The dental practice needs to ensure that the insurance policy information of a patient is updated and accurate. A planned dental insurance verification process can help garner all the details needed, as well as avoid the possibility of unanticipated costs for patients. It also lowers the possibility of any rejection of claims.
The verification of all insurance details in advance can offer better service and a positive patient experience for the patient. It also helps the practice and the patient to manage cash flow and finances more effectively. The practice can also receive timely reimbursement from the insurance company.
Outlined below are five steps that can assist the practice in streamlining the dental insurance verification process.
Time and timing are vital in the dental insurance verification process. If a patient visit has been scheduled and just before the patient comes to the practice the team realizes some discrepancies, there could be some unwanted worry. Before the patient encounter begins, any unclear details need to be confronted. Hence, timing is important, and the team should commence the verification process at least four days before the scheduled visit.
The dental team must keep in mind that no two patients are alike, and their insurance benefits can vary based on their needs. Each patient visit must be considered a new requirement, and the team must go through all the rigours of the verification process.
The team must also make notes and a checklist for key requisites for all treatment procedures. Such notes and lists can guide the dental team across all the steps of the patient journey without leaving anything to chance. In case any details need to be confirmed or shared by the patient, then the team must provide sufficient time for the patient to revert with the desired information.
It is very important for a practice to maintain clear lines of communication in the dental insurance verification process between both the insurance company and the patient.
The practice needs to regularly communicate with patients to obtain precise and updated insurance details and other policy information. This is vital before recommending any procedure or service to the patient. A friendly approach by the team also makes them share updated policy details through calls or appointment reminders.
While interacting with insurance companies, the practice must have strong relationships and lines of communication that can aid in garnering any vital information as well as resolving any verification-related doubts promptly.
Communication channels and standard operating procedures go hand in hand. The practice must craft a list of sharply defined and documented standard operating procedures (SOPs) for managing the insurance verification process. This can also substantially augment the efficacy of the process.
These SOPs must touch upon all aspects of the verification process. This includes the collection of all patient information as well as details needed to interact with insurance providers.
Following a set of defined procedures helps lower errors and confirm that all insurance details are verified in a standardized format. These SOPs also help to train and onboard new team members in the verification process.
The practice can avail of multiple insurance verification software solutions to manage the verification process. Such software solutions can effectively streamline the insurance verification process. Technology can play a vital role in verifying patient eligibility and benefits promptly and accurately.
By entering all the relevant details in the practice management software, any denial of the claim as well as any delayed payment can be prevented. These solutions can automatically recall any insurance data, analyze errors, or alert staff on any potential problems. The dental team can also receive real-time updates if a patient has recently received changes in coverage details or eligibility benefits.
A dental practice must consider investing in insurance verification software as it can considerably shorten the time needed for process completion. In addition, it also improves accuracy and lowers the workload on the dental team.
When the dental team verifies all the eligibility conditions before the patient visit, the practice will avoid any potential claim denials or even a delay in payment. Verification is a tedious and skilled task, and it needs a dedicated billing executive to undertake the job accurately. The practice can look at outsourcing solutions for billing and claims management, and insurance verification can also be added to the tasks expected to be done.
The practice must get hold of all benefits of the insurance policy. This means that a full breakdown of benefits will enable the team to understand the patient’s insurance plan as a detailed summary.
Having a complete breakdown can help the dental team identify all the procedures that can get covered as well as the percentage of coverage. This will also help to understand if the patient has used any benefits somewhere else, the maximum extent of coverage, copayments, and deductibles. Hence, a complete breakdown of the plan is critical to ensuring accuracy in the Dental Insurance Eligibility Verification process.
A comprehensive understanding of insurance benefits and plan details also enables the dental team to calculate all patient benefits. This can also include any relevant out-of-pocket expenses that might have to be borne by the patient.
While a full breakdown might not be needed every single time a patient enters the practice, it is necessary to ask a few basic questions just in case if any information has changed since they last visited the practice.
Some basic questions can include a confirmation of the address or name of the insurance company used by the patient. Hence, the team can then ensure that all policy details are still the same since the patient's last visit to the practice.
The dental team needs to be properly trained and careful when recording information in the patient record system. This information forms the basis for claims from the insurance company. A simple error can spell the difference between receiving compensation for a claim or a denial of the claim. Such errors can cause a delay in reimbursements running from a few days or weeks.
Hence it is important for a practice to maintain accurate records obtained through the insurance verification process. This helps accelerate the submission of and prevents any problems with dental billing and reimbursement.
Some vital information that needs to be accurately recorded includes eligibility verification details, changes made in the policies, issues in eligibility status, and patient acknowledgment, among others.
The dental insurance verification process plays a critical role in improving cash flows for the practice and needs to be managed and handled effectively. When the process is followed by using set SOPs, it reduces errors as well as the workload of the dental team. When all details of the patient’s policy coverage details are accurately collected, then the practice can be confident that the claims submission process will be smooth with minimal risk of claim denials as well as faster reimbursement from the insurance company.
