Get Your Insurance Claims Paid
“Outstanding Insurance Claims” - “Insurance Claims Aging Report” - these are names of a very important report that you should be generating in your practice at least monthly and preferably weekly.
What is it?
Why is this report important?
Who should be responsible?
Electronic or Manual?
In order to submit electronically, the practice must purchase this service from one of several companies that can be found through the internet or through your practice software company. Prices can vary - some companies charge per claim and others charge a flat fee per month. Determine which works best for your practice.
In addition to subscribing to a service for processing your claims, you must also subscribe to a service that will process your attachments, such as x-rays, photos, periodontal charting, etc. If you choose not to use this service, any claims that must have attachments to them will have to be handled manually by printing the claim, attaching the x-ray or other documentation and mailing the claim. This is not only time consuming but it delays the payment process of your claim, as electronic claims are processed more expeditiously than manual claims.
What should be attached?
In order to get your claims paid quickly, send along with the claim a narrative as well as a photo or x-ray that will support the reason for the treatment. Why wait until the insurance company requests the information - send it with the claim initially!
Narratives are vital to the payment of a claim for specific procedures such as onlays, inlays and crowns. The insurance company is looking for a reason to either downgrade the procedure to a filling or deny it altogether. The narrative supports the treatment, since often the photo or x-ray will not illustrate the condition of the tooth.
Narratives can easily be generically created in the form of a checklist for reasons such as: cracks, lost tooth structure, previous endodontic therapy, etc. This checklist can be attached to the routing slip of the patient that is receiving treatment for a procedure that needs a narrative. The dentist indicates which narrative is applicable for the treatment and when the routing slip is brought to the front desk, along with the patient, the narrative is then included with the attachment on the insurance claim. It is a simple matter of “copying and pasting” the appropriate narrative into the “notes” section of the claim before it is submitted.
What is my objective?
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