Worst Billing Case of 2025 - Part II - End of Day Checklist

We show how chart prep sets expectations and end of day confirms reality, so money stops leaking and compliance issues get fixed the same day. A practical checklist, time blocking, and coaching turn chaos into a repeatable close that protects revenue and trust.

• redefining end of day as daily accountability 
• chart prep for expectations, end of day for verification 
• composite case of a busy office with open charts and rolled balances 
• building a lean checklist that closes every visit 
• spotting patterns: missed copays, incomplete notes, idle claims 
• coaching conversations that improve collections and documentation 
• blackout time to finish reconciliation without interruptions 
• route slips or digital equivalents for clear expectations 
• daily compliance as a habit, not an annual event 
• financial stability through same‑day close and follow‑up

You can go grab the chart prep and the end‑of‑day checklist, and there’s a little guide in there on how to implement it in the show notes if you want to implement this right away 
If this series has been helpful for you friends, I’d really appreciate it if you would leave us a review 
Make sure you’re subscribed so you don’t miss part three 
And if this episode made you think of your doctor or your office manager, share it with them

Get the Chart Prep + End of Day Checklist and Guide for Only $19 Here:

https://ericka-aguilar-dental-billing-expert.kit.com/products/chart-prep-checklis

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Join The Biller Acceleration Mentorship Wait List Here: (Only 5 Spots Left in 2025!!)

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Would you like to set-up a billing consultation with Ericka? She would love the opportunity to discuss your billing questions and see how Fortune Billing Solutions may help you.

Email Ericka:
ericka@dentalbillingdoneright.com

Email Jen:

jen@dentalbillingdoneright.com

Email Ed:

ed@dentalbillingdoneright.com

Schedule a call with Ericka:

https://calendly.com/ericka-dentalbillingdoneright/30min

Perio performance formula:

(D4341+D4342+D4346+D4355+D4910)/(D4341+D4342+D4346+D4355+D4910+D1110)

Delta Dental Locum Tenens Form:

https://www1.deltadentalins.com/content/dam/ddins/en/pdf/dentists/locum-tenens-form.pdf

Chapters

• 1:35 Resetting What End Of Day Means
• 4:19 End Of Day As Accountability To Chart Prep
• 6:08 Composite Case: Busy Office, No Closeout
• 9:29 Building A Checklist That Stops Leaks
• 12:56 Patterns That Reveal Hidden Problems
• 17:09 Fraud Rarely Starts As Fraud
• 19:58 Time Blocking And Blackout Time

