Customized Consulting Virtual Academy Podcast Events About Contact SCHEDULE A CALL Login

433: Cut Down Insurance Verification Time

Kiera’s here to share how to verify insurance the tried and true, Dental A-Team-approved way! DAT consultants have been to a lot of offices lately, and have seen that many teams are fumbling over the basics, like insurance verification. Kiera shares how to shift to membership plans, cut down on time while verifying, clustering plans, and why calling insurance companies is not the way to go.

We even have an insurance verification form for you to use in your practice!

Episode resources:

Reach out to Kiera

Subscribe to The Dental A-Team podcast

Listen to episode 204: You Need to Put This in Place

Become Dental A-Team Platinum!

Review the podcast on iTunes

Podcast Transcript:

[music]

0:00:05.6 Kiera Dent: Hey everyone, welcome to The Dental A Team podcast. I'm your host, Kiera Dent, and I have this crazy idea that maybe I could combine a doctor and a team member's perspective, because let's face it, dentistry can be a challenging profession with those two perspectives. I've been a dental assistant, treatment coordinator, scheduler, filler, office manager, regional manager, practice owner, and I have a team of traveling consultants where we have traveled to over 165 different offices, coaching teams. Yep, we don't just understand you, we are you. Our mission is to positively impact the world of dental, and I believe that this podcast is the greatest way I can help elevate teams, grow VIP experiences, reduce stress and create A teams. Welcome to The Dental A Team podcast.

[music]

0:00:50.4 KD: Hello, Dental A Team listeners. This is Kiera and you guys, man, talk about a fun week. I've been in some practices, Tiffany's been in practices, Britney has been in practices, not traffic, and Dana, Dana is our new consultant as well, and she has been on quite a few different calls, so it's been a fun consulting week for us. We love to help our practices and we're getting new Dental A Team offices, so if you've been thinking about it, guys, end of year is the best time, we get quite a few offices that sign up, so if you've been thinking about it, just take the plunge, I promise you won't regret it. We are definitely... We screen you guys, so we'll see if you're a good fit for us, so if you've been thinking about it, wanna see if you're a great fit for Dental A Team, if you'd be a good client, email us, [email protected] Would be great, we'd love to welcome you if you're a good fit with us, and we think that you guys fit into our family.

0:01:40.1 KD: So today's topic, I wanna just dive into the last couple of offices I've been in, and a lot of it has to deal with insurance verification and AR. I think a lot of you guys don't know, or maybe you do know, or I don't know why this is coming up, but I realise like Let's pop on, let's talk about some relevant topics, and I think what it is, is we just had a lot of people shifting, we had a lot of people changing positions, we've lost some team members, we've brought in some team members, we've had COVID, we've gone around and around, and I think that we're just kind of forgetting some of the basics, so let's dive into insurance verification.

0:02:13.8 KD: So first and foremost, I recommend insurance verification on every single hygiene patient and every single new patient, even for big practices. I just came back from an office, it's basically four practices in one, nine doctors, and we had about 50 employees, so a really, really, really large practice, and I felt like they should be a DSO, and they were not verifying insurance on these patients, they have in-network and out-of-network doctors, and so helping them just understand how to verify. Guys, I recommend an insurance verification form. We have one, we'll attach it into our notes, you guys can definitely snag that and see, but really, it's a pain, I'm not going to lie, but it's a great way for new hires to get really, really, really involved in dental. So if you've got new people new to dentistry, I recommend they learn insurance verification, it helps them learn what maximums mean, do you guys know what an MTC is? A missing tooth clause? Those are just little nuances that definitely impact the treatment plan. I was not confident as a treatment planner or coordinator until I really understood my insurance benefits, not because I feel like those impact my treatment plan, but because those little nuances definitely and drastically impact my coverage.

0:03:25.1 KD: I still remember the day that I quoted somebody about $400 out of pocket. Well, they had a missing tooth clause in there, and guess what, they ended up having to owe about two grand. Yes, I'm a really good word ninja, and yes, I can walk myself out of a lot of different things, however, that one was a tricky one because I really... That's like four times what they were expecting to have to pay, so with that said, you wanna make sure that you guys have a verification breakdown. I recommend one full breakdown per group number at least once a year, and then after that is eligibility checks. Also, if we send them out for referrals, remember that they've used part of that insurance benefit to another practice, so we might not have the correct estimate in there, and remember once they max that insurance out their cleanings are not covered under most insurance plans. Their X-rays are not covered, which is totally fine, we just need to set clear expectations with our patients. Also, right now with open enrollment coming up soon, it's a great time to start converting some of our insurance patients over to membership plans.

