Dental RCM ensures smooth billing and faster payments for dental practices.

Overview

Dental RCM (Revenue Cycle Management) Solutions are systems and services that help healthcare providers manage the financial processes related to patient care. These solutions cover the entire cycle—from patient registration and insurance verification to billing, claims processing, and payment collection. RCM ensures accurate and timely reimbursement for medical services rendered. By automating workflows and reducing errors, it improves financial performance and operational efficiency. Effective RCM is critical for maintaining the financial health of medical practices, hospitals, and healthcare organizations.

Credentialing

We help healthcare professionals get enrolled with insurance networks by managing the entire credentialing process. From application submission to follow-ups and verification, we ensure a smooth and timely approval. This reduces delays in billing and ensures providers can legally bill for services rendered. Proper credentialing is crucial for compliance and uninterrupted revenue flow. We stay updated with payer-specific requirements and deadlines.

Patient Scheduling

Efficient appointment management is key to improving patient satisfaction and provider productivity. We streamline the scheduling process based on availability, preferences, and treatment needs. Our system reduces no-shows, last-minute cancellations, and overbooking issues. We also send reminders and confirmations to patients to ensure attendance. This helps optimize clinical workflow and revenue outcomes.

Fee Schedule Management

We maintain and regularly update your fee schedules in accordance with payer contracts. Accurate fee schedules ensure correct claim submissions and avoid underpayments. Our team compares contracted rates and actual payments to spot discrepancies. Proper fee management maximizes reimbursements and ensures financial integrity. We also assist in setting competitive yet compliant rates for new services.

Eligibility Verification

Before every visit, we check the patient’s insurance coverage, co-pays, and deductibles. This proactive step minimizes claim denials due to inactive or insufficient coverage. We verify eligibility in real-time with multiple payers across various plans. Our process ensures transparency for both providers and patients. It also improves billing accuracy and patient trust.

Initial Claims Submission

We prepare and submit accurate claims promptly after services are rendered. Each claim is thoroughly reviewed to ensure coding and documentation compliance. Our team uses electronic submission for faster processing and tracking. We reduce the risk of rejections and delays through clean claim practices. Proper submission helps maintain consistent cash flow for your practice.

AR Follow-Ups

We track and follow up on all unpaid or underpaid claims regularly. Our team works with payers to resolve issues, clarify denials, and secure payments. This reduces outstanding balances and improves collections. We provide detailed reports to keep you informed about financial performance. Effective AR follow-up is vital for maintaining a healthy revenue cycle.

Denial Management

We analyze denial reasons and take corrective action for timely resubmission. Our team works to reduce recurring denials by identifying root causes. We communicate with insurance companies to appeal and resolve denied claims. Our focus is on maximizing revenue recovery from every valid service. Comprehensive denial management protects your practice from lost income.

Payment Posting

All payments received from insurance companies and patients are recorded accurately. We reconcile payments with EOBs (Explanation of Benefits) to ensure correctness. Our system detects underpayments or incorrect adjustments instantly. Accurate posting helps in financial reporting and auditing processes. It also enables a clear understanding of revenue trends and account status.