{"id":2149,"date":"2024-11-05T14:45:49","date_gmt":"2024-11-05T14:45:49","guid":{"rendered":"https:\/\/www.dentalsupportspecialties.com\/blog\/?p=2149"},"modified":"2024-12-09T14:46:04","modified_gmt":"2024-12-09T14:46:04","slug":"dental-insurance-verification-prior-authorization-difference","status":"publish","type":"post","link":"https:\/\/www.dentalsupportspecialties.com\/blog\/2024\/11\/05\/dental-insurance-verification-prior-authorization-difference\/","title":{"rendered":"Dental Insurance Verification and Prior Authorization: What\u2019s the Difference?"},"content":{"rendered":"
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\"patient<\/figure>\n<\/div>\n\n\n

If you are a planner by nature, you probably enjoy feeling as in control as possible. Sure, life can change quickly, and surprises can come up, but good planning and preparation can go a long way to give you peace of mind about the future. For example, do you have a good portion of your holiday shopping done already?<\/p>\n\n\n\n

When it comes to billing dental insurance companies, doing some prework will not only spare you from experiencing preventable headaches but also save you valuable time and money. This preparatory effort may likely consist of either insurance verification<\/a> and\/or prior authorization. What exactly is the difference between these two concepts, and why are they important? Keep reading to find out!<\/p>\n\n\n\n\n\n\n\n

What Is Dental Insurance Verification?<\/h2>\n\n\n\n

Dental insurance verification is the process of confirming that the patient has coverage with a certain insurance company and that their information has been correctly entered into your system. This process starts well before the visit and entails collecting the patient\u2019s Group ID and policy numbers and other information either on the phone or online as they make the appointment. After calling the insurance company and verifying the information you have, your team will receive specific coverage percentages and available benefits for the patient.<\/p>\n\n\n\n

Why Is Dental Insurance Verification Important?<\/h2>\n\n\n\n

Perhaps you wonder if verifying the patient\u2019s insurance coverage before they even show up for their appointment is even worth spending the time and effort. However, if you aren\u2019t certain that the patient even has benefits with a specific insurance company, you won\u2019t go far in getting paid for your services. You\u2019ll quickly run into problems and significant delays in receiving the revenue you\u2019re owed. Confirming the patient\u2019s policy beforehand can ensure that the billing and claims process can go smoothly and that you\u2019ll get paid on time from insurance.<\/p>\n\n\n\n

What Is Prior Authorization?<\/h2>\n\n\n\n

Unlike verification, prior authorization refers to making arrangements for coverage for a specific procedure in a patient\u2019s treatment plan. Before the patient can undergo a specialized treatment, the insurance company may require the dentist\u2019s official recommendation and justification for it. For example, to get a bone graft approved for coverage, you or the dentist may need to submit prior authorization paperwork and documentation. Once insurance accepts and approves the procedure, your practice can move forward with full confidence that the claims and payment shouldn\u2019t present a stumblingblock down the road.<\/p>\n\n\n\n

Why Is Prior Authorization Important?<\/h2>\n\n\n\n

Without prior authorization established before the procedure takes place, the patient\u2019s dental insurance company has the right to refuse to help pay for it. As a result, your team may have to follow up with the patient and collect a much higher payment from them directly. As you might imagine, this situation doesn\u2019t usually reflect well on your practice. The patient may wonder why you didn\u2019t get it right, feel financially cheated, and want to search for another dental office to work with in the future.<\/p>\n\n\n\n

Although you can\u2019t prepare for everything in advance, taking care of these tasks is a smart way to stay on top of your dental practice\u2019s finances and ensure your success!<\/p>\n\n\n\n

About Dental Support Specialties<\/strong><\/p>\n\n\n\n

Dental Support Specialties has offered remote administrative support for dental practices across the country for more than 15 years. In addition to general practices, we can serve periodontal as well as oral surgery practices. We are experts when it comes to dealing with dental insurance companies, and we can make billing a breeze for you and your team. If you are interested in learning more about our services, contact us for a consultation<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

If you are a planner by nature, you probably enjoy feeling as in control as possible. Sure, life can change quickly, and surprises can come up, but good planning and preparation can go a long way to give you peace of mind about the future. 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