How is Dental Insurance Verification Helpful in Validating Patient Benefits?

by Nikki Gordon

Insurance is an intimidating concept for most patients. Understanding what their plan offers, how much it offers, and what it covers in terms of treatments and care services could be really hard for them. Thus, it’s important for dental clinics to validate the patient benefits; just collecting patient information isn’t enough.

Wondering what the ideal way to do that is? We’ve got you covered by detailing the entire dental insurance verification process in this blog post.

Dive into this blog post to determine how dental insurance verification can help validate patient benefits like never before!

But before we jump on to the process, let’s take a look at why it is important to verify patients’ benefits in the first place.

Why Is It Important To Verify Patients’ Benefits?

Dental insurance verification counts as an important factor in the overall growth of your dental practice. It is the core element of your clinic’s business aspect, for it helps ensure that you’d be able to earn everything you owe.

There are three reasons why you should invest in dental insurance verification. They include –

It helps educate patients 

Verifying patients’ dental insurance benefits beforehand can help you educate them about their coverage in detail. As mentioned above, most patients are least likely to know the details of their insurance plans. Thus, you must inform them of what is covered under their plan and for which areas a co-pay would be required.

It helps prevent last-minute cancellations, claim denials, and co-pay rejections 

Now that you’ll educate your patients about their coverage rightly, the chances of last-minute cancellations, claim denials, and co-pay rejections would automatically decline.

It makes your practice proactive 

Conducting dental insurance verification can surely make your practice highly proactive. Since most patients are least likely to know the important details of their insurance plans, verifying them on your end can really represent the proactiveness of your dental clinic.

The Dental Insurance Verification Process

The first step in this process is to keep an up-to-date record of your patients’ information. In addition to that, you must inquire if there has been a change in their information every time that they schedule an appointment. If a patient has scheduled their appointment at your clinic for the first time, you must send them a patient information form to fill out. This can help you maintain their record in the system.

The next crucial step in the process of dental insurance verification is – to cross-check the information provided by your patient with their respective insurance company. You’ll have to reach out to the insurance company yourself and get detailed information about the patients’ benefits and coverage. You can make notes of the information in the patients’ profiles to brief them later.

As soon as the insurance benefits are verified, you can send a templated email to your patients reminding them of the appointment alongside sharing the information you’ve gathered from the insurance company.

This action will bring both you and the patient on a similar page. They might already know about the details you’ve shared, but your efforts can reflect that you’ve been proactive about their health plan – positing a positive image.

If you want to make your dental insurance verification process more streamlined, you can also create a list of all patients who are covered under the same insurance company. That can save you from making repetitive short calls to the same company for insurance verification. Instead, you can get a major chunk of your work done in just one call.

The Dental Insurance Verification Checklist

Here’s the list of information you must gather when aiming to verify your patients’ insurance benefits successfully!

  • The date until the coverage is effective
  • The codes which are specific to the procedure needed to be performed
  • The waiting period required to ensure a particular set of procedures are insured (the time is required at times)
  • The type of plan the patient is covered with and their fee schedule
  • Maximums and deductibles
  • The documentation required for the procedures
  • All the information such as phone number, payer Id, address, fax number, etc. to rightly fulfill the claim submission requirements
  • The percentage of coverage for each different category
  • The frequency for full-mouth and panoramic x-rays
  • Last date of service
  • Missing tooth clause

Keeping a checklist by yourself when you’re gathering information from both the patients and their insurance companies could be an effective measure. It can help you collect all the information that’s required without really missing out on anything important.

To put it all short and condensed, dental insurance verification can really help validate all your patients’ benefits. The more efficient your verification process, the better you can ensure that you are collecting all the money you’re owed.

If you feel like implementing a streamlined process could be difficult while you also have to handle other core operations of the clinic, you can always utilize the option of hiring a dental insurance verification company and outsourcing your operations to them.

Author Profile

Nikki Gordon is dental billing and marketing specialist at DentalRevu. Having served for years in the dental billing industry, she’s got command over all the significant insights and loves to share them with newbies in the field. With an eye for practical procedures, her articles are a treat to those curious about learning the dental billing’s technical side.