Dental denial management
Dental claim denial management
Every denial has a reason code, and most trace back to a fixable habit. We appeal what is recoverable and correct the cause, so the same denial stops coming back.
What's included
Root-cause review
Each denial is traced to its source: verification, coding, documentation, or coordination of benefits.
Corrected claims and appeals
Recoverable claims are corrected, documented, and appealed.
Underpayment detection
Contractual adjustments are checked, so an underpayment is not hidden inside a routine write-off.
Prevention for your team
Recurring patterns come back to your team as simple process fixes.
How it works
Step 1
Denial review
We sort your recent denials by reason code and dollar value.
Step 2
Recover
We correct and appeal the claims that can still be collected.
Step 3
Prevent
We fix the upstream process, so next month shows fewer denials.
Common dental denial codes
| Code | What it means | How to prevent it |
|---|---|---|
| CARC 27 | Expenses incurred after coverage terminated | Verify eligibility for the actual date of service |
| CARC 119 | Benefit maximum for this time period or occurrence has been reached | Check frequency limitations and remaining benefits before treatment |
| CARC 6 | Procedure is inconsistent with the patient's age | Confirm age limitations during verification |
| CARC 22 | Care may be covered by another payer per coordination of benefits | Submit secondary claims with the primary EOB attached |
| CARC 252 | An attachment or other documentation is required | Send images and clinical notes with the first submission |
| CO-45 | Charge exceeds the fee schedule or maximum allowable | Confirm the correct fee schedule is attached to each plan in your PMS |
Codes shown are common examples. Always confirm the codes on your own ERAs.
Common questions
What is a CO adjustment?
CO stands for contractual obligation. It is normal when a payer applies your contracted fee, but it can also hide an underpayment, such as a claim paid under a leased network the practice did not expect.
Why do secondary claims get denied?
The most common reason is a secondary claim sent without the primary payer's explanation of benefits. Holding the secondary claim until the primary EOB arrives prevents it.
How do we get a quote?
Every practice is different, so pricing depends on the services you choose and the size of your practice. Schedule a consultation and you will get a clear quote for your practice.
Next step
Schedule a consultation.
Tell us what your practice is dealing with and we will show you the right starting point, whether that is a revenue review, ongoing billing, or consulting.