Artificial intelligence (AI) is becoming ubiquitous in all our lives, but what is its role in dental billing? And when is the right time to dive in?
As any dentist will tell you, patient satisfaction is at the heart of a successful practice. Happy customers result in loyalty, repeat business, positive reviews, and valuable referrals. That’s where dental billing comes in. The faster we can process pre-authorizations and claims, the quicker patients are done with their procedure, the happier they are, and the more likely they are to return to your practice. AI is at the forefront of enabling these capabilities.
As an early adopter and a developer of an AI dental billing solution, I’m pleased to answer questions we’re commonly asked about this emerging technology.
What are the advantages of using AI for dental billing?
Using AI for dental billing has two core advantages: accuracy and efficiency.
On the efficiency side, AI will allow dental billers to do more in the same amount of time by automating many rote tasks. On the accuracy side, AI makes it possible to submit error-free claims, leading to faster payment times. Case in point: We compared hundreds of thousands of claims submitted through our AI tool, eAssist Copilot, to claims sent outside of Copilot with the existing practice management system. Claims submitted through Copilot were processed 40% faster.
Additionally, higher accuracy reduces lengthy reviews, rejections and denials, which are painful for practices and patients alike. In this way, faster claims processing enhances the patient experience.
There are several ways dental practices can leverage AI for dental billing:
- Utilizing new features released by their existing PMS system
- Partnering with service providers that drive results with AI (so you don’t have to)
- Using add-on AI tools that revenue cycle management software providers are now offering
How is AI enhancing the eligibility space?
There are emerging AI players looking to ease the burden of offices by improving data accuracy as well as access to (and accuracy of) eligibility information.
As most people in the industry are aware, current eligibility technology is dated and cumbersome. The recent shutdown of a major player in the electronic data interchange (EDI) space has exposed the vulnerability of this system. Additionally, that old electronic format doesn’t map perfectly in a standard way to the available fields in a practice management system.
The lack of standardization is a big headache for office staff. This can lead to confusion on the practice side and for anyone trying to access eligibility information. To address this challenge, several AI companies are working to normalize EDI data so that it can be consistently transmitted to practice management systems. The other challenge we’ve seen is that EDI data at the different carriers comes from disparate databases that are, again, not consistent.
This can cause inaccuracies when checking a patient’s eligibility. If the EDI-connected insurance carrier database lags behind the updated database that typically drives the payor portals and their support staff, this can cause additional issues in a significant 5% of eligibility requests..
To resolve this issue, AI companies are working to complement EDI data with data from each insurance carrier’s website. This enables higher quality data without the cumbersome requirement of logging into each payor’s portal to do an eligibility check, since the software “scrapes” the data off the portal.
What role does AI play in payment processing?
We’re seeing more automation in the posting of payments. AI companies are streamlining and automating payment verification through a number of approaches.
- Automatically entering an explanation of benefits (EOB) and associated payment information into some practice management systems
- Automatically connecting with the dental practice’s bank to confirm a check amount and reconciling it with the EOB
- Using AI to interpret the EOB, determining where data sets on the EOB need to flow into the practice management software, or into the AI tool that helps to streamline this workflow
Will AI replace dental billers?
The short answer: not any time soon.
AI-powered tools help dental billers do their jobs more effectively. They’re still performing dental billing functions, but AI technology accelerates that. Additionally, their work may be shifting a bit. We may rely on expert dental billers to check the AI and bring their own knowledge to each transaction.
AI may make their work more enjoyable because it eliminates many tedious tasks ripe for automation. This can bring additional meaning to how they’re spending their time. Instead of working on repetitive tasks, dental billers can apply their expertise to guide the practice in billing best practices and spend time tackling more complex work.
What dental billing tasks can AI support?
While AI is advancing rapidly, it’s no substitute for the judgment and experience of a skilled dental biller. Even with today’s most sophisticated systems, human expertise is essential. Some insurance claims, like teeth cleaning and dental checkups, can be streamlined with AI, but a human expert is still verifying accuracy before the claim is sent to the insurance carrier
The abilities of AI will gradually increase to handle more complex tasks; however, trained dental billers will be needed to address the nuances of complicated dental claims. Automation may support the process and increase payment velocity – getting the job done faster, but human expertise continues to drive it, to get the job done right.
