How To Handle Conversations On Dental Insurance

Today, as healthcare has become more responsive to marketplace needs, patients are increasingly searching for high-quality care that minimizes their out-of-pocket expenses.

The importance of a well-trained office team

It's essential to establish your office's insurance practices and determine which plans you accept, which ones you serve an in-network provider, or if your policy is to help patients submit for reimbursement. Your business office and office manager need to be well versed in all aspects of dental insurance benefits and know which plans your office accepts towards full or partial payment. Your front desk team also plays a vital role in providing callers with information about whether or not your office accepts insurance coverage, participates in a particular plan, or if a patient covered by a DMO or government plan is assigned to your office location.

The key to discussing insurance coverage with patients is a well-trained office team that provides information in a clear, informative, and friendly way. Insurance coverage typically comes up during the initial contact conversation and is then discussed in greater detail once a treatment plan is determined.

What to ask and say about insurance coverage during the initial phone call

Whether a patient is calling your office for routine care or a dental emergency, your receptionist needs to gather information in a friendly, knowledgeable, and professional manner. While the conversation begins with getting information on the patient and the purpose of the call, the patient will also be asked about their dental insurance coverage. If your office accepts the patient's plan, your receptionist will request the patient's insurance information and then make the appointment. However, if you do not accept a particular plan or plans, you should have a script in place to give patients other options and reasons for choosing your office. Your front desk mustn't make any assumptions. Even if you do not accept their coverage, patients may select your office because of your outstanding reputation, a New Patient Special, a discount for seniors, veterans, etc.

Presenting a treatment plan and fees

Whether a patient requires routine care, a cosmetic dental procedure, the replacement of missing teeth, or any other service you provide, how your office presents the treatment plan, the fees, and discusses insurance coverage influences the patient's acceptance of care. It's best the dentist focuses on the clinical findings, explaining to patients the best solutions for their smiles, and answering any treatment questions. Then your office's treatment plan coordinator, a member of your business team, or office manager can explain all the financial aspects of care. This discussion generally includes a patient's insurance coverage, any preauthorization required, the patient's responsibility for the cost of care, out-of-pocket expenses, forms of payment accepted, payment plans available, or opportunities for financing.

Discussions for the patient and the insurance company

Keep in mind that, like medical insurance, dental coverage is a contract between the patient and the insurance company. When patients sign up for a plan with their employer or obtain coverage through other sources, they receive abundant information on their plan and the benefits it provides. With in-network plans, there is also a published list of participating providers that patients can refer to when searching for care. If the extent of benefits, paying the deductible, the lack of coverage, or a change in coverage for dental work is not to a patient's liking; the patient needs to take that up with the insurance company.