June 28, 2023

The 7 Best Practices for Dental Insurance Verification

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Here’s a Breakdown of How to Verify Dental Insurance the Accurate (and Easy) Way

In talking to dental offices nationwide, one universal complaint I hear is the cumbersome process of accurately verifying dental insurance. But with more than half of patients having some type of dental coverage, it's imperative for your business to master this process. To make it easier, many organizations consider outsourcing the process. However, that is made even more challenging by the variations between payors, practice management systems (PMS), and clearinghouse providers.

If you’re grappling with the dental insurance verification process, these seven tips can streamline procedures, ensure accuracy, and make your job a little easier.

1. Verify Coverage Before Appointments 

Make sure to verify patients' insurance coverage before their appointments. This allows you to avoid any surprises resulting in an unexpected bill. Your PMS should have a simple user screen to allow entry of the verified CDT codes and items.  

2. Confirm Patient Information

Always confirm patient information, such as their name, date of birth, and insurance plan identification number. When you have accurate information, you can ensure there are no mix-ups when verifying coverage. In fact, typos or inverted numbers in DOBs are the number one reason claims are sent back.  

3. Understand Insurance Policies and Limitations

Familiarize yourself with the insurance information, such as policies and limitations, to understand how the insurance company will cover the procedure. Your PMS should also have detailed insurance benefit details by payor and plan.  

4. Document Everything

Always ensure that you keep detailed notes of the insurance verification process. This includes the date and time of the call, who you spoke with, and what you discussed. Additionally, you should update these notes right in your PMS as it is the legal system of record.

5. Educate Patients About Their Coverage 

Educate patients about their dental insurance coverage limitations, any out-of-pocket expenses they may incur, and any needed pre-authorizations. It provides a transparent, full breakdown of costs for patients. Sharing details on the explanation of benefits (EOB) also helps patients understand why an item was paid less than they perhaps originally expected. 

6. Complete All Three Phases of the Eligibility Process

As your office staff verifies each patient, be sure to complete all three phases until every appointed procedure code is confirmed.  

  • Real-Time Electronic Eligibility: This provides instant verification, reducing wait time.
  • Payor Website Check: An extra step to cross-check the information and ensure accuracy.
  • Payor Phone Call: This can clarify any remaining questions and provide the most accurate information.

7. Check for Updates

Verify insurance coverage for every patient at each visit, as policy changes or other updates may occur. This should always include co-pays, annual max confirmation, and lifetime max confirmations for each patient. Treating each patient as one group ensures the most accurate data for estimates and predictive insurance AR.  

Let Ora Guide You Through the Dental Insurance Verification Process

By following these best practices, your dental practice can ensure patients accurately understand their insurance coverage. Likewise, you can reduce unexpected bills and improve overall patient satisfaction while enhancing your revenue cycle management time. 

Ora is one of the few platforms that can help you effectively manage each of these best practices. With its Electronic Claims feature, dental insurance verification becomes a streamlined process.  

Ora empowers dental practices with end-to-end tracking of claims, removing the need for manual follow-ups. It allows for unlimited claim processing, making it cost-effective for high-volume practices. Additionally, its real-time claims dashboard and emphasis on accuracy ensure fewer rejections and improved acceptance rates.  

With Ora, your dental practice can transform the daunting task of dental insurance verification into a manageable, efficient process. Take a step towards revolutionizing your eligibility verification experience by scheduling a demo with Ora today.  


ADA Position on Explanation of Benefits (EOB) Statements. (n.d.). American Dental Association. Retrieved June 8, 2023, from https://www.ada.org/en/resources/practice/dental-insurance/ada-position-on-explanation-of-benefits

Documentation/Patient Records. (n.d.). American Dental Association. Retrieved June 8, 2023, from https://www.ada.org/en/resources/practice/practice-management/documentation-patient-records

Michas, F. (2022, February 21). Dental patients by insurance coverage U.S. Statista. https://www.statista.com/statistics/964707/dental-patient-distribution-by-insurance-us/

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