Want your full insurance cover paid? Choose your dentist wisely

Having the right financial cover is a pressing factor when it comes to dental healthcare. Despite being expensive, it is a necessary investment we have to make in order to ensure our overall health in the long run.

The American Dental Association says that approximately 65 percent of Americans own dental health insurance. These people, who have their services covered, are more likely to take routine dental check-ups and undergo necessary procedures and thus less likely to develop complicated medical situations like heart diseases, osteoporosis, and diabetes (according to a study by the National Association of Dental Plans).

The insurance package may not completely cover the expenses we incur at a dental practice. Sometimes the claims may get partially paid or at other times it could be turned down completely.

Getting that superb smile and staying orally healthy is crucial, not just for the tooth but for overall health too and for this, a patient must do more than just pay his monthly due to an insurance provider. Believe it or not, your choice of a dentist goes a long way in your success on the insurance front too.

A right dentist is not just the skilled medic who can ensure your gnashers stay dashing but they also ensure, from a medical point of view, that your care is periodic and supported.

So what are the reasons why someone might end up with a heavy unsupported bill for dental healthcare?

They could be several, ranging from authorization and credentialing issues to manmade and mundane errors. Very often the validity of the dentist’s work license may become a reason for rejection by the insurance house. The registration status of the dental practice could also be a trigger. Further on another very common reason for denials and rejections is inconsistency in the records- like wrong birth dates or subscriber IDs or any other digital content. Such errors are more common in facilities where non-electronic data and claim processing takes place.

Some insurance policies may not cover the procedure that your dentist performed for you or it could so happen that the performed procedure was covered but was recorded in your insurance documents with a procedure code (the treatment code used to identify the procedure performed) which could be unsupported or uncovered by the scheme. It is also possible that the treatment performed was complicated enough to warrant preauthorization or requires post-procedure authentication with the support of medical documents and other digital records like X Rays. If the dental practice fails to produce these vital pieces of information your company could deny your claim leaving you staring at a huge dental healthcare bill.

Well, all this information could leave you worried as these errors do not creep in from your side. Your claims could be denied or rejected because your facility wasn’t equipped with the best dental practice management systems and protocols. Now how do you mitigate these risks?

One way is to see how digitally savvy your dentist and dental health facility are. Don't worry, it is easy to assess. Since most of the factors that can cost you your insurance cover are mundane errors that creep in during data entry or are errors of omission, the key to better insurance delivery will be to choose a more digitally upgraded provider. There are facilities that let you check-in through kiosks, book online and other means to ensure your information is loaded into the facility’s database by yourself- thus reducing chances of error, speeding up the process and saving your time.

Modern dental clinics with upgraded practice management also ensure that patients get full disclosure and discuss the procedure and costs with the clients beforehand, thus letting you cross-check whether your service is covered by the insurance scheme that you have. As an additional step, you could also cross-check the treatment codes that the dentists enter in your charts as these codes are available on the public domain. If your facility has a web portal to store your medical and treatment records that you can access remotely, even at home, you could easily do these cross-checks to ensure your finances are secure.

Another major reason why claims go unpaid is delayed filing. Again, if your provider is set on the old fashioned paper claim submission mode, you could lose out as the process would be cumbersome, error-prone and possibly crawling compared to providers who are digitally upgraded.

So next time you go to fix your tooth make sure you are at a place where you move digitally, from front desk to payor end- happy smiling!

For more details visit - https://carestack.com/

CareStack is an all-in-one, cloud based dental practice management software with built-in scheduling, clinical charting, patient financing and analytics.