How does timely filing work? A quick guide for filing dental insurance claims

9 minute read

Imagine delivering top-notch dental care, only to have your hard-earned revenue slip away because of a missed insurance deadline. Timely filing is one of the most critical aspects of managing your dental claims, as it can do significant damage to your bottom line, yet it’s often overlooked — until it’s too late.

Waiting to file insurance claims can lead to denied reimbursements, inconsistent cash flow, and unnecessary write-offs that hurt your bottom line. And sometimes, knowing — or not knowing — the specifics of timely filing policies directly impacts your claim submission workflow.

We’re here to point you in the right direction. This article is your quick guide to all things timely filing for dental insurance claims. We’ll cover exactly how timely filing works, the consequences of missing deadlines, and how you can approach these key deadlines with confidence.

DCS offers long-term insurance billing services and limited-term special project engagements to help you beat timely filing deadlines and ensure prompt insurance claim reimbursement.

With access to such expertise through the DCS Knowledge Network, we spoke to our head of Special Projects, Jeff Smith, to gather his insights on timely filing and why it’s a crucial piece of claim reimbursement.

Key takeaways on meeting timely filing deadlines:

Luckily, most insurance companies share the same active claim period
For best results, dental claims should be created and submitted within 2 days of treatment
If your in-house billing team struggles to keep up with production, 3rd-party billing experts can manage claims submissions and stay well ahead of those deadlines

What is timely filing in dental insurance?

We asked Jeff Smith, head of DCS Special Projects, for his definition of timely filing:

“Timely filing is the time frame a claim has for being on file with an insurance company. If the insurance doesn’t get that claim within their timely filing guidelines, then they're ultimately going to deny it on the front end, saying, ‘It was never in our hands or in our system.’”

Each insurance provider sets its own filing deadline, which can range from 90 days to 12 months from the date of service. For example, some private insurers may have a 90- to 180-day window, while many PPOs and HMOs allow 6 to 12 months for claim submission. Medicaid and government plans often have stricter deadlines.

Insurance companies implement timely filing limits to manage their spending and prevent unpredictable payouts from older claims that could negatively impact their financial projections. It’s also another excuse for them to deny claims to avoid paying them.

We can’t change their rules, but we can be smart about how we approach them.

How do you track and manage timely filing deadlines?

Ideally, claims should be submitted within 48 hours of service — but Jeff recommends submitting them even sooner whenever possible:

“It's very important to get a claim on file with insurance as quickly as possible. It just avoids a lot of headaches on the back end.”

By “headaches,” he’s not only referring to missing timely filing deadlines.

Jeff also means the risk of forgetting vital information needed for a clean claim submission, which may have initially been top of mind. This includes patient and insurance information, clinical notes, and all necessary attachments and narratives — all part of the formula to avoid claim denials and unnecessary write-offs.

Of course, submitting claims within 2 days of treatment can be challenging when you’re also managing an entire office — today’s in-office patients are more important than yesterday’s paperwork.

So here’s Jeff’s advice on how to prioritize insurance claims to coordinate their timely filing deadlines:

“I try to identify the insurance companies I know have stricter timely filing deadlines. My priority would be to submit those insurance claims first. I also identify claims that could be approaching that one-year mark, and make those oldest claims a higher priority.”

When it comes to tracking claims, your practice management software (PMS) is your friend.

Your PMS should display claim statuses, highlight pending submissions, and notify your team of upcoming deadlines. As Jeff suggested, be sure to prioritize creating and submitting claims for insurance companies with tighter timely filing deadlines to make collecting on those dental claims easier.

This small upfront effort will prevent bigger problems down the line — and also protect your practice from unrecoverable financial losses.

What happens when you miss a timely filing deadline?

So, what happens if you miss the deadline? Jeff explains:

“Every insurance is a little different. If a claim is denied only due to timely filing, there are a couple of scenarios that can happen: You can go to your clearinghouse, and if you can prove to insurance that you sent that claim within timely filing guidelines, there are appeal options. So, there is a possibility of getting a timely filing-related denial overturned, but it can be tough, and again, every insurance is a little different depending on how lenient they are with overturning that.”

Now, if you didn’t create the claim before its deadline, then getting it accepted will be more complicated with less chance of success.

