report will look like: 

Auditing

In order to maintain consistent reports that do not change, we recommend tightening your Transaction locking to less than 5 days and running regular audits. The primary reason for inconsistent reports is that the transaction locking has been edited by a user in order to enter back dated transactions – and as soon as that happens, that changes reports in the past. 

So, as you establish your auditing procedure, the first thing you will want to do is confirm that your transaction locking has not been changed. You also can restrict the rights to change transaction locking and educate all team members who have this ability on the impact of back dating.

Next, we recommend running a more detailed report – adding in patient and guarantor names – and saving this into a file for the sole purpose of simplifying any investigation into why previous report numbers have changed.

Here are the instructions:

• At each payroll, run the regular provider compensation report – save.
• Next, run the same provider compensation report and add in guarantor and patient names – this will be saved for future auditing.
• On a quarterly basis, re run the last 3-6 months of provider compensation using the same dates and confirm that the numbers for production or collection are the same. If you see any differences, then go back to the detailed reports to find the specific patient and ledger differences.

Handling initial balance forward adjustments impact

If your practice recently converted to Dentrix Ascend and you will be manually bringing over patient balances from your legacy software, you may want to consider how these adjustments are set up and how to maintain accuracy of your doctors compensation reporting. 

Our recommendation for setting up these adjustments is:

Initial balance forward – default to production

Initial Credit balance forward – default to collection

For practices that pay providers on net production, you can see that when you enter the initial balance forward adjustment (and it is set to impact production), this would inflate the provider's production - on treatment the provider has already been paid for. To avoid paying your provider twice, we recommend using the report above and including a filter to exclude the initial balance forward adjustment. 

For practices that pay providers on collections, there is no impact when the initial balance forward adjustment is set to impact production. 

To review the full article on setting up adjustments: Common Adjustments and How to Use Each One.

How the Day Sheet Compares

If you have transaction locking set tightly and the Auto Post PPO Write Off option turned on, then the Estimated Net Production on the day sheet will be consistent with the report described above. If no additional credit adjustments are posted outside the date range on the day sheet, then the day sheet and power report will match. And  if they do not match, that indicates that an  adjustment has been posted outside the date range of the report and applied to a charge within the date range of the report. 

If you do not have the Auto  Post PPO Write off option turned on and the adjustment is not posted on the same day as the service was completed, then the day sheet could be drastically different (especially for PPO offices). The downside of using the day sheet for net production (listed as Estimated Net Production) is that this one line item on the day sheet is actually pulled based on service date, while all the other transactions listed are pulling from the transaction date. Also, the day sheet only takes into consideration primary insurance, not secondary. This can cause frustration when trying to match reports. So, the best approach for calculating net production is to turn on the Auto Post PPO Write-Off option and then run a custom report based on transaction date.

(Article authored by J. Alldredge, J. Nesbitt 2019)