Considerations for Handling Patient Billing Disputes

April 8, 2019 | 0

Considerations for Handling Patient Billing Disputes

What do you do when a patient complains about their bill? What do you take into account? Do you just demand payment for the services you performed? Do you consider whether the dispute is legitimate, even if the charges were legitimate, too?

In The Business of Dentistry Facebook community, a dentist asked the community for advice handling a dispute over a cleaning bill.

Here's what happened:

“What is the proper way to deal with this situation . . . a patient had her wisdom teeth extracted under GA with and OMFS in early 2018. She then had a cleaning in late 2018. We got a call today from the patient’s mother stating the cleaning was not covered by ins. as she was out of benefits. The patient’s mother said this was our fault and we should never have cleaned her daughter’s teeth as we should have known she was out of benefits. She spoke to my front desk and demanded we write off this. My front desk did not offer this and said we could arrange a payment plan (balance is ~ $200). How should I proceed? I really do not think this is our fault. The patient's mother is razzed, and I’m concerned about her ripping us apart online, etc.”

In true Business of Dentistry community style, dozens of this dentist’s colleagues responded to the post to help. Here are some of the common considerations and advice provided by the community.

You Performed a Valuable Service

Considerations for Handling Patient Billing Disputes

Many dentists rightfully pointed out that the practice performed a valuable service and deserved to be paid. Even those who suggested other options did not dispute this. 

Although having the right to be paid for the services provided is not disputed, in this situation, the value of the services is not the only issue. That said, it is important to remember you performed a valuable service for the patient.

Was the Patient’s Assumption Reasonable?

Considerations for Handling Patient Billing Disputes

While the doctors agreed that insurance coverage is the patient’s responsibility, patient service is about more than technical responsibility. Is it possible that you or your team could have recognized the patient had used her benefits with the wisdom teeth transaction and checked on the cost for the cleaning? Some dentists suggested checking for every cleaning might be cumbersome, of course. But some compromise might be appropriate in a unique case like this. Some dentists suggested a compromise could be appropriate. In this case, the doctor might start by having a productive conversation about what happened to deescalate the situation. As one dentist put it, in part:

Ask her what she thinks the service you provided was worth. Let her pay that. Write off the rest. If you feel the amount she chooses is a fair compromise, continue to see them. If they think your services are worth nothing, write it all off and part ways.
It’s a mix-up, but they have to understand you should get paid for the services you provide.

Is it “Worth It” to Push the Issue?

Considerations for Handling Patient Billing Disputes

Even with this in mind, some colleagues suggested it might not be worth it to pursue the $200. One person suggested considerations to determine if it is worth it in his mind:

  1. Insurance is the patient’s responsibility, not the dentist’s. 
  2. Patients leave bad reviews when they’re angry or upset, regardless of whose fault it is. 
  3. The dentist gets to decide for yourself the cost/benefit of writing it off. 
  4. How much goodwill will you gain by helping the patient out, or meeting them halfway? 
  5. How much goodwill will you lose by making them pay the full amount? 
  6. Is this a patient you want to keep?

These thoughts echo the reasonableness of the patient being a factor. If you push the issue, it’s possible that the patient will move on and post a negative review online. If this is a good patient who is reasonably upset, pushing it could cause you to lose a good patient and their family for life. And quietly writing it off after a reasonable conversation could buy you a lifetime of loyalty without other patients thinking they can reduce their bill by complaining no matter how unreasonable their complaint may be.

With respect to the risk of negative reviews, many colleagues suggested not letting the threat of a negative review run your practice. If someone leaves a negative review, just keep serving people well and earn more positive reviews. But don’t let the threat of one negative review make the decision for you.

How do you handle patient billing disputes?

When it comes to patient billing disputes, there’s often not a one-size-fits-all solution. What advice would you give to this doctor? Let us know in the comments or join the conversation in The Business of Dentistry Facebook community.