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6 Tips for Winning Your Dental Insurance Appeals by Using Medusind’s Expertise

6 Tips for Winning Your Dental Insurance Appeals by Using Medusind’s Expertise

Because insurance claims comprise a substantial amount of your dental practice’s revenue, it’s imperative that you collect the maximum amount if your practice is going to prosper.

But why do insurance companies deny so many claims? The answer is simple. It’s a business strategy. Insurance companies only gain profits by collecting premiums from patients and then using as many technicalities as possible to deny their claims. That drastically limits their payout requirements.

How can you overcome this obstacle? Medusind is a national leader in dental billing, and in our over 20 years of experience as experts in the field, we’ve got six valuable tips to share with you that will reclaim revenue from the coffers of those devious insurance companies and place it firmly in your dental practice’s bank account.

1

When you first file a claim, make sure you submit all the information that the insurance company asks for.

Many claims are denied simply because a dental staff member didn’t give the insurance company all the information it required. When you submit a claim, you must always double-check your work. We know it’s painstaking, but it’s necessary. (That’s why it can be much easier to have a recognized dental billing leader like Medusind handle your claims. We’re pros at it.)

By furnishing the insurer with all available information, you can seriously eliminate a lot of claim denials. For example, sometimes X-rays don’t tell the full story, so supply a descriptive narrative when possible to demonstrate the medical necessity of a procedure.

2

Know each insurance company’s appeal requirements

Each insurance company has a different set of standards for appealing a dental claim, which further seriously complicates the process — another reason to engage a seasoned dental billing provider like Medusind.

• Some insurance companies ask you to submit additional information with a new claim.
• Others might request the original Explanation of Benefits (EOB) with more information attached.
• An insurer might require you to mail the new claim or the original EO (or both) sent to a different address from one designated for initial claims.
• Certain insurers might only let you submit an appeal via their website.


If you know the submission requirements for each insurance company, you’ll expend less time submitting an appeal.

3

Prepare appeal templates in advance

No matter how well you’ve documented your claim, insurance companies will still possibly find an excuse to deny it, just to fortify their bottom line. As a result, create an appeal template for each procedure so you don’t waste time.

When you already have an appeal template in place, it’s simple to just drop in a patient’s name, claim number, and unique information. This saves you from having to reinvent the wheel every time you respond to a rejected claim.

4

Be persistent

In many dental offices, the staff members in charge of billing don’t pursue claims. They automatically accept denials from insurance companies, which is counterproductive, since claims are often paid out when appealed.

Be persistent and don’t give up on appeals. This is money in your bank. Don’t leave it on the table. You can get it if you’re willing to put out the additional effort.

If you disagree with the claim denial, by all means, file an appeal. Don’t let the insurers control your dental practice’s financial well-being. You can get results by fighting back.

5

Pursue claims so your valued patients benefit financially

Chasing after claims doesn’t only benefit you and your practice—it also helps your standing with your patients. If you challenge disputed claims and see to it that the insurers pay—and not your patients—your patients will know you’ve got their best interests at heart. They’ll appreciate it, and they’ll be happy their dentist in their corner. They’ll tell their friends.

6

Have Medusind take the hassle out of claim resubmission

Your staff can waste over an hour over the phone with an insurance company haggling over just one single resubmitted claim. Multiply that by hundreds of rejected claims, and you get an idea of why it might be wiser to have a national leader in dental billing like Medusind go to bat for you.

Contact us and let us show you how we can take the headache out of resubmitting hundreds of rejected claims at a time. Why should your staff members devote endless hours of their time chasing after rejected claims that in the end might never be reimbursed because lack of resubmission or a simple oversight like a coding error, when Medusind’s dental claims experts can take the wheel and get you and your patients the insurance reimbursements you deserve?



See how Medusind can work for you

Tell us about your business or organization and we’ll connect you with a Medusind expert who can show you the products in depth, and answer any questions you have. See how a provider, office manager, or biller use Medusind to empower their practice.

See How Medusind Can Work for You

Tell us about your business or organization and we’ll connect you with a Medusind expert who can show you the products in depth, and answer any questions you have. See how a provider, office manager, or biller use Medusind to empower their practice.