Are you the cleanup crew? New dental office manager discovers the patient accounts are a mess

Are you a new dental office manager facing the cleanup of accounts?

Are you the cleanup crew?

New office manager discovers the patient accounts are a mess


You just got the job as dental office manager for a really nice dentist. This dentist is kind and friendly, the office is beautiful and although you wish you were making a little more money (who doesn’t wish that, right?) everything is starting out great.  So, you get started. You get settled at the front desk, moving your supplies around to fit your style of work and you start meeting the patients and doing the normal check in and checking out for each one.

At first, things seem to be just fine and then you start having questions. Why is there such a large balance on Mrs. Jones account? And what about that last patient, what is that balance from? As you start to research, you realize there are more questions than answers and frankly, not enough time to clean up the mess of the patient accounts and do your regular job!

What to do when you’re in clean up mode

First, don’t get overwhelmed. It can be easy to realize that there is more work in this practice than you signed up for and then very quickly realize you couldn’t possibly put in enough hours to get things fixed! Your next worry may be that the dentist who seemed so nice, will be upset with you because things are such a mess – and she may think that either its your fault or that you are incompetent.

So, your next step is to get a handle on how big the problem is. Run your aging. How does it look? Run your outstanding claims aging.  How old are the claims? Run  statements (don’t send them!). How many are there? When were statements last sent? With these report results, you should have a sense of how much work you are facing. Is the outstanding insurance list over 30 days and up only 10 pages or is it 30 pages? How many patients show up on your aging report?

Next, set a meeting with the dentist to share these reports. She needs to see the problem and understand what you are facing. Then, talk together abut how she wants you to proceed. I can see a couple options you could suggest:

#1- Hire another front desk staff person, perhaps part time to either cover the desk so you can focus in a quiet office on these lists or they can tackle them.

#2- The dentist doesn’t want to hire someone else, and prefers that you just work on it as you can, little by little.

No matter the dentist’s decision, you may want to create a file for each report and then tape  a blank paper  to the inside left cover. You can use this paper to track the date and the number of accounts you tackled that day. If you worked on insurance, then you can note the number of claims you followed up on and sent the insurance everything they need or perhaps printed a copy of the EOB and entered the payment. For the aging report, you could document the number of patients you called and collected from, or at least moved to the next stage of the collections process.

Be sure to track your success. At end of month, run your aging and insurance reports and document the totals at the end of the pages. It is fun to see the numbers come down and even better to track the number of pages and see these reports shrink over time. Thanks to this tracking, you can show the dentist your progress each month so she knows that you are being successful, even if this process takes far longer than you ever would have anticipated.

Hang in there! There is no silver bullet to fixing a dental practice’s patient accounts once they have been messed up so the slow and steady approach will prevail. In the meantime, be sure to celebrate the little victories and as you work with your new  patients, you know that everything is correct from the start!

Filling the schedule is just one way to run a successful dental practice. If you’re interested in new ideas on running a dental practice, please subscribe to my weekly blog. One of the biggest challenges to managing a dental practice is managing dental insurance. With dental insurance handled, then dental marketing for new patients becomes a primary focus. In today’s day of online reviews, handling patient complaints well is essential. As your practice grows, hiring dental staff becomes more important. With 16+ years of dental practice management experience, I’m open to your questions to help you run a successful dental office.

Feel free to email me.

AUTHOR: Jill Nesbitt
  • C. Smith dds

    Wow! What a mess. How did you find it?

    September 17, 2014
  • Sara

    Thanks for reassuring me that I’m on the right path, Jill. I took over as OM just under 2 years ago and am still cleaning up. The previous OM was here 30 years and had a ‘unique’ way of doing things (and was computer phobic!) A new doc took over a few months ago and I’m now not only still cleaning up the mess from before, but am trying to get a brand new practice up and running the right way while assimilating the old one into it. I just recently was able to hire an assistant for a few hours a week to share some of the load.
    Your posts are a lifeline and I look forward to each one!

    November 12, 2014
    • Sara,
      Thank you so much for your kind comments!

      I feel your pain on the cleanup job you’re still tackling. Setting up a system to handle each and every account that comes in new – as you’re still digging through past accounts, it just takes time. I think it’s helpful to track your progress so you don’t get overwhelmed. And, you can show your dentist what you are working on as well. You deserve to celebrate once you’re all caught up too!

      Have a great day!

      November 12, 2014
  • Jerri

    Thank you for this blog. I am newly hired as a billing/insurance Coordinator and the person that is doing this particular area has really messed it up. She doesn’t like computers though she uses it but not to it’s full potential as well as the software, Dentrix. When I printed the Aged Insurance I was horrified to see 18+ pages and an 18 figure. The more I work there and find things she has done or hasn’t done really worries me to the point I’m thinking she is stealing or worse.

    August 6, 2015
  • Cindy

    I took over a dental OM job following a manager of 12 years. The doctor is awesome, so fun and sincere. He thinks his previous OM did a great job — while at each daily meeting I bring up more and more issues. He wasreally depressed to get the again report (which I don’t think he ever knew about — at least that far back). I’m working at home around the clock to put procedures in place, and to train the staff on things functions of Dentrix that really should have been 101. Any advice on how to approach the dentist with this sensitive matter. I have been stating facts (ie EOBs haven’t been filed for a year!) and trying not to associate the last OB with the situation. I have found years of insurance claims never sent. Help!

    September 19, 2015