Insurance negotiations and credentialing are essential parts of maintaining a dental practice. To have the most profit, negotiations for fee schedules will need to be done regularly and by someone who is trained and familiar with the processes. Providers credentialed with a variety of insurance will benefit from the most patient flow and retention. Let’s look at 10 easy tips to optimize these negotiations and, ultimately, guarantee patient retention.
Know Your Current Situation
It is important to understand the importance of PPOs, and how they affect patient retention in your practice. Be well-informed of your current PPO contracts. Review your current fee structure and parameters of all contracts. Are your contracts affecting multiple DSO locations, if applicable? Next, make note of the annual revenue for each PPO in each of your locations. For example, if your dental practice is close to a major company, like a hospital, it would be beneficial to explore their dental provider benefits.
Maintain a Stable Environment
Credentialing and negotiations, while necessary, can be a lengthy process. High employment turnover can affect the process and can drastically impact patient turnover and revenue. It can lengthen the process due to new employees needing to be credentialed or trained on new policies. Try to maintain your workplace and staff, to ensure adequate patient flow during the credentialing and negotiation processes.
Review Standard Practice Fees
The reason to review fees is to maintain the price of services and safeguard against inflation and neglect. Standard fees should be reviewed regularly by someone who values input from different departments. Also, consider factoring in multiple outside data sources to ensure your team has made an accurate assessment. If adequate, then use the data for your pricing model and to renegotiate adequately for new fees when the time comes.
Define Your Desired Outcomes
To be successful, define your objectives and goals early in the negotiation process. Your goals may change throughout the process. As goals change, ensure you are also developing success plans for each goal. It is recommended to have both short-term and long-term goals that are measurable and attainable. Each goal should have objectives or steps to achieve the result. Once goals are set, circle back and monitor your progress frequently to ensure you are staying on track.
Develop a Process to Collect and Analyze Data
Analyze your current process for collecting, processing, and comparing data. How can your current process be improved to be most efficient? Having a goal for analyzing processes is needed to ensure that no time or money is being wasted on insufficient processes. Once you have fine-tuned your process, monitor and periodically reassess for improvements, asking yourself if goals are being achieved in a timely manner.
Be Patient, but Persistent
Like mentioned earlier, negotiation and credentialing processes can be lengthy and time-consuming. Having an expert team working on negotiations can make for a smoother process. Maintain open communication and communicate frequently to ensure the process is running efficiently and to avoid delays. It may be helpful to set benchmarks for responses and follow up with representatives if responses are not received timely. If you do have a specialized team performing these duties for you, make a point to be in frequent communication with them to ensure they are following up on contracts efficiently.
It is important to honor confidentiality agreements without exception. Using an unrelated organization’s compensations in a negotiation is irrelevant and a confidentiality breach. Promote and emphasize confidentiality to all team members. Breaching confidentiality can negatively impact your DSO contracts and patient retention.
Be prepared for questions from those not involved in the decision-making process, especially when big changes are being implemented. Understandably, the changes may incite anxiety in some team members. Examples of change include adding new plans or becoming out of network with payors. Communicate updates with staff throughout the process and, if necessary, provide training and support to help them adjust and be efficient in their roles.
Keep Track of Agreements
Keep track of all new agreements. The effective dates will vary throughout the year. Every agreement should be honored for at least two years before negotiating again. For example, review monthly which contracts are ending and plan to follow up with negotiations. Staying on top of negotiation contracts will ensure your practice is getting the best fees.
Obtain Adequate Resources
As your dental organization grows, there will be more profits at stake when negotiating with insurances. Use your most educated experts to assist in negotiations. If needed, contact a professional third party for managing the tasks of credentialing and negotiations. PPO Negotiation Solutions can increase your practice revenue and assist in streamlining your processes for improved outcomes. Contact the professionals today and let them help your practice thrive!