Dental billing services involve the expertise of professionals to administer the financial aspects of a dental practice. This work includes confirming patients’ insurance benefits, accurately coding dental treatments, preparing and submitting claims to the insurance company, posting payments, appealing denied claims, and managing patient billing and collections.
The purpose of dental billing services is to enable and assure timely and accurate reimbursement for the dental services provided, and facilitate fewer errors and denials of claim submissions. Furthermore, it manages recordkeeping of financial details while allowing the dentist to practice without the additional management of the business.
The Main Functions of Dental Billing Services are:
1. Insurance Verification
Before rendering services, it is important to review a patient’s insurance to avoid having the claim being denied or charges for the patient. Insurance verification break down what the plan covers. These can be coverage, benefits, co-pays, deductibles, and annual limits.
2. CDT Coding
Utilizing the appropriate Current Dental Terminology (CDT) codes streamlines documentation of dental procedures. This process will help to more quickly achieve claim processing, while avoiding costly errors.
3. Claims Preparation & Submission
This process involves gathering all data from treatment and the patient, attaching supporting notes, and submitting claims properly based upon the insurance company’s regulations, electronically or paper submitted.
4. Payment Posting
Payments which are received from insurers and patients are recorded. This process includes writing off any amounts that are eligible, as well as tracking patient account balances. It is an important part of the financial reporting process and is useful for identifying issues quickly.
5. Denial Management
When a claim has been denied, staff will examine the explanation for the claim denial in the EMR (electronic medical record). An example of a claim denial would be due to missing information or a coding error. In any case, the issue must be addressed on a timely basis to recover the lost revenue.
6. A/R Follow-Up
This task involves an activity designed to instigate the collection of unpaid claims from an insurer or the patient. These activities may include a review of claims status, subsequent follow-up on denials, and often reminders or even a direct contact with a patient. A timely follow-up generally results in a shorter revenue cycle and quicker flow of cash.
7. Patient Billing and Collections
An invoice is sent to the patient once insurance payment is received, if there is any remaining balance. Good communication and options for payment will assist in completing the collection cycle for the practice.
Why Dental Billing Services are Important?
Dental billing services are important to keep a dental practice financially healthy. These billing services submit accurate claims to insurance payers, receive timely payments from insurers, and bill patients correctly which are all vital for a steady cash flow. With insurance policies and codes frequently changing, the prospect of managing the billing process in-house can become overwhelming. Nonetheless, it becomes increasingly prone to mistakes and takes up a lot of time.
Professional companies that provide dental billing services will manage and oversee the entire revenue cycle for the practice, manage the entire billing requirements, reduce administrative responsibilities, and reduce claim denials. Most importantly, they ensure the dental team focuses primarily on what truly matters which is quality treatment while providing peace of mind in knowing the practice is maintaining compliance, paid appropriately, and financially healthy.
Why Hire a Professional Dental Billing Company
1) Fewer Errors:
Professional billing services have expertise in dental procedures, billing codes, and insurance documentation requirements. This expertise minimizes the risk of denied claims due to billing errors or missing information, meaning more claims are approved and fewer errors so that payments are processed faster.
2) Faster Payments
Practices will receive payments faster when claims are submitted correctly and on time. After submitting claims for reimbursement, a professional billing company will follow up promptly on unpaid claims or delayed payments.
3. Complete Revenue Cycle Management
A professional billing company should serve as more than just a claims filing company. They should run the entire financial cycle from checking insurance benefits prior to an appointment, to sending statements to the patient, to collecting unpaid balance. This streamlines the entire billing process.
4. Decreased Overhead Costs
An in-house billing department can become expensive by hiring, training, and retaining staff and buying billing software, and keep pace with the constantly changing billing and compliance environment. Outsourcing billing allows for reducing these overhead expenses and simply pays for the utilized services.
5. Cash Flow
Practices can significantly enhance revenue efficiency by reducing claim denials and improve collection rates. Faster payment processing ensures a steady income stream. As a result, it will minimize financial disruptions.
6. Regulatory Compliance
Billing companies ensure compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations, CDT codes, and insurance regulation changes. This ensures practices keep the patient’s provider compliant limits, potential penalties and legal issues from arising billing errors.
7. More Time for Patients
Offloading billing to professionals allows more focus to patient care. A more engaged patient experience is a more satisfied patient and a more efficient practice and staff.
Why Outsource Dental Billing Services
Outsourcing dental billing is a smart investment from all angles. Primarily, it cuts down on overhead expenses by relieving the in-house billing staff. Instead, with expert billers, there is less room for error in claim submission and quicker returns on revenue. Thus, cash flow rises and delays are reduced. Outsourcing handles all aspects of managing the revenue cycle instead of just the claim submission part. In effect, it leads to more time spent providing for your patients. While billing companies stay updated on compliance and coding changes, they strike down on errors or denials. Outsourcing drives efficiency, minimizes cost, and promotes steady growth in practice amongst other things.
Outsourcing helps in cutting the billing cost by up to 80% and the hourly rates may drop as low as $7/hour. Access is not just provided, it gives the ability to steer the revenue cycle and pair each project with a leading expert in dental coding. Thereby, it should save time, reduce stress, and find better patient service.