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Five Challenges of Dental ERA Data!
No one likes change. Change presents a new challenge for many Dental practices and developing the proper procedures for new methods of receiving and handling remittance data can certainly be challenging.
Frustrations
Remittance (ERA) data is delivered in different formats. Having a wide array of channels and formats has been a source of frustration for many practices handling remittance data and getting all of their ERA data in an organized system can seem overwhelming.
ERA data is delivered separately from the payment. When data is separated from the payment itself, practices may have to spend more time, effort and resources to retrieve and apply the data.
Additional time and effort is needed to handle ERA data. Electronic payments are a faster, more efficient payment option but, when ERA data is formatted inconsistently requires the accounts receivable team to spend more time and effort to identify and correctly apply the data.
Inefficient Handling
Inefficient handling of ERA data increases cost. Practices must streamline the process by which they receive and apply ERA data from EFT payments to ensure they are as efficient and cost effective as possible in the short and long term.
The Fix: Include remittance (ERA) data with EFT payments:
EFT without ERA is an administrative suicide. Setting up both is essential for an efficient process.
ERA’s with NO EFT = old school
ERA’s with EFT’s = efficient technology systems
EFT’s with no ERA’s = Disaster
Solution- postable EDI 835 (ERA) files that streamline the processing of EFT payments must create a more efficient, pandemic resilient process.
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Dental EFT Technology During COVID-19
The Main Trend
The main trend in EFT is toward technology for providers and payers that is easy to use, cloud-based to be accessible from home offices, and customizable to each payer network’s needs.
These needs will become even more varied as COVID-19 impacts each provider differently, depending on how they have adjusted their patient load to comply with state mandates regarding the COVID-19 virus.
The dental profession faces a number of emerging financial changes and challenges. Combined, they make achieving and sustaining a stable cash flow a difficult yet still essential part of any management plan.
How It Works
With skilled revenue management billing, you should get paid within 2-7 days by dental insurance if your team is sending “clean claims” by using technology. Otherwise, you wait for claims to be resolved, and your cash flow is affected.
Sending “clean claims” takes expertise, time, persistence, clinical knowledge, and hours of follow-up. If your billing over 30 days is not within the efficient range, then there is an internal problem. The top problems among dental clerical staff when it comes to dental billing include:
- A lack of time;
- Interruptions by phones and patients;
- A lack of expertise in insurance billing, coding, and claims processing
- A lack of motivation.
As a Result..
As a result, you acquire unresolved claims that hold up your cash flow due to several common errors:
- Incorrect patient, practice, provider, or employer information such as demographics (35% of errors);
- The front office forgets something and supporting documentation has not been submitted with the initial claim (25%);
- The insurance company delays payment by asking for more information (20%);
- The insurance is set up incorrectly in the patient’s account (10%);
- The front office does not know how to set up the account, especially in dual insurance, blended families, or plans that are administered by major dental insurances (5%);
- The insurance company did not receive the claim so there is a need to follow up with phone calls (5%).
In Addition..
In addition, as the insurance benefits decrease, the patient’s copay is increasing. As a result, the treatment-plan acceptance to proceed with treatment has decreased, and patient balances accounts receivable has increased. If patients’ balances are not collected at time of service, the aging patient balances get out of control and the team will need time to work the collections. Recovery of patient balances decreases significantly with time, and so does the dentist’s cash flow.
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Connecting The Dots With EFT & ERA Technology
Recognize Automation
To help Dental industry providers recognize and realize the benefits of automation using the healthcare EFT standard and ERA, this technology proved that practices of all sizes can achieve cost savings and benefits from converting their claims reimbursements payments from paper checks to the EFT standard transaction and automating the reconciliation and posting process using the ERA.
What Do Practices Gain?
