A practical dental AR workflow for claim status, payer follow-up, denials, exceptions, and documented next actions.
Turn the aging report into a work queue
An aging report shows where balances sit. An AR workflow explains what happens next. Prioritize claims using practice-defined rules such as age, balance, payer, known rejection, missing attachment, or lack of a current status.
The goal is not to touch every claim equally. It is to surface the claims that need action and keep them from returning to the report unchanged.
Record the current claim status
CMS identifies the 276 request and 277 response as standard claim-status transactions. Depending on payer support, status may also come from a clearinghouse, payer portal, or phone call.
Whatever the channel, the result should be documented in a consistent format so the next person or system can act without repeating the same investigation.
- Accepted and pending adjudication
- Rejected before adjudication
- Additional information requested
- Denied with a reason code
- Paid with remittance pending
- No reliable status available
Separate denials from other exceptions
A denial has been adjudicated and needs review against the remittance and payer explanation. A rejection, missing attachment, unmatched payment, or unavailable status belongs in a different exception path.
Clear routing prevents teams from treating every unpaid claim as the same problem.
Close the loop with ownership and timing
Lavender's AR Agent checks claim status and follows up with payers after the practice's expected payment window. Practice rules determine escalation, appeal, and write-off decisions.
- Assign the claim to a person or automated queue
- Record the latest status and source
- Set a dated next action
- Preserve payer reference numbers and notes
- Stop only when the balance is resolved or formally transferred
