The primary function of all dental practices is to provide oral health care to patients. It is essential for the practice to become financially successful. Proper coding is critical for successful dental billing as it accelerates claims approvals, ensures on-time payments, and reduces denials.
Coding errors lead to substantial stress as well as loss of revenue. According to the American Medical Association (AMA), it is estimated that these mistakes cost the US healthcare system $36 billion annually.
Understanding Dental Billing
Professional billing experts provide dental billing services that involve administering the financial aspects of a dental practice. It includes confirming patients’ insurance benefits, precisely coding dental treatments, preparing and submitting claims to the insurance company, posting payments, appealing denied claims, and managing patient billing and collections.
Expert dental billing services enable timely and accurate reimbursement for the dental services provided. Additionally, it helps avoid errors and denials of claim submissions. Furthermore, specialists manage recordkeeping of financial details while allowing the dentist to practice without the additional administrative burden.
Key Functions of Dental Billing
1) Insurance Verification
It is important to review a patient’s insurance before providing the services. This will help to avoid claim denials or making the patients pay for any changes. The process of insurance verification takes care of the coverage, benefits, co-pays, deductibles, and annual limits.
2) CDT Coding
Appropriate use of Current Dental Terminology (CDT) codes makes the documentation process of dental procedures smooth leading to faster claim processing.
3) Documentation
Patient documentation ensures precise claims, timely reimbursements, and compliance. These along with insurance data, and treatment notes help prevent errors and reduce denials.
4) Claims Submission
This process involves gathering all data from the treatment and the patient. It also includes attaching supporting notes and submitting claims properly based upon the insurance company’s regulations, electronically or paper submitted.
5) Payment Posting
Payments are recorded that are received from insurers and patients. It includes writing off any amounts that are eligible. It is an important financial reporting process and is useful for identifying issues quickly.
6) Denial Management
The billing staff will examine why the claim was denied. For example, a claim denial would be due to incorrect information or an error in coding. In any case, to recover lost revenue, the issue must be addressed on a timely basis.
7) A/R Follow-Up
It is the process where unpaid claims from an insurer or the patient are collected. It may include a review of claims status, following up on denials, and sometimes reminders or even a direct contact with a patient. A timely follow-up results in a shorter revenue cycle and fast cash flow.
8) Patient Billing and Collections
Once the insurance payment is received, an invoice is sent to the patient. It can be dent via email or through paper work.
Importance of Dental Billing Services
Dental billing experts help submit precise claims to insurance payers, ensure timely payments, and bill patients correctly. These are all vital for a steady cash flow. As the insurance policies and codes frequently change, it can become an overwhelming prospect to manage the billing process in-house.
Professional dental billing companies manage and administer the entire revenue cycle for the practice. Additionally, they manage the entire billing requirements; reduce administrative responsibilities, and cuts down claim denials. Most importantly, with the help of medical billing professionals, practices can have peace of mind while providing quality patient care. Moreover, experts help in maintaining compliance, make sure practices remain financially healthy and are paid appropriately.
Why Hire a Professional Dental Billing Company
In order to achieve clean claims and faster reimbursements with fewer errors, hiring a professional dental billing company can be a good option. These medical billing professional stay updated with the latest rules and regulations. Here’s why to hire an expert dental billing company:
1) Fewer Errors
Dental billing experts have robust knowledge of dental procedures, billing codes, and requirements in insurance documentation. As a result, it minimizes the risk of denied claims due to errors in billing or missing information. It leads to more claim approvals and fewer errors, which leads to faster processing of payments.
2) Faster Payments
When claims are submitted correctly and on time, practices will receive payments faster. A professional billing company follows up promptly on unpaid claims or delayed payments after submitting claims for reimbursement.
3) Revenue Cycle Management
A professional dental billing company covers checking insurance benefits prior to an appointment, sending statements to the patient and collecting the unpaid balance. As a result, it streamlines the entire billing process.
4) Reduced Overhead Costs
It is expensive to run an in-house billing department as the process involves hiring, training, and retaining staff. Additionally, it requires keeping updated with the ever changing billing and compliance environment. When the billing is outsourced, it allows practices to reduce these overhead expenses and only pay for the services utilized.
5) Cash Flow
When the claim denials are reduced, practices can significantly enhance revenue efficiency and improve collection rates. A steady flow of income is only possible when the payment process is faster, leading to fewer financial disruptions.
6) Regulatory Compliance
Billing professionals ensure compliance with the Health Insurance Portability and Accountability Act (HIPAA) Act, CDT codes, and insurance regulation changes. It helps remaining compliant; reduce penalties and legal issues from billing errors.
7) More Time for Patients
Outsourcing billing to experts allows for reduced administrative burden for the practices and more focus on patient care. As a result, patients can be satisfied due to increased engagement.
Why Outsource Dental Billing Services
Outsourcing dental billing is a smart investment from every angle. Primarily, it cuts down on additional expenses by relieving the in-house billing staff. Expert billing experts help in reducing errors in claim submission and faster returns on revenue. This leads to increased cash flow and reduced delays.
Outsourcing manages the revenue cycle in a proper and seamless way. While billing companies stay updated on compliance and coding changes, they reduce errors and denials. It can help minimize operational costs by up to 80% with rates starting as low as $7 per hour. Expert billing teams drive efficiency, reduce cost, and help in steady growth.
