7 Steps of the Dental Revenue Cycle

Transcript performed by A.I. Please excuse the typos.
00:00
everyone. Welcome to your weekly motivational moments with Eric Vickery, president of coaching at All-Star Dental Academy. With me is my fellow coach, Larissa, and we’re Jersey Girl. We’re gonna be talking about the importance of the seven steps of the dental revenue cycle. So, Larissa, just share with us, what does that mean, seven steps? What is that? Yeah, that’s for sure, Eric. Hi, I’m happy to be here.

00:29
all you want to know is that you’re collecting, so you don’t think about what takes you there. So there’s six steps behind before collecting that we need to talk about. And the first one is as simple as patient intake information, patient registration on your software. If you don’t make sure that you have subscriber information, like, you know, we’re talking about insurance here, but even when you are looking at fee-for-service patients, if you’re taking assignment of benefits,

00:57
If a patient’s information is not complete and correct, your subscriber information is not complete and correct, that’s gonna delay the revenue cycle. Got it. Date of birth, important to be there. Next step on the dental revenue cycle is insurance verification. Now this is a topic that I always hear, we take assignment of benefits, we’re not a network, but although you’re still taking those assignment of benefits, you need to know what’s gonna happen if your claim is gonna be paid or not.

01:27
Another thing that I hear a lot from my clients is that, oh no, I can’t do that every time because it takes too much time. So this is a great topic because if you’re not verifying those benefits beforehand, it’s just like you are filling a cavity without x-rays. Would you do that? You would not. So yeah, you want to provide a service that you were as much as you can sure that’s gonna be paid.

01:55
And I’m not going to even go into pre-authorizations because we all know what they mean, right? The fine letter in the bottom says, this is not a guarantee of payment. So making sure to invest and talent that the people that work with you at the practice that are responsible for this. And even when you’re outsourcing your insurance verification, I see a lot of work that’s not up to par with these, when you’re outsourcing your insurance verification.

02:23
So you still need to have someone in office that’s fully capable of understanding those benefits and translating those benefits into the patient’s account. That way you won’t end up with balances at the end of the day and you won’t delay your revenue cycle. Got it. Three area is treatment planning and presentation. Making sure that you know your coding, making sure that you are presenting treatment clearly with good financial options is key.

02:51
If you don’t have patients accepting treatment, you don’t have a revenue cycle. So 95-5 rule case presentation, all of that is so important in your revenue cycle. Fourth step is claim submission. Now that you know that you’re quoted properly, you understand the ADA coding, you have a coding Bible at your office, you want to make sure that your claims are being submitted on a timely manner.

03:18
You want to make sure they’re accurate, that all the information that is needed is within that claim. So you don’t get that claim back three or four weeks out asking for more information that will delay you in your revenue cycle as well. Next step of the dental revenue cycle is insurance payment posting. Again, it’s so important to have people in the office that fully understands those EOBs, the explanation of benefits.

03:47
you see different columns. You see submitted fee, allowed fee, contracted fee, deductible, chargeable, not chargeable. What I see a lot in those is, I see a lot of offices writing off balances that were supposed to be paid by the office. That’s right. This is a very important step. Again, just going back to your talent, make sure that your insurance works. Trained, yeah.

04:17
is aware and fully trained on how to recognize this. And keeping an eye on your write-offs on that step is so important to make sure that you have this person doing what they need to be doing. The next step is step six, which is AR management. And again, once you get the payment in there, you need to be quick in looking for outstanding claims, abuse, and statement submissions.

04:42
If you get a payment, you end up with a balance and you don’t have enough time to work on it, which is what we hear all the time, how’s your AR going? Oh, I don’t have time to work on it. So a system in place is so important. So the longer it takes for you to address the account, the less chances you’re gonna collect. Industry says anything over 45 days is pretty much uncollectible. I know offices- Oh, wow.

05:12
getting paid within 60 days. Yeah, yeah. Well, you hear about write-offs and bad debt and all that. So this is really good. I love this. So collections, so quickly, patient intake information, accurate insurance verification, making sure you’re having time to do that, not taking too much time. Treatment planning and presentation, that’s a whole series of topics there, of course. Claim submission accurate, you know, it’s gonna tell you if you’re missing things, timely manner, I would suppose daily. And then insurance payment hosting.

05:42
Do you know how to read an EOB? Explain that to your whole team. Show them different EOBs and what comes back, and then AR management. So that’s also your weekly statements and also your insurance aging reports. Larissa, I love this. So good. We’ll have more of this in the future, but if you want help with this, you want support, let us know, just reach out. Thank you, Larissa. Appreciate having you on. Thanks, Ken.