Extracting the Pain from Dental Benefits Administration
Matt Martin | January 1, 2016
Ask any dentist what his or her favorite part of the profession is, and odds are dental benefit administration will not appear on the list. Tasks such as checking patient eligibility, submitting insurance claims, and chasing down payments (from patients as well as payers), are often expensive and take inordinate amounts of staff time. This is especially true for those using manual methods of gathering and submitting information, ie phone calls, paper forms, snail mail, etc.
But it doesn’t have to be that way. Many payers are now offering dental provider portals that can make a positive difference in administrative workflow as well as cash flow. These portals, which are often free, can help clinicians deliver superior service to patients by offering fast answers to questions about their dental insurance coverage.
These portals are extremely easy to use, allowing even the least tech-savvy provider to navigate through the portals with ease. Here are some of the ways provider portals can alleviate the stress of dental benefits administration, so clinicians can spend more time helping patients:
1. Receive Faster Authorizations
Using traditional methods, it can take 5 to 7 business days to request and receive authorization to perform a service. With a portal, providers can fill out and submit forms in minutes; this speeds up the entire ecosystem, and cuts the end-to-end time down to 24 to 48 hours. This same speed applies to other forms such as claims. These programs operate similarly to clearinghouses, but the portals do the work for free.
2. Receive Payments Faster
Errors on claim forms result in delayed payments, but a good portal submission system will catch most errors, so they can be corrected prior to submission. In fact, some systems will now move error-free claims into the payer’s system automatically, eliminating the time lost waiting for a manual review.
If providers enable an electronic fund transfer (EFT), a claim can be paid within 24 to 48 hours. So in the time it takes for a paper claim to be mailed and received (not even adjudicated yet), the money could have already been transferred into the provider’s account.
3. Use Time More Effectively
Making phone calls to check eligibility and follow up on the status of claims and authorization requests can occupy an exorbitant amount of staff time. In one instance, a provider with 11 locations averaged 375 phone calls per month. When that provider began using the payer’s web portal, the volume dropped to under 75 calls per month. Even if staff spent only 4 minutes per call (and that’s being kind), this would be an 80% improvement, saving approximately 20 hours of administrative time each month.
By using a provider web portal, staff can search for and find the answers online, allowing time spent on the phone to be put to better use.
4. Improve Security
Technology-averse providers will sometimes use concerns about the security of protected health information (PHI) as a reason not to use web portals. The reality is that it’s safer to submit PHI through a secure web portal than to expose it to a manual mailing process that takes 3 to 5 days to reach the payer.
Additionally, storing encrypted data electronically on a portal (that is routinely backed up), is more effective than storing information in manila folders in a file cabinet where it’s more vulnerable to fire, flood, thieves, etc.
5. Instant Access to Updates
Rather than waiting days for information, updates, or new manuals to arrive in the mail, providers can view changes as soon as they’re available on a portal. And if providers can’t remember the details, they can simply search the portal, rather than having to sift through pages upon pages to find the details.
6. Painless Practice
These days, painless dentistry is about more than just a clinician’s approach to patients. It can now also apply to benefit administration. By using a payer’s provider portal in place of paper and phone calls, providers can significantly reduce administrative time and effort by getting paid faster and gaining a competitive edge in patient service and satisfaction. Once you make the change, you’ll wonder how you ever got by without it.
Matt Martin is web portal manager at Scion Dental (www.sciondental.com), a world-class dental administration company focused on bringing next-generation claims management and technology solutions together for government entities and commercial payers that enable them to improve process efficiencies, achieve compliance, and dramatically reduce the cost of delivering dental benefits. Scion Dental is part of the distinguished SKYGEN USA family of companies (www.SKYGENUSA.com). Matt can be reached at matthew.martin@skygenusa.com.
