Submitting a dental claim seems like a no-brainer, but the process is often riddled with myths and differences in submission processes between insurance payors and from state to state. Finding your way through these myths will help you submit your dental claims in NY with confidence and efficiency. It also allows you to streamline the process from claim submission through payment processing and it all begins with setting the right goals.

You read that correctly, setting goals is essential to creating and maintaining a healthy dental practice. It’s not enough for you to have money in the bank to pay the bills today if you’re not certain that money will be there tomorrow as well. Sure, your practice is surviving if you have money in the bank today, but to thrive, you need to do more. Establishing clear, concise dental billing goals will get your practice started on the path to financial health.

Myth #1: Setting Payment Goals is Unnecessary and Time-Consuming

Goal-setting need not be difficult or consume an excessive amount of your time. Your billable and non-billable hours are valuable and if you’re not making money or doing something that’s going to help benefit your practice, what’s the point, right? That is precisely what goal-setting can help you with – boosting the financial health of your practice and improving dental claims payment processing time.

A thriving practice should meet or exceed a 99% collection ratio for dental claims annually, according to an article by Gary Takacs and Dental Economics. Sounds like a lot, right? Yet, it’s more achievable than you think and it begins by ensuring that your practice maintains a 60-day maximum benchmark for your accounts receivables.

Just as having personal goals makes sense for your health, setting and achieving business goals for your practice makes sense and can help your practice thrive. However, there are a few other misconceptions about claims submissions to clear up and it begins with knowing how your dental claims process works.

Myth #2: All Dental Claims Go Straight to the Insurance Company

Dental claims submissions sounds like an easy process and perhaps it is from your practice’s perspective, but there’s more to this process that you should know about. Contrary to popular belief, all dental claims are not directly forwarded to the insurance companies for payment processing. Instead, they are often forwarded to clearinghouses or dental billing companies who then submit to the appropriate insurance payor.

It’s a bit of a process, but with today’s electronic claims submission capabilities, processing dental claims is easier and faster than before. Working with a dental insurance billing company allows you to focus on what you do best – dentistry and patient care. The key to improved claims submissions, then, is ensuring that your practice management software and your clearinghouse or billing company integrate well. This streamlines your claims transaction process with improved efficiency and transparency.

Myth #3: The Dental Billing Company Automatically Knows Where to Submit Claims

Whether you’re using a dental billing company or a clearinghouse, clear communication is the key to ensuring that claims are properly submitted to the right payor and at the right time. Billing companies and clearinghouses can eliminate many common claims submissions errors.

Like dentists with intimate, specific knowledge about their field, billing companies and clearinghouses likewise are skilled and experienced with the dental billing claims process. However, sometimes errors still occur whether human error or technology, but fear not. You can help eliminate potential errors with your billing company by keeping them updated on which insurance companies you bill. Communication helps saves time, energy, money, and costly submissions errors later.

Myth #4: Claim Attachments are Automatically Included with Claim Submissions

One of the most common claims submission errors is missing information and it happens more often than you think. The job of the insurance company is to pay claims that adhere to each patient’s specific policy. The problem is, each policy often differs from the next. So, services covered under one policy may not be covered under another. For this reason, insurance companies require adequate “proof” of services rendered, usually in the form of dental records, x-rays, and such.

The best way to provide dental proof and expedite a seamless payment process is by ensuring two main things about each claim that you submit.

  1. You know which attachments are required for claim submissions for each insurance billing payer.
  2. You submit all required attachments with each claim submitted.
  3. All required attachments are complete and legible for payor review.

We all get busy. We have busy days, busy weeks, busy months, and busy years. Common claim submission mistakes quickly become costly errors that eat up your time requiring you to re-submit or even appeal a claim denial. So, check and double-check to ensure accuracy before submitting your claim batches. A complete claim submission means fewer headaches and a faster payment later.

Myth #5: Batched Claims are Synonymous with Submitted Claims

Speaking of missing dental claim information, batching your claims at the end of the day does not guarantee a complete submission. Processing batched dental claims is more efficient than submitting claims individually, but sometimes a batched submission fails. Usually, it’s due to receiving illegible documentation or missing information. Referring back to missing claim attachments, human and technology errors occur.

You submitted the claim, but it comes back that some of the attachments are illegible. The insurance company needs more information – an attachment that you thought was sent with the claim, but somehow didn’t get attached. It happens. When batched claims are submitted at the end of the day, whether you are submitting them or your billing staff, everyone is anxious to go home and sometimes rushing to finish the last of the day’s work. However, taking a few extra minutes each day to ensure that all batches are properly submitted with all necessary attachments and everything is legible can mean the difference between a smooth batch submission with a faster processing time and a lag in payment due to missing or illegible information.

An efficient dental claim billing process closes the gap between claims submission and processing, and hastens payments to your dental practice. The faster and more efficient your dental claims are paid, the financially healthier your practice will be and a billing company can help further expedite a more seamless process to help you reach your billing and payment goals faster. Let your dental expertise shine in your community while a dental payment company boosts your billing process behind the scenes to get you faster, more efficient claims payments and, ultimately, a financially healthier dental practice. Don’t just survive as a dental practice – thrive. Call us today to get started.

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