Billing Statements to be Overhauled

rmsdds52 · Post by **rmsdds52** » Mon Jan 14, 2008 9:58 am

Hi...
We are having a real issue with the appearance of the statements. We find them confusing and almost unreadable.
I had a patient complain the other day that he can't figure out the bills; that he puts his charges and payments on his own spreadsheet so he can keep track.

I agree with him. Our old bills were so clear: here is what we charged, here is what has been paid, here is what you owe.

The bills, a critical function of business software, are just a real problem.

I don't know if we are alone in this feeling. I cannot imagine we are.

How does anyone else deal with this confusion?

Post by **jordansparks** » Mon Jan 14, 2008 12:45 pm

Hmm. Well, I used to have trouble with the statements that Dentrix put out, so I was always putting them into a spreadsheet. Five years ago, I tried to make the Open Dental layout look like my spreadsheets. After five years of mutation and refinement, you see the situation we have today.

I think there is general consensus that the statements could be more readable. I think part of the problem is that we put the estimates on there. The insurance estimates on work that has already been paid do not affect the amount, but are there for reference.

We also have more columns than other software so that we can show the column for how much the patient portion is on each procedure. I think I am ready to finally give up on the extra columns. In an effort to simplify, and in an effort to become compatible with electronic billing software, I propose that we move to essentially a two column format. Additions and subtractions. We can have a third column for running total, but that should be a display issue which doesn't affect the core data showing in the two primary columns.

There could be various levels of verbosity, but the extra data would be shown in paragraph or note format in the description column rather than as a number to be used for calculation. Furthermore, I propose that we finally remove insurance estimates from calculations in the main grid. Insurance estimates would show as part of the notes in the description, and they could show at the very end, possibly even affecting the amount due. But they should no longer show intermingled with true financial data.

rmsdds52 · Post by **rmsdds52** » Mon Jan 14, 2008 1:31 pm

Jordan, thanks for your response!
Going to a three column format would be a fabulous development.
We love OD, but the billing statements have just been an issue for us and for our patients.

I say three columns for this reason. I just asked a neighbor for his EZ Dental statement, and it is 2-column, no running balance, and thus seems still a bit confusing. You keep looking around to figure out where you stand.
I really think people are comfortable with the three-column situation, just like their check-book registers: charges, payments and credits, running balance as they go.

This change would be most welcome, Jordan!

Post by **jordansparks** » Mon Jan 14, 2008 1:50 pm

As long as we're at it, I think we should have a patient view and a family view. The family view should intermingle all the patients into one grid. The reason I say this is because that will make it compatible with other billing software. Other software doesn't know how to handle a different table for each patient. They just want us to pass one table, and that means the patients need to be intermingled. This would also simplify the issue of splitting to different family members for offices that don't care. To keep from angering any users we should probably also retain the ability to print separate grids for each family member. Each office just does things differently, so I'm trying to think of all the things that could go wrong before starting.

I just changed the title of this topic to make it more obvious. I want plenty of thought to go into this change.

rmsdds52 · Post by **rmsdds52** » Mon Jan 14, 2008 2:26 pm

This is the best news I've had in awhile.
Jordan, overhauling the billing statement parameters will be a huge development.

This really just has made my day.

Post by **jordansparks** » Mon Jan 14, 2008 2:45 pm

Here I go! This could take close to a full week, so there will still be plenty of time for others to chime in if they think I forgot something.

rmsdds52 · Post by **rmsdds52** » Mon Jan 14, 2008 3:29 pm

Great, Jordan.... Just great...
I am going to get with my business staff to get input, then I will post here.
Thanks!

drtech · Post by **drtech** » Mon Jan 14, 2008 5:11 pm

Yeah!!! This has been on our wish list ever since we started using OD. We had over 15 patients complaining when our first bills after converting from Dentrix. They said they couldn't figure out the bill at all. I had to agree and decided I must try to make it easier to understand. I made my own statement option that was less confusing for this very reason. All it really does is hide the insurance estimates and the running balance and add a bigger total balance at the top.

****************************
Until Jordan gets this implemented, you can try out my simplified bill by selecting "Print simple statements with less detail" in the Setup | Misc window.
****************************

I think all the things you have mentioned Jordan are good steps. I will try to think of any others we were wishing for.

Having an entire family view is really good. Most people like this, as long as the ability to still view individual patients is there if needed.

There could be various levels of verbosity, but the extra data would be shown in paragraph or note format in the description column rather than as a number to be used for calculation. Furthermore, I propose that we finally remove insurance estimates from calculations in the main grid. Insurance estimates would show as part of the notes in the description, and they could show at the very end, possibly even affecting the amount due. But they should no longer show intermingled with true financial data.

