Dental Revenue Cycle Management in Your Practice

Achieving positive financial results in your practice requires a level of dedication and business knowledge that may initially seem overwhelming and complex. Your dental practice revenue health is dependent on the moving parts of your overhead, insurance billing processes, and patient retention all working together to create cash flow. The innate rule is simple: wherever you can make money, you should be making money. Starting from the bottom up, let’s get an overview of some common aspects of dental revenue cycle management.

What does RCM stand for in the dental industry?

Dental revenue cycle management (RCM) is the process of optimizing all financial aspects of your practice. As well as this, RCM encompasses all the activities that are involved in the management of a patient’s financial relationship with a dental practice, from the initial appointment scheduling to the final payment for services rendered. The goal of RCM is to ensure that you are reimbursed accurately and timely for all services provided, while also ensuring that your patients receive the appropriate care and support throughout.

What are the 4 steps in the revenue cycle?

It can be easier to break down each process in dental RCM separately to avoid confusion in management:

1. Initial patient registration and insurance verification
   We start each appointment booking by verifying insurance, EOB matching, and gathering any necessary preauthorizations and fee schedules for the treatment provided. If they are an existing patient, insurance verification is still a must to verify benefit coverage during the treatment period. New patients should have all personal information recorded at the time of booking to be verified prior to the appointment. There’s no need for them to fill out paperwork once they finally step into your office. Once that happens, it’s as simple as verifying the information they already provided to you.
2. Dental billing and claim submission
   During treatment, it is the responsibility of the doctor and hygienist to accurately record clinical and procedural steps to best provide evidence for reimbursement. Without detailed narratives, accurate coding, and verifiable procedural necessity, you run the risk of having a claim denied due to insufficient evidence. This step in the process also requires you to be aware of the possibility of denial or rejection and be able to advocate appeals in a timely manner to collect what you are owed.
3. Claim payment posting
   Ideally, your submitted claim should be approved by the insurance carrier without issue. However, best intentions aside, denials and rejections happen to every office. Mitigating them requires careful attention and managed operating procedures, from narrative templates, coding resources, and the ability to justify treatment for every claim.
4. Accounts receivable follow up and patient statements
   Once a payment has been posted to an account, you must follow through with collecting any remaining patient portion. If the extra amount is due to inaccuracies in benefits, implement a consistent verification strategy to mitigate benefit timeline errors. Some providers will reject a claim on the basis of expired benefits if it is submitted outside of the initial treatment window, so timely submission is critical to reimbursement. Without this, your patients may be stuck with a large bill that can take months to pay if at all.

Gaps in your dental revenue cycle management

The gaps in your revenue cycle take many forms, and paying attention to the burgeoning signs of diminished cash flow is critical to achieving financial success:

• You face increasing claim denials or rejections
• You experience frequent cancellations
• Your unpaid accounts over 90 days are growing
• Staff turnover due to lack of morale and justified processes

The only benefit to noticing the signs of decreased revenue is understanding where the problems lie. Implementing strategies that work doesn’t need to be a daunting task with a myriad of extra moving parts that you are unable to control. A better solution is to outsource comprehensive financial management tasks to a trusted partner in revenue health services.

Putting your dental revenue cycle on autopilot

The variety of processes in managing your overall dental revenue health don’t have to be taken on solely by your staff. eAssist Dental Solutions offers you the nation’s leading platform of bespoke practice revenue solutions, from scheduling, dental billing, and insurance verification. Here are just a few of the benefits you can anticipate from eAssist:

• Dental billing claim submission and appeal
• Working your aging to increase collections
• Improving workflows to allow your staff to focus on patients, not finances
• A trusted partner with transparency in reporting and ROI

Regardless of what your specific needs are, with eAssist you are able to create your own customizable plan that benefits every area of your practice on top of increasing cash flow. Revenue cycle management doesn’t need to be a losing game for your practice. You can increase your income by outsourcing your billing and more on the eAssist platform. Schedule a consultation with a Business Development Specialist at your convenience to learn more about tailoring revenue cycle management to your biggest financial goals.