Introduction

For many dental offices, insurance claims are the heartbeat of cash flow—and when they're done incorrectly, it can choke your revenue cycle fast. Claims rejections, delays, and missing documentation can lead to thousands of dollars stuck in limbo. So, what’s the solution? A solid, step-by-step training protocol designed specifically for entry-level team members who are new to dentistry.

This article will break down best practices for claims submission, offer a beginner-friendly training outline, and provide practical tips to help your team build confidence and get paid faster.

Part 1: Claims Submission Best Practices

Let’s start with the foundations every dental office needs to build a reliable claims process:

1. Get Accurate Patient and Insurance Info—Every Time

• Always verify benefits before treatment.

• Use online portals or real-time eligibility tools from your practice management software.

• Double-check coverage details like frequencies, waiting periods, and annual maximums.

2. Document Everything

• Clinical notes should include: diagnosis, procedure rationale, and any special circumstances.

• Include intraoral photos, perio charts, and X-rays when required. Attach them with the claim, not afterward.

3. Use the Correct CDT Codes

• Train staff to stay up-to-date with the current CDT codebook.

• Avoid outdated or vague codes; specificity reduces denials.

4. File Claims Promptly

• File claims daily to avoid backlogs.

• Use electronic claims submission whenever possible—it speeds up processing and tracks submission status.

5. Monitor and Follow Up

• Use an aging report to review unpaid claims weekly.

• Create a system for following up on claims over 30 days old.

Part 2: Training Outline for Entry-Level Dental Team Members

This training outline is ideal for a 1–2 week onboarding process. You can expand it into modules or repeat sections as needed.

Day 1–2: Introduction to Dental Insurance

• What is dental insurance?

• Types of plans: PPO, HMO, indemnity, discount plans

• Overview of EOBs (Explanation of Benefits)

• Introduction to your office’s practice management software

Day 3–4: Verification and Pre-Authorizations

• How to call/verify benefits

• Understanding coverage tables (frequencies, exclusions)

• Recording benefits in software

• When and how to submit pre-auths

Day 5–6: CDT Codes and Claim Forms

• Intro to CDT codes (bring out the codebook!)

• How to look up and assign codes for common procedures

• Filling out ADA claim forms

• Attaching clinical documentation and narratives

Day 7–8: Submitting Claims

• Step-by-step practice on submitting electronic claims

• Troubleshooting rejected claims

• When and how to print and mail claims (if necessary)

• Sending attachments (X-rays, intraoral images)

Day 9–10: Payment Posting and Follow-Up

• Reading EOBs and posting payments

• Adjusting balances

• Creating a “claims aging report”

• Following up on outstanding claims

Bonus Tips for Training Success

• Role Play Phone Calls: Simulate calling insurance companies for verifications or claim follow-ups.

• Use Real Scenarios: Practice with anonymized patient records for hands-on learning.

• Daily Huddles: Use 5–10 minutes in the morning to discuss unusual claims or insurance changes.

• Create a Claims Manual: Build a binder or digital file with screenshots and walkthroughs of your exact software and workflows.

• Designate a Mentor: Pair new team members with a more experienced staffer for shadowing and support.

Tools That Can Help

• NEA FastAttach or similar software for sending images and attachments securely.

• DentalXChange or ClaimConnect for submitting and tracking electronic claims.

• Practice management systems like Dentrix, Eaglesoft, Open Dental, etc., each have built-in claims workflows—be sure your team is trained specifically on the one you use.

Conclusion

Submitting dental insurance claims isn’t just an admin task—it’s a critical process that ensures your practice gets paid for the valuable care you provide. With proper training, even brand-new team members can master claims submission, reduce denials, and contribute to a healthy revenue cycle.

Remember, consistency is key. Create a simple system. Stick to it. And most importantly, invest in your team’s learning early—they’ll thank you, and so will your bank account.

Benjamin Tuinei

Founder - Veritas Dental Resources, LLC
Phone: 888-808-4513

Services:
PPO Fee Negotiators | PPO Fee Negotiating | Insurance Fee Negotiating
Insurance Credentialing | Insurance Verifications

Websites:
www.VeritasDentalResources.com | www.VerusDental.com