Improving Practice Productivity with Analytics

Improving Practice Productivity With Analytics

With almost 11 ADA recognized dental specialties and having a burgeoning market share, the specialty dental business is here to make significant gains in the coming years as we take a cursory glance on the latest trends of the dental industry.

Listen to Ryan Arnold, Principal, Wisdom Teeth Guys as he explains the possibilities that lie ahead for Dental Specialty business and how he has paid attention on patient care,technology adoption and brand management to further sustainable practice growth for his specialty.

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Creating Sustainable Specialty Dental Businesses

Dentistry's Inner Circle Podcast

A series of podcasts from practice owners on how they navigated the change and successfully transitioned to CareStack. 

Enabling Technology to Connect Better with Your Patients

How Dr. Williams' Practice Optimized Growth with CareStack

Case Study: How Dr. Williams' Practice Optimized Growth with CareStack

Expanding Dental Care beyond the Clinic

Expanding Dental Care Beyond the Clinic

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Embracing Change To Grow Your Group

Enable Dental Completes Its Migration To CareStack

Enable Dental Completes Its Migration To Industry Leading Cloud Based Dental Software

Beatrice

Ishtiaq Rouf

Dana Veach

Dr. Himesh Kana, DDS

Himesh Kana

 Penny Filipe

Promoted to Manager, Now What

Promoted to Manager, Now What?

Top Trends in Dental Software for 2025

Top Trends in Dental Software for 2025: What Practices Should Prepare For

Brand Guidelines for Dental Offices to Attract and Retain Gen-Z Patients

Reducing patient no-shows and cancellations begins by accepting that 

it’s impossible to guarantee that your patients will always keep their appointments

. Once you accept that this falls outside your control, you can pool your efforts on the aspects that are within your control, and which help reduce no-shows and cancellations.

missed appointments cause a ripple effect

 that impacts your schedules, revenues, and the effectiveness of treatments. It strikes a serious blow to your bottom line. But with that said, there are 

effective safeguards you can put in place

 to address this issue. Before we explore these safeguards, let’s examine the key reasons behind no-shows and cancellations. 

Typically, patients miss their appointments when they:

Don’t understand the importance of keeping their appointments

Misunderstand when their appointment is scheduled

Self diagnose and decide to skip their appointments

Worry about bad news and try to avoid the situation

Have a shallow relationship with the provider

There is a wide range of reasons for patients to miss their appointments, but most can be mitigated with improved patient-provider communication and by implementing the following safeguards.

It became widely accepted as a care delivery method after the 2020 pandemic, but thanks to the convenience offered to patients, 

 is here to stay. Outside the initial check-up and actual treatment, consultations and routine post-op visits can be performed remotely. The virtual interactions offer patients the opportunity to 

receive treatment in the comfort of their living room

 or office. The added benefit of leveraging teledentistry is it adds one less reason for patients to rethink or opt out of their dental appointments. 

Another approach that has gained traction is using 

 to collect vital patient information. E-forms are a key feature of modern practice management software (PMS). This feature is now used widely to stay in line with the COVID-19 safety protocols. With this new norm, practices have completely replaced the clipboard and embraced digitization. Another fact that supports this approach is that 

98% of patients who take time to fill out online forms commit to their appointments

COVID-19 has added fuel to the fire of dental anxiety among patients. The risk of exposure is a valid fear. The best way for you to 

 is with communication and education. Ensure you convey the safety protocols and measures followed at your practice to reduce the risks from COVID-19. Launching targeted email campaigns, and updating relevant information on your practice website and 

convey your commitment to patient care and safety

 and encourage patients to follow through with their appointments.

When you provide your patients with the option to make payments in advance, it reduces the instances of no-shows and benefits your collections and accounts receivable. Get paid upfront instead of having to wait for 2-3 months. Paying cash in advance leads to 

. You can provide this option during patient checkout, especially when both you and your patient agree with the importance of scheduling the next appointment.

Offering upfront payment at this stage is apt, as the patient is likelier to take action and commit to their oral health. Another way to make it easy for them to pay is by providing an 

. Make sure that you inform your patient about your prepaid payment options. Market it through your campaigns, newsletters, and phone scripts.

Reminders are an effective way to reduce patient no-shows. Plan your 

and decide on a frequency that works best for your target clientele. Start off with a postcard, followed by email and text reminders. Add a phone reminder a few days before the scheduled appointment. Ensure that you cut down on reminders once you receive confirmation from your patients. Practice management software aids you to launch, coordinate and track your recall campaigns effectively.

reward patients who keep their appointments

. The reward initiatives can include discounts or gift cards. The benefits of such an approach are twofold. You encourage your patients to follow through on your appointments and 

convey how much you value their participation

. Moreover, curating such experiences helps you retain your customers.

