Apex Reimbursement Specialists

3 Dental Billing Errors and How to Avoid Them

Dental billing errors can lead to many issues for dental practices, including delayed payments, reimbursement denials, and potential legal consequences. It’s crucial for every dental professional to understand the most common billing errors and take proactive steps to prevent them. How can you avoid the most common errors?

Coding Errors

Coding errors are among the most common dental billing errors. These errors can occur due to the incorrect use of procedure codes, inaccurate coding, or failure to use the most updated version of codes. Such errors can result in claim denials, delayed payments, or even audits.

To avoid coding errors, you should ensure that you regularly update your coding practices and codes based on insurance changes. Train your staff on proper coding guidelines and ensure they use the most recent codes. Additionally, you can utilize electronic billing systems or software to validate codes and flag potential errors before claims are submitted.

Incomplete Documentation

Incomplete documentation is another common cause of dental billing errors. Insufficient documentation can lead to claim denials or payment delays, as insurers may ask for more detailed information to process the claim. Supporting documentation can include things like treatment details, diagnostic records, and supporting documentation.

To avoid documentation errors, you can implement documentation processes that record all necessary information for billing and claims submission. Teach your staff the importance of thorough and accurate documentation so that they understand their role in the financial health of your practice. You can also use electronic health record (EHR) systems or dental practice management software that will streamline documentation processes and keep everything organized.

Unverified Insurance Coverage

Another significant cause of billing errors is failing to pre-verify patients’ insurance coverage. When you don’t take the time to check their eligibility ahead of time, you might experience claim rejections or denials if the services are not covered by the patient’s insurance. Incorrect insurance information can also lead to billing discrepancies.

If you want to limit insurance verification problems at your dental practice, you should start by always pre-verifying insurance information before patients arrive for their appointments. Have staff confirm insurance information with patients when confirming the appointment and when patients arrive for their appointment. Many practices also choose to invest in software that can automatically verify patient insurance information.

Improve Your Dental Practice with APEX Reimbursement Specialists

Whether you’re looking for a way to make revenue cycle management at your dental practice easier or hoping to improve your overall patient communication plan, APEX Reimbursement Specialists is here to help. Contact our team today by calling (410) 710-6005. We look forward to working with you to make your practice a more profitable place.

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Why Insurance Verification Is So Important for Every Dental Practice

Insurance verification is your first defense against claim denials. This process involves confirming a patient’s insurance coverage before their appointment so that you can make corrections and provide them with an accurate treatment cost estimate. While it may seem like an administrative task, insurance verification plays a pivotal role in the financial health and operational efficiency of dental practices. Why is insurance verification so important?

Accurate Patient Information

Insurance verification starts with ensuring that the patient information that you have is accurate, including insurance details, policy numbers, and coverage information. Verifying this information upfront helps prevent errors, discrepancies, and delays in claim processing. By confirming patients’ insurance coverage before their appointments, you can ensure that the information you’re submitting is accurate which minimizes the risk of claim denials and payment delays.

Improve Your Revenue Cycle Management

Prompt insurance verification is also essential for your dental practice’s revenue cycle management. By taking the time to verify insurance coverage and benefits before treatment, you can more accurately estimate patients’ out-of-pocket expenses, co-payments, and deductibles. This gives you a chance to collect payments in advance, which lowers the risk of unpaid balances and improves your cash flow.

Fewer Claim Denials

High claim denial rates can negatively impact your dental practice’s revenue and profitability. Many claim denials are the result of incomplete or inaccurate patient information. By completing thorough insurance verification before appointments, you can identify potential issues upfront and address them proactively.

Better Experience for Patients

One of the biggest frustrations that many patients have is anticipating a visit costing one amount and receiving a bill that says something totally different. Patients appreciate transparency and clarity when it comes to understanding their insurance coverage. By completing insurance verification and communicating what they’re responsible for upfront, you can improve the patient experience and build loyalty.

