Learn how submitting electronic claims and attachments can help you get paid faster and maintain your cash flow.
For all practices, keeping accounts receivable (A/R) low is a fundamental part of running a profitable business. In most practices, a significant portion of the overhead for each procedure is realized at the time that the production occurs. Rent, utilities, salaries, taxes, and fees for perishable supplies are typically due every month regardless of when, and how much, production occurs. Other expenses, like lab fees and supplies, are usually incurred within 30 to 60 days of production. If fees are not collected in a timely manner, there is a strong likelihood that the overall cash flow of the practice will be affected. Cash is critical to a practice’s ability to operate and to excel.
In order to have the cash you need to run your business, you need to collect as much money as possible as close as possible to the time of service. When you’re dealing with patients, create and enforce a sound, written policy that describes the cost of the procedure, the anticipated insurance contribution, and the patients’ out-of-pocket obligation. A written agreement between the doctor and the patient is an absolute necessity that will allow for simplified, stress free collection of the patient’s up-front, outof-pocket expense.
For those practices that participate with insurance companies and/or accept assignment of benefits, collection does not stop at the patient. A portion of the cost (sometimes more than 50%) must then be collected from an insurance company. One of the fundamental beliefs I incorporate in my Million Dollar PPO Coaching/Consulting firm is “profitability through efficiency,” and there is no more efficient way to collect money from insurance companies than through the effective use of electronic claims and attachments.
When you’re working with claims that don’t requiring additional documentation, like hygiene visits or basic restorative procedures, Dentrix allows you to generate a walkout statement for the patient, create an insurance claim, and send that claim electronically with one click of the Fast Checkout button in the Ledger.
While in the past this claim would be printed, signed, and mailed to an insurance company, with Dentrix eClaims it can now be submitted immediately. You can expect reimbursement from insurance companies for hygiene visits and basic restorative claims that were submitted electronically in less than 14 days.
Sending electronic claims is not limited to just hygiene visits and basic restorative procedures. Submitting electronic attachments along with your electronic claims can allow for a more rapid reimbursement from insurance companies. Periodontal, oral surgery, and endodontic procedures, along with major restorative procedures such as crowns and onlays, can be submitted electronically with electronic attachments. Traditional paper claims for similar procedures can take up to 8 weeks to be paid, while you can expect payment time of less than 30 days when you send electronic claims with attachments, such as digital X-rays and intra-oral images. And Dentrix helps improve the consistency and accuracy of the submission process by reviewing the claims for mistakes before sending them to the insurance company electronically, thereby reducing errors and the need for re-submissions that would extend the reimbursement timeline.
To add electronic attachments to a claim, from an insurance claim, double click the Claim Information block to open the Insurance Claim Information dialog box.
In the Attachments group box, indicate the number of radiographs, oral images, and other attachments enclosed and click Include Attachments to open the Include Attachments dialog box.
You can then attach files from the Document Center, Perio Chart, DEXIS Imaging Suite, or the hard drive on your omputer. With Dentrix G5, you can also use the Screen Capture tool to capture and attach an image of anything being displayed on your computer.
In addition to speeding up the reimbursement timeline and improving the accuracy of claim submissions, sending electronic claim attachments can also decrease the chances that a claim will be denied. Many times what we as clinicians see in the mouth cannot be seen at all on an X-ray. In some cases, major problems requiring significant restorative procedures only show up as minor issues on a radiograph. If given the choice between denying a claim that includes extensive and illustrative documentation submitted digitally or denying a paper claim with unclear duplicated copies of traditional radiographs, an insurance company will more likely deny the claim with the unclear documentation.
In my practice we send electronic claims and claim attachments. We have created a claim submission checklist for all restorative, periodontal, oral surgery, and endodontic claims to ensure that the following are sent with every electronic claim:
- Dentrix electronic claim
- DEXIS digital X-ray (pre- and post-op)
- DEXcam intra-oral photos (pre-op, intra-op, and post-op)
- Necessary periodontal charting imported from Dentrix Perio Chart
- Narrative (can be pre-loaded into the Office Manager by clicking Maintenance > Practice Setup > Custom Notes > Claim Remarks Setup)
As part of our claim submission process we also generate an insurance aging report on the first day of every month, which helps us easily track our outstanding claims and insurance dollars. To run the Insurance Aging Report in Dentrix, from the Office Manager click Reports > Ledger > Insurance Aging Report.
Implementing and following this streamlined, convenient system of sending electronic claims and attachments has allowed my practice to improve its cash flow and maintain an A/R of less than 5% at 30 days. The time that we save through such an efficient process allows us to utilize our available cash for training, education, and expansion. Our efforts can be focused on improving our practice for the benefit of our patients instead of chasing after money just to pay our bills.
To learn more about sending electronic claims and claim attachments, visit www.dentrix.com/products/eservices/eclaims.
To learn more about claim attachments, see the Sending Claim Attachments Overview topic in the Dentrix Help.
By Matthew Krieger, DMD, Founder and CEO, Million Dollar PPO
Dr. Matthew Krieger graduated from New Jersey Dental School in 1998. He launched his own practice in 2003 and built it into a full-time practice in just one year. Dr. Krieger has collected more than one million dollars in each of the last five years and has grown his practice by 30 percent annually–all while working only in 3.5 days per week, maintaining an overhead of 57 percent, and participating in PPO insurance plans. Dr. Krieger is the founder and CEO of Million Dollar PPO, a dental practice management coaching and consulting firm. He also lectures on practice management and CAD/CAM dentistry. Dr. Krieger is an active member of the ADA, AGD, AACD, ACE, and the Crown Council and has earned over six hundred hours of continuing education. For more information about how Million Dollar PPO Coaching and Consulting can help your practice, visit their website at www.milliondollarppo.com.
Originally published in Dentrix Magazine, Spring 2013