As a rule, checking your patient’s insurance plan is a must before they reach your practice. Your patient’s insurance plans are all different; some plans provide partial and some plans full coverage for treatment. These different factors could surprise you and lead to denied claims. In short, this blog will teach you how to check your patient’s insurance to prevent denials.
Check-In With Patients
Check with your patients to verify their insurance before they arrive at your office. For instance, you must call them and gather all their insurance information before the visit. This step allows you to verify benefits in advance which can subsequently save you time and help you prepare accordingly. Lastly, getting all this info will allow you to give the patient the exact amount they will need to pay ahead of time.
Check the limits of your patient’s plan
You’ll encounter insurance plans that will only allow a certain number of exams and won’t cover any procedures beyond that. Figuring out your patient’s plan limits helps avoid denials and otherwise having to send an EOB. In summary, this step will prevent any problems later.
Always Keep Your Patient Records Up to Date
Similarly, you can prevent denials by making sure your patient information is always up-to-date. For instance, to ensure your patient information is always up to date, ask your patients if any of their information has changed during every visit. You can also do this step whenever you confirm their appointments. As a rule, do this step at least once a year to avoid surprises.
Check with Your Patients Insurance Company
You can also verify your patient’s insurance plan by contacting their insurance company. In addition to calling their insurance company, setting up your own automated follow-up system can save time. Using a message template that lets them know their appointment is coming up along with their insurance type can also help you move things along.
To begin with, you can streamline your patient’s dental verification by creating a list of clients under the same insurance provider. In this case, the list provides efficiency wherein one phone call allows you to verify all of your patient’s insurance for that one provider. When you call patients, be sure to check in if any of them and their dependents are also turning 18. Finally, you should contact them and update their information if your patients have dependents turning 18
Use a Dental Insurance Verification Checklist
You should be working with a checklist to prevent missing any important details.
Here is a sample of a checklist you should use when checking for patient verification:
- Effective dates of patient coverage
- Specific codes for the upcoming procedure
- The waiting period to ensure coverage
- Find the patient’s type of plan and its fee schedules
- Patient plan’s deductibles and maximums
- Necessary documentation
- Patient information such as payer ID, address, fax number, phone number
- Percentage of coverage for each category
- Tooth implant coverage
- Tooth grafting coverage
- Coverage for procedures such as cleaning, crowns, and build-ups
- Number of allowed full mouth x-rays and panoramic x-ray
- Clause for missing tooth
- The final day of service
The list will help you thoroughly check your patient’s insurance to make the process easier down the line.
In conclusion, you need to be methodical when verifying your patient’s insurance. You also need to check your patient’s insurance plans, their plan’s limits, keep your patient’s records up to date, check with their insurance company, and use a checklist to prevent denials. All of these steps will ensure a smooth reimbursement process.