Outsourcing Dental Insurance Verification

To outsource or not. That is the question!

Being a dental insurance coach one of the many questions that I get each week is “Do you think we should outsource our Insurance Verifications?” 

My answer to everyone is the same: Maybe.  

This is not an easy yes or no question.  You want to explore what you are trying to accomplish along with goals and budget.  Many offices are looking for that quick fix when they think about outsourcing their breakdowns and verifications and AR, but in many cases they do not get the results they wanted.

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One of the consequences that has resulted from Covid-19 and the shut down of the country has been a lack of qualified workers. Combine that with many parents in the unusual situation of not being able to work 5 days outside the house due to schools not being open. The Dental field seems to have been hit quite hard in this area.  As a result, offices are thinking outside the box and it seems to have created a perfect time for the growth of outsourcing companies and the need for them.

So what are my options you ask:

1. Dental Insurance Verification/AR Company
   Most companies out there are relying on someone who has transitioned from the office to maybe working remote. They typically hire people who have been “in the trenches”.  There are quite a few that have an office that the employees all report to.
   
   These companies offer varying versions of the breakdowns and the services they offer.  Some will input it into your software to your specifications.  Some require your team to inform them of who to verify where others determine that on their own.  Most companies out there offer AR assistance also. These companies handle all your AR including your insurance claims payments. This will involve your administrative teams time to scan and send checks to them so they can enter the information.
   
   
2. Automated Dental Insurance Verification systems
   These companies for the most part can get you a breakdown like what you find on the website. In many cases you still must translate this into your software. There are some companies, like Zuub, that are starting to integrate this service to aid in your dental treatment planning also.
   
   Please remember that it is the employer and insurance company that limits what you can get from these automated systems. There are quite a few with very sophisticated systems and they get better each day.

So how do you decide who is right for you?

There are many variables when it comes to insurance breakdowns and outsourcing AR. You need to have a clear picture of what your office needs are:

1. Do you need someone to do a full complete breakdown on every patient and input it into your computer system?
2. Are you looking for a company that will also handle follow up on the dental claims themselves?
3. What kind of breakdowns is your team capable of? What have they been doing?
4. Have you recently lost a team member that you plan to replace with outsourcing?
5. Are you comfortable having an outside source entering your payments?

When looking into to the companies have a clear picture before you start to look at your options. Decide if you want a team that is in an office or if you are comfortable with those working remote.  Ask questions.  Find out what responsibilities will still land on the administrative team and if outsourcing will be the time saver you need. Ask questions about how they hire and train.  Lastly look at how they report what has been done to the office. You will still need checks and balances to verify that nothing is getting missed.

Do your homework.  Do not choose someone strictly based on price as many times you get what you pay for. Remember that those breakdowns are the foundation of your office. From treatment plans to collections we all want to be accurate, and your office reputation depends on being accurate in your estimations.