How to Appeal Denied Dental Claims and Rejections

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How to Appeal Denied Dental Claims and
Rejections
918-221-7769
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Often dental claims get rejected due to missing
patient details, errors in submitted codes, and
failure to verify patients 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
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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
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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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