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Frustration Free Insurance Narratives

Frustration Free Insurance Narratives
by: Teresa Duncan, MS, FAADOM

One of the most frequent questions in my coding seminars is ‘how do I write a successful narrative?’ The good news is that it is not as hard as you may think. An effective narrative contains these elements:

• a short, concise description of the treatment performed
• supporting images or documentation
• if this is an appeal, the original claim identification number

We are often tempted to send as much documentation as possible including copies of charts and multiple copies of radiographs. Insurance consultants don’t want to read through pages and pages of notes to justify a crown. Nor do they want to see our photocopied checklists of what could possibly be wrong with the tooth.

A well-written narrative helps your claim sail through processing. We speak to our patients in layman’s terms but avoid this in your narrative. You and your doctor are writing this to be read by another dental professional. Instead of writing ‘lots of decay – loose filling,’ be more specific:

Tooth #14 had open margins around the existing amalgam filling. Recurrent decay was present upon removal of filling. Please refer to radiograph.

This narrative is short enough to fit into box #35 (Remarks). However, I highly recommend sending your attachments electronically to reduce the time needed for claim approval. Information sent by postal mail (snail mail!) will then be scanned into electronic format anyway. And it may not be as high quality as if you were to scan or capture the image yourself.

When writing the narratives be sure that your doctor is aware of what you are submitting on his or her behalf. I recommend having your doctor just quickly review your narratives so that it most accurately represents the condition of the patient. This is a good time to also compare notes on the images you are sending with the claim. A good narrative writer does not need to be in a clinical position but must know clinical terms and procedures.

When it comes to writing fantastic narratives, it takes a team effort between the team and the doctor. Take a deep breath and approach the job differently – in this case, practice does make perfect!

Do you still have more questions? Why not listen to our recent Insurance Webinar, hosted by Teresa Duncan.

AADOM Solutions: Your Top Dental Insurance Questions Answered






Teresa Duncan, MS, FAADOM is an international speaker who focuses on revenue, dental insurance & management issues. She is a Fellow of the American Assn. of Dental Office Management and received her Master’s Degree in Healthcare Management. Her website features more insurance information along with online insurance training.