It may not be surprising to learn that two-thirds of denied dental claims are linked to eligibility issues. Many of those errors are found in either a failure to check eligibility or the use of inaccurate eligibility data. That is why verification is an important step, even for existing patients. Insurance plans change frequently and patients are not always aware if—or how—their benefits, have changed.
The first step to having a healthy revenue cycle is for office staff to check with insurance carriers on the eligibility and benefits of patients the day or week before walking into a practice each day. Real-time is by far the most efficient verification of dental insurance breakdowns and continues to be one of THE most important tools in a practice.
There are several ways you can check eligibility:
1. Go to insurance carrier’s website.
2. Fax-back of eligibility.
3. Call insurance carrier
4. Use your clearinghouse real-time eligibility process
There are currently over 600 insurance carriers using x-ray attachment systems. This system allows dentists to attach x-rays from the start of the claim submission with other attachment options listed below.
2. Perio charting
3. Intra-oral pictures
5. Any scanned document ( EOB’s, specialist letters)
By verifying eligibility and benefits electronically, and attaching x-rays a dental office can improve claim accuracy and patient payment responsibilities. Therefore, you not only start your claim process correctly, you also set the proper expectations for your patients. Furthermore, you can retain a permanent record of patient eligibility information. As a result of electronic verification facilitated through our partnerships with clearinghouses, dental offices may experience faster turnaround times and fewer returned or denied claims due to eligibility issues. Inefficient systems and inaccurate information at the start of the claim process are major contributors to poor cash flow, which is detrimental to the financial stability of a practice. Make sure to spend the proper amount of effort before the claim is submitted to ensure the best possible remittance collection.