Dental Insurance Eligibility Verification Services Company

Dental Insurance Verification


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Dental Insurance Verification Services Company

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to get dental insurance verification done before rendering services as there are chances of patient’s benefits being outdated, patient having incorrect information or the policy being terminated or modified.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 Insurance Verification?

Dental insurance 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

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?

  • We request the Dental Office to share the patients insurance details through an online form or if you are using any dental software like Eaglesoft we can get the details through remote access of the system.
  • Our agents call the insurance company on your practice’s behalf to check and verify the patient’s plan, coverage and other required information.
  • They follow up and cross check your patient’s benefits to make sure every detail in your records is accurate.
  • Insurance policies and providers keep changing time to time. So, it is our duty to keep you informed and quickly pass on the information to your staff.
  • We keep unpleasant surprises away. We have seen patients complaining about unexpected deductible or fee from the practice. We keep such issues away by making sure that your patients are fully informed about what expense they owe before the treatment begins.
  • How we share information with the Dental Offices: We have an IV form which we share with the dental offices however it can be customized based on your requirement.

Why Is Dental Insurance Verification Important?

For the Practice

  • To help the office better understand which services are covered.
  • It also offers clarity on the services that are not covered.
  • It also gives them an overview of the services the patient needs or need not be billed.
  • Your staff can easily explain the patient’s responsibility on the spot.
  • Speedier cash flow.
  • There’s no worry of whether or not your patients will be receiving their reimbursements in a timely manner.

For the Patients

  • Most patients do not understand why their insurance will not cover their medical costs and refuse to pay. However, when a patient verifies coverage, he/she is prepared for any extra costs and can create a payment plan if necessary.
  • No more unpleasant surprises! Patients are fully informed about what they will owe before the treatment begins.

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

After the form has been delivered to the office, your staff will be able to know what treatments are covered by the patient’s insurance policy.

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.

  • $4.99 per IV (PPO/HMO/Medicaid).
    Note: An additional $1 will be charged for Rush IV’s
  • $200 set-up charges waived until Dec 31, 2019.

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.