Considering the amount of time spent on processing a claim manually, along with cost and other factors, it has become mandatory for dental practices to switch to electronic claims. Switching over from paper to electronic claim processing comes with a lot of advantages. Besides cutting down costs and hassle, electronic claims have proved to be quite beneficial in eliminating the most time-consuming tasks of your staff.
Have you ever given a thought why insurance carriers always promote dentists to use electronic claims? The reason is simple! The cost of an electronic claim is comparatively lesser than the ones submitted on paper. Paper claims go through different clerical channels before final submission. This turns out to be time consuming. However, electronic submission reduces the time for payment. Error reduction is another advantage with automatic claim submission. Managing payments electronically also makes it easier to track checks and pull information if required.
Automating claim submission process helps with the following:
Electronic claims processing makes payments quick because claims are submitted electronically. Presently, you can send an electronic claim to almost 2,000 insurances and government payers. As discussed above, accuracy, efficiency and speed of submission are some major elements where electronic processing is highly helpful.
So, avoid the costly delays and disruption to your cash flow by opting for electronic claim processing. At Capline Dental Services, our experts can help you submit claims electronically. Our potential lies in our commitment to accuracy, efficiency and flexibility, which we incorporate across the entire process of claim submission.
Our experts have a profound control over the claim processing. They can easily check how the claim is progressing and also analyze the efficiency at various stages of claims handling. Our electronic claim processing can ease your work and contribute in the improvement of your practice.
If you’re not using electronic claims, you are seriously hurting your practice. With the above compelling reasons, we can help you understand how electronic claim processing can maximize cash flow for your practice. Schedule a call with us today and speak to our representative to make submissions more accurate and quick.
Following up on unpaid claims is an important part of the collection process. However, if it is done in the wrong way, it can result in loss of revenue. The only solution to the problem is to analyze your collection process for inefficiencies or missed opportunities. The more you keep analyzing your process, the greater are chances of denials and rejection, which in turn maximizes revenue.
When following up on claims, there are certain things to be considered:
Are Your Claims Being Received by the Insurance Provider?
This problem occurs the most with paper claims. So, filing claims electronically can help resolve the issue.
Are Claims Being Denied or Rejected?
It is extremely important to identify the reasons behind claim denial or rejection. Claims that are rejected can certainly be fixed whereas denied claims should be appealed and take longer to process again.
Claim rejections occur when claims do not meet specific data requirements or basic formatting as designed by a set of guidelines in Centers for Medicare and Medicaid Services. If the payer did not receive claims, they can’t be processed. Rejected claims can be resubmitted once the errors are fixed.
Denied claims are an entirely different issue. They are defined as claims that were received and processed by the payer, however, a negative determination was made. This kind of claim cannot be resubmitted. A research should be done to identify why the claim was denied. This helps in writing an appropriate appeal or reconsideration request.
Are You Tracking Outstanding Collection?
Proper tracking can help identify issues quickly and following up on them help in addressing correctly and timely. It is important to track and analyze trends in payer denials and work to those issues to fix them as quickly and efficiently as possible.
So, if you are not proactive about why a claim was denied or rejected could seriously impact your practice’s revenue. Therefore, we constantly encourage practices to follow a thorough process towards claim management. Our trained staff works on immediate appeal of all denied claims and closure of all paid claims. With our trained staff in insurance verification and charge entry, we minimize denials.
We understand that denials are a universal problem for providers across the world. At Capline Dental Services, our billing experts can resolve appeals and denials. Additionally, we also provide reporting. So, you have less headache with maximized cash flow. Give us a call today if you have any questions about improving your follow-up process.
Payment posting is a fundamental part of revenue cycle. It affects the other major functions of the billing and can have a major impact on patient satisfaction, efficiency and financial performance. Accuracy in payment posting is extremely important for an optimized revenue cycle. Once payments are posted to the patient accounts, any kind of denials can be easily addressed. Payment posting should not be ignored as it helps you catch billing issues promptly and make corrections.
Why Is Payment Posting Important?
The dental billing process comprises a large number of steps with multiple claims being processed on a daily basis. It acts as the first line of defense to identify payer problems. At Capline Dental Services, we have a team of extremely talented professionals who take up the responsibility of payment posting for your practice.
Our team validates all data entries to ensure that your practice receives results without a glitch.
Factors:
In this the payment records of patients are recorded in the practice management software. It also helps identify the problematic areas and their reasons along with action to be taken:
Analyzing Explanation of Benefits (EOB): EOB has all the personal details of patient starting from services rendered, to the amount of insurance billed, allowed and adjusted money. It also includes denials, co pay etc.
Analysis is conducted to verify the information and to check if the claims were processed accurately.
Patient Billing: If there is payment pending from the insurer, the rest of copays, deductibles, coinsurance and uncovered bills are further sent to the patient for payments. This info should be passed to the billing department to increase cash flow.
