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How to Do Dental Billing the Easy Way

Patrycja DeGradi

Patrycja DeGradi

Team Leader Director

Picture the scene: You’ve just completed treatment for a patient, and your hardworking, diligent front office staff have quickly and accurately submitted a claim to the insurance provider; only, it comes back denied. What happened? The myriad of reasons used to deny claims is nearly as complicated as learning how to do dental billing itself. Now you’re stuck talking to a brick wall of insurance representatives until someone can see the light and get your claim paid. Imagine if you weren’t having to fight tooth and nail for overlooked narrative mistakes or unforeseen gaps in insurance coverage. What if there was an easier way to help you save time and money?

Why are my dental billing claims being denied?

Whether you already know how to do dental billing or you’re just starting out, knowing the basics of claim denials and rejections is incredibly helpful in maximizing reimbursement and collecting 100% of what you’re rightfully owed. You can find solutions that help by implementing best practices as well as beneficial operating procedures, your office can come out ahead with more accurate and credible reimbursement claims.

Problem: Inaccurate or incomplete information

Completing patient treatment is just one part of the process. What comes next is the most valuable in terms of whether or not you get your money. If narrative claims are left unchecked, unfinished, or unclear, they’re denied. Oftentimes, something as simple as name-matching or a misspelling will warrant a denial, which is not something you can afford to spend more time on once it gets back to you.

Many practices just don’t have the manpower or the time to pursue unpaid claims of a small nature (under $200), leading to a consecutive buildup of unpaid, uncollected claims that leave money out of your pocket. Plus, what’s the point of spending hours training staff on dental billing codes that might be obsolete next year or even next month? Having to keep pace with industry trends isn’t the job of your staff members: it’s to ensure that your clients are given the perfect patient experience, each and every time they walk into your practice.

Solution:

While we’re learning how to do dental billing, it’s helpful to notice that the list of steps to getting a claim paid isn’t too long, but requires dedicated attention and special processing in order to ensure that it is collected:

  • Ensuring clinical notes aren’t vague and accurately describe the treatment in detail
  • Verifying patient benefits prior to treatment to ensure their benefit plan covers procedure costs and accurately defines their payment portion
  • Matching relevant codes with narratives

Always double check that your patient’s info matches what is provided by insurance, and instead of simply changing it on the claim form, also correct it in your practice software so subsequent claims don’t have the same issue.

Problem: Excluded or non-covered services

Some dental procedures may not be covered under the patient’s insurance policy, and if the claim is for such services, the insurance provider may deny the claim. This can happen if the patient has reached the maximum coverage limit for a particular procedure, or if the procedure is not covered under the policy at all. For example, a dental implant was a covered benefit, but the claim was denied because there was a missing tooth clause, and the tooth being replaced had been extracted prior to the date of coverage.

Solution:

Insurance eligibility verification should be your primary focus a few days to 24 hours before an appointment. Plans can change drastically in a matter of weeks between a booking and the appointment itself, and any limitations or exclusions should be known prior to providing treatment. Without doing so, you and your patient can be saddled with a surprise bill costing hundreds of dollars. When you take the time to offer an accurate portrait of your patient’s benefits, they’re more likely to accept treatment as well as pay their portion.

Problem: Not sending clean claims

There’s a simple rule for how to do dental billing the right way: There’s no such thing as too much supporting documentation. This means we need to think like a pack rat when it comes to intraoral attachments, charting, and the doctor’s notes during and after treatment. The basics of a clean claim start with the basics of making sure that everything being reimbursed has been accounted for.

eAssist Dental Billing blog dental claim tips documentation

Solution:

Use narrative templates to ease the burden off your staff in getting claims reimbursed.

How do I reduce dental billing claim denials?

Even with all the advice in the world, you still need a plan to implement these crucial tips to maximize your collections and reduce denials. Here’s an example to help guide you to building better claims::

  • Always check patient personal info against their EOB
  • Perform an insurance verification check prior to service and benefits breakdown for the patient to understand their copay and benefit coverage for treatment
  • Be aware of the proper treatment codes and any coding additions, deletions and revisions (Most PMS updates will give you updated code additions but not any deletions or revisions, that has to be done manually)
  • Always use treatment narrative templates to ensure that the most accurate information is attached to the claim

Dental billing training and implementation doesn’t need to be difficult. When your office needs 100% of what you’re rightfully owed, you’ll turn to eAssist Dental Solutions to help you get there. The eAssist platform was created by dentists for dentists, and when you outsource the dental billing process to us, your staff never need to worry about code updates or claim submission. Our achievable goal is getting your over 90 accounts as close to zero and keeping it there. Learn how by scheduling a call with us at your convenience.

how to do dental billing the easy way

Patrycja DeGradi

By Patrycja DeGradi

Team Leader Director

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