Adit’s Insurance Verification service is billed in two parts: your Minimum Monthly Commitment (MMC) is invoiced automatically each month, then you are charged separately for any verifications over that minimum amount.
Monthly Billing
Your MMC is the minimum amount you will be billed for Insurance Verifications per month. Your MMC does not include any specific number of verifications; Adit will charge you for each verification we perform according to the type of verification, its outcome, and the rate per verification that you selected in your MMC package.
Each month, you will be charged your MMC for insurance verifications. We will then look at your total verification charges for the month and compare that to your MMC.
- If your total verification charges are less than your MMC: you will pay your MMC amount that month.
- If your total verification charges are equal to your MMC: you wil pay your MMC amount that month.
- If your total verification charges are more than your MMC: you will pay your MMC amount for the month, then we will calculate the remaining balance (total charges minus MMC) and bill you for that balance along with your other Adit App overage charges.
Here’s an example:
ABC Dental chooses a Minimum Monthly Commitment of $500.
They are billed $500 per month as part of their recurring billing.
In July, Adit performed $573.26 of verifications.
ABC Dental has already paid $500 as their MMC, leaving $73.26 remaining.
$73.26 is billed to ABC Dental along with their other Adit App overages.
How We Calculate the Cost of a Verification
There are a number of factors that affect the actual cost of an individual verification, including:
- If it is an Advanced or Basic Eligibility Verification
- Which treatment codes are included in that type of verification
- How many questions are included for that type of verification
- The outcome of the verification
- Successfully verified
- Failed
- If you have a volume discount based on your MMC
Verification Type
The first determining factor in the cost of a verification is the type: Advanced Eligibility Verification or Basic Eligibility Verification. When you set up your Insurance Verification preferences, you select which treatment codes to include in each type of verification. Every treatment code has between 1 and 4 questions associated with it; it is the total number of questions that determines the cost per verification.
We offer 4 pricing tiers for Advanced Eligibility Verification, and 2 pricing tiers for Basic Eligibility Verification. Your pricing tier is selected for you automatically based on how many questions are needed for that type of verification.
Advanced Eligibilty Verifcation Pricing Tiers
Tier 1: Standard
0 to 40 Questions
$1.50 Per Verification
|
Tier 2: Extensive
41 to 80 Questions
$2.25 Per Verification
|
Tier 3: Premium
81 to 120 Questions
$3.00 Per Verification
|
Tier 4: Premium Plus
121 to 160 Questions
$3.75 Per Verification
|
Basic Eligibility Verification Pricing Tiers
Up to 15: Basic
0 to 15 Questions $1.00 per Verification | Up to 40: Standard 15 to 40 Questions $1.50 per Verification |
For more information about your specific pricing tier, please go to your Adit platform and navigate to the RCM module, then to Preferences > Verification Settings and scroll down.
Verification Outcome
The second factor that determines the cost of a verification is its result. Verfiications that are completed successfully are billed the amount per verification specified in your pricing tier for that type of verification.. Verifications that Adit attempts but fails to complete are charged a lower rate, usually $0.75.
Volume Discounts
Adit provides an automatic volume discount if you choose a higher Minimum Monthly Commitment for your verifications. Practices who commit to a monthly minimum of $500 get an automatic 10% discount off of the retail price per verification. Practices who commit to a monthly minimum of $750 get an automatic 20% discount off the retail price per verification.
High-volume practices can save money in the long run by making a higher Minimum Monthly Commitment and taking advantage of the lower price per verification. Practices whose volume varies from month to month may prefer a lower MMC, but will be stuck paying more for each verification.
Examples
ABC Dental has set up their Advanced Eligibility Verification to include 30 treatment codes with a total of 92 questions. This automatically puts them in the Premium pricing tier at $3.00 per verification.
ABC Dental’s MMC is $500, as seen in the previous example above.
Adit successfully verifies patient Sara Smith for ABC Dental.
Adit charges $3.00 for that verification, minus a 10% discount according to the MMC.
The total charge for this verification is $2.70.
Adit attempts to verify patient Abby Platt but fails to do so because Abby’s policy has termed.
Adit charges $0.75 for this verification, minus a 10% discount according to the MMC.
The total charge for this verification is $0.68.
Other Considerations
Adit only charges for the verifications that we attempt for your practice.
If a verification is Rejected, we have not attempted to verify that patient. You will only be charged if we receive the information we need to attempt the verification and make an attempt to verify the patient.
If you Cancel a verification or otherwise indicate in the Verifications page that a patient does not need to be verified, we will not attempt to verify that patient. If we have already made an attempt before you cancelled the verification, we will charge for our attempt.
If you verify a patient yourself, we will not charge for that verification regardless of if you are successful or fail to verify. If you would like us to make another attempt, we will charge for our attempt.
If a patient has both primary and secondary insurance, we will verify both and charge for both verifications.