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Entering Adjustments when Primary and Secondary are in Network 

7/18/2016

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Dealing with primary and secondary insurance can be confusing when the office is a participating provider for both plans. Errors are routinely made when entering insurance payments in this situation. Recently Christine Taxin, shared an easy to understand process that I'm confident will be helpful for many practices.
  1. When filing Primary and Secondary insurance, you MUST bill your full fee on the patient's ledger.

  2. Submit Primary claim and Secondary Claims.

  3. The patient is responsible only for the fee up to the lower of the two insurances. 
    • For example, if the fee for a crown is $700 from one insurance company and $800 from the other, then the patient is responsible for his/her portion only up to the lower fee of $700. If the office receives $700 or more from both insurances, then the patient owes nothing.

    • The office is ALLOWED to collect up to their office fee.

    • If the office receives more than their office fee, they must refund to the insurance company.

    • The patient does not collect any portion of the fee received by the office.
If you find that your patients with secondary insurance often have a large credit balance, you need to make sure your team is properly trained on this topic. Dental Insurance Navigator is an online program provides team training in all areas of insurance.
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Stop Giving Your Patients the Finger

6/13/2016

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How many times have you had that happen in your practice or even when you are at your own doctor appointment? No, not “the” finger, but the “wait one minute” finger when a patient walks in for their appointment and the front desk person is on phone. They are not meaning to be rude or disrespectful; they are simply trying to complete much needed tasks. Unfortunately, to a patient who is standing in front of them it sends a signal that they are not the first priority of the practice.
 
When I talk to people about using a virtual assistant for their dental practice, they think that the purpose is to contact the insurance company to make sure claims are paid and insurance benefit information is up-to-date. Although that is true, the real BENEFIT of using a virtual assistant to allow your team to focus on your patients and making them feel like they are always the first priority.
 
Does the dentist in your practice answer the phone? Of course not, because it is not the highest and best use of their time. The same principle applies to your front desk team member contacting insurance companies. The most valuable use of a front office team member’s time is spent greeting patients, answering patient phone calls, filling the schedule, presenting treatment and financial arrangements. They are the first and last person that your patients communicate with at every visit. Ensuring that from when the patient walks in the door until they walk out, they have an amazing experience.
 
Delegating your insurance tasks to a virtual assistant provides your team the support they need to focus their attention where it needs to be, on your patient, not on the insurance company.

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Thinking You Are In - When You Are Not!

4/27/2016

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Dental Front Office Training
Credentialing can be a long process. Typically it takes between 1-6 months. This can cause some confusion among practices and potentially lead to a loss of collections and unhappy patients. 

A common issue that our Virtual Dental Office team is finding when following up on outstanding claims is that the practice believes they are credentialed, but the insurance company says they are not. As you can imagine, this creates an unfortunate situation for practices when they have to explain to the patient that the services were not covered to the degree that was presented to them, or not covered at all. Thankfully we typically have been able to resolve these issues within a few phone calls, however backdating the provider participation starting date varies per situation. 


The key to preventing this from happening to your practice is consistent follow up with the insurance company representative. Your practice should be contacting the insurance company every 2-4 weeks once the credentialing process starts. Also I recommend that you request an email that states the start date for credentialing for your practice.

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Why You Should Be Using An Automated Eligibility Service

2/1/2016

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Dental Insurance Frustrations
In the dental industry there are many services available to help make the administrative side of running a dental practice easier. One of the services that I recommend all practices use is an automated eligibility service. 
 
This type of service can check the eligibility of patients, and sometimes provide a full breakdown of benefits, with click of a button. While not every insurance company participates, most of the big ones do. This will save your team a lot of time on the phone with insurance companies, and typically for just a low, flat monthly fee.
 
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When evaluating eligibility services, an important differentiating factor to look for is ease-of-use. The benefit of this type of service is efficiency, so make sure you have the ability to check an entire days’ worth of patients with the click of a button.  If you have to click on every patient each day it is not as efficient.
 
