Has your insurance denied your dental claim? Not to worry, we are here to help! Most dental insurances usually refuse dental claims that are common, easy corrections. We suggest being well-informed on your insurance policies before starting a dental procedure to prevent additional cost from your pocket. Identification is necessary when it comes to insurance, so, let us begin there.
We recommend reviewing your information and benefits thoroughly for your records and our own. The most common dental claims come from incomplete, inaccurate or unreadable claim information which can delay or deny the claim. Always make sure your coverage and group number haven’t changed, even if you still have the same employer. Legibility is a must when it comes to filling out your information since electronic scans input claims.
Unreadable documentation such as X-rays or charts can cause delay or denial of claims because they are difficult to interpret. X-rays might be necessary to show the necessity of the treatment you need. If x-rays are needed, make sure there is a form narration reasoning why you need the treatment.
Of course, not all dental contracts cover all dental services. Familiarizing yourself with the benefits and the services your insurance pays in handy when it comes to getting a procedure. Some insurances might exclude services or have them at a lower cost. It’s better to know how much of the cost of treatment could potentially cost you out of pocket.
Beware of the limitations of your dental contracts! The control of dental cost comes from the limitations you are allowed in a year. Restrictions can vary based on age and frequency. An age limitation can restrict you from getting certain procedures. Frequency is another limitation that places restrictions on the number of services covered within a given year. This could be for example, how many cleanings and x-rays you are allowed to get. Know the specifics of your plan to see what it includes and excludes. However, if you find you have an outstanding dental claim, our team is here to help you.
Depending on the denial reason and insurance, we assist in sending an appeal on patient’s behalf or provide our patient with all the information the insurance needs to handle the appeal. Our account managers are here to answer any questions or concerns you might have regarding denied claims, so just ask us!
If you have a denied dental claim, learn why it’s been rejected. You can call inquiring for more information on the reason of the denied claim and what additional information the insurance might need to pay the claim.
To help prevent getting a denied dental claim, we strongly recommend requesting a list of the services your insurance covers, plan limitations, in/out network providers, maximum benefits and patient/family eligibility. You might also want to know about your primary and secondary insurance is for setting it up correctly. The more informed you are about your insurance, the smoother the procedures will be in getting the dental work you need.
So please, give us a call, and our Account Managers would be more than happy to assist you!