Insurance and network
Insurance verification
Insurance verification is the step of checking a patient's coverage and benefits before treatment, so the office can estimate what the plan and the patient will pay.
Offices verify insurance before a visit to learn if the patient is covered and what the plan pays. The American Dental Association says it is essential that dental offices verify eligibility on the date of service to avoid recoupment requests in the future.
Plans can change eligibility after the fact. The ADA notes that plans may reflect changes retroactively, and contract clauses may let them take back payments. A check on the visit date lowers that risk.
Verification covers things such as active coverage, yearly maximums, waiting periods and covered services. A front desk team often does it. See dental benefits and dental billing.