Understanding RCM in Dental Billing

Profitable dental practices recruit and retain patients with ease because they provide high-quality dental services. But there’s also another part of the profitability equation that some practice managers and clinic owners sometimes overlook: Dental billing and collecting payment. At Medusind, we know strong dental revenue cycle management (RCM) (i.e., the end-to-end process of managing a dental practice’s financial transactions) ensures dental providers collect every dollar owed, leading to maximum profitability. That’s why we specialize in it, helping dental providers sustain lucrative businesses.

What is Dental RCM?🔗

Dental RCM is the umbrella term for various steps in the dental billing and collections process, including patient scheduling and registration, insurance verification, prior authorization, coding and charge capture, claim submission, denial management and appeal, patient collections, and accounts receivable follow-up. One misstep in dental RCM workflows can result in nonpayment or delayed payments, or it may trigger audits and recoupments. That’s why Medusind ensures a solid dental RCM process, including compliant dental billing.

Key Indicators of Effective Dental RCM🔗

Practice managers and clinic owners cannot assess dental RCM effectiveness subjectively. It’s not sufficient to ‘feel strongly’ that the dental practice’s dental billing is largely accurate and compliant. Why? A feeling or assumption may not be accurate. Instead, practice managers and clinic owners must take a deep dive into their dental billing data because data doesn’t lie. Instead, it provides an unbiased, objective view of overall dental RCM functioning.

More specifically, here are a few critical performance metrics that can help practice managers and clinic owners identify whether their dental RCM processes are effective:

• Claim denial rate (should be below five percent)
• Days in accounts receivable (should be below 30 days)
• First-pass claim acceptance rate (should be above 90%)
• Net collection rate (should be 95% or higher)
• Patient collection rate
• Percentage of accounts sent to collections
• Time to submit claims (should be within 24-48 hours after the visit)

To ensure optimal dental RCM, practice managers and clinic owners must examine these dental billing metrics frequently. Once they identify any negative changes in dental billing performance, they should investigate those changes immediately to identify the root cause of the problem. Ineffective dental RCM processes can occur suddenly, or they may develop slowly over time. For example, an unexpected change in payer policy could cause an immediate uptick in dental billing denials whereas a subtle shift in volume of patients with high-deductible dental plans might cause the emergence of patient collection challenges over several months. The key is being able to monitor dental billing data to get an accurate, real-time pulse on performance. Without these insights, dental providers are essentially ‘flying blind’ and on autopilot, potentially leaving revenue on the table and setting themselves up for financial failure even in the face of high-quality care.

Why RCM is Essential for Dental Organizations🔗

Every dental organization needs proactive RCM workflows and processes to promote profitability, and Medusind can help. That’s because dental RCM includes the nuanced, interconnected steps providers must take to get paid and optimize revenue collection. However, dental RCM is also important because it:

• Augments a positive patient experience
• Enhances operational efficiency
• Ensures regulatory compliance
• Improves patient collections and cashflow
• Promotes data-driven business decisions
• Reduces claim denials
  

Giving dental RCM the time and attention it deserves—including partnering with Medusind for dental RCM outsourcing—helps dental providers exceed revenue and growth targets while also increasing patient satisfaction and engagement.

Benefits of Outsourcing Dental RCM to Medusind🔗

Outsourcing dental RCM to Medusind benefits dental practices in many ways. Consider the following:

• Ability to meet and exceed key dental RCM performance metrics with ease, including timely claim filing for improved cashflow
• Elimination of repetitive administrative tasks leading to improved staff productivity and satisfaction
• Immunity from dental RCM staffing shortages that prohibit operational continuity
• Integration with existing practice management software, including mainstream, cloud-based, and proprietary solutions
• Minimized compliance risk so dental practices retain the revenue they generate
• More accurate reimbursement stemming from Medusind’s knowledge of dental billing fundamentals as well as specialized expertise in dental coding versus medical coding
  

Medusind’s unique combination of deep dental billing expertise, robust operational capability, and client-focused service significantly improves the efficiency and profitability of today’s dental practices.

Transform Your Dental RCM with Medusind🔗

With the Medusind’s help and insight, dental providers can focus on providing high-quality dental services knowing they will be paid accurately and on time. Medusind’s comprehensive approach to dental RCM ensures no dental billing step is omitted. Let Medusind remove a barrier to growth and profitability with our suite of Dental RCM Solutions. To learn more about Medusind’s full-service dental RCM offerings, visit https://www.medusind.com/get-started/.