A Simple Trick to Streamline Out-of-Network Claims in Open Dental

How one simple setting can save hours of follow-up, keep your claims list clean, and boost your cash flow—especially for out-of-network offices.

Let’s talk about out-of-network carriers. If your practice is out of network with certain insurance companies, you’ve likely run into a frustrating issue—many major carriers, such as Delta Dental and Anthem BCBS, do not accept the assignment of benefits for out-of-network offices. This means that instead of sending payment directly to your office, they send it to the patient, leaving your team to track down payments and clean up the outstanding claims list manually.

If this sounds familiar, there’s a simple tool in Open Dental that can save you time, reduce administrative headaches, and improve your cash flow: the automatic closing of claims when the "Assignment of Benefits" box is unchecked.

Why Should You Use Automatic Claim Closing?

Enabling this feature in Open Dental offers two major benefits:

1. Collect the Full Amount at the Time of Service

When a carrier doesn’t accept assignment of benefits, there’s no need to estimate what insurance might pay. Instead, you can collect the full treatment amount from the patient on the day of service (DOS) without insurance estimates interfering. This eliminates the risk of under-collecting and ensures your practice gets paid immediately.

2. Save Your Team Time & Reduce AR Inflation

If out-of-network claims don’t automatically close, they stay on your outstanding claims list—making it look like you’re waiting for payment when, in reality, the patient already received the check. This creates unnecessary work for your team, requiring them to:
✔️ Look up each claim
✔️ Determine if the insurance paid the patient
✔️ Manually close the claim

Not only is this a huge time suck, but it also inflates your accounts receivable (AR), making it look like you have more outstanding collections than you actually do.

How to Set This Up in Open Dental

Setting up automatic claim closing is simple and ensures that out-of-network claims don’t clutter your outstanding claims list. Follow these steps:

1️⃣ In the Family Module:

• Open the Insurance Plan

• Uncheck the Assignment of Benefits button

2️⃣ In Preferences:

• Navigate to Auto-Closing Settings

• Ensure the Auto Close Assignment of Benefit option is checked

Once this is set up, any claim that is sent where the Assignment of Benefits box is unchecked will automatically close in Open Dental.

Why This Setup is So Helpful

One of the best parts of this system is that it allows you to customize the setup by plan. For example, some Delta Dental plans will pay the office directly, while others will only send payments to the patient. This tool allows you to configure each plan appropriately so that claims are processed correctly without extra manual work.

Final Thoughts

If you’re out of network with any carrier that doesn’t accept assignment of benefits, this simple setting in Open Dental can save you hours of unnecessary follow-up while keeping your AR accurate. By ensuring claims are automatically closed, you’ll:

✅ Get paid upfront without relying on insurance estimates
✅ Reduce manual claim follow-ups
✅ Keep your outstanding claims list clean
✅ Improve the accuracy of your accounts receivable

Are you using this tool in Open Dental yet? If not, now’s the perfect time to set it up and take a huge administrative burden off your team!