Transcript

SPEAKER_00: 0:48

Hey there. Welcome back to part two of the worst dental case we saw in 2025 at Fortune Billing Solutions. As you guys know, that is our billing company. I am the president, and I see a lot of crazy stuff come past my desk, if that makes sense. I have a quick question for you. Since today we're going to be talking about accountability and how to prevent becoming the worst case that we see in 2026. I have a quick question for you. Have you ever ended the day at the office and thought, at least we survived? We survived. Hallelujah. And called that end of day. If you have, like I have, then I think this episode is going to be very interesting for you. Today we're going to be talking about why surviving the day and actually closing it out are two different things. And if you listened to part one of this series, you know we talked about the worst billing case we saw in 2025 and how it did not start with fraud. It started with blind trust and no preparation for the day, no chart prep. Today I want to talk about the other half of that equation, the piece that also gets missed, even when offices think that they're doing better. So let's just say you learned about chart prep and you want to implement chart prep. Well, there's another side of the coin that you have to incorporate in order to close the loop. And that is what we call end of day. Now, everyone's end of day obviously is going to look different, but there's some fundamentals in there that I want to go over with you so that maybe if these are new concepts for you, you can implement them and close the loop to the day. When you want chart prep to be solid, you want to include an end-of-day checklist and you want to close the loop because things can still slip through the cracks, even with the best chart prepping. And when they slip through long enough, that's when these small problems quietly turn into big ones. So what we're gonna do is reset what end of day is actually for. Let's talk about that. End of day is not about checking boxes so everyone can go home. That's not what it's for. It is not a report that you glance at, and it's definitely not something you rush through at 559 because you're tired. End of day, excuse me, is the accountability piece to chart prep. And chart prep is about what you expected to happen today. And end of day is about confirming what actually happened. And that's the difference that matters more than most practices realize. I have yet to see an office that I work with that has a solid end of day. Usually we work with our clients and implement a good end-of-day system so that we're all on the same page with regards to how the day went, how the billing went, are there any patients with statements? I'm sorry, that need statements. So our end of day is pretty solid. This is also where compliance is really gonna live, even though most people don't think about it that way. Compliance isn't something you deal with once a year. It's not like a training that you take once a year. It's not just for audits or when an insurance company sends a scary letter. Compliance is built into what happens every single day in the practice. If treatment happened today and the documentation isn't there, that's a problem. That's a compliance problem. If money was due today and no one can explain why it was not collected, there's another problem. If a claim is submitted later that doesn't reflect what actually happened during the visit, that's another problem. End of day is where you are going to catch those things while they are still fixable. Let me tell you about a practice. Now, this is a composite story. These details are blended, but the situation is very real. Very much the opposite of part one, where I actually told you about a real case scenario with the worst dental billing case that we've seen in Fortune in 2025. This office trusted their team. This office was busy and they didn't feel like anything was wrong. They didn't have chart prep. They didn't have an end-of-day checklist, and they assumed things were being handled. Patients would leave at the end of the day, their balances were rolled forward, charts stayed open, accounts stayed open, and financial conversations lived in people's heads. Like one of the pet peeves I have is when a treatment coordinator has this financial conversation with the patient and does not document what the patient said, what financial options were presented, which option did the patient like? Which option did the patient say I need to go talk to my spouse about? Which option did the patient say I need more time to think about it? What happened in that financial conversation? So that when the patient calls back in the event they do, and they say, okay, I'm ready to move forward. I spoke with Janice, and Janice had given me an option to move forward with no interest. And you're like, well, how many months no interest? And the patient says, I don't remember. Nothing's documented. So that conversation is living in Janice's head. These are the types of things that end of day is going to eliminate because we're going to set protocols in place by having an end-of-day checklist so that we have, again, a list of things that need to be checked off in order to say that we had a successful day. So think about end of day as in what does a successful day look like to you? And how do you create a checklist that the office manager uses to verify and hold the team accountable to good work? That is what end of day does for a practice. Over time, money starts leaking and compliance risk starts growing. And this happens quietly. No one could tell you with confidence what happened during each visit by the end of the day, and that's where control starts slipping. When we stepped in, we didn't start with billing. We didn't accuse anyone of anything. We started by putting structure around end of day. And honestly, we usually start with chart prep and end of day simultaneously. So each visit had to be closed out properly. Every balance had to make sense. Every treatment had to be reconciled. And every expectation had to be documented, meaning conversations with patients, conversations with coworkers. We need to get this stuff documented. And once that started happening, patterns showed up almost immediately. And this is one of the conversations that I have with potential clients when we talk about, you know, when you take over billing, what else are you guys going to help us with? And I always respond with the same answer. It's the patterns that start to emerge and tell the story as to how the accounts became a mess in the first place. And if you really pay attention and you have a solid end of day, these patterns show up almost immediately. And we're able to get in there and start coaching and training the teams so that we can eliminate those patterns and improve the financial stability of the practice just by identifying those patterns. Copays that are consistently missed, these are some of the things that we find all the time. Documentation is incomplete. Procedures done are not clearly