How a Verification of Benefits Sets You Up for Success
“Why should I complete a verification of benefits?” This is a question commonly asked by dental practices starting to bill medical insurance. When you complete a verification of benefits, whether through Imagn Billing or by doing it yourself, you set yourself up for the best possible outcome. As a result of a verification of benefits, you receive information that you need to make an educated choice, while also giving the patient information about their insurance benefits.
Live Verification of Benefits
When our Imagn Billing Service Team completes a live VOB, we speak to a real person at the insurance company. This lets our team provide you with more accurate and detailed information. If you are thinking of doing live VOB’s be prepared to be on hold for long periods of time. Our team experiences hold times ranging from 15 mins to 2 hours. Below is the list of the items that are provided when you do a live VOB.
Live VOB Includes:
- In and Out of Network Deductible
- Out of Pocket Max
- Pre-Auth Requirements
- Live Phone Call with Real-Time Detail
- Procedure Specific Coverage – Up To 12 Codes
- In and Out of Network Coinsurance
- GAP Exception Policy
- Policy Exclusions if Applicable
When you have the Imagn Billing Service Team complete your VOB all of the information is entered into you Imagn Billing software. All VOBs done by the Imagn Billing team are guaranteed to be completed within 24 hours. This allows you to quickly present the treatment plan to the patient with the accurate information that you need. It’s important to remember that a VOB is NOT a “guarantee” of benefits. Your patient needs the recommended treatment regardless of how it is paid for. So, let your patient know that you will be pursuing medical insurance as a courtesy to them, but they will need to pay you in full at the time of the service. You may want to consider offering different financial arrangement options, such as payment plans or a resource like CareCredit.
Electronic Verification of Benefits
Many companies that do VOB’s use technologies like Availity or NaviNet. However, insurance websites generally make it hard to find plan exclusions and pre-authorization requirements. So the Information that you get with electronic VOB’s is limited and in our opinion not enough to confidently talk with the patient about their options.
Electronic VOB Includes:
- In and Out of Network Deductible
Out of Pocket MaxPre-Auth RequirementsLive Phone Call with Real-Time DetailProcedure Specific Coverage – Up To 12 CodesIn and Out of Network CoinsuranceGAP Exception PolicyPolicy Exclusions if Applicable
Do It Yourself Verification Of Benefits
If you need to call on VOB’s for your office, be prepared to be on the phone for a long time. Most dental admins or billers already have a large workload so piling another time-consuming task is not our recommendation. With Imagn Billing’s verification of benefits being only $35 each, it makes the cost savings a no-brainer. However, if you have no other choice here are our recommendations.
- Be Thorough
- Be Organized
- Create a Question Sheet Prior to Calling
- Do Not Let Them Push You Around
The more you do, the better you will become. If you believe you have received false information from an agent we recommend calling back and speaking to someone else. There are all levels of insurance representative and some are definitely better than others.
Conclusion
Whether you outsource to a service like Imagn Billing or do the Verification of Benefits yourself, it is important that you complete one for every medical billing case. Without this vital information, you are unable to confidently present the option of medical insurance to your patient. This can lead to unclear expectations and upset patients.
