Dental Insurance Payment Reconciliation
The claim was submitted. Whether it was paid is a different question.
Payments that don't reconcile become a backlog that compounds. We work through outstanding insurance payments methodically, inside your practice management software, so your accounts stay current and your team isn't managing a growing list of unresolved claims alongside everything else.
Mint Ops matches every insurance payment to its claim, follows up short-paid and rejected claims with carriers, and corrects your ledger in your software, from $1,500 a month.
The problem
A backlog nobody decided to create.
No clinic sets out to carry unresolved claims. It happens one busy afternoon at a time. A payment comes in short and gets posted anyway because the day is moving. A rejection arrives with a code nobody has time to look up. A claim is resubmitted and then nobody checks whether the second attempt landed. Each individual instance takes ten minutes to resolve, which is exactly why it keeps getting left.
Six months of that and the outstanding report is long enough that opening it feels like a project rather than a task. So it doesn't get opened. The number on it stops meaning anything, because everyone knows some of it is real money and some of it is noise, and nobody has gone through to find out which is which.
Part of the cost is the uncollected money, which is usually more than clinic owners expect. The rest is that your accounts stop being a reliable picture of your practice. When the receivables number is partly fiction, every decision that depends on it is made on a guess.
In plain terms
What payment reconciliation is.
Insurers almost never pay exactly what was claimed. The explanation of benefits arrives with the payment, and the amounts differ for a dozen routine reasons: a downgraded material, a deductible applied, a frequency limit hit, two plans coordinating in an order you didn't expect. Reconciliation is the work of matching every payment to its claim, understanding every difference, and doing something about each one.
Each difference forks three ways: it's correct, and the remaining balance moves to the patient, accurately; or it's an insurer error or a fixable rejection, and it gets resubmitted or appealed; or it's a write-down the clinic should knowingly accept, and it gets adjusted deliberately. Skipping the fork is how clinics end up donating money to insurers or, worse, billing patients for amounts that were never theirs.
Left unworked, unreconciled payments compound into a ledger that lies: a receivables number that's partly fiction, claims aging past their appeal windows, balances nobody can confidently explain to a patient. The fix is unglamorous: every payment matched, every discrepancy resolved, on a regular rhythm, inside your practice management software.
Knowing how reconciliation works is the easy part. The hard part is having someone sit down and do it every week. Clinics that struggle here understand the process. They are out of hours.
The service
Methodical, and finished.
We work your outstanding insurance claims the way they need to be worked: one at a time, until each one is either collected, corrected and resubmitted, or closed with a reason. Payments get matched to claims, short payments get investigated rather than absorbed, and rejections get read properly instead of set aside. The point is to make the number on it true, even if the list shrinks slowly.
Everything happens inside your practice management software: MaxiDent, Dentrix, ClearDent, Curve, ABELDent, Tracker, and other major Canadian platforms. Postings and notes land in the ledger and the patient record where your team already looks. Nothing lives in a separate spreadsheet, and nothing requires a handoff to be useful.
The people doing this have spent at least ten years inside dental clinics, much of it dealing with carriers. That experience matters on this work. Knowing which denial is a coding fix, which one needs a phone call, and which one isn't worth pursuing comes from years of doing it, and that judgment decides whether the effort pays for itself.
This is one of five Remote Administration services. It runs alone, or alongside recall, treatment follow-up, insurance verification, and patient accounts receivable, with the same team representing your clinic across all of them.
What your team gets
- Every outstanding claim worked methodically
- Short payments and rejections investigated, corrected, resubmitted
- Postings and notes made inside your practice management software
- A receivables number that reflects what is collectible
- Mis-postings and duplicate claim entries corrected in the ledger as we work
- A monthly report of what was worked, collected, and closed
We deal with carriers directly. How far back depends on insurer deadlines.
Questions
Asked before you ask.
What exactly does reconciliation cover?
The work between a claim being submitted and the money being accounted for: matching payments to claims, identifying what hasn't been paid, following up on outstanding and short-paid claims, and correcting the ledger so your outstanding balance reflects reality rather than a backlog nobody has worked.
Isn't this our bookkeeper's job?
Bookkeeping records what happened. Reconciliation chases what didn't. Those are different tasks with different skills: the second one means calling insurers, reading rejection codes, and knowing which denials are worth resubmitting. Most clinics have someone doing the first and nobody with time for the second.
How far back can you work?
Further than most clinics expect, though it depends on the insurer's own timelines for resubmission and appeal. We'd start by assessing what's outstanding and telling you which of it is recoverable and which is past the point of pursuing. There's no value in billing you to chase what can't be collected.
Do you talk to the insurers directly?
Yes, where it's needed. Our team has spent at least ten years in dental clinics, which means they've spent a good part of those years on the phone with carriers. They know the difference between a denial that needs a corrected code and one that needs a conversation.
Will this disrupt how our front desk works?
It should do the opposite. We work inside your practice management software, so postings and notes land where your team already looks. Nothing moves into a separate system, and nobody has to learn a new process or wait on a handoff to know where a claim stands.
What will we see at the end of a month?
A report covering what was worked, what was collected, what's still outstanding, and what we've concluded isn't recoverable. Clear numbers, no interpretation required, and whether the list is shrinking.
Can we run this on its own?
Yes. Insurance payment reconciliation is one of five Remote Administration services and every engagement is scoped individually. Clinics often pair it with verification, since preventing claim problems upfront and clearing the ones already stuck are two halves of the same billing picture.
Pricing
What insurance payment reconciliation costs.
Insurance payment reconciliation starts at $1,500 a month on a six-month commitment. Where your clinic lands above that depends on the size and age of the outstanding claims list and whether this service runs on its own or alongside the others.
Month one is setup and an assessment of what is outstanding and what can still be recovered. Six months is long enough for the months after that to compound. After six months it continues month to month, and either side can end it with 30 days’ written notice. You get your number in the first conversation, before anything is signed.
Get started
It all starts with a conversation.
Tell us about your clinic: your software, how long the outstanding list has been growing, and who has been working it. We'll tell you what we'd recommend, whether that's reconciliation alone or alongside other services, and what it would cost.