capline dental services

Five Dental Billing Mistakes Costing You Patients and Profit

What Is a Copayment or Coinsurance in Dental Billing?
What Is a Copayment or Coinsurance in Dental Billing?
December 13, 2023
Outsourcing Insurance Verification to Increase Revenue
December 27, 2023

Dental billing is a complicated process that can get worse if the practice indulges in outdated dental insurance billing practices or makes claims without adequate training. Billing errors create a loss in revenue due to delays in payments as well as deploying additional working hours to compensate for mistakes.  

It is the minute details including coding errors that are a cause for more probable mistakes. Such errors are a boon to insurance organizations as they benefit at the cost of the dental practice. It is hence imperative to identify and rectify possible mistakes early on and stop them from occurring in the first place. 

A thorough understanding of denial reasons as well as periodic training can help the billing team to ensure more accurate billing and a faster collection rate.  

Common dental billing mistakes made by practices

1. Incomplete or inaccurate patient data 

Incorrect information in insurance claims is a very common error in dental billing.  Such errors are detrimental to the cash flows of the business. It raises the probability of claim denials and causes a delay in payouts from the insurance company.  

In addition, denied claims from insurance companies correspond to an additional increase in the workload to identify and correct or appeal rejected claims.  

On average, a practice garners nearly half of the revenue through insurance companies and hence it becomes crucial to ensure precise and effective insurance billing that can help in a smoother revenue stream for the practice. 

Data entry errors must be avoided and this is possible as such mistakes can be effectively avoided by the billing team. Data that is checked and cleaned is the initial step to preventing billing errors and is vital to smoother insurance billing and a more profitable business.

2. Timely filing of claims  

Besides ensuring all claims are filed with the precise data, the practice has to make sure that all filing is done promptly. There needs to be a tried and tested protocol and process for filing claims. This must also be accompanied by a system that monitors the outstanding insurance aging report for the practice.  

Filing has its deadlines and insurance organizations have their guidelines when it comes to a stipulated timeframe for submitting dental claims. Hence, delays in submission can lead to a delay in payments or even missing out on a payment.  Ideally, filing must be done within a working day.

3. Coding errors 

A regular factor for a poor collection is coding errors. This is a tough phase in dental billing. It is known that CDT procedure codes are constantly evolving and keeping up with all changes can be a challenge.  

This calls for regular training on coding for the billing team. Errors due to coding often lead to claim denials. However, one can inadvertently get penalized for fraud by using the wrong codes. Such events can cause a dent in the reputation of the practice.

4. Lapses in the insurance verification 

The process of insurance verification is about regularly correcting and updating the information about the patient’s coverage and eligibility before the commencement of treatment. 

Moreover, incorrect data collected for insurance claims can lead to billing errors.  Checks and balances need to be established for the verification of all data periodically. Getting this step right paves the way for the entire billing process till collection as this determines whether claims will get passed or rejected.  

Most importantly, making sure all patient data is precise and verified keeps the patients happy and aware of their entitlements and benefits.

5. Pressures on the billing team  

Handling the incessant and strenuous demands of dental billing and doing it right is a  huge pressure on the dental staff. This calls for a considerable amount of effort and time. Such a focus could disrupt other administrative workloads and other processes at the dental practice.  

When the team is stressed, it can lower the quality of the patient experience. If the team strength is not adequate then the strain could increase. Billing errors that lead to claim denials lead to additional work for a busy team. Duplication of efforts as well as damage control is a drain on the team’s energy and motivation levels.  

Automation of patient billing systems can lead to enhanced revenue cycle management as well as streamlined workflow. The team can focus on managing the patient experience instead of continuous efforts on billing accuracy and patient receivables. 

The practice can outsource billing and revenue cycle management to experts who can implement an automated patient billing system that can be a viable and profitable decision in the long run.