Denial Management: Denial management is about bringing denials down. It includes charge entry analysis, tracking payer denials, claim resubmission and so on. Denial claims should be resubmitted within a week. Tracking of denials help to ensure that claims are not denied for the same reason again. It is the first step to getting paid successfully.
To help your practice thrive with better cash flow, payment posting must be done right. The faster problems are spotted, the quicker will be the billing process. Billing issues can be addressed quickly, payers will be billed correctly and patients will receive their statements immediately, thereby increasing the entire billing cycle efficiency.
In short, it will be a win-win situation for your practice all the way round. Your dental practice should always look for ways to improve each area of the revenue cycle. Therefore, it is important to continuously monitor processes that multiply reimbursement by staying in compliance with the other billing practices.
Every dental practice aims at getting paid for the service delivered on the day of treatment. However, there are a lot of challenges that comes as an obstacle to make this seemingly simple task unachievable. It all starts with waiting for dental insurance to process claims. This means your office doesn’t get paid in full until the insurance company processes paperwork.
There is always a scope of error and there could be times when the insurance pay less than expected amount, thereby leaving your patient with an out-of-pocket expense. This also leads patients to cancel their appointments, leaving a remaining balance on books until the patient reschedules.
Listed below are some of the best ways that can be adopted to get your patients pay on time:
Have an Established Payment Procedure
Having a written payment policy beforehand not only maintains transparency but also avoid the scope of unexpected billing errors. You must have a policy that allows patients to pay co-pays or service fees before the appointment. Taking care of payments before the appointment allows your staff to avoid excessive billing chaos throughout the month. It is also convenient for patients since they are no longer waiting for a balance due, searching for payment method and signing receipts with a question in mind.
To eliminate such hassle, you should make it easier for your patients to pay before the appointment. Also, offering multiple payment methods like cash, credit card or cheque is an added benefit.
Make Payment Due on or Before Day of Service
You should avoid billing patients for Copays. Collecting payments prior to the appointment reduces the chances of no-shows and cancellations. Another thing you can do is collecting copays before patients go back for treatment, especially if they have treatment scheduled for one or more days.
So, you need to make it comfortable for them by collecting their payment and making any necessary follow up appointment before they go for a treatment.
When Insurance Is Involved
Tell them about the full treatment fee, the estimated insurance amount and copay that is due at the time of treatment. Let patients know you will be sending them claim and inform them if anything changes. Keep a close eye on your insurance aging report and quickly follow up on any unpaid claims, rejected claims and request for additional information.
Be Upfront About Fee
Patients are more likely to hold back payments if they don’t understand what they are being charged. You need to take time to explain patients that their out-of-pocket expense is based on the estimated amount the insurance provider will pay. The patient may be responsible for more if the insurance company pays less than projected.
It is your responsibility to explain in full the cost of treatment. A set payment policy ensures that everyone in the office is following the same guidelines. This helps in keeping payments streamlined.
Outsourcing your collections to Capline Dental Services and we will handle your finances successfully. This will help your office staff to focus on patient care and improving collections at the same time.
With the inception of technology and other advanced procedures, operating a dental business has become quite simple and hassle-free. However, there is still room for improvement as far as record keeping and patient management is concerned. Billing and collection has always been a challenge but this can easily be overcome if you follow the below given tips:
Stay Up to Date With the Coding Changes
We have discussed this earlier too. Coding allows insurances to understand whether certain procedures should be reimbursed, reduced or strictly denied. Therefore, it is extremely important that practices don’t make any errors while coding.
Using the wrong coding could result in a claim being denied even though the actual service provided to the patient is covered by their insurance. To prevent such errors from happening, it is important for practices to review and note the changes for codes and understand how they are affected. Coding updates help to innovate ways for receiving reimbursements and address new procedures. These could be changes in material or even technology.
Owing to plentiful regular changes, our billing specialists keep themselves pre informed to ensure that they bill and code the procedures accurately.
Collect Co-Pays in Full
Collecting payments and co-pays at the time of service is best for both the patients and the practice. A huge bill after a procedure could be more difficult to pay, therefore, practices must collect copays and inform patients of policies. Effectively communicating to patients that payment is expected at the time of the visit can eliminate potential excuses. You should also train your staff members on the importance of collecting payment before patients are seen.
Unpaid balances are sometimes bound to happen in a dental practice. It also may be unpleasant to ask patients to pay their outstanding balances but as far as maintaining the revenue stream is concerned however, practices must adopt this practice or better revenue cycle management.
