Dental Insurance Verification | Eligibility Verification Services

Dental Insurance Verification

Insurance verification is the process of verifying the patient’s eligibility, active benefits and coverage with the insurance companies to prevent billing issues.

For any dental practice, successful billing is entirely dependent on correct and complete dental insurance verification (IV). Owing to the increase in the number of people getting insured, it has become difficult for several practices to manage the dental insurance verification (IV) workload in-house.

Our experts undertake the process of verifying patients’ eligibility, active benefits and coverage with the insurance company for you. To prevent claim rejection, it is important to get dental insurance verification done before rendering services as there are chances of patient’s benefits being outdated, patient having incorrect information or the policy being terminated or modified. Any such information could get the claim denied.

Our experts work round-the-clock to obtain information from insurances through website and fax. They also call them regularly to get every patient’s history as it affects treatment planning. They take care of all these tasks so that you can focus on your patients without any worry.

Availing our Dental Insurance Verification Service would relieve you from the headache of getting verification done and will let you maximize your reimbursements and minimize your denials ratio.

What is Dental
Eligibility Verification?

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    Dental Insurance Eligibility Verification is all about assessing a patient’s active coverage with the insurance provider. It also involves verifying the eligibility of their insurance claims. To ensure approval of the claim, a verification process is done before the patient has already started up with the treatment and other processes.

    A patient calls your office to book an appointment for Dental Treatment. Your staff asks them questions about whether his treatment is covered by any Insurance plan. If yes the front office takes details of the insurance coverage which includes:

    • Patients Name
    • Patients DOB
    • Member ID
    • Continues / Recall / New Patient etc.

    What Happens Next?

    Your staff calls the insurance provider. However, due to certain reasons, the call is put on hold. This could be either the representative is busy navigating the information or unable to find the patient’s data. All this ends up taking a lot of time. Meanwhile, your office’s phones are ringing and not being answered because your staff is engrossed figuring out patient’s insurance benefits. Believe it or not, it ain’t that simple!

    Here comes the role of dental insurance verification company. You can have Capline’s experts call the insurance company get all the insurance information ready.

    So, we will be sitting on the phones and freeing up your staff to do anything else except the verification part because dental insurance verification is our forte.

    How Capline Handles Dental Insurance Verification for Your Practice?

    Get patient insurance details via an online form

    Follow up and verify patient’s benefits

    We make sure that your patients are fully informed about what expenses they owe before treatment begins

    Our agents call insurance company, verify patient plans, coverage and other required information

    We make sure that every details in your record is accurate

    We have an IV form for sharing the information with dental offices

    • Get patient insurance details via an online form
    • Our agents call insurance company, verify patient plans, coverage and other required information
    • Follow up and verify patient’s benefits
    • We make sure that every details in your record is accurate
    • We make sure that your patients are fully informed about what expenses they owe before treatment begins
    • We have an IV form for sharing the information with dental offices

    Why Is Dental Insurance Verification Important?

    For the Practice

    • Give clarity on which services are covered and uncovered.
    • Gives an overview of the services that the patient needs to be billed or not.
    • Helps your staff easily explain the patient’s responsibility on the spot. Speedier cash flow.
    • No more guessing around whether your patients will be receiving their reimbursements on time or not.

    For the Patient

    • Patients are prepared for any extra cost once they verify coverage.
    • Patients will be able to create a payment plan, if necessary.
    • No more hidden surprises as far as billing is concerned.
    • Patients are prepared of the amount they require to pay once the coverage is verified.
    • Patients do not deny paying bills. This ultimately turns advantageous for the practice.

    Outsourced Dental Insurance Verification OR
    In House Dental Insurance Verification:
    Which One to Choose?

    Why Outsourcing Dental Insurance Verification Makes Sense?

    • Dental Insurance verification requires specialized knowledge and skill to get it done in a timely and efficient manner. This is the reason dental offices feel the need to outsource dental insurance verification.
    • With the constantly changing policies, it becomes quite obvious for an unexpected fee to be overlooked. Hiring a proficient in the process gives peace of mind and ensures that all tasks are being done correctly.
    • It also allows your staff to focus on scheduling the appointment and patient engagement.
    • When you have a team that makes the dental insurance verification process easier, you can focus on giving your patients outstanding dental care.
    • If your practice experiences higher volume, it is worth outsourcing an expert team who handles all your funds efficiently.