0:04:25.9 KD: I just talked about that on another podcast, if you missed it, go check it out, it was a great podcast for you guys to help you start to learn how to convert people over from insurance to membership plans. But basically what you wanna do is, I personally like to cluster all of my insurance plans together, so if I'm going about to verify, they've also shown that Tuesdays and Thursdays are the least busy days at dental insurance offices, Mondays are psycho, so I try not to verify on Mondays, and I typically like to do it between 9:00 to 11:00 AM. Most of the time, whomever my insurance verifier is, I usually have them have one to two hours of block time per day just because it's a lot faster just to get it done. A lot of offices are asking me about outsourced insurance verification companies, right now, the best ones I've heard of are Verrific, Verifixed, also CallSource, so just let them know The Dental A Team sent you. Try it out guys. I haven't vetted a lot of these, they usually pay per plan that you break down, so today, I just had a pediatric office ask me about it, and I said, honestly, with the amount of patients you see, I personally would just hire somebody, even part-time to help out as a part-time insurance verifier who could even be working from home, maybe a mom who's left the dental world who could work from home, it's a really an awesome opportunity to help somebody have a job, but save your practice money as well.

0:05:42.3 KD: So I like to cluster all of my appointments, I don't like to go 8 o'clock, 9 o'clock, 10 o'clock and verify one by one by one that way, instead, I like to pull up all of my Deltas, all of my MetLifes, all of my Aetnas and put them all together, so that way I'm super efficient as I'm verifying. Then I have a form and I fill in that whole form every single time. Make sure it's linked to the group number, 'cause that group number actually is the same, so you can asterisk it to 21, or 22, whatever year you're in, that way, you know you've updated it for that year, so that way all future patients that are on that group number, notice it's group number, not employer, it's group number, because there can be different group numbers with the same employer, so you gotta just make sure it's on our group number, but once I verify that one time I can pull that. The only thing that will change is typically their max and how much they've used, so you just double-check that, make sure that they're still eligible. It's really simple, and it cuts down your time. Then make sure you're utilising online. I can't tell you how mean people I hear that call the insurance company.

0:06:41.1 KD: Ladies and Gents do not do that. That takes a lot of time, so be sure to go on their websites of each insurance carrier, they all have it, pop in the information and you usually will get a FaxBack, also make sure that you actually have an email fax. If you haven't set that up, do so because then we're not getting all that paper jammed up, it also comes right to your inbox and then we can pop it right into the patient's account. I take that FaxBack, fill in my form, yes, you can type it or you can handwrite it, super annoying, but every single FaxBack does not actually give me all the same information. So I hand fill it into an insurance verification form, and then I change the percentages in the software, so I'm gonna wanna go in and make sure I update 50% for major, 80% for basic, 100% for preventative, they might have some codes that actually aren't covered, so I wanna update that because the more accurate you can make your coverage tables per group number, the better your treatment plans are going to be estimated. Also putting notes of it fluoride's covered, if sealants are covered, if night guards are covered, whatever you do in your practice, putting those notes in an easy spot that everybody knows exactly where it is, and I recommend one spot that you put those notes.

0:07:48.7 KD: So I usually will scan or upload a picture of the insurance verification form, and then also have notes in the account information, that way there's two places, but only those two places, so I've got the scan copy so everybody can read it and then I actually upload it into my software. So again, we can outsource this. It's a pain in the derrière to call people, yes, it is, however, outsource companies don't usually act as invested as you do, and they also might not actually enter into your software for you. If you really are gonna bind those three companies I listed off, tend to be the best ones right now. I'm constantly vetting, constantly having offices try them out. We used to recommend Medusind and we found out they were making a lot of errors and mistakes, so as of right now, we're currently not recommending them. ESS, we just heard is not able to do it due to manpower, so those are some of the ones we used to recommend in the past, again, we're always checking to see which the best ones are. If you are using someone that you love, some offices love Zuub, others tell me that it's just not that great. So again, if you have any great success with any verification companies, please email us, [email protected], that's a way you can help us be a better consulting company and share with other offices the best of the best. That's what this podcast is for.

