02/24/2017

Online-based practices are the way of the near future


Technology is advancing quickly here in the 21st century. As a result, dentists should take steps to upgrade the technological capabilities of their practices with internet access, up-to-date software and computers or they could be left behind.

With electronic transmittal of business and regulatory requirements becoming the norm rather than the exception, signing up to receive electronic funds transfers as a means to receive payment from dental plans is one way dentists can upgrade and take a big step into the future — which, it could be said, has already arrived. EFTs offer a safe, convenient, timely and less expensive alternative to paper checks or virtual card payments. CDA Dental Benefit Plan Specialist Greg Alterton says more and more dental plans are moving to EFTs.

“This is the 21st century and this is a growing thing,” he said. “Lots of business is being done online now. Medical carriers have been doing it for years. This is just a growth spin-off.”

HIPAA regulations went into effect Jan. 1, 2014, requiring health plans to make EFT via Automatic Clearing House available to health care providers upon request and giving health care providers the right to choose the electronic payment option for claims reimbursement. That year, health plans transferred $876.6 billion in claim payments to health care providers through 149 million EFT transactions, according to data reported by the National Automatic Clearinghouse Association.

By most accounts, dental plans prefer to pay claims through EFT and plans report multiple advantages for dental practices that receive EFT payments. Some of those advantages include faster receipt of payments, often in days rather than weeks; same-day access to funds deposited; online documentation to reconcile payments; and payments made directly to a practice's account, eliminating the need for staff to leave the office to make deposits at a bank. With EFTs, the days of checks being lost in the mail are over. Additionally, the potential for a breach of HIPAA requirements on patient confidentiality or breach of security of a patient's record is less of a concern with direct deposit.

Dental practices will ultimately save money by accepting EFTs and electronic remittance advice. Data collected from non-dental health care providers in 2014 and reported by the nonprofit alliance Council for Affordable Quality Healthcare show that the average cost per claim was $4.15 for manual transmission and just $1.11 for electronic, resulting in a $3.04 savings per transaction. Electronic transmission of remittance advice resulted in an even greater savings, with manual transactions costing $5.36 per claim compared to $1.19 for electronic.

The facts about EFTs

Not all dental practices are jumping on the technology fast track due to several “myths” about EFTs, according to CAQH, which addressed those myths with facts in an information booklet titled “EFT and ERA Overview for Healthcare Providers.” Some of those myths and facts include:

Myth – Receiving EFTs requires special equipment and a dedicated bank account.
Fact – Dental practices may sign up to receive electronic payments directly into their existing bank account. Some practices may need to upgrade their practice management or accounting software to accommodate automated posting, but it’s not necessary if a provider simply wants to receive EFTs. CDA strongly encourages dentists to contact their practice management software company and ask if there are any widgets or updates available that will help manage EFTs and claims submissions, Alterton says.  Also, while a dedicated bank account isn’t necessary, some offices may find this preferable as a means of receiving electronic payments.

Myth – EFTs are less secure than other methods of payment.
Fact – EFTs are among the safest forms of payment available. Funds are transferred directly from the health plan bank account to the provider’s bank account via the ACH Network. EFT eliminates the risk of lost or stolen checks or stolen virtual card numbers.

All this information reinforces CDA’s recommendation to dentists to update the technology capabilities of their practices. In addition to EFTs, some regulatory requirements must also occur electronically, CDA Practice Analyst Michelle Corbo explains.

“In a number of cases, it is becoming mandatory for employers and business owners to register for or obtain documents or pay taxes, etc.,” she said. “Employers especially need to keep up on the latest regulations, policies, mandates, laws, notices and postings. Most if not all of these are available for download from various state and federal websites.”

Being compliant increasingly means getting online

Without an ability to get online, or without the most up-to-date software, some of these regulatory resources are difficult to use. For example, because of the security built into the new Form I-9, which verifies the identity and employment authorization of individuals hired for employment in the U.S., a current version of Adobe Reader 8 or higher is required to view and use the form. Several notices, brochures and forms that employers must provide to new hires are also available online. Gathering and recording these documents without internet access would be time-consuming and cumbersome, Corbo says.

Additionally, as of Jan. 1, 2017, employers with 10 or more employees are required to register with the Employment Development Department's e-Services for Business and electronically file all wage reports and employment tax returns and electronically pay all contributions for unemployment insurance premiums. Under this new law, all employers are required to register and file by Jan. 1, 2018.

“With incidents of fraud and suspected scams becoming more and more prevalent, I suspect more and more of these forms and filings, which are now optional, will require online registration and reporting,” Corbo said.

Other regulatory requirements that must occur electronically include registration and use of CURES, the state’s prescription drug database that tracks prescriptions of Schedules II, III and IV controlled substances, which applies to any dentist with a DEA registration, and registration and annual reporting on CERS, the state’s environmental reporting system, which applies to any dental facility with an EPA registration.

Alterton suggests that dentists who want to upgrade the technology of their dental practice consider assigning the project to an office staff member who can research EFTs and other electronic regulatory filing requirements and develop a plan for helping the practice move seamlessly into the new online-based practice and business requirements of the 21st century.

Find practice management resources on CDA's website.



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