The biggest problem causing trouble to patient care is the paperwork burden. While billing is important, many dentists find it is bogging them down and reducing the time they are able to spend with patients. Dental billing turns out to be a tedious task for a practice to manage in-house. Dentists are drowning in administrative work and wasting their valuable time. This adds nothing to patient care however contributes a lot to dentists’ stress and fatigue.
Capline can take care of all the paperwork related to your practice so that you can sit back, relax and devote all your time to your patients.
WE ARE EXPERTS AT HANDLING PAPERWORK, YOU ARE EXPERTS AT PATIENT CARE.
A great patient experience doesn’t end with the treatment. The billing process is equally important since a bad billing experience can adversely impact patient satisfaction. A survey by Connance Consumer Impact revealed that a bad billing experience can disrupt your practice and make it difficult to retain patients and collect payments. Managing the patient experience is a crucial step towards a happy patient base.
We understand that providing the highest quality of care is something that drives you as a dentist. Clerical work is the last thing you want to worry about. The choice to outsource us for paperwork not only saves your time and money but also speeds up the billing process.
Below are three ways we can improve patient satisfaction via our effective billing process:
It is important for your practice to talk to your patients about what payment is expected. If the patient has remaining balance, you must collect it on the spot. Similarly, if your patient receives a statement, regardless of whether there is a balance, the patient should be informed about this. We generate clear and easy to understand patient statement. Our experts bill your patients on your practice’s behalf and make it clear that the patient is expected to pay the remaining balance. This is how we can manage patient expectations and move towards a happy patient experience.
Patients are least interested in knowing how much their care will cost until they have to pay it for themselves. However, there are times when a patient opts a particular test/surgery/treatment over another, considering the fact that insurance may not cover the charges. We are here to answer all the queries your patient has related to costs and insurance coverage. We make them understand their bill so that the clutter is eliminated.
Collecting patient balance is stressful for practices because it has a direct impact on cash flow. That’s where Capline comes in. We are a reckoned name for accounts receivable in dental care, we can support your practice with reliable collections. Our process for Dental Insurance Billing Services is extremely reliable. We monitor patient balances and reach out to them directly whenever there are outstanding balances.
Capline is experienced at communicating with the insurance companies. Whether it’s reimbursement, claim follow-up or billing, we are in your corner at every stage. Your dental assistant will be able to focus more only on taking care of the patients coming in. They will be able to give their full attention to listen and understand patient’s needs, without calling insurances.
Ending Notes:
With less stress involved in billing and more time to spend with patients, practices are able to deliver outstanding and high-quality patient care. It is therefore required to hire a dedicated team which has specialized knowledge and expertise in managing the billing function of your practice.
If your practice is losing patients, schedule a call with us today. We can help you put more money into your pocket and ensure that your patient satisfaction goes through the roof.
According to the recent survey conducted by the American Dental Association, approx. 65% of patients rely on insurance to help them pay for the treatment they want. However, there are times when a claim gets denied or delayed for a variety of reasons. Claim denials can hurt both Dental Insurance Billing Company and patients. Every once in a while when a claim gets denied, it leaves patients with huge dental bills.
To prevent such scenarios in the future, let’s understand the top reasons for claim denial.
Common Causes for Claim Denial
The Treatment Procedure Is Uncovered
When patients opt for dental care, the first thing they worry about is whether their dental insurance will cover it or not. So, whenever the patient opts for treatment that wasn’t covered by the insurance policy, there are increased chances of a claim getting denied.
Error in Entering Patient’s Information
Sometimes a claim gets denied because of simple errors like a misspelled name, policy number and so on. Our experts go through the information carefully and correct any kind of errors before processing a claim. If there was an error on the part of the provider, we ask them to correct it.
Claim Denied for No Pre Authorization
It is seen that 80% of claims get denied with no authorization being obtained. There are some dental treatments that may require prior authorization. It is quite obvious for payers to get prior authorization for complex dental treatments like surgeries. As a part of our eligibility verification process, we work closely to mitigate denials from having an incorrect code on prior authorization.
