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Best Practices to Help Avoid Rejections & Denials

rejections and denials

Let’s face it: submitting an insurance claim is never fun. And the process quickly becomes excruciating when you receive a claim denial or rejection. Fortunately, many of the most common reasons for rejections and denials are avoidable!

Paper claims are a challenge.

Paper claims submission and acceptance can be frustratingly slow, often bringing the business side of dental practices to a screeching halt. Even when functioning efficiently, paper claims are a burden with a never-ending mountain of paperwork. 

In addition to the staff resources, paper claims represent an oversized risk of problems that may lead to insurance claim denials or rejections. Introduced errors such as transposed numbers, misspelled names, or incorrect dates are just a few problems inherent to this manual process.

The problem is not insurmountable! Submitting claims electronically addresses many of these problems, while reducing inefficiencies and boosting bottom lines. Electronic claims aid in quicker processing, faster payments, and cleaner claims while reducing paper and eliminating hassles.

There’s a code for that.

A leading cause of dental claim rejection and denial – and one of the easiest mistakes to make – is incorrect coding. Codes are complex and ever-changing. A solid understanding of coding is the basis of a good process. Technology helps too – keep your Open Dental practice management software up-to-date and partner with a reputable clearinghouse for claims submissions.

A clearinghouse adds another layer of protection. Built-in functionality catches incorrect procedure codes before claims are submitted to the insurance payer. Claims are rejected at the clearinghouse level; providing an opportunity to save time and money by avoiding a payer rejection. Consider it built-in quality assurance.

Even forms don’t like forms.

Claim codes aren’t the only thing to change regularly. Claim forms are frequently updated. Utilizing the right form is essential.  

Manually verifying the correct form can be time-consuming. It’s also not necessary with a clearinghouse whose core business is built on expert communication between providers and insurance payers. Taking the information entered into the Open Dental practice management system, an integrated clearinghouse maps it to the correct fields as required by the payers. Bonus! It also catches missing information.

Failure to verify benefits.  

One of the leading causes of denials is ineligibility for care. Checking a patient’s insurance coverage status prior to receiving care is vital. The benefits go beyond simply determining if the patient has dental coverage. Verification gives precise benefit details including updated group numbers and other information that might currently be inaccurate in your practice management system.

Technology helps here too! Using an eligibility verification solution integrated with Open Dental eliminates the need to chase information from multiple payer websites. Connectivity to hundreds of payers provides immediate transparency on a patient’s insurance benefits and populates that information directly into your practice management system.

Make incomplete claims a thing of the past. 

The easiest way to avoid rejections and denials is to submit the claim correctly the first time. A complete claim includes required supporting documentation – X-rays, perio charts, narratives, etc. Missing or deficient attachments are a good way to slow the process down. Mailing or even electronically submitting separately can lead to lost, damaged, or incomplete claims. The quickest and easiest way to submit this information is with the claim rather than mailed or submitted separately.

Accelerate your business.

No matter what technology you rely upon, it is essential to create, implement, and optimize systems designed to support the best insurance claim submission practices. Keep your practice management software up to date, maintain proper clinical documentation, and provide your staff with the time and tools necessary for timely claim processing. Finally, consider integrated solutions to connect your data, workflows, teams, and patients.

 About DentalXChange

DentalXChange’s platform isn’t just technology. It’s backed by people who realize we’re in a service business, to support your practice. With our technology and unrivaled team, we’re built to support our clients and bring ease to the dental payments process. And we’ve been doing it for over 30 years.  

We’re committed to service through technology that makes your job easier.  And the best part? Most are integrated into Open Dental!

Ready to talk to a Payments Pro? Please visit or call 800.576.6412 ext. 472.

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