Verify Patient Eligibility and Benefits Information with Ease
- Save Time and Money, Too! Our research shows that the average eligibility verification call is over five minutes. ...
- Verify Electronically. The online Dental Office Toolkit (“DOT”) is available 24/7/365 at no cost to you. ...
- Phone Number. We’ve established a single, dedicated toll-free number exclusively for dental offices. ...
Full Answer
Is there a dental plan without a waiting period?
Often, employer-based dental benefits plans do not have waiting periods. If you had previous dental insurance, you can present the information to your new dental benefits insurance plan provider, and they may be willing to waive the waiting period in cases where there has been no break in coverage.
Should you bite on dental insurance?
There’s no question that dental work is expensive – especially when you need to have major work done. If you’re not covered through your job, you may have to purchase it on your own. However, purchased privately, dental insurance can be a huge waste of money if your plan doesn’t match your needs.
Can I get dental coverage in the marketplace?
In the Marketplace, you can get dental coverage 2 ways: as part of a health plan, or by itself through a separate, stand-alone dental plan. IMPORTANT: You can’t buy a Marketplace dental plan unless you’re buying a health plan at the same time. Health plans that include dental coverage. Dental coverage is included in some Marketplace health plans.
What does my Humana dental plan cover?
What does Humana dental cover? For some, “full coverage” means a dental insurance plan that covers basic services like routine checkups, cleaning and X-rays. The good news is that Humana has a range of dental plans, including both dental insurance and dental discount plans, so you can find the coverage that best fits your needs.
What methods could be used to verify insurance benefits?
Contact the insurance company directly to ensure eligibility. Place a phone call using the provider hotline provided by the payer or use your integrated EMR and Billing System to ping larger payers such as Medicaid, Medicare, or Blue Cross for eligibility data.
How do you read dental EOBS?
4:449:36Need to Know Dental Insurance Terms, Claim & EOB, Pre ...YouTubeStart of suggested clipEnd of suggested clipOkay the eob is the explanation of benefits. And that's common commonly referred to as an eob. AndMoreOkay the eob is the explanation of benefits. And that's common commonly referred to as an eob. And it's the statement that the insurance. Company sends to the patient.
What is a dental predetermination of benefits?
A predetermination of benefits is a written estimate from your dental insurer of the amount your dental plan will pay for a specific treatment based on information provided by your dentist. SDC's predetermination process is helpful for both the patient and the treating dentist.
Why is it important to verify benefits?
By verifying eligibility, practices can determine a patient's medical insurance coverage status prior to the appointment and report demographic information accurately on insurance claims. Additionally, prioritizing eligibility promotes proactive patient collection measures and prevents payment delays.
How do I claim dental insurance expenses?
Claim Process For Dental InsuranceInform the company about the possibility as soon as it happens.Submit the documents supporting your claim along with the signed and filled claim form.After this step is done and the insurance company gets the documents, they will begin with the verification procedure of the same.More items...•
What is allowed amount on EOB?
The maximum amount a plan will pay for a covered health care service. May also be called “eligible expense,” “payment allowance,” or “negotiated rate.”
What is a dental preauthorization?
Dentist perspective Dentists use the pre-authorization process to determine a patient's coverage. Sometimes a treatment plan has been pre-authorized or pre-approved by the carrier and the treatment is performed by the dentist with the expectation that the claim will be paid, but it is denied.
What is the difference between predetermination and preauthorization?
A predetermination is a courtesy, where a pre-authorization is a requirement under a plan.
What is a predetermination request?
A predetermination is a voluntary, written request by a provider to determine if a proposed treatment or service is covered under a patient's health benefit plan. Predetermination approvals and denials are based on our medical policies, coverage documents and benefits. View Medical Coverage Policies.
What is the insurance verification process?
Simply put, insurance verification is the process of contacting the insurance company to determine whether the patient's healthcare benefits cover the required procedures. Also, it is necessary to complete insurance verification before a patient receives medical services.