Approving Procedures That Require Pre-Authorization
Before opting an expensive procedure, the provider must know what all is covered under a patient’s plan. It helps in determining if there is something the patient needs to cover as an expense. There are many patients who are unable to cover the cost of their portion of the procedure. However, there are a few who may think a procedure is fully covered by insurance, however, the patient is responsible for the uncovered portion. If the patient is pre-informed and offered a payment plan before procedures, he would be able to manage the payment terms and conditions.
Billing challenges will continue to evolve, but if you follow the right procedures and address shortcomings, it becomes easier to handle. At Capline, we have the best billing experts hired to take care of your practice’s billing and collection needs. Don’t let your practice suffer, get in touch with us and give us a chance to manage your practice’s billing requirements.
Rather than just wasting time, patient no-shows can cost your practice money. Missed appointments are a great source of frustration and lost revenue. No matter how well organized your office is but if your patients fail to appreciate you for your schedules, it’s a no-show. While it is not possible to get rid of every no-show, here are a few tips that can help:
Use an Automated PMS for Appointment Reminder
The Griffin survey also says that the biggest reason for no-show is patient forgetting their appointment. There are some dental offices that remind patients of appointment via a phone call. This could be of great help for patients who prefer this mode of communication. However, to make the process efficient for everyone, it is important to have something that works best. To prevent this from happening, practices should use a PMS that reminds patients of their upcoming appointments. This can be made possible via an automated text, email or call reminder at specific dates and time before the appointment.
This type of engagement with the patient has proven to decrease the number of no-shows drastically.
Reduce Waiting Times
If you keep asking the patient to wait for 20-40 minutes, there are increased chances that the patient will move out by canceling the appointment. If at any moment, the patient feels you don’t value their time, they are less likely to show up.
Pre-Pay for Appointments
Offering prepayment options creates an urge to be available for the appointment since patients have already made a financial commitment. The number of patients registering online can also be increased if you offer discount options to those who opt to pre-pay. Offering discounts will compel them to come back to your practice again.
The possibility to show is enhanced when patients know that they have already paid for the appointment.
Be Transparent About Your Appointment Policies
Emergencies and mishappenings can occur anytime. They also contribute a major role in choosing patients not to show up. However, with a structured late arrival policy, you will be able to ensure clearer communication. To make this easily accessible amongst patients, place it on brochures and website. The more informed patients will be about the policy, the better decision they will be able to take.
Patient no-shows can hit your practice’s bottomline. However, following these tips will limit patient no-shows and help appointments to run smoothly.
Taking care of past due balances is a big fight, be it for dental or any other industry. If we talk about the dental industry, the increased number of deductibles and expenses have compelled practices to come up with innovative and contemporary ideas that make easy to pull payments from patients.
If your dental practice is still lacking behind and not following innovative approaches to deal with patient collections, now is the time to push the boundaries.
The studies/research done in the past has also clearly proven that there are many patients who in the past skipped dental examination or cleaning owing to potential dental care costs. Another study revealed that patients in the USA with insurance encountered a lot of problems paying their dental bills. Similarly, there were other patients who came across the same problem without insurances. So, as per the research, it is clear that paying dental bills is a huge concern for most of the patients.
At Capline, we can help practices reduce the bad debt in collections by putting your practice in a better position. Listed below are some of the ideas shared by our experts that ensure your dental bills are covered in a timely manner:
Set payment expectations prior to the appointment
Make sure to verify all patients in advance. This will help set payment expectations before the appointment.
This should further be communicated to the patient during the process so that they can easily decide whether they wish to continue ahead or not.
Inform patients about past due balances
If a patient fails to pay past balances, for any reason, you must tell them clearly. You can make use of email or invoices to remind patients of their payments before the due date arrives.
You can still continue to follow up if the payment has not been made. Our experts keep following up to make sure that you get paid on time, without any hassle.
Outsource Us for Your Practice’s Billing and Collection Needs
If your in house methods stop working, don’t hesitate to contact us. At Capline Dental Services, we can take care of your practice’s bad debt by keeping collections high. Our collection strategies will give your practice a leg up to move towards increased revenue and patient retention.
These days dental practices have to deal with a lot of challenges that not only hinders their revenue cycle but also brings patient care to a standstill. This is the reason practices started outsourcing dental billing and collections that allowed them to focus on their core service, i.e. patient care. The benefits of outsourcing dental practice appear to outweigh the negative. Listed below are a few warning situations that indicate that you must outsource dental billing and collection services:
Your Revenue Comes in Slowly
Whether it’s patient billing for their outstanding balances or insurance firms reimbursing you for your provided services, your practice has to be paid fully once the treatment has been done. Therefore, it is extremely important to get paid on time to remain profitable.
The best you can do is to monitor your Accounts Receivable. This will give you an idea of how quickly you are being paid. By outsourcing RCM services, you will be able to track AR time. Our experts will create a report indicating how much of your AR is 30 days old and how much is over 90 days old. Once you identify the problematic areas, you will be able to come up with an ideal solution.
