Dealing with insurance coverage claims can really feel such as you’re caught in a endless wrestling match—time-consuming, exhausting, and nowhere close to what you signed up for whenever you go into dentistry. But it surely doesn’t must be like this.
By making just a few easy changes, you’ll be able to handle insurance coverage claims with out all of the stress. And if simply the considered being on maintain with an insurance coverage firm makes you wish to scream, don’t fear—we’ve obtained your again.
Right here’s a step-by-step information that will help you take management of the method and reclaim your time. And when you need assistance streamlining every little thing, Knowledge can do it for you.
1. Preparation is Every little thing: Collect All of the Particulars
Earlier than you even take into consideration choosing up the cellphone, ensure you have all the data at your fingertips:
- Affected person’s identify and date of delivery
- Date of service
- Subscriber’s ID or social safety quantity
- Declare whole and procedures billed
- Your observe’s Tax ID, NPI quantity, and physician’s license quantity
- NEA quantity (if wanted)
- Submission/resubmission dates and proof of acceptance from the clearinghouse
Many of the info, however not all, will be discovered in your insurance coverage growing old report. Having every little thing prepared upfront saves you from fumbling by the decision and hurries up the complete course of.
*Professional-Tip: Examine your clearing home rejections BEFORE ready on maintain. The worst factor that may occur is ready on maintain for 4-hours to search out out it by no means made it to the insurance coverage firm.
2. Knock Out Calls by Grouping Insurance coverage Suppliers
Don’t waste time leaping from one insurance coverage supplier to the following. Name one insurer and deal with all claims for that supplier in a single sitting. So, when you’re calling Cigna, verify on each excellent Cigna declare when you’re on the road. It cuts down on time and will get extra achieved in fewer calls.
*Professional-Tip: As some insurance coverage corporations restrict the quantity of claims they are going to permit on one name, begin with the oldest claims for that firm first, and work your method again. The oldest claims are a very powerful to keep away from well timed submitting points.
3. Keep Productive Whereas on Maintain
Let’s face it—maintain occasions are inevitable. However you don’t have to take a seat there and wait. Use on-line insurance coverage portals to verify on different claims when you wait. It’s multitasking that can prevent time in the long term.
*Professional-Ideas for on maintain:
- Examine insurance coverage portals
- Write appeals
- Examine and proper rejected claims
- Ship affected person statements
4. Hold Meticulous Notes
Monitor each name for each declare. Doc every little thing within the declare standing notice of your observe administration software program:
- Standing of the declare (e.g., not acquired, denied)
- Actions you took (e.g., resubmitted declare, faxed paperwork, despatched attraction)
- Identify of the consultant you spoke with
- Reference numbers they supply
For instance:
- Date: October 1, 2024
- Declare Standing: Requesting extra info: prior date of crown
- Motion Taken: Confirmed insurance coverage info and resubmitted declare with NEA #5678, together with date of prior crown > 10 years previous. Resubmitted with Declare #123456789 within the remarks part and faxed to 1-800-444-4444, consideration: claims division.
- Rep Identify: Sarah
- Ref #: 789654
*Professional tip: Once you run your insurance coverage growing old report weekly—ensure you are additionally printing your declare standing notes together with it. Place up to date notes within the declare in actual time as properly. Group right here is essential!
5. Don’t Give up—Resubmit
If a declare wasn’t acquired, don’t let it sit…and forestall a blind resubmit.
Blind resubmit: resubmitting a declare that hasn’t paid, with out first calling the insurance coverage firm to see why the declare will not be on file. It would be best to affirm the insurance coverage deal with, payor ID, and all info on file so the basis of the difficulty is resolved.
Collect what you want and resubmit it as quickly as doable. Skip the postal mail when you can—faxing is quicker and provides a digital path for if you find yourself informed it’s “not on file”. If the insurance coverage firm signifies they didn’t obtain an attachment, present them with the required NEA or DCN numbers offered by your clearing home.
*Professional-Tip: Need assistance with finding insurance coverage firm fax numbers, or understanding what procedures want attachments? We’ve got you lined with our free downloadable Dental Billing Cheat Sheets.
6. Be Well mannered However Persistent
Some claims are simply cussed. Should you’re not getting anyplace, don’t be afraid to escalate. Ask for the best stage supervisor when you’ve hit a wall, and at all times insist on a fax quantity for resubmitting claims. Reference numbers, detailed notes, and persistence is your buddy right here. The squeaky wheel will get the grease!
7. Monitor Claims Weekly
Ensure that each declare is correctly tracked from submission to cost to stop any from slipping by the cracks. Assessment your insurance coverage growing old report, widespread denials, and your follow-ups along with your physician on a month-to-month foundation.
Monitor your insurance coverage growing old numbers each week to observe your percentages of aged claims. An excellent objective is to get your Over 90 beneath 5% of your whole insurance coverage a/r.
*Professional-Tip: Obtain our Unique Information to Dental Billing Secrets and techniques to optimize your declare administration course of. It’s filled with insider tricks to ensure you’re getting paid sooner!
8. Hold Your Cool
Look, coping with insurance coverage will be irritating. However holding a optimistic mindset (even when issues don’t go your method) could make a giant distinction. Consider it as a sport: cut back your “Over 90 Days” growing old claims beneath 5%, and also you win!
*Professional-Tip: Workplace Managers: ensure you are working your assortment % and adjustment sheet each week and on the finish of each month. Sadly, you’ll be able to “cheat” the system of a low a/r by closing claims early. Should you may use some assist, Knowledge may help out with a FREE PRACTICE ANALYSIS to go over your Assortment % and the A/R well being of your observe
By following the following tips, you’ll be able to flip the insurance coverage claims course of into one thing way more manageable.
BONUS TIP: Need to make issues even simpler? Schedule a name with Knowledge, and we’ll handle the executive burden of dental insurance coverage for you. Let’s eliminate the billing stress and free your staff as much as deal with sufferers. We’ll streamline your billing course of, lower down your declare occasions, and offer you again the time you might want to run your observe easily.
Name 314-648-2663 or go to www.withwisdom.com/aadom to study extra.
About Our Sponsor
Ashley Bond
Ashley Bond is a famend chief in dental billing—in addition to an official AADOM influencer and member of the AADOM Speaker/Guide Alliance (ASCN).
Leveraging years of expertise in her father’s observe, Ashley co-founded Knowledge (beforehand Bond Dental Billing) — a full-service firm that helps remove tedious billing duties and insurance coverage complications.
Ashley additionally shares her ardour for serving to dental practices work higher for everybody concerned by talking, writing, and educating all through the dental neighborhood.
