Managing the revenue cycle is vital for any dental practice. It helps the practice to be profitable and keep patients and staff happy. A crucial component of the revenue cycle is submitting insurance claims to the insurance company. The team must submit claims once treatment has been rendered.
But it is important to note that the claims process does not end once the claims have been submitted. The dental insurance follow-up process and tracking payments start once claims have been submitted. The team can adopt a few dental claims management tips to track claims regularly and at every step of the way. It must then verify that payment has been received.
For any dental practice, a denied claim means a loss in revenue or delayed revenue. Over a period, this can lead to a large volume of claims denied if not meticulously tracked and monitored. The potential revenue loss can have an impact on any dental practice. Hence, the dental team must ensure that all denied claims are appealed consistently and at the earliest. Consistent follow-up through a structured dental insurance follow-up process helps maintain a steady cash flow. This will help to streamline revenue flows for the practice.
The dental practice can also consider the option of outsourcing dental billing and claims to a third-party specialist. This can also help in claim submissions, along with regularly tracking the status of claims that are due for reimbursement.
For a dental practice that has a team to manage the dental billing and claims submission, a few steps must be followed to effectively track claims. But before following a sequence of steps on how to track, the team must know a few basic reasons and causes for denials.
There are multiple reasons an insurance claim can be rejected. Once these causes are identified, the team can avoid making such errors in the future. Some dental claims management tips that can be adhered to for tracking claims are as below.
The dental team ideally needs to create and submit all insurance claims within 24 hours of the patient receiving treatment at the practice. This helps to kickstart the billing process, thereby helping the insurance claim to be sent to the insurance organization at the earliest.
This enables the dental practice to receive payment faster, as the claim process is initiated by the dental team within approximately 24 hours. The team must also ensure that no errors have been committed by oversight. Once the submission is complete, the tracking through the dental insurance follow-up process can then commence.
The dental team must be fully aware of the amount of time that has lapsed between performing the procedure, when the claim gets batched, and when that claim is sent to insurance for reimbursement. Insurance companies do not pay attention to timelines, and hence it is in the best interest of the practice that the dental team monitors the submissions carefully.
The practice can use the latest practice management software solutions available in the market to track and monitor critical dates. The team needs to regularly check that payment for all claims has been paid by the insurance company. Once claims have been submitted, the staff member assigned to the respective claims must check on the status within a few days. This activity must not be considered complete just because the claim has been submitted.
The billing team needs to monitor the status of all unpaid claims at fixed intervals. Claims that are submitted need to be added to the insurance ageing report. Claims will continue to feature in the ageing report till payment for the same has been received.
Many practices might not have adequately staffed teams. Common observations also indicate that most teams are stretched at work. There is also a tendency to keep putting things off due to a shortage of time and resources. This can turn into a problem for the practice. If claims are delayed, it can create irregular cash flows. This happens when the insurance ageing report has not been regularly monitored and worked on.
The team can consider designating a day of the week when the team spends time monitoring all claims on the insurance ageing report. It is advised that the oldest claims must be appealed or followed up with the highest priority. Hence, the ageing report must be sorted to record the oldest claims first, and the newest claims will be right at the bottom.
When the team reviews the ageing report every week, it gets easier to remain aware of all unpaid claims. This helps to ensure that all claims, especially the older claims, do not stay on the report for a long time and too long.
When the dental team is stretched for time, the dental billing and claims submission can be affected. It thus makes sense for a dental practice to hire a reliable outsourced partner in case the right resource within the team is unable to manage the billing and claims process.
Managing the billing and claims process needs a skilled person with industry-specific knowledge to navigate through claims and appeals. The person also needs to have adequate experience to minimize the possibility of errors while also deftly handling interactions with insurance organizations. Most dental practices do not have a dedicated full-time resource to manage the billing and claims submission process. This resource must be completely committed to managing the steering claims through the billing process from start to finish.
Many practices partner with dental billing services to streamline workflows, reduce administrative burden, and enhance overall claim success rates. The key benefit of outsourcing this critical function of billing and claims is the focus and expertise that a dependable partner can bring on board. They are seasoned insurance coordinators and adept at billing and the intricacies that come along with it. The outsourced team will accord the highest priority to timely billing and meticulous monitoring of claims submission.
Thus, a practice can look at the insurance ageing report as an important source of cash flows that can help it to stay sustainable and profitable. Hence, the practice can harness the benefits of higher collections and a negligible ageing report due to timely submission and tracking.
For any practice, a focus on the revenue cycle can make a difference to cash flows. A timely submission of claims to the insurance companies is important to keep patients happy as well as to stay profitable. The practice must invest in resources to ensure that billing and claims are submitted on time. The resource also needs to be trained and experienced in billing practices and interacting with insurance companies. This can then bring about consistent results in line with the expectations of the practice.
