The Dental Insurance Broker: An Employer’s Ally in Navigating the Claims Process

Dental insurance claims can involve a lot of paperwork, confusing jargon and unexpected denials. For both employers and employees, understanding the process and getting timely reimbursement can be challenging.

This is where brokers can step in, simplifying the complexities and ensuring a smoother claims experience. Let's explore how brokers can help streamline the claims process for everyone involved.

The Broker's Role: Beyond the Sale

Many see insurance brokers as salespeople who help businesses or individuals select the right dental plan. But their role extends far beyond the initial sale. Brokers often provide expertise, guidance and advocacy to ensure that claims are processed correctly and efficiently. This is particularly crucial when considering benefits plans for small businesses or even mid size business benefit plans, where resources might be limited.

The dental insurance claims process can be a source of frustration for various reasons:

• Complex paperwork: Filling out claim forms can be confusing, especially for those unfamiliar with insurance terminology.
• Coding errors: Mistakes in coding dental procedures can lead to delays or denials. Missing information: Incomplete documentation can cause claims to be rejected, requiring additional time and effort to rectify.
• Lengthy processing times: Waiting for claims to be processed and reimbursed can be a major inconvenience.
• Claim denials: Dealing with denied claims and appeals can be a frustrating and time- consuming.

7 Ways Brokers Can Help Clients

Dental insurance ties up brokers and their clients with endless claims and paperwork. But there’s a different solution: a dental savings plan. Offered as a supplement or alternative to dental insurance, Altogether Dental is an affordable, less complicated option than dental insurance.

With Altogether Dental for business, employees will enjoy discounts of 15-50% on all dental procedures and don’t have to worry about waiting periods, deductibles or claims. Plus, Altogether Dental’s partnership with Aetna gives employees 260,000+ choices of in-network general and specialty care dentists.

One of the main reasons employers and brokers enjoy partnering with Altogether Dental is because employees pay their dentist directly; saving the broker and their client time on administrative tasks. But for brokers who work with clients who need help navigating dental insurance costs and clerical issues, here’s what they can do:

1. Educate clients and members: Provide comprehensive information about the dental plan, including coverage details, exclusions and limitations. They can offer resources like brochures, webinars or online tutorials to help clients understand the claims process.
2. Simplify the paperwork: Assist clients with completing claim forms accurately and thoroughly. Consider offering online claim submission tools or templates to make the process easier and reduce errors.
3. Ensure accurate coding: Partner with dental offices to ensure that procedures are coded correctly to avoid delays and denials. Offer training or resources to help dental staff understand insurance coding guidelines.
4. Follow-up on claims: Proactively track claim status and follow up with insurance carriers to ensure timely processing. Brokers can also advocate on behalf of their clients if there are any issues or delays.
5. Assist with appeals: If a claim is denied, brokers can help clients gather the necessary documentation and submit a comprehensive appeal. They can provide guidance and support throughout the appeals process.
6. Be available for questions: Brokers can offer ongoing support and be readily available to answer questions or address concerns throughout the claims process. Tip: Consider establishing a dedicated helpline or online chat for quick access to assistance.
7. Stay updated on industry changes: Learn about the latest changes in dental insurance regulations, coding guidelines and carrier policies. Share this information with clients and members to ensure they are well-informed and prepared.