Sometimes, patients simply forget an appointment. Send 

 that can include a “We missed you at the practice” message. Follow this up with a phone call to encourage them to reschedule immediately.

It is crucial that your patients know the impact of your treatments on their oral health. If your patients are not invested in the outcomes of your treatment plan, it is unlikely that they will uphold their commitments. 

 before every appointment. Remind them of the benefits of the procedure and the progress they’ve made so far. 

 of the scheduled appointment and ensure that they are fully onboard. A phone reminder before the appointment will help refresh what they already know about the 

Patients skip appointments because they owe your practice money or are worried the procedure will be too expensive. When this happens, it’s time to 

. It’s important that payments never come as a surprise to the patient. This causes anxiety in the patient, especially when they expect hidden expenses from each visit. When 

 and benefits are discussed upfront and agreed upon, patient no-shows due to financial concerns can be avoided. 

 allows you to effectively educate and communicate with your patients. Automating tasks like appointment reminders or confirmation/cancellation emails, filling last-minute openings, and sending online forms and other notifications to engage patients, practices can drastically cut revenue loss and staff workload while reducing patient no-shows and cancellations.

Eliminating No-Shows and Cancellations at Dental Office

For a dental practice, revenue cycle management is the equivalent of the body’s circulatory system and the heart of a practice’s financial success. The revenue cycle incorporates data capture, claims and denials management, and the collection of payments from both patient and insurance receivables. A healthy system works in concert with industry best practices and technical solutions to optimize efficiencies, identify “leaks” and improve operational workflows. As every practice is unique, it is difficult to prescribe a “one size fits all” approach. However, there are key performance indicators, which can and should be followed to measure practice performance. There are several potential KPIs which provide valuable insight into the collection’s performance and financial health of practice including, but not limited to: Collections percentage, Production growth, Aging accounts receivable, Days sales outstanding, Adjustments percentage, and Credit balances. 

Since 2011, the dental industry has experienced a steady and upward trend in aging receivables, with the majority of balances aged greater than 90 days. The good news is that CareStack offers a solution that combines modern technology, effective processes, and industry expertise to kick start the heart and breathe life back into the revenue cycle.

Revenue Cycle Playbook for Dental Professional

Revenue Cycle Playbook for Dental Professionals

From small, solo practices to large, multi-location clinics, these case studies demonstrate the versatility and value of CareStack in improving the patient experience and driving practice . 

The frustrating occurrence of claim denials continues to put enormous pressure on healthcare providers. For the most part, it presents to be a hefty investment for both the healthcare providers and the patients.

But here’s some good news: with the proper understanding of the strategic touchpoints of clean claims, your team can decrease the chance of a claim being rejected while ensuring faster turnover rates and profitability.

However, the real question is how to prevent claim denials in the first place. To answer this question, let’s explore the critical features, processes, and steps required for clean claims submission while taking care of the profitability of your practice.

 is defined as “a claim which has no defect, impropriety or special circumstance, including incomplete documentation that delays timely payment”.

Identify the provider and facility in order to verify, if necessary, the affiliation status.

Identify the patient and insurance plan subscriber.

Only be for covered services for an eligible individual within the insurance policy.

Substantiate the dental necessity and appropriateness of the service provided, if necessary.

Contain sufficient information to establish that prior authorisation was obtained if required.

Identify the service rendered using a generally accepted Methodology for coding procedures or services.

Include additional documentation based on services rendered as reasonably required by the plan.

Have providers who bill a dental plan within one year — or a stipulated period — after the date of service.

Choose the best practices to increase the Clean Claim Rate

A high Clean Claim Rate (CCR) is vital for the operational health and success of a dental practice. Therefore, the CCR is a crucial 

 metric that indicates the quality of claims-related data being collected and reported as a claim as it begins its journey from the provider to the clearinghouse and on to the payor.

CCR is the ratio of claims that pass all edits without requiring manual intervention to the total number of claims processed for billing.

However, it is important to remember that a 100 percent CCR may not be realistic, given that payor requirements are constantly changing and upstream errors and data quality issues are tough to overcome entirely. Therefore, with the right combination of people, processes and technology, practices can target and achieve higher CCR rates of up to 90 percent, thereby enabling tighter control over revenue and increasing the bottom line and competitiveness of the practice.

 can be defined as verifying the state of claims before submitting them to insurers. This ensures accuracy and completion while significantly increasing the chances of claims being accepted.

