Tired of Wrestling Insurance Claims? Try These 8 Game-Changing Tips!

 

Handling insurance claims can feel like you’re stuck in a never-ending wrestling match—time-consuming, exhausting, and nowhere near what you signed up for when you go into dentistry. But it doesn’t have to be like this.

By making a few simple adjustments, you can manage insurance claims without all the stress. And if just the thought of being on hold with an insurance company makes you want to scream, don’t worry—we’ve got your back.

Here’s a step-by-step guide to help you take control of the process and reclaim your time. And if you need help streamlining everything, Wisdom can do it for you.

1. Preparation is Everything: Gather All the Details

Before you even think about picking up the phone, make sure you have all the information at your fingertips:

• Patient’s name and date of birth
• Date of service
• Subscriber’s ID or social security number
• Claim total and procedures billed
• Your practice’s Tax ID, NPI number, and doctor’s license number
• NEA number (if needed)
• Submission/resubmission dates and proof of acceptance from the clearinghouse

Most of the information, but not all, can be found on your insurance aging report. Having everything ready upfront saves you from fumbling through the call and speeds up the entire process.

*Pro-Tip: Check your clearing house rejections BEFORE waiting on hold. The worst thing that can happen is waiting on hold for 4-hours to find out it never made it to the insurance company.

2. Knock Out Calls by Grouping Insurance Providers

Don’t waste time jumping from one insurance provider to the next. Call one insurer and handle all claims for that provider in one sitting. So, if you’re calling Cigna, check on every outstanding Cigna claim while you’re on the line. It cuts down on time and gets more done in fewer calls.

*Pro-Tip: As some insurance companies limit the amount of claims they will allow on one call, start with the oldest claims for that company first, and work your way back. The oldest claims are the most important to avoid timely filing issues.

3. Stay Productive While on Hold

Let’s face it—hold times are inevitable. But you don’t have to sit there and wait. Use online insurance portals to check on other claims while you wait. It’s multitasking that will save you time in the long run.

*Pro-Tips for on hold:

• Check insurance portals
• Write appeals
• Check and correct rejected claims
• Send patient statements

4. Keep Meticulous Notes

Track every call for every claim. Document everything in the claim status note of your practice management software:

• Status of the claim (e.g., not received, denied)
• Actions you took (e.g., resubmitted claim, faxed documents, sent appeal)
• Name of the representative you spoke with
• Reference numbers they provide

For example:

• Date: October 1, 2024
• Claim Status: Requesting additional information: prior date of crown
• Action Taken: Confirmed insurance information and resubmitted claim with NEA #5678, including date of prior crown > 10 years old. Resubmitted with Claim #123456789 in the remarks section and faxed to 1-800-444-4444, attention: claims department.
• Rep Name: Sarah
• Ref #: 789654

*Pro tip: When you run your insurance aging report weekly—make sure you are also printing your claim status notes along with it. Place updated notes in the claim in real time as well. Organization here is key!

5. Don’t Quit—Resubmit

If a claim wasn’t received, don’t let it sit…and prevent a blind resubmit.

Blind resubmit: resubmitting a claim that hasn’t paid, without first calling the insurance company to see why the claim is not on file. You will want to confirm the insurance address, payor ID, and all information on file so the root of the issue is resolved.

Gather what you need and resubmit it as soon as possible. Skip the postal mail if you can—faxing is faster and offers a digital trail for when you are told it is “not on file”. If the insurance company indicates they didn’t receive an attachment, provide them with the necessary NEA or DCN numbers provided by your clearing house.

*Pro-Tip: Need help with locating insurance company fax numbers, or knowing what procedures need attachments? We have you covered with our free downloadable Dental Billing Cheat Sheets.

6. Be Polite But Persistent

Some claims are just stubborn. If you’re not getting anywhere, don’t be afraid to escalate. Ask for the highest level supervisor if you’ve hit a wall, and always insist on a fax number for resubmitting claims. Reference numbers, detailed notes, and persistence is your friend here. The squeaky wheel gets the grease!

7. Track Claims Weekly

Make sure that every claim is properly tracked from submission to payment to prevent any from slipping through the cracks. Review your insurance aging report, common denials, and your follow-ups with your doctor on a monthly basis.

Track your insurance aging numbers every week to watch your percentages of aged claims. A good goal is to get your Over 90 under 5% of your total insurance a/r.

*Pro-Tip: Download our Exclusive Guide to Dental Billing Secrets to optimize your claim management process. It’s packed with insider tips to make sure you’re getting paid faster!

8. Keep Your Cool

Look, dealing with insurance can be frustrating. But keeping a positive mindset (even when things don’t go your way) can make a big difference. Think of it as a game: reduce your “Over 90 Days” aging claims under 5%, and you win!

*Pro-Tip: Office Managers: make sure you are running your collection % and adjustment sheet every week and at the end of every month. Unfortunately, you can “cheat” the system of a low a/r by closing claims early. If you could use some help, Wisdom can help out with a FREE PRACTICE ANALYSIS to go over your Collection % and the A/R health of your practice

By following these tips, you can turn the insurance claims process into something far more manageable.

BONUS TIP: Want to make things even easier? Schedule a call with Wisdom, and we’ll take care of the administrative burden of dental insurance for you. Let’s get rid of the billing stress and free your team up to focus on patients. We’ll streamline your billing process, cut down your claim times, and give you back the time you need to run your practice smoothly.

Call 314-648-2663 or visit www.withwisdom.com/aadom to learn more.

 

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About Our Sponsor

 

Ashley Bond

Ashley Bond is a renowned leader in dental billing—as well as an official AADOM influencer and member of the AADOM Speaker/Consultant Alliance (ASCN).

Leveraging years of experience in her father’s practice, Ashley co-founded Wisdom (previously Bond Dental Billing) — a full-service company that helps eliminate tedious billing tasks and insurance headaches.

Ashley also shares her passion for helping dental practices work better for everyone involved by speaking, writing, and educating throughout the dental community.