Let’s face it. Most patients have NO idea how their dental benefits work. Patients look to the front office to help guide them through the murky waters of dental benefits.
We recommend that the front desk constantly verify dental benefits about a week before the patient is scheduled.
Why a week in advance? Well, if you find out that benefits have terminated for a patient, you will have adequate time to contact him/her to sort out the new benefits plan before their appointment.
As you obtain benefits, be sure to make any notes in the patient’s appointment in your software regarding any limitations, x-ray frequency, or maximums that have been reached.
This is the type of information that the practice may need to know at a moment's notice during the appointment, so be sure to have it handy.
Be systematic in obtaining benefits.
We have provided a PDF that you can download and use to obtain benefits. Scan the benefit information into the patient's account in your practice management software.
Our verification form, shared below, is broken down into sections.
Top of Form
The top part is for the patient logistical information. This information can be found on new patient paperwork and/or when doing daily patient contact updates.
Rest of Form
The rest of the form is where the office can indicate specific plan information.
- It is important to verify that a patient’s dental plan is currently active.
- We must also find out about patient deductibles, what they are, what services they are applied to, and if they’ve been met.
- We must know yearly maximums, what benefits the patient may have already used, what their remaining benefits are, and if they have any pending claims.
- Dental procedures are broken down into different categories. We must know at what percentages those categories will be paid.
- We have also included a place to add orthodontic, occlusal guard, and implant coverage information. Feel free to skip these benefits if your practice does not offer these services
- Many insurance companies have frequency limits on how often they will cover certain procedures.
- Ask about plan restrictions and if any procedures are downgraded, so that all of this information can be factored in when talking to patients about their co-payments.
Need help getting dental benefits?
Contact Mary Beth at Dental Support Specialties at 330-639-1333. Obtaining benefits is one of the many remote admin tasks that her company offers!