Navigating Dental Insurance Claims

Navigating Dental Insurance Claims

There are many different factors that impact a dental practice’s profitability. While some issues are out of your control – like the economy and what insurance your patients have – you do have control over how you manage insurance claims. Read on to learn how you can improve your dental practice’s claims management procedures and expedite reimbursements.

Lasting Impact of Incomplete Insurance Verifications

Although the initial impact of incomplete insurance verifications is lower reimbursements, the effects can be significant and long-ranging:

Reduced Reimbursements

The magnitude of reduced reimbursements can sneak up on you. While it may not seem like a large amount of lost revenue in one quarter – or even one year – the cumulative effect of missing out on eligible reimbursements can have a big effect on your long-term bottom line. Making sure that verifications are complete BEFORE it affects reimbursement is essential.

Delayed Reimbursements

Delayed reimbursements can create a cash flow bottleneck – and frustration. When benefits verifications aren’t accurate, it can delay claims processing as your team and the insurance carrier go back and forth about the verification details.

Client Satisfaction

Weakened relationships with patients. Most people will be frustrated if they receive a large bill, especially if they haven’t been notified ahead of time. If a patient isn’t aware that policy details and reimbursement amounts have changed, it can create negative feelings.

Common Billing Mistakes That Can Cost You

In addition to taking the proactive step of verifying insurance, it’s critical that your billing staff submits error-free claims. Watch out for these little things that create big hurdles to speedy reimbursement:

Maximize Insurance Reimbursements

If you want to increase your practice revenue, take a close look at your insurance reimbursement numbers. You may be missing out on reimbursements that your group is entitled to. Consider taking these four steps:

Train your staff on best practices for billing.

Your administrative team is the starting point for claim submissions, so it’s important they understand the impact of their work.

Verify patient insurance information.

We recommend doing this at the beginning of each year so that you catch any policy changes within your patient base. Pay attention to eligibility, pre-authorization requirements, benefit amounts, deductibles and co-pays.

Submit claims promptly and follow-up on outstanding claims.

Don’t let time work against you. If your team is too busy to manage claims in a timely manner, consider partnering with a billing service.

Appeal denied claims.

When appealing a claim, make sure you understand the reason for the denial and double-check that you provided the correct information. Learn more about common causes of denials and how you can avoid them.

In addition to the tips shared here, reach out if you’d like to learn how Medusind’s Dental Billing Services and Solutions can support your 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.