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Streamline Dental Insurance Verification with Memberships

December 02, 2024
Written by: Jordon Comstock

In today’s fast-paced dental practices, managing dental insurance verification can be a significant administrative burden. Dental insurance verification, especially for PPO (Preferred Provider Organization) plans, requires meticulous attention to detail, frequent communication with insurance companies, and substantial time investment. This administrative load often distracts from the primary goal of providing high-quality patient care. However, a growing number of dental practices are finding a solution through the implementation of membership plans. These plans, particularly when managed using tools like BoomCloud, can streamline administrative tasks, boost profits, and enhance patient experience by reducing reliance on PPOs. In this article, we will explore the pains of PPO administrative work, the benefits of membership patients, and how BoomCloud can revolutionize your practice.

The Administrative Burden of PPOs

Time-Consuming Processes

Dental insurance verification for PPO plans is notoriously time-consuming. Staff must continuously verify patient eligibility, benefits, and coverage details, which involves navigating through complex insurance policies and often being placed on hold for extended periods while communicating with insurance providers. This process can detract from the time and attention that could be better spent on patient care.

Frequent Errors and Miscommunications

The intricate nature of insurance policies often leads to errors and miscommunications. Inaccurate information regarding coverage can result in unexpected costs for patients and additional administrative work to rectify mistakes. These errors can harm the practice’s reputation and erode patient trust.

Financial Strain

PPOs often pay less than the usual and customary fees for dental services, leading to lower revenue for practices. This financial strain is compounded by the overhead costs associated with managing PPO administrative tasks. As a result, practices are compelled to see more patients to maintain profitability, which can compromise the quality of care.

Substantial Write-Offs

The financial impact of PPOs extends beyond just lower reimbursement rates. The average dental practice writes off between $36,000 to $47,000 per month due to the differences between billed charges and the amount paid by insurance companies. To understand the magnitude of this loss:

  • Monthly Loss: $36,000 to $47,000
  • Yearly Loss: $432,000 to $564,000
  • Loss Over a 40-Year Career: $17,280,000 to $22,560,000

These staggering figures highlight the significant income lost just from write-offs, which can have a substantial impact on the financial health of a dental practice over time.

Time Lost to Administrative Tasks

In addition to the financial losses, the time spent on managing PPO administrative tasks is considerable. The time that dental staff spends on verifying insurance details, handling claims, and resolving disputes with insurance companies could be redirected towards enhancing patient care and improving practice efficiency.

The Benefits of Membership Patients

Simplified Administration

Membership plans simplify the administrative processes that come with PPOs. Instead of verifying insurance details for every visit, practices can quickly check a patient’s membership status and benefits, drastically reducing administrative workload. This simplification allows staff to focus more on patient care rather than paperwork.

Predictable Revenue

Membership plans provide a predictable revenue stream through recurring payments. This stability enables practices to better manage their finances and plan for future growth. Moreover, membership fees are often higher than the reimbursement rates from PPOs, leading to increased profitability.

Enhanced Patient Loyalty

Patients enrolled in membership plans tend to be more loyal to the practice. They appreciate the transparency and simplicity of a membership model, which often includes preventative care and discounts on additional services. This loyalty translates into higher patient retention rates and more consistent care.

Improved Patient Experience

Membership plans offer patients a more straightforward, predictable way to manage their dental care expenses. Without the complexity and uncertainty of dealing with insurance companies, patients can focus on maintaining their oral health. This improved experience fosters a stronger patient-practice relationship.

How BoomCloud Can Help

BoomCloud is a powerful tool that enables dental practices to create and administer membership plans effortlessly. By leveraging BoomCloud, practices can streamline administrative tasks, boost profitability, and enhance patient experience.

Creating and Administering a Membership Plan

BoomCloud provides an intuitive platform for creating and managing membership plans. Practices can design custom plans that cater to the needs of their patients, including benefits such as free preventative care, discounts on treatments, and more. The platform also handles billing and payments, ensuring a seamless experience for both the practice and the patients.

Increasing Profits and Patient Quality

By transitioning to a membership model with BoomCloud, practices can eliminate the financial strain associated with PPOs. The predictable revenue from membership fees allows for better financial planning and investment in high-quality care. Additionally, the simplified administrative processes mean that staff can dedicate more time to patient interactions, leading to improved patient satisfaction and outcomes.

Scaling a Membership Plan

BoomCloud’s platform is designed to scale with your practice. Whether you are just starting with a small number of members or expanding to a large patient base, BoomCloud can accommodate your needs. The platform’s automation features reduce the administrative burden as your membership base grows, allowing you to focus on providing excellent care.

Verification Process for Membership Patients on BoomCloud

One of the standout features of BoomCloud is its straightforward verification process for membership patients. Here’s how it works:

1. Login

To begin, practice staff simply log into the BoomCloud platform. The login process is quick and secure, ensuring that only authorized personnel have access to patient information.

2. Go to Members Section

Once logged in, staff navigate to the “Members” section of the platform. This section provides a comprehensive overview of all active membership patients, making it easy to manage and verify membership details.

3. Verify if Patient is Active and What Benefits They Get

Unlike complexities and time consuming task of Dental insurance verification, membership verification is 10 times easier and provides a better experience for patients.  the “Members” section of BoomCloud, staff can quickly verify a patient’s active status and review the benefits they are entitled to. The platform displays all relevant information in an easy-to-read format, allowing staff to confirm details within seconds. This process eliminates the need for lengthy phone calls and complicated insurance verifications, streamlining patient check-ins and appointments.

It’s That Easy

With BoomCloud, verifying membership patients is incredibly straightforward. The platform’s user-friendly interface and efficient processes mean that staff can complete verifications in just a few clicks, freeing up valuable time to focus on patient care.

Case Studies

Wood River Dental

Wood River Dental has successfully implemented a membership plan managed through BoomCloud, enrolling over 800 patients who pay $55 per month. This has resulted in substantial Monthly Recurring Revenue (MRR) and Annual Recurring Revenue (ARR) for the practice.

  • Monthly Recurring Revenue (MRR): 800 patients x $55 = $44,000 per month
  • Annual Recurring Revenue (ARR): $44,000 x 12 = $528,000 per year

The predictable revenue stream has significantly impacted Wood River Dental’s financial stability, allowing the practice to reinvest in advanced technologies and enhance patient care. The administrative simplicity provided by BoomCloud has freed up staff time, enabling them to focus more on patient interactions and less on insurance verifications.

Ala Dental

Ala Dental has also embraced the membership model with impressive results. They have enrolled 3,768 patients, each paying $40 per month.

  • Monthly Recurring Revenue (MRR): 3,768 patients x $40 = $150,720 per month
  • Annual Recurring Revenue (ARR): $150,720 x 12 = $1,808,640 per year

The substantial ARR has transformed Ala Dental’s operations. The financial predictability allows for strategic investments in staff training, patient amenities, and practice expansion. Patients benefit from the clear, straightforward pricing and the comprehensive care included in their memberships, enhancing overall patient satisfaction and loyalty.

Conclusion

The burdensome administrative work and dental insurance verification associated with PPOs can significantly detract from the quality of patient care and overall practice efficiency. By transitioning to a membership model and utilizing tools like BoomCloud, dental practices can streamline their administrative tasks, increase profitability, and enhance the patient experience. Membership plans simplify the verification process, provide a predictable revenue stream, and foster patient loyalty. BoomCloud’s platform makes it easy to create, manage, and scale membership plans, transforming the way dental practices operate.

Incorporating a membership plan into your dental practice not only alleviates the administrative strain but also positions your practice for sustained growth and success. By focusing on patient-centric care and leveraging innovative tools like BoomCloud, you can ensure a better experience for both your patients and your staff.


Key Takeaways

  • Time-Consuming PPOs: Managing PPO dental insurance verification is time-consuming and detracts from quality patient care.
  • Substantial Write-Offs: The average practice writes off $36,000 to $47,000 per month, translating to significant annual and lifetime losses.
  • Simplified Membership Plans: Membership plans simplify administrative tasks, reducing errors and miscommunications.
  • Predictable Revenue: Membership plans provide predictable revenue and improved financial stability.

Schedule a demo of The BoomCloud™ Patient Membership Platform and build a high quality practice with loyal patients!

My Top Podcasts

Download "The Million Dollar Membership Plan" E-book!

Learn tactics and strategies from practices that have built a million dollars in recurring revenue from their membership subscriptions alone! Creating a patient membership plan is the smartest strategy to implment in your practice. You will increase patient satisfaction & loyalty, Increase predictable recurring revenue & improve your case acceptence by 3X with members. Download the book Now!

What is BoomCloud™?

BoomCloud is a software platform that allows you to create, manage & grow your own membership program. Build unlimited plans, track recurring revenue, active members metrics. Integrate your online membership enrollment with your website & start growing recurring revenue. Schedule a demo!

Fire The PPOs With These Proven Strategies!

Discover how to break free from the grip of PPOs and transform your practice into a thriving, profitable business. Imagine better cash flow, higher profits, and stronger patient relationships. It’s not a dream – it’s a reality waiting for you.

Say goodbye to PPOs and hello to a thriving, independent dental practice. Don’t miss out – your journey to financial freedom starts here!

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Jordon Comstock

Author Bio

Jordon Comstock is the Founder & CEO of BoomCloud™, a software that allows practice, clinic & spa owners to build, manage and scale a membership program. This helps practice & clinic owners to create recurring revenue & improve loyalty via membership programs. Jordon is passionate about Music, Hawaii, Healthcare businesses like: dentistry, optometry, med spas and massage spas. Schedule a demo of BoomCloud™ and learn how membership programs can improve your business. Here are more dental books to improve your practice

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