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Denied claims disrupt cash flow, increase admin workload, and lead to rework that your team shouldn’t have to do twice. Most of these losses are avoidable—and the ones that aren’t can often be reversed with the right process. This guide walks through six focused strategies to help your team prevent denials, fix them quickly, and improve overall billing performance. From documentation and coding to rebilling workflows, appeals, and patient communication, each section gives you practical steps to protect your revenue and reduce write-offs.
Aug 6, 2025
1. Understand Dental Insurance Claims
Rebilling starts with knowing why claims get denied. Most issues fall into three categories: administrative errors, documentation gaps, and plan-based exclusions. Each one slows payments and increases follow-up work.
Administrative errors are the most common. Mistakes like incorrect birth dates, missing tax IDs, or outdated ADA forms lead to automatic rejections. CDT coding errors—such as using outdated codes or mismatched procedure details—are flagged immediately by clearinghouses.
Incomplete documentation causes denials even when clinical work was appropriate. Carriers routinely reject scaling and root planing claims without perio charting or decline crowns submitted without current radiographs. Missing this kind of supporting evidence is one of the fastest ways to lose reimbursement.
Plan-level restrictions create denials unrelated to claim quality. Common issues include:
Frequency limits (e.g., cleanings twice per year)
Exclusions for cosmetic procedures
Lapsed coverage or inactive benefits
Missing Coordination of Benefits details when patients have multiple plans
Submitting after the filing window has closed (ranges from 90 days to 12 months depending on the carrier)
Before rebilling, make sure your team understands the key terms they’re working with:
EOB (Explanation of Benefits): Details how each procedure was processed—paid, adjusted, or denied
COB (Coordination of Benefits): Explains how two insurance plans split payment
Preauthorization/Predetermination: Required in advance for higher-cost procedures
Medical necessity: Links documentation to clinical need and appropriate CDT codes
Fee schedule/UCR: Defines how much the insurer is willing to pay for each service
To make rebilling effective, track denial trends. Run weekly reports by procedure code, provider, and payer. If scaling and root planing shows a 30% denial rate, audit charting documentation. If one payer is rejecting more claims than usual, review their policy updates. Use tags and follow-up dates at 30, 60, and 90 days to track status and keep aging claims from slipping through. Understanding the root cause of each denial is the first step to recovering revenue and preventing future write-offs.
2. Set Up an Effective Rebilling Process
Rebilling works best when it’s treated as a structured workflow, not a reactive task. A consistent process helps your team address denials efficiently, reduce delays, and recover lost revenue without added stress.
Start with Clean Submissions
Every successful rebill begins with accurate, complete claim data. Use the current ADA form, confirm patient and provider details, and attach all required documentation—such as current radiographs for crowns or perio charting for scaling. Even small errors like a mistyped birth date or missing tax ID can cause automatic denials.
Establish a Clear Follow-Up Timeline
Track each claim from the moment it’s submitted. Set reminders in your practice management system or claims dashboard so no claim goes unchecked. Waiting for the payer to respond wastes valuable time and increases the risk of missing resubmission deadlines. A structured timeline helps your team spot stalled claims early, avoid preventable write-offs, and maintain consistent follow-through across all carriers.
Day 30: Confirm it's in adjudication
Day 60: Call the payer to request updates or address missing information
Day 90: Resubmit, escalate, or begin the formal appeal process
Add these checkpoints to your SOP and update them whenever CDT codes or payer rules change. Standardizing this workflow reduces uncertainty and cuts training time for new staff.
Assign Responsibilities
Make sure someone owns each part of the process. One team member should track unpaid claims, another should handle appeals, and a third should oversee documentation or payer communications. Weekly check-ins help your team flag trends, prioritize large balances, and stay focused. Use software that supports this workflow. Choose tools that:
Pre-check claims for missing documentation
Send real-time alerts when claim statuses change
Combine eligibility, e-claims, and payment posting in one dashboard
Platforms like Jarvis Analytics and others in your PMS can help you track denial rates by code, carrier, or provider.
Review Performance Quarterly
Look at how many denials were overturned, how long claims stayed open, and which carriers or codes caused the most delays. Use that data to adjust your workflows and training.
A reliable rebilling system improves cash flow, reduces staff burnout, and turns denied claims into resolved payments—without letting them fall through the cracks.
3. Prevent Denials Before They Happen
Denied claims reduce revenue and create unnecessary rework. Most of these losses are preventable with strong front-end processes. When billing issues are caught before submission, your team spends less time reprocessing claims and more time focusing on active production. Prevention also strengthens patient communication by eliminating billing surprises tied to incomplete coverage checks or missing documentation.
Start with Early Verification
Check insurance coverage 48 to 72 hours before the appointment. Confirm plan status, patient eligibility, and frequency limits for each scheduled procedure. Use payer portals or call directly, and document the rep’s name, reference number, and any restrictions or uncovered services. For high-cost or less common procedures, request pre-authorizations and flag out-of-pocket estimates for the patient in advance. This step reduces surprise denials and improves patient communication.
Treat Documentation Like a Case File
For claims involving crowns, implants, or periodontal therapy, clinical notes need to go beyond one-line explanations. Include diagnostic X-rays, periodontal measurements, and a short narrative explaining medical necessity. Add photos or chart screenshots when relevant. Insurers look for specific evidence that supports the CDT code—give them exactly what they need before they ask.
Review Coding Accuracy Regularly
A single outdated or misused code can void an otherwise clean claim. Update CDT codes annually, and confirm that each procedure is coded correctly in your PMS. Avoid unbundling procedures that are billed as a single service, and include modifiers or diagnosis codes when required by the payer. Always cross-check that the coding reflects both the clinical notes and supporting documentation.
