Get Your Claims Processed Quickly, Accurately

Posted by Kate Ranta on Apr 18, 2013 11:06:00 AM

   

Want to speed up your claims fulfillment? Of course you do! Here are some submission tips to help move the process along:

General Recommendations
Include on all claims:
• Member name and I.D. number.
• Treating dentist’s name, license number, and tax I.D. or social security number.
• Address where services were rendered.
• Date of service.
• Procedure codes and description.
• Amount charged.
• Tooth number, surfaces, quadrants, locations, or arch and clinical diagnosis if needed.
 
Claim submission limitation is one year from date of service.

Radiograph Quality
All radiographs should be:
• Current and of diagnostic quality.
• Dated, mounted, and labeled right and left.
• Labeled with patient’s name and provider’s name and address.

Periodontal Charting
Charting must be:
• Comprehensive full mouth.
• Legible and dated.
• Documented with probing depths (six per tooth).
• Recorded in millimeters per tooth.
• Labeled right and left, mandibular and maxillary—with classified furcation defects, tooth mobility, BOP (bleeding upon probing) and CAL (clinical attachment loss) noted.

Written Narratives
Narratives must:
• Support need for procedure.
• Describe specific conditions addressed by procedure.

Questions? Call Solstice’s customer service department at 877-760-2247.

Topics: claims, claims processing, claims fulfillment, submitting claims

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