Dental Billing Checklist: Claims & Payment Verification

Maximize your dental practice's revenue and minimize errors! This Dental Billing Checklist ensures accurate claims submissions, efficient payment processing, and complete audit readiness. Streamline your billing workflow and boost your bottom line.

This Template was installed 1 times.

Patient Information Verification

1 of 8

Confirm patient demographics, insurance details, and authorization are accurate and complete.

Patient First Name

Patient Last Name

Patient Date of Birth (Year)

Patient Date of Birth

Patient Address (Street)

Patient City

Patient State

Patient Zip Code

Primary Insurance

Procedure Coding & Documentation

2 of 8

Verify correct CPT/HCPCS codes are used and documented in patient records to match services rendered.

Procedure Code (CPT/HCPCS)

Procedure Description

Narrative Notes (if applicable)

Anesthesia Type (if applicable)

Units/Quantity of Service

Date of Procedure

Diagnosis Codes (ICD-10)

Claim Submission

3 of 8

Ensure claims are submitted electronically or manually to the correct payer and in the required format.

Submission Method

Claim Number (if applicable)

Payer ID

Date of Service

Notes/Comments (e.g., authorization number, specific instructions)

Claim Form Version

Payer Eligibility & Authorization

4 of 8

Confirm patient eligibility and obtain necessary pre-authorizations before providing treatment.

Insurance Verification Method

Authorization Number

Verification Date

Pre-Authorization Required?

Authorization Expiration Date

Notes/Comments

Claim Tracking & Follow-up

5 of 8

Monitor claim status, investigate denials, and resubmit claims as needed.

Claim Number

Date Claim Submitted

Date of Initial Follow-Up

Claim Status

Payer Notes/Communication Log

Reason for Follow-Up (if applicable)

Date of Next Follow-Up

Contact Person at Payer

Payment Posting & Reconciliation

6 of 8

Accurately post payments received and reconcile them with outstanding claims.

Payment Amount Received

Date of Payment Received

Payment Method

Claim/Invoice Number

Notes/Comments (e.g., Explanation of Benefits details)

EOB Amount

Adjustment Reason (If Applicable)

Patient Statements & Appeals

7 of 8

Generate patient statements, handle patient inquiries about billing, and process appeals for denied claims.

Statement Balance

Statement Date

Patient Inquiry Summary

Resolution Status

Resolution Details (if applicable)

Appeal Filed?

Appeal Submission Date (if applicable)

Appeal Notes (if applicable)

Compliance & Audit

8 of 8

Maintain compliance with billing regulations and conduct periodic audits to ensure accuracy and identify areas for improvement.

Last Compliance Audit Date

Number of Claims Audited

Areas Audited (Check all that apply)

Details of 'Other' Area Audited (if selected)

Number of Coding Errors Found

Number of Documentation Errors Found

Corrective Actions Taken (if any errors found)

Date Corrective Actions Completed

Audit Outcome

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