Two major reasons lead to the re-processing of claims — 

. While these terms are often used interchangeably, they are different and require distinct solutions.

Rejected claims These are claims that have come back due to missing or invalid information required for an insurance carrier to properly process a claim. A claim that has been rejected has not been entered into the payor’s adjudication system. From the perspective of the payer, that claim is non-existent.

Rejections happen at two touchpoints in the claim management workflow:

These rejections typically include payor-related information that the clearinghouse builds into edits to prevent claims from being passed on to the payor only to be rejected by the payor. For example, if a subscriber ID is required to have an alpha prefix and a provider submits a claim that is missing that prefix, the clearinghouse edits catch that error and return the claim as rejected.

These are commonly related to patient demographics and eligibility issues discovered when the claim reaches the payor. The most common patient-related rejections are also the most preventable. “Subscriber and Subscriber ID Mismatched” or “Not Found” are usually an indication that the patient was not eligible at the time of service or that there is a data-entry error in the patient’s demographics. These rejections can be prevented by solely making sure that eligibility is verified at the time of service. It’s all too common for practices to lose revenue on visits due to the failure of eligibility verification and then fall behind in reworking the rejected claims.

These are claims accepted by the payor but returned to the provider with either no payment or partial payment after adjudication. Denials must be either adjusted off, appealed, or reopened if the provider has a valid reason. A claim that has been processed and denied cannot be corrected and resubmitted as a rejection.

There are generally no appeal rights for claims that have been denied for delayed filing, so it is crucial to make sure that rejected claims are corrected and resubmitted as soon as possible.

How the fastest-growing practices improved their CCR (Clean Claim rate) with CareStack?

At CareStack, we are uniquely positioned to help fast-growing dental practices continuously improve their Clean Claim Rate (CCR). This is facilitated by -

A modern technology foundation that enables aggregating and analyzing data across all locations of a practice

A simple interface that prioritizes usability and accessibility to this data for all types of business users

Multiple layers of built-in claim-scrubbing logic cover provider setup, practice setup, payer setup, patient demographic and eligibility information, as well as documentation specific to services

Ability to create and customize workflows around lists and notes to enable users to communicate and collaborate efficiently across geographies and time zones


Learn how we can help you reduce claim rejections and denials.

Book a demo with us!

In the subsequent sections, we will explore the claim-scrubbing process and how claim-scrubbing is facilitated in CareStack.

How Claim-Scrubbing Is Facilitated in CareStack

When your practice is onboard the CareStack platform, your existing data — including the provider, patient, and insurance information — is migrated as-is. We have tied up with two of the largest clearinghouses in the United States to provide electronic claims, eligibility, and ERA services, and our customer support team members take you through any new credentialing and enrollment requirements if you are crossing over from another clearinghouse service. This ensures a smooth transition into our platform and eliminates any possibility of errors in setting up new providers or locations even before you start billing.

Immediately after data migration and credentialing, the application setup begins. In this phase, our customer support team works with the practice champion to ensure that the following entities are set up accurately in Practice Settings in CareStack:

Insurance carriers: name, address, insurance ID, and eligibility forms

Insurance plans: plan type, benefits coordination method, pre-auth requirements, and fee schedules

Providers: details include name, DEA, NPI, State License Number details

Billing codes: details include ADA billing codes, CMS billing codes, ICD 10 diagnostic codes, along with their associated expiry date, chart drawings, and sales tax Claims: details include default claim type and electronic attachment NEA rule setup

During the initial setup, the CareStack team ensures that the data associated with each billing entity

— including provider, payor, and plan — is accurately created so that at the time of billing, any rejection or denial due to wrong data is minimized.

CareStack's built-in features validate billing information at the point of care coordination itself. This ensures that the users are immediately informed about the possible impact of their actions on billing, thereby enabling decision-making as early as possible in the workflow. Some of these features in CareStack are

18-level rule hierarchy to accurately calculate fees during treatment completion

Visual cues for identifying manual changes in fees

Ability to re-estimate fees on change of insurance

Preset tooth and surface-level validations for each procedure code to ensure accurate

claims, Validating the expiry of procedure code based on the Date of Service, to eliminate accidental billing and check-out of expired codes

User prompting to validate the address of the patient before they leave the office.

In addition to the built-in validations, users can also set up their own rules in CareStack. This comes in the form of two features:

 This feature, which can be turned on and off, enables users to define messages for a particular procedure code. These messages are displayed when each code is being checked out. This information is also available on-demand for users wherever they are in the application, aiding them in identifying dependencies or alternatives to the billing codes at the point of completion, thereby reducing billing errors.

