Why is dental billing important?

How do I increase collections in my dental office?
November 14, 2022
Is dental billing difficult?
November 14, 2022

Dental billing can make or break your dental practice. It is a complex process, and even the slightest error can cause huge revenue loss. It is vital to entail what dental billing is and the scope of the process, as it is a determining factor in the practice’s cash flow. 

What is dental billing? 

Dental billing is submitting the claim to the insurer for timely reimbursement per the patient’s insurance plan. The health of your billing system is a team sport. That also ensures the correct CDT  codes while submitting the claim and ends when the provider receives the payment from the insurer.  However, it comprises many steps, and even the slightest miss results in payment delays from the insurer. 

Your practice likely works from the clinical team to the provider to the billing administrator to fulfill all the components that can help optimize the revenue cycle. Periodontal charting,  radiographs, clinical notes, etc., ensure you have up-to-date information that allows you to submit an accurate claim and get timely paid. Another challenging step is verifying the claim information,  including the insurance information, subscriber information, and CDT codes. 

Claims denied due to missing or incorrect claim information are unnecessary delays in the payment. 

Why is dental billing crucial? 

As per statistics, nearly 65% of dental practices participate in dental insurance. Around 50% of the adult population in the United States utilize dental insurance for their treatment. Hence, the dental billing process is key in revenue cycle management. On average, a dental practice loses nearly 9 percent of the collectible revenue in the dental billing process, regardless of the size of the dental practice. 

That is a common source of confusion, so it is beneficial to have dental billing professionals in your corner. Doing a good job requires expert-level knowledge of the coordination of benefits, patient payment responsibility, calculation of write-offs, documentation for specific procedures, updated codes, how to appeal denied claims, posting all payments promptly, and reports. 

Common myths causing unnecessary complications in your practice 

  • Many practices feel that dental billing is just the process of submitting claims. However,  there are many other components like copayments before rendered service, information about a patient’s insurance and coverage, and verifying the details. Getting all the information ensures you receive the patient’s portion at the time of service. 
  • Patients have to have separate dental insurance plans, which means specific procedures get  covered by medical insurance. That means the process covered under medical insurance is  medically necessary; cosmetic dental treatment is not a viable option in their regular health  insurance plan. To make your’s and your patients’ lives easier, get an adequate understanding of billing medical insurance as a dental provider. 
  • There are not equal resources available in the dental industry compared to medical billing to help in the dental billing process. 
  • Outsourcing is a short-term solution. Many practices prefer outsourcing to a third-party company to save money on technology, training, and staffing. That also ensures timely cash flow by scrubbing claims before submitting for accuracy and time saving as professional billing staff that are experts with all the necessary information related to the dental claim.

Master the Dental Billing Process 

Ensure that your team has an understanding of the billing process that includes: 

  • Patient’s eligibility, 
  • Collection of the patient’s payment portion, 
  • Sharing the procedure and the diagnosis codes for each visit to avoid any discrepancies,
  • Verifying the CDT Codes are correct or not, submission of claims electronically, and
  • Receive the reimbursements from the insurance company. 

Know your patient and do not assume that the patient always knows what amount they have to pay.  Sometimes they get confused by their insurance plans, deductibles, copays, etc. 

Always have some option for the payment to avoid follow-up over the phone or email. 

The most common mistakes found in a claim form are as 

  • Incorrect patient names.
  • Dates of birth.
  • Wrong addresses.
  • The incorrect contact information of the service provider.
  • Incorrect insurance information.
  • Handwritten documentation.
  • Incorrect claim number information on the appeals.

That can affect the financial health of the dental practice.