top of page

Claim Denial Management

Claim denials occur when a submitted dental service claim is rejected by the insurance company for various reasons. Common causes include incomplete or inaccurate information, coding errors, eligibility issues, lack of supporting documentation, and contractual discrepancies. Effective denial management is essential to identify the root causes of denials and address them promptly to minimize financial losses and optimize revenue collection. Here are the steps we ensure as part of our denial management.​

​

  • Proactive Pre-Claim Processes: Our team's accurate eligibility verification and meticulous claim preparation can significantly reduce the likelihood of denials. We ensure that patient information, insurance details, and treatment codes are correctly recorded which helps prevent errors from occurring initially.​

​

  • Root Cause Analysis: Upon identifying a denied claim, the biller perform a thorough root cause analysis. This involves scrutinizing the claim details to understand why the denial occurred and whether the issue is procedural, coding-related, or a documentation deficiency.​

​

  • Effective Communication: Regularly engaging with insurances and practitioners to discuss denied claims and promptly rectify issues leads to faster resolution and reduced denial rates.​

​

  • Coding Accuracy: Our billing team adhere to current coding standards (such as CDT codes) to accurately represent the provided services. Regular training and updates on coding guidelines minimize errors and decrease the chances of denials due to coding issues.​

​

  • Appeals Process: Diligent tracking of appeals ensures that claims are resubmitted promptly and correctly.

Colors  logo
Contact

208 N Dunton Ave, Arlington Heights,

IL 60004 

 

Phone: 414 394 0107

Email: info@colorshealthsolutions.com

© 2023 Colors Health Solutions.

Get In Touch

Thanks for submitting!

bottom of page