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Should I still be getting paid if there is an insurance screwup and the office doesn’t get paid?

I am a hygienist working extremely part-time in a new practice due to it’s gaining patient base. Currently, I am receiving commission for pay, but receiving a base per patient until insurance rolls in and I surpass what I’ve been paid and am able to start seeing my commission. Since I’m not salary or hourly, I’m only commissioned on what insurance pays (if they pay). We’ve had cases where there was a mix-up with insurance and we did not take theirs as well as an S&RP of all 4 quads that insurance would not pay so it was all written off. This leaves me with having done a lot of work, but not receiving a dime for it. Is this fair? Should I be requesting some kind of pay for it?

Also, there has been a tremendous amount of no shows. Should I be getting some kind of pay for these since I did my part and showed up, confirmed appts, etc.? Thank you!!!



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Wow, unbelievable! First, who is the person who is in charge of patient’s insurance and doing the insurance breakdown? If it’s not you, then YOU should not be “punished” for THEIR (big) mistake. Coverage should be checked before the patient even sits in the chair! So in my opinion, doing any work (especially SRPs!) you should be compensated and no it’s not fair that you aren’t. The Fair Labor Standards Act, which is Federal law, states that any work done on behalf of your employer must be compensated at or above minimum wage. Of course I believe you deserve more than minimum wage, but that’s just what the law says! So this almost makes me wonder if a Federal law is being broken here…

 

Regarding the no shows: I wonder why there are so many no shows. Do you have an office policy that patients sign stating that after so many no shows they will be released from the practice? Also, are these recall patients not showing up or new patients? If its recall patients, then something is going on there. Whether it be a patient care issue, front desk issues, whatever, finding out why this is happening, so it can be fixed, should be number one. I have heard of some offices making the hygienist clock out if there is a no show, however I think if you remain busy stocking, sharpening, even filing, I believe you should be paid for the same reasons I stated above.

 

If these things continue to be a problem, honestly, I would look for another office to work for. I know that’s hard, especially since you are only working part time right now and are probably looking for a full time job anyway. On the bright side, if and when the patient base grows in the practice getting paid on production can be extremely lucrative.

 

I hope I was able to help at least a little, and best of luck going forward!

More Answers

I would caution agreeing to commission based on collections. You only have so much control over money the office collects. I’m paid commission off of collections but I also receive a base salary. There is always a big difference between what I produce and collect. I would discuss your concerns with the doctor and see if you can have your salary based on gross production.

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I would talk to the doctor about how the mix up wasn’t your fault and you should be compensated at least a percentage of what you should have received. If he says no at least you can use the opportunity to discuss what will happen in the future if this every happens again. I’m surprised there isn’t already protocol in place for when your situation occurs. I would have asked before I started if i would still get paid if insurance problems or write offs happen. No shows should get charged a fee ($25 in my office). You should get a percentage of that since you did your part and showed up for work. When payment is based on what and when insurance pays that can get complicated and tricky. Front desk needs to be on top of collections and you need to be on top of them about filing and collecting properly. I personally would never work in an office that payed me that way but if you stick it out and show loyalty it can pay off in the long run.

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No way!! If you work on commission then you should be receiving a certain percentage of the production not the collection. It is unfair to base your pay on what the practice collects. Commission based pay should be based on what you as a clinician produce. As far as no shows…is your front office working hard to ensure the schedule is full and confirmed? If he or she has no incentive than that may be your problem. Most front office staff are paid by the hour and have no incentives for keeping the schedule full and confirmed. I would talk to your up front team and stress to them the importance of your patients keeping their appointments. See if that helps. As far as getting some type of compensation for those appointments…I have never heard of an office doing that. 🙁 Good luck!

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You should NOT be penalized for inaccurate billing. Plus being Commission based means you are paid on what you as an RDH produces, not what is collected…try to see if you can work with the front office to see how they approach no shows and cancellations, what systems do they have in place to keep the sched. full?v Is there any incentive for them to keep the sched full? Maybe a chat with the DDS or OM is in order.

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