While quality care and service must be the hallmark of any dental practice, focusing on revenue and collection is essential for survival.
A positive cash flow is essential to maintaining the practice and optimally utilizing expertise and available resources. Maximizing revenue through effective dental insurance payment management helps to deliver sound financial performance and achieve the desired goals of the practice. A few ways how this can be achieved are as follows:
In most cases, more than half of a dental practice's revenue comes through insurance claims. Hence, the team managing these claims needs to be experienced and skilled at ensuring all claims submitted are precise and as per norms. They need to know how to handle appeals, review the insurance aging report, and contest any denials received from the insurance company.
The practice can depend on in-house insurance experts to manage billing and collections and all things related to insurance reimbursements. This could result in not giving this team or individual any other administrative tasks so that they have adequate time to focus on insurance claims and collections.
The resident expert or team needs to be strong in quantitative skills and understand how insurance plans work with all their intricacies and clauses. They need to communicate this knowledge and understanding to patients and clarify all queries.
Since this team will be presenting the treatment plan to a patient, they need to inform the patient about the cost of treatment and how much the insurance policy will cover. The patient should also know about any copayments or out-of-pocket expenses that the patient will have to bear.
An advantage for the dental practice of an in-house team or expert is control as the results can be tangible. The amount of revenue coming to the practice can be measured or quantified. So the practice can then judge the efficacy and worth of this team or individual.
A major setback to the practice of depending on in-house experts is cost outlay. Such an option leads to high overheads. It can be an expensive proposition if the collection rate is low and revenues are not flowing as expected. As the billing and regulatory landscape is dynamic, the team must keep up with codes and rules that keep changing regularly.
Instead of depending on such a team, the practice can outsource such a critical function to a professional dental billing company. These outsourced experts are specialists who can provide the practice with complete control of insurance billing and collections and generally with much lower overheads.
The practice will get access to a remote team who are expert billers and can work daily on behalf of the practice to manage dental billing operations, get claims reimbursed, or argue for denials sent by the insurance company.
These experts can operate the dental software of the practice and thus their work can be reviewed and monitored. The team can also submit and track claims that the staff of the practice has created and sent to insurance companies.
The outsourced team can review the insurance aging report and work on getting all pending outstanding claims processed.
The practice needs to evaluate options for selecting the best specialist for this function by choosing a partner based on need, size, and budget.
Common observations across sectors reveal that the longer one waits for customers or patients to pay any bills due, the lesser the chances of getting paid by them.
Direct billing of patients fetches nearly half of the revenue for the practice. Since practices deal with patients directly and these patients also lead regular lives, chances of nonpayment are possible. This can be due to genuine reasons or otherwise.
Hence, the dental team must always insist on tactfully making upfront payments to patients. The team must make best efforts to ask them to make payments before they exit from the clinic and not send the bill later.
The dental team needs to complete the verification of insurance benefits based on the policy plan. Once this is done, an estimate of out-of-pocket expenses needs to be computed and shared with the patient. While this amount might fluctuate a bit based on actual treatment, the patients are at least aware of the tentative amount that would be borne by them.
Such a process of keeping patients informed on expected payments due by them will make it much easier for the dental team to receive payment from them on time and without much argument.
Besides communicating an amount due directly from patients, the patients need to know all the details of the insurance policy. When the dental team completes the insurance verification process, they will receive a complete breakdown of the insurance benefits.
These breakdowns are useful as they outline all dental procedures that are covered and the percentages they are covered. During the year, the patient might have already used some of these benefits elsewhere and the same needs to be informed to them.
As patients might not remember what the plan’s maximum is or any other benefits, the dental team can inform them about treatment coverage and items that are not covered by the plan. This will help in smoothening the payment flow.
A streamlined insurance verification process must not begin when a patient walks into the clinic for treatment. The dental team must verify patient benefits before their arrival for the initial appointment. Insurance verification aids in avoiding possible confusion about the
benefits of the insurance coverage and thus helps in avoiding any claim denials. This ensures a greater flow of revenue for the practice.
Insurance verification is a very mundane and repetitive process and the team might not be very excited about these tasks. Hence, a streamlined and organized method to navigate through this process can make the task seamless, and productive. The team needs time to verify the benefits due to patients and if they are up to date and active. This can prevent any unpleasant situations when the patient comes to the practice.
Insurance verification can consume time and needs checking of extensive details about the benefits that a patient can accrue from a plan. These include coverage percentages of various procedures, deductibles, copayments, maximums, and more. Verification software can help the team to complete the process with far greater accuracy.
Automation saves time, reduces human effort, and yields greater accuracy. The practice must invest in an efficient automated solution for dental patient billing. This can help reduce the usage of paper and postage. These solutions can convey all bills and dues to patients on their preferred devices. Automated patient billing solutions also offer patients various payment options, including bank transfers, cards, and wallet apps.
The practice can maximize revenue through effective dental insurance payment management that includes relying on automation, a smooth billing process, thorough insurance verification, and most importantly, highlighting the benefits of the insurance plan to patients and their expenses of the bill.