This sounds great.

I vote for three columns in FAMILY view...two as the core as you suggested Jordan, with the 3rd a running balance calculated from the other two. I think there should only be two columns in an individual patient view, because the balances can too easily get off if $ is paid on one patient and then ins payments get applied to other accounts. We find this happening all the time and end up with negative balances on some people and + on others. For this reason the running balance should only show for the entire family, then all should be dandy!

Post by **jordansparks** » Tue Jan 15, 2008 9:03 am

Any opinions on how to handle insurance payments? We currently put them on the same line as the claim. I am strongly inclined to move the actual insurance payment further down, to the date it was really paid. We can still put a comment about the payment as part of the claim description.

rmsdds52 · Post by **rmsdds52** » Tue Jan 15, 2008 9:29 am

We are currently compiling our suggestions for the billing statement rehab. I'll be posting them probably Wednesday after work.
But just to toss in that yes, Jordan, I do like the insurance payments posted in real time/date on the statements.
I like the analogy to a checkbook register....
More to come!

rmsdds52 · Post by **rmsdds52** » Tue Jan 15, 2008 9:34 am

We are compiling our suggestions for the rehabilitated statement and I'll have them submitted Wednesday after work. But yes, Jordan, we like the real-time posting of the insurance payments on the statement.
The analogy of check book register is good here.

drtech · Post by **drtech** » Tue Jan 15, 2008 9:37 am

I agree Jordan, I think it would be better for an entry to appear on the date it was actually paid for chronological viewing of the running balance. The comment should stay as it is now.

Second thoughts:
Are you taking out the ins paid column in the account grid? Now that I look at it, I think the estimates should be eliminated, but the Ins Paid column should stay, that way you can still see what was paid on individual procs without opening the ins window. This would be confusing on statements though if you add in the ins paid amt on the actual date, so maybe on the printouts that column should be hidden.

Post by **jordansparks** » Tue Jan 15, 2008 11:36 am

The new way of doing it would be for the insurance paid amount to be a second line in the description column of the procedure. It could be set to show or not.

rmsdds52 · Post by **rmsdds52** » Wed Jan 16, 2008 2:31 pm

We've discussed the statement and here is our wish-list, Jordan:

1. Upcoming patient appointments automatically print on statements, as opposed to manually.

2. Format the statement so that more info fits on a single page so as to avoid multiple-page statements.

3. Batch-billing statements have very little information on them. Should include procedures, insurance payments etc. And should go back 90 days since insurance often takes 3-6 weeks to come in.

4. Would like to see 6 columns: date; description; patient's name; charges; payments/credits; running balance.

I am going to fax over an EZ Dental statement I got from a neighbor. We love everything about it, from the design, the set-up--everything. The only thing that could improve on it is the "running balance".

If we could get something like the EZ Dental statement, that would be fabulous.

We like how the Dr's name and address and the patient's name and address is boxed in.

5. We'd like the ability to add notes on the bottom of a statement; and we'd also like to add notes for batch billing automatically on each statement, according to the need.
So, one at a time as needed or automatic for batch.

6. The "security code" from the back of the credit card is needed for credit card transactions.

Again, I am faxing over a sample EZ Dental bill. Something as close to this as possible would be ideal!!
Please look for this fax....

Thanks, Jordan, for allowing this input. I really appreciate this!

sparkly · Post by **sparkly** » Wed Jan 16, 2008 7:20 pm

i second the security code for credit cards!

drtech · Post by **drtech** » Thu Jan 17, 2008 7:40 am

could we post the example statement here for everyone to see?

cneelley · Post by **cneelley** » Thu Jan 17, 2008 1:26 pm

Jordan, I sort of like the way you have insurance payments entered. We highlight the claim and it shows the claim and all attached procedures.

If you make a separate line entry for insurance payment, then when it is highlighted it should also highlight the insurance claim and all attached procedures for easy reference.

cneelley

Post by **jordansparks** » Thu Jan 17, 2008 6:54 pm

The rough draft of the overhaul is nearly complete. There is now a separate line for the insurance payment a few weeks after the claim. And the automatic highlighting does indeed work very similarly to the way it is now.

As for all the requests for the statements, I consider those to be separate feature requests. All we're focussing on right now is the grid. Also, if we can get the sheets feature fleshed out a bit more, it will allow everyone to customize their own statements as needed.

It turns out also that this might be the best time to overhaul the payment plan feature, putting each payment plan and associated payments it its own grid rather than in the main grid.

drtech · Post by **drtech** » Thu Jan 17, 2008 8:07 pm

sounds good about customizing the statements with sheets..I will look forward to seeing how that works.

