In Dental Billing

Every dental practice needs at least one team member responsible for handling insurance claims. Whether your office is PPO dependent or fee for service,  insurance billing tasks are required to provide quality service to your patients. These tasks, created by the dental claims billing process, force offices to hire full time staff, part time staff, or extend the dental billing workload to other team members. 

Dental ClaimSupport, an outsourced dental billing company, was founded to help dentists with the mismanagement of dental billing within dental practices. The mission of Dental ClaimSupport is to ensure dentists get paid by eliminating insurance strain.

Have you always handled dental insurance in-house?  

You may be just beginning to explore the option of outsourced dental billing. Many dentists and office managers seek outsourcing services due to employee turnover, collections are decreasing, or in house training is not available. In this article, we will explain to you what outsourced dental billing is, why it exists, and why it is becoming the norm in dentistry today.  


Can you define outsourced dental billing?

Outsourced dental billing is the contracting of dental insurance services to an outside agency. Traditionally, these tasks have been handled by in-house dental team members. Outsourcing allows businesses to cut costs of labor and training.  The dental office would not have to pay per hour or pay for specific training for staff members.

Outsourcing can be commonly known as working remotely.  This can be done in a couple different ways.  One is via remote desktop applications and another is VPN, or Virtual Private Network.

According to a definition by TechTarget, “remote desktop is a program or an operating system feature that allows a user to connect to a computer in another location, see that computer’s desktop and interact with it as if it were local.”

According to Cisco, a VPN, defined as “a virtual private network, is an encrypted connection over the Internet from a device to a network. The encrypted connection helps ensure that sensitive data is safely transmitted. It prevents unauthorized people from eavesdropping on the traffic and allows the user to conduct work remotely. VPN technology is widely used in corporate environments.


Is outsourced dental billing HIPAA Compliant?

Remote access can be given via a VPN to a computer or the server in your dental practice. The VPN makes the connection HIPAA compliant. With a Business Associate Agreement in place, the outsourced dental billing company would connect a computer to the server in your practice. 

Once a connection has been established, the dental billing company would then gain access to your dental software. At this point, the connection would be live. Any edits by the dental billing company would be live and in real time. Basically, the dental billing company is now afforded the ability to work in your dental software as if they are in your physical location. 

Would outsourcing dental billing replace my in-house team?

Outsourcing your dental billing can certainly have an affect on your in-house team. Replacing an individual is not the intent of dental billing companies.  

The goal is to have your in-house team be more patient focused instead of insurance focused.  Eliminating insurance phone calls for your staff will alleviate undue stress. Allowing your staff to be present with your patients will make all the difference in your team’s culture.

Ultimately, the decision to replace your in-house team or coordinator would fall solely on the dental practice itself.   

What are the common dental billing services included?

These are the most common services that dental billing companies include in their dental billing services: 

  • Appeal denied claims
  • Insurance aging report follow up
  • Sending claims (through a clearinghouse)
  • Posting insurance payments
  • Posting insurance EFT payments
  • Posting insurance Virtual Credit Card payments 
  • Applying PPO adjustments and write offs
  • Submission of secondary claims
  • Attachments with electronic claims
  • Mailing claims, when applicable
  • Daily and weekly communication
  • Fee schedules input
  • Reporting

What is considered a dental billing service and what is not?

When you think of dental billing services, you want to know what is considered a dental billing service and what is not. These services are not provided under the dental billing tag as an included service:

  • Credentialing
  • PPO Fee Negotiations
  • Insurance Verification
  • Patient Collections

These services may be provided by dental billing companies, however they will likely be performed as additional services and charged additional fees.

Is dental billing outsourced overseas?

Outsourced dental billing does not mean services will be handled outside of the United States; however, some dental billing companies do outsource services overseas to countries such as the Philippines or India. 

Insurance verification is one service that is seen more outsourcing overseas versus the dental billing duties typically kept within the United States. Insurance verification is more labor intensive, systematic, and with less training and problem solving needed. If hiring in-house, insurance verification is going to be hired as a data entry position at an entry level salary.

When considering a dental billing company, be sure to ask if services are outsourced overseas.

What are the benefits of outsourced dental billing?

Outsourcing will streamline your dental billing process. An outsourced dental billing company has the time and expertise to devote to tasks such as researching claims on the insurance aging report, posting accurately to patient ledgers, and appealing your denied claims.

Outsourcing creates more time for your dental team to be patient focused. Dental billing takes time and dedication to perform at an expert level. As you know, your admin team wears many hats. Utilizing a billing company allows the dental team to focus more on the patient experience.

Your dental office will stay up to date with coding and insurance administration changes. The dental field changes frequently. The American Dental Association (ADA) updates and changes codes yearly. Insurance laws in the various states sometimes change year-to-year. Your staff needs to stay abreast of these changes, however sometimes it’s difficult and expensive to send your dental team to conferences and seminars.

Lastly, outsourced dental billing may save your dental practice money. In most situations, outsourced dental billing costs less than in-house employees. With outsourced billing, not only do you have a team of experts dedicated to your account, but it can sometimes be at half the cost of your typical in-house employees.

How quickly can outsourcing increase my collections?

It usually takes 1-2 months for offices to really see significant improvement when utilizing a good dental billing company; sometimes sooner. Significant improvement could be anything from a more streamlined process and peace of mind, to higher collections and clean reports. Once claims become aged and outstanding (usually over 30 days), it’s the responsibility of the dental billing company to get these claims corrected and reprocessed. The insurance company also has a responsibility to pay clean claims, usually within 30 days of them being received, depending on any state or federal prompt payments laws that may apply. Clean claims are dental claims sent to the insurance company that have no validation issues such as wrong ID, birthday, payer ID, etc. Also, unprocessed dental claims that have been researched with a call to the insurance company should be processed within 10-15 business days.  .  

What are the problems with outsourced dental billing?

Outsourcing can work, but sometimes it’s not the best fit for all dental practices. 

Setting unrealistic expectations that all insurance related problems can be fixed immediately is one problem we see.  Whether there are credentialing issues or claim submission issues within the office, the issues did not occur overnight and cannot be fixed immediately. Especially those problems that lie with the insurance companies.  

It’s important to note the adjustment period between your staff and the billing company.  Some staff may feel timid about bringing in a new team to handle insurance claims, and this may affect your office culture.  Creating trust takes time. 

Be aware of these problems as any problem can be avoided or corrected with open communication.

How much does outsourced dental billing cost?

You may be deciding between an in-house insurance coordinator or employing an outsourced dental billing company, but what does an outsourced dental billing company cost and what are the services provided? 

At Dental ClaimSupport, an outsourced dental billing company, every chat or call we receive from a dentist concludes with the same question: “How much does outsourced dental billing cost?” 

The average cost for outsourced dental billing is about $1,500-$1,600 per month

To make the right decision, you must compare outsourced costs vs in-house costs and consider what’s best for you and your practice.

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