Improving revenue cycle management

Improving revenue cycle management

Improving revenue cycle management is crucial to the financial well-being of a dental practice. If it seems like your practice takes longer than the needed time to receive payments, you are betting your profits on future collections. While this looks comfortable over time (as you receive payment every month), you are not in the best spot. If revenue takes a month longer to reach you, fixing that gives you immediate cash equivalent to the entire revenue of a month. Imagine how you can use the extra cash in hand to invest in future profits. Cash collected late or not collected at all has a huge opportunity cost, one that commonly goes unnoticed.

How can practice management systems help you reduce your collection time?

Irrespective of whether a practice is accepting insurance, keeping accounts receivable (A/R) low is fundamental to running any profitable business. The use of modern practice management systems can fix critical gaps in implementing an effective revenue cycle management strategy.

Eligibility checks to reduce late & rejected payments

It is better to stem a problem at the source. If your production time schedules with priority to patients who are more likely to pay on time, you would not be facing a revenue cycle issue, to begin with. The key here is to ensure that you can do this eligibility check fast and before the patient checks-in. A modern dental practice management system manages this process with simple one-click solutions.

Error-free claims submission with just a single click

The collected information can be compiled into an error-free claim, that is ready to be sent for processing. Automated workflows ensure due process and leave little margin for error. This saves valuable time and effort while processing claims, leading to a predictable revenue cycle. When executed well, this can eliminate the need for clearinghouses.

Make informed choices in treatment planning

Being able to choose the right plan for a patient, based on his insurance and payment capability, helps reduce confusion while billing. Furthermore, the choices made available for the patient will improve patient experience and ensure that the patient made the best available choice.

Automated ERA postings for faster and better accounting

ERA postings have always been a source of constant headaches for dental practices. The latest practice management systems enable you to completely automate this, making your accounting and collections more streamlined. Problems and discrepancies are detected early, and corrective measures can be taken pre-emptively.

Payment reminders to ensure faster collection

As a practice owner, you would have seen your collections increase when you actively follow up on receivables. Many times all it takes is a timely reminder to get a payment. These are the low hanging fruits in collection. Such follow-ups should be consistent and timely to be able to work. Automation features in modern practice management solutions ensure your collection effort is running consistently and efficiently.

Automation and process streamlining

Most of the financial processes currently utilized have a lot of redundancies that do not need active human participation. These systems once converted into automated workflows makes processing not just faster but also cheaper and more accurate. Therefore choose a practice management system that is serious about automation and continuously improves its capability in this space.


Billing, coding, and collections are sophisticated, yet crucial pieces for maximizing cash-flow and profitability. Therefore choose a system that ensures the optimal functioning of your revenue cycle with the least possible effort. Hence look for eligibility checks, treatment planner, billing, claims processing, ERA postings as necessary features when choosing your practice management system. Choose a system that allows and is keen to expand on its automation abilities and is built for improving revenue cycle management. Automation of such tasks is the future.

cashflow management

Cash flow management for dental practices

Revenue cycle management for dental practices is quite complex for the size of the organization. This is due to various challenges like generating and collecting revenue from both insurance and direct channels, as well as other nuances like UCR (Usual, Customary and Reasonable) fee schedule and various measures to optimize revenue and reduce denials.

The biggest challenges faced by dental practices include ensuring effective reimbursements, optimizing upfront patient payments, and bringing overall efficiency in the revenue cycle process.

Let us try and see how to organize all this in a simple strategy.

Five key areas that should lie at the core of your strategy are:

Reducing collection costs:

Keep looking at where the major costs in collection come from. It may even be your time to resolve problems. Reducing errors maybe your best way to reduce management time spent on the task. Maybe you have to route a lot of patients to collection agencies, increasing the cost of collection considerably, when regular follow-up alone could have solved the issue.

Raising net collections:

An active regular follow-up of accounts receivables is important. This helps to reduce lost production value and adds to your revenue. Focus on increasing net collections by automating follow-ups and reminders and sticking to a routine regular process.

Reducing effort and error:

It is important to confirm dental insurance coverage for specific procedures, so that when a patient sits in the dental chair and contemplates a treatment, the costs are at the dentist’s fingertips. This helps faster decision making and reduces errors and hassles.

Increasing speed of collections:

Modern systems provide advanced revenue cycle management features like automated tools that work to improve dental office billing and follow-up to enhance the speed of collections. Automated ERA postings can also help dentists get a grip on the situation faster.

Revenue cycle management in practice management systems:

Getting a modern cloud based practice management system with built in advanced revenue cycle management is perhaps the simplest way to bring the best practices in revenue cycle management to your office. This is almost a plug and play solution that takes care of everything from cross checking insurance eligibility to sending out payment reminders.

