Episode 651: Insurance Verification 101

insurance verification Mar 08, 2023

Kiera and Tina are making insurance verification sexy again. In this episode, they break down why property verification makes or breaks your practice’s operations. They touch on the following topics:

  • Myths and truths of insurance verification

  • Whether outsourcing is good/bad

  • How to know if you’re verification is being done right

  • And more!

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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.

0:00:52.2 KD: Hello, Dental A-Team Listeners. This is Kiera, and you guys, I'm super jazzed because you guys may have already heard her, but I don't feel like I've been able to intro the one and only Tina Boyer. She's one of our traveling consultants, one of my dearest friends. She's only been with Dental A-Team for a little while. She's a freaking guru when it comes to dentistry, but her and I have known each other for a long time, and she may or may not choose to share why we've known each other for so long. But Tina, welcome to the show today. One of my faves, how you doing?

0:01:18.2 Tina Boyer: Hey, good. How about you?

0:01:21.0 KD: I'm doing super well, thanks. It's super fun to have you. This is the first time we've podcasted together, so how are you feeling?

0:01:26.5 TB: I'm good, and that was a great intro. I love it. How we've known each other for so long? They'll have to come back for a few episodes before they get to know that. [laughter]

0:01:35.8 KD: Tina's not willing to give away the farm right now, guys, so you'll have to come back, but Tina is awesome, guys. If you have not gotten the opportunity to work with her, she has raving fans across the board, so her practices love her. I adore her. I think the thing I love about Tina the most is Tina's a wizard, guys. She is so smart, and yet she's able to speak at the high, like, CEO, doctor-level and then also have it be very informative and empowering for teams 'cause sometimes, I feel like those two sides of the coin, #DentalATeamsPodcast, she really does a beautiful job of that. And Tina has raving team fans. We have offices who literally text their doctors and say, "Hey, when do we get more Tina time?" And I don't think most consultants have their offices craving for their team to actually work with the consultant more. So Tina, what is, like, one or two of your magic sauces as to why offices love you so much? That's awkward to put you on the spot, but I'm gonna ask, like, what do you think it is?

0:02:30.8 TB: Oh, I love that. That's lots of fun. I would say... [laughter] Why do people love me? Let me tell you. [laughter]

0:02:39.0 KD: That's why I wanna ask. I love uncomfortable questions, guys.

0:02:41.8 TB: Yeah, that's good. I would say that anyone that I come in contact with, I'm just trying to align with them where they're at and create the path for success that they're looking for. If that means that the office is looking to get to this objective, how am I going to help each team member realize what their path is along the way to get to that same objective, and really just making sure that this is easy, simple, and is something that that person knows how to do so they feel confident as they implement it and then integrate it into their office.

0:03:12.8 KD: Yeah. I love that because, at the end of the day, guys, that's, I think, what Dental A-Team is all about, and Tina embodies it so well of, let's make sure you guys are confident and know what you're doing. Let's also make it to where it's easy, and then let's make sure that we're all aligned in the direction that's really gonna move the needle forward. I think Tina can come in, and she has that, like, super... I feel like we're, like, playing Mario Kart, and we can see the mushrooms, and we can see where the gold stars are when we go into an office. We can literally see in your practices what you need to do to get from A-B. It's so clear, and then you're able to, like, navigate it and get it to team buy-in and doctor buy-in.

0:03:46.5 KD: So if your practice is a practice who's thinking about maybe having a consultant but afraid of that team buy-in, guys, I promise, like, this is something that's real life. We've got offices raving about it, and if you want that to be your office, be sure to reach out, [email protected]. We'd love to have you. Tina's a freaking rock star. You'd be lucky to have her as your consultant. You'll see 'cause today's topic is one that I think is a hot topic and kind of a boring one, but we're gonna spice it up, and that's about insurance verification. Oh, like, mic drop. It was on a high Tina," and now look. Hey, let's talk about insurance, it's verification, like, my least favorite thing to do.

