Alleviating Insurance Verification Challenges

There are few things that challenge modern healthcare on both the provider and patient side quite like managing insurance. Patients find their coverage difficult to understand and dental practices struggle to verify coverage and benefits prior to in office visits. For that reason, patients often rely on their dentist offices to verify their insurance for care and procedures. The insurance verification process should be easy, but instead it’s often lengthy and slow, occupying resources that could be better used to improve office efficiencies and client services.

Still, it’s a necessary task. Insurance verification and pre-approval ensures your dental practice is paid for its services. As important as it is to ensure payment for your practice, the verification process comes with costs as well. Finding ways to both improve the process and save resources is, for many dental practices, a top priority.

Quick Links

• What is Insurance Verification?
• What is the Dental Insurance Verification Process?
• Top 3 Challenges of the Insurance Verification Process
• 5 Ways to Improve the Insurance Verification Process

What is Insurance Verification?

Insurance verification is the process by which medical and dental practitioners verify a patient’s insurance eligibility and coverage for care and procedures. During the process, both practice and patient will learn whether insurance will cover costs and determine if any out of pocket payment will be necessary.

What is the Dental Insurance Verification Process?

Most dental offices are still relying on manual insurance verification processes which can be done in a few different ways, each of which is time consuming. One, you have patient information on file, but must go record-by-record to check any patient on the schedule. Or you have to wait until a patient completes a form which includes all their insurance information. Regardless of the pathway, an administrative  staff member typically calls or faxes the insurance company. The claims process includes all the steps from the time the patient completes their paperwork through the time staff contacts the insurance company, receives approval, updates information, and processes the claim.

There are other options to a manual insurance verification process available. From automated services to outsourcing, alternatives exist, but some of those come with their own challenges. As a result, many offices rely on manual verification methods to ensure all necessary information regarding the patient and coverage has been transmitted accurately. Often, practices only verify new patients because there simply isn’t time to get through everyone on the schedule.

The last thing a dental practice or patient wants is to delay this process any further or have a claim denied. Denied claims not only delay care and frustrate patients, but they also delay cash flow to your dental practice.

Top 3 Challenges of the Insurance Verification Process

Given the importance of insurance verification for your practice and your patient’s care, understanding the challenges and mechanisms to overcome them is crucial.

1. Time- Perhaps one of the biggest challenges a dental practice faces is the amount of time it takes to manually verify insurance. Dental practice staff will need to call the insurance provider and talk about coverage and benefits with a member of their team. Those calls can last a half hour or more. Or practice staff can spend hours, even days, waiting for faxes or other electronic verification to be returned from the insurer. Unfortunately, employers change plans all the time and the need to discuss and verify those changes can complicate the process adding in more phone calls and further delays.

Additionally, when changes are made to insurance plans, your staff must also spend time on the administration of a patient account updating insurance information.

2. Resources- Many dental offices are already finding themselves short staffed. When insurance verification takes valuable team members away from other tasks, either services suffer or other team members are overwhelmed. Most practices dedicate at least one staff member to insurance for at least 20 hours per week.

In addition to service level and human resource allocation, you’re also losing money. First, you’re paying a staff member to make phone calls rather than provide support or patient services. You may also be losing money on uncollected payments.

3. Human error- Across nearly every industry or manual process, human error is a concern. From data entry errors to miscommunications and agent errors on the insurance side, human error can add additional time to the process and increase staff and patient frustrations. 

Though the list of challenges may appear short, that’s not reflective of how taxing any of these issues can be on your staff, your service level, or, ultimately, your cash flow. Delayed insurance verifications mean delayed service which means delayed payment. And, if and when your team needs to go back and track down the errors, you lose even more valuable resources.

How can dental practices simplify and improve the insurance verification process?

5 Ways to Improve the Insurance Verification Process

Knowing that the challenges of the insurance verification process can have significant impact on your staff, patients, and practice, investigating ways to streamline and improve the process can reap equally significant rewards.

1. Verify early

Whether it’s staffing constraints or patient delays, waiting until the day of or day before a scheduled appointment can be a mistake. For instance, it limits staff to checking only new patients or patients with known insurance changes. If there are miscommunications, or other unexpected errors or delays, it may lead to a canceled appointment or worse. Any effort that can not only streamline the process but support your bottom line is an effort worth making. 

2. Create a thorough, but simple process 

Are there ways for you to skip steps and speed up the process? It’s likely.

First, consider online forms. Manual data entry is one area with potential for human error to complicate the process. Further, when emailed a form or a form is available online, patients can quickly fill it out. In terms of customer experience, and delays on the customer side, manual forms often mean access to a printer or waiting until the day of the appointment to complete paperwork. Both of these impact patient experience and can delay the process.

Further, many online forms will integrate with your existing systems and not only facilitate the process, but they can improve accuracy as well.

3. Identify families or family plans within your system

Whether a parent/child, spousal, or other dependent relationship, identifying these relationships in your system can speed up verifications as you can simply transfer information from one account to another. This can all be handled well before an appointment and speed up both patient intake and insurance verification.

4. Get a full breakdown of insurance benefits

Keeping dental insurance benefits thorough, and updated, means you can quickly verify whether certain dental services or procedures are eligible through the patient’s insurance. A full breakdown will help you provide information to the patient regarding coverage percentages, out of pocket costs and more. Not only does this assist your insurance verification process, but that kind of transparency improves patient experience.

5. Consider an alternative

There are alternatives, as noted above, to the manual insurance verification process. Outsourcing is one option, but that comes with its own costs, and potential data security risks and HIPAA compliance questions when it comes to file transfers. An even better option is an automated insurance verification software.

Automated insurance verification software, like iCoreVerify, offers considerable advantages such as:

• Verification in seconds for every patient on the schedule each week  (rather than one patient at at time)
• Built-in error reporting for quick resolutions
• More accurate estimates and higher acceptance rates (fewer denials)
• Real-time benefit information and remaining coverage data
• Robust reporting and revenue updates

Leveraging technology to improve your practice by saving time and resources doesn’t require an IT degree, it requires the right partner. Let’s talk about how iCoreConnect can help you improve efficiency and your practice. Book a demo now to see how we can help you.