Question: I am new to the front office and have a question about verifying dental insurance...

I am brand new to the front office and I have a question about verifying dental insurance. Can you explain exactly how I go about doing that and what information I should be looking for?

ANSWER:  Welcome to dental, I hope you end up loving it as much as I do!

As far as verifying benefits, I suggest that you first check with your doctor or office manager to make sure they agree with my suggestion. I think that benefits should be checked for all new patients or whenever a patient of record has a change in insurance.

Here is how I would suggest doing your verification:

New Patients: As soon as you receive a new patient’s insurance information, verify their benefits. This can be done by phone, or online. Each office has their own specifications as to what they are looking to verify. Minimally, you want to make sure you know the basic coverage and that their insurance will pay if they come to your office.[mepr-show if=”loggedout”]Members only resources[/mepr-show] [mepr-active memberships=”629,630,37388,37393,37672,37676,37670,37668,37674,44674,232156″ ifallowed=”show” unauth=”message” unauth_message=”Answer hidden, please login or purchase a membership to view.”] I would suggest that you have a benefit breakdown form to follow along with and fill in all the information you need as you go. There is a template available in the Resources section of our site that you can use or adapt to work for your office.

I would not wait until the day of the appointment to do this if you can avoid it. Try to get the benefits verified at least 48 hours in advance so that when you make the confirmation calls you are confident that their insurance will work in your office. If there were any issues that arose during verification, you will then be able to discuss them with the patient during your call and prior to their treatment.

Current Patients: I suggest that anytime a patient tells you that their insurance has changed, collect all their new information and call to get their benefits verified so you are ready for their next visit.

I also suggest that you work with either an electronic eligibility system (many times it is a resource right in your practice management software) or work with a company such as Trojan, that electronically checks that your patients still have active benefits. It is a simple one button push to check that all your patients are still eligible. If your check comes back with a red flag or an error, then it is time to investigate. Just like with new patients, I suggest doing this at least 48 hours in advance so that when you are making your confirmation calls, you can confidently address anything insurance related with the patient prior to them coming to the appointment.

I hope that this helps and thank you for reaching out with your question.[/mepr-active]