Dental Insurance Verification Service Explained

Before every appointment, whether for a cleaning or complex oral surgery, your dental practice needs to contact a patient’s insurance company for insurance eligibility verification. Using an integrated dental insurance verification service through your dental office management software can help you ensure your office revenue keeps the lights on.

Patients may not know that they have already met their frequency limitation for a procedure or that they don’t have coverage for specific procedures. Your dental billing department needs to verify coverage for these procedures before the patient’s appointment to ensure the insurance company will pay the appropriate claims.

Unpaid claims and patients’ inability to pay them can cost your office thousands each month. Ensure you get paid with a dental insurance verification service before the appointment.

What Is an Insurance Verification?

Dental insurance verification involves verifying patient insurance eligibility for active coverage, dental insurance benefits, and prior authorization of procedures, from cleanings to oral surgery. A patient’s insurance plan features four essential parts, including:

• Deductibles
• Coinsurance
• Copays
• Maximum out-of-pocket (MOOP) expenses

Before a patient’s appointment, an insurance verification specialist in your dental office should call the patient’s insurance company to confirm their dental insurance eligibility. The insurance company may use an interactive voice response (IVR) system that your dental billing department representative can navigate to verify patient eligibility.

Dental and medical billing departments across the U.S. and Canada spend hours every week performing insurance verification tasks stuck on hold with the insurance company. Outsourcing dental insurance verification to a built-in dental billing service saves hours of labor for your dental practice and improves approvals for dental claims.

An insurance company is more likely to deny an insurance claim for a new patient than an existing patient. Still, insurance companies will deny existing patient dental claims if a dental practitioner doesn’t perform the correct dental insurance eligibility verification.

Whether Delta Dental, Humana, UnitedHealthcare, or another dental insurance coverage provider, your dental insurance billing department or dental insurance verification service will need to confirm a patient’s benefits before a procedure so you can submit an insurance claim for payment and avoid claims denials.

What Do Dental Insurance Verification Services Entail?

Dental insurance verification services automate your benefit verification processes at your dental office and integrate new insurance information into your patient management software. Whether your dental practice focuses on restorative dentistry, cosmetic dentistry, orthodontics, or family dental services, the dental insurance verification service works with your dental practice software.

Outsourcing dental insurance verification to an automated system makes it easy for your dental practice to manage benefits verification for new patients, particularly when you combine the dental insurance verification service with your patient communication and office management systems.

Posting and Finding Openings for Dental Insurance Verification Jobs

Many dental practitioner offices are looking for dental billing service professionals who can verify eligibility to confirm active coverage before a patient’s appointment, submit claims to the insurance company for payment, and make new and existing patients feel comfortable understanding their dental billing.

Like a new patient reading reviews online for your dental practice, a prospective dental insurance coverage verification professional might check your reviews to determine whether your dental practice is a good fit. Use Weave Reviews to ensure every patient leaves a review after an appointment.

When you post a job opening in your dental practice, prospective patient benefits professionals will look at your reviews to see whether your office gets good patient reviews for insurance coverage claims. Whether your office focuses on restorative dentistry, cosmetic dentistry, or another dental practice area, you need recent five-star reviews to attract the top talent.

Dental Insurance Verification Job Description Example for Dental Offices

When looking for an insurance benefits and eligibility verification specialist, your job description needs to effectively list your prospective employee’s responsibilities for dental billing, eligibility verification, answering insurance plan questions, and filing insurance claims. Consider including some of the following bullet points:

Responsibilities:

• Perform insurance eligibility verification to confirm coverage and benefits before each patient appointment.
• Coordinate with front office staff to explain patient benefits and coverage, including deductibles, coinsurance, copays, and MOOP expenses.
• Maintain dental practice patient records for appointment history, insurance eligibility verification, and active coverage status.

Qualifications:

• Minimum of one year experience in insurance benefits eligibility verification in dental or medical billing.
• Able to collaborate with other departments for appointment management, dental billing, and maintaining insurance information in the patient file.
• Able to contact the insurance company to verify patient coverage and get prior authorization for procedures.

Dental Insurance Verification Jobs from Home

For work-from-home eligibility verification, you must ensure a few additional steps to protect patient privacy and adhere to HIPAA regulations. Remote eligibility verification professionals verifying patient benefits and coverage need digital and physical file protection for any patient information stored in a home workstation.

Remote employees should access dental practice systems using a HIPAA-compliant VPN or ZTNA connection to protect private patient information. Information over a standard data connection is vulnerable to hacking, making additional protection essential for confidentiality.

Conclusion

Your dental practice needs efficient insurance eligibility verification to process claims through your dental billing department. You need a qualified dental insurance verification service to relieve your billing professionals with automated insurance verification.

To attract the best dental billing professionals, your dental office needs active online reviews from your patients. Remind each patient to review your office online after every appointment.

At Weave, our comprehensive dental office management software streamlines your daily and weekly operations, including online scheduling, patient appointment reminders, missed call texts, and more. Call us today at 833-572-2139 to see how Weave can help your dental practice grow with our dental insurance verification service.

FAQ

What Do Dental Insurance Verification Companies Do?

While many systems can streamline your office’s patient eligibility verification in your dental billing department, automated benefit verification can’t fully replace an insurance verification specialist. Dental insurance verification companies can outsource your verification processes.

How to Prepare for Dental Insurance Verification Training?

Training for dental insurance verification can be as simple as finding an online course and completing your certification for billing, dental coding, best practices, and privacy protection. You can get certification for the first time or practice continuing education with an online provider like the Dental Claims Academy.