Are you struggling to hire a full-time insurance billing specialist? Maybe now is the right time to consider outsourcing instead and offload the stress of getting paid.

By Amy Hernandez

Amy Hernandez of PPO ProfitsIF YOU HAVEN’T already switched to cloud-based services and data storage, you’re likely considering it. It’s less costly, safer, more reliable, requires less hardware and even updates itself. Outsourcing your insurance billing is a lot like that. It will lower your costs, reduce infrastructure, make scaling your operations easier and be self-sufficient—no more managing the process yourself, no more worrying about continual staff training to navigate the ever-changing world of billing.

Let’s start with the money savings. Rising salary demands on the clinical side and a shortage of hygienists have left many practices feeling squeezed. Outsourcing insurance billing can help ease this burden, allowing you to put the savings to work where it counts most: hiring or redeploying team members to enhance patient experiences. Or you can use it to contract for services like digital marketing that spur growth. Depending on how your practice’s job responsibilities are divided, it can also give you hiring flexibility. Since your team will only have to compile and send information to your billing company, you won’t need someone with specific insurance experience. That makes it easier to attract a larger pool of candidates for front-desk jobs who might even bring fresh perspectives from outside dentistry.

Outsourcing also ensures that your practice can’t be trapped if you hire an unscrupulous billing specialist. Because it’s often only one person doing all the billing, that person can, in essence, hold you hostage. If they quit with little or no notice, you’re in trouble—and they know it. Outsourcing puts you in control and means you never have to worry that your billing is interrupted. That’s not the only danger. Your practice’s financial success can be scuppered by a team member who isn’t constantly learning and applying the latest information. Outsourcing solves this, because a good billing company will fully immerse its team in learning the latest tips and tricks. Plus, those teams offer the added benefit of experience with multiple practices, not just yours.

In addition to lower costs, outsourcing billing should also boost overall collections, reduce coding turnaround times and lead to fewer accounts-receivable days and even lower denial rates. It’s almost impossible to lose . . . unless you hire the wrong company.

What, then, should you look for? First, choose a company that looks for proper billing and coding procedures, and which ADA codes should be used and how, to maximize patient benefits. Second, the company should know what insurance companies require to get claims paid quickly, and be able to proactively identify problems before the claim goes to insurance. Third, the company must post payments correctly so you avoid any hassles with insurance fraud. Your billing company should also be able to train your team to help them understand what’s needed on the front end to reduce errors on the back end that lead to patient balances. Finally, you should be able to have a real relationship with your billing com­pany, including personal communication whenever you need it.

Outsourcing puts you in control and means you never have to worry that your billing processes are interrupted.

Outsourcing insurance billing allows your team to concentrate on patient care and practice flow while ensuring that your collections stay over 98 percent without you having to police it. Think of it as uploading all the hard stuff into the cloud and letting the “app”—your billing company—do all the work. And if it rains down some extra dollars, you can just thank the cloud.

AMY HERNANDEZ leads the revenue cycle management division of PPO Profits, one of the market’s leading providers of dental fee negotiations. Previously, she was the founder and CEO of Dental Performance Experts, a PPO claims processing and accounts-receivable firm, before selling it to PPO Profits and joining that company. PPO Profits is now part of Benco Dental, the publisher of this magazine. Contact Hernandez at