Dental claim denials can be a frustrating and costly issue for dental practices. However, most denials are avoidable with the right precautions. Here are the top five reasons dental claims are denied, and how you can avoid them.

1. Incorrect or Missing Information

One of the most common reasons for claim denials is incomplete or incorrect information. Missing patient details, incorrect insurance information, or outdated eligibility can lead to denials.

Solution: Always verify patient information before the appointment. Use automated tools to confirm eligibility in real-time to prevent errors.

2. Incorrect or Incomplete Coding

Improper coding is another leading cause of denied claims. Whether it’s using the wrong code or failing to use specific modifiers, incorrect coding can result in delays or denials.

Solution: Stay up-to-date with the latest dental codes and ensure your billing team is trained to code correctly. Using specialized dental billing software can reduce errors.

3. Lack of Pre-Authorization

Certain procedures require pre-authorization from the insurance company. If the required authorization isn’t obtained, the claim may be denied.

Solution: Always check with the insurance company before performing high-cost or specialized procedures to obtain pre-authorization.

4. Submitting Claims After the Deadline

Insurance companies have strict deadlines for claims submissions. Failing to submit a claim within the designated timeframe often results in an automatic denial.

Solution: Set up systems to track claim deadlines and ensure timely submission. Automated reminders from your billing software can help keep things on track.

5. Errors in Patient Eligibility

If a patient’s insurance coverage has changed or expired, claims may be denied due to incorrect eligibility.

Solution: Verify patient eligibility before each appointment. Encourage patients to inform you of any changes to their insurance coverage.

How AR Dental PRO Helps

At AR Dental PRO, we proactively manage these issues to reduce the risk of denials. We verify eligibility, ensure accurate coding, and handle pre-authorizations to minimize the chances of your claims being denied.

Struggling with claim denials?

AR Dental PRO can help reduce your claim rejection rate by streamlining the billing process. Get in touch today to learn how we can assist your practice.