How to respond to “Does my insurance cover this?”

Posted on by Jen McGuire | Category Coding and Insurance

shutterstock_127690166Dental insurance should not dictate the treatment provided. It’s easy to say, but often difficult to live by when patients’ top concern is out of pocket expense. Here are three things you can do to move patients past the insurance obstacle.

1. Manage patient expectations
Patients often do not understand that dental insurance, unlike more comprehensive medical insurance, is simply a benefit to offset a portion
of the total cost of care. Dental coverage is not determined by treatment need, but by the employer who purchased the policy. Develop scripting
(or play this video) to use with new patients, and during treatment presentation, that explains the role of dental insurance in your practice.“At our practice, your health is our number one priority. Our treatment recommendations are determined by your short-term and long-term health needs, not by the dental coverage purchased by your employer. We are sensitive to the budgets of our patients and can provide financing options to ensure you receive the treatment needed to maintain a healthy mouth and body.”

2. Use risk assessments to personalize recommendations
With the prevalence of media stories like this one, patients, especially new patients, can be skeptical of the need for comprehensive dental treatment. Using risk assessments or health checklists can help patients understand why they might need treatment, even before a diagnosis is made and the case presented.  When explaining the recommended treatment, reference the patient’s personal risk factors for caries or periodontal disease to demonstrate why the treatment is critical to their oral health. Outline the potential consequences of delaying or refusing treatment to reinforce the immediate need.

3. Incorporate technology to validate the treatment need
Intraoral cameras and digital x-rays can increase both patient acceptance and insurance reimbursement by clearly demonstrating the need for treatment. Magnified on a monitor, patients can easily see the cracked tooth or visible decay. Motivate patients to action by letting them see what you can see.

For more help managing insurance participation, request a free in-office workshop.

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