Outsource Insurance Billing and Insource Revenue and Relief

Henry Shaw

Director of Content

As a dentist the perfect impression to create the crown that will seat on the first insert makes your day. Tunneled into a mouth creating the aesthetically pleasing moment when the patient tears up and thanks you is worth the blood sweat and tears shed over paying the monthly bills. Most dentists shed those tears rather than really look to what is causing the lack of revenue.

Speaking to many dental office managers and dental office workers I hear the same responses when asked whether they go over the accounts receivable monthly with their employers. “My job is to keep the doctor busy in the treatment rooms. There is never any time to discuss the accounts receivables.”

Not only is the accounts receivable an orphan in discussion it is often not given enough attention as far as follow-up on unpaid claims and follow-up on unpaid patient portions on account. The pressure to keep the dentist or dentists busy to produce more is evident due to the lack of system to collect what is by rights the monies owed. The “hamster wheel” in progress every day to produce more and to collect less makes little sense or should I say “cents”?

Your staff is busy and thoughts go to hiring more help but you can’t afford more help. Let’s face it; hiring a permanent staff member to work the accounts receivables can be expensive when you consider salary, benefits, taxes and more office drama assimilating another staff member.

Outsourcing patient billing and insurance filing in the medical field has been standard for quite a while and has been shown to be cost effective. We have little statistics with this in dental but as practices grow and insurance billing and collection becomes more complicated and time consuming, the need for a professional billing service increases.

Why should you consider outsourcing your billing?

It can save you money. If you choose a company that works off of a commission or a flat rate that is affordable versus the costs to hire a permanent office worker that may not be experienced enough to appeal claims and collect from patients.
Your billing system is not achieving success. A professional billing service has to hire people that are experienced and successful at this type of work or they wouldn’t be in business.
You have constant staff turnover and every time you change the “watch” in your practice, claims submissions and collections go down.
You are a start-up practice and you want to spend time marketing, networking and communicating with your new patients not trying to train and manage employees that were affordable but not experienced.
A billing company can help with technological issues that you may not have the experience with or the time to deal with such as updating fee schedules and CDT codes.
Your business acuity is not even near what it should be. The billing company can help you to achieve a better understanding of your numbers and write-offs by supplying you reports as to their progress in collections and insurance processing.

Having fewer red flags pop up that may trigger an insurance audit is another reason for hiring a professional billing service. Those red flags can be in the form of:

Using outdated codes or wrong codes regularly on submitted claims
Falsifying the dates of treatment (Seat date, Prep date etc.) to get paid.
Offering to waive co-payments and or deductibles to give discounts to patients in network.
Concealing other or secondary coverage to achieve higher payout from the insurance companies.
Code switching to bill for a covered service when a non-covered service was performed.

How to hire an outsourced billing service?

Use the same care as you would in hiring a new staff member. Look at their resume, their website and any written materials. How long in business? Interview the person in charge or the owner. Check online reviews and ask for real time testimonials from actual clients. Ask about the start-up fees and monthly fees and their billing process. Is there room to negotiate? How much time will your staff have to invest to provide information to the billing company? Is there a contract or an agreement?

Outsourcing may be the answer for improving your revenue and the relief of having someone else in charge of the results that reports directly to you.