Marshall Orthodontics

Orthodontic practice in Simpsonville, South Carolina, running Ortho2 Edge.

I've been very impressed with what it has done.

The situation

At Marshall Orthodontics, insurance verification belonged to the coordinator, Candice, alongside everything else on her desk. Benefit information came from payer portals when the data was there, and from phone calls when it wasn't, which meant hold time competing with patients at the front desk.

The problem

“Sometimes we can't get all of that information from the portal, and Candice may not always have time to call and sit on hold forever trying to get it,” says Erin Darnell, Office Manager. Incomplete breakdowns flowed into consultations, and when insurance paid less than the patient expected, the practice absorbed it: “At times we end up having to write off unpaid insurance because of those types of issues.”

What changed

Azops Dental now verifies every patient ahead of their appointment, retrieving benefits from insurance portals, faxed benefits and from talking to live representatives. The breadth and accuracy come from reconciling all the available channels provided by payers. Every source is documented and uploaded as a PDF in Ortho2. “Having the call source is super helpful so we can provide it to patients if there is any sort of discrepancy.”

All benefits are also written back in the employer/group table: deductible, percentage coverage for orthodontics, lifetime maximum, assignment of benefits, payment percentage at binding, payment frequency, and more.

The moment it mattered

Azops Dental verified a patient already scheduled to start treatment and found the policy had been terminated. The office was about to send a contract that credited insurance benefits that no longer existed. “We were able to catch that prior to sending that out,” Erin says. “That was very helpful.”