Work More Efficiently

Finally, insurance verification streamlines the check-in and appointment scheduling process, which helps improve operational efficiency at your dental practice. When you already have accurate insurance information on file, front desk staff can expedite the check-in process and collect payments more efficiently. This can also reduce wait times and enhance overall practice workflow, which frees up your staff to focus on providing quality care.

Improve Your Dental Practice with APEX Reimbursement Specialists

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Why You Should Outsource Your Dental Billing

Managing a dental practice involves juggling numerous responsibilities, from providing care to patients to handling administrative tasks. Dental billing is one of the most important administrative tasks, as it can make or break your bottom line. Many dental practices struggle with the managing billing procedures, which can lead to inefficiencies, errors, and lost revenue. Choosing to outsource your dental billing is one way to streamline your operations, maximize revenue, and let you focus on other things.

Save Time and Money

Processing dental claims and managing billing issues can be time-consuming and take away from what you do best—helping patients in your chairs. By outsourcing your dental billing, you will free up valuable time and resources that can be spent providing quality care, expanding your practice, or pursuing professional development. Outsourcing lets you focus on what you do best and leave the nuances of billing to dedicated professionals.

Increased Revenue

Effective dental billing practices can have a significant impact on your practice’s revenue and cash flow, and opting to outsource your dental billing can radically improve your billing processes. Through prompt claims submission, quick follow-up on denied claims, and proactive management of accounts receivable, outsourcing can help optimize your practice’s finances.

Decreased Administrative Burden

Handling dental billing in-house requires a significant amount of time, manpower, and resources that many practices struggle to sustain. Choosing to outsource your dental billing will lessen a lot of administrative burden, including the need to hire and train billing staff, invest in new billing software, and manage all billing-related tasks. Instead, you’ll have a dedicated team of professionals to efficiently handle all aspects of your billing for you.

Easier Compliance and Accuracy

Staying on top of healthcare regulations and insurance requirements is a key part of dental billing to avoid penalties and delays in getting your reimbursements. Outsourcing your dental billing makes it easy to stay compliant with HIPAA regulations, changing codes, and insurance policies. This dramatically reduces the risk of billing errors, which also saves you stress and time spent resolving issues.

Scalability Made Simple

As your dental practice grows or your patient volume changes in either direction, your billing needs will shift accordingly. Outsourcing your dental billing gives you greater scalability and flexibility without needing to worry about hiring and training someone new or letting go of an employee because you simply don’t have the volume to justify keeping them.

Improve Your Dental Practice with APEX Reimbursement Specialists

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Understanding the Interstate Dental Compact Bill

On Wednesday, March 13^th, an innovative Interstate Dental Compact Bill had its first hearing in the Minnesota Senate’s Health and Human Services Committee. This bill is designed to allow dentists who are licensed to practice in the state of Minnesota the freedom to also practice in other states. Five other states are currently members of the compact, and 11 others have pending legislation. What should dentists know?d

What Is the Interstate Dental Compact?

The Interstate Dentist and Dental Hygienist Compact is an occupational license compact that allows dentists and hygienists who are licensed in one state to also practice in all other participating states. This eliminates the need to procure a separate license in every state. For example, if you are licensed in the state of Virginia and move across the country to Washington state, you can also practice there without getting a new license.

What States Are Involved?

Currently, five states are participating in the Interstate Dental Compact: Washington, Wisconsin, Iowa, Virginia, and Tennessee. There are 12 states (including Minnesota) where legislation has been introduced or is pending, including Maine, Pennsylvania, New Jersey, Ohio, Indiana, Illinois, Alabama, Missouri, Kansas, Nebraska, and Colorado. Other states are expected to introduce legislation with the support of the American Dental Association and the American Dental Hygienists’ Association.

How Does the Interstate Dental Compact Work?

Dentists who apply to participate in the Interstate Dental Compact must have an active and unencumbered license in a participating state, They must have also passed the National Board Exam or another accepted exam and completed a clinical assessment. They must also have graduated from an education program that is accepted by the Commission on Dental Accreditation.

