How Does Dental Robotic Process Automation Optimize Revenue Cycle Tasks?

Remember the times when billers used to spend hours on submitting just one dental claim? And, despite putting in much effort, claim denials were high, and revenue loss was uncontrollable.

Many dental practices experience this issue when they manage their revenue cycle tasks via manual processes.

But the fact is that your practice shouldn’t be losing revenue if you deliver excellent clinical care. And your staff shouldn’t get exhausted while trying to manage complex claims.

Guess what? Advanced technology resolves all of that. Now, by leveraging robotic process automation, you can complete lengthy tasks in seconds and submit clean claims for quick payer approvals and reimbursements.

Want to optimize revenue cycle tasks for smooth payments? Let’s discuss how using reliable dental RPA services makes processes clean and easier to secure your payments and maximize your earnings.

What is Robotic Process Automation in Dental RCM?

Simply put, robotic process automation is a high-tech solution that works on a pre-defined set of rules. Using these rules, the RPA manages all tasks in the dental revenue cycle, from scheduling appointments and verifying eligibility to submitting claims and posting payments. 

Most billing systems combine RPA technology with artificial intelligence to make all dental RCM steps easier and ensure these tasks are completed faster and more accurately. 

Gone are the times when billers used to spend hours on a single claim. Now, with RPA, claims are sent, processed, and reimbursed more quickly, saving you time and effort. According to the Council of Affordable Quality Healthcare (CAQH), practices that submit electronic claims can save up to $18.3 billion annually. And using an RPA solution is the right approach.

The Impact of a Dental RPA on Revenue Cycle

Let’s find out how you can optimize your revenue cycle tasks by deploying robotic process automation in your billing processes.

Improved Staff Productivity

According to DentalPost, 62% of the dental practices struggle with increasing staff turnover. It affects a practice’s day-to-day operations and also causes financial losses. A key reason leading to this is excessive workload, which consumes much of the practice staff’s energy and time, due to which they’re unable to perform important practice tasks like managing patient care, arranging for dental equipment, and scheduling appointments.

The RPA solution is built to solve the issue. It works by using automated bots, which act as digital partners of your practice staff. The bots function like humans to easily complete repetitive routine revenue cycle tasks, such as logging in to systems, filling forms, uploading attachments, checking claim status, and posting payments. These digital associates support your staff, allowing them to focus on more important practice aspects.

RPA completes most of your billing tasks, but still needs support from revenue cycle specialists to supervise the process and make sure it’s fully in compliance with payer policies.

24/7 Functionality

Investing in high-quality RCM automation and software solutions always pays off. A dental RPA system works 24/7 without any interruption, managing your claim submissions all the time. When you assign these tasks to manual staff, they need to take a rest after hours of working and time off to come back fresh.

But the RPA doesn’t get tired. It maintains the speed and accuracy around the clock. You can leverage the solution anytime to process claims.

Faster Claims Processing

Claims are processed much faster when you use dental RPA solutions. An RPA system automatically fills all the fields in the form, pulls the right CDT code for a dental procedure, attaches uploaded documents if required, and submits claims using billing software.

An RPA system can submit up to hundreds and even thousands of claims per day. But that depends on the nature of claims, the billing process, and system capabilities. Still, the process is very fast, completing in just a few minutes and even seconds for repetitive dental claims. It’s much more efficient, as compared to manual billing, where barely two or three claims are submitted in an hour.

Reduced Claim Denials

The RPA follows the pre-set payer policy rules and processes all claims accordingly. RPA completes RCM tasks like:

• Verifying patients’ coverage and eligibility before a treatment
• Checking and obtaining prior authorization if required by the payer for a dental claim
• Entering all the fields in the form using available patient, provider, and payer data

This automated system makes sure that the claims are submitted by complying with payer policies for each dental claim. When the claims are free of errors, they are clean and compliant and are likely to get approved by the payer.

Plus, these electronic claims are sent fast, and the payer immediately confirms if they’ve received the claim. Clean claims leave little to no reason for payers to deny claim submissions.