Practices no longer need to wait for your Explanation of Benefits (EOB) to arrive in the mail. Once you enroll in ERA, you can access the information you need to reconcile your patient accounts as soon as it is available to you. Each ERA will have a trace number (TRN) attached and name of insurance company to give you the ability to automatically re-associate the claim remittance information you receive from the clearinghouse. The TRN is designed to help providers confidently match EFT deposit with corresponding ERA’s that are deposited in the bank account. The benefit of this is huge, being it is available electronically and gives you access to the information it contains sooner than with a mailed paper EOB. Administrative savings are realized as a result of the paperwork reduction and the ERA can be scanned into the patient file.
Benefits Achieved Among Practices Include
Faster patient billing, as EFT payments are received faster allowing for quicker secondary billing and billing of patient responsibility.
Reduced posting errors through automation of EFT and ERA.
Reduced processing costs.
Improved payment cycle within 2-7 days.
Threat of lost and stolen checks is eliminated.
Drastically cut down on the possibility of embezzlement in the practice.
Get On Top Of The New Era
A new era in Dentistry has begun, if dentists want to increase the cash flow coming out of their practice he/she needs to learn how to manage their businesses, or hire the right experienced professional with the help of their management team to help them do so.
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The Key To Reducing EFT Administrative Waste
The virus.
In the era of the corona virus pandemic, it’s more important than ever for revenue cycle management to operate at maximum efficiency. Many practices are facing economic uncertainty and cannot afford any additional fiscal leakage.
Unprecedented times.
These are unprecedented times for Providers, which will require more efficient systems. Starting in November of 2019 is when insurance carriers started enforcing this EFT payment system more so than in the past and with many more carriers to roll EFT payment out in 2020. This will almost certainly be a driver that will require practices to modernize their systems and business processes regarding EFT payments.
The ADA agrees that there are advantages to electronic reimbursement as long as a dental practice is technologically ready for that. Many offices that were not set to receive EFT payment during the Pandemic, more than likely would find it taking longer to receive payment by check. Claims being submitted electronically and were set up to receive EFT payment would receive payments in a timely manner.
Dental providers are seeing the benefit of investing in this EFT technology, but are looking for staff that know how to apply it to their work flows and processes. Waste in the administrative system between providers and payers that’s generated from a lot of inefficiency, from inaccurate documentation and coding, a lack of transparency, and both sides not being aware of the appropriate steps a lot of times to achieve EFT systems.
The Solution?
To help Dental industry providers recognize and realize the benefits of automation using EFT standard and ERA, this technology has proved that practices of all sizes can achieve cost savings and benefits from converting their claims reimbursements payments from paper checks to EFT standard transaction and automating the reconciliation and posting process using the ERA.
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Empowering Dental EFT & ERA Technology In The Digital Age
EFT & ERA are applicable to all practice sizes.
To help Dental industry providers recognize and realize the benefits of automation using the healthcare EFT standard and ERA, this technology proved that practices of all sizes can achieve cost savings and benefits from converting their claims reimbursements payments from paper checks to the EFT standard transaction and automating the reconciliation and posting process using the ERA.
Practices no longer need to wait for your Explanation of Benefits (EOB) to arrive in the mail. Once you enroll in ERA, you can access the information you need to reconcile your patient accounts as soon as it is available to you. Each ERA will have a trace number (TRN) attached and name of insurance company to give you the ability to automatically re-associate the claim remittance information you receive from the clearinghouse. The TRN is designed to help providers confidently match EFT deposit with corresponding ERA’s that are deposited in the bank account. The benefit of this is huge, being it is available electronically and gives you access to the information it contains sooner than with a mailed paper EOB. Administrative savings are realized as a result of the paperwork reduction and the ERA can be scanned into the patient file.
Benefits achieved across practices included:
Faster patient billing, as EFT payments are received faster allowing for quicker secondary billing and billing of patient responsibility
Reduced posting errors through automation of EFT and ERA
Reduced processing costs
Improved payment cycle within 2-7 days
Threat of lost and stolen checks is eliminated
Drastically cut down on the possibility of embezzlement in the practice
A new era.
A new era in Dentistry has begun, if dentists want to increase the cash flow coming out of their practice he/she needs to learn how to manage their businesses, or hire the right experienced professional with the help of their management team to help them do so.
Homedentalwebsmart2022-01-07T23:11:20-05:00