What are the obstacles to adopting AI?
Change is always difficult in a fast-paced dental office. Your focus is on patients and ensuring they have a good experience, so you may be reluctant to adopt a new process or software that uses AI. In that case, you may prefer to work with a partner who has embraced AI internally for its own practices and can take the AI learning curve burden off your practice.
There are many practical considerations when you’re bringing an AI tool into your practice. How will this change my current processes? Who’s going to be in charge of driving this project and has the capacity to do so? Do they have the bandwidth to deal with technical issues, keep one foot in the old process and one in the new, and blend those two worlds? Consider your staff’s expertise, availability, and enthusiasm for new technology when making this decision.
What should I consider when evaluating AI tools?
When considering AI tools for a dental practice, take a hard look at the return on investment. During demo calls, it should be clear what the ROI is going to be. Also, check how early adopters are faring so you can learn from their experiences. In addition, be sure that potential AI vendors are cognizant of HIPAA guidelines and follow industry best practices for safeguarding protected health information (PHI).
Currently, there are three different approaches to enabling AI in your practice.
- Large language models like ChatGPT are self-hosted, so you retain total control over your data. You operate the AI tool on your own servers in the cloud, so the data is retained there.
- Some dental practices have special provisions with an AI service provider whereby the practice’s data cannot be used to “teach” the model. This doesn’t improve the model, but it does protect patient data, which is the first priority.
- Some providers use practice data to improve their large language models, essentially helping their AI to become “smarter”. I would caution against going this route unless it’s very clear how the provider uses your data, and that PHI data is not used.
Do I have to train an AI tool to work for my dental practice?
In most cases, that work falls to the AI vendor. Most of the dental practice AI tools are trained independently of the office. The vendors have spent a great deal of time fine-tuning AI models so they’re applicable across all dental practices.
How is eAssist using AI?
At eAssist, we developed an AI tool called eAssist Copilot internally to improve claim efficiencies and collection rates for our dental practice clients. When Copilot is integrated into the practice management system, it is populated with data that our employees enter to submit cleaner claims. The system automatically reviews historic patient data, so it has all that context for processing more complicated claims.
We combine that functionality with Coding for Confidence from Practice Booster, one of our subsidiary companies. They produce the leading guide on submitting clean codes to insurance companies. Copilot also features a suggestion engine that recommends to our employees what should be included in a particular claim.
All of this intelligence is built into our system and combined with the collective intelligence of our 1,800 dental billing clients. That data enables Copilot to get an edge on submitting clean claims on the first round. In this way, our clients benefit from AI without having to do the heavy lifting or transition their processes.
Frequently Asked Questions About AI in Dental Billing
Can AI help reduce insurance denials?
Yes. AI can dramatically reduce denials by helping ensure claim accuracy and catching common errors before submission. At eAssist, we’ve seen a marked improvement in initial acceptance rates with Copilot.
Does my practice need to invest in new software to benefit from AI?
Not necessarily. Practices that partner with a billing provider like eAssist can benefit from advanced AI capabilities, like our proprietary Copilot tool, without changing their current practice management system or investing in new software.
How quickly can we see results after implementing AI-supported billing?
Practices working with eAssist typically see improvements in claim turnaround time and collections within the first few billing cycles. When we compare claims sent by Copilot to claims in another popular PMS, we see a 40% increase in time to first payment.
What types of practices benefit most from AI-enhanced billing?
AI can benefit all dental practices, whether solo, group, or DSO. Any practice with recurring billing challenges, high claims volume, or staffing constraints can see improved financial outcomes through automation.
How can I ensure my patients’ data is secure when using AI?
Patient data security is a top priority. At eAssist, we follow strict HIPAA guidelines, and our AI systems are designed with data privacy in mind. We never use patient data to train public models and take extensive steps to keep PHI secure.
Is your practice ready for smarter, faster dental billing?
At eAssist, we combine the power of AI with the irreplaceable expertise of experienced dental billers. You don’t need to overhaul your systems or train a new team—we’ll bring AI-driven efficiency and accuracy to your billing process, so you can focus on what matters most, patient care. Schedule a consultation today to see how eAssist can help your practice thrive with AI-enhanced dental billing.
