Insurance Strategies Insurance Strategies

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Eliminate Dental Insurance Complications

Eliminate Dental Insurance Complications and Become Your Patient’s Hero

Dental insurance can be a win for your patients. Help them reduce or eliminate the confusion about their dental benefits and you’ll be a “hero.”

It’s unfortunate that the insurance conversation can come with hassles. Consider those aggravations an opportunity for you to be your patient’s advocate.

Are you opting out of patient insurance management?

It might be tempting to opt-out and consider dental insurance details to be your patient’s full responsibility. Depending on the nature of your practice, it may be advantageous in some circumstances for you to transfer responsibility for submitting insurance claims to your patients.

To make this happen let’s simplify the process:  

  • Collect payment in full for services up front
  • Prepare insurance claims on behalf of your patients such that they are the payees and hand the patients the completed forms after treatment.

You will then enjoy the great advantages to your practice by freeing your team from the responsibility for insurance receivables management. However, be prepared for a possible substantial reduction in retention of existing patients who may not want to take on insurance responsibility themselves.   

Only If you have a very dedicated patient base will the opt out strategy be potentially feasible for your practice. Otherwise the risk may outweigh the benefits.

Rise above the competition with best-of-class support for your patients

You can’t afford to sit this one out. Dental patient expectations are high.

They trust you to diagnose, present treatment that maintains their health and appearance, treat them for a lifetime of good oral health, and…

Help them maximize their financial resources for payment…including their dental insurance coverage.

Step up and you’ll both win.

How to help your patients understand and get the most benefit from their dental insurance plan

Inform your patients about how their dental coverage works

Up-front, clear communication will educate your patients about what’s otherwise confusing. Realize if you’re initially confused about coverage details they are too!

  • Create an informative brochure or a downloadable document available via your website. Outline an easy-to-read, 101-level explanation of general coverage, how their co-payments work, and what they should expect from their insurance provider.
  • Communicate face to face with your patients about the specifics of their dental benefits package. Not all plans are the same and not everything is covered. Prepare in advance of the conversation so you’re fully informed about their specific insurance plan.
  • Compel them to connect with their dental insurance provider for final confirmation of coverage details. This places the burden on their company not you as their dental services provider.

Invest time clarifying co-payments and patient financial responsibility for treatment

Co-payment policies can differ from dental practice to dental practice. For example, you might require full payment up-front, you might be satisfied with the co-payment portion initially prior to treatment, or you might not ask for any payment or co-payment until their insurance has paid.

All said, it can be to your advantage to have some form of co-payment agreement in place. Communicate this alongside presentation of the treatment plan. Be clear and informative about what is their responsibility (as the patient) and what is to be billed to their insurance company. Clarity and up-front communication will help you avoid “surprises” that can negatively impact your patient relationships.

Initiate the insurance conversation and be your patient’s advocate

Your goal is to provide the treatment your patient needs and desires. Remove any and all barriers from that goal including helping them get the most from their dental insurance benefits.

  • Check their coverage scope and limits prior to their appointment.
  • Submit their insurance claim to enable them to get the full benefit they’re due for treatment.
  • Compel them to use their annual benefits before they expire. Use your dental content streams (email, social media, blog posts, etc) to communicate as the end-of-year approaches.
  • Appoint an insurance point-person on your front-office business team to keep up with insurance industry changes, patient-specific coverage, claim filing, and related follow-up communication.

The patient wins and you win when you become their advocate for dental insurance coverage. Apply these strategies, improvise as necessary, and you’ll achieve “hero” status with your patients.

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Hygiene Codes to Maximize Insurance Benefits

Picture this: your hygienist has a full day of patients. A couple of S/RPs, a couple of new patients, and some nice recalls. Ahh… it’s a beautiful thing.

But wait! What’s that I see here? She hasn’t been using the correct CDT codes for her procedures. Oh no! Poor coding is about more than just lost revenue; it can lead to benefit claims bouncing back and over- or under-treatment.

We should periodically sit down with our hygiene teams and discuss treatment philosophies, like when to refer to a periodontist or how often a full mouth probing should be done. A super important part of this conversation is which codes can be used and when.

