I want to discuss three common dental revenue cycle mistakes that every dental office should stop making in 2025. I'm passionate about this topic because in the dental industry, dentists and practice owners lose up to 10% of their hard-earned revenue due to billing errors and ineffective collection processes. Wisdom Dental Billing is dedicated to helping dental offices correct these mistakes.
Mistake No. 1: Last-minute or no insurance verification
One of the biggest and most frequent mistakes I see is verifying insurance at the last minute ... or not verifying it at all. This is the leading cause of claim denials, especially when patients have terminated policies or incorrect plan information.
Ashley Bond.
Failing to verify insurance can mean losing revenue forever. Once a patient walks out the door, delayed payment is just one issue. It also creates extra work for your team on the back end.
I understand that insurance verification is time-consuming, but spending just five, 10, or 15 minutes on the front end can save hours of work later. If a patient has terminated insurance, retrieving their correct information can take multiple phone calls and significant back-and-forth communication. What could have been a simple five- to 30-minute verification process can turn into several hours of unnecessary work.
While verifying insurance is challenging, I promise it pays off in the long run. It is a simple yet crucial step in revenue cycle management, and if you need help, you can always outsource it.
Resolution
Develop a process for verifying insurance at least 48 hours before nonemergency patient visits. At a minimum, ensure you have the patient's maximum remaining coverage percentages and plan limitations before they arrive. This simple step prevents costly errors and speeds up payment processing.
Quick tip
Always store a digital copy of the patient's insurance card. If they don't have one, take a clear screenshot of their plan details and save it in the patient's document center.
Mistake No. 2: Failing to properly set up and maintain insurance plans
Once you verify insurance, you must correctly enter all the details into your practice management software (PMS). Unfortunately, many offices gather the necessary information but fail to input it accurately. The saying "garbage in, garbage out" applies here: Incorrect data leads to billing headaches, undercharged patients, disputed charges, and unpaid claims, all of which negatively impact cash flow.
Your team must be trained on how to properly enter insurance plan details, including deductibles, maximum coverage, percentages, downgrades, frequencies, and clauses. Every software system is different, and updates are frequent, so ensure that your team understands the correct process for maintaining insurance plans.
A common mistake, especially in pediatric offices, is failing to keep up with the coordination of benefits. Incorrect coordination can lead to payment delays, claim denials, unnecessary refunds, and adjustments.
Resolution
Establish a clearly defined, documented process for setting up and maintaining insurance plans in your PMS. Assign a dedicated team member responsible for the accuracy of this process.
Updating insurance plans isn't just about entering new ones -- it also includes regularly checking deductibles, updating payment tables when posting payments, and ensuring the correct group numbers are assigned.
Quick tip
The "birthday rule" does not refer to the oldest parent. Instead, the primary insurance holder is the parent whose birthday falls earlier in the calendar year, regardless of birth year.
Mistake No. 3: Allowing patients to leave without paying their balances
From my experience working in my father's practice, I know how difficult it can be to ask patients for payment. However, think about it this way: No one goes to the grocery store, picks up items, and asks to pay later. In dentistry, we need to normalize the expectation that patients pay for services at the time of treatment.
Many team members fear discussing money with patients, but you should never assume what a patient can or cannot afford. If you provide an estimate before their appointment, they will expect to pay. Failing to collect payments at the time of service does a disservice to both the patient and the practice.
We've all had patients who rush out without stopping at the front desk. To prevent this, establish a hand-off process from the clinical team to the front office. Ensure that a team member escorts the patient to the front desk and provides details about the completed treatment. Retraining patients to pay at the time of service may take some time, but with consistency, they will adapt within six months.
Resolution
Create a structured process for collecting payments at the time of service and stick to it as a team. I recommend using route slips, even in paperless offices. The clinical team can note completed treatments and additional needs on the slip, which is then handed to the front office team. At checkout, the front desk staff should do the following:
- Provide the patient with an estimate for their next appointment.
- Schedule their next visit.
- Collect their outstanding balance.
When requesting payment, use a simple script: "Ms. Jones, after today, your estimated account balance is $1,250. How would you like to take care of that today?" Then remain silent. Let the patient respond without prompting or negotiating payment options unnecessarily.
Quick tip
For large treatments, such as crowns, some offices allow patients to pay 50% upfront and 50% at the seat appointment. If you offer this option, be mindful of your lab fees. Ensure that what you're charging covers your costs -- even in cases where the patient does not return for their final appointment. If you do allow partial payments, make sure to collect the final balance before seating the crown.
By avoiding these three common mistakes, your practice can significantly improve revenue cycle efficiency, reduce claim denials, and increase overall profitability. Implement these strategies today and you'll see the difference in your bottom line!
At Wisdom, we see how often little oversights like these can lead to big revenue loss (and hours of extra stress). We have compiled a more complete list of the most common dental insurance and billing mistakes we encounter and strategies to fix them. Download our free e-book or watch our recent webinar on this topic.
Ashley Bond is the co-founder and chief dental billing officer at Wisdom, a dental billing company. She previously founded Bond Dental Billing. Bond has a background deeply rooted in the dental industry. She worked alongside her father in his dental practice. Bond is passionate about helping dental practices thrive through innovative solutions and effective dental billing strategies.
The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.
