Profitable dental practices recruit and retain patients with ease because they provide high-quality dental services. But there's also another part of the profitability equation that some practice managers and clinic owners sometimes overlook: Dental billing and collecting payment. At Claims Crafter, we know strong dental revenue cycle management (RCM) (i.e., the end-to-end process of managing a dental practice's financial transactions) ensures dental providers collect every dollar owed, leading to maximum profitability. That's why we specialize in it, helping dental providers sustain lucrative businesses.

What is Dental RCM?

Dental RCM is the umbrella term for various steps in the dental billing and collections process, including patient scheduling and registration, insurance verification, prior authorization, coding and charge capture, claim submission, denial management and appeal, patient collections, and accounts receivable follow-up. One misstep in dental RCM workflows can result in nonpayment or delayed payments, or it may trigger audits and recoupments. That's why Claims Crafter ensures a solid dental RCM process, including compliant dental billing.

Key Indicators of Effective Dental RCM

Practice managers and clinic owners cannot assess dental RCM effectiveness subjectively. It's not sufficient to 'feel strongly' that the dental practice's dental billing is largely accurate and compliant. Why? A feeling or assumption may not be accurate. Instead, practice managers and clinic owners must take a deep dive into their dental billing data because data doesn't lie. Instead, it provides an unbiased, objective view of overall dental RCM functioning.

More specifically, here are a few critical performance metrics that can help practice managers and clinic owners identify whether their dental RCM processes are effective:

To ensure optimal dental RCM, practice managers and clinic owners must examine these dental billing metrics frequently. Once they identify any negative changes in dental billing performance, they should investigate those changes immediately to identify the root cause of the problem. Ineffective dental RCM processes can occur suddenly, or they may develop slowly over time.

For example, an unexpected change in payer policy could cause an immediate uptick in dental billing denials whereas a subtle shift in volume of patients with high-deductible dental plans might cause the emergence of patient collection challenges over several months. The key is being able to monitor dental billing data to get an accurate, real-time pulse on performance. Without these insights, dental providers are essentially 'flying blind' and on autopilot, potentially leaving revenue on the table and setting themselves up for financial failure even in the face of high-quality care.

Why RCM is Essential for Dental Organizations

Every dental organization needs proactive RCM workflows and processes to promote profitability, and Claims Crafter can help. That's because dental RCM includes the nuanced, interconnected steps providers must take to get paid and optimize revenue collection. However, dental RCM is also important because it:

Giving dental RCM the time and attention it deserves—including partnering with Claims Crafter for dental RCM outsourcing—helps dental providers exceed revenue and growth targets while also increasing patient satisfaction and engagement.

How Optimized Dental RCM Improves Cash Flow

The ability to maintain and even improve cash flow is perhaps the most important reason why dental practices must promote effective dental revenue cycle management. Without cash flow, practices can't sustain a functioning business. By optimizing dental RCM, dental practices promote efficient cash flow because they:

Optimized dental RCM lays the foundation for successful financial management, including smooth, uninterrupted cashflow.

Tips for Optimizing Dental RCM

Creating an optimized, streamlined process for dental RCM requires a team approach. Everyone in the dental practice must understand their role in dental revenue cycle management. For example, medical coders directly impact dental revenue cycle management through the medical and dental codes they assign and/or validate. Similarly, physicians and other clinical staff supply the data and documentation on which codes are assigned. Front desk staff capture important demographic and insurance information. Even patients themselves play a role by providing accurate and complete information so payers can process claims correctly.

Here are six tips to streamline dental RCM:

Reducing Claim Denials, Improving Collections

With optimized dental RCM, denial management and patient collections become much easier and more efficient. That's because optimized dental revenue cycle management promotes the following: