Capline Dental Services

Appealing a dental insurance claim denial is necessary because nearly half of the practice's revenue depends on it, and payers make it difficult for providers to avoid reimbursing the claim. If the practice believes claim adjudication is inappropriate, appealing is a reasonable resolution with the insurer. Insurance companies focus on profits by collecting monthly premiums while systematically denying claims. There is always some language in the contracts through exclusions, frequency provisions, or limitations to challenge payment by reducing payouts, leading to higher profit margins. That means using all precise information, supporting documentation, and unwavering confidence in the claim process. Even for seasoned billers, this is daunting and intensive work. Capline Dental Services provides billing experts to save your team members time from lengthy calls with insurers and focus on patient care. Here are successful tips to tackle  dental insurance claim denial  and help pa...

  Dental credentialing acts as a line of defense for patients by insurers to protect them, ensure they get the best care, and ensure everything happens in compliance. The process verifies the practitioner's qualifications, education, licenses, training experience, and accreditations to check if the practitioner can offer services to patients. The dental industry has a lot of challenges, and one of them is how to bill non-credentialed providers to have accurate claims. Credentialing is a necessary process with no room for regulatory errors to avoid fines and audits. The dental credentialing vetting process happens before hiring dental professionals so the patients receive good treatment. The professionals can have a network of payers helping the practice. The challenge is treating providers who recently joined the practice, are convinced to submit claims during the credentialing process, resulting in delayed payments, dissatisfied patients, claim denials, and lost revenue. Let'...

  Many dental practices find monitoring and tracking accounts receivables a challenge. If collections are not prioritized by the billing team, the outstanding dues keep increasing. Many a time, it is the collection process that needs to be blamed. For any practice, collection is linked to cash flows, and this considerably impacts profitability. It is imperative to follow  dental billing  best practices that speed up payments and improve cash flows. Some tips to boost collections and cash flows are outlined below. 1. Patients Need to be Aware of Estimated Payments and the Insurance Policy Before Receiving any Service Once a patient has been diagnosed and the practice has recommended solutions or procedures, the dental team needs to make the patient aware of all possible costs. Before commencing any treatment, the team needs to get the treatment plan signed by the patient. This plan must encompass all possible expense heads that include total fees, the estimated insurance c...