Dental Revenue Cycle Management: A Comprehensive Guide

Running a successful dental practice comprises various challenges, especially for dentists, such as stabilizing the practice's finances. Plus, addressing staffing issues, billing and coding, and the responsibility to provide improved patient care more often prove to be a burden for dentists. However, in dentistry, healthy dental revenue cycle management (RCM) proposes many solutions to your in-house team to collect payments efficiently and operate the entire process fittingly, from the patient visit to the final insurance or patient payment. The only need for dental professionals is to pay careful attention to every step of RCM, its essentials and advances to achieve the goals of receiving revenue faster. Stay with us to add to your knowledge the complete RCM step-wise process in this comprehensive guide and ensure you can keep improving your practice performance, including your staff involved in achieving the purpose of delivering first-rate dental care. On top of that, you must keep analyzing the top dental revenue cycle management companies, such as MedsDental Billing, that can efficiently and accurately deal with every step of RCM and guide you best regarding the "essentials" needed in each management step.

Why is effective dental revenue cycle management crucial for your dental business?

Proper dental revenue cycle management services for your practice are crucial for grooming the business aspect of your practice. Furthermore, it has to offer advances to a great extent:

• To add to the dental practice's profitability
• Easy collections from both patients and insurance providers
• Offers a structured system to track services and payment collections
• Increase the confidence that every step in RCM is accurately completed
• Reduce the risk of claim denials, saving the practice's dollars uncollected in revenue
• Determine the goals and targets for your team to achieve

The Description And Essentials Of RCM Steps

Step 1 - Patient Registration

• The RCM begins with the patient getting appointed in the hospital
• The front-desk staff registers the patient by collecting their personal information
• Patient registration is the determining point for how smoothly the rest of the process will work.

Essentials:

• Accuracy is a must for your in-house team while gathering patient data.
• Accuracy helps to ensure a more cost-effective patient registration.
• It is essential to keep focus on double-checking the qualitative and quantitative information collected.
• Entering data manually may lead to errors or misinformation, especially when the patients' number increases.
• Errors will likely result in denied claims and inaccurate patient statements and cause additional costs to the practice.

Step - 2 - Insurance Verification

• The second step of the RCM process, insurance verification, administers both the patient and provider.
• The process ensures that the provider keeps all the current and necessary details regarding the services covered by the insurance plan.
• Patients are also aware of their financial responsibility and payments to compensate, along with their insurance, before treatment begins.
• Insurance verification encompasses collecting and recording patient data and comparing it to the details mentioned in the insurance provider's notes.

Essentials:

• Dental practices can lift their revenue at this stage if they find an insurance verification partner proficient in utilizing technology.
• Current technology or insurance verification software leaves no room for errors in practice and, consequently, contributes to revenue boost.
• MedsDental Dental Billing company is one of the leading partners in efficiently proceeding with the latest technology in revenue cycle management.
• We utilize the latest technology and automation for both the collection and updation of patient records before their appointment confirmation.
• If the insurance verification is smoothly handled with the technology, the team can easily get prepared for the next step.
• To formulate the measure of costs and treatment plan along with the insurance benefits prior to the patient's record.

Step - 3 - Presenting The Treatment Plan To Patient

• After successful patient registration and insurance verification, the next step is for the dentists to perform a patient examination and create a treatment plan.
• The plan carries the anticipated service costs and insurance reimbursement.
• Dental services charges vary according to the specific location, level of service, and the dentist's expertise.
• The treatment plan also includes the patient's financial responsibility and payment methods.

Essentials:

• One of the contributing factors to the success of your practice revenue is that this is an excellent place to offer convenience to patients.
• Reconsider the various payment methods and policies for patients and carefully determine how better a certain treatment should take place.
• Clear communication and transparency is the key to success in this stage.
• Ensure that your patients clearly understand what you expect from them.
• They should feel comfortable resolving queries, and you should also ensure that you can easily answer their questions.
• Make sure your practice avoids overcharging and undercharging, the leading cause of claim denials.

