Any dental practice must focus on quality treatment and care, as this helps to attract and retain patients. However, the practice must also keep an eye on profitability to run the business successfully. A practice can deliberate a shift to real-time insurance verification in order to reduce denials in claims. This helps to accelerate the revenue cycle. An investment in the right software can lower manual effort and claim denials while also reducing costs.
About Real-Time Insurance Verification
It is the process of confirming the benefits of insurance coverage by using an automated software solution as compared to traditional manual means. The dental team can submit patient information directly to the insurance organization or to a clearinghouse. The team then gets instant access to patient details such as policy coverage details that include copay, validity dates, and more.
The Need To Verify In Real Time
According to various studies, the primary reason for claim denials across dental practices is an eligibility issue. Nearly ten per cent of insurance claims are rejected on the first attempt. A practice can lose nearly three per cent of patient revenue due to denials.
Moreover, the practice has to spend on appealing for a denied claim. The best part is that a large portion of such denials could be avoided if the dental team took adequate steps to prevent them.
For the practice, insurance eligibility verification in real time can become an integral component for success. It makes the process of claim submission smooth by reducing the probability of claim denials, as well as bringing down costs associated with claim submission.
Streamlining The Verification Process For Greater Efficiency
Insurance eligibility verification for a patient before rendering procedures or services is a vital step for a practice to deliver quality and timely care to a patient.
Verification of insurance details before the scheduled appointment can prevent unwanted denials and financial setbacks. More importantly, the practice can render optimal care the patient needs without a delay.
This helps the dental practice to lower administrative work. A reduction in wait time can enhance the patient experience. The patient is not surprised by an unforeseen financial outlay. The process involves confirming various aspects of insurance coverage based on the policy plan. These include benefits, possible out-of-pocket expenses, etc.
Performing such a task before the appointment results in accurate treatment plans. It also results in a more productive appointment for the practice and a pleasant experience for the patient.
Selection Of Software Based On The Needs Of The Practice
The solutions available to a practice are varied. Automated batch workflows, code error detection are among other options available. These solutions can be integrated with the existing PMS of the dental practice. Estimates can be automatically generated and sent to patients by email, while copays and deductibles can be identified through automated batch workflows.
Real-Time Insurance Eligibility Verification And The Benefits
Real-time insurance eligibility verification checks coverage instantly by connecting directly with the insurance organization. Practices benefit because the process does not involve slow and manual checks. Some of the benefits include:
Lowering Of Claim Denials
Denial rates of submitted claims fall because of a reduction of errors, both data and unforced. The number of days taken to receive payments is also reduced. This helps to improve cash flows. Unlike manual means, real-time verification takes help from electronic data exchanges while adhering to HIPAA rules. This results in precise and accurate data.
Augmented Cash Flows
Real-time verification enables greater cash flows due to accurate checks and fewer denials. The process is faster, and this means better cash flows. When service is stopped before care has been rendered, the team spends less time handling claims and can concentrate on other activities. The practice does not have to hire an additional resource merely for insurance verification.
An Improved Patient Experience
Most patients are covered by an insurance policy. They could be covered by an individual policy or through the company insurance policy. Most of these patients are not aware of their policy costs or benefits.
When the dental team uses real-time verification, they get access to accurate information about deductibles, copays, and balance amounts based on coverage. As surprises are avoided, patients are satisfied and place greater trust in the process.
Practices can outsource the task of insurance verification to a specialist or opt for a platform that can connect with multiple insurance organizations. The team can share a tentative cost to patients. Real-time verification lowers wait times while making patient visits smoother and easier.
Lowering The Administrative Burden
The regular manual process of insurance verification consumes time, effort, and is cumbersome. Moreover, there could be unexpected errors that lead to claim denials. Since automated systems verify coverage and benefits in real time, the team can focus more on patient care. Real-time verification includes scanning of insurance cards and placing information into electronic health records.
Empowering Dental Practices to Scale
Practices can scale operations effectively while using accurate data consistently in real time. Compared to manual modes, the practice can respond to patient needs more precisely and fast. This also positions the practice in a better light and makes it more aggressive in a highly competitive market.
Standardized data across multiple insurance organizations
The data format and structure can vary across insurance organizations. Using advanced insurance verification APIs, a practice can circumvent this challenge and generate standardized outputs. This curtails the need for the dental team to address challenges posed by insurance companies while simplifying the verification process.
Comprehensive Data Through Multi-Channels
These APIs provide comprehensive data through multiple sources and enable customized verification processes. They can sync with existing workflows while receiving accurate and timely data syncs. The dental team is thus empowered to make informed decisions faster.
Richer And Useful Data Insights
Beyond EDI data, other useful information, such as coordination of benefits, missing tooth clauses, exhaustive patient history, and complete coverage of ADA codes. These insights help to lower claim denials and boost cash revenues through faster collections. It also helps to reduce administrative time, phone calls, and overtime expenses.
Real-time eligibility verification needs to be adopted by dental practices today, as the benefits are manifold. It boosts the patient experience through transparency. It builds patient trust and ensures negligible claim denials.
