Hello and welcome to season two of Dentistry Support the Podcast with your host, the kindhearted and infectious Sarah Beth Herman. We're back for a new season and ready to pack a punch. In every episode, we'll be sharing you quick, impactful insights into the challenges our dental community and leaders in all industries face.

Expect a little bit of flair, a few laughs, and you might even recognize a friend or two. Because of you, we are the number one podcast in dentistry and number one in management and business, and we couldn't be more excited. to keep bringing you practical wisdom and leadership with a servant's heart, all delivered in just enough time for your commute or morning team huddle.

We're glad you're here. So let's get into it. Please welcome your host, Sarah Beth.  

Hello friends, and welcome to Dentistry Support the Podcast.  I'm your host, Sarah Beth Herman. And today we're diving into a game changing topic for dental practices and dental billing companies, billing gaps.

So what exactly is a billing gap? Well, I want you to think of it as a small hidden crack in your billing processes, where inefficiencies, errors, or missed opportunities creep in. They cost your practice and your company time, money, Money and trust. These gaps aren't always easy to see, but they add up really fast.

They impact your collections. They impact your team morale and they impact your patient experience. My goal is to shine light on these gaps. And more importantly, teach you how to hold yourself accountable in bridging them. Whether you're a dental office manager, or you have your billing in house, or you have a dental billing company that serves multiple dental practices, accountability is the key to making real improvements in all of this.

This episode is part one. Of a two part series where I'm going to walk you through the top billing gaps I see across the industry and why addressing them is the most important thing that we can do today.  And part two, we'll build on this foundation by exploring a few tips and tricks for creating transparency within your team or your billing company to take your processes to the next level.

So if you're ready to stop leaving money on the table and start holding yourself accountable for the health and wellness of your billing processes. You're in the right place. Let's jump in.  First, let's talk about why this matters so much. Billing gaps aren't just a problem for the billing team. They affect everyone in your practice and your company.

They lead to lost revenue, higher denial rates, delayed payments, and frustrated patients. Over time, these gaps erode trust with patients, team members, even owner doctors. If you're a dental billing company, the stakes are even higher. Your clients rely on you to keep their revenue cycle running smoothly.

When billing gaps go unchecked, you risk damaging your reputation and losing client relationships. The root cause of most billing gaps? Lack of accountability. It's easy to assume everything is running as it should, but without proper checks in place, Even small errors can snowball into major problems.

That's where I come in. My mission is to teach you how to identify and fix these gaps while holding your team or company accountable for making lasting improvements.  Let's start with a big one.  Missed secondary insurance coverage. For offices, this often happens when secondary coverage isn't verified during the intake process. 

For billing companies, it's typically due to incomplete patient records or a lack of follow up on primary claims. The accountability piece here is twofold. First, you need a process to confirm secondary coverage at every patient visit. Second, you need a system for tracking and submitting secondary claims as soon as the primary payment posts. 

Without this, your revenue will get left behind, and the patients are left footing a higher bill than necessary. It's happened before, it's going to happen a lot in the future, but we can stop this.  Billing gap number two is lack of clear coordination of benefits, or COB.  Coordination of benefits is an area where accountability often breaks down, whether it's unclear which payer is primary or misunderstanding of the COB rules.

These errors will lead to unnecessary denials and delays.  The accountability solution? I want you to train your team. Train your company on COB policies regularly. For billing companies, this means creating Standard Operating Procedures, or SOPs,  for coordination of benefit cases, and holding your team members accountable for adhering to it. 

If you need help understanding these, I have a whole free training page on my website  dentistrysupport. com forward slash free training. You can click in there and search COB or coordination of benefits. I teach a ton of things on the birthday rule and how to ask insurance companies the right way so that you can document and know that you are billing properly. 

Billing gap number three is inconsistent patient insurance eligibility verification. That's a mouthful, but it really is.  Eligibility verification is the foundation of a clean claim. Without it, you're setting yourself up for denials and patient frustration.  I talk to dental offices every day, over a thousand every year.