Your Claim Denials Are Too Frequent
Claim denials indicate a lot of issues that may be present in your practice. If a claim gets rejected for any reason, you may not be getting as much money as you should. Secondly, claim rejections and denials also indicate a lack of expertise or staff training. Rejections and denials also require a lot of time to submit, correct and resubmit them. This takes a lot of your staff’s time, thereby distracting them from providing quality patient care.
The best part is that by outsourcing billing and collection services you get to work with billing experts who make sure to process your claims accurately. This will help minimize denials.
Your Staff Is Overburdened
Providing high-quality care amidst all the paperwork burden becomes unmanageable. But, if you outsource billing and collection services, your staff will be relieved of the paperwork burden and be able to focus only on delivering high-end patient care. Your staff will become more proficient and responsible for their intended task. While everyone is working efficiently, your practice will be able to produce more in a shorter time span.
By outsourcing billing and collection services from us, you will experience a steady flow of claims going in and cash coming out. Not only it helps in improving your practice’s bottom line but also streamlines productivity.
To keep patients coming back to your practice and to maintain a healthy flow of revenue, dental practices need to understand their unique expectations. This helps in delivering effective patient care and also make the billing process streamlined.
Patient billing is one of the most important tasks a practice has to cope with on a daily basis. While your office staff is busy handling the paperwork, the patient care related to your practice is often ignored. Not only this but also there are other aspects that get affected owing to a bad billing practice. In this article, we will be sharing all the necessary steps you must take to streamline patient billing and keep your patients happy.
Here’s what you can do:
Fight Claim Denials
In order to prevent denials in the future, it is important to understand the common reasons that cause denials. Denials can occur due to the following reasons:
To prevent errors related to patient’s critical data, our verification experts acquire patient information over the call both before and after the registration.
Get Pre-authorization Done Correctly
The amount of time your staff spends on getting pre-auth done from insurance companies could be spent on patient care if you outsource pre-authorization to us. Some insurance plans state that if a patient looks for services requiring preauthorization, however, fail to obtain pre-auth, the patient is liable to pay the price. If the payment is denied by the insurer, the cost of treatment will directly be collected by the patient. This not only impacts the patient experience but also the bottom line of your practice.
It is important to provide the correct CPT code before the service has been provided. We obtain authorization for any treatment that requires it.
Following Up on Unpaid Claims
Accumulating unpaid claims can have a significant impact on the revenue and cash flow of your practice. We implement a standard process to handle all unpaid claims. This saves your practice’s time and makes sure that all claims are filed on time.
The right professional approach to manage billing can make a critical difference in building rapport with patients and improving revenue for your practice. Connect with our billing and insurance verification team today to know how to reduce claim denial losses.
Being the most crucial aspect of a dental practice, billing and collections is one important area that should be nurtured well. To maintain the livelihood of your practice, it is important to get reimbursed at the right time. Therefore, practices must look out for ways that can keep their collection numbers under control. Collecting payments sometimes turn out to be a terrible experience when the office staff is seen overburdened with clerical work, patient dealing and a lot more.
The ultimate quick fix to get rid of such hassle is to contact an expert dental insurance billing service provider. Dental billing is strictly related to the cash flow, therefore, it should not be avoided and taken care of properly.
At Capline, we have encountered a lot of issues related to accounts receivable. To manage accounts receivable properly, it is important to handle everything thoroughly. So, whether it’s patient payment, billing claim or payers, everything needs to be in sync. Remember, if you fail to figure either one correctly, you will see a drop in the numbers.
With so many billing mistakes happening around, we have assembled the most common ones that your dental practice must avoid while managing patient collections.
Failing to Track Reports and Check Accounts Receivable
Do you want to leave your practice as a guessing game? If no, you need to have a clear understanding of the different sides of funding. It is important to track denial rates, accounts receivable and other funding expenditure related to your practice. This helps in spotting the challenges your practice is facing. To balance patient care with the practice’s success, you must be financially sound. If you are still missing on claim submission and patient collection, take a moment to reconsider all of them to successfully maintain the financial health of your practice.
Delay in Claim Submission
Claim management should be as effective as possible. It helps to keep the revenue cycle streamlined. Claims must be submitted within 24 hours and practices must track claims. If the deadline for resubmission passes, your practice might miss out those funds.
Sending Confused and Complex Patient Statements
A study by 2017 InstaMed report says, “More than 70% of patients are confused by billing statements and insurance policies.” It is important to present statements that are easy to understand. You can also send them contact information for further assistance. The statement should not come out as a surprise to patients. If that’s the case, they will definitely deny paying. So, the best you can do is communicate upfront about the type of charges they can expect.
Now is the right time to consider and review your policies and rework on them to move towards an error-free billing and collection process.
