• Best Practices New Normal
  • Digital Dentistry
  • Data Security
  • Implants
  • Catapult Education
  • COVID-19
  • Digital Imaging
  • Laser Dentistry
  • Restorative Dentistry
  • Cosmetic Dentistry
  • Periodontics
  • Oral Care
  • Evaluating Dental Materials
  • Cement and Adhesives
  • Equipment & Supplies
  • Ergonomics
  • Products
  • Dentures
  • Infection Control
  • Orthodontics
  • Technology
  • Techniques
  • Materials
  • Emerging Research
  • Pediatric Dentistry
  • Endodontics
  • Oral-Systemic Health

4 ways to get dental benefit claims right [VIDEO]

Issue 12

If you took a poll of all the dental offices across America, their number one frustration would be the challenge of dealing with insurance claims.

If you took a poll of all the dental offices across America, their number one frustration would be the challenge of dealing with insurance claims.

Dental benefit plans don’t pay well, claims get delayed or lost in the processing, and claims reviewers will often lower payment on a dental treatment by paying an alternate benefit.

Filing claims and receiving reimbursement for them has remained a frustration for decades. 

Here are some necessary strategies to do it right so, you don’t have to do it over:



Get the correct information in the right order. When a patient initially calls the office, always ask relationship-building questions such as “Who may we thank for referring you?” and “Who was your previous dentist?”   This lets the patient know you are more interested in them and their dental care. Then, when they inform you they have dental insurance … congratulate them. This is now the perfect opportunity to inform them of your guidelines.   Be sure to collect the estimated balance due at each appointment and that they are responsible for all balances regardless of outcome of insurance payment.  


Involve the patient in each step of the process. Always reassure your patient you want to assist them in getting the optimum result.  This is why you partner with them.   

  The more your patient knows about their dental benefit plan, the more they are able to help you help them resolve claims. Ask the patient to bring a copy of their dental benefit book and dental benefits card to their first appointment.   


Be accurate. This is where dental practices stumble the most. Make sure you mark the appropriate boxes on major claims. Most dental benefit guidelines are very specific on what is required to accompany a claim on major dentistry.  


Finally, track your claims. Every computer system has a report you can generate to track claims status. If you accept assignment of benefits, you must track your claims.

They will not pay themselves and the insurance company won’t contact you to let you know the claim is past due. Print the outstanding claims report monthly and track it as often as you have an opportunity. It is impossible to keep up with outstanding claims if you don’t make the time to do it.




Related Videos
Process of Care Workflow and Repairing Early Caries with Guided Enamel Remineralization
Addressing Unmet Needs in Early Childhood Oral Care - an interview with Ashlet Lerman, DDS
Mastermind Episode 33 – Charting the Course for the Future of Dentistry
CDS 2024 Midwinter Meeting – Interview with Debbie Zafiropoulos, who discusses a trio of new infection control products from Armis Biopharma.
2024 Chicago Dental Society Midwinter Meeting – Interview with Peter Maroon, business development and sales lead at Spectrum Solutions® on the new salivary diagnostic test, SimplyPERIO.
CDS 2024: Ivoclar's e.max ZirCAD Prime Blocks with Shashi Singhal, BDS, MS
CDS 2024: Diving Deep on J. Morita's New Root ZX3 & HF Module
CDS 2024: What's New at TAG University? with Andrew De la Rosa, DMD
CDS 2024: Breaking Down Barriers to Care with Eric Kukucka, DD
© 2024 MJH Life Sciences

All rights reserved.