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When Patients’ Dental Plans Don’t Go to Plan

Dental plans are not only supposed to help your patients financially. They are also supposed to give them peace of mind whenever they require unexpected care. So when things go wrong, it can place huge burdens on your patients, both financially and emotionally. But what if a lot of the billing and insurance problems aren’t the insurance company’s fault – but yours?

At Dental Practice Enhancement, we know that dental insurance can be incredibly complex. If you’re not properly trained in its subtle nuances, it can take the joy out of dentistry. That is why we offer administrative training geared specifically for dental offices. And if you’re feeling completely overwhelmed, you can outsource your administration to our experts!

Below are some of the most common reasons for a claim denial. If you still have questions or think your practice could use some additional assistance, contact us today!

Top Reasons a Claim May Be Denied

1. Incorrect Information on the Claim Form

It may seem like a no-brainer, but misspellings and incorrect insurance numbers are frequently why claims get rejected. 

How to avoid these mistakes?

  • Ask patients if their personal information (employer, address, insurance provider, etc) has changed since their last visit.
  • Make sure that the person processing claims can focus on this task and is not pulled in many different directions at once.

2. Incorrect Coding 

Insurance codes change every year, so it’s frighteningly easy to make a mistake. Even scarier, incorrect coding can sometimes result in a charge of insurance fraud.

Make sure you are staying abreast of the latest coding changes. And make sure that anyone who handles billing in your office is thoroughly trained in insurance coding.

3. Claims Not Filed in Time 

If you wait too long to submit your claims, dental companies may refuse to cover the services. Although most dental plans give you a year to submit claims, others may only give you 90 days. 

To avoid potential claim rejections, we recommend filing all claims within 24 hours of service.

4. Not Completing Insurance Verification 

This is one of the biggest mistakes you can make because it opens the door for so many different grounds for claim rejections. Patients may have changed dental plans without notifying you. Or insurance may refuse to cover certain procedures or certain preferred procedures (such as dental implants vs. a crown). 

Make sure that your administrative staff verifies insurance every time a patient comes into the office!

Avoid Insurance Pitfalls with Dental Practice Enhancement

If you want the best assurance that nothing will go wrong with your patients’ dental plans, consider providing financial administrative training for your team. Or you could dramatically reduce the likelihood of insurance errors by outsourcing your billing entirely!

The team at Dental Practice Enhancement has decades of experience solely in dental administration. We tailor our training and services to meet your needs and to capitalize on your existing strengths.

Contact Us to Avoid Further Problems with Your Patients’ Dental Plans

To learn more about our services or to inquire about training, contact Dental Practice Enhancement today.

Reach us online or call (833) DPE – FOR – U.

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