Inefficient billing and coding lead to claim denials, which cost a provider an average $5 million per year. This is a huge amount if you calculate it per annum or via a monthly breakdown.
Many practices experience this revenue loss due to relying on in-house billing and coding, which is often costly and prone to errors.
But this issue can be resolved if you outsource dental billing and coding to a trusted partner.
Want to know how? Let’s discuss.
Challenges in In-House Dental Billing and Coding
Keeping up with the Latest CDT Codes
The American Dental Association (ADA) annually revises the dental codes and dental practices that fail to adapt to the new codes; as a result, they often end up using incorrect or outdated codes for each dental procedure. Insurance companies use these codes to process claims, and wrong codes lead to claim denials.
Changing Insurance Policies
Insurance companies may frequently change their policies. Staying current with these changes can be challenging for your dental practice. If you don’t submit claims by following the insurer’s policies, your claims are most likely to be denied by the company.
Increasing Workload and Costs
Dental billing is a time-consuming process. Billers are required to pay attention to detail, so claims are processed accurately. Due to that, you have to dedicate dental billers, which results in a spike in your expenses and administrative burden.
Managing your dental claims billing by paying each biller an average monthly salary of $3000-4000, and investing in dental billing software, is very costly!
Along with finances, it also impacts your administration.
Prone to Manual Errors
In-house dental billing and coding are always prone to errors. Regardless of the high amount you pay these billers, they can still make mistakes. These mistakes can include wrong CDT codes, typos in names or details, incomplete documentation, and failure to comply with the insurer’s policies. And each mistake can result in a huge financial strain for your dental practice.
Cash Flow Disruptions
Discrepancies in your dental billing result in payment delays that affect your practice’s finances and eventually affect the quality of patient care. During in-house billing, claims can be denied due to manual errors. Resubmitting claims after denials is a hassle. On average, insurance companies take 30-60 days to settle these claims.
On top of that, your in-house billing staff may forget to follow up on claim denials, which can delay claim settlement further.
High Staff Turnover
Dental billing can be very stressful for your staff, causing them fatigue and burnout. It creates a huge possibility for in-house dental billers to leave. Due to that, there is a gap in your billing processes. Training new staff all over again to manage billing requires a lot of time and expense for your dental practice. And again, it’s no guarantee that this new staff is going to stay for long! Staff turnover is a continuous process, impacting your billing processes.
Compliance Risks
If your in-house staff isn’t aware of industry regulations, it can be a huge danger. Sometimes, billers end up either charging more than the policy or charging much less than the amount for an insurance plan. Undercharging leads to financial setbacks, while overcharging makes your practice subject to external audits and other legal complications.
Your dental practice can face regulatory fines and penalties. These penalties damage your credibility among payers and patients in the industry.
Tracking and Pursuing A/R
In-house billers often forget to pursue and resolve accounts receivable (A/R), leaving a huge amount in recovery. A/R begins aging if you don’t pursue them on time. Frequently pursuing A/R and tracking its progress can be challenging for your in-house staff.
Considering these factors, the thought looms that in-house billing comes with its fair share of challenges for your dental practice.
Here, outsourcing dental medical billing services to a reliable third-party service provider can be a viable option.
Want to know more about it? Let’s jump to the next section and explore its benefits.
What you Get by Outsourcing Billing and Coding?
Near Accurate Processing
With third-party dental billing solutions, you can almost eliminate manual errors with zero billing headaches. Outsourcing companies are well-versed with all the processes of billing and coding, and use their expertise to enter all correct details, use up-to-date CDT codes according to a dental procedure, attach the right documentation, and submit claims fast.
Revolutionizing Billing with AI
The healthcare industry is rapidly adopting AI to automate billing tasks. By implementing robotic process automation (RPA) into the billing process, AI tasks are processed quickly, resolving complex billing tasks in a matter of seconds.
Companies leverage AI to streamline dental claims billing and CDT coding for practices. Robust AI tools offer the perfect combination of accuracy, along with real-time insights on your billing and suggestions based on the billing history. If you outsource dental billing and coding to an AI billing company, you can improve your practice’s cash flow and stay ahead in the competitive environment.
Moreover, AI tools can operate 24/7, so your billing is uninterrupted, and you don’t encounter issues like staff turnover and the need to train staff. Dental companies have trained experts who supervise the AI-powered billing software for quality assurance.
Meeting Regulatory Compliance
Avoiding legal complications is essential for your dental practice to continue operations and cement a positive reputation among patients and payers. Dental billing outsourcing companies make sure that you don’t face any compliance issues.
