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Patients fear insurance. Patients may not be aware that they have reached their procedure frequency limit or that they may not have coverage for certain operations. Before the customer comes in for their visit, your dental insurance verification specialist should check with the patient’s insurance provider to be sure they’ll cover the necessary services. Understanding their plan’s benefits, coverage, and cost may be difficult. Thus, dental clinics must verify patient benefits beyond gathering patient data.

This blog post explains how the dental insurance verification specialist handles the process and how that specialist can authenticate patient benefits like never before!

Why Verify Patients’ Benefits?

Your dentist’s office must verify each patient’s insurance coverage with their provider before each visit, whether it’s for a routine cleaning or a more involved oral surgery. Your dental practice can make sure the bills are paid with the use of an insurance verification specialist.

Dental insurance verification boosts practice development. It’s essential to your clinic’s operation since it ensures you’ll be paid. Dental insurance verification has three benefits. They include

Educates patients

Before seeing patients, check their dental insurance advantages to inform them. As indicated previously, patients seldom know their insurance policies. Thus, you must notify them about their plan’s coverage and co-pays.

Prevents last-minute cancellations, claim denials, and co-pay rejections

If you educate your patients on their coverage, last-minute cancellations, claim denials, and co-pay rejections will decrease.

Your practice becomes proactive

Dental insurance verification makes your clinic proactive. Verifying patients’ insurance plans show your dental clinic’s reactiveness as most patients don’t know the facts.

Who is a Dental Insurance Verification Specialist?

By integrating updated insurance information into your practice management system, dental insurance verification specialists streamline the verification of patient benefits. The dental insurance verification specialist may be involved in dental practice management systems regardless of whether the clinic provides general, cosmetic, orthodontic, or family dental care.

By incorporating a dental insurance verification specialist with your patient communication and office management systems, you may streamline the process of verifying new patients’ dental coverage without adding staff. Your practice might lose thousands of dollars per month due to unpaid claims and patients who are unable to pay them. Use a dental insurance verification specialist to make sure you are paid before the appointment.


Before seeing a patient, makes sure their insurance is valid by calling the insurance company to verify coverage and perks.

Work with the receptionists to educate patients on their payment options, such as their deductible, co-insurance, co-pay, and out-of-pocket maximum.

Keep track of patients at the dental office, including their visit history, insurance verification, and current coverage information.


One year’s worth of experience in the medical or dental billing industry, confirming insurance coverage.

Capable of working with other teams to coordinate patient care, such as scheduling appointments, processing dental insurance claims, and updating patient files.

Being able to speak with a patient’s insurance provider to confirm coverage and obtain necessary pre-approvals is an essential skill.

HIPAA standards need extra precautions to be taken when verifying a patient’s eligibility for a remote job. Eligibility verification specialists who operate from home must ensure the security of all patient records, both digital and physical, to ensure that no patient is denied coverage or services due to improper file security.

When working remotely, personnel should connect to the dentist’s office’s systems over a VPN or ZTNA that complies with HIPAA regulations to safeguard patient data. Data received through a regular Internet connection is susceptible to hackers, thus extra security measures are required to ensure privacy.

How does a specialist verify dental insurance?

Maintaining patient records is the first step. Every time they make an appointment, ask if their information has changed. Send first-time patients a patient information form. This helps keep their system record. Cross-checking your patient’s insurance information is the next critical step in dental insurance verification. You must contact the insurance carrier for patient benefits and coverage details. To brief patients, take notes on their profiles.

After verifying insurance benefits, you may send a template email to patients reminding them of the appointment and giving them insurance company information. This will align you and the patient. Your efforts might show that you’re proactive regarding their health plan, boosting your image. Create a list of patients with the same insurance carrier to simplify dental insurance verification. That can save you from repeated brief insurance verification calls to the same firm. Instead, one call can finish most of your tasks.

Dental Insurance Verification Checklist

A Dental insurance verification specialist will gather this information to check your patients’ insurance coverage!

Date coverage begins

Procedure-specific codes

The waiting period needed to ensure a specific set of processes (the time is required at times)

Patient plan and price schedule


Procedure documentation

Phone number, payer ID, address, fax number, etc. to properly submit a claim.

Category coverage percentages

Full-mouth and panoramic x-ray frequency

Specialist Expiration

No-tooth clause

What does a specialist in dental insurance verification do?

A dental insurance verification specialist entails checking a patient’s dental insurance plan, and benefits, and authorizing specialists in advance, such as checkups and extractions. The four main components of a patient’s insurance plan include deductibles, coinsurance, Copayments, and maximum out-of-pocket costs (MOOP).

To make sure that patients are covered by their dental insurance, a specialist at your dental clinic should contact the patient’s insurance provider before the scheduled visit. Your dental billing department representative may need to utilize the insurance company’s interactive voice response (IVR) technology to check a patient’s coverage.

When a patient has dental insurance through a company like Delta Dental, Humana, UnitedHealthcare, or another, it is the responsibility of your dental insurance billing department or dental insurance verification specialist to verify the patient’s benefits before the procedure to submit a claim for payment and prevent claims denials.

Why do you need a dental insurance verification specialist?

Dentists’ offices often need the assistance of dental billing specialist staff who can check patients’ insurance coverage ahead of time, file claims with insurers, and put patients at ease by explaining their dental bills. A potential dental insurance verification specialist may look at your web reviews in the same way a new patient would. Employ so that each client leaves a comment following their visit.

If you’re a dentist and you’re looking to hire a patient benefits specialist, they’ll check your online ratings to see how your clinic rates with patients who have filed claims with their insurer. Attracting the best dentists requires a string of recent five-star ratings, regardless of whether your business specializes in restorative dentistry, cosmetic dentistry, or some other branch of dentistry.

Save your time through Revu Billing

Every week, dental and medical billing departments in the United States and Canada waste many hours on wait with their insurance provider as they do routine verification procedures. The dental office may save a lot of time and get more claim approvals by using Revu Billing billing solution to verify patient coverage. New patients are more likely to have their insurance claims denied than current ones. However, insurance providers will continue to reject dental claims from current patients whose dentists haven’t verified their dental coverage.


To process claims smoothly through the , your dental practice requires accurate insurance eligibility verification. Finding a reliable dental insurance verification provider may ease the burden of manual insurance verification on your billing staff. Your dental practice requires robust patient online reviews to recruit the top dental billing experts. It’s important to remind patients to leave online reviews of your practice after each visit.

With Revu Billing you can schedule appointments online, send text messages to remind patients of upcoming appointments, and more. If you’re a dentist interested in learning more about how Revu Billing dental insurance verification specialist might help your business thrive, we encourage you to give us a call or book an appointment.

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