A dental billing audit is the most crucial part of dental practice management. This is where you ensure that everything in your billing process is working correctly. It’s also where you can catch any issues before they become significant problems for your practice.
What Is a Dental Billing Audit?
A dental billing audit is a way to improve your practice’s performance and demonstrate cost control. It can also help you achieve financial results and increase productivity at work. A dental billing audit ensures that all transactions are recorded clearly across time, so you can quickly identify errors in patient treatment costs that could impact your bottom line. You’ll see where there is room for improvement within the system or with specific practices within your network.
Purpose of Comprehensive Dental Billing Audit
A complete dental billing audit can point out areas where you could generate more revenue or improve productivity. For example: If your practice is currently performing root canal fillings on patients who don’t need them, an audit can show why this practice isn’t delivering what its customers want. It might be time for a change!
The best time for a billing audit is when the practice has a period of stability but needs an extra push to get over that hump and become financially successful. This cannot be easy because it will require spending some time with the accountant and working out ways in which they can help you improve profitability. A comprehensive dental billing audit can be performed by following these steps:
- Gathering all relevant information, such as patient demographics, insurance information, and treatment plans.
- Examine insurance policies and contracts to ensure the billing codes align with the insurance company’s coverage.
- Verify the billing codes’ accuracy by comparing them to those listed in the treatment plan.
- Ensure all supporting documents, such as diagnostic tests and treatment notes, are included with each claim.
- Submitting claims within the time frame specified by the insurance company to prevent payment delays.
- Check that the charges on the bill match the services provided to the patient and are under the fee schedule agreed upon with the insurance company.
- Examine the insurance company’s payments to verify the expected amount based on the insurance policy and fee schedule.
- Investigating denied claims and determining the reason for the denial.
- Taking appropriate action to resolve the issue, such as resubmitting the claim with corrected information or appealing the denial.
- Update the billing system and processes to prevent future errors and ensure compliance with insurance policies.
- Documenting the audit results, including any issues identified and steps taken to resolve them, for future reference and ongoing improvement of the billing process.
Identify Revenue Gaps With Dental Billing Audit
Dental practice auditing is essential for ensuring a dental clinic’s efficient and effective operation. A dental billing audit can help you to identify gaps in your current revenue information and highlight opportunities for revenue generation.
The audit will help you understand the following:
- The process generates the data that is used to make your payments. This includes how patients are referred, what they pay and when they pay it, and what happens during the collection process (whether payments are made), etc.
If you are looking to audit a dental practice:
- Make sure that you have adequate time and resources available to do the job properly
- Consider hiring an auditor who has experience with dental auditing practices
Dental billing audits can help you identify areas where you need to improve or expand your services. It can pinpoint areas where costs could be higher or more efficiently managed. They can also show whether or not any problems with patient care could be addressed through improved training or better equipment use. In short, if anything needs changing about how you run things—why not?
Dental billing audits are inevitable and integral to ensure proper payment for your services. They’re also just plain difficult to navigate, which is why this guide is here to help. We hope that this guide has been informative for you. We provide dental practices with an efficient and comprehensive dental billing audit that enhances their revenue cycle management and overall collection efficiency at an affordable cost. If you have any questions, please feel free to contact us. We are always happy to help.