How to Compare Dental Billing Services
August 8, 2023
Every dental billing company wants you to believe they have the leg up on the competition. But how do you sift through the noise to find a dental billing solution that will really meet your needs, without breaking the bank? What are the factors that actually matter when it comes time to choose between seemingly identical dental billing services?
This article will guide you through the selection process, highlighting the aspects of dental billing outsourcing companies that have the potential to make a real difference for your dental practice. Do they have a superior workflow? Are they using dental billing software their competitors don’t? Here’s what to look for in dental billing companies.
The dental billing process
Dental billing is a complex process that involves multiple steps to ensure that dental services are billed and paid for correctly. First, we’d like to break down the dental billing process, so you have an idea of what can vary from one service to another.
1. Patient Registration and Verification of Benefits:
- The patient fills out forms providing personal and insurance information.
- The front office staff verifies the patient's insurance eligibility and benefits.
2. Treatment Plan and Estimate:
- The dentist performs an examination and creates a treatment plan.
- The treatment plan is translated into appropriate dental procedure codes.
- An estimate of costs is provided to the patient, including what insurance is expected to cover and what the patient will be responsible for.
3. Preauthorization (when necessary):
- Some treatments may require preauthorization from the insurance company.
- The dental office submits necessary documentation and awaits approval.
4. Treatment and Documentation:
- The dentist performs the treatment.
- Proper documentation, including clinical notes, x-rays, and other supporting materials, is maintained.
5. Dental Coding:
- The treatment is translated into the appropriate CDT (Current Dental Terminology) codes.
6. Claim Submission:
- The dental claim form is completed with all relevant information, including procedure codes, dates of service, fees, etc.
- The claim is submitted to the insurance company, either electronically or by mail.
7. Claim Processing:
- The insurance company processes the claim.
- They may request additional information or deny parts of the claim, requiring an appeal.
8. Patient Billing:
- After the insurance company has paid their portion, the patient is billed for any remaining balance.
- This may include copayments, deductibles, or non-covered services.
9. Payment Collections:
- Payments from both insurance and patients are collected and recorded.
- Payment plans may be arranged if necessary.
10. Follow-up and Appeals:
- If the insurance payment is denied or less than expected, the dental office may need to follow up with the insurance company.
- This can include submitting appeals with additional documentation or clarification.
11. Reconciliation and Reporting:
- Regular reconciliation ensures that all payments are accounted for.
- Reporting can include analysis of payments, adjustments, aging of accounts, and more.
The dental billing process requires careful attention to detail and thorough knowledge of dental coding and insurance policies. It involves collaboration between the dental office staff, insurance companies, and patients.
Errors or delays in any part of the process can lead to payment delays, denied claims, and other issues, so accurate and timely handling is crucial. Many dental offices choose to outsource dental billing services to specialized dental billing companies to ensure compliance and efficiency.
What makes for a good dental billing service?
Identifying a good dental billing service is essential for the smooth functioning of a dental practice. It can save time, reduce errors, and ensure timely payments. Here are some factors to consider when selecting a dental billing service:
Experience and Expertise:
- Look for a service with experience specifically in dental billing, not just general medical billing.
- Verify that they have a strong understanding of dental procedures, coding, and insurance practices.
Certification and Training:
- Check if the team members have certifications or training in dental billing, coding, and compliance.
- A company that invests in continuous education for its staff is usually a good sign.
Compliance and Security:
- Make sure the billing service complies with all federal and state regulations, including HIPAA.
- Ensure that they have robust security measures in place to protect patient data.
Technology and Integration:
- Check if the service uses advanced and secure technology for billing.
- Determine if their system can integrate seamlessly with your practice management software.
Transparency and Reporting:
- A good billing service will provide regular reports and updates on the status of claims, collections, etc.
- Make sure you'll have access to transparent, real-time data about your billing.
- Evaluate their level of customer service. Are they responsive and accessible when you have questions or concerns?
- Consider looking for reviews or testimonials from other dental practices that have used their services.