When I speak to these offices, most people think I just need a billing solution. Well, in my opinion, you need an eligibility solution because it starts there.  Many offices and many billing companies skip or rush through this step and you've got to slow down. You've got to be intentional and create true best practices that everyone adheres to.

Accountability here means making eligibility checks a daily priority. For billing companies, this could involve partnering with whoever does insurance eligibility for that office that you work for or if your team also offers insurance eligibility verification, making sure the right hand is talking to the left. 

You've got to train your front desk team to double check every patient. Make sure that before they step into an operatory, The insurance information is known. You've got to check this.  Our team here at Dentistry Support verifies on several different schedules. Our dental offices can choose what schedule works best for them, and yes, we do same day verifications within 10 minutes, but that doesn't mean you pay more for that.

We don't charge per verification, and we don't charge you more because you need something done same day. It takes the same amount of time to do the verification same day as it does when we do it in advance. It's having the proper staffing to make sure we can support your dental practice properly. And we're in place for that. 

Billing gap number four. Delayed claim submissions.  Man, delayed claim submissions are a silent killer for dental practices. They're a silent killer for billing companies. The longer a claim sits unsubmitted, the higher the risk of missed deadlines and cash flow problems.  Accountability here is all about urgency.

Set a standard for claims to be submitted within 24 hours of treatment. For billing companies, this means creating daily or weekly claim submission goals and tracking performance. When I answer calls from dental practices, And I hear about their billing woes. Some of them tell me they submit their claims once a month, once every other week. 

Right now, I need you to make a commitment to yourself, your patients, and your business that you will submit claims within 24 hours. No more time than that. Once you have that habit knocked out, I want you to commit to same day. You've got to do it. You can't wait for it to be submitted by itself or for someone to finally pull a report. 

The other day I was speaking to an office and I said, tell me about your outstanding claims. They said, we've got X number over 90 days and Sarah Beth, if we go with your company, I don't need you to check any claims under 90 days aging.  Okay, well, let's talk about that here in just a minute.  Billing gap number five, lack of a strategy for managing claim denials. 

Maybe you've never heard of this. Maybe you've never thought of this,  but I'll tell you this, denials, they're inevitable, but they are preventable.  All too often, practices and billing companies lack a clear strategy for managing denials, and this leads to a pileup of unresolved claims.  Accountability means assigning responsibility for denial management.

Yes, accountability means assigning responsibility for denial management. I said it twice on purpose. Whether it's a dedicated team member or a shared task amongst your front office, someone needs to own this process and be held accountable for reviewing, correcting, and resubmitting denials. Listen, when you have someone in charge of being accountable for something, it doesn't mean they're wrong if there's something on the report.

Accountability It means they're doing their job to help mitigate risk. I need you to pay attention to these. Bridge the billing gap.  Billing gap number six, not working claims every 14 days. Let's bring up that story again. I talked about the dental practice I talked to that said, Sarah Beth, we don't need you to work claims until it gets to the 90 day aging part. 

Oh man.  Oh man. I just cringe. I cringe at this because. We can be better.  This gap is all about consistency. Claims need regular follow up, point blank. And I believe at least every 14 days. This is to ensure that they're not getting stuck in limbo. Unfortunately, many practices and billing companies let claims linger way too long without followup. 

I hear all the time, ex billing company charges me a percent of collections. This incentivize them to collect more.  I argue with that. I argue with that because it doesn't incentivize them to collect more. It incentivizes them to try to make you happy by saying they're working because they're getting a guaranteed check because it's guaranteed you're going to get paid.

You will get a check from an insurance company every month in dental. But what I think you should focus on is timing and metrics and their performance. They should be giving you a report. I'm going to talk about that in billing gap number seven.  For now, accountability means creating a system for bi weekly claim reviews.

This can be as simple as setting calendar reminders or assigning follow ups in your billing software. Know what's going on.  You should know what's going on with every claim before you get a letter in the mail from insurance. You should see a letter come in and say, we already know, we handled it, we got it, it's done. 

Billing gap number seven.  Let's talk about transparency. If you're not tracking your daily claims results and sharing actionable ways that we can fix this with the owner doctors or your clients, You're missing a huge opportunity to build trust and to improve processes. Accountability here, it starts with daily reporting.