My recommendation is that you have the eligibility system check patients a week in advance of their appointment. This provides the dental team time to contact patients if needed before their appointment.
I strongly believe that the best thing that practices can do is put these type of automated systems in place. This allows the team to focus on more important tasks and most important, their patients.
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Virtual Dental Office is now providing an eligibility service for a low monthly fee of $29.95. To learn more about it contact Jennifer Schultz at jennifer@virtualdentaloffice.net or 563-582-4762.

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What will make 2016 "successful"?

1/13/2016

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What are the top three things that need to happen to make 2016 be considered “successful” for your dental practice?

It’s that time of year again when we need to sit down and think about the year ahead. ​Take some time now to think through your goals. Write them down and put them on your desk, or some other very visible place, to keep them to-of-mind every day.
 
Once you have defined goals for the year you can breakdown them into monthly or quarterly goals that will get you to where you want to be at the end of the year. This will help make your longer-term goals more achievable and give you milestones to celebrate, or readjust as needed. The monthly and quarterly progress will provide motivation and confidence to keep working toward the bigger goals.
 
The year will go fast, before we know it February will be here, so don’t procrastinate. Take some time out of your busy schedule this week to think through your goals, write them down, and create a plan for success. Make 2016 your best year yet!

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New Year, New Benefits

12/11/2015

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With the New Year upon us, many of your patients’ insurance benefits will be changing.  That means a significant time investment for your team to get the new insurance information and update your software.

Patients have come to expect that their dentist understand their insurance.  By providing them with an estimate of their benefits in office, it helps them feel more comfortable moving forward with treatment.  This is why is it is so important to have the most up-to-date benefits readily available.

This can be time consuming for the front desk team, but is a worthwhile investment. For practices that don’t have the capacity to take this on, you may want to consider outsourcing.  When outsourcing, remember that the information is best utilized when it is entered back into your software. 


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What You Need to Know About Credentialing

12/3/2015

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The credentialing process to be a provider for a PPO plan with an insurance company can be a lengthy and cumbersome process.  The best advice is to go in prepared and with your eyes open.
 
Allow Time for the Process
Getting a provider credentialed can take anywhere from two to six months. It is important for doctors to understand this, especially when purchasing a practice, so they have enough time to complete the credentialing process and are giving accurate estimates to patients. Unfortunately, I have spoken with many doctors who have learned this the hard way. 
 
Read the Contract!
Remember, this is a legal document so make sure all of your bases are covered and that you understand all aspects. Typically a contract is going to favor whoever draws it up, so the practice should take the time to review the document and make sure their needs are being met. There are some questions that need to be answered before the contract is signed.
 
  • What is the fee schedule that you are agreeing to accept?
  • Are you able to charge your office fee to a patient when the insurance company doesn’t cover that procedure?
  • How much notice do you need to give when opting out of the contract?
  • What happens when the patient is covered by another insurance plan (coordination of benefits)?
 
The credentialing process can be overwhelming. There is a lot of follow-up that needs to be done on behalf of the practice. Someone from the practice should contact the insurance company every 30 days, and it is important to keep a record of who they spoke with and the next step to make sure the process is moving forward. Fortunately, you don’t have to take it on yourself; there are several reputable companies out there that will complete the process for you. 
 
Whether you complete this yourself or hire an outside company to help, make sure your practice’s needs are being addressed and you are comfortable with the final contract before you sign on the dotted line.  

