Dental insurance verification is the process of confirming a patient’s dental coverage with their insurance provider before offering any treatment. For dental practices, it’s a crucial step that ensures services are billable and covered—while patients avoid surprise bills and claim denials.
Whether you're a front desk staff member, billing specialist, or practice owner, verifying insurance before an appointment can improve patient trust, cash flow, and operational efficiency.
Collaborating for patient care requires constant connectivity and up-to-date information. Simplifying how you exchange that information with insurance companies is more important than ever since their coverage policies change annually. MedsDental makes it easy to work with insurance companies, from the first check of a patient’s eligibility through final resolution of your reimbursement.
Insurance verification is an extremely time consuming process for your staff. Benefit breakdown are not always available on the portal and that’s when your staff calls insurance companies and speak to representative which on average can take up to 45 minutes to confirm a verification, imagine call dropped!!! Moreover, incorrect insurance verification can affect your practice productivity in form of low collections, denied claims, high account receivable and the most important low patient turnover.
Skipping this step can lead to major issues, including delayed payments and unsatisfied patients. Here’s why verification should never be skipped:
Ensures accurate billing and avoids submitting claims for non-covered services.
Patients are fully informed about what’s covered and what’s not.
Helps patients understand deductibles, copays, and coverage limits.
Keeps your front desk organized and billing teams proactive.
Here’s a simple, actionable process dental offices can follow:
Collect Accurate Patient Information
Gather the full name, date of birth, insurance ID, employer details, and the name of the insurance provider. Confirm these during scheduling or before the first visit.
Contact the Insurance Provider
Call the insurance company or use an online portal to confirm
Record and Update Information
Document everything in the patient file and your practice management software. Keep a verification log in case issues arise.
Communicate with the Patient
Let patients know what their plan covers, what’s not covered, and any expected costs before their appointment.
Even when processes are in place, these issues often occur:
Long Hold Times
Insurance companies can be slow to respond
Outdated Information
Patients may not know about policy changes.
Human Error
Miscommunication between staff and providers can lead to wrong entries.
Last-Minute Verifications
Waiting until the appointment day can create chaos.
Dental process authority to fetch information directly from EHR system
Many dental offices now use software and third-party services to automate insurance verification.
Popular Solutions
Insurance verification is an extremely time consuming process for your staff. Benefit breakdown are not always available on the portal and that’s when your staff calls insurance companies and speak to representative which on average can take up to 45 minutes to confirm a verification, imagine call dropped!!! Moreover, incorrect insurance verification can affect your practice productivity in form of low collections, denied claims, high account receivable and the most important low patient turnover.
Outsourcing verification to a specialized billing team can:
Billing certain procedures under medical can be beneficial for both you and the patient. Our specialist can assist in coding and billing a wide range of dental procedures under medical including but not limited to implants, dental diagnostic and preventive procedures, dental restorations of fillings, tooth replacement as well as endodontic procedures such as root canals.
If you want to know your practice setup can process dental procedures under Medical.
The complexity of dental benefits is market driven. It can be time consuming for the dental office to first learn about and then explain the terms of any particular policy to a patient. Also, since policies can change at the beginning of a plan year, this can make it very difficult for any dentist to understand how they will be paid for any procedure. Dentists use the pre-authorization process to determine a patient’s coverage.
The slow turnaround on a preauthorization often creates frustration for patient and practitioner. The process can be used to uncover proposed treatment which is not covered or is disallowed. Patients must understand the benefit outlined in the preauthorization is tempered by the allowable benefits at the time of service, not the time of preauthorization submission. “Preauthorization” and “predetermination” are processes that payers make available to dentists to clearly determine the potential benefits for a specific patient. These are distinct and different terms and processes which are outlined in many state statutes. They are not interchangeable. (“Pre-approved” is not a term generally used by payers.)
Avoid the frustration of collecting additional payments that fall between an estimated co-pay and what an insurance policy covers. An angry patient is far less likely to pay because they feel betrayed and tricked. Using the MedsDental platform to help you verify your patients’ insurance up front, you significantly reduce this issues in your practice and save thousands each year!
Having updated and accurate insurance information on file for your patients means you can provide accurate treatment plans and better estimated costs to your patients. This decreases the likelihood of a patient having an outstanding balance when the insurance company has paid its share. Keep your patients happy and your accounts receivabe low with the better insurance verification!
We don’t have to tell you that when a patient is happy your practice is profitable. Balances are paid, no-show appointments are reduced, and patient referrals flood in. Eliminate the unpleasantness of having to tell a patient they owe you far more than you quoted them.
It’s the process of confirming a patient’s dental benefits and eligibility with their insurance provider.
Government programs such as Medicare have their provider enrollment, chain, and ownership system (PECOS). The approval of provider enrollment and provider credentialing in medical billing is faster than commercial insurance providers, and Medicare has an average approval time of 41 days. On the other hand, commercial insurance carriers can take anywhere from 60 to 180 days. Therefore, this is a game of waiting, hurrying, and waiting again.
Timely arrangements of the required documents, e.g., malpractice, DEA, state license, and various other documents, with the utmost efforts of initial research with every state payer to have everything ready before filing the new credentialing applications.
The first and foremost thing is to initiate applications with available IPAs to get contracted in the first place. Otherwise, we can escalate/expedite our request to join the network with payers in the form of appeals.
Full name, DOB, insurance ID number, group number (if applicable), and provider name.
Dental insurance verification isn’t just an administrative task—it’s a strategic process that helps practices reduce losses, improve cash flow, and give patients a smoother experience.
Want help verifying dental insurance or managing your billing more efficiently? Contact us for professional RCM and verification services customized for dental practices.
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