FYI

This year, dental providers are predicted to face a landscape of evolving workflows, technology expectations and requirements. Thoughtful preparation now will set your practice up for smoother operations and a better patient experience in the year ahead.
 

#1 Stay ahead with real-time eligibility verification

One of the most impactful workflow improvements your practice can adopt is real-time eligibility verification. Rather than relying on manual benefit checks or post-service adjudication, modern practice management systems and clearinghouses (such as DentalXChange) now offer instantaneous eligibility responses at the point of scheduling or check-in. This capability helps your front desk team confirm a patient’s active coverage, benefit utilization and outstanding waiting periods before treatment plans are built — reducing surprise denials and billing disputes.

To implement a real-time eligibility workflow:

• Connect your practice management software to an eligibility clearinghouse that supports up-to-date data feeds.
• Train front desk staff on interpreting eligibility responses and communicating them clearly to patients.
• Document benefit limitations in your clinical chart notes so treatment coordinators can reference these during consent discussions.
   

Pro tip: Regularly auditing your eligibility workflows can also uncover coverage trends (e.g., certain procedures consistently denied) that may signal coding or benefits changes providers should review.
 

#2 Elevate patient communication — begin with transparency

Effective communication is core to patient trust and compliance. Proactive outreach and clear benefit explanations will be especially critical as coverage patterns and coding change.
 

• Communicate coverage early: At the initial visit, discuss benefit information such as annual maximums, deductibles, waiting periods and frequency limitations. Patients who understand their financial responsibility are more likely to accept recommended care and pay their portions promptly.
• Use multi-channel messaging: Whether confirming appointments via text, emailing pre-visit benefit summaries, or offering online patient portals for benefit review, modern communication channels improve clarity and reduce administrative workload.
• Educate about benefit changes: As policies and benefits evolve for 2026, prepare templated messages or FAQ sheets that briefly explain major changes to patients, especially if certain common procedures see coverage shifts.
   

Pro tip: Tie transparency to timing, not just clarity. The most effective practices don’t just explain benefits, they deliver the right information before a decision point (scheduling, treatment planning, checkout). A brief, plain-language summary sent before the visit improves acceptance and reduces billing friction.
 

#3 Stay on top of 2026 changes: Review benefits, policies and codes

• A key part of readiness for 2026 is interpreting updated coding and policy guidelines, particularly as they affect claim submission and coverage determinations.
• The American Dental Association’s 2026 Current Dental Terminology (CDT) updates include 31 new codes, 12 revisions and 6 deletions, along with policy revisions that may influence how insurers process claims. Providers must use these updated codes on claims for services performed on or after January 1, 2026. For a complete breakdown of the CDT changes and how they may affect claims, refer to our detailed article on Updated 2026 CDT Codes.
   

Pro tip: It’s also a good idea to review carrier-specific coverage policies because some plans may cover new codes differently and certain previously covered codes may be modified or removed. Understanding these nuances supports accurate treatment planning and minimizes denied claims.

Entering 2026 with updated workflows for eligibility checks, patient communication strategies and a solid grasp of coverage changes helps your practice deliver better care with fewer administrative headaches. Begin implementing these processes now, and make incremental improvements to stay organized, compliant and patient-centered in the year ahead.