Fewer dental claim denials, starting before the claim is sent

The 2024 CAQH Index puts a manual claim status inquiry in a dental office at about 18 minutes, and estimates a 12-minute saving per inquiry when it's done electronically. The ADA's Council on Dental Benefit Programs has warned that common coding mistakes lead to denials.

Sources: CAQH, 2024 CAQH Index Report (2023 data); ADA News, tips to avoid claim denials due to common coding mistakes (Dec 2025)

1. 1Checked three ways before sending. Against the patient's own insurance check (coverage on the date of service, plan year, frequency limits, waiting periods, exclusions, downgrades, missing-tooth clauses and other coverage); against the clinical notes, where an AI review looks at whether the code matches the notes, whether medical necessity and the narrative are documented, and whether the attachments payers commonly ask for are there; and for required details (NPIs, tax ID, payer ID, member ID, patient and policyholder details, CDT code, fee, tooth and surfaces). A claim can't be sent with any of these missing. The result reads "Ready to submit", "Check warnings" or "Fix before sending".
2. 2Electronic claims. Claims go to payers through Stedi, the clearinghouse.
3. 3Everything comes back to one place. Acknowledgments, claim status and payments return to the claim. A claim the payer confirmed stops showing as "no answer".
4. 4Denials and appeals. Pick the denial, and the AI drafts a formal appeal letter. Your team edits and approves it before anything is sent.
5. 5Days to payment. From claim sent to paid, by payer. Your starting point comes from your own past claims (a file export) or, if you have none, your first 60 days, and a change is shown only once there are at least 5 paid claims on each side.

• It doesn't send anything to a payer or a patient without a person approving it.
• It doesn't predict which claims will be denied. It checks each claim and flags what to fix.
• It doesn't guarantee a claim gets paid, and it doesn't estimate what you'll recover. It measures what actually happens.
• It doesn't replace your practice software's ledger. It works alongside it, and claims billed from your practice software aren't counted in its figures.
• Electronic claims switch on for each practice when it goes live on them.

The BillingIQ overview shows claims sent through DentalIQ over the last 30 or 90 days: sent, waiting on the payer, paid, denied and rejected, with dollars billed, insurance paid and denied amounts from the payers' payment files. A denial rate appears once at least 5 claims have a payer answer. Denied claims to work also show in the morning briefing, and the month's figures go into ReportIQ. Also in BillingIQ: AR aging by age bucket, ledger audit, clinical narratives and PPO fee schedule review.

BillingIQ is part of Practice OS, $999/month, everything included. Founding practices get Practice OS at 50% off for six months, and on day one we record their days to payment. See all plans.

• Dental insurance verification (InsureIQ)
• Dental claim denials: where practices lose revenue after the visit
• Trust & safety: how DentalIQ handles data