Monday, November 29, 2021

Dental EFT Technology during COVID-19



The main trend in EFT is toward technology for providers and payers that is easy to use, cloud-based to be accessible from home offices, and customizable to each payer network’s needs.

These needs will become even more varied as COVID-19 impacts each provider differently, depending on how they have adjusted their patient load to comply with state mandates regarding the COVID-19 virus. 

The dental profession faces a number of emerging financial changes and challenges. Combined, they make achieving and sustaining a stable cash flow a difficult yet still essential part of any management plan.


How It Works: 

With skilled revenue management billing, you should get paid within 2-7 days by dental insurance if your team is sending “clean claims” by using technology. Otherwise, you wait for claims to be resolved, and your cash flow is affected. 

Sending “clean claims” takes expertise, time, persistence, clinical knowledge, and hours of follow-up. If your billing over 30 days is not within the efficient range, then there is an internal problem. The top problems among dental clerical staff when it comes to dental billing include: 

  • A lack of time;
  • Interruptions by phones and patients;
  • A lack of expertise in insurance billing, coding, and claims processing
  • A lack of motivation. 

As a result, you acquire unresolved claims that hold up your cash flow due to several common errors: 

  • Incorrect patient, practice, provider, or employer information such as demographics (35% of errors);
  • The front office forgets something and supporting documentation has not been submitted with the initial claim (25%);
  • The insurance company delays payment by asking for more information (20%);
  • The insurance is set up incorrectly in the patient’s account (10%);
  • The front office does not know how to set up the account, especially in dual insurance, blended families, or plans that are administered by major dental insurances (5%);
  • The insurance company did not receive the claim so there is a need to follow up with phone calls (5%). 

In addition, as the insurance benefits decrease, the patient’s copay is increasing. As a result, the treatment-plan acceptance to proceed with treatment has decreased, and patient balances accounts receivable has increased. If patients’ balances are not collected at time of service, the aging patient balances get out of control and the team will need time to work the collections. Recovery of patient balances decreases significantly with time, and so does the dentist’s cash flow.





Connecting the Dots with EFT & ERA Technology

To help Dental industry providers recognize and realize the benefits of automation using the healthcare EFT standard and ERA, this technology proved that practices of all sizes can achieve cost savings and benefits from converting their claims reimbursements payments from paper checks to the EFT standard transaction and automating the reconciliation and posting process using the ERA.

Practices no longer need to wait for your Explanation of Benefits (EOB) to arrive in the mail. Once you enroll in ERA, you can access the information you need to reconcile your patient accounts as soon as it is available to you. Each ERA will have a trace number (TRN) attached and name of insurance company to give you the ability to automatically re-associate the claim remittance information you receive from the clearinghouse. The TRN is designed to help providers confidently match EFT deposit with corresponding ERA's that are deposited in the bank account. The benefit of this is huge, being it is available electronically and gives you access to the information it contains sooner than with a mailed paper EOB. Administrative savings are realized as a result of the paperwork reduction and the ERA can be scanned into the patient file.

Benefits achieved across practices included:

  • Faster patient billing, as EFT payments are received faster allowing for quicker secondary billing and billing of patient responsibility
  • Reduced posting errors through automation of EFT and ERA
  • Reduced processing costs.
  • Improved payment cycle within 2-7 days
  • Threat of lost and stolen checks is eliminated
  • Drastically cut down on the possibility of embezzlement in the practice

A new era in Dentistry has begun, if dentists want to increase the cash flow coming out of their practice he/she needs to learn how to manage their businesses, or hire the right experienced professional with the help of their management team to help them do so.

The Key to Reducing EFT Administrative Waste

In the era of the corona virus pandemic, it’s more important than ever for revenue cycle management to operate at maximum efficiency. Many practices are facing economic uncertainty and cannot afford any additional fiscal leakage.


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