Services

Insurance Verification:

 Verification of patient benefits completed through insurance portals and direct carrier contact to ensure accurate coverage details before treatment.

Services include:

• Verification through insurance portals and live representatives

• Documentation of benefits, limitations, frequencies, and waiting periods

• Breakdown of patients' responsibility and estimated out-of-pocket costs

• Updating payment schedules based on prior services and insurance network guidelines

• Uploading verification details directly into the patient's charts

Treatment Plan Follow-Up: 

Follow up with patients who have unscheduled treatment plans to help dental offices recover missed production, answer insurance questions, and encourage scheduling.

 Services include:

• Review of unscheduled treatment reports

• Follow-up communication regarding recommended treatment

• Assistance answering insurance estimate questions

• Encouraging of scheduling through the dental office

Claim Support: 

Support for insurance claim submission, troubleshooting, and follow-up to help prevent delays and ensure claims move through insurance process efficiently. 

Services include:

• Claim review prior to submission

• Assistance with rejectied or delayed claims

• Insurance folloow-up for unpaid claims

• Communication with insurance representatives of claim status withing patients accounts and accurately noted

Pre-Authorization Follow-Up: 

Tracking and follow-up on submitted pre-authorization to prevent treatment delays.

Services include:

• Monitoring outstanding pre-authorizations

• Contacting insurance companies for status updates

• Documenting approvals, denials, and requesting information

• Updating patients' charts with authorizations

Accounts Receivable Management:

 Follow-up on outstanding insurance and patient balances to help reduce aging accounts and recover missed revenue.

 Services include:

• Insurance aging follow-up

• Research and resolution of unpaid or partially paid claims

• Patient account review when appropriate

• Insurance payment investigation and correction

• AR report review and cleanup - 30/60/90+ days

Insurance Payment Review & Underpayment Audits

 Audit insurance payments to identify underpaid claims based on contracted fee schedules and previously processed claims.

 Services include:

• Reviewing EOB payments against fee schedules

• Identifying follow-up to correct payment discrepancies

• Documentation of adjustments and corrections