Dental Billing Outsourcing – A Business Owner’s Guide

Authored By: Bhaskar
Bhaskar Singh is an experienced legal researcher known...

Dental billing outsourcing is an increasingly popular practice among dental practice owners who aim to streamline their administrative duties, enhance revenue collection, and maintain a focus on providing high-quality patient care.

As a dental practice owner, the decision to outsource your billing operations can be transformative, impacting not only the financial health of your business but also its operational efficiency and patient satisfaction levels.

Mainly, the process of dental billing can be analyzed in two major parts, i.e., the billing of patients and the processing of insurance claims.

Outsourcing dental billing has become a recent trend today.

Medical businesses also want to outsource their dental billing to

• Re-align their billing processes and
• Minimize administrative costs

Outsourcing the task of handling the records of patients, insurance claims, and payments helps you save a lot of your time.

This allows you to concentrate on other significant aspects of dental care.

Outsourcing your dental billing services also offers additional benefits, such as eliminating labor costs and training charges.

Also, the dental business may feel relaxed about paying on an hourly basis.

It may also be comfortable for the dental billers to pay for specific training for staff employees.

So, every medical business should seek to outsource its dental billing processes to provide high-quality dental care to patients. 

This guide helps you analyze all the major aspects of dental billing outsourcing.  

First, let’s quickly have a look at the outsourced dental billing.

1. Understanding Outsourced Dental Billing

Outsourced dental billing is contracting your dental insurance services to an external agency.

In case, your contract with a dental billing company, a professional or professionals on the grounds of your practice size shall be assigned to your office.

Such an expert will work on your insurance billing daily.

Your biller shall understand the team and your present billing procedure, analyzing where rectifications may be made.

Your team has a chance to create a strong bond with this significant new team employee.

Conventionally, these operations have been managed by in-house dental team employees.

Whether your office is PPO-based or fee-for-service, insurance billing operations offer quality facilities to your patients and resources to the practice.

These vital dental billing operations make dental offices duty-bound to

• Hire full-time employees
• Part-time employees, or
• Distribute the burden of dental billing to other employees of the team.  

Are you adapted to managing dental insurance in-house?

You can be new to exploring the alternative of outsourced dental billing.

Most dentists and office administrators choose outsourcing services because of employee turnover, collections are minimized, or in-house training is not accessible.

You may also be wondering what kind of services can be outsourced.

These are some of the major services offered by dental billing companies:

• Appeal rejected claims
• Insurance aging data overview
• Transferring claims (by a clearing house)
• Channelizing insurance payments
• Channelizing insurance electronic funds transfer payments
• Applying PPO verifications and rundowns
• Granting of secondary claims
• Accessories with electronic claims
• Claims for mailing, in case applicable
• Daily and weekly interaction
• Fee schedules processing
• Reporting

Being a member of the administrative group, you remain forward in your practice and shall continue to manage the following operations:

• Analyze your patients
• Specify appointments
• Responding phone calls
• Remain active while managing co-pays
• Collect the payments for which the patients are liable
• Current treatment
• Office merchandizing
• Experience of the patient

There is still a requirement to verify that your daily processes are rightly programmed.

It is to also ensure that the data on record aligns with the work, that was executed in your office that day.

It is still mandatory to inspect coverage and interaction costs and insurance claims with patients.

Full-time engagement is necessary to run and manage a dental office. It includes various people, all assisting each other.

Why do businesses outsource their dental billing?

The question may strike your mind while outsourcing- “Why do other dental businesses outsource?”

Evaluating the cause, your peers opting for this strategy may be helpful and involve reasons you might take into account also for your practice.

Looking at why businesses outsource their dental billing can help you understand that you are not alone in your insurance worries. 

This may strengthen you to take action and make your plan to manage insurance billing.

There are some of the very famous reasons businesses outsource their dental billing- 

• You have a good insurance aging resource or less collection probability
• You are facing concerns for employees related to the dental practice
• Your office administrator is extremely busy to manage billing
• You are assessing your alternatives for dental billing
• Your procedure for insurance billing is taking a long time
• You require assistance resolving issue claims
• You observe improper claims and channelizing in your dental office
• You require assistance with getting your dental practice certified
• You require support for analyzing the overall procedure of dental billing
• You are a newly opened dental business

2. Outsourcing and In-House Billing: Merits and Demerits

An in-house biller is a big financial allegiance for your practice

It is like a pledge to include another full-time salary with advantages to your overhead.

It is sure that you are obtaining what you are paying. 

What is the reason for hiring an in-house team?