There is a simple four-step process to participate in the Interstate Dental Compact after your state approves it.

A dentist or dental hygienist who already has a license in a participating state applies for compact privilege.
Next, an FBI background check is performed.
After the background check is approved, the license and eligibility of the applicant is verified. You will also need to pay any associated fees for this process.
Finally, your compact privilege is issued.

What Are the Benefits of the Compact?

Dentists and dental hygienists stand to benefit in a big way in participating states, as they will be able to take their licenses with them without updating their state of residence. If it expands from Virginia into DC and Maryland, it will give dentists the ability to have multistate practices without needing to maintain three separate licenses. The compact also lowers the financial burden associated with having multiple licenses.

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Market Update: United Concordia Dental and Ameritas

As a dentist or dental practice owner, it’s important to understand market factors that might impact your practice. United Concordia Dental and Ameritas recently announced a partnership that will allow Ameritas patients to access the United Concordia Dental network. What does this partnership mean for your business and your patients?

What Does the Partnership Mean?

As of May 1st of this year, any patients who have PPO coverage through Ameritas will be able to access United Concordia Dental’s Advantage Plus Network. This is a notable expansion to the Ameritas network, and it is also an opportunity for current providers who are enrolled in the United Concordia network. If you are currently a part of the Advantage Plus Network, you will be able to take on Ameritas patients to potentially expand your patient base.

What Happens If You Partner with Ameritas?

Insured members of the Ameritas network are able to access an online provider directory when choosing where to receive care. The Ameritas website is updated every day, so you will be granted almost instant access to a broad new patient base. If Ameritas is commonly used in your area, this is a great opportunity.

You do not need to complete the credentialing process with Ameritas like you would when traditionally adding another insurance provider to your practice. Instead, you’ll be able to directly send information to Ameritas. To learn more about the specific billing details, click here or read below:

The networks being added to United Concordia Dental’s Advantage Plus Network are called the Ameritas Classic Dental Network and the Ameritas Classic Plus Dental Network
Reimbursement will initially be your current United Concordia Advantage Plus maximum allowable charge schedule (unless otherwise negotiated)
ID cards from patients will still display the Ameritas network, not the United Concordia Dental network
If you have any questions about the addition of Ameritas, you should direct them to United Concordia for the time being at (800) 307-8514

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What Dentists Need to Know About Change Healthcare’s Cyberattack

At the end of February, Change Healthcare experienced a serious cybersecurity incident that completely disrupted its ability to process prescriptions and payments. Because it happened so recently, all of the effects have not been realized yet. However, there are still things that dental practices need to know in the meantime to protect their patients and prepare for the slow process of Change Healthcare coming back online.

What Happened?

Change Healthcare is a massive organization, and it works with virtually every hospital in the United States in one way or another according to the American Hospital Association. As many as 50% of all medical claims in the country currently flow through them. Change Healthcare was hit by a cyberattack on February 21st. After realizing there was a problem, they disconnected their systems immediately to prevent additional impacts. A recent Bitcoin transaction has also revealed that a ransom may have been paid to stop additional damage to the system.

In the immediate aftermath, some pharmacies were unable to process prescriptions, and some dentists were unable to send electronic claims to insurance companies like they normally would. While some parts of the system are slowly getting back online and pharmacies are able to call insurance companies to manually confirm coverage, this mess is not going to be fully resolved for weeks or potentially months.

Because of the scale of the attack, Senate Majority Leader Chuck Schumer and numerous leading medical organizations, including the American Medical Association, are calling on the Department of Health and Human Services to intervene. If federal support is extended, it can help healthcare and dental practices to recover and ensure that patients are still able to receive the care that they need.

What Can You Do?

First, you should keep an eye out for any information from your payers or other vendors about when services are going to be restored. In the meantime, be prepared to manually reach out through payer portals or service lines for things like benefits verification. Track claims carefully, as things may fall through the cracks during this challenging period. For some practices, it may be worth considering switching to another service or using traditional paper forms and mail for claims.