0:04:21.5 TB: Yeah.

0:04:22.9 KD: But let's talk about it, 'cause I think it's important because, to me, I feel insurance verification, even though it's not sexy, it's not a super fun topic, this is what makes your life great or miserable. It is one of the foundational pieces, so Tina, take it away. What's kind of your take on Insurance Verification?

0:04:37.7 TB: Oh, I feel like that we look at insurance verification, one, most people don't want to do it, we're passing the ball of, like, "Oh, I didn't realize I was supposed to do that. That's so-and-so that's going to do it." "Oh, I thought so-and-so was going to do this." So really clarifying, like, who is responsible for this, but then looking at it a lot from the patient point of view of the closer that we can get their estimates when they're coming in the office, the happier they will be with their overall experience. We don't want them to leave and end up with an unexpected balance because now, they're feeling like, "Why is this here? What happened?" Even if it was something that's from their insurance, they are looking to you for you to be able to prevent that. So I wanna just put a bow on that patient experience and not end up having to send them a statement later.

0:05:19.0 KD: And again, that's why Tina's teams love her because as you just heard, Insurance Verification is for the patient experience, and that's really what it is. Yes, we can say all day long it's for the practice, but, like, none of us wanna have that patient fall off because we didn't verify their insurance correctly, we gave 'em a misquote. Like, I know, as a TC, I hated misquoting how much... Like, I can work my way out of it, and I know Tina can too, and I'm real good with word ninjing, but man, if I don't have to call them and be like, "Hey, so your insurance didn't pay, AKA we didn't verify. Let's figure it out." So I also think if, from a business standpoint, insurance verification helps you keep your AR much lower because then, we're confidently collecting. We're not having to chase as much money later.

0:06:02.9 KD: And so I feel like, well, yes, it's not super fun. It is a pivotal piece to me, almost as important as scheduling correctly 'cause your schedule can make your life miserable or awesome, and same thing with insurance verification. So Tina, if an office is wanting to check themselves to see how their insurance verification is, or they're like, "Hey, we've never done it, but we're gonna buckle down, and we're actually gonna get it done," what is, like, step one of Insurance Verification? I want insurance verification for dummies, like, the... Imagine that book flipping right now. We're gonna take you guys through this, so Tina...

0:06:32.2 TB: I love this.

0:06:32.8 KD: Take us through...

0:06:33.2 TB: This is good.

0:06:34.2 KD: How does this work out?

0:06:34.9 TB: Okay. [laughter] So I think one of the important pieces is just recognizing insurance benefits are tied to the group number or to that employer. So if I have called and I have received full benefits for this employer within the last year, I don't need to do that for that same group number, that same employer again because those same benefits are going to apply to anyone in my office that I'm seeing that has that same group number. So that's a big time saver.

0:06:58.5 KD: So Tina, what you're saying is I don't have to actually verify every single patient in my office?

0:07:04.5 TB: So you don't have to do a full breakdown of benefits. I like what you're doing here, though.

0:07:07.3 KD: Correct!

0:07:08.4 TB: Yeah. [laughter]

0:07:08.5 KD: Correct! No, it's so... Because...

0:07:09.8 TB: You're like, "Hey!"

0:07:10.7 KD: I can already hear... Like, I hope you guys heard that, and that's why I wanted to highlight that is because Tina just saved you guys hours of time because offices usually think with insurance verification, "I have to call every single patient, and otherwise, I'm not doing it," where no, it's every group number. And if you really will identify those two, it will save you thousands of hours of time. So I just wanted to put that out there that, like, no, you don't have to get a full breakdown for every patient if you already have that group number. You've gotta get every group number full breakdown every year, but not every patient, and I hope that that's a differentiator you guys understand, and if not, be sure to reach out so we can help you with that. But I love how Tina came in with a sinker, guys. Step one is let's save you hours of time 'cause I agree like, yes, you're right. A full breakdown, everything on there per group number, not... Like, every patient needs it, but it's by group number.

