It takes focus- right from the appointment to the payment. Getting access to each dollar that you are entitled to, is vital for the practice, particularly when ineffective denial management can lead to revenue losses directly. As your practice grows, a loss of 6-8% in revenue creates inconsistency in cash flow. Here are three practical tips to improve denial management that can lead to a collection rate followed by patient satisfaction.
Tip #1: Prioritize knowing the reason for claims denial and streamlining the process
How often does your dental team know why your patient’s claim gets denied? The foremost crucial step is to streamline the revenue collection and avoid future denials. Not all your patients know how the claim and denial system works. In cases like this, the dental office’s responsibility is to educate the patients and make them understand how to solve the issue.
That paves the way for a smooth function while the practice thrives, and you also create a long-lasting relationship with the patient. For a long-term solution, manually handling a claim is a quick fix that will not help minimize recurring issues.
The revenue and credibility are at stake if you lose track of denied claims. Hence, a well-organized system through advanced tools that simplify the process and help the team to monitor the recurring denials efficiently is paramount. Ascertaining this staple advice helps keep track of all denied claims without losing a single one.
Tip #2: Process claims within a week and track claims denial using a log implementation & incentivize the process
Timely resubmission of the appeals and keeping track of your claims help avoid piling up the issue. As per statistics, 65% of the denied claims never get filed again, showing not so strong denial strategy. The team needs to process the appeal as soon as they receive the denial from the insurance company. There will be less time spent, say within a week.
A robust workflow ensures quick payment with no recurring errors. An electronic version of the claims denied log is a wise option to keep relevant information, such as demanded amount, service date, discrete claims number, codes for denied claims, and documentation with the service providers to improvise the claim denials.
The dental industry is drastically transforming, and quick updates are trending. An effective procedure for claim denial management can help to assess past filing mistakes. Dental offices can save many costs and get an edge over competitors.
An appealing incentive program promotes healthy competition that leads to staff bonuses and motivates them to reduce claim denials. The ultimate goal is to improve the organization’s efficiency by having the collection process in place, offering time-offs to the staff, and rewarding the team for exemplary work.
Tip #3. Outsource the claim denial management
There is no business without patients and payments. That is what an expert outsourcing service can contribute, like reducing time and effort, minimizing cost, and hands-on claim processing. The specialized trained teams relieve you from the complications of the insurance system. You and your team can focus on patient care and delight while the draining task gets delegated to the efficient firm.
Claim errors can get handled through motivated and trained staff. Despite the higher software cost, there could be other denial management challenges like lack of automation, poorly trained staff, absence of applicable technology, financial resources, and moving to value-based care.
As the team fixes the claim denials, the dental practice can witness improved cash flow, a suitable solution to devised categories, increased recovery amounts from the payers, and prevention of future claim denials.
Insurance companies are making profits. And they will think based on what’s best for them and not for their patients. It is the responsibility of the dental practice to collect maximum payments and fewer denied claims to increase the overall performance of the practice revenue generation.