The success of any dental clinic begins with a patient making a dental appointment. The procedure is simple and has remained unchanged for a long time. A patient calls the practice and asks for an appointment to get scheduled. The dental team offers a choice of dates and times that are available for treatment. However, the most vital exchange of information during these calls is the details of the patient’s insurance information, and here is where dental eligibility verification services play a critical role.
While on the call, the dental team needs to extract all policy details of the patient. The data obtained needs to be verified by the dental team regarding insurance coverage and benefits. This needs to be done before the date of service rendered, as this helps ensure prompt payment by the insurance company.
When the team verifies all policy details in advance, it knows what procedures are covered by the plan and what are not covered, as well as how much of each procedure is covered by the plan. The team can verify all details by checking the insurance web portals or by calling the insurance company and confirming all the information gathered from the patient.
The dental practice can opt for real-time insurance eligibility verification checks. This helps the team to instantly verify policy details and eligibility by connecting directly with the insurance organizations. Besides financial and operational benefits for the practice, it also results in happier patients, which results in repeat visits. Some benefits are as follows:
The key advantage of insurance eligibility verification is a reduction in the number of claim denials. Moreover, the amount of time taken to receive the reimbursement by the insurance company also gets reduced, and this results in better cash flows.
Rejected claims due to wrong details or policy issues can create additional work for the dental team as well as a revenue loss. Using real-time verification, one can get accurate data instantly about the patient’s policy coverage. Due to the usage of electronic data exchanges, verification happens instantly. The software also adheres to HIPAA regulations. Patients can thus be informed about their policy details before treatment starts. The patient will not be presented with an unpleasant surprise at the time of receiving any bill.
Insurance verification makes the revenue cycle smoother and boosts the financial performance of the practice. This results in negligible claim rejections and faster payments from the insurance company. The team can prevent the possibility of denials before treatment is given. Besides spending time on handling rejected claims, the patient can also be made fully aware of the policy, copayments, deductibles, and other crucial points that the patient needs to know.
It is often observed that not all patients can comprehend their insurance plans and corresponding benefits. The practice can share precise details with patients about copays or deductibles and balances available for the year. As a result, a patient will not be astonished by any unexpected financial payout. This ensures that patients are happier and trust the process followed by the dental team.
Many software and automation solutions can connect dental practices to multiple insurance companies. This can help the dental team to provide patients with tentative estimates so procedures can be planned accordingly.
The dental practice can opt for real-time verification systems instead of manual insurance checks. Checking for insurance details manually consumes time and can also be accompanied by errors. Automated solutions can verify policy coverage details instantly and save staff hours for the practice. The practice can leverage software solutions that also ensure that the data is accurate and can be processed instantly. The time and energy saved can be deployed into patient care, which results in happier patients. The practice can outsource dental eligibility verification services to a
The usage of automated patient eligibility verification helps to generate a quick estimate and enables the dental team to collect payment upfront from the patient since eligibility has been checked before treatment can be provided. The patient also gets a clear idea of the amounts that would be borne by the insurance company and the amount to be borne by themselves.
Verifying the insurance eligibility and details keeps the patients in the loop for all out-of-pocket expenses. The patient can then make sure that the required funds are made available. By getting all the insurance details of the patient after verification, the dental team can share a complete breakdown of insurance benefits with the patient.
A breakdown of the policy is a detailed summary of the patient’s insurance plan that showcases dental procedures that are covered, as well as the extent of coverage. In case a patient has benefits elsewhere, then the dental team can identify what the patient’s plan maximum is. The team can also educate the patient about any issues that the patient may have with the plan's benefits.
Some patients do not have complete awareness of policy benefits. This could range from the coverage amount to the extent of coverage for various procedures. Other important details, such as validity dates, plan maximum, procedures not covered, might not be known by the patient. The dental team needs to convey all relevant information to the patient before treatment begins. This makes the entire process transparent and keeps the patient happy with the process followed by the practice.
The dental team must make a checklist when gathering information from both the patients and the insurance companies. Dental insurance verification is an important requirement for the practice as it helps to confirm the patients’ benefits based on the insurance plan. By being efficient in the verification process, the dental team can help patients learn about the benefits of the plan and any payments that need to be made by the patient, which could include copayments, deductibles, or other out-of-pocket expenses.