Which of the following is required for insurance verification?
Listed below are the information to be verified and validated during Insurance Eligibility Verification: Insurance details like Insurance name, ID and group number. Insurer name and Dependent details. Policy Effective and Lapse date.
What is benefit verification?
The Benefit Verification letter, sometimes called a "budget letter," a "benefits letter," a "proof of income letter," or a "proof of award letter," serves as proof of your retirement, disability, Supplemental Security Income (SSI), or Medicare benefits.
Why is it important to verify dental insurance?
Insurance verification is essential when it comes to dental care. If you fail to verify patients’ insurance benefits, you won’t know if a deductible applies to a new patient’s first visit — and the practice may lose money later.
What can you gain from patients' insurance verification?
Here are some things you stand to gain from patients’ insurance verification: Prevention of a denial of payment from patients’ insurance providers for root planing and scaling. Prevention of a denial of payment for an emergency appointment and limited exam for existing patients.
What happens if your insurance doesn't cover dental root planing?
If their insurance plan doesn’t cover the procedure, you can discuss other payment options with them. Additionally, one benefit of dental insurance verification is you receiving payment after scaling and root planing.
What is insurance verification?
Insurance verification services allow you spend more time with your patients, and less worrying about insurance. These services call payors on your behalf to get any eligibility information you require. They also call payors on your behalf to get any eligibility information you require.
How to know if insurance is primary or secondary?
It’s crucial to know if the insurance is the patient’s primary or secondary insurance. Most patients are not sure if their insurance information supplied is the primary or secondary insurance information. If it’s their secondary insurance, the insurance company will deny your payment. You will have to tender a statement of Estimate ...
Does Opencare require insurance verification?
Also, it prevents you from getting less than the expected amount from insurance. The insurance verification process requires that you get the patient’s information. At Opencare, we can make the dental insurance verification process easier for you.
Can dental benefits change?
Also, remember to write down the exact date you called the patient’s insurance company. Benefits change from time to time, depending on if the patient changes their insurance plan. Also, insurance companies can decide to change the patient’s benefits.
Why do dental offices need to verify insurance?
Dental Insurance verification requires specialized knowledge and skill to get it done in a timely and efficient manner. This is the reason dental offices feel the need to outsource dental insurance verification. With the constantly changing policies, it becomes quite obvious for an unexpected fee to be overlooked.
What is dental insurance eligibility verification?
Dental Insurance Eligibility Verification is all about assessing a patient’s active coverage with the insurance provider. It also involves verifying the eligibility of their insurance claims. To ensure approval of the claim, a verification process is done before the patient has already started up with the treatment and other processes.
What happens if you don't speak to dental insurance?
If you do not speak to dental insurance verification companies, there are increased chances of errors occurring while fetching patient’s data. A lot of time goes wasted in gathering inaccurate data and confirming claims.
Do patients deny paying bills?
No more hidden surprises as far as billing is concerned. Patients are prepared of the amount they require to pay once the coverage is verified. Patients do not deny paying bills.
Verifying Dental Patient Benefits Each Day
Verifying dental patient benefits is a truly important task for the dental administrative team. And this is a task that is also extremely challenging. It’s true that many dental patients don’t even realize who their insurance carrier is.
Verifying Dental Patient Benefits For New Patients
New patient insurance verification should begin as soon as possible. Verify new patient insurance information immediately. And it’s best to do this prior to an appointment. Especially if we are missing information or the patient has used most of their dental benefits for the year.
Verifying Dental Patient Benefits Is Risky Business
It’s true! Especially when the team must make every insurance phone call. And then update the insurance tables within the dental software. Here are 8 reasons why you may want to consider turning this project over to the professionals!
Why outsource your dental insurance verification?
let eAssist give you the peace of mind that comes from knowing the specific details of your patient’s insurance coverage at the time of treatment planning. Get in touch with us today and see how fast and simple the insurance verification process can be for your dental practice.
3 Reasons to Choose Our Dental Insurance Verification
Avoid the frustration of collecting additional payments that fall between an estimated co-pay and what an insurance policy covers. An angry patient is far less likely to pay because they feel betrayed and tricked.
Patient Billing Add-On Service
In addition to the Dental Insurance Billing Service described above, we also offer a Patient Billing Add-On Service.
Verify benefits eligibility information electronically
Electronic eligibility and benefits information is available at any time, for all our dental plans.
What do I need to submit an inquiry?
The information you’ll need depends on the method you use to submit an inquiry.
What if I get an error response?
Your message will explain the cause of the error. Depending on the error, you may have to re-enter your data or contact your vendor for help.
Verify patient benefits and eligibility in Provider Tools
Be sure to verify patient eligibility before providing services to make sure you’ll receive the appropriate compensation. Use Provider Tools for up-to-date, unlimited eligibility and benefits information, including remaining maximums and deductibles.
Access the automated telephone service
Our automated voice response telephone service is a convenient way to obtain eligibility and benefits information and more for your Delta Dental PPO™, Delta Dental Premier® and DeltaCare® USA patients.
Obtain a faxed eligibility and benefits summary
Fast Fax is an eligibility and benefits summary that is faxed to your office. Follow the steps on this PDF to use the automated telephone service and obtain Fast Fax.
How to verify your health insurance?
Article Summary X. To verify your health insurance, call your insurance company and ask if it's still active. You can also check the information packet you received when you first enrolled. This should tell you what plan you’re on, what it covers, and how much your deductible is.
What to do if you don't understand your health insurance?
If there's anything you don't understand about your health insurance, schedule an appointment with a representative to discuss it. It's also important to keep your health insurance provider informed of any personal changes, like getting married or having a child, since this can affect your plan.
What to do if a patient is not covered by insurance?
If there are certain services your patient requires that are not covered by his insurance, make sure the patient understands this. Verify whether the patient is in- or out-of-network. This refers to whether you, as a healthcare provider, are an in-network health care provider or out-of-network health care provider.
What happens if you don't have insurance information?
If you do not have the information required by the insurance company, and if this information is not accurate, you may not be able to verify the patient’s insurance. Many factors regarding insurance coverage can change over a short period of time.
What to keep your health insurance provider informed of?
Keep your health insurance provider informed of any life events. Certain life events may affect your coverage. Therefore, it is important to keep them updated on certain events (e.g if you get married, have a baby, adopt a child).
Where is the toll free number on my health insurance card?
A toll-free number is generally noted on the back of the insurance card, along with other relevant contact information for the health insurance company. ...
What is deductible insurance?
A deductible refers to a set amount of health care costs that a patient must pay before the insurance will begin to pay. The amount varies, so be sure to verify this amount with the provider. Also be sure to verify whether or not the amount has already been met from other visits (perhaps with other doctors).
How to contact insurance carrier?
The most common way to contact payers (and, incidentally, the most time-consuming) is over the phone. Just pull up the info you got from your patient, find the insurance carrier’s phone number, and dial away. Once you get someone on the phone, double check that you’re talking with a representative on the provider services line, as some payers have lines exclusively for hospital admissions or referrals. After you confirm you’re speaking with the right rep, this resource says you’ll have to provide some information about your practice to confirm that this is a HIPAA-secure exchange. Finally, the rep will ask you to provide some of the patient’s information (usually the patient’s name, date of birth, and the policy number) so he or she can locate the correct policy.
Do you have to tell your insurance when your insurance changes?
In a perfect world, patients would remember to tell you the moment their insurance changes. But patients have a lot on their plates too, and if their insurance plan is changing due to something like birth, adoption, marriage, divorce, or a change in employment, it might slip their mind to keep their therapist’s front office in the loop. As such, it’s a good idea to reverify your patients’ insurance plans on a regular basis— monthly, if possible.
