Get Dental Claims Paid Faster : How To Guide

dentist practice management consultantsTechnology has transformed practically everything in our fast-paced technological society, including how a dentist performs dentistry. Additionally, it has changed the way dental benefit plans handle claims.

The majority of dental benefit plans now use auto-adjudication to process a large percentage of their claims, which helps speed up the process. With auto-adjudication, it benefits dental clinics by helping them get their dental claims paid faster than the traditional claiming process.

Understand Dental Insurance Claims Processing

It is essential for dentists, particularly those in private practice, to understand the insurance claim process to better know what to do to have the dental claims paid faster.

Before a patient receives their final bill, claims go through many stages after they see a dental provider:

  1. Billing – Insurance receives a bill for service charges, excluding any co-pays provided at the time of check-in.
  2. Adjudication – A licensed claims processor will examine the claim, check its accuracy, and compares it to the insurance plan to determine whether or not the services performed were covered by insurance.
  3. Reconciliation – If the services were covered by benefits, the insurance company will pay the claim depending on the coverages available. Depending on their plan, they may pay the entire claim in full; otherwise, the patient will be billed for the remaining balance.
  4. Validation – The amounts will be verified and applied to the total deductible, and the total deductible will be updated instantly.
  5. Explanation of Benefits – An EOB is provided to the patient, detailing the services received, the amount covered by insurance, the amount paid by the provider, and what remains to be invoiced.
  6. Final Billing – Before settling the claim, the patient should compare the EOB and final bill to ensure that everything is correct.

Choose A Reliable Clearinghouse

Dental insurance claims can be submitted both on paper and electronically. If you prefer to have an electronic transaction, it is important to choose a reputable clearinghouse.

Clearinghouses provide dental practices with the resources and access they need to send, receive, and request data from various payers. A clearinghouse is an organization that successfully facilitates the interchange of data between dental care providers and insurance companies.

Use Auto-Adjudication To Get Dental Claims Paid Faster

Auto-adjudication is the process of paying or denying insurance and public benefits claims quickly, and without deciding on each claim manually.

Auto-adjudication is the process of a computer being programmed to approve and pay, or deny a service based on the plans and the patient’s processing policies. The claim is not assessed by a human in these circumstances.

When compared to an insurance claim processed by a licensed claim processor, the claim process will be substantially faster with Auto-adjudication.

Benefits of Auto-adjudication

The majority of insurance firms use auto-adjudication, and it has become the new standard for claim handling. Because of its higher success rate, it will continue to be the standard practice in the future.

Here are some other advantages of auto-adjudication:

  • A higher adjudication rate: A higher percentage of the payer’s claims are assessed without any manual intervention. With auto-adjudication, their efficiency rate improves dramatically, allowing to decrease denial of claims and helping the clinic to receive payment sooner.
  • Close claims faster: The adjudication of claims that are done with auto-adjudication can decrease the claim lifecycle from weeks or months into minutes.
  • Cost-effective: Auto-adjudication can help you get paid faster on your claims. It will assist your clinic in maintaining financial stability by allowing you to receive payments more quickly. You can utilize the budget to improve your business as well.

How to Take Advantage of Auto-adjudication

Because auto-adjudication speeds up the claim process, utilizing it correctly could help you have your dental claims paid much faster. Here are a few pointers on how to get the most out of auto-adjudications:

  • Submit Electronic Claims – Insurance companies preferred to process electronic claims compared to handwritten claims. It’s more likely that your electronic claims will be processed immediately.
  • Choose your clearinghouse – Clearinghouse is essential in submitting electronic claims. Choose a trusted and reliable clearinghouse.
  • Check the insurance coverage of your patients – This will allow you to file claims to the correct insurance company and avoid denials, saving you time and money. Verifying your patient’s insurance can help you estimate how much the patient’s out-of-pocket expense will be, which can be useful information to share with the patient.
  • Unless absolutely required, do not put comments in the claim form’s Comments box.
  • Notes regarding an account or the number of times you contacted about a claim do not need to be included in the Remarks section. This type of behavior merely slows down the process of your claim.
  • Send attachment with a properly explained narrative

If the information to support the requirement of your procedure is easy to understand and your narratives are clear and specific, your claim will be paid fast.

dental consultingChoose 2740 Consulting To Guide You in Getting Your Dental Claims Paid Faster

If you want to use the finest methods for getting your dental claims paid faster, you should have a trusted and reliable dental practice management consultant for your dental practice and management needs.

The following are some of the services provided by 2740 Consulting:

2740 Consulting will not only assist you in getting your dental claims paid faster, but they will also assist you in increasing earnings, revenue, KPIs, EBITA, and collections.


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