Have you ever had a hard time getting your dental insurance claims paid on the first submission? Payment delays hurt your cash flow. And if denials become unexpected bills, patient satisfaction goes down too. Fixing snags in the claims process can help you say goodbye to these issues.
Let’s retrace your steps. What simple fixes could speed up payment on dental insurance claims? There are several common mistakes dental professionals can make when submitting claims. And the reason they’re common is that they're so easy to make. So no need to be hard on yourself.
Fortunately, improving your claim submission process can be a huge win for your cash flow. At DCS, we work with you to produce easy revenue collection. We’ve been providing claims processing solutions for over a decade and we’ve seen claim denials for all kinds of reasons.
That’s why we’re writing this article on the most common errors when submitting dental insurance claims. When you understand what mistakes dental billers are making that lead to claim denials, you can know how to avoid them. This will lead to higher insurance collections and a steadier stream of income for your practice.
1. Choosing the wrong insurance claim form
There are really only two types of claims you’re likely going to choose from: Medical or dental.
And occasionally, depending on the patient’s treatment, you might need to file a medical insurance claim and a dental claim. This typically happens during oral surgery, trauma (broken jaw, broken tooth, or teeth), and/or pathology.
In these cases, the Medical insurance would be filed as primary and the dental as secondary claims.
Related: 3 times a dentist should file a medical claim versus a dental claim
When in doubt just call the medical and dental insurance companies to confirm which to send to, in which order.
This is where your knowledge of Coordination of Benefits is very useful. This leads us to our next mistake in claim submission.
2. Filing claims in the incorrect order
When a patient is covered by multiple insurance plans, you have to know which will be primary, and which will be secondary when filing their claims.
We understand that COB (Coordination of Benefits) is a tough topic for many dental professionals. It’s several rules with so many conditions that change the order in which to file insurance claims. And keeping up with these rules is a challenge.
But filing claims in the incorrect order will lead to a really quick denial from insurance companies. This means a delay in the money you are owed.
The only way to avoid this is to educate yourself on COB rules and try to memorize them as best you can. You can always refer to resources to help you remember when to file primary or secondary claims.
The video above will help you understand the 10 standard COB rules that every dental professional should know.
3. Filing without necessary attachments or supporting documentation
Attachments and supporting documentation are key for submitting clean insurance claims. Why? Because they are proof that the services you provided were necessary.
Attachments and supporting documents come in form of:
- Clinical notes such as SOAP notes
- X-rays and intraoral photos
- Narratives
- Dated Periodontal Charting
- Radiographs
- Specialist letters
- Pathology reports
- Previous history of SRP or Osseous surgery with dates
These are your medical evidence that your patient needed treatment at your practice. And therefore you will need to be compensated by the insurance company for it. There are different attachments required for different procedures, as well as procedure codes (CDT).
Keeping up with when to attach what can be a challenge, which is why this error is made easily. We have a chart for common procedures and their needed attachments in our Learning Center.
This can be a good reference for how to handle your supporting documentation and attachments. You can also take our DCA course on Clinical Documentation and Recordkeeping to have a better understanding of how attachments affect your insurance claim submission.
4. Not submitting claims within 24 hours after they are created
A best practice for dental insurance claim submission is to submit claims within 24-48 hours after they are created. This will ensure the claim information is still fresh in your mind, but also it’s crucial that you have quick turnaround times on your claims so that you can get paid ASAP.
Dental insurance can take weeks to approve and reimburse your insurance claim. To keep this turnaround as short as you can, you need to submit your claims fast. Doing this quickly does require expertise on handling claims. We understand if this is challenging, but your income depends on it.
Related: How to close 90% of your claims fast: 3 ways a dental biller helps
Don’t let claims sit in your software without being submitted. The longer they do sit there, the more likely they are to be forgotten about. This can lead to a huge hit to your cash flow if it happens often enough. And you need that cash flow to keep your practice running.
So make sure that your claim submission process handles all claims promptly.
And ideally, submit that claim within 24 hours after the day sheet has been reviewed by the provider.
5. Rushing through data entry
You know how we just said your claim should be submitted fast? Well, not so fast that you make careless mistakes!
There is a lot of data entry required when creating insurance claims. And this is the biggest mistake of all because it’s so easy and anyone can make a data entry error. From the patient’s birthday to their insurance number, you need to be sure all of this data is correct. Take time to double-check patient and claim data for accuracy.
The best way to avoid being rushed when entering insurance claim data is to have a dedicated biller working on your insurance billing.
When someone on the administrative team is handling creating claims but also has several other responsibilities, rush jobs can happen more frequently. And can you blame them? It’s all very time-consuming! And important.
So, if the person creating your claims can’t dedicate their day to claims alone, maybe it’s time to find a billing solution.
Avoid claim submission mistakes by outsourcing your insurance billing process
Claim submission, and claims work in general is time-consuming. And if your team is short-staffed or pressed for time, mistakes are more likely to be made.
Knowing the 5 common errors when submitting claims can help you take steps to avoid these errors in order to be paid by insurance in a timely manner.
Finding the issues is one thing. You may also see that no one has the time to fix them. Does this sound like your situation at all? DCS claims processing service helps teams stay patient-centered and give them the necessary support to collect on claims. Our expert billers know how to avoid these mistakes to get your practice cash flow you can count on.
To learn more about our billing solutions, schedule a call with one of our billing experts.
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