31/07/2022
Whenever someone sends us their collections/write-off report and they arenโt collecting 98 โ 100% of their production, we know one thing for sure, insurance verifications are not being done correctly.
So what are insurance verifications, why are they so critical to collecting all the insurance owed to your practice and why are they not being done correctly?
Insurance verification is checking your patientโs insurance coverage and benefits, you need to confirm that the patient has active coverage, that the treatment is covered and how much the insurance company will pay, before their treatment date.
The industry standard is to enter it into the practice software at least 48 hours before the treatment date.
The process is tedious and time consuming and that is why many practice staff either donโt do it, or cut corners, verifications are usually done through web portals or calling the insurance company, you need an extensive verification for each new patient and at least annually for existing patients or if their insurance coverage changes.
Otherwise, existing patients only need a standard verification before treatment to ensure they have the same coverage and eligibility.
We are often asked, what are the consequences of not doing insurance verifications, the main consequence is that claims are not going to be paid if the patient does not have the insurance you thought they had, this means that the claims are going to show up on your accounts receivable report, which leaves you with two options, write the amount off or collect it from the patient, as you can imagine collecting from the patient leaves them very unhappy and as we all know the best form of advertising is word of mouth from happy patients.
The saddest part of this story is that we often see that the dentist is unaware that insurance verifications are not being done, not entered into the practice software, that insurance companies are not paying because the patient wasnโt covered and that the amount is written off, often large amounts.
When we quote dentists, they usually wonder why they need this service, as you can imagine being time consuming it is also the most expensive service we offer, although if you arenโt paying us, you are going to need to pay someone else to do it and usually at a higher rate.
We donโt like to, although we do take on dental insurance billing jobs without doing the insurance verification ourselves, we work with practice staff so that they understand how to do the verifications, although it rarely works out, usually the practice staff are too busy to do this task the correct way and the practice asks us to take it over, it is very difficult to achieve 98 โ 100% collections, unless insurance verifications are done correctly.
The reason we donโt like to take on insurance billing work without the verifications is because our goal is to collect 98 โ 100% of your production and without the verifications done correctly this is very difficult to achieve.