0:09:02.8 KD: Don't you guys love being in the office that just stands out? I'm always looking for ways for us to dazzle and shine in the most effective, easy way possible, and you guys, Weave is a company that does that. They allow the patient information to pop up when the phone rings, and so you can actually talk to the patient about their likes, their family, the things that they're working on, and so you can actually have a really, really personable conversation, plus, they do a ton more. So you guys text the number 'PHONES', so text PHONES, P-H-O-N-E-S to 797979. You guys can get a free demo of Weave and a $25 gift card, so you guys check them out, I think they're awesome, and they can help you guys stand out. That's 797979 PHONES, P-H-O-N-E-S.

0:09:49.6 KD: So that's kind of in a nutshell how you verify insurance. And I think it's really important to do this because the office that I was just in, they weren't doing it. Well then guess what happens? If we don't have the correct insurance information at the beginning, and then we send claims, funny, and we're not checking our claims before they go to the insurance company to make sure that they're clean claims. So we have our attachments, we have our documentation. Well if we don't have both of those steps done, we send it off to insurance, guess what, they kick it back to us and then we don't get paid, then it sits in AR, then it's a lot of follow-up. And it just gets messy. So I'm really, really, really, really sticky on having insurance verification done, and then also having somebody to check my claims to make sure that they're completely clear and clean as much as we can before they're actually submitted, I like to have less than five claims come back requiring more information per month. That's my goal.

0:10:40.7 KD: Yes, it's a lot to go, even in that huge practice, that's what I tell them, because if you think about it, if we can do that, that's less AR, if we're getting our money to our practice faster, that allows us opportunities to hire more people, to be more profitable as a business, so we can bring on different services for our patients, it's just an all-around great way to benefit your practice, and it keeps our AR lower. I had an office, shout out to them in Seattle, where they literally had less than 2% of collections in their 30, 60, 90 and over 90 buckets. Insanely impressive in a high PPO practice with multiple doctors, multiple hygienists, super impressive, and I really do believe when you have the correct systems at the beginning, when you're super thorough with it, and you have a set system to do, so you really don't have that much sitting in AR, then we can confidently collect from our patients, then we can confidently treatment plan, then we can confidently schedule, it just makes the whole process so much smoother for everybody.

0:11:36.3 KD: So I want you guys to make sure that you have a true insurance verification process in play, that you actually have a form that everybody is following, that it's actually being uploaded. Once I get it verified, I like to put an asterisk or an IV on that appointment so at a quick glance, everybody can see all those appointments have been verified. Insurance is just a coupon, it's just a tool, it is not a driving force, but it is something that can be a benefit, and if we have clean information going in, clean information coming out. Typically, depending upon the number of doctors you have, so for probably a two-doctor for-hygiene practice, it usually takes about one to two hours of dedicated time per week, and then maybe a few more here and there, that's if you're super efficient on it. At the most, I usually give us four hours per week for a practice of that size, so if that helps, give you guys guidance of how quickly insurance verification can take, yes, as you're learning, it might take a little bit longer, and yes, we do train on this and we help several offices.

0:12:34.4 KD: But again, for new hires that have no dental background, this is a very easy system that they can follow, that they can call on, that they can cluster, have it more efficient also pro-tip when you're calling those insurance companies, because if you don't have all the information on a FaxBack, you've gotta call the insurance company. Instead of... They usually can only verify so many patients for you. So let's say I've got 10 belt of patients called Delta and they can only verify four patients, that's totally fine, ask that rep after you're done to please transfer you to the next representative, that way you don't have to get out of the queue and back into the queue, you can just transfer from rep to rep to rep and get all those Delta patients verified. Again, I recommend some block time and do it in the morning, tends to be a lot faster and easier for you guys, that way you can get it done, cleaned and buttoned up. I like to be at least one week ahead on all insurance verification and as a minimum, two days ahead, that way we're all clean, everything's set, and if you absolutely are really struggling, I typically do it on all new patients and all of hygiene, that way you know exactly who to do.

0:13:34.3 KD: If you have a perfect world then you could get Doctor done as well. That would be ideal, but at the end of the day, guess what? Hygiene and new patients and any limited patient, those are the best ones to verify. Alright guys, go try it out, let me know. Email us [email protected], and as always, thanks so much for listening, I'll catch you next time on The Dental A Team podcast.

[music]

0:13:56.3 KD: Alright, Dental A Team listeners, that's a wrap. Thank you so much for listening, and if you love today's Podcast, go leave us a review. It takes you five seconds and your review helps more offices, more practices, more team members, just like you find out about The Dental A Team. Thank you guys so much for being part of my Dental A Team family.

[music]

Close

Grab your FREE Resources