4 ways to get dental benefit claims right [VIDEO]

December 26, 2013

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:

 

1.

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.  

2.

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.   

3.

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.  

4.

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.