Dental Insurance Verification Checklist: Benefits & Pre-authorization

Simplify dental insurance verification! Our checklist ensures accurate benefits confirmation and pre-authorization, reducing claim denials & maximizing revenue for your practice. Download now & streamline your process!

This Template was installed 2 times.

Patient Information Verification

1 of 9

Confirm patient demographics and insurance card details.

Patient First Name

Patient Last Name

Patient Date of Birth

Patient Phone Number

Patient Gender

Insurance Carrier

Insurance Card Details

2 of 9

Record policy number, group number, and subscriber information accurately.

Policy Number

Group Number

Subscriber's First Name

Subscriber's Last Name

Subscriber's Date of Birth (MM/DD/YYYY)

Insurance Company Name

Insurance Card Type

Insurance Card Image (Front)

Eligibility Verification

3 of 9

Confirm patient's coverage status and plan type.

Coverage Status

Plan Type

Member ID (First 4 Digits)

Effective Date of Coverage

Waiting Period Applicable?

Days Remaining in Waiting Period (if applicable)

Benefit Summary Review

4 of 9

Identify covered services, limitations, and any waiting periods.

Annual Maximum Benefit

Deductible Amount

Coinsurance Percentage

Plan Type (e.g., PPO, HMO, Indemnity)

Specific Exclusions or Limitations

Waiting Period for Major Services?

Benefit Expiration Date

Pre-authorization Requirements

5 of 9

Determine if pre-authorization is needed for specific procedures.

Is Pre-authorization Required?

Procedure(s) Requiring Pre-authorization

Rationale for Pre-authorization (if applicable)

Estimated Cost of Procedure (for Pre-authorization)

Date Pre-authorization Request Submitted

Details of Communication with Insurance for Pre-authorization

Upload Pre-authorization Forms/Documentation

Coordination of Benefits (COB)

6 of 9

Assess if the patient has multiple insurance plans.

Primary Insurance Carrier

Secondary Insurance Carrier (if applicable)

Primary Insurance Claim Submission Order

Notes on Coordination of Benefits

COB Submission Method

Date of COB Contact

Out-of-Pocket Costs

7 of 9

Calculate patient's deductible, co-pay, and co-insurance.

Patient Deductible

Co-pay per Visit

Co-insurance Percentage

Maximum Annual Benefit

Services with Separate Co-pays

Deductible Waived?

Documentation & Record Keeping

8 of 9

Maintain records of verification attempts and results.

Verification Date

Policy Number (recorded)

Notes on Verification Process (e.g., phone call details, website used)

Verification Method

Authorization/Claim Number (if applicable)

Screenshot of online verification (optional)

Communication with Patient

9 of 9

Inform patient about insurance coverage and estimated costs.

Patient Informed About Coverage?

Notes on Coverage Explanation (if applicable)

Estimated Patient Cost (if known)

Coverage Questions?

Date of Coverage Discussion

Time of Coverage Discussion

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