Claim Denied Due to Issues in COB
COB or Coordination of Benefits is a term used when patients have two or more health insurance plans. There are certain rules that decide which dental insurance plan pays primary, secondary or tertiary. Providers need to ask patients whether they have primary, secondary or any other carrier. Once the information is acquired, we can easily use it while billing the insurance carrier. This ultimately reduces the number of delays or denials.
Claim Not Filed on Time
One of the major issues practices encounter is when claims are denied for timely filing. Since each carrier has its own set of guidelines and policies, it becomes important to stick to them. Claims are often denied for timely filing when the claim was submitted on time but not received by the insurance carrier.
To prevent such issues, it becomes mandatory to file claims within the time period.
By implementing these tips, you will be able to optimize claim processing for your practice.
Dental offices are crowded places wherein office staff has multiple tasks that require to be completed before the day finishes. This is the reason answering patient calls come across as a hurdle to them. So, in spite of greeting patients with their queries or scheduling their appointment, the office staff tries to get off the phone as quickly as possible. This, in turn, leads to poor patient base and unhappy customers.
If patients get a feeling that their query is not valued, they would schedule appointment with another provider and never come back to you. This results in customer abandonment. Imagine how your dental practice would look like if it lacks a great patient base? We know you would never like to deal with something like that. So, we are here to help. Capline makes sure that you offer quality care to your patient while we keep an eye on the billing, scheduling and verification process of your practice.
We help by converting your patient calls to appointments, thereby generating revenue for your practice. To help your practice, improve patient care and revenue for your practice:
We make it easy to create and track all existing patient appointment activity and new patient registrations via practice management software.
When you outsource Dental Billing and Collection Services to us, your front desk team has only a single task and that is to focus on patient care. They can now take more time to answer patients on the phone. A high level of patient care is also guaranteed with this. This way your patient ends up feeling valued and cared for the service. This method of treatment maximizes customer loyalty and retains them with you for years.
Our billing team will make sure that there are fewer billing errors because what happens with the billing ultimately affects your practice’s bottomline. An inexperienced dental biller will face difficulty keeping up with the changes in dental billing, however, when you outsource us, we will get the job done correctly and efficiently by providing patients with an accurate bill.
There has been a huge concern about patients complaining that doctors rush through appointments and do not invest time in handling the queries of customers. Since most of the effort is involved in completing the paperwork and seeing patients, there is no time left to schedule actual appointment. Our experts at Capline get the paperwork done and free your office’s staff time, thereby allowing you to build personal relationship with your patients as well as delivering high level of patient care.
Redefine patient care and get passionate about your practice again by leaving the paperwork to us.
The health of your practice is more or less interlinked to patient payments. Therefore, it is important to ensure patient collections are as adequate as possible. At Capline Dental Services, we work with your practice to improve collections. Our specialists examine patient benefits and insurance information to calculate the estimated total cost for patient care. Patient billing statements produced by our team are quite effective to facilitate faster payments.
At Capline Dental Services, we create patient statements that are easy to read and understand. To make sure that your practice delivers patient statements that multiply revenue, here are following tips to consider:
Accuracy in billing
To maintain billing accuracy, we work on claim rejections, resubmission of correct claims and also appeal submission to process timely patient statements. These patient statements are reviewed further to ensure accuracy. Our team sends patient statements regularly on a monthly basis. Sending regular and timely statements increases the chances of obtaining timely payments in return.
You also might face a situation wherein patients become non-responsive to their bills. Here, you need to set in place the policy for outstanding balances.
Be upfront
It is important for any practice to collect patient payment at the time of rendering service itself. To do this, practices must have the patient’s insurance information beforehand. Confusing bills and frustrating collection can derail treatment experiences for patients. A negative patient experience ultimately impacts reimbursement. Bad experiences make it difficult to collect unpaid balances and also impact patient retention.
Providing patient’s insurance information
One of the most annoying parts of a patient’s experience is to deal with dental insurance. This troubles more if the provider does not help them understand the system. Adding a section about their insurance status not only adds to the authenticity of their bill but also helps in delivering a better patient experience.