0:07:56.9 TB: Yep. And so, most of the time, when you're talking to doctors, they know which employers they get the most patients from, so they're like, "Oh, you know, that's easy. I'm getting 30% patients from this same insurance, same employer." Oh, that's great because now, you really only need to be calling on that full breakdown once. And then, as far as when patients are coming in, we're just checking this to make sure that they are eligible for benefits, that they have current benefits, and that needs to be done, I say, once every 90 days. So usually, you can come in for your preventative appointment, we can get treatment done, and I usually don't have to check again to see if you're eligible for benefits because there hasn't been a reason for you to just jump off of that eligibility.

0:08:36.5 KD: And also tracking that in your software will really help you. And so, Tina, how do you tend to recommend that people mark that they've verified that group number for that year, just as a quick time-saving hack?

0:08:48.1 TB: Yeah, so something that stays with that group number, so that's going to be in with maybe doing, like, an asterisk by where that group number is at. Maybe there's an asterisk by the employer's name so that that way, you recognize like, "Okay, in 2023, I used an asterisk. They have an asterisk. I know it's been done." In 2024, maybe I go to an exclamation point, and now I know it's been done for 2024.

0:09:13.6 KD: For sure. And even, guys, you can do asterisk 2023 or just '23, exclamation point, but the point is, have that on there so you can see it. And then what's great is then, next year, when you're verifying, you just go through the same process, but that will absolutely save you a ton of time. So Tina, my next question is, 'cause I hear this all the time and I see it in offices, people are picking up that phone and calling. Do you call for every insurance breakdown? [laughter] I'm like, Tina can't even let me get the words out. [laughter]

0:09:38.2 TB: I'm like, please don't. Only if I have to, right? And then, on those days, I expect some treats are coming in with some ice cream for me, some chocolate, something. I mean, let's get us through this. So what I'm doing is, you can change your appointment book view so that you can view patients by their insurance plan, and I'm just grouping together, "Okay, all of these patients have Delta Dental." And I'm going to look on Delta Dental's website for their provider, see if I can get all the information there. If I can't, I'm gonna try and get a fax back by calling the insurance and requesting they fax me back the benefits. Or if I do have to call a representative and actually get the breakdowns, I'm going to do as many patients at a time as I can. So I just got Delta on the phone, I'm gonna breeze through them the first patient, the second patient. I might get to the third or fourth, and they're gonna say, "Hey, you reached your cap for how many we can do this with," and I usually will try and butter 'em up, let 'em know, "Hey, we're having real fun today. I think that this has been a lot of fun. How about we do one more?" And sometimes, I can get them to keep going from there, so...

0:10:40.3 KD: Are you guys sick of trying to figure it out on your own? I know I am. When I'm trying to run a business, sometimes, I just think, like, "There's got to be a better way to do this." And so for me, my answer has been to find someone who's done it and does it really, really, really well. Like, I'm talking the best of the best of the best. I want someone who's been in my shoes, somebody who understands what I'm going through. When I was looking for the consulting business, I found a coach who literally has run a consulting business. Well, that seemed like the perfect fit. So you guys, right now, we have a few spaces open in our Platinum Consulting. That is in the consulting where we actually come to your practice. We help you get systems implemented. We don't just tell you what systems to implement, we actually implement them with you and for you. You guys, it is one of the best investments I have ever made is to hire a coach who understands the business I'm in, who's lived it, who's done it. And that's what we in the Dental A-Team do. We literally, physically fly to you. So if you're sick of trying to figure it out on your own, if you just want somebody who understands you, join our Platinum. I'd love to have you. I'd love to have our consulting team come out and see you, be in your office, be with your team, and truly help you get onto the easy path of dentistry. It doesn't have to be hard. So join us in the Platinum. We'd love to have you.

