Jaycee Brown

Jaycee Brown

Director of Communications

Why is Insurance Verification So Important to Our Clients?

In the past, whenever I visited my dentist, I did not worry about insurance verification because I assumed that my father’s insurance plan would cover every treatment. My dentist always cleaned my teeth thoroughly two times a year. He or she then recommends ways to clean my teeth better at home, such as flossing, using a proxy brush, and brushing the back of my teeth. At one point, when I had braces, I could not floss well in the back regions of my teeth. A few months after my orthodontist removed my braces, I visited my dentist for a cleaning. She observed that in the back areas, my gums accumulated bacteria, causing them to be inflamed. Fortunately, my dentist had a laser to treat those areas. Before she could proceed with this procedure, she relied on her staff to check if my father’s insurance plan covered this treatment. According to Ashleigh Swanson’s blog, “Verifying Patient Insurance Benefits,” on the Lockton Affinity Health’s website, “In cases where patients are covered by an insurance plan, it’s equally important to verify their insurance eligibility before you provide any care. Failing to do so could leave you with an unpaid claim by the insurance company or a patient unable to pay their bill in a timely manner.” In my case, while my insurance covered my cleaning, my dentist’s staff told her that my father’s insurance plan did not cover the laser treatment. Nevertheless, I paid out-of-pocket for it because I wanted to take good care of my gums. I know that medical treatments are not free, but this memory still feels surreal to me since I am used to not paying the clinic during a cleaning appointment.
My experience showed me that insurance verification is important for both patients and dental clinics. According to MB-Guide.org, “Each patient’s insurance needs to be verified each time they come into the office. Although it takes time, it is one of the most important responsibilities of the medical office staff” (“Verification of Patient Insurance Coverage”). Regarding services, including cleanings, MB-Guide’s site states, “In order for insurance to pay for a patient’s medical claims, the patient has to be active and the service has to be a covered benefit. When you verify benefits, on the other hand, you are checking to see if the patient has coverage for specific services, as well as how much insurance will pay for these services, if anything at all” (“Verification of Benefits”). Although my dentist recommended that I should get the laser treatment, I appreciated that she notified me about its cost, implying that I could choose whether she could apply the laser on my gums. Through the process of insurance verification, dental clinics foster more awareness of the costs covered and not covered by insurance, allowing patients to determine the best course of action to take care of their teeth and gums.
 

Swanson, Ashleigh. “Verifying Patient Insurance Benefits.” Lockton Affinity Health. Accessed
July 3, 2017. http://locktonmedicalliabilityinsurance.com/verifying-patient-insurance-benefits/.
“Verification of Benefits.” Mb-Guide. Accessed June 30, 2017.
http://www.mb-guide.org/verification-of-benefits.html.
“Verification of Patient Insurance Coverage.” MB-Guide. Accessed June 30, 2017.
http://www.mb-guide.org/verifying-insurance-coverage.html.

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