The financial success of every service-based business is inherently tied to its ability to bill for the work being produced, often referred to as revenue cycle management. This holds true for dental practices of every size and shape, but most especially for small independents. If you don’t have the systems in place to invoice and collect on the hours you’ve invested, your short-term stability and long-term growth are in jeopardy.
This article will discuss those processes at length, but it begins with a component far too many offices are overlooking: new CDT’s. The cost is roughly $90 each year, and it is well worth it.
In 2019 alone, 19 new dental procedure codes were introduced. If you don’t know what they are, you are failing to take advantage of the opportunity to offer and bill for new allowable services. In addition, there are new codes for services you’re already offering, and if your team doesn’t utilize the new codes, your claims are denied and your collection process delayed.
The takeaway? If you don’t have the new CDT materials, get them. If you do have the materials, assign each associate in your office one or more of the codes to research, study, and present them to your team. It is more than likely you will find at least one new service to offer and build your practice.
Now let’s discuss the services that you’re already offering. Are you maximizing your opportunities to collect on the work you and your clinical staff are performing daily? Odds are, the answer is no, because either the right systems aren’t in place or they aren’t being utilized.
Those systems are:
1. Co-payment collection before the patient goes back to the operatory.
This requires that insurance has been verified, a treatment plan created and shared in advance of the appointment, and the patient prepared to make that payment. It also requires staff being ready to ask for that co-payment, confident in knowing it has been previously discussed.
2. Proper—and prompt—claims submittal.
Claims should be submitted a maximum of 24 hours after the patient appointment, and every claim needs to be filled out correctly. All insurance carriers require your license and tax ID number, as well as patient identification numbers, dates of birth, correct dental procedure code(s), etc. A solid narrative and any supporting attachments should also be collected or created and attached to that claim before submission.
3. Ongoing insurance carrier follow-up.
Fourteen days after submitting a claim, your financial team needs to be following up with the insurance carrier by phone. By then, the carrier will have the claim in process. A quick status call allows for rapid correction of a claim if needed and further expedites processing — no waiting 30 to 60 days or longer for insurance funds.
4. Posting claims and billing immediately.
When payment is received from the insurance provider, it needs to be posted same-day, and any unpaid balance billed. Dental offices that only issue statements on a monthly basis not only delay payment but actually reduce the likelihood of receiving it. Your office should be producing and mailing statements daily.
5. Have a plan and process for past-due accounts.
Every dental practice ultimately has to deal with past-due accounts. Having a standard process to deal with those accounts is a necessity. As with billing, this process should occur not once a month, but triggered based on individual patients. Reminders, collection letters, and finally correspondence detailing a timeline and future actions, and finally a referral to an attorney or collection agency should all be a part of that systematic contact process.
Putting these critical systems in place improves your opportunity to receive payment for the work you and your team are producing is compromised. Emphasizing them is worth the time and resources you invest, as they will grow your profits today and strengthen your bottom line for years to come. To learn more about revenue cycles, download our free Revenue Cycle Management eBook. For more recommendations on how to improve collections and streamline your practice, consider conducting a practice analysis with an expert from our Avitus Dental Management Services team.