Claim Process Training

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There is a distinct difference between a productive practice and a profitable practice.

GREAT practice has great people and great process. In any practice, we prefer to have dental services be paid for through insurance benefits rather than patient payments when insurance is an option. This is where great people execute great process.

Establishing a repeatable process with your team will make an incredible difference in the amount you get paid and the time it takes to get the money from the insurance company into your checkbook. There is more control over this process than we generally impose.

  • Make sure that all of the information that is gathered prior to the patient visit is complete and accurate.
  • The original claim must be sent correctly, with the proper attachments and narration the first time
  • Tracking must be done weekly. Practices that are sending claims electronically MUST schedule time every week to make calls or check on the status of the claim through the appropriate portal to minimize the length of process time if additional attention must be made
  • Claims that are declined can be appealed. You owe it to your patient and the practice. Statistics show that 85% of declined claims are not appealed. Of those claims, 75% are reprocessed and paid on.
  • Make a reputation for you and your practice. When the company understands that you are on top of processing and following up on claims for your patients and practice, they will become more dependable and responsive to you.

The insurance industry keeps moving forward. Keeping your process and people honed to be accomplished in understanding and execution keeps the insurance aging clean, money in the checkbook and the Doctor happy!

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