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How to Appeal Denied Dental Claims and Rejections

Dental offices that face claim denials and rejections due to coding errors, missing patient details or documentation mistakes can go for the appeal process. <br>

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How to Appeal Denied Dental Claims and Rejections

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  1. How to Appeal Denied Dental Claims and Rejections 918-221-7769

  2. Often dental claims get rejected due to missing patient details, errors in submitted codes, and failure to verify patient’s dental eligibility among other reasons. If there is no error in the claim, you can prepare an appeal. ADA Recommendations to Appeal a Dental Claim • Include additional documentation of why the treatment is recommended • Provide the dentist consultant as much information as possible • Follow specific instructions provided by the particular carrier • Send appeal letter to the specified department of the carrier • Include the word “appeal” in the title and the text of the document

  3. Major Dental Claim Rejections Patient ineligible for the procedure For all new patients, insurance details must be verified before visit Coverage on periodontal scaling and root planing (SRP) Patients and dentists must be clear about SRP coverage Limited benefits for periodontal maintenance Dentists must make patients aware about procedures not covered Core buildup procedure Make patients understand the limitations of the plan prior to treatment

  4. How to Prevent and Resolve Such Claim Errors? • Using the right CDT codes without errors • Providing a clear narrative in the document • Determining the date of service Experienced medical billing companies can help dental practices meet their medical billing and claim submission requirements.

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