FYI

Dentist blog from Delta Dental

Tag: claim tips

Why your claims with x-rays are being denied and what you can do

Some procedure codes require the submission of documentation with claims for Delta Dental PPO™ and Delta Dental Premier® patients. Let’s review radiographic image requirements for common procedures and the associated denials that can occur.

Crowns

Pre-operative and periapical (depicting the apex) radiographic images are required when submitting crown procedures D2710 through D2794. Do not substitute a panoramic radiograph to replace periapical images. Radiographs must show the endodontic and periodontal state of the tooth and must be taken within one year of the crown prep procedure.

Photographs must accompany radiographs when evidence of necessity is not obvious on the radiographs.

Lab slips should be maintained as part of the patient record.

In this example, the following radiographic images fail to depict the entire tooth. Pre-operative radiographic images must show the apex (tip of the tooth’s root) and are requested to rule out associated periapical pathology.

In comparison, the following radiographic image correctly depicts the apices of the submitted teeth.

Common reasons for crown denials

Core buildup, including any pins

Periapical radiographs taken within one year of the planned treatment are required when submitting core buildup and post and core procedures D2950 through D2957.

Do not substitute a panoramic radiograph to replace periapical images.

A narrative is also required. Per the American Dental Association, build-ups should not be reported when the procedure only involves a filler to eliminate any undercut, box form, or concave irregularity in the preparation.

Common reasons for core buildup denials

  • 570. Benefits could not be determined because of missing pre-operative periapical radiographic images.
  • 5L8. Benefits could not be determined because of missing pre-operative periapical radiographic images.
  • 5RX. Benefits could not be determined, because the submitted radiograph does not depict the entire tooth.
  • 569. Benefits could not be determined because of the non-diagnostic nature of the radiographic images submitted.
  • 564. Submit clinical treatment narrative.
  • 5BU. The fee for buildups is included in the fee for the completed restoration unless there is extensive loss of tooth structure.

Endodontics

Pre-operative and post-operative periapical radiographs are required when submitting endodontic procedures D3310 through D3330 and D3921. All radiographs, including working radiographs, should be maintained in the patient treatment record.

The following radiographic image fails to depict completed root canal therapy on the submitted teeth.

In contrast, the following radiographic images correctly depict an acceptable pre-operative periapical x-ray and post-operative x-ray of completed root canal therapy on the submitted tooth.

In this second example, the following radiographic images correctly depict an acceptable pre-operative periapical x-ray and post-operative x-ray of completed root canal therapy on tooth #19.

If your endodontic claim is denied, you may see one of the following denial codes:

  • 570. Benefits could not be determined because of missing pre-operative periapical radiographic images.
  • 5L8. Benefits could not be determined because of missing pre-operative periapical radiographic images.
  • FMW. Benefits could not be determined because of missing pre- and post-operative periapical images.
  • 8L9. Benefits could not be determined because of missing post-operative radiographic images of completed root canal therapy.
  • 5RX. Benefits could not be determined, because the submitted radiograph does not depict the entire tooth.
  • 569. Benefits could not be determined because of the non-diagnostic nature of the radiographic images submitted.

Periodontics, including scaling and root planning

When submitting periodontic procedures D4210 through D4212, D4240 through D4245, D4260 through D4285, D4341 through D4342 or D4381, you must include bitewing radiographs taken within 12 months of the planned treatment that show both arches of bone levels. Furthermore, loss of alveolar crest height beyond the normal 1-1.5-millimeter distance to the cementoenamel junction (CEJ) must be evident on radiographs. Periapical or panoramic radiographs can only be substituted when bone loss exceeds levels that can be captured in a vertical bitewing.

Other requirements include periodontal charting (probing) completed within the past 12 months, periodontal case type and diagnosis with detailed clinical chart notes regarding the necessity of the periodontal treatment.

The following bitewing x-ray is nondiagnostic, as the interproximal contacts are overlapped and fail to show bone loss. 

Compare this to the following bitewing x-ray, which depicts both appreciable bone loss and calculus. 

