Importance of Comprehensive Insurance Verification for Periodontal Care

by | Published on Apr 1, 2022 | Dental Insurance Verification (P), Podcasts | 0 comments

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Outsource Strategies International is experienced in providing comprehensive dental insurance verification services in the U.S. As a medical billing company assisting physicians and other healthcare entities, we understand that in the field of dentistry, verifying eligibility benefits for every patient is key to maintaining a smooth flow of revenue for the dental services provided.

In today’s podcast, Loralee Kapp, one of our Solutions Managers, discusses the importance of comprehensive insurance verifications for periodontal care.

Podcast highlights

00:11 Importance of insurance verification for periodontal care

01:35 How a medical billing company can help

Read Transcript

I am Loralee Kapp, Solutions Manager with Managed Outsource Solutions, and today I want to talk about the importance of comprehensive insurance verifications for periodontal care.

00:11 Importance of insurance verification for periodontal care

Periodontal care ranges from routine treatment to treating advanced gum disease and may be covered by a dental insurance plan, which makes verifying insurance benefits crucial to avoid claim denials and ensure appropriate reimbursement. It is important to verify coverage for surgical and nonsurgical periodontal treatment prior to the visit, as the dental benefit plan may provide coverage for conditions such as periodontal gum disease which is a bacterial infection of the gums. This is caused by an infection called gingivitis that can be treated with dental visits. Treatment for these conditions may be covered by the dental plan. Insurance may provide full or partial coverage for periodontal treatment. There may be an extra cost for cleanings related to preventing gingivitis from progressing to periodontitis, or have periodontal maintenance coverage for patients who have historically been treated for periodontal disease. It is also crucial to verify patient’s coverage, as they may be responsible for the cost of care. Dental plans are unique in that dental care is not an insurable risk, so the total maximum benefits are small, making claim submission and payment complex especially with the recent cost shifting to patients which makes proper benefit verification extremely important prior to providing care.

01:35 How a medical billing company can help

Relying on a medical billing company can alleviate some of the headache and complexity of dental billing, as they have specialists who verify plan coverage details including waiting periods, plan exclusions, co-pays, coinsurance, deductibles, effective dates, out of network benefits, insurance mailing address, and if a pre-authorization is required.

Make sure to partner with a reputable billing company that is HIPAA-compliant, to ensure clean claim submission with professional services including insurance verification and authorization as well as being able to follow up on the claim submission with efficient billing and collection services. Experienced companies can work within your billing software, as if they were an extension of your office as well as reduce the number of claim denials, increase your work flow and reimbursement rates by submitting clean claims to begin with. This enables practices to focus more on the patient care.

For more information on our services, please contact our Solutions Manager today.

Loralee Kapp

Since joining our RCM Division in October 2021, Loralee, who is HIT Certified (Health Information Technology/Health Information Management), brings her extensive expertise in medical coding and Health Information Management practices to OSI.

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