Spilling the Teath: Eligibility Verification Shouldn’t Be This Difficult
In this episode of Spilling the Teath, Dr. Ryan Hungate, DDS, MS, Chief Clinical Officer, spoke with Martin Kearns, GM and Executive Director of Revenue Cycle Management, about how Henry Schein One is revolutionizing the eligibility verification processes. Today, we’re sharing the top takeaways from their discussion.
The current marketplace
The standardization of payor-provided data is massively broken in the dental industry. Often, practices add two or more disconnected solutions to their existing practice management system (PMS), requiring them to work out of disparate workflows. This can get super expensive, and practices are creating inefficient workflows if they've digitized it to a software vendor. They also still need to pick up the phone and call the payer, get on the portal and download that side or fax backs, or a combination of both those things.
Treatment case acceptance has also taken a hit with the current system. Patients need to be empowered and know without a shadow of a doubt what their coverage is going to be. And if they don't know, then they're going to wait and put that treatment on hold.
It's a domino effect when you don't have it right up front, leading to poor treatment plan acceptance, inaccurate claim assessments, and more challenges during reconciliation and collection from the payor.
Henry Schein One is changing that with Eligibility Essentials
With Eligibility Essentials, data is being pushed directly into Dentrix and Dentrix Ascend’s document center. Not only is the information autosaved in the document center and appointment book, but now it's coming back in a standardized response that’s uniform across all payors, and data – including deductibles, minimums, and co-pays -- writes back to the coverage tables.
Gone are the days of having to navigate to one place to get the data, pulling it in, then interpreting it because it's going to be different depending on the payor. With Eligibility Essentials, customers also now see very slick, clean color-coded statuses in their appointment books with details on the responses.
Boost your process further with Eligibility Pro
Eligibility Pro responses deliver a more comprehensive level of granularity up to 100 codes deep. This is going to eliminate the need to call the payor or visit their portal because that data is all being pulled back in that standard PDF. This will cover 99% of all the different procedures that you're possibly going to do out there. It's writing back into Dentrix and Ascend, like Essentials, but it's much deeper data and it's covering those cases that you're not seeing in EDI.
Our aim is to make sure that this time saved is redeployed into more high value activities, ultimately providing great care for your patients.
The benefits
When the patient portion is correct, you've got their buy-in at the time of service because you were able to take that eligibility response and put it side by side with third-party finance responses. Providers are empowered thanks to a more comprehensive and confident treatment presentation, and consumers are more confident because they know without that layer of doubt what their true coverage is.
You build trust, loyalty, and confidence in your patient. You empower them as a consumer. You give them confidence in the affordability and remove many of the headaches that hit your staff when you don't have the claim submitted right.
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Check out the full discussion to learn more about how Eligibility Pro and Eligibility Essentials can revolutionize your practice.