Keeping Up with Insurance Benefit Changes

People often see the start of a new year as an opportunity to make changes. While some of those changes may be small, others can be significant. From moves and job changes to building a better budget, for some, changing insurance providers or plans is just one outcome of the changes made.

For your patients that may mean better care and coverage, but it also means understanding new benefits. For your staff, it could mean time spent verifying new insurance plans and benefits for existing clients. This doesn’t have to be the time consuming and daunting task that causes your staff to hunker down indefinitely. With automated insurance verification, you can help alleviate some of the dental insurance verification challenges presented by insurance providers and plan changes.

Quick Links

• Top Reasons Dental Insurance Benefits Change
• How Insurance Benefit Changes Impact Patients and Practices
• Common Changes to Dental Insurance Benefits
• How to Help Your Practice and Patients Navigate Dental Insurance Benefit Changes

Top Reasons Dental Insurance Benefits Change

One of the first questions you likely ask patients as they schedule a new appointment is whether there have been any changes to the patient’s dental insurance. Those changes are important as they change what treatments and procedures are covered, co-pays, and more.

Of course, it’s great when a patient is aware that there has been a change due to:

• Marital status
• Employment status or job change
• Employer changed insurance providers
• Finances for the self-insured
• Start of a new year/enrollment period

However, in a few of those instances, patients may not be aware of changes. For example, an employer may have stayed with an insurance carrier but changed plans and that can also impact benefits. This can make insurance verification difficult and confusing, especially if the changes impact co-pays or coverage and the patient doesn’t know until the day of the appointment.

How Insurance Benefit Changes Impact Patients and Practices

As a dental practice, handling dental insurance changes can be time consuming. Often, it requires gathering new data from the patient and coordinating with the insurer. This is more time your staff is tied up on the phone verifying coverage and updating information.

Additionally, if there are major changes, it may impact existing treatment plans or scheduled procedures.

As for your patients, whether the insurance change comes as a surprise or not, coverage and co-pay changes may be shocking, especially if it’s something their insurance covered in the past. Similarly, if there’s a sudden increase in co-pays, it may limit their ability to complete scheduled procedures.

And this is where it gets cyclical. These changes can then adversely impact your revenue and cash flow, especially if those changes aren’t realized until days before the appointment.

Common Changes to Dental Insurance Benefits

Often, changes to dental insurance involve changes to the types of care provided and the amount of coverage: preventive, basic, major restorative, and orthodontics. In addition to the type of coverage, changes also often include the amount that is covered.

For example, many plans cover 100% of preventative care, 80% of basic care, and 50% of major restorative care. Often, orthodontics are not covered or only covered in a superficial way unless there is a medical issue compounding the need for orthodontic work.

In short, common changes typically encompass the type of care, such as not covering major restorative work, or the amount such as severely limiting what is covered and when. For example, patients who need multiple major procedures may have to space those out over multiple years to ensure dental insurance covers it in part, if at all.

How to Help Your Practice and Patients Navigate Dental Insurance Benefit Changes

One of the best tools to help your staff and your patients navigate dental insurance benefit changes is automated insurance verification software. While the obvious benefit is the amount of time it saves your staff from phoning insurance providers to get updated information, the benefits go well beyond that, especially when it comes to changes in dental insurance providers or plans.

• Verify your weekly schedule in one shot rather than one at a time. Automated insurance verification happens in seconds and is updated daily, saving your team 20 to 30 hours per week. Further, you’ll know days before if there are dental insurance changes and be able to address issues before your patient is at your reception desk.
• Real-time benefit information. iCoreVerify automated insurance verification software stands out because it connects with more than 2,100 different insurance carriers, ensuring your team has the most up-to-date benefits information to provide your patients with the information they need, even if there have been plan changes!
• Revenue identification opportunities. Up-to-date information regarding coverage, including unscheduled treatments, means you can more easily recommend and schedule treatment and services. Utilizing all the benefits available to them, especially when it’s a new plan, means you can improve your patient’s dental health and boost revenue.

In addition to those benefits, automated dental insurance verification can also help:

• Improve accuracy 
• Identify errors more quickly, decreasing claim denials
• Keep your calendar booked by scheduling treatments before patients even walk out the door

If you’re ready to help your patients make the most of their benefits while improving the accuracy, efficiency, and revenue generation of your dental practice, book a demo with the iCoreConnect team. We’re ready to talk about how we can help your staff and patients effectively navigate the insurance landscape.