Imagine that it's a typical Monday morning at your bustling dental office. The computers are down, the phone is ringing off the hook, and every patient seems to have a crisis that demands immediate attention. Amid the chaos, your team is running around, each tackling problems independently instead of working together. It's a scene of disarray that highlights the crucial need for a well-coordinated approach to revenue cycle management (RCM).
In this article, I will explain how every member of your dental team can play a pivotal role in transforming chaos into seamless efficiency.
RCM is the backbone of a successful dental practice, ensuring that the services provided translate into revenue collected. Every member of the dental team plays a crucial role in optimizing RCM. Everyone contributes to a seamless billing process, from doctors and hygienists to dental assistants and front office team members.
Here's a closer look at how each role impacts RCM.
Doctors: The leaders of clinical documentation
Doctors are responsible for providing precise and comprehensive clinical documentation. Detailed notes on diagnoses, treatments, and procedures are essential for clean claim submissions. Insurance companies rely on these notes to validate claims, so accuracy is paramount.
Practical tips
- Ensure that every note is comprehensive and specific to the patient's condition and treatment. Avoid generic statements. For example, instead of noting "Crown needed due to decay," write "Crown required due to severe mesial buccal decay and recurrent caries compromising the tooth structure."
- Write in clear, concise language that can be easily understood by insurance reviewers.
- Stay updated on insurance requirements and documentation standards through continuing education and professional development.
Hygienists: The preventive care specialists
Hygienists play a vital role in gathering pretreatment documentation. They ensure that all necessary diagnostic information, such as x-rays and intraoral photos, are captured accurately and promptly. This documentation supports the medical necessity of treatments.
Practical tips
- Ensure that x-rays and intraoral photos are clear, comprehensive, and up to date. Most insurance companies require x-ray images to be taken within the last year or two. For example, take bitewing x-rays that clearly show areas of decay or bone loss. Look for cone cuts and open contacts.
- Document the patient's history thoroughly, noting any changes in their oral health since the last visit, new symptoms, changes in their medical history, and previous treatments.
- Use standardized forms to document pretreatment information to ensure accuracy and completeness.
Scaling and root planing
For procedures like scaling and root planing, hygienists must provide detailed periodontal charting that demonstrates bone loss and other periodontal conditions. This information is crucial for insurance claims and ensures that treatments are justified and reimbursed. Scaling and root planing is one of the highest denied claims.
Practical tips
- Measure and record pocket depths, bleeding points, and recession accurately. Use a consistent method for probing and recording measurements. How often does your office provide training and calibration? Make this a regular habit.
- Provide descriptive notes on the condition of the gingiva, bone loss, and any signs of infection. Note specific areas of significant bone loss or inflammation.
- Update periodontal charts at each visit to track progress and identify new issues promptly.
Dental assistants: The backbone of clinical efficiency
Dental assistants are responsible for capturing and attaching all necessary documentation during procedures. This includes taking preop and postop x-rays, intraoral photos, and ensuring that all images are of diagnostic quality.
Practical tips
- Capture clear, diagnostic-quality x-rays and intraoral photos. Verify that x-rays show the entire tooth structure and surrounding bone. Again, pay attention to cone cuts and open contacts. Posterior-to-anterior images should show the entire root and bitewings should show the entire crown.
- Organize the attachments. Label and organize attachments correctly to ensure they are easily identifiable and linked to the correct procedures. This is a crucial step for claims filing. Use standardized naming conventions for digital files and keep each other accountable.
- Check for completeness. Double-check that all necessary attachments for the claim have been taken before seating the patient, during the procedure, and prior to the patient leaving the chair. For instance, for a crown, ensure you have preop x-rays, intraoral photos, and relevant narratives.
- Ensure smooth procedure coordination. Assistants help coordinate procedures, ensuring that all required documentation is collected before, during, and after the treatment. They work closely with doctors to pause and capture images at critical points, ensuring nothing is missed. To that end, dental assistants should do the following:
- Coordinate with the dental team to ensure all required documentation is prepared before the procedure begins. For example, you may have a checklist for each procedure that includes all necessary documentation and attachments.
- Pause for documentation. Ensure that key moments during procedures are documented with photos or notes. Take the lead here! Take intraoral photos before, during, and after a crown preparation.
- Train the team. Train the dental team on the importance of documentation and how to capture it correctly. Conduct regular training sessions on using intraoral cameras and updating clinical notes.
Front office team members: The gatekeepers of dental billing
Front office team members play a crucial role in managing patient demographics and insurance information. Accurate data entry and regular verification are essential to avoid claim rejections and ensure smooth billing processes.
Practical tips
- Confirm patient details and insurance information at every visit to ensure accuracy. Ask patients to review and update their contact and insurance information regularly, especially during check-ins and prior to their appointments.
- Use standardized forms. Utilize standardized forms for collecting patient and insurance information to ensure consistency. Create templates that capture all necessary information, including the patient's name, date of birth, insurance ID, and policy details.
- Train staff regularly. Conduct regular training sessions on the importance of accurate data entry and updates. Regularly highlight common rejections and denials in your practice and ways to avoid them.
Claims submission and follow-up
Timely claims submission and diligent follow-up on rejections are critical for maintaining a steady cash flow. Front office team members are responsible for ensuring that claims are submitted correctly and any issues are promptly addressed.
Practical tips
- Ensure that claims are submitted daily to avoid backlogs and delays. Set aside dedicated time each day for claims submissions, ideally at the end of the day to include all services provided.
- Monitor rejection reports. Review rejection reports daily and address any issues promptly. As part of your process, identify common rejection reasons and take corrective actions to prevent future occurrences, such as verifying payer IDs and checking for demographic discrepancies.
- Run regular reports. Run regular reports to track the status of claims and identify any outstanding issues. Use reports to monitor claims aging, follow up on overdue payments, and address any trends that indicate systemic problems.
Take your practice to the next level
Unlock the secrets to efficient RCM with Wisdom's free e-book, "The Exclusive Guide to Dental Billing Secrets." Discover practical tips and strategies tailored to optimize your dental practice's billing process.
Ashley Bond is the co-founder and chief dental billing officer at Wisdom, a dental billing company. She previously founded Bond Dental Billing. Bond has a background deeply rooted in the dental industry. She worked alongside her father in his dental practice. Bond is passionate about helping dental practices thrive through innovative solutions and effective dental billing strategies.
The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.
