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Data Quality and Point Solutions

May 4, 2024

The issue of dental claims being rejected due to low-quality dental insurance verification data is a significant concern in the DSO space. Dental Insurance verification is a critical step in ensuring that patients receive the coverage they are entitled to for their dental procedures. When this process is not carried out effectively, it can result in claims being denied or delayed, causing frustration for both patients and dental providers. However, what's particularly critical is that inadequate data quality concerning comprehensive breakdowns or historical frequencies can cause significant disruption within the DSO (Dental Support Organization). 

Several factors can contribute to low-quality dental insurance verification data, including inadequate training of staff members responsible for verifying insurance coverage, outdated or un reliable verification systems, lack of understanding of the complexities, and errors in entering patient information. Additionally, discrepancies between the information provided by patients and the information obtained from insurance companies can lead to claim rejections.

To address this issue, dental support organizations can implement two single very important steps.

a)    Utilize AI-driven technology for dental insurance verification: Deploy sophisticated software tailored AI for dental insurance verification, capable of extracting data from various payer sources, initially focusing on dental payer portals. These systems streamline the verification process, minimize inaccuracies, and offer immediate updates on patient coverage. Of note, dentalrobot stands out as the sole company equipped to comprehensively address this data quality issue, offering extensive coverage including full breakdowns, histories, and frequencies. Our prowess in extracting data from payer portals is notably expansive, reaching an impressive 240.

b)   Employ AI-agents to input insurance verification data into dental practice management systems. With various methods used by dental support organizations to integrate insurance coverage data into their software, errors may arise. Leveraging intelligent AI agents can address this issue effectively.

Most point solutions and tools do little help in solving these problems. By implementing these strategies, dental support organizations can minimize the risk of claim rejections due to low-quality insurance verification and improve the overall efficiency of their billing process.


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