0:12:00.4 KD: I've never tried buttering up. I love that. I usually just asked. And this came from Tiff, I didn't even know you could do this, just ask for another representative so you don't have to get off the phone, but agreed. So much of that information can be collected, and if you guys just have a form that every person's filling in, awesome, we scan that in, we asterisk '23, whatever you need to do to know it, and then move along. And then like Tina said, you should not be calling every single plan. I think that that's a misnomer that so many people do, which is why insurance verification feels like a suck because if I'm having to call, one, every patient 'cause I'm not lumping by group numbers, two, I'm not lumping by insurance plan, and then three, I'm calling every one of them, yeah, guys, you are never gonna get anything done, but the reality is, if you can group it like this, like we're telling you, insurance verification can actually be pretty simple, and then it's just, "Good data in, we'll give you good data out." And so I do... I can hear Tina, and I'm sure you can hear some offices really will say to you, like, "But Tina, I just wanna have enough time." So if you're an office that feels like you don't have enough time, is this something that could be outsourced? Is it not something you recommend outsourcing? What's kind of your take on this whole outsourcing world for insurance verification?

0:13:07.2 TB: Yeah, this is definitely something that can be outsourced. I will usually just ask a few more questions to make sure that the protocol that we're currently following is one that goes over the fact that I'm not calling on every single patient every time, I'm calling on the group number once. If they are following an efficient protocol and they still want to outsource it, then there are great reasons to do that, and there's a good benefit. Your human capital, your team members, their time is valuable to you, so it's always weighing what's most valuable. Is it something that they're doing for me in office or is it spending that time calling insurance? If it's not doing those insurance verifications and you could be utilizing their time better in office, then yeah, outsource it.

0:13:46.4 KD: And I think there are some good companies to outsource, so I would also look at my cost because some of them are, like, 15 bucks per verification, but again, if they're just verifying our group numbers for us, that actually could be a massive ROI for you guys. So some companies that I'm a huge fan of, I know Tina is, there's Verific, there's VERIFIXED, there's Dental ClaimSupport, ESS I know has it. I would do some checking. I've heard some things about, like, Zuub and Medusind. I've heard those ones aren't as accurate, but they could have improved. But bottom line is, you've gotta make sure like, for me, sure, if I'm gonna outsource it, rock on, but you have got to 1000% make sure it's accurate.

0:14:21.0 KD: Otherwise, it does nobody any favors, and if it's not being inputted into your software, to me, I actually don't think that's saving you much time because guess what guys, these insurance companies that are verifying benefits, they're going to just getting group numbers, they're pulling that information and giving it back to you and then doing a quick internet search to see what that patient has used for this year or not. Like, that is what they're doing, which is why it's not always accurate 'cause they're just pulling from the group numbers. But I do think Verific with Vivic, he's pretty awesome. I know that company is pretty top-notch with their verification. Verifixed, Easy Dental ClaimSupport, I think, is another one.

0:14:54.5 KD: So that hopefully, is just, like, a Rolodex for you guys, but like Tina said, get your process correct first, and then outsource it because if you have that super dialed in... I don't know. I just think back, and I feel... I don't know, Tina, how you feel, but I kinda feel like I'm getting old-school, and I never thought I would feel this way, but I'm like, "Back in my day, there were no Insurance Verification Companies everywhere." Like you had to figure it out, which is why I think we've learned how to efficiently do it, so I feel like, for offices, take the challenge on because as a TC, I was a lot more confident when I knew that the insurance had been verified correctly by our in-house. But again, if you don't have a lot of manpower or you've lost team members, this is surely something. Delegate it out, outsource it. That way, you can be there. Tina, any other thoughts you've got on Insurance Verification or how to make it easier for practices?

