Common errors spotted during Eligibility Verification - Capline Dental Services

Common errors spotted during Eligibility Verification

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Dental billing can pose complexities, if not done properly. Claim denials in the dental billing not only upset your patients but also affect your practice’s revenue, cash flow and efficiency. Errors in the dental billing or insurance verification process could be costing you more money than you think. Insurance eligibility verification is one of the most integral parts of a dental billing process. The researches done in the past have shown that most of the denials in claim processing occur due to the incorrect coverage information.

Failing to do insurance and eligibility verification properly can result in delayed payments, increased errors and non payment.

Capline increases your practice’s efficiency by reducing the average time you spend on the phone. Our insurance verification experts can get it all done for you by submitting error-free claims.

Here are some common errors you must avoid to ensure an error-free claim submission process.

Inappropriate Patient Information
Incorrect spelling names, typos in entering policy numbers and other mismatched data can cause a claim to get denied. There can be some other inaccurate information on a claim, like wrong SSN, date of birth or a misspelled name, that could result in claim denial.

To fix it, we verify claims for accuracy and missed information before submitting it with insurances. Our insurance verification team is experienced to automatically discover errors and other incorrect information that could result in revenue loss.

Patient’s Insurance Is Inactive
This is one of the most common reasons why a claim gets rejected. To make sure this does not happen, we check the patient’s eligibility at the time of appointment before the treatment process begins. Another good thing that you can do is to perform a batch check prior to a patient’s visit. Use the patient’s full name correctly to make sure that denials do not occur.

Sending Duplicate Claim Submission
A duplicate claim is the one that is resubmitted on the same day by the same provider and for the same service. In such a scenario, the provider will process the original claim by denying any other claim as a duplicate claim or service.

We can fix it by checking with your insurance provider. We will check whether the original claim is processed for payment or if it is denied and then take action accordingly. Claims rejected as duplicates may be valid for payment if the correct code is applied to prove that a claim is not actually duplicate.

Missing Documentation
In some situations, a claim may be denied if it lacks required documentation. In that case, the payer may require additional documentation to support the treatment.

Avoiding denials is not an easy task. However, our IV experts can simplify the entire process to avoid administrative errors that may lead to claim denials.

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