One Dental Billing

Why attachments are important in dental insurance claims?

Dental Claim Attachments is an electronic claims-attachment solution for dental providers that want to simplify the transmission of x-rays, perio charts, narratives, or any other documentation and streamline the claims adjudication process.
A dental claim attachment is supporting documentation that proves the necessity of the procedure being performed. Simply put, it aids in proving medical or dental necessity.
Procedures requiring attachments should be included with the initial claim submission utilizing an electronic clearinghouse. Depending on the procedures listed, the number and type of attachments may vary.
However, it is best to submit all supporting documentation upon initial submission to prevent any delay in processing the claim. Delayed claims lead to headaches and lost revenue. Send everything you have the first time!

Key Benefits

  • Eliminates lost or damaged attachments
  • Speeds up claim and pre-determination processing
  • Reduces your follow up time with payers
  • Know what to attach before you send it with payer specific attachment criteria
  • Save on paper, printing, and postage costs
  • Get paid faster when claims are submitted appropriately the first time
  • For a list of Dental Payers Online

How do I submit a dental claim attachment?
The preferred method for submitting a dental claim attachment is to utilize an electronic clearinghouse with attachment capabilities. An analogy would be an email with a picture attachment. An electronic clearinghouse works similarly when sending attachments with claims. Depending on your dental practice management software, the exact steps to adding an attachment will vary, however the attachment itself will not. The most popular attachment software is National Electronic Attachment (NEA) FastAttach. NEA FastAttach creates an electronic file number associated with your attachment. Think of it like a receipt you get when you go to the post office to mail a package or certified letter. If an insurance company claims to have not received your attachment(s), you can give them that NEA number, and they can search the national database for that specific image and find your “package”.
This cuts back on all the back-and-forth between an insurance company and your dental practice. There are other great clearinghouses with similar capabilities and attachment softwares embedded. Also, NEA is widely known and utilized, however there are other clearinghouses with comparable capabilities.

What happens when supporting documentation or attachments are missing on an insurance claim?
Short answer: your insurance claim is more likely to be denied.
Supporting documentation is key for a clean claim. When we say “clean claim,” we mean a claim that has everything it needs to be reimbursed by insurance: accurate patient information, proper coding, and of course, supporting documentation. Insurance companies look for any reason to deny your claims or downgrade your procedures for lower reimbursement, so with your due diligence, you won’t be giving them a reason.

If this is so obvious, why do these claim details get forgotten?
Sometimes claim details are forgotten just because the dental team gets caught up in the routine of the day, especially if they are busy, and neglect to attach certain x-rays or intraoral photos. Or other times, they don’t realize that an x-ray is insufficient and need to attach an intraoral photo to show why dental services were needed. Sometimes an x-ray doesn’t show what the naked eye can see. Then, of course, there are some patients who cannot handle having the camera mechanism in their mouth. This specifically, is something you should add to your claim in the clinical notes. The more details are missing on your claim, the more likely it will be denied. Specifically, consider taking intraoral photos of the original condition prior to treatment.

This is important for three reasons:

  • It provides evidence of medical necessity.
  • It documents your clinical findings before any work is done. Showing the original condition is essential in case you need to send in an appeal.
  • It helps you educate your patients so they can see and accept the need for treatment.
You can always still fight insurance on this, but it does get difficult when you do not have effective documentation.

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