Dental Claims Cleanup®, LLC
National Dental Billing Services


1810 Erie Blvd. Syracuse, NY 13210
800-652-3431

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What are the 3 top things that increase payment on claims within 3 weeks?

Posted on October 8, 2015 at 6:45 PM

Q: What are the 3 top things that increase payment on claims within 3 weeks?

A: It's called sending a "clean claim".

1. Correct patient/practice/provider information (demographics).

40% of the time the front office forgets something

2. Submitting supporting documentation at initial claim submission

35% of the time the insurance delays payment by asking for more information

3. Correct insurance setup in patient account.

25% of the time the front office does not know how to setup the account especially in dual insurance, blended families, or plans that are administered by major dental insurances.

We recommend electronic claim service with attachment capabilities. One feature is that before claims submission the software will alert that there is missing information which gives the opportunity to correct it prior to submission. We have found offices that have e-claims service but are not using this feature?!?!? OR Have the service that does not allow supporting documentation availability (change the service!) Insider for Dentists: We as Dentists have no idea about the mistakes that are happening and the reasons for unresolved claims because the front office corrects them as they research the outstanding claims. We recommend Dentist meeting with their person responsible for AR from week to week and review claims status: 1) what was done from week to week 2) why the claim was unresolved 3) spot checking yourself. Call on some of the claims and see what's going on. You might see a trend. Set goals i.e.: "I want you to resolve at least 4 pages of claims by next week". Hope this helps!

Categories: dental insurance

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