Common reasons for periodontic denials

  •  Benefits could not be determined because of missing full-mouth radiographic images. (Note: This code may also be used to request bitewing x-rays.)
  • 5F5. Submit dated pre-operative diagnostic radiographs, current periodontal chart, dated appointment schedule and clinical treatment notes. 
  • 426. Benefits could not be determined because of missing radiographic images, periodontal charting and treatment record.
  • 5GB/5GC. Submit current periodontal chart, dated pre-operative diagnostic radiographs and a copy of the patient treatment record.
  • 574. Benefits could not be determined because of missing periodontal charting.
  • 569. Benefits could not be determined because of the non-diagnostic nature of the radiographic images submitted.
  • 5GJ. Submit dated copy of the original treatment notes.
  • 5F8. Submitted documentation fails to support payment of benefits for scaling and root planing.

Crown lengthening

Pre-treatment bitewing radiographs taken within 12 months of the planned treatment are required when submitting for the crown lengthening procedure (D4249).

A detailed clinical narrative is also required.

When procedure D4249 is performed on the same day as the preparation/placement of the crown, a separate fee for procedure D4249 may not be charged to the patient or Delta Dental. Prior to final restoration of a tooth, a minimum of four weeks must be allowed following clinical crown lengthening.

Common reasons for crown lengthening denials

  • 573. Benefits could not be determined because of missing full-mouth radiographic images.   (Note: This code may also be used to request bitewing x-rays.)
  • 564. Submit clinical treatment narrative.
  • 569. Benefits could not be determined because of the non-diagnostic nature of the radiographic images submitted.
  • 9WA. The fee for this procedure is considered to be part of and included in the fee for a completed service.

Implant supported prosthetics

You are required to include current periapical radiographs, including the apex of the implant body and surrounding bone, when submitting for implant-supported prosthetic procedures D6055 through D6077, D6082 through D6088, D6094, D6097 through D6099, D6110 through D6123 and D6194 through D6195. 

Do not substitute a panoramic radiograph to replace periapical images. Pre-operative x-rays depicting each implant site are required to determine payment of benefits on pre-authorizations. We must receive post-operative x-rays of implant placement to determine payment of benefits on paid claims. These x-rays must depict the entire implant.

Photographs, if available, may also be submitted for review.

For example, the following panoramic radiographic x-ray is nondiagnostic. It fails to clearly depict implant placement at site #9. Do not substitute a panoramic radiograph to replace periapical images.

The following post-operative periapical x-ray, however, correctly depicts the apex of the implant body and surrounding bone.

Common reasons for implant-supported prosthetic denials

  • 570. Benefits could not be determined because of missing pre-operative periapical radiographic images.
  • 5L8. Benefits could not be determined because of missing pre-operative periapical radiographic images.
  • 586. Benefits could not be determined because of missing post-operative radiographic images.
  • 5RX. Benefits could not be determined, because the submitted radiograph does not depict the entire tooth.
  • 569. Benefits could not be determined because of the non-diagnostic nature of the radiographic images submitted.

Fixed prosthodontics (bridge abutment crowns)

When submitting for fixed prosthodontic procedures D6710 through D6794, you are required to include pre-operative periapical radiographs that show the current endodontic and periodontal state of the tooth. These x-rays must be taken within one year of the crown prep procedures. Do not substitute a panoramic radiograph to replace periapical images.

Photographs, if available, may also be submitted.

Lab slips should be maintained as part of the patient record.

In this example, the radiographic image is nondiagnostic, as it fails to clearly depict the submitted abutment teeth.

In comparison, the following radiographic images for proposed bridge 13-15 clearly depict abutment teeth #13 and #15.

Common reasons for fixed prosthodontic denials

  • 570. Benefits could not be determined because of missing pre-operative periapical radiographic images.
  • 5L8. Benefits could not be determined because of missing pre-operative periapical radiographic images.
  • 5RX. Benefits could not be determined, because the submitted radiograph does not depict the entire tooth.
  • 569. Benefits could not be determined because of the non-diagnostic nature of the radiographic images submitted.

Oral surgery (impacted tooth)

Current periapical or panoramic radiographs are required when submitting oral surgery procedures D7210 through D7241 and D7251. Radiographs are necessary to evaluate conditions detected by history and clinical examination and are essential to detect, diagnose, and treat conditions that otherwise may be difficult to identify.

Further, as the classification of impactions is based on the anatomical position of the tooth rather than the surgical technique employed in removal, preoperative radiographs should be maintained in the patient treatment record.

Detailed, tooth specific clinical chart notes regarding the necessity of the treatment and photographs, if available, should be submitted.

The following panoramic x-ray clearly depicts the anatomical position of the third molars.

