How To Verify Dental Insurance

Posted by Rachel Lenton on Oct 1, 2019 7:05:00 AM
Rachel Lenton
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Insurance is a daunting world to your patients. Just understanding what plan they have, how much it is, and what that means they can afford are 3 basic question topics that are hard for them to answer. Knowing how and why you should verify their dental insurance prior to their appointment is important.

Verifying your patient's dental insurance is being proactive and keeping your practice's and patient's best interests in mind. As a practice, you want to give each patient the best care you can. Part of that goes beyond providing good hygiene. It involves knowing their insurance and being able to explain it to them in a way that's simple and easy to understand.

What do I mean by this?


Insurance Verification Benefits

Patient

Oct Insta_April Insta-19 copyWhen you verify a patient's dental insurance before they come in, you'll be able to educate them on what their options are for payment that day. Depending on the procedure, you'll also be able to inform them of their eligibility for benefits.

Most patients don't understand the 4 basic insurance payment concepts: deductible, co-pay, co-insurance, and out-of-pocket maximum. It's important to explain the one they are enrolled in clearly and prior to them coming in for their appointment...so they are prepared. If there is no opportunity prior to their appointment, at least explain it before their procedure. This shows them that you care about them; getting them proper dental care without breaking the bank.

Practice

When your patients know their insurance (a.k.a. know they can afford their appointment) they are less likely to cancel, keeping your schedule full. Keeping your patient's insurance information folders updated and clean will allow your transactions to be faster.

Another benefit is staying up-to-date on your patient's insurance, which will reduce the amount of denied insurance claims. Creating a positive experience for your patients will leave them wanting to come back.

Proactive

Insurance verification is a way to be proactive by anticipating your patient's needs. Like we said before, most patients don't understand their insurance options and what they mean. Taking the time to look into their insurance prior to contacting them should be a first step in your insurance verification checklist - but it's also a proactive step.

 

How do you do insurance verification?

Ensure patient records are up-to-date. An easy way to consistently do this is to ask them if any of their information has changed every time they come in for an appointment or when you confirm their appointment. This should happen at least once a year during their scheduled hygiene appointment

Reach out to the insurance company to verify their insurance plan. Make a note in the patient's profile. Contact the patient using your automated follow up system with a templated message letting them know their appointment is coming up and they have a *insert insurance type* and if they have further questions to call.

This puts everyone on the same page but eliminates potential time-wasters of calling each patient to go over their insurance. They may already know or not care to discuss further. Doing this lets them know you've been proactive in their health plan and gives them a choice for more information if they want it.

If you'd like to streamline your dental verification process more, consider creating lists of clients all under the same insurance provider. Working off this list will require one long call instead of repetitive short ones. When calling regarding a patient with a family, ask about each member. Patients who are turning 18, or aging out of being a dependent, should be contacted to update their insurance information.

 

Dental Insurance Verification Checklist

While you are working on insurance verifications, you should be working off a task or checklist. A detailed task list will ensure that you don't miss any important details. Out Source Strategies wrote a great checklist for insurance verification that we'd like to share with you below:

Information Required for Successful Verification Checklist:

  • The dates for which the coverage is effective
  • The codes specific to the procedure to be performed
  • The waiting period which is sometimes required for certain procedures to ensure they are covered
  • The type of plan and the fee schedules
  • Maximums and deductibles
  • Required documentation
  • Information regarding claim submission such as phone number, address, payer ID, and fax number
  • Coverage percentage by category
  • Coverage for tooth implant
  • Coverage for tooth grafting
  • Coverage for crowns, cleanings and build-ups
  • Frequencies for panoramic and full mouth x-rays
  • Missing tooth clause
  • Last date of service

Using a checklist like this will keep your proactive steps as time efficient and useful as possible. If you were to miss one of these, you'd need to call back again, which will take time to do so!

 

Final Thoughts

Dental insurance verification is a pretty simple process. Implementing task list management helps keep any project or tasks you are working on organized. The challenge with verifications is doing it in an efficient way. With tasks that can be as tedious as these, it's an ideal strategy to keep them quick and painless for you, the patient, and insurance company.

 

Topics: Dental Case Acceptance, Improve Dental Practice Operations