Maximizing Revenue: Best Practices for Dental Billing and Collection

While quality care and service can help build a dental practice's reputation, revenue keeps the business going. A dental practice must follow a few steps that can help maximize revenue through billing and collection.

Getting a System and Process in Place

• Build a robust and rigid billing system – The dental team can streamline the entire billing system if the practice invests in quality dental billing software. These solutions can handle the whole spectrum of billing and claims submissions for the dental practice.
• Ensuring Higher Accuracy in Documentation – All documentation performed by the dental team across processes needs to be precise as this is how the practice can avoid unnecessary claim denials and delays in reimbursement. The practice needs to spend time and resources on staff training since billing requirements involve codes and capturing an accurate record of events, diagnoses, and pertinent patient information.
• The practice can also conduct periodic audits that can recognize any gaps in capturing the necessary documentation gaps as well as ensure adherence to all compliance norms when it comes to insurance claims.
• Verification of the patient’s policy details – The dental team needs to verify the patient’s insurance coverage and benefits before it renders any service or procedure to a patient. Such a step helps to keep the patient informed about coverage of any recommended procedure and if any out-of-pocket expenses need to be borne by the patient. The team also stays compliant with the No Surprises Act.

Streamline the Claims Submission

• Timely submission of claims – As a rule, the dental team must submit all claims immediately after providing service to the patients; this improves the probability of getting reimbursed quickly. The practice needs to rationalize or introduce processes that can aid the billing team to ensure that claims are submitted to the insurance company within two days. A point to consider for dental insurance reimbursement is that timing is critical.
• Clean Claims Submission – The dental team needs to submit clean and accurate claims to get accepted by the insurance company. Claims sent by the team need to be error-free and accurate. This ensures that the insurance company accepts the claims and processes the same for reimbursement.
• The team needs to thoroughly check all details including patient information, procedure codes, and any supporting documentation, to ensure accurate submission. In case of a claim denial, the team needs to appeal the denial and ensure that all the necessary documents and information are collected and checked before sending the same again.
• Regular follow-ups on pending claims – The dental team needs to keep track of all pending claims and ensure that regular follow-up is done with insurance companies. This will help to reduce claims on the aging report by expediting the reimbursement process. Such an approach aids in minimizing delays in claims and enhancing cash flows.

Managing the Revenue Cycle Management Effectively

Appropriate Fee Schedule – The practice must instill a comprehensive fee schedule for patients that echoes and justifies the value of services provided to them. The team must regularly evaluate and update its fee schedules based on prevailing industry standards and competitive benchmarks regional benchmarks.

Efficient Patient Billing – The practice can simplify the patient billing process in terms of understanding the bill through clear and concise statements. The patient must be offered various payment options to enable faster and timely payments. The practice should ensure transparency about insurance coverage based on the patient’s policy as well as any out-of-pocket expenses that the patient needs to pay.

Team training – The practice needs to ensure that the dental team undergoes periodic training and that he staff is made aware of the latest regulatory guidelines and procedures. This helps to ensure that the team has the expertise to handle intricate billing scenarios as this can help to maximize revenues. There are multiple ways for the team to get trained including seminars, online courses, etc.

By combining a well-structured fee schedule, streamlined patient billing, and a well-trained staff, dental practices can lay the foundation for effective revenue cycle management. These efforts not only enhance cash flow but also reduce billing errors and improve overall financial health. Prioritizing each step in the cycle ensures long-term sustainability and profitability for the practice.

Reviewing patient billing metrics with the outsourced partner

When deploying the billing function to outsourced specialists, the practice needs to clearly define the roles and responsibilities of the team. Success metrics and other measurement criteria need to be discussed with the respective teams.

The practice also needs to set clear expectations between the outsourced team and itself to ensure that both parties are aligned and working towards common objectives. Setting clear goals and metrics can help to evaluate performance and progress. The practice can fine-tune the operational processes to ensure productivity and ROI.

Maximizing patient billing solutions

Leaning on consumer insights to automate the patient billing process can hold the practice in good stead. An understanding of consumer demands can act as a starting point. What payment options do patients want and how frictionless can the payment experience be? Convenience, safety, and security are vital as this increases patient trust and improves collection rates.

Some other elements that need to be considered include

• Complete automation that includes initiating patient billing statements, payments, etc.
• Multiple payment options across cards, wallets, etc.
• Seamless integration with the existing practice management software • Branding option for the software
• Finance options
• An anywhere access dashboard that can be monitored by the team at any time, from anywhere
  The practice must establish a collaborative relationship with the outsourced team’s point of contact.

The practice need not rigorously communicate with the point of contact. One can also provide adequate space to operate flawlessly.

The objective of the practice is to ensure that the point of contact must act as an extension of the internal dental team. This collaborative approach can help to achieve revenue goals as well as patient satisfaction.
For any practice, the dental billing and collections process can be a challenge. To ensure the best interests of the practice such as revenue, operational efficiency, and patient experience, the practice needs to follow a few best practices suggested for billing and collection. These could include an investment in billing software. A focus on streamlining processes and team training are among other measures that can be utilized.