Dental Billing for Dummies: Tracking Claims, Payments, and Rejections
- Maxillo Team
- Sep 23
- 3 min read
In the first two articles of this series, we covered the foundation of dental billing and the process of coding and submitting clean claims. In this third installment, we shift focus to what happens after the claim has been sent. Effective claim tracking, payment posting, and rejection management are critical for protecting your practice’s revenue cycle.
Dental Billing for Dummies: Why Claim Tracking Matters
Submitting a claim is not the end of the billing process. Without systematic follow-up, practices risk losing revenue to preventable denials or simple processing errors. In fact, industry studies show that nearly 65 percent of claim denials are never resubmitted, which means practices leave money on the table unnecessarily [1].
Tracking ensures that every claim reaches the payer, is processed correctly, and results in timely payment. This step turns billing from guesswork into a predictable revenue system.
Step 7: Monitor submissions and resolve rejections
Clearinghouse rejections vs payer denials
A clearinghouse rejection occurs before the claim even reaches the insurer. These rejections typically result from missing information, mismatched patient data, or formatting errors. They must be corrected and resubmitted immediately [2].
A payer denial occurs after the claim is accepted but rejected for coverage reasons. Common reasons include lack of documentation, non-covered services, or coordination of benefits issues [3].
Best practices for tracking
Daily review: Check the clearinghouse dashboard daily for rejections.
Aging reports: Run insurance aging reports weekly to identify unpaid claims over 30 days.
Denial management: Keep a log of common denial reasons to spot patterns and fix root causes.
Timely action
Most payers enforce timely filing limits ranging from 90 days to one year. Failing to act quickly can result in permanent write-offs [4].
Step 8: Post payments and reconcile accounts
When insurance payments arrive, accuracy in posting is critical. Posting errors distort financial reporting and confuse patients.
Posting ERAs and EOBs
Electronic Remittance Advice (ERA): Automatically posts payments when integrated with your practice management system.
Explanation of Benefits (EOB): Paper or PDF notices must be entered manually if not automated.
Steps for accurate posting
Record the insurer’s payment exactly as received.
Apply contractual adjustments according to PPO agreements.
Post any patient responsibility to the patient ledger.
Match payments to bank deposits to confirm reconciliation [5].
Handling partial payments and takebacks
Sometimes insurers issue partial payments or retroactive adjustments. Document these carefully and track them in the patient’s account. Regular reconciliation ensures that what is recorded in your practice management system matches the deposits in your bank account [6].
Step 9: Handle secondary and tertiary billing
Many patients carry more than one insurance plan. In these cases, proper coordination of benefits (COB) is essential.
Coordination of benefits basics
The primary insurer pays first according to the plan rules.
The secondary insurer processes the remaining balance, based on what the primary has already paid.
A tertiary plan may cover additional costs if applicable.
Submitting secondary claims
Attach the primary EOB or ERA to the secondary claim as proof of what has already been paid.
Submit electronically whenever possible to avoid delays.
Verify whether crossover processing is available, where the primary insurer automatically forwards the claim to the secondary [7].
Common COB challenges
Incorrect primary/secondary designation, especially for children’s coverage under dual parents.
Denials due to missing EOBs.
Missed deadlines for secondary claim submission.
By training staff to handle secondary billing efficiently, practices can avoid unnecessary write-offs and capture the full reimbursement available.
What comes next in the series
At this point in the series, you have learned how to:
Submit clean claims
Track them after submission
Manage rejections and denials
Post insurance payments accurately
Handle coordination of benefits
In the final article, Dental Billing for Dummies: Patient Billing, Appeals, KPIs, and Automation, we will cover:
Patient statements and collections
Appeals and grievance workflows
Key performance indicators (KPIs) for billing success
Compliance requirements and opportunities for automation
Dental billing is one of 20+ AI agents available, run a self-guided demo and explore the #1 dental front office AI solution:
References
MGMA. “Top Denial Management Benchmarks.” Link
Dental ClaimSupport. “How Dental Billing Works: A Step by Step Guide.” Link
ADA. “Dental Claim Form Completion Instructions.” Link
Transcure. “Dental Billing Process with CDT Code Sheet.” Link
Outsource Strategies International. “Overview of the Dental Billing Process.” Link
IRCM. “Dental Billing Guide.” Link
PMN Inc. “Dental Billing for Dummies.” Link
Comments