Whether it’s securing patient data for HIPAA compliance or following ongoing industry regulations, dental practices adhere to rules and process dental claims accordingly. They’re well aware of these details and utilize their expertise and knowledge by entering the correct info in the form and processing all the claims accordingly. This keeps your practice safe from compliance-related hurdles.
Maximum Claims Recovery
Dental billing companies ensure that you’re paid for the dental services offered to patients at your practice, and you’re able to recover the maximum amount on the claims. They don’t just leave the process after submitting your claims. They keep contacting the insurance companies to track the progress of your claims recovery and ensure your claims are settled.
Top-tier billing companies have good claims recovery rates that prove their success with claim settlements for dental practices. This helps you invest in your dental practice’s infrastructure to enhance it, so patients can get the best care they deserve.
Cost-Effectiveness
Working with a dental billing company is a cost-effective option, as compared to hiring in-house billers and paying them monthly salaries. Billing companies usually charge a minimum percentage of your claims recovery. This percentage can be somewhere between 4-10%. It varies per company. A company may also change the percentage according to your total amount recovered.
A billing company can easily handle multiple billing tasks simultaneously, while a salaried dental biller may not be able to do so. Choosing a billing company is a great option, as you earn more by spending less. It increases your dental practice’s savings and accelerates financial growth.
Real-Time Reporting and Transparency
A major concern for a dental practice while outsourcing billing is that there is no control over the billing. Your practice must rely on the billing company. And, with that, you don’t get an idea of how close you’re to recovering their claims.
But, since you want to know and gain confidence that the right partners handle your billing, you must choose a reliable service provider. A reputed company prioritizes client satisfaction and offers you real-time insights on the billing status, with frequent reporting. Moreover, the billing company assigns dedicated account managers, who handle your account and provide you with assistance on your queries related to billing.
This transparency strengthens trust between your practice and the billing company, fostering a long-term, healthy business partnership.
Smooth A/R Recovery
Partnering with a third-party company helps recover A/R with a significant margin. Just recently, a healthcare provider managed to recover an impressive 78.2% of the amount during a timespan of 11 months. And that was all possible due to outsourcing A/R recovery to a major consulting firm!
You can achieve similar results if you choose to work with a company that guarantees maximum recovery from A/R. Consider working with dental billing companies that have an impressive history of speeding up collections for practices, especially in A/R.
Reduced Workload and Increased Staff Productivity
With outsourced dental billing, your staff is no longer bound to just processing claims and pursuing insurers. They can easily focus on other important administrative and clinical tasks, including:
- Supervising staff attendance
- Recording patient check-in and check-out
- Maintaining patient records and documentation
- Communicating with patients for reminders on treatment.
- Arranging for clinical supplies and other inventory.
- Performing and interpreting dental X-rays
- Assisting dentists during treatment.
- Caring for patients during and after treatment.
- Guiding patients about post-operative dental care.
There are many more tasks that your staff does to improve the quality of patient care, resulting in full patient satisfaction. It reduces your staff workload and makes patient care efficient. After all, it’s the primary task and should be a priority for a dental practice.
Billing Audits
Some dental billing companies evaluate and review your billing history, performing audits to identify loopholes in your workflows. By doing so, you can identify unpaid claims, which these companies try to resolve. These companies also implement strategies to improve your practice’s billing accuracy, so you can rake in dollars.
Conclusion
In-house billing has a fair share of challenges, which your dental practice can easily overcome by outsourcing the dental billing to a third-party company. This company handles all your billing and financial aspects with ease, relieving you of all the worries of recovering claims. It allows you to serve your patients with full care, while dollars fill your accounts!
So, make a timely decision and partner with TransDental, a reliable service provider to help kickstart your practice’s journey to financial growth!
Frequently Asked Questions (FAQs)
Is it secure to share my patient data with an outside company?
You can confidently share your Patient Health Information (PHI) with a third-party dental billing company if it is HIPAA-compliant and uses encrypted systems.
What happens if there are errors in the claims?
Most billing companies have quality assurance checks. If errors occur, they’re responsible for correcting and resubmitting claims quickly, saving your team time and stress.
How do I know if it’s the right time for my practice to outsource dental billing?
Outsourcing dental billing is required if your collections are infrequent, the A/R rate is increasing, and the staff is stressed out. It helps you identify the right time to partner with a billing company.
Will outsourcing billing affect my relationship with patients?
Dental billing companies usually manage billing-related aspects or offer some complementary tasks. But, they mainly work with payers to recover your claims, while your in-house staff caters to patients.
How much involvement will my front desk team still have?
Your front desk will still manage check-ins, co-pays, and patient communication, but they will no longer have to chase insurance or resubmit denials, freeing them up for better patient service.
