Unpaid Dental Insurance Claims Over 30 Days
Unpaid dental insurance claims over 30 days are overdue! I know there are insurance companies who are slower than others to process claims. But 30 days is enough time for a dental claim to process. Especially in our speedy technology era. Hopefully, most of our dental claims go out electronically with any necessary attachments. And we are able to even receive our payments electronically. Not that these electronic payments don’t come with our own challenges and requirements! However, it’s worth it to have the payments automatically deposited for us.
Where we have the technology available to us, let’s put it to good use. And let’s work on getting claims paid within a 30 day window of time. There may be a few claims that roll over into the “over 60” day category. But there should be very few! And if there are any unpaid dental insurance claims over 90 days, there’s a systems problem! But don’t worry. We can fix that!
Start With Oldest Claims First!
Most dental insurance companies have a time limitation from the date of service. And for most of our dental plans, the time period expires one year from the date of service. However, there are insurance policies and companies that only give us 90 days to follow up and resubmit a claim. Which is just one more reason why we want to start working on unpaid claims well before 90 days.
Plus, we’ll add more processing time to any claim re-submission. And if a claim was denied and we just didn’t know that, we have to now explain to our patient why they are now receiving a statement so many days for their visit with us. If it’s been 90 days or more since our patient was in the office, this is a bit embarrassing. And the patient may have even forgotten they were in to see us!
Unpaid Dental Insurance Claims Calls
Unpaid dental insurance claims may require follow-up phone calls. I have found that many insurance websites give us the ability to check the status of a claim. And many times this gives us some very basic information. However, we may not find the details we need on the claim. But we may be able to tell if the claim was received. Or if the patient was even eligible on the date of service in question.
Before we pick up the phone to make the first call, it is helpful to check on some basics first. Is the patient identification number and date of birth correct? Do we have the correct insurance claims address or payor identification number? Does everything on the original claim look correct? And are we sure the claim ever went out? Because sometimes our claims get batched electronically and don’t ever make it out. Or we can even find several claims with the same date of service that aren’t paid when they should be. And some funky technological glitch happened. Just one more reason to check on our claims at the “over 30 day” mark!
Be Prepared – What To Ask
So, let’s say we are ready to pick up the phone and make the call. Be prepared ahead of time with a note pad and information about the original claim. You will also want to have the dentists’ NPI and tax id# handy. As the dental insurance representative will have lots of questions for you. And you won’t get anywhere without the NPI and tax id# of the dentist or practice.
In addition, you will need the patient’s name and date of birth. As well as the subscriber’s name and date of birth. And then the subscriber’s identification number. Sometimes you can use a social security number. So, if there is some trouble with the identification number, try the social security number if you have it! And once you have made it this far, here are some questions to ask:
- Was the claim received for the date of service in question?
- If no – ask if the claim can be resubmitted by email or fax to someone specifically – and confirm the claims address & payor id#.
- If the claim was received – ask when the claim will be processed or if there is additional information needed on the claim
- make a note of the date you made the call and who you spoke to as well as the outcome of that call on patient’s account.
Unpaid Dental Insurance Claims Add Up Fast!
Unpaid dental insurance claims can become a receivables problem very quickly. So it’s important to stay on top of and be aware of what is happening with the unpaid claims as a whole. It is an area that can suffer when new dental administrators come into the practice. And it’s not their fault. There is only so much a person can learn and manage all at once.
Therefore, it’s a great idea to have other team members who can manage this task too. Cross-training is always a great idea! Because unexpected things do come up for us as individuals and as a team. And it’s always a smart idea to have dentists and practice owners review receivables reports and unpaid dental claims reports as well. Not because we are looking for problems. But we need to be aware and to understand exactly what is happening in the business.
Review Reports Weekly
Month end reviews are great! And we want to look at our month end numbers and compare them to previous months and quarters.
But we also want to look at our receivables reports at the beginning or end of each week. If you are not used to looking at these reports each week, you will soon find it very helpful. And numbers, questions and problems will begin to jump out at you once you are familiar with them.
Keep reports in a folder from week to week in a folder for that month. It may be helpful to make notes directly on the report that you can reference later if you need to. I know you may not want to keep a lot of paper. But these are just one or two sheets of paper for you, I hope! However, if you find your reports are difficult for you to understand or you fear they are out of control, I’m here for you. Please let me know how I can help.