Dental Insurance Claims Don’t Have To Get You Down!
Dental insurance claims are a necessary evil in most dental offices. I say evil, because they are time sucking little devils. They can steal our energy and even our good mood some days. Dental insurance claims don’t have to get you down! Stay consistent & persistent to see the best results. Put more energy into information gathering in the beginning of this process to avoid delay in payment at the end.
Some people say ignorance is bliss. I think it is best to know exactly where you stand. Don’t be fooled into thinking your accounts receivable is okay. Check your numbers to be sure! Don’t wait until you are in deep!
You want to take a look at your average monthly production and your total accounts receivable. If your total accounts receivable (including all outstanding insurance claims) is less than your average monthly production, you are in good shape! If not… you have some work to do) ! No worries. As there are many great tools to help you here.
Prevention Is The Best Plan
How do you keep yourself from getting into trouble in the first place? Start by collecting great information about your patient’s insurance company and their individual benefits first! You may want to download this Insurance Verification Form and customize it to suit your dental practice needs.
Details matter when we are collecting a patient’s insurance information. I have found that insurance company representatives are not always forthcoming with information that would be helpful. The dental office must take the time to ask specific questions about frequency and limitations. Remember, the insurance company’s only purpose is to make money!
Once you have gathered the insurance information, you need to enter it into your computer system. It might sound silly, but be careful here. Typing in the wrong member id# or payor id# will result in a delay in payment.
It might also lead to a phone call you don’t want to make to the insurance company. Double check it all! I also recommend scanning any benefit information you gather into your patient’s file. The more back-up the better!
Dental Insurance Claims Over 30 Days
All dental claims over 30 days deserve a follow-up phone call. Don’t just resubmit the claim. If something is wrong with the claim, you are just resubmitting the same wrong information. Call the insurance company to see if they received the claim. Sometimes, they even deny the claim but never send the denial.
Recently, I called an insurance company to check on a claim that was over 30 days out. The insurance representative told me the claim had been denied. (No denial had been received) When I asked the representative why the claim was denied, she reported that there was another carrier listed as the patient’s primary insurance.
The patient was a minor. I called her mom who said there was no other insurance carrier. She would call her dental insurance and clear it up.
Ten days later I called the insurance company again. I asked if the claim I had called about was not being processed. The insurance representative told me again that there was another insurance company who was the primary. We referenced my previous phone call.
The insurance representative assured me there was another company who was the primary carrier. And they said that Mom was also aware of this.
There Are Important Details Patients Don’t Understand
I called Mom back again. Mom was frustrated and told me she had talked to her insurance company and cleared it all up. Yes, there was another insurance company that was primary. She didn’t realize it. Dad had dental insurance for their daughter too. He just didn’t tell her.
Mom didn’t realize she had to tell me this information so that I could submit the claim to the correct insurance carrier.
If I had waited and not called on this claim, who knows how long this could have gone on!