Getting Dental Claims Paid Within 30 Days
Getting dental claims paid within 30 days is always my goal! Accurate data entry is the first step. One wrong key stroke, and it’s a claim denial. If I hear anything back at all. Because sometimes insurance carriers don’t even let us know there’s a problem. And I also know the patient’s eligibility. As well as their benefit information.
Benefit verification and patient history is a must. And we have the technology to speed this process. Fabulous! Although a phone call is sometimes necessary. But will be less time consuming. Because we have the basics. And might have just a question or two.
Include Supporting Documentation
Then, of course, let’s discuss supporting documentation. X-rays, photos, narratives, and even history are helpful. And keep in mind, it must be supportive. Or what’s the point? Explain in concise, descriptive language. Imagine the insurance processor knows nothing about this tooth or treatment. Because in reality, they do not. Only what we share is known.
There is no guarantee of payment. That’s the tough pill to swallow with dental benefits. Some insurance claims are easy to see process. Such as an adult or child prophy. But that’s the only truly easy one. And every insurance plan and policy is different. Yet, there’s one more thing I can offer you to consider.
Enlist Your Patient’s Help
For every claim over 30 days, bring your patient into the mix. Of course, call on that unpaid claim first. Be sure the insurance company has the claim. And that the office has done everything correctly. But then, bring the patient into the journey. Let them know the insurance company didn’t receive the first claim submission. And the claim has been resubmitted.
If there is an issue, advise the patient right away. Especially if the claim is under review for some reason. Or if payment is denied because the insurance decided treatment wasn’t necessary. Or that a less costly treatment option was ignored. Encourage your patient to call and to bring their human resource person on board too.
Getting Dental Claims Paid Takes a Village
Sometimes, the squeaky wheel gets the grease. Make some noise and be heard. But don’t carry the load by yourself. This is your patient’s benefit, after all. There is no guarantee of payment by insurance carriers. Really ever! It’s a phrase we hear over and over and over again. We don’t get to decide when a payment is justified. Even if it seems the right thing to do.
The right treatment isn’t decided by third party payors. Any more than payment is decided by dentists. However, we can work to bring our patients alongside us in the journey. Just be sure to prepare patients before treatment begins. That’s where the foundation is laid. Let patients know that dental insurance companies may provide a benefit. The dental office can estimate based on the information available.
Then encourage patients to also check on their benefits. Promise to provide patients with the best care and treatment. And that you submit claims with all supporting documentation, x-rays, photos, and narratives. Inform patients that the team will stay on top of all unpaid claims. And will let the patient know of any unpaid claims over 30 days. Pause. Then ask the patient if they are ready to move forward with treatment. With a better understanding of their role in treatment and claim management.
(Amazon Affiliate Link)