The Patient Life-Cycle
Navigating the Dental Revenue Cycle: Understanding the Patient Life-Cycle
Welcome back to our series on dental revenue cycle management! Today, we're exploring the patient life-cycle and its pivotal role in ensuring a smooth revenue flow for your practice.
Scheduling and Insurance Information Gathering: The journey begins with scheduling the new patient appointment and gathering essential patient and insurance information. Whether the initial appointment is scheduled with the hygienist or the doctor, accuracy is paramount. Any errors in patient or insurance data at this stage can lead to significant delays and complications down the line.
Patient Information Entry: Once the patient is scheduled, it's crucial to enter their information accurately into the dental software. This step lays the foundation for successful claim processing. From demographic details to insurance specifics, everything must be meticulously documented to avoid claim denials or delays. Pro-Tip: Collecting the patient’s SSN and License (front and back) is also essential for any future cases being sent to collections.
Thorough Insurance Verification: Insurance verification is a critical step that cannot be overlooked. For new patients, this involves obtaining all relevant insurance codes and benefits specific to the office with a FULL BREAKDOWN. Gathering a comprehensive breakdown of the patient's plan, including frequency limitations, age limits, waiting periods, payor ID, and insurance mailing address, ensures smooth claims processing and maximizes reimbursement. Alongside gathering a full breakdown, it is best practice to also get a “blueprint” of the policy and scan both into the patient's chart. The “blueprint” usually can be obtained through fax or the online portal. Pro-Tip: request the “blueprint” via fax or look up the plan through the online portal and gather all required information on the full breakdown specific to your office FIRST. Then, once that is done, any missing information to be completed on your office full breakdown can be achieved with a phone call to the carrier.
Existing Patient Insurance Re-Verifications: For existing patients, the process of insurance verification should be streamlined. If the patient presents the same plan, by maintaining accurate records and obtaining a yearly "blueprint,” practices can easily verify any changes in coverage. This means once the “initial full breakdown” is gathered from that patient’s policy from that first visit or when coverage changed and the full breakdown was gathered, verification should be simple and quick, only needing to check if the patient is active and if there are any changes to the maximum or deductible. The office needs a “blueprint” scanned into the patient's chart once per year for the lifetime of that active plan. This proactive approach minimizes surprises, ensures continued reimbursement accuracy, and, most importantly, saves your staff time.
Collecting Co-Pays at Every Visit: Since the office spends so much time gathering the patient's breakdowns, collecting the patient's copays at each visit is paramount; always remind patients that their co-pay is an estimate before collecting. This transparency fosters trust and clarity in financial transactions. Patients are informed about their financial responsibility upfront, empowering them to make informed decisions about their care. As part of the office’s commitment to financial integrity, patient co-pays are collected at every visit before they leave the office. This proactive approach minimizes the need to send statements once the claim is paid, minimizing the office’s patient accounts receivable and ensuring a steady flow of revenue for your practice.
Signed Financial Policy: A well-defined financial policy clarifies payment expectations, insurance coverage expectations, and financial responsibilities for both patients and staff. Transparency in financial matters fosters trust and reduces misunderstandings. A carefully crafted financial policy protects your practice from potential legal disputes by clearly outlining payment terms, collection procedures, and patient rights. Having a written policy can serve as documentation in case of conflicts or misunderstandings. Communicate the financial policy to patients during their initial visit and provide written copies for reference. Educate staff on the policy to ensure consistency in implementation. While maintaining firm financial policies, demonstrate flexibility and compassion when working with patients facing financial hardships. Offer payment plans or financial assistance options when appropriate.
By implementing a clear and comprehensive financial policy, your dental office can enhance financial stability, foster patient trust, and mitigate potential legal risks. At Elite Dental Systems, we specialize in helping dental practices optimize their financial policies and streamline revenue management processes.
Example of a Financial Policy- Clink on the link
Example of a Full Breakdown- Clink on the link
At Elite Dental Systems, we understand the importance of each stage in the patient’s life cycle. As experts in the field, we work tirelessly to optimize your revenue cycle, from initial appointment scheduling to insurance verification and beyond. By leveraging our expertise, you can focus on providing exceptional patient care while we handle the intricacies of revenue management.
Stay tuned for more insights into optimizing your dental practice's revenue cycle! If you have any questions or need assistance with your revenue management processes, don't hesitate to reach out to us by phone at 916.269.9899 or email at contact@elitedentalservices.net.
