Keeping It Simple
In the dental industry it is a well-known fact that Insurance companies change their coverage policies yearly. Over the years dental plans have added exclusions, waiting periods, alternate benefits and tricky benefit wording to add to the confusion. Incorrect insurance verifications can affect your bottom line leading to low collections, high accounts receivable, outstanding claims, incorrect treatment plans, and unhappy patients.
insurance details
When your office is unaware of insurance details, the patient may be seen without active coverage, or a procedure is unexpectedly denied. These are major roadblocks to revenue cycle management and result in your front office spending hours chasing down payments.
patient’s benefits
But this example is 100% avoidable by simply verifying the patient’s benefits prior to their appointment. Treatment plans can be presented with more accurate estimated amounts, patient estimated copayments can be collected at the time of service, and you can establish a loyal, happy, and trusting patient base.
Examples of what we verify include, but are not limited to:
- Effective coverage dates
- Waiting periods
- Maximums and deductibles
- Treatment history
- Benefits used to date
- Type of plan and fee schedule
- Verify claim submission information (address, phone number, payor ID etc.)
- Coverage percentage by category
- Implant and Orthodontic coverages
- Frequencies, limitations, and exclusions
- Missing tooth clause