Step - 4 - Claim Submission

• After the dentists determine the charges and assign accurate codes to the treatments, it's time to submit a claim to the dental insurance provider.
• Claim submission can be performed electronically or in print, as per the insurance company's preferred method.
• Coding and documentation are the most important components of the claim submission process.
• Submitting claims for the first time for insurance reimbursement can become more than a challenge; hence, ensure you proceed with each step cautiously.

Essentials:

• The success of your practice revenue relies on accurate and prompt claim submission.
• Make sure you actively proceed with assigning the right codes to the services delivered.
• Accurate code assignment and complete documentation will offer your practice complete reimbursement.
• Outsourcing dental revenue cycle management (RCM) to the RCM experts is another significant strategy to consider.
• Experts supporting your in-house team also understand the value of insurance revenue as the fundamental part of your revenue cycle management.
• Plus, these experts are efficient at getting faster payments from insurance providers, reducing costs, and overturning denials.
• MedsDental Billing company is a dedicated dental revenue group to keep the practice updated and compliant, saving dentistry thousands or millions of collections.
• We stay ahead in knowing the codes, rules, and industry policies that keep changing across the period.

Step - 5 - Claim Adjudication And Insurance Payment Posting

• Claim adjudication takes place after the claims are submitted to the insurance provider.
• They review and analyze claims to ensure the accuracy of payment records and whether the charges match the expected amounts.
• Insurance companies pay the dental practice via electronic funds transfer (EFT) or with a paper check.

Essentials:

• If the payment posting lacks accuracy, errors are likely to occur, causing late payments, payment posting errors, or denials.
• Discrepancies or irregular adjustments may lead to fraudulent cases.
• Avoid the hurdles of inaccurate payment posting by accompanying dental billing companies providing proficient RCM solutions.
• They can efficiently internalize the issues through their extensive knowledge and expertise, reducing the risk of embezzlement.

Step - 6 - AR Management

• Claims getting denied or partially paid is a common phenomenon in revenue cycle management.
• Denials require the dental practices to recheck the claims and find out the reason for denials or incomplete payments.
• They also evaluate the documents by correcting errors or missing information or sending appeals to insurance providers to reconsider the claims until they are paid and posted.

Essentials:

• If the A/R is managed in due course, you will see an increase in your practice cash flow with fewer write-offs.
• Ensure proper follow-ups to maximize your practice reimbursement.
• If your practice's A/R is managed by experts, such as appeal denials and follow-ups, your practice can claim the amount you owe.
• They know the best practices to communicate with insurance companies and appeal management until your claims are paid.
• A successful A/R management will ensure your practice:
• Holds timely collections
• Improve compliance with regulations
• Reduce bad debts
• Increase patient satisfaction by offering them the best to get from their insurance benefits.

Step - 7 - Patient Collections

• Once you are done with insurance reimbursement, it's time to work with patients to collect the remaining dues.
• Your in-house team collects the patient balance by sending them reminders with tech-enabled tools.
• The front desk staff discusses the patient's financial responsibility, collects payments, and offers them a receipt.

Essentials:

• The patient collection is the final stage to complete the RCM.
• Help patients by offering them the convenience they need to acquire due balances.
• Automating patient billing is the best option to increase revenue and save your budget by mailing paper bills.
• Automation can help you collect payments and help patients pay you efficiently.
• When automated billing with AI technology, your patients can get timely reminders on what they are required to do.
• Utilizing all the above-mentioned RCM strategies can streamline patient billing and help you save additional administrative costs.
• Plus, your team can save time by automating the time-consuming billing and payment collections and lay their focus solely on fulfilling the purpose of providing preferred patient care.

Align Your Practice Dental Revenue Cycle Management With MedsDental Billing: An End-to-End RCM Company

Partner with end-to-end dental revenue cycle management companies such as MedsDental Billing that not only aim to improve your practice efficiency but also revolutionize your practice profitability. We understand how important it is to support your dental business for growth and quality patient care delivery. Furthermore, we keep interpreting your practice needs to design the best revenue cycle management strategies according to the current standards of dental coding and billing. In short, our efforts are extended to help you achieve an advancement in revenue and practice reputation.