Improved Collections

RPA doesn’t just improve claim submissions. It also helps maximize your collections, so you get paid right for the dental services rendered.

Payment Reconciliation

When a payer reimburses the amount, RPA reviews the dental EOB and reconciles it with your fee schedule to confirm if you’re paid fairly according to the agreed amount. If the EOB matches the payer’s allowed amount for the dental claim, RPA automatically posts the payment into the respective patient’s account.

But if the amount is less than the fee schedule, the RPA flags it as a mismatch, categorizes it as an underpayment, and routes it to the staff to follow up with the payer. Advanced RPA bots can also assist the practice staff with the follow-up process by sending automatic alerts.

In any case, RPA helps improve revenue growth by making sure you receive appropriate reimbursement and collect more.

A/R Management

High-tech solutions, like TransDental’s RPA, improve the accounts receivable management process for dental practices. When the system submits a dental claim, it immediately confirms the status. The payer provides a claim tracking number to view its status. RPA tracks the status in real-time, checks if a claim is accepted or denied, and updates the system accordingly.

Practices that use automation see improvement in collections, recovering most of their payments on time. And when there are barely any outstanding balances, you can smoothly manage your finances, maintain a healthy revenue cycle, and run practice operations.

Real-Time Financial Metrics

The RPA system produces a dashboard in your billing software, so you can view your financial performance in real-time. The dashboard helps see all the metrics, like clean claim rate, net collection rate, A/R aging and collections, and denial reduction rate, among other data.

Now, there is confusion that you need to clear. RPA itself doesn’t create a dashboard. In fact, it pulls data from your EHR or practice management system, cleans it by removing duplicates, and uploads the data to the dashboard.

Viewing these metrics helps you make data-driven decisions to improve future revenue cycle processes.

Who Can Benefit From A Dental RPA?

RPA in dental billing is a versatile solution for practices of all sizes, whether it’s a solo practice, a multi-location practice, or a large-scale DSO. Smaller practices have fewer staff, due to which they experience more burden, and it’s not easy to manage billing tasks, which can be complex at times. Similarly, DSOs have a bundle of tasks, and it becomes difficult for them to manage as well.

In both cases, RPA is the perfect option, which can be customized for every practice’s specific billing needs.

Best Practices to Implement RPA in Dental Revenue Cycle

Here are a few ways to implement RPA in your dental revenue cycle and get effective results.

Automate Routine RCM Tasks

Analyze your complete revenue cycle process. Make a list of repetitive tasks that operate on the same rules and don’t need any modification in payer rules. Processes are the same for almost every claim, payer, and dental practice. Examples include patients’ eligibility verification, claim scrubbing, claim submission, and payment posting. All these tasks work the same way.

Make sure to automate these routine RCM tasks and train the RPA bots to efficiently complete these steps. It resolves more than half of your issues.

Integrate RPA with Billing System

RPA must function together with your existing systems to pull data, determine CDT codes, and submit claims. All-in-one systems function both as a practice management system and a dental billing software. These may also contain EHR records for patients’ demographics, treatment history, and insurance data. When you integrate the dental RPA solution with your system, you get all the information that you can use for your billing processes, making them easy and quick.

Monitor RPA Performance

Despite its speed and accuracy, RPA can’t be completely relied on. Supervision is required from RCM experts to monitor its performance and check each of its tasks. Yes, it’s quick and handles tasks of multiple billers at a time. But, still, RPA works on pre-determined rules, which may not work in every dental claim.

Some dental claims for complex procedures, like bridges, crowns, dentures, and oral surgery, require human expertise. So, make sure to check RPA on every claim. See where it’s making mistakes, and correct them.

To Sum It Up

Technology has revolutionized the way dental practices submit claims and receive payments. Bots are now the trusted billing partners for routine revenue cycle tasks, doing more than half of the job for your billers. Whether it’s eligibility verification, claim submission, or payment posting, RPA completes all the tasks quickly with near-accuracy, saving up your time, and reducing manual errors that eat up much of your dollars. So, invest in the right RPA solution, train it as per your custom requirements, and put it into action to optimize billing and maximize payments.

Frequently Asked Questions (FAQs)