If time is the scarcest resource at your practice, you are not alone. Running a dental operation involves spending considerable time on administrative activities that are critical to the success of your business, yet are not directly associated with your core focus of caring for patients.
You or your office manager are saddled with figuring out how to get all of this work accomplished, and most of the staff end up with very “fuzzy” job descriptions, pitching in where needed or asked regardless of their primary role. Coordinating provider and facility resources, managing vendor relationships and insurance contracts, scheduling appointments, getting patient intake and insurance data, managing predeterminations and claims with insurance payers, generating and distributing patient statements, posting insurance and patient payments, and the constant follow-up on rejected and denied claims, aging patient accounts, etc. can be overwhelming to a small staff trying to provide patients with quality care and experiences.
When staff are oversubscribed, usually one or more “heroes” emerge, working extra hours on evenings and weekends to make sure that the most critical tasks are accomplished. While their efforts are certainly appreciated, the situation can result in a “workstyle” that is not often sustainable. Depending on your team dynamics and leadership, this type of office environment can put the practice at risk of losing staff, which only exacerbates the challenge as everyone left has to do more while new employees are being recruited and trained. While a high-stress environment can wear on employees and foster tension within the office, it can also lead to staff having less patience with your patients, which can directly impact your patients’ experience and your business.
If any of this is relatable to your practice, there are opportunities to “claw back” some of your staff capacity by taking some of these responsibilities off their plates. Freeing them from some of the administrative burdens can elevate morale within the office, and that translates into better experiences for your patients. In reviewing operations within the practice, anything involving direct patient-facing engagement is not something that can be outsourced, especially if you want to build relationships with your patients and directly control their experiences at your practice. The most “extractable” components are related to revenue cycle management. While the thought of outsourcing revenue cycle activities is often viewed as an unnecessary expense, that perspective can be shortsighted.
With most modern software, it is true that getting a preauthorization or building and submitting an insurance claim only takes a minute or two, but when you do that hundreds of times per month, how many minutes can be freed for other activities? How much time is spent following up on rejected and denied claims or trying to confirm a patient’s eligibility? Nothing is more time consuming than having to call multiple payers or navigate various portals to resolve claims or coverage questions that require exceptional handling. The vast majority of time in healthcare billing is spent on a very small percentage of the claims as most claims are “clean” and are adjudicated and paid without further effort. Nonetheless, the exceptions represent significant value in absolute dollar terms, and most practices cannot afford to simply write-off denied balances.
On the patient side, ensuring that predetermined coverage and benefits are obtained in advance of treatment enables patient balances and to be minimized as patients understand in advance what their costs will be and their portions can be more easily collected at the time of service. This not only provides your practice with lower risk and aging on patient balances, it minimizes the number of patient statements that need to be generated, distributed, and followed-up on.
If your practice is struggling to keep up with the demands of running the business with your current staff, getting outside help is certainly worthy of consideration. Doing so will not only free your staff to focus more energy on patient care, but it will put your revenue management in the hands of specialists that can work more efficiently since that is their core focus. It will also enable you to leverage the benefits of a shared service that applies learnings across practices to streamline their operations and maximize revenue recovery for their clients.