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ELIGIBILITY / BENEFITS
VERIFICATION

Verifying a patient's insurance eligibility and benefits prior to the appointment time is vital toward insuring that treatment plans are properly prepared and that a patient's expectations relative to fees due are clearly explained and understood by them. It also insures that procedures will not be performed that are later denied and found to be the responsibility of the patient. To date, there is no electronic eligibility/benefits service that provides the detailed information needed by a dental practice to make an informed decision with regard to treatment of patients. It therefore becomes necessary for office staff to call the appropriate insurance carrier to get additional information, a process that keeps them on the phone for many hours a day taking away time that should be spent with patients in the reception area or with new patients on the telephone.

Through its Eligibility and Verifications Services, Medusind provides timely and accurate insurance eligibility checks and verifies patient benefits information including , but not limited to, maximums available, deductibles used, exclusions/limitations and individual procedure allowable fees. Our staff then enters this data into your practice management software and attaches the appropriate plan to the patient, all without the involvement of your office staff. It is important to note that all calls are recorded and can be retrieved for review should questions arise in the future.

Based upon discussions with your administrators, Medusind determines the best questions to ask to get the information you require whether it be for new or existing patients; PPO, HMO or Medicaid insurance; or specific specialties (including Medical). In addition, schedules for such verification checks are discussed and agreed upon. Most of our clients require they be done 3-4 days prior to the appointment. Medusind's staff also provides same day eligibility/benefits verification for walk-in and emergency patients and, in some states, for Medicaid patients. Many of our clients ask us to do re-verifications of all patients just before their appointment time to insure they are still eligible.

Eligibility/Benefit Verification services are customized to meet the specific needs of a dental practice or dental group taking into consideration your current practice management software as well as internal procedures. Your office staff will no longer be spending long hours on the phone with insurance carriers "ignoring" patients in the reception area or new patients calling for appointments. They will be able to concentrate on more meaningful areas to help grow the practice.



 
 

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Medusind Success Story

This client, with more than 50 clinics, had asked Medusind to verify eligibility and benefits calling insurance carriers, using web portals, AVR, and rosters for HMO patients. VIEW CASE PAPER

 

 

For more information, please contact us at

1-800-407-0106

 
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