For billing companies, this means providing your clients with clear, concise updates on claims activity. For offices, It's about sharing results with your owner doctor to ensure that everyone's on the same page. You're building trust.  Here's the bottom line. Bridging billing gaps isn't just about processes.

It's about accountability. Whether you're in an office or you are a dental billing company that operates remotely, someone needs to take ownership of each step in the billing cycle. This means verifying insurance. Submitting claims on time, following up on denials, and tracking performance metrics. 

Accountability isn't about placing blame. It is about creating a culture of responsibility. When everyone on your team understands their role and takes ownership of their tasks, the entire process now runs more smoothly.  The best part? You're going to see results not just in your collections, But in your team's confidence and your client's and patient's trust. 

All right friends, let's wrap up this episode with our that's good moment, a quick recap and a thought that I want to leave you inspired with.  Today we explored the top seven billing gaps that can impact your practice or billing company. From missed secondary claims to inconsistent eligibility checks.

And each gap represents an opportunity to improve. But the real game changer. It's accountability. When you hold yourself and your team accountable for bridging these gaps, everything changes.  One of the philosophies I always share with my team is this.  When everyone owns their role, the entire team wins.

That's what accountability is all about. Stepping up, taking responsibility, and delivering results. So let's make it our mission to bridge those gaps and build a better billing process for everyone involved. We can truly make the dental industry better one patient, one dental office, one claim at a time.

for tuning in to Dentistry Support the Podcast.  This was part one of our two part series on dental billing gaps and accountability. In part two, I'll be sharing practical tips and tricks for creating transparency and accountability within your team or your billing company. Yes, I want to help everyone.

We're going to talk about everything from daily check ins to reporting metrics and how to foster a culture of prioritizing excellence. I also want to share with you an incredible opportunity for you to receive the training that you and your team desire. Whether you're a billing company or a dental office, I want to share an opportunity for those of you who want a hands on approach to transforming your dental billing process.

I offer a 90 minute virtual power course that's designed to help you and your team identify and close those billing gaps quickly and efficiently.  In this one time session, we'll go deep into each of the billing gaps we discussed today. I'll give you tailored strategies and a structured action plan.

Have practical tools to keep your billing on track. Your team will receive a workbook and multiple checklists so that you'll have lasting guidance long after the course ends. Here's how it works. For a team of up to three team members, it will be $999 for the course for a team of up to 10. It's $1,599 for the course, and for a team of up to 25, it is $2,599.

Because this is a one time session that can bring powerful changes to your billing process, there is a huge demand and currently we are only operating out of a waitlist. If you're interested, you can secure a spot for your team by adding them to the waitlist. Just follow the link that's in the show notes today.

This course will set your practice up for successful, smooth running billing processes and help you bridge the gaps that can impact collections and patient experience. And a quick note. Prices will be increasing in the new year, so now is a great time to jump in and reserve your team's spot on the wait list.

If you are ready to bridge those gaps in your billing and empower your team, I don't want you to wait. Click the link in the show notes to join the wait list. It doesn't cost anything to be on a list.  I look forward to helping you bridge those gaps and achieve a new level of success in your dental practice.

Don't forget to check the show notes for links to not only our virtual mentoring sessions, but also our free training and digital downloads available for your practice. These 90 minute sessions are designed to help your team and company thrive. Until next time, keep making those claims count. Remember, accountability is the key to success, and I'll catch you on the next episode.

Thank you so 

much for tuning in to this episode of Dentistry Support the Podcast. If you want to get in on the conversation or have something to share, join us on our Facebook group, The Dental Collaborative. Looking to connect or to be a guest? Head over to DentistrySupport. com. Or if you'd like to learn more about your host, Sarah Beth, or maybe you're thinking of starting your own podcast or looking for mentorship opportunities, well, just visit SarahBethHerman.

com. If you've got just a sec, remember to rate, subscribe, and leave a review for the podcast. That helps us keep growing. Thanks for supporting the show, and we hope you'll join us again in the next episode of Dentistry Support the Podcast.