0:15:41.3 TB: I think that those are all the main points as far as making it easier for practices. Sometimes, it's just recognizing what's happening when we aren't doing it correctly, and how that's impacting the patient experience, but also, we are now paying for it on the backside 'cause now, when we're going to collect for it later, that's also time that that team member's taking. I'd rather put that time, if I'm going to put it somewhere, then we're gonna put that at the front and get the insurance verification done correctly, make it so the patient has a good experience and then get those estimates accurate.

0:16:10.4 KD: Got it. Tina, what are some... Like, let's pretend I'm a brand-new doctor and I don't even know what insurance verification is. What are some of the things that doctors or owners or office managers could look for to know, was insurance done correctly, or was it not done correctly? What are some of those quick highlights to know, "We're not doing this right," or "We are doing it right"?

0:16:28.4 TB: So if you're ending up with patient balances later, then that's a clear sign that something's been missed. And so sometimes, what you see is there's a different person who's giving the estimate than who's entering in the payments, and that's totally fine, but whoever entering in the payments from the insurance is the one who's seen the fact of, "Were our estimates correct to begin with?" And if they weren't, you can start to identify, like, okay, I'm finding over and over again that these are... This is the group number that's not coming back correct or this is the insurance company that's not coming back correct, and looking for those connecting pieces of let's fix this because I don't want to have 15 more patients come back not accurate too. Instead, I'm noticing it right now, and I'm gonna take the next step so that I can go ahead and fix this which will, again, help with the patient experience, but then also make it so we're not spending that time on the backend and we get paid up upfront from the patient portion correctly so that our cashflow is a healthy, positive.

0:17:26.1 KD: Which is ultimately, at the end of the day, what it's for is great patient experience and to make sure our practice is profitable and that our cash flow is there. I do love how Tina just gave me some quick highlighted points to know. Also, another fun fact, do not enter a new employer every time, guys. Go look for that group number 'cause that also can get real funky because then we've got, like, 200 of the same employer, same group number. So really make sure that that's cleaned up and tight. That will also expedite this Insurance Verification Process for you, but really, bottom line is, like Tina said, I feel it's just getting all those patients. Maximize it so we're doing each group number, we're also clumping it by insurance plans, and then we're getting everything off of the internet that we possibly can, and then calling if we have to, and then buttering up. I love that. I wanna hear how many of you are buttering up their insurance people. I used to be a total jerk, and I'm like, "Just get me the info."

0:18:17.2 KD: That probably don't make me very many insurance friends out there. So definitely be kind to them, but then maximize it. And for me, I tried to consolidate it to say, "Hey, I only have one hour to get this done for the entire day." And then try to get myself at least a week out. Also on your schedule, you guys can put little notes if you're in open dental, you can put like INS and it can pop up on your appointment card, that way you know that the insurance has already been verified. If you're in Dentrix or other softwares, you can put that like a little asterisk on the procedure notes so it actually prints. So it's just a quick glance.

0:18:48.0 KD: You can actually see it. You can make appointment views where it's insurance name first, so it's easier to cluster. I just feel insurance verification to me is not hard. I feel it's a process to be disciplined and to really just make sure that we're doing it in a way that maximizes our time and our patient experience. Tina, thank you for that. I did wanna have like our last like couple of minutes today. I just wanted like, I didn't even have you share what's kinda your background in dentistry? How did you even get to Dental A-Team? Like how did Tina become awesome enough to be a consultant? What's kinda your background, what have you done?

0:19:23.0 TB: Oh, this...

0:19:24.1 KD: I wanted to see how people would get to know you a little bit better.

0:19:26.9 TB: Yeah, this is a lot of fun. So my dad is a dentist. I like to start there just because I feel like it gives me that view of what it was like in the home life for a dentist. So you could always tell when he was winning, you could always tell when he was losing. You could tell when he was stressed, when he wasn't stressed. And I originally went to school thinking, okay, I'm gonna become an oral surgeon or maybe I'll become a dentist. Not really sure. And along the way I ended up working a lot in the business side of dental offices, met some consultants and now I've worked with, as far as in the office, I've worked with many different consulting companies and I really just found like, hey, this is where my passion is at, is helping to realize the potential in these businesses.

