Dental Insurance Verification Form


Dental Insurance Verification Form

What is a dental insurance verification form?

A dental insurance verification form is a document used to verify an individual’s insurance coverage. It records and confirms the details of the individual’s medical insurance policy, including maximum benefits, coverage type, exclusions, and limitations. Since dental treatment can prove to be quite expensive, this form is often required by dental offices before they proceed with treatment to check if the patient’s insurance policy will cover the cost of the treatment. This type of form comes in handy for both individual dental policies and group dental policies. 

What purpose does a dental insurance verification form serve?

This type of verification form serves a variety of purposes: 

  • It provides confirmation that the individual has a dental insurance policy that will cover the cost of treatment.
  • It is used to identify the type of dental insurance policy and the coverage it offers. 
  • With all insurance details recorded in the form, there aren’t any issues during the time of billing, both with the insurance company and the dental office. 
  • It helps ease out the claim process and ensures efficient processing of the insurance claim. 

What if you don’t use a dental insurance verification form?

While using a this form isn’t mandatory, it is generally considered to be a best practice for dental offices. Using the form helps confirm the policy coverage, avoids billing-related disputes, verifies the policy details, and streamlines the claims processes. The absence of this form can lead to denied or delayed claims, can burn a hole in the patient’s pocket, and can lead to billing issues with the insurance company later on. 

What details does a dental insurance verification form include?

This form typically includes the following details: 

  • Personal information of the patient: name, date of birth, contact details, address
  • Information regarding insurance policy: name of policy, policy number, insurance company, name of policyholder 
  • Type of coverage: basic services, major services, preventive care 
  • Maximum benefits provided by the insurance company: Annual maximums, lifetime maximums 
  • Procedures and treatments that are not covered under the policy 
  • Details about the treatment being provided, the cost of the treatment, to submit a claim 

Who fills out a dental insurance verification form?

This particular form can be filled out by both the individual and the dental office. If it is filled out by the patient, then it requires personal information and insurance information. If the dental office is filling out the form, then it requests the patient to provide their details and insurance details or they can also contact the insurance company to verify the information. In the end, the dental insurance verification form is sent out by the dental office to the insurance company to claim the cost of treatment. 

What are the legal requirements of a dental insurance verification form?

The legal requirements of this form depends on the jurisdiction in which the treatment is being provided. However, there are some general legal implications of this form: 

  • All the information in the form must be accurate and complete. Inefficiency in the same can result in disputes with the insurance company. 
  • The form must comply with the Health Insurance Portability and Accountability Act (HIPAA). This means that the dental office must protect the privacy of the individual and maintain confidentiality of information. Any non-compliance with the same will lead to legal action.