When the practice I was managed found itself looking for a new insurance coordinator I knew hiring for that position was going to be a real challenge. I’m not sure why hiring became so difficult post Covid, but it certainly had. As if finding an experienced assistant wasn’t hard enough, here I was needing to find someone I could trust with one of the most critical roles in the practice. For the short term I added it to my plate, knowing that was just a stop-gap solution. I needed someone who already knew what to do, needed little to no onboarding, and I needed them…..yesterday.
I had heard buzz surrounding the topic of outsourcing from podcasts, social media forums, WhatsApp chats, and various dental consultants. Most of what I had heard seemed to be focused on routine administrative duties such as answering phones, scheduling appointments and verifying insurance eligibility. I definitely wasn’t sold on having someone halfway across the world answering our phones! What I hadn’t heard much about was outsourcing the heavy lifting aspect of our revenue cycle. Posting payments, reconciling EFTs, and working aging claims completely consumed most of my time, in the interim. As I shared my struggles with our practice consultant, she offered up a possible solution. She knew a gal, that she had worked with in the past, who just started her own claims outsourcing business. It felt like divine intervention and, at least for awhile , it was.
It is often said, ” you don’t know what you don’t know” and I certainly knew very little about outsourcing. I understood the concept, the basic logistics of how it was done, but there’s more to filing claims than just filing the claims-and this is where traditional outsourcing can become problematic. So (in my best Nacho Libre voice) “let’s get down to the nitty gritty” of what works well, with dental claims outsourcing, and what doesn’t.
The good: No training and very little onboarding required. Much like a traditional in-office role, you have a dedicated person submitting primary and secondary claims consistently. To state the obvious, they are experienced in what they do. They are good at posting EFTs. In our experience our gal was super organized and surprisingly accessible. She was also the queen of spreadsheets, more on that in a sec. Most are 1099 employees, so less payroll tax, no 401Kmatch or profit sharing, and none of the other fringe benefits associated with hiring an in office employee.
The bad: Most of the claim errors are handed back to your team to figure out and fix. We were naive to think we could delegate all things claims related and we wouldn’t have to dedicate much time at all to the cause. The spreadsheets I mentioned earlier proved otherwise. The time needed for our in-office employees to work on claims ultimately proved to be our biggest disappointment with traditional outsourcing.
I could choose to wrap up my final thoughts by telling how we are different, but instead I want to share with you why we are different. We are different because we outsourced for 14 months and then spent 4 months digging ourselves out of a hole. A hole we want your practice avoid. We’ve been there, we’ve done that, and in doing so realized we had an opportunity to help other practices do it better.
Legacy Dental Claims Management 