Dental Billing Best Practices: Tips To Optimise Your Revenue Cycle

The evolving dental industry relies on efficient revenue cycle management. Inefficiencies in claim processing, billing, and patient scheduling consume a lot of time and hinder patient care. Dental billing services by Capline can drive significant results by embracing modern technologies. The dental professionals at Capline manage the business side of the practice, thus transforming the practice's revenue so that patient care does not take a backseat.

Optimizing RCM is a way forward for thriving. RCM refers to managing claims, payments, and revenue generation in practice, and it involves patient registration, verification, and claim submission for the final reimbursement.
The efficient RCM improves cash flow, avoiding dental billing mistakes and reducing overhead costs that lead to delayed payments and claim denials.

The Role of Dental Billing Services in Dental Practices

• According to the American Dental Association, many claims get declined due to coding errors, incomplete documentation, or inaccuracies in patient information.
• Collaboration with RCM providers like Capline Services and dental practices can minimize errors and enhance the likelihood of clean claims on the first submission.
• Utilizing dental billing services empowers the dental practice and guarantees accurate claim processing, resulting in accelerated RCM. The services provide revenue cycle analysis and equip practitioners to reflect on insights for further improvements.

Efficient Dental Billing Services result in efficient RCM:

Eight key areas for dental practices to target that result in improved RCM.

Patient Registration:
Before every patient enters the doctor's clinic, verify and update the existing information. Incorrect or missing date of birth, wrong payer details, incorrect insurance identification number, and a missing middle initial, all these inaccuracies snowballed into a crisis. Accuracy at this point is crucial, and confirming all these details helps deliver the best care.

Eligibility Verification:
The practice staff contacts the patient's insurance company to verify the policy status, provider network status, procedure and visit coverage, prior authorization, and patient financial responsibility. This proactive approach does not neglect the insurance verification benefits that can result in claim denials and revenue loss for the practice if not checked properly. Patient satisfaction is highly dependent upon the verification process.

Patient Check-in, Check-out:
A seamless workflow can facilitate communication between two departments, the front desk staff and the team handling referrals and prior authorization.
This effective communication ensures that when patients check in at the front desk, staff members are ready with the insurance verification details and can access details related to copayments or deposits needed during the patient's appointment.

Dental Coding:
Billing and coding require meticulous documentation with all essential elements in the patient chart to bill for specific services. Each CDT code must match the corresponding procedure. The team is pivotal in ensuring CDT codes are correct and aligned with the diagnosis code. If there are discrepancies, they should be rectified at the review stage, as they are the primary reason for claim denials.

Claim Submission:
The billing team should double-check whether the claim is accurate and complete before sending it to the insurance carriers. Different insurance companies have different requirements for claim submission.
The billing staff should have the information that each insurance company wants, as incomplete and incorrect claim forms can lead to claim denials and rejections, causing unnecessary delays in the reimbursement for the rendered service.

Keep track of payer decisions:
After the claim submissions, the practice has to monitor the payer's decisions about the claim. It should start by confirming whether the claim is submitted. If there are unsubmitted claims, resolve the issue as per the requirement.
The proactive approach focuses on denied or rejected claims, as these claims have errors that need attention before resubmission. Prompt action can improve reimbursement.

Patient Statements:
Explanations of benefits from the insurance company can outline the claim covered, the patient's financial responsibility, and any denied or rejected codes with specific reasons. The patient statements can help the practice send payments to patients. The dental practice must verify adjustments with the result that they are applied accurately to the patient's account before distributing the statement.
A regular schedule for creating and sending patient statements is a good practice to avoid payment delays.

Managing Collections:
Working through the receivable reports is a way to identify the gaps and address the collection issues. Substantial collections depend upon the practice's sharp clinical judgment and effective collaboration with Capline Services to address the challenges.
The resources and support can help achieve success and expand the RCM.

Strategies for seamless Dental billing services:

Create Financial Protocol
Creating a financial protocol is crucial for establishing clear patient expectations. It defines the payment handling process with all the details and payment options. Communication about the fees, insurance coverage, and payment expectations can help the practice to minimize delays.

Investing in Advanced Technology
The practice should harness the power of automation tools and not cling to outdated systems that affect RCM efficiency and result in costly errors.
For instance, practice management software can handle the operations. Automation can handle the stages of the RCM, such as appointment scheduling, claim submissions, and payment reminders.

Regular Audits
The audits identify the inefficiencies in the RCM, whether conducted internally or with external consultants. The thorough audits bring confidence to uncover issues such as delayed insurance
reimbursements, coding errors, and underpayments, and help make decisive improvements in the billing processes.

Training and Development for Staff
Billing and coding are pivotal for the RCM, thus impacting the practice's success. A single error can cause delayed payments and claim denials that are enough to disrupt cash flow and erode patient trust.
The training about the updates related to dental codes, insurance policies, and claim submissions ensures compliance and minimizes dental billing errors.

Outsourcing RCM:
Managing RCM in-house can result in challenges while taking care of the patient. The solution lies in collaborating with companies like Capline Services. The dental practices can concentrate on providing patient care while the professionals handle the billing and collections. The experts are skilled with the latest industry regulations, ensuring claims preciseness and empowering the practice to tackle complex payer requirements, thereby reducing administrative burdens.

Avoid Dental Billing Mistakes for Maximizing Dental Billing Services:

• Uncollected revenue or low insurance collections are the most common issues the practice has to solve. Submitting clean claims and quick appeals is a way to increase insurance collections.
• Outdated billing practices cause costly outcomes that tank dental profits. Automation and advanced technology can help organize billing processes.
• A dedicated team of experts in Capline can handle the RCM and tedious billing tasks.
• The practices lose a lot of revenue due to a pile of unpaid claims. The solution is to work on the aging report, especially the unpaid claims older than 2 weeks.
• Billing tasks neglect the patients, and they can notice the rush of getting things done. However, automating these tasks can build the patient-doctor relationship.
• As per the report, the reason for fraud is predominantly the practices of employees. Partnering with Capline can reduce the risk of embezzlement and create stringent oversight for financial controls.