By Helen B. Funk
It’s no news flash that handling insurance can be a real pain for dental front offices. This office manager has been there, and she’s found several tips that have helped her streamline the front office. Find out her secrets here.
1. Prior to patients coming to the office, it’s essential to verify dental eligibility to stay on top of their current insurance. If it’s a new patient, the front desk should gather all of the insurance information before their visit. That way benefits can be verified ahead of time and the front office can be prepared. This also saves time when a patient is in the chair and needs dental work. You don’t have to call their plan and you can give them an estimate right then and there!
2. If it’s returning or recall patients, verify their eligibility one week prior to their appointment. Also, check that their continuing care matches their treatment due date. Some insurances allow exams and cleanings twice a year anytime, and others limit the service to once every six months. Staying on top of this will prevent having your claims denied. It will also save you the trouble of dealing with angry patients who received an EOB from the insurance company declining the service because of a plan limitation.
3. Call the insurance plan and speak to a representative for a breakdown of benefits in order to have the most accurate and up-to-date information. This is especially helpful for new patients. Create an insurance verification form with the most frequently used procedure codes and other necessary details pertaining to your office. An efficient way to do this is to gather all of the patients with the same insurance plan and bang it out in one shot.
4. Be transparent about copayments with your patients. For small cases, our office developed a system where the treatment plan and cost estimate is emailed to patients one week before they come in for treatment. Create a template you can copy and paste into the body of the email that will tell patients the date and time of their appointment (this also serves as an extra appointment reminder), what is being done during their visit, what insurance will pay, and what the patient’s responsibility will be. You can also include details about what type of payment plans are offered in the office. We also include our cancellation policy, and a brief paragraph stating that if insurance does not pay, the patient is responsible for the difference. That way, there are no surprises. No one likes unexpected bills or being told they owe more than expected. If a patient has an issue, you can address it before they come in.
5. Most insurance plans now downgrade posterior composites to the amalgam rate. Instead of chasing down patients to pay the difference that was uncovered by the insurance plan, you can collect the copayment based on the downgraded rate. In the case that insurance does reimburse at the full composite rate, contact your patient and refund the overpayment. Everyone loves getting money back and your patients will appreciate the attention to customer service.