Revenue is the loop that keeps the dental practice ongoing. But to keep this wheel running is pivotal. Dental revenue cycle challenges affect RCM and practice profitability. Successful revenue cycle management keeps the cash flow running, resolving several issues immediately.
The technology uses specialists and automation to enhance collections and decrease errors. The administrative and financial opposition fabricates and exponentially affects the economic stability of the dental practice.
The revenue cycle is a way money moves. But difficult to manage different collecting parts, endless tasks, and dealing with challenges. In this article, you will learn a few revenue cycle challenges with strategies and tools to conquer them.
The top 5 dental revenue cycle challenges with tools that provide dental practices the bandwidth and result in positive outcomes.
Patient information is an essential part of this process, and not just any information but accurate and complete. It helps to avoid disturbances in the RCM process that hold up payments or lost collection. The incorrect details result in claim denials.
The cause of this error is there are so many details to gather that mistakes are likely to happen. Inaccurate information is as simple as wrong date of birth, misspelled name, and inaccurate insurance details. The delay in the payments affects the smooth operation of the business and negatively affects the cash incoming and stability of the dental practice.
To prevent this, work with RCM services provided by Capline Dental Services. The experts are pro and double-check the patient information to avoid claim denials. That leaves the administrative staff with less on the plate and focus on patient care and a smoother billing experience. Everything gets organized in a way the person handles what they are supposed to handle, leaving a stress-free environment in the practice.
Prior authorization is a way to confirm the payment with the insurer before providing any treatment. It is the correct way to control costs and follow treatment on a necessary basis with evidence. Prior authorizations are crucial for dental specialists to develop a treatment plan that meets the unique needs of different payers.
Source out the prior authorization process to third parties like Capline Dental Services that acknowledge esoteric requirements that can revamp clean claim rates, reduce denials, and expand reimbursements.
Correct dental coding for a dental provider is like a nightmare for revenue cycle management. The ICD-10 keeps evolving based on the latest updates, new procedures, advanced technology, etc. The annual update is rapid and keeps the coders watchful of every variation. Revenue leakage can happen if the practices use improper coding due to half-knowledge.
Consider outsourcing coding needs to an offshore revenue cycle management company like Capline Dental Services to address payment challenges caused by frequent changes in coding guidelines.
Dental providers must be credentialed with the Payer's network to provide services to members of the Payer's plans. Credentialing is one of the complex processes and is mandatory because it authenticates the doctor's standards for carrying out professional care.
The insurers validate the dental practitioner's education, licenses, and accreditations before seeing the patients. It is time-consuming, and the insurance company can delay or refuse the payments if the provider refrains approval. The wait time impacts the financial stability of the dental practice. It is easier said than done that the provider gets credentialed before appointments to validate their skills.
The process requires recent information about them. Failure to get credentialed can heckle the payments. Allowing external companies like Capline Dental Services to handle credentialing on your behalf can help with cash flow and a comfortable experience.
Accounts receivable is becoming challenging for the dental teams day by day. The insurance companies are making this process complicated for dental practices. They enrich their profits by collecting premiums from the members, that is, patients, and deny as many claims as possible by conditions applied through limitations, frequency provisions, and exclusions.
A/R under 30 days has more chances of collection, and professionals like Capline Services keep it that way. Otherwise, the dental practice is busy with appeal claims, leading to additional costs, administrative work, and lost revenue.
The standard operating procedure can prevent claim denials and reduce piles. CFOs should collaborate with COOs and revenue cycle operations managers to create one for accounts receivable and collections. That will shift the focus to denial prevention and ensure that all claims are promptly addressed based on defined guidelines.
