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Dental insurance verification is stuck in the 1990s, but insurance companies have dramatically changed how they operate—leaving dentists with surprise balances, frustrated patients, and a mess of accounts receivable. In this eye-opening episode, I reveal how insurance carriers are secretly leasing networks behind the scenes and potentially pulling your practice into networks you never directly signed with.

Drawing from a recent consultation where a practice saw their AR spike by $70,000 due to inadequate verification, I walk through exactly why checking just the basics—deductibles, maximums, and coverage percentages—is no longer enough. The game has fundamentally changed. Through leased networks and umbrella plans like Connection Dental and DentaMax, carriers can apply completely different fee schedules than you expect, even when you think you're out of network.

Most importantly, I share the specific questions you must ask during insurance verification to protect your practice: Are we in-network or out-of-network with this specific plan? Are we directly contracted or leased through another network? Which fee schedule applies to our office for this plan? Does this patient's plan fall under a specific PPO tier, group or level? These questions will transform how you set up patient accounts and present treatment plans.

Ready to stop the bleeding and take control of your insurance verification process? Download my free verification checklist in the show notes and start mapping your complete network participation status today. Your billing department—and your bank account—will thank you.

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Would you like to set-up a billing consultation with Ericka? She would love the opportunity to discuss your billing questions and see how Fortune Billing Solutions may help you.

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Perio performance formula:

(D4341+D4342+D4346+D4355+D4910)/(D4341+D4342+D4346+D4355+D4910+D1110)