Ori Bekerman, founder of PracticeAlpha, sits down with DrBicuspid.com editor in chief Kevin Henry to talk about the numbers behind dental billing and what to do when they look wrong.
If you produce $100,000 a month, Ori's view is that you should collect close to all of it. These are the checks he walks through.
Owners juggle twenty things a day, so billing gets judged on how the week felt. Ori's point is that billing leaves no room for gut feel: there is an EOB, a fee schedule and a plan's benefits.
His first step is always the same. Pull the aging report from your practice management software and look at what is over 60 and over 90 days old. Practices often come to him with tens of thousands of dollars aging 11 months and 29 days, right at the edge of the 12-month timely filing limit many carriers enforce.
Walkthrough in our aging report guide.
A big over-90 bucket is a flag, not an answer (ortho practices read high because ortho pays over time). Ori breaks it down by carrier. If one payer dominates, the cause is often basic: the provider is not credentialed correctly, the payer ID is wrong, or the clearinghouse is not transmitting the claims. The office thinks the claim is filed while it collects dust.
Treatment plans are priced off the plan's benefits and your fees. Get a frequency, an uncovered service or a coverage percentage wrong and the patient gets a surprise bill later. Ori counts communicating cost and collecting it up front as part of patient experience, which is why verification matters before the visit.
Ask dentists for their collection rate, days in AR and top denial reasons, and Ori says one or two out of ten can answer. Part of the reason is software: he estimates most practices use 40 to 50 percent of what their practice management system can report. His team reviews key reports with offices on weekly calls, with the goal of owners reading the numbers themselves rather than depending on a third party.
Billing is a stream of follow-ups for missing documentation, subscriber numbers, x-rays and clinical notes. Without a clear channel and clear owners on both sides, those threads get lost and claims sit another 90 days. Ori's one question for any billing company: who on your team owns my account, and how do we talk? PracticeAlpha assigns each practice a dedicated point of contact and works inside the office's existing software.
Ori admits he leans toward outsourcing, and says large groups may still be better off in-house. For everyone else he asks:
It does not have to be all or nothing. PracticeAlpha runs full verification-to-billing for some offices and only claim submission or aging follow-up for others. The cost side is in in-house vs outsourced dental billing.
Ori is not a dentist. He came into dentistry on the operations side when his brother, a dentist, brought him into the family practice. He worked the front desk and served as office manager, billing coordinator and treatment coordinator, then helped grow the practice into a multi-location group in the Philadelphia area.
Staffing turnover after COVID pushed the group to centralize billing, verification and calls into a back office. After the group was sold, Ori built PracticeAlpha to offer that same back office to independent practices and emerging groups.
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Get a free AR analysisOri's benchmark is about 10 to 15 percent. With $100,000 in open insurance claims, he wants roughly $10,000 to $12,000 or less sitting past 90 days. More than that usually means claims are not being followed up, or denials and appeals have not been resubmitted or closed. Ortho-heavy practices read higher because ortho claims pay out over time.
Ori puts the average at about 30 to 45 days from submission to payment, which is why the 0 to 30 day bucket of the aging report roughly equals what a practice bills in a month.
When one carrier dominates the over-90 bucket, Ori checks the basics first: the provider may not be credentialed correctly, the payer ID in the practice software may be wrong, or the clearinghouse may not be sending the claims to the payer at all. The office believes the claim is on file while it quietly ages.
Ori's one question: how do you communicate? Billing runs on follow-ups for missing documentation, subscriber numbers, x-rays and notes. Ask who on their team owns your account and who on yours is responsible, so nothing gets lost and turns into another 90 days on the books.