Importance of Dental Eligibility Verification in Dental Billing

Most patients are overwhelmed by the notion of insurance. It may be difficult for them to understand what their plan gives, how much it offers, and what it covers in terms of treatments and care services. As a result, it is critical for the dental office to confirm the patient’s benefits; simply gathering patient information is insufficient. And this impacts the dental billing and revenue for the dental office. Dental insurance verification is an important part of dental billing and coding. A dental insurance breakdown gives an accurate estimate for the procedure being done.

Do you want to know the best approach to go about it? This blog article will walk you through the complete dental insurance eligibility procedure.

What Exactly Is Insurance Verification?

Insurance verification is the process of confirming a patient’s insurance coverage and benefits to a particular service request by their physician. In medical care terminology, it’s the process of verifying that a patient’s insurance plan covers the services you provide and is in your network.

Dental Eligibility Verification is the process in which the front-office staff of a dental practice will validate if a patient is eligible for a particular dental care service by their insurance provider.

Why Is It Important To Verify Patients’ Benefits?

Dental insurance verification is a critical component in the overall success of your dental business. It is the most crucial feature of your oral care clinic since it ensures you can earn what you owe. The following reasons will all but make dental eligibility verification a no-brainer!

You or your front-office staff should engage in dental insurance verification for five distinct reasons. They are as follows:

Aids in patient education

Verifying your patients’ dental insurance policies ahead of time will assist you in educating them on their coverage in depth. Most patients are unlikely to understand the specifics of their insurance coverage. Especially if they know that their dental procedure is not covered or only partially covered in their plan at the last moment. As a result, you must notify them of what is covered under their plan and which areas demand a co-pay.

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

Now that you’ve properly familiarized your patients with their coverage, the likelihood of last-minute cancellations, claim denials, and co-pay rejections will naturally decrease. This will improve the doctor-patient relationship and the overall patient experience in general. A thorough verification beforehand will do great good for your clinic and should be a part of standard operating procedures (SOPs).

Turns your practice into a proactive one

Verifying dental insurance may undoubtedly make your business more proactive. Because most patients are unlikely to know the crucial elements of their insurance plans, confirming them on your end demonstrates your dental clinic’s proactiveness. This will set you apart from the competition, and your dental practice will certainly positively affect patients.

Builds trust and credibility

Regardless of the type of insurance coverage people have, it is critical to check their insurance eligibility before providing any care. Failure to do so may result in an unpaid claim by the insurance company or a patient who is unable to pay their payment on time. This might lead to consequences that are mainly your fault. A claim delayed is a claim denied. No business can survive with outstanding fees and payables. Thus, the approach to dental eligibility requires a great deal of caution.

Patients hate to surprise dental bills.

This goes without saying, a patient does not mind paying their dental fees, but what they do despise is paying unexpected dental expenditures. Remove the element of surprise from the process by providing your patient with the most accurate insurance quote upfront. While we do accept that insurance is always an estimation and never a guarantee of payment, it’s our responsibility to give them the most accurate insurance breakdown possible.

Checklist For Verifying Dental Insurance Eligibility

Consistently verifying the eligibility of your patient’s insurance plan for every minor care may seem unnecessary, but it may save you a lot in the long term. Here is a list of the information you must collect to effectively verify your patients’ insurance coverage!

  • The time until the coverage takes effect.
  • The codes that are relevant to the operation that must be completed
  • The time necessary to verify that a specific set of processes is insured (the time is required at times)
  • The kind of plan under which the patient is covered, as well as their cost schedule
  • Deductibles and maximums
  • The documentation required for the procedures
  • To correctly satisfy the claim submission criteria, all information such as phone number, payer ID, address, fax number, and so on must be provided.
  • The proportion of coverage for each category
  • The frequency of panoramic and full-mouth x-rays
  • Service termination date
  • The tooth-loss clause

Consider Outsourcing Your Dental Insurance Verification Process

If you believe that creating a simplified method would be challenging while simultaneously handling other essential clinic activities, you can always hire a dental insurance verification business and outsource your operations to them. Dental billing services are complex and require massive customization and an understanding of the core business functionality. Thus trusting an expert instead for dental support services can make a world of difference.

Let Dental Billing Assist Relieve You Of The Billing Strain

We are solely concerned with dealing with insurance and patient billing and ensuring that you receive the revenue you have earned. We make it our business to be up to date on the codes, abreast on insurance policies… and up to the task of collecting your fees- all of them.

Book a 15-minute appointment, and we will show you how you can save money and improve your collection. Please click on the following link.

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