    Why In House Dental Insurance Verification Goes Wrong?

    • Even the smallest wrong information can lead to the entire form being rejected. If you do not speak to dental insurance verification companies, there are increased chances of errors occurring while fetching patient’s data.
    • A lot of time goes wasted in gathering inaccurate data and confirming claims.
    • Rejection in claims due to mismatched information.

    You don’t want your patients to get annoyed when they realize that their treatment isn’t covered properly. Similarly, you would also not want their forms to get rejected because of an inappropriate detail. This is where outsourcing comes in!

    What Is the Process of Dental Insurance Verification?

    We are quick at finding out the information from the insurance provider. We match all the details with the insurance representative to ensure that there are no obligations on the part of patients. Our experts call the insurance company to check information like policy holder’s name, policy number, group number, employer’s name, phone number, etc.

    We Verify the Following:

    • Effective date of coverage
    • Coverage terminated? If yes, what date?
    • In-network benefits (co-payment amount)
    • Deductible amount
    • Has deductible been met?
    • Co-insurance amount
    • Other out-of-pocket expense
    • Benefits for treatment?
    • Is a referral necessary?
    • Is prior-authorization necessary?
    • Out-of-network benefits?
    • Out-of-network financial responsibilities?
    • History of Services

    Why Choose Capline Dental Services for Dental Patient Eligibility Verification?

    Capline Dental Services is one of the fastest growing dental insurance verification companies in the USA. Over the past few years we have successfully helped many dental practitioners with dental insurance eligibility verification. We perform comprehensive verification of claims submitted with respect to the underlying insurance criteria. This helps in verifying whether the patient is eligible for the service or not and if any portion of the cost will be borne by them. By outsourcing insurance verification to Capline dental practitioners and dental offices not only save on infrastructure and administration staff expense but can give their entire focus to patient care.

    Below is a list of reasons to choose Capline Dental Services for Insurance Verification:

    Certified Dental Insurance Verification Company

    All the healthcare services we provide are HIPAA compliant conforming to the guidelines laid out through international standardization for nationwide compliance.

    Short Turnaround

    With our experienced staff we are able to complete the verification in the quickest of times so that we do not keep the patient’s waiting.

    High Quality of Service and Accuracy

    Our team of experts ensures that every step of the way you get high quality of service as per insurance best practices with accurate results by employing state of the art software and advanced technology.

    Data Security

    Every type of patient information stored in our systems is accessible only to authorized personnel as we offer the highest level of data security for all documentation.

    Scalability

    With the growth of any practice comes more responsibility which is why we can easily increase our process rate as your patient inflows increase to maintain the same speed of revenue management as well as patient care.

    Single Point Contact

    We offer single point contact for all our patient queries so that they get the solution or answer right away for the problem they are facing or the information they want.

    Flexible Pricing Options

    We offer flexible pricing options as per the needs of our individual practice so that you get the best value for money.

    24/7 Availability

    We offer 24/7 availability as you can contact us at any time be it via phone, email or chat to give you instant solutions and information.

    Hire Capline to Outsource Dental Insurance Verification Services

    We are sincerely dedicated to providing the best customer experience to all our patients as we think of their problems as that of our own. Our team of experienced professionals processes the documentation to the insurance provider in a jiffy and tallies all the necessary patient information against their coverage plan. After this they convey to the patient whether they will be fully covered for the treatment they plan to seek or not. When you choose us you are not just minimizing risks that can occur with dental insurance verification, you are completely eliminating them outright. Apart from dental insurance eligibility verification we also provide billing and collection, credentialing, patient statement and other services for smooth revenue cycle management.

    What Is the Turnaround Time?

    Normal IV: The standard turn around to complete a normal IV is up to 48 hours and also depends upon the insurance companies call volume which may result in longer wait time on the IVR.

    Rush IV: Any IV reported within a time frame of 2 hours to 24 hours prior to the patient’s appointment time will be considered as a rush IV, our turn around time is up to 2 hours from the time of entering the patient’s information in the IV tracker.

    What Is the Cost of Getting IV Done Through Capline Dental Services?

    Our rates are economical.