 These rules are set up manually or electronically while verifying patient eligibility. Like care audit rules, they also present themselves automatically during the different stages of treatment completion and billing. By prompting the user about payer-specific rules in relation to many factors, such as frequency, age, time limitations, exclusions, and bundling, this allows users to make corrections while checking out even before a claim is generated.

During the claim-creation process, all setup-related activities are validated further. This includes:

Information about entities such as treating provider, billing provider, place of treatment, and orthodontic claim-related information is validated when each claim is generated in CareStack.

Claims that require immediate action are made available as a filtered list. These claims are submitted to the clearinghouse only after users complete the missing information, thereby ensuring a high First Pass Acceptance Rate. Integrated attachment validations: All required additional documentation, such as x-rays and narratives, is validated by integrating third-party services like NEA.

As soon as a claim is created, the user is redirected to a filtered list of claims created by the automatic validation process. These claims can only be submitted after the required attachment is added by the users.

In the claims process, most rejections occur due to missing or invalid data. Other errors that lead to rejections include the use of the wrong date format, the invalidity of zip codes and inconsistencies in user data. With built-in validation features and rule-based data capture, many of these rejections can be avoided.

If credentialing and provider setup are carried out accurately in the onboarding phase itself, the chances of rejections shrink to a great extent. The claims process can be made smoother when crucial information fields (such as Subscriber ID, NPI no) are made mandatory in the process of onboarding. Carestack offers a suite of tools that work to minimize errors due to missing data.

In the CareStack system, crucial data fields are required to be filled before proceeding to payment or claim creation. This includes the patient’s complete name, date of birth, SSN, subscriber ID and so forth. CareStack’s comprehensive eligibility forms ensure that every single detail about the patient’s insurance plan is captured as a part of rejection prevention.

During onboarding, the CareStack support team facilitates provider credentialing and initial set-up of all the codes and rules.

When it comes to denials, the lack of supporting documentation, data inaccuracies, improper dental coding, and untimely filing of 

 are seen to have the most profound effect. Another aspect that affects denials is the change in regulations and policies in claim processing.

Features such as code-level rules allow the user to assign a date of service to the procedure code, which automatically renders the code invalid on expiry. Age restrictions can also be implemented using the same rules. Additional documentation like x-rays, charts or EOBs can be made mandatory for specific codes to aid in better claim processing. Eligibility rules, once set up by the user, monitor the frequency of code usage for specific procedures. CareStack’s features are built for denial prevention. Rules assigned during set-up flag expired procedure codes and alert users trying to check out them.

CareStack employs Care Audit Rules, a system-wide rule manager that can suggest alternative procedure codes and prompt users with informative messages on checkout. The built-in document manager can be used to upload, save, and organize crucial documentation that can be attached to claims using technologies like NEA FastAttach.

The CareStack Impact

Reducing billing hassles and ensuring clinical efficiency come from a well-organized claim management system. CareStack is 

 in the market, helping you to achieve clean claims while easily providing the status of all your dental insurance claim processing without the time and effort to create external spreadsheets.

Clean Claims in Dental Practice Management

What You Need To Know About Clean Claims in Dental Practice Management

For a dental practice, revenue cycle management is the equivalent of the body’s circulatory system and the heart of a practice’s financial success. In fact, its success can be defined by the time taken to collect payments while ensuring a smooth billing process from the moment patients schedule a visit.

From a dental RCM perspective, a healthy system works in concert with industry best practices and technical solutions that help identify leaks and improve operational workflow. But as every practice is unique it is difficult to prescribe a “one size fits all” approach. Therefore, there are key performance indicators that can and should be followed to measure the dental billing and coding performance of a practice.

The revenue cycle incorporates data capture, claims and denials management, and the

collection of payments from both patient and insurance receivables. Basically, it lets you keep your receivables and aging organized with many automated tools to improve revenue and reduce costs.

Within Dental Revenue Cycle Management, several potential KPIs provide valuable insight into the collection’s performance and the financial health of the practice. These include, but are not limited to, Collections percentage, production growth, Aging accounts receivable, Days sales outstanding, Adjustments percentage, and Credit Balances. At the end of the day, the ultimate goal of any practice is to generate revenue appropriate for financial stability and continued growth.

Understanding the cycle as a holistic and comprehensive view of a 

 is the first step in developing the strategy to respond. Therefore, a healthy revenue cycle management strategy enables practices and providers to

 Identify gaps and employ proactive measures to reduce the time spent collecting past-due balances and get paid faster. 

