Having up-front, real-time eligibility verification helps a practice answer patient questions, determine accurate deductibles and co-pays and ensure claim information is accurate before submission. Possibly more importantly, an informed patient is a loyal patient, and one that is more likely to schedule the recommended treatment plan.

Top three things to know about eligibility verification:

It impacts claims submission. Eligibility verification is the first line of defense against denied claims. Practices that don’t verify benefits have twice the denial rate of those that do. In fact, two thirds of all denials are linked to eligibility issues, costing the practice time and money. Taking this extra step helps to eliminate unnecessary administrative follow-up and time spent resubmitting claims.

The method matters.  Eligibility verification via phone, fax, payer websites or claim submission software can vary greatly in the amount of time they take. When determining the best means of predetermining eligibility, you should factor in how much employee time is used for the process. While this is a soft cost that can be hard to quantify, it quickly adds up. For example, manually calling and checking each patient’s information may take hours a day, while real-time claims software only takes a few minutes. This reduces human error and leaves more time for patients. See an example of how to calculate your time spent verifying eligibility each month.

Patients are affected. While benefits and coverage types change often, patients are not always kept fully up-to-date on these changes or even receive new insurance cards. And as their trusted dental resource, they come to you for answers. It may not be your responsibility to know a patient’s benefits, but it’s been shown that having this information up front tends to make patients more comfortable about scheduling procedures. In the end, predeterminations enable office managers and dentists to engage in more comfortable conversations about finances, resulting in more confident, satisfied patients.

What's New at MDE

Mark your calendars! Teresa Duncan, experienced dental practice consultant and editor of the Progressive Dentist, will present at the Virginia Dental Association (VDA) Meeting in Williamsburg, Va. on June 16. This MDE-sponsored seminar will cover the basics of dental office management; dental, periodontal and implant coding; and A/R and insurance management. To learn more and to register to attend, visit the VDA website.

Information Center

• Elevate yourself to “Super Hero” status with MDE’s “How to Become a Revenue Cycle Hero” workshop in Boulder, CO on Friday, June 22. You’ll learn the 6 Steps to Becoming a Hero at your practice. We will also provide you with detailed information on how to manage your revenue cycle for maximum profitability. Please visit our News & Events page to register and to find more information.

• Please join us for one of MDE’s informational webinars, “Why MDE, Why not?” MDE offers the tools to bridge the gap between you, the payer and the patient with instant predeterminations and EOBs and takes the guesswork out of the patient and payer financial responsibilities. MDE helps practices reduce denied claims, improve case acceptance and accelerate cash flow. For more information, please visit our News and Events page.

MDE Highlights

Did you know you can check benefits for a day’s worth of patients with just one click?  With MDE’s Eligibility and Benefits solution you can drastically reduce the time you spend on the phone with insurance companies verifying benefits. Knowing your patients’ benefits before they come into the office helps you more accurately estimate patient payments so you collect payments up front. Checking eligibility and benefits for every patient at each visit also helps cut down on denied claims and rework. Don’t forget – your time is money, so use it as wisely as possible.

To learn more about how MDE can help, visit www.whymde.com or call 866.633.1090.