Insurance claims are a vital part of a dental office’s revenue. Yet, many practices face delays or denials because of simple, avoidable mistakes. Understanding these errors—and knowing how to prevent them—can improve cash flow and reduce stress for your team.
1. Incomplete or Incorrect
Patient Information
Even a small error in patient details can lead to claim rejections.
How to Avoid: Always verify patient demographics, insurance ID, and coverage before starting treatment.
2. Using the Wrong Codes
Dental insurance claims require precise CDT codes. Using outdated or incorrect codes is a common reason for denials.
How to Avoid: Keep your coding manuals updated and provide regular training to billing staff.
3. Missing Documentation
Many claims are denied because they lack necessary attachments like X-rays, narratives, or treatment notes.
How to Avoid: Check each insurer’s requirements and attach all supporting documents before submission.
4. Ignoring Coordination of Benefits (COB)
If a patient has more than one insurance policy, claims must be filed in the correct order.
How to Avoid: Confirm primary and secondary insurance at every visit and file accordingly.
5. Not Following Up on Claims
Unmonitored claims can sit unpaid for months.
How to Avoid: Use a tracking system to check claim status regularly and resubmit if needed.
Conclusion:
Avoiding these five common mistakes can greatly improve your insurance claim success rate. Train your staff, maintain accurate records, and stay on top of claim follow-ups to keep your dental practice running smoothly.