A Financial Control Series for Dental Practice Owners
By: Dawn Patrick, COO and Dental Business Strategy Coach, IgniteDDS
Let me start by saying this plainly: If the money isn’t showing up in your practice, it’s not because you’re a bad dentist.
It’s because most dentists were never taught how to run financial systems, only how to produce dentistry.
So let’s talk through this like I would in a coaching call, direct, honest, and focused on fixing the leaks without overwhelming you.
Part 1: The Silent Cash Drains in Your Dental Practice
Most cash loss in dental practices is quiet. No alarms. No angry patients. Just… money that never arrives.
Here are the four biggest silent drains I see every week.
1. Unworked Insurance: Where Cash Flow Goes to Die
If I asked you right now:
- How much insurance money is outstanding?
- How old is your oldest claim?
- Who is working insurance daily?
Most dentists think they know — but they don’t actually see it.
What’s Really Going On
Insurance claims are:
- Sent without proper documentation
- Never followed up on
- Paid incorrectly and not appealed
- Sitting untouched for weeks (or months)
Red Flags You Might Be Missing
- Insurance A/R is more than 30% of total A/R
- Claims over 30 days old with no notes
- “We’re waiting on insurance” as a standard answer
What a Simple System Looks Like
You don’t need fancy. You need consistency.
Daily (Non-Negotiable):
- Run the insurance aging report
- Work all claims over 14 days
- Document every call (date, name, reference #)
Weekly:
- Review total insurance A/R
- Identify claims over 30 days
- Assign follow-ups with deadlines
Monthly Targets:
- Insurance A/R ≤ 30% of total A/R
- Zero claims over 90 days without a resolution plan
If You Don’t Fix This…
Cons
- Delayed cash
- Increased write-offs
- You end up financing insurance companies
The “Pros”
- Fewer uncomfortable insurance calls
- Less internal accountability
2. Poor Financial Trust Transfers: Where Treatment Acceptance Falls Apart
Here’s something I see constantly:
The doctor explains treatment beautifully…and then the patient walks out confused — and unpaid.
Not because the team didn’t try — but because no one owns the trust transfer.
Red Flags
- No written financial arrangements
- No tracking of treatment presented
- “They’ll call us back,” with no follow-up
A Better Way (Step-by-Step)
At Diagnosis
- Clinical team explains why treatment matters (not fees)
- Patient is warm-handed to the financial coordinator
At the Financial Conversation
- Treatment explained in simple language
- Full fee + estimated insurance + patient portion reviewed
- Payment options are presented immediately
Tracking Is Required
Every practice needs a Treatment Tracker. This is one of the biggest opportunities I see missed with dental teams. Measuring treatment acceptance holds the dental team accountable for ensuring that patients are followed up on and don’t fall through the cracks.
Your treatment tracker should include the following and be tracked daily with a review at the end of each month. It becomes your playbook for consistency.
- Patient name
- Procedure
- Dollar amount
- Accepted / Pending / Declined
- Follow-up date
Benchmarks
- Minimum 67% treatment acceptance
- Follow-up within 48 hours for pending cases
3. Inconsistent Financial Policies: Training Patients to Delay Payment
If your team explains money differently depending on the patient, the schedule, or the mood — you don’t have a policy. Written policies are critical to maintain consistency among your dental team.
If you don’t have written policies, you have suggestions.
Patients learn this fast.
Red Flags You May Hear From Your Team
- “We made an exception.”
- “I didn’t want to upset them.”
- High patient A/R over 60 days
How to Fix It (Without Being Rigid)
- One written financial policy
- Same language used every time
- Signed by patients
Policy Must Clearly State:
- Payment is due at the time of service
- Insurance is an estimate
- Balances unpaid by insurance are due upon statement receipt
Benchmarks
- The majority (70–80%+) of patient A/R under 30 days
- Total A/R under 1 month of average production
4. AR & Adjustment Red Flags Most Dentists Never Review
Adjustments are one of the easiest places for money to disappear — intentionally or unintentionally. Dental practices rarely review the write-offs completed each month by the team. This is a critical missed step by dentists.
Red Flags
- High adjustments with vague notes
- No doctor review
- A/R aging is creeping up monthly
Simple Oversight
Monthly (Doctor or Owner): Doctors should review AR and adjustments each month in detail with their financial coordinator and/or office manager.
- Review A/R aging
- Review adjustments by category
- Ask: Why was this adjusted?
No blame. Just visibility.
Key Takeaways
If you take nothing else from this first blog, take this:
Money problems in dental practices rarely come from a lack of production. They come from a lack of visibility and follow-through.
Unworked insurance, dropped financial handoffs, inconsistent policies, and unchecked A/R don’t feel urgent day to day — but over time, they quietly starve cash flow and create unnecessary stress for you and your team.
The good news? Once you see the leaks, you can fix them.
In Part 2, we’ll shift focus to the front desk — specifically the conversations, systems, and daily metrics that either support strong cash flow or sabotage it without anyone realizing it.
If you’d like help identifying where these silent drains exist in your own practice and how to correct them, you can learn more and book a complimentary coaching call here:
👉 https://ignitedds.com/coaching/
