The impact of denied insurance claims goes beyond mere inconvenience. Denied insurance claims can inflict serious damage on the long-term health of your dental business.
You might be thinking, “I deal with denials all the time, of course I know their negative impact.”
But have you considered how wide that impact reaches? When your revenue is impacted, so is everything else, such as your livelihood, the salaries of your employees, and more.
In this article, we will explore 3 harmful results of denied insurance claims that can:
- Disrupt your financial stability
- Create operational obstacles, and
- Erode patient trust and satisfaction
By understanding the full impact of denied insurance claims, you will see the benefits of our #1 solution to reducing your claim denials.
Harmful Result #1: Financial fallout within your dental business
Insurance claims revenue likely accounts for around 50% of your overall revenue. When there is a pattern of denied insurance claims, you may be missing out on hundreds of thousands of dollars over time.
Losses in insurance claims revenue can make it challenging to pay for your bills, employee salaries, equipment repairs and even your own take-home pay.
Missing income also means you can’t expand your dental business in any way. You can’t invest in equipment. You can’t hire new team members.
And as unpaid claims build up on your insurance aging report, it gets more and more difficult to appeal every single one. And the longer a claim is left unpaid, the less likely the insurance company will ever pay it.
This is money you’re owed. You’ve earned every dollar. It belongs in your pocket!
Here are 10 common reasons insurance claims are denied. Knowing these reasons can give you more context on how to avoid denials.
- Incomplete or incorrect information on the dental insurance claim
- Not reviewing patient benefits (insurance verification)
- Contractual denials: clinical and limitation
- No explanations on the claim form
- Unreadable information and files
- Outdated insurance claim forms
- Trying to juggle everything
- No student verification
- Incorrect dental codes
- Missing tooth clause
Dive deeper into all 10 reasons your insurance claims are denied in our Learning Center.
If that list feels long, that’s because it is! Keeping up with all the ways your insurance claim can be denied and delivering excellent service to your patients is a challenge — some find it is impossible.
That’s why savvy dental business owners leave insurance billing to the experts, like our team at DCS.
You need every dollar you’ve earned for your dental business to run smoothly, afford top talent, keep up with evolving technology, and expand. Don’t let unpaid claims limit your business potential.
Harmful Result #2: Operational obstacles and creating turmoil in your workflows
Denied insurance claims create operational challenges within your dental practice, disrupting your daily workflows and causing inefficiencies. A long, messy insurance aging report leads to an increased administrative burden for your team when they don’t have proper support.
When a claim isn’t paid, and the revenue cycle of that patient isn’t completed, it’s like a piece of glass in your tire. The tire won’t totally deflate (yet), but it will gradually go flat, becoming more inefficient over time.
Similarly, your team has to take extra steps to appeal each denied claim, which turns into hours on the phone with insurance representatives. This takes away time from other tasks, such as patient check in (which we’ll cover more later), scheduling, new claim creation, and other tasks essential to the success of your practice.
Being stretched to the limit creates chaos that results in an overworked and stressed administrative team.
“Of course, increased workloads and staffing shortages are major causes of burnout in healthcare. If you’re already suffering from a staffing shortage, denied claims can exacerbate the issue. With frequent rejected claims, your already overworked employees have even more responsibilities. Reworking on rejected claims intensifies frustrations, leading to more burnout.”
And burnout leads to turnover, which means you will have even fewer hands on deck to manage your denied claims and your aging report grows longer. It’s a vicious cycle!
Harmful Result #3: Fractured trust and lower satisfaction among dental patients
One reason claims are denied is because your team did not verify the patient’s insurance coverage. This means the patient’s coverage could have expired, reached its maximum, or simply did not cover your treatment.
If you don't take time to get patient information right, you'll have to make time to do it over.
Unfortunately, this pattern of mistakes is damaging to your relationship with the patient.
When the patient’s coverage is not properly verified, and you face a denial as a result, you’ll need to collect the difference from them. An additional bill for what the insurance wouldn’t cover will not be well-received by your patient.
Related: Master dental patient collections process for profitability: 3 smart tips
Properly verifying insurance helps increase your chances of claim reimbursement and fewer surprise bills for your patients.
And as mentioned in Harmful Result #2, if your team is bogged down with claim appeals, they won’t have the time or bandwidth to give your patients the attention they deserve.
Your patients will notice that your team is stressed out and stretched thin, trying to run the office and get claims paid.
Billing mishaps and your team’s attitude can create a negative environment for patients, which will lead to them finding a new dental provider. Goodwill with patients is invaluable, but can be broken when neglected.
Your #1 Solution: Rescue your dental business — take advantage of RCM as a resource
RCM (revenue cycle management) services are the solution to all the harmful results that denied claims bring.
The goal of RCM services for your dental business are:
- Boosted efficiency and productivity across all operations
- Rapid reimbursement recovery from insurance claims
- Lasting and elevated patient satisfaction
- A fueled engine for business growth
- Accelerated revenue generation
DCS offers dental insurance claims management that takes care of submitting, tracking, and appealing your insurance claims. With our experts managing your insurance claims, your process will move more efficiently, and you’ll see a drastic decrease in mistakes that lead to denials.
This will increase your revenue, and also enable your team to devote their valuable time and skills to patient care. Both of these benefits will let your dental business thrive.
Don’t let denied insurance claims harm your livelihood: Revitalize your business with RCM services
Understanding the damaging consequences of denied insurance claims is your first step towards safeguarding your dental business from:
- Financial fallout within your dental business
- Operational obstacles, creating turmoil in your workflows
- Fractured trust and satisfaction among dental patients
Your next step is to avoid financial fallout, streamline business operations, and prioritize patient trust and satisfaction by minimizing the number of denied claims.
The revenue cycle management services at DCS can take care of that and more. Our expert revenue cycle management services will optimize your insurance claims processes, improve reimbursement rates, and enhance the overall financial health of your dental practice.
Revolutionize your claims revenue and stave off denials with expert RCM. Book a call with a consultant today.
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