0:20:13.9 TB: And I would see, most dentists, they want to provide that care for the patient and that's why they became a dentist. It wasn't so that they could deal with insurances. It wasn't so that they could do team morale. It wasn't so that they had all these other pieces that they had to do. They just wanted to provide a service to patients. And so what can we do now to open up that opportunity for them and give them energy so they have that to take to the patient. So I was like, okay consulting's for me. And then you and I have our long, beautiful history. [laughter] And...

0:20:44.9 KD: It's a beautiful... It's a beautiful story guys.

0:20:46.0 TB: Yeah.

0:20:46.1 KD: One day we'll share it with you.

0:20:47.8 TB: Yeah.

0:20:49.0 KD: So Tina, I'm curious, are you more passionate about the dentistry side of it or are you more passionate about the business and the gears and how it all comes together? What lights Tina's fire when it comes to dental practices?

0:21:00.0 TB: Definitely the business and the gears. I've done clinical side in the office and I just found I always gravitated to, I love numbers, I love seeing results in numbers, but it's even beyond that. I would say that as we get better at communicating with patients, we're helping them align with the treatment that they need. We're creating a path for them and we're going to see that in our production and collection numbers. But when I'm looking at numbers, I'm not looking at it as in, oh, are you producing and covering overhead? Yes, that matters. I want you to be here tomorrow. Your team wants you to be here tomorrow. Your community needs you serving these patients tomorrow. But I'm more looking at it like, okay are we talking with patients in a way that they understand? Are we making a path so that they can choose the treatment and get it done?

0:21:46.9 TB: We know that if you have decay today, it's not going to wait tomorrow by not treating it, it's just going to get bigger and you're just going to have a bigger problem later. And so to me it's if we are ending up with a lot of unaccepted treatment, if that number is growing, then we've identified that we have an opportunity to connect better with our patients and get it so they're getting the services that they need.

0:22:11.5 KD: And that's why I wanted you guys to hear Tina because I just love how her brain thinks. I love how she thinks about the practice, but from a clinical patient side and then also coming from a family side of it, I really do feel Tina is such a well-put-together person to consult. She gets the family side of it, she gets the clinical side of it, she gets the business side of it, and yet she's also wicked competitive. So guys, you're welcome to weigh in on, if Tina and I were in a competition, would Kiera or Tina win? Now I think I need to clarify what kind of a competition this would be. So let's just put us on Survivor and we have to stand on a post holding some stick in the air forever. Is Tina's mind or Kiera's mindset?

0:22:49.3 KD: 'Cause at the end of the day, it's not physicality. We're about the same. I think we're about the same heights, we look about the same. Tina's got short hair and cute glasses. I've got long hair, no glasses. That's about our only difference. I have freckles. She doesn't, beyond that we're about the same. She's freezing cold all the time. I'm freezing cold all the time. We're both super fair-skinned. We don't tan very well. Like we're pretty similar that way. So we'll both get massive sunburns on this. [laughter] But like I'm curious guys, way in on this, would Tina or Kiera win the challenge? And Allison will probably crop this up and put it as a real, and you guys can vote on it right there. But Tina, I just wanted to say thank you for being here. Thank you for being an amazing coach and consultant and just mentor to your offices, their going to be. And then thanks for sharing Insurance Verification today. It was a good time.

0:23:29.1 TB: Yeah, that was a good time. Definitely my favorite topic. [laughter]

0:23:34.9 KD: Tina's been in billing land guys, I felt like it was appropriate. But for all of you listening, if we can ever help you out, please reach out, [email protected]. And as always, thanks for listening. I'll catch you next time on the Dental A Team Podcast. And that wraps it up for another episode of the Dental A Team Podcast. Thank you so much for listening and we'll talk to you next time.



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