Best practices and benchmarks for dental RCM — 5 takeaways

In an interactive session at Becker's Future of Dentistry Roundtable, Paul Bernard, CEO of InsideDesk, shared insights on innovation in revenue cycle management, drawing on his own experiences operating scaled RCM services and working extensively with DSOs and dental practices.

Mr. Bernard emphasized the need for accurate and timely eligibility and benefits verification, as well as the importance of maintaining insurance plans and fee schedules in practice management systems. Additionally, he highlighted opportunities in applying technology to improve RCM processes, citing the use of artificial intelligence in automating tasks such as claim follow-ups. He introduced InsideDial, a cutting-edge digital assistant integrated into their AI-driven Revenue Cycle Management solution.Mr. Bernard stressed how AI can help reduce costs, increase efficiency, and free up staff to focus on more complex tasks. He encouraged DSOs to "fight for their data," as interoperability promotes innovation. 

Below are five key takeaways from Mr. Bernard's discussion with healthcare executives. 

Editor's note: Quotes have been edited lightly for clarity.

1. RCM best practices include checking eligibility for at least 90% of appointments, ensuring data quality in EDI transactions and collecting the right data for each appointment. 

Paul Bernard: "I know people in this room probably check it [appointment eligibility] once a year, and the reason it gets checked once a year is because many of your practice management systems require you to update plans. And the way the practice management systems are configured is based on employer plans, and there are certain percentages, and all of that is valid — but you should be checking intermittently as well. Not all data is equal."

2. "Practical" automation with AI can ease tasks in the revenue cycle like claim follow-up calls, reducing the need for human intervention and saving time and resources. Modern systems can handle conversations with payers, providing consistent and accurate information every time.

PB: "The reality is, for us to achieve more efficiency and better RCM processes, there's no new technology that needs to be invented. It's been invented, and in some cases, it's been around for a long time." 

3. Integrating AI and automation into RCM drives practice efficiency, leading to faster payment collection and reduced days revenue outstanding. 

PB: "Typically, you want to target your RCM costs at somewhere around 2% or less of your revenue. In today's day, where the cost of capital for many of you is higher than it's ever been, that velocity of cash flow is really important. And if you're compensating your doctors on collections, it's super important." 

4. Dental RCM has been slower to embrace new technology compared to other areas of the healthcare industry, but there is increasing interest and potential for growth. 

PB: "The advent of the DSO is putting a lot more pressure — good pressure — on practice management systems, especially to liberate the data. DSOs are actually forcing practice management systems to think differently and to push for more interoperability, which promotes innovation." 

5. When it comes to innovation in RCM, healthcare providers are in the driver's seat. Payers are generally receptive to AI and automation in RCM, as it can drive efficiency and accuracy.

PB: "If we think dental payers want to keep spending money staffing call centers, there's a reason why the hold times are 20 minutes and so forth. They're trying to cut costs. Innovation will come from the provider side; this is what I believe, always. Providers will shine a light that says, 'hey, why can't we do this?' I'm extremely confident that's what's going to happen." 

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