Ori Bekerman, founder of PracticeAlpha, joins Dr. Len Tau to talk through the revenue leak most independent practices never see: the billing process.
A practice can produce plenty of dentistry and still leave money uncollected. These are the points Ori makes in the episode.
Ori's first step is the aging report in your practice management software. He pulls two: what insurance owes you, and what patients owe you.
More in our aging report guide.
The leak usually starts at insurance verification. Quote a 50% copay on a crown when the plan pays 80%, or the reverse, and the patient portion is wrong from the start.
A month later the patient gets a bill they did not expect. What could have been collected at the chair becomes a collections problem. That is why verification sits at the top of the revenue cycle.
Asking one person to answer phones, check patients in and out, schedule, and work claims sets them up with unfair expectations. Money and treatment conversations deserve focus, and quality drops the moment too many tasks are combined.
Owners running on gut feel are usually missing three things: benchmarks, regular reporting, and someone responsible for flagging what is not working. Ori does not expect dentists to pull reports themselves, but someone in leadership should review the numbers with them weekly or monthly.
The myth Ori hears most is that insurers do not want to pay. His view: most denials explain exactly what was missing, from documentation that did not support the procedure to frequencies and limitations nobody read. Learning from denial reasons is how claims start paying the first time. See our guide to denial codes.
Virtual credit card payments cost the practice processing fees. Ori prefers electronic funds transfer: it is more secure, every payment lands in one place, and it shortens time to payment. He says practices fully on direct deposit collect in about 15 days on average.
Ori is clear that outsourcing is not right for every practice. He asks:
Yes to all three, and in-house billing can work. A no to any of them means fixing that gap or outsourcing it. The full comparison, including cost, is in in-house vs outsourced dental billing.
Ori's ideal fit is the independent practice owner with one to three associates collecting roughly $800,000 to $3 million a year, who sees better collections as a hedge against inflation, rising costs, and ever more expensive marketing.
As he puts it, production is not even the top line. What you collect is what matters.
Listeners were offered a free RCM sanity check: send your practice management software name and get a guided checklist for reviewing your billing numbers. Ask for it here, or have us run the numbers with a free AR analysis.
Want to see your own aging numbers the way Ori describes them? We pull your AR and show what is recoverable, free.
Get a free AR analysisStart with the aging report in your practice management software. Ori's rule of thumb: if more than about $10,000 is sitting in the older aging buckets, especially over 90 days, it is time to look closely at how claims are being worked.
Ori looks at two things. Insurance should owe you more than patients do in an insurance-driven practice, and claims under 30 days old should make up roughly 90% of your insurance receivables. Money piling up past 90 days is at risk of hitting timely filing limits.
Before treatment, at insurance verification. If the plan is not verified correctly, the patient estimate is wrong, the patient portion is wrong, and the balance billed weeks later is harder to collect.
Ori's three questions: do you have a dedicated person on billing, are they trained and held to benchmarks, and is someone in leadership reviewing the numbers? Yes to all three means in-house can work. A no to any of them means fix that gap or outsource.