Nothing in a dental practice is more upsetting than learning that your dental insurance claim was rejected or wasn’t reimbursed fully. Which means you have to go back and figure out what went wrong. However, the majority of medical practices rely heavily on insurance payments, so it’s crucial to monitor claims and look into the causes of rejections, even if it is time consuming. In most cases, practices have to wait for EOBs (Explanation of Benefits) before identifying the errors or mistakes in claims. However, with proper tracking practices, we can detect errors in claims early on and take the required action to ensure that claims are processed promptly.
The claims billing process at your practice doesn’t end with successfully submitting the claims. To handle challenges like the payment of smaller claim amounts, erroneous fund redirection, rejection of the ID you have provided, and to answer any inquiries from the insurance provider, your practice needs to be actively involved in the dental insurance claim process. It is really important to keep tabs on the progress of your insurance claim, as it enables your practice to stay informed about the claim’s status and learn about any delays or obstacles that may have occurred during the claim’s processing. When checking for the status of your claims, you may come across different claim status types, and each may require different action.
Here are some of the claim statuses you can come across:
Approved
This means that the claim has been approved by the insurance provider, and all you have to do now is to wait for the payment of your claim.
Under process
This means that your claim has not yet been processed, and you need to keep a continuous check on it to make sure that it gets approved.
Details required / Issues
This means that you have to contact your insurance provider and submit the necessary additional documents so that the insurance provider can continue with the claim processing.
Rejected
This means that your claim has been rejected, and you now need to contact the insurance provider and find out the reason for the denial. You can file an appeal if you think that there was an error while processing the claim.
What are the benefits of tracking your dental claims?
Helps prioritize denials
With continuous tracking of claims, your practice does not have to wait for the explanation of benefits to take action against denials. Tracking your unpaid claims helps identify the reasons for denial, thus helping you correct the mistakes or errors and appeal claims without much delay. Tracking unpaid claims gives your practice the chance to work on them early on and prevent the claims from going unpaid.
Helps identify red flags
Continuous and thorough tracking of claims helps in identifying patterns in claim underpayments or denials. It is crucial for practices to identify internal issues or trends that might be contributing to these denials. These can be considered learning opportunities that will help avoid repeating the same mistakes that lead to claim denials.
Helps pursue appeals
Since tracking claims helps you identify unpaid claims and reasons for denials early on, it thereby helps practices submit appeals faster and much easier. Your claim appeals can be accurate and efficient with claims tracking, as it helps you identify the errors early on and fix them quickly.
Increase in revenue
Proper tracking of claims helps your practice submit claims efficiently and on time, increasing the clean claim rate and thereby increasing the overall income at your practice. It also helps in making sure that no claim goes unpaid or unnoticed. Even the ones that get denied are appealed for on time.
Here are some tips to improve the tracking of claims at your practice:
- Obtain the most up-to-date claim status.
- Work on your dental insurance aging report at least once a week.
- Keep an eye on your average monthly production and your total accounts receivable.
- Follow-up on all dental claims that are more than 30 days old.
The main aim of submitting a claim is to get reimbursed for the services provided. While promptly filing a claim with your insurance provider is essential, it’s also critical to monitor the status of your claim. This ensures that action is taken on time, regardless of the issues with your claims.
