The dental practice’s primary focus is providing excellent patient treatment to ensure smooth, efficient, and maximum revenue. The critical area is dental RCM which refers to practices finances from patient billing to collections.
It looks simple, but dental RCM includes a range of tasks such as scheduling, appointment, insurance verification, eligibility checks, treatment planning, claim submissions, insurance and patient payment collection, account receivable, and total revenue analysis that directly affect the practice’s financial health.
Here are top dental strategies to improve dental practice revenue and reach the breakeven point as soon as possible.
Verify patient eligibility:
To optimize your RCM, insurance verification is a vital step. It starts before the date of service, which is scheduling appointments and gathering insurance information. Before seeing the patient, the office knows the patient’s financial responsibility, dental coverage, and active advantages.
For existing patients, the office verifies the insurance plan and, if there is any update in the information, what are the active coverage and dental advantages?
For a new insurance plan, repeat the entire process of insurance verification to avoid the situation where you send the bill to the insurer, and they return stating the service does not cover in the plan.
Follow up on the contracted fee schedule:
Dental business profit depends on patient satisfaction and retention. Therefore, setting a fee that positively impacts the ROI for dental treatments will boost your billing numbers exponentially. Adjusting the fee schedule can provide extra revenue rather than fixing a percentage. As per ADA, the cost of infection control and personal protective equipment will rise for dental procedures. That makes it even more necessary today to review and readjust the fee schedule.
Create effective payment policies for the patients:
Practices should collect the payments for the services rendered. No matter how good care the practice offers to the patient or how large the footfall is, the dental practice will not be able to generate revenue if they do not manage the payment.
Patients’ copays and fees should get collected at the time of service. A proactive payment strategy like biweekly, weekly, or daily reminders, an incentive for early payment to keep the cash flow consistent and patient’s obligations get met. The dental revenue cycle changes exponentially as and when the patient understands their financial duties.
Clean claim submission process:
Having a system that ensures all the claim submissions are in place as the overall financial growth of the dental practice depends on the reimbursement. Submitting claims daily, and a way to check the accuracy of claim submissions before they get submitted. Another way is to track the submitted claim instead of walking away from the situation and send notifications to the insurer if necessary.
To fix the denied claim quickly, review and identify the issue and then go for an appeal after making the updates to avoid the delay or non-payment scenario.
Correct coding:
Correct coding is essential to the dental billing claim. The American Dental Association (ADA) has given a list of codes depending on the dental process, and it keeps everything moving in a timely direction. The list is annually updated. Each of these code sets has a purpose, and if you have devoted personnel to handle the dental billing, it is mandatory to keep up with the codes to minimize the chances of claim denial, delay, or no reimbursement.
Delayed payments play a vital role in the non-operational situation of the dental practice and are a challenge to the RCM process. So, if the reported code does not match the performed procedure, it may result in an allegation of fraud.
Outsourcing the dental billing process:
All the above strategies ensure RCM optimization allowing the dental practice to grow and maintain a healthy cash flow. However, today many dental professionals are considering outsourcing to dental billing companies so that they have enough time to provide quality patient care.
Dental billing companies alleviate the RCM challenges by introducing certified experts with years of experience to generate more revenue. The methodologies are effective for dental clinics.
