American Dental Association

Managing Finances: Guidelines for Practice Success


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       Acknowledgments

      This publication was developed by the American Dental Association’s Center for Dental Practice. The American Dental Association thanks the following individuals for their contributions:

      • Dr. Andrew B. Brown, Council on Dental Practice 2012-2016, chair 2015-2016

      • Dr. Joseph G. Unger, Council on Dental Practice 2011-2015, chair 2014-2015

      • Dr. Jean L. Creasey, Council on Dental Practice 2012-2016

      • Dr. Miranda Childs, Council on Dental Practice 2011-2015

      • Dr. Scott Theurer, Council on Dental Practice 2014-2018

      • Dr. Irene Marron-Tarrazzi, immediate past member, New Dentist Committee; Second Vice President 2015-2016

      • Dr. William “Bill” Blatchford

      • Ms. Teresa Duncan

      • Ms. Debra Engelhardt-Nash

      • Ms. Susan Gunn

      • Ms. Cathy Jameson, Ph.D.

      • Dr. Roger Levin

      • Ms. Virginia Moore

      • Ms. Tammara Plankers

      • Mr. William Prescott, EMBA, J.D.

      • Mr. Allen Schiff, CPA, CFE

      • Dr. Roy Shelburne

      In addition to the individuals cited above, principal contributors to this publication include Dr. Pamela M. Porembski, director, Council on Dental Practice, Cynthia Kluck-Nygren, manager, Dental Team Activities and Publications, and Dr. Diane Metrick, senior manager, Special Projects and Emerging Issues. Special thanks to the ADA’s Council on Dental Benefit Programs, Council on Dental Practice, Council on Ethics, Bylaws, and Judicial Affairs and the ADA’s Legal Division staff for their review of and contributions to this module.

       Legal Disclaimer

      In making this publication available, the ADA does not, nor does it intend to, provide either legal or professional advice. Nothing here represents ADA’s legal or professional advice as to any particular situation you may be facing. To get appropriate legal or professional advice, you need to consult directly with a properly qualified professional or with an attorney admitted to practice in your jurisdiction.

      Managing Finances generally discusses certain federal and state laws, but does not and cannot address every federal and state law that could affect a dental practice. Each dental practice must be aware of and comply with applicable state and federal laws. Managing Finances refers to federal and state statutes and regulations, including regulations adopted by agencies such as the U.S. Department of Health and Human Services (HHS) and the Federal Trade Commission (FTC), among others. However, the materials that follow have not been approved by HHS, the FTC, or any other federal or state agency. Dental practices vary widely, and each should address legal issues and develop and implement various compliance programs appropriate to its circumstances and in compliance with all applicable laws and regulations.

      We have made every effort to make these materials useful and informative. As a consumer of the information, however, you must understand that the law varies from jurisdiction to jurisdiction, and it sometimes changes more rapidly than these materials. For that reason, we make no representations or warranties of any kind about the completeness, accuracy, or any other quality of these materials or any updates, and expressly disclaim all warranties, including without limitation all implied warranties (including any warranty as to merchantability and fitness for a particular use).

      To the extent we have included links to any websites, we intend no endorsement of their content and imply no affiliation with the organizations that provide their content. Nor do we make any representations or warranties about the information provided on those sites, which we do not control in any way.

      © American Dental Association 2016

      Table of Contents

       Introduction

       Revenue

       Considerations in Developing a Financial Policy

       image Patient Direct Pay Practices

       image Discounts

       image Barter

       image Collecting Payments

       image Overdue Accounts

       image Overpayments

       image Credit Card Disputes and Chargebacks

       image Patient Financing Options

       • Internal Financing

       • External Financing

       Dental Benefit Plans

       image Indemnity Plans

       image Managed Care Plans

       • Preferred Provider Organization Plans

       • Capitation/DHMO Plans

       • Medicaid

       • Medicare

       • Medicare Advantage

       Risk Management and Fraud Prevention