In-house billers: Advantages

An in-house biller is physically present to resolve queries or answer questions

Do you or anyone else in your dental group have a question about the patient’s coverage? An in-house insurance biller is there for you.

You may directly approach their office, or have a face-to-face interaction with them.

It is not necessary to wait long for an answer or reply from your in-house biller as they are physically present with you there.

You preserve the controlling tendency over your insurance billing

An in-house biller is an internal member of your staff. Your office administrator may still feel in dominance of your billing procedure if you hire your insurance supervisor.

A dental billing company does not snatch the dominance from your team, but it is common adaptability, which is shown by the in-house team members.

Your in-house biller is well-adapted to your team

In case your billing is in-house, it is like building a team, where everyone targets to fulfill the same goal.

It is easy to place faith in a person with whom you are developing a friendly relationship as you have a personal strong bond with that person.

You may observe their working pattern and practices, and it is easy to collaborate with them. This may develop a huge dynamic staff in your office.

In-house billers: Demerits

It’s costly

An insurance supervisor’s salary may range between $50,000-$70,000 yearly, not involving a compensation package if that’s something you provide.

Any extra payments you give to staff are included in your expenses.

This is not a role you may fill with any individual who shall accept minimum wages. It is a must to get in touch with someone who has professional expertise.

Expert insurance supervisors may cost around 60% more than outsourcing this operation. 

Low adaptability in case of a trial period

As you are hiring a full-time employee, you have faith that they understand how to perform this job role.

It happens more frequently than you contemplate that dentists hire someone who is not aware of

• How to channel payments rightly,
• Work with adaptations,
• Claims related to research, and 
• Appeal claim rejections. 

You may not always be dependent on a resume. It is necessary to evaluate their skills before hiring them.

In-house billers don’t have exposure to a network of other top billing experts

It’s probably your in-house insurance supervisor who works on your insurance billing solely.

If they have any queries or require help or support, there are no else chances in the office to analyze how to perform their job.

If they are not present in the city or case of any emergency, insurance billing is held off till the moment they return.

Now, after analyzing the pros and cons of hiring an in-house insurance supervisor, let’s have a look at the essentials of hiring an outsourced dental billing company.

Hiring an outsourced dental billing company at your dental set-up

Outsourcing to a dental billing company provides exposure to a diverse range of professionals. They frequently submit claims and follow with the support of each other unless they are paid.

Advantages of Outsourced Dental Billing

They manage the insurance billing, therefore your team is not required to do so

People have usually become tired of working with insurance claims and managing with insurance companies.

Outsourced dental billing companies have adapted to it.

They shall manage the essentials of

• Working on outstanding claims aging reports
• Researching rejected claims, and
• Waiting on pause to appeal to them while your team concentrates on other significant operations in your office.

Insurance billing outsourcing is the cheapest alternative

A vast number of dental billing companies invoice dental offices on the grounds of the dimension of the practice and profit.

The monthly cost lies between $1,300-$5,000. 

An insurance supervisor with high experience charges approx. $5,000 every month at the lowest.

That is, in case, you require only one insurance supervisor (in case, you manage a huge business, you can require more).

Outsourced remote billers have a diverse range of professionals at their disposal

In case, any individual has a query, a big network of other billing professionals may be easily accessed for responses or top practices.

This knowledge network highly prepares them to deal with any challenge related to claims your dental business could be facing.

Outsourced dental billing: Demerits

Outsourcing can be a hard shift for your dental group if they aren’t consigned

Team employees- such as office administrators and various administrative teammates oppose working with a dental billing company.

It is not easy to decide whether delegating the insurance billing to a stranger can be good or not.

Regular interaction is included

This is for the individuals who are adapted to their billing person available for them.

Your outsourced biller shall be operating remotely in your dental software, i.e., if there are any queries or worries, you have to contact or email them.

Effective communication is a must to work with a remote biller without any trouble.

You are delegating your insurance billing to a person independent from the office

The outsourced biller shall work remotely on your dental application. Probably, you will never have a face-to-face interaction with them except on the Zoom platform.

This may be a big threat to several offices as it needs the team to have faith in the procedure and the individual to whom they are delegating the insurance billing.

It may seem like a loss of control to several teams.

Although, obtaining rapid, precise insurance payments assists you in directing all your profit channels under control.

Patient billing becomes clear and in place of the loss of control, you feel that you are more in systematic accordance than before.

In the case of outsourcing your insurance billing, you have to properly interact with your team about the reason you are making an amendment.

This shall restrict you from feeling dominated by the remote biller who is present to minimize the troubles associated with insurance billing.

