Dental insurance billing is, to a lot of dental professionals, their least favorite part about working at the dental office. It’s complicated, tedious, time-consuming, and always challenging. But it’s also vital because claims are a major revenue source.
What to do when dental insurance won’t pay? The rules, insurance carriers, codes, and regulations of insurance policies update constantly. It’s hard to keep up and is becoming increasingly more difficult to get claims processed and paid. It’s frustrating when you work hard and you still see dental insurance not paying claims.
When you have other tasks on your plate, it’s hard to find time to better understand dental insurance billing. And as you might have guessed, the more you understand it, the better your dental insurance billing process will be.
Dental ClaimSupport specializes in helping dental practices receive higher amounts from insurance billing - without the headaches that come with claims. Our team of expert billers devotes their time and brainpower to help you get the most income from insurance claims with the least strain on your overhead and your workload.
We’ve helped offices increase their revenue by tens of thousands (or more) per year, proving the importance of this process, and just how much money can be made when it is executed efficiently.
In this article, you will learn 3 myths about dental insurance billing that hurt the bottom line for many private dentists in ways most people don’t see. Understanding these myths, and the truth behind them will help you see what you can do to fix hidden problems, and what processes to implement in order to have a successful dental insurance billing process.
Let’s get into the 3 myths about dental insurance billing.
Myth #1: Anyone can handle dental insurance billing
A big reason dental offices outsource their insurance billing is that they once believed anyone in the office who had some extra time in their day, could handle the insurance billing.
It was the kind of task that was given to the person who had the time to do it. This person might be learning on the job, maybe they have some insurance billing experience but they aren’t confident every time they create, batch, or process a claim.
Sometimes a well-meaning office manager will even volunteer to take on the insurance billing thinking this will save the dentist the cost of outsourcing the task. While it’s admirable to see an employee step up to the challenge of insurance billing, it’s a false economy. It’s much too big a job for someone (especially someone as busy as the office manager) to take on alone.
A claims specialist is going to be faster than someone wearing many hats. Office staff will rightly give attention to patients and doctors first, which disrupts billing. Unless your claims get undivided attention, you’ll see uncollected revenue grow quickly. A super-efficient claims service actually saves a practice about 62% in overhead.
This is NOT a task anyone can do, or learn on the job.
Learn about the 3 skills an expert dental biller should have in our Learning Center.
Here’s the truth: You need a seasoned expert spearheading your insurance billing.
You can’t out-produce inefficient billing. You need to invest in a seasoned expert to take on the task of insurance billing. Passing it off to someone else at the office will cost you.
The process is far too technical and complex to collect the money you earned without an expert. Learning coding and compliance requires formal training, and a lot of guidance at first if you have little to no experience. Insurance companies constantly find new ways not to pay. You need to stay on top of these tactics and always update your process to keep collecting your claims.
Lack of expertise in insurance billing will lead to mistakes on claims, which will result in denied claims and delayed payment from insurance companies. As we all know, the longer payment is delayed from insurance, the less like it is to ever be paid.
So you have two options: take on the work to hire an insurance coordinator, verify that their knowledge is up to par, keep their training up-to-date, or outsource to a billing company that manages staffing and training, as well as the claims process.
To compare the cost of both of these options, read our article, “The cost of outsourced dental billing vs in-house dental billing.”
Either way, this position needs to be filled, not pushed to the side. We’ll get into that next.
Myth #2: Dental insurance billing can be sidelined compared to other tasks
It’s common for dental teams to put their insurance billing on the back burner, especially if they want to put patient care first, have distractions like turnover, or other major changes at the practice.
Insurance claims provide the largest source of dental practice revenue, about 50% of your cash flow. Should the work to bring in that much money be pushed to the side?
Yes, patient care, scheduling, patient billing - all of these things are important. And these things feel more urgent than billing because they impact the people right in front of you - staring you and your dental team in the face if they aren’t completed.
Insurance billing can feel more like a background, behind-the-scenes assignment that you keep procrastinating… but the more these claims aren’t sent and followed up on, the more it will cost your practice.
Here’s the truth: insurance billing needs to be a top priority.
You always need someone 100% dedicated to insurance billing. It drives so much of your revenue that it can’t take a back seat, even to your dental work. If you don’t have anyone in place who makes collecting your insurance income a top priority currently - make it your next to-do to find the right dental billing solution for your practice.
If you want a healthy dental practice, dental billing tasks need to be treated like a full-time job! With a person (in-house or remote) who is always held accountable for the dental insurance billing, you will have an easier time getting claims paid because that person is seeing them through from start to finish.
The longer you wait to get a hold of your insurance billing process and find an expert to handle this process, the less money your practice is going to bring in.
It sounds harsh, but that’s how important it is that this process is perfected and optimized by an experienced biller.
Myth #3: Once you submit claims, you’ve completed the insurance billing process
Many dental teams, especially if they do not have a designated expert biller in place, think that the billing process is completed once they submit a claim.
Because of this misconception, claims are not being followed to be sure they’re paid.
This also leads to the insurance aging report being neglected, which means claims are stuck in insurance purgatory, and they’ll eventually never be paid. You should look at your oldest unpaid claims first, and do the research to figure out why they aren’t paid - then do the work to get them paid. Not doing this could lead to thousands in insurance collections that the practice is missing out on!
The billing process isn’t completed until you see that money in your bank account.
Here’s the truth: The billing process is not completed until all payments are reconciled.
Truly, submitting the insurance claim is only half the battle. You do need to take the time to be accurate and verify insurance when doing so, which can take a lot of time.
But you’ll then follow that claim to the finish line, aka your bank account.
As we said, there might be some bumps along that road with claim denials - but if you have an expert in place who’s responsible for insurance billing, they’ll know how to make sure each claim is looked at, researched, paid, posted to your dental software and reconciled.
When we say reconciled, this means everything - your dental software and your bank account - match! This is when the cycle of a claim is complete.
Learn 3 steps to take you through the dental billing process with ease in our Learning Center.
Understand your dental billing process so that you can collect what you’re owed from insurance
Knowledge is power, and in the case of dental insurance billing - you can take control of your income through learning more about the process and keep on improving it.
These myths are more common than you think - which is why Dental ClaimSupport isn’t just a tool for taking care of your claims, but also a tool for education. Learning dental insurance billing is no walk in the park, and it’s not exactly a college course anyone can take!
To continue your dental billing educational journey, learn what a great dental billing process looks like. It will let you know what your process should look like from start to finish, and give you a few tips along the way.
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