Dos And Don’ts Of Dental Revenue Cycle Management

Dental RCM is not an easy task. You have to dedicate proper time and resources to get your claims approved. However, a final medical bill or claim must go through several steps to have the essence of the correct RCM. So there is a checklist of dental revenue cycle management dos and some things to avoid that will help you perform accurate RCM.

When you work in a dental facility, you have a lot of duties. But running an RCM cycle will keep all your operations under an umbrella and each aspect of billing like patient scheduling, medical coding, and claim filing contributes to a perfect claim.

Let’s discover some secrets of effective dental revenue cycle management by listing some things to do and a few to avoid.

An Overview Of Dental Revenue Cycle Management

RCM is the same everywhere. All you have to do is collect the patient’s personal as well as medical information and create bills out of them.

But to break it down for you, dental RCM is a process that caters to the entire healthcare facility’s billing. It involves several steps:

First, a patient will come to your facility to get dental treatment. At this stage, you will collect their information and perform pre-authorization. This is basically a step where you contact the patient’s insurance company and ask whether they are eligible for specific dental treatments.

Once you get a green signal, begin with the treatment. At this stage, all dental services done on the patient and supplies used by them are mentioned in a list.

When the treatment is completed, those services and detailed medical records are translated into universal codes which are then used to create dental claims.

These claims are then sent to the payer and payment is received in return. And after that, the last stage is the medical bill. These bills are sent to the patients, which marks the completion of the RCM process.

Only claims and bills will get you the payment you spent on patients, so it must be done with proper considerations and tips at hand.

Dos And Don’ts Of Dental RCM

Dental revenue cycle management is a simple process. If you follow all the steps carefully, you are surely going to get positive results.

So maximizing the revenue of your dental facility depends on these dos and don’ts. Have a look and create a notebook listing all these things to keep in mind during RCM.

Dos:

Verify Patient Information Thoroughly

Patient verification is the most crucial step in RCM. Before anything, at the time of visit just ask about all the patient’s personal and insurance details and save them in your systems.

Then contact the insurance payers and ensure the patient is eligible for specific dental treatments. This process guarantees accurate claim filing and prevents claim denials.

Implement Regular Staff Training

Training of RCM staff is another essential aspect of your dental facility. 

This training will help them understand the latest RCM updates, rules and regulations, and code inventions. By having this knowledge, they will perform well in terms of medical billing and coding and the end result will be much more productive.

Monitor and Analyze RCM Metrics

Implementing RCM measures is incomplete without monitoring. You can’t just modify your strategy and expect increased revenue.

You must have some benchmarks identified to regulate whether you are going the right way or not. Without setting goals, you can’t make sure dental revenue cycle management is bearing results.

In healthcare, these are called key RCM metrics, which include:

• Claim submission times
• Denial rates
• Payment turnaround times

And many other KPIs. The goals may vary depending on the needs of your dental facility. So spend proper time finding out your KPIs and dedicate a team to monitor them regularly.

Engage in Consistent Follow-Up with Payers

Establish a routine to regularly contact insurance payers and follow up on the claims you submit. This practice will help you find errors marked, resolve them, and resubmit.

Consistent follow-up maximizes the chances of full reimbursement and results in fewer claim denials.

Leverage Technology for RCM Automation

Another good dental RCM practice is to use modern RCM software that must offer automation features.

This way the tasks that you were doing manually, will be conducted electronically and automatically. It saves time for repetitive and time-consuming operations like massive claim submission, patient verification, and payment posting.

Also, automated dental RCM software has the potential to identify errors in your claim submission and resolve them before submitting. So it helps in fixing your entire claim submission process.

Stay Updated with Regulatory Changes

The healthcare industry is all about regulatory changes. So it is your duty to stay updated with any modification in laws and policies. Redesign your RCM strategy to stay compliant and avoid penalties and fines.

Foster Clear Communication with Patients

The patient is an important part of RCM. you must keep transparent communication with them by informing them about their insurance coverage, expected bill expenses, and any available patient programs to offer if they are financially weak to bear dental treatment expenses.

This communication builds trust and results in an efficient payment-receiving process.

Don’ts:

Delay Claim Submission Processes

The key to claim approval is timely filing. If you keep on delaying a claim submission process, then it has a lower chance that you will get paid in full or even sometimes not paid a little.

The more the delay in filing the claim, the more it diminishes the chances of payment. So you must establish a proper workflow and submit claims regularly.

Train your staff to send applications for all the patients on the same day as they receive the treatment. DO NOT ignore the importance of prompt claim filing.

Overlook Denied Claims

Denied claims doesn’t mean lost revenue; it means you have to overlook the problem and resolve the issue if you can and then get paid.

If you are facing massive claim denials, don’t ignore them. Work on each claim separately, find out the root cause, and resubmit. Many times denied claims when resubmit gets you the revenue you might be neglecting.

Underestimate the Importance of Coding Accuracy

Dental codes are the base of accurate claims. Any mistake even in a single digit, your claims rejected. 

Make sure your coding staff has a list of all updated dental codes. Review each application again before submitting it to make sure the right codes are being mentioned for the relative services.

Disregard Patient Billing Inquiries

Many times dental facilities don’t pay attention to what their patients inquire for. Some inquiries are listened to. But many of them are ignored because it is considered important and a waste of time.

But wait. Patient satisfaction somehow does affect your dental revenue cycle management. When they pay medical bills late or will face some financial issues, the AR process will be negatively affected. Thus, you won’t be able to collect more in dedicated time.

That’s why we emphasize on paying attention to patients and providing every possible facility to them to ease payments.

Overcomplicate the Billing Process

Another mistake that many facilities make is that their billing is overcomplicated. There may be many steps or extra charges in the bill that you would want patients to understand. But, they too need a simplified process.

They need hassle-free health care as well as a billing system, where they can just receive the dental treatment, fill out the forms, and pay the bills.

Here you can offer some online payment opportunities to them so that you can experience an efficient dental RCM.

Simplify Your RCM Process

As you can see, these dos and don’ts were some of the basic rules you must keep in mind during dental revenue cycle management.

Trust me, these strategies are very easy to implement. And it will give you beneficial results too in return.

So don’t waste time on meaningless RCM, just follow the tips we mentioned and see how your dental revenue doubles and triples.