Pricing and Contract Terms:
- Understand the pricing structure and what services are included.
- Carefully review the contract terms to ensure there are no hidden fees or long-term commitments without an exit strategy.
Customization and Flexibility:
- Determine if they offer customizable solutions that align with the specific needs of your practice.
- Check if they are flexible enough to adapt to changes in your practice or industry regulations.
Reputation and References:
- Investigate the reputation of the service by looking for online reviews, ratings, or complaints.
- Request and contact references to ask about their experiences with the billing service.
Performance Metrics and Guarantees:
- Ask about their performance metrics such as the average time to collect payments, the success rate in appealing denied claims, etc.
- Some companies might offer performance guarantees or incentives based on results.
Trial Period or Demo:
- If possible, ask for a trial period or a demo to test how the service works and whether it fits your practice's needs.
By considering these factors and performing thorough due diligence, you can identify a dental billing service that meets your practice’s unique needs and ensures a streamlined billing process. It may also be wise to consult with other dental professionals in your network who have used billing services, as they may provide valuable insights and recommendations.
A few things good dental billing companies don’t do…
Good dental billing companies maintain professional standards and ethical practices. While their specific approaches may vary, there are certain things that reputable dental billing companies typically don't do:
Ignore Compliance Regulations:
- Reputable companies adhere strictly to regulatory compliance, including HIPAA rules. They don't take shortcuts or ignore legal requirements.
Hide Fees or Costs:
- Transparent pricing is a hallmark of a trustworthy dental billing company. Just like a good dental practice, they won't conceal fees or surprise clients with hidden charges.
Neglect Communication and Customer Service:
- Good companies prioritize communication with their clients and provide responsive customer support. They don't leave clients in the dark about the status of their billing and claims.
Use Outdated Technology or Insecure Systems:
- Reputable dental billing companies invest in modern, secure technology to manage billing and protect patient data. They don't rely on outdated or insecure systems that may jeopardize information security.
Engage in Aggressive or Unethical Collections Practices:
- While collecting payments is part of their role, ethical billing companies use professional, respectful methods to pursue outstanding balances. They don't resort to aggressive or unethical tactics that could harm the reputation of the dental practice.
Make Unrealistic Promises or Guarantees:
- Trustworthy dental billing companies set realistic expectations and don't make exaggerated promises about their performance or results. They don't guarantee specific outcomes that are beyond their control.
Fail to Provide Regular Reporting and Transparency:
- Regular reporting and transparency are essential for maintaining trust and accountability. Good billing companies don't withhold information or fail to provide clear, comprehensive reports on billing activities.
Avoid Ongoing Training and Education:
- Dental billing regulations and practices evolve, and reputable companies prioritize ongoing training and education for their staff. They don't neglect professional development or ignore industry changes.
Overlook Errors or Mistakes:
- Quality dental billing companies prioritize accuracy and are proactive in correcting any errors or mistakes. They don't ignore or overlook inaccuracies that could lead to denied claims or compliance issues.
By avoiding these practices, good dental billing companies demonstrate their commitment to ethical behavior, professional service, and client satisfaction. When selecting a dental billing company, look for signs that they adhere to these standards and ask pointed questions to ensure they align with your practice's needs and values.
How to evaluate dental billing services’ performance
Evaluating the performance of a dental billing service is crucial to ensure that it meets the needs of your dental practice and maintains compliance with industry standards. Here are some key areas and specific metrics to assess when evaluating a dental billing service's performance:
Claim Submission and Rejection Rates:
- Assess how quickly claims are submitted after the treatment date.
- Monitor the rejection rate and the reasons for rejections to identify potential areas for improvement.
Claim Approval Rates and Timeliness:
- Track the percentage of claims approved on the first submission.
- Measure the average time taken to receive payment from insurance providers.
Accuracy and Compliance:
- Evaluate the accuracy of coding and adherence to compliance regulations.
- Check for any errors or inconsistencies that may lead to claim denials or legal issues.
Collections and Accounts Receivable:
- Assess the effectiveness in collecting patient payments, including copays, deductibles, and balances.
- Review the accounts receivable aging report to understand how long balances are outstanding.
Customer Service and Communication:
- Evaluate responsiveness and the quality of communication between the billing service and your practice.
- Consider feedback from staff and patients on their interactions with the billing service.
Transparency and Reporting:
- Review the regular reports provided by the billing service for completeness and usefulness.
- Check that they provide real-time access to billing data, if applicable.
Adaptability and Flexibility:
- Assess how well the billing service adapts to changes in regulations, payer requirements, or practice needs.
- Look at how they handle special situations or unique cases that may arise.
- Compare the cost of the service against the value provided.
- Consider looking at revenue growth, reduced denials, or other financial metrics to evaluate the return on investment.
- Gauge patient satisfaction with the billing process, including clarity of bills, payment options, and handling of billing inquiries.
- Unhappy patients can indicate issues in the billing process that may reflect poorly on your practice.
Security and Compliance:
- Ensure that the billing service maintains stringent security measures to protect patient information.
- Confirm adherence to compliance regulations like HIPAA.
Alignment with Practice Goals:
- Evaluate how well the billing service's performance aligns with the overall goals and mission of your dental practice.
Regular communication and collaboration with the billing service can also facilitate continuous improvement and alignment with your practice's needs and expectations. If issues arise, a detailed evaluation can help guide corrective actions or even a decision to switch to a different provider if necessary.
The latest in dental billing software
Dental billing software is constantly evolving to accommodate the changing needs of dental practices, improve efficiency, enhance security, and incorporate the latest technological advancements. Here's a look at some of the latest trends and features in dental billing software:
Integration with Practice Management Systems:
- Modern dental billing software often integrates seamlessly with practice management systems, allowing for easy access to patient records, scheduling, treatment planning, and more.
Artificial Intelligence (AI) and Automation:
- AI-powered algorithms can assist in coding, claim submission, and error detection, reducing manual effort and human error.
- Automation of repetitive tasks such as claim follow-ups, payment reminders, and reconciliation streamlines the billing process.
- SuperBill’s AI service, SuperDial, even automates phone calls to insurance payers.
Enhanced Analytics and Reporting:
- Advanced reporting tools provide insightful analytics, allowing practices to monitor key performance indicators, identify trends, and make informed decisions.
- Customizable dashboards offer a personalized view of financial performance.
Patient Engagement Tools:
- Patient portals facilitate communication regarding billing, allowing patients to view statements, make payments, and set up payment plans online.
- Automated reminders and notifications help in timely collections.
Compliance and Security Measures:
- Updated dental billing software complies with regulations like HIPAA and ensures the security of sensitive patient information.
- Regular updates and patches help keep the system secure and aligned with the latest compliance requirements.
- With the rise of telehealth, especially during the COVID-19 pandemic, some dental billing software now includes features to manage and bill for virtual consultations and appointments.
- Intuitive user interfaces and guided workflows help in ease of use, reducing the learning curve and enhancing efficiency.
Sustainability and Paperless Options:
- Many dental billing software options promote paperless billing, offering e-statements, electronic claims, and digital record-keeping, supporting sustainability efforts.
Customization and Scalability:
- Solutions that can be customized to suit the specific needs of a practice, whether large or small, are valuable in providing relevant functionality.
- Scalable solutions can grow with a practice, accommodating new patients, additional locations, or expanded services.
These trends and features reflect a move towards more intelligent, efficient, patient-centric, and integrated solutions in dental billing. As technology continues to evolve, dental practices can expect further advancements that enhance the effectiveness and ease of managing the billing process.
If you’re considering outsourcing dental billing services to a third-party billing company, it’s worth checking to see if they’re using the latest in dental billing technology. SuperBill keeps you covered with all of these features PLUS 24/7 concierge support. With SuperBill, you can harness the power of AI to save your practice time and money, while still counting on real humans to ensure you get the results you want.