How To Navigate the Complex World of Dental Insurance Plans

December 5, 2023 | 3 min read

If you dread dealing with insurance payers, you’re not alone. 

“Dental insurance plans are complicated and can vary widely from state to state and payer to payer. Effectively managing this chaos requires planning, organization, and consistent data hygiene.” ~ Revenue Cycle Management (RCM) Best Practices for Enhanced Dental Practice Performance white paper.

Effective insurance management is essential for maintaining healthy cash flow and your practice’s financial health. But how do you minimize payment delays, maximize revenue generation, and ensure patient satisfaction? You must build a solid foundation by maintaining rich, updated insurance and patient data in your dental practice management software (PMS).

Why You Can’t Afford To Ignore Dental Insurance Management

Poor insurance management could lead to delays in reimbursement and denied claims due to incorrect or incomplete information, impacting your cash flow and revenue while increasing administrative costs. 

Errors in claim submissions can also lead to unexpected invoices and out-of-pocket expenses for patients, causing frustration and inconveniences. Dissatisfied patients may switch providers, leading to lost revenue and a tarnished reputation for your practice.

As DSOs scale, bad habits and efficiencies associated with poor insurance management often multiply — creating systemic issues that impact all affiliated dental offices and resulting in significant financial risks and complications.

Unlock Insurance Management Success With Consistent Data Hygiene

Effective insurance management requires accurate and up-to-date data on all insurance plans you accept. Additionally, you should maintain comprehensive records of patient insurance information, including policy details, coverage limitations, copays, and deductibles, to verify patient eligibility, estimate patient costs, and ensure an efficient claim submission process.

You must proactively collect, verify, and maintain detailed information on all insurance plans. Stay informed about the latest updates and changes in policies. These include alterations to coverage, reimbursement rates, and billing guidelines. Then, set up standard operating procedures (SOPs) to regularly update the data in your PMS.  

Also, keep track of changes in patient insurance information by regularly verifying eligibility. For example, you can use tab32’s e-forms and patient communication module to automate the process and ensure you have the latest patient data.

For DSOs with multiple practice locations, cloud dental software like tab32 allows you to centralize insurance management. When you update policy information or patient data on your PMS, the changes will be reflected across all offices in real-time to save time and minimize errors and delays in the claim submission process.

Get the action plan to improve insurance management: The Revenue Cycle Management (RCM) Best Practices for Enhanced Dental Practice Performance white paper shows you how. 

How To Promote Data Hygiene In Your Dental Practice

Follow these steps to ensure your practice has access to clean and accurate data:

  • Establish data entry standards: Specify the format, fields, and data points required for each patient and their insurance coverage to store the information uniformly for easy reference.
  • Implement verification processes: Confirm patient insurance information at scheduling, during patient check-in, and before treatment to verify coverage and eligibility.
  • Provide employee training: Educate team members on data entry best practices, patient interactions, and compliance with insurance regulation.
  • Conduct quality control checks and routine data audits: Enforce periodic audits and spot-checks to ensure data accuracy and completeness. You may need to cross-reference information with insurance providers or contact patients to verify their details.
  • Document data maintenance procedures: Maintain clear documentation for updating patient and insurance data and ensure all employees follow the guidelines consistently.
  • Leverage software and technology: Use a cloud-based, integrated PMS to automatically sync updated insurance and patient information across all locations to streamline processes and minimize errors and delays.

Power Up Insurance Management with tab32

tab32’s dental billing module integrates with the platform’s patient database and EHR to ensure seamless claim submission. Our intelligent workflows help you get your claims right the first time, every time while identifying and eliminating the root causes of errors and delays.

Request a demo to see how tab32 can help you streamline claim submission and improve revenue cycle management. 

Learn more now!

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