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Dental Insurance Verification: 5 Ways to Speed It Up

Dental Insurance Verification: 5 Ways to Speed It Up

Practical tips to streamline your dental insurance verification process

Let’s face it: efficient dental insurance verification is the foundation of your practice, no matter its size. You must verify a prospective patient’s dental insurance coverage before they open their mouth in your chair, so both you and your patient know exactly how much their insurance company will cover regular cleanings and other dental work.

If you don’t get a patient’s dental insurance verification right, they’re going to be hit by a much larger bill. And then they’re going to ask, “Why didn’t my dentist didn’t check in advance that my last visit was going to cost me so much money?”

And don’t forget: if you mess up your patient’s dental insurance verification and do work not covered by their policy, the insurance company won’t honor the claim, and you get zero dollars as a result. That’s a lot less money in your practice’s checking account.

Here are five valuable tips you can use to speed up your dental insurance verification process, so you can cut down your patient’s out of pocket expenses and boost your reimbursement from the insurer:

1

Verify insurance coverage and benefits at least two business days before the patient’s scheduled visit.

Get your patient’s insurance information as soon as they schedule their appointment over the phone to give you lead time to look up their insurance benefits. Interruptions happens, so factor in time for that. These two days will let you read the full breakdown of their benefits on their insurer’s website, understand it, and see if you need any additional information from the patient before their visit. Give yourself time to get that additional information from the patient. They may not respond to your phone call or voicemail right away.

If you don’t give yourself a window of time to verify their dental insurance benefits, they might

show up the day of their appointment and you’re going to have to tell them their bill is going to be bigger than expected. (They won’t be happy.) It pays to clarify insurance information before their visit. 

2

Create a form so you can collect patient data quickly.

Don’t reinvent the wheel every time you have to verify insurance. Create a form in Excel or Word so you can easily transcribe insurance information as the patient feeds it to you over the phone. You can easily download patient forms online (see: Google) or upload them to your dental software.

Here is the checklist of the data you need to fill in your form:

      1. Name of the patient’s insurance provider
      2. Member ID number
      3. Member Date of Birth (DOB)
      4. Patient’s DOB, if it’s different from the Member’s
      5. Employer’s name
      6. Group ID number
      7. The insurance company’s telephone number (if you don’t have login information for the insurer’s web portal)

Another reason to create an online form: it’s easy to update if your patient’s insurance information changes!

3

Check online with the insurer and get a full breakdown of patient benefits in advance of their visit.

When you’re in the insurance company’s portal, verifying your patient’s benefits, take a look at a detailed summary of the patient’s insurance plan so you can see a full breakdown of their insurance benefits. You’ll see which dental procedures are covered, at what percentage they’re covered, if the patient has already used any benefits elsewhere, what the patient’s plan maximum is, and other important coverage details. 

Your patient’s full breakdown of benefits is all-important when verifying dental insurance.  It will enable you to inform the patient what their out-of-pocket expenses will be, and you’ll know what you can expect to collect from the insurance claim you file. 

Also, always ask patients at every appointment if their dental insurance has changed. You never know.

4

If there is umbrella coverage, use the same dental insurance information for each family member.

When a parent calls to make a dental appointment for their child, check to see if they’re covered by the same plan as the parent. If so, you can easily verify their insurance coverage, and you don’t need a breakdown of benefits.

But each time a parent asks for an appointment for a child who’s a new patient, check to make sure that the child is covered by the same policy. Assume nothing.

5

What’s the patient’s dental insurance minimum?

Say a patient returns, and their insurance hasn’t changed that year. Check if they have the same coverage, if they’re still eligible for coverage, and if they’ve used up their annual maximum at the present time. Since most patients are unaware that they’ve got remaining coverage dollars that could be wasted, remind them to attend to their dental needs while coverage is still available. Because insurance benefits won’t roll over to next year, you’ve got to use them now.

Tip Number 6

This is the five-step process for streamlining dental insurance verification. Does it sound complicated? Does it sound time-consuming? Does it seem like it requires a large, unnecessary staff overhead to pay for in-house personnel to get this complex, arduous bureaucratic task done? Does it sound like focusing on this back-office chore might distract your staff from your primary focus—taking care of your patients and making them happy?

If you checked any of the above boxes, then consider contacting Medusind to see how we can save you money and promote operational efficiency. That’s why we’re considered one of the very top dental insurance verification companies in the United States. Talk to us, and see how we can handle all the headaches that come with dental insurance verification so you can focus on patient satisfaction and increased profits for your practice.



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