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Why outsourcing dental claims are on the rise

The goal in a dental office, is to give each individual patient the care and attention they need. Patients in the dental industry require education and motivation to understand where their dental health lies in conjunction with their medical health, as well as helping them to prioritize which procedures need to be taken care of first. Yet the battle that most offices have, is exactly that. Office managers are responsible for making sure the doctors schedule is full and productive. Front office staff have the pressures of scheduling appointments, answer patient questions, and making sure the day is ready. As your practice gets busier, patients become more demanding, accounts receivable and insurance processing falls to the wayside because it is time consuming, tedious, and too often completely overlooked by staff who are burnt out and overworked. Resulting in restricted cash flow, angry patients, inaccurate balances, and a spiderweb of financial problems to fix. What is the solution to this epidemic?


If we look to our big sister the medical field, they have been outsourcing their insurance processing and accounts receivables for years. This has reduced the overwhelming paperwork for staff, increased efficiency in day to day operations, allowed providers to grow their practices, and dedicate their time to what matters most, patient care. Outsourcing has proven to have a beneficial impact on reducing costs and boost revenue. But will this have the same effect on the dental industry?


Below is a list of red flags when it is time to consider outsourcing dental claims:


  • Constant front office staff turnover. Employees that say they have experience, but don't truly have the knowledge of the proper coding, laws, regulations, and clinical knowledge it takes to complete this task efficiently.

  • A collection ratio less than 98%, which is detrimental to the financial foundation of a dental practice.

  • Patients upset about their claims not being processed and do not understand their balances.

  • Low insurance reimbursement rates and delayed insurance payments

  • High adjustments without clear and legitimate justification.


Benefits of utilizing a company to outsource your dental claims and accounts receivable processing:


  • Your practice is guaranteed to save money. At a fixed rate to pay for this service, you avoid paying employer taxes, vacation time and medical contributions, and have the tax benefit of utilizing professional services.

  • Increased cash flow and regular insurance payments.

  • Monthly patient account receivables being processed.

  • Significant reduction in account adjustments.

  • Staff members not being overloaded and enabled to spend more one on one time with your patients.

  • Consistent and accurate coding, eliminating the risk of an insurance investigation due to insurance fraud red flags.

  • The ability to spend more time on your practice marketing, networking, and communicating with your patients versus training and managing your employees who may be affordable but not experienced.


Outsourcing your dental insurance processing and your accounts receivable will give you the relief of using a trusted company, minimize financial risks and set backs while guaranteeing to boost your revenue.


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