Process of Dental Billing and how it works. Let first understand the whole process since Dental billing can also be referred as Revenue Cycle

Management which is most commonly used for Medical Billing. Revenue cycle management (RCM) is a process of putting together various aspects of the billing and creating a one large process and each process is linked to the other. Let’s just look at the different components of RCM.

• Insurance Verification
• Demographic Entry
• Coding
• Charge Posting/claim creation
• Claim Submission
• AR Follow up
• Payment posting

Let’s just understand all these components one at a time.

Dental Insurance Verification:

First step for Dental billing is to verify the insurance coverage for the pt. who is scheduled with Dental clinic to make sure he/she has the benefits available for the procedure which is being performed by the Dentist. To verify insurance coverage patient must provide insurance card or Insurance id number to the Dental Office prior to the appointment.

Demographic Entry: 

Once Patient benefits are verified, next step is to enter the data into the practice management software that office is using which may be open Dental, Curve, Dentrix etc. so that next processes in the cycle can take place.

Coding:

This is one of the most important components of RCM and plays decisive role in revenue. Dentists use ADA codes to report a service that was rendered to the patient.

Charge Posting:

After a report is coded the next step is to create a claim to submit to the insurance company. Charge posting can also be referred to the Claim Creation.

Claim Submission:  

Now since the claim has been created the next step is to submit the claim to the insurance company, this can be done electronically, by mail or fax.

AR Follow Up: 

This is one of the key components for Dental Billing since once claim are submitted to the insurance company it’s AR Team’s responsibility to find out what’s happening with pending claims and if they are under or partially paid and re-submit them with corrections.

Payment Posting:

Last step in RCM is payment posting. Once the claim is processed by the insurance the dental office receives EOB that explain how much payment is made by the insurance company and what is patient responsibility or if the claim has been denied or underpaid.

Every single component in the RCM plays an important role to make next process successful. For example if charge posting is not done properly then claim might get rejected due any error.