The best option will be the individual who is highly profitable and who will maximize the financial status of your company.

Also Read: Top Medical Billing Companies in the UK

3. Cost of an Outsourced Dental Billing Company

The nominal cost for outsourced dental billing is approx—$ 1,500-$1,600 every month.

To obtain your yearly expenses, it is important to multiply this by 12 months.

The calculation is as follows

If we multiply $1,600 by 12, the result will be a $19,200 nominal yearly charge for an outsourced dental billing company.

Cost is influenced by the following constituents

Insurance profit

Approx. more than 55% of the dental billing companies charge solely on the grounds of your insurance collections.

The billing companies shall oversee the receivables of your insurance accounts solely for the involved charge.

Patient augmented reality is an extra service offered by solely several dental billing companies.

As it is a sole-standing service, it shall usually be included in your monthly cost.

The dimension of your business

Certain businesses have a single doctor, whereas others have various providers. The number of providers providing services emphasizes the collections.

Dental billing companies in bulk charge on the grounds of your total collections from insurance every month.

There are various levels of insurance collections, employed for determining the cost of outsourcing:

• Below $40,000
• Within $40,000-$100,000
• Within $100,000-$150,000
• Within $150,000-$200,000
• Above $200,000

Startup destination and new business cost pattern

Without analyzing your estimated production and collection stages before opening, an immense number of startups shall be regarded under “Startup Pricing”.

Firstly, it is necessary to set up the application for startups. This may involve set-ups for the granters, claims, and costs.

For a startup involving a sole doctor, a cost between $750-$1300 can be charged for a specified period.

This may be usually for about 5 months after the checking of patients and claims have begun to be transferred.

Dental businesses at different destinations

In case, you have various destinations, this can influence different pricing.

This is ensured depending on the number of destinations and the production and collection stages of every practice combined. 

In many instances, those destinations would be combined for billing processes.

However, there are situations, where various offices may be billed individually. 

For a conservative approximation, include the monthly insurance collections from every practice, and take into account the cost structure.

Extra Costs

Set-up charge- Set-up costs lie between $200-$999.

Set-up charges differ by company and can involve IT services to install an application on equipment processed by the outsourced dental billing company.

Set-up costs involve the guarantee and delivery of computer equipment and training of the team.

Stamp charges- The charges of stamps lie between $ 0.50 and $0.70 on every commodity.

Substantial companies direct a standard price for every stamp used while mailing claims or directing an affirmation or declaration is important.

PPO cost timetable entering- Cost schedule entering lies between $100-$200.

Medical invoicing- Medical invoicing for dentists can be billed on every claim sent approx. till $50-$75.

Several companies impose the cost on the production quantity and certain companies will bill the percentage of the obtained amount.

Reunification of the electronic funds transfer- Reunification ranges between $150-$300 every month.

Additional Services

Accrediting- Accrediting services can be important to confirm that the payment on time has been received periodically.

Accrediting one insurance granter with one insurance will range between $200-$500. 

Accrediting costs may differ based on the number of granters and the necessities of the payer.

The more PPOs will be there in your network, the less you will pay on every insurance.

PPO cost adjustments- PPO fee adjustments are also the sole fee on every insurance or umbrella web.

These may lie between several hundred dollars to thousand dollars depending on the network PPO costs are adjusted. 

Several insurance companies shall not adjust or be members of the bigger umbrella network (for eg, Delta Dental). 

Insurance evaluation- Insurance Evaluation cost may be on an hourly basis or every claim.  

The various stages of insurance evaluation may influence price. Those stages can involve

• Qualification
• Standard disintegration
• Complete disintegration

Now, after analyzing the outsourcing cost, let’s have a look at how it contrasts with hiring an in-house biller or insurance supervisor.

Cost differences: Outsourced dental billing and In-house dental billing

Let’s explore a descriptive contrast of the outsourced dental billing costs and the option you have with insourcing. 

Consider that both outsourcing and in-house dental billing might provide the same outcomes for your insurance profits.

Dental Insurance Supervisor Cost

A dental office insurance supervisor’s (in-house) nominal salary is $18.26 hourly. 

An insurance supervisor making $18.26 per hour shall range between $47,476-$53,173 every year in salary.

In-house W2 staff also have extremely high costs above and beyond their hourly or salary rate.

For any service, W2 employees cost usually 1.25-1.4 times the normal salary structure. 

This additional compensation involves employer taxes, for eg.,

• Social protection,
• Central and state joblessness,
• Medical healthcare,
• Employee’s compensation insurance,
• Payroll processes, and
• Advantages that you can provide. 

