A virtual dental administrator is a trained specialist in their area of outsourcing. These individuals use their own equipment and usually work from home. They are traditionally 1099 contractors who devote their day to working in a specialized role for your office.
Recent events (the COVID-19 pandemic and lockdowns) have greatly changed processing times, call times, and front office responsibilities. Now more than ever, it is important to focus on patient engagement and care.
Here are four commonly outsourced roles that virtual office administrators perform:
1. Insurance billing
Insurance billing is a diverse landscape that requires constant attention. Keeping up with new procedure codes, new forms, documentation standards, claim attachment requirements, and insurance portals are just some of the areas that require attention. Depending on the volume of your practice, this position can equate to a full-time role.
Dental Billers perform clean claim submissions. This involves reviewing the patient’s insurance breakdown, reviewing clinical documentation, determining the necessary procedure code used, and attaching all required information required by the insurance carrier.
Dental Billers have an important role to submit clean claims for timely insurance payments. Healthcaremanagement.com suggests that this role has experienced a 16% growth rate from 2012 to 2022. This trend is likely to continue as the demand grows.
2. Insurance claims follow-up
After a dental claim is submitted, the next phase of responsibility comes into play. It is increasingly common for dental practices to be limited in the amount of time available to invest in this important endeavor.
Once a claim is submitted, it is customary to receive a payment within 30 business days, although this turnaround time is always increasing. During this processing time, several things may come up on the insurance carrier’s end.
Sometimes the cleanest claims get audited and require additional information. Sometimes a new code is recommended or perhaps something is needed from the policyholder and the patient should be contacted. The faster you can act on these requests, the faster the provider will get paid.
3. Insurance credentialing
Often times we think of insurance credentialing as only something that new providers and new offices require. If you participate with insurance companies and are a contracted (PPO) provider, then insurance credentialing is an ongoing responsibility.
Insurance credentialing applies to the work performed on insurance credentialing, contracting, renewals, and fee negotiating. Insurance credentialing can be a complex matter. Sometimes less is more. It is important to understand the roles of fee schedules, policy benefits, and provider requirements.
All of the information can become quickly accessible and accomplished with an insurance credentialing specialist.
4. Insurance verification
Although this responsibility falls at the bottom of the list, it is arguably the role that initiates it all. Insurance verification is the task of collecting all relevant patient, policyholder, and insurance information. It is then used to contact the insurance company to obtain a breakdown of the patient’s benefits.
These benefits include vital information such as maximums, deductibles, frequencies, missing tooth clause, replacement clause, and waiting periods. Having this information prior to your patient’s appointment is vital to providing a comprehensive treatment plan.
According to Healthcare Finance, “eligibility expired” is one of the top five reasons claims are denied. A dental administrator performing this necessary work on the front end can save a practice hundreds of thousands of dollars in insurance collections per year.
Let our virtual dental administrator help you!
Want to outsource these tasks and free up your team to serve your patients better? Contact Dental Practice Enhancement today by filling out our online form or calling us at 833-DPE-FOR-U.