Teresa Duncan dental

Coach's Corner for Dental Coding: The importance of asking for ID and preventing fraud in the dental practice

Aug. 2, 2013
When new patients visit your office, you should review the information they give you before the doctor sees them. Once the doctor or clinical team member begins the appointment, the patient has become a patient of record with your office. Ideally, we should ensure that Mrs. Jones truly is Mrs. Jones and not Mrs. Smith, who does not have insurance but is fraudulently using someone else’s card.

By Teresa Duncan, MS

Question: At my old office, we never asked the patient for identification but now I’m supposed to do this with every new patient. What do you think about this? I really don’t like asking patients for their IDs because they always ask why. All I know is that it’s the office policy. – A.T.

Answer: Your doctoris probably concerned about the growing incidences of health care fraud and I applaud your office for doing this. Although it is much more rampant in the medical field than the dental field, it still happens. The National Health Care Anti-Fraud Association has recently estimated that $68 billion is lost annually to health care fraud.

When new patients visit your office, you should review the information they give you before the doctor sees them. Once the doctor or clinical team member begins the appointment, the patient has become a patient of record with your office. Ideally, we should ensure that Mrs. Jones truly is Mrs. Jones and not Mrs. Smith, who does not have insurance but is fraudulently using someone else’s card.

If the patient is concerned for the reason, be honest with them. Explain that your office takes steps to protect your records and that includes verifying that the benefits belong to the person attached to the appointment. You could phrase it like this:

“We want to make sure that your benefits are safe and used only for you. By verifying your identity, we’re making sure that we have the correct information. Your license is safe in your patient record with all your other information.”

Keep your tone light, pleasant, and helpful. You are doing a service, not only for the patient but also for the practice. If your patient is lying about his or her prospective coverage, then the chances of him or her paying their bill are very low. It’s better to catch this in the beginning than having mail returned and dialing disconnected numbers when you attempt to collect a balance.

To see previous articles by Teresa Duncan on dental coding and other issues, please click here.

Teresa Duncan, MS, FADIA, FAADOM is an international speaker who addresses topics such as Insurance Coding, Office Manager Training, and Revenue Growth. Her company, Odyssey Management, Inc., provides virtual, customized training in these areas. She can be reached at [email protected].