“If you can't prove a claim was submitted within the guidelines of timely filing, and you get a denial, that is going to be much tougher to overturn. We’ve worked with offices on best practices for claims that might have to be written off, and every scenario is different.”

Even if success seems unlikely, you should always at least try to appeal claim denials. Remember, a claim is like your paycheck: it represents income that’s been earned but hasn’t yet been paid. You wouldn’t allow your employer to hold onto your paycheck, so don’t let insurers keep your unpaid claims.

And if insurance refuses to accept the claim? Well, that’s a hard lesson learned, and now you know how to manage claims filing to avoid it happening again.

Missing timely filing deadlines and being unable to appeal those denied claims is money left on the table simply because the submission was late. When you consider all the other reasons insurance companies deny claims, late claim submissions are an easy one to avoid when your PMS can help you monitor deadlines.

It’s unfortunate if a claim or two slips through the cracks, but it becomes detrimental if this is a recurring mistake. You’ll see its impact on your bottom line through write-offs — and how it complicates your ability to pay your bills, pay your people, and keep your practice open.

If keeping up with these deadlines feels impossible — or your growing aging report reveals that your billing processes can’t keep pace with production — DCS is here to take those tasks off your plate and lighten your team’s load.

How will DCS manage timely filing rules and deadlines for your dental team?

DCS offers Insurance Billing services to handle your claim filings day after day. But if you’re faced with an overwhelming backlog of unfiled claims, your office — and your bottom line — will benefit from a more intensive approach.

Our A/R Special Projects service designed for private practices, oral surgery practices, and DSOs with extensive aging reports needing focused, immediate attention.

The DCS A/R Special Projects team of insurance billing experts will:

Find old money – Track down outstanding claims and get them paid.
Insurance aging report cleanup – Eliminate backlogged claims and substantially reduce A/R.
PMS cleanup – Bring your patient records up to date for faster, easier use.
Prioritize timely filing claims – Ensure claims don’t miss critical deadlines for reimbursement.

Meanwhile, our systems experts will help refine your processes so you can create, submit, and track claims more efficiently, ensuring that unfiled claims won’t pile up again.

Jeff, the head of DCS Special Projects, fills us in on how DCS clears aging reports to drive reimbursement to practices before it’s too late:

“Our experts will prioritize claims based on the insurances we know have strict timely filing requirements. I think with any A/R report, there should always be a game plan — a plan of action of where to start. And if timely filing deadlines come up as a reason we can’t appeal a claim, we’re transparent with dental teams on what the next steps will be. DCS is committed to doing everything we can to get denied claims overturned if possible.”

No matter how many claims are in your accounts receivable — both patient A/R and insurance A/R — our billing experts are here to get your dental billing back on track by collecting your earned revenue and optimizing your processes for easier claims filing in the future.

Let’s get the last word from Jeff—

“DCS gets things cleaned up to put every office into more of a maintenance mode. That ultimately sets everyone up for success, especially when there's not some big outlier mess that is looming over everyone in the office every day. We come in to get the mess cleaned up, and to really streamline the process to make life and work easier for everyone.”

Ready to see an A/R success instead of an A/R mess? Learn more about DCS A/R Special Projects Services

Meet timely filing deadlines to collect ALL the cash you’ve earned

To recap, here’s what you need to know about timely filing deadlines for dental insurance claims:

Timely filing deadlines vary by insurance company and plan types
Submit claims as soon as possible after treatment to avoid even coming close to deadlines
Your PMS should have at least 3 features to keep your team informed about claim deadlines
Claims denied due to filing date can sometimes be overturned, but filing them on time is much easier with far less risk
Large billing backlogs can be entrusted to dedicated teams of experienced billers
The experts at DCS can reset your billing processes to calm the chaos of keeping up with insurance claims

Missed filing deadlines can result in thousands of dollars in lost revenue. Don’t let administrative hurdles prevent you from collecting every dollar that you’ve earned — and are owed.

Partner with DCS to ensure every claim is filed on time, every time. We’ve recovered $300,000 in 4 months for one of our clients; imagine what we could do for you.

Cut the chaos of tracking insurance claims when you choose DCS: Book a free consultation

Dental revenue resources from Dental Claim Support