Dental Insurance Benefit Maximums

As we enter the second half of the dental benefits’ year, it is important to check remaining insurance maximums when calculating patient co-pays.  Many dental insurance companies provide a $1,000 maximum which can be reached quite quickly.  Often, dental patients are not aware of how low this maximum is and will not be keeping track of how much of their benefit maximum has been used.  In order to ensure the proper collection of a patient’s co-pay and maintain goodwill with your patients, a quick check of the patient’s remaining benefits should be conducted prior to presenting the patient with an estimate.  Patients may have received treatment in the office of a dental specialist and used most of their dental benefit amount there.  Some dental insurance companies provide year to date benefit usage information through online benefit systems or faxes, thus facilitating the verification process.

One of the biggest mistakes made in today’s dental practice is that of calculating inaccurate pre-treatment estimates.  Not only is this bad for your production/collections ratio, it can also tend to leave a very bitter taste in the mouth of patients who assumed their bill was paid in full, only to later discover that they are left with a weighty balance after insurance reimbursement.  The best advice I can offer to prevent this practice breaker is to get their bill right the first time!