Use practice management software to automate patient statements
Eliminate the time your office staff spends on paperwork by making use of a practice management software. It allows you to send out statements in a timely manner while improving your bottom line and simplifying the collection process.
The patient statements designed and passed this way have a greater impact on your practice’s revenue and patient retention. Therefore, it is important to focus on delivering best-in-class patient care by improving patient forms/statements.
Find more information here about our Dental Patient Statement Services
When a practice, especially the one dealing with complex billing attempts to do everything on their own, problems will definitely cross the path. There is a lot to deal with in addition to just delivering quality patient care. These days practice suffer a lot owing to staffing overhead cost, overwhelming administrative burden and lack of knowledgeable experts to take care of their billing needs. The billing department of any practice has to deal with a lot of paperwork which results in errors and declining revenue. This brings the need to outsource this to a billing specialists who can take the burden off your office staff and help improve your practice’s bottom line.
Other than this, there are some other ways that can help streamline operations to reduce the burden. Let’s explore some of them.
Outsource billing services for your practice
When you outsource your billing needs to experts, you have increased chances of getting your claims submitted on time. This minimizes the chance of rejection, fast claim approval and ensures maximum returns for your practice.
Billing is a rigorous and time-consuming process. There are times when billing can cause holdup in other essential tasks. However, when you outsource billing experts for your dental practice, you can definitely concentrate only on patient care as the rest will be handled by the team of experts.
Use of practice management software
To manage the operations behind your practice efficiently, the use of practice management software helps. These days many dental practices have started using practice management to create better patient flow, maximize productivity and lessen stress for both the practice and patients. This ultimately contributes to a superior patient experience that your patients look out for. Therefore, you need to ensure that your dental practice has the most efficient, flexible and up-to-date scheduling system possible.
By reducing admin workload, you will be able to focus more on patient care and experience greater cash flow for your practice.
EOB or Explanation of Benefits is a document that a patient receives after visiting a dentist. It is an explanation of the procedures that were performed during your visit to the dentist. An EOB encompasses the dentist’s fee, the portion paid by your provider and any extra amount the patient may owe.
EOB can be in the form of either deductible, coinsurance or an uncovered service. It also includes an update of the total annual maximum that has been used and the amount that has been paid by the patient towards their deductible.
The EOB form generally has 4 major sections:
In addition to just showing the way a claim is being processed, EOB forms also let your dentist know whether any remaining balance is due by the patient. It elaborates a simple way to track the services you receive and the expenses associated with your healthcare. It also details what portion of the services have been paid and what portion were not covered earlier.
An EOB is filed to ensure that all services have been paid and processed correctly. It should not be confused with a bill, EOB is not a bill. EOBs are explained in the code descriptions.
A patient must look out for the below-given information while reviewing an EOB.
It is very important to understand your insurance benefits. For any queries or concerns, you can anytime reach your insurance provider. So, instead of getting surprised with unexpected billing charges, you must keep a detailed record of copays, services or any kinds of payments made.
EOB is the ultimate medium that helps you to understand how your dental insurance plan works. So, make sure to get an explanation of your benefits next time when you visit your dentist, to know about services already availed by you and services yet are covered under your insurance plan.
Insurance billing in your dental practice often proves to become forth as an extremely complicated thing. There are many patients who come across issues with their bills either being very expensive or showing unexpected balances. Billing errors in any dental practice are quite common. Fixing billing errors can be a very tiring process. It requires an expert’s assistance to understand and fix billing errors. When you hire a Dental Billing and Collection Company, you not only minimize the chances of errors in your billing process but also improve the patient experience.
Dealing with billing errors in your practice
Since the process of billing involves multiple parties, chances of errors occurring are quite high. Be it an inaccurate code or a mistyped value. Regardless of the reason, it is very important to monitor your bills and EOB forms.
Balance billing- Balance billing can definitely get your practice in trouble and make your patients furious. It is the process of billing a patient for costs over and above their deductible, coinsurance, copayment and the amount the insurer is obligated to pay. When a balance remains even after these payments and the patient is billed for the same, problems can definitely arise.
