How RPA can Boost Primary Claims Filing for your Dental Practice

How RPA can Boost Primary Claims Filing for your Dental Practice

It should come as no surprise that Dental is a critical industry in the US. In fact, North America accounts for over 36% of the global dental market. And the dental industry is the 5th ranked Healthcare and Social Assistance industry by market size in the US. But while the industry is thriving, there's still plenty of room for improvement. 

Many dental practices are still managing their claims filing and processing tasks manually, leading to frustratingly slow delays and costly errors. Luckily, claims filing is a prime candidate for automation, specifically robotic process automation (RPA). 

Boost Primary Claims Filing in Your Dental Practice With RPA

With billing operations becoming more complex, the need for RPA in dental care has never been more critical. Automation can offer numerous benefits, including reduced errors, boosted consistency, improved revenue cycles, and faster operations. Despite this, it's estimated that dental providers are leaving approximately $2.1 billion on the table due to poor automation adoption rates. But how can RPA help?

Handling Medical Claims vs. Dental Claims

Medical claims use CMS 1500 forms with CPT codes, while dental claims use ADA forms with CDT codes. As a result, dental teams often have to choose between filing a medical insurance claim or a dental insurance claim, depending on the treatment provided. For example, in the case of oral surgery, trauma (broken jaw or teeth), and pathology (biopsies to check for disease), dental teams often need to file a medical claim for dental services. 

RPA can help by automatically analyzing treatment on a case-by-case basis and determining the most appropriate claim based on predefined rules. You can configure the rules based on the type of treatment, insurance conditions, patient history, and more. 

Generating Claims

RPA bots can collect data from different sources and auto-fill claims templates without any human input. It can copy and enter data from one system to another, regardless of whether those systems usually struggle to communicate. It can also extract data from images and PDFs using optical character recognition (OCR) technology. The manual process of gathering this information from disparate sources and documents and entering it into claims processing portals takes a lot of time. Luckily, RPA can do this in a matter of seconds. 

Reconciling and Verifying Claims Data

Accuracy is vital in claims filing. Any errors can cause significant delays and frustration for patients. RPA can combat this by verifying patient data before filing the claim. It can cross-check information across systems and send automated communications to patients if any details need verification.

Today, dental practices have an abundance of choices regarding highly effective, cost-cutting, and time-saving claims filing RPA bots. Finding the bots that meet your specific business need has never been more straightforward. 

Here's the bottom line. RPA bots cut costs, improve efficiency, and, most importantly, improve patient outcomes. Dental practices can ensure a smoother patient journey by speeding up the primary claims filing process and eliminating costly errors.

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Published On:

January 9, 2024

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