Denied Dental Insurance Claims: Why It’s Happening, and How to Fix It

Dental insurance claims are confusing for patients and practices alike. But, prioritizing insurance claims may be the best way for you to collect what you’re owed. Not only that, but it ensures that your patients get optimal care and coverage, too. Virtual administration services with Dental Practice Enhancement can help.

Virtual administration allows you to add qualified talent to your team without drastically increasing your overhead. No need to spend time on training or showing new team members the ropes. Just highly-skilled personnel that help you focus on your true passion–your patients. Contact Dental Practice Enhancement today at (833) DPE-FOR-U or online here for information and consulting.

In today’s post, we tell you three reasons why you may be collecting denied dental insurance claims rather than revenue. After identifying the reasons behind denied claims, we’ll tell you how you can fix them for good.

Three Reasons for Denied Dental Insurance Claims

When it comes to denied dental insurance claims, there are usually three, main culprits:

Insufficient information
Slow filing
Coverage discrepancies

Insufficient Information

When your team submits dental insurance claims, they must provide sufficient information. Otherwise, insurance companies reserve the right to reject claims and send them back to your office in a quest for more information. This adds more tasks and time to your team’s agenda, and it significantly delays your rightful earnings.

Slow Filing

Your team must submit dental insurance claims at the time of service to ensure prompt payment. Delaying insurance claims may be an easy way for insurance companies to deny the claim and refuse payment. Not only that, but it makes the appeal process that much harder if you try to seek recourse in the future.

Coverage Discrepancies

You could spend years comparing insurance plans within one insurance company because plans are so variable and customizable. But, understanding your patients’ insurance plans is crucial to your practice’s success. So, make sure you know what patients’ insurance can reasonably cover before recommending treatments.

Three Ways to Fix Denied Dental Insurance Claims

Simple fixes can increase the amount of claims insurance companies accept, such as:

Appropriate information
Timely filing
Plan inspections

Appropriate Information

When submitting a dental insurance claim, make sure your team includes every morsel of useful information. If necessary, list every procedure the patient has received within the past six to 12 months for added security.

Timely Filing

As soon as the patient leaves your office, your team should be compiling insurance documents to submit to the patient’s insurance company. While same-day filing is a lofty goal for many of us, it is always best to submit claims within 30 days to ensure payment.

Plan Inspections

Never assume that one insurance plan translates to another. Always check to see if the treatment you want to recommend is covered. If it is not, try recommending the next, down-coded option (e.g. a dental bridge in place of a dental implant). This can help you get a lesser payment rather than no payment at all.

Boost Dental Insurance Claims with Virtual Administrators

The best way to eliminate rejected dental insurance claims is to seek virtual administrative services with Dental Practice Enhancement. Our remote experts have extensive training and years of experience to help you run your practice like a well-oiled machine.

Denied Dental Insurance Claims: Why It’s Happening, and How to Fix It