The Impact of Claim Denials on Healthcare RCM
There’s a saying about challenges being inevitable but defeat being optional. When it comes to both claims management and healthcare revenue cycle...
4 min read
Robert McDermott Jun 1, 2023 11:00:00 AM
Right now, in most dental offices across the country, finding staff is an issue. In fact, many practices are reducing patient capacity by 10% to enable staff to complete necessary and business-critical tasks, like verifying insurance. Imagine what your staff could do if you were able to free up their time so they can be present with your patients as well as assist you or your other staff. With more time, your staff can also help complete additional administrative tasks and even take on new roles.
But how can you free up time? Adding more staff is challenging, and even if you could, it would add to overhead, impacting your bottom line. What if there were a way to resume, perhaps even grow, patient capacity and free up time all without adding to your head count? Automated insurance verification may just be the solution you’re looking for.
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Prior to making a purchase as an individual, you know where the funds are coming from to cover it. It’s reasonable to assume, as a service provider, that your clients and patients expect the same. Insurance verification helps both our patients and our practices understand the anticipated coverage as well as out of pocket expense. Without that process, we can potentially create problems that impact not just our patient relationships but also accounts receivable and cash flow.
Insurance verification primarily helps your dental practice identify what current procedures or treatments are covered by your patient’s insurance plan. And, when automated and using the right insurance verification tool, it can also help you map out an effective treatment plan to maximize patient benefits, improving care and generating revenue.
Rather than seeing it as solely an administrative task, it’s important to view it as a vital part of your practice for day-to-day operations as well as long term planning and improved patient care.
With that kind of importance, finding ways to simplify and improve the insurance verification process is a top concern for a lot of practices. This is even more urgent when one considers the potential challenges to insurance verification.
1. Staffing- It’s no secret that staffing shortages persist in the dental world. It’s a challenge for handling administrative tasks in general, but when a process can eat up the equivalent of a full-time employee, it’s significant.
2. Errors- Humans make mistakes and, sadly, data entry, required for dental insurance verification, is one of the most frequent places those mistakes happen. Whether it’s a patient or staff error, a simple misspelling or missed number can create long delays and tie up your resources.
3. Claim Denials and Rejections- Claims can be denied or rejected for a variety of reasons from data entry to benefit or insurance changes. Regardless of the cause, the resolution can be time-consuming for staff and confusing for patients.
4. Overhead- Insurance is responsible for generating a good portion of your revenue. But dedicating most of that revenue to pay the staff who ensure you get it isn’t the ideal situation. Still, insurance verification and callbacks require staff, adding to overhead when other options exist.
When you consider the role of this process in revenue generation, it becomes even more essential to find ways to overcome the obstacles and ensure seamless dental claims and billing.
Revenue generation and cash flow are fundamental for any successful business and, for a dental practice, that all comes down to billing and claims. For most of your patients, the largest percentage of their bill will be paid by insurance (claims), provided they have the coverage. The rest of their payments will be handled out of pocket (billing).
Knowing and providing that breakdown prior to performing a procedure is essential when it comes to having confidence that the costs for your services will be covered.
Additionally, insurance verification ensures your payments are received, in full, on a timely basis. That helps your bottom line. It also ensures your patients aren’t billed for more than they expect and that helps you, your staff, and your practice build relationships.
Insurance verification is needed for dental billing and claims for the immediate financial ramifications but also for long term success.
If insurance verification and insurance claims play such an important part in the cash flow that keeps your dental practice running, then looking for ways to improve that process, making it more accurate and efficient, is a great place to start.
First and foremost, it’s essential to find a way to optimize your valuable human resources so they can focus on direct patient service and care. That’s where automation comes in. Automated insurance verification software can verify the insurance for your entire schedule with one click. What could take a member of your staff nearly a full week’s worth of work to handle, automated insurance verification can do in seconds, clearing your patients for care and ensuring their benefits information is up-to-date.
Another challenge that can slow down your staff are errors that result in claim denials or necessitate call backs, placing your team on the phone rather than with patients or other revenue-generating work. With iCoreVerify, the automated insurance verification solution from iCoreConnect, your insurance verification checks happen automatically and as comprehensively as the insurance provider offers. With the verifications done, you can check any patient on the schedule that week, at any time, for their verification status. Importantly, automatic error identification ensures that you and your staff can correct errors before they escalate into a larger issue impacting your claims and billing process.
Further, with iCoreVerify, you can identify treatment opportunities for your patients because you’re able to see remaining coverage amounts alongside unscheduled treatments. Your patients will appreciate helping them maximize their benefits and your bottom line will appreciate the revenue. You won’t have to wait for reminders from insurance companies any longer, or rely on staff to identify these opportunities.
Insurance verification not only helps your patients maximize their benefits, but also helps your practice optimize its revenue. iCoreVerify automates the process, ensuring you realize both those amazing benefits while also saving your team time and effort. Book a demo today and take the next step to improve your practice and patient care.
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