Dental Insurance Benefits
It is approaching that time of year when dental insurance benefits are there for patients to use, but their procrastination about paying the co-payments have kept them out of the treatment room. An email or letter campaign is in order to remind those with diagnosed treatment to “use it or lose it” with regard to their $1,000 to $2,000 in allotted benefit dollars. When you consider that about 34% of the population without dental insurance visit the dentist, versus 70% with dental insurance, it is important to market to the insured group this time of year. A follow-up phone call two weeks after the letter or email is the next step to helping patients to get appointed. Dental care is often postponed by even the most health conscious, so calling them is often appreciated.
When making outbound calls to the unscheduled, the typical response will be “Why doesn’t my dental insurance pay more on the crown?” Or, “that co-payment is too high; I am going to shop around for better coverage.” A simple response is: “Insurance companies need to make a profit and because most people use their dental insurance for professional cleanings, examinations and x-rays at least twice a year, the insurance company has to make more than they charge for their product. That is why the patient is supposed to participate in the costs at a higher percentage level for crowns than for preventive services like cleanings.”
For example: A dental insurance policy has a $1,000 per calendar year cap. The professional cleaning is $105, the exam is $65 and the x-rays range from $80-$120. Twice a year cleanings, two exams and at least one set of bitewings and you are at about $420 of the $1,000 cap. Most adults need restorative work of fillings or crowns routinely because as we live longer more maintenance is required. Children need sealants and restorative also to maintain healthy pain free mouths. On average, most people do not use all of the benefit maximum yearly because when it comes to restorative, the co-pay and deductible apply anywhere from 20-50% of the total. To patients this sounds unreasonable because the cleanings, examinations and x-rays are covered at typically 100%. After the deductible of an average of $50 they now have about $530 left of the $1,000 calendar year benefit. If a crown is needed and it costs $980-$1200 and the insurance pays 50% of the UCR, the policy has now maxed out for the year. This is a typical scenario.
Insurance companies have to charge a high enough rate to take into consideration that the product will be used by most that purchase it, but also a low enough rate to make it worth the investment to the average person. Medical insurance and dental insurance are often compared by consumers, but they are very different products. Medical insurance covers preventive services but also catastrophic medical events that could bankrupt most people. Hence the premiums for medical insurance are much higher in comparison to dental insurance premiums. Dental insurance has never been comprehensive in scope and is considered a bonus benefit like coverage for eyeglasses.
Encouraging patients to use what benefit dollars they have despite the fact that they have out of pocket costs is a communication challenge and can be frustrating to all involved. Waiting and postponing care for years has never been an option for good dental health, but many people do it. At some point everyone needs dental care, even the edentulous. If you have kept in contact with your patients, show them you care and want to help them - when it comes time for them to see a dentist, they will think of you.
Your message can read:
Dear Patient (Name),
This is a courtesy reminder that you may have dental insurance benefits left to use toward the recommended dental services from your examination on (date). We know that you value your health and excellent dental care, and we are here to serve you when you are ready to schedule your appointment. Your dental insurance benefits for this year will expire on 12/31/12 and do not roll over to the next year. Please call us soon to schedule to avoid the holiday rush. Have a wonderful summer.
Best to you,
To learn more about communicating with success, enroll today in the Dental Front Office Training here at McKenzie Management.
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