Dental Billing
Our dental billing service provides comprehensive revenue cycle management solutions tailored for hospitals and clinics. We specialize in handling all aspects of dental billing, from patient data management and insurance verification to claims submission and payment posting. Our team ensures accuracy in coding and compliance with insurance regulations, maximizing reimbursement while minimizing claim denials. We offer seamless integration with existing systems, robust reporting capabilities, and dedicated support to optimize financial performance. By outsourcing dental billing to us, hospitals and clinics can streamline operations, reduce administrative burden, and focus on delivering exceptional patient care.
Our dental billing process is up to industry standards to ensure best practices. There are total ten step overall. Each step further consists of several steps. Below is a flowchart that briefly describes the process.
Data Collection and Entry
The dental office sends patient information, treatment details, and insurance data to the third-party billing company.
This includes demographic information, diagnosis codes (ICD-10), procedure codes (CPT or ADA codes), and insurance details.
Verification and Eligibility
The billing company verifies patient insurance coverage and eligibility.
They check for any pre-authorizations required by the insurance company for certain procedures.
Claim Preparation
Using the information provided, the billing company assigns appropriate procedure codes and diagnosis codes.
They ensure accuracy and compliance with insurance company guidelines.
Claim Submission
The billing company submits claims electronically or via paper to the insurance company on behalf of the dental office.
They monitor claim submissions for acceptance and track claim statuses.
Adjudication and Follow-Up
The billing company receives and reviews Explanation of Benefits (EOB) or remittance advice from the insurance company.
They handle any denials, rejections, or partial payments by appealing or resubmitting claims as necessary.
Payment Posting
Once payments are received from the insurance company, the billing company posts payments to the dental office's accounts.
They reconcile payments against outstanding balances and patient responsibilities.
Patient Billing and Communication
The billing company generates patient statements for any remaining balances after insurance payments.
They handle inquiries from patients regarding billing and payments, providing customer service as needed.
Reporting and Analytics
The billing company provides regular reports to the dental office summarizing financial performance, claim status, and accounts receivable aging.
They assist the dental office in financial analysis and decision-making based on billing data.
Compliance and Documentation
The billing company maintains detailed records of all transactions and communications related to billing.
They ensure compliance with healthcare regulations and industry standards.
Continuous Improvement
The billing company may suggest process improvements to streamline billing operations and optimize revenue cycle management for the dental office.
Conclusion
By outsourcing dental billing to a third-party company, dental offices can focus more on patient care while ensuring efficient and effective revenue management processes. This partnership also helps in navigating complex insurance rules and regulations, potentially improving revenue capture and reducing administrative burden.