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Costly Errors Every Practice Should Be Aware Of

11/18/2015

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Over the years working with multiple practices we have uncovered numerous processes regarding insurance payments that lead to confusion, inefficiencies and bookkeeping nightmares. Knowledge is key to making working with insurance companies easier. Listed below are common mistakes that my team at Virtual Dental Office have found when working with practices, that every practice should be aware of.
  • Insurance checks that have been cashed by the practice, but not posted to the appropriate patient’s ledger. This makes it appear to be an outstanding claim and the team ends up wasting time following up on claims that have actually already been paid.
  • Insurance company payments via credit card remit. This can create a bookkeeping mess because most software isn't equipped to enter these payments, which increases the amount of time the team needs to spend putting the payment in the system. In addition, the practice pays merchant fees and loses approximately 3% on all insurance payments, which can add up quickly.
  • Electronic Fund Transfer (EFT) payments that are deposited directly into the doctor’s account and not posted to the ledger. This form of payment can be convenient, but there needs to be communication between the doctor and the team so they know the date and amount of payment. In addition, it is best practice for team members to login to insurance company’s website weekly to check for these payments (if they do not receive an email from the insurance company).
  • Inaccurate insurance information that is entered into the practice management software.  This leads to delayed claims and time wasted when following up on unpaid claims. It also doesn’t allow the practice to leverage the information among other patients.
 
Working at the front desk is a very challenging position. The constant interruptions are a part of the job but from a productivity standpoint, a nightmare.  The multi-tasking that is needed is inefficient and causes more mistakes.  That is why it is always good to have another set of eyes on your insurance processes. 

It also illustrates the importance of training and education in regards to working with insurance. Our work through Virtual Dental Office has lead to the development of DentalInsuranceNavigator.com, because we have seen the need for more team knowledge on dental insurance. 
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Is Your Practice Losing With Insurance?

10/21/2015

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In my over 20 years in the dental industry, I have seen practices lose money time and time again because of lack of knowledge and/or training in working with insurance.  Many don’t even realize to what extent they are losing. Here are some of the most common ways practices lose money every day.
 
  • Writing off money when it is not necessary
  • Missing the timely filing deadline for insurance claims
  • Submitting PPO plan fee on the insurance claim form
  • Not charging the full practice fee when procedures are not covered by insurance (when applicable)
  • Not following up on unpaid insurance claims
  • Credentialing errors
  • Not leveraging benefit information in the practice management software
  • Not reading/understanding the PPO contract
  • Not asking for a fee schedule of the PPO plan before they sign
  • Not knowing which companies the practice is in network for
 
This is why I started Virtual Dental Office. I wanted to help dental practices better manage the insurance side of their business. Over the past few years I have had the pleasure of seeing how staying on top of insurance can make a huge impact on the bottom line.
 
As much I as I love being able to take these insurance tasks off the hands of dental practices, I know they need more. I believe that with the proper training and education dental professionals can stay educated in the ever-changing world of dental insurance, and make a significant impact on their dental practice’s bottom line.
 
This is why I have been working feverishly over the past few months to figure out how I can provide practices the tools to avoid costly insurance mistakes. Next week I will be launching an exciting new platform that has the power to change all of that.
 
Is your practice losing money on insurance? Stay tuned…

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Fully Utilizing The Benefits of Insurance

9/21/2015

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Insurance Benefits
It’s that time of year.  Kids are back in the school. The air is getting cooler (at least if you live in the Midwest like me).  That means the year will quickly be coming to a close, and most of your patients will have dental benefits that will be renewing on January 1.

Everyone is concerned about money, especially when it comes to dental treatments. Your patients are already paying for the benefits, and if they don’t use it they will lose it.  In addition, the most conservative treatment is to treat decay early and every year. So if a patient has work to be done, it is in their best interest to have a little done each year to stay on top of their oral health and take complete advantage of their benefits.

This provides dental practices the perfect opportunity to reach out to patients who have outstanding treatment. Best practice is for dental practices to run their outstanding treatment reports this time of the year and contact the patients to schedule their procedures before their benefits expire.

Another proactive way to finish the year strong is to review your patient’s remaining benefits for the year, as well as outstanding treatment prior to all dental hygiene appointments. Many times the patient doesn’t realize the benefits they still have available to them before their policy renews in January, and having this information can help treatment acceptance.

The best value for the patient is to utilize all of their insurance benefits every year.  As a dental professional you are obligated to inform your patients of the treatment needed to become or stay healthy. These last few months of the year provide the perfect opportunity for a win-win for your patients and your practice.

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