Dental Denial Management: Recovering Lost Revenue for Your Practice

At Advantawise, we understand that dental claim denials can significantly impact your practice's revenue. Our specialized dental denial management services are designed to systematically address denied claims, recover lost revenue, and implement strategies to prevent future denials.

Common Dental Claim Denial Reasons:

Dental practices face unique denial challenges that require specialized expertise:

• Exceeded Annual Maximum: Claims denied when patients have reached their annual benefit limits.
• Waiting Period Violations: Services provided before waiting periods for major procedures have been satisfied.
• Frequency Limitations: Preventive services provided too frequently according to insurance guidelines.
• Alternative Benefit Limitations: Insurance coverage for alternative, less expensive treatment options.
• Pre-authorization Required: Major procedures performed without required pre-authorization.
• Missing Documentation: Lack of required X-rays, periodontal charting, or treatment notes.

Our Dental Denial Management Process:

Our systematic approach to dental denial management ensures maximum recovery:

• Denial Analysis: We thoroughly analyze each denial to identify the specific reason and develop appropriate appeal strategies.
• Documentation Review: Our team reviews all available documentation to support the appeal, including clinical notes, X-rays, and treatment plans.
• Appeal Preparation: We prepare comprehensive appeals with proper dental terminology and supporting evidence.
• Timely Submission: Appeals are submitted within insurance carrier deadlines to preserve appeal rights.
• Follow-up Management: We track appeal status and follow up with insurance carriers to ensure timely resolution.
• Pattern Analysis: We identify denial patterns to implement preventive measures for future claims.