Dental insurance verification is the first step of the dental billing process with a patient. The effectiveness of this process can lead to collection of more money from dental insurance claims. And most importantly, the money can be collected on time.
However, dental practices always struggle to streamline dental insurance verification process. Some of these reasons include inability to manage administration and dental care, shortage of skilled staff, inability to handle patient rush, inordinate time consumption, and inaccurate eligibility data.
Over the years, dental practices with an in-house verification team have found that the process can be streamlined by following some best practices. In this blog, we discuss about those effective practices and how they make dental insurance verification more result yielding.
Dental Insurance Plan Coverage: Things to Look for in a Plan
- In network and out-of-network coverage
- Services covered and not covered – diagnostic, preventive, and emergency.
- Extent of coverage of services and plan exclusions
- Referrals to dental specialists
- Annual maximum allowed by the plan
- Amount utilized from annual maximum
- Limitations of exams and x-rays
- Crown frequency
- Dual coverage
- Medicaid/Medicare coverage
- Medical health insurance coverage – that cover exclusions in the patient’s dental plan
Commence the Dental Insurance Verification Process at Least 3 Days in Advance
A dental verification process can be carried out efficiently only if you have sufficient time in hand. Not having time between means you will have to scrutinize the patient’s insurance benefits in haste. This opens up the possibility of errors. The chances of mistakes multiply if you are overloaded with work or have little staff to run the show. Ideally, you must have a gap of 3 days before the appointment.
A gap of 3 days will give you the time needed to go through the full breakdown of the plan and understand it in the right perspective. You get all the time in the world to decide on whether you need any additional information from the patient prior to the appointment.
Sometimes, it so happens, that a call to a patient for additional information may go unanswered because of various reasons. Therefore, a buffer time will ensure you get the needed elbow room to procure the additional information from the patient.
The other big advantage of starting early is that it helps avoid misgivings. In case of discrepancies, you can intimate them in advance and ensure they come prepared.
Collect Patient Data with an Online Form
You need to have a well-defined information collection process in place. It must collect all essential data. Also, the process of collecting the information has to be error free. Some practices prefer to collect critical information over phone and key it in excel sheets. Such a practice is always prone to errors.
The best option is to get it filled by the customer. For this, you need to have a specific online form. The form must be designed as per all important information that you need to capture. These include Name of patient, insurance provider, member ID number, member and patient DOB, Name of employer, group ID number, insurance telephone number etc.
The form can be sent to most patients but not all. Senior citizens many not be able to do it correctly. Therefore, you need to be prepared for requests to get the form filled at your end. So, you need to have a dedicated person for assisting such patients. Even in cases like this, it is better to seek a screen shot or scanned copy of their ID proofs. This will eliminate chances of mistake in either end.
Always Look at the Full Breakdown of Plan Benefits
Try to get a full break down of the patients’ insurance plan. This is possible only when you have access to the detailed summary. A complete breakdown will tell you clearly the dental procedures that are covered, the benefits of the coverage, the percentage of coverage, the plan maximum, if the benefits have been availed before, and other critical details.
A clear picture of the patient’s benefits has other advantages too. You can tell the patient upfront about the out-of-pocket expense and clearly explain to them the insurance amount which the carrier will pay. This helps in avoiding surprise billing shocks which is so important to building good relationship
Bucket Returning Patients
It always makes great sense to have a different insurance verification process for returning patients with same insurance coverage. This will help you save time and efforts. The only aspect that you need to look into is that their annual maximum utilized.
It’s important to have the process handled by those who understand the full breakdown. Only an expert can make a patient understand things like if a patient is utilizing maximum benefits, or if they must avail all the benefits before year end. This, again, goes a long way in building trust.
There are many practices that do not have an in-house team to manage the process. Such practices can always outsource insurance verification to dental insurance verification companies. A third-party insurance verification service specialists depend on a well-developed process to check patient coverage benefits in complete details well in advance.
Most of them deploy a two-pronged approach to verify benefits i.e., by calling up payers and by cross checking through the carrier’s website. This ensures no slip ups whatsoever and guaranteed accurate claims submission. It also expedites turnaround times and keeps cash inflow intact.
Who We Are and What Makes Us an Expert?
This article is brought to you by Medbilling Experts one of the best dental insurance verification companies in the market today. We specialize in a range of services, one of which is dental insurance verification. We have over a decade of experience in delivering top-notch services to our clients and have emerged as one of the best dental insurance verification companies. Our experience in assisting several large and small dental practices in the US, has helped us come up with a robust process for quick payment by both the carrier and patient. If you too are looking for ways to improve your entire billing process talk to our experts now.
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