Dental Billing List Services
1. Claims Management: Follow-up on all unresolved claims in over 30 days, claim correction, resubmission, narrative letters & appeals $1500/month
2. Billing Insurance: Daily e-claims review, errors correction, & submission, narratives submission, attachments drafted $400/month
3. Patient Balances aging over 30 days: research, collection calls after EOB/ETFs entry to recover remaining balance $1500/month
4. Statements-Aging patient balances statements and overdue letters, accounts management up to collection agency processing (postage charged to client)
5. Bi-Weekly reporting on progress with owner
6. Enter payments: insurance payments from EOBs, ETFs, & patient payments $1000/month
7. Benefits Verification: eligibility, full plan breakdown in your system for new and emergency patients, and updating changes to existing accounts $1400/month
8. Collection Agency Process: submission to collection agency, and overseeing funds recovery and litigation (collection agency fees charged to client) with Results! Dental Collection Services or client's choice of collection agency. Fees are based on a % of collection.
9. Evaluation of current technology and proposal of new technology to improve productivity and efficiency (ALL plans)
10. Phone support for dental billing (ALL plans): claims processing, financial practice management forms and systems, general dental billing questions, accounts receivable management guidance (15 minute increments, limit one phone call per day) $100/month
Service Fee Configuration monthly service fee is configured based on a location with the following criteria:up to $20,000 total insurance/patient balances & up to 250 claims per month (based on a typical single Provider operation in the US) If your office falls outside those limits, we will prorate the fees respectively and we will add: a) AR volume fee and/or b) claims volume fee.
Bundled Service Plans Fees
1. DCC will take initiative to analyze and restructure your dental operation to optimize the manpower at the office. Our intent is not to terminate employment but instead, propose systems to increase efficiency and productivity of your operation. For instance, this may include proposal to utilize your employee handling the accounts currently in an accelerated hygiene system to increase hygiene production. Accelerated hygiene will immediately increase production and create potential for increased treatment revenue.
2. Goal is to have no more than $3000-5000 in unresolved claims in over 30 days and no more than $1500 in patient balances per $80,000 monthly production. All efforts will be made to reach that goal in less than 6 months.
3. All contracts are on a month to month basis and can be terminated by any party within 30 days of notice.
4. Our company operates in the back ground of your existing operation and does not interfere with your existing daily operation. Changes by DCC to client's software data is limited only to information dealing with accounts and billing of patient or insurance. We do not code for the provider and the provider is responsible for reviewing and posting procedures performed daily. DCC is responsible for dental billing of posted transactions.
5. We currently only work with offices that are digital in dental software, billing, and have digital radiography and digital intra-oral photography necessary for e-claims approval. We will engage in a contract with non-digital offices after proposed technology is integrated, and we will over see the technology setup upon request. We provide a free evaluation of your current technology and will suggest changes and companies to work with.
(example: changing your current phone system to voice over internet service which saves you on your monthly phone bill and allows you to track phone calls and has other important features you are missing out on. These technologies in turn allow DCC to be more efficient in what we need to do for you)
6. Some offices hire us to jump in and help out their existing team come out from falling behind in working insurance claims and patient accounts, while other offices utilize us as their entire billing department., yet other use us for training. We have so much to offer and can help on many levels.
7. Payment is due on the anniversary day of every month and the service contract can be terminated by either party with 30 days notice. Payments can be pre-authorized by auto charge of credit card on file.
8. Dental Billing Phone Support Service is a service for your team to call us with questions, account setups, help you resolve billing issues, advise in billing situation or dealing with insurances and claim issues. It also includes up to 10 insurance phone calls on your behalf. For instance if you have unresolved claims that you can not get to, you can provide us with the list, we will call the insurances for you and provide you with a report of claim status. From there you can correct your system and resolve the claim issues which may include unreceived claim, wrong demographics, procedure issues, incorrect insurance setup just to name a few. This allows your team to catch up on some of these outstanding claims and avoid time on the phone.
9. Benefits Verification Service Information:
We will verify active coverage on all patients coming in for hygiene appointments to ensure they have active coverage and no plan changes with electronic eligibility or phone call if electronic eligibility is not available. Electronic eligibility provides confirmation that the patient has active coverage and some plan breakdown of benefits. To obtain complete breakdown of plans account specialists will call the insurance companies and record findings on a benefits verification sheet for new patients, some emergency patients, and new insurances for existing patient accounts. All changes are entered and corrected in client’s patient management system. We also verify all new patients with a complete breakdown, recorded on a client’s benefits verification sheet, that includes custom questions specific to the client’s needs or the client may choose to use DCC’s benefits verification sheet. The benefits verification sheet is design to obtain plan specific information on frequencies, coverage on specific codes, exclusions, and limitations. We start the verification process 3 days prior to patient’s appointment. We ask that you email the Benefit Verification Form back to us with the top portion completed. We will verify the patient and respond to your email. For New Patients, Existing Patient Account New Insurance, or Emergency Patients same day verification is available with a 20 minute response window. The client will call DCC to notify of the rapid response verification. All emergency patients are verified with electronic services (if they came in for hygiene within 6 months) and with a phone call (if they did not come in for hygiene within 6 months and if their insurance is not linked with e-services verification). The service monthly base fee includes 6 benefits verification sheets per day, or 96 per month (4 days work week)/ 120 per month (5 days work week), and a charge of $10 per sheet for any benefits verification sheets exceeding the daily 6. DCC will be responsible for tracking and providing the client with documentation of patient names and dates of benefits verification sheets provided for the client on a monthly basis with their monthly invoice emailed to client. DCC and the account specialists are responsible to update existing patient’s accounts, setup new insurance plans, and will scan the benefits verification sheet to patient’s digital chart in client’s requested place. We will need a 2nd designated workstation so that we can be efficient with our productivity. NOTE: Speciality offices, extensive detailed benefits breakdown requests, or offices that require medical and dental breakdowns for each patient are $15/full benefits verification above the base.
10. Aging patient balances management: DCC has developed a very effective patient's balances collection process. We start the collections process the following way:
a. after we enter the EOB's we call the patient to collect balance after insurance resolved over the phone. If we do not reach the patient, we send a statement with 10 days response request.
b. we run patient balances over 30 days weekly and send 1st statement with a 10 days response request
c. we run the 2nd statement with a 10 days response request 21 days later
d. we run the overdue reminder 21 days after the 2nd statement with a 10 days response request
e. we then send the final demand statement with 10 day response request 21 days
f. we call the patient 14 days later and tell them that we are trying to intercept the automatic collection agency taking over the overdue accounts. We want to work with the patient and certainly do not want them to go to a collection agency. We use strong communication to make sure we salvage the patient relationship and that they understand we are on their side and want to prevent the collection agency automatic proceedings. We try to collect over the phone or work out a payment plan
g. if we do not reach the patient or have no results with step #e, we forward accounts to our client for review to go to collection agency.
h. we forward the accounts to Results! Dental Collection Agency and work with them to recover the money. The collection agency fee or litigation fee is charged to the client.
With our service money should be recovered within 60 days and should not reach 90 days.
Please contact us regarding your service plan proposal and any other questions.
Dental Claims Cleanup, LLC
118 S. Main St.
Canastota, NY 13032