What is the best way to track unpaid dental claims?

Managing dental insurance claims is many dental professionals’ least favorite part of their job. Why?

Well, it’s because of how time-consuming and complicated it can be to resolve unpaid dental insurance claims. 

The claims process doesn’t stop once you submit your claim — in fact, you’re just getting started. You have to revisit that claim early and often until you confirm it’s been paid, and then track it every step of the way.

Denied claims are delayed income. Multiply that by hundreds or thousands of dental claims, and it’s clear why claim denials need to be appealed immediately, continuously, and consistently: to make certain that revenue flows steadily into your business. 

At DCS, our Account Specialists are responsible for ensuring insurance claims are paid as soon as possible, so they are constantly tracking the status of unpaid claims. 

Dental practices who are trying to handle their insurance billing themselves often ask us, “What is the best way to track denied and unpaid claims?” 

Here are the 4 key steps our insurance billing experts offer them…  

First things first: Determine why the claim was denied

There are nearly a dozen reasons an insurance claim could be denied, and here’s the annoying part: most of them are small mistakes that you won’t know you’re making (it happens to everyone!).

Once it’s determined exactly why a claim was denied, that mistake can be avoided in the future — especially if it was a small mistake, like a typo or a misused code. 

Read more: 10 reasons your dental insurance claims are being denied

But let’s say you have a stack of unpaid claims right now. How should be they tracked, as well as monitored and managed until they’re paid?

Step #1. Create and submit claims within 24 hours of treatment

We recommend creating and submitting insurance claims within 24 hours of the patient’s treatment, ideally immediately after their treatment. This jumpstarts your billing process, guaranteeing the claim gets to the insurance company ASAP. 

This will also help your dental office get paid sooner, because the claim process began without delay, and ideally, without errors. To maintain this momentum, tracking the claim should begin right away.

Step #2. Begin tracking immediately

It’s crucial to pay attention to the timeframe between when the procedure is performed, when its claim is batched, and when that claim is sent to insurance for reimbursement. Payers don’t care about your timeline! So your team has to. 

The good news is that most dental practice management software keeps track of these critical dates. However, you still need someone on your team dedicated to consistently checking that each claim gets paid by insurance. (We’ll talk more about that in a bit.) 

After a claim is submitted, your designated insurance biller can wait a few days before checking on its status, but they should not consider this task complete just because the claim has been sent in. They will still need to track the status of this claim — along with every other unpaid claim — regularly and often. 

Once a claim is submitted, it’s added to the insurance aging report automatically, and it will continue to appear on that report until it is paid. This is where tracking of an unpaid claim begins.

And here is what regularly working through your insurance aging report looks like…

Step #3. Ensure your insurance aging report will be worked at least once a week

You know when you have a project that isn’t pressing, so you keep putting it off? And then it hangs over your head, growing into a larger and larger problem that you need to solve?

That’s what it’s like when an aging report isn’t worked consistently or frequently enough.

We recommend designating a day of the week when your insurance biller spends a few hours following up with every claim on the aging report — every week.

We also suggest appealing your oldest claims first, because their timely filing limit is closer. To make this easier, your biller can sort the aging report to list the oldest claims first, and then work their way down to the newest claims at the bottom.

When you partner with DCS, our Account Specialists will work your aging report every week, or even more than once a week if there’s a large backlog when we start.

Revisiting the aging report often makes it much easier to stay on top of unpaid claims, and guarantees that nothing stays on the report too long and is lost to timely filing.  

Related: 3 mistakes dental insurance coordinators make with aging reports

Pro Tip: Batch your appeals by insurance company

Looking for a quicker way to work the aging report? Of course, you are! Well, our experts optimize their time by appealing multiple insurance claims at a time. 

We mentioned sorting claims by age, oldest to newest, and you can also sort the aging report by insurance provider. That way, when you finally get an insurance company representative on the phone, all the unpaid claims with that insurance company can be appealed at once. 

Batching appeals greatly reduces the number of phone calls and amount of time spent on hold — a smart, simple improvement to the efficiency of your appeals process.

That said, it’s essential that you assign the right person for the job. Following up on unpaid claims means making regular calls to payers — a task we all hate because it’s time-consuming and frustrating. Picture it: You wait on hold for an age, you get hung up on, and call back just to wait on hold again … and again.

Aging report work needs someone with the patience of a saint and a bulldog’s persistence. You want someone who has a to-do list for each day of the week, lives by it, and gets excited when they can check something off their list.

(P.S. We have a nationwide team of expert billers who are this exact type of person). 

Step #4. Partner with an outside expert or hire a designated insurance biller

As we mentioned above, you need the right person to handle your claims process, particularly when it takes a frustrating turn. It requires a distinct personality paired with industry-specific knowledge to deftly push through problematic claims, plus personal experience and proven strategies for dealing with insurance companies. 

So, you need to either hire a seasoned dental insurance coordinator, or partner with an insurance billing expert, like the ones we have at DCS. 

Managing your dental billing is a full-time job that requires someone’s full attention. One person (or more, if you have a larger practice) should be wholly committed to steering claims through the billing process from start to finish. 

We know dental offices that have no one dedicated to insurance billing. Instead of treating their aging report like the vital source of revenue it is, tracking unpaid claims is just one of those things that someone will eventually get to — but rarely does.

The result? Low collections, a mile-high aging report, avoidable write-offs, and income lost to timely filing. When tracking unpaid claims is set aside, the practice has a slow trickle of revenue instead of the heavy, steady cash flow every business requires.

Don’t let your business suffer. Bring in someone with the skills, experience, and focus to handle your insurance claims from initial billing to the bank.

We know hiring is a huge challenge right now with the staffing shortage, and there’s no end in sight. For a cost-effective, long-term solution with consistent results, we recommend partnering with a third-party billing provider staffed with experts, like we have here at DCS. 

Compare costs of each option in our article, “The cost of revenue cycle management services vs. in-house dental billing: 5 questions answered.”

Don't let denied dental insurance claims go unpaid: Partner with dental insurance billing experts

To recap, here are our 3 major tips for tracking unpaid dental insurance claims and making sure every dollar you bill ends up in the bank: 

• Step #1. Create and submit claims within 24 hours of treatment
• Step #2. Begin tracking immediately
• Step #3. Ensure your insurance aging report will be worked at least once a week
  • Pro Tip: Batch your appeals by insurance company
• Step #4. Partner with an outside expert or hire a designated insurance biller

At DCS, we work with dental businesses of all shapes and sizes to take the claims process off their dental teams’ plates so they can focus on patient care and cultivate strong patient relationships.

Dental insurance claims management is one of our specialties, with some client aging reports whittled down to just 1% unpaid —  with Sprout Dental, for example, we collected $800,000 in just 30 days.

Another customer describes the relief of our services generously: 

“Onnie made this transition so easy. Talking with her on a daily basis to get outstanding insurance claims paid has been wonderful, and I don't have to pick up the phone to call and argue with an insurance company. She does it all for me! And the knowledge she has of insurance and our PMS could fill volumes. If you are on the fence about hiring this company, call me, and I'll push you over it!” –Rebecca L., Office Manager, Tom Touhey DDS, Inc.

Let us track your unpaid claims and deliver consistent cash flow, while you and your team focus on growing your practice and giving your patients an amazing dental experience: Book a free 30-minute call today.