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Article
Streamline the Claims Adjudication Process and Expedite Payment with Dental Claim Processing Software
Summary
As the blueprint of the dental practice continues to evolve, claims reimbursement cycles get longer and the complexity of insurance plans increases. Dental providers need solutions that create a practice that is more efficient and costs less to run. Organizations of all sizes deserve the availability of dental claim processing software with an electronic attachment solution that helps speed up collection, reduce denial rates, and contain costs.
By: Colleen Ayala, director of Dental RCM Product, Change Healthcare
Although committed to reducing waste and inefficiency, the healthcare industry still spends too much time and money managing administrative tasks manually.
What is a claim attachment?
Dental claim attachments are supplemental documents that provide additional information to the claim processor, which support the necessity of the procedure being performed. Common attachments include narratives, pre- and post-operative radiographs, periodontal charting, sedation records, and other supporting documentation. Procedures requiring attachments should be included with the initial claim submission, preferably utilizing an electronic clearinghouse. As a federal standard has yet to be mandated, electronic adoption of claim attachments is low for both medical and dental industries. According to the 2021 CAQH Index, approximately 40 million dental attachments were exchanged between health plans and providers, of which 32 million were processed manually.
The problem with paper-based documentation
Dental providers still submitting dental attachments manually are incurring a lot of expense related to paper, printing, envelopes, and postage: more than $4 per attachment according to Change Healthcare’s internal statistics. These providers must also purchase and store materials while accepting there will be a lag time in reimbursement. Lastly, office staff must allocate time for these manual processes, reducing overall efficiency within the practice.
Submitting attachments electronically to boost efficiency
The Patient Information Transaction Set (275) is an EDI transaction designed to carry attachments electronically, either unsolicited (without a request from the receiver) or in response to a request for supporting documentation. Alternatively, portal-based solutions have been designed to enable providers to submit attachments electronically to supplement low adoption rates of the 275 transactions. Though the exact steps to adding an attachment will vary, the attachment itself will not.
While dental providers who adopt electronic claim processes experience significant improvements in their revenue, it’s not the only benefit. The efficiencies gained and the ability to follow a claim and supporting attachments through the entire claim cycle provide a comfort and confidence that often surpass any money saved.
Here for you when you need it
Change Healthcare’s Dental Claim Attachments solution is a simple, web-based solution that enables both payers and providers to send and receive dental claim attachments electronically. This solution helps dentists accelerate submissions and reduce errors, reduce printing and mailing costs, and cut payment time for improved cash flow. Its easy-to-use interface helps improve efficiency and reduces time spent printing and mailing. With payer-specific attachment guidance, providers know exactly what to submit, helping reduce denied claims and rework.
Important features
- Electronically transmit claim attachments (e.g., radiographs and intraoral images, periodontal charts, EOBs, narratives, etc.)
- Unlimited attachments
- Attachments are delivered electronically
- 24/7 online access to your images
- Supports rules-based submissions
