What is the End-to-End Dental RCM Process?

Dental revenue cycle management (RCM) is more than just the latest industry buzzword. It’s a step-by-step optimization process that works to keep your practice efficient and profitable. By layering on each of these steps, you can effectively put your finances on autopilot. Of course, with this layer comes the ability to fully streamline administrative tasks from scheduling to dental billing. Today, we’ll take a deep dive into the dental RCM processes that eAssist Dental Solutions can provide for your practice to help you to achieve your financial goals, starting the minute an appointment is booked.

1. Scheduling, booking, and completing an appointment

Your patients’ first experience with your practice starts when they book treatment. Your front office staff greet them with a smile and get them scheduled. What happens next? Of course, ideally, the patient makes the appointment. But how do you know that that patient is covered during that time for that specific treatment? The answer is simple: insurance verification. This is one of the most crucial aspects of preappointment readiness.

Preappointment readiness

Knowing that your patients have consistent insurance coverage is crucial to avoiding appointment and patient portion collection headaches. If a patient knows their obligation to you before treatment, they’re much more likely to pay in advance instead of requiring a phone call down the road. Here are a few preappointment readiness tips that tie everything together before treatment starts:

• Verify insurance coverage dates and exemptions prior to the appointment
• Double check that your PMS includes a patient’s legal name (ie: Bill versus William)
• Don’t assume medical coverage pays for dental, always check

Consider preappointment readiness as your “prevention is the best medicine” toolkit. It’s much better to know beforehand than have to make up for lost time (and money). eAssist offers DIY and done-for-you insurance verification as soon as 24 hours before an appointment to set you up for success.

2. Dental billing and claims submission

Dental billing is your bread and butter in terms of long term, consistent cash flow. Without accurate and consistent insurance reimbursement, your ability to scale is diminished. There are three primary cogs in the dental billing machine to be aware of for proper reimbursement:

• Collect clinical notes from doctor and staff during the appointment
• Attach relevant x-rays and photos as needed
• Utilize dental coding resources to ensure correct reimbursement for specific treatments

The role of CDT-10 codes in the dental RCM process

If you don’t have the latest CDT-10 code updates, your practice could be losing out on collecting 100% of what you’re rightfully owed. Consider CDT codes as the “dental billing language”. If you aren’t fluent, you won’t be able to hold the conversation with the insurance company to get fully reimbursed for patient treatment. Consider Practice Booster’s industry-leading resources for dental coding, with the latest revisions, changes, and deletions as they’re decided.

3. Dental billing claim follow up

eAssist makes collecting on insurance from your over 30, 60, and 90 AR simple. By diligently working from the most recent claims, you can see improved cash flow that much quicker. Plus, you’ll have an open line of communication with your remote team of billing experts and receive daily reporting for accountability. Transparency with your finances is important, and eAssist platform users understand this need through diligent ROI management. If you have rejected or denied claims, they are followed up on timely.

How to stop dental billing rejections and denials

No practice wants to be served a reimbursement denial from an insurance company. Unfortunately, due to the amount of information needed for each specific claim, they can become common without diligent processes. Here are the top three reasons why claims are rejected:

• Missing or incorrect patient information, address, SSN, legal name, etc
• Lack of insurance verification to prove coverage for treatment
• Using obsolete claim forms

eAssist’s platform solution to denials and rejections is insurance verification as well as diligent follow up for any claims that may have slipped through the cracks, giving you the peace of mind in knowing that these claims and subsequent reimbursement won’t disappear forever.

4. Reconciling patient statements

Of course, it isn’t just insurance reimbursement that you’ll be looking for in your dental RCM process optimization. Patient statements can become a real burden on your cash flow. Copayments aren’t paid on time, patient portion isn’t collected at the time of service, and suddenly you’re looking at a patient with thousands of unpaid dollars on their account that they don’t want to pay. Once again, we’ll be looking at prevention as the best medicine when it comes to patient billing, through insurance verification and staff training to collect during the appointment, Of course, if you already have a backlog of patient AR over 90, eAssist’s platform solutions can help.

The role of patient billing in the dental RCM process

The eAssist platform was created by dentists for dentists, so we understand the need to handle patient billing processes delicately and professionally from start to finish. Our solutions process follows a number of steps to collect payment:

• Confirm balance accuracy
• Send first statement
• Second statement is sent
• Contact patient using their preferred communication method (phone, email, text, etc)
• Create and send personalized letter requesting payment along with another phone call or email, etc
• Final letter to patient is sent, if no response, office can decide next steps (eAssist does not relay to collection agencies)

5. Reconciling finances in the dental RCM process

Of course, no dental RCM process would be fully complete without final accountability in bookkeeping and reconciliation. The eAssist platform offers these solutions to practices in a bespoke package that fits your needs:

• Accounting that balances your books daily and can even pay your bills
• P&L statements
• Expense categorization
• EFT reconciliation
• Reduction of embezzlement risk through outsourcing
• Daily, weekly, monthly reporting for complete transparency
• And more

Your partner in outsourced dental RCM solutions

Gone are the days where your staff have to handle every administrative task in the office. Lead with peace of mind by partnering with the nation’s largest platform provider of bespoke RCM solutions. Your consultation is free of obligation, and our Business Development Specialists want to hear your goals. Our solutions are for the health and longevity of your practice. Through diligent management, you can achieve the cash flow you need to scale. Schedule below and tell us where you’d like to see your practice in the next year and beyond.