About 25% of today's dentists work in dental practices with two or more locations. Of these, nearly 10% work in practices with 100+ locations. And while multi-location growth is exciting, without proper dental RCM oversight and critical dental billing solutions, it can also cause revenue leakage, higher administrative costs, staff confusion, increased claim denials, and patient frustration. None of these outcomes bode well for a booming dental business and its profit margins. In particular, mid-size dental practices often struggle with inconsistent billing across locations. Learn how to unify your dental RCM strategy and boost collections using dental billing solutions.
With multiple locations, mergers, and acquisitions, comes the risk of the following common dental billing problems:
Certain locations may have a clearly defined workflow for insurance follow up within a certain time period while others may be laxer or not follow up at all.
Each location may have its own process for patient registration, insurance verification, and coordination of benefits. Some may have the ability to perform these tasks digitally and/or in real time using dental billing solutions while others may use manual, retrospective processes.
Without standardized coding protocols, each location may interpret procedures differently, leading to significant billing discrepancies. Some offices might use conservative coding approaches while others push the boundaries, creating compliance risks and revenue inconsistencies. This variation in coding practices can trigger insurance audits, result in claim denials, and potentially expose your entire practice group to regulatory scrutiny. Establishing uniform coding guidelines and providing regular training across all locations is essential for maintaining billing accuracy and protecting your practice's reputation.
Each location may have its own process for collecting payment at the time of service, sending patient statements, communicating financial responsibility, and providing transparent prices using various types of dental billing solutions.
Certain locations may not monitor KPIs at all, and those that do monitor them may not use the same metrics. For example, one location may strive to submit claims within 24 hours while another aims for 48 hours. Or one location may require a 95% clean claim rate while another settles for 92%. This variability affects overall group performance and financial sustainability.
Given these dental RCM challenges, groups with multiple locations must take a proactive approach using dental billing solutions to ensure consistency and revenue integrity, prevent denials, and promote a uniform experience for patients and staff. Consider the following strategies:
Create a unified department of revenue cycle experts tasked with billing for all locations rather than allowing each location to retain its own department. Centralized departments create billing efficiencies, reduce redundancies, and decrease administrative costs—all of which make the dental group more profitable overall.
Ensure all locations use the same policies and procedures for front-end and back-end dental RCM tasks, including patient registration, eligibility verification, medical coding, insurance follow up, and patient communication.
Identify the KPIs all locations will track, and the specific benchmarks associated with each one. Having a consensus is important. In addition, track data at both the practice and group levels to pinpoint areas for improvement.
Provide the same training to staff across all locations followed by customized training, when needed. Similarly, establish documentation guidelines and expectations so providers document dental procedures consistently and with all the details necessary for patient billing.
Ensure all locations use the same systems and dental billing solutions for ease of information exchange, ease of data analytics and reporting, scheduling efficiencies, and revenue integrity. Consistent dental billing solutions help everyone stay aligned and working toward the same goal.
For dental groups with multiple locations, outsourcing dental RCM may be the best option in terms of dental billing solutions. This is especially true if the dental group faces one or more of the following:
Outsourced teams can handle insurance verification, accounts receivable follow-up, appeals, and more with the help of dental billing solutions. In addition, the decision to outsource isn't an 'all or nothing' debate. For example, dental groups may benefit from a hybrid model in which they keep front-end tasks in-house and outsource dental billing and other back-end functions. It all depends on the level of available in-house expertise and leadership, current turnover rates, current financial performance, and other factors.
As dental groups look ahead to expanding across multiple locations, leaders need dental billing solutions to address revenue cycle challenges. Still struggling with billing consistency across your mid-size dental group? Talk to us about building a centralized dental RCM model that works for you.
Let ClaimsCrafter help you build a centralized dental RCM model that works for your growing practice.
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