Keys to hassle-free claims

At Delta Dental of Tennessee, we want the claims process to be a painless, efficient experience for network providers. Dental Office ToolkitTM (DOT) is the most efficient way to submit claims. 

Most claims submitted through DOT are processed in a matter of seconds, and if enrolled in the voluntary electronic funds transfer system, they are usually paid within 24 hours. However, sometimes, claims  are rejected simply because of an inadvertent mistake  when submitting. Here are a few common mistakes to avoid that can lead to delays in processing claims.

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Stay inside the box

Make sure all info is contained within the box provided in the form for paper claims

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Keep your caps on lock

Use all capital letters (CAPS) when entering data. This is easier for the system to read and will lead to fewer processing errors.

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Don’t get too attached

When submitting a claim, there is no need to attach a primary carrier EOB. Simply mark the amount that primary paid in  the remarks section.

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Zero is not your hero

Do not enter $0 unless the primary carrier’s determination was actually $0.

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Practice good form

When submitting for services previously approved on a  pre-treatment estimate, use the pre-treatment form and fill in the date the service was completed. Do NOT send a new claim.

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Your fees, your schedule

Always submit claims using your own fee schedule and not the amount on Delta Dental’s fee schedule. The DOT system will adjust the fee if necessary. 

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Who done it?

Always submit a claim with  the treating dentist’s name and license number regardless of the business name or business owner. The claim form is a legal document and the treating dentist’s information must represent who treated the patient.

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Save the date

For procedure codes that require multiple appointments, always submit using the date the treatment was completed. For example, if submitting for a crown, always use the seat date, not the prep date.

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Step away from the marker

Do not highlight any section of the claim form, as this will black out the highlighted areas.