recorded. And claims sitting untouched because no one realized they needed follow-up. These are some of the most common things we find, the patterns that show up almost immediately that are just not addressed. Because let's be honest, I mean, offices are short staff. So it's it's kind of like we'll get to it when we can get to it. But in the meantime, things are becoming bigger and bigger issues. None of this we find is malicious, but all of it matters. And this is the part people don't always love hearing, but it's important. Most fraud doesn't start as fraud. And I want you to hear this loud and clear. And I maybe I use the term fraud a little too much and I throw it around a lot. And I do that intentionally, but fraud, honest mistakes, contract violations, these things start with shortcuts, unnecessary workarounds. And it can be it can create compliance risk down the road. End-of-day systems are not meant to accuse anyone, but they don't assume bad intent. They simply remove the space for shortcuts to hide. When something doesn't line up, you see it the same day, not six months later when somebody decided that they had time to do some follow-up. Not when an insurance company starts asking questions, and certainly not when money is already gone. That's how end of day protects you. And this is why chart prep and end of day have to work together. Chart prep sets you up for the visit, and end of day confirms how that visit actually went. As I mentioned, you really do need both. One without the other just simply leaves blind spots. And blind spots, these things are not good because we get into the thick of the day, we get into the day-to-day hustle and bustle, and we forget to look for our blind spots. So together, both chart prep and end of day give you control without micromanaging and accountability without distrust. So if you're listening to this and thinking, we don't really do end of day like this, that's okay because most offices don't until they realize how much money and risk live there, right? For not having some end-of-day, it doesn't have to be elaborate, friends. It just has to be something that works for your practice. And I am telling you that you can take the end-of-day checklist that we created for you and make it your own. Ours tends to be a little over the top because, you know, as I sat there and I was thinking through all the areas that are potential blind spots for practices, I put it on the end-of-day checklist. Now, not all of that will apply to all offices, but it's a very comprehensive end-of-day checklist. It's all admin related. And these are areas that I have found over the years working with hundreds of offices, common blind spots that offices tend to overlook. The other part of the puzzle is really carving out the time in order to manage end of day. And what I mean by that is you may have to rearrange your day and you may have to have some blackout time. I would place a black sheet of paper and I would put it on my door. This is when I was managing offices, and I would call that blackout time. And that was when I was doing end of day or anything important, anything that was time sensitive that I needed to get completed. Either maybe our accountant needed something, but it was when I was working on time-sensitive things. End of day was very important to me because it was when I would do all of my checks and balances specifically with regards to the money, making sure that what was indicated to be collected on the route slip was collected. And if it didn't match, I questioned it. So, as an example, we would fill out a route slip. And this is very old school because we would print blank route slips for every appointment and then fill out a route slip for every patient, right? So you may think of a digital way to do that. We were very old school. So we would indicate for today's visit the patient's coming in for a route canal on number eight, and the co-payment is$340. At the end of the day, I would take each route slip and look at what was collected and verify that we did collect the correct amount. Now, if there was a discrepancy, then I would go back to the person who collected the copayment and find out what was happening. Actually, first I would go to the clinical, I'm not the clinical notes, the conversation log. I would go to the area where notes are supposed to go in. So there should be a note regarding why the copayment was not collected based on what was on the route slip. And usually it would be something like patient, you know, needed to pay half and gave a credit card to pay the other half next week, something like that, just as an example. The end of day is where the accountability lives. And it should not take you more than 30, 45 minutes to get through. Because remember, chart prep is about preparing for the day. End of day is about verifying for accountability. And from a coaching standpoint, this is also where I got to see opportunity or find opportunity for coachable moments with my team members as well. So if I see that maybe co-payments are not being collected accurately, and maybe the individual who is responsible for collecting the copay just has a hard time having that financial conversation with the patient, that's a coachable moment. And we can teach them how to have that financial conversation. But if there's no end-of-day accountability worked in closing out the day, you're not going to pick up on that blind spot. And that's what I mean by using your combined chart prep and end-of-day checklist because one without the other does not work long term. Yeah, if you do chart prep, immediately you're going to see improvement in operations, right? That's an operational improvement. So is end of day. You want to operationalize the way we are preparing for our appointments and also how we are closing out our day. This system alone saves practices thousands of dollars every month and hundreds of thousands over the lifetime of the practice because money stops slipping through quietly and compliance issues get caught early. You can go grab the chart prep and the end-of-day checklist, and there's a little guide in there on how to implement it in the show notes if you want to implement this right away. If this series has been helpful for you friends, I'd really appreciate it if you would leave us a review. It helps offices and office managers and billers like yourself and doctors, owners to find our podcast that we so thoughtfully put together for you so that you have quality information and up-to-date standards and all the things that we talk about. So make sure you're subscribed so you don't miss part three. And if this episode made you think of your doctor or your office manager, share it with them. These conversations work best when the whole leadership team hears them. In part three, we're going to talk about the shortcuts that feel harmless in the moment but create serious risk over time. The kind of things no one warns you about until it's too late. So until then, friends, I hope that this episode was helpful for you, and I will see you in part three.