Gain financial control over your practice

 Monitor and manage all areas of the practice, thereby establishing standards and benchmarks required for collective action if required. 

 Streamline and automate tasks, saving time on administrative duties and leading to effective patient care.

CareStack’s practice management platform is built to help growth-focused practices run their revenue cycle management operations smoothly and efficiently. With integrated features for credit card processing, electronic claims attachments and auto posting of claims, CareStack helps your office to streamline your RCM operations better than all other software.

Identifying and resolving leaks in the Revenue Cycle

When a dental practice is leaking revenue, issues need to be identified and resolved promptly. Both clinical and administrative processes can lead to revenue loss. Therefore, understanding the entire revenue cycle in a complete and thorough way is the first step in creating a strategy to address these issues.

Here is a short guide to Dental RCM and how to resolve leaks within your revenue cycle:

With changes in the healthcare landscape, network participation is becoming more necessary. It is also the area that produces among the highest claim rejections, often as a result of lapses in licensure, missing documentation, or failure to meet filing deadlines.

When performing such a repetitive task, it's common to transpose a number or transcribe a name incorrectly. A simple mistake can lead to significant issues over time, resulting in processing delays and lost revenue. Everyone at the practice should understand the importance of data in an environment that prioritizes quality over quantity.

With more than 80 per cent of patients covered by some form of dental insurance, it is critically important that a practice employs comprehensive verification processes. Capturing insurance demographics, plan coverage details, and eligibility specific to each patient is the gateway to optimizing a practice's reimbursement potential. Proper carrier and plan setup, including fee schedule attachment and limitation or exclusion details, ensure accurate fee estimation and secure the trust of your patients.

Often overlooked or disregarded altogether, coding and charge-outs play a significant role in the revenue cycle. As each dental procedure code is specific to the diagnosis, proper understanding of Current Dental Terminology (CDT) is vital. Accurate charge-outs result in clean claims, which ultimately results in faster reimbursements and fewer denials.

Maximizing reimbursement potential extends beyond complete and accurate claim forms and avoiding common data entry mistakes. It requires a fundamental understanding of how insurance companies receive, process, and pay claims. Many procedures require the attachment of supporting evidence, including radiographs or clinical photographs, periodontal charts, narratives, or other relative reports or findings necessary to review and determine clinical requirements.

Payment posting in today's landscape is more sophisticated than ever. It requires knowledge of complex technology, downloading and reconciling reports from multiple platforms, and capturing EOBS from various sources. Many of the issues in the revenue cycle can be prevented or resolved with accurate payment posting and the lessons learned from payment and denial trends. The ability to identify reasons for line item denials or differences in expected reimbursements is the first step in preventing them in the future.

While denial management has become an expected part of day-to-day operations, working denials is a tedious and time-consuming task that is subject to timely filing constraints. Failure to measure denial rates, identify trends, and analyze the root cause for common denials leads to a cycle that unnecessarily repeats itself. "An ounce of prevention is worth a pound of cure."

The likelihood of accounts receivable collections decreases as the balances age. When you consider the staff time, mailing, and supply costs associated with collections efforts, the total revenue lost is more damaging to the practice than the actual charges. It is essential to have a process in place that automates the recovery process and alerts users to take action to minimize the amount of time it takes to secure payment.

With many moving parts and claims undergoing processing every day,

real-time insight is essential to identifying gaps early. The longer an issue moves through the cycle, the harder it is to recoup the time and financial resources lost in the attempt to recover. Consistent monitoring of the trends and financial performance allows a practice to learn and resolve the root cause of issues in the revenue cycle and develop strategies to influence positive change.

CareStack’s unique opportunity miner module helps you quickly identify patients who owe you money, and helps you reach out to them via text or email to collect outstanding debt.

Successful claim submission and faster reimbursement

While insurance rates, reimbursements, or limitations should never influence clinical diagnosis or quality of care, it is crucial to understand what is needed for insurance to process a claim and get paid the first time.

Filing electronic claims with attachments results in faster processing. All dental insurance claims need to be verified to contain accurate information, including carrier name, address, group number, and payor ID.

Radiographs should be clear and of diagnostic quality, ensuring that the entire crown and root are visible and pathology is evident. Pre and post-operative X-rays should be sent for the following procedures:

Periodontal charts need to have the following details:

Dental Revenue Cycle Guide for Dental Professionals

A Beginner's Guide: Revenue Cycle Management for Dental Professionals

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