Best Practices for Dental Practice Revenue Cycle Management

Cash flow is always top of mind for dental practices; after all, it’s the lifeblood of a healthy practice. Along with providing outstanding patient care, your long-term success relies on timely payments from insurance carriers and patients and accurate claims submissions. In times of economic instability, it is particularly vital that you fine-tune your revenue cycle management (RCM) practices so that you can collect payments and reduce the number of denied claims. RCM begins with patient registration and, when successful, ends with 100% collection of accounts receivable balances.

Common Culprits that Can Hurt Dental Practice RCM

All too often, dental practice owners leave money on the table by not following RCM best practices. Common reasons include:

• Failure to check a patient’s insurance to verify coverage before any procedures
• Failure to collect copays the day of the appointment
• Failure to collect outstanding balances after insurance payments are made to the account
• Incorrect coding and/or not staying on top of coding changes
• Not following up on insurance denials in a timely manner

If any of the above resonate with you, know that you are not alone. It is challenging for most dentists to provide top-notch patient care and stay on top of constantly changing regulations and insurance requirements. However, if you want to improve your dental practice RCM, consider the following best practices to improve your practice revenue, boost cash flow, and get those accounts receivable in tip-top shape.

Patient Registration

From the minute an individual makes their first appointment, it is critical to capture all contact information accurately. This includes name identification, demographics, and insurance information. Be sure to capture any available and current insurance information to prevent future billing issues. Insurance verification is key—you should be able to verify the patient’s coverage, eligibility, and benefits. Above all, your front desk staff must communicate your financial policies in writing. This should include copays, methods of payment, and how you treat unpaid balances.

Patient Visits

At each visit, ask the patient whether there have been any changes to insurance and contact information. If you overlook verification, it can result in weak links in your dental RCM process. Before the visit, remind patients about any copays they may have and answer questions about the cost for specific services. Whenever possible, collect the estimated patient portion for the services they will receive. If the patient is not able to make the entire payment, work with them on a payment plan schedule.

Billing Practices

It is not always feasible to collect full payment from a patient. Many dental practices submit charges to insurance carriers, if applicable, and bill the patient for the balance. If you are submitting charges to insurance carriers, be certain you use the right billing codes. Coding can be complex, so it’s essential to get it right the first time. Payment denials can wreak havoc on your cash flow and take valuable time away from office administrators who have to resubmit claims.

Be timely in sending billing statements to patients. The sooner you bill, the more likely you are to collect the full amount. Take advantage of available software to send electronic statements or have paper statements sent automatically. Bill patients throughout the month—there is no need to wait until month-end.

Decide how long you will work an account before turning it over to a collection agency. Many practices use 90 or 120 days. You may also want to consider outsourcing the entire insurance billing and coding process—you should work with your dental accounting professional to determine whether it’s cost-effective for your practice.