Steps to Simplify the Dental Insurance Verification Process

Insurance verification is the procedure of verification of the coverage, active benefits, and eligibility of the patients with the insurance companies to stop billing problems. For any practice of dental, successful billing is fully based on complete and correct dental insurance verification.

Because of the increase in the number of person availing insurance, it has become tough for various practices to handle the verification of dental insurance in-house workload. As per a health affairs study, patients explains that they did not avail the dental care they required due to appointment times, inconvenient locations, fear, price and difficulty in discovering a dentist who gets their insurance. One of the primary challenges confronting offices of dental is dental insurance verification.

Few of the problems which the front office of a dental practice has to manage with when the task is verification of insurance benefits are:

Time length involved in calls making to the insurance company for verification of the benefits for both existing and the new patients.

Often insurance plan modified by employers, result into extra phone calls numbers that require to be placed to get new details of the coverage.

Insurance misinformation risks by insurance representatives.

Time spent in upgrading the information of the insurance and schedules of fee to setup new system plan.

Verification of benefits and coverage is crucial for patients and the practice. These patients depend on their insurance to assist pay for their treatment. Here are few steps to assist practices to streamline their process of verification of eligibility of the insurance.

Set up a file of insurance for every patient:

Every patient must have an insurance file with all the necessary information entered into it. All insurance details must be obtained during the starting phone call or before the point of service. Returning patients must be asked if their insurance has modified and if it has, new benefits and coverage must be verified.

 The most often used codes of procedure and other essential information must be entered in the insurance verification form of the office. The better option would be to involve all the patients with the similar insurance plan. Confirming dental eligibility prior to treatment saves time and permits the practitioner to give them with a price estimate during the visit.

Contact the insurance company:

Providers must call the insurance company to get correct and up-to-date details relating to patient benefits.

Document all information relating to Coverage

All important insurance eligibility aspects must be confirmed and documented like name of the patient, name of the policy holder, social security number, group number, policy number, name of employer, phone number name, phone number and address of insurance company.

Coverage aspects to confirm include: x-ray frequencies, tooth implant coverage, tooth grafting coverage, build-ups, crowns, tooth cleanings, and coverage percentage by category.

Inform patients in advance regarding what is covered:

Patients do not comprehend their benefits and the coverage of all out of pocket and the coverage costs. It is therefore essential to tell them regarding what is not covered and what is covered.

 As per a survey conducted in 2016, only four percent of US citizens who have private insurance trust that they comprehend their insurance coverage, and only fourteen percent of them really understand all 4 of the general insurance payment concepts – out-of-pocket maximum, coinsurance, co-pay and deductible.

Patients require to be imparted knowledge relating to these aspects, must get details regarding information of the dental service delivered during the visit, what  is the responsibility of the patient and what is covered by the insurance. This will assist in ignoring the issue of surprise bills.

Provide Information to patients regarding guidelines of claims processing:

You should impart information to patients regarding before their first appointment how their claims will be processed. An effective method to perform this would be to give the information on a sheet of information by the consultant, get it signed by the patients and preserve the sheet in the records of patient.

Handling benefits of insurance and expectations of patient is not easy. Practices have to manage with a huge number of insurance plans that are consistently modifying and dental eligibility. Performing the afore-mentioned steps can assist practitioners efficiently handle the process of insurance, grow satisfaction of patient and improve flow of cash.

Outsourcing the dental insurance verification job to a trusted company is a viable option to accomplish these objectives. Experienced companies have effective systems in place to assist dental practitioners in submitting error-free claims, stop rejections, and make sure smooth flow of cash.