In today’s world of dental insurance dependency, the average dental office faces new daunting financial challenges which makes achieving consistent cash flow, which is an integral part of managing a dental practice, difficult and at times what feels impossible.
Why outsource to an expert
The most important factor of operating a dental practice is consistent cash flow. By outsourcing to a reputable company, you are decreasing your expenses, creating a more efficient work place for your employees, and limiting the demeans of technology demands to keep up to date with the current electronic data interchange (EDI).
The demand of insurance dependent patients seeking office who are assigned to their insurance company has increased the need for dental billing experts along with dedicated time spent on insurance billing without interruption.
There are no formal classes, certification, or continuing education offered to keep up with the responsibilities it takes to run a front desk at a dental practice let alone how to accurately process dental claims and what legally the dental office is entitled to when it comes to non covered charges.
As the demands of patients increase, the need to manage a productive schedule, and effectively present and close treatment plans, errors become more frequent and more serious which greatly restricts cash flow to a detrimental effect.
Outsourcing ensures you will not have an employee call out sick, you will be updated bi-weekly of corrections your dental practice may need to make, and now your front desk team can manage your schedule and focus on treatment plan presentations.
The average hourly rate for staff to process claims is $18.00 hour, not including taxes, cost of workmans comp, vacation time, and bonuses. This will cost close to $50,000.00 annually when said and done. Ask yourself: Is my office getting the results it needs for the amount I am spending?
How It Works
NMG Practice Solutions stays abreast of the State and Federal Laws that will dictate how you balance bill for non covered procedures. We send out clean claims the first time, eliminating the delay and denial due to additional information needed to process a claim. What’s the average turn around time you may ask, typically we get claims paid and resolved within 3 weeks. Boosting your cash flow, keeping it consistent, and increasing your collection ratio to a healthy 99%.
How do you send clean claims: It takes an expert, with dedicated time, persistence, clinical knowledge, and constant follow-up. If your aging accounts are over 30 days, this is not an efficient time range and is a clear sign of an internal processes and procedural issue.
The top problems among dental clerical staff when it comes to dental billing include:
A lack of time
Interruptions by phones, patients, and staff
A lack of in depth understanding in insurance billing, coding, and claims processing
A lack of motivation
Because of this, you will begin to have an increasing amount of unresolved claims and patient balances that restrict your cash flow: Below are the statistics of what causes claims to be delayed:
Incorrect patient, practice, provider, or employer information such as demographics (35% of errors);
The front office forgets something and supporting documentation has not been submitted with the initial claim (25%);
The insurance company delays payment by asking for more information (20%);
The insurance is set up incorrectly in the patient’s account (10%);
The front office does not know how to set up the account, especially in dual insurance, blended families, or plans that are administered by major dental insurances (5%);
The insurance company did not receive the claim so there is a need to follow up with phone calls (5%).
This creates a domino effect; insurance benefits decrease, patient balances increase, treatment plan acceptance decreases which directly results in production and collection digressing instead of progressing. Staff becomes confused what is truly a patient balance so they stop collecting resulting in the patient aging balance become out of control. Recovery of patient balances becomes significantly difficult passed 30 days which again restricts the office cash flow.
NMG Practice Solutions systematically works insurance claims and predeterminations on a weekly basis, ensuring the process is seamless so you can get your reimbursement as quick as possible. We work to clean up unresolved claims, patient balances and increase cash flow. We maintain bi-weekly conference calls without clients to update them of any issues within the dental practice that may inhibit the claims from being processed.