Top Challenges in Dental RCM & How to Overcome Them

Dental Revenue Cycle Management (RCM) is a critical part of a dental practice’s success, ensuring receipt of timely and accurate reimbursements for services provided. Managing the RCM process in the dental industry has become increasingly complex, leading practices to face numerous challenges that can hinder their financial health.  

Patient Eligibility Verification

Verifying patient eligibility for insurance coverage before treatment is a vital step in the RCM process. Yet, eligibility verification is often time-consuming and prone to manual errors.  

Solution: Implementing automated eligibility solutions allows practices to verify a patient’s insurance status days ahead or on the fly, reducing the risk of non-payment and enhancing the overall efficiency of the RCM process.  

Claim Submissions and Denials

‍One challenge in dental RCM is the high rate of insurance claim denials and rejections. These denials are frequently due to errors in claim submissions such as incorrect coding, missing information, or manual reconciliation. This ultimately leads to longer reimbursement cycles, increased administrative costs, and reduced cash flow.  

Solution: Practices can integrate automated solutions that address the full RCM lifecycle; from submitting and tracking accurate, complete claims to reconciling claim payments electronically.  

Patient Payment Collection

Collecting payments directly from patients can also be difficult. Patients may struggle with the upfront costs of dental procedures or may delay payment altogether. Delays collecting patient payments can lead to higher accounts receivable (AR), increased bad debt, and compromised cash flow for the practice.  

Solution: Adding comprehensive merchant service capabilities like text-to-pay or Apple Pay adds modern efficiency to dental payment collections. Offices can also consider offering flexible payment plans and implement automated payment reminders to bring transparency and ease to patient payments.  

Changing Payer Policies

Staying current with changes to payer policies can be hard for dental practices, especially when dealing with multiple insurance payers. Failure to stay on top of these can lead to underpayments, claim denials, and compliance issues.  

Solution: Using RCM software that automatically updates with changes in payer policies can help practices remain compliant. Offices can also partner with dental billing experts that can help take the burden off offices by ensuring they stay current with the ever-evolving payer policies.   

Conclusion

Navigating the complex world of dental RCM comes with many challenges. But no matter what challenge your practice is facing, DentalXChange has a solution for you. Go to DentalXChange.com to learn how adding the right solutions can help your practice overcome these obstacles and optimize your revenue cycle management for greater profitability and long-term success.