Are Your Dental Insurance Mistakes Costing Your DSO Big Money?

Costly Insurance Mistakes

In my over 20 years in the dental industry, the one thing that I see practices continue to struggle with is dealing with dental insurance. Time and time again I see practices lose money, and not even realize it, because of insurance. Usually it is because of the lack of dental team’s knowledge and training in an area that is constantly changing and difficult to keep up with.

This can be a bigger struggle with multiplied losses when managing multiple practices. Consistent training protocols can be time consuming and challenging. Here is a list of important insurance concepts for anyone on your team to thoroughly understand.

• Timely Filing Limitations: Each insurance company has their own timely filing periods, and if you miss their deadline you aren’t getting paid. The timely filing deadlines vary from 30 days to a year and they are getting more stringent. Tracking eclaims and unpaid claims is essential to avoiding this roadblock.

• CDT Code Changes: It is critical to be using the correct codes when submitting to insurance. Did you know that the dentists can be held liable for errors their team makes? Errors that happen fairly regularly can be construed as “intent to defraud”, which can lead to fines and jail time. Ignorance is no excuse in the eyes of the law.

• Responding to Patient’s Insurance Questions: Dental patients now expect their dentist and their team to understand their specific insurance plan. “I’m not sure” can seem like an appropriate answer given all the insurance plans available. In the eyes of the patient it can be seen as poor customer service unless the patient has been thoroughly trained on their responsibility concerning their insurance benefits.

• Outstanding Insurance Claims: Unpaid claims can easily be procrastinated or over looked. Weekly unpaid claim follow up is essential to ensure final statements sent to patients are as close to the day of treatment as possible. This helps reduce A/R and avoids unpleasantly surprised patients who have since long forgotten about their treatment.

• Leveraging Software Information: Most practices are not utilizing their practice software as designed, which makes them less efficient, less profitable and in danger of a time consuming and costly clean-up. Your software is the system that charges procedures, bills insurance companies and patients and tracks your productions and collections. Ensuring that the information entered into this valuable system is accurate is critical.

Education and training for the dental team is the key to eliminating unnecessary losses. A small mistake repeated among multiple patients among multiple practices can easily become a large financial loss. Training is even more important for group practices for this reason.

Accepting insurance is beneficial for practices. It is often how patients find your practice. It can also be a source of frustration when looking at the associated costs of accepting insurance. Preventing these errors will help ensure that you are not writing off any more money than is absolutely necessary and providing the highest benefit for your practice and your patients.

Jennifer Schultz has spent over 20 years in dentistry working in and with dental practices as an employee, software trainer, practice management consultant, and the owner of DentalInsuranceNavigator.com and VirtualDentalOffice.net. Jennifer can be reached at, jennifer@dentalinsurancenavigator.com or 1-563-582-4762.