Dental and Vision Insurance: Key Components for Claims Solutions

Attracting and retaining talent is an important focus area for companies to continue to grow, innovate, and succeed. In addition to competitive salaries, the total benefits package that employers, both large and small, offer can give them an advantage with their current employee base as well as with future hires. It is not surprising that in response, the voluntary benefits market is a growing segment of insurance.

Voluntary dental insurance is popular among employees and can lead to a more loyal and satisfied workforce. According to a recent survey by Delta Dental, 70% of employees surveyed said that dental benefits coverage is somewhat or very important to them.

As a result, insurance carriers and software providers alike are focusing their attention on and investing in the voluntary benefits market. As insurers assess their offerings, products like dental and vision are becoming more important in terms of having the comprehensive insurance portfolio that employers and employees need.

Dental and vision plans are generally simpler products for insurance carriers to manufacture and for insureds to understand. As the number of dental plans increases for an insurer, its ability to process the large transaction volumes associated with the claims becomes an extremely important factor in profitability. The ability to auto-adjudicate the overwhelming majority of dental claims is a critical component of the technology insurance carriers require.

Dental and vision insurers have a diverse market of solutions to select from for claims processing. In addition to making the operation efficient with straight-through claims processing, a solution’s workflow, financials, fraud detection, and reporting capabilities are key considerations, as are its data management, credentialing capability, and fee scheduling.

Although many software vendors offer modern systems with configurable rules and fee scheduling, functions such as comprehensive provider data management and credentialling may require third-party integrations to provide the entire solution and provide the most efficient, effective, and automated process.

Provider portal capabilities are advantageous to both the insurer and the provider. Allowing dental and vision practices to easily update profile information, check on benefit availability for their patients, and directly submit claims improves the experience of the provider and the efficiency of the carrier.

Insurers’ goal should be to provide an excellent claims experience for customers and providers while maximizing the efficiencies of their organization. For more on this topic, check out the full report Dental and Vision Claims Systems: Overview and Prominent Providers.

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