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Top 5 Reasons Your Dental Claims Aren’t Getting Paid

Are you looking to increase your dental practice cash flow? One area of business that heavily impacts monthly production is the dental insurance claim process. A very time-consuming, tedious process, dental claims may not be getting paid due to several reasons, but almost always begins with lack of follow up with the insurance companies after submission.

  1. The dental claim didn’t make it to the insurance company.

Many times, dental claims are submitted electronically and staff don’t check to see their rejections report or if an area of the claim is incorrect. The issue lies with the quality of the information.

  1. The dental claim is missing complete clinical documentation.

Insurance companies require a detailed clinical report and narrative depending on the procedure. The dental claim may be missing narratives or x-rays, and there isn’t enough documentation on clinical notes for reimbursement.

  1. The dental claim was submitted with bad information.

Sometimes it’s as simple as poor information from the patient or a mistake inputting information on the staff’s behalf (i.e. birth date, address, social security number, etc.) Always verify eligibility information before the patient sits in the chair.

  1. The dentist’s credentialing is out of date.

If the dentist’s credentialing is out of date, insurance companies hold onto the claim. Manage your renewal closely and start the credentialing update process at least three months ahead of time to ensure ample time for completion.

  1. The insurance payment has been completed, but hasn’t been posted.

 

Often, the claim has been submitted and payment from the insurance company has been sent, but a bottleneck is created at the posting phase. This happens when staff are too busy and the payment hasn’t been recorded in your software.

As we all know, dental billing management is a full-time job. Dental Support Essentials offers a turnkey Accounts Receivable solution for your practice from insurance eligibility checks, billing, follow up, appeals, and more! Trusting experts to manage your AR will save your staff valuable time and increase your reimbursement rate. So, what are you waiting for? I’d love to connect and discuss opportunities to streamline your dental practice!