Welcome to our latest free training! Today, we’re diving into an essential topic for all dental practices—navigating the 2024 dental insurance landscape. With significant updates and changes to dental insurance policies and regulations, it's crucial to stay informed and adapt your practice accordingly. For a deeper dive into these topics, be sure to check out our latest episode of Dentistry Support The Podcast, where we discuss these changes in detail.

Major Updates from Top Dental Insurance Companies

Three major dental insurance companies—Delta Dental, Cigna Dental, and Aetna Dental—have introduced significant updates this year. These changes are designed to enhance patient care, streamline administrative processes, and improve overall treatment outcomes.

Enhanced Telehealth Coverage: Delta Dental has expanded its telehealth services to include comprehensive consultations. Dentists can now conduct virtual visits for routine check-ups and emergency consultations. This increases access to care for patients in remote areas, those with mobility issues, and even those who are traveling.

Back in 2020, during the major shutdowns, Dentistry Support was a pivotal choice for dental practices, teaching over 100,000 practices how to handle telemedicine and teledentistry. If you need help in this area, please schedule a call with us—there's no charge. We want to help you maximize the benefits of these telehealth options.

Increased Preventive Care Benefits: Delta Dental has also increased coverage for preventive care services, including additional cleanings and fluoride treatments per year. This encourages more frequent preventive care visits, helping to reduce the incidence of serious dental issues.

When dealing with Delta Dental patients, don’t just check if they allow preventive services—check what is included in preventive care. Even if it’s a healthy mouth cleaning, if the insurance company allows three per year, ensure your patients utilize these benefits. Let’s change the game by maximizing your patients' benefits—they’re paying those premiums, so let's make sure they get the most out of them.

Simplified Claims Process: Cigna has introduced an AI-powered claims processing system that significantly reduces the time for claim approvals. This helps dental offices receive reimbursements faster and reduces the administrative burden on office staff. However, there are key considerations when dealing with AI-powered claims processing, which we'll discuss later in this free training.

Expanded Network of Providers: Cigna has also expanded its network to include more dental specialists. This offers patients a broader range of covered services without the need for referrals. If you are a specialty-based dental office or have specialists in-house, this is crucial. It allows your patients to get covered services right away without having to be referred elsewhere, improving overall treatment outcomes.

Integrated Health and Dental Plans: Aetna has launched integrated health and dental insurance plans that provide coordinated benefits and lower out-of-pocket costs for patients. This promotes holistic health management and simplifies the insurance process for both patients and providers.

Enhanced Digital Tools: Aetna introduced new digital tools, including a mobile app for easy access to insurance information, appointment scheduling, and real-time claims tracking. This improves communication and transparency between patients and their dental providers.

Keeping Up with New Laws and Regulations

The dental insurance landscape is always evolving, and staying informed is key to running a successful practice. Here are some strategies to help you keep up with new laws and regulations:

Join Professional Organizations: Organizations like the American Dental Association (ADA) and the National Association of Dental Plans (NADP) offer regular updates on legislative changes and industry trends. Being a member of these organizations provides valuable resources and information.

Attend Industry Conferences: Participating in dental industry conferences and seminars is another excellent way to stay informed. These events provide opportunities to learn about new regulations directly from experts and policymakers.

Subscribe to Industry Publications: Stay subscribed to reputable dental industry publications and online resources that provide timely news and analysis on regulatory changes. This ensures you are always up-to-date with the latest information.

Adjusting Practice Policies to Comply with Updated Guidelines

Adapting your practice to comply with updated guidelines involves several critical steps:

Review and Update Documentation: Regularly review and update your practice’s policies and procedures to reflect the latest insurance guidelines. Ensure all staff members are trained on these changes to maintain compliance and provide consistent care.

Implement New Technologies: Utilize updated software and digital tools provided by insurance companies. These tools can help streamline administrative processes, making it easier to comply with new requirements and improve overall efficiency.

Communicate with Patients: Clearly communicate any changes in insurance policies to your patients. This includes updates to their coverage and any impact on their treatment plans. Transparency helps maintain trust and avoids confusion.

Best Practices at Dentistry Support

At Dentistry Support, we follow several best practices that we believe are crucial for managing dental insurance effectively:

Work Aging Claims Every 14 Days: It's essential to work on aging claims every 14 days to ensure there are little to no claims aging over 30 days. This helps maintain a steady cash flow and reduces the risk of lost revenue due to claim denials.

Lean on Specialized Teams: If your staff doesn’t have the time to handle dental billing, it's okay to lean on specialized

teams like Dentistry Support. However, avoid paying 3-3.5% of collections, and don’t let third parties charge extra to work

outstanding aging claims. This can save your practice significant amounts of money.

Understanding AI in Claims Processing

While AI-powered claims processing systems offer many advantages, there are some disadvantages and areas that require human intervention:

Disadvantages of AI Claims Processing:

1. Bias and Errors: AI systems can sometimes make errors or exhibit biases, leading to incorrect claim denials or approvals. It’s important to monitor these systems and address any issues promptly.

2. Metering of Claims: AI claims processing can be metered at certain times of the month or quarters to benefit insurance companies, potentially delaying reimbursements. Dental practices need to be aware of these patterns to manage cash flow effectively.

Human Intervention:

1. Complex Claims: AI may struggle with complex claims that require detailed understanding and judgment. Ensure these claims are reviewed by experienced billing staff.

2. Appeals: When a claim is denied, it often requires a human touch to appeal the decision effectively. Having a dedicated team for this can improve your success rate in overturning denials.

3. Accountability: At Dentistry Support, we record all our verifications to hold dental insurance companies accountable. We use these recordings to appeal claims, achieving a success rate of about 70%. This process takes time and effort but is essential for accurate claims processing.

Navigating the ever-evolving dental insurance landscape in 2024 requires staying informed, adapting your practice policies, and leveraging both new technologies and human expertise. By following best practices and keeping up with regulatory changes, you can ensure your practice runs smoothly and efficiently.

For more in-depth insights and detailed discussions on these topics, be sure to listen to our latest episode of Dentistry Support The Podcast. We cover everything from major insurance updates to practical tips for managing your dental practice.

Thank you for participating in this free training. Stay inspired and keep making a difference in your dental practice!

Feel free to reach out with any questions or topics you’d like us to cover in future free trainings or podcast episodes. We’re here to support you in navigating the complexities of dental insurance and ensuring the success of your practice.

Disclaimer:

To learn more about Sarah Beth Herman, the author of all free training content you can read her bio here. These materials are intended to provide helpful information to dentists and dental team members. They are in no way a substitute for actual professional advice based on your unique facts and circumstances. This content is not intended or offered, nor should it be taken, as legal or other professional advice. You should always consult with your own professional advisors (e.g. attorney, accountant, or insurance carrier). To the extent, Dentistry Support ®has included links to any third-party website (s), Dentistry Support ® intends no endorsement of their content and implies no affiliation with the organizations that provide their content. Further, Dentistry Support ® makes no representations or warranties about the information provided on those sites. You can view our privacy policy and terms and conditions by clicking those pages in the footer of our website.