    • New Patient Verification $4.99
    • Any Rush/Urgent Verification $1 Additional
    • $200 set-up charges waived

    Don’t let dental insurance come across as a barrier in your patients’ way of receiving treatment. Schedule a consultation with us to learn more on the benefits of having an insurance support team on board.

    Frequently Asked Questions – Insurance Verification Service

    CAPLINE SERVICES will create a fillable PDF form based on the types of procedures you provide in your office. All the collected information will be typed in the form for better readability and saved as a PDF file in your Practice Management Software
    Comprehensive Verifications is primarily for Brand New Patients and Patients with New Plans or Reverify the patients in the New Year. Our associates will call the Insurance Companies and obtain all the information on the form created for you.
    Basic Verification is primarily for Returning Patients. Patients whose complete benefits were Verified before will then be verified to make sure policy is still active and update other Basic information such as, remaining annual maximum etc. We obtain this information through Fax or Directly from Insurance Web Portal.
    CAPLINE SERVICES has been working on many Practice Management Software such as Dentrix, Eaglesoft, Open Dental, Fuse, Dentrix Ascend, Softdent, Tab32, and many other software. Even if we never worked on your specific software, it will be very easy for us to understand your software and we should be ready to work on it in a day.
    We save the PDF file in your Practice Management Software, Documents section; ex. Document Center in Dentrix, Images in Open Dental or Smart Docs in Eagle Soft, etc.
    Yes, we do take care of it for a small addition charge. We will enter all the information such as annual maximum, deductibles, coverages, etc. In your Practice Management Software Coverage table or Benefit Modules section, so your staff can easily do the treatment plan after Doctor’s diagnosis.
    Yes, we can do that. We may be able to do this based on the volume. Please call us at 925-557-7902 and we can discuss more details and accommodate for a reasonable price. Our goal is to be a good part of your business and help make your work easy with reliability.
    Depending on your requirement. Most of the offices ask us to verify 3 to 4 days in advance. We complete all verification based on the guidelines we discuss in the on boarding meeting.
    We do take care of the verification for same day appointments. You can message us the patient name and appt time using our communication tool. Lead time to start working on any same day appointment is 30-45 mins. From there whatever time normally takes to call insurance and obtain the information, depending on insurance wait times.
    All our associates are well trained and have hierarchy with managers and leads monitoring the entire work. Also, we follow a robust process. However, since we depend on Insurance Representatives to provide correct information, there is a possibility of errors, same as if your staff was verifying with Insurances. We always take the representative name and call reference number to refer to if ever needed in the future. Our accuracy rate has been about 98-99%.

    We add different codes (a letter) for different statuses on your appointment description, which you can see on the appointment book without opening the appointment.

    'V' - Verification Completed (Nothing else to be done)

    'I' - Incomplete information (In this case, read the note in the appointmnet to see what’s missing such as DOB or Sub ID or Insurance Name, etc. Please provide of necessary information and remove ‘I’ and our Team will verify the patient immediately.

    'N' - No Active Policy (When staff sees this code, call patient and see if patient has any new policy or any changes to the policy, update the Practice Management software and remove code. Our Team will verify the patient immediately.

    We will need a signed agreement, a remote system set-up, and a welcome call. Which should take about 2-3 days if done without missing time.
    The set up cost is $999 but we have waived-off this for clients signing-up in the Current Month.
    We can go live in the next 24 hours if you sign-up today.
    Yes, we can work without setting up a remote access as well. We can share a G-Sheet with you, where you can fill up the details of the patients for us to verify. Once verified, we will also fill up the coverage and the complete breakdown in the G-Sheet itself.
    In the welcome call, all your office specific guidelines are noted down by the team and followed sincerely with attention. Your office can always change or add to the guidelines whenever needed.
    For regular patient verification it can be done within 24 hours too. For Rush patients, it can be done within 2 hours.
    Usually the system we utilize has to be left idle and staff cannot work on it. But if you have a system with good configuration, we could install a Virtual Machine which can allow simultaneous usage as well.
    Capline has been in the market since 2016, is providing Insurance Verification services to over 100s of satisfied offices across the USA.
    We usually take 30-45 minutes and in some cases a maximum of 2 hours to verify the patient's eligibility.
    We will not charge for those insurance verifications if their information is incorrect and the insurance is unable to locate it in their database.
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