Payment plans:
My request is that no matter what grid it shows up in, that there are two balances showing with payment plans on both the account and statements:
1. Actual Account Balance (unchanged even when a payment plan is active)
2. Balance currently due with payment plan. (the balance changed like it works now)

drtech · Post by **drtech** » Thu Jan 17, 2008 8:11 pm

So if I understand you right Jordan, when you are done with this section of overhaul, the statements will print just like the new grid you are putting in right? And then customizing further will come later?

Post by **jordansparks** » Thu Jan 17, 2008 9:32 pm

Yorek · Post by **Yorek** » Tue Jan 22, 2008 8:11 pm

We all have our own ideas as to what's important.

My feeling is less is better as long as we have a running balance column.

All the discussion here reminds me of a funny but annoying Pelton Crane Unit we have.
Bare with me..
The Chair is about 5yrs old, still very sleek and modern looking.
However, with all the thought and money that went into the design of the thing,,
Very few patients can figure out how to fill their water cup with out being shown first.
It's hard to believe the designers were so happy with how the Unit looked they failed to test it out on real patients.

So it's probably a good idea to do a little market research and ask
our audience what they think before we finalize the 'Statement' and it's appearance.
(and any form that ends up in a patient's hands.)
Make a few sample statements with several lines of treatment, fees, insurance pymnts,
pt pymnts and throw in some adjustments.. the works!

Show them to non dental people: friend's, wives, husband and a some trusted patients
Then, without giving them instructions or any input

Give them a questionare and ask..
>Which form is easiest to understand.
>Best Design and professional appearance.
>And most important.. Ask what is the patient's balance in each example
(..This is really important, because they may think it's a good form.. but not really understand it.)
> Suggestions and improvements, etc.

It might be worth this extra effort so we don't have to tell them 'how to fill their water cup" each time we send them a bill.
Sorry for the long post, I tried to keep it short.

Post by **jordansparks** » Wed Jan 23, 2008 2:02 pm

That's why we do iterative programming with quick releases.

drtech · Post by **drtech** » Wed Jan 23, 2008 3:42 pm

I was thinking if we could have "coupons" print out with the payment plans that would be good. Like the top part of the statement, 3 to a page with the due date for payments and the amount due. That way you could print that off, staple them together and make a "coupon book" for the patient to mail in with their payment.

B.Thomas · Post by **B.Thomas** » Wed Jan 23, 2008 4:26 pm

I'm liking many of these suggestions. I think the main thing is to critically look at every bit of information on a "Standard" statment and eliminate what is not Absolutely Neccessary for the patients to understand what they are paying for.

Then maybe have an "Advanced" button where the user can check additional items needed that are not as common.

Some more suggestions:
-Have as few colums and rows as possible
-Eliminate columns so that rows can be longer and single (eg. Visa payments take up 2 rows)
-Standard Statment does not print items with a $0 fee
-Eliminate Comm logs from Standard statements
-Eliminate Broken Appointments from Standard statments
-Add some graphics to soften the appearance (Rounded corners of tables and boxes, office logo in background)

Post by **jordansparks** » Wed Jan 23, 2008 4:41 pm

I'm just spending tons of time working out all the math and so on. My only focus right now is moving to a three colum format without causing major bugs. The payment plans had to be part of that overhaul. I don't think any of the other requests are going to be part of the change.

drtech · Post by **drtech** » Wed Jan 23, 2008 6:53 pm

yes, I can imaging just what you are doing is a ton of work Jordan...keep up the good work.

Everyone keep bringing your ideas and maybe they can be incorporated down the road.

B.Thomas · Post by **B.Thomas** » Thu Jan 24, 2008 1:07 pm

Out of curiosity what are the 3 columns? My manager and I were discussing it and we felt the only 3 columns needed are Balance, Patient paid and insurance paid amounts.

I'm guessing the difficulty is in combining the math from the other columns. Feel free to post the code in the advanced forum and maybe we can help out. I think the time is well spent though since billing is probably one of the most important functions of dental software.

Post by **jordansparks** » Thu Jan 24, 2008 2:33 pm

Charges, Credits, and Balance.

rmsdds52 · Post by **rmsdds52** » Fri Jan 25, 2008 8:49 am

Jordan, your work on this is hugely appreciated...

Yorek · Post by **Yorek** » Mon Jan 28, 2008 7:08 pm

In Account module, we have 2 filters now..
Show history and Show Notes.

We'd like to see an additional filter to show only 'Claims Pending'.

When pt's have a lot of work done there are many lines of treatment,
sometimes a claim becomes hidden under the top header line.

This would make it easier to spot a 'hidden' unpaid claim.
especially when the patient is in front of you at the busy check out desk.

