Blog, Dental Billing

Here’s Your Guide to Handling Dental Claim Denials and Rejections

handling dental claim denials

Dental billing and insurance verification is one hectic task for almost every dental practitioner and clinic. And that becomes much problematic when you’re hit with dental claim denials and rejections at the same time. Even if you’ve put in all the righteous efforts and made sure your dental claims are foolproof, there’s still a chance of delay or rejection dangling on your head, and so you must be prepared to handle them.

Be it because of missing patient information, error in the dental codes, or the patients’ ineligibility for the said treatment, you can always make an appeal, and get your delayed or denied claim reimbursed with the right tricks and tactics.

To help you handle all the dental claim denials and rejections smartly, we’ve put together a list of great tricks and tactics in this blog post.


When Do You Need to Send a Dental Appeal?

A dental appeal is made when your claim to an insurance company has been rejected. Though most dental practitioners and clinics tend not to make appeals, it is crucial to send an appeal in case of denial or delay in your dental claims. Making an appeal immediately after your claim is denied or delayed can really help you recover the payment you’re about to lose. There are a few more situations when you shall appeal, and they include –

  • When your dental claim is downgraded, I.e., a payment less than your claimed amount gets reimbursed.
  • When you’ve been reimbursed for an incorrect treatment benefit.
  • When your claims have been incorrectly denied.

No matter the reason, you must always make appeals in response to each of your dental claims delayed or rejected. Because most of the time, insurance companies do so as an outcome of small issues so that they don’t have to reimburse bigger payments. The ideal way is always to make appeals and try sorting out those small issues which caused a delay or denial of your dental claims than to lose your hard-earned money.

Four Ways You Can Best Handle the Dental Claim Denials and Rejections 

Here’s how you can handle all the dental claim denials and rejections in the best manner!

Share Everything You Know About the Claim with the Insurance Company

If you really wish to prevent dental claim denials and delays, the most crucial thing is to share everything you know about the claim with the insurance company. Sending detailed yet clear dental claims is ideal for getting your payments reimbursed smoothly and cutting down the risk of denials and rejections.

Sometimes even attaching all the proof of treatment such as X-rays and images isn’t enough to get your claim processed. And so, you must always send along with them the detailed narratives in writing or recording so that the insurance companies have no chance of rejecting your claim.

Create Submission-Ready Standard Appeal Templates

Most dental claims are rejected or delayed for nearly similar reasons, such as missing patient information, incorrect dental codes, and so on. The best way to quicken your appeal process is to create submission-ready standard appeal templates for each different situation and keep them handy. As soon as a claim gets rejected or delayed, you can easily fill in the respective template with relevant information and boom – make an instant appeal to get your payments reimbursed.

Don’t Accept Denials & Make an Appeal, Always 

A very significant tip to handle dental claim denials and delays is never to accept them. No matter how big you think is the error in your claim, do never let that go and miss on your hard-earned money. Even if it looks impossible to get the claim processed, make an appeal with all your efforts and pray for a positive outcome.

How To Prevent Dental Claim Denials and Delays in the First Place?

The only way to prevent dental claim denials and delays is to submit error-free claims in the first place. And sending inaccurate claims requires complete patient information, in-time verification of your patients’ dental eligibility, and that too in a professional manner. Since a dental practitioner or a clinic already has a lot on their plate, outsourcing dental insurance verification could be a great option to get all your claims perfectly processed and reimbursed.

DentalRevu is one of the best dental insurance verification companies providing incredible services to each of the clients. We have all the top industry professionals hired in the team who are experts in creating and submitting successful dental claims. With the best dental insurance verification solutions at hand, we take pride in helping our clients grow exponentially over a smaller span of time.

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About Nikki Gordon

Nikki Gordon is dental billing and marketing specialist at DentalRevu. Having served for years in the dental billing industry,