Insurance verification for dental practices

Every patient on your schedule, verified before they walk in.

Benefits, frequencies, and remaining annual maximum — written into your practice management system two days ahead.

Your front desk doesn’t log in and doesn’t call.

Open Dental today · Dentrix and Eaglesoft next HIPAA compliant · BAA provided Month to month
THU 07/23  ·  18 APPOINTMENTS 17 verified · 1 flagged

MARTINEZ, ELENA

DELTA DENTAL PPO · GRP 4471190 · 07/23 10:40A
Verified 7/21
Maximums & coverage
Annual maximum$1,500$840 left
Deductible$50Met
Preventive / Basic / Major100 / 80 / 50%
Frequencies
Prophy D11102 / 12 moLAST 01/14/26
Bitewings D02741 / 12 moLAST 01/14/26
FMX D02101 / 36 moLAST 03/09/24
Perio maintenance D4910Flagged
Frequency history not returned by the payer. Called 7/21, callback requested — we'll confirm before the appointment.

ILLUSTRATIVE RECORD. NOT A REAL PATIENT.

01  ·  The problem

Getting it wrong is expensive. Getting it right takes all afternoon.

The estimate is off.

You quote $180. The claim comes back and they owe $600. Now it’s an uncomfortable phone call, a write-off, or a patient who tells people about it.

Someone is always on hold.

It’s 4:40 on a Thursday, your coordinator is thirty minutes into hold music with Cigna, and there’s a patient at the counter waiting to schedule.

Eligibility and registration are the single largest source of claim denials — 26.6% by Change Healthcare’s count, 24% by Optum’s.

02  ·  What lands in your system

You don't get a report. You get a filled-in chart.

Two days before each appointment, the verification is on the patient's record — the same fields your coordinator would have filled in, in the same place she'd have put them.

Anything the payer won't confirm is marked, with the reason. Never a blank field, never a guess.

  • 01Active coverage, effective dates, plan and group details
  • 02Deductible — individual and family, met and remaining
  • 03Annual maximum remaining, as of today
  • 04Coverage percentages: preventive, basic, major
  • 05Frequencies and last-service dates
  • 06Waiting periods, missing tooth clause, downgrades
  • 07Ortho and riders where they apply
03  ·  How it works

Three steps, and then you stop thinking about it.

  1. Once, at the start

    We connect

    Read access to your schedule, write access to patient records. About an hour of your office manager's time.

  2. Every day after

    We work ahead of your schedule

    Every appointment two days out gets verified — electronically where the payer allows it, by portal or phone where it doesn't.

  3. Before they arrive

    Results land in your system

    No portal to check, no PDF to open. Your team opens the chart and it's there.

Your team's remaining job: review whatever got flagged. Usually a handful a week.

04  ·  Who it's for

Who this is for.

A good fit
  • One to four dentists, one or two locations
  • PPO-heavy — most patients have insurance you have to chase
  • Verification runs through a receptionist or coordinator
  • On Open Dental (Dentrix and Eaglesoft next)
Probably not
  • Fee-for-service or membership plans — you don't have this problem
  • Large groups and DSOs — you need a platform, and there are good ones
  • Anyone who wants software their team operates. This isn't that.

Not sure which side you're on? Ask on the call. I'll tell you if it isn't worth it.

05  ·  Pricing

Every tier is the full breakdown. The only thing that changes is volume.

One rate, whatever the plan. Most services bill per verification — $2.75 to $12.50, depending on how hard the plan is to pin down. We don’t charge more when it’s complicated.

Included in every tier

An insurance coordinator costs about $50,000 a year loaded. This is a fraction of that, and it doesn’t call in sick or quit in March.

TierVolumeMonthly
Solo1 DENTIST UP TO 250 VERIFICATIONS A MONTH $1,200PER MONTH
Practice2 DENTISTS UP TO 500 VERIFICATIONS A MONTH $2,200PER MONTH
Group3–4 DENTISTS UP TO 900 VERIFICATIONS A MONTH $3,600PER MONTH
FIRST 100 VERIFICATIONS FREE · MONTH TO MONTH · NO CONTRACT · CANCEL ANY TIME BEYOND YOUR BAND, $6 PER VERIFICATION. ADDITIONAL LOCATIONS QUOTED SEPARATELY.
06  ·  Security and questions

Before you hand anyone your schedule.

Do we need new software?

No. Nothing to install, no logins for your team, no change to how anyone works. Results appear on the patient record you already open.

How do you access our system?

[ Straight technical answer — bridge, API, or remote access, whichever is accurate. Office managers ask this, and vagueness reads badly. ]

Is this HIPAA compliant?

Yes. A BAA is signed before any patient data moves. Encrypted in transit and at rest, access logged, minimum necessary data only — the schedule and the fields required to verify benefits.

Who actually does the work?

Eligibility runs electronically against the payer. Where a payer doesn't expose data electronically, we retrieve it by portal or phone, using automation for routine calls. Anything automation can't resolve goes to a person. Nothing gets written to your system that the payer didn't confirm.

What if you get something wrong?

Tell me and I'll fix it the same day, and tell you what caused it. [ Add a concrete remedy if you'll stand behind one. ]

What if benefits change after you verify?

Verification reflects what the payer reported at the time. For appointments booked far out, we re-verify inside the window rather than relying on a stale check.

How is this different from a service that charges per verification?

Different scope. A per-verification rate usually buys an eligibility check, with your team still working the portals, frequencies and exceptions. This is the whole task, ending in your system.

Do you do billing and claims too?

No. Verification only, on purpose. It's the part that breaks everything downstream.

Fifteen minutes, and you'll know whether this is worth doing.

Tell me your practice management system, your payer mix, and roughly how many patients a day. If it's not a fit, I'll say so on the call.

Book 15 minutes OR CALL [ name ] AT [ phone ]