A simpler way to easily visually track claims..
would be to change the color of paid and unpaid claims.

drtech · Post by **drtech** » Mon Jan 28, 2008 7:18 pm

maybe paid claims turn green like payments and unpaid stay red

Yorek · Post by **Yorek** » Mon Jan 28, 2008 8:58 pm

Thats what i was thinking..
And yellow for pending.

Also, possibly black for paid to reduce a rainbow of colors.
Would it be possble to let us pik`n choose colors in setup preferences?

Nate · Post by **Nate** » Mon Jan 28, 2008 9:49 pm

I also would like to see all of theses suggestions as future add on features:

Having the ability to add notes on the bottom of a statement
Standard Statment does not print items with a $0 fee
Eliminate Comm logs from Standard statements
Eliminate Broken Appointments from Standard statements
Have an "Advanced" button where the user can check additional items needed that are not as common

rmsdds52 · Post by **rmsdds52** » Tue Jan 29, 2008 3:43 am

More later, but quickly, we LIKE items with $0 charge posted. I want folks to know what we do for no fee. In our office this is pretty important.

drtech · Post by **drtech** » Tue Jan 29, 2008 6:40 am

instead of hiding $0 fee items, I think it would be better to have an option on proc codes to "not show on statements." Then each office could choose.

steveng · Post by **steveng** » Tue Jan 29, 2008 10:23 am

Not sure if this is part of it Ã¢â‚¬Â¦

Due to the fault of our own, weÃ¢â‚¬â„¢ve spoiled our high-tech patients.

They now like to receive their statements on their Blackberries, Crackberries and other mobile devices. There is currently no option, or maybe I didnÃ¢â‚¬â„¢t see it yet, to choose emailing statement for a single patient rather than entire family. Some would like to see statements and pay only for themselves.

Post by **jordansparks** » Fri Feb 01, 2008 1:21 pm

When you change something as core as this, there is a bit of a domino effect. The three column format has been done for a number of days, but it has now forced us to overhaul the entire statement printing process. Since we have been planning this overhaul for a number of years, it's already pretty clear what needs to be done.

My point is that because of the required statement printing overhaul, a number of the associated feature requests will indeed be making their way into the next version. It's far too complex to try to explain in this short space all of the changes, so it will be best to just watch the version 5.6 page and the changes that will soon be coming to the manual.

drtech · Post by **drtech** » Fri Feb 01, 2008 5:16 pm

another feature request...

I am thinking if we could print the billing list instead of only being able to print all the statements, or better yet, implement the "Goto" function directly from the billing window to an account and leave the billing window 'floating' or easily accessible. That way you can check accounts if you are not sure you want to send a statement and not waste the paper or type typing in the name again.

I might try to work on this and see how difficult it would be to implement.

Post by **jordansparks** » Fri Feb 01, 2008 5:29 pm

Make sure not to touch it until I'm done. I'm doing a lot of heavy overhauling in those windows right now.

The way it will work is that the user will basically create the list of bills to be sent, but will not be required to immediately print them. Printing/e-sending will be able to be performed separately if desired. This will allow users to review and fine tune the batch over the course of several hours, jumping around just like you indicated.

drtech · Post by **drtech** » Fri Feb 01, 2008 5:51 pm

great

drtech · Post by **drtech** » Mon Feb 04, 2008 4:35 pm

while you are working on the statements, one thing I think would really help with readability for patients is to have everything print since the family running balance was last zero. Secondarily you could filter by date range.

This way, procedures done before the normal 30 or 45 day range that were not paid off still appear, showing the patient where the balance came from. Then we would never end up with statements with a balance and no procedures showing. (ideally this would never happen anyway, but it does)

Also, if we could have two fields added for tracking statements/accounts. 1)Like a billing note to write an internal status of an account during review. 2) An option to hold the account out of the billing process for 30 days. Because sometimes you don't want to send a statement to someone that month but would like them to be held out of the auto billing process without saying you "Statement Sent" if you didn't really send one.

Yorek · Post by **Yorek** » Wed Feb 06, 2008 12:35 pm

In Account module.
Is it possible to put the date a claim was sent to ins Co in the same text box as the original claim?

This way we wouldn't have to click and open the claim to see this information.

I know we're heading towards a separate real time line entry for the claim, which is great..

But we'll have two entry's of a claim..(that's ok)
It would reduce stress if the claim date is easy to identify with the original tx as well.

Thanks.

drtech · Post by **drtech** » Mon Feb 11, 2008 9:42 am

Is there going to be an option to print the grid with the whole family together like the account? That's what we would like.

drforlano · Post by **drforlano** » Tue Feb 12, 2008 1:04 pm

I realize the focus right now is on the three column format, but for future consideration....the request for printable payment coupons would be a great addition to our practice.