By Guest writer Don Khouri, PhD, Managing Director Fortune Northeast
Anyone reading this article likely knows that dental insurance is not really insurance. It is nothing like medical insurance because the more treatment you need from medical, the more your health insurance covers. The more dental treatment you need, the less dental insurance covers. That’s the reason we coach our clients to say, “dental benefits” instead of insurance, and “patient portion” instead of “patient responsibility.” The challenge is that patients don’t understand what you understand about dental insurance–that their benefits will pay for only part of their treatment. Massachusetts voters recently passed dental insurance regulation by voting yes on question 2. This will help, but not completely solve the problem. Today’s dental patient seems unwilling to go out of network, wants credible reviews, wants convenience, and wants financing (affordability).
On average, nearly 50% of new patient phone calls result in a scheduled patient. One of the most common questions that a new patient will ask is, “do you take my dental insurance?” How have you trained your team to answer that question? The way this initial phone call is handled will make a difference on how much emphasis a patient places on their dental benefits.
The key way to differentiate yourself from the PPOs is the experience you provide your patients. Patients judge you on the experience you provide, not the quality of care. What could you do today to make the patient experience even better than it is today?
Here are seven simple steps you can take to go out of network with an insurance company:
- Print out the list of patients from the insurance company you want to drop.
- Six (6) months prior to going out of network, start a conversation with those patients about your plan. In the huddle each morning, identify the patients with whom you will discuss this change.
- Monitor those patients for any change in status.
- Some insurance companies, like Delta Dental for example, will send the reimbursement directly to the patient, which means you need to be prepared to collect the full amount from the patient at time of service.
- When you send the termination letter to the insurance carrier, immediately send a letter to your patients explaining your decision to go out of network.
- Consider offering 20% off your UCR fee or honoring the insurance fee for the patient’s first visit after you go out of network.
- Monitor any patients who have left the practice and reasons why.