Tuesday, September 12, 2017

Two tips for faster claims payment and benefit checks

Last week, I attended the AADOM (American Association of Dental Office Management) annual conference and I have learned about many new products and services that integrate with your Dentrix software. I will be writing about some of these in my upcoming posts and newsletter. On Saturday, I attended an insurance panel where my friend and fellow consultant, Teresa Duncan, was the moderator between the insurance industry and an audience of office managers.

On the panel of insurance industry representatives was a rep from GEHA, Dentegra, NEA and Unlock the PPO. One of the questions that Teresa posed to the panel was, “What can the office do, or stop doing, to help them be more successful in the claims processing arena?” 

Here was their recommendations . . .
  • Automation – There are many software solutions that you can use to help the office automate the process of collecting insurance benefit information and send the most complete dental claim possible. The dental team spends hours on the phone calling insurance companies to look up dental benefits when there are services that offer this type of information on an automated basis. Also, there are many dental claims that come into the processing center that are either incomplete or missing important diagnostic information.
    • My recommendation is to use the Dentrix eCentral Insurance Manager system for checking on benefits for your patients. It checks benefits automatically for patients on the schedule so you can have up-to-date information before the patient comes in or you can call the patient if the status has changed since the last time he or she was in. I realize that not every insurance company has chosen to participate in the eCentral program, but if you can get 80% from this automated system, it will still save you a ton of time.
    • When you use the Dentrix eClaims system, it will alert you of procedures that require some kind of documentation so you can make sure to attach an X-ray or perio chart of the image before the claim is sent.
  • STOP SENDING PAPER – I was surprised at this because I thought everyone was sending electronic claims at this point but the panelists said this is one of the top things on their list. It does not help your claim if you send your claim with items highlighted with a bright pink highlighter. You should know that every claim that comes into the processing center is scanned as soon as it comes in from the mail room. If you have bright pink (or any color highlighter), it will scan in black and your claim will get kicked out. Your best chance at getting your claim paid in the fastest way possible is to send it electronically.


I have talked about both of these things before and it was good to get validation from people working at the dental insurance companies and working in the dental insurance industry that the best option for dental insurance benefits and claims processing is via an electronic method. For more information on these topics, click below to be directed to other articles.


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