Case Study: Dental Insurance Verifications Done Successfully for U.S. Based Dental Practice

Dental Insurance Verifications Provided for Dental Practice

Overview

Outsource Strategies International (OSI) has been providing dental insurance verification and prior authorization services to dental offices in all 50 States, for many years. This client is a U.S. based dental practitioner, a one-physician practice located in Washington DC, who needed our support in verifying patients’ coverage, to streamline their front office operations and improve the quality of patient care.

The Challenge

The entire staff here was busy dealing with patients and providing quality care. The client contacted us for accurate dental insurance verification services.

They needed 10-20 verifications to be completed per month.

The Solution

The verification form that we follow for this client is very extensive, making the verification process for each one time-consuming. “Extensive” in the sense, they had a whole lot of codes to be specifically verified and wanted extra information on them as well such as limitations and frequencies.

We implemented the Piece Rate model and handled the volume with a 24-48 TAT.

We found that pricing per verification was in the best interest of the client, due to how extensive the form is but also with the low volume due to COVID. We were able to price the piece rate to be cost effective for both the client and us – win-win for sure.
To implement this Piece Rate model,

  • We spoke with the team about realistic expectations regarding how long it would take to complete each verification using the client’s form
  • Worked out the price per verification to benefit both parties.

The Result

The client is very happy with the quality of the verifications and the process. Piece Rate model is essentially like paying per piece. No issues have come up so far. The team has handled the verifications really well and the client remains satisfied with our services.