Because of these interruptions to the traditional revenue cycle, many practices should also prepare for possible delays in claim payments and interruptions to their normal revenue cycle. The American Dental Association has additional resources available on recordkeeping and digital security to make sure that your practice remains secure.

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Avoid These Common RCM Mistakes in Your Dental Practice

Revenue Cycle Management (RCM) is the backbone of any successful medical practice, and your dental practice is no different. RCM encompasses everything from scheduling appointments to processing payments and ensuring proper reimbursement from insurance providers. However, there are numerous RCM mistakes that can harm your practice’s profitability.

Inaccurate Patient Information

One of the most common RCM mistakes in dental practices is inaccurate or incomplete patient information. When you are not sending the correct patient information to insurance companies, it can lead to billing errors, claim denials, and delays in reimbursement. You should proactively confirm information with patients during the registration process and before their appointments. When confirming information with patients, check for address changes, insurance changes, and any other discrepancies.

Claim Submission Problems

Timely and accurate claim submission is crucial for maximizing revenue and minimizing payment delays. However, many dental practices struggle with inefficient claim submission processes, which can increase the likelihood of rejected or denied claims. To avoid this issue at your dental practice, explore automated claim submission systems that can help streamline the process and reduce human error. Always monitor claim status and follow up on any rejections or denials promptly to correct any problems and avoid missing out on potential revenue.

Not Verifying Patient Insurance Coverage

Failing to verify insurance coverage before an appointment is a costly example of the most common RCM mistakes that can result in claim denials and payment delays at your dental practice. Make it a standard practice to verify each patient’s insurance benefits before their visit. Additionally, communicating any potential out-of-pocket expenses to the patient beforehand can help improve the patient experience, avoid surprises, and ensure timely payment.

Failing to Communicate Clearly with Patients

Effective communication with patients is key to any successful dental practice, and it is also a critical part of revenue cycle management. Misconceptions and a lack of knowledge about treatment plans, insurance coverage, and financial responsibilities can lead to billing disputes and payment delays. These problems can also cost you patients, as their frustration over surprise expenses pushes them to go to another practice entirely. Take the time to explain treatment options, costs, and insurance coverage to patients in clear and simple terms. Provide written estimates and payment plans as needed to help patients understand their financial obligations and make informed decisions about their care.

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3 Signs It Might Be Time to Sell Your Dental Practice

Even if you love being a practicing dentist and serving your community, you will eventually want to retire and move onto something else (even if that means just taking a break!). There are many different reasons why practice owners choose to sell, but there are some universal signs that indicate it might be time to sell your dental practice.

You Are Ready to Retire

One of the most common reasons why dentists choose to sell is retirement. Choosing to sell your dental practice can give you the capital that you need to pursue your hobbies, take time to relax with your family, or start another business venture that you have a passion for. If you are selling your practice as part of retirement, it gives you plenty of time to find the right buyer who will value the patient base that you’ve built up and take excellent care of your remaining employees.

You Find Yourself Dreading Work

It might feel vulnerable or uncomfortable to admit it, but if you find yourself dreading work and missing the drive that led you to open your practice, it might be time to sell your dental practice. There are many parts of running a practice that can be stressful, even if your practice is doing well.

If you are starting to resent your practice or the profession and you’re in a financially stable position, selling your practice might just be the best thing that you can do! Your physical and mental health are important. If your heart is no longer in running a dental practice, you should not feel ashamed for moving on.

Your Value Is High

Due to your hard work, you might find that your dental practice has a much higher value than it did when you purchased it. If you have worked hard to attract a large patient base, hire great staff, and optimize your revenue, interested buyers might make you an offer that is too good to refuse. If your practice value is high, it can be a great time to sell your dental practice and profit from all of your hard work. Make sure that you work with the right service to make the sales process seamless, like APEX Reimbursement Specialists.

