Tips to Optimize Your Dental Billing in the Fall

So much happens in the fall: cooler days, schools reopening, parties, thanksgiving, and so much more. For dental practices, this season can be a challenging time due to the dip in patient volume due to the transition from summer to fall and the start of the school year. However, it also presents some unique opportunities to prepare for the year-end rush and revitalize your billing efforts. Leveraging dental billing services is a practical way to navigate revenue cycle management (RCM), ensure timely reimbursements, reduce denials, and ensure smooth operations not only in autumn, but also for the long term.

Six Strategies for Seamless Dental Billing Operations this Fall

Here are some strategies to help you make the most of your dental billing in the fall:

Send Appointment Reminders

Patient visits typically decline when the fall sets in. With summer vacations ending and families busy with back-to-school preparations, dental appointments decline. To keep your schedule full:

• Ensure patients keep their appointments by send timely reminders via phone calls, text messages, and emails.
• This can reduce no-shows and ensure patients get the treatment they need, while keeping your schedule full.

Encourage Patients to Utilize Unused Insurance Benefits

As the year-end approaches, many patients find they have not used all of their dental insurance benefits. Many dental insurance plans have a benefit deadline of December 31st, meaning that any remaining benefits are lost after that date. So, remind patients to take advantage of their remaining coverage before it resets in January. This will help fill your schedule during fall and ensure that patients can complete their treatments while insurance benefits are still available.

• Send reminder emails or texts to patients with unused benefits.
• Tell them how using their benefits before the year ends can improve their oral health help them save money on dental care
• Identify patients who haven’t visited in the last six months
• Offer discounts for treatments like cleanings, fillings, or crowns that may be partially or fully covered.

Verify Patient Eligibility and Coverage

It’s crucial for dental practices to verify each patient’s insurance coverage before the holiday rush. Confirming insurance details ensures that patients are aware of their coverage limits, co-pays, and deductibles. This helps them understand their financial responsibilities upfront and prevents unexpected out-of-pocket expenses or surprise bills. Early verification will help ensure that you’re submitting clean claims and reduce the risk of denials or underpayments, promoting smooth operations during peak times.

• Use real-time dental insurance eligibility verification services to confirm coverage and plan details.
• Check annual maximums, deductibles, and covered services before scheduling major treatments like crowns, implants, or orthodontics. Most plans have an annual maximum. Knowing a patient’s remaining balance can help determine if they should proceed with a major treatment now or wait until the next calendar year when their benefits reset. Understanding how much of their deductible has been met helps patients understand their financial responsibility. Confirming coverage ensures that both the practice and the patient have realistic expectations about costs and reimbursements.
• Encourage patients needing expensive treatments to get pre-treatment estimates from their insurance company. When patients understand their financial responsibility, it will reduce the chances of surprise billing disputes.

Ensure Prompt Claim Submission

With patients rushing to utilize their remaining benefits before they expire, insurance companies are flooded with claims towards the end of the year. Submitting claims in a timely manner is important to avoid end-of-year bottlenecks. Submitting claims promptly during the fall season will help you prevent delays and ensure timely reimbursements.

• Submit claims within 24-48 hours of the service.
• Focus on claims for high-value procedures like crowns and root canals.
• Track claim status to resolve any issues before they cause delays.

Address Common Causes of Denials

If your dental practice is seeing a lot of denials, fall is an ideal time to address them and polish your claims process. Common issues that cause denials include incorrect coding, missing information, or out-of-date or incorrect patient information.

• Devise efficient denial management strategies.
• Conduct an audit to identify recurring issues causing claim denials.
• Ensure your billing team is up-to-date on the latest coding guidelines as well as common pitfalls to avoid.
• Automate claims scrubbing to catch issues before submission.

Prepare for the Holiday Schedule

It is crucial for dental practices to ensure smooth operations even during the holidays. However, the year-end holiday season can disrupt normal billing processes and appointment scheduling. Preparation is key to avoid any hiccups:

• Plan for billing and front-office staff vacations, reduced hours, and holiday closures
• Prioritize strategies to maximize resources, such as scheduling billing staff to cover key dates and high patient volume periods.
• Inform patients about holiday hours to facilitate scheduling appointments and billing inquiries.

Leverage Efficient Billing Support

Optimizing your dental billing before the busy holiday season can reduce headaches and improve cash flow. Outsourcing RCM to an experienced dental billing company can significantly improve practice efficiency. Dental billing specialists utilize the latest technologies to streamline billing and will implement the right strategies to improve your revenue cycle during the fall season and beyond. They can utilize your software or their own to streamline the entire billing process, including claim creation, scrubbing, electronic submission, and payment posting. This optimizes patient and insurance collections, reducing administrative burdens and maximizing your reimbursements.

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Amber Darst

Amber Darst is our Solutions Manager in the Healthcare Division, Practice and RCM. She is CPC certified by the American Academy of Professional Coders (AAPC). With a rich background in dental services, her expertise ranges from insurance coordination to office management.

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