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Top 5 Reasons Your Dental Claims Aren’t Getting Paid

Are you looking to increase your dental practice cash flow? One area of business that heavily impacts monthly production is the dental insurance claim process. A very time-consuming, tedious process, dental claims may not be getting paid due to several reasons, but almost always begins with lack of follow up with the insurance companies after submission.

  1. The dental claim didn’t make it to the insurance company.

Many times, dental claims are submitted electronically and staff don’t check to see their rejections report or if an area of the claim is incorrect. The issue lies with the quality of the information.

  1. The dental claim is missing complete clinical documentation.

Insurance companies require a detailed clinical report and narrative depending on the procedure. The dental claim may be missing narratives or x-rays, and there isn’t enough documentation on clinical notes for reimbursement.

  1. The dental claim was submitted with bad information.

Sometimes it’s as simple as poor information from the patient or a mistake inputting information on the staff’s behalf (i.e. birth date, address, social security number, etc.) Always verify eligibility information before the patient sits in the chair.

  1. The dentist’s credentialing is out of date.

If the dentist’s credentialing is out of date, insurance companies hold onto the claim. Manage your renewal closely and start the credentialing update process at least three months ahead of time to ensure ample time for completion.

  1. The insurance payment has been completed, but hasn’t been posted.

 

Often, the claim has been submitted and payment from the insurance company has been sent, but a bottleneck is created at the posting phase. This happens when staff are too busy and the payment hasn’t been recorded in your software.

As we all know, dental billing management is a full-time job. Dental Support Essentials offers a turnkey Accounts Receivable solution for your practice from insurance eligibility checks, billing, follow up, appeals, and more! Trusting experts to manage your AR will save your staff valuable time and increase your reimbursement rate. So, what are you waiting for? I’d love to connect and discuss opportunities to streamline your dental practice!

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Top 5 Reasons to Outsource Dental Billing

Is your dental practice experiencing a low collections rate or low morale due to overworked staff? As the practice owner, you may recognize things need to change but feel stuck and don’t know where to begin. Don’t fret! An effective, non-invasive solution of outsourcing billing and insurance eligibility to experts can help your dental practice thrive with satisfied patients, content staff, and increased monthly production.

There are common signs to look out for that indicate your dental practice could benefit from outsourcing, including:

  1. When phone calls with insurance companies (to get a breakdown of a patient’s benefits) are taking up too much time from your dental staff. Lengthily phone calls can take away valuable time with patients and can negatively impact your business. If patient interactions are suffering, it’s time to outsource your eligibility so your front office staff can focus on what matters most.
  2. When the dental office manager says, she can’t get all her work done or refuses to take a lunch break and works overtime. This is a sign you need a second pair of eyes on your dental office’s books. The office manager is overworked and likely experiencing burnout, which increases the likelihood of her finding a new place of employment and leaving your dental practice in a bad spot. Outsourcing billing will allow your business operations freedom and not dependent on one person.
  3. When there is a big stack of EOBs that haven’t been posted or monthly production is taking longer than 30 days. There should always be less than a month’s production on the books for the said month. If it has been over 90 days old, you need to outsource.
  4. When your over-the-counter payments are not being collected by the front office staff because of competing demands (eligibility checking and billing). If these over-the-counter collections aren’t happening, it’s time to outsource.
  5. When you know you need a staffing change, but are afraid to act because your business hinges on your existing employees.

 

If your dental practice is experiencing any of these pain points, compare the financial impact of hiring an additional employee verse outsourcing. Hiring a billing manager requires a salary, benefits, employee management, etc. Outsourcing to experts such as Dental Support Solutions is paid on a percentage (3.5%) of monthly collections. If you have a slow month and collect less, you pay them less. It’s a smart, scalable solution to increase collections and decrease Accounts Receivable.

Outsourcing dental billing operations ensures that the practice can survive apart from any one employee and business can continue if an employee leaves. Outsourcing can remove fear and present you with another option. Don’t feel stuck! Dental Support Essentials works with dental practices to manage their eligibility and billing operations. Your Accounts Receivable will improve, productivity of your staff will increase and they’ll have more time to fill your schedule, since they won’t be bogged down by billing management.