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Is Dental Insurance Eligibility Taking Too Much Time?

Did you know checking your patient’s dental insurance eligibility (ahead of their appointment) takes an average of two hours a day? That’s at least 10 hours a week or 40 hours a month, at a minimum. Spending ¼ of an 8-hour day making phone calls, checking websites, and digging for information can really add up!

Dental insurance eligibility verification is like flossing. It’s a preventative measure that keeps from costing you more down the road! If patients don’t floss, they are prone to gum disease and more expensive treatments. If you don’t check eligibly ahead of time, more time and money will be spent on tracking down payments.

Ring…Ring…Ring…More Phone Calls?

Many insurance companies’ websites have eligibility information, but can really vary and either be comprehensive or extremely limited and inaccurate. This means hopping on the phone and starting the insurance phone call tunnel. Insurance companies greet you with a slew of automated prompts, having you repeat the reason of your call several times without the promise of a helpful (human) representative.

Two Tasks at the Same Time

Front desk staff often must manage two tasks – calling insurance companies and welcoming patients – which requires two different approaches. Phone calls require a firm tone and approach to get through prompts and reach live help (who often read scripts) and uncover the answers you need. While greeting patients requires a warm, pleasant, and welcoming tone. After spending 20 + minutes on a likely frustrating phone call, it’s hard to flip a switch to a warm smile and genuine tone when a patient walks through the door.

Secondly, it’s easy for front desk staff to prioritize easier tasks ahead of checking insurance eligibility because of the inevitable frustration and time suck. Eligibility is almost always going to be last, but it is also one of the most important because it heavily impacts your collections. It also happens that patients with “easy” insurance companies get checked, but the companies that are difficult to deal with fall low on the priority list.

Negativity from insurance phone calls can bleed into a patient’s treatment planning discussion if you aren’t careful. If a patient has an insurance that is very difficult to deal with on the back end, those feelings can unknowingly influence your conversations with patients. You must work around the negativity that can be generated when dealing with insurance companies.

Dental Support Essentials helps save time and boost internal morale with insurance eligibility verification, which is based on a flat monthly fee per volume of patients. We check eligibility three days in advance of an appointment, allowing for enough time for difficult cases, making patients, doctors, and staff happy!

 

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Top 5 Reasons Your Dental Claims Aren’t Getting Paid

Are you looking to increase your dental practice cash flow? One area of business that heavily impacts monthly production is the dental insurance claim process. A very time-consuming, tedious process, dental claims may not be getting paid due to several reasons, but almost always begins with lack of follow up with the insurance companies after submission.

  1. The dental claim didn’t make it to the insurance company.

Many times, dental claims are submitted electronically and staff don’t check to see their rejections report or if an area of the claim is incorrect. The issue lies with the quality of the information.

  1. The dental claim is missing complete clinical documentation.

Insurance companies require a detailed clinical report and narrative depending on the procedure. The dental claim may be missing narratives or x-rays, and there isn’t enough documentation on clinical notes for reimbursement.

  1. The dental claim was submitted with bad information.

Sometimes it’s as simple as poor information from the patient or a mistake inputting information on the staff’s behalf (i.e. birth date, address, social security number, etc.) Always verify eligibility information before the patient sits in the chair.

  1. The dentist’s credentialing is out of date.

If the dentist’s credentialing is out of date, insurance companies hold onto the claim. Manage your renewal closely and start the credentialing update process at least three months ahead of time to ensure ample time for completion.

  1. The insurance payment has been completed, but hasn’t been posted.

 

Often, the claim has been submitted and payment from the insurance company has been sent, but a bottleneck is created at the posting phase. This happens when staff are too busy and the payment hasn’t been recorded in your software.

As we all know, dental billing management is a full-time job. Dental Support Essentials offers a turnkey Accounts Receivable solution for your practice from insurance eligibility checks, billing, follow up, appeals, and more! Trusting experts to manage your AR will save your staff valuable time and increase your reimbursement rate. So, what are you waiting for? I’d love to connect and discuss opportunities to streamline your dental practice!