Accepting and filing dental insurance can often feel non-negotiable in your Endodontic practice. While it can attract a higher influx of patients, it also poses challenges such as stifling write-offs, denial losses, and the time-consuming pursuit of claims. In this article, we’re tapping into 7 Insurance filing innovations your Endodontic practice can leverage to optimize reimbursements while reducing administrative burdens. Let’s explore these transformative strategies.
1. Centralized Insurance Verification
Verifying patient insurance eligibility often involves time-consuming processes like contacting insurance companies directly or accessing online portals for benefit details. To streamline this vital task, consolidating insurance verification procedures into a unified platform equips your team with immediate access to real-time eligibility reports when needed.
Certain clearinghouses provide centralized insurance verification as a user benefit. DentalEMR, in partnership with EDSEDI, integrates eligibility and benefits reporting into our practice management services. With this feature, administrative staff can swiftly retrieve eligibility information for both new and existing patients, ensuring accurate treatment estimates and effective patient expectation management. By facilitating seamless access to up-to-date data, this centralized approach minimizes the risk of claim denials due to coverage issues, ultimately enhancing the efficiency of the patient billing process.
2. Treatment Pre-Authorizations
Although less prevalent in Endodontics compared to General Dentistry, Treatment Pre-authorizations represent a valuable resource for gaining firsthand insight into a patient’s insurance benefits toward intended treatments. This tool proves particularly beneficial for navigating insurances with less detailed benefit reports or those mandating pre-authorization for treatment coverage approval. Pre-authorizations can also offer crucial assistance to patients facing significant cost concerns.
As an Endodontic professional, there are many uncertainties surrounding insurance coverage and you simply cannot guarantee coverage any more than the insurance provider itself (which is minimal, at best). However, presenting a pre-authorization of coverage can offer reassurance to patients seeking additional clarity on their insurance benefits.
While not suitable for every patient, it’s essential to note that Pre-Authorizations typically require 7-10 business days for processing when submitted electronically. This timeframe may not align with the urgent needs of patients experiencing discomfort. Nonetheless, maintaining this option provides a valuable resource for addressing patient care and cost considerations when necessary.
3. Electronic Submission and Attachments
Submitting claims electronically is the most efficient and cost-effective strategy for most practices. Electronic submission provides sanity checks and real-time processing, ensuring prompt validation and submission of claims. It also allows your team to include electronic attachments. This method significantly accelerates your reimbursement as a provider.
While there is a possibility of electronic claims being sent to the wrong destination, correcting this error is much faster than printing and manually sending the claim. NEA FastAttach enables seamless integration of x-ray images, narratives, and EOBs into your submissions, reducing processing delays.
For payers that do not support electronic submissions, consider a clearinghouse such as EDSEDI that provides printing and mailing solutions in additional to electronic submission.
4. Automated Claim Validation
Insurance claim checks play a crucial role in your practice’s claim filing workflow, ensuring that errors, omissions, and necessary information are addressed before submitting the claim to the insurance company. This proactive step is essential for facilitating smooth claim processing from the outset. Without this tool, the claiming process can easily become laden with errors. It’s not about administrative negligence, but rather a recognition of the intricate nature of insurance filing procedures.
Even with the best intentions, when processing a high volume of insurance claims, details can inadvertently slip through the cracks. Implementing an automated claim check system provides a safety net, allowing your team to identify and rectify mistakes or missing details before submission. This approach optimizes efficiency, saves time for everyone involved, and ensures prompt reimbursement for your Endodontic practice.
Our partner, EDSEDI provides this automated workflows to it’s users, streamlining the claim submission process, offering seamless error reporting and editing tools that enhance the efficiency of claim corrections.
5. Real-time Claim Statuses
The accessibility of your clearinghouse through your practice management software may vary. Some practice management software platforms may integrate their own branded version of the clearinghouse access, which can restrict your team’s ability to oversee outstanding claims effectively.
However, with a clearinghouse like EDSEDI, your team gains valuable transparency. EDSEDI offers it’s own readily accessible portal with real-time updates into the progress of claims, including submission status, payer acceptance, denial/process, and even reimbursement reporting. This functionality empowers billing administrators to closely track each claim’s status, and proactively address delays or issues. Such transparency enhances reimbursement rates, enabling practices to sustain a steady collections flow rather than relying on paper denials or uncertain feedback from the insurance company.
6. EFT Payments and ERA Reporting
Electronic Funds Transfer (EFT) payment options present Endodontists with the convenience of receiving electronic reimbursements, eliminating the need to manually process checks. This streamlined payment method can significantly accelerate reimbursement processing. Practices can enjoy improved cash flow and operational efficiency by embracing this modern payment method, however not all insurance companies support EFTs and not all EFTs are created equal. Before taking the leap to enroll in EFT payments for your practice, you’re encouraged to read our Mastering EFT Payments article, so you know exactly what to look out for.
One common hurdle hindering Endodontic practices from adopting EFT payment methods is the challenge of accurately tracking them. Typically, Insurance EFTs are scattered across individual insurance websites, making tracking a time-intensive task as billing teams must manage multiple logins and remember to check them regularly. Fortunately, Electronic Remittance Advice (ERA) reporting consolidates EFT information into a single platform, a service that some clearinghouses offer. For instance, DentalEMR collaborates with EDSEDI to furnish ERA reporting to its users, providing a unified view of all electronic payment transactions in one location. By simplifying reconciliation processes and reducing the risk of oversights, ERA reporting bolsters efficiency when tracking EFT payments.
7. Contract Negotiations
Endodontists (and most dentists for that matter) often overlook a crucial strategy in insurance contracting: Negotiations. This fact is primarily because it’s not well known that insurance in-network contracts can be negotiated, especially upon initial enrollment. Not only is it important to negotiate your initial insurance contract terms when enrolling for the first time, but to continuously renegotiate these agreements on a regular basis. Typically revisited every 2 years, renegotiations empower you to increase allowable fees, extend coverage provisions, and optimize your insurance claim process for greater success.
To handle this complex task effectively, it is advisable to enlist the support of professionals with the requisite experience and skill. Services like Unlock the PPO specialize in PPO negotiation and can streamline this process for your Endodontic practice. Without challenging your insurance contracts, you could be leaving potential lost revenue on the table. In fact, insurance companies are banking on it.
Conclusion
While you might feel like you have little to no choice when accepting and filing to dental insurance, the above strategies prove effective both individually and collectively for optimizing this process in your practice; ensuring streamlined operations, timely reimbursements and minimal overhead.
If you’d like to learn more about the claiming solutions provided by DentalEMR and strategize how to improve these processes in your practice, connect with our team today.