Revenue cycle management involves a comprehensive process encompassing Credentialing, eligibility verification, preauthorization, billing, payment posting, and meticulous claim resubmissions.
Provider credentialing & Provider enrollment
The credentialing team plays a crucial role in the US dental process by providing various services related to credentialing and provider enrollment. These services are essential for dental practitioners to be eligible to work with insurance companies and provide covered services to patients.
Checking Patients eligibility with particular insurance
Our team verifies the eligibility of each scheduled patient with their dental insurance and completes the necessary insurance forms for easiness of dental office staff.
This task can be challenging due to the complex language used by insurance companies. Therefore, we opt for straightforward and standardized forms to simplify the process.
Ensuring meticulous insurance verification is crucial to our operations.
Getting Estimate from dental insurance companies before performing certain procedures for patient
Every day, our team follows the Doctor office’s instructions and electronically sends Pre-authorization requests to insurance companies. Our objective is to determine the exact amount that the insurance companies will cover for specific major services rendered to the patients.
Daily billing of each provided services to the patient
Each day, our team electronically submits both Primary and Secondary Claims with the aim of expediting your payment process. Our goal is to ensure precise claim submissions along with the necessary attachments, facilitating a smooth and timely reimbursement process.
Daily POSTING OF THE EOBs
On a daily basis, we either receive EOBs (Explanation of Benefits) from dental offices or download them from the insurance website, after obtaining approval from the dental office. Once received, we proceed to post them accordingly.
Resubmission of claims with more information
In case of claim denials by the insurance, it becomes our responsibility to furnish any missing information they require. We then initiate the process of filing appeals and disputes to ensure that we obtain the best possible outcome from the insurance companies.