by Sponsored: OneMind
Group practices and Dental Support Organizations arose from an industry-wide need to reduce the complexity around running a dental business. By definition, DSOs were created to support dentists by taking on the complex, non-clinical aspects of practice such as accounts receivable and insurance management. Group practices find economies of scale by centralizing, automating and sometimes outsourcing time-consuming manual tasks.
OneMind Health is helping DSOs and group practices create efficiency by automating the process of verifying insurance eligibility and benefits. A surge in PPO participation marked by increased variability among plans is a major trend in the dental industry. This is creating urgency to find more efficient ways of dealing with insurance. Patients count on their insurance as a primary funding source for dental care. Practices that help educate patients about their benefits and assist them to maximize their insurance dollars will score important customer service points with patients. But that’s not always easy.
As a whole, in 2014, the dental industry spent over $25 billion on administrative costs related to claims adjudication, eligibility verification, payment collections and staffing. That’s a lot of dental office team members placing verification calls to insurance companies, sending claims, posting EOBs and mailing collection letters. And it’s a lot of people at the insurance companies churning out inconsistent and complex information and rules. Though this takes a lot of the team’s time, patients are putting the onus of what their insurance covers directly into the hands of practices. In a recent survey conducted by OneMind Health, we asked why practices verify eligibility and benefits – many responded by saying that patients expect dental teams to know what’s covered and are unsatisfied if the team can’t help them understand their insurance plan.
Our goal at OneMind Health is to deliver performance, visibility, and efficiency to dental practices where complexity, inefficiency, and lost opportunities abound. We do that by removing work from payer-provider relations, especially in the area of eligibility and benefits verification. By automating the process of obtaining eligibility and benefit data, staff is freed up to use the information in the following ways:
- No. 1: Reduce eligibility denials. Industry data shows us that 20 percent of all dental claims are denied at the insurance company. Of those, 80 percent are denied for an eligibility reason. Verifying coverage before the patient arrives and service is provided will greatly reduce these denials and the associated rework and write-offs.
- No. 2: Increase production by maximizing benefits. Another result of verifying benefits is to be aware of production opportunities. Knowing a patient’s history, frequency and coverage details can directly impact production and help the patient get the most out of their plan. For example, if you know a patient has coverage for a FMX on this visit, you can provide it instead of just a bitewing and increase hygiene production each time you catch that opportunity.
- No. 3: Improve treatment estimates and reduce writeoffs. Having complete benefit details at hand allows the team to create an accurate cost estimate for recommended treatment. Patients are less likely to hesitate to make a commitment when clinical and financial information can be presented together. Additionally, creating more accurate estimates lessens the need for write-offs when an unhappy patient gets a bill they didn’t expect.
