How to work a dental insurance aging report
Your practice management system can produce an insurance aging report that groups outstanding claims by how long they have been open, usually in 0-30, 31-60, 61-90 and 90+ day buckets. Work it by payer, oldest first. One phone call or portal session can then cover several claims with the same carrier.
A weekly claim follow-up routine
- Clear rejections first. A clearinghouse rejection means the payer never received the claim. Fix and resend these before anything else.
- Check status. For each open claim past your trigger point (often around 30 days), check the payer portal or send an electronic status inquiry.
- Record the answer. Put the status, reference number, date and next step in the claim notes so the next person doesn’t repeat the work.
- Act on it. Send the X-rays or narratives the payer asked for, correct and resubmit, or move the claim to the denial queue.
- Report. Send a short weekly summary of claims touched, money moved to paid and claims escalated.
Claims that come back denied go to a separate queue; the dental denial management and appeals page explains how that queue is sorted.
Common reasons dental claims stall
- A missing tooth number, surface, quadrant or arch on a procedure that needs one.
- No attachment where the payer expects one, such as images for crowns or perio charting for scaling and root planing.
- Wrong subscriber details: date of birth, member ID or relationship to the patient.
- Coordination of benefits questions when the patient has more than one plan.
- Payer requests for information that came by mail and were never opened.
Several of these start before the visit. Checking coverage and subscriber details ahead of time, as described on the eligibility verification page, prevents a share of them.
Dental timely filing limits
Every payer sets a deadline for submitting claims and a separate one for corrections and appeals. Limits vary widely by payer and plan type, and provider contracts can change them, so check the payer’s provider manual or your agreement instead of relying on a general rule. Your follow-up routine should flag any claim that is getting close to its limit.
What the practice provides
- A signed business associate agreement before any access is granted.
- Named user accounts for the practice management system, clearinghouse and main payer portals.
- Scanned mail from payers, or a secure way to receive it.
- A contact who can approve narratives and answer clinical questions.
Claim follow-up questions
Does the billing team call payers?
Yes, when a portal or status inquiry doesn’t give an answer. Calls are made in the practice’s name with the practice’s provider details, and notes go into the claim.
How fast will the aging go down?
That depends on how old the claims are, why they stalled and how quickly payers respond. Track the 90+ day bucket month by month to see progress.
What counts as a trigger point for follow-up?
Many practices start checking a claim when it has been open around 30 days with no payment or denial. Pick a number that suits your payers and apply it every week.
Send your current insurance aging totals by bucket and your main payers.
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