Revenue cycle management for dental practices is quite complex for the size of the organization. This is due to various challenges like generating and collecting revenue from both insurance and direct channels, as well as other nuances like UCR (Usual, Customary and Reasonable) fee schedule and various measures to optimize revenue and reduce denials.
The biggest challenges faced by dental practices include ensuring effective reimbursements, optimizing upfront patient payments, and bringing overall efficiency in the revenue cycle process.
Let us try and see how to organize all this in a simple strategy.
Five key areas that should lie at the core of your strategy are:
Reducing collection costs:
Keep looking at where the major costs in collection come from. It may even be your time to resolve problems. Reducing errors maybe your best way to reduce management time spent on the task. Maybe you have to route a lot of patients to collection agencies, increasing the cost of collection considerably, when regular follow-up alone could have solved the issue.
Raising net collections:
An active regular follow-up of accounts receivables is important. This helps to reduce lost production value and adds to your revenue. Focus on increasing net collections by automating follow-ups and reminders and sticking to a routine regular process
Reducing effort and error:
It is important to confirm dental insurance coverage for specific procedures, so that when a patient sits in the dental chair and contemplates a treatment, the costs are at the dentist’s fingertips. This helps faster decision making and reduces errors and hassles.
Increasing speed of collections:
Modern systems provide advanced revenue cycle management features like automated tools that work to improve dental office billing and follow-up to enhance the speed of collections. Automated ERA postings can also help dentists get a grip on the situation faster.
Revenue cycle management in practice management systems:
Getting a modern cloud based practice management system with built in advanced revenue cycle management is perhaps the simplest way to bring the best practices in revenue cycle management to your office. This is almost a plug and play solution that takes care of everything from cross checking insurance eligibility to sending out payment reminders.
The final strategy should be designed based on these principles, in a way that works on your local community and your practice. Once this strategy is in place, the next step is to ensure smooth and consistent execution.
Choose a practice management system that has the following features that can help you implement your strategy:
- Integrated electronic payments: Securely process debit and credit card transactions using integrated electronic payment solution.
- Patient credits: Easily add payments and adjustments to all patients in a family during checkout.
- Payment plans: Set up financial agreements for services done over a period of time and use them to create payment plans.
- Finance charges: Apply finance charges to accounts which have overdue payments.
- Fee schedule management: Maintain multiple provider fee schedules across multiple insurance plans.
- E-claims and paper claims: Create and send batch insurance claims for all locations and providers from a central site.
- Carriers and plans: Set up common carrier, plan and code lists to be used across a single or multiple locations.
- Claim tracking and denial management: Monitor responses from the carrier / clearing house and notify the users with action items.
- Manual payment posting: Post payments for services done for a patient at a claim level as well as at a code level.
- Collections: Integrate with participating collection agencies for seamless collections management.
- Electronic payment posting: Setup remittance posting rules and auto-post ERA’s. Manual intervention is only required to handle exceptions.
- Statements: Quickly list patients with outstanding dues and send them statements by email or mail and allow patients to pay online.