Dental insurance verification is a critical function in any dental practice irrespective of size. It helps a practice to manage an efficient claims process while also boosting the patient experience.
An effective verification methodology offers multiple benefits for the patient and the practice.
Visible savings in cost and time: When a member of the dental team spends time and effort online or through phone calls to verify patient details, some costs get incurred. If there is a streamlined verification process, it results in more valuable time for undertaking productive activities that can directly help in improving patient care while also curtailing operational expenses.
Boosting the patient experience: When the insurance details and plans of a patient are accurately verified, it results in happy patients as well as no unpleasant billing surprises. A precise understanding of what procedures and services are covered also ensures that a patient has a favourable financial experience which is as vital for patient satisfaction as the overall service itself.
The process of insurance verification comes with its own set of challenges that need to be effectively managed.
Handling inaccuracies that delay the process – The entire methodology of the insurance verification system is prone to errors that result in billing faults that cost the practice money and time.
Reimbursements that are delayed – Any deviation in the verification process can lead to mistakes which in turn causes a delay in filing a claim. Most practices depend on insurance revenue for maintaining a positive cash flow a delay can cause an unwarranted financial strain
Patient eligibility needs to be verified at the time of scheduling the appointment The dental team needs to collate all the personal and insurance details of the patient at the time of scheduling and enrollment. Confirming the eligibility and coverage at this moment helps to ensure that the patient is eligible for services or procedures that are required.
The information gathered at the pre-registration must be validated to confirm that it is complete and precise. This aids in preventing errors and unpleasant surprises.
The dental team needs to be adept in the verification of insurance coverages for all services rendered by the practices and with multiple insurance providers on site. It must safeguard the practice and patient by always ensuring accuracy. This encompasses checking active coverage with the insurance company and includes
All the prerequisites needed to attain prior authorization need to be gauged. Gaining consent and approval from the insurance provider before any dental service or procedure or service can help prevent any possible denials or delays in the treatment process.
The dental team must convey all the relevant information about insurance coverage to the patient. This includes sharing particulars about the extent of policy benefits, coverage limits, any out-of-pocket expenses, or other policy information.
When a patient is informed of all the details, there is transparency and understanding of all financial liabilities and responsibilities.
The potential cost of treatment for services and procedures needs to be calculated and an approximate amount must be shared with the patient. This helps the patient to prepare and plan for meeting such expenses. An estimate also enables a patient to make an empowered decision concerning the treatment they are about to receive.
The dental team must ensure that all protected health information (PHI) is managed with care and precision. The confidentiality of patient data needs to be maintained as per HIPAA privacy rules. This applied to oral and written communication with the patient. The practice must be compliant with the HIPAA Security Rule for digital transactions.
Following some of the abovementioned best practices can help a dental practice ensure patients accurately realize the insurance coverage based on their plan. Likewise, it also helps to lower unanticipated bills and improve overall patient satisfaction.