Claims
Resources and information on provider rights; navigating claim denials, the payment dispute process and appeals; and understanding the role of the plan regulators.
Dental Benefit Plan Handbook – Chapter 05: Working with Patients and Their Plans
Help patients understand the relationship the practice holds with plans; overview of: in network, out of network, pre-authorization, predetermination, discounts, dual coverage and claims.
Dental Benefit Plan Handbook – Chapter 06: Completing and Filing the Claim Form
Common reasons for claim delays and denials; correct use of procedure codes, Tax Identification (TIN) and National Provider Identification (NPI); practice’s fee schedule and radiographic image attachments; electronic claim (E-Claim) filing.