Dental Insurance Waiting Period - What You Need To Know

So, what exactly is a dental insurance waiting period?

The waiting period is the amount of time your practice or the patient needs to wait between the purchase of the insurance plan and the date the services are completely covered. This period varies from plan to plan. The length of a waiting period for dental benefits might range from a few months to a full year, depending on the type of plan you've chosen and the details of your insurance policy. So it is important to understand the specifics of the policy. There are chances that the dental insurance may not cover certain procedures while the waiting period for the dental plan is in effect. Also, not all dental insurance companies have a waiting period. Waiting periods for dental insurance aid in containing your patient’s overall dental insurance expenses. They stop your patients from getting expensive dental work done and then canceling their coverage soon after, which raises everyone's costs. In essence, waiting periods assist in keeping the cost of dental insurance reasonable for all your patients.

Services covered during the waiting period

Understanding which procedures require a waiting period before providing the services can help your practice in the long run. Therefore, it is important to contact the insurance provider if you have any doubts regarding the services covered under the waiting period. Keep in mind that some plans have longer waiting periods than others. Here are some of the treatment categories for waiting periods:

Preventive

Preventive care is usually not subject to a waiting period under most dental insurance policies. These include checkups, cleanings, x-rays, etc.

Basic

Basic procedures like non-surgical extractions or fillings may have a three to six months’ waiting period.

Major dental works

Major dental work like dentures, bridges, and crowns may have a three months to one year’s waiting period.

How is the dental insurance waiting period a limitation?

Most patients only need the insurance for a limited period of time. Since insurance firms are aware of this. Waiting periods protect them against such circumstances. There are waiting periods in some insurance plans, but not in all of them. Waiting periods are a way to limit how much insurance money a patient can get in reimbursement over the course of the plan's implementation. As a result, insurance costs are reduced for both your patients and your practice. However, during insurance verification, it is crucial to inquire if a patient has a waiting period as waiting periods can delay patient treatment payment collection, thus affecting the overall revenue collection at your practice. The patient will be required to pay out of pocket for the procedure if neither the patient nor the dentist are aware of the waiting period and the insurance does not cover the cost. We can almost certainly predict that the patient  will not be thrilled by such surprises that they  are not prepared for. This can negatively impact their experience at your practice. As a result, unexpected waiting periods in dental insurance plans can prevent your practice from receiving payment for services rendered.

Common mistakes when it comes to waiting periods.

The most common mistake that the practice as well as the patients make when it comes to waiting periods is not being prepared for them. Another important mistake they make is assuming that waiting periods are the same for all plans.

What should you do about the waiting periods of patients’ insurance plans?

Make it a priority at your practice to ask the insurance provider if the patient has a waiting period in their plan during the time of verification. Also, make sure to collect information or details regarding the waiting periods as you need to inform your patients regarding their waiting period before providing any services. If you do not, the patient is likely to hold you responsible if the insurance company does not cover for the procedure. Upset patients and possible financial loss could be the result of this.

Your practice needs to be aware of the different types of waiting periods, what they are, and how they work. It is also critical to understand what services are covered during the waiting period in order to plan accordingly so that the revenue cycle of your practice does not get affected and the practice runs smoothly.

Navigating the complexities of dental insurance waiting periods is crucial for maintaining smooth operations and ensuring timely revenue collection for your practice. By understanding the details of your patients’ insurance plans and incorporating effective verification processes, you can minimize delays and avoid unexpected costs. CareStack, with its cutting-edge dental practice management solution, and CareRevenue’s Dental RCM services empower practices to streamline insurance verification, reduce claim rejections, and optimize revenue cycles. These tools help eliminate the administrative burden so you can focus on delivering exceptional patient care.

Take control of your practice’s financial health today—contact CareRevenue to learn how we can help you navigate insurance waiting periods and optimize your revenue cycle management.