Dental Claims in Dentrix Made Easy with eAssist Dental Solutions

By streamlining your dental billing with clean, accurate dental claims you can solidify a steady cash flow for your practice.

Running a profitable dental practice is challenging enough without the constant worry over complex insurance processes, rejected claims, and other issues that prevent you from getting paid for what you produce. Have you evaluated your dental claims process? We have a tip: clean dental claims out, cash flow in. Research from the American Dental Association shows that 65% of dental practices are insurance driven, so reviewing every dental claim in Dentrix for accuracy is vital to your revenue cycle management. Keep reading to learn what constitutes a clean claim, why they are crucial to your dental practice revenue, and how you can optimize your processes to create the patient-focused dental practice you have always dreamed of.

Why are clean dental claims crucial to your revenue cycle?

Sending clean dental claims daily helps solidify steady cash flow for your practice. But what is a “clean claim”? A clean claim is a claim that meets the following criteria:

  • Claim submitted on the most current ADA format
  • Correct CDT codes listed for procedures completed
  • Correct patient and insurance plan information included
  • Claim submitted under the correct rendering provider
  • All documentation attached per insurance plan requirements

You don’t have to wait for a denial to correct a mistake. If you catch a claim that has been submitted with incorrect information, you should resubmit it immediately. Make sure to include “Corrected Claim” and the original claim number in the Remarks section of the dental claim form to prevent your clearinghouse from denying it as a duplicate claim.

What are signs that your dental claims may not be the correct format?

Insurance companies may not tell you that your claim format is out of date, and it won’t usually be listed as a denial reason on the EOB. But there are some clear signs that your dental claims are being rejected due to being submitted on an old claim format.

  • Claims are being rejected by your clearinghouse
  • Continually having insurance companies tell you they don’t have the insurance claims on file when you call to follow up
  • Aging is ballooning or out of control

The current ADA format for claims is the 2019 format. Check with Dentrix Support for possible software updates if that claim format isn’t available. Another important tip is to check with Dentrix Support to be sure you are using a compatible option for claim submission. If you are not using eCentral Claim Submission, your clearinghouse compatibility may be keeping your claims from being processed.

Does your office use a billing and coding resource?

To receive timely reimbursement on a dental claim, it is important to use the CDT code that best describes the treatment rendered. With CDT codes changing yearly, best practice is to match the CDT code with the nomenclature. Investing in current, complete and accurate billing and coding reference materials each year will improve claim reimbursement, treatment planning and more. It also opens the door for more successful appeals if the service is denied.

How do you identify holes in your dental billing processes?

According to dental coding expert, Dr. Charles Blair, approximately 33% of denied dental claims are appealed. This could be because the dental biller doesn’t have the time to appeal every denial or because they may not know when an appeal is warranted. Identifying the types of dental claim denials you see regularly will give insight into where the holes in your dental billing processes may be.

Have you considered dental billing outsourcing? You get dental billing specialists on your team that completely focus on consistent dental claim follow-up, get claims paid, and work diligently alongside Dentrix to streamline your dental practice revenue. This opens up the in-office team to focus on what matters: maximizing their important role in the office. So when a $100 claim comes back denied, the office manager that you pay $20-30 an hour doesn’t have to shift focus from patient care for 3 hours to get it paid — which is losing you money.

Optimize your clean dental claims process

There are over 20 dental billing processes and missing even one can cause unnecessary delays in reimbursement for treatment rendered. These delays put a strain on your dental practice financially, but also on the relationship with your patients. This means that the dental billing processes are just as much customer service and patient satisfaction processes as they are operational processes.

eAssist Dental Solutions is here to help. As the nation’s leading platform for remote dental billing services, eAssist hosts a professional network of dental billing specialists, who know Dentrix inside and out, to streamline the areas in your practice that are causing gaps in your dental practice revenue. While your eAssist team is optimizing your clean dental claims process and streamlining your dental billing, your office manager and front desk team are utilizing your Dentrix software to its fullest extent to schedule new and existing patients, increase treatment plan acceptance, deliver excellent patient care and a long list of other tasks that make your practice successful. The extra, knowledgeable eyes on your dental practice revenue cycle help keep you profitable and your staff focused on what matters: the patients.

Learn More

Schedule a no-obligation consultation today to see how the dental billing specialists at eAssist Dental Solutions can improve your profitability, maximize your Dentrix software, and help you reach your goals.

For more information read, 7 Ways to Improve Claim Quality & Reduce Denials.

By Lindsay Salazar, Dental biller and Dentrix user of 22 years, eAssist Dental Solutions