Why Is It Important To Verify A Patient’s Dental Insurance?

Verify and stay on top of your patient’s dental insurance when it comes to running a seamless dental business. Even though it can occasionally seem overwhelming, routinely checking your patients’ insurance can save you from having to deal with more serious issues down the road.

Too many patients, insurance plans can be difficult to understand; many don’t even understand the specifics of their plans.

It is crucial to know how to check dental insurance before an appointment because many people are not aware of their advantages and are unable to respond to questions about them.

The importance of Verifying a patient’s dental insurance includes the benefit of helping you better understand their benefits so you can inform them about their coverage when they visit the dentist.

The Importance of Verifying A Patient’s dental insurance

Insurance Verification is crucial when it comes to dental care. You won’t know if a deductible applies to a new patient’s first visit if you don’t check patients’ insurance benefits, and the practice could end up losing money. Additionally, you’ll also prevent getting less than you expected payment from insurance.

We frequently discover that many patients lack knowledge of the four insurance payment ideas. They consist of the following:




Out-of-Pocket Maximum

However, you must be aware of your patient’s insurance coverage in order to convey these payment concepts to them. You can benefit from patients’ insurance verification in the following ways:

avoiding the insurance companies’ refusal to pay for root planning and scaling

Preventing a payment refusal for a restricted exam and emergency appointment for current patients

Avoiding paying less for cleaning and examination visits

avoiding an insurance company from refusing to pay for a preventive visit for a new patient

How can I Verify dental insurance benefits?

You have a choice of fax, internal, automated, or online portal. Additionally, always check with your patients to see if their information has changed. Additionally, by contacting the insurance provider, you can confirm their policy. Here are a few techniques for confirming a patient’s insurance benefits:

Verification of dental insurance on the in-office form

To complete this form, your team must call the patient’s insurance provider. It gives you all the information you need and is the greatest technique for insurance verification. When compared to other methods of insurance verification, it takes a long time.

IV Services

With the help of IV Services, you may spend more time caring for your patients and less time worrying about insurance. These services will contact payors on your behalf to obtain any necessary eligibility information. Additionally, they make calls to payors on your behalf to request any necessary eligibility information.

Online resource

There aren’t many companies that offer dental insurance that have an online portal where you can view patients’ claims. Online records for the insurance providers you deal with must be available at your office.

It would also be beneficial if you didn’t rely on this approach to gather information. For some conditions, such as waiting periods before root planning and scaling, this method is unreliable.

Important terms for insurance verification

When learning why it is important to verify a patient’s dental insurance, some terms are crucial to understand:


Make sure to ask the insurance provider if a deductible is required. and inquire as to whether or not it relates to prophylactic measures. Be aware that some insurers even charge a deductible for cleanings or exams performed as preventative procedures. You must call the insurance provider and confirm this.

Additionally, not all insurance carriers apply deductibles and do not cover 100% of preventative services. Some only use the deductible for specific preventive care, though most do. Some patients believe their yearly or biannual cleanings and x-rays are completely covered by insurance. Make sure the insurance provider confirms this to avoid any unpleasant surprises when the claim is paid.

Dental benefits as-of date

Additionally, don’t forget to record the precise day you called the patient’s insurance provider. Benefits fluctuate based on whether the patient switches insurance plans. The benefits for the patient may also be changed by insurance companies.

Keep track of any modifications you make to the sheet as well. Open a new template, for instance, if the patient wishes to switch insurance plans. The patient’s benefits under the new insurance policy should be included in the new template.

Benefits used to date

New patients who recently changed dentists during the benefit period are affected by this. You must find out how much the patient utilized for the remainder of the benefit period.

After that, edit this data in your office’s file. It will be useful to know if the cost of treating the patient exceeds what their insurance will pay out in total.

Primary or secondary insurance

Knowing if the insurance is the patient’s primary or secondary insurance is essential. The majority of patients are unsure of whether the insurance information they provided was for their primary or secondary insurance.

The insurance provider will refuse to reimburse you if it is their secondary insurance. A declaration of the estimated benefit from the primary insurance must be submitted.

Dental Insurance Verification is essential for avoiding payment rejection. There are several possibilities for choosing how to confirm insurance. An internal insurance verification form, automated services, or fax are all options.

Knowing your patient’s insurance benefits will allow you to inform them of their coverage. If their insurance policy does not cover the procedure, you can talk to them about other available payment options.

Written by Dentalrevu

Dental billing is an exhausting process from origin. DentalRevu is a leading dental billing firm that utilizes the best strategies and practices to assist you in resolving billing issues and achieving outstanding earnings.

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