Duplicate billing- It is one of the most common billing mistakes that practices commit. It is very easy for a duplicate billing to occur for a process. Duplicates usually occur at the time when a patient and doctor analyze the same treatment or procedure for a patient.
Issues in verifying patient’s insurance coverage- The insurance coverage of a patient can vary at any time, even for regular patients. Therefore, it is important that the provider verifies the member’s eligibility every single time services are offered. Providers who do not assess the patient insurance coverage before serving them are likely to have the claims denied. Claim denial can be very expensive and difficult to deal with. So, it is important to check coverage before the service. This prevents delayed claim payments in the future.
If your practice submits a claim without checking the patient’s coverage, the claim will be denied. To prevent such errors, you should always keep your staff informed about verifying patient eligibility in the initial stages and also investigate the causes of claim denials when they occur.
Mismatched or Outdated billing codes- A claim may be denied if a wrong or mismatched code is entered. To prevent revenue loss, it is very important for practices to check and understand the new billing protocols and how they may affect billing. The treatment code and diagnosis code should always be reviewed to make sure they match.
Including incorrect patient data- Insurance firms rely on the correct data to find your patients in their databases. Even a misspelling on a patient’s name can lead to a claim denial.
The first thing you can do is to have the patient check their records before they come in for an appointment. This opportunity can also be used to get additional information related to insurance. Also, cross-check your claim with the patient’s records. It will help in catching the subtle errors easily.
So, these are some common errors that your practice must avoid. This will eventually improve the practice’s cash flow along with a streamlined operation that multiplies your chances of surviving in today’s competitive landscape.
Confusing dental bills and collection processes derails the experience of patients coming to your practice. To prevent the billing and collection process from hurting patient experience, dental practices should focus on managing patient’s expectations and encourage them to be accountable for paying their bills on time.
One of the crucial aspects that determine the success or failure of your dental practice is COLLECTIONS. With the increasing rise in high-deductible plans, patients are coming across huge dental bills that they are not even prepared to pay. This ultimately affects your practice.
Once you are done with the treatment part, the next step would be the collection of balance in your accounts receivable. You cannot afford to lose patients or profits by not collecting balances. Right? Collecting payments becomes a piece of cake if you have expert assistance backing up.
At Capline, we can help you collect your money so that you can focus on strengthening relationship with your patients.
How to Increase Collections?
To keep your practice running through, you need a plan of action that can help you improve patient collections. Given below are a few suggested by our experts:
Be As Upfront and Transparent As Possible
Dental treatment bills can be hard to budget for. There are times when patients expect to get treatment free of charge and sometimes they fail to realize whether the insurance has covered the entire procedure or not. In that case, you need to be transparent with patients about the treatment costs. Patients who are on high-deductible plan must be clearly reminded that they will likely be paying out-of-pocket.
Open Communication
As discussed above, it is very important to advise patients about payment policies. This not only creates a streamlined partnership between patient and provider but also keep things smooth. Patients are generally confused about what they are being billed. This is one of the key reasons they disagree to pay. They simply ignore the bills that they don’t understand. Being able to consistently communicate with the patients about their bills reduces the chances of denials in billing and maintains cash flow.
Send EOB’s
EOB or Explanation of Benefits is a direct window to your billing history. The EOB gives a clear picture indicating which benefit(s)/charge(s) are covered or not covered by the dental benefits plan. It is recommended to send clear and easy to understand EOB statements to eliminate any kind of confusion in billing. It should delineate the benefits and limitations of plan along with any balance due by the patient.
Dealing With Conflicts
When there are loopholes in the way things work, there are increased chances of error. Sometimes a bill may be sent out to a patient who has already paid the bill. The reasons for the same could be a miscommunication with insurance. To keep things organized, you should simply send out the statements to address the problem effectively.
Keep Your Patients Informed About the Policies
It is important to give patients a clear understanding of the policies related to your practice. Before the treatment starts, a financial agreement must be signed that states the responsibilities of patients and when the payment is expected. Any kind of changes made in the policy should further be communicated with the patients.