Common reasons for oral surgery denials

  • 570. Benefits could not be determined because of missing pre-operative periapical radiographic images.
  • 5L8. Benefits could not be determined because of missing pre-operative periapical radiographic images.
  • 5T2. Benefits could not be determined because of missing pre-operative panoramic radiographic image.
  • 5RX. Benefits could not be determined, because the submitted radiograph does not depict the entire tooth.
  • 569. Benefits could not be determined because of the non-diagnostic nature of the radiographic images submitted.

General tips for submitting x-rays

To expedite the processing of your claim and to ensure timely benefit determination, always submit the appropriate mounted and dated x-rays and supporting documentation on your initial submission. Enter the required documentation information in the “Remarks” or “Comments” field of the claim.

You can refer tothe Submission Requirements table, which is located on pages 4-1 through 4-3 of the 2022 Claims Processing Policies and Procedures Handbook, to identify the necessary documentation and clinical information required for review of specific procedure codes.Please refer to the specific procedure code in the handbook for more details regarding the description of procedures.

Please do not submit original radiographic images if they are the only diagnostic record for your patient. Duplicate radiographs or radiographic image copies of diagnostic quality, including paper copies of digitized images, are acceptable. We do not return radiographic images or other documentation submitted with paper claims; however, we will make an exception when we receive a stamped, self-addressed envelope with the claim.

During clinical review of claims and pre-treatment estimates, Delta Dental reserves the right to request radiographic images and documentation for procedures that otherwise may be identified as not requiring the submission of documentation.

CDT coding and nomenclature are the copyright and a trademark of the American Dental Association, all rights reserved.

Claim tips: Dental implants

Implants and the procedures associated with them are not covered benefits under most Delta Dental plans. But when implant services are covered, most denials are because of coding errors rather than a lack of coverage.

Let’s take a look at some common reasons for denials for implants and the procedures and prostheses associated with them.

Prefabricated abutment vs. custom fabricated abutment

Prefabricated abutments and custom fabricated abutments use separate codes:

  • D6056: Prefabricated abutment — includes modification and placement
  • D6057: Custom fabricated abutment — includes placement

Prefabricated abutments are machine made and may require modification, while custom fabricated abutments are created by a laboratory process and are specific for an individual application.

Abutment-supported vs. implant-supported crowns

Abutment-supported crowns use a prefabricated abutment (D6056) or a custom fabricated abutment (D6057) to attach a prosthetic crown to the implant body. Abutment-supported single and fixed partial denture crowns require the submission of accompanying abutment codes.

Implant-supported crowns attach directly to the implant body without an abutment. Implant-supported single and fixed partial denture crowns do not require the submission of accompany abutment codes.

The following image contains an example of incorrect coding. In it, the dental office submitted custom fabricated abutments (which are coded D6057) with implant-supported crowns (coded D6065) for teeth #19 and 20. But implant-supported crowns are not attached to the implant with an abutment, so the procedures should have been coded as abutment-supported crowns.

In the following correctly coded image, the dental office submitted custom fabricated abutments (D6057) with abutment-supported crowns (D6058) for teeth #19 and 20 implant supported crowns, which are attached to the implant using an abutment.

If you receive a denial for abutment-supported or implant-supported crowns, it may be one of the following:

  • 161. Benefits could not be determined because of missing/conflicting information
  • 7C2. The submitted procedure is not payable due to the absence or conflict of a related service.
  • 9WA. The fee for this procedure is considered to be part of, and included in the fee for, a completed service.

Single implant crowns vs. fixed partial denture implant crowns

A prosthetic crown that is used to restore one implant is known as a single implant crown. A prosthetic crown that is attached to an implant and is used as a bridge anchor to replace missing teeth is known as a fixed partial denture implant crown.

Here is an example of incorrect coding for these crowns.

ToothCode
#29D6065 (incorrect)
#30D6245
#31D6065 (incorrect)

In this example, the coding is incorrect because the abutments on teeth #29 and 31 are coded as single crowns. For this restoration, the following coding is correct:

ToothCode
#29D6075 (correct)
#30D6245
#31D6075 (correct)

Here, the abutments on teeth #29 and 31 are correctly coded as fixed partial denture crowns.

Natural tooth single crown and fixed partial denture retainer crown codes are often used in error to code implant-supported prosthetics. Instead, they should be coded as fixed partial denture implant crowns.

Incorrect, coded as natural teethCorrect, coded as implants
D6740, #29 (incorrect)
D6056, #29
D6245, #30
D6740, #31 (incorrect)
D6056, #31
D6068, #29 (correct)
D6056, #29
D6245, #30
D6068, #31 (correct)
D6056, #31

If you receive a denial for single implant or fixed partial denture implant crowns, it may be one of the following:

  • 161. Benefits could not be determined because of missing/conflicting information
  • 7C2. The submitted procedure is not payable due to the absence or conflict of a related service.
  • 9WA. The fee for this procedure is considered to be part of, and included in the fee for, a completed service.

Alternate benefits when there is no implant coverage

Delta Dental’s standard plans pay an allowance or alternate benefit towards the cost of implant-supported prosthodontic appliances, subject to the same limitations as standard prosthodontic services. The allowance is based on the fee for a standard pontic procedure. The patient is responsible for any difference in the cost of the implant-supported procedure.

Denial codes for alternate benefits when there’s no implant coverage may be one of the following:

  • FLM. An alternate procedure/benefit has been applied.
  • 503. This service isn’t a covered benefit of the enrollee’s program. An alternate procedure/benefit has been applied.

Implant with natural tooth bridge

When dental implants are covered by a patient’s plan, the fees for the placement of an implant to support a hybrid natural tooth and implant-supported bridge will be denied. Under our guidelines, a fixed partial denture should be retained by either all natural teeth or all implants, not a combination of the two. In the absence of a stress breaker, implant/natural tooth hybrid bridges will be denied. Bridges anchored this way severely stress the natural tooth and the implant and eventually cause bone loss, mobility and bridge failure.

Denial codes for hybrid bridges may include the following:

  • 5A1. The long-term prospects of a tooth must be considered. Under our guidelines, a fixed partial denture should be retained by either all natural teeth or all implants, not a combination of the two.

Congenitally missing teeth

Implant placement will not be considered for the replacement of congenitally missing permanent teeth or for the correction of other developmental or congenital defects resulting in spacing due to migration or drifting of teeth.

Denial codes for congenitally missing teeth implant placement may include the following:

  • 511. Procedures to correct congenital or developmental malformations are not covered.

Associated denials related to implant procedures

X-rays

Pre-operative x-rays depicting each implant site are required to determine the payment of benefits on pre-authorizations. Post-operative x-rays of implant placement are required to determine payment of benefits on paid claims and must depict the entire implant. Implant length, width and location must be appropriate for the clinical condition and allow for adequate function of the implant-supported restoration/prosthesis.

Denial codes for x-rays may include the following:

  • 570. Benefits could not be determined because of missing pre-operative radiographic images.
  • 586. Benefits could not be determined because of missing post-operative radiographic images.
  • 5RX. Benefits could not be determined because the submitted radiograph does not depict the entire tooth.
  • 569. Benefits could not be determined because of the non-diagnostic nature of the radiographic images submitted.

Re-cementation of implant prosthetics

The code D2920 (re-cement or re-bond natural tooth crown) is often used in error to code re-cementation of implant prosthetics. The appropriate implant crown recement codes are as follows:

  • D6092 – Re-cement or re-bond implant/abutment supported crown
  • D6093 – Re-cement or re-bond implant/abutment supported fixed partial denture

Denial codes for re-cementation may include the following:

  • 788. A benefit allowance cannot be made for the requested procedure as our records show that this tooth was previously extracted.
  • 161. Benefits could not be determined because of missing/conflicting information.

Edentulous arches

For a completely edentulous arch, replacement of teeth and restoration of the occlusion can be adequately restored with four to six dental implants.

D6190 – Radiographic/surgical implant index, by report

When your patients’ plans include implant benefits, Delta Dental considers the fee for procedure D6190 to be included in the fee for the definitive treatment for one implant. A separate fee may not be charged to the patient or Delta Dental. Under contracts with implant coverage, procedure D6190 may be covered at the prosthetic benefit level when two or more implants are placed during the same treatment episode. If implants are not covered by the patient’s plan, this procedure is not a benefit, and the patient is responsible for the fee.

Denial codes related to D6190 may include the following:

  • 9WA. The fee for this procedure is considered to be part of, and included in the fee for, a completed service.
  • 7BB. This service is not a covered benefit of the enrollee’s plan.

D6011 – Second stage implant surgery

When implant services are covered by the patient’s contract, Delta Dental considers the fee for this procedure to be included in the fee for procedure D6010, surgical placement of implant body. A separate fee may not be charged to the patient or Delta Dental.

Denial codes related to D6011 may include the following:

  • 9WA. The fee for this procedure is considered to be part of, and included in the fee for, a completed service.
  • 718. This fee for this procedure is considered to be part of, and included in the fee for, a completed service.

D6199 – Unspecified implant procedure, by report

Please provide a narrative report with a complete description of the procedure and its rationale. Tools used, parts, healing caps, etc. will be considered inclusive in the implant procedure and not a separate benefit.

Denial codes related to D6199 may include the following:

  • 564. Submit clinical treatment narrative.
  • 9WA. The fee for this procedure is considered to be part of, and included in the fee for, a completed service.

Delta Dental’s processing policies for implants and the procedures and prostheses associated with them should be considered guidelines. Whenever an exceptional case is involved, please provide a full narrative description and any available supporting documentation to help our staff determine benefits. To ensure timely benefit determination, always submit the appropriate supporting documentation on your initial submission.

Why your SRP claims are denied and what you can do

Claims for periodontal scaling and root planing (D4341 and D4342) are denied more frequently than those for many other procedures, according to the American Dental Association.

Delta Dental defines periodontal scaling and root planing (SRP) as “a definitive non-surgical periodontal treatment involving the judicious and thorough planing of the root surface.” The procedure involves instrumentation of the crown and root surfaces of the teeth to remove plaque and calculus.

Although you should always refer to the Delta Dental Dentist Handbook for specific processing policies and guidelines, we’ll highlight some common reasons for denials for SRP and associated procedures.

Documentation fails to support payment of SRP

Delta Dental considers a quadrant of procedure D4341 to consist of at least four diseased teeth (4-6mm pockets, early bone loss).

  • When fewer than four diseased teeth are involved, Delta Dental bases its allowances on procedure D4342.
  • In addition to qualifying pocketing, radiographs must show loss of alveolar crest height beyond the normal 1-1.5mm distance to the cemento-enamel junction (CEJ).
  • Exposure of cemental surfaces of the roots is necessary for root planing.
  • Without a reduction in the alveolar crest level, root planing isn’t achievable.
Qualifying: X-rays clearly shows appreciable bone loss and calculus
Non-qualifying: X-rays show no appreciable bone loss and calculus 

Denial code: 5F8. Submitted documentation fails to support payment of benefits for scaling and root planing.

Submission of more than two quads of SRP on the same date of service

Without supporting documentation, the fees for more than two quadrants of SRP performed on the same date of service are disallowed. Acceptable supporting documentation includes:

  • Clinical progress notes
  • Evidence of length of appointment (successful scaling typically takes 30-45 minutes per quadrant with local anesthesia)
  • Information about the local anesthetic used
  • The reason for performing more than two quadrants on the same date of service

Four quadrants of SRP may be approved on a pre-authorization when criteria are met. However, you’re expected to know the policy upon payment.

Denial code: 447. No more than two quadrants of scaling and root planing are allowable on the same date of service.

Inadequate periodontal charting or x-rays

The D4341 and D4342 procedures require you to submit periodontal charting that indicates at least Case Type II periodontal disease (4-6mm pockets, early bone loss).

  • Periodontal charting should be dated no more than 12 months before the date of service.
  • Full-mouth series or bitewings that clearly show appreciable bone loss are preferred because these images are usually the most accurate determinant of bone loss.
  • Submit corresponding images for each submitted quadrant.
Qualifying: Labeled periodontal charting that indicates exam date
Non-qualifying: X-ray is non-diagnostic as interproximal contacts are overlapped and fail to show bone loss

Denial codes:

  • 5F8. Submitted documentation fails to support payment of benefits for scaling and root planing.
  • 574. Benefits could not be determined because of missing periodontal charting.
  • 570. Benefits could not be determined because of missing pre-operative radiographic images.
  • 573. Benefits could not be determined because of missing full mouth radiographic images.
  • 569. Benefits could not be determined because of the non-diagnostic nature of the radiographic images submitted.
  • 426. Benefits could not be determined because of missing radiographic images, periodontal charting, and treatment record.
  • 5GB/5GC. Submit current periodontal chart, dated pre-operative diagnostic radiographs, and a copy of the patient treatment record.

