Editor’s intro: Rose Nierman wants to help clinicians avoid claim denials. Did you know that 90% of claim denials from medical insurance are preventable? She offers helpful advice on streamlining medical billing.
by Rose Nierman, CEO, Nierman Practice Management
Did you know that 90% of claim denials from medical insurance are preventable? Medical billing is perhaps the most vital activity in dental sleep medicine practice. Whether your office outsources medical billing or bills in-house, technology makes the task much more straightforward and leads to fewer denials. The following are a few suggestions on how to streamline medical billing with modern technology.
- Adopt an online Dental Sleep Questionnaire. Have patients complete a dedicated sleep questionnaire. Specific forms such as Nierman Practice Management’s Dental Sleep History Intake & Exam save administrative time, paper, and confusion. The data from the questionnaire informs the insurer of medical comorbidities related to obstructive sleep apnea. Without specific data, the claim may be delayed while the insurer is waiting for more information.
- Electronic claims take precedence over paper claims, so use electronic billing when possible. You may see your claims reimbursed within two weeks, instead of the 30 to 90 days commonly found with paper claims.
- Implement Secure Electronic Fax. E-fax allows you to supply your narrative reports, sleep studies, and prescriptions directly to the insurer, saving time and eliminating excess paper.
- Request Electronic Remittance Advice (ERA’s) – An electronic version of the explanation of benefits (EOB), the ERA provides claim payment information much more quickly than a phone call or waiting on the paper EOB…by snail mail.
- Use Web Portals to save time on initial eligibility verification and other details. An example: Medicare’s online web portal for providers and suppliers reveals if the patient has had “same or similar equipment” (such as CPAP).
- Embrace repeatable systems whenever possible. When used correctly, technology can reduce the number of human errors that are possible and take some of the burdens off administrative staff. Consider a program that collects medical and sleep history online, generates custom narrative reports based on your evaluation, and creates completed claims for electronic submission.
Establishing a repeatable process for medical billing will increase patient access to care for sleep apnea and TMJ appliances, oral surgeries, and other medically necessary services. Don’t leave money on the table when medical benefits may be available.
With proper training, and the use of modern technology, it’s possible to become a well-oiled cross-coding machine. That way your team can focus on what is most important: providing the best possible patient care!
Rose Nieman is a frequent contributor to Dental Sleep Practice writing to help clinicians avoid claim denials. Read about why dental sleep medicine is important to her.