This ensures that you may expect the overall compensation for one of these employees to be 25-40% higher than their normal salary. 

On $18.26 on an hourly basis, your average dental insurance supervisor charges for your practice approx. around $50,325 annually. This involves the advantages and taxes of the employer. 

Any perks provided to W2 employees would be included in this estimation.

Comparison between the cost of an outsourced dental billing company and an insurance supervisor

The nominal cost for an outsourced dental billing company is approx—$ 1,500-$1,600 every month.

If we multiply $1,600 by 12, the result will be $19,200. This is the average annual cost for an outsourced dental billing company.

For an insurance supervisor- $50,000

For a dental billing company- $19,200

The total estimated cost is $30,800. 

Every year $30,800 you save on your insurance billing- a large variation yearly.

Reference: -ezddsbilling

4. Duration of working with an outsourced dental billing company

Collaborating with a dental billing company may streamline your collection rate and help you save a majority of time and money.

This question may come to your mind- “What is the duration for which you are supposed to work with this dental billing company?”

Would it be a 6-month contract or a long-year procedure to regulate your dental practice’s low collections and high aging report?

What does it lead to when you are observing the outcomes?

It would help if you worked with a dental billing company as long you are looking for a neat and dependable billing system.

This effectively collects from your insurance claims.

Turning back to in-house insurance invoicing may upgrade the overhead

If you are willing to turn back to the in-house invoicing, you will be required to displace your outsourced biller instantly. This operation may not be postponed while you spend your time hiring an insurance supervisor.

This must be before you leave your billing company.

Outsourced dental service is a regular, long-period service. Never switch to in-house insurance invoicing unless you have a qualified and screened individual to manage the task. 

5. Major challenges with outsourced dental billing

There is a general adaptation period

The majority of dental offices that hire an outsourced dental billing company feel that all the liabilities may be raised by their executive team. 

This is not relevant in the majority of cases.

It is still required to have an in-house executive team.

A huge number of dental billing companies oversee the claims that have been created and grouped.

This ensures that they execute operations associated with dental claims being transferred, affixed, and examined.

Dealing with this issue: Highlight the objective of outsourcing dental

billing and give your team space to adapt

Your team requires time to identify the way they will work with the dental billing team.

Anticipate a learning curve as your team gets the chance to understand the dental billing company and make space for it.

The period of adaptability is much less when the office executive or dentist may clearly explain the objective of the dental billing company.

Interaction challenges

After your team passes through the adaptability period of becoming familiar with a dental billing company, then the major challenge is getting adapted to the interaction involved.

Everyone interacts uniquely, and identifying the way to do the same with a new individual may be a big challenge.

Several offices face difficulties collaborating with an outsourced biller in case interaction is tough. It is an additional step and an additional individual to be involved in their billing procedure- which they were used to managing on their own.

Dealing with this issue: Streamline interaction with your remote biller

It is very easy to forget a person who is not physically present in your office. Motivate your team to develop a bond with the outsourced billing company, as they are present in the same office.

Whether you interact through text, phone call, video conferencing, or e-mail- The biller and the administrative team may select the best pattern of interaction and frequency for both groups.

Working together

Several offices fire the remote biller as they see provincial related to the insurance billing activity. 

This leads to a major loss in the time and money associated with the dental practice.

Unitedly, you may upgrade your collections by a regulated and systemized billing procedure.

Dealing with this issue: Have faith in the proficiency of the remote biller and believe that they are an addition to your team

There can be several uncertainties while making an effective decision. When both parties get adapt to the contract agreement, such confusions are easily avoided.

To a certain extent, jurisdiction may have been delegated to the outsourced dental billing company, and some may have remained in-house.

The proficiency of the biller is irreplaceable. Such a biller is highly concentrated on insurance invoicing.

Many billers hold a diverse range of experience and constant training in insurance invoicing. 

The remote biller often has access to a wide range of other professionals to switch to for queries and recommendations and shall help your claims get paid easily.

Also Read: Eight Hidden Benefits of Medical Billing Outsourcing Services

Conclusion

Dental billing outsourcing is one of the major tasks of a dental office. A dental hospital or set-up should always look to outsource their billing processes to

• streamline operations,
• minimize costs, and
• handle the satisfaction of consumers.

To outsource your dental billing services, you must consult a professional or take guidance from an expert. Invedus has top professionals, who are experts at providing advice to businesses relating to dental billing outsourcing.

Many dental offices consult our experts to outsource their billing processes. If you are also confused about outsourcing your dental billing management, immediately get in touch with our service providers. They are always available to help you with your primary outsourcing requirements.