The New Year is synonymous with personal resolutions, but have you considered making them for your practice as well? This is an ideal time to reflect on the health and wellness of billing practices to improve efficiency, compliance, and reimbursements and payments.

Here are a few areas to consider for bringing more efficiency and convenience in 2023.

• Embrace Technology

Maximize billing and payment productivity by adopting technology designed to simplify processes and reduce manual tasks. Integrated clearinghouse solutions such as claims, remittances (ERAs), and eligibility within Open Dental’s practice management system helps eliminate barriers to efficiency for staff and can increase the realization of revenue. These solutions enable more of the claims lifecycle to be managed within a single system and normalize payer responses into a consistent, readable format. Integrated solutions also help consolidate claims, remittance, and payment data for easier reporting. Increased use of technology can help free up time to focus on other tasks.

• Automate Eligibility

Stop manually checking patient benefits via payer websites and dedicated numbers! By utilizing eligibility solutions through a claims clearinghouse or another service, real-time eligibility responses can be obtained directly from the payer. Fully electronic benefits verification not only presents an upfront savings of between $3.17 and $5.85 per transaction according to the 2021 CAQH Index, but it also prevents downstream rejections and denials that can create a ripple effect across the practice.

• Monitor Clean Claims

Make first pass clean claim submission percentage a key performance indicator (KPI). A clean claim is one that contains all information required by the Payer to process the claim without rejection.* Clearinghouses assist by running claim files through a series of edits to catch common problems before they reach the payer. Common clearinghouse rejection reasons include:

• Duplicate claim submission
• Eligibility
• Missing or invalid Payer ID
• Missing or invalid billing provider
• Diagnosis code invalid or not in effect on service date

A clean claim rate below 90% should be considered a red flag for billing practices. On average, DentalXChange clients realize a 98% clean claim rate.

*Note that a clean claim does not mean that a denial will not happen.  

• Automate Payments

In addition to a top-notch clinical experience, patients increasingly expect a smooth billing and payment process. Consider offering flexible patient payment options including the ability to pay by credit and debit card, FSA, or HSA. Working with a dental merchant service partner enables easy payment collection while improving office efficiency. Offering more ways to pay increases patient and staff satisfaction while boosting the bottom line.

Make a New Year’s Resolution for Healthier Revenue

Increased billing practice efficiency and convenience can be achieved with process improvements and robust technology offerings. For best results, ensure your Open Dental practice management solution and claims clearinghouse work well together.

About DentalXChange

DentalXChange has supported the dental industry for over 30 years reducing friction across the dental industry value chain. We have strategically partnered with Open Dental since 2008 to create a unified experience for our 7,500+ mutual clients. We offer solutions with full integration into Open Dental, including:

• Real-Time Patient Eligibility and Claim Status
• Claims Processing
• Electronic Attachments
• Electronic Remittance Advice (ERA)
• Merchant Services
• Electronic Patient Statements

To learn more, visit DentalXChange or call 800.576.6412 Ext 455.