Associated denials related to SRP

Gingival irrigation (D4921)

Gingival irrigation isn’t a separately payable procedure when provided in conjunction with SRP or any other periodontal procedures. You can’t charge a separate fee for the procedure to Delta Dental or the patient.

Denial code: 449. The fee for gingival irrigation is included in the fee for any periodontal services performed on the same date of service.

Localized delivery of antimicrobial agents (D4381)

This procedure isn’t a benefit under some plans and requires you to submit periodontal charting indicating pockets of at least 5mm. When submitted with nonqualifying SRP, these procedures will be denied due to conflict with the denied SRP.

Denial codes:

  • 7BB. This service is not a covered benefit of the enrollee’s program.
  • 7C2. The submitted procedure is not payable due to the absence or conflict of a related service.

Unspecified periodontal procedure (D4999)

These are most commonly submitted as bacterial decontamination, laser or irrigation.

Delta Dental considers specialized techniques, such as those that use lasers or antibacterial medicaments, to be included in the fee for any SRP or surgical procedure. You can’t charge a separate fee for the procedure to Delta Dental or the patient.

Don’t forget:

  • Delta Dental pays for completed procedures, not tools used for treatment.
  • Please provide a narrative report with a complete description of the procedure and its rationale.

Denial codes:

  • 440. The fee for this procedure is considered part of and included in the fee for periodontal services.
  • 9WA. The fee for this procedure is considered to be part of, and included in the fee for, a completed service.
  • 564. Submit clinical treatment narrative.

Delta Dental’s periodontal processing policies described above should be considered guidelines. Whenever an exceptional case is involved, please provide a full narrative description and any available supporting documentation to help our staff determine benefits.

And remember, to ensure timely benefit determination, always submit the appropriate supporting documentation on your initial submission.

Adjust claims online in Provider Tools

Need to make an adjustment to a claim? You can now submit a claim adjustment online in Provider Tools.

How to submit claims online

It’s easy: Just log in to your Provider Tools account. New to Provider Tools? Register for an account.

Once you’re logged in, click on My Claims, locate the processed claim you want to adjust and click on the claim ID. One the next page, scroll down to Claim Adjustment, click Submit a request and select the reason for the adjustment.

Next, make the adjustments, including any attachments or additional explanations. If there are multiple lines that need adjustment, add the details in the explanation box.

Click Continue to review your changes. You must agree to the terms before you can submit your request.

After submission, you’ll receive a confirmation and tracking number. Claims adjustments can take up to 30 days to process. No further action is needed from you.

Which claims are eligible?

Claim adjustment is eligible for all claims submitted to us within the last 90 days. It doesn’t matter whether your original claim was submitted through Provider Tools, a third-party claim clearinghouse or by mail.

The top 5 reasons claims are rejected

You’ve probably been there before. You, or someone on your staff, submitted a claim. You used the proper form, included all the required information, dotted the i’s and crossed the t’s — or so you thought — and yet for some reason your claim was rejected.

It’s frustrating, but it happens frequently. To help you avoid the needless exasperation and delays, here are the five most common reasons why claims are rejected.

The claim rejection hall of shame

  1. The enrollee ID is incorrect or missing. The enrollee ID is the key to all our electronic interactions and must be correct for our system to recognize it. Before you submit a claim, double-check the ID to ensure you didn’t miss, transpose or add an extra digit.
  2. The patient information was incorrect. Any incorrect subscriber information will lead to a rejection. Check carefully to ensure that names are spelled correctly and dates of birth are accurate.
  3. The patient was incorrectly submitted as a dependent. When you provide patient information, include dependent information only when the claim is for a dependent.
  4. The submitted CDT code was revised or deleted. The American Dental Association (ADA) updates its CDT procedure codes and nomenclature annually. For instance, the ADA’s 2021 updates include 28 new codes, four deletions and 11 revisions. Ensure that you stay on top of the latest updates and use the correct CDT codes.
  5. The claim was submitted more than once. So nice you submitted it twice? Duplicate claims are a common mistake. To help keep track of your claims and submissions, register for Delta Dental’s Provider Tools. Provider Tools gives you eligibility and benefits information, remaining maximum and deductible amounts, claim submissions with attachments, claim status and treatment history in real-time — and at no cost.

Rejected claims are aggravating, and having to wait for reimbursement can be stressful, particularly during the current coronavirus pandemic. By keeping an eye out for these common errors and taking advantage of Provider Tools, you can minimize rejections and maximize your time and profits.

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