1.22.10 Issue #411 Forward This Newsletter To A Colleague


Belle DuCharme CDPMA
Instructor/Consultant
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Dental Insurance - Running the Same Old Tapes

Okay, so it is 2010 and we vow to have a better year - certainly anything can be better than last year. As patients phone in to make appointments, the subject of dental insurance comes into the conversation and your mind goes off to Hawaii or the Bahamas as you run the same old verbal tapes to the inquiring patient.  “No, we don’t take your plan; however, we can file it for you.”  Somehow, this line just doesn’t work for securing an appointment for patients who will not seek care with someone who does not “take their insurance.”

Let’s face it - we are still having a verbal contest with the insurance companies who have sold the policy to the employer with the promise of 100% coverage for basic care and 50% for major services. That verbiage still sells policies, so why change it. It falls on the dental office to throw in “you have a calendar year maximum of $1,000 (some policies go up to $2,000 pcy) and we will use that up for one crown and two regular prophys.”  The patient then wonders why dentistry is so expensive that it takes maybe three procedures to go through their entire year of benefit dollars. It seems like the dental practice spends most of its time trying to defend its’ right to do the kind of dentistry that benefits the patient the most.

We in the business of dentistry know that dental insurance is not insurance at all. Real insurance is designed to cover catastrophic losses such as a life threatening medical crisis or a totaled car. Routine dental care is certainly not catastrophic, so “dental insurance” is the wrong terminology for the product the patient has purchased.  Getting insurance companies to change the name of their product to Dental Maintenance Plan would benefit dental practices as they struggle to explain coverage to the patient, but that probably will not happen. 

Into the New Year, keep your eye on providing the best comprehensive care but realize that it starts with the chief concern to gain the patient’s trust. These chief concerns are most often cleanings and broken teeth. If the patient’s referral was that of the PPO plan, then use it to the patient’s advantage and they will thank you. Here are some verbal tools that may help along the way to establishing the right connection and securing the appointment.  This scripting is designed to give you words of communication to patients that helps the patient understand enough to make a decision to schedule an appointment in your practice. Taking the time with the patient on the phone is vitally important to making a positive connection resulting in an appointment. 

Patient: “Do you accept or take my insurance?”
They probably want to know if you accept assignment of benefits. If the practice accepts assignment of benefits (you agree to receive payment from the insurance company) the answer would be: “We accept assignment of benefits from all dental PPO insurance companies after verifying your eligibility and benefits. Estimated co-payments and deductibles will be due at the time of service.”

Patient: “Are you a CIGNA (or other company) provider?”
The patient wants to know if you are a “contracted provider” - this will mean less out of pocket for them because you have agreed to charge the plan’s contract fees and not your usual fees.

If the practice is not a contracted provider you can state: “No, we are not contracted with CIGNA but we can file your claim to CIGNA and they will pay according to the contract they have with your employer. You will be responsible for any co-payment and deductible today.” OR - “You will be responsible for payment in full today and the insurance company will reimburse you. Do you have any other questions you would like to ask?”

If the practice is a contracted provider, say: “Yes, we are contracted with CIGNA (or other insurance company). Upon verification of your eligibility and benefits, we will provide a written treatment estimate. Co-payments and deductibles are required as services are rendered. Do you have any questions in regard to this information?” (Proceed to get insurance information.)

Want to learn more about the business of dentistry and making patient connections? Sign up today for one of McKenzie Management’s Advanced Training Programs customized to your office needs.

If you would like more information on McKenzie Management’s Advanced Training Programs  to improve the performance of your team, email training@mckenziemgmt.com.

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