Failing to follow through on claims puts control of your income in the hands of insurance companies.
“In golf as in life, it’s the follow-through that makes the difference.”
This anonymous golfer’s adage also applies to dental insurance management. Following through after the patient leaves your office helps you get a better grip on insurance claims so you can hit your income targets.
Many dental practices fail to follow through after filing insurance claims. Not following through puts control of your income—up to 50 percent in most practices—in the hands of insurance companies.
To regain control of your income flow, track your insurance claims daily. Your dental software should be able to generate the reports you need. If you don’t have clearinghouse software that gives you real-time claims status updates, register for an account on each insurance company’s web portal and track your claims from there.
For effective insurance management, follow through after your patients leave the office. The four steps below, recommended by dental insurance expert Teresa Duncan, will keep your practice income on par.
1. Review claims reports on a regular basis.
Regularly reviewing insurance reports shows you if anything is missing from your claims and allows you to provide additional information or correct any problems. It also alerts you when a claim is older than 30 days, so you stay aware of monthly cash-flow delays.
Review the following insurance-related reports at these recommended times:
- Daily—Clearinghouse claim submission report
- Daily—Unsubmitted claims report
- Weekly—Procedures not attached to insurance reports
- Weekly or biweekly—Insurance aging report
2. Appeal all denied claims.
Dental insurance denial rates can be as high as 20 percent in some states. Timely filing and incorrect medical codes are ranked among the top reasons for denials.
Appeal every insurance claim that gets denied so you can find out why it was denied. Be sure you know each insurance carrier’s appeal process so when a claim is denied, you can make the necessary adjustments and resubmit the claim in a timely manner.
For every claim you resubmit, include the explanation of benefits, document control number and claim ID number.
3. Monitor all unpaid claims.
Consistently running reports helps you better monitor all your unpaid claims. Follow up on claims that are aged 30 days or older. Do your follow-ups at least monthly on all unpaid claims. Read Finding the information you need on the Insurance Aging Report for more information.
If your list of aging claims is large, begin your follow-up process with the oldest balance. Then move to your largest balance and follow that up with insurance carriers that have the most outstanding claims.
Your practice’s cash flow largely depends on your ability to stay in control of your aging claims. If you haven’t already, hire a well-trained insurance coordinator to monitor claims and prevent income delays.
4. Stay up-to-date with the dental insurance industry.
Dental insurance coverage changes frequently. Keeping up-to-date with insurance changes helps you avoid coverage surprises or denied claims. It also makes you a trusted dental insurance resource who can answer patients’ questions, since patients are not likely to keep up with all the changes.
Visit www.dentrix.com/products/eservices/ecentral/insurance-manager to learn how Dentrix helps you follow up on claims.
Learn more about sending eclaims with Dentrix at www.dentrix.com/products/eservices/eclaims.
By Teresa Duncan, MS, FAADOM, and the Dentrix Product Management Team
Originally published in the Dentrix eNewsletter, October 2016