2025 has been a difficult year for the industry, with 40% of billers reporting an increase in claim denials over the past year. Denials significantly impact the overall revenue of practices. Ineffective revenue cycle management is a major reason for leading practices to lose money.
This is often because practices rely on staff who are either untrained or burnt out enough, leading to a massive revenue loss.
Getting concerned?
Well, worry not.
Partnering with a trusted dental RCM outsourcing team, such as TransDental, can help prevent this. Want to know how? Let’s discuss.
RCM Expertise
Dental RCM companies actively work in the industry and seamlessly handle the revenue cycle of multiple dental practices in one go. These companies dedicate staff to your RCM. Their staff comes with years of experience from working with practices and payers, and resolving various complex billing cases. This expertise helps them know the complications, and they take proactive steps to prevent any discrepancies.
But there is one thing you must consider. You should seek revenue cycle management services from a well-reputed company that manages everything seamlessly. New companies may struggle with things, but companies with a proven track record of efficient handling are more reliable for the task. Conduct your research and collaborate with industry experts for desirable outcomes.
Timely Eligibility Verification
Eligibility verification is the most crucial step in your dental revenue cycle management, because you can be paid by insurance companies for only insured procedures. And if you end up treating patients for services not covered in the plan, without charging them, it can lead to a huge financial setback!
Reliable dental RCM companies start the process as soon as the patient registers with your practice for a treatment. They review the patient’s insurance plan and see what’s covered and what you need to charge the patient on the spot. Details in eligibility verification include benefits, limitations, pre-authorization for certain procedures, and out-of-pocket expenses like co-pays and deductibles.
They seamlessly integrate with your existing EHRs to access patient data and negotiate with payers to verify each detail, and update your patients promptly, so they can pay their amount if required. It saves the hassle for you and your patients.
Accurate Billing and Coding
Claims can be denied if codes are outdated and inaccurate. The American Dental Association (ADA) revises the CDT codes each year, so it’s important for dental billing and coding staff to be well aware of the latest CDT codes.
A dental RCM outsourcing company is active in the industry and stays current with the latest CDT codes and other evolving healthcare trends. The company’s staff utilizes that expertise and uses the right coding for each dental procedure to maintain accuracy and achieve success with claims submission.
But billing accuracy isn’t just limited to coding. There are many more things required, including all the prescriptions, test reports, patient invoices, and other essential documentation. Everything must be complete, so claims can be processed successfully. These companies use a detail-oriented approach, filling in each detail in the form and doing it precisely.
Faster Claims Recovery
Dental RCM companies process your claims really fast. Since they’re actively working on the process right from eligibility verification, it takes them just a matter of time to prepare your documentation and submit claims to the insurers according to the relevant protocols.
And they don’t just leave it here. They constantly communicate with insurers for updates on the progress and ensure that claims are settled soon. In fact, with good RCM handling, claims can be settled within just 24-48 hours!
Once claims are settled, these are instantly posted to the respective patient ledgers. Quick payment settlements mean lower wait times and an improved cash flow for your dental practice.
Improved Patient Care
A dental practice is totally reliant on its patients, and it can expect to earn from patients only if it treats them with proper attention and great care.
That’s possible only if your practice’s finances are stable. You’re relieved of billing stress. This gives you a piece of mind and reduces your staff’s workload, so they can perform other important tasks with ease.
Together, you and your staff can devote yourself to treating your patients and help them restore their smile. Happy patients mean greater satisfaction. They’re likely to return to you and recommend you to others. As a result, you can treat more patients and generate revenue.
Lower Operational Costs
As compared to in-house dental billers, the costs of outsourcing your dental RCM to a third-party service provider are considerably lower. Rates may vary by company, but these are usually affordable and can be easily covered in the amount of claims these companies recover for you.
You have reduced labor costs, and the need to invest in technological infrastructure is lessened to a huge extent.
By cutting down on unnecessary expenses, you can maximize your profitability and boost staff productivity. This leads to revenue growth and proper administration for all the tasks in your dental practice.
Real-Time Analytics and Reports
An RCM outsourcing company keeps you updated with the claims progress and overall state of your practice’s finances by generating real-time reports with useful analytics. These give insights into all the aspects of your dental RCM, including services billed, recovered payments, outstanding dues, and claim denials or pending A/R.
It helps you stay on top of your billing trends. And things can get better if the RCM company is using AI. The reason is that AI-driven insights come with useful suggestions for you to improve your revenue cycle.
Moreover, some companies also offer free billing audits to evaluate your billing. These can be on a monthly, quarterly, or annual basis. Billing audits help you review your overall finances, so you can identify loopholes and make corrections to boost recovery.
Healthy A/R Follow-up and Recovery
On average, practices in the U.S. suffer losses amounting to $300-$400 on bad debt write-off per patient. And that’s a huge amount, right?
A good RCM outsourcing company doesn’t leave your revenue cycle just after billing. It also looks after your unpaid claims and aging A/R. They send swift reminders to patients and payers, notifying them of pending payments, and help recover maximum payments from A/R.
Studies report that good dental revenue cycle management helps recover A/R by 10-15%.
Is Outsourcing Dental RCM The Right Choice For Your Company?
Availing revenue cycle management services from a renowned company helps streamline processes. By choosing a responsible company for your RCM, you see an increase in your clean claims rate, lower costs, more staff productivity, and maximum revenue growth with profitability.
So, what’re you waiting for? Collaborate with TransDental, one of the best in dental billing outsourcing. Enjoy competitive rates, premium service, and outstanding claim recovery.
Frequently Asked Questions (FAQs)
How do RCM companies stay up to date with dental insurance rules and code changes?
Dental RCM companies frequently follow evolving industry regulations and stay current with annual CDT revisions by the American Dental Association (ADA). These companies also use systems that synchronize with insurance companies and automatically notify them of the latest industry changes.
Can I choose only specific RCM services to outsource?
You can opt for specific RCM services such as credentialing, eligibility verification, claims submission, or A/R follow-up during contract negotiations with a company. But policies vary for each company. Usually, companies offer entire RCM services at a reasonable fee.
Will I lose visibility or control over my revenue cycle?
You retain control of your EHR portals and dental practice management software while outsourcing dental RCM to a third-party service provider. You provide them access to manage your revenue cycle, while you continue to operate the system and monitor the processes in real-time.
Do RCM providers help identify patterns or trends in claim denials?
An RCM outsourcing company reviews your claim denials and identifies key reasons. Based on these patterns, these companies resubmit claims through the right protocols and get them settled, while also ensuring that future claims are processed precisely to prevent denials again.
How frequently will I meet or communicate with my RCM provider?
RCM outsourcing companies assign dedicated account managers, who supervise your billing and address your concerns in real-time.
