Have you heard of the “Three Cs” of dental revenue cycle management? Each one of these outsourced revenue enhancements works to keep your practice profitable and scalable. By outsourcing your dental RCM, your practice can focus on what matters most: your patients. Why spend the time away from smiling faces in your office for spreadsheets and claim forms? Packaged together, the Three Cs give your practice access to the nation’s leading platforms for comprehensive dental revenue cycle management. Here are those “Three Cs” that are integral to your practice’s success:
Credentialing
Everything starts with credentialing. After all, how can dentists expect to provide for the most patients without an insurance network, or PPO? Getting the proper credentialing to be able to practice within a provider network is an essential element of dental RCM.
What does PPO stand for in dentistry?
PPO, or Preferred Provider Organization, means that your insurance company maintains a network of dentists to provide treatment. These dentists enter into a contract with the insurance company and agree to adhere to the company’s predetermined fees for their services. Here’s a simple example using an office’s standard, customary, and reasonable (UCR) fee for a typical cleaning:
- Without insurance, the UCR fee is $150
- The agreed-upon fee with the PPO insurance company is $100
PPO plans allow your patients to choose from a network of providers that all charge the same amount for the same services. As a dentist, it’s in your best interest to provide services with maximum reimbursement potential, such as cleanings or referral surgeries. By contracting with and negotiating with a PPO, you gain the advantage of access to dozens to hundreds of patients in your community, allowing you to provide a greater range of treatment. Unitas PPO Solutions can give you an idea of the best PPO networks to join, and a free half hour (or less!) consultation is all you need.
Which is better for dental RCM, a PPO or HMO?
HMOs are Health Maintenance Organizations, which are tied to specific insurance companies. Patients are tied to specific insurance companies and dentists to get treatment. In terms of dental RCM, your office should have a PPO network that allows you greater access to patient choice as well as a wider range of service types. Unitas PPO Solutions gives dentists a wealth of credentialing and PPO negotiation solutions. Here’s how it works:
Coding
Along with dental billing, coding is one of the most important aspects of your dental RCM. Without access to the right resources, a thorough understanding of treatment types, and the ability to pivot to new changes every quarter, your claim reimbursement rate can suffer. Thankfully, the industry-leading authorities at Practice Booster have a suite of coding solutions products that make dental coding simple and effective when it comes to collecting 100% of what you’re rightfully owed.
How do CDT codes connect to dental RCM?
Simply put, without the right CDT codes, your claims will be rejected or denied. This makes the appeal process take that much longer and disrupts cash flow.
How often do CDT codes change?
CDT codes change annually, making updates essential to streamlining dental RCM. If you’re not aware of changes, how can you expect to submit a clean claim?
Why do I need a coding resource?
Coding resources give you all the dental coding answers you need at your fingertips. Plus, Practice Booster’s Code Advisor lets you dive deep into the intricacies of well-known codes and tricky claim submissions.
Collections and dental RCM
Finally, the third C is collections, which is where eAssist Dental Solutions comes in. We are the nation’s leader in dental billing and collections solutions, allowing you to craft a bespoke package of dental RCM services that fit your needs. You don’t pay for what you don’t want or need, and we only get paid when you do! Created by dentists for dentists, eAssist understands the business of “your business” when it comes to collecting 100% of what you’re rightfully owed.
Explaining dental RCM
After all of this talk of dental RCM, let’s break it down to it’s simple parts:
- Scheduling and providing treatment
- Collect copay and patient portion
- Send clean claims
- Get reimbursed quickly and fully
eAssist can help with every aspect of this process and more. From patient recall to accounting and EFT reconciliation, you can streamline your operations every which way and put your dental RCM on autopilot.
How outsourcing dental RCM helps your practice
Collecting 100% of what you’re rightfully owed doesn’t need to be rocket science. Automate your processes using the Three Cs as your personal toolkit to sustainable profits. Schedule a chat with a Business Development Specialist below today and tell us where you want to take your business.
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