Guides

Dental billing and reporting guides

Plain explanations of the reports, claims and payer rules your office deals with every week. Written for the person who has to work the list. Where a figure appears it carries its source, and where a number does not exist we say so rather than borrow one. That habit is why we also publish our research on dental insurance data.

Reading your reports Claims and payers Insurance and verification Working with your software

Reading your reports

What the numbers on your practice software's own reports actually count, and why two of them disagree.

Start hereYour insurance aging report, decodedWhat the report counts, why it disagrees with your A/R report, and the four things that quietly inflate it.Read the guide Reading your reportsWhy two reports in your office give two different A/R totalsTwo reports, two totals, and neither one is broken. What each is counting, and how to reconcile them.Read the guide Reading your reportsEstimated insurance, and why it moves your A/R without anyone touching itThe number behind most unreconcilable A/R totals, and the one that decides who gets a statement.Read the guide Reading your reportsHow old is that claim, reallyThree dates, three answers, and the one basis a resubmission cannot reset.Read the guide

Claims and payers

Why claims come back unpaid, what the words on the remittance mean, and what to do about each one.

Start hereWhy dental claims get deniedThe real reasons claims come back unpaid, which ones are yours to fix, and which are the plan working as written.Read the guide Claims and payersPreauthorization and predetermination are not the same thingWhich one binds the payer, which is only an estimate, and when each is worth the wait.Read the guide Claims and payersA rejection is not a denial, and the difference decides what you do nextThree places a claim can stop, only one of which is a denial, and the fix is different for each.Read the guide Claims and payersDenied for timely filing, and what can still be doneThe one denial that is usually permanent, what still works against it, and how to prevent the next.Read the guide Claims and payersDenied for coordination of benefits, and how to unpick itTwo plans, one claim, and a denial that is usually about order rather than about coverage.Read the guide

Insurance and verification

What to capture before the appointment, what an eligibility check will not tell you, and where the answers belong.

Start hereThe dental insurance verification checklistEvery field worth capturing, why each one is there, and where to put the answers so they are found again.Read the guide

Working with your software

The reports your own system gives you, what each column counts, and what to settle before anybody gets access to the database behind them.

Your practice softwareThe Eaglesoft outstanding claims report, read correctlyWhere it lives, what each column counts, and why the status codes behind it are different in every office.Read the guide Your practice softwareSubmitted and estimated are two different numbers about the same claimTwo columns, two meanings, and the case where one of them is zero on a claim that plainly is not.Read the guide Your practice softwareTwo ways Open Dental shows unpaid insurance, and why they disagreeTwo views that both look like a list of unpaid claims, and the job each one is actually for.Read the guide Working the listWhen a payer says there is no claim on fileWhat to check before you resend, what counts as proof, and how not to create a duplicate.Read the guide Working the listGiving a vendor access to your practice database, safelyWhat read only really means, how to verify it, and the questions to ask before you hand over access.Read the guide

Also worth reading

Research: what is published about dental insurance

The figures we could trace to the body that collected them, each one linked.

How the connection to your practice software works

What we read, what we never write, and what leaves your building.