7.30.10 Issue #438 Forward This Newsletter To A Colleague

Carol Tekavec, RDH
Hygiene Consultant
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"Scripts" Can Help
By Carol Tekavec, RDH Hygiene Consultant

Patients have many concerns when it comes to their dental treatment. It is often up to office staff to address these concerns, and it is helpful to have some ready answers to questions that you know will likely come up. Obviously we do not want to appear to be parroting a memorized script.  However, familiarizing yourself with a “script” that fits your office philosophy can make your answers come easily and comfortably.

Some examples:
Your patient has a broken distal cusp on #30. He already has a large MOF amalgam in that tooth. Your dentist has recommended a build-up and a full coverage crown. You know that this patient’s insurance will not cover build-ups, unless a tooth has previously been treated with endo. Now your patient is asking: “Why do I need a crown, can’t I just have another filling?”

What could you say to address his question, and possibly pre-empt his follow-up concern over the lack of insurance coverage for the build-up?

“A crown is a way of re-creating the anatomy of your tooth so that it can continue to function normally. Your tooth has a broken cusp, which means it is badly damaged, plus it already has much of its normal anatomy replaced by amalgam. This means that there is little left of your original tooth. A crown can replace the damaged top part of your tooth and make it strong for years to come. A filling can only be used when there is enough natural tooth structure left to support the filling material.

Dr. A has also recommended that you have what we call a “build-up” on this tooth. There is so little of your natural tooth left that he will use a material to make the tooth sturdier before putting the crown on it. Without this build-up material, there would not be enough tooth structure to hold the crown in place. Your insurance will likely cover a portion of the cost of the crown, but typically it does not cover build-ups. We want the crown to have a long life. Your insurance wants to have the smallest cost to them. We will apply to your insurance for payment for everything, but don’t be surprised if they won’t pay toward the build-up. We can help with outside financing if you need it.”

After presenting the treatment plan and the fees for the build-up and crown, your patient asks: “Why do crowns cost so much?”

You might say: “A crown is an intricate replacement for a part of your tooth that takes a huge amount of wear and tear every day. Even when you are not eating, your teeth touch together more than 2,000 times daily - every time you swallow! (Source: American Academy of Head, Neck and Facial Pain). Your crown is a custom replacement made just for you. If a person could just buy a crown, ready-made like a sweatshirt, it would not cost very much. Your tooth is prepared by a professional, and fitted with a tailor-made replacement. It is “one-of-a-kind.”

Patients also often have questions concerning other aspects of their limited insurance benefits. For example: “The hygienist is recommending that I come for more frequent “cleanings.” Will my insurance cover these?”

You might say: “Your plan contract specifies how many of certain types of services it will cover each year. Most plans limit the number of x-rays, professional cleanings, and “gum” treatments they will cover because these are the types of treatments that many people need; and need to have frequently. It is our job to let you know what you need to do to get healthy and stay healthy. It is the insurance carrier’s job to limit their costs. With what we now know about the importance of the health of a person’s mouth and teeth, it is a mistake to let a plan decide what is best for you. The good news is that your plan benefits can help, and may cover at least two of these professional cleanings a year!”

Patients may ask you to “fudge” on their dental claims. For example: “My insurance doesn’t go into effect until next month. Can you send in the claim next month for my appointment today?”

You might say: “We always try to help our patients get the most from their insurance plans, however, it we change the dates on a claim form, both you and Dr. A could be prosecuted for insurance fraud. We can delay some of your future treatment until your plan goes into effect, but changing claim dates is not possible.” (Patients may not care very much if Dr. A could be prosecuted, but it sometimes comes as a surprise to them to find out that they would be implicated as well.)

Patients may have a hard time understanding the differences among a cleaning, root planing and a periodontal maintenance procedure. In fact, state dental boards have seen an increase in patient complaints regarding “my dentist and hygienist are just cleaning my teeth, but charging me more!”

While detailed information should be supplied to patients before embarking on root planing and subsequent periodontal maintenance, all staff members should be able to articulate a simple explanation. They might say: “A professional cleaning is for persons who do not have any bone loss or infection around their teeth, a root planing is for a person who is suffering from gum and bone disease due to bacteria and diseased deposits on the tooth roots, and periodontal maintenance is for persons who have received gum and bone treatment and need to keep their health from going downhill.”

These are just a few examples of answers to questions you hear every day. Knowing what to say can help keep patients happy and can give staff the confidence to deal with their concerns.

Carol Tekavec CDA RDH is the Director of Hygiene for McKenzie Management. Carol can improve your hygiene department in just one day of training “in your office.” Interested in knowing more about how to improve your hygiene department? Email hygiene@mckenziemgmt.com

Carol is also a speaker on dental records, insurance coding and billing, patient communication and hygiene efficiency for McKenzie Management.  Interested in having Carol speak to your dental society or study club?  Click here

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