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Collecting Co-Pays and Deductibles

Are your front desk personnel trained to collect patient co-payments and deductibles at time of service? Do they know the amount of receivables due from each patient and their insurance company? If not, your practice could be losing a significant amount of income. Studies show that collecting payment from patients at the time of service maximizes your collection percentage and decreases collection costs. Taking steps now to collect every dollar earned will prevent your profits from slipping through the cracks. This article offers strategies to successfully collect payments at time of service and is geared towards helping your front desk staff achieve winning performance.

Attitude is Everything

A patient’s first impression of your practice is their front desk experience. Your staff should be greeting patients by name, while presenting a professional attitude and appearance. They should be polite, and possess strong customer service and communication skills. Front desk staff must feel comfortable asking for co-pays and deductibles and indicate that payment is expected at the time of service. Their attitude needs to be friendly, yet firm. The dentists in the practice need to be supportive of the collection policy and refer all discussions regarding financial matters to the appropriate personnel, rather than discussing with the patient. Your office should have a clear, written financial policy, which should specifically state when you expect payment. This will empower your front desk personnel and send a clear message to patients.

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Clinical Excellence = Business Success? My story.

I worry about dental students, new graduates, and those in their early years of practice. Are they as naïve nowadays as was I a few decades ago?  I hope not, but chances are that many will have difficulty finding their way in the first few years (perhaps much longer) for lack of business knowhow.  I wonder how other dentists with extensive practice experience, looking back, would rate their preparedness for the real world of dentistry upon graduation.

When I was going to dental school, academic and clinical demands precluded even the slightest thought about the business of dentistry. It was only when graduation was approaching that I started to think about my future, but in kind of an indirect fashion, in the context of what clinical situation was I going to place myself in – associateship, partnership, or solo practice?  My perspective was 100% clinical, which is no big surprise when you consider that no family member, relative, or personal acquaintance owned a business, dental or otherwise.  The business blind spot had in no way been addressed in dental school. In four years of training not a single course, instructor or guest speaker had dealt with how to set up the business structure or run a dental practice as a business entity. I had filled the void by becoming a passionate clinical perfectionist, but I was unprepared for the world of business challenges that I was about to enter.

The only business advice I got in my first four years of practice was from an accountant. No offense to accountants. They do have an important role to play. However, for someone who had a complete void of business knowledge, an accountant could never fill that void adequately. There were matters of leadership, management, acquiring and training staff, personal development, etc., all of which were critically important in building a successful practice.  I simply didn’t know to look for help, and my only hope defaulted to doing perfect dentistry and praying that alone would lead to success. Didn’t happen. I learned the hard way that clinical excellence did not equal business success, except of course for the very few dental savants out there who were so good that movie stars, the wealthy, and dentists themselves, flocked to them for care and clinical training.

Looking back it seems to me that any one of the following could have provided a healthier, more certain, and shorter path to practice success.

  1. Having business in my family tree.
  2. Taking business, management, and leadership courses pre-dental.
  3. Dental school bringing in practicing dentists (preferably non-faculty) to discuss the business of dentistry.
  4. Seeking out a dentist business mentor while in dental school.
  5. Seeking out a dentist business mentor in the early years after dental school and beyond.
  6. Undertaking personal development training early in my career, learning more about human nature, and becoming a more powerful person so I could be a more powerful dentist leader.
  7. Getting in front of world class leaders.
  8. Reading many books throughout the early years about leadership, management, marketing, advertising, innovation, personal development, etc.

Recently, I met a newly graduated dentist who related that she learned nothing about the business of dentistry during dental school. The guest speakers were all non-dentists with a personal agenda to sell the graduating students a service or a product, and she felt completely confused about how to weigh the practice options in front of her. Guess the same problems do persist today.

What was your experience in the years following graduation? Smooth sailing or rough waters? How prepared were you for the business of dentistry? What were your biggest setbacks and how could they have been avoided. What would you recommend to dentists to help them navigate their early years? What can we do as a profession to help those new to our profession?

I am particularly interested in pursuing the idea of approaching dental schools with a view to pair up experienced dentists as mentors for those students that are interested in having a coach as they begin their careers.

Dentistry has been very kind to me and many others. However today, according to a recent ADA article, dental students graduate with student loans averaging over $200,000, the same individuals who will step out into a business world that many are ill prepared for.  Wouldn’t it be wonderful to support these young colleagues as they start their careers in our chosen profession?

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