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Partnering with you to help create healthy smiles

Adjust and escalate claims online with Provider Tools

If you’re having issues with a claim you’ve submitted, such as a denial, you can avoid going through the slow process of submitting adjustments and disputes by mail. Take care of adjustments and disputes through your Provider Tools account instead! This process is fast and secure.

How to submit claim adjustments online

Here’s a quick overview of the steps. Need a handy reference?  Download a PDF version of these instructions.

1. First, log into your Provider Tools account.

If you don’t already have one, you can make one for free.

2. File a claim adjustment

Navigate to My claims and find the processed claim you want to adjust. Click on the claim ID, scroll down to the Claim adjustment section and click Submit a request. Follow the prompts.

You can submit adjustments for any claims you’ve submitted within the past 90 days.

3. Get your decision

You’ll get an answer for your adjustment request within 30 days of submitting it.

How to file a claim dispute

But what if your claim is still denied even after filing an adjustment? If that happens, you can file a dispute online. Disputes can be submitted for any claim that’s gone through the adjustment process and will receive a response within 45 days of submission.

Get claims processed faster with Provider Tools

With Provider Tools, you can submit and review claims adjustments online. That’s just one way Provider Tools makes it easier and simpler to run your practice. To learn how to use this feature and many others, sign up to attend a Provider Tools webinar!

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