For Office Managers & Insurance Coordinators

Insurance Coordinator Workflow

Streamline insurance verification, claims management, and treatment coordination with AI insights.

Roles

Insurance Verification & Breakdown

Before appointments, verify eligibility and break down benefits, including co-pays, deductibles, annual maximums, and limitations.

Claims Management

Prepare, submit, and follow up on dental insurance claims for accurate and timely payment.

Treatment Planning & Estimates

Collaborate with providers to align treatment plans with insurance coverage, providing accurate estimates to patients.

Revenue Cycle Support

Manage outstanding claims, resolve denied claims, and assist with collections, ensuring the practice receives maximum reimbursement.

Patient Education & Communication

Act as a liaison, answering patient questions regarding coverage and financial responsibilities.

Data Management

Update insurance fee schedules and patient accounts in PMS, ensuring compliance and accuracy.

Workflow

Preparation and Review

Review Daily Patients page. Identify patient's Findings and verify eligibility and provide benefits.

Verify coverage and set clinical team up to proceed with same day dentistry.

For example:

  • Due for Sealants

  • Crown → DMF 50%

  • Crown coverage

  • Crown replacement frequency

  • Preventive – Incipient decay

  • Fluoride Varnish

  • Curodont

  • Periodontal Therapy (D4341, D4342, D4910, D4346)

  • Implant / Abutment / Implant Crown

  • 3rd Molars

  • PARL

  • Endo coverage

  • Retreatment coverage

Morning Huddle Support

Provide insight on eligibility and benefits captured.

Insurance Pre-authorization, Claims, and Appeals

Use Overjet Vision AI screenshots as supplemental evidence and support for claims.

Note: It is best practice to follow the payer specific guidelines outlined in the review manual which includes the right imaging (including x-ray/photos, where applicable) that is of diagnostic quality that clearly indicates the need of the treatment planned or conducted.