Revenue cycle management 101: What it means and how it can affect your dental business

Sarah Traeger.
Sarah Traeger.

Welcome to revenue cycle management 101. Revenue cycle management (RCM) is a crucial process for any dental business, from small private practices to small dental groups to dental service organizations (DSOs). But RCM can be a complex process to understand as it applies to dentistry.

What does it really mean? In this article, I break down the basics of RCM 101 so that your dental business can take advantage of RCM and RCM services to improve your practice’s financial health.

What is revenue cycle management?

Sarah Traeger.Sarah Traeger.

RCM is a process that reduces the time between providing patient services and receiving payment. Your revenue cycle begins when your patient schedules a visit, and it concludes with the receipt of final payment for the treatment provided. Then it starts again with a new appointment and treatment.

When this cycle is managed effectively, RCM increases dental business revenue and time devoted to patient care. Full RCM includes the following:

  • Credentialing the providers
  • Verifying insurance eligibility
  • Creating and filing clean claims  
  • Patient billing
  • Insurance follow-up 
  • Accounts receivable management

Each part of the process affects how well RCM serves the financial health of the practice. It’s like a machine: If one piece is damaged, the machine won’t work the way it’s meant to.

Why is RCM important for dental businesses to understand and apply?

RCM is essential for dental businesses to understand because it directly impacts their financial health and success. RCM has become an integral part of running a successful dental business.

A few benefits you’ll notice when RCM is a top priority include:

  • Increased efficiency
  • Improved cash flow
  • Reduced errors
  • A better patient experience
  • Enhanced compliance

By managing your revenue cycle successfully, you’ll see not only your revenue increase but an improvement in the patient experience. Your dental business will be more organized with easy patient payment systems and streamlined processes.

What are some common challenges dental businesses face, and how can RCM help meet them?

As the dental industry becomes more dynamic, new challenges arise for dental businesses. Here are a few challenges that RCM combats: 

  • Facing the staffing shortage: RCM centralizes administrative functions for every location. For example, instead of placing one insurance coordinator in each dental office, a team serves the whole group. The practice is less vulnerable to a single point of failure, such as an unexpected vacancy. The challenge remains to find experts who are qualified to perform complex tasks quickly. 

  • Improving standardized processes: To manage your revenue cycle at a high level, you need to streamline and standardize your dental practice workflows and processes. This takes time and requires knowledge of RCM best practices.

  • Using new and changing technology: Most dental businesses struggle to keep up with the ever-changing dental technology landscape. RCM services, through their use of technology platforms, can increase your productivity and reduce manual administrative work. Technology can also reduce errors that could be affecting your patient billing experience. 

Are there resources for optimizing the revenue cycle and how it’s managed? 

As your dental business grows, so, too, do the administrative burdens. Revenue collection demands more time, technology, and expertise than what most dental teams can provide on their own. 

The knowledge needed to file clean claims, correct errors, manage patient payments, and remain compliant with changing rules (all in a timely manner) can grow beyond a team’s capacity to handle that growth.

How can my dental business benefit from RCM services?

There are several benefits when you partner with an RCM vendor. Three benefits of working with a qualified RCM partner for your dental business include: 

  1.  Increased revenue. RCM services streamline the billing process and reduce errors in claim submissions. RCM services can also help identify missed charges and underpayments and ensure prompt payment for services provided.

  2. Reduced administrative burden. RCM services help reduce the administrative burden on a dental business by managing the entire billing process from claim submission to payment. This can free up staff time to focus on patient care and other important business activities.

  3. Access to expertise. RCM services provide access to a team with knowledge of industry regulations, coding guidelines, and payer policies. This expertise can help ensure that claims are submitted accurately and comply with regulations.

RCM is critical for the success of any healthcare organization, no matter the size of your dental business. By understanding the basics and implementing best practices, dental businesses can optimize their revenue cycles, increase cash flow, and improve patient satisfaction.

Sarah Traeger is the content manager for the dental billing company Dental Claim Support.

The comments and observations expressed herein do not necessarily reflect the opinions of, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

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