DECODING DENTAL BENEFITS
PERPETUAL PERPLEXITY!
As long as there has been dental insurance, there has been confusion: for dentists, for team members, and for patients. Patients often think dental staff are responsible for interpreting their dental insurance benefits, rather than their employers. In fact, one of the most appreciated services mentioned by satisfied patients when surveyed is deciphering the benefits due them and filing their claims with the third party payer.
Patient portals, now available from most third-party payers, are the surest way to find accurate information regarding a patient's plan. Portals can be accessed quickly, providing information such as member benefits and eligibility, details of claim submission, history and status of pending claims, and on-demand print forms. Some payers allow submission of real-time claims and pre-treatment estimates. Furthermore, plan limitations, deductibles, and frequencies are often available through the portal.
Such information can be used by dental staff to alert patients to their financial responsibility in order to collect deductibles and non-covered fees as treatment progresses. Many offices find the collection percentage rate improves significantly with the use of patient portals to educate patients about their benefits.
Although a few dental plans use third-party websites which might limit information such as pre-treatment estimates or the status of pending claims, the majority of insurance companies maintain their own portals to allow direct access to their plans. The wealth of information available on these portals is well worth the time and effort staff expends learning to use them. The ADA Center for Dental Benefits, Coding, and Quality is a resource for dentists and staff with benefits-related concerns or problems. Access the Center by email at dentalbenefits@ada.org or by calling 1-800-621-8099.
Be sure to check out our Free Resources for Your Practice for additional insights, information, and practice management tips.
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