Why Your Practice Should Automate the Insurance Verification Process

There are some work tasks that are a hassle to do. It’s the tasks that have many small “work for work” steps you have to take. Verifying your patients' insurance is one example. It’s time-consuming because you have to be methodical about it. Because you know that if you give patients the wrong information, it leads to a poor patient experience and claim rejections. It also takes a toll on you and your team because you'll be on the receiving end of an upset patient.

The reality is many dental practices lack the right solution and/or process to verify insurance in an efficient, reliable way. Practice teams spend a lot of their days tracking down insurance details for every patient. They do their best to be as thorough as possible. But, with the current process of calling providers, logging into provider portals to verify information, or using a pricey tool that doesn’t provide accurate data, there’s always a possibility that what’s shared with patients may or may not be accurate leaving the patients to wonder if they’ll receive a bill or not and how much it will end up being. That’s a stressful situation for patients.

The encouraging news is that you can change your process if it’s not working for you and your patients.  

In this post, you'll learn the pitfalls of your existing process, how an automated verification tool can help, and what to consider in a new solution (when you’re ready and if you have the budget).  

1. The pitfalls of manual processes and some automated tools

As the saying goes, “change is hard.” But think about what’s currently happening as you verify insurance for each patient with your current method:

  • Time-consuming, More Admin Work: In a study done by CAQH and the Colorado Dental Association, it can take practice teams an average of 24 minutes, per patient, to do benefit and eligibility checks using a standard process. It’s understandable when you think about all the small steps it involves: Calling the provider, searching for the different provider portal login credentials, keying the information into your practice management system (PMS), calling or emailing the patient to let them know what’s covered and what they’ll owe, waiting to hear back from the patient and answering follow up questions. It’s inefficient and these aren’t the only tasks you have to get done each day.  
  • Prone to Errors: You’re human, so mistakes can potentially happen when verifying insurance manually. Unfortunately, these errors can impact your practice in a lot of ways including claim denials, upset patients, negative reviews, retention, and more.
  • Higher Accounts Receivable: If you submit inaccurate claims, this leads to denials and delayed payments and affects your collections. It also increases the amount of time you spend correcting and resubmitting the claim, adding to your workload.  
  • Difficult to Scale: Whether you’re a new or established practice, growth is a priority. As your patient base increases, it will be harder to rely on manual processes to get work done. This can lead to potential burnout, impact quality of patient care, and increase your workload.  

2. Benefits of an insurance verification tool

If you’re open to changing your process, there’s several advantages to investing in an automated insurance verification tool.  

  • Increase Efficiency: One of the biggest benefits of automation is that you’ll be able to verify insurance faster. If you currently verify 10 patients a day manually, and you switch to an automated solution, that’s over 4 hours/day you’d get back to work on other high value jobs around the office.
  • More Accuracy: Some insurance verification tools connect to provider portals to ensure accuracy in verifying patients' insurance coverage and eligibility. They also provide comprehensive reports so you can give patients a clearer understanding of what’s covered and what they owe.  
  • Scalability: Automation can help you scale and keep up with the growing workload and number of patients you serve. You’ll spend less time on this task and more time making patients happy.
  • Lower Accounts Receivable: You’ll get a comprehensive report from an automated verification tool which helps you submit cleaner claims that are less likely to be rejected.  
  • Increase Patient Satisfaction: Quoting patients with the correct cost estimates means setting the right expectations and giving patients the time to budget for their dental care. This increases their trust and respect for your practice so they’re likely to return and recommend you to their peers.
  • Tighter Integrations: An insurance verification tool should be integrated into the vendor’s other systems, so you don’t find yourself switching in and out of tools, disrupting your focus. The tool should also be able to write back insurance information to your PMS and/or store it as PDFs in your PMS document center, reducing data silos. Having consistent insurance information across systems helps you give patients the appropriate care.  
  • Better Compliance and Security: You’ll have higher standards around maintaining HIPAA compliance and personally identifiable information (PII). Data breaches always leave a stain on a business or healthcare provider, and it does influence how current and prospective patients view your practice.

3. How to choose the right verification tool (for your practice)

Like with any solution, it’s worth evaluating both the product and vendor. You can make a pros and cons list to help you decide. Talk with your team to get a clear idea of where you’re struggling and what could be helpful.

Here are some considerations you can think about.  

  • Verification Method: How does the solution verify insurance? Does the information come directly from the provider portals, or clearinghouses only? Provider portals tend to be the most accurate, up-to-date data you find, so tools that leverage provider portals tend to be more accurate.
  • Scope of Verification: What does the tool verify? What kind of reports would you get? The more detailed the reports are, the better off you’ll be quoting patients what’s covered and what they’ll owe.  
  • Onboarding and Setup: Find out how long the onboarding takes and what it entails. Ask questions like onboarding length, what information you’ll need to provide, what you have to configure, to name some. You’ll be more prepared for the transition if you have the information early on.  
  • Security: Ask what the vendor does to keep PII data secure and maintain HIPAA compliance.  
  • Support: Will you have a customer success manager and a support team to contact if you have questions? Check out the vendor’s Help Center to see if it’s up to date. Look at review sites to see what other practices have to say. It’s helpful to have a human to talk to and have a place where you can troubleshoot things yourself.
  • Integrations: Find out if the tool integrates with your PMS and other tools. As you invest in your tech stack, you want the tools to play well together and ensure there’s consistent data across systems.
  • Cost vs Benefits: Cost is important, and for many, it can be the deciding factor. Before you begin searching for a new tool, get clear on what matters most to your practice and what you want to accomplish with it. Have a comprehensive list of pros and cons when you’re evaluating solutions. This way you’re looking at it holistically instead of making a snap judgement based on one factor.  

Dental insurance is a complex and sensitive topic for patients. It’s why the “admin” piece of the practice experience matters just as much as the quality of care they receive from the clinical side. Getting the wrong benefits information and an unexpected bill can shake up a patient’s livelihood. And you can be on the receiving end of a patient’s emotions. Investing in a reliable verification tool can go a long way in helping you do your job efficiently and giving patients the right insurance information, so they have a positive experience with your practice. Your role in a patient experience is equally impactful as the clinical teams. But you and your team need to be equipped with the right tools to do that.

RevenueWell has a dental insurance verification tool that automates your verification process. As part of the Marketing Platform, the tool will verify insurance prior to a patients’ appointment by verifying data from a combination of provider portals and clearinghouse data that you connect to the RevenueWell system. You’ll receive a comprehensive verification form or eligibility report to put together cost estimates for patients. Visit our website for more information.