Dental Insurance Verification Forms: What Info Is Needed?

Posted by Rachel Lenton on Oct 15, 2019 7:00:00 AM
Rachel Lenton
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Dental insurance verification forms are an important part of the insurance eligibility process. Based on the information on an insurance form, you'll be able to verify someone's insurance. Today, we are going to do a Q&A about dental verification forms.

What is a dental insurance verification form?

Dental Insurance Verification Square Practice BlogA dental insurance form is a document that is filled out by a practice and used for requesting insurance information for a patient. The form is complied of basic information the insurance company needs in order to find the patient profile and let the dental practice know what insurance options are available.


What is dental insurance verification?

Dental insurance verification is when a practice reaches out to a patient's insurance provider to see what they qualify for. They are verifying what kind of work or treatments are covered for their client. They'll also find out what rolls into the new year and what their patient should take advantage of now while it's still covered.

This is why a dental insurance form is important. Practices can base their sales and re-care strategies on the information acquired through these forms. Understanding a patient's insurance when treatment planning or rescheduling is an added bonus. These forms also allow the opportunity for patients to get the best care at a low cost.


What information needs to be acquired from a dental insurance form?

The information ranges from basic (like first and last name) to more personal (like a social security number). From there it'll become more dental specific and technical. eForms created a great Dental Insurance Verification Form example PDF that you can see here.

The top priority with this information is that it is accurate. When data entry or form fill-outs aren't precise, it can extend the verification time, cause more back and forth, or even get a patient's eligibility denied. This makes your efforts counter productive.


How do you establish proof of eligibility for a patient?

Proof of eligibility is made after a verification form is submitted and comes back as approved. That approved form is the proof of eligibility!


What does an insurance verification specialist do?

An insurance verification specialist is a health care professional who is responsible to verify and confirm people's eligibility for coverage. The role doesn't require more than a high school diploma, but it's preferred that they have some experience. This role is very insurance paperwork heavy and a specialist will need to be proficient in insurance terminology, coverage plans, and providers. We recommend using automation whenever possible in this process.


How do I verify out-of-network benefits?

First, what's the difference between in-network and out-of-network benefits? An in-network dentist is one that has a contract with a dental insurance agency. Members of this plan have preset insurance rates. The benefit of being in-network is it's less hassle insurance wise and it's an easy way to advertise to potential patients.

If you are working with an out-of-network patient or if you aren't involved in any network you will need to see their insurance card (if they have one). From their card, you'll be able to contact their insurance company, send them a verification form, and begin getting them processed. It is more time consuming to process someone who is out-of-network but it isn't necessary for them to be in your network.


Final Thoughts

Your practice should take full advantage of the tools available. This includes dental insurance verification forms. Keeping these filled out with all the proper and accurate information will improve your process and your patient experience.


Topics: Dental Case Acceptance, Improve Dental Practice Operations