After over a decade of working with several thousand dental offices, eAssist has created the ultimate guide to dental billing outsourcing eBook available for free download here. We cover all areas of outsourcing, from insurance verification to dental billing to payment posting, and help alleviate some concerns you may have with the process. By the end of this eBook, you will learn how dental outsourcing is not something to fear but, instead, something to embrace. In this ebook sneak peek, we’ll give you a first look into the ebook’s content. To view more details, click here to download the free eBook.
Pros of In-House Billing
By keeping dental billing in-house, the office manager maintains complete control over the billing process. They handle insurance verification, patient billing, claim submissions, appeals, and payment posting. As they are fully involved in the billing process, they are also fully responsible for all aspects, both positive and negative. Many office managers are skeptical of outsourced billing as they are afraid it may lead to a future job loss. While that is not the case, keeping billing in-house can give them a sense of job security.
Cons of In-House Billing
Currently, the average dental billing specialist salary in the US is $43,525 and can range from $39,405 to $47,860, which is significantly higher than the cost of outsourcing. It also doesn’t include the additional expense of employee benefits, payroll taxes, and worker’s compensation insurance, which can add a significant dollar amount to the cost of each employee. In addition, there are also the overhead costs associated with in-house billing.
Pros of Outsourcing
Keeping billing in-house can be expensive when considering the cost of salaries, benefits, training, and overhead. Outsourcing is inexpensive as there are no salary, benefit, training, or overhead costs. Instead, there’s just an outsourcing fee, which can vary depending on the size of your office.
Cons of Outsourcing
Outsourced billing requires frequent contact between the office and the dental biller. Since the biller is not in the office, the staff will need to call or email them with any questions or concerns. Although this type of communication is more challenging than asking them in person, the biller is readily available to discuss all billing matters.
Impediments to In-House Billing
There are numerous dental plans available, and each of these plans comes with its own set of rules and regulations. These rules and regulations must be followed for an insurance claim to be properly processed. When completing dental billing in-house, there is not enough time and resources available to help navigate dental plan complexities.
Overview of Revenue Cycle Management
Dental billing is submitting a dental claim to an insurance company to receive reimbursement for services rendered. It may sound simple, but, there are many more processes involved both before and after a claim is billed. These additional steps make up the components of revenue cycle management.
Choosing the Right Dental Billing Service
When choosing a dental billing service, there is much to consider. Think about your office staff and how much time they spend on billing. Is it not enough? Or too much? For either situation, outsourcing is a helpful solution. Also, think about how much time they spend on patient care. Is the billing distracting them from serving the patients? Are the patients causing too much distraction from the billing?
Insurance Verification
Insurance verification is contacting a patient’s insurance company and verifying the coverage available for treatment. It may sound simple, but it’s an involved task. Several factors need to be addressed, from the validity of the coverage to plan limitations such as deductibles and annual maximums, to plan restrictions such as treatments not covered and frequency limits.
Credentialing
Credentialing a doctor can be a lengthy process. You need to gather all the necessary paperwork, have the doctor review and sign it, and send it to the insurance company. Then, you need to wait for the insurance company’s response. It can take weeks and sometimes months as many carriers have a significant backlog. If any item should be incorrect, like an address, name, or TIN, there can be an added delay.
Dental Billing
When working in an office, the biggest impediment to dental billing is time. It’s a time-consuming task that’s hard to complete when the distractions of the office surround you. Even without distractions, dental billing takes up a significant amount of the workday. To complete it sufficiently and promptly, it’s a task that needs absolute focus.
Deposit & Reconciliation
When a payment is received, you will need to post it to its matching claim. If multiple claims are sent to the same insurance carrier, you will receive a bulk payment that must be broken up and distributed to several different claims. These payments arrive daily and must be kept up with to maintain a healthy A/R. Claim payments are the lifeblood of a dental office, and proper posting keeps the practice running smoothly.
Dental Coding
There are over 800 CDT codes and you must be familiar with them to bill a claim properly. Dental codes are often differentiated by only one digit and can be easily mixed up. The correct code must be billed for each treatment for claims to go out correctly and be paid promptly.
PPO Negotiation
Negotiating with a PPO is a lengthy, multi-stepped process that requires a significant amount of knowledge about PPO insurance and a lot of patience. First, you will need to determine how you are working with a specific provider. Are you out-of-network or in-network? If in-network, do you have a direct contract, under either a PPO-to-PPO lease or an umbrella network? You will need to determine this for each PPO you want to negotiate with and for each provider whose fees you want to increase.
Conclusion
From our experience with dental practices over the years, we created an ebook that is the ultimate guide to dental billing outsourcing. Click here to download the ebook for free!
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