How to Spot Billing Red Flags That Could Be Costing Your Practice Money

f your dental office is busy but your collections don’t reflect it, your billing process might be to blame. The truth is, many practices lose thousands each year—not because they aren’t doing the work, but because of silent issues hiding in their billing systems.

The good news? These billing red flags are easy to miss—but fixable once you know what to look for.

Here are some of the most common warning signs that could be costing your practice money—and how to address them before they impact your bottom line.

🚩 1. Claims Sitting in “Unsent” or “Draft” Status

Why it’s a problem: Claims that were never finalized or sent out won’t bring in revenue—no matter how clean or accurate they are.

What to look for:

• Claims stuck in draft or hold status

• Claims waiting on documentation that was never attached

• Batch submissions that failed but weren’t caught

What to do: Audit your claim queue weekly to catch unsent claims early. Make sure your team has a clear, daily workflow for submitting and confirming transmission.

🚩 2. High Percentage of Denied or Rejected Claims

Why it’s a problem: Frequent denials delay payment, increase administrative time, and can lead to lost revenue if they’re never followed up on.

What to look for:

• Repeat denials for the same codes or payers

• Missing documentation (like X-rays or narratives)

• Coding errors or mismatched insurance info

What to do: Track denial trends monthly. Even a few consistent errors—like using the wrong code modifier—can point to larger training or process issues.

🚩 3. Inconsistent Insurance Verification

Why it’s a problem: If insurance isn’t verified accurately before treatment, your practice could end up underpaid—or not paid at all.

What to look for:

• Claims denied due to eligibility or terminated policies

• Frequent write-offs due to uncovered services

• Confusion over patient portions at checkout

What to do: Set a clear verification process for every appointment. Don’t assume returning patients still have the same coverage—benefits change all the time.

🚩 4. A/R Aging Over 60 Days is Climbing

Why it’s a problem: Old claims are harder to collect—and once they hit the payer’s timely filing limit, you may never be paid.

What to look for:

• Insurance balances in the 60–90+ day range

• Claims not followed up on after submission

• A/R report that isn’t reviewed regularly

What to do: Run A/R aging reports regularly and flag claims approaching timely filing deadlines. A dedicated biller can keep this under control with consistent follow-up.

🚩 5. Payments Not Posted Accurately or Timely

Why it’s a problem: If payments aren't posted correctly, your ledger may show balances that have already been paid—or worse, miss underpayments.

What to look for:

• Inconsistent production vs. collections reporting

• Claims marked unpaid when payment was received

• Adjustments not applied or misused

What to do: Make sure payments are posted based on the EOB—not estimated amounts. Posting should happen daily to keep reports accurate and avoid confusion when following up.

Final Thoughts

Even a few small billing errors, repeated consistently, can add up to big losses over time. If you’ve noticed one or more of these red flags in your practice, it may be time to get support.

As a dedicated remote biller, I specialize in:

• Submitting clean claims daily

• Following up consistently on unpaid claims

• Catching posting errors and coding issues

• Keeping your A/R lean and under control

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Want a second set of eyes on your billing systems? Contact me for a no-pressure review—I’ll help you find out where your money might be getting stuck.