Dental insurance verification can be a daunting task for dental offices. It is important to verify that patients have the correct coverage in order to provide the best possible care and avoid denied claims or recoupment requests. In this comprehensive guide, we will discuss all aspects of how to verify dental insurance benefits, what information to ask for and what to do when there is a discrepancy between the information on file and what the patient provides.

Required Information for Dental Eligibility Verification

Before we move towards the distinct approaches to verify dental insurance, you first need to know the type of information you need to ask your patient before performing any treatments. This information is required for verifying dental insurance regardless of what method you’re using. The required documentation is thus:

  1. Name of insurance provider company
  2. Name of employer
  3. Patient ID number
  4. Patient DOB
  5. Telephone number of insurance
  6. Login for the web portal (ask them to show dental insurance plan or provide screenshot)

How To Verify Dental Insurance

There are multiple ways one can verify the dental insurance plans of a patient. Some are more time-consuming while some require more resources. You can choose the one that works the best for you to avoid future losses when treating patients.

The first step in dental insurance verification is to verify that the patient has active coverage. Below are some ways to approach this.

Call Insurance Company Directly

The most straight forward way to do this is to contact the insurance company directly. You will need to provide the patient’s name, date of birth, and social security number in order to verify their coverage. Once you have verified that the patient has active coverage, you will need to obtain a copy of their benefits schedule. This document will list all of the dental insurance verification services that are covered by their plan and any limitations or exclusions that apply.

If you find a discrepancy between the information on file and what the patient provides, it is important to reach out to the insurance company for clarification. In some cases, patients may be responsible for payment if they receive services that are not covered by their plan. In other cases, the insurance company may deny the claim outright. If you are unsure about how to proceed, it is always best to contact the insurance company for guidance.

The only drawback of this approach is that it may take some time to get a response from the insurance company’s helpline number. Hence, if you wish to verify the patient’s dental insurance on spot then this may not be the best option.

Ask Patient Directly On First Call Or Visit

The easiest way would be to ask the patient for this information on their first call or visit. This is because this will help you as well as the patient to understand what benefits their dental insurance plan covers to avoid any future claim denials or misunderstandings. However, the only drawback of this is the effort of penning down all these details. These details can get mixed up or misheard while writing (if on call) resulting to problems in future.

Online Forms For Dental Insurance Verification

This is a solution to the previous problem and comes in handier than the rest. Considering the automated systems, you can get a list of the dental insurance information of all patients with minimum errors. You can provide the link to this online form through your website or some other means which will save your time both on calls and in person visits. As a precaution, you can re-verify this information with your patient when they come for the treatment.

Dental Insurance Verification Company Online Portal

You can check the patient’s dental insurance eligibility through the company’s online portal. However, this may not be the best way in cases where the patient’s employer suddenly decides to terminate the given dental insurance benefits. In such a scenario, the online portal may not be up to date thus, it is recommended to ask the patient to provide a screenshot of the last time they checked their dental insurance eligibility period and its date of termination.

Outsourcing Dental Insurance Verification to Your Practice?

Dental Insurance Verification can be a complex and time-consuming task for dental offices. The best way to manage your dental insurance verification is by hiring a dental billing company who may use an efficient dental insurance verification software. By outsourcing your dental insurance verification, you can focus on providing the best possible care for your patients. We will verify patient coverage, obtain benefits schedules, and handle denied claims on your behalf. Contact us today to learn more about how we can help!

How Often Should I Run Verifications For My Patients?

Normally a verification of dental insurance is done once before creating a treatment plan for the patient and then just as a precaution before every major appointment. You may do it less often for an existing patient.

How Long Can It Take For Insurance To Approve Dental Work?

There are normally no waiting periods for preventive procedures while, basic procedures may take between three to six months. The major procedures take the longest waiting periods – about six months or more.

Conclusion

Conclusively, verifying dental insurance of your patients is very crucial to prevent denial claims or recoupment requests. This will help you plan dental treatments accordingly and avoid losses. As discussed, there are multiple ways to go about it so choose the approach that suits you best! To make it a lot easier, you can use a dental insurance verification company to help you out with it. We hope that this guide has been helpful in understanding the process and what you can do to ensure that your patients receive the best possible care.

For any more concerns or queries regarding dental insurance verification or dental billing, don’t forget to contact us!