So, let’s start working on these tips and see how you can expand your practice’s bottom line.
Still struggling to get paid from patients?
SIGN UP TODAY FOR A FREE AUDIT REPORT
Our experts will analyze the loopholes in your collection process and help you recover what is rightfully yours.
According to the reports by “The Wall Street Journal”, 30-70% of dental bills are presented with errors. Avoiding errors is not possible especially when a practice has to deal with thousands of codes. Billing errors in your dental practice not only enrages your patients but also impacts your practice negatively. A patient might end up paying unnecessary expenses when billing errors occur. To avoid such scenarios, physicians must understand how to avoid the common problems that are associated with coding and billing.
The most common billing issues that come as a hindrance in patient care are:
Missing Information
Errors are one of the common reasons owing to which claims get denied. These errors can only be prevented by verifying all fields and then submitting a claim. Incorrect information related to patient name, address, treatment date etc lead to problems. There may be times when the information is accidentally entered wrong. If the information is entered wrong in the patient’s record and submitted for further use, chances are that a claim denial will follow.
Errors in Coding
Coding mistakes also happen when the claim is submitted with the wrong diagnosis. Dental codes that are not coded to the highest level of specificity result in denials. At Capline, our dental billing specialists stay updated on the latest dental coding type that helps in speedy claim processing.
Incorrect Claim Information
Wrong patient info on a claim is one of the common billing mistakes. This mistake can be in the form of a misspelled name, incorrect date of birth or SSN entered. In this case, whenever a claim goes to the insurance company, it gets rejected due to inaccuracy.
Unbundling of Charges
Some charges on dental bills are bundles collectively under a procedural code. However, if the charges are entered separately, it results in dramatically increasing the total bill. Unbundling errors are difficult to track, however, if you see charge values that should be bundled together, you must clarify and work on them.
How Capline Helps?
We keep your cash flow consistent by delivering bills that are simple and accurate. Our IV experts offer the updated insurance benefits for your patients which minimize the chance of errors. Not only this, but you will also be saving thousands on collections. Let us handle your dental insurance billing services and allow your staff to focus only on patient care.
No dentist would ever wish that his or her practice falls victim to fraud or scams.
Dentists in the USA are routinely double-crossed. As per some studies, statistics suggests "At least 40 percent of practices suffer due to scam and embezzlement in the field of dentistry." Such practices can put the future of dental practice at risk. There are myriad ways through which dental office theft can be carried out. Sometimes they occur in predictable forms and the other times they are quite unclear. However, if you understand the fraud detection techniques in a dental practice, you can ultimately keep your practice clean and safe.
Identifying the Signs of Fraud:
Every dental office is a prospect for embezzlement. So, you need to identify the different ways that prevent such fraud from happening. The signs of fraud may include:
● Patients using a different ID to acquire benefits
● Submitting claims for covered services as a substitute for non-covered service
● Keeping other active coverage out of sight
● Misreporting service dates to avoid annual maximum or time limitation
In order to mitigate risks, the best you can do is:
A Keen Eye on Account Receivables
Patients should be made aware of their financial obligations that include coverage and other fees before the treatment starts. Make sure to send out monthly statements, unpaid balances. An explanation for each transaction in the patient management system should also be provided to prevent any kind of issues in the future.
Employ a Code of Conduct That Includes Fraud Policy
Keep your employees informed about out-of-bounds behavior that includes falsifying patient data, theft, insurance claim, expense reports and so on. You need to ensure that everyone is aware of reporting any kind of suspicious behavior.
Using The Right Hiring Practices
This should be done to minimize the recruitment of dishonest employees. The best way is to carry out background checks that include work history, educational achievement, criminal background, credit references, etc. This would give you a clear picture of their ethics and sense of responsibility. Take assistance from a third-party expert to help you gather the right information that can help you.
The growing exposure to fraud is a huge problem for dental offices. However, the good news is that any dentist can reduce their vulnerability to fraud by taking some basic measures. So, let’s just try one of these and see what wonders it brings for your dental practice.
