At times, trying to get paid by insurance can be a chore, but completing some extra steps on the front end can help save you time and effort in the long run. Read this post to learn tips and tricks to make sure you’re getting paid for insurance claims.
Verify Benefits and Eligibility
Before your patient even comes in for their appointment, make sure insurance information is up to date. Verify the patient’s plan information with them and make sure to verify the plan benefits and patient’s eligibility. In Open Dental, you can use the Insurance Verification List to see which patients are coming in for appointments and need to have benefits or eligibility verified.
Take it a step further and automate the process through your PMS or clearinghouse. With Open Dental, you can set up Ins Batch Verify in Scheduled Processes to automatically verify patient eligibility along with some other insurance details with your clearinghouse.
Making sure to verify insurance ahead of time will help prevent the dreaded claim denial when you find out that a patient’s coverage has lapsed or changed.
Send Claims in a Timely Manner
This may seem like a no-brainer, but you can’t get paid by insurance if the carrier never gets a claim (or if they get it too late). Making sure to send out claims each day will ensure that you don’t end up with a backlog and don’t delay payment. Figure out which workflow works best for your office – sending claims after each appointment or sending claims at the end of the day. Make sure staff know who is responsible for each part of the process.
Use reports, like the Procedures Not Billed to Insurance Report and Claims not Sent reports in Open Dental, to audit which claims still need to be created or sent. The Procedures Not Billed to Insurance Report even lets you create multiple claims for multiple patients with a just a few clicks.
Send Accurate Claims
Claims with missing data and attachments are a recipe for delayed payment, so make sure you’re reviewing any warnings and make changes before sending claims. Open Dental will alert you about missing data before sending claims and your clearinghouse may provide more detailed warnings.
Follow up on Claims
It’s a common tale that insurance takes their time responding to or paying claims, and sometimes they need a little push. Once claims have been sent, make sure to follow up on them when you haven’t heard from insurance or received payment yet.
In Open Dental, use the Outstanding Insurance Claims Report to see a list of claims that haven’t been received yet. Easily set parameters to follow up on specific date ranges or carriers. One you’ve followed up, make sure you update the claim status or add notes, so another person doesn’t follow up with the same claim again until it’s necessary.
Automate the Process
Tired of having to cash check or manually process credit card transactions for claims? Check with your clearinghouse to see if they support Electronic Remittance Advice (ERAs), if they do, you may be able to sign up with carriers to get claims back electronically. You’ll normally have to enroll with individual carriers, so it can take some time to set up, but once it is, you’ll be able to process claims much more quickly. With Open Dental, you can even set ERAs to be automatically processed.
Making sure to follow these steps and take advantage of the tools at your disposal can be a help ease the burden of making sure your practice gets paid on insurance claims with as little hassle as possible and in a timely manner.
Want to know more about the tools in Open Dental to efficiently manage insurance claims and reimbursement? Give us a call!