The final strategy should be designed based on these principles, in a way that works on your local community and your practice. Once this strategy is in place, the next step is to ensure smooth and consistent execution.

Choose a practice management system that has the following features that can help you implement your strategy:

  • Integrated electronic payments: Securely process debit and credit card transactions using integrated electronic payment solution.
  • Patient credits: Easily add payments and adjustments to all patients in a family during checkout.
  • Payment plans: Set up financial agreements for services done over a period of time and use them to create payment plans.
  • Finance charges: Apply finance charges to accounts which have overdue payments.
  • Fee schedule management: Maintain multiple provider fee schedules across multiple insurance plans.
  • E-claims and paper claims: Create and send batch insurance claims for all locations and providers from a central site.
  • Carriers and plans: Set up common carrier, plan and code lists to be used across a single or multiple locations.
  • Claim tracking and denial management: Monitor responses from the carrier / clearing house and notify the users with action items.
  • Manual payment posting: Post payments for services done for a patient at a claim level as well as at a code level.
  • Collections: Integrate with participating collection agencies for seamless collections management.
  • Electronic payment posting: Setup remittance posting rules and auto-post ERA’s. Manual intervention is only required to handle exceptions.
  • Statements: Quickly list patients with outstanding dues and send them statements by email or mail and allow patients to pay online.
seven tips and tricks to win insurance in dental

7 steps to supercharge your dental insurance management

Insurance management and filing claims are some of the most tedious and monotonous workflows in dental practices, if not done right. Since it is a task that decides when a patient’s payment is completed and in extension the revenue cycle, it goes without saying that the workflow must be smooth, bug-free and efficient. Workflows may vary with how your dental practice is set up, but here we will look at a couple of ways in which you can improve how insurances and claims are managed and thus boost effective practice performance.

1. Collecting patient details and verifying eligibility before the patient comes in.

Getting things done beforehand is always an efficiency booster. It gives you more time to dedicate to other important things and peace of mind that you are ready for the task at hand. When setting an appointment with the patient, make sure to collect as much information about the person using forms or questionnaires. The insurance data, thus collected can be verified by contacting the insurance carrier. This will ensure that when the patient comes in for the treatment, you will be ready to split the costs and move on to filing claims without a hitch, undoubtedly reducing the time spent on paperwork and increase time spent on patient care at the dental practice.

2. Confirming the details with the patient on arrival.

Assuming that, all the insurance data collection and verification were done beforehand, it will be very helpful to re-confirm the details with the patient just before the treatment. This is to eliminate the chances of any errors or changes that took place since the previous contact with the patient. It is better to find out and rectify changes during the treatment than, at the time of payment.

3. Submitting the claims without errors or omissions.

There is nothing more satisfying than getting things done right on the first try itself. Done wrong, the claim filing process can prove to be very monotonous. Getting a claim properly filed without any issues the first time is a win! Here are some things which may go about unnoticed.

  • Omission of important procedure codes and license numbers.
  • Usage of deleted or expired procedure codes.
  • Typos in names, addresses, NPI, SSD etc.

Also, keep a note of codes and practices which are identified as fraudulent. An example is code bundling, where a multitude of codes are used to describe the treatment when just one is enough. For example, A dentist performs a one-surface occlusal amalgam. He sends in a claim for 09210-Local Anesthesia; 09430-Office Visit; 02140-Amalgam-One Surface; and 03120-Pulp Cap-Indirect, when Code 02140 Amalgam-One Surface is enough.

4. Developing a good rapport with the insurance provider.

If your practice contacts the carrier directly via email or calls, it is essential that there should be a good rapport between the carrier representative and your practice. Good communication means better reception of claims and in effect less waiting or complications. Consider referring patients without insurance to carriers who are closely connected with your dental practice.

5. Weekly follow-ups and claim revisions.

Claims do take time to be processed and it will help immensely to follow-up on pending claims on a regular basis, preferably on a weekly basis. This is yet another method to boost rapport with the carrier. Also, tracking claims those are rejected will give you some insight on how to prevent future rejections.

6. Staying up-to-date on industry standards.

Updated is always better than outdated. Staying up-to-date with changes in codes, procedures, claim details, carrier plans, etc. is crucial, for both time management and avoiding complications. Consider adding a session to discuss changes along with your weekly or bi-weekly team meetings. This helps keep everyone working on the same page.

7. Using a proper dental practice management system.

So, by now we can understand that there are a lot of places where things can get messy. The best way to overcome all these issues is by using a practice management system which has all these features in-built. It will demand all details for the claim to be submitted, thus avoiding omissions and typos. It is always updated on the latest changes in the industry and will almost always run off the latest industry standards. Why go through the hassle of doing all of these by hand when it can be automated and simplified. This saves a lot of time for you and your staff.