It’s not often that dental staff have any downtime; however, if you do, you can use this time to investigate, follow up on, and resubmit any unresolved insurance claims. Resolving claims is critical to your practice’s bottom line. Now is the best time to investigate why each insurance claim has not been paid, correct any errors (for example attach missing documentation), and resubmit these claims.
How to:
On the location’s Overview page (dashboard), click (or tap) the Unresolved Claims widget. The Unresolved Claims page opens.
The unpaid dollar amount reported on the Unresolved Claims widget is the total amount of the unpaid insurance claims that are over two weeks old or have a status of rejected.
Note: The unresolved claims are grouped by insurance carrier, which appear as expandable and collapsible sections.
Click (or tap) a plan’s button to view the corresponding claims. The claim options become available.
Review any claim Notes, and contact the insurance carrier and/or patient, if needed.
Click (or tap) Review/Edit to review and edit the claim, if needed. The Claim Detail dialog box opens.
In the Claim Detail dialog box, make any necessary changes by clicking the appropriate tab. For example, select the Attachments tab. From here you can add missing images, documents, or perio exams. Then, click (or tap) Save and Resubmit.
In the Notes area, communicate with your team by adding a note of what you did and when you did it. To specify that the claim needs additional follow-up, type any Notes, and specify who to Follow up with (carrier or patient) and when you want to be reminded to follow up. Then, select the Dismiss Claim check box to remove the claim from the list until the specified number of days has elapsed.
Additional Information
For an electronic claim submission, Dentrix Ascend transmits separate service lines for identical procedures on the same claim. For carriers, such as Medicaid and Blue Cross/Blue Shield, that are known to require a single line with a quantity value for identical procedures on the same claim, claims are processed accordingly through the clearinghouse. If you receive a notice from a payer, stating that a quantity value is required for identical procedures, contact Support with that information, so the needed functionality can be provided.
To learn more about if the claim has missing or insufficient data or if the payer has requested a replacement claim, read Resubmitting rejected claims.