Improve Your Dental Practice with APEX Reimbursement Specialists

Whether you’re looking for a way to make the insurance verification process easier or hoping to improve your overall patient communication plan, APEX Reimbursement Specialists is here to help. Contact our team today by calling (410) 710-6005. We look forward to working with you to make your practice a more profitable place.

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Should You Expand to Two Dental Practices?

Growing your business can mean a variety of things. While it might sometimes look like adding more services to your current practice, it could also mean deciding to expand to two dental practices. Taking on a second set of patients, hiring new staff, and investing in new equipment is a big decision that shouldn’t be made lightly. What are some of the things that you should consider when contemplating expansion?

Why Are You Expanding?

First, you should consider the reasons why you want to expand to two dental practices. Are you suffering from too many patients and not enough space to see all of them? Do you have effective systems in place that will make it easy to expand to a new space? Are you interested in helping serve an underserved patient base further away from your current location that needs your services? Your motivation is key to ensuring that you have the foundation for expansion.

Where Will You Be?

For all that technology has done for us, it still doesn’t allow us to be in two places at once. If you’re going to expand to two dental practices, you need to decide if you are going to add another business partner, hire additional dentists, or have one practice open some days and the second practice open the remaining days. Even if you do work at both practices every week, you’re still going to need to have a skilled staff member who can take care of the little fires that pop up every day that need to be taken care of.

What’s Your Plan?

Before you decide to expand to two dental practices, you should also consider if you’re truly ready with a business plan in hand. Work with a trusted partner to evaluate your current finances, go through your existing processes, and develop a plan that will ensure success in your new venture. Professional business coaches and consultants can help you prepare not only for purchasing a second practice but also for potential problems that might arise.

Additionally, you should carefully walk through all of the risks of choosing to expand to two dental practices. While you might be able to get great outcomes on every level, you could also end up with twice the effort, twice the fires to put out, twice the time spent, and twice the money to spend. Proper preparation can ensure that you don’t end up making a bad business decision.

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4 Tips to Improve Your Dental Practice’s Online Reputation

In a digital world, maintaining an active online presence is critical for the success of any business, and dental practices are no exception. The majority of people turn to search engines and review websites before deciding what to buy or where to go. As a result, the online reputation of your dental reputation can significantly impact how many new patients you get. Here are some of our best tips to improve your practice’s reputation.

Claim Online Business Listings

Did you know that you can exert some control over online listings for your dental practice? Claim and verify your online listings on sites like Google My Business and Yelp. Make sure that all the information, including your address, contact details, and business hours, is accurate and up-to-date. Some bad reviews come from miscommunications, like a wrong telephone number or inaccurate hours. Additionally, complete profiles are more likely to attract potential patients and add to a positive online reputation.

Encourage Patients to Leave Good Reviews

Happy patients are always going to be your best advocates. Encourage current patients to leave positive reviews on review sites and share their experiences on social media. One of the easiest ways to do this is by sending follow-up emails or text messages after appointments asking patients to leave a positive review with a link to your preferred site, like Google. Positive reviews will boost your online reputation and help attract new patients to your dental practice.

Don’t Wait to Respond

Your dental practice should regularly monitor and respond to both positive and negative reviews. Timely responses show that you truly care about patient feedback, even if a patient had a bad experience. When responding to bad reviews, be empathetic and focus on finding a solution. In many cases, offering a compromise or making things right will lead to the patient removing the review or changing their rating to something higher.

Use Social Media and Websites to Your Advantage

Social media platforms and your website are powerful tools for growing and maintaining your dental practice’s online reputation. Make sure that you have active profiles on platforms like Facebook and Instagram and check them regularly. Social media profiles and websites are also a great way to build trust and make your practice look legitimate. Would you trust a plumber with a website that only had a phone number and poorly formatted text, or would you prefer a plumber with a website that has a photo of the staff, a phone number, hours, and clear and relevant copy?

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