Pairing early verification with proper documentation and correct coding catches most issues before the claim goes out the door. These habits prevent revenue leaks, reduce rework, and protect your collections from slipping through the cracks.
4. Develop a Claim Appeal Strategy That Protects Revenue
Every denied claim puts part of your revenue on hold. Once you receive the Explanation of Benefits (EOB), most insurers allow between 30 and 180 days to file an appeal. That window varies by carrier, so log the denial date, confirm the exact appeal deadline, and set reminders in your practice management system. Missing this step makes the claim uncollectible.
Start with a clear review. Check the denial code against the chart notes, documentation, and any attached radiographs. The most common issues—missing perio charting, incorrect CDT codes, or incomplete narratives—can often be corrected quickly. Once the issue is identified, update the claim in your system, attach supporting evidence, and prepare your appeal.
Write your appeal letter with a tight, professional format:
List the claim number, service date, patient name, and denial code at the top
State your request clearly: “Please reconsider payment for D4341 scaling and root planing”
Address the denial reason directly with relevant evidence (e.g., “Perio charting enclosed showing 5–6mm pocket depths”)
Use a short bullet list to call out attached documents: X-rays, charting, narratives
Include a contact name, direct phone number, and preferred follow-up method
Send the appeal electronically if possible. Digital submissions generate timestamps and reduce delivery delays. Track status updates weekly, and if there’s no movement after 30 days, call the payer directly. Document the conversation, including the rep’s name and the expected timeline for a decision.
If the appeal stalls, escalate. Ask for a supervisor review, then request a peer-to-peer consult if the denial is based on clinical judgment. Keep thorough call notes and file copies of all submissions. This documentation is essential if you escalate to the state insurance department or involve a professional association.
Most denials can be overturned with accurate documentation and consistent follow-up. Treat each appeal as part of your billing workflow and the revenue you recover will reflect that discipline.
5. Support Patients Proactively When Claims Are Denied
Your team sees a denial before the patient does. That timing gives you an opportunity to control the conversation and prevent confusion.
Without context, a denied claim often leads to billing questions, delayed payments, or canceled follow-up care. Reaching out early helps patients understand what happened, what they owe, and what options are available. It also reduces avoidable callbacks and keeps your front desk focused on current patients.
Start During Benefit Verification
When you identify plan limits or exclusions, share them upfront in plain language: “Your plan covers two cleanings per year, not three.” Patients are more likely to accept out-of-pocket costs later when they’ve had time to prepare—and when they hear it from your team first, not the insurance company.
When a Denial Happens, Explain It Clearly
Walk through the Explanation of Benefits (EOB) with the patient. Replace payer codes with direct terms, and explain exactly what was denied and why. Then ask if they’d like your office to file an appeal. That question reinforces that you’re on their side and reduces the chance they’ll blame your team for the outcome.
Handle the Financial Side with Empathy and Options
When coverage falls short, provide clear, manageable ways to close the gap. This could include:
Short-term in-house payment plans
Healthcare credit options like CareCredit or Sunbit
Preventive-care membership plans
Same-day payment discounts for uncovered services
Match the option to the patient’s situation and make it easy to accept.
Document the Conversation and Keep It Accessible
Record what was discussed, what the patient agreed to, and which solution was offered. This protects your team and makes follow-up easier if the patient calls back with questions.
Patients don’t expect perfection from insurance, but they do expect transparency from your office. When you guide them through a denial calmly and offer realistic next steps, you reduce complaints, strengthen loyalty, and protect your revenue without compromising the relationship.
6. Train Your Team to Prevent Denials and Protect Revenue
Accurate billing depends on the people entering data, not just the software behind it. A well-trained team reduces denials, shortens the revenue cycle, and lowers the need for rework. But that only happens when training is consistent, targeted, and reinforced over time.
Focus on five core skills across your team:
Insurance verification: Make sure front desk staff confirm eligibility, plan limits, and coverage details before each visit.
Documentation standards: Teach providers how to consistently include radiographs, periodontal charting, and clear narratives that support clinical necessity.
CDT coding fluency: Ensure every team member using codes knows how to apply the most current set and avoid common bundling errors.
Payer communication: Train staff to speak clearly and confidently with insurance reps, using denial codes and patient data to resolve claims efficiently.
Plan rule awareness: Help your team recognize limitations like frequency caps, waiting periods, and exclusions so they can set the right expectations with patients and code claims accurately.
Training only works if it's supported by culture. Use short weekly huddles to review denial trends, share updates on payer policy changes, and highlight successful appeals or zero-error claim batches. Create space for open discussion and treat mistakes as coaching opportunities, not performance failures.
Keep education ongoing. CDT codes change annually, payers update requirements frequently, and new tools emerge regularly. Use short in-house refreshers, online billing courses, and peer-led lunch-and-learns to keep your team up to date. A team that understands the full billing process—from verification to appeals—reduces preventable denials and strengthens your entire revenue cycle.
Create the Right Team With Teero
When hygienists are missing, your billing suffers. Hygienists capture the radiographs, perio charts, and clinical notes your billing team needs for clean claims. Missing records mean stalled claims and rising denials. Cross-training helps, but no one can replace missing clinical data. Smooth hand-offs between clinical and billing teams cut errors, and timely, complete documentation gets you paid faster.
Teero fixes the root problem: coverage gaps. Our on-demand hygienist network fills shifts quickly. Every procedure gets charted, photographed, and documented the same day. Your billing coordinator finds complete claims ready to submit. Consistent staffing frees your front office for proactive follow-ups and appeal tracking, turning write-offs into collected revenue.
Sign up for Teero or call today to get started. Get skilled hygienists when you need them, maintain complete documentation, and watch collections move at the pace your practice deserves.