The trend of outsourcing dental claims billing to third-party companies is picking up in the industry, due to various issues, including complex billing issues, administrative burden, and surging operational costs with high salaries.
As the industry is shifting towards outsourcing, you also need to upgrade your dental practice’s billing workflows to stay ahead.
But is outsourcing a viable option for your practice?
Let’s explore the pros and cons in this article, so you can make the right decision according to your practice requirements.
Pros of Outsourcing Dental Claims Billing
These are some of the benefits you can unlock if you outsource dental insurance billing to a third-party service provider.
Streamlined Billing
When you outsource your dental billing and coding, the billing company manages and handles all the tasks, like:
- verifying insurance eligibility
- processing all the documentation
- using accurate coding for dental procedures
- communicating pre-authorization (for certain procedures)
- submitting claims
- following up with insurers
These billing companies know all the aspects of dental billing very well. They are aware of the latest industry trends and the changing compliance and insurance policies. The billing companies manage everything efficiently, relieving you of worry and stress.
Cost Savings
Training and hiring staff to manage dental billing can be costly. The monthly salary of dental billers is about $4,000 on average, which means that if you hire 5 billers, it costs you about $20,000 on average per month on billing salaries.
But if you outsource dental billing to a billing company, you can save up on much of the labor costs and reduce other operational expenses.
It’s because these billing companies usually charge around 4-5% on your total claim recovery. These charges can vary by each company, and the commission on billing also varies according to the total amount recovered in a claim.
Expertise and Compliance
Dental billing companies use their expertise to accurately process your claims, minimizing the chances of claim denials. They manage everything, whether it’s claims, payments, or denials. These companies make sure that you recover your amount for dental services rendered.
Billing companies are also compliant with healthcare regulations to protect your dental practice from regulatory fines, reputational damage, and penalties.
One key factor is that the American Dental Association (ADA) revises the CDT codes each year, and keeping up with these changes is important for accuracy in claims and avoiding legal complications.
Another important aspect is compliance with the Health Insurance Portability and Accountability Act (HIPAA), which requires dentists, insurers, billing companies, and all other professionals to protect patients’ sensitive data, and there should be no breach.
Better Staff Productivity
When dentists and dental staff are relieved of the overwhelming dental billing tasks, they can focus fully on their administrative and financial tasks. It helps reduce staff burnout, boost productivity, and achieve a better employee retention rate.
More Focus on Patient Care
Along with an efficient billing process, dental billing companies have the major benefit of outsourcing dental billing. They devote their entire time to the dental patients, who deserve the most care and attention.
Patient quality care and treatment should be the priority for a dental practice, and that’s only possible if the practice staff doesn’t have to worry about handling complex billing tasks.
It also helps your practice gain a positive reputation among patients for offering premium care, leading to maximum revenue growth opportunities.
Cons of Outsourcing Dental Billing
Loss of Control
When you hire in-house dental billers, you control every aspect of billing. You communicate directly with the dental billers and supervise them.
But when you outsource dental medical billing services to a company, you can’t control the billing aspects. You have to completely rely on the dental billing company to handle everything.
Data Security & Privacy Concerns
While opting for third-party dental billing solutions, you may be prone to risking your company’s private and sensitive data.
Billers integrate with your EHRs and payers’ systems, so they gain access to your patients’ sensitive health information and also know all the key aspects of your company. If the billing company is not reliable, there are chances of data breaches.
Quality and Reliability Variability
Since you can’t control or supervise a dental billing company, you don’t know their quality of work, and it may be difficult to trust them.
There are a huge number of dental billing companies operating nationwide, and each company has its own protocols for handling billing. Trusting a company and making the right choice can be very challenging for you.
Cost Transparency
By accessing your software, billing companies know each and every detail of your finances, including the hidden costs, which are major secrets of a company.
Lack of Accountability
In-house dental billers work as your practice’s employees, so you can hold them accountable for poor billing outcomes. But when you outsource billing, it becomes difficult to pinpoint them for lower collections from insurance claims. They may not claim responsibility and may put the blame on you for that.
Should You Outsource Dental Billing?
Considering the pros and cons of outsourcing dental billing, it can be challenging to decide whether to partner with a billing company or hire in-house staff.
You can opt for outsourcing billing if you have high claim value, huge staff turnover, and a lack of in-house training and expertise. A billing company can easily manage these aspects.
But, while you’re working with a company, make sure that it’s a reliable company with a positive reputation in the market and years of mastery in solving complex billing complexities.
Conducting business with the right company results in a stress-free dental billing experience, an impressive clean claims rate, maximum collections, and steady growth for your practice.
Conclusion
There is a fair share of pros and cons when you outsource your dental claims billing. It depends on various factors such as your billing requirements, budgeting, and claims success rate.
Outsourcing is a great option if you choose to work with TransDental. We have a proven track record of transforming claims submissions into revenue growth for dental practices. Make your claim recoveries smooth, reliable, and fast by choosing our dental billing services. Schedule a free consultation to book a demo and learn more about our processes.
Frequently Asked Questions (FAQs)
How do I choose the right company to outsource dental billing?
While you’re partnering with a company, ensure that it can easily integrate with your dental software, complies with HIPAA, and offers transparent pricing. Furthermore, verify if the company has a proven track record of successfully recovering claims for its clients.
Is outsourcing a short-term fix or a long-term solution?
Outsourcing dental billing is a long-term solution if you choose to work with a reliable company. It manages your entire revenue cycle smoothly, reviewing every aspect of it and ensuring that your collections are maximized.
How can a billing company’s performance and accuracy be monitored when billing is outsourced?
The established dental billing companies share frequent billing reports and updates with you in real-time, so you know the ongoing status of billing. This increases the confidence level between you and the company.
Does a dental billing company just deal with insurers or also handle patient billing?
Dental billing companies can easily negotiate with insurance companies and dental patients, managing all the financial aspects smoothly. These companies don’t affect your relationship with patients, as their RPA systems or billers work as an extension of your staff.
What if the billing company makes a mistake on a claim?
A reliable dental billing company assumes complete responsibility for errors in a claims submission. But the better approach is to communicate with the company beforehand and set the right terms during contract negotiations.
