capline dental services

How to Avoid Claim Denials

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One of the major issues dental practices face is denial of claims. Other than just being frustrating, it causes a major dip in the revenue cycle management of a practice. It can have an adverse effect in the long run, if not taken care of properly. It is observed that most of the dental practice often spend huge amount of dollars to investigate the underlying reasons for claim denials. However, the best thing one could do is avoiding claim denial mistakes in the first place. Dental billing is definitely complicated, however, paying a bit of attention could definitely prevent huge blunders.

Here’s What You Need to Do:

Set Ground Rules and Follow Them Rigorously
There are times when claim denials occur as a result of not checking the reimbursement requests prior to submission. This means a lot of claims are submitted with errors. Therefore, it is important that you set some ground rules and advise your team to follow them strictly. Verifying claim status before submission is really important to bring down the number of claim denials.

Analyzing Why Denial Happened
As the saying goes, “prevention is better than cure”. So, if you let your denial claims be like that, you are wasting your hard earned money. It is very important to follow up and find the reason for the rejection in the first place. This gets you reimbursed faster and help you understand the reasons for denials. Having this knowledge with you will help you and your staff to avoid further denials in the future.

Keep Yourself Updated With the Ever Changing Coding Regulations
If you do not keep yourself in sync with the constantly changing codes and regulations of dental insurance, it might lead to denial of claims. So, the best you can do is to ensure that your practice is always at par with the regulations. It will automatically streamline all your codes and requirements as per the changes implemented. This streamlines your front office workflow and also brings down the number of claim denials.

Keep a Track of Changes
If you have a practice management software (PMS) that takes care of the inaccuracies, it is important that you and your staff must be in sync and well-versed with the changes that come across. Another good thing you can do is research on the latest newsletters to see what is happening around. The more you will keep yourself updated, the lesser will be the chances of a claim getting denied.

Verifying the claim before submitting it to the insurance avoids both errors and denials. There is a consistency required to process claims efficiently, which further helps in maximizing revenue for a dental practice.