Insurance Eligibility And Benefit Verification: Technology + People. It Takes Both.

Insurance Eligibility And Benefit Verification: Technology + People. It Takes Both.

Insurance Eligibility And Benefit Verification:
Technology + People. It Takes Both.

Dental Insurance Eligibility Verification

There is no shortage of companies offering “automated” eligibility/benefit verification services. These companies promise no more staff hours will be spent talking with insurance carriers or sitting on hold waiting for an agent. Just press a button and you’ll have all the information you need for proper treatment plans and satisfied patients. 

Not so fast.

Welcome to Real Life

There are only a few ways to get some or all of the accurate information you need:

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Shouldn’t practice management software do verification & eligibility?

Your practice management system is absolutely necessary to run your practice properly, but without complete and accurate information, it can’t formulate appropriate treatment plans for patients or meaningful revenue projections for you. 

The perils of magical thinking

An automated system with that special button” or third-party software will only send a request to the patients insurance carrier for verification information. And that’s only if your system has a relationship” with that carrier. If not, youll get zero information. Even with a relationship, you’ll get only the information the carrier chooses to send. 

Meaning, you probably won’t get enough of the right information to help prepare a proper treatment plan. So not only doesn’t the treatment plan happen magically (aka automatically), but your staff will still have to call the insurance carrier. 

More magical thinking madness

When you do get the information, it has to be entered into the patient record of your practice management system, and a plan still has to be created in order to prepare claims and treatment plans.  

But what about the magic button that gets and sends…things? Formats differ among insurance carriers, information is inconsistent, and practice management systems each have their own specifications for accepting data. As you can imagine, there are many opportunities for systems to NOT work well together.

What about insurance carrier websites?

Sure, a lot of large payers have websites with information for verifying patient eligibility and benefits. Here’s the but:

Your staff has to spend time going to the website, entering the data into your practice management system, and (probably) having to call the insurance carrier to get missing data.

Making the dreaded phone call

And you thought it couldn’t get worse. When all magical thinking fails, it comes down to calling the insurance carrier. Get ready for your staff to:

The real life answers

Put your insurance eligibility and benefit verification on the professional level where it belongs with an RCM outsourcing company.

But again, not a magic push-button solution. An RCM company has to have both the technology and a knowledgeable, available staff (not an 800 number or a chat bot) to partner with you. And by partner, we mean Medusind.

Medusinds proprietary QuickVerifyTM technology, along with a large staff of highly experienced and knowledgeable RCM professionals, will ensure that your verifications are done on time, every time, and with unparalleled high level of accuracy. 

We work with the largest DSOs and the smallest practices, performing approximately 50,000 verifications every day. We align with each clients protocols and assign dedicated teams to each one.  And in addition to eligibility and verification, we provide a full range of services to meet all Revenue Cycle Management needs. 

To determine how we can best serve you, a 15-minute conversation is a good place to start. Call us at 949-240-8895 or email dental@medusind.com and we’ll set up a time. It will be time well spent.

Medusind, Inc., founded in 2002 has nine US offices and five global centers employing more than 4,000 staff. Utilizing its proprietary technology and platforms, and a highly experienced and knowledgeable staff, Medusind provides a full range of revenue management services to the healthcare marketplace.  

See how Medusind can work for you

Tell us about your business or organization and we’ll connect you with a Medusind expert who can show you the products in depth, and answer any questions you have. See how a provider, office manager, or biller use Medusind to empower their practice.