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5 tips to streamline insurance verification in your dental practice

Updated: Aug 16, 2023

Finding the perfect insurance verification system can be as elusive as that one stubborn popcorn kernel wedged between your teeth. Let's face it, for many dental teams, insurance verification is the ultimate snooze-fest - a repetitive task that can make you feel like a dental insurance robot. But fear not! We're here to save you from the monotony and elevate your dental practice to dazzling heights of efficiency.

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Tip #1: The Early Bird Catches the Insurance Worm - Verify 72 to 96 Hours in Advance!

Ah, the elusive treasure of dental insurance verification - time is its greatest ally! Picture this: you have a patient scheduled for a visit, and their dental adventure is about to begin. But before the journey commences, you must uncover the hidden insurance gems. Timing is everything!

Here's the secret to dental insurance mastery: Begin the verification process a full 72 to 96 hours before the scheduled visit. Yes, you heard that right - a few days in advance is the sweet spot. While we'd love to jump into it right after that initial phone call, we know life and work can throw curveballs. But fear not, with this early start, you'll be well-prepared for the adventure ahead.

Every Patient, Every Time - The Power of a New Breakdown

In the realm of dental insurance, no two patients are alike, and neither should their benefits breakdowns be. Yes, you heard that right - for every patient, every time, unleash the magic of a fresh breakdown! Each visit is a unique quest, and a new breakdown is your trusty map to navigate the intricacies of coverage.

Leave Notes for a Smooth Journey

Ah, the wise traveler leaves breadcrumbs on the trail! For a seamless dental odyssey, leave notes for the top 15 codes on hygiene and all treatment procedures. These trailblazing notes will guide you and your dental team through each step of the patient's journey, ensuring nothing is left to chance.

But remember, dear dental explorers, if you require additional information from the patient, be patient! Leave a window for them to return your call, and soon you'll have all the missing pieces to complete the puzzle.

So, don your dental adventurer's hat, verify in advance, and embrace the power of new breakdowns and trailblazing notes. With these strategies, you'll sail through the dental insurance seas with confidence, leaving your patients smiling and satisfied at the journey's end!

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Tip #2: Harness the Power of Fillable PDFs and Excel Sheets for Swift Patient Data Collection

Time is of the essence in the busy world of dental practice, and when that initial phone call rings, you need patient data at your fingertips in a flash. Fear not, for we have the secret ingredients to streamline this process and save you from the perilous pitfall of number chaos!

Here's the vital intel you need from your patients to verify dental insurance:

  • Name of insurance provider

  • Member ID number

  • Member DOB

  • Patient DOB (if different than the Member)

  • Name of employer

  • Group ID number

  • Telephone number of insurance (if you don't have a web portal login)

But fret not! Gone are the days of scribbling and chaos. Say hello to the wonders of the digital world - Fillable PDFs and Excel Sheets, your trusty companions for dental data collection.

Why are Fillable PDFs and Excel Sheets the Knights in Shining Armor for Patient Data?

  1. Effortless Updates: Life happens, and patient details can change in a heartbeat. The beauty of Fillable PDFs and Excel Sheets lies in their flexibility. Whether it's an address update or a new insurance provider, simply update the relevant fields, and voilà! Your patient data is up-to-date and ready to roll.

  2. Seamless Integration: Wave goodbye to clunky paperwork! Fillable PDFs and Excel Sheets integrate smoothly into your dental software. No more manual data entry - just imagine the joy of swift and accurate information transfer.

Remember, efficiency is the name of the game. Embrace the digital tools at your disposal, and let Fillable PDFs and Excel Sheets work their magic in your dental oasis! It's time to ride the wave of modern convenience and conquer the dental data maze with finesse. Your patients will thank you with beaming smiles!

Tip #3: Unveil the Hidden Gems - The Power of Full Benefits Breakdown

Ah, the treasure trove of dental insurance benefits - a dazzling maze of covered procedures, percentages, and plan limits! Let us reveal the secrets that lie within - the magical "full breakdown" of insurance benefits. Brace yourself for a dental adventure like no other!

Unlock the Full Benefits Breakdown

Yes, we've mentioned it before, but it's worth repeating - access to each patient's full benefits breakdown is your golden ticket to dental prosperity. This detailed summary holds the key to a treasure trove of information:

  • Covered dental procedures and their percentages of coverage

  • Previous benefit usage elsewhere

  • The patient's plan maximum and so much more.

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The Hidden Power of the Full Breakdown

Knowing this precious information is like wielding a powerful wand that reveals the patient's out-of-pocket expenses and the anticipated insurance claim amounts. With this knowledge in hand, you can guide your patients through the financial labyrinth with confidence, leaving them smiling and satisfied.

When to Unleash the Power

While not every visit requires a full benefits breakdown, it's wise to always inquire about any changes in their insurance information since their last visit. A quick question can make all the difference, just like when your dentist asks, "Is your address still the same? Are you still using Guardian dental insurance?"

Remember, dear dental trailblazers, stay vigilant in collecting and updating insurance information for a seamless dental journey. Embrace the power of the full benefits breakdown, and watch your patients embark on a rewarding dental adventure with you as their trusted guide!

Tip #4: Unleash the Power of Family Insurance Cohesion

Ah, the beauty of family - where dental insurance can sometimes become a bundle of joy! Picture this: a parent calls to schedule their child's dental appointment, and you sense an opportunity for insurance efficiency.

Let the magic unfold - when a child and parent are covered under the same insurance plan, you can use the parent's information to verify the child's insurance details too! No need for individual breakdowns when you've got family insurance cohesion.

But Beware - The Coordination of Benefits (COB) Rules

Before you embark on this insurance adventure, a word of caution - the dreaded Coordination of Benefits (COB) rules may lurk in the shadows. Not all families sail seamlessly under one insurance flag, and you must navigate this terrain with care.

For those cases where a child is under separate insurance from their parents, COB rules demand your attention. Ignoring them could lead to a claim denial - a fate we must avoid.

The Smart Approach - Asking the Right Questions

Don't worry, brave dental adventurers, for armed with knowledge, you shall prevail! During the initial phone call, be sure to inquire about the child's insurance details. With the right questions, you'll uncover the necessary information for a smooth insurance verification.

So, embrace the power of family insurance cohesion, but keep a watchful eye on the COB rules. Ask the right questions, and you'll navigate this insurance labyrinth with finesse, leaving your dental practice and patients gleaming with satisfaction!

Tip #5: Unleash the Power of Monthly Insurance Renewals

Ah, the valuable dental insurance benefits - a treasure trove that should never go to waste! For our beloved returning patients with no changes to their insurance, we've crafted a masterful plan to ensure they make the most of their coverage throughout the year.

A New Breakdown Every Month - The Key to Success

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Imagine this: as the calendar turns, a new month begins, and with it comes a golden

opportunity. For returning patients, kickstart the month with a fresh insurance breakdown. This diligent practice will save you precious time and ensure that their coverage remains intact.

The Call to Action - Confirming Accuracy

In the realm of dental insurance, vigilance is paramount. For returning patients within the same month, a quick confirmation of the previous breakdown's accuracy is all it takes. As your dental knights, protect your patients from potential benefit loss, for insurance benefits do not rollover - they vanish like a fleeting dream.

The Dental Insurance Minimum - Your Secret Weapon

While reading the full breakdown, embrace the power of understanding. Armed with this knowledge, your dental team can confidently guide patients to maximize their benefits, fostering a bond built on trust and care.

Let your patients know when they're approaching their benefit limits, or when there's a chance to utilize more coverage before the year's end. Empower them to seize every dental opportunity, for their smiles deserve the utmost care!

With monthly insurance renewals and proactive guidance, you'll ensure that your patients' insurance benefits never go untapped. Embrace this strategic approach, and watch as your dental practice becomes a haven of dental wisdom and patient satisfaction. Together, you'll paint a canvas of dazzling smiles that last a lifetime!


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To learn more about Sarah Beth Herman, the author of all free training content you can read her bio here. These materials are intended to provide helpful information to dentists and dental team members. They are in no way a substitute for actual professional advice based on your unique facts and circumstances. This content is not intended or offered, nor should it be taken, as legal or other professional advice. You should always consult with your own professional advisors (e.g. attorney, accountant, or insurance carrier). To the extent, Dentistry Support ®has included links to any third-party website (s), Dentistry Support ® intends no endorsement of their content and implies no affiliation with the organizations that provide their content. Further, Dentistry Support ® makes no representations or warranties about the information provided on those sites. You can view our privacy policy and terms and conditions by clicking those pages in the footer of our website.

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Raul Pacia Jr.
Raul Pacia Jr.
Sep 12, 2023

love this post!!


Glenna Grace
Glenna Grace
Aug 15, 2023

thank you for this information.


Joel Balita
Joel Balita
Aug 15, 2023

Thank you for Sharing!


Ela Calpito
Ela Calpito
Aug 15, 2023

This is awesome. Thankyou for sharing !


thanks for sharing!

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