Unprecedented increase in qualified dental practitioners, technological advancement, and market-driven competition has all contributed to continual decrease in operating margins. The fact that dental practitioners, whose core-concern is to maintain highest standard in dental care, rarely find time or resources to address revenue issues has further compounded the issue. But, there exists unanimous consensus on leveraging people, process and technology to positively impact operational efficiency and revenues.
Consequently, identification of functional entities that require well-coordinated efforts towards realizing the objective of operational efficiency and revenue maximization becomes crucial. Generally, Patient Registration, Patient Scheduling, Eligibility Verification (EV) and Benefits, Cash Posting, Analysis, Insurance Follow up, Denial Management, and Patient Collections are the areas that need to be managed in a sequential manner.
Patient Registration, which involves creating or updating the personal details of the patient, guarantor & subscriber in the system database, enables entry & archiving of the patient's coverage information in the system.
Patient scheduling, both for new and follow up appointments, ensures time-specific appointment with dentists, resulting in optimum time management. As in dental practices follow up and procedure visit are recurrent and delays and cancellation of appointment happen frequently.
Eligibility Verification and Benefits
Eligibility Verification and Benefits find out whether the patient is eligible for dental insurance, and if so, to what extent: preventive, basic or major. Establishing a proper communication channel with the patients’ insurance providers is crucial to mitigate undesirable delays or denial of dental bills.
Cash posting is the act of applying the insurance payments to the patients’ account, which ensures reconciliation of medical bills on your billing system.
Analysis is a crucial effort that identifies causes for claims held up for too long, and devises means – such as modifiers, and resubmission – to speed up the realization of Account Receivables. Ideally, Accounts Receivables Analyst ensures that AR is under control & acceptable by industry standards.
Denial Management is the process of devising suitable action on denied claims. Usually, it comprises reprocessing the claim for payment and closing of the claim.
Patient collection takes care of informing patient about the portion of their bill payable by them individually and time period for payment before moving the account to a collection agency.
Thus, having a billing mechanism that can ideally complement your dental practice will render the realization of following benefits:
Of late, social media tools – blogs, Facebook, Twitter and other viral marketing opportunities – too have their significance in broadening dental patient base along with operational tools for cost and revenue optimization. Therefore, applying social media tools for marketing propaganda over the web media in tandem with the regular cost and revenue optimization measures is an ideal combination for comprehensive optimization of your dental practices.
Owing to the complexities involved, dental practitioners have often reported these strenuous optimization exercises as detrimental to their core medical efficiency, and outsourcing as the best recourse. Medicalbillersandcoders.com (www.medicalbillersandcoders.com) – whose optimization measures are complete with accurate charge-capture, intricate procedure coding, electronic filing of claims, patient billing, multi-tiered appeal process, denial elimination initiatives, and compliance standards – is the prescription for simplification of your revenue cycle, appreciable increase in collection rates, more patient inflow and referrals.
Sources of Reference: