Insurance management and filing claims are some of the most tedious and monotonous workflows in dental practices, if not done right. Since it is a task that decides when a patient’s payment is completed and in extension the revenue cycle, it goes without saying that the workflow must be smooth, bug-free and efficient. Workflows may vary with how your dental practice is set up, but here we will look at a couple of ways in which you can improve how insurances and claims are managed and thus boost effective practice performance.
1. Collecting patient details and verifying eligibility before the patient comes in.
Getting things done beforehand is always an efficiency booster. It gives you more time to dedicate to other important things and peace of mind that you are ready for the task at hand. When setting an appointment with the patient, make sure to collect as much information about the person using forms or questionnaires. The insurance data, thus collected can be verified by contacting the insurance carrier. This will ensure that when the patient comes in for the treatment, you will be ready to split the costs and move on to filing claims without a hitch, undoubtedly reducing the time spent on paperwork and increase time spent on patient care at the dental practice.
2. Confirming the details with the patient on arrival.
Assuming that, all the insurance data collection and verification was done beforehand, it will be very helpful to re-confirm the details with the patient just before the treatment. This is to eliminate the chances of any errors or changes that took place since the previous contact with the patient. It is better to find out and rectify changes during the treatment than, at the time of payment.
3. Submitting the claims without errors or omissions.
There is nothing more satisfying than getting things done right on the first try itself. Done wrong, the claim filing process can prove to be very monotonous. Getting a claim properly filed without any issues the first time is a win! Here are some things which may go about unnoticed.
Omission of important procedure codes and license numbers.
Usage of deleted or expired procedure codes.
Typos in names, addresses, NPI, SSD etc.
Also, keep a note of codes and practices which are identified as fraudulent. An example is code bundling, where a multitude of codes are used to describe the treatment when just one is enough. For example: A dentist performs a one-surface occlusal amalgam. He sends in a claim for 09210-Local Anesthesia; 09430-Office Visit; 02140-Amalgam-One Surface; and 03120-Pulp Cap-Indirect, when Code 02140 Amalgam-One Surface is enough.
4. Developing a good rapport with the insurance provider.
If your practice contacts the carrier directly via email or calls, it is essential that there should be a good rapport between the carrier representative and your practice. Good communication means better reception of claims and in effect less waiting or complications. Consider referring patients without insurance to carriers who are closely connected with your dental practice.
5. Weekly follow-ups and claim revisions.
Claims do take time to be processed and it will help immensely to follow-up on pending claims on a regular basis, preferably on a weekly basis. This is yet another method to boost rapport with the carrier. Also, tracking claims those are rejected will give you some insight on how to prevent future rejections.
6. Staying up-to-date on industry standards.
Updated is always better than outdated. Staying up-to-date with changes in codes, procedures, claim details, carrier plans, etc. is crucial, for both time management and avoiding complications. Consider adding a session to discuss changes along with your weekly or bi-weekly team meetings. This helps keep everyone working on the same page.
7. Using a proper dental practice management system.
So, by now we can understand that there are a lot of places where things can get messy. The best way to overcome all these issues is by using a practice management system which has all these features in-built. It will demand all details for the claim to be submitted, thus avoiding omissions and typos. It is always updated on the latest changes in the industry and will almost always run off the latest industry standards. Why go through the hassle of doing all of these by hand when it can be automated and simplified. This saves a lot of time for you and your staff.