Dental Claims Over 30 Days Need Attention
Dental claims over 30 days may not seem overdue. But consider a few things first. We send most of our claims electronically these days. And hopefully you send your claims every single day. So, the claims arrive the same day they leave. And insurance companies typically process claims electronically. At least for the most part. A few claims may require some additional attention from the insurance company.
Claims will even pay out electronically. And as great is this may seem, comes with its own headaches. Although your money gets to your bank account sooner, I’ve seen some challenges. For example, you may see a deposit with no explanation of benefits. And you may have no idea where this money came from. So, this creates a problem on the other end. You must track where the money came from.
The bottom line is claims can and should be paid within 30 days. If a claim is taking longer than 30 days, there is a problem. Now, I know there are insurance companies that are not this prompt. And they just don’t pay within 30 days. But we typically know who they are. And all of our claims out to this company may be unpaid after 30 days. These claims still need to be checked. As you still want to know they are in process.
Call On Dental Claims Over 30 Days
There are a couple of reasons to call on these unpaid claims. The most obvious reason is that we want to get paid now! This is your money! Whether you own the practice or work for the practice. This is your money. Services were provided and need to be paid. The longer you wait, the longer you wait. No one likes to wait to get paid.
The goal is always 100% collections. And to avoid a roll-over. We certainly don’t want to see any claims roll-over into the over 60 or over 90 day category. Let’s get those unpaid claims taken care of while they are still in the early stage. And it’s so much easier if there is a problem to get it fixed now. The longer it takes to identify a problem, the harder it can be to get it fixed. Especially if there is a problem with patient eligibility or an issue like that.
When Do We Work On Dental Claims Over 30?
In my Weekly Management Systems, we work on this particular group of unpaid claims on the 3rd Wednesday of the month. And if you haven’t yet seen my Weekly Management Systems, today is your day! Trust me! You want this system. It grew over time. Time with dental coaches and consultants. And with education and training. I’ve taken the best information and systems. And created Weekly Management Systems for the dental front office myself. And used it everywhere!
How Do We Access Dental Claims Over 30 Days?
Every dental software is different. Reports vary from one system to another. But ultimately, you need the insurance aging report. And once you have this report in hand, you are ready to go! It really is that simple! No matter what software system you use, this is the easy part.
Insurance aging reports contain lots of information. And you might even find claims you can eliminate right away. This is especially true if you haven’t looked at your report in a while. Or maybe this is your first time. As a new team member this could be possible. Or if you are new in this position. There might be some initial clean up necessary.
You might see claims with a $0 dollar amount. I’ve seen this too. An office may send crown seat claim with a $0 charge. Or you may find missed appointment fees. Any number of things are possible if this is your first visit. Hang in there.
Focus only on the over 30 days. Remember to focus. Let’s visit only the over 30 days today. And yes, the goal is to get through the entire over 30 days column in one day. But we want to work on this early in the day. Shoot for morning time. And you need to consider time zone changes. You may need to call an insurance company in another time zone.
What To Say To Insurance Representatives On Dental Claims Over 30 Days
Now it’s time to pick up the phone. And we want to start at the top of our list. Then call through one by one. You may have an insurance aging report that gives you almost everything you need. It may in fact give you everything you need to call insurance. But just in case, prepare yourself. Bring up the patient account and insurance information.
Keep a notepad handy. And make notes as you go. Take a clean sheet of paper for each call. Write the date and time as you call. Then write your patient’s name. A small legal pad is a great idea! And you can flip pages as you make calls. If you have the ability to scan, you can scan the notes into your patient’s chart. Or you can make notes on the claim itself in your software if you prefer. Or any other location that serves you well. Just be consistent in where you put these notes.
The inquisition begins! Once you reach someone and answer their questions, it is your turn. You first want to just ask if they have received a claim. Provide all of the information they request. Usually this will include the patient ID#, name, date of birth, etc. The insurance representative will guide you along the way. And remember, ask if they are in receipt of the claim in question.
No Claim On File
The insurance company say there is no claim on file. Drat! That means something is wrong. The insurance representative tells you the patient is eligible. However, they have no claim for that date of service from you. So, let’s run through a list of questions.
- What Is The Claims Address?
- Is The Payor ID Correct?
- Verify Member ID & Group#
Make any necessary corrections. If there is a correction to make, do so. Then delete the existing claim. Resend a brand new claim with the corrected information. This step is critical. Then make a note. You want a note that tells you when the claim was resubmitted. And why the claim was resent. Note if you had the wrong ID# or claims address.
What if everything is correct? Then let’s try again. But ask if a claim can be sent by email. Or if there is a fax number of someone you can send this to. This is great if no x-rays are needed. If not, then resend your claim. Either way, make a note as to what you do. And also make a note to call on this claim again in 10 days. In 10 days you want to make sure it was received. Do this on a calendar or whatever “To Do” list you use to keep yourself on track.
The Claim Is In Process
Great news! That unpaid dental claim is in process! Whatever that means. Only the insurance company knows for sure. But there are a couple of questions we can ask. Claims do get stuck. Don’t ask me how. But I know they do.
- When can I expect that claim to be paid?
- Is there any additional information needed to process this claim?
- How soon should I check back?
Because you are going to want to check back! If there is no additional information you need to provide, make a note to check back. Note the person’s name that you spoke with And whatever information you were given. If this claim does get stuck, you want some back up to show you have called. And you may need this information for your patient too.