No one likes to write a narrative! They take time to put together, and many times, the submitting office is not certain what the carrier is looking for. But narratives don't have to be difficult or long. The goal is to provide supporting information to help the carrier and its dental consultants determine whether the patient’s contract covers the requested procedure. Narratives do not take the place of legal documentation, such as the patient record and/or clinical notes, but they can provide additional detail leading to faster and better payment outcomes.
What are some factors to consider?
-
Be concise. This makes it easier for both the submitting dentist and the dental consultant.
-
Be as specific as you can, avoid extraneous information and include objective clinical findings. For instance, when submitting for a fractured tooth, be sure to include the location of the fracture (including missing cusps) and the amount of existing caries; any symptoms the patient is experiencing; how much healthy tooth is left; the condition of the existing restoration; and, if it is cracked tooth syndrome, the tests used to diagnose the condition.
-
Try to include information not already noted in the existing documentation.
-
Try to avoid jargon or abbreviations that are not commonly understood.
-
Make the narrative patient specific.
- If it is helpful, include supporting documentation, such as additional charting and photographs, to help clarify.
-
Remain positive and objective.
The treating dentist has the advantage of knowing the patient and their condition first-hand and being able to share information that may not be obvious in an X-ray or on a standard claim form. A good narrative provides important and relevant clinical detail that can result in more prompt and accurate reimbursement.
Michael D. Weitzner, DMD, MS
Dental Director, Delta Dental of Virginia
