8 Solid Reasons to Outsource Your Dental Billing, Insurance Verification and Claims Processing

A dental practice is a business like any other, meaning that you need to pay attention to your bottom line as you focus on your main goal of providing high quality care. It’s necessary to generate adequate revenue and profits to build a successful dental practice and keep it running smoothly. However, dental practices have to deal with many challenges, from administrative burdens and regulatory changes to insurance reimbursement challenges. Outsourced dental billing services are an efficient way to handle these challenges. Partnering with an expert will ensure you get compensated for services rendered and increase practice revenue.

The common billing challenges that dental practices face are:

• Administrative burdens and obstacles due to complexity involved in filing claims, the multiplicity of insurance plans, and varying payer rules and requirements
• Regulatory changes, new technology requirements, increasing administrative burdens, changing marketing needs, and declining reimbursements
• Uncollected insurance revenue– in an average dental practice, uncollected insurance revenue is reportedly around 9% of the revenue it generates annually

Dental office staff can be easily overwhelmed by this revenue cycle management (RCM), leading to delayed and denied payments and high accounts receivable (AR). All of this will ultimately impact the overall patient experience.

Why Outsourcing Dental Billing makes Good Financial Sense

An efficient way to handle these challenges, get compensated for services rendered, and increase practice revenue is to outsource the dental billing process. Having an experienced dental billing company manage these processes can reduce costs, optimize core competencies, and boost overall efficiency.

Here are 8 solid reasons to outsource your dental billing:

1. Expert team on your dental billing project: In professional dental billing companies, coders and billing specialists stay current with evolving industry regulations, payer guidelines and continual updates in CDT, ICD, CPT, and HCPCS codes by making the most of training opportunities.

2. Accurate and timely claims processing: Entrusting an experienced dental billing company with your claims processing tasks can ensure that coding and billing processes are handled efficiently and without delay.

3. Verifications and authorizations done ahead of schedule: Dental insurance verification is a critical part of the dental billing process. The front desk should have patients’ current insurance information ready ahead of their appointment. Verifying dental eligibility for new and returning patients is a time-consuming and tedious process that can take up precious staff time. Comprehensive insurance verification and preauthorization support provided by dental billing companies ensure that patient benefits are verified ahead of the office visit. This reduces the risk of claim denials and rejections, paves the way for timely reimbursement, and relieves stress for both the practice and patients.

4. Improved patient satisfaction: Outsourcing dental billing improves practice efficiency, and you don’t have to spend excessive amounts of time on your insurance billing. When you don’t have additional administrative duties to tend to, you can spend that saved time focusing on patient concerns, addressing them, and optimizing the patient experience. This will build trust and improve patient relationships.Efficient insurance verification support also plays a key role in improving patient satisfaction. Many patients have no idea how their insurance policy works. With proper dental eligibility verification, you can show them how to maximize their benefits. Importantly, educating patients about their coverage and copayments before they come in will ensure that ‘balance bills’ do not come as a surprise.

5. Saves money: Outsourcing saves money by:
   • Doing away with the additional costs of setting up additional infrastructure, recruiting, onboarding, and retention expenses
   • Eliminating worries about payroll taxes, benefits, vacation, or holiday pay. You save on training and equipment costs.
   • Ensuring a more flexible team that can scale up and down when your volume/needs change.

6. Frees up your staff, improves practice efficiency: Dental office managers and staff have many duties to handle every day, with the overall goal being to build an efficient practice that delivers excellent patient care. They must answer telephone calls, manage patient appointment scheduling, answer patients’ questions and help them fill out forms, prepare patient charts, update patient records, create daily schedules for the dental staff, schedule follow-up appointments, arrange referrals to other dental specialists, and much more. Handling insurance verification and billing in addition to these responsibilities can leave your staff feeling stressed and burned out, lead to errors, affect productivity, and have a negative impact on patients.Dental billing services come to the rescue by reducing the workload. Having these important and time-consuming tasks handled by experts ensures that they are handled efficiently. With less time spent on the phone, your staff can focus more on keeping appointments on track and meeting the patients’ needs, which will improve practice efficiency.

7. Reports to track your performance: Efficient tracking of your key performance indicators (KPIs) is essential to take steps to optimize your revenue cycle processes. An experienced dental billing company will provide reports that have the information necessary to monitor the health of your practice and keep performance on target.

Here are some reports that you can expect from a reliable dental billing service provider:

• Accounts Receivable Aging Report: This report shows outstanding insurance claims and patient balances as well as the number of days they were paid in and the length of time the amounts have been unpaid. It allows you to keep track of patient billing, get an idea of the total amounts owed, and when they are due.

• Key Performance Indicators Report: There are many key performance indicators (KPIs) in a dental practice, such as debt rate, gross collection rate, net collection rate, resolve rate, denial rate, outstanding Accounts Receivable, unbilled claims percentage, etc. Tracking and constantly analyzing (KPIs) is essential to understand how your practice did in the past, is performing at present, and predict how it will perform in the future.

• Insurance Analysis Report: This report lists the top payers and CPT codes, units, payments and collections. It will help a dental practice identify how carriers are making payments, renegotiate better contracts, and make informed decisions.

• Payment Trend and Collection Report: These reports show you how much you billed and collected and how long a claim has remained unpaid.

• Patient Payment Report: This report provides information on collections and helps you understand how much patients owe.

8. Dedicated denial management: If you think a claim has not been properly adjudicated your dental billing company can help you resubmit it and appeal the benefit decision. Appeal processes vary among payers and considerable knowledge is necessary to manage the complex claim denials. Experienced dental billing professionals respond to and work on denied claims using the best practices and strategies.

Making the Outsourcing Decision

Many dentists have apprehensions about outsourcing major processes such as dental billing, revenue cycle and accounts receivables management. Having a third-party vendor handle sensitive financial tasks can seem risky. But these fears are largely unfounded. When you partner with a reliable dental billing company, you can rest assured that your billing will be timely and efficient, maximize revenue, and ultimately help your practice achieve long-term financial success.