Medical Billing for each specialty varies based on the intensity of the medical procedures and treatments, time involved during pre and post procedures. Dental billing is one such complex specialty with a separate set of codes “Current Dental Terminology (CDT)”. Billing process is comparatively difficult as not all healthcare policies cover for Dental Procedures, moreover, the rules and regulations for Dental Billing also vary which requires dedicated billers and coders who are trained and experienced to handle Dental Medical Billing. This article aims at detailing the key challenges of Dental Billing and ways to avoid them.
Key Challenges of Dental Billing
- Regular Updates And Changes in CDT Codes: CDT – the codes for Dental Procedures are regularly updated mandating the team involved to stay atop of the changes in existing codes, learn new codes and be knowledgeable about the deleted codes to prevent Dental Claim denials.
- Insurance Coverage Limitation: As not all insurance policies cover for Dental Procedures, Billers are required to cross-check, validate the patients’ coverage details prior to the appointment to determine the payment methods if the services to be rendered are not covered.
- Lack of Dental Billers and Coders: Staff retention is crucial to ensure the expertise and attention to meticulous process nuances are closely monitored targeting every claims to be processed successfully. Attrition, absenteeism and constant staff changes can affect billing quality leading to increased denials and revenue loss.
Having efficient Dental Verification and Dental Billing Support is mandatory for Quality Billing and Maximum Reimbursement. Acknowledging the possible challenges in Dental Billing and creating a streamlined and strategical approach reduces probable challenges in Dental Billing. Read through the below points to know how to avoid Key Challenges in Dental Billing:
- Indispensable Insurance Eligibility and Benefit Verifications
- Acquiring Prior Authorization and Referrals as and when required
- CDT Coders certified from American Academy of Professional Coders (AAPC)
- Experienced Billers with Claim processing and Denial Management expertise
- Timely submission of claims to avoid denials and delayed payment
- Accuracy in Data Entry Process such as Demographic Entry, Charge Entry and Payment Posting
- Skilled AR Callers to ensure maximum reimbursement
- Effective Billing Partner or Dental Billing Company for Qualitative Dental Billing
- Outsourcing to an established Dental Medical Billing Company with expertise handling Dental Claims Processing
Keeping an eye on meticulous details and nuances helps the billing company achieve its business goals while not affecting the quality of Dental Billing and Revenue Cycle Management Process. Choosing the right medical billing partner as your services provider is the key to a successful business and to achieve targeted financial growth.
Tips To Avoid Dental Billing Confusion
As electronic innovation keeps on changing the manner in which dental practices work together improving the cycle for recording and following patient health stays an essential challenge. Dealing with their dental billing and coding processes and getting paid is another. In the present healthcare industry, dental specialists face different difficulties because of time limitations. This affects dental billing, which is principal to the presence of any dental practice. In the event that claims are not submitted on schedule, practices don’t get paid for the services provided. Disrupted income brings about the failure of providers to get new innovation roll out vital improvements to enhance patient satisfaction.
Learn the Dental Insurance Verification Benefits
- Constraints on no of times patients can receive procedures like routine dental leanings, exams and x-rays
- Insurance may not cover each dental service that your dental specialist suggests, and gives a lower repayment rate to more costly methodology, for example, root canals, crowns.
- Time limits, holding up periods or “missing tooth clauses” for the substitution of prosthetics, for example, dentures
- Services, for example, orthodontics and fluoride treatments might be repaid just for kids younger than 19.
- Another advantage provision, In the event that the dental specialist proposes a dental system, the plan may just take care of another lower-expense dental service that gives an expertly worthy outcome. For instance, a plan may just cover a silver filling rather than a greater expense white composite filling.
- Services for carefully restorative reasons are once in a while covered by dental insurance.
- Most dental plans have a yearly maximum and deductible. When a patient’s yearly maximum is reached, their plan won’t cover any extra services until the beginning of the next plan year.
Staying Informed About Coding Changes
There are numerous -regular coding changes. Medical Equipment and innovation have changed, so have the Medical Equipmentsbeing utilized in dentistry for strategies and inserts. As new equipment and methodology emerge, so does the requirement for the coding to help them. On the off chance that was insufficient, there is a yearly coding refresher each year that can keep even the most experienced practice supervisors entangled.
Each practice must survey and note the progressions for codes regularly utilized and assess how they are influenced. Codes changes are needed for the business to react to need and change inside the business. The coding refreshers help target better approaches to make efficiencies for getting repayments and address new techniques. There are changes in materials and even advancements, for example, tele-dentistry, that must have comparing codes to adjust to sector developments, just as better approaches to submit claims and payments.
How Your Practice Benefit From Dental Billing Outsourcing?
Billing and collection can be two of the greatest pain points of owning a dental practice. Billing collections are impeded by billing statements, managing with past-due payment and making better approaches to get paid on time. Ultimately you cannot run any practice without benefit The challenges with Dental billing are involve more complexity and require auxiliary support. That is the reason, outsourcing dental billing is profitable. Keep perusing to know how outsourcing can improve your dental billing and collection process.
Dental Billing Outsourcing
Dental billing outsourcing company streamlines the medical billing process for dental offices. They help you to increase cash flow while decreasing the overhead expense. By outsourcing your medical billing, you will get a complete solution for your billing hassles. Dental billing outsourcing services include Dental Billing Eligibility Verification, Dental Claims Processing, and Dental AR follow-ups.
Ensure an Effective Claim Submission Process
Having the best dental billing experts for submitting insurance claims is basic to ensure timely reimbursement. While submitting claims on a daily basis it is essential to have a streamlined process to review and validate the claims to eradicate erroneous information and maximized quality and monthly collections. Our dental billing and coding experts track the status of the claims to find out the claim denials and claim rejections reason. Thus we fix all the claim related issues and ensure dental billing and coding is effectively handled
Minimizes Medical Billing Errors
Medical billing errors are minimized by verifying the patient’s information like patient name, address, Date of birth, insurance information, policy number, etc, and by avoiding duplicate claim submission. Billing errors negatively impact the revenue cycle.
Claim filing on time is another important factor in medical claim processing. Each insurance provider has different time limits for claim submissions. For initial claim submission, 60 to 90 days is the time limit. To appeal for denial claims, additionally time limit extends to 45 days. If the reworked claim is not filed on time, it leads to write-offs.
Improve Cash Flow And Revenue
Outsourcing Company improves the cash flow of dental practice with help of the dental denial management team. Successful denial management is one of the significant keys to keeping up cash flow. The major goal of the denial management team is to keep the clean claim ratio above 97%. Because claims denials increase the AR days and impact the cash flow. If the claim denials are not reworked that will affect the revenue of the business. So the dental AR follow-ups and denial management teams track the status of the claim and reworked it to maximize the reimbursement.
How Does Dental Billing Outsourcing Increase Your Billing Collection Rate?
Dental Billing and Coding can vary compared to billing for other medical specialties. Dental practices should have a strong Billing and Coding Strategy to ensure ceaseless cash flow. Staff handling Dental claims are obligated to be adept with Billing and Coding to process quality claims reflecting maximum reimbursement and increased collections. An outsourced Medical Billing Company should have all the experience and expertise to handle all the prerequisites for Dental Claims Processing while guaranteeing to increase your Billing Collection Rate.
Outsourcing Dental Billing Services is an investment that can fetch guaranteed maximum ROI. Recent researches have proved that during the COVID hit and ongoing pandemic many dental practices have witnessed maximized collection percentage with Outsourcing Billing in comparison to In-house Dental Billing.
How does Outsourcing Dental Billing Increase Collection Percentage?
To notice a significant increase in your Dental Billing collections and ROI, opting for Outsourcing Dental billing is the most recommended choice. Offshore Outsourcing Dental Billing can be beneficial in various ways as discussed below:
What Can Be Outsourced?
Revenue Cycle Management and Medical Billing Companies provide an array of services apart from end-to-end Medical Billing Services.
- Appointment Scheduling and Patient registration
- Insurance Eligibility and Benefit Verification
- Dental Billing and Coding
- AR Follow up and Denial Management
- Handling Old AR and aging claims
- Physician Credentialing and Re-credentialing
End to End RCM Support
Outsourcing to a well-established Medical Billing Company enables the coverage for end-to-end billing services right from Demographic Entry to AR Follow-up and Denial Management assuring scope for business expansion and growth. With complete billing support, Physicians can focus on quality patient care.
Dental Verifications and Prior Authorizations
Dental Verification is a mandatory process as not many insurances cover Dental Services. Some services might require prior authorizations and referrals to be obtained before performing the services. Complete insurance eligibility and benefit verification along with checking for prior authorizations and referrals should be the first step on every dental claim.
Time Advantage
Outsourcing Dental billing can mean, practices and physicians can focus on real-time requirements of their Dental practice while the back office billing tasks are taken care of with maximized reimbursement. Offshore Outsourcing proves to be more beneficial in terms of time advantage with the time difference of 9-12 hours from the US to India, making it a prime reason for the recent hike of the Offshore Outsourcing business model.
Cost Saving and Increased Collections
Outsourcing Dental Billing reduces your expenses on hiring, staffing and training resources for end-to-end billing process as your billing partner will handle them with enhanced expertise and experience. Billers and Coders from an Outsourced Medical Billing Company are adept with the billing requirements and protocols, thereby reducing claim denials and guaranteeing increased collections.
About e-care
e-care India is one of the pioneering offshore Dental Verification and billing companies based in India that promises to avoid the risks involved with missed Charges. With 20 years of experience in the industry, e-care’s 3 delivery centers have been providing end-to-end Dental claims processing services seamlessly to its clients. To know more about e-care and its services call 1-813-666-0028 or log on to www.ecareindia.com