Dental billing requires both practice and time to get it right — and in order to do that, you must work hard to understand how the process of dental billing works. There are two parts of the process of billing: patient billing, and insurance claims processing. These are the primary revenue streams for dental practices, and both consist of different steps. We’ll cover the non-insurance side of finances in a later module, since this one is focused specifically on insurance.
However, overall, dental billing consists of seven critical steps:
- Gathering patient information.
- Verifying their insurance coverage.
- Documenting each dental treatment as well as its code data.
- Submitting and tracking insurance claims, and making sure to provide any necessary attachments or narratives.
- Resolving issues with outstanding insurance claims.
- Billing patients as needed.
- Posting payments.
Insurance claims are filed according to a specific set of procedures. Sometimes, in the case of a denial or when more information is required, you may have to revisit an insurance claim in order for it to be completed. Of course, every dental office will have their own specific procedures for handling insurance. However, the process of filing dental insurance claims is pretty much the same when it comes down to the actual process.
When filing insurance claims, it is imperative that you accurately perform each step. Mistakes that arise in this area can be costly for revenue, administrative workload, and patient morale. The billing staff, who are oftentimes the business staff, make or break the financial health of their dental practice. It might sound intimidating, but don’t worry! There are several things that you can make sure to do that will prevent any mistakes from being made:
- Ensure that you understand the claims process. Make sure that you understand the process of filing an insurance claim. If you are not sure or you feel like you still need some clarification, never be afraid to ask for help! Your colleagues will understand, and there is no shame in needing extra training in this area.
- Do your best to avoid assumptions. If there is something that you do not know, do your best to get the information from the most reliable source. Making an assumption when filing a claim could not only complicate the process further, but it could create a huge unnecessary workload for you and the other business staff, as well as complicate the patient’s experience as well.
- Remember the most common errors. It can be a bit tedious to fill out forms. This makes it especially easy to make small mistakes, which result in big issues with insurance claims. Always pay careful attention to how you fill out these areas — hopefully, you’ll be able to catch yourself in the act of making the mistake instead of having to go back and correct it later! These common areas include an incorrect name or date of birth for the patient, the wrong address or contact information for the patient, the incorrect payor ID and policy number, illegible handwritten documentation, and missing claim number information when dealing with appeals.