Finding a good system for insurance verification can be hard for dental teams. It’s the least favorite part of the process for many people because it can feel a little mindless and repetitive. For this reason, many dental practices struggle to find a streamlined process for insurance verification.
Insurance verification is the first step of the dental billing process with a patient. It lays the foundation for how quickly you will get paid by the patient and insurance company. At Dental ClaimSupport, we see how offices improve their entire billing process by perfecting this first step. It’s typically one of the first things our billers will notice if an office is struggling with it.
Getting this process right can directly result in collecting more money from insurance claims. It also keeps your patients happy with clear communication about their insurance benefits. In this article, you will learn 5 tips that will help your dental team streamline their insurance verification process.
From when to begin the process, to getting a full breakdown of each patient’s benefits, you are sure to have fewer claim denials and happier patients through mastering this process.
Tip #1: Start early: 2 business days before the scheduled visit
You need at least a few days between scheduling the appointment with your patient and taking the time to look up their insurance benefits. Ideally, you’d be able to do this right after you got all of their information from them when they made the initial phone call about scheduling their appointment.
Alas, life and work happen. You might get another call or a patient may ask you a question that pushes insurance verification back. So, make sure you at least get this step done 2 days before the scheduled visit.
This will give you time to read their full breakdown, understand it, and see if there is any additional information you need from the patient before their visit. Keep in mind - if you do need additional information, the patient might not answer the phone the first time you call them. So you need to leave a window for them to listen to your voicemail and call you back.
What happens if you don’t leave plenty of time to verify dental insurance benefits?
If these questions or concerns aren’t answered before their appointment, there is a risk of them arriving the day of their appointment and being told they will have a bill larger than they expected. Or perhaps they need additional information from personal documents that they didn’t bring with them.
This will make for an unhappy patient. You can avoid this by clarifying any insurance information before their visit.
Tip #2: Use a form or process that helps you collect patient data quickly
The information you need from patients when you do have that initial phone call needs to be easy to collect. It includes several numbers such as:
Name of insurance provider
Member ID number
Patient DOB, if different than the Member
Name of employer
Group ID number
Telephone number of insurance (if you do not have a login for the web portal)
Because so much of this is number-based, it’s easy to mess up. Writing down these numbers is probably not the best strategy for keeping up with this patient data. You need to either have an online form ready to input information into or some other type of system that works for your team. Some offices use an Excel spreadsheet.
Why is an online form the best choice for inputting dental patient information?
When you have an online form, you can easily update patient information as needed. If their address or their insurance provider changes, you can easily go into their chart in your dental software and update it. This leads us to the other reason an online form is a more efficient option for patient data.
Online patient forms are easy to scan in or upload to your dental software. We know you shouldn’t always take the “easy” way out, but let’s be real. If there’s an option that helps you work more efficiently, you should take advantage of it.
Tip #3: Get a full breakdown of benefits when necessary
We mentioned this in an earlier tip - you need to have access to each patient’s full breakdown of insurance benefits. This means you have a detailed summary of the patient’s insurance plan.
Full breakdowns indicate which dental procedures are covered benefits, at what percentage they are covered, if the patient already used any benefits elsewhere, what the patient’s plan maximum is, and much more.
The patient’s full breakdown is the key information when verifying dental insurance
Knowing the full breakdown of the patient’s benefits can help you communicate what the patient’s out-of-pocket expense will be, and what you can expect to collect from the insurance claim you will file after their appointment.
You don’t need a full breakdown every single time a regular patient comes in - but it’s smart to always ask the patient before they come in if any of their information has changed since their last visit. For example, when I go to the dentist, my dentist will always say, “Is your address still the same? Are you still using Guardian dental insurance?”
Not only should you be collecting insurance information, but you should also be keeping up with it and making sure everything is still the same from the previous visit.
Tip #4: Use the same information for each family member
So let’s say you have a parent call to make a dental appointment for their child. More than likely, this child is under the same insurance as the person calling and making the appointment.
You can easily use the information from the parent to also verify the child’s insurance information. There’s no need to get a full breakdown for each person individually if they’re covered by the same plan.
Caveat: Don’t forget about coordination of benefits (COB) rules
This tip seemed a little too easy… Well, unfortunately not everyone’s family is seamlessly all under one insurance plan. As you know, if a child is under separate insurance than one of their parents, you need to take COB rules into account or else your claim could be denied.
For the most part though, as long as you ask all of the right questions about the child’s insurance during the initial phone call, you should have all of the information you need. If it’s the same as the parent already in your system, great! If it’s different, just make sure to verify that insurance plan like you would anyone else.
Tip #5: Verify the patient’s dental insurance minimum
For returning patients with no insurance changes that year, save time by checking that returning patients have the same coverage and are still eligible and that their annual maximum used is up to date.
The vast majority of your patients will let coverage dollars go to waste. It’s up to you to remind them to take care of their dental needs while the coverage is available. Unfortunately, insurance benefits don’t roll over to the next year. If you don’t use it, you lose it.
Verifying the patient’s dental insurance minimum can be done while reading their full breakdown
It’s important the person reading the patient’s full breakdown can understand it. They should be able to advise the patient on how to best use their benefits. This creates a trusting relationship between the patient and your dental team.
It helps you give your patient a heads up if they are about to max out on benefits, or if they should consider using more of their benefits before the end of the year.
Ready to collect more through a seamless dental insurance verification process?
Insurance verification seems simple. You obtain information from patients over the phone, then make sure it’s all correct with the insurance company. But dental teams struggle with it because of how monotonous it can feel. That’s why this step is underestimated and approached strategically.
These steps will help your team follow best practices to make this process easy and seamless, for your patient communication to be better, and for you to have less denied claims from insurance companies.
Our billers at Dental ClaimSupport see a lot of mistakes with insurance data input when there is no verification before the patient’s appointment. This is always a top tip our billers offer dental teams, and it can really help increase their collections percentage.