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Your Guide to Dental Claims Processing

Your Guide to Dental Claims Processing 2025

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The document is a Provider Inquiry Form from Delta Dental, outlining the procedures for providers to resubmit claims for clerical corrections or additional information. It specifies that claims can be reviewed within 30 days and disputes must be preceded by a resubmission attempt. Disputes require written documentation and will receive a response within 45 days. The form includes sections for provider and patient information, inquiry type selection, and contact details.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How long does it take for dental insurance to process a claim?

A claim is usually processed within two weeks unless your insurance company requires or asks for additional information about your treatment. What you should know? You must be aware of all the details of your dental insurance coverage.

Why would a dental claim be denied?

Primary Reasons for Dental Claim Denials. Lack of sufficient information or data errors is the most common reason for a delayed or denied claim. The dental claim should have accurate dental patient information as well as their all of their insurance information.

How long does it take to file a dental claim?

How much time do I have to submit a claim? You or your provider should send us claims within the time frame specified in your certificate of coverage, which is usually 90 days. You can access your certificate through your employer or through the Dental member portal.

What does a dental claims processor do?

A dental claims processor assesses insurance claims for patient visits to a dentist office. These claims could include any procedure performed by a dentist on a patients teeth, which might cover everything from essential cleaning to surgical procedures.

How do dental insurance claims work?

Once the member has their dental exam, the dentist will file the claim with the insurance company. The carrier then processes the claim and makes a payment for 100% of the allowed charges filed by the dentist. The carrier then sends a payment back to the dentist, and also sends an Explanation of Benefits to the member.

How long does an insurance company have to pay a dental claim?

In the USA, most dental insurance claims are processed within 2 to 4 weeks (14 to 30 days) from the date the claim is received by the insurer. This is a common timeframe if all required documentationsuch as treatment details, billing codes, and patient informationis submitted correctly upfront.

How does a dental claim work?

A dental claim explains the services and procedures provided by your dentist and his team during your visit. Once your dentist submits the claim to your dental insurance provider, itll go through numerous phases of reviews/approvals before you receive the final bill.

Your Guide to Dental Claims Processing 2025

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