mConsent

Case Study: How Streamlined Insurance Verification Reduced Claim Denials & Improved Cash Flow

mConsent

March 14, 2025

insurance-verification-reduced-claim-improved-cash-flow

Verifying insurance is an important part of having a dental office. This ensures that both the practice and the patient understand how the insurance works, which helps to avoid billing problems, unexpected costs, and lost income.

However, even though it is very important, insurance verification is often difficult, time-consuming, and mistake-prone. Unfortunately, this is a major problem for many practices that costs a lot of time and money.

This blog post will discuss some of the most common problems dental offices have when verifying insurance and some of the ways that automation and dedicated concierge services might help.

Constantly Time-Consuming and Labor-Intensive Process

Dental offices can feel like they have an endless job checking each patient's insurance. Before every meeting, staff members have to make sure the patient's insurance is still valid, look over their coverage information, confirm their deductibles, and get reports on their eligibility from several insurance portals.

To do this, they often have to use complicated tools, call people, and even wait for faxes, which can slow down the whole process.

On any given day, a front-office staff member may spend hours just performing insurance verifications—tasking them with what could be an entire day's worth of work. This labor-intensive process can lead to burnout for staff and delays in getting patients into the exam room. As a result, patient wait times increase, and the practice's overall productivity takes a hit.

Solution:

One of the best ways to solve this problem is to use automated dental insurance proof. With today's platforms, dentist offices can quickly check to see if patients' insurance plans cover them in seconds. Because they work with practice management systems like Dentrix, Eaglesoft, and Open Dental, these tools eliminate the need to make phone calls and enter data by hand.

This means that your team can spend more time caring for patients and less time on administrative chores. These automation tools make the proof process much easier. This reduces the time needed for insurance checks and makes things run more smoothly overall.

High Staffing Costs

High Staffing Costs

Many dental practices dedicate one or more full-time employees to insurance verification. This means a practice is paying upwards of $3,000 to $5,000 per month for the sole purpose of verifying patient insurance details. While this staff member is crucial to the practice's operations, the cost of maintaining such an employee adds a significant burden to overhead costs.

Moreover, having a dedicated individual solely responsible for insurance verification creates a dependency on that person. If the employee calls in sick or goes on vacation, there's a risk of delayed verifications, which could potentially lead to billing delays or disruptions in patient flow.

Solution:

By automating the insurance verification process, practices can eliminate the need for full-time verification staff. This reduces payroll expenses and ensures that the verification process continues seamlessly even when a team member is unavailable.

Automation tools also help provide 24/7 access to insurance eligibility reports, meaning staff aren't constrained by business hours or slow insurance portal response times.

In addition, concierge services, where a dedicated insurance manager handles the verifications and communicates directly with insurance companies, further reduce the workload on practice staff. The insurance manager works behind the scenes to ensure all details are accurate, taking the burden off your team and freeing them up to focus on patient care.

Risk of Revenue Loss and Patient Dissatisfaction

Insurance verification isn't just about checking a box—it's about ensuring that the practice gets paid in full for the services it provides.

Without accurate insurance information, a practice risks losing revenue. For example, if a patient's coverage or deductible isn't appropriately verified before the appointment, the practice may not be able to collect the full amount owed. This revenue loss can hurt the practice's bottom line, especially when it happens repeatedly.

In addition, when insurance details are incomplete or incorrect, patients may be blindsided by unexpected out-of-pocket costs. This can create dissatisfaction, frustration, and even lost patients, further eroding the practice's financial stability and reputation.

Solution:

Having real-time, accurate insurance verification helps practices avoid these pitfalls. With automated verification, practices gain access to complete eligibility details before a patient walks through the door.

This prevents unpleasant surprises for patients and ensures the practice collects the proper payment, reducing the chances of revenue leakage.

Limited Effectiveness of Basic Verification Software

Many practices rely on basic insurance verification software, which only provides a partial view of the patient's coverage information. These systems often give only basic eligibility data, which doesn't include crucial details like the exact coverage, deductibles, or patient out-of-pocket costs.

As a result, office staff must still manually log into insurance portals or place calls to verify the full details. This creates more work for staff, undermining the potential benefits of the software.

Solution:

More advanced verification platforms, like mConsent's automated verification tool, provide comprehensive reports in seconds. These systems pull accurate and up-to-date information directly from insurance portals, ensuring practices have all the information they need to complete the verification process.

Integrating these platforms into practice management systems eliminates the need for manual verification, allowing practices to access full, actionable information without additional steps.

Inconsistencies and Errors in Data Entry

Inconsistencies and Errors in Data Entry

Manual insurance verification has its own challenges, the most prominent of which is human error. Staff members who are manually entering data may accidentally input incorrect information or overlook critical coverage details. These errors can snowball, leading to billing mistakes, insurance denials, or reimbursement delays.

When there are multiple systems and portals to work with, the likelihood of data inconsistency increases, which creates additional problems for the practice.

Solution:

Automating the verification process ensures that the information pulled from insurance providers is accurate and consistent. By reducing manual data entry, the chances of human error are minimized. Systems like mConsent can directly integrate into a practice's management software, automatically populating the correct patient information into the system and reducing the need for manual intervention.

This increases the accuracy of insurance verification, improves billing accuracy, and reduces errors.

Dependency on Unreliable Insurance Portal Access

The reliance on insurance portals is another challenge that dental practices often face. Unfortunately, these portals aren't always reliable or accessible when needed.

Whether the portals are down due to maintenance, slow to load, or the information isn't up to date, practices are in a frustrating and time-consuming situation. The lack of reliable access can delay patient care, disrupt office flow, and reduce efficiency.

Solution:

With a dedicated insurance concierge service, practices can avoid these frustrating interruptions. A dedicated insurance manager works directly with insurance providers to gather accurate, real-time data and update the practice's management system with all the relevant information.

This ensures that practices don't have to worry about slow or unreliable portal access—they get the insurance details they need, when they need them.

Conclusion

Insurance verification is one of the most challenging aspects of dental practice management. From time-consuming manual processes to the high cost of dedicated staff, the inefficiencies can add up quickly, costing practices time and money. Furthermore, incomplete or inaccurate verification information can result in financial losses and patient dissatisfaction.

However, with the advent of automated insurance verification platforms and concierge services, dental practices now have the tools to overcome these pain points.

By automating the insurance verification process, practices can reduce administrative burdens, improve revenue cycle management, and enhance patient satisfaction. This not only helps the practice run more efficiently but also ensures a better experience for both staff and patients alike.

By investing in the right tools and services, dental practices can transform operations, reduce costs, and ultimately provide higher-quality care to their patients.

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