How to Avoid Insurance Companies Denying Your Dental Claims

Business professionals looking at paperworkInsurance companies are notorious for collecting monthly premiums and then denying as many claims as they possibly can in order to increase profits. These companies will refer to the contract your patient has with them, including exclusions, limitations, and frequency provisions. They’ll use these to deny payment, which will result in decreased payouts and more money for the insurance companies.

Why Insurance Companies Deny Dental Claims

Below are some of the most common reasons why insurance companies deny dental claims and how to avoid these situations:

  • Lack of information from the provider – Around half of all dental claims will be sent back to the office due to lack of information from the provider. Because of this, it’s a good idea to send all the pertinent information the first time around. This includes any endodontic, periodontal, orthodontic, or other major or minor services.
  • Filing late – To avoid filing late, claims should be submitted immediately after services have been performed. Otherwise, a late claim is an easy and convenient excuse for insurance companies to deny the claim. Some companies require filing within 90 days, so always err on the side of caution and send claims early.
  • Limitations, exclusions, and frequencies – All dental plans are different. Meaning that limitations such as lifetime or annual maximums make sure that there’s control over how much money is paid out on a dental policy. Certain plans only cover patients for certain procedures and treatments every year or every couple of years. Some plans won’t cover certain procedures at all, opting to cover less expensive treatments instead.

Insurance companies are in the business of making sure that their profits increase, even over the dental health of your patients. The best way to protect your patients and your practice is to anticipate these moves and avoid them.

For help with dealing with dental insurance companies, please contact CTC Associates today.  

Posted by

Share:

Archive

Nov 12, 2019, 4:25 PM
Having your dental office properly organized involves making sure that you and the rest of your employees are trained well on…
Oct 30, 2019, 11:57 AM
When you first meet a new dental patient, you really don’t know much about them, their oral hygiene, and the goals they have…
Oct 21, 2019, 11:53 AM
It’s not uncommon for dental team members to unintentionally sabotage scheduling attempts. Most team members don’t want to…
Oct 14, 2019, 1:02 PM
Bonuses are a great way to help keep your staff motivated. When your staff knows that a bonus is possible, you’ll see them…
Sep 23, 2019, 12:23 PM
Gossiping in the office is a growing problem for many businesses. It’s not uncommon for employees to spread rumors not only…

Our Blog

#
Dental Practice Office Organization
Having your dental office properly organized involves making sure that you and the rest of your employees are trained well on…
#
Interviewing New Dental Patients
When you first meet a new dental patient, you really don’t know much about them, their oral hygiene, and the goals they have…
#
Improving the Appointment Confirmation Process at Your Dental Practice
It’s not uncommon for dental team members to unintentionally sabotage scheduling attempts. Most team members don’t want to…
#
Improving the Bonus System for Your Dental Employees
Bonuses are a great way to help keep your staff motivated. When your staff knows that a bonus is possible, you’ll see them…