Dental RCM: Real-Time Billing for Same-Day Dentistry

With the increased patient demand for speed and convenience in healthcare, it’s not surprising that same-day dentistry has grown in popularity. Another contributing factor? Digital dentistry and advancements in technology, including Chairside Economical Restoration of Esthetic Ceramics that allow dentists to design, mill, and place restorations (e.g., crowns, veneers, bridges) in a single appointment; 3D imaging; intraoral scanners; and more. Same-day dentistry is important because it improves scheduling efficiency, minimizes downtime, reduces no-shows, and often leads to higher patient satisfaction and retention. However, given the expedited timelines associated with same-day procedures, medical practices may also face billing errors that can negatively impact dental RCM. Understanding and addressing RCM dental challenges helps practices leverage the competitive and financial advantages of same-day dentistry while mitigating risk. In this article, you will learn how same-day dentistry impacts billing, coding, and collections—and how to avoid dental RCM mistakes that hurt your cash flow.

The front-end dental RCM challenges of same-day dentistry🔗

Due to the fast-paced, on demand nature of care delivery, same-day dentistry is ripe for dental RCM challenges on the front end of the billing process. Some of these RCM dental challenges include:

• Inability to perform RCM dental eligibility checks and coordination of benefits immediately prior to the same-day procedure
• Lack of RCM dental pre-authorization for various same-day dental procedures
• Patient registration errors and omissions
• Rushed patient financial discussions
  

The back-end dental RCM challenges of same-day dentistry🔗

Without accurate dental RCM information and processes on the front end, dental practices are at risk for the following back-end challenges:

• Clinical documentation gaps or inconsistencies that lead to medical and dental coding errors
• Inaccurate CPT, CDT, or ICD codes, leading to denials or rejections that compromise cashflow and increase administrative burden
• Over- or underpayments that increase compliance risk
• Over- or under-estimating the patient financial responsibility, leading to patient confusion and frustration not to mention the potential need for patient refunds
  

Best practices for dental RCM teams🔗

These eight proactive strategies can help dental practices overcome dental RCM challenges associated with same-day dentistry:

1. Consider computer-assisted coding tools. Use these tools to promote RCM dental medical coding accuracy.
2. Create prior authorization protocols. Flag procedures that typically require prior authorization, and work with payers to streamline RCM dental workflows for same-day procedures.
3. Implement transparent pricing tools and patient financing options. Also train teams on in-visit estimate scripting using current fee schedules and insurance data.
4. Integrate real-time eligibility tools into the RCM dental practice management system to speed up the dental insurance verification process. Also consider partnering with a practice management software agnostic dental RCM vendor that can manage this process across diverse practices so providers can focus on patient throughput and maximum revenue generation.
5. Leverage RCM dental claim edits. Use these edits to flag missing or mismatched information and check for payer-specific rules.
6. Offer digital intake forms, when possible, to reduce manual data entry errors.
7. Provide staff education. Focus on educating front-end dental RCM staff on the importance of accurate data collection and its role in RCM dental workflows.
8. Use clinical documentation templates. Templates help providers document all clinical details necessary for same-day procedures to ensure coding and revenue integrity.

Dental RCM: Don’t forget to monitor and audit regularly🔗

In addition to the eight RCM dental strategies listed above, it’s important to leverage data analytics in the following ways:

• Audit high-volume procedures for documentation and billing compliance. Then use audit results to identify areas for improvement, including provider and staff education, use of dental RCM technology, and more.
• Monitor the clean claim rate, meaning the rate at which payers pay claims upon initial submission.
• Review denials and rejections by reason code, payer, volume, and overturn rates. Drill down into the root causes of denials and implement proactive strategies to improve dental RCM compliance.
  

You shouldn’t have to choose between providing same-day dentistry and having a healthy revenue cycle🔗

Same-day dentistry requires streamlined and compliant dental RCM workflows. Is your dental billing team prepared for same-day procedures? Let’s talk about how to make your dental RCM process as fast and frictionless as your chairside care. Visit https://www.medusind.com/ to learn more about RCM dental best practices and the technology that promotes them.