Why a profitable dental revenue cycle depends on a good billing process
Is your dental revenue cycle profitable? It can be a challenge to keep making sure your patient payments and insurance claims help you sustain and build a practice that’s exciting to lead.
But if you hone in on your billing process, your dental revenue cycle will deliver smooth, reliable income. You’d be surprised how many facets of your dental practice depend on a streamlined billing process, including your revenue cycle.
DCS is a trustworthy dental RCM partner that helps dental teams improve revenue collection easily. Efficient claims processing leads to a less stressed team, more time in the day to tend to patients, and more money for the dental business.
In this article, you’ll learn why your dental business depends on well-run RCM to be profitable. Without streamlined processes, you’ll face delays in payment from insurance claims, and frustrated patients who don’t want to pay what they owe you.
This will cause your revenue cycle to come to a grinding halt, leading to you missing out on the money you’ve earned. Let’s dive in.
How would you define the dental revenue cycle?
First thing’s first - what do we mean when we say dental revenue cycle?
The dental revenue cycle refers to all the activities to identify, collect and manage patient service revenue, from appointment-making to accounting for all payments. The faster and more accurate these activities, the better the financial health of your dental practice.
The activities include your processes for scheduling patients and collecting payments. This involves submitting insurance claims to make sure you are paid by insurance companies. Any effort your team is making to bring in more money is part of your dental revenue cycle.
The forces that impact your revenue include whether or not insurance pays on your claims. Denials and delays happen, and this can affect your dental revenue cycle. Cancellations or no-call, no-show appointments happen, and this can also affect your revenue cycle.
Related: 10 reasons your dental insurance claims are being denied
Your revenue cycle is like a wheel turning on a bicycle. The patients and your dental team’s efforts supply the energy to drive the pedals and move the ride forward smooth and steady.
Things such as claim payment delays, cancellations, or patient payment misunderstandings are like friction on the wheels or even the brakes, that hold you back and can even prevent the wheels from turning.
So what does your billing process have to do with this?
Your dental billing process can make or break your revenue cycle
The dental billing process refers to all the steps involved to receive payment from insurance companies and patients for services your practice provides. Your dental billing process is the standard operating procedure (SOPs) used to collect revenue.
Because there are so many moving parts to a dental billing process, having set SOPs and strategies when moving through the billing process can make things flow more smoothly. In other words, the better your dental billing process is, the better your dental practice is. Let us explain.
Your dental billing process starts with a patient making an appointment. You then will verify their insurance benefits, perhaps give them an out-of-pocket estimate, and schedule their appointment.
This in itself is a process. Your insurance verification process is the first step of the billing process, and if it runs smoothly, you can count on successfully collecting payment from your patient right after their treatment. This is something that keeps the revenue cycle profitable!
But this means you have a trained team member verifying the patient’s insurance, who knows what information to look for when looking through the patient’s coverage. This person needs to also be capable of calculating out-of-pocket costs confidently and communicating this information with the patient.
Your insurance claims process is even more vital to your revenue cycle
Now that you’ve guaranteed you’re collecting your patient portion, now let’s get to the other half of your revenue cycle: insurance claim payments.
The insurance claims process is a huge chunk of your dental billing process. It is complicated and requires niche dental insurance expertise.
Not only does someone on your team need to be creating claims within one day of the patient’s treatment, they also need to be:
- Sending these claims to the clearinghouse to be batched
- Attaching the appropriate images and documentation to the claims as required
- Submitting claims to the appropriate insurance
- Following up on submitted claims by working the insurance aging report at least once a week
- Working and researching to appeal denied claims
- Posting claim payments to the practice management software daily.
Each part of this process depends on the previous step. If this process isn’t organized, errors will be made that will lead to denied insurance claims, leading to delays in payment. This is where your revenue cycle starts to slow down or even stall.
To combat this and to keep your dental billing process moving smoothly, here are a few quick tips from our dental billing experts:
- Have a person, team or service dedicated to your insurance claims. This is not a passive task that someone can squeeze into their day when they have an extra hour.
- Create SOPs for each step of your dental billing process. This way, if a team member is out of the office, the insurance billing won’t be on the back-burner.
- Seek out formal, continuous billing education and training for your dental team. Dental insurance rules and regulations change constantly, and training can help your team keep up.
When the process runs smoothly, everyone knows their roles and responsibilities, and you have clear processes for your billing - money is going to flow easily into the bank. And you and your dental team will be less stressed.
And your revenue cycle will be profitable.
Take your revenue to the next level with RCM support
You now understand how much your resources affect your revenue cycle. Without a clear and smooth billing process, cash will cease to flow at your practice.
Through the creation of SOPs, having strategies for each step, and continuous education, your dental revenue cycle will thrive - leading to your financial and professional success.
But hey - you don’t have to do it all on your own. Dental ClaimSupport is a dental billing service dedicated to helping your practice be more profitable.
To learn more about how outsourcing your dental billing can increase your practice’s income, visit our Ultimate Guide to Outsourcing Your Dental Billing.
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