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Common Barriers to Obtaining Coverage Details from Dental Insurance Companies


We all feel a massive panic attack coming on when the patient asks, "Can you find out what my coverage is?" Dental insurance companies have made it so difficult to assist our patients that we often fail to provide them with all of the answers to their questions. Dental insurance companies exist to make money, not to help their customers.


Why? Because we would have all of the information and would assist our patients in understanding their plan so that they could take advantage of the benefits to which they are entitled.


There are some difficult ways to obtain only specific information.


Calling them is one option. Some insurance companies will give you a general breakdown that is not detailed, some may include some brief frequencies, others will only disclose the portion of coverage, others will only provide eligibility for only certain procedure codes, while others will dismiss you after a painfully lengthy wait on the line, stating that they do not disclose plan details without the member's consent. Another difficult aspect is that certain customer service representatives can't always answer all of your questions and frequently aren't sure what they're talking about because they lack of knowledge or training.


The second option is to check plan details online (for only specific insurance companies that allow online services for providers). It works in some cases for specific things you want to know, but there are always unknown variables and incomplete information. In certain cases, the plan does not come through, and we are forced to call and wait on hold.


The third option is to send a quote. We may receive a reply straight away, or the answer will be sent via mail. The response is sent to the patient, and we must then contact our patient, who is a person with a lot on their plate. To obtain information from the patient, at least two phone calls are required. Either that, or have the patient call the insurance company and give permission to share the estimate results with their dental care provider. Following that, we must contact the insurance company to obtain information and then contact the patient to discuss the results.


Meanwhile, the phones are ringing as I navigate through all of the time-consuming options. As receptionists, we must balance answering patient inquiries with the fear that the customer service representative will pick up the phone and hang up. That diverts our attention away from our patient on the phone or the patients who walk in who deserve our full attention.


Also, due to all of the privacy policies that they've implemented over the years, they don't disclose any plan changes or deactivation with us, and the patient has no idea what's going on, which causes problems and consumes their time.


Patients are unfamiliar with dental policies and rely on us, but I always have to rely on my experience to fill in the gaps, and with that method, I can't really guarantee that it will be correct, because every policy is unique, and I am still surprised by some quite interesting and different rules that the policy contains. This explains all of the valuable time we have to spend obtaining information that is limiting, not always correct, and prevents us from helping our patients in the way they require.


Thanks to iVerify automated dental insurance verification, we can now say goodbye to all of those headaches!


They have direct integration with over 300 insurance companies, you'll have all plan details in seconds, and the fee for the service is not comparable to how much time you'll save and how much confidence you'll gain from the patient. It is especially important with new patients. Their inquiry does not end when they leave the office. Consider how much easier it will be for them to proceed with their required treatment once they have answers.


When I learned about this automated dental insurance verification software, I was relieved that there was finally a solution to my problems as a front office staff member, because many of the patient's questions and concerns are about insurance details. Because we have all of this information at our fingertips, we can provide our patients with the care they deserve.


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