Best Practices for Revenue Cycle Management in Dentistry

Patient care is top of mind for dental practices, but optimizing revenue flow is also vital. Without revenue coming in, your practice can’t succeed. Get your revenue cycle management (RCM) right so your staff isn’t overworked, patients are satisfied and all the numbers work out. Strong RCM processes can help maintain financial stability while supporting a seamless patient experience.¹

What Is Revenue Cycle Management in Dentistry?

Revenue cycle management for dental practices refers to the administrative and clinical processes used to manage all functions associated with patient billing, claims processing, payment collection and revenue generation. In the simplest of explanations: Dental RCM is used to improve efficiency and help ensure profitability to keep up with expenses so the work can continue and patients are happy.¹

The basic components of the revenue cycle management process involve a charge capture, the coding process, claims submission, payment collection and payment processing.¹ However, the process of healthcare billing and collection doesn’t always move along smoothly, which can lead to some common RCM challenges in dentistry:

• Dental billing errors. Coding and compliance errors can lead to thousands of dollars in lost revenue.²
• Insurance claim denials. Insufficient documentation or support for a claim can result in lost revenue.²
• Patient nonpayment or underpayment. When a claim is unpaid or underpaid because of line-item denials or errors, the provider attempts to collect to close the claim properly.
• Lack of employee training. Inadequate support and training for staff can lead to user error in the administrative and financial workflow of a dental office.

Increase Efficiency and Improve RCM Within Your Dental Practice

Patients usually don't want to spend more time at the dentist than necessary; they also often don’t want to think about insurance complications or healthcare billing errors after a procedure is complete. When your dental practice engages effectively with patients, that can help treatments and costs be presented accurately and billed properly, creating a good patient experience that may help your revenue cycle continue smoothly.

Here are some of the ways to increase efficiency and improve revenue cycle management for your dental office:

• Communicate. Correspond in a timely manner with insurance companies.
• Train. Provide thorough staff training to avoid errors in the reimbursement process. Also, make sure you have enough staff.
• Innovate. Update in-house billing software and systems so all patient information, history and communication preferences are at your fingertips.
• Pay attention to details. This will help minimize complications and maintain efficient healthcare revenue cycle management.

Streamline Appointment Scheduling and the Verification Processes

Maintaining a full schedule is something dentists know is critical, but making sure this effort supports your healthcare revenue cycle management at every turn can be a challenge. Organization, communication and consistency can help through the following methods:

• Keep an accurate calendar. Make accurate appointments so dates don’t have to be changed, patients are not inconvenienced and data is entered into your system cleanly.
• Verify insurance. Conduct insurance verification eligibility before the appointment occurs so there is no need to delay treatment and no confusion about coverage and costs.
• Confirm appointments. Contact patients several days before their appointment to minimize no-shows and help ensure patients show up when they’re supposed to. Leverage automation to support these efforts.
• Schedule annual visits. It’s not easy for anyone to plan six months ahead of time, but it’s worth getting patients on the calendar for a cleaning and check-up so neither of you forgets about it later.
• Use an online system. An easy-to-use online scheduling system and digital forms can make it convenient to schedule appointments quickly and gather up-to-date information.¹
• Ask for referrals. One way to fill in dead spots on your calendar is to ask patients for referrals. Every interaction with a patient is a possibility to welcome someone new through your door.

Invest in Your People and Practice

Strategic revenue cycle management at your dentistry office can cut down on manual labor and associated errors, helping improve accuracy and efficiency, especially when it comes to the billing process, collections and accounts receivable. Take the time and resources to invest in what matters most and what can truly help your dental practice management thrive:

• Provide employee training. A well-trained staff can help to improve dental RCM efficiency.

• Enhance claims management. Invest in accurate coding and timely claims management training to help minimize claim denials or the need for resubmission.
• Optimize payment processing. Provide flexible payment options for patients and offer different forms of payment that can help reduce payment processing times. Many consumers prefer electronic options for medical-related bill-paying.³
• Focus on patient communication and education. The more your patients know about treatments, costs and payment options, the more informed they may feel. Clear communication about patient responsibility and other financial concerns can help reduce patient healthcare billing inquiries. Additionally, educating patients about healthcare costs can help avoid claim denials.¹
• Conduct audits and performance monitoring. Regular reviews of your dental RCM systems can help identify and rectify inefficiencies.
• Utilize technology and automation. Technology can help streamline RCM processes with solutions like automated appointment reminders and coding, electronic claims submission and online payment portals.³

Performance Monitoring, KPIs and Their Effect on Dental RCM

Regular audits can highlight ineffective elements at your dental practice, whether you’re looking at coding, billing or payment collection efforts. There are many possible errors in the dental RCM process, but the following key performance indicators (KPIs) can help determine how to keep the business end of things healthy — so you can make improvements as needed:²

• Patient access. The goal for patient access is typically five to 10 days before their visit so you have time for insurance verification and to avoid any setbacks when the patient arrives.
• Accuracy. Ideally, dental staff obtain insurance verification info quickly to complete tasks efficiently. Hold times for appointment scheduling can be measured, as can correctness in answering patient inquiries and the need to reschedule appointments due to an inability to secure pre-authorization.
• Speed. The time between when services are rendered to when coding is complete should be done quickly but accurately. The result is enhanced productivity and timely clearing of queues.
• Timeline. The business end of a dental office is measured by metrics such as clean claims submissions, the time it takes to get a bill out the door, the average number of claims issued correctly the first time without needing edits and the speed with which a claim is paid and closed.

The Path to Mastering the Dental Revenue Cycle Management

Lasting profitability can be impossible to come by without smart ways to track and measure KPIs that help define the success of your dental revenue cycle management process. Monitoring performance and having all possible enhancements in place (including software) to support your team can help deliver insights into efficiency and aid with optimizing RCM so adjustments can be made as needed.¹

Focusing on and improving revenue cycle management at your dental office can help you get paid in a timely manner.¹ It can also enhance the patient financial experience.³ A proactive approach to dental RCM can help create sustainable success. A financing solution like the CareCredit health and wellness credit card, for instance, can help ensure timely payment, typically within two business days. It can also provide patients with an alternate option to pay for out-of-pocket expenses and help reduce the patient portion getting pushed to accounts receivable. By streamlining these processes, your dental team can minimize time spent on administrative tasks and focus more on patient care.

A Dental Patient Financing Solution for Your Practice

Want to help more patients move forward with the dental care they want or need? Consider offering CareCredit as a financing solution. CareCredit allows patients to pay for out-of-pocket dental care costs over time while helping enhance the payments process for your practice.

When you accept CareCredit, patients can see if they prequalify with no impact to their credit score, and those who apply, if approved, can take advantage of special financing on qualifying purchases.* Additionally, you will be paid directly within two business days.

Learn more about the CareCredit credit card as a dental patient financing solution or start the provider enrollment process by filling out this form.

Author Bio

Elizabeth Weiss is a freelance writer and editor with more than 20 years of experience in content development for dentistry, orthodontics and cosmetic dermatology. She focuses on making healthcare topics accessible to readers and contributes to many fields, from family and estate law to industrial services and landscape design.

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