INSURANCE VERIFICATION

Insurance Verification (IV) means verifying all necessary details about the customer/patient from the insurance provider. Verification has to be done every time your team gets an inquiry about dental treatment. In case the treatment is insured, a set of questions are asked to verify criteria such as patient’s eligibility, active benefits, coverage with insurance companies. 

These are some information we require every time, in order to do the task for you.

  • Patients Name:
  • Patients DOB:
  • Member ID:
  • Continues / Recall / New Patient:

The purpose of this verification is to have clear information about services being covered by the insurance provider. (One of the reasons why verification is done before the treatment and other procedures)

Our teams of experts make sure and double-check on all necessary eligibility criteria and save you all the hassle. A few of the most common causes include incidents like patient’s benefits being out-of-date, having false information or even modified policies in a few rare cases.

Accurate & complete Insurance Verification (IV) is the key to successful billing. We are determined and work 24*7 by reaching out to insurances through all mediums; website, fax and even on-call, on a regular basis to get the patient’s history. Despite sounding like a minor task, it takes a lot of time. We keep all the information up & running way before the treatment, to witness minimal wastage of time & resources.

Choosing our services will not only help you reduce your denials ratio but will also save your staff time and help you boost your reimbursements!

How we handle IV for your staff:

  1. Coordinating with the Dental office manager for the patient’s insurance details using a digital form or software e.g. Eaglesoft, Dentrix, and Advance MD etc.
  2. Calling the insurance company on your behalf to check & verify the patient’s plan, coverage & other information.
  3. Following & cross-checking patient’s details by Insurance to make sure everything is up to the mark.
  4. Informing the staff about any changes in Insurance policies/providers.
  5. The Office Manager then informs & guides patients regarding all/any kind of unexpected/unwanted expense they owe, just in case.

Why is Dental IV Important?

For Your Staff:

  • Better understanding of the services covered
  • Clarity on services not covered
  • Overview of the services that need/need not be billed
  • Easier for staff to explain the patient’s responsibility on the spot
  • Faster cash-flow.
  • No worries regarding the patients’ timely reimbursements.

For Patients:

Nobody likes to pay any kind of unwanted/hidden charges. Patients are regularly informed about what they owe before the treatment begins to avoid any kind of trouble. Patients with verified coverage are always up for any extra costs and can make a plan if required.

Dental Insurance Verification Form

We draft our own Insurance Verification form as per your office needs.

Here are a few questions asked to an Insurance provider during verification.

  • The effective date of coverage
  • Coverage terminated? If yes, what date?
  • In-network benefits (co-payment amount)
  • Deductible amount
  • Has deductible been met?
  • Co-insurance amount
  • Other out-of-pocket expense
  • Benefits for treatment?
  • Is a referral necessary?
  • Is prior-authorization necessary?
  • Out-of-network benefits?
  • Out-of-network financial responsibilities?
  • History of Services

After the form has been delivered to the office, your staff will be able to know patient eligibility and what treatments are covered by the patient’s insurance policy.