Services

Dental Insurance Verification Services

Full Breakdown Verification

Our most comprehensive verification service. Captures every benefit detail — annual maximum, deductible, frequency limits, waiting periods, missing tooth clauses, downgrade rules, alternate benefit provisions, pre-authorization requirements, and coordination of benefits. Built for practices doing significant crowns, bridges, implants, orthodontics, or any case where verification accuracy directly affects collections.

Inside Full Breakdown

Dental Implant Insurance Verification

Implant cases routinely run thousands of dollars per fixture and tens of thousands for full-arch reconstruction. Our implant-specific verification handles missing tooth clauses, alternate benefit provisions (bridge equivalents), abutment and crown coverage separation, pre-authorization workflow, and the policy details that decide major case approvals. Built for general dentists, oral surgeons, and prosthodontists doing implant work.

Implant verification details

Orthodontic Insurance Verification

Orthodontic cases operate on a different insurance structure than general dentistry — lifetime orthodontic maximums instead of annual maximums, age-based coverage limits, clear aligner parity rules, and monthly billing payouts across the treatment period. Our ortho verification captures the lifetime max, predetermination workflow, and the structure ortho practices need to quote accurately.

Orthodontic verification details

DSO Insurance Verification at Scale

Multi-location dental groups face verification challenges single-location practices do not — inconsistent reporting between sites, volume that exceeds in-house capacity, denial-rate variance across locations. Our DSO model delivers standardized reporting across every site with a hybrid software-plus-specialist workflow that handles 1,000+ weekly verifications without quality drift.

How the DSO model works

Periodontal Insurance Verification

Periodontal verification is one of the most denial-prone categories in dental insurance. Frequency limits on SRP per quadrant, the periodontal maintenance vs prophy distinction, surgical perio pre-authorization, and carrier-specific documentation requirements all matter. Verification depth on these cases directly affects whether $1,500-$5,000 perio treatment plans collect cleanly.

Periodontal verification details

Endodontic Insurance Verification

Endodontic cases run $1,000-$2,500 depending on tooth position. Coverage varies substantially by anterior, bicuspid, and molar classification. Molar endodontics increasingly require pre-authorization in 2026. Retreatment waiting periods and apicoectomy coverage have their own rules. Our endo verification captures the tooth-position-specific coverage tiers and pre-auth workflow these cases require.

Endodontic verification details

Crown and Bridge Insurance Verification

Crowns and bridges are the highest-volume major procedure category. They are also the category with the most policy variation — downgrades from porcelain to base metal, missing tooth clauses on bridges, 5-7 year frequency limits per tooth, and pre-authorization differences by carrier. Verification depth determines whether the case gets quoted accurately.

Crown and bridge details

Pediatric Dental Insurance Verification

Pediatric practices handle a verification mix that adult general dentistry does not — heavy Medicaid managed-care volume through DentaQuest, Liberty, and MCNA, CHIP programs, family-panel coordination of benefits, age-based coverage transitions, and pediatric-specific CDT codes. Built for the pediatric workload.

Pediatric verification details

Medicare Advantage Dental Verification

Medicare Advantage dental riders show up in retiree-heavy patient panels at rates exceeding 35 percent. These plans operate on different rules than commercial PPOs — lower annual maximums, separate frequency limits, plan-specific pre-authorization, and significant variation between specific plan IDs under the same carrier. Verification at the plan ID level catches what carrier-level assumptions miss.

Medicare Advantage details
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