Dental Logic founder Kinzie Hess Broxson has been helping me crack the dental insurance code for years. During our recent talk, Kinzie and I agreed that these COVID-19 slows down have given practices the opportunity to finally clean up insurance messes and cash in on work already done.
Initiated from Kinzie’s combined experience in banking and as a dental office manager, she launched Dental Logic to handle practices’ dental insurance verification and billing from start to finish.
I asked Kinzie what is the biggest mistake she sees when she goes into practices to begin cleaning house. Grinning, she easily pointed out that when working though most of her clients’ Practice Management Softwares, she always has to begin by tackling the insurance builds.
Essentially for every particular group number, whether it has one or multiple patients associated with it, you should have just one build per option plan.
It can be painstaking, but going through each of your patients’ group numbers and linking those with the same number together will powerfully increase your ability to verify insurance and make universal updates. Instead of creating a coverage book or blue book for just a select few people on the same plan as many others, you can use this organized system to ensure that every plan is updated and easily verifiable. Having this sorted out first is important because it affects everything else involved in billing and insurance verification.
The next important issue to tackle during this time is following up on insurance claims. If you’ve been waiting for an insurance company to pay up for some time, it may be wise to check if the claim was sent at all. I’ve had moments in the past where my colleagues and I have wondered why they haven’t been paid yet only to discover the claim was never submitted.
It’s time to change that. Send in any ignored claims and the money will begin coming in, especially for procedures that are auto-adjudicated.
If you’re unsure of how to check this, Kenzie walked us through Open Dental with the following steps to see if any claims are still waiting to be sent:
- Go to reports
- Select standard
- Go to the production and income section
- Choose monthly
- View claims
She recommends printing the whole list and sorting it. Sort by the insurance company and tackle those over 90 days first. Ensure the member ID and date of birth are correct so that the claim on file can reach the insurance company to begin with. Sometimes you can see if the claim was accepted or processed, prompting you to give additional information if necessary.
Act soon on reaching out to insurance companies, because even if they do not get back to you initially due to new circumstances, when they catch up, you will have a history of attempting to reach out to them.
Some insurance companies have a 90-day claim submission period, but most companies will process claims up to a year old if you have waited to send in additional documentation. So keep following up. Send your claim off now and work on them later if you have to.
Considering the effects of COVID-19, there are two additional things to consider when dealing with insurance. First, as difficult as it may be, we need to inquire about our patients’ employment status to not run the risk of being unpaid for treatment. Collect fees upfront or create a payment plan for patients whose insurance is temporarily or permanently unavailable.
Lastly, to eliminate potential health risks, many insurance companies are no longer accepting paper claims. If you’re someone still sending them, now is the time to learn how to send out electronic claims, saving you additional time and money.
If you’re having trouble working through your insurance and billing processes, Dental Logic can make sure your builds and claims are done right. With COVID-19 already prompting people to grasp this low-hanging fruit, their staff already has their hands pretty full, but any extra room will be made available to Nifty Thrifty members. If you can, do it in-house, but if you’re still not sure, outsourcing the work to a team like Dental Logic can help you stay on top of insurance issues.
Find out about:
- The most common mistake dentist make with insurance builds
- How to save time and increase billing accuracy
- Time limits associated with filing a claim
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