Every year, healthcare providers lose a staggering $5 million on average to claim denials. And that’s a huge amount!
These claims are usually denied because patient details are often incorrect or ignored. Billers don’t evaluate patients’ dental insurance plans before approving them for treatment and forwarding them for claims submission, leading to a significant revenue loss.
But this loss can be avoided if you outsource dental insurance verification to a reliable verification company such as TransDental.
Want to know how? Let’s discuss.
Benefits of Outsourcing Insurance Eligibility Verification
Real Time Insurance Eligibility Verification
Dental insurance verification companies are well-versed in the complexities of insurance policies that a dental practice may struggle to understand.
The eligibility verification department starts verifying the patient’s insurance plan right when the patient registers with your dental practice for a treatment. Using robust AI-powered systems, the department matches patients’ existing plan details in your EHR with the details in the payer portal. Alerts are triggered in case of a mismatch, and necessary changes are made in the system. The entire process is in real-time to prevent any hassles for you and your patient.
Lower Costs, Better Outcomes
Outsourcing the patient insurance eligibility verification to a third-party company reduces your staff’s workload and cuts down on unnecessary operational costs that come with paying salaries and investing in the latest tech systems.
The average salary of a dental insurance verification specialist is $3,270 per month, and it totals about $39,247 per annum. By outsourcing verification to companies, you gain access to expert specialists without needing to pay hefty salaries. You just pay some amount to the companies for their dental insurance eligibility verification services. These companies charge you a very reasonable amount per verification.
Eligibility verification specialists hired by these top-notch companies bring their expertise to the table and check each detail of the insurance plan. In fact, nowadays, companies leverage AI to automatically scan details and generate reports for processing. A complete eligibility verification, combined with proper documentation and accurate dental coding, minimizes the chances of claim denials, ensuring you’re paid the right dues for your dental services.
Attention to Detail
Eligibility verification specialists review all the aspects of a patient’s insurance plan and ensure they don’t miss any important details.
A patient’s insurance plan includes:
- Total coverage
- Frequency limitations
- Procedures covered in the plan
- Pre-authorization for certain procedures
- Co-pays and deductibles
- Waiting periods
- Coordination of benefits
It’s important that the specialists review all these aspects and notify you if the patient’s treatment can be covered by the insurance plan. They proceed accordingly, attaching the right documents and filling in details, leaving no chance for claim denials.
Tech-Savvy Specialists
As technology is progressing, the healthcare landscape is evolving. If you partner with a dental insurance verification company, services get faster and accurate. It’s because these companies use the latest AI-powered software and are experts in operating these systems. AI makes workflows smoother, automating verification tasks and reducing manual errors.
Furthermore, these specialists are knowledgeable about the latest dental practice tools, allowing them to manage patient data and extract the required details easily. It helps them streamline the process precisely.
Up-to-Date with Insurance Policies
These verification companies constantly monitor the eligibility and insurance policies. Insurers keep on modifying their requirements with time. It’s essential to stay up-to-date with changes, and these companies adapt their practices accordingly. They make sure that your claims submission is according to the latest dental insurance policies, so claims are settled smoothly.
Timely Claim Submissions
When the patient’s frequency limitations and benefits are evaluated, it becomes easier to process claims. This speeds up the process, and insurance eligibility verification companies take little time in submitting claims once the verification is complete.
Timely claims submissions with proper documentation and complete details result in quick claim settlements and faster recoveries for dental services rendered.
These are some ways in which we learn how outsourcing dental insurance verification helps reduce claim denials, as compared to in-house eligibility verification.
However, this can’t be possible without partnering with the right dental insurance verification company. You might be wondering how to choose the best company that verifies details with accuracy, minimizing claim denials and payment delays.
Let’s explore that!
Choosing the Right Outsourcing Partner
To outsource dental insurance verification to a company, make sure it meets all the criteria required for eligibility verification.
Check the following characteristics in a company before making the decision:
- Experience in accurately verifying patient insurance plans with a proven track record
- Capability of operating the latest software and integrating with your EHR and payer portals proficiently
- Compliance with HIPAA regulations
- Availability throughout the day
- Services tailored to your dental practice’s requirements
- Reviews by satisfied clients on online platforms like Capterra, G2, LinkedIn, and other sites
- Reports for daily progress on eligibility verification
If a company fulfills the criteria, you can consider it for patient insurance eligibility verification with confidence.
Conclusion
Insurance eligibility verification is the most crucial step in dental billing and your practice’s entire revenue cycle management. It’s important to verify all the patient’s insurance details on time for smoother claims submission and speedy recovery of claims.
So, outsource your eligibility insurance verification to a trusted company. TransDental stands out among dental verification companies by ensuring complete quality checks before patient appointments. You can avoid denied claims and make sure you’re paid for the care you provide.
Frequently Asked Questions (FAQs)
Can outsourcing patient eligibility verification help reduce rework and appeals?
Outsourcing eligibility verification to a reliable third-party provider ensures that patient details are verified promptly, so claims are submitted clean. This eliminates the need to appeal for denied claims or submit claims again.
Does outsourcing help with eligibility checks in real-time?
Eligibility verification companies check patient eligibility in real-time to verify if the patient’s insurance plan covers the ongoing dental procedure. They integrate with payer portals and contact patients to update details and proceed accordingly.
How does insurance eligibility verification impact our revenue cycle?
Outsourcing insurance eligibility verification ensures claims are submitted and settled properly. It helps dental practices maximize collections and maintain a healthy cash flow to manage finances steadily.
How fast is outsourced dental insurance eligibility verification?
Insurance eligibility verification varies per company, depending on their policies and technological capabilities. Reputed companies can verify eligibility within 24 hours, or even in real-time, by integrating with software to get instant data on the patient’s insurance plan.
Can outsourcing insurance verification help with verifying benefits for specialty procedures like implants or orthodontics?
Dental insurance verification companies are well-versed in verifying patients’ benefits and limitations for all dental specialties. They